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1

Update on the discovery and development of cholesteryl ester transfer protein inhibitors for reducing residual cardiovascular risk.  

PubMed

Cholesteryl ester transfer protein (CETP) facilitates the transfer of cholesteryl ester and triglycerides between plasma lipoprotein particles HDL and LDL/VLDL, resulting in equilibration between these lipoprotein fractions. Therapy that modulates HDL metabolism to increase HDL-c levels could be an effective strategy to reduce residual cardiovascular risk since it is estimated that for each mg/dL increase in plasma HDL cholesterol, there could be a 2-3% decrease in cardiovascular risk. Modification of the lipoprotein profile by CETP inhibitors is promising, but the beneficial effect of reducing coronary heart disease risk has not yet been proven. To date, four CETP inhibitors have advanced to phase 3 cardiovascular outcome clinical trials, and two have been terminated for off-target adverse effects and lack of efficacy. This perspective will summarize recent events, new research developments, and the discovery of new classes of CETP inhibitors. PMID:23941686

Mantlo, Nathan B; Escribano, Ana

2014-01-01

2

Aldosterone and cardiovascular risk  

Microsoft Academic Search

Through its classic effects on sodium and potassium homeostasis, aldosterone, when produced in excess, is associated with\\u000a the development of hypertension and hence with higher cardiovascular and renal risk. In recent years, experimental and epidemiologic\\u000a data have suggested that aldosterone also may be linked to high cardiovascular risk independently of its effects on blood\\u000a pressure. Thus, aldosterone has been associated

Bruno Vogt; Michel Burnier

2009-01-01

3

Residual Antibiotics in Decontaminated Human Cardiovascular Tissues Intended for Transplantation and Risk of Falsely Negative Microbiological Analyses  

PubMed Central

We investigated the presence of antibiotics in cryopreserved cardiovascular tissues and cryopreservation media, after tissue decontamination with antibiotic cocktails, and the impact of antibiotic residues on standard tissue bank microbiological analyses. Sixteen cardiovascular tissues were decontaminated with bank-prepared cocktails and cryopreserved by two different tissue banks according to their standard operating procedures. Before and after decontamination, samples underwent microbiological analysis by standard tissue bank methods. Cryopreserved samples were tested again with and without the removal of antibiotic residues using a RESEP tube, after thawing. Presence of antibiotics in tissue homogenates and processing liquids was determined by a modified agar diffusion test. All cryopreserved tissue homogenates and cryopreservation media induced important inhibition zones on both Staphylococcus aureus- and Pseudomonas aeruginosa-seeded plates, immediately after thawing and at the end of the sterility test. The RESEP tube treatment markedly reduced or totally eliminated the antimicrobial activity of tested tissues and media. Based on standard tissue bank analysis, 50% of tissues were found positive for bacteria and/or fungi, before decontamination and 2 out of 16 tested samples (13%) still contained microorganisms after decontamination. After thawing, none of the 16 cryopreserved samples resulted positive with direct inoculum method. When the same samples were tested after removal of antibiotic residues, 8 out of 16 (50%) were contaminated. Antibiotic residues present in tissue allografts and processing liquids after decontamination may mask microbial contamination during microbiological analysis performed with standard tissue bank methods, thus resulting in false negatives. PMID:25397402

Gatto, Claudio; Manara, Sabrina; Dainese, Luca; Polvani, Gianluca; Tóthová, Jana D'Amato

2014-01-01

4

Microalbuminuria and cardiovascular risk.  

PubMed

Microalbuminuria is a marker for generalized vascular dysfunction. Its prevalence in United States and European general population surveys ranges from 6% to 10%. Increased risk for cardiovascular morbidity and mortality begins with albumin excretion rates that are well within normal limits. Although microalbuminuria interacts with the traditional cardiovascular risk factors, it has an independent relationship to renal and cardiovascular outcomes. For example, microalbuminuria doubles the risk for a cardiovascular event in patients with type 2 diabetes mellitus even after adjusting for the usual risk factors. Elevated rates of urinary albumin excretion predict target organ damage, notably renal disease, but are also related to left ventricular dysfunction, stroke, and myocardial infarction. Screening for microalbuminuria, which is recommended by several expert committees and associations, has become a readily accessible procedure. Screening can give clinicians prognostic information concerning cardiovascular risk and assist in guiding therapy. The goal of treatment is to prevent progression of, and even to reverse, microalbuminuria. Abundant evidence demonstrates that antihypertensive therapy is an important key to the control of urinary albumin excretion, and blockade of the renin-angiotensin system (with angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers) is the treatment of choice. These drugs have successfully halted or delayed the progression to nephropathy and have reversed elevated rates of albumin excretion to normal values, even when blood pressure reduction has been minimal. PMID:15485765

Karalliedde, Janaka; Viberti, Giancarlo

2004-10-01

5

Hyperuricemia and cardiovascular risk.  

PubMed

There is an increasing prevalence of gout and hyperuricemia worldwide. Gout confers a significant individual and social burden and is increasingly recognized as a prevalent chronic disease state requiring appropriate long-term management. Gout and hyperuricemia appear to be independent risk factors for incident hypertension, renal disease and cardiovascular disease. Multiple epidemiologic studies confirm an association between hyperuricemia and "cardiometabolic disease". We review the evidence stating the relationship between hyperuricemia and the development of comorbid conditions contributing to cardiovascular risk and disease. PMID:24554489

Grassi, Davide; Desideri, Giovambattista; Di Giacomantonio, Anna Vittoria; Di Giosia, Paolo; Ferri, Claudio

2014-12-01

6

Spirituality and Cardiovascular Risk  

Microsoft Academic Search

This study extended current research linking spirituality to health by investigating the relationship between extrinsic and intrinsic spirituality and cardiovascular risk factors. Participants included 111 healthy males and females, ages 28 to 63. Measurements consisted of the Lifestyle Assessment Questionnaire (LAQ), a version of Kelly's Repertory Grid, hematological analysis, and blood pressure. A greater sense of spirituality was associated with

Joseph A. Doster; Michelle B. Harvey; Celeste A. Riley; Arthur J. Goven; Renee Moorefield

2002-01-01

7

Sleep Deprivation and Cardiovascular Risk  

MedlinePLUS

Sleep Deprivation and Cardiovascular Risk (0:31) Dr. Janet Mullington discusses how studies suggest a link between sleep deprivation and increased risk for cardiovascular disease. choose settings to watch ...

8

Cardiovascular risk in rheumatoid arthritis.  

PubMed

The objectives of this review are to discuss data on the cardiovascular risk increase associated with rheumatoid arthritis (RA), the effects of RA treatments on the cardiovascular risk level, and the management of cardiovascular risk factors in patients with RA. Overall, the risk of cardiovascular disease is increased 2-fold in RA patients compared to the general population, due to the combined effects of RA and conventional risk factors. There is some evidence that the cardiovascular risk increase associated with nonsteroidal anti-inflammatory drug therapy may be smaller in RA patients than in the general population. Glucocorticoid therapy increases the cardiovascular risk in proportion to both the current dose and the cumulative dose. Methotrexate and TNF? antagonists diminish cardiovascular morbidity and mortality rates. The management of dyslipidemia remains suboptimal. Risk equations may perform poorly in RA patients even when corrected using the multiplication factors suggested by the EUropean League Against Rheumatism (EULAR) (multiply the score by 1.5 when two of the following three criteria are met: disease duration longer than 10 years, presence of rheumatoid factor or anti-cyclic citrullinated peptide (CCP) antibodies, and extraarticular manifestations). Doppler ultrasonography of the carotid arteries in patients at moderate cardiovascular risk may allow a more aggressive approach to dyslipidemia management via reclassification into the high-risk category of patients with an intima-media thickness greater than 0.9 mm or atheroma plaque. PMID:24880190

Soubrier, Martin; Chamoux, Nicolas Barber; Tatar, Zuzana; Couderc, Marion; Dubost, Jean-Jacques; Mathieu, Sylvain

2014-07-01

9

Testosterone and cardiovascular risk.  

PubMed

Cardiovascular (CV) disease is one of the most common causes of death in the western populations and, nowadays, its incidence is increasing even in the developing countries; although CV disease affects both sexes, it is more frequent in males in whom it shortens the average life expectancy. In this regard, this difference has been wrongly attributed for many years to the negative effects of testosterone (T); however, nowadays, a large amount of evidence suggests that this hormone may have protective effects on the CV system and that, indeed, the low levels of T could be associated with an increased CV risk and with an augmentation of morbidity and mortality in males. Such an aspect gains great relevance in light of the consideration that T decrease, besides occurring as a consequence of rare pathological conditions, can often take place with natural aging, causing a state of "male menopause", also called late-onset hypogonadism. In this review, we aimed to summarize the present state of the art concerning the association between T deficit and CV disease by analyzing the protective role of T on CV system and the relationship of this hormonal lack with metabolic syndrome, CV morbidity and mortality, and with the CV complications, such as ischemic heart disease, heart failure and stroke, that frequently occur in T deficiency. PMID:23475207

Tirabassi, Giacomo; Gioia, Angelo; Giovannini, Lara; Boscaro, Marco; Corona, Giovanni; Carpi, Angelo; Maggi, Mario; Balercia, Giancarlo

2013-04-01

10

Genetic risks for cardiovascular diseases  

Microsoft Academic Search

Atherosclerotic cardiovascular disease (CVD), which involves the heart, brain, and peripheral circulation, is a major health problem world-wide. The development of atherosclerosis is a complex process, and several established risk factors are involved. Nevertheless, these established risk factors do not fully explain the occurrence of CVD and further insight is required in factors such as genetic determinants that may identify

M. H. Zafarmand

2008-01-01

11

[Sexual activity and cardiovascular risks].  

PubMed

Sexual activity is a major aspect of the quality of life in the general population as well as in cardiac patients. It can be compromised by the disease itself (endothelial dysfunction, vascular or cardiac impairment) or by the treatments prescribed. An appropriate treatment should be proposed, including phosphodiesterase inhibitors in men with erectile dysfunction. The risk of cardiovascular complication during sexual activity is low and should not restrain sexual activity in the vast majority of patients. An evaluation of this risk should be made on an individual basis and counseling should be proposed to men and women with cardiovascular diseases regarding their sexual activity. But the most important point, for general practitioners and cardiologists, is to take initiative and talk to the patients about these problems. PMID:25087113

Bosser, Gilles; Chodek-Hingray, Anne; Kazmierczak, Céline; Juillière, Yves

2014-10-01

12

Human immunodeficiency virus & cardiovascular risk  

PubMed Central

Highly active antiretroviral therapy (HAART) significantly changed the prevalence of the cardiovascular manifestations of human immunodeficiency virus (HIV)/AIDS. In developed countries, a 30 per cent reduction in the prevalence of cardiomyopathy and pericardial effusion was observed, possibly related to a reduction of opportunistic infections and myocarditis. In developing countries, however, where the availablity of HAART is limited, and the pathogenic impact of nutritional factors is significant, a 32 per cent increase was seen in the prevalence of cardiomyopathy and related high mortality rate from congestive heart failure. Also, some HAART regimens in developed countries, especially those including protease inhibitors, may cause, in a high proportion of HIV-infected patients, a lipodystrophy syndrome that is associated with an increased risk of cardiovascular events related to a process of accelerated atherosclerosis. Careful cardiac screening is warranted for patients who are being evaluated for, or who are receiving HAART regimens, particularly for those with known underlying cardiovascular risk factors, according to the most recent clinical guidelines. PMID:22310821

Barbaro, Giuseppe; Barbarini, Giorgio

2011-01-01

13

Influenza Vaccine for Cardiovascular Risk Reduction  

PubMed Central

Cardiovascular disease is a leading cause of morbidity and mortality. Individuals with underlying cardiovascular disease are at high risk for adverse outcomes from influenza infections. Although additional studies are needed, current evidence suggests the influenza vaccine may reduce the risk of cardiovascular death and coronary events. In addition to their overall efforts to encourage influenza vaccination for all eligible persons, pharmacists should pay special attention to these high-risk individuals. PMID:24421432

Howard, Patricia A.; Kleoppel, James W.

2013-01-01

14

Posttraumatic Stress and Cardiovascular Disease Risk  

Microsoft Academic Search

A growing literature indicates that posttraumatic stress is associated with cardiovascular risk and cardiovascular disease (CVD). Research on specific CVD risk factors and their prevalence in posttraumatic stress disorder (PTSD) may improve understanding of CVD development in this population. The primary purpose of the present article is to outline the evidence relating posttraumatic stress to CVD risk, with an emphasis

Jeffrey L. Kibler

2009-01-01

15

Cardiovascular Risk Assessment in Organ Transplantation  

E-print Network

Cardiovascular Risk Assessment in Organ Transplantation Donald M. Lloyd-Jones, MD ScM FACC FAHA Anton I. Skaro, MD, PhD Lisa B. VanWagner, MD, MS Orthotopic liver transplantation (OLT) is a life no consensus as to the optimal evaluation of perioperative cardiovascular risk prior to liver transplantation

16

Obesity, obstructive sleep apnea, and cardiovascular risk  

Microsoft Academic Search

Obesity is a major risk factor for cardiovascular disease, the number one killer of Americans. It is also a major risk factor\\u000a for obstructive sleep apnea, which is rising in the US population as the obesity epidemic continues. Obstructive sleep apnea,\\u000a in turn, has been implicated as a risk factor for hypertension, glucose dysregulation, and cardiovascular disease. Understanding\\u000a the pathophysiologic

Muhammad Iqbal; Syed Shah; Sonalis Fernandez; Jocelyne Karam; Girardin Jean-Louis; Samy I. McFarlane

2008-01-01

17

Neighborhoods and cardiovascular risk: Beyond individual-level risk factors  

Microsoft Academic Search

Efforts to prevent and treat cardiovascular disease have traditionally focused on individual-level risk factors. However,\\u000a recent work has highlighted the role of residential environments in shaping the distribution of cardiovascular outcomes and\\u000a risk factors. Living in disadvantaged neighborhoods has been associated with greater cardiovascular disease risk even after\\u000a accounting for personal measures of socioeconomic status. Current research efforts focus on

Ana V. Diez Roux; Kiarri Kershaw; Lynda Lisabeth

2008-01-01

18

[Kidney stone as a cardiovascular risk marker].  

PubMed

Most of the time, kidney stones are considered as minor, but painful events. However, several studies have recently shown an association between kidney stone and an increased cardio-vascular risk. We review here these studies and explore the underlying pathophysiological hypotheses. At the end, we propose that lithiasis should be considered as a red flag intervening early during life-time and allowing a check of cardiovascular risk factors and early preventive intervention. Such approach may be successful in reducing the incidence of cardio-vascular events in stone formers. PMID:25322624

Ernandez, Thomas; Bonny, Olivier

2014-09-10

19

Gender differences in cardiovascular risk indicators and cardiovascular disease among veterans with PTSD.  

E-print Network

??Using the allostatic load model of disease processes, this study investigated gender differences on cardiovascular risk and cardiovascular disease among PTSD and MDD veterans. Cross-sectional… (more)

Frazier, Elizabeth C.

2008-01-01

20

Residual macrovascular risk in 2013: what have we learned?  

PubMed Central

Cardiovascular disease poses a major challenge for the 21st century, exacerbated by the pandemics of obesity, metabolic syndrome and type 2 diabetes. While best standards of care, including high-dose statins, can ameliorate the risk of vascular complications, patients remain at high risk of cardiovascular events. The Residual Risk Reduction Initiative (R3i) has previously highlighted atherogenic dyslipidaemia, defined as the imbalance between proatherogenic triglyceride-rich apolipoprotein B-containing-lipoproteins and antiatherogenic apolipoprotein A-I-lipoproteins (as in high-density lipoprotein, HDL), as an important modifiable contributor to lipid-related residual cardiovascular risk, especially in insulin-resistant conditions. As part of its mission to improve awareness and clinical management of atherogenic dyslipidaemia, the R3i has identified three key priorities for action: i) to improve recognition of atherogenic dyslipidaemia in patients at high cardiometabolic risk with or without diabetes; ii) to improve implementation and adherence to guideline-based therapies; and iii) to improve therapeutic strategies for managing atherogenic dyslipidaemia. The R3i believes that monitoring of non-HDL cholesterol provides a simple, practical tool for treatment decisions regarding the management of lipid-related residual cardiovascular risk. Addition of a fibrate, niacin (North and South America), omega-3 fatty acids or ezetimibe are all options for combination with a statin to further reduce non-HDL cholesterol, although lacking in hard evidence for cardiovascular outcome benefits. Several emerging treatments may offer promise. These include the next generation peroxisome proliferator-activated receptor? agonists, cholesteryl ester transfer protein inhibitors and monoclonal antibody therapy targeting proprotein convertase subtilisin/kexin type 9. However, long-term outcomes and safety data are clearly needed. In conclusion, the R3i believes that ongoing trials with these novel treatments may help to define the optimal management of atherogenic dyslipidaemia to reduce the clinical and socioeconomic burden of residual cardiovascular risk. PMID:24460800

2014-01-01

21

Optimal dietary intake for cardiovascular risk reduction  

Microsoft Academic Search

Healthful dietary intake and physical activity are advocated as first-line prevention and treatment of many diseases. Dietary\\u000a intake plays a major role in preventing and promoting the leading cause of death in the United States: cardiovascular disease.\\u000a Despite continually growing evidence on the relationship between nutrition and cardiovascular risk, many Americans consume\\u000a an atherogenic diet resulting in a proinflammatory and

Wendy M. Miller; Katherine E. Nori Janosz; Kerstyn C. Zalesin; Peter A. McCullough

2009-01-01

22

Cardiovascular Risk Reduction in Children.  

ERIC Educational Resources Information Center

The paper presents a community model for reducing the risk of coronary heart disease in children and youth. The model addresses the individual, the family, social groups, and the larger social and physical environments. Exemplary programs are described and recommendations are made for additional research and program development. (Author/DB)

Murray, David M.; And Others

1987-01-01

23

Cardiovascular risk factors and future risk of Alzheimer's disease.  

PubMed

Alzheimer's disease (AD) is the most common neurodegenerative disorder in elderly people, but there are still no curative options. Senile plaques and neurofibrillary tangles are considered hallmarks of AD, but cerebrovascular pathology is also common. In this review, we summarize findings on cardiovascular disease (CVD) and risk factors in the etiology of AD. Firstly, we discuss the association of clinical CVD (such as stroke and heart disease) and AD. Secondly, we summarize the relation between imaging makers of pre-clinical vascular disease and AD. Lastly, we discuss the association of cardiovascular risk factors and AD. We discuss both established cardiovascular risk factors and emerging putative risk factors, which exert their effect partly via CVD. PMID:25385322

de Bruijn, Renée Fag; Ikram, M Arfan

2014-01-01

24

Weight Loss Drugs and Cardiovascular Risks  

Microsoft Academic Search

Overweight and obesity have been rising dramatically worldwide and are an independent risk factor for cardiovascular disease\\u000a (CVD). The majority of overweight and obese patients who achieve a significant short-term weight loss fail to maintain their\\u000a lower weight in the long term. As a result, there has been focus on the role of pharmacotherapy for long-term weight management.\\u000a Since the

Paul Poirier

2011-01-01

25

Lifetime cardiovascular risk of childhood obesity.  

PubMed

An increase in the incidence and an earlier onset of coronary artery disease is expected because of the increased prevalence of childhood obesity. Comorbidities of obesity, such as dyslipidemia, insulin resistance syndrome, hypertension, associated nutritional deficiencies, and a sedentary lifestyle or associated lifestyle factors such as tobacco smoke exposure, are likely to account for this increase because these are all independent risk factors for accelerated atherosclerosis. Because clinical atherosclerotic cardiovascular disease does not manifest in obese children, assessment of the subclinical markers of atherosclerosis may help in the evaluation of the progression of atherosclerosis, in further stratification of risk, and in monitoring the effects of intervention. Furthermore, because multiple risk factors with poorly understood interplay might be present in obese children, assessment of the vasculature directly, and perhaps the assignment of a "vascular age," may be a useful method to quantify the "end organ" effect of exposure to these various risks. Obese children may show favorable changes in their behaviors that result in an improvement in clinically measurable risk factors with various clinic-based and behavior modification therapies, but the vascular benefits of such interventions need to be studied further. Broad social, cultural, legislative, and policy changes that support healthy lifestyles within families and communities need to be implemented to decrease the prevalence of childhood obesity and its cardiovascular consequences in communities. The effect of risk factor modification on the vasculature will continue to be a resource for the direction of evidence-based therapy in obese children. PMID:20335556

Raghuveer, Geetha

2010-05-01

26

Assessment of Cardiovascular Risk in Collegiate Football Players and Nonathletes  

ERIC Educational Resources Information Center

Collegiate American football players may be at risk for cardiovascular disease. Objective: To compare cardiovascular disease risk factors and cardiovascular structure and function parameters of football players, stratified by position, to a group of sedentary, nonathletes. Participants: Twenty-six collegiate football players and 13 nonathletes…

Dobrosielski, Devon A.; Rosenbaum, Daryl; Wooster, Benjamin M.; Merrill, Michael; Swanson, John; Moore, J. Brian; Brubaker, Peter H.

2010-01-01

27

Telemedicine Cardiovascular Risk Reduction in Veterans  

PubMed Central

Background Patients with co-occurrence of hypertension, hyperlipidemia, and diabetes have an increased risk of cardiovascular disease (CVD) events. Comprehensive programs addressing both tailored patient self-management and pharmacotherapy are needed to address barriers to optimal cardiovascular risk reduction. We are examining a Clinical Pharmacy Specialist (CPS), telephone administered intervention, relying on home monitoring, with a goal of providing tailored medication and behavioral intervention to Veterans with CVD risk. Methods Randomized controlled trial including patients with hypertension (blood pressure (BP) > 150/100 mmHg) or elevated low density liporotein (LDL) (> 130 mg/dl). Longitudinal changes in CVD risk profile and improvement in health behaviors over time will be examined. Conclusion Given the national prevalence of CVD and the dismal rates of risk factor control; intensive, but easily disseminated interventions are required to treat this epidemic. This study will be an important step in testing the effectiveness of a behavioral and medication intervention to improve CVD control among Veterans. PMID:23537965

Melnyk, S. Dee; Zullig, Leah L.; McCant, Felicia; Danus, Susanne; Oddone, Eugene; Bastian, Lori; Olsen, Maren; Stechuchak, Karen M.; Edelman, David; Rakley, Susan; Morey, Miriam; Bosworth, Hayden B

2013-01-01

28

Cardiovascular disease risk in youth with diabetes mellitus  

Microsoft Academic Search

In the United States, cardiovascular disease is the leading cause of mortality in adults with diabetes over age 30 years.\\u000a Studies in persons without diabetes have shown that atherosclerosis, a central factor in cardiovascular disease, begins in\\u000a childhood and the presence of cardiovascular disease risk factors in youth lead to increased cardiovascular disease risk in\\u000a adults. Therefore, youth with diabetes

R. Paul Wadwa

2006-01-01

29

The Residual Risk Reduction Initiative: a call to action to reduce residual vascular risk in dyslipidaemic patients  

Microsoft Academic Search

Despite current standards of care aimed at achieving targets for low-density lipoprotein (LDL) cholesterol, blood pressure and glycaemia, dyslipidaemic patients remain at high residual risk of vascular events. Atherogenic dyslipidaemia, specifically elevated triglycerides and low levels of high-density lipoprotein (HDL) cholesterol, often with elevated apolipoprotein B and non-HDL cholesterol, is common in patients with established cardiovascular disease, type 2 diabetes,

Jean-Charles Fruchart; Frank M Sacks; Michel P Hermans; Gerd Assmann; W Virgil Brown; Richard Ceska; M John Chapman; Paul M Dodson; Paola Fioretto; Henry N Ginsberg; Takashi Kadowaki; Jean-Marc Lablanche; Nikolaus Marx; Jorge Plutzky; Zeljko Reiner; Robert S Rosenson; Bart Staels; Jane K Stock; Rody Sy; Christoph Wanner; Alberto Zambon; Paul Zimmet

2008-01-01

30

Cardiovascular disease risk reduction with sleep apnea treatment  

PubMed Central

Cardiovascular diseases are the leading cause of death among adults in developed countries. An increase in prevalent cardiovascular risk factors (e.g., obesity, hypertension and diabetes) has led to a concerted effort to raise awareness of the need to use evidence-based strategies to help patients at risk of developing cardiovascular disease and to reduce their likelihood of suffering a stroke. Sleep apnea has emerged as an important risk factor for the development of cardiovascular disease. Epidemiologic and clinical evidence has prompted the American Heart Association to issue a scientific statement describing the need to recognize sleep apnea as an important target for therapy in reducing cardiovascular disease risks. This article examines evidence supporting associations of sleep apnea with cardiovascular disease and considers evidence suggesting cardiovascular risk reductions through sleep apnea treatment. Perspectives on emerging therapeutic approaches and promising areas of clinical and experimental research are also discussed. PMID:20602560

Jean-Louis, Girardin; Brown, Clinton D; Zizi, Ferdinand; Ogedegbe, Gbenga; Boutin-Foster, Carla; Gorga, Joseph; McFarlane, Samy I

2014-01-01

31

Cardiovascular risk assessment for persons living with HIV.  

PubMed

Systematic assessment of cardiovascular risk among persons living with HIV (PLWH) has become more important as HIV survival has increased. Since the advent of effective antiretroviral therapy (ART), PLWH often enjoy life expectancies equal to those of the general population. PLWH then share the same comorbidities as the general population, with some increased risks due to HIV and ART. One comorbidity, cardiovascular disease, is the leading cause of death in the United States. As the current population of PLWH ages, reducing cardiovascular risk will become even more important. Before cardiovascular risk reduction can take place, providers must first know the patient's risks. This paper describes the importance of cardiovascular risk assessment for PLWH based on current literature and presents findings from a quality-improvement (QI) initiative designed to implement systematic cardiovascular assessment using the Framingham Risk (FR) for PLWH in an infectious-disease practice. PMID:21775164

Burke, Emily G; Nelson, Joan; Kwong, Jeffrey; Cook, Paul F

2012-01-01

32

Cardiovascular Risk Factors in the Antiphospholipid Syndrome  

PubMed Central

A major cause of morbidity and mortality in the context of the antiphospholipid syndrome (APS) is the occurrence of thrombotic events. Besides the pathogenic roles of antiphospholipid antibodies (aPL), other risk factors and medical conditions, which are conditions for traditional risk of an individual without the APS, can coexist in this patient, raising their risk of developing thrombosis. Therefore, the clinical and laboratory investigation of comorbidities known to increase cardiovascular risk in patients with antiphospholipid antibody syndrome is crucial for the adoption of a more complete and effective treatment. Experimental models and clinical studies show evidence of association between APS and premature formation of atherosclerotic plaques. Atherosclerosis has major traditional risk factors: hypertension, diabetes mellitus, obesity, dyslipidemia, smoking, and sedentary lifestyle that may be implicated in vascular involvement in patients with APS. The influence of nontraditional risk factors as hyperhomocysteinemia, increased lipoprotein a, and anti-oxLDL in the development of thromboembolic events in APS patients has been studied in scientific literature. Metabolic syndrome with all its components also has been recently studied in antiphospholipid syndrome and is associated with arterial events. PMID:25133195

da Silva, Felipe Freire; Levy, Roger Abramino; de Carvalho, Jozelio Freire

2014-01-01

33

Increased Cardiovascular Risk Associated with Reduced Kidney Function  

Microsoft Academic Search

Background: Individuals with chronic kidney disease (CKD) are at substantial risk for cardiovascular mortality, but the risk associated with specific glomerular filtration rates (GFRs) is unknown. The objective of this study was to investigate the relationship between level of kidney function and the risk of cardiovascular mortality in a diverse population. Methods and Results: This was a nonconcurrent cohort study

Timothy P. Ryan; Susan G. Fisher; Jessica L. Elder; Paul C. Winters; William Beckett; James Tacci; James A. Sloand

2009-01-01

34

[New perspectives in cardiovascular risk reduction: focus on HDL].  

PubMed

Cardiovascular diseases represent the leading cause of morbidity and mortality worldwide, mostly contributing to hospitalizations and health care costs. Dyslipidemias represent one of the major cardiovascular risk factor and its management, throughout life-style modifications and pharmacological interventions, has shown to reduce cardiac events. The risk of adverse cardiovascular events is related not only to elevated LDL blood levels, but also to decreased HDL concentrations, that exhibit protective effects in the development of atherosclerotic process. Aim of this review is to summarize current evidences about defensing effects of such lipoproteins and to show the most recent pharmacological strategies to reduce cardiovascular risk through the increase of their circulating levels. PMID:23923587

Paolillo, Stefania; Della Ratta, Giuseppe Luca; Vitagliano, Alice; Cirillo, Annapaola; Lardino, Elisabetta; Formisano, Tiziana; Fabiani, Irma; Pellegrino, Angela Maria; Riello, Pietro; Filardi, Pasquale Perrone

2013-03-01

35

Obstructive sleep apnea and cardiovascular risk  

PubMed Central

Obstructive sleep apnea (OSA) is a form of sleep disordered breathing characterized by episodes of apnea (during sleep) lasting at least 10 seconds per episode. The apneic periods are associated with arterial hypoxemia and disruption of normal sleep as a result of awakenings. It is increasingly being recognized that OSA is a public health hazard and there is increasing evidence that it is associated with an increase in morbidity (and possibly mortality). Patients with OSA also utilize the healthcare resources at higher rates than control patients long before their diagnosis is confirmed. Early recognition of this condition may lead to earlier treatments (eg, nasal CPAP) with reduction of the risk of cardiovascular diseases such as hypertension, ischemic heart disease, arrhythmias, platelet activation and pulmonary hypertension. PMID:18516275

Dorasamy, Punginathn

2007-01-01

36

Liver enzymes: potential cardiovascular risk markers?  

PubMed

Several cross-sectional studies have reported a relationship between elevated serum activity of liver enzymes [e.g. alanine aminotransferase (ALT) and gamma-glutamyltransferase (?GT)] and metabolic syndrome (MetS) and/or diabetes mellitus (DM). Raised serum activity of liver enzymes independently predicted the future development of MetS and DM as well as cardiovascular (CV) events and/or total/CV mortality in prospective studies. However, this association was not consistently demonstrated and it appears to be independent of alcohol intake. Even though these associations can be partly attributed to non-alcoholic fatty liver disease (NAFLD) and insulin resistance, there may be additional underlying mechanisms that contribute to the increased CV risk (e.g. inflammation and oxidative stress). The association of ?GT with atherosclerotic plaque is of particular importance. PMID:22074433

Lioudaki, Eirini; Ganotakis, Emmanuel S; Mikhailidis, Dimitri P

2011-11-01

37

Adaptive Patient Education Framework Featuring Personalized Cardiovascular Risk Management  

E-print Network

Adaptive Patient Education Framework Featuring Personalized Cardiovascular Risk Management Interventions Selena Davis and Syed Sibte Raza Abidi Health Informatics Laboratory, Faculty of Computer Science of cardiovascular risk. We present a web-based adaptive hypermedia system to create and deliver the personalized

Abidi, Syed Sibte Raza

38

Cardiovascular Risk Factor Levels in Adults with Mental Retardation.  

ERIC Educational Resources Information Center

Comparison of cardiovascular risk factors (blood lipids, obesity, and smoking) in 329 adults with mental retardation residing in various settings with subjects in the Framingham Offspring Study found that adults with mental retardation had cardiovascular risk profiles similar to those of individuals without mental retardation. (Author/DB)

Rimmer, James H.; And Others

1994-01-01

39

Psychosocial Indexes and Cardiovascular Risk Factors in a Community Sample  

Microsoft Academic Search

Background: Psychosocial characteristics might contribute to a more comprehensive understanding of cardiovascular disease as it is increasingly recognised that biomedical risk factors do not fully explain its dynamics. This study aimed to describe psychometric indexes in a Portuguese community sample relating them to known cardiovascular disease risk factors. Methods: Anthropometric, blood pressure, serum measurements and information on demographic, social, medical

Rui Coelho; Elisabete Ramos; Joana Prata; Henrique Barros

2000-01-01

40

Cardiovascular risk factors in young Gypsy population.  

PubMed

Lipid and non-lipid cardiovascular risk parameters (cholesterol, HDL- and LDL-cholesterol, triglycerides, homocysteine, C-reactive protein, insulin resistance) and data about blood pressure, smoking, body mass index were assessed in two ethnic groups aged 19-35 years--the Gypsy group (n=122) and the Slovak group (n=137) of two regions with a high density of Gypsy population. In the Gypsy group, the values of triglycerides, atherogenic index, insulin, insulin resistance were significantly increased and the level of HDL-cholesterol was significantly decreased. The risk value of atherogenic index was found in 27 % of Gypsy vs 13 % of majority subjects, and 28 % vs 24 % of subjects had hypertriglyceridemia. Risk value of insulin resistance (HOMA) was presented in 11 % of the Gypsy vs 5 % of the majority group. More obese subjects (20 % vs 8 %), more smokers (55 % vs 25 %) and more subjects with low education (85 % vs 27 %) were recorded in the minority group. The greater occurrence of dyslipidemia, obesity and insulin resistance in young Gypsy subjects is influenced with lifestyle (nutrition /prevalence of animal fat consumption, low consumption of food with low glycemic index and soluble fibre/, smoking, low physical activity) as well as low educational status. (Tab. 2, Ref. 22.). PMID:15543846

Krajcovicova-Kudlackova, M; Blazicek, P; Spustova, V; Valachovicova, M; Ginter, E

2004-01-01

41

Temporal Shifts in Cardiovascular Risk Factor Distribution  

PubMed Central

Background Complementary strategies to shift risk factor population distributions and target high-risk individuals are required to reduce the burden of type 2 diabetes and cardiovascular disease (CVD). Purpose To examine secular changes in glucose and CVD risk factors over 20 years during an individual and population-based CVD prevention program in Västerbotten County, Sweden. Methods Population-based health promotion intervention was conducted and annual invitation for individuals turning 40, 50, and 60 years to attend a health assessment, including an oral glucose tolerance test, biochemical measures, and a questionnaire. Data were collected between 1991 and 2010, analyzed in 2012 and available for 120,929 individuals. Linear regression modeling examined age-adjusted differences in CVD risk factor means over time. Data were direct-age-standardized to compare disease prevalence. Results Between 1991–1995 and 2006–2010, mean age-adjusted cholesterol (men=?0.53, 95% CI=?0.55, ?0.50 mmol/L; women=?0.48, 95% CI=?0.50, ?0.45 mmol/L) and systolic blood pressure declined (men=?3.06, 95% CI=?3.43, ?2.70 mm Hg; women=?5.27, 95% CI=?5.64, ?4.90 mm Hg), with corresponding decreases in the age-standardized prevalence of hypertension and hyperlipidemia. Mean age-adjusted 2-hour plasma glucose (men=0.19, 95% CI=0.15, 0.23 mmol/L; women=0.08, 95% CI=0.04, 0.11 mmol/L) and BMI increased (men=1.12, 95% CI=1.04, 1.21; women=0.65, 95% CI=0.55, 0.75), with increases in the age-standardized prevalence of diabetes and obesity. Conclusions These data demonstrate the potential of combined individual- and population-based approaches to CVD risk factor control and highlight the need for additional strategies addressing hyperglycemia and obesity. PMID:24439344

Long, Grainne H.; Simmons, Rebecca K.; Norberg, Margareta; Wennberg, Patrik; Lindahl, Bernt; Rolandsson, Olov; Griffin, Simon J.; Weinehall, Lars

2014-01-01

42

Cardiovascular Risk and Responsivity to Mental Stress: The Influence of Age, Gender and Risk Factors  

Microsoft Academic Search

Background Exaggerated cardiovascular and neuroendocrine responses to mental stress may enhance cardiovascular disease risk, Coronary heart disease and hypertension increase in prevalence with advancing age, whereas the excess male\\/female ratio declines in later middle age. Psychosocial factors may contribute to these changing risk profiles. The hypothesis that cardiovascular and neuroendocrine stress responses are associated with age and gender differences in

Andrew Steptoe; George Fieldman; Olga Evans; Les Perry

1996-01-01

43

Pesticide Residues and Bees - A Risk Assessment  

PubMed Central

Bees are essential pollinators of many plants in natural ecosystems and agricultural crops alike. In recent years the decline and disappearance of bee species in the wild and the collapse of honey bee colonies have concerned ecologists and apiculturalists, who search for causes and solutions to this problem. Whilst biological factors such as viral diseases, mite and parasite infections are undoubtedly involved, it is also evident that pesticides applied to agricultural crops have a negative impact on bees. Most risk assessments have focused on direct acute exposure of bees to agrochemicals from spray drift. However, the large number of pesticide residues found in pollen and honey demand a thorough evaluation of all residual compounds so as to identify those of highest risk to bees. Using data from recent residue surveys and toxicity of pesticides to honey and bumble bees, a comprehensive evaluation of risks under current exposure conditions is presented here. Standard risk assessments are complemented with new approaches that take into account time-cumulative effects over time, especially with dietary exposures. Whilst overall risks appear to be low, our analysis indicates that residues of pyrethroid and neonicotinoid insecticides pose the highest risk by contact exposure of bees with contaminated pollen. However, the synergism of ergosterol inhibiting fungicides with those two classes of insecticides results in much higher risks in spite of the low prevalence of their combined residues. Risks by ingestion of contaminated pollen and honey are of some concern for systemic insecticides, particularly imidacloprid and thiamethoxam, chlorpyrifos and the mixtures of cyhalothrin and ergosterol inhibiting fungicides. More attention should be paid to specific residue mixtures that may result in synergistic toxicity to bees. PMID:24718419

Sanchez-Bayo, Francisco; Goka, Koichi

2014-01-01

44

[Cheyne-Stokes respiration and cardiovascular risk].  

PubMed

Due to its high prevalence in patients with heart failure and its negative predictive value concerning morbidity and mortality, Cheyne-Stokes respiration (CSR) is a sleep disorders of major interest. CSR correlates with the degree of heart failure and is characterised by a typical crescendo/decrescendo breathing pattern combined with phases of central sleep apnoea, caused by pulmonary oedema and oscillation of ventilatory control. Thus, CSR is a marker of the severity of heart failure. Treatment of CSR first involves optimisation of heart failure therapy by cardiologists and then application of non-invasive means of ventilatory support. Treatment of patients with severe heart failure with non-invasive positive pressure ventilatory support leads to a significant reduction of CSR, sympathetic activity, and daytime sleepiness and improves cardiac output and 6-minute walking distance. At present, a prospective randomised, controlled intervention-study (Serve-HF study) is being conducted in order to show if therapy of CSR can improve patient survival. This review describes the pathophysiology, epidemiology, and therapeutic options of CSR with a special focus on the elevated cardiovascular risk of patients with CSR. PMID:19591086

Duchna, H-W; Schultze-Werninghaus, G

2009-07-01

45

Molecular Basis of Obesity and the Risk for Cardiovascular Disease  

Microsoft Academic Search

Atherosclerosis and cardiovascular disease (CVD) are the main causes of death in the Western world, for both men and women. The onset and development of diseases of the cardiovascular and cerebrovascular system are strongly dependent on multiple risk factors that promote pathologic conditions like atherosclerosis, hypertension and thrombosis. Besides genetic factors also environmental influences such as diet composition are known

Muhidien Soufi; Alexander M. Sattler; Matthias Herzum; Bernhard Maisch; Jürgen R. Schaefer

2006-01-01

46

Air Pollution and Blood Markers of Cardiovascular Risk  

Microsoft Academic Search

Recent studies have linked air pollution to tens of thousands of premature cardiovascular deaths per year. The mechanisms of such associations remain unclear. In this study we examine the association between blood markers of cardiovascular risk and air pollution in a national sample of the U.S. population. Air pollution concentrations were merged to subjects in the Third National Health and

Joel Schwartz

2001-01-01

47

Generating Personalised Cardiovascular Risk Management Educational Interventions Linking  

E-print Network

72 Generating Personalised Cardiovascular Risk Management Educational Interventions Linking SCORE and Behaviour Change Selena Davis, Syed Abidi, Jafna Cox* Health Informatics Laboratory, Faculty of Computer Science, and *Departments of Medicine and of Community Health and Epidemiology, QEII Health Sciences

Abidi, Syed Sibte Raza

48

The putative mechanisms underlying testosterone and cardiovascular risk  

PubMed Central

The use of testosterone supplementation therapy (TST) is increasing primarily in men with symptomatic hypogonadism. While TST has been shown to have numerous benefits, as its use increases, the role on cardiovascular health must be explored. Previous evidence showed no adverse cardiovascular risks associated with TST use; however, more recent studies suggest that there may be an associated risk. The exact mechanism by which TST may contribute to cardiovascular risk has not been elucidated. Numerous mechanisms have been proposed which include testosterone’s effect on thromboxane A2 receptors, vascular adhesion molecule 1 receptors, erythropoiesis, and obstructive sleep apnea, all of which can ultimately lead to atherogenesis and increased cardiovascular risk. PMID:24795810

Maganty, Avinash; Kovac, Jason R.; Ramasamy, Ranjith

2014-01-01

49

Prolonged Sitting and the Risk of Cardiovascular Disease and Mortality  

Microsoft Academic Search

Prolonged sitting behaviors are a distinct subset of sedentary behaviors. They include television viewing, computer and video\\u000a use, sitting in automobiles, and workplace sitting. I reviewed scientific literature from 2005 to 2010 to assess the effects\\u000a of prolonged sitting on cardiovascular disease mortality and risk factors. I conclude that prolonged sitting is positively\\u000a associated with cardiovascular disease risk factors and

Wendell C. Taylor

2011-01-01

50

Occupational Health Promotion Programs to Reduce Cardiovascular Risk.  

ERIC Educational Resources Information Center

Surveys literature on worksite health promotion programs targeting cardiovascular risk factors. Reviews findings on health-risk appraisal, hypertension control, smoking cessation, weight reduction, exercise, and programs addressing multiple risk factors. Discusses current knowledge, highlights exemplary studies, and identifies problems and…

Glasgow, Russell E.; Terborg, James R.

1988-01-01

51

Hypertension Management in the High Cardiovascular Risk Population  

PubMed Central

The incidence of hypertension is increasing every year. Blood pressure (BP) control is an important therapeutic goal for the slowing of progression as well as for the prevention of Cardiovascular disease. The management of hypertension in the high cardiovascular risk population remains a real challenge as the population continues to age, the incidence of diabetes increases, and more and more people survive acute myocardial infarction. We will review hypertension management in the high cardiovascular risk population: patients with coronary heart disease (CHD) and heart failure (HF) as well as in diabetic patients. PMID:23476746

Maraj, Ilir; Makaryus, John N.; Ashkar, Anthony; McFarlane, Samy I.; Makaryus, Amgad N.

2013-01-01

52

Psoriasis and Cardiovascular Risk: Assessment by CUORE Project Risk Score in Italian Patients  

PubMed Central

Background. Psoriasis is a common inflammatory and immune-mediated skin disease. There is growing controversy as to whether cardiovascular risk is elevated in psoriasis. A number of studies suggest a high prevalence of cardiovascular risk factors as well as cardiovascular diseases in psoriasis patients. Objective. The objective of this study was to estimate cardiovascular risk score in psoriasis patients and the relation between cardiovascular risk and psoriasis features. Cardiovascular risk was assessed by CUORE project risk score built within the longitudinal study of the Italian CUORE project and suited to populations with a low rate of coronary heart disease. Results. A case-control study in 210 psoriasis outpatients and 111 controls with skin diseases other than psoriasis was performed. CUORE project risk score was higher in patients than controls (6.80 ± 6.34 versus 4.48 ± 4.38, P < 0.001). Compared to controls, psoriasis patients have higher risk of developing major cardiovascular events. Cardiovascular risk was not related to psoriasis characteristics. Conclusion. Increased focus on identifying cardiovascular risk factors and initiation of preventive lifestyle changes or therapeutic interventions in patients with psoriasis is warranted. PMID:24082881

Caputo, Valentina; Bongiorno, Maria Rita

2013-01-01

53

Modified lipoproteins as biomarkers of cardiovascular risk in diabetes mellitus.  

PubMed

Prevention of high incidence of cardiovascular disease in diabetes is one of the challenges of endocrinology. Validation of new biomarkers that may contribute to a better assessment of cardiovascular risk and help implement treatment strategies is one of the promising approaches in research on prevention and reduction of cardiovascular risk. Modification of low density lipoprotein (LDL) is a key element in development of atherosclerotic lesions. Several pathophysiological characteristics of diabetes are crucial for the LDL of these patients to have higher modification rates as compared to the healthy population. Diabetic dyslipidemia, hyperglycemia, and oxidative stress synergistically promote the occurrence of lipoperoxidation, glycosylation and glycoxidation processes, which will generate modified lipoproteins that stimulate development of atherosclerosis. This article reviews the role of different types of modified LDL in development of atherosclerosis in diabetes, as well as the possibility of using its quantification in cardiovascular risk prediction. PMID:23545115

Sánchez-Quesada, José Luis; Pérez, Antonio

2013-11-01

54

Serum FGF23 and Risk of Cardiovascular Events in Relation to Mineral Metabolism and Cardiovascular Pathology  

PubMed Central

Summary Background and objectives Circulating fibroblast growth factor-23 is associated with adverse cardiovascular outcomes in CKD and non-CKD individuals, but the underlying mechanism remains unclear. This study tested whether this association is independent of mineral metabolism and indices of subclinical cardiovascular pathology. Design, setting, participants, & measurements The prospective association between fibroblast growth factor-23 and major cardiovascular events (a composite of hospital-treated myocardial infarction, hospital-treated stroke, or all-cause mortality) was investigated in the community-based Prospective Investigation of the Vasculature in Uppsala Seniors (n=973; mean age=70 years, 50% women) using multivariate logistic regression. Subjects were recruited between January of 2001 and June of 2004. Results During follow-up (median=5.1 years), 112 participants suffered a major cardiovascular event. In logistic regression models adjusted for age, sex, and estimated GFR, higher fibroblast growth factor-23 was associated with increased risk for major cardiovascular events (odds ratio for tertiles 2 and 3 versus tertile 1=1.92, 95% confidence interval=1.19–3.09, P<0.01). After additional adjustments in the model, adding established cardiovascular risk factors, confounders of mineral metabolism (calcium, phosphate, parathyroid hormone, and 25(OH)-vitamin D), and indices of subclinical pathology (flow-mediated vasodilation, endothelial-dependent and -independent vasodilation, arterial stiffness, and atherosclerosis and left ventricular mass) attenuated this relationship, but it remained significant (odds ratio for tertiles 2 and 3 versus tertile 1=1.69, 95% confidence interval=1.01–2.82, P<0.05). Conclusions Fibroblast growth factor-23 is an independent predictor of cardiovascular events in the community, even after accounting for mineral metabolism abnormalities and subclinical cardiovascular damage. Circulating fibroblast growth factor-23 may reflect novel and important aspects of cardiovascular risk yet to be unraveled. PMID:23335040

Arnlov, Johan; Carlsson, Axel C.; Sundstrom, Johan; Ingelsson, Erik; Larsson, Anders; Lind, Lars

2013-01-01

55

Effect of Age on the Relationship of Occupational Social Class with Prevalence of Modifiable Cardiovascular Risk Factors and Cardiovascular Diseases  

Microsoft Academic Search

Background: Previous studies on cardiovascular risk profile in different socioeconomic status were focused on younger populations and many of them have not been able to take into account age and sex differences. Objectives: To investigate the relationship of occupational social class with the prevalence of cardiovascular disease risk factors and cardiovascular diseases in younger (<65 years) and older (?65 years)

Phyo K. Myint; Robert N. Luben; Ailsa A. Welch; Sheila A. Bingham; Nicholas J. Wareham; Kay-Tee Khaw

2006-01-01

56

Radiation as a Risk Factor for Cardiovascular Disease  

PubMed Central

Abstract Humans are continually exposed to ionizing radiation from terrestrial sources. The two major contributors to radiation exposure of the U.S. population are ubiquitous background radiation and medical exposure of patients. From the early 1980s to 2006, the average dose per individual in the United States for all sources of radiation increased by a factor of 1.7–6.2?mSv, with this increase due to the growth of medical imaging procedures. Radiation can place individuals at an increased risk of developing cardiovascular disease. Excess risk of cardiovascular disease occurs a long time after exposure to lower doses of radiation as demonstrated in Japanese atomic bomb survivors. This review examines sources of radiation (atomic bombs, radiation accidents, radiological terrorism, cancer treatment, space exploration, radiosurgery for cardiac arrhythmia, and computed tomography) and the risk for developing cardiovascular disease. The evidence presented suggests an association between cardiovascular disease and exposure to low-to-moderate levels of radiation, as well as the well-known association at high doses. Studies are needed to define the extent that diagnostic and therapeutic radiation results in increased risk factors for cardiovascular disease, to understand the mechanisms involved, and to develop strategies to mitigate or treat radiation-induced cardiovascular disease. Antioxid. Redox Signal. 15, 1945–1956. PMID:21091078

Moulder, John E.; Hopewell, John W.

2011-01-01

57

Prevalence of cardiovascular risk factors and concentration of C-reactive protein in Type D personality persons without cardiovascular disease  

Microsoft Academic Search

Background: Type D personality is associated with poor cardiovascular outcome in patients with coronary or peripheral arterial disease. Whether Type D personality is associated with cardiovascular risk in persons without overt cardiovascular disease remains unknown. We hypothesized that Type D personality is associated with higher prevalence of traditional cardiovascular risk factors and higher concentration of C-reactive protein.Design: Cross-sectional study.Methods: Type

Gunnar Einvik; Toril Dammen; Harald Hrubos-Strøm; Silje K Namtvedt; Anna Randby; Håvard A Kristiansen; Virend K Somers; Inger H Nordhus; Torbjørn Omland

2011-01-01

58

Type 2 diabetes: postprandial hyperglycemia and increased cardiovascular risk  

PubMed Central

Hyperglycemia is a major risk factor for both the microvascular and macrovascular complications in patients with type 2 diabetes. This review summarizes the cardiovascular results of large outcomes trials in diabetes and presents new evidence on the role of hyperglycemia, with particular emphasis on postprandial hyperglycemia, in adverse cardiovascular outcomes in patients with type 2 diabetes. Treatment options, including the new dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1 mimetics that primarily target postprandial hyperglycemia, are also discussed. Hyperglycemia increases cardiovascular mortality, and reducing hyperglycemia lowers cardiovascular risk parameters. Control of both fasting and postprandial hyperglycemia is necessary to achieve optimal glycated hemoglobin control. Therefore, anti-hyperglycemic agents that preferentially target postprandial hyperglycemia, along with those that preferentially target fasting hyperglycemia, are strongly suggested to optimize individual diabetes treatment strategies and reduce complications. PMID:20448799

Aryangat, Ajikumar V; Gerich, John E

2010-01-01

59

RISK FACTORS FOR CARDIOVASCULAR DISEASE IN PATIENTS UNDERGOING PERITONEAL DIALYSIS  

Microsoft Academic Search

Patients on peritoneal dialysis (PD) are at high cardio- vascular risk. Although some risk factors are unmodifiable (for example, age, sex, genetics), others are exacerbated in the unfriendly uremic milieu (inflammation, oxidative stress, mineral disturbances) or contribute per se to kid- ney disease and cardiovascular progression (diabetes mel- litus, hypertension). Moreover, several factors associated with PD therapy may both increase

Elvia García-López; Juan J. Carrero; Mohamed E. Suliman; Bengt Lindholm; Peter Stenvinkel

60

CURRENT OPINION Lipoprotein(a) as a cardiovascular risk factor  

E-print Network

(a) ,80th percentile (less than 50 mg/dL). Treatment should primarily be niacin 1­3 g/day, as a meta-analysis of randomized, controlled intervention trials demonstrates reduced CVD by niacin treatment. In extreme cases cardiovascular risk, and use of niacin for Lp(a) and CVD/CHD risk reduction. ---------------------------------------------------------------------------------------------

Paris-Sud XI, Université de

61

Cardiovascular risk factors among retired attendees visiting primary care clinics  

PubMed Central

Objective: The aim of this study was to highlight cardiovascular risk factors among retired attendees attending a primary care clinic, Riyadh, Saudi Arabia. Methods:A cross sectional study was conducted from Januaryto February 2013 at Primary Care Clinics of King Khalid University Hospital and College of Medicine, King Saud University, Riyadh, Saudi Arabia. All retired attendees were interviewed by family physician, and their duration of retirement was determined. Their cardiovascular risk factors were confirmed from their medical records. The cardiovascular risk factors included history of diabetes mellitus, hypertension, dyslipidemia, obesity, and smoking. Their weight and height were recorded during the consultation and Body Mass Index was calculated to decide about those classified as obesity ? 30 All data were entered and analyzed using statistical package of social science SPSS version 17 software. Results: The present study showed that 19.5% of retired attendees presenting at primary care clinic were early retired before the age of 60 years, while 80.5% were normally retired. The prevalence of cardiovascular risk factors showed: Hypertension among 73% attendees, Diabetes Mellitus in 67%, dyslipidemia in 71%, Obesity 29%, and Smoking 13% of the patients. Conclusion:This study concluded that cardiovascular risk factors among retired attendees of a primary care clinic are common, and need to be taken in to priority consideration while improving the health care of retired people. PMID:24948970

Al Turki, Yousef Abdullah

2014-01-01

62

Arterial function in youth: window into cardiovascular risk.  

PubMed

Noninvasive measures of arterial function, such as intima-media thickness (IMT), endothelial function, and arterial stiffness are associated with and are prognostic of cardiovascular events in adults. Postmortem evidence, however, has established that the atherosclerotic process starts in childhood. Furthermore, cardiovascular morbidities in childhood disrupt arterial health and may lead to adverse outcomes in adulthood. Thus it is important to examine the developmental changes in IMT, endothelial function, and arterial stiffness in healthy youth in contrast to the arterial health profile of youth with cardiovascular morbidities and to examine the effect of lifestyle interventions. In healthy youth, IMT may increase slightly, arterial stiffness increases, but there is no change in endothelial function from 5 to 20 years of age. In youth with cardiovascular risk factors there are larger increases in IMT and arterial stiffness, and reductions in endothelial function compared with healthy youth. The reduced arterial function in youth with cardiovascular risk factors may be related to the atherosclerotic process. Exercise and physical activity appear to exert a protective effect on arterial function, and exercise training can improve arterial function in children with cardiovascular risk factors. Furthermore, although diet alone can improve arterial function in children, the combination of exercise and diet appears to be more effective than either intervention alone. Future studies need to focus on the mechanism by which exercise and diet improve arterial function, the most effective types of diet and exercise, and if intervening in childhood leads to favorable outcomes in adulthood. PMID:18450990

Fernhall, Bo; Agiovlasitis, Stamatis

2008-07-01

63

Cardiovascular risk in pediatric-onset rheumatological diseases  

PubMed Central

Cardiovascular morbidity and mortality are becoming major health concerns for adults with inflammatory rheumatic diseases. The enhanced atherogenesis in this patient population is promoted by the exposure to traditional risk factors as well as nontraditional cardiovascular insults, such as corticosteroid therapy, chronic inflammation and autoantibodies. Despite definite differences between many adult-onset and pediatric-onset rheumatologic diseases, it is extremely likely that atherosclerosis will become the leading cause of morbidity and mortality in this pediatric patient population. Because cardiovascular events are rare at this young age, surrogate measures of atherosclerosis must be used. The three major noninvasive vascular measures of early atherosclerosis - namely, flow-mediated dilatation, carotid intima-media thickness and pulse wave velocity - can be performed easily on children. Few studies have explored the prevalence of cardiovascular risk factors and even fewer have used the surrogate vascular measures to document signs of early atherosclerosis in children with pediatric-onset rheumatic diseases. The objective of this review is to provide an overview on cardiovascular risk and early atherosclerosis in pediatric-onset systemic lupus erythematosus, juvenile idiopathic arthritis and juvenile dermatomyositis patients, and to review cardiovascular preventive strategies that should be considered in this population. PMID:23731870

2013-01-01

64

Cardiovascular risk under electromagnetic exposure in physiotherapy  

Microsoft Academic Search

The aim of the study was to assess the long-term effects of electromagnetic radiation (EMR) on cardiovascular system of medical\\u000a staff in physiotherapy. A number of 52 exposed subjects (4 male and 48 female; aged 47.3 ± 8.7 years), and a control group\\u000a of 52 subjects, matched by sex and age, with similar job characteristics without EMR exposure were studied. The EMR exposure

Michel Israel; Katia Vangelova; Michaela Ivanova

2007-01-01

65

Panoptic total cardiovascular risk prediction using all predictors versus optimized risk assessment using variable subsets.  

PubMed

Cardiovascular disease remains the primary cause of mortality and morbidity in the developed world. Risk scores can provide clinical risk stratification and many exist for use in cardiovascular disease prevention and treatment. Cardiovascular risk scores predict mortality, coronary heart disease and other vascular disease using risk predictors such as patient age, sex, BMI, smoking history, cholesterol level, blood pressure, glucose level or diabetes diagnosis, family history of cardiovascular disease and creatinine. While the risk scores in existence are excellent for risk stratification, actual use in a clinical environment is lagging behind the rate of new risk score creation. Future research should focus on how to utilize risk scores most effectively and efficiently in clinical practice. PMID:23013127

Horne, Benjamin D; Knight, Stacey; May, Heidi T

2012-09-01

66

Lipoprotein(a) as a cardiovascular risk factor.  

PubMed

Evidence for the role of lipoprotein(a) (Lp[a]) in atherosclerosis and thrombosis has considerably increased over the past few years. Therefore, Lp(a) is currently classified as an emerging lipid risk factor for cardiovascular disease. High Lp(a) plasma levels carried in particles with small-sized apolipoprotein(a) isoforms are associated with preclinical vascular changes, cardiovascular disease and the mode of presentation of coronary artery disease (acute coronary syndromes). However, randomized clinical trials with an emphasis on agents that specifically lower plasma Lp(a) do not exist. At present, screening for increases in Lp(a) in the general population is not recommended. The measurement of Lp(a) may be of value in individuals with an increased risk of cardiovascular disease, particularly in patients with high low-density lipoprotein cholesterol plasma levels, since a high Lp(a) concentration in such subjects further increases the risk of coronary heart disease. PMID:19804152

Katsouras, Christos S; Tsironis, Loukas D; Elisaf, Moses; Goodevenos, John A; Michalis, Lampros K; Tselepis, Alexandros D

2005-07-01

67

Assessment of Cardiovascular Disease Risk in South Asian Populations  

PubMed Central

Although South Asian populations have high cardiovascular disease (CVD) burden in the world, their patterns of individual CVD risk factors have not been fully studied. None of the available algorithms/scores to assess CVD risk have originated from these populations. To explore the relevance of CVD risk scores for these populations, literature search and qualitative synthesis of available evidence were performed. South Asians usually have higher levels of both “classical” and nontraditional CVD risk factors and experience these at a younger age. There are marked variations in risk profiles between South Asian populations. More than 100 risk algorithms are currently available, with varying risk factors. However, no available algorithm has included all important risk factors that underlie CVD in these populations. The future challenge is either to appropriately calibrate current risk algorithms or ideally to develop new risk algorithms that include variables that provide an accurate estimate of CVD risk. PMID:24163770

Hussain, S. Monira; Oldenburg, Brian; Zoungas, Sophia; Tonkin, Andrew M.

2013-01-01

68

Childhood cardiovascular risk factors in South Asians: A cause of concern for adult cardiovascular disease epidemic  

PubMed Central

Cardiovascular risk factors in children are increasing at an alarming rate in the western world. However, there is limited information regarding these in the South Asian children. This review attempts at summarizing such evidence. South Asians are remarkable for the earlier onset of adult cardiovascular disease (CVD) by almost a decade compared to the Caucasians. We identified published literature, mainly on PubMed, Embase and Cochrane library using specific search terms such as lipid abnormalities, high blood pressure, hyperglycemia, tobacco use, obesity, physical inactivity, and unhealthy dietary practices. Atherosclerotic CVD processes begin early in childhood and are influenced over the life course by genetic and potentially modifiable risk factors and environmental exposure. 80% of adult CVD burden will fall on the developing nations by 2020. The concept of primordial prevention is fast emerging as a necessary prevention tool to curb adult CVD epidemic. Established guidelines and proven preventive strategies on cardiovascular health exist; however, are always implemented half-heartedly. Composite screening and prediction tools for adults can be adapted and validated in children tailored to South Asian population. South Asian children could be at a greater risk of developing cardiovascular risk factors at an earlier stage, thus, timely interventions are imperative. PMID:21976880

Prasad, Duggirala Sivaram; Kabir, Zubair; Dash, Ashok Kumar; Das, Bhagabati Charan

2011-01-01

69

Recommendations for management of dyslipidemia in high cardiovascular risk patients  

PubMed Central

Overwhelming evidence supports a causal relationship between elevated levels of plasma cholesterol, particularly low-density lipoprotein cholesterol, and increased risk of coronary artery disease, which remains the leading cause of death and morbidity worldwide. Low-density lipoprotein cholesterol lowering has been the main goal of therapy, and clinical trial results from recently published studies of intensive statin therapy confirm the benefits of more aggressive lipid-lowering targets, particularly in subjects at high risk for cardiovascular events. This management update will focus on the implications of risk reduction in patients at high cardiovascular risk, and will provide practical steps to help further risk stratify these patients and help them reach their target goals. PMID:19343119

Braga, Manoela B; Langer, Anatoly; Leiter, Lawrence A

2008-01-01

70

A Review of Calcium Supplements and Cardiovascular Disease Risk12  

PubMed Central

A group of academic and industry experts in the fields of nutrition, cardiology, epidemiology, food science, bone health, and integrative medicine examined the data on the relationship between calcium supplement use and risk of cardiovascular events, with an emphasis on 4 of the Bradford Hill criteria for causal inference: strength, consistency, dose-response, and biological plausibility. Results from 2 epidemiological studies and a meta-analysis of randomized, controlled clinical trials, including a subgroup analysis from the Women’s Health Initiative, have prompted concern about a potential association between calcium supplement use and a small increase in the risk of adverse cardiovascular events. However, a number of issues with the studies, such as inadequate compliance with the intervention, use of nontrial calcium supplements, potential bias in event ascertainment, and lack of information on and adjustment for known cardiovascular risk determinants, suggest that bias and confounding cannot be excluded as explanations for the reported associations. Findings from other cohort studies also suggest no detrimental effect of calcium from diet or supplements, with or without vitamin D, on cardiovascular disease risk. In addition, little evidence exists for plausible biological mechanisms to link calcium supplement use with adverse cardiovascular outcomes. The authors do not believe that the evidence presented to date regarding the hypothesized relationship between calcium supplement use and increased cardiovascular disease risk is sufficient to warrant a change in the Institute of Medicine recommendations, which advocate use of supplements to promote optimal bone health in individuals who do not obtain recommended intakes of calcium through dietary sources. PMID:23153730

Heaney, Robert P.; Kopecky, Stephen; Maki, Kevin C.; Hathcock, John; MacKay, Douglas; Wallace, Taylor C.

2012-01-01

71

Central autonomic network mediates cardiovascular responses to acute inflammation: Relevance to increased cardiovascular risk in depression?  

PubMed Central

Inflammation is a risk factor for both depression and cardiovascular disease. Depressed mood is also a cardiovascular risk factor. To date, research into mechanisms through which inflammation impacts cardiovascular health rarely takes into account central effects on autonomic cardiovascular control, instead emphasizing direct effects of peripheral inflammatory responses on endothelial reactivity and myocardial function. However, brain responses to inflammation engage neural systems for motivational and homeostatic control and are expressed through depressed mood state and changes in autonomic cardiovascular regulation. Here we combined an inflammatory challenge, known to evoke an acute reduction in mood, with neuroimaging to identify the functional brain substrates underlying potentially detrimental changes in autonomic cardiovascular control. We first demonstrated that alterations in the balance of low to high frequency (LF/HF) changes in heart rate variability (a measure of baroreflex sensitivity) could account for some of the inflammation-evoked changes in diastolic blood pressure, indicating a central (rather than solely local endothelial) origin. Accompanying alterations in regional brain metabolism (measured using 18FDG-PET) were analysed to localise central mechanisms of inflammation-induced changes in cardiovascular state: three discrete regions previously implicated in stressor-evoked blood pressure reactivity, the dorsal anterior and posterior cingulate and pons, strongly mediated the relationship between inflammation and blood pressure. Moreover, activity changes within each region predicted the inflammation-induced shift in LF/HF balance. These data are consistent with a centrally-driven component originating within brain areas supporting stressor evoked blood pressure reactivity. Together our findings highlight mechanisms binding psychological and physiological well-being and their perturbation by peripheral inflammation. PMID:23416033

Harrison, Neil A.; Cooper, Ella; Voon, Valerie; Miles, Ken; Critchley, Hugo D.

2013-01-01

72

Prevalence of the methylenetetrahydrofolate reductase 677C > T mutation in the Mediterranean Spanish population. Association with cardiovascular risk factors  

Microsoft Academic Search

Methylenetetrahydrofolate reductase (MT-HFR) is a key enzyme involved in folate metabolism. A common cytosine (C) to a thymine (T) mutation at nucleotide 677 (677C > T) in the MTHFR gene which converts an alanine residue to a valine, has been related with several biochemical phenotypes and with cardiovascular risk, depending on the population studied. Our objective was to estimate the

M. Guillén; D. Corella; O. Portolés; J. I. González; F. Mulet; C. Sáiz

2001-01-01

73

Cardiovascular Risk Factors and Behavioral Contracting in Exercise Programs.  

ERIC Educational Resources Information Center

The use of behavioral contracting in exercise programs has been shown to be effective in increasing the frequency of exercise activity and in reducing dropout rates. A study was undertaken to examine the impact of three cardiovascular risk factors (poor physical fitness, obesity, and smoking) on both client willingness to sign a behavioral…

Neale, Anne Victoria; And Others

74

Developing and Evaluating a Cardiovascular Risk Reduction Project.  

ERIC Educational Resources Information Center

Describes the development and baseline evaluation data from the Ozark Heart Health Project, a community-based cardiovascular disease risk reduction program in rural Missouri that targeted smoking, physical inactivity, and poor diet. Several Ozark counties participated in either intervention or control groups, and researchers conducted surveillance…

Brownson, Ross C.; Mayer, Jeffrey P.; Dusseault, Patricia; Dabney, Sue; Wright, Kathleen; Jackson-Thompson, Jeannette; Malone, Bernard; Goodman, Robert

1997-01-01

75

Assessment of Cardiovascular Risk Factors in the Healthy Elderly.  

ERIC Educational Resources Information Center

Cardiovascular risk factors in 57 healthy older individuals were measured (blood pressure, lipids and lipoproteins, and lifestyle behaviors) via a personal health questionnaire. Results indicated that, though the subjects were generally healthy, their lifestyle behaviors, particularly diet and physical activity, could be improved. (SM)

Waller, Kathy V.; And Others

1992-01-01

76

Cardiovascular Disease Risk Factors in Black College Students.  

ERIC Educational Resources Information Center

This study examined cardiovascular risk factors in Black first-year college students (N=238). Students completed surveys about blood pressure, cholesterol level, smoking, and physical activity. Results found low rates of high blood pressure, low awareness of cholesterol levels, and low numbers of students who smoked. Females had lower physical…

Kelley, George A.; Lowing, Larry

1997-01-01

77

Tissue Plasminogen Activator (Cardiovascular Risk Marker): Interventional Studies on Periodontitis  

Microsoft Academic Search

The association between periodontal disease and cardiovascular disease has received considerable attention, although it is not clear whether these is a casual component. We used a treatment intervention model to s tudy the rel ationship between periodontitis and tissue p lasminogen activator ( t-PA) cardi ovascular i ndicator of risk. We studied ten adults with periodontitis requir ed scaling and

Balwant Rai; Simmi Kharb; Rajnish J ain; S. C. Anand

78

[Coffee and cardiovascular disease risk: yin and yang].  

PubMed

Many epidemiological studies have addressed the effects of coffee on cardiovascular disease. Most case-control studies suggest an increased risk in high coffee consumers, whereas cohort studies indicate no clear association with cardiovascular risk. Several aspects could be considered to explain and/or reconcile these inconsistencies. Selection bias and recall bias may explain a positive association supported by case-control studies. An inadequate adjustment for many confounding factors (i.e., smoking, poor diet, sedentary lifestyle, etc.) could also affect the relationship between coffee consumption and cardiovascular risk. Moreover, coffee contains several biologically active substances that may have either beneficial or harmful effects on the cardiovascular system. The development of complete/partial tolerance to some caffeine effects in habitual drinkers adds to the complexity of coffee effects. Variation in cup size and methods of coffee preparation may also explain some conflicting results. As it is not reasonable to conduct randomized controlled trials, it is recommended that coffee consumption be moderate in healthy people and limited in individuals at high risk. PMID:19209536

Silletta, Maria Giuseppina; Marchioli, Roberto

2008-11-01

79

Exercise and Acute Cardiovascular Events: Placing the Risks into Perspective  

Microsoft Academic Search

Habitual physical activity reduces coronary heart disease events, but vig- orous activity can also acutely and transiently increase the risk of sudden cardiac death and acute myocardial infarction in susceptible persons. This scientific statement discusses the potential cardiovascular complications of exercise, their pathological substrate, and their incidence and suggests strategies to reduce these complications. Exercise-associated acute cardiac events generally occur

Paul D. Thompson; Barry A. Franklin; Gary J. Balady; Steven N. Blair; Domenico Corrado; N. A. Mark Estes III; Janet E. Fulton; Neil F. Gordon; William L. Haskell; Mark S. Link; Barry J. Maron; Murray A. Mittleman; Antonio Pelliccia; Nanette K. Wenger; Stefan N. Willich; Fernando Costa

80

Alcohol consumption metabolic cardiovascular risk factors and hypertension in women  

Microsoft Academic Search

Background Low to moderate alcohol consumption is associated with reduced mortality, primarily due to a reduction in coronary heart disease (CHD). Conversely, heavy drinking increases mortality, mainly due to haemorrhagic stroke and non- cardiovascular diseases. It is important to identify the threshold of alcohol consumption above which the balance of risk and benefit becomes adverse. We examine the relationship between

Kiran Nanchahal; W David Ashton; David A Wood

81

Job strain and autonomic indices of cardiovascular disease risk  

Microsoft Academic Search

Background Despite the epidemiological evidence linking job strain to cardiovascular disease, more insight is needed into the etiologic mechanisms. This, in turn, would help to more precisely identify risk. Methods We measured Job Strain using the Job Content Questionnaire, 8\\/day diary reports, and nationally standardized occupational code linkage, as well as autonomic regulation utilizing heart rate variability including spectral-derived components

Sean M. Collins; Robert A. Karasek; Kevin Costas

2005-01-01

82

A multidimensional integrative medicine intervention to improve cardiovascular risk  

Microsoft Academic Search

BACKGROUND: Integrative medicine is an individualized, patient-centered approach to health, combining a whole-person model with evidence-based\\u000a medicine. Interventions based in integrative medicine theory have not been tested as cardiovascular risk-reduction strategies.\\u000a Our objective was to determine whether personalized health planning (PHP), an intervention based on the theories and principles\\u000a underlying integrative medicine, reduces 10-year risk of coronary heart disease (CHD).

David Edelman; Eugene Z. Oddone; Richard S. Liebowitz; William S. Yancy; Maren K. Olsen; Amy S. Jeffreys; Samuel D. Moon; Amy C. Harris; Linda L. Smith; Ruth E. Quillian-Wolever; Tracy W. Gaudet

2006-01-01

83

Women with Cardiovascular Disease Have Increased Risk of Osteoporotic Fracture  

Microsoft Academic Search

This study investigated whether women with cardiovascular disease (CVD) would have an increased risk of fractures as osteoporosis\\u000a and CVD share many common risk factors. From February 2006 to January 2007, 17,033 women aged ?50 years (mean 71.8, range\\u000a 50–106) were recruited by 1,248 primary care practitioners and interviewed by trained nurses. For each woman, 10-year probability\\u000a of a future major

Jian Sheng Chen; Chris Hogan; Greg Lyubomirsky; Philip N. Sambrook

2011-01-01

84

Childhood obesity and adult cardiovascular disease risk: a systematic review  

Microsoft Academic Search

Background:Although the relationship between adult obesity and cardiovascular disease (CVD) has been shown, the relationship with childhood obesity remains unclear. Given the evidence of tracking of body mass index (BMI) from childhood to adulthood, this systematic review investigated the independent relationship between childhood BMI and adult CVD risk.Objective:To investigate the association between childhood BMI and adult CVD risk, and whether

L J Lloyd; S C Langley-Evans; S McMullen

2010-01-01

85

Cost effectiveness of ramipril treatment for cardiovascular risk reduction  

PubMed Central

OBJECTIVE—To assess the cost effectiveness of ramipril treatment in patients at low, medium, and high risk of cardiovascular death.?DESIGN—Population based cost effectiveness analysis from the perspective of the health care provider in the UK. Effectiveness was modelled using data from the HOPE (heart outcome prevention evaluation) trial. The life table method was used to predict mortality in a medium risk cohort, as in the HOPE trial (2.44% annual mortality), and in low and high risk groups (1% and 4.5% annual mortality, respectively).?SETTING—UK population using 1998 government actuary department data.?MAIN OUTCOME MEASURE—Cost per life year gained at five years and lifetime treatment with ramipril.?RESULTS—Cost effectiveness was £36 600, £13 600, and £4000 per life year gained at five years and £5300, £1900, and £100 per life year gained at 20 years (lifetime treatment) in low, medium, and high risk groups, respectively. Cost effectiveness at 20 years remained well below that of haemodialysis (£25 000 per life year gained) over a range of potential drug costs and savings. Treatment of the HOPE population would cost the UK National Health Service (NHS) an additional £360 million but would prevent 12 000 deaths per annum.?CONCLUSIONS—Ramipril is cost effective treatment for cardiovascular risk reduction in patients at medium, high, and low pretreatment risk, with a cost effectiveness comparable with the use of statins. Implementation of ramipril treatment in a medium risk population would result in a major reduction in cardiovascular deaths but would increase annual NHS spending by £360 million.???Keywords: angiotensin converting enzyme inhibitor; cardiovascular risk; cost effectiveness; ramipril PMID:11303006

Malik, I; Bhatia, V; Kooner, J

2001-01-01

86

Importance of Heart Rate in Determining Cardiovascular Risk  

Microsoft Academic Search

A body of evidence indicates that subjects with tachycardia are more likely to develop hypertension (1–3) and atherosclerosis in future years (4–6). However, the connection between heart rate and cardiovascular risk has long been neglected on the grounds that tachycardia\\u000a is often associated with the traditional risk factors for atherosclerosis, such as hypertension or metabolic abnormalities\\u000a (7). A high heart

Paolo Palatini

87

Cardiovascular risk factors in hematopoietic cell transplantation survivors: role in development of subsequent cardiovascular disease  

PubMed Central

Hematopoietic cell transplantation (HCT) recipients may be at an increased risk of developing hypertension, diabetes, and dyslipidemia (referred to as cardiovascular risk factors [CVRFs]); and these factors can potentially increase the risk of cardiovascular disease (CVD). We examined the incidence and predictors of CVRFs and subsequent CVD in 1885 consecutive 1+year survivors of HCT performed at City of Hope between 1995 and 2004. Ten-year cumulative incidence of hypertension, diabetes, dyslipidemia, and multiple (? 2) CVRFs was 37.7%, 18.1%, 46.7%, and 31.4%, respectively. The prevalence of CVRFs was significantly higher among HCT recipients compared with the general population; contributed to largely by allogeneic HCT recipients. Older age and obesity at HCT were associated with increased risk of CVRFs. History of grade II-IV acute graft versus host disease was associated with an increased risk for hypertension (relative risk [RR] = 9.1, P < .01), diabetes (RR = 5.8, P < .01), and dyslipidemia (RR = 3.2, P < .01); conditioning with total body irradiation was associated with an increased risk of diabetes (RR = 1.5, P = .01) and dyslipidemia (RR = 1.4, P < .01). There was an incremental increase in 10-year incidence of CVD by number of CVRFs (4.7% [none], 7.0% [1 CVRF], 11.2% [? 2 CVRFs], P < .01); the risk was especially high (15.0%) in patients with multiple CVRFs and pre-HCT exposure to anthracyclines or chest radiation. PMID:23034279

Sun, Can-Lan; Vase, Tabitha; Ness, Kirsten K.; Blum, Emily; Francisco, Liton; Venkataraman, Kalyanasundaram; Samoa, Raynald; Wong, F. Lennie; Forman, Stephen J.; Bhatia, Smita

2012-01-01

88

Calcium supplements and cardiovascular risk: 5 years on  

PubMed Central

Calcium supplements have been widely used by older men and women. However, in little more than a decade, authoritative recommendations have changed from encouraging the widespread use of calcium supplements to stating that they should not be used for primary prevention of fractures. This substantial shift in recommendations has occurred as a result of accumulated evidence of marginal antifracture efficacy, and important adverse effects from large randomized controlled trials of calcium or coadministered calcium and vitamin D supplements. In this review, we discuss this evidence, with a particular focus on increased cardiovascular risk with calcium supplements, which we first described 5 years ago. Calcium supplements with or without vitamin D marginally reduce total fractures but do not prevent hip fractures in community-dwelling individuals. They also cause kidney stones, acute gastrointestinal events, and increase the risk of myocardial infarction and stroke. Any benefit of calcium supplements on preventing fracture is outweighed by increased cardiovascular events. While there is little evidence to suggest that dietary calcium intake is associated with cardiovascular risk, there is also little evidence that it is associated with fracture risk. Therefore, for the majority of people, dietary calcium intake does not require close scrutiny. Because of the unfavorable risk/benefit profile, widespread prescribing of calcium supplements to prevent fractures should be abandoned. Patients at high risk of fracture should be encouraged to take agents with proven efficacy in preventing vertebral and nonvertebral fractures. PMID:25114781

Grey, Andrew; Reid, Ian R.

2013-01-01

89

Trading off dietary choices, physical exercise and cardiovascular disease risks.  

PubMed

Despite several decades of decline, cardiovascular diseases are still the most common causes of death in Western societies. Sedentary living and high fat diets contribute to the prevalence of cardiovascular diseases. This paper analyses the trade-offs between lifestyle choices defined in terms of diet, physical activity, cost, and risk of cardiovascular disease that a representative sample of the population of Northern Ireland aged 40-65 are willing to make. Using computer assisted personal interviews, we survey 493 individuals at their homes using a Discrete Choice Experiment (DCE) questionnaire administered between February and July 2011 in Northern Ireland. Unlike most DCE studies for valuing public health programmes, this questionnaire uses a tailored exercise, based on the individuals' baseline choices. A "fat screener" module in the questionnaire links personal cardiovascular disease risk to each specific choice set in terms of dietary constituents. Individuals are informed about their real status quo risk of a fatal cardiovascular event, based on an initial set of health questions. Thus, actual risks, real diet and exercise choices are the elements that constitute the choice task. Our results show that our respondents are willing to pay for reducing mortality risk and, more importantly, are willing to change physical exercise and dietary behaviours. In particular, we find that to improve their lifestyles, overweight and obese people would be more likely to do more physical activity than to change their diets. Therefore, public policies aimed to target obesity and its related illnesses in Northern Ireland should invest public money in promoting physical activity rather than healthier diets. PMID:23906130

Grisolía, José M; Longo, Alberto; Boeri, Marco; Hutchinson, George; Kee, Frank

2013-09-01

90

Marine Carotenoids and Cardiovascular Risk Markers  

PubMed Central

Marine carotenoids are important bioactive compounds with physiological activities related to prevention of degenerative diseases found principally in plants, with potential antioxidant biological properties deriving from their chemical structure and interaction with biological membranes. They are substances with very special and remarkable properties that no other groups of substances possess and that form the basis of their many, varied functions and actions in all kinds of living organisms. The potential beneficial effects of marine carotenoids have been studied particularly in astaxanthin and fucoxanthin as they are the major marine carotenoids. Both these two carotenoids show strong antioxidant activity attributed to quenching singlet oxygen and scavenging free radicals. The potential role of these carotenoids as dietary anti-oxidants has been suggested to be one of the main mechanisms for their preventive effects against cancer and inflammatory diseases. The aim of this short review is to examine the published studies concerning the use of the two marine carotenoids, astaxanthin and fucoxanthin, in the prevention of cardiovascular diseases. PMID:21822408

Riccioni, Graziano; D'Orazio, Nicolantonio; Franceschelli, Sara; Speranza, Lorenza

2011-01-01

91

Method and apparatus for assessing cardiovascular risk  

NASA Technical Reports Server (NTRS)

The method for assessing risk of an adverse clinical event includes detecting a physiologic signal in the subject and determining from the physiologic signal a sequence of intervals corresponding to time intervals between heart beats. The long-time structure of fluctuations in the intervals over a time period of more than fifteen minutes is analyzed to assess risk of an adverse clinical event. In a preferred embodiment, the physiologic signal is an electrocardiogram and the time period is at least fifteen minutes. A preferred method for analyzing the long-time structure variability in the intervals includes computing the power spectrum and fitting the power spectrum to a power law dependence on frequency over a selected frequency range such as 10.sup.-4 to 10.sup.-2 Hz. Characteristics of the long-time structure fluctuations in the intervals is used to assess risk of an adverse clinical event.

Albrecht, Paul (Inventor); Bigger, J. Thomas (Inventor); Cohen, Richard J. (Inventor)

1998-01-01

92

Gastrointestinal and Cardiovascular Risk of Nonsteroidal Anti-inflammatory Drugs  

PubMed Central

Nonsteroidal anti-inflammatory drugs (NSAIDs) confer a gastrointestinal (GI) side effect profile and concerns regarding adverse cardiovascular effects have emerged associated with considerable morbidity and mortality. NSAIDs are highly effective in treating pain and inflammation, but it is well recognized that these agents are associated with substantial gastrointestinal toxicity. Cyclo-oxygenase-2 inhibitors may also reduce the risk for gastrointestinal events, although they may increase cardiovascular adverse events. The selection of an appropriate analgesic or anti-inflammatory agent with or without gastroprotective therapy should be individualized. PMID:22253945

Al-Saeed, Abdulwahed

2011-01-01

93

Familial predisposition to cardiovascular risk and disease contributes to cardiovascular risk and disease interacting with other cardiovascular risk factors in diabetes: implication for common soil (JDDM 14).  

PubMed

In diabetic population cardiovascular morbidity is high and the effects of genetic predisposition remain elucidated. In a large-scale multicenter-based diabetic population, clinical parameters including conventional cardiovascular risk factors and first-degree family history (FH) of diabetes, hypertension, coronary heart disease (CHD) and stroke were investigated in association with presence of CHD and stroke. Among 3611 diabetic patients, 181 (5.0%) had CHD and 118 (3.3%) had stroke. After adjustment for conventional risk factors, FH of CHD (OR 2.32, p<0.0001) and of diabetes (OR 1.44, p<0.05) were associated with CHD, and FH of stroke (OR 1.86, p<0.01) was associated with stroke. FH of hypertension was significantly associated with presence of hypertension and obesity. Synergistic effect of FH of CHD in combination with hypertension or aging on increasing CHD, and that of FH of stroke in combination with microalbuminuria on increasing stroke were found. FH of diabetes, of hypertension, of CHD and of stroke were significantly associated with FH of each disease, indicating clustering of FH. In diabetic population, FH of CHD and FH of stroke doubled the risk of CHD and stroke, respectively, and had synergistic effect in combination with other risk factors. Clustering of FH may indicate interrelation of genetic predisposition. PMID:18423471

Yokoyama, Hiroki; Kawai, Koichi; Ohishi, Mariko; Sone, Hirohito

2008-12-01

94

Cardiovascular risk profile: Cross-sectional analysis of motivational determinants, physical fitness and physical activity  

Microsoft Academic Search

BACKGROUND: Cardiovascular risk factors are associated with physical fitness and, to a lesser extent, physical activity. Lifestyle interventions directed at enhancing physical fitness in order to decrease the risk of cardiovascular diseases should be extended. To enable the development of effective lifestyle interventions for people with cardiovascular risk factors, we investigated motivational, social-cognitive determinants derived from the Theory of Planned

Barbara Sassen; Gerjo Kok; Herman Schaalma; Henri Kiers; Luc Vanhees

2010-01-01

95

Relationship of socioeconomic status with cardiovascular risk factors and lifestyle in a Mediterranean population  

Microsoft Academic Search

Summary. Background: Socioeconomic status greatly affects cardiovascular risk factors and lifestyle. Aim of the study To analyse the relationship between socioeconomic status and both cardiovascular risk factors and behavioural variables. Aim of the study: To analyse the relationship between socioeconomic status and both cardiovascular risk factors and behavioural variables. Methods: The present random sample of 838 men and 910 women

Helmut Schröder; Izabella Rohlfs; EvaMaria Schmelz; Jaume Marrugat

2004-01-01

96

Cardiovascular disease: Pathogenesis, epidemiology, and risk among users of oral contraceptives who smoke  

Microsoft Academic Search

Smoking increases the risk of lung cancer and cardiovascular disease among persons of both sexes. The risk of cardiovascular disease is further increased among users of oral contraceptives who smoke, particularly those who are ?35 years old or carry the coagulation factor V Leiden mutation. Other important cardiovascular disease risk factors in women include waist\\/hip girth ratio >0.8, high concentration

William P. Castelli

1999-01-01

97

Does occupational driving increase the risk of cardiovascular disease in people with diabetes?  

PubMed

Occupational driving may increase cardiovascular events. We studied the risk of overall cardiovascular events in occupational professional drivers against matched controls in a cohort of people with diabetes (N=6563). There was an increase in overall cardiovascular events in occupational drivers despite similar risk factors. This particular occupational risk factor may need to be addressed. PMID:23122186

Quah, Claire H; Ng, Jen M; Puar, Troy H

2013-01-01

98

Tobacco as a Cardiovascular Risk Factor  

Microsoft Academic Search

Tobacco use in the form of cigarettes has long been established as a major risk factor for coronary heart disease (CHD). It\\u000a is the most preventable cause of mortality. Each year, cigarette smoking causes more than 400,000 deaths in the United States\\u000a alone, more than the number of American lives lost during World War I, Korea, and Vietnam combined (1,2).

Robyn Bergman Buchsbaum; Jeffrey Craig Buchsbaum

99

Risk of cardiovascular disease in inflammatory bowel disease  

PubMed Central

Abundant scientific evidence supporting an association between inflammatory bowel disease (IBD) and venous thromboembolic events, caused by an IBD related hypercoagulability, is acknowledged and thromboprophylactic treatment strategies are now implemented in the management of IBD patients. In contrary, the risk of arterial thromboembolic disease, as ischemic heart disease, cerebrovascular events, and mesenteric ischemia in patients with IBD remains uncertain and the magnitude of a potentially increased risk is continuously debated, with ambiguous risk estimates among studies. The evident role of inflammation in the pathogenesis of atherosclerosis forms the basis of a biological plausible link; the chronic systemic inflammation in IBD patients increases the risk of atherosclerosis and thereby the risk of thrombotic events. Further, studies have shown that the burden of traditional risk factors for atherosclerosis, such as obesity, diabetes mellitus, and dyslipidemia is lower in IBD populations, thus further strengthen the role of non-traditional risk factors, as chronic inflammation in the linking of the two disease entities. Likewise, mortality from cardiovascular disease in IBD remains questioned. The aim of the current review is to give an up-date on the existing evidence of the possible association between IBD and cardiovascular disease and to discuss traditional and non-traditional risk factors. PMID:25133036

Andersen, Nynne Nyboe; Jess, Tine

2014-01-01

100

The cardiometabolic syndrome as a cardiovascular risk factor.  

PubMed

The cardiometabolic syndrome (CMS) is associated with cardiovascular disease (CVD) and includes a constellation of risk factors such as central obesity, hypertension, insulin resistance, dyslipidemia, microalbuminuria, and hypercoagulability. Collectively, these risk factors increase CVD endpoints such as stroke, congestive heart failure, chronic kidney disease (CKD), and overall mortality. The CMS is associated with endothelial dysfunction, inflammation, abnormal thrombolysis, and increased oxidative stress that accentuate progression of CVD. We will review how the varying components of the CMS relate to an increased CVD and renal disease risk. PMID:16355016

Govindarajan, Gurushankar; Whaley-Connell, Adam; Mugo, Maryann; Stump, Craig; Sowers, James R

2005-12-01

101

Stress and cardiovascular disease risk in female law enforcement officers  

Microsoft Academic Search

Purpose  To assess the levels of stress and the prevalence of cardiovascular disease (CVD) risk factors in female law enforcement officers\\u000a (LEOs).\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Self-reported data including job-related stress and CVD risk factors were obtained from 65 female LEOs. Stress scores were\\u000a compared with 429 males LEOs and CVD risk factors were compared with 1,213 demographically similar female respondents to the\\u000a CDC BRFSS

Hyelim Yoo; Warren D. Franke

2011-01-01

102

Associations of blood rheology and interleukin-6 with cardiovascular risk factors and prevalent cardiovascular disease.  

PubMed

Haemorheological variables (whole-blood, plasma and relative blood viscosity, haematocrit, red cell aggregation, white cell count and fibrinogen) were measured in 753 men and 821 women aged 25-74 years, and related to cardiovascular risk factors and prevalent cardiovascular disease (CVD). Men had higher levels than women of blood viscosity, haematocrit, corrected viscosity and relative viscosity. Post-menopausal women had higher levels than pre-menopausal women of blood viscosity, haematocrit, corrected blood viscosity, plasma viscosity and fibrinogen: each of these differences was completely or partly abolished by use of hormone replacement therapy. Serum total cholesterol, triglycerides, diastolic blood pressure, body mass index and smoking markers showed positive associations with most rheological variables, whereas HDL-cholesterol, plasma vitamin C and social class showed inverse associations. Rheological variables were associated with prevalent CVD after age-adjustment. However, after multiple risk factor adjustment only plasma viscosity and red cell aggregation showed significant (P<0.04) associations in both men and women (comparing top to bottom quarters). Plasma interleukin-6 (measured in a 25% subsample of 196 men and 221 women) correlated significantly with age, fibrinogen, white cell count, plasma and blood viscosity, current smoking, and (in men) with low serum vitamin C levels; but not with other major risk factors or with prevalent cardiovascular disease. PMID:10050704

Woodward, M; Rumley, A; Tunstall-Pedoe, H; Lowe, G D

1999-02-01

103

Chronic Hyperuricemia, Uric Acid Deposit and Cardiovascular Risk  

PubMed Central

Hyperuricemia is commonly associated with traditional risk factors such as dysglicemia, dyslipidemia, central obesity and abnormal blood pressure, i.e. the metabolic syndrome. Concordantly, recent studies have revived the controversy over the role of circulating uric acid, hyperuricemia, and gout as an independent prognostic factor for cardiovascular morbidity and mortality. In this regard, different studies also evaluated the possible role of xanthine inhibitors in inducing blood pressure reduction, increment in flow-mediated dilation, and improved cardiovascular prognosis in various patient settings. The vast majority of these studies have been conducted with either allopurinol or its active metabolite oxypurinol, i.e. two purine-like non-selective inhibitors of xanthine oxidase. More recently, the role of uric acid as a risk factor for cardiovascular disease and the possible protective role exerted by reduction of hyperuricemia to normal level have been evaluated by the use of febuxostat, a selective, non purine-like xanthine oxidase inhibitor. In this review, we will report current evidence on hyperuricemia in cardiovascular disease. The value of uric acid as a biomarker and as a potential therapeutic target for tailored old and novel “cardiometabolic” treatments will be also discussed. PMID:23173592

Grassi, Davide; Ferri, Livia; Desideri, Giovambattista; Giosia, Paolo Di; Cheli, Paola; Pinto, Rita Del; Properzi, Giuliana; Ferri, Claudio

2013-01-01

104

Cardiovascular risk profile of veteran men beginning androgen deprivation therapy.  

PubMed

We sought to describe the cardiovascular profile of veteran men before beginning androgen deprivation therapy (ADT), with the eventual benefit of targeting treatments to manage harmful cardiovascular side effects. We performed a secondary analysis with chi-square and Fisher's exact tests for associations between demographics and cardiovascular comorbidities on 375 veteran men diagnosed with prostate cancer. Those who were overweight and current smokers were more likely to be younger, whereas men with a systolic blood pressure >120 mmHg were more likely to be older (all P < 0.05). Men with total cholesterol 180 mg/dL were more likely to be identified in the Hispanic/other/unknown ethnicity category. Interventions to manage cardiovascular risk should focus on preventive lifestyle changes for younger men, and chronic disease management for older men. Men in the smaller Hispanic/other/unknown category are at risk for marginalization within the Veteran Administration system owing to their low numbers and should be closely monitored for cholesterol levels when receiving ADT. PMID:25131756

Williams, Lindsay; Hicks, Elisabeth; Kwan, Lorna; Litwin, Mark; Maliski, Sally

2014-09-01

105

The forgotten majority: unfinished business in cardiovascular risk reduction.  

PubMed

Despite meaningful progress in the identification of risk factors and the development of highly effective clinical tools, deaths from cardiovascular disease continue to increase worldwide. Sparked by an obesity epidemic, the metabolic syndrome and the rising incidence of type 2 diabetes have led to an upsurge of cardiovascular risk. Although pharmacologic treatments with the statin class of drugs have reduced cholesterol levels and lowered mortality rates, several large controlled clinical trials, including the Scandinavian Simvastatin Survival Study, the Cholesterol and Recurrent Events trial, the Air Force/Texas Coronary Atherosclerosis Prevention studies, and Long-term Intervention with Pravastatin in Ischemic Disease study, have indicated that cardiovascular events continue to occur in two thirds of all patients. Follow-up studies, such as the Heart Protection Study and the Pravastatin or Atorvastatin Evaluation and Infection Therapy/Thrombolysis In Myocardial Infarction-22 trials, reinforced these earlier results. Although therapy with gemfibrozil, a fibric acid derivative, showed reduced occurrence of cardiovascular events in the Helsinki Heart Study and the Veterans Affairs HDL Intervention Trial, results of other studies, e.g., the Bezafibrate Intervention Program and the Diabetes Atherosclerosis Intervention study, showed less encouraging results. Although lifestyle modifications, such as improved diet and increased exercise levels, benefit general health and the metabolic syndrome and insulin resistance in particular, most people continue to resist changes in their daily routines. Thus, physicians must continue to educate their patients regarding an optimal balance of drug therapy and personal behavior. PMID:16198835

Libby, Peter

2005-10-01

106

Dietary lignans: physiology and potential for cardiovascular disease risk reduction  

PubMed Central

We reviewed lignan physiology and lignan intervention and epidemiological studies to determine if they decreased the risks of cardiovascular disease in Western populations. Five intervention studies using flaxseed lignan supplements indicated beneficial associations with C-reactive protein and a meta-analysis, which included these studies, also suggested a lowering effect on plasma total and low-density lipoprotein cholesterol. Three intervention studies using sesamin supplements indicated possible lipid and blood pressure lowering associations. Eleven human observational epidemiological studies examined dietary intakes of lignans in relation to cardiovascular disease risk. Five showed decreased risk with either increasing dietary intakes of lignans or increased levels of serum enterolactone (an enterolignan used as a biomarker of lignan intake), five studies were of borderline significance, and one was null. The associations between lignans and decreased risk of cardiovascular disease are promising, but are yet not well established, perhaps due to low lignan intakes in habitual Western diets. At the higher doses used in intervention studies, associations were more evident. PMID:20883417

Peterson, Julia; Dwyer, Johanna; Adlercreutz, Herman; Scalbert, Augustin; Jacques, Paul; McCullough, Marjorie L

2010-01-01

107

Cardiovascular risk awareness, treatment, and control in urban Latin America.  

PubMed

Effective prevention and treatment of cardiovascular diseases require regular screening for risk factors, high awareness of the condition, effective treatment of the identified risk factors, and adherence to the prescribed treatment. The Cardiovascular Risk Factor Multiple Evaluation in Latin America study was a cross-sectional, population-based, observational study of major cardiovascular risk factors-including hypertension, diabetes, and hypercholesterolemia-in 7 Latin American cities. This report presents data on assessment, diagnosis, extent, and effectiveness of treatment, adherence to treatment, and reasons for nonadherence. Data were collected through household questionnaire-based interviews administered to 5383 men and 6167 women, 25-64 years of age, living in the following cities: Barquisimeto, Venezuela; Bogota, Colombia; Buenos Aires, Argentina; Lima, Peru; Mexico City, Mexico; Quito, Ecuador; and Santiago, Chile. Participants also completed a clinic visit for anthromorphometric and laboratory assessments. Rates of prior diagnosis of hypertension and diabetes were high (64% and 78% of affected individuals, respectively) but relatively low for hypercholesterolemia (41%). The majority of affected individuals (hypercholesterolemia 88%, diabetes 67%, and hypertension 53%) were untreated. Among individuals who were receiving pharmacologic treatment, targets for control of hypertension, diabetes, and hypercholesterolemia were achieved by 51%, 16%, and 52%, respectively. Adherence to treatment was observed in 69% of individuals with hypertension, 63% with diabetes, and 66% with hypercholesterolemia. Forgetfulness was the major cause of nonadherence for all 3 conditions. There is a substantial need for increasing patient education, diagnosis, treatment, adherence, and control of cardiovascular risk factors in the 7 Latin American cities. PMID:19535966

Silva, Honorio; Hernandez-Hernandez, Rafael; Vinueza, Raul; Velasco, Manuel; Boissonnet, Carlos Pablo; Escobedo, Jorge; Silva, H Elif; Pramparo, Palmira; Wilson, Elinor

2010-01-01

108

Endothelial Dysfunction: Cardiovascular Risk Factors, Therapy, and Outcome  

PubMed Central

Endothelial dysfunction is a well established response to cardiovascular risk factors and precedes the development of atherosclerosis. Endothelial dysfunction is involved in lesion formation by the promotion of both the early and late mechanisms of atherosclerosis including up-regulation of adhesion molecules, increased chemokine secretion and leukocyte adherence, increased cell permeability, enhanced low-density lipoprotein oxidation, platelet activation, cytokine elaboration, and vascular smooth muscle cell proliferation and migration. Endothelial dysfunction is a term that covers diminished production/availability of nitric oxide and/or an imbalance in the relative contribution of endothelium-derived relaxing and contracting factors. Also, when cardiovascular risk factors are treated the endothelial dysfunction is reversed and it is an independent predictor of cardiac events. We review the literature concerning endothelial dysfunction in regard to its pathogenesis, treatment, and outcome. PMID:17319104

Hadi, Hadi AR; Carr, Cornelia S; Al Suwaidi, Jassim

2005-01-01

109

Heart Rate Variability Dynamics for the Prognosis of Cardiovascular Risk  

PubMed Central

Statistical, spectral, multi-resolution and non-linear methods were applied to heart rate variability (HRV) series linked with classification schemes for the prognosis of cardiovascular risk. A total of 90 HRV records were analyzed: 45 from healthy subjects and 45 from cardiovascular risk patients. A total of 52 features from all the analysis methods were evaluated using standard two-sample Kolmogorov-Smirnov test (KS-test). The results of the statistical procedure provided input to multi-layer perceptron (MLP) neural networks, radial basis function (RBF) neural networks and support vector machines (SVM) for data classification. These schemes showed high performances with both training and test sets and many combinations of features (with a maximum accuracy of 96.67%). Additionally, there was a strong consideration for breathing frequency as a relevant feature in the HRV analysis. PMID:21386966

Ramirez-Villegas, Juan F.; Lam-Espinosa, Eric; Ramirez-Moreno, David F.; Calvo-Echeverry, Paulo C.; Agredo-Rodriguez, Wilfredo

2011-01-01

110

Role of childhood food patterns on adult cardiovascular disease risk.  

PubMed

Accumulating evidence indicates that childhood nutrition plays a role in the adulthood cardiovascular health. A lifelong tracking of dietary habits, following a long-term exposure to unhealthy dietary patterns or independent effects, is a potential effect-mediating mechanism. Dietary patterns have been studied by data-driven and hypothesis-based approaches. Typically, either data-driven healthy or prudent childhood dietary patterns have been characterized and found to be associated with lower adulthood cardiovascular disease (CVD) risk in the published cohort studies. With regard to the individual food groups or food quality indices, intakes particularly of vegetables and fruits (or fiber indicating plant food intake) and polyunsaturated fatty acids have shown protective effects. The evidence which could confirm the long-term healthiness of a hypothesis-based Mediterranean diet is limited, requiring further investigation. Overall, the recent literature strengthens the view that a healthy childhood diet is associated with lowered adulthood CVD risk. PMID:25092579

Kaikkonen, Jari E; Mikkilä, Vera; Raitakari, Olli T

2014-10-01

111

Fetal and infant growth and cardiovascular risk factors in women  

Microsoft Academic Search

AbstractObjective: To examine whether cardiovascular risk factors in women are related to fetal and infant growth.Design: Follow up study of women born 1923-30 whose birth weights and weights at one year were recorded.Setting: Hertfordshire.Subjects: 297 women born and still living in East Hertfordshire.Main outcome measures: Plasma glucose and insulin concentrations during a standard oral glucose tolerance test; fasting plasma proinsulin

C H D Fall; C Osmond; D J P Barker; P M S Clark; C N Hales; Y Stirling; T W Meade

1995-01-01

112

Baseline Cardiovascular Risk Predicts Subsequent Changes in Resting Brain Function  

PubMed Central

Background and Purpose The Framingham Heart Study group cardiovascular disease risk profile (FCRP) score was used to assess the relationship between baseline cardiovascular risk and subsequent changes in resting state cerebral blood flow (CBF) in cognitively normal older participants from the Baltimore Longitudinal Study of Aging (BLSA). Methods 97 cognitively normal participants underwent annual resting-state PET scans at baseline and over a period of up to 8 years (mean interval 7.4 years). Images quantifying voxel-wise longitudinal rates of CBF change were calculated and used to examine the relationship between baseline FCRP score and changes over time in regional CBF. Individual components of the FCRP score (age, cholesterol, blood pressure, smoking status and type-II diabetes) were also correlated with changes in regional CBF to examine the independent contributions of each component to the overall pattern of change. Results Higher baseline FCRP scores were associated with accelerated longitudinal decline in CBF in orbitofrontal, medial frontal/anterior cingulate, insular, precuneus and brainstem regions. Of the components that make up the FCRP score, higher diastolic blood pressure and diabetes were associated independently with greater decline in the medial frontal/anterior cingulate and insular regions, respectively. Conclusions Baseline cardiovascular risk factors are associated with greater rates of decline in resting state regional brain function. The regions showing accelerated decline participate in higher order cognitive processes and are also vulnerable to age-related neuropathology. These results, in conjunction with other studies, encourage early treatment of cardiovascular risk factors in older individuals. PMID:22492519

Beason-Held, LL; Thambisetty, M; Deib, G; Sojkova, J; Landman, BA; Zonderman, AB; Ferrucci, L; Kraut, MA; Resnick, SM

2012-01-01

113

Bedtime Dosing of Antihypertensive Medications Reduces Cardiovascular Risk in CKD  

PubMed Central

Time of ingestion of hypertension medications can affect circadian patterns of BP, but whether this translates into an effect on clinical outcomes is unknown. Here, in an open-label trial, we randomly assigned 661 patients with CKD either to take all prescribed hypertension medications upon awakening or to take at least one of them at bedtime. We measured 48-hour ambulatory BP at baseline and 3 months after any adjustment in treatment or, at the least, annually. After a median follow-up of 5.4 years, patients who took at least one BP-lowering medication at bedtime had an adjusted risk for total cardiovascular events (a composite of death, myocardial infarction, angina pectoris, revascularization, heart failure, arterial occlusion of lower extremities, occlusion of the retinal artery, and stroke) that was approximately one-third that of patients who took all medications upon awakening (adjusted HR 0.31; 95% CI 0.21 to 0.46; P < 0.001). Bedtime dosing demonstrated a similar significant reduction in risk for a composite outcome of cardiovascular death, myocardial infarction, and stroke (adjusted HR 0.28; 95% CI 0.13 to 0.61; P < 0.001). Furthermore, patients on bedtime treatment had a significantly lower mean sleep-time BP and a greater proportion demonstrated control of their ambulatory BP (56% versus 45%, P = 0.003). Each 5-mmHg decrease in mean sleep-time systolic BP was associated with a 14% reduction in the risk for cardiovascular events during follow-up (P < 0.001). In conclusion, among patients with CKD and hypertension, taking at least one antihypertensive medication at bedtime improves control of BP and reduces the risk for cardiovascular events. PMID:22025630

Ayala, Diana E.; Mojon, Artemio; Fernandez, Jose R.

2011-01-01

114

Gambling with cardiovascular risk: picking the winners and the losers  

Microsoft Academic Search

See page 278 The number of successful lipid-intervention trials is on the increase, and evidence is accumulating that lipid modification can reduce the risk of cardiovascular events among individuals with only modest degrees of blood-lipid abnormalities. 1-4 The number of adults targeted for lipid therapy is therefore bound to increase in the coming years. Although this growth may be scientifically

Steven Grover

1999-01-01

115

Cardiovascular Risk and Neuroradiological Profiles in Asymptomatic Vertebrobasilar Dolichoectasia  

Microsoft Academic Search

Background: Clinicoradiological variability of vertebrobasilar dolichoectasia (VBD) is known. Little is known about cardiovascular disease (CVD) risk and neuroradiological profiles of asymptomatic VBD. Methods: A total of 7,345 adults (5,534 men and 1,811 women) underwent physical checkup (PC) and brain magnetic resonance (MR) studies between 2004 and 2007. Asymptomatic VBD was diagnosed by neurological examination and MR angiography. Neuroradiological features

Ken Ikeda; Yoshikazu Nakamura; Takehisa Hirayama; Tokinori Sekine; Riya Nagata; Osamu Kano; Kiyokazu Kawabe; Tetsuhito Kiyozuka; Masaki Tamura; Yasuo Iwasaki

2010-01-01

116

Cardiovascular risk associated with nonsteroidal anti-inflammatory drugs  

Microsoft Academic Search

Since the introduction of selective cyclooxygenase-2 inhibitors (coxibs), there has been an ongoing discussion about the cardiovascular\\u000a (CV) safety of coxibs and the traditional nonsteroidal anti-inflammatory drugs (NSAIDs). Available data about the CV safety\\u000a of NSAIDs come mostly from meta-analyses and a few clinical trials. Current evidence suggests that NSAIDs may increase the\\u000a risk of CV events. Naproxen might be

Matthias Hermann

2009-01-01

117

Cannabis Use: Signal of Increasing Risk of Serious Cardiovascular Disorders  

PubMed Central

Background Cannabis is known to be associated with neuropsychiatric problems, but less is known about complications affecting other specified body systems. We report and analyze 35 recent remarkable cardiovascular complications following cannabis use. Methods and Results In France, serious cases of abuse and dependence in response to the use of psychoactive substances must be reported to the national system of the French Addictovigilance Network. We identified all spontaneous reports of cardiovascular complications related to cannabis use collected by the French Addictovigilance Network from 2006 to 2010. We described the clinical characteristics of these cases and their evolution: 1.8% of all cannabis?related reports (35/1979) were cardiovascular complications, with patients being mostly men (85.7%) and of an average age of 34.3 years. There were 22 cardiac complications (20 acute coronary syndromes), 10 peripheral complications (lower limb or juvenile arteriopathies and Buerger?like diseases), and 3 cerebral complications (acute cerebral angiopathy, transient cortical blindness, and spasm of cerebral artery). In 9 cases, the event led to patient death. Conclusions Increased reporting of cardiovascular complications related to cannabis and their extreme seriousness (with a death rate of 25.6%) indicate cannabis as a possible risk factor for cardiovascular disease in young adults, in line with previous findings. Given that cannabis is perceived to be harmless by the general public and that legalization of its use is debated, data concerning its danger must be widely disseminated. Practitioners should be aware that cannabis may be a potential triggering factor for cardiovascular complications in young people. PMID:24760961

Jouanjus, Emilie; Lapeyre?Mestre, Maryse; Micallef, Joelle

2014-01-01

118

[Cardiovascular risk factors in France. Prevalence and association].  

PubMed

The object of this study was to assess the prevalence of modifiable cardiovascular risk factors and their association in 61,108 subjects over 15 years of age who volunteered for a systematic medical check-up, free of charge, and performed in a health centre in central France. The risk factors were defined as follows: hypertension, diabetes, hypercholesterolaemia, hypertriglyceridaemia: medical treatment or value above the upper limits of normal defined by national or international recommendations. obesity and android fat distribution as defined by the principal recommendations. The commonest risk factor was hypercholesterolaemia (60% of men and 64% of women) followed by android obesity. The prevalence of hypertension was greater in men than in women (44 vs 33%). Twenty eight per cent of men and 17% of women admitted to smoking. The percentage of smokers was higher in people under 30. Diabetes was observed in 3% of men and 2% of women. The association of risk factors was observed at an older age in women than in men. The association of 3 risk factors was four times greater in men than in women in the whole population. In conclusion, this study shows that cardiovascular risk factors are very common in persons undergoing a medical check-up and that these factors are often associated at an earlier age in men than in women. PMID:12055761

Asmar, R; Pannier, B; Vol, S; Brisac, A M; Tichet, J; el Hasnaoui, A

2002-04-01

119

E-cigarettes and cardiovascular risk: beyond science and mysticism.  

PubMed

Cigarette smoking is the most important cause of premature death, and it is currently listed as a major independent risk factor for cardiovascular disease. Because of restrictive measures and widespread control policies, tobacco companies are now using aggressive marketing strategies in favor of smokeless tobacco, including electronic nicotine delivery systems, which are also known as electronic cigarettes or e-cigarettes. Although the regular use of these devices appears less hazardous than traditional cigarettes or other forms of smokeless tobacco, recent studies have shown that various potentially harmful substances, especially nicotine, ultraparticles, and volatile organic compounds, may be effectively inhaled or liberated in exhaled air during repeated e-cigarette puffing. This would enhance the risk of cardiac arrhythmias and hypertension, which may predispose some users to increased risk of cardiovascular events, which may be further magnified by other potential adverse effects such as arrhythmias, increased respiratory, and flow respiratory resistance. Some cases of intoxication have also been described, wherein large amounts of nicotine and other harmful compounds may be effectively absorbed. As the use of e-cigarettes is continuously rising, and it is also considered a potentially effective method for smoking cessation, more focused research is urgently needed to definitely establish the cardiovascular safeness of these devices. PMID:24343348

Lippi, Giuseppe; Favaloro, Emmanuel J; Meschi, Tiziana; Mattiuzzi, Camilla; Borghi, Loris; Cervellin, Gianfranco

2014-02-01

120

Prevalence of stroke/cardiovascular risk factors in Hungary  

NASA Astrophysics Data System (ADS)

A cross-sectional survey was conducted in Hungary using the Cerberus system which includes: 1) a questionnaire addressing the risk factors for stroke/cardiovascular disease; 2) amplifiers to record the pulse waves of cerebral arteries (rheoencephalography) and peripheral arteries, electrocardiogram and electroencephalogram. Additionally, subjects were measured for carotid stenosis by Doppler ultrasound and 12-lead electrocardiogram; subjects were also screened for blood cholesterol, glucose, and triglyceride levels. Prevalence of the following stroke risk factors was identified: overweight, 63.25%; sclerotic brain arteries (by rheoencephalogram), 54.29%; heart disease, 37.92%; pathologic carotid flow, 34.24%; smoking, 30.55%; high blood cholesterol, 28.70%; hypertension, 27.83%; high triglyceride, 24.35%; abnormality in electrocardiogram, 20%; high glucose, 15.95%; symptoms of transient ischemic attack, 16.07%; alcohol abuse, 6.74%; and diabetes, 4.53%. The study demonstrates a possible model for primary cardiovascular disease/stroke prevention. This method offers a standardizable, cost effective, practical technique for mass screenings by identifying the population at high risk for cardiovascular disturbances, especially cerebrovascular disease (primary prevention). In this model, the rheoencephalogram can detect cerebrovascular arteriosclerosis in the susceptibility/presymptomatic phase, earlier than the Doppler ultrasound technique. The method also provides a model for storing analog physiological signals in a computer-based medical record and is a first step in applying an expert system to stroke prevention.

Bodo, M.; Sipos, K.; Thuroczy, G.; Panczel, G.; Ilias, L.; Szonyi, P.; Bodo, M., Jr.; Nebella, T.; Banyasz, A.; Nagy, Z.

2010-04-01

121

Prevalence of type 2 diabetes mellitus, other cardiovascular risk factors, and cardiovascular disease in Turkish and Moroccan immigrants in North West Europe: a systematic review  

Microsoft Academic Search

Background. The prevalence of diabetes, other cardiovascular risk factors, and cardiovascular morbidity and mortality varies between immigrant groups in Western societies, but epidemiological data on these topics are scarce for Turks and Moroccan immigrant living in North West Europe.Methods. Medline and Embase were systematically searched for studies containing data on the prevalence of diabetes, cardiovascular risk factors, and cardiovascular morbidity

P. J. M. Uitewaal; D. R. Manna; M. A. Bruijnzeels; A. W. Hoes; S. Thomas

2004-01-01

122

Cardiovascular protection for all individuals at high risk: evidence-based best practice  

Microsoft Academic Search

Patients with cardiovascular risk factors are largely undertreated, for many reasons. Vulnerable individuals may not be aware\\u000a of the risks they are facing or an individual’s risk of cardiovascular disease may be underestimated, particularly among those\\u000a at high risk. Furthermore, in individuals identified as being at high total cardiovascular risk, the full spectrum of therapeutic\\u000a options may not be implemented

George Bakris; Michael Böhm; Gilles Dagenais; Hans-Christoph Diener; Toshiro Fujita; Philip Gorelick; Sverre Erik Kjeldsen; Markku Laakso; Giuseppe Mancia; Bertram Pitt; Arya Sharma; Peter Sleight; Koon Teo; Thomas Unger; Michael Weber; Bryan Williams; Faiez Zannad

2008-01-01

123

Critical appraisal of inflammatory markers in cardiovascular risk stratification.  

PubMed

Despite great progress in prevention strategies, pharmacotherapy and interventional treatment of coronary artery disease (CAD), cardiovascular events still constitute the leading cause of mortality and morbidity in the modern world. Traditional risk factors, including hypertension, diabetes mellitus, smoking, obesity, dyslipidemia, and positive family history account for the occurrence of the majority of these events, but not all of them. Adequate risk assessment remains the most challenging in individuals classified into low or intermediate risk categories. Inflammation plays a key role in the initiation and promotion of atherosclerosis and may lead to acute coronary syndrome (ACS) by the induction of plaque instability. For this reason, numerous inflammatory markers have been extensively investigated as potential candidates for the enhancement of cardiovascular risk assessment. This review aims to critically assess the clinical utility of well-established (C-reactive protein [CRP] and fibrinogen), newer (lipoprotein-associated phospholipase A2 [Lp-PLA2] and myeloperoxidase [MPO]) and novel (growth differentiation factor-15 [GDF-15]) inflammatory markers which, reflect different pathophysiological pathways underlying CAD. Although according to the traditional approach all discussed inflammatory markers were shown to be associated with the risk of future cardiovascular events in individuals with and without CAD, their clear clinical utility remains not fully elucidated. Current recommendations of numerous scientific societies predominantly advocate routine assessment of CRP in healthy people with intermediate cardiovascular risk. However, these recommendations substantially vary in their strength among particular societies. These discrepancies have a multifactorial background, including: (i) the strong prognostic value of CRP supported by solid scientific evidence and proven to be comparable in magnitude with that of total and high-density lipoprotein cholesterol, or hypertension, (ii) favourable analytical characteristics of commercially available CRP assays, (iii) lack of CRP specificity and causal relationship between CRP concentration and cardiovascular risk, and (iv) CRP dependence on other classical risk factors. Of major importance, CRP measurement in healthy men ?50 years of age or healthy women ?60 years of age with low-density lipoprotein cholesterol <130?mg/dL may be helpful in the selection of patients for statin therapy. Additionally, evaluation of CRP and fibrinogen or Lp-PLA2 may be considered to facilitate risk stratification in ACS patients and in healthy individuals with intermediate cardiovascular risk, respectively. Nevertheless, the clinical utility of CRP requires further investigation in a broad spectrum of CAD patients, while other promising inflammatory markers, particularly GDF-15 and Lp-PLA2, should be tested in individuals both with and without established CAD. Further studies should also focus on novel performance metrics such as measures of discrimination, calibration and reclassification, in order to better address the clinical utility of investigated biomarkers and to avoid misleadingly optimistic results. It also has to be emphasized that, due to the multifactorial pathogenesis of CAD, detailed risk stratification remains a complex process also involving, beyond assessment of inflammatory biomarkers, the patient's clinical characteristics, results of imaging examinations, electrocardiographic findings and other laboratory parameters (e.g. lipid profile, indices of renal function, markers of left ventricular overload and fibrosis, and biomarkers of myocardial necrosis, preferably cardiac troponins). PMID:24918900

Krintus, Magdalena; Kozinski, Marek; Kubica, Jacek; Sypniewska, Grazyna

2014-10-01

124

[Civilization stress, cardiovascular risk, evidence-based medicine, guidelines].  

PubMed

Cardiovascular diseases have the pole-position on the list of morbidity and mortality statistics. Despite the great advances have been made in management of cardiovascular diseases, prevalence of these disorders increases worldwide, and even younger and younger ages are threatened. This phenomenon is strongly related to obesity and type 2 diabetes pandemic, which shows an unequivocal association with expansion of modernized life-style. The pathomechanism proposed to have central role is the chronic stress induced by civilized life-conduct. The authors criticizes the everyday practice suggested for management of cardiovascular diseases, focusing on normalization of cardiovascular risk factors, instead of fighting against the primary cause ie. chronic stress. There is growing evidence, that achieving the target values defined in guide-lines will not necessarily result in improvement of patient related clinical outcomes. The statistical approach generally practiced in randomized clinical trials is primarily striving for the drug-sale, instead of discovering novel pathophysiological relations. Pharmaceutical industry having decisive role in research and patient-care is mainly interested in profit-sharing, therefore patients' interest can not be optimally realized, and costs are unnecessarily augmented. Separation of patient-, and business-oriented medical care is an ethical question of fundamental importance. PMID:19403433

Simon, Kornél

2009-05-10

125

Comprehensive cardiovascular risk management - what does it mean in practice?  

PubMed Central

The continued movement away from the treatment of individual cardiovascular (CV) risk factors to managing overall and lifetime CV risk is likely to have a significant impact on slowing the rate of increase in cardiovascular disease (CVD). However, the management of CVD is currently far from optimal even in parts of the world with well-developed and well-funded healthcare systems. Effective implementation of the knowledge, treatment guidelines, diagnostic tools, therapeutic interventions, and management programs that exist for CVD continues to evade us. A thorough understanding of the multifactorial nature of CVD is essential to its effective management. Improvements continue to be made to management guidelines, risk assessment tools, treatments, and care programs pertaining to CVD. Ultimately, however, preventing the epidemic of CVD will require a combination of both medical and public health approaches. In addition to improvements in the “high-risk” strategy, management, an increase in the utilization of population-based management strategies needs to be made to attempt to reduce the number of patients falling within the “at-risk” stratum for CVD. This review outlines how a comprehensive approach to CVD management might be achieved. PMID:18078010

Erhardt, Leif; Moller, Robert; Garcia Puig, Juan

2007-01-01

126

Effects of Muscular Strength on Cardiovascular Risk Factors and Prognosis  

PubMed Central

Physical fitness is one of the strongest predictors of individual future health status. Together with cardiorespiratory fitness (CRF), muscular strength (MusS) has been increasingly recognized in the pathogenesis and prevention of chronic disease. We review the most recent literature on the effect of MusS in the development of cardiovascular disease (CVD), with special interest in elucidating its specific benefits beyond those from CRF and body composition. MusS has shown an independent protective effect on all-cause and cancer mortality in healthy middle-aged men, as well as in men with hypertension (HTN) and patients with heart failure. It has also been inversely associated with age-related weight and adiposity gains, risk of HTN, and prevalence and incidence of the metabolic syndrome. In children and adolescents, higher levels of muscular fitness have been inversely associated with insulin resistance, clustered cardiometabolic risk and inflammatory proteins. Generally, the influence of muscular fitness was weakened but remained protective after considering CRF. Also interestingly, higher levels of muscular fitness seems to some extent counteract the adverse cardiovascular profile of overweight and obese individuals. As many of the investigations have been conducted with non-Hispanic white men, it is important to examine how race/ethnicity and gender may affect these relationships. To conclude, most important effects of resistance training (RT) are also summarized, to better understand how higher levels of muscular fitness may result in a better cardiovascular prognosis and survival. PMID:22885613

Artero, Enrique G.; Lee, Duck-chul; Lavie, Carl J.; Espana-Romero, Vanesa; Sui, Xuemei; Church, Timothy S.; Blair, Steven N.

2012-01-01

127

Coffee components and cardiovascular risk: beneficial and detrimental effects.  

PubMed

Abstract Coffee consists of several biological active compounds, such as caffeine, diterpenes, chlorogenic acids, and melanoidins, which may affect human health. The intake of each compound depends on the variety of coffee species, roasting degree, type of brewing method and serving size. The bioavailability and the distribution of each compound and its metabolites also contribute to coffee mechanisms of action. The health benefits of coffee consumption regarding cardiovascular system and metabolism mostly depend on its antioxidant compounds. In contrast, diterpenes and caffeine may produce harmful effects by raising lipid fraction and affecting endothelial function, respectively. Studying the mechanism of action of coffee components may help understanding weather coffee's impact on health is beneficial or hazardous. In this article, we reviewed the available information about coffee compounds and their mechanism of action. Furthermore, benefits and risks for cardiovascular system associated with coffee consumption will be discussed. PMID:25046596

Godos, Justyna; Pluchinotta, Francesca Romana; Marventano, Stefano; Buscemi, Silvio; Li Volti, Giovanni; Galvano, Fabio; Grosso, Giuseppe

2014-12-01

128

Chapter III: Management of cardiovascular risk factors and medical therapy.  

PubMed

Critical limb ischaemia (CLI) is a particularly severe manifestation of lower limb atherosclerosis posing a major threat to both limb and life of affected patients. Besides arterial revascularisation, risk-factor modification and administration of antiplatelet therapy is a major goal in the treatment of CLI patients. Key elements of cardiovascular risk management are smoking cessation and treatment of hyperlipidaemia with dietary modification or statins. Moreover, arterial hypertension and diabetes mellitus should be adequately treated. In CLI patients not suitable for arterial revascularisation or subsequent to unsuccessful revascularisation, parenteral prostanoids may be considered. CLI patients undergoing surgical revascularisation should be treated with beta blockers. At present, neither gene nor stem-cell therapy can be recommended outside clinical trials. Of note, walking exercise is contraindicated in CLI patients due to the risk of worsening pre-existing or causing new ischaemic wounds. CLI patients are oftentimes medically frail and exhibit significant comorbidities. Co-existing coronary heart and carotid as well as renal artery disease should be managed according to current guidelines. Considering the above-mentioned treatment goals, interdisciplinary treatment approaches for CLI patients are warranted. Aim of the present manuscript is to discuss currently existing evidence for both the management of cardiovascular risk factors and treatment of co-existing disease and to deduct specific treatment recommendations. PMID:22172471

Diehm, N; Schmidli, J; Setacci, C; Ricco, J-B; de Donato, G; Becker, F; Robert-Ebadi, H; Cao, P; Eckstein, H H; De Rango, P; Teraa, M; Moll, F L; Dick, F; Davies, A H; Lepäntalo, M; Apelqvist, J

2011-12-01

129

Risk of cardiac arrhythmias during hypoglycemia in patients with type 2 diabetes and cardiovascular risk.  

PubMed

Recent trials of intensive glycemic control suggest a possible link between hypoglycemia and excess cardiovascular mortality in patients with type 2 diabetes. Hypoglycemia might cause arrhythmias through effects on cardiac repolarization and changes in cardiac autonomic activity. Our aim was to study the risk of arrhythmias during spontaneous hypoglycemia in type 2 diabetic patients with cardiovascular risk. Twenty-five insulin-treated patients with type 2 diabetes and a history of cardiovascular disease or two or more risk factors underwent simultaneous continuous interstitial glucose and ambulatory electrocardiogram monitoring. Frequency of arrhythmias, heart rate variability, and markers of cardiac repolarization were compared between hypoglycemia and euglycemia and between hyperglycemia and euglycemia matched for time of day. There were 134 h of recording at hypoglycemia, 65 h at hyperglycemia, and 1,258 h at euglycemia. Bradycardia and atrial and ventricular ectopic counts were significantly higher during nocturnal hypoglycemia compared with euglycemia. Arrhythmias were more frequent during nocturnal versus daytime hypoglycemia. Excessive compensatory vagal activation after the counterregulatory phase may account for bradycardia and associated arrhythmias. QT intervals, corrected for heart rate, >500 ms and abnormal T-wave morphology were observed during hypoglycemia in some participants. Hypoglycemia, frequently asymptomatic and prolonged, may increase the risk of arrhythmias in patients with type 2 diabetes and high cardiovascular risk. This is a plausible mechanism that could contribute to increased cardiovascular mortality during intensive glycemic therapy. PMID:24757202

Chow, Elaine; Bernjak, Alan; Williams, Scott; Fawdry, Robert A; Hibbert, Steve; Freeman, Jenny; Sheridan, Paul J; Heller, Simon R

2014-05-01

130

Usefulness of atherogenic dyslipidemia for predicting cardiovascular risk in patients with angiographically defined coronary artery disease.  

PubMed

The identification of factors contributing to residual cardiovascular risk is important to improve the management of patients with established coronary artery disease (CAD). This study was conducted to assess the predictive value of atherogenic dyslipidemia (defined as high triglycerides and low high-density lipoprotein [HDL] cholesterol) for long-term outcomes in patients with CAD. In 284 patients (238 men, 46 women; mean age at baseline 59.2 +/- 8.9 years) with coronary stenosis (>50% in > or =1 vessel), the presence of atherogenic dyslipidemia was prospectively associated with the incidence of major adverse cardiovascular events (MACEs) during a median follow-up of 7.8 years. MACEs were defined as cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, the recurrence of angina, and revascularization procedures. MACEs were observed in 111 (39.1%) patients with CAD. MACEs occurred more frequently in patients with atherogenic dyslipidemia (50.9%) than in those with isolated low HDL cholesterol or high triglycerides (33.0%) or with normal HDL cholesterol and triglyceride concentrations (29.2%) (p <0.01 for trend). Kaplan-Meier survival analysis showed a decrease in event-free survival in patients with compared with those without atherogenic dyslipidemia (log-rank p = 0.006). Patients with atherogenic dyslipidemia presented with increased plasma concentrations of remnants, denser low-density lipoprotein, more atherogenic HDL particles, and insulin-resistant status. After adjustment for potential confounding variables, the magnitude of increased risk associated with atherogenic dyslipidemia was 1.58 (95% confidence interval 1.12 to 2.21, p = 0.008). In conclusion, these data provide evidence that atherogenic dyslipidemia is an independent predictor of cardiovascular risk in patients with CAD, even stronger than isolated high triglycerides or low HDL cholesterol. PMID:17996510

Arca, Marcello; Montali, Anna; Valiante, Sofia; Campagna, Filomena; Pigna, Giovanni; Paoletti, Vincenzo; Antonini, Roberto; Barillà, Francesco; Tanzilli, Gaetano; Vestri, Annarita; Gaudio, Carlo

2007-11-15

131

Impact of Cardiovascular Calcifications on the Detrimental Effect of Continued Smoking on Cardiovascular Risk in Male Lung Cancer Screening Participants  

PubMed Central

Background Current smokers have an increased cardiovascular disease (CVD) risk compared to ex-smokers due to reversible as well as irreversible effects of smoking. We investigated if current smokers remain to have an increased CVD risk compared to ex-smokers in subjects with a long and intense smoking history. We in addition studied if the effect of smoking continuation on CVD risk is independent of or modified by the presence of cardiovascular calcifications. Methods The cohort used comprised a sample of 3559 male lung cancer screening trial participants. We conducted a case-cohort study using all CVD cases and a random sample of 10% (n?=?341) from the baseline cohort (subcohort). A weighted Cox proportional hazards model was used to estimate the hazard ratios for current smoking status in relation to CVD events. Results During a median follow-up of 2.6 years (max. 3.7 years), 263 fatal and non-fatal cardiovascular events (cases) were identified. Age, packyears and cardiovascular calcification adjusted hazard ratio of current smokers compared to former smokers was 1.33 (95% confidence interval 1.00–1.77). In additional analyses that incorporated multiplicative interaction terms, neither coronary nor aortic calcifications modified the association between smoking status and cardiovascular risk (P?=?0.08). Conclusions Current smokers have an increased CVD risk compared to former smokers even in subjects with a long and intense smoking history. Smoking exerts its hazardous effects on CVD risk by pathways partly independent of cardiovascular calcifications. PMID:23840486

Jairam, Pushpa M.; de Jong, Pim A.; Mali, Willem P. T h. M.; Isgum, Ivana; de Koning, Harry J.; van der Aalst, Carlijn; Oudkerk, Matthijs; Vliegenthart, Rozemarijn; van der Graaf, Yolanda

2013-01-01

132

Prehypertension: A Warning Sign of Future Cardiovascular Risk  

PubMed Central

Since the report from the national high blood pressure (BP) education program working group on BP in children and adolescents and the introduction of a new description called prehypertension many data have been provided on its rate of progression to hypertension, its prevalence and association with other cardiovascular (CV) risk factors and its therapy. Making a diagnosis of prehypertension in a child or adolescent identifies an individual at increased risk for early-onset CV disease who requires specific treatment. Thus, routine BP measurement is highly recommended at every health-care encounter beginning at 3 years of age. This review will present updated data on prehypertension in children and adolescents to increase awareness of health-care providers to the seriousness of this condition. Optimal BP measurement techniques as well as the evaluation and management of prehypertension will be discussed and preventive strategies to reduce the CV risk will be presented. PMID:24791190

Assadi, Farahnak

2014-01-01

133

Pregnancy and cardiovascular risk for women with Turner syndrome.  

PubMed

Most women with Turner syndrome (TS) are infertile due to primary ovarian failure. However, approximately 5% experience spontaneous pregnancy, and recently, more women with TS have used assisted reproductive technology with donated oocytes (ART-OD) to become pregnant. The first generation of Turner patients undergoing ART-OD demonstrated a high rate of fatal aortic dissection in late pregnancy or postpartum. More recent observations, particularly from Nordic countries, suggest a lesser risk of dissection, but confirm a high rate of pre-eclampsia in ART-OD pregnancies. This article reviews publications since 2000 concerning maternal outcomes for pregnancies in women with TS to determine if specific risk factors such as type of pregnancy, age, or presence of underlying congenital cardiovascular disease may identify women at special risk. PMID:25259906

Bondy, Carolyn

2014-07-01

134

[Global treatment of cardiovascular risk in the hypertensive patient].  

PubMed

During 2006, new evidence supporting the need to adopt a global approach to the treatment of cardiovascular risk in hypertensive patients has been reported. It is increasingly clear that it is not sufficient to aim for optimum blood pressure control, which in any case is not easy to achieve, and that it is essential to treat all cardiovascular risk factors by using drugs with proven benefits, even when those benefits are supplementary to the drug's principal effects. In addition, drugs that could have a detrimental effect or that are, merely, less beneficial should be avoided or kept as a last resort. This appears to have happened with atenolol, and with beta-blockers in general, which have been withdrawn as first-line treatment in the recommendations of some professional societies. To lower cardiovascular risk, it is essential to prevent the development of conditions like diabetes, which are known to have drastic effect on the patient's prognosis. Recently, the results of the DREAM study, which are discussed in detail in this article, have been reported. They could lead to a change in therapeutic strategy in patients who are expected to develop diabetes. In addition, this year has seen the publication of substantial data on a new antihypertensive agent, aliskiren, the first oral renin inhibitor. It is awaiting approval by the international medicine agencies (i.e., the FDA and the EMEA), but should provide a very promising tool in the difficult area of high blood pressure management. Despite numerous advances in the pharmacologic treatment of high blood pressure, control is very difficult to achieve, principally in the elderly, in whom the prevalence of hypertension is high. In these patients, social factors and difficulties with treatment compliance also have an influence and must be dealt with by public health measures aimed at improving blood pressure control. PMID:17352858

Mazón-Ramos, Pilar; Bertomeu-Martínez, Vicente; Palma-Gámiz, José L; Quiles-Granado, Juan; Guindo-Soldevilla, José; González-Juanatey, José R

2007-02-01

135

Cardiovascular disease risk following a 758 km pilgrimage.  

PubMed

Millions of people participate in pilgrimages around the world such as the Camino de Santiago. However, few studies have examined the effects of this type of activity on cardiovascular disease risk factors. The aim of this study is to evaluate changes in cardiovascular disease risk factors: c-reactive protein, cholesterol, triglycerides, blood pressure, and cardiorespiratory fitness levels following a 758 km, 30-day pilgrimage. 11 healthy male and female subjects between the ages of 18-56 participated in pre and post pilgrimage blood pressure and blood tests, as well as pre, during, and post pilgrimage weight, skin-fold, and aerobic fitness testing. Heart rate monitors and pedometers provided maximum, average, and minimum heart rates as well as distances covered during the exercise. The mean daily walking distance was 25 km at an average intensity of 55.96% (±1.93%) of maximum heart rate. Statistically significant changes were seen in body weight (79.3 kg±3.4 pre vs. 76.4±2.98 post, p<0.05), body fat percentage (24.48%±2.31% pre vs. 23.01%±2.12 post, p<0.05), systolic and diastolic blood pressure (119±3.82/75±2.73 pre vs. 110±5.07/69±3.10 post, p<0.05), as well as cardiorespiratory fitness. These data suggest that some cardiovascular disease risk factors can be improved in healthy subjects participating in a low intensity, long duration, high frequency activity such as a walking pilgrimage. PMID:23382008

Harris, M B; Wolf, M R

2013-08-01

136

Role of coronary artery calcium in cardiovascular risk assessment.  

PubMed

Coronary artery disease (CAD) is associated with substantial morbidity and mortality worldwide. Despite many advances in prevention and therapy for CAD, a third to one-half of cardiovascular events occur in those with no prior symptoms. Assessing subclinical disease using coronary artery calcium (CAC) has been shown to provide additional risk stratification and to improve prediction of cardiovascular events over traditional strategies such as the Framingham Risk Score. In this review, we aim to cover the current data available on utilization of CAC as a tool in the general population as well as in targeted subgroups such as those with diabetes and metabolic syndrome. For this review, the authors performed thorough Pubmed and Medline searches using keywords coronary artery calcification, X-ray computed tomography, multidetector computed tomography, CAD, diabetes mellitus and metabolic syndrome. Based on the authors' review of literature, they believe that CAC is an excellent risk stratification imaging modality, especially in patients with diabetes and metabolic syndrome; behavioral changes in patients and therapeutic interventions based on CAC scoring are cost-effective. PMID:24345092

Sunkara, Nirmal; Wong, Nathan D; Malik, Shaista

2014-01-01

137

Cardiovascular Risk Factors and Chronic Kidney Disease--FGF23: A Key Molecule in the Cardiovascular Disease  

PubMed Central

Patients with chronic kidney disease (CKD) are at increased risk of mortality, mainly from cardiovascular disease. Moreover, abnormal mineral and bone metabolism, the so-called CKD-mineral and bone disorder (MBD), occurs from early stages of CKD. This CKD-MBD presents a strong cardiovascular risk for CKD patients. Discovery of fibroblast growth factor 23 (FGF23) has altered our understanding of CKD-MBD and has revealed more complex cross-talk and endocrine feedback loops between the kidney, parathyroid gland, intestines, and bone. During the past decade, reports of clinical studies have described the association between FGF23 and cardiovascular risks, left ventricular hypertrophy, and vascular calcification. Recent translational reports have described the existence of FGF23-Klotho axis in the vasculature and the causative effect of FGF23 on cardiovascular disease. These findings suggest FGF23 as a promising target for novel therapeutic approaches to improve clinical outcomes of CKD patients. PMID:24678415

Jimbo, Rika

2014-01-01

138

Managing tobacco use: the neglected cardiovascular disease risk factor.  

PubMed

Cigarette smoking is a major risk factor for cardiovascular disease (CVD) and the leading avoidable cause of death worldwide. Exposure to secondhand smoke (SHS) increases the risk of CVD among non-smokers. Smoking cessation benefits all smokers, regardless of age or amount smoked. The excess risk of CVD is rapidly reversible, and stopping smoking after a myocardial infarction reduces an individual's risk of CVD mortality by 36% over 2 years. Smoking cessation is a key component of primary and secondary CVD prevention strategies, but tobacco use often receives less attention from cardiologists than other risk factors, despite the availability of proven treatments that improve smoking cessation rates. Both psychosocial counselling and pharmacotherapy are effective methods to help smokers quit, but they are most effective when used together. The first-line medications licensed to aid smoking cessation, nicotine replacement therapy, bupropion and varenicline, are effective in and appropriate for patients with CVD. An evidence-based approach for physicians is to routinely ask all patients about smoking status and SHS exposure, advise all smokers to quit and all patients to adopt smoke-free policies for their home and car, and offer all smokers in the office or hospital brief counselling, smoking cessation pharmacotherapy, and referral to local programmes where psychosocial support can be sustained in person or by telephone. Like other chronic diseases, tobacco use requires a long-term management strategy. It deserves to be managed as intensively as other CVD risk factors. PMID:24014389

Rigotti, Nancy A; Clair, Carole

2013-11-01

139

Sex Differences in Risk Factors for Cardiovascular Disease: The PERU MIGRANT Study  

Microsoft Academic Search

IntroductionAlthough men and women have similar risk factors for cardiovascular disease, many social behaviors in developing countries differ by sex. Rural-to-urban migrants have different cardiovascular risk profiles than rural or urban dwellers. The objective of this study was to evaluate the sex differences with specific cardiovascular risk factors in rural-to-urban migrants.Methods and ResultsWe used the rural-to-urban migrant group of the

Antonio Bernabe-Ortiz; Catherine Pastorius Benziger; Robert H. Gilman; Liam Smeeth; J. Jaime Miranda

2012-01-01

140

Cardiovascular outcomes in high risk patients with osteoarthritis treated with ibuprofen, naproxen or lumiracoxib  

Microsoft Academic Search

BACKGROUND: Evidence suggests that both selective cyclooxygenase (COX)-2 inhibitors and non-selective non-steroidal anti-inflammatory drugs (NSAIDs) increase the risk of cardiovascular events. However, evidence from prospective studies of currently available COX-2 inhibitors and non-selective NSAIDs is lacking in patients at high cardiovascular risk who are taking aspirin. OBJECTIVE: To determine the cardiovascular outcomes in high risk patients with osteoarthritis treated with

M. E. Farkouh; J. D. Greenberg; R. V. Jeger; K. Ramanathan; F. W. A. Verheugt; J. H. Chesebro; H. Kirshner; J. S. Hochman; C. L. Lay; S. Ruland; B. Mellein; P T Matchaba; V. Fuster; S. B. Abramson

2007-01-01

141

Traditional Cardiovascular Risk Factors as Predictors of Cardiovascular Events in the U.S. Astronaut Corps  

NASA Technical Reports Server (NTRS)

Risk prediction equations from the Framingham Heart Study are commonly used to predict the absolute risk of myocardial infarction (MI) and coronary heart disease (CHD) related death. Predicting CHD-related events in the U.S. astronaut corps presents a monumental challenge, both because astronauts tend to live healthier lifestyles and because of the unique cardiovascular stressors associated with being trained for and participating in space flight. Traditional risk factors may not hold enough predictive power to provide a useful indicator of CHD risk in this unique population. It is important to be able to identify individuals who are at higher risk for CHD-related events so that appropriate preventive care can be provided. This is of special importance when planning long duration missions since the ability to provide advanced cardiac care and perform medical evacuation is limited. The medical regimen of the astronauts follows a strict set of clinical practice guidelines in an effort to ensure the best care. The purpose of this study was to evaluate the utility of the Framingham risk score (FRS), low-density lipoprotein (LDL) and high-density lipoprotein levels, blood pressure, and resting pulse as predictors of CHD-related death and MI in the astronaut corps, using Cox regression. Of these factors, only two, LDL and pulse at selection, were predictive of CHD events (HR(95% CI)=1.12 (1.00-1.25) and HR(95% CI)=1.70 (1.05-2.75) for every 5-unit increase in LDL and pulse, respectively). Since traditional CHD risk factors may lack the specificity to predict such outcomes in astronauts, the development of a new predictive model, using additional measures such as electron-beam computed tomography and carotid intima-media thickness ultrasound, is planned for the future.

Halm, M. K.; Clark, A.; Wear, M. L.; Murray, J. D.; Polk, J. D.; Amirian, E.

2009-01-01

142

Cardiovascular Imaging for Assessing Cardiovascular Risk in Asymptomatic Men Versus Women  

PubMed Central

Background Coronary artery calcium (CAC), carotid intima-media thickness, and left ventricular (LV) mass and geometry offer the potential to characterize incident cardiovascular disease (CVD) risk in clinically asymptomatic individuals. The objective of the study was to compare these cardiovascular imaging measures for their overall and sex-specific ability to predict CVD. Methods and Results The study sample consisted of 4965 Multi-Ethnic Study of Atherosclerosis participants (48% men; mean age, 62±10 years). They were free of CVD at baseline and were followed for a median of 5.8 years. There were 297 CVD events, including 187 coronary heart disease (CHD) events, 65 strokes, and 91 heart failure (HF) events. CAC was most strongly associated with CHD (hazard ratio [HR], 2.3 per 1 SD; 95% CI, 1.9 to 2.8) and all CVD events (HR, 1.7; 95% CI, 1.5 to 1.9). Most strongly associated with stroke were LV mass (HR, 1.3; 95% CI, 1.1 to 1.7) and LV mass/volume ratio (HR, 1.3; 95% CI, 1.1 to 1.6). LV mass showed the strongest association with HF (HR, 1.8; 95% CI, 1.6 to 2.1). There were no significant interactions for imaging measures with sex and ethnicity for any CVD outcome. Compared with traditional risk factors alone, overall risk prediction (C statistic) for future CHD, HF, and all CVD was significantly improved by adding CAC, LV mass, and CAC, respectively (all P<0.05). Conclusions There was no evidence that imaging measures differed in association with incident CVD by sex. CAC was most strongly associated with CHD and CVD; LV mass and LV concentric remodeling best predicted stroke; and LV mass best predicted HF. PMID:21068189

Jain, Aditya; McClelland, Robyn L.; Polak, Joseph F.; Shea, Steven; Burke, Gregory L.; Bild, Diane E.; Watson, Karol E.; Budoff, Matthew J.; Liu, Kiang; Post, Wendy S.; Folsom, Aaron R.; Lima, Joao A.C.; Bluemke, David A.

2011-01-01

143

Does albuminuria predict renal risk and/or cardiovascular risk in obese type 2 diabetic patients?  

PubMed Central

Increased urinary albumin excretion (UAE) is a marker of renal and cardiovascular risk in patients with type 2 diabetes (DT2). What about the obese patient with DT2? Does albuminuria predict the progression of renal disease and/or cardiovascular disease? The objective of this study is to determine the link between albuminuria, renal risk and cardiovascular risk in a cohort of obese DT2 patients. This is a prospective study begun in September 2006. It included DT2 patients presenting obesity defined by a body mass index (BMI)>30 Kg/m2. Three groups of patients were defined: normo-albuminuria (Urinary Albumin Excretion UAE<30 mg/day or Albumin Creatinine Ratio ACR<30 mg/g), micro-albuminuria (UAE=30-300 mg/day or ACR=30-300 mg/g) and macro-albuminuria (UAE>300 mg/day or ACR>300 mg/g). Data on 144 obese DT2 patients were compiled: The mean age of our patients was 59 ± 9 years and the sex ratio 0.26. The incidence of ESRD was higher in the macro-albuminuria group than in the two other groups (26.5% vs. 1.2%, p<0.001). The incidence of cardiovascular events was 15.4%, 14.3% and 23.5% in the normo, micro and macro-albuminuria groups (p=0.48). A history of cardiovascular comorbidities was the main cardiovascular risk in multivariate analysis (0R=15.07; 95% CI=5.30-42.82; p<0.001) and the low admission GFR (0R=5.67; 95% CI=1.23-9.77; p=0.008) was the main factor for progression of kidney disease in multivariate analysis. Albuminuria may be a better marker of kidney disease progression than of cardiovascular risk in the obese DT2 patient, according to our results. However, to accurately demonstrate the link albuminuria - renal risk and albuminuria - cardiovascular risk in the obese DT2 patient, additional studies using very strict criteria of selection and judgment are needed. PMID:24551483

Bentata, Yassamine; Abouqal, Redouane

2014-01-01

144

Prevalence of obesity and associated cardiovascular risk: the DARIOS study  

PubMed Central

Background To estimate the prevalence of overweight and obesity in the Spanish population as measured with body mass index (BMI), waist circumference (WC) and waist to height ratio (WHtR) and to determine the associated cardiovascular risk factors. Methods Pooled analysis with individual data from 11 studies conducted in the first decade of the 21st century. Participants aged 35–74 years were asked about the history of cardiovascular diseases, hypertension, diabetes and hypercholesterolemia. Height, weight, WC, blood pressure, glycaemia, total cholesterol, low-density and high-density lipoprotein cholesterol and coronary risk were measured. The prevalence of overweight (BMI 25–29.9 kg/m2), general obesity (BMI ?30 kg/m2), suboptimal WC (? 80 cm and?cardiovascular risk factors were significantly associated with abnormal increased values of BMI, WC and WHtR. Hypertension showed the strongest association with overweight [OR?=?1.99 (95% confidence interval 1.81-2.21) and OR?=?2.10 (1.91-2.31)]; suboptimal WC [OR?=?1.78 (1.60-1.97) and OR?=?1.45 (1.26-1.66)], with general obesity [OR?=?4.50 (4.02-5.04), and OR?=?5.20 (4.70-5.75)] and with WHtR ?0.5 [OR?=?2.94 (2.52-3.43), and OR?=?3.02 (2.66-3.42)] in men and women respectively, besides abdominal obesity in men only [OR?=?3.51 (3.18-3.88)]. Diabetes showed the strongest association with abdominal obesity in women [OR?=?3,86 (3,09-4,89). Conclusions The prevalence of obesity in Spain was high. Overweight, suboptimal WC, general, abdominal obesity and WHtR ?0.5 was significantly associated with diabetes, hypertension, hypercholesterolemia and coronary risk. The use of lower cut-off points for both BMI and particularly WC and could help to better identify the population at risk and therefore achieve more effective preventive measures. PMID:23738609

2013-01-01

145

Special Diabetes Program for Indians: Retention in Cardiovascular Risk Reduction  

PubMed Central

Purpose:?This study examined the associations between participant and site characteristics and retention in a multisite cardiovascular disease risk reduction project.?Design and Methods:?Data were derived from the Special Diabetes Program for Indians Healthy Heart Demonstration Project, an intervention to reduce cardiovascular risk among American Indians and Alaska Natives with diabetes. In 2006, a total of 1,072 participants from 30 participating sites completed baseline questionnaires measuring demographics and sociobehavioral factors. They also underwent a medical examination at baseline and were reassessed annually after baseline. A Provider Annual Questionnaire was administered to staff members of each grantee site at the end of each year to assess site characteristics. Generalized estimating equation models were used to evaluate the relationships between participant and site characteristics and retention 1 year after baseline.?Results:?Among enrolled participants, 792 (74%) completed their first annual assessment. Participants who completed the first annual assessment tended to be older and had, at baseline, higher body mass index and higher level of physical activity. Site characteristics associated with retention included average age of staff, proportion of female staff members, and percentage of staff members having completed graduate or professional school.?Implications:?Understanding successful retention must reach beyond individual characteristics of participants to include features of the settings that house the interventions. PMID:21565816

Manson, Spero M.; Jiang, Luohua; Zhang, Lijing; Beals, Janette; Acton, Kelly J.; Roubideaux, Yvette

2011-01-01

146

Lipoprotein (a) and cardiovascular risk factors in children and adolescents  

PubMed Central

OBJECTIVE: To review the relationship between lipoprotein (a) [Lp(a)] and other risk factors for cardiovascular disease (CVD) in children and adolescents. DATA SOURCES: This systematic review included studies from 2001 to 2011, a ten-year time period. Epidemiological studies with children and/or adolescents published in English, Portuguese or Spanish and fully available online were included. The searches were performed in Science Direct, PubMed/Medline, BVS (Biblioteca Virtual em Saúde) and Cochrane Library databases, using the following combination of key-words: "lipoprotein a" and "cardiovascular diseases" and "obesity". DATA SYNTHESIS: Overall, 672 studies were obtained but only seven were included. Some studies assessed the family history for CVD. In all of them, Lp(a) levels were increased in patients with family history for CVD. There was also a positive correlation between Lp(a) and LDL-cholesterol, total cholesterol, and apolipoprotein B levels, suggesting an association between Lp(a) levels and the lipid profile. CONCLUSIONS: The evidence that CVD may originate in childhood and adolescence leads to the need for investigating the risk factors during this period in order to propose earlier and possibly more effective interventions to reduce morbidity and mortality rates. PMID:24473960

Palmeira, Astrid Camelo; Leal, Adriana Amorim de F.; Ramos, Nathaly de Medeiros N.; de Alencar F., Jose; Simoes, Monica Oliveira da S.; Medeiros, Carla Campos M.

2013-01-01

147

Association between Birth Weight and Cardiovascular Risk Factors in Adolescents  

PubMed Central

Background Birth weight (BW) is a medium- and long-term risk determinant of cardiovascular risk factors. Objective To assess the association between BW and cardiovascular risk factors in adolescents of the city of Salvador, Bahia state. Methods Cross-sectional study with comparison of BW groups. Sample comprising 250 adolescents classified according to the BMI as follows: high-normal (? 50th percentile and < 85th percentile); overweight (? 85th percentile and < 95th percentile); and obesity (? 95th percentile). The risk variables compared were as follows: waist circumference (WC); arterial blood pressure; lipid profile; glycemia; serum insulin; HOMA-IR; and metabolic syndrome. The BW was informed by parents and classified as follows: low (BW ? 2,500g); normal (BW > 2,500g and < 4,000g); and high (BW ? 4,000g). Results One hundred and fifty-three (61.2%) girls, age 13.74 ± 2.03 years, normal BW 80.8%, low BW 8.0%, and high BW 11.2%. The high BW group as compared with the normal BW group showed a higher frequency of obesity (42.9%, p=0.005), elevated SBP and DBP (42.9%, p=0.000 and 35.7%, p=0.007, respectively), and metabolic syndrome (46.4%, p=0.002). High BW adolescents as compared with normal BW adolescents had a prevalence ratio for high SBP 3.3 (95% CI: 1.7-6.4) and obesity 2.6 (95% CI: 1.3-5.2). The WC of high BW adolescents was 83.3 ± 10.1 (p=0.038). The lipid profile showed no statistically significant differences. Conclusion Our findings suggest that obesity, elevated SBP and DBP, and metabolic syndrome during adolescence might be associated with high BW. PMID:23740400

de Sousa, Maria Amenaide Carvalho Alves; Guimaraes, Isabel Cristina Britto; Daltro, Carla; Guimaraes, Armenio Costa

2013-01-01

148

[Type 2 diabetes mellitus and cardiovascular risk factors: is comprehensive treatment required?].  

PubMed

Diabetes mellitus, especially type 2, is a metabolic disease involving the coexistence of several cardiovascular risk factors. Affected patients are therefore at high cardiovascular risk (2-3 times higher than that of men in the general population and 2-6 times higher than that of women). Cardiovascular disease is the main cause of death in the diabetic population, followed by cancer. Cardiovascular risk cannot be compared between diabetic patients and persons who have already shown one or more manifestations of cardiovascular disease (such as myocardial infarction). Single risk factors should be evaluated in combination with other risk factors and a person's cardiovascular risk should be individually assessed. Cardiovascular risk assessment in patients with diabetes through current calculations methods is complex because their ability to predict risk in individuals is very low. Studies such as that by Steno have demonstrated the validity of a comprehensive strategy to control all the risk factors present in persons with type 2 diabetes mellitus, which can reduce the development of micro- and macrovascular complications and mortality by almost 50%. The present article reviews each of the classical cardiovascular risk factors (hypertension, dyslipidemia, smoking, obesity, sedentariness) in relation to diabetes, as well as their recommended targets and the benefits of their control. In view of the above, a comprehensive approach is recommended to control the multiple risk factors that can coexist in persons with type 2 diabetes mellitus. PMID:24444518

Nadal, Josep Franch; Gutiérrez, Pedro Conthe

2013-09-01

149

Association of sympathovagal imbalance with cardiovascular risks in young prehypertensives.  

PubMed

Although cardiovascular (CV) risks have been reported in prehypertension, their link to sympathovagal imbalance (SVI) has not been investigated. In the present study, we have assessed the factors contributing to SVI and the prediction of CV risk by SVI in prehypertensives. Body mass index, CV parameters such as heart rate, systolic blood pressure (BP), diastolic BP, mean arterial pressure, rate-pressure product (RPP), stroke volume, left ventricular ejection time, cardiac output, total peripheral resistance, baroreflex sensitivity recorded by continuous blood pressure variability monitoring using Finapres, autonomic function tests recorded by spectral analysis of heart rate variability (HRV), and heart rate and BP responses to standing, deep breathing, and isometric handgrip, and biochemical parameters such as homeostatic model assessment of insulin resistance, lipid risk factors, inflammatory markers, thyroid profile, and renin and oxidative stress parameters were analyzed in young normotensives (n = 118) and prehypertensives (n = 58). Contribution of CV risks to low-frequency/high-frequency (LF/HF) ratio of HRV, the marker of SVI, was determined by multiple regression analysis, and prediction of SVI to RPP, a known CV risk, was assessed by logisitic regression adjusted for body mass index. BP variability, HRV, and autonomic function test parameters were significantly altered in prehypertensives and these parameters were correlated with LF/HF. Insulin resistance, dyslipidemia, inflammation, and oxidative stress contributed to SVI in prehypertensives. LF/HF and baroreflex sensitivity had significant prediction of RPP in prehypertensives. In conclusion, SVI in young prehypertensives is due to both increased sympathetic and decreased vagal tone. CV risks are linked to SVI and SVI predicts cardiac risk in prehypertensives. PMID:24035167

Pal, Gopal K; Adithan, Chandrasekaran; Ananthanarayanan, Palghat H; Pal, Pravati; Nanda, Nivedita; Thiyagarajan, Durgadevi; Syamsunderkiran, Avupati N; Lalitha, Venugopal; Dutta, Tarun K

2013-12-01

150

Circadian Role in Daily Pattern of Cardiovascular Risk  

NASA Astrophysics Data System (ADS)

Numerous epidemiological studies demonstrate that sudden cardiac death, pulmonary embolism, myocardial infarction, and stroke have a 24-hour daily pattern with a broad peak between 9-11am. Such a daily pattern in cardiovascular risk could be attributable to external factors, such as the daily behavior patterns, including sleep-wake cycles and activity levels, or internal factors, such as the endogenous circadian pacemaker. Findings of significant alternations in the temporal organization and nonlinear properties of heartbeat fluctuations with disease and with sleep-wake transitions raise the intriguing possibility that changes in the mechanism of control associated with behavioral sleep-wake transition may be responsible for the increased cardiac instability observed in particular circadian phases. Alternatively, we hypothesize that there is a circadian clock, independent of the sleep-wake cycle, which affects the cardiac dynamics leading to increased cardiovascular risk. We analyzed continuous recordings from healthy subjects during 7 cycles of forced desynchrony routine wherein subjects' sleep-wake cycles are adjusted to 28 hours so that their behaviors occur across all circadian phases. Heartbeat data were divided into one-hour segments. For each segment, we estimated the correlations and the nonlinear properties of the heartbeat fluctuations at the corresponding circadian phase. Since the sleep and wake contributions are equally weighted in our experiment, a change of the properties of the heartbeat dynamics with circadian phase suggest a circadian rhythm. We show significant circadian-mediated alterations in the correlation and nonlinear properties of the heartbeat resembling those observed in patients with heart failure. Remarkably, these dynamical alterations are centered at 60 degrees circadian phase, coinciding with the 9-11am window of cardiac risk.

Ivanov, Plamen Ch.; Hu, Kun; Chen, Zhi; Hilton, Michael F.; Stanley, H. Eugene; Shea, Steven A.

2004-03-01

151

Changes in diet, cardiovascular risk factors and modelled cardiovascular risk following diagnosis of diabetes: 1-year results from the ADDITION-Cambridge trial cohort  

PubMed Central

Aims To describe change in self-reported diet and plasma vitamin C, and to examine associations between change in diet and cardiovascular disease risk factors and modelled 10-year cardiovascular disease risk in the year following diagnosis of Type 2 diabetes. Methods Eight hundred and sixty-seven individuals with screen-detected diabetes underwent assessment of self-reported diet, plasma vitamin C, cardiovascular disease risk factors and modelled cardiovascular disease risk at baseline and 1 year (n = 736) in the ADDITION-Cambridge trial. Multivariable linear regression was used to quantify the association between change in diet and cardiovascular disease risk at 1 year, adjusting for change in physical activity and cardio-protective medication. Results Participants reported significant reductions in energy, fat and sodium intake, and increases in fruit, vegetable and fibre intake over 1 year. The reduction in energy was equivalent to an average-sized chocolate bar; the increase in fruit was equal to one plum per day. There was a small increase in plasma vitamin C levels. Increases in fruit intake and plasma vitamin C were associated with small reductions in anthropometric and metabolic risk factors. Increased vegetable intake was associated with an increase in BMI and waist circumference. Reductions in fat, energy and sodium intake were associated with reduction in HbA1c, waist circumference and total cholesterol/modelled cardiovascular disease risk, respectively. Conclusions Improvements in dietary behaviour in this screen-detected population were associated with small reductions in cardiovascular disease risk, independently of change in cardio-protective medication and physical activity. Dietary change may have a role to play in the reduction of cardiovascular disease risk following diagnosis of diabetes. PMID:24102972

Savory, L A; Griffin, S J; Williams, K M; Prevost, A T; Kinmonth, A-L; Wareham, N J; Simmons, R K

2014-01-01

152

Review Article Relation between Childhood Obesity and Adult Cardiovascular Risk  

E-print Network

The incidence of overweight and obesity is rising at an alarming pace in the pediatric population, just as in the adult population. The adult comorbidities associated with this risk factor are well-recognized and are being further elucidated continually. Additionally, we are gradually developing a better understanding of the risks of overweight and obesity among children while they are still young. However, there is now a growing body of evidence showing that childhood obesity not only leads all too frequently to adult obesity, but is in itself a risk factor for cardiometabolic syndrome and resultant cardiovascular risk in adulthood. If current trends continue, the problem of pediatric overweight and obesity will become of unmanageable proportions once these individuals reach adulthood. Future research efforts toward understanding this complex problem will need to focus on those overweight and obese children who later went on to change their metabolic course and become normal-weight adults. Copyright © 2009 Darren M. Allcock et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 1.

Darren M. Allcock; Michael J. Gardner; James R. Sowers

153

Plasma Total Cysteine and Cardiovascular Risk Burden: Action and Interaction  

PubMed Central

We hypothesized that redox analysis could provide sensitive markers of the oxidative pathway associated to the presence of an increasing number of cardiovascular risk factors (RFs), independently of type. We classified 304 subjects without cardiovascular disease into 4 groups according to the total number of RFs (smoking, hypertension, hypercholesterolaemia, hyperhomocysteinaemia, diabetes, obesity, and their combination). Oxidative stress was evaluated by measuring plasma total and reduced homocysteine, cysteine (Cys), glutathione, cysteinylglycine, blood reduced glutathione, and malondialdehyde. Twenty-seven percent of subjects were in group 0 RF, 26% in 1 RF, 31% in 2 RF, and 16% in ?3 RF. By multivariable ordinal regression analysis, plasma total Cys was associated to a higher number of RF (OR = 1.068; 95% CI = 1.027–1.110, P = 0.002). Total RF burden is associated with increased total Cys levels. These findings support a prooxidant effect of Cys in conjunction with RF burden, and shed light on the pathophysiologic role of redox state unbalance in preclinical atherosclerosis. PMID:22593672

De Chiara, Benedetta; Sedda, Valentina; Parolini, Marina; Campolo, Jonica; De Maria, Renata; Caruso, Raffaele; Pizzi, Gianluigi; Disoteo, Olga; Dellanoce, Cinzia; Corno, Anna Rosa; Cighetti, Giuliana; Parodi, Oberdan

2012-01-01

154

Aerobic fitness related to cardiovascular risk factors in young children.  

PubMed

Low aerobic fitness (maximum oxygen uptake (VO(2 PEAK))) is predictive for poor health in adults. In a cross-sectional study, we assessed if VO(2 PEAK) is related to a composite risk factor score for cardiovascular disease (CVD) in 243 children (136 boys and 107 girls) aged 8 to 11 years. VO(2 PEAK) was assessed by indirect calorimetry during a maximal exercise test and scaled by body mass (milliliters per minute per kilogram). Total body fat mass (TBF) and abdominal fat mass (AFM) were measured by Dual-energy X-ray absorptiometry. Total body fat was expressed as a percentage of total body mass (BF%) and body fat distribution as AFM/TBF. Systolic and diastolic blood pressure (SDP and DBP) and resting heart rate (RHR) were measured. The mean artery pressure (MAP) and pulse pressure (PP) were calculated. Echocardiography, 2D-guided M-mode, was performed. Left atrial diameter (LA) was measured and left ventricular mass (LVM) and relative wall thickness (RWT) were calculated. Z scores (value for the individual - mean value for group)/SD were calculated by sex. The sum of z scores for DBP, SDP, PP, MAP, RHR, LVM, LA, RWT, BF%, AFM and AFM/TBF were calculated in boys and girls, separately, and used as composite risk factor score for CVD. Pearson correlation revealed significant associations between VO(2 PEAK) and composite risk factor score in both boys (r = -0.48 P < 0.05) and in girls (r = -0.42, P < 0.05). One-way ANOVA analysis indicated significant differences in composite risk factor score between the different quartiles of VO(2 PEAK) (P < 0.001); thus, higher VO(2 PEAK) was associated with lower composite risk factor score for CVD. In conclusion, low VO(2 PEAK) is associated with an elevated composite risk factor score for CVD in both young boys and girls. PMID:22159955

Dencker, Magnus; Thorsson, Ola; Karlsson, Magnus K; Lindén, Christian; Wollmer, Per; Andersen, Lars B

2012-04-01

155

Prospective Relationship of Change in Ideal Cardiovascular Health Status and Arterial Stiffness: The Cardiovascular Risk in Young Finns Study  

PubMed Central

Background In 2010, the American Heart Association defined ideal cardiovascular health as the simultaneous presence of 4 favorable health behaviors (nonsmoking, ideal body mass index, physical activity at goal, and dietary pattern that promotes cardiovascular health) and 3 favorable health factors (ideal levels of total cholesterol, blood pressure, and fasting glucose). The association between a change in ideal cardiovascular health status and pulse wave velocity, a surrogate marker of cardiovascular disease, has not been reported. Methods and Results The study cohort consisted of 1143 white adults from the Cardiovascular Risk in Young Finns Study who were followed for 21 years since baseline (1986). This cohort was divided in 2 subgroups: 803 participants (aged 9 to 18 years at baseline) to study the health status change from childhood to adulthood and 340 participants (aged 21 to 24 years at baseline) to study health status change from young adulthood to middle age. The change in the ideal cardiovascular health index was inversely associated with pulse wave velocity (adjusted for age, sex, and heart rate), every 1?point increase corresponded to a 0.09?m/s (P<0.001) decrease in pulse wave velocity in both groups. This association remained significant in subgroups based on the ideal cardiovascular health index at baseline. Conclusions The change in ideal cardiovascular health status, both from childhood to adulthood and from young adulthood to middle age, was an independent predictor of adult pulse wave velocity. Our results support the concept of ideal cardiovascular health as a useful tool for primordial prevention of cardiovascular disease. PMID:24614756

Aatola, Heikki; Hutri-Kahonen, Nina; Juonala, Markus; Laitinen, Tomi T.; Pahkala, Katja; Mikkila, Vera; Telama, Risto; Koivistoinen, Teemu; Lehtimaki, Terho; Viikari, Jorma S. A.; Raitakari, Olli T.; Kahonen, Mika

2014-01-01

156

Mania and mortality: Why the excess cardiovascular risk in bipolar disorder?  

Microsoft Academic Search

Individuals with bipolar disorder experience twice the cardiovascular mortality expected from general population estimates.\\u000a The metabolic syndrome is more common in those with bipolar disorder, with a prevalence ratio of 1.6, and includes many traditional\\u000a cardiovascular risk factors, which may explain much of the elevated risk. Manic symptom burden also predicts cardiovascular\\u000a mortality, begging questions regarding other explanations for elevated

Dylan P. Murray; Miriam Weiner; Maithri Prabhakar; Jess G. Fiedorowicz

2009-01-01

157

Screening Children to Identify Families at Increased Risk for Cardiovascular Disease  

Microsoft Academic Search

OBJECTIVES.Atherosclerotic cardiovascular disease is the leading cause of death in the United States. Atherosclerosis begins early in life; however, children and young and middle-aged adults are not universally screened for the presence of modifiable cardiovascular disease risk factors. The purpose of this study was to investigate whether cardiovascular disease risk-factor assessment in children can identify families who are at increased

Evelyn Cohen Reis; Kevin E. Kip; Oscar C. Marroquin; Marin Kiesau; Lee Hipps; Ronald E. Peters; Steven E. Reis

2010-01-01

158

Cardiovascular event-free survival after adjuvant radiation therapy in breast cancer patients stratified by cardiovascular risk.  

PubMed

The objective of this study was to estimate the risk of a cardiovascular event or death associated with modern radiation in a population of elderly female breast cancer patients with varying baseline cardiovascular risk. The data used for this analysis are from the linked Surveillance, Epidemiology, and End-Results (SEER)-Medicare database. The retrospective cohort study included women aged 66 years and older with stage 0-III breast cancer diagnosed between 2000 and 2005. Women were grouped as low, intermediate, or high cardiovascular risk based on the presence of certain clinical diagnoses. The risk for the combined outcome of a hospitalization for a cardiovascular event or death within 6 months and 24 months of diagnosis was estimated using a multivariable Cox model. The median follow-up time was 24 months. Among the 91,612 women with American Joint Committee on Cancer (AJCC) stage 0-III breast cancer: 39,555 (43.2%) were treated with radiation therapy and 52,057 (56.8%) were not. The receipt of radiation therapy in the first 6 months was associated with a statistically significant increased risk for the combined outcome in women categorized as high risk (HR = 1.510; 95% CI, 1.396-1.634) or intermediate risk (HR = 1.415; 95% CI, 1.188-1.686) but not low risk (HR = 1.027; 95% CI, 0.798-1.321). Women with a prior medical history of cardiovascular disease treated with radiation therapy are at increased risk for an event and should be monitored for at least 6 months following treatment with radiation therapy. PMID:25044867

Onwudiwe, Nneka C; Kwok, Young; Onukwugha, Eberechukwu; Sorkin, John D; Zuckerman, Ilene H; Shaya, Fadia T; Daniel Mullins, C

2014-10-01

159

Gender Differences in Genetic Risk Profiles for Cardiovascular Disease  

PubMed Central

Background Cardiovascular disease (CVD) incidence, complications and burden differ markedly between women and men. Although there is variation in the distribution of lifestyle factors between the genders, they do not fully explain the differences in CVD incidence and suggest the existence of gender-specific genetic risk factors. We aimed to estimate whether the genetic risk profiles of coronary heart disease (CHD), ischemic stroke and the composite end-point of CVD differ between the genders. Methodology/Principal Findings We studied in two Finnish population cohorts, using the case-cohort design the association between common variation in 46 candidate genes and CHD, ischemic stroke, CVD, and CVD-related quantitative risk factors. We analyzed men and women jointly and also conducted genotype-gender interaction analysis. Several allelic variants conferred disease risk for men and women jointly, including rs1801020 in coagulation factor XII (HR?=?1.31 (1.08–1.60) for CVD, uncorrected p?=?0.006 multiplicative model). Variant rs11673407 in the fucosyltransferase 3 gene was strongly associated with waist/hip ratio (uncorrected p?=?0.00005) in joint analysis. In interaction analysis we found statistical evidence of variant-gender interaction conferring risk of CHD and CVD: rs3742264 in the carboxypeptidase B2 gene, p(interaction)?=?0.009 for CHD, and rs2774279 in the upstream stimulatory factor 1 gene, p(interaction)?=?0.007 for CHD and CVD, showed strong association in women but not in men, while rs2069840 in interleukin 6 gene, p(interaction)?=?0.004 for CVD, showed strong association in men but not in women (uncorrected p-values). Also, two variants in the selenoprotein S gene conferred risk for ischemic stroke in women, p(interaction)?=?0.003 and 0.007. Importantly, we identified a larger number of gender-specific effects for women than for men. Conclusions/Significance A false discovery rate analysis suggests that we may expect half of the reported findings for combined gender analysis to be true positives, while at least third of the reported genotype-gender interaction results are true positives. The asymmetry in positive findings between the genders could imply that genetic risk loci for CVD are more readily detectable in women, while for men they are more confounded by environmental/lifestyle risk factors. The possible differences in genetic risk profiles between the genders should be addressed in more detail in genetic studies of CVD, and more focus on female CVD risk is also warranted in genome-wide association studies. PMID:18974842

Silander, Kaisa; Saarela, Olli; Ripatti, Samuli; Auro, Kirsi; Karvanen, Juha; Kulathinal, Sangita; Niemela, Matti; Ellonen, Pekka; Vartiainen, Erkki; Jousilahti, Pekka; Saarela, Janna; Kuulasmaa, Kari; Evans, Alun; Perola, Markus; Salomaa, Veikko; Peltonen, Leena

2008-01-01

160

Cardiovascular risk assessment in primary care: a new vital sign? An evidence-based approach for integrating the cardiovascular risk assessment approach in family practice  

Microsoft Academic Search

The Framingham Heart Study has taken the lead in developing the concept of risk factors, a concept that is now widely accepted and used. In 2000, the Heart Outcomes Prevention Evaluation Study (HOPE study) has emphasized the importance and benefits of treating high cardiovascular risk patients.Major organizations see a role for medical office assessment in the detection of risk factors

Denis Drouin; J. L. Guy Tremblay; Paule Maltais; Francine Borduas

2002-01-01

161

Sarcopenic-obesity and cardiovascular disease risk in the elderly  

Microsoft Academic Search

Objectives  To determine: 1) whether sarcopenic-obesity is a stronger predictor of cardiovascular disease (CVD) than either sarcopenia\\u000a or obesity alone in the elderly, and 2) whether muscle mass or muscular strength is a stronger marker of CVD risk.\\u000a \\u000a \\u000a \\u000a Design  Prospective cohort study.\\u000a \\u000a \\u000a \\u000a Participants  Participants included 3366 community-dwelling older (65 years) men and women who were free of CVD at baseline.\\u000a \\u000a \\u000a \\u000a Measurements  Waist circumference (WC),

W. C. Stephen; I. Janssen

2009-01-01

162

Stressors Influencing Middle Eastern Women's Perceptions of the Risk of Cardiovascular Disease: A Focus Group Study  

Microsoft Academic Search

To better understand Australia-dwelling Middle Eastern women's lack of service utilization in cardiovascular health, we undertook a study to investigate their understandings and meanings of cardiovascular disease (CVD) and its risk factors. Eight focus groups were conducted in community settings with Turkish, Persian, and Arab women. We found that the women understated their risk of CVD, faced many barriers in

Leila Gholizadeh; Michelle DiGiacomo; Yenna Salamonson; Patricia M. Davidson

2011-01-01

163

Cardiac Adiposity and Cardiovascular Risk: Potential Role of Epicardial Adipose Tissue  

Microsoft Academic Search

Emerging evidence suggests that cardiac adiposity may play an important role in the development of an unfa- vorable cardiovascular risk profile. The concept of adiposity of the heart, as new cardiovascular risk factor and marker, is rapidly emerging. Recent papers suggest that epicardial fat, an index of cardiac visceral adiposity could locally modulate the morphology and function of the heart.

Gianluca Iacobellis; Navneet Singh; Arya M. Sharma

2007-01-01

164

Initial combination therapy reduces the risk of cardiovascular events in hypertensive patients: a matched cohort study.  

PubMed

This study evaluated the effects of initial versus delayed treatment with a drug combination on blood pressure (BP) control and the risk of cardiovascular (CV) events in hypertensive patients. Clinical trials suggest that the time to BP control is an important determinant of long-term outcomes, but real-world evidence is scarce. Using electronic medical charts (2005-2009), we retrospectively analyzed 1762 adult patients with BP elevation initiating combination therapy matched 1:1 with similar patients initiating monotherapy and later switched to combination therapy. Incidence rate ratios of CV events (myocardial infarction, stroke/transient ischemic attack, or hospitalization for heart failure) or all-cause death and Kaplan-Meier analyses of time to BP control were compared between cohorts. Hazard ratios indicating the effects of initial treatment on CV events and BP control were estimated using time-varying Cox proportional hazard models. Initial combination therapy was associated with a significant reduction in the risk of CV events or death (incidence rate ratio, 0.66 [95% confidence interval, 0.52-0.84]; P=0.0008). After 6 months of therapy, 40.3% and 32.6% of patients with initial versus delayed combination treatment reached BP control, respectively. Achieving target BP was associated with a statistically significant risk reduction of 23% for CV events or death (hazard ratio, 0.77 [95% confidence interval, 0.61-0.96]; P=0.0223); the residual effect of initial combination therapy did not reach statistical significance (hazard ratio, 0.84 [95% confidence interval, 0.68-1.03]; P=0.0935). Initial combination therapy was associated with a significant risk reduction of cardiovascular events. More rapid achievement of target BP was found to be the main contributor to the estimated risk reduction. PMID:23184383

Gradman, Alan H; Parisé, Hélène; Lefebvre, Patrick; Falvey, Heather; Lafeuille, Marie-Hélène; Duh, Mei Sheng

2013-02-01

165

Trans fatty acids - A risk factor for cardiovascular disease  

PubMed Central

Trans fatty acids (TFA) are produced either by hydrogenation of unsaturated oils or by biohydrogenation in the stomach of ruminant animals. Vanaspati ghee and margarine have high contents of TFA. A number of studies have shown an association of TFA consumption and increased risk of cardiovascular disease (CVD). This increased risk is because TFA increase the ratio of LDL cholesterol to HDL cholesterol. Food and Agriculture Organization of the United Nations and World Health Organization have come up with the recommendation that the contents of TFA in human dietary fat should be reduced to less than 4%. There is high prevalence of CVD in Pakistan. High consumption of vanaspati ghee which contains 14.2-34.3% of TFA could be one of the factors for this increased burden of CVD in Pakistan. Consumption of dietary fat low in TFA would be helpful in reducing the risk of CVD in South Asia. Denmark by banning the sale of food items with TFA has brought down the number of deaths due to coronary heart disease by nearly 50% over a period of 20 years. Public awareness about the adverse effects of TFA on human health would be extremely important. Media can play a very effective role in educating the masses and advocating the policy for the sale of only low TFA food items. Literature sources: Google and US National Library of Medicine, National Institute of Health were the sources of papers cited in this review article. PMID:24639860

Iqbal, Mohammad Perwaiz

2014-01-01

166

Modifiable Cardiovascular Disease Risk Factors among Indigenous Populations  

PubMed Central

Objective. To identify modifiable cardio-metabolic and lifestyle risk factors among indigenous populations from Australia (Aboriginal Australians/Torres Strait Islanders), New Zealand (M?ori), and the United States (American Indians and Alaska Natives) that contribute to cardiovascular disease (CVD). Methods. National health surveys were identified where available. Electronic databases identified sources for filling missing data. The most relevant data were identified, organized, and synthesized. Results. Compared to their non-indigenous counterparts, indigenous populations exhibit lower life expectancies and a greater prevalence of CVD. All indigenous populations have higher rates of obesity and diabetes, hypertension is greater for M?ori and Aboriginal Australians, and high cholesterol is greater only among American Indians/Alaska Natives. In turn, all indigenous groups exhibit higher rates of smoking and dangerous alcohol behaviour as well as consuming less fruits and vegetables. Aboriginal Australians and American Indians/Alaska Natives also exhibit greater rates of sedentary behaviour. Conclusion. Indigenous groups from Australia, New Zealand, and the United States have a lower life expectancy then their respective non-indigenous counterparts. A higher prevalence of CVD is a major driving force behind this discrepancy. A cluster of modifiable cardio-metabolic risk factors precede CVD, which, in turn, is linked to modifiable lifestyle risk factors. PMID:24649368

Lucero, Adam A.; Lambrick, Danielle M.; Faulkner, James A.; Tarrant, Michael A.; Poudevigne, Melanie; Williams, Michelle A.; Stoner, Lee

2014-01-01

167

Modifiable cardiovascular disease risk factors among indigenous populations.  

PubMed

Objective. To identify modifiable cardio-metabolic and lifestyle risk factors among indigenous populations from Australia (Aboriginal Australians/Torres Strait Islanders), New Zealand (M?ori), and the United States (American Indians and Alaska Natives) that contribute to cardiovascular disease (CVD). Methods. National health surveys were identified where available. Electronic databases identified sources for filling missing data. The most relevant data were identified, organized, and synthesized. Results. Compared to their non-indigenous counterparts, indigenous populations exhibit lower life expectancies and a greater prevalence of CVD. All indigenous populations have higher rates of obesity and diabetes, hypertension is greater for M?ori and Aboriginal Australians, and high cholesterol is greater only among American Indians/Alaska Natives. In turn, all indigenous groups exhibit higher rates of smoking and dangerous alcohol behaviour as well as consuming less fruits and vegetables. Aboriginal Australians and American Indians/Alaska Natives also exhibit greater rates of sedentary behaviour. Conclusion. Indigenous groups from Australia, New Zealand, and the United States have a lower life expectancy then their respective non-indigenous counterparts. A higher prevalence of CVD is a major driving force behind this discrepancy. A cluster of modifiable cardio-metabolic risk factors precede CVD, which, in turn, is linked to modifiable lifestyle risk factors. PMID:24649368

Lucero, Adam A; Lambrick, Danielle M; Faulkner, James A; Fryer, Simon; Tarrant, Michael A; Poudevigne, Melanie; Williams, Michelle A; Stoner, Lee

2014-01-01

168

Relationships Between Cardiovascular Disease Risk Factors and Depressive Symptoms as Predictors of Cardiovascular Disease Events in Women  

PubMed Central

Abstract Background Modifiable risk factors for cardiovascular disease (CVD) account for much of the variability in CVD outcomes and are also related to psychosocial variables. There is evidence that depression can undermine the treatment and advance the progression of CVD risk factors, suggesting that CVD risk factor relationships with CVD events may differ among those with depression. Methods This study tracked CVD events and mortality over a median of 5.9 years among a prospective cohort of 620 women (mean age 59.6 years [11.6]) completing a diagnostic protocol including coronary angiography and CVD risk factor assessment. Depressive symptoms were assessed using the Beck Depression Inventory (BDI). The study outcome was combined cardiovascular mortality and events. Results Over the follow-up interval, 16.1% of the sample experienced one or more of the cardiovascular outcomes. In separate Cox regression models adjusting for age, education history, ethnicity, and coronary angiogram scores, we observed statistically significant CVD risk factor?×?BDI score interactions for diabetes, smoking, and waist–hip ratio factors. Simple effect analyses indicated that diabetes and smoking status were more strongly associated with cardiovascular outcomes among participants with lower BDI scores, whereas waist–hip ratio values predicted outcomes only among those with higher BDI scores. Conclusions These results suggest that the relationship between modifiable CVD risk factors and CVD outcomes may vary with depression status in clinical samples of women. This evidence augments prior research by demonstrating that depression may influence CVD risk jointly with or independent of CVD risk factors. It also provides further support for the inclusion of depression assessment in cardiovascular clinic settings. PMID:21988550

Linke, Sarah E.; Johnson, B. Delia; Bittner, Vera; Krantz, David S.; Cornell, Carol E.; Vaccarino, Viola; Pepine, Carl J.; Handberg, Eileen M.; Eteiba, Wafia; Shaw, Leslee J.; Parashar, Susmita; Eastwood, Jo-Ann; Vido, Diane A.; Merz, C. Noel Bairey

2012-01-01

169

Usefulness of Risk Scores To Estimate the Risk of Cardiovascular Disease in Patients with Rheumatoid Arthritis  

PubMed Central

Patients with rheumatoid arthritis (RA) suffer from an excess burden of cardiovascular disease (CVD). CV risk scores for the general population may not accurately predict CV risk for patients with RA. A population-based inception cohort of patients who fulfilled 1987 American College of Rheumatology criteria for RA in 1988–2007 was followed until death, migration, or 12/31/2008. CV risk factors and CVD (myocardial infarction, CV death, angina, stroke, intermittent claudication and heart failure) were ascertained by medical record review. The 10 year predicted CVD risk was calculated using the general Framingham and the Reynolds risk scores. Standardized incidence ratios were calculated to compare observed and predicted CVD risks. The study included 525 patients with RA aged ?30 years without prior CVD. The mean follow-up was 8.4 years, during which 84 patients developed CVD. The observed CVD risk was 2-fold higher than the Framingham risk score predicted in women and 65% higher in men, and the Reynolds risk score revealed similar deficits. Patients aged ?75 years had observed CVD risk >3 times the Framingham predicted risk. Patients with positive rheumatoid factor or persistently elevated erythrocyte sedimentation rate also experienced more CVD events than predicted. In conclusion, the Framingham and Reynolds risk scores substantially underestimated CVD risk in patients with RA of both sexes, especially in older ages and in patients with positive rheumatoid factor. These data underscore the need for more accurate tools to predict CVD risk in patients with RA. PMID:22521305

Crowson, Cynthia S.; Matteson, Eric L.; Roger, Veronique L.; Therneau, Terry M.; Gabriel, Sherine E.

2012-01-01

170

Usefulness of risk scores to estimate the risk of cardiovascular disease in patients with rheumatoid arthritis.  

PubMed

Patients with rheumatoid arthritis (RA) have an excess burden of cardiovascular (CV) disease (CVD). CV risk scores for the general population may not accurately predict CV risk for patients with RA. A population-based inception cohort of patients who fulfilled 1987 American College of Rheumatology criteria for RA from 1988 to 2007 was followed until death, migration, or December 31, 2008. CV risk factors and CVD (myocardial infarction, CV death, angina, stroke, intermittent claudication, and heart failure) were ascertained by medical record review. Ten-year predicted CVD risk was calculated using the general Framingham and the Reynolds risk scores. Standardized incidence ratios were calculated to compare observed and predicted CVD risks. The study included 525 patients with RA aged ?30 years without previous CVD. The mean follow-up period was 8.4 years, during which 84 patients developed CVD. The observed CVD risk was 2-fold higher than the Framingham risk score predicted in women and 65% higher in men, and the Reynolds risk score revealed similar deficits. Patients aged ?75 years had observed CVD risk >3 times the Framingham-predicted risk. Patients with positive rheumatoid factor or persistently elevated erythrocyte sedimentation rates also experienced more CVD events than predicted. In conclusion, the Framingham and Reynolds risk scores substantially underestimated CVD risk in patients with RA of both genders, especially in older ages and in patients with positive rheumatoid factor. These data underscore the need for more accurate tools to predict CVD risk in patients with RA. PMID:22521305

Crowson, Cynthia S; Matteson, Eric L; Roger, Veronique L; Therneau, Terry M; Gabriel, Sherine E

2012-08-01

171

Does improving mood in depressed patients alter factors that may affect cardiovascular disease risk?  

Microsoft Academic Search

To determine if improvement in mood would ameliorate autonomic dysregulation, HPA dysfunction, typical risk factors and C-reactive protein in depressed patients with elevated cardiovascular disease risk (CVD), 48 depressed participants with elevated cardiovascular risk factors were randomized to a cognitive behavioral intervention (CBT) or a waiting list control (WLC) condition. Twenty non-depressed age and risk-matched controls were also recruited. Traditional

C. Barr Taylor; Ansgar Conrad; Frank H. Wilhelm; Diane Strachowski; Anna Khaylis; Eric Neri; Janine Giese-Davis; Walton T Roth; John P. Cooke; Helena Kraemer; David Spiegel

2009-01-01

172

Traditional and Nontraditional Cardiovascular Risk Factors in Comorbid Insomnia and Sleep Apnea  

PubMed Central

Objectives: Insomnia and sleep apnea frequently co-occur and are independently associated with an increased risk of cardiovascular disease, but little is known about cardiovascular disease risk among individuals with comorbid insomnia and sleep apnea. The current study examined traditional risk factors and a physiologic biomarker of cardiovascular risk in comorbid insomnia and sleep apnea. Design: Community-based participatory research study. Participants: The sample comprised 795 participants without preexisting cardiovascular disease from the Heart Strategies Concentrating On Risk Evaluation (Heart SCORE) study. Measurements and Results: Participants were assessed for symptoms of insomnia and sleep apnea risk, as well as for presence of obesity, smoking, a sedentary lifestyle, hypertension, dyslipidemia, and diabetes. Baseline resting brachial artery diameter was measured by B-mode ultrasonography. A total of 138 participants (17.4%) met criteria for insomnia syndrome alone, 179 (22.5%) were at high risk for sleep apnea alone, 95 (11.9%) reported both insomnia syndrome and high sleep apnea risk, and 383 (48.2%) reported having neither insomnia nor sleep apnea symptoms Both high sleep apnea risk alone and comorbid insomnia and high sleep apnea risk groups had greater frequencies of obesity, sedentary lifestyle, hypertension, and three or more traditional cardiovascular risk factors and significantly larger brachial artery diameters than the insomnia alone group and those without insomnia or sleep apnea symptoms. No differences in traditional cardiovascular risk factors or brachial artery diameter were found between the high sleep apnea risk and comorbid groups. Conclusions: These findings suggest that sleep apnea is a major contributor to cardiovascular risk and co-occurring insomnia does not appear to add to this risk. Citation: Luyster FS; Kip KE; Buysse DJ; Aiyer AN; Reis SE; Strollo PJ. Traditional and nontraditional cardiovascular risk factors in comorbid insomnia and sleep apnea. SLEEP 2014;37(3):593-600. PMID:24587583

Luyster, Faith S.; Kip, Kevin E.; Buysse, Daniel J.; Aiyer, Aryan N.; Reis, Steven E.; Strollo, Patrick J.

2014-01-01

173

Cardiovascular prevention in a high risk sport, ice hockey: applications in wider sports physical therapy practice.  

PubMed

Although acute myocardial infarction and sudden cardiac death are relatively rare occurrences in athletics, cardiovascular accidents do occur. This manuscript presents information on the cardiovascular risks in athletics. In addition, information is provided on screening for cardiovascular risk - including history taking, chart review, physical examination - and the appropriate guidelines on the treatment of athletes found to be at risk. For the purpose of this article, the sport of ice hockey is used to illustrate the subject matter and highlight the behaviors in sport that carry cardiovascular risk. Physical therapists have ethical and legal responsibility to undertake the necessary screening procedures to recognize and respond to any signs of cardiovascular risk in their clients. PMID:21522221

Hopkins-Rosseel, Diana H

2006-11-01

174

Cardiovascular risk factor profiles in mild to moderate hypertensives seen at Kenyatta National Hospital.  

PubMed

Sixty newly diagnosed adult patients with mild to moderate essential hypertension were assessed to determine their cardiovascular risk factor profiles. Detailed history and physical examinations were done. Resting 12-lead ECG was done and serum levels of uric acid, fasting cholesterol, and fasting glucose were determined. Twenty nine patients had hypertension and two or more cardiovascular risk factors. The most prevalent cardiovascular risk factors other than hypertension were electro-cardiovascular left ventricular hypertrophy (31.7%), obesity (28.3%) and hypercholesterolaemia (28.3%). About a half of these patients (48.3%) can be classified as high risk hypertensives. This calls for aggressive management of cardiovascular risk factors as a whole and not just hypertension alone if we are to reduce incidence of hypertensive complications. PMID:8033770

Yonga, G O; Ogola, E N; Juma, F D

1993-11-01

175

Ankle-brachial index and the incidence of cardiovascular events in the Mediterranean low cardiovascular risk population ARTPER cohort  

PubMed Central

Background Peripheral arterial disease (PAD) of the lower limbs is a cardiovascular disease highly prevalent particularly in the asymptomatic form. Its prevalence starts to be a concern in low coronary risk countries like Spain. Few studies have analyzed the relationship between ankle-brachial index (ABI) and cardiovascular morbi-mortality in low cardiovascular risk countries like Spain where we observe significant low incidence of ischemic heart diseases together with high prevalence of cardiovascular risk factors. The objective of this study is to determine the relationship between pathological ABI and incidence of cardiovascular events (coronary disease, cerebrovascular disease, symptomatic aneurism of abdominal aorta, vascular surgery) and death in the >49 year population-based cohort in Spain (ARTPER). Methods Baseline ABI was measured in 3,786 randomly selected patients from 28 Primary Health Centers in Barcelona, distributed as: ABI<0.9 peripheral arterial disease (PAD), ABI ?1.4 arterial calcification (AC), ABI 0.9-1.4 healthy; and followed during 4 years. Results 3,307 subjects were included after excluding those with previous vascular events. Subjects with abnormal ABI were older with higher proportion of men, smokers and diabetics. 260 people presented cardiovascular events (incidence 2,117/100,000 person-years) and 124 died from any cause (incidence 978/100,000 person-years). PAD had two-fold greater risk of coronary disease (adjusted hazard ratio (HR)?=?2.0, 95% confidence interval (CI) 1.3-3.2) and increased risk of vascular surgery (HR?=?5.6, 95%CI 2.8-11.5) and mortality (HR?=?1.8, 95%CI 1.4-2.5). AC increased twice risk of cerebrovascular events (HR?=?1.9, 95%CI 1.0-3.5) with no relationship with ischemic heart disease. Conclusions PAD increases coronary disease risk and AC cerebrovascular disease risk in low cardiovascular risk Mediterranean population. ABI could be a useful tool to detect patients at risk in Primary Health Care. PMID:24341531

2013-01-01

176

Shiftwork and metabolic risk factors of cardiovascular disease.  

PubMed

We conducted this study to examine the relationship between shift work duration and the metabolic risk factors of cardiovascular disease among shift workers. The study population consisted of 226 female hospital nurses and 134 male workers at a firm manufacturing diapers and feminine hygiene materials, whose mean ages were 28.5 yr for the nurses and 29.1 yr for the male workers. The fasting blood sugar level, serum cholesterol, blood pressure, height and weight, waist and hip circumferences (only for the nurses), and numbers of walks during work (as a measure of physical activity) were measured. Using the Karasek's job contents questionnaire, job stress was assessed. Information about the years of work, shift work duration, past medical and behavioral history, including smoking, was obtained by a self-administered questionnaire. With definitions of hypertension as systolic blood pressure (SBP) > or =160 or diastolic blood pressure (DBP) > or =90 mmHg occurring at least once, hypercholesterolemia as serum total cholesterol > or =240 mg/dl, obesity as body mass index (BMI) > or =25 kg/m(2) and as waist to hip ratio (WHR) > or =0.85, we examined the prevalences of metabolic risk factors among subjects. Regression analyses to show the relationships between shift work duration and metabolic risk factors were performed using simple and multivariate models stratified by age, and adjusted for smoking, drinking, job strain and physical activity. Duration of shift work was significantly associated with SBP or cholesterol level among male workers aged 30 or more. Among female nurses, it was inversely associated with DBP (in those who were below 30 yr old) and cholesterol (in those who were aged 30 or more). BMI was non-significantly associated with the duration of shift work in both male workers and female nurses who were 30 yr old or more. WHR in female nurses increased slightly according to increasing duration of shift work. Fasting blood sugar was not significantly associated with the duration of shift work in either sex regardless of age-group. These results suggest an association between shift work duration and the metabolic risk factors of cardiovascular disease. PMID:15824472

Ha, Mina; Park, Jungsun

2005-03-01

177

BRCA1/2 mutation carriers are potentially at higher cardiovascular risk.  

PubMed

BRCA1/2 mutation carriers have an elevated risk of developing breast and ovarian cancer at a relatively young age. Risk-reducing salpingo-oophorectomy is an established strategy to tremendously reduce the risk of ovarian cancer. It is recommended to perform this surgery at age 35-40 years (BRCA1) and at age 40-45 years (BRCA2) resulting in an early and abrupt menopause. BRCA1/2 mutation carriers are potentially at higher risk of cardiovascular diseases due to early surgical menopause, and cardiotoxic effects of adjuvant treatment for breast cancer. Furthermore, preliminary results of experimental studies suggest a possible causative function of the BRCA genes in cardiovascular risk. More research on cardiovascular health risks in BRCA1/2 mutation carriers is needed, especially in the field of cardio-oncology, requiring additional attention to potentially cumulative effects on cardiovascular risks in this specific group of women. PMID:24529552

Arts-de Jong, M; Maas, A H E M; Massuger, L F; Hoogerbrugge, N; de Hullu, J A

2014-08-01

178

Pesticide residues and bees--a risk assessment.  

PubMed

Bees are essential pollinators of many plants in natural ecosystems and agricultural crops alike. In recent years the decline and disappearance of bee species in the wild and the collapse of honey bee colonies have concerned ecologists and apiculturalists, who search for causes and solutions to this problem. Whilst biological factors such as viral diseases, mite and parasite infections are undoubtedly involved, it is also evident that pesticides applied to agricultural crops have a negative impact on bees. Most risk assessments have focused on direct acute exposure of bees to agrochemicals from spray drift. However, the large number of pesticide residues found in pollen and honey demand a thorough evaluation of all residual compounds so as to identify those of highest risk to bees. Using data from recent residue surveys and toxicity of pesticides to honey and bumble bees, a comprehensive evaluation of risks under current exposure conditions is presented here. Standard risk assessments are complemented with new approaches that take into account time-cumulative effects over time, especially with dietary exposures. Whilst overall risks appear to be low, our analysis indicates that residues of pyrethroid and neonicotinoid insecticides pose the highest risk by contact exposure of bees with contaminated pollen. However, the synergism of ergosterol inhibiting fungicides with those two classes of insecticides results in much higher risks in spite of the low prevalence of their combined residues. Risks by ingestion of contaminated pollen and honey are of some concern for systemic insecticides, particularly imidacloprid and thiamethoxam, chlorpyrifos and the mixtures of cyhalothrin and ergosterol inhibiting fungicides. More attention should be paid to specific residue mixtures that may result in synergistic toxicity to bees. PMID:24718419

Sanchez-Bayo, Francisco; Goka, Koichi

2014-01-01

179

Combining antihypertensive and antihyperlipidemic agents - optimizing cardiovascular risk factor management  

PubMed Central

Clinical guidelines now recognize the importance of a multifactorial approach to managing cardiovascular (CV) risk. This idea was taken a step further with the concept of the Polypill™. There are, however, considerable patent, pharmacokinetic, pharmacodynamic, registration, and cost implications that will need to be overcome before the Polypill™ or other single-pill combinations of CV medications become widely available. However, a medication targeting blood pressure (BP) and lipids provides much of the proposed benefits of the Polypill™. A single-pill combination of the antihypertensive amlodipine besylate and the lipid-lowering medication atorvastatin calcium (SPAA) is currently available in many parts of the world. This review describes the rationale for this combination therapy and the clinical trials that have demonstrated that these two agents can be combined without the loss of efficacy for either agent or an increase in the incidence of adverse events. The recently completed Cluster Randomized Usual Care vs Caduet Investigation Assessing Long-term-risk (CRUCIAL trial) is discussed in detail. CRUCIAL was a 12-month, international, multicenter, prospective, open-label, parallel design, cluster-randomized trial, which demonstrated that a proactive intervention strategy based on SPAA in addition to usual care (UC) had substantial benefits on estimated CV risk, BP, and lipids over continued UC alone. Adherence with antihypertensive and lipid-lowering therapies outside of the controlled environment of clinical trials is very low (~30%–40% at 12 months). Observational studies have demonstrated that improving adherence to lipid-lowering and antihypertensive medications may reduce CV events. One means of improving adherence is the use of single-pill combinations. Real-world observational studies have demonstrated that patients are more adherent to SPAA than co-administered antihypertensive and lipid-lowering therapy, and this improved adherence translated to reduced CV events. Taken together, these findings suggest that SPAA can play an important role in helping physicians improve the management of CV risk in their patients. PMID:22162939

Zamorano, Jose; Edwards, Jonathan

2011-01-01

180

Combining antihypertensive and antihyperlipidemic agents - optimizing cardiovascular risk factor management.  

PubMed

Clinical guidelines now recognize the importance of a multifactorial approach to managing cardiovascular (CV) risk. This idea was taken a step further with the concept of the Polypill™. There are, however, considerable patent, pharmacokinetic, pharmacodynamic, registration, and cost implications that will need to be overcome before the Polypill™ or other single-pill combinations of CV medications become widely available. However, a medication targeting blood pressure (BP) and lipids provides much of the proposed benefits of the Polypill™. A single-pill combination of the antihypertensive amlodipine besylate and the lipid-lowering medication atorvastatin calcium (SPAA) is currently available in many parts of the world. This review describes the rationale for this combination therapy and the clinical trials that have demonstrated that these two agents can be combined without the loss of efficacy for either agent or an increase in the incidence of adverse events. The recently completed Cluster Randomized Usual Care vs Caduet Investigation Assessing Long-term-risk (CRUCIAL trial) is discussed in detail. CRUCIAL was a 12-month, international, multicenter, prospective, open-label, parallel design, cluster-randomized trial, which demonstrated that a proactive intervention strategy based on SPAA in addition to usual care (UC) had substantial benefits on estimated CV risk, BP, and lipids over continued UC alone. Adherence with antihypertensive and lipid-lowering therapies outside of the controlled environment of clinical trials is very low (~30%-40% at 12 months). Observational studies have demonstrated that improving adherence to lipid-lowering and antihypertensive medications may reduce CV events. One means of improving adherence is the use of single-pill combinations. Real-world observational studies have demonstrated that patients are more adherent to SPAA than co-administered antihypertensive and lipid-lowering therapy, and this improved adherence translated to reduced CV events. Taken together, these findings suggest that SPAA can play an important role in helping physicians improve the management of CV risk in their patients. PMID:22162939

Zamorano, José; Edwards, Jonathan

2011-01-01

181

Central Versus Peripheral Cardiovascular Risk in Metabolic Syndrome  

PubMed Central

Individuals with metabolic syndrome (MetS; i.e., three of five of the following risk factors (RFs): elevated blood pressure, waist circumference, triglycerides, blood glucose, or reduced HDL) are thought to be prone to serious cardiovascular disease and there is debate as to whether the disease begins in the peripheral vasculature or centrally. This study investigates hemodynamics, cardiac function/morphology, and mechanical properties of the central (heart, carotid artery) or peripheral [total peripheral resistance (TPR), forearm vascular bed] vasculature in individuals without (1–2 RFs: n?=?28), or with (?3 RFs: n?=?46) MetS. After adjustments for statin and blood pressure medication use, those with MetS had lower mitral valve E/A ratios (<3 RFs: 1.24?±?0.07; ?3 RFs: 1.01?±?0.04; P?=?0.025), and higher TPR index (<3 RFs: 48?±?2?mmHg/L/min/m2; ?3 RFs: 53?±?2?mmHg/L/min/m2; P?=?0.04). There were no differences in heart size, carotid artery measurements, cardiovagal baroreflex, pulse-wave velocity, stroke volume index, or cardiac output index due to MetS after adjustments for statin and blood pressure medication use. The use of statins was associated with increased inertia in the brachial vascular bed, increased HbA1c and decreased LDL cholesterol. The independent use of anti-hypertensive medication was associated with decreased predicted VO2max, triglycerides, diastolic blood pressure, interventricular septum thickness, calculated left ventricle mass, left ventricle posterior wall thickness, and left ventricle pre-ejection period, but increased carotid stiffness, HDL cholesterol, and heart rate. These data imply that both a central cardiac effect and a peripheral effect of vascular resistance are expressed in MetS. These data also indicate that variance in between-group responses due to pharmacological treatments are important factors to consider in studying cardiovascular changes in these individuals. PMID:22375126

Edgell, H.; Petrella, R. J.; Hodges, G. J.; Shoemaker, J. K.

2012-01-01

182

Type 2 diabetes and cardiovascular disease: Have all risk factors the same strength?  

PubMed Central

Diabetes mellitus is a chronic condition that occurs when the body cannot produce enough or effectively use of insulin. Compared with individuals without diabetes, patients with type 2 diabetes mellitus have a considerably higher risk of cardiovascular morbidity and mortality, and are disproportionately affected by cardiovascular disease. Most of this excess risk is it associated with an augmented prevalence of well-known risk factors such as hypertension, dyslipidaemia and obesity in these patients. However the improved cardiovascular disease in type 2 diabetes mellitus patients can not be attributed solely to the higher prevalence of traditional risk factors. Therefore other non-traditional risk factors may be important in people with type 2 diabetes mellitus. Cardiovascular disease is increased in type 2 diabetes mellitus subjects due to a complex combination of various traditional and non-traditional risk factors that have an important role to play in the beginning and the evolution of atherosclerosis over its long natural history from endothelial function to clinical events. Many of these risk factors could be common history for both diabetes mellitus and cardiovascular disease, reinforcing the postulate that both disorders come independently from “common soil”. The objective of this review is to highlight the weight of traditional and non-traditional risk factors for cardiovascular disease in the setting of type 2 diabetes mellitus and discuss their position in the pathogenesis of the excess cardiovascular disease mortality and morbidity in these patients. PMID:25126392

Martin-Timon, Iciar; Sevillano-Collantes, Cristina; Segura-Galindo, Amparo; del Canizo-Gomez, Francisco Javier

2014-01-01

183

Type 2 diabetes and cardiovascular disease: Have all risk factors the same strength?  

PubMed

Diabetes mellitus is a chronic condition that occurs when the body cannot produce enough or effectively use of insulin. Compared with individuals without diabetes, patients with type 2 diabetes mellitus have a considerably higher risk of cardiovascular morbidity and mortality, and are disproportionately affected by cardiovascular disease. Most of this excess risk is it associated with an augmented prevalence of well-known risk factors such as hypertension, dyslipidaemia and obesity in these patients. However the improved cardiovascular disease in type 2 diabetes mellitus patients can not be attributed solely to the higher prevalence of traditional risk factors. Therefore other non-traditional risk factors may be important in people with type 2 diabetes mellitus. Cardiovascular disease is increased in type 2 diabetes mellitus subjects due to a complex combination of various traditional and non-traditional risk factors that have an important role to play in the beginning and the evolution of atherosclerosis over its long natural history from endothelial function to clinical events. Many of these risk factors could be common history for both diabetes mellitus and cardiovascular disease, reinforcing the postulate that both disorders come independently from "common soil". The objective of this review is to highlight the weight of traditional and non-traditional risk factors for cardiovascular disease in the setting of type 2 diabetes mellitus and discuss their position in the pathogenesis of the excess cardiovascular disease mortality and morbidity in these patients. PMID:25126392

Martín-Timón, Iciar; Sevillano-Collantes, Cristina; Segura-Galindo, Amparo; Del Cañizo-Gómez, Francisco Javier

2014-08-15

184

Lifestyle and cardiovascular disease risk factors as determinants of total cysteine in plasma: the Hordaland Homocysteine Study 1-3  

Microsoft Academic Search

Background: Plasma total homocysteine (tHcy) is a cardiovas- cular disease risk factor and is related to several components of the established cardiovascular disease risk profile. Cysteine is structurally and metabolically related to homocysteine, but data on its association with cardiovascular disease and cardiovascular disease risk factors are sparse. Objective: Our objective was to search for the determinants of plasma total

Lina El-Khairy; Per M Ueland; Ottar Nygård; Helga Refsum; Stein E Vollset

185

C-reactive protein levels in patients at cardiovascular risk: EURIKA study  

PubMed Central

Background Elevated C-reactive protein (CRP) levels are associated with high cardiovascular risk, and might identify patients who could benefit from more carefully adapted risk factor management. We have assessed the prevalence of elevated CRP levels in patients with one or more traditional cardiovascular risk factors. Methods Data were analysed from the European Study on Cardiovascular Risk Prevention and Management in Usual Daily Practice (EURIKA, ClinicalTrials.gov Identifier: NCT00882336), which included patients (aged ?50 years) from 12 European countries with at least one traditional cardiovascular risk factor but no history of cardiovascular disease. Analysis was also carried out on the subset of patients without diabetes mellitus who were not receiving statin therapy. Results In the overall population, CRP levels were positively correlated with body mass index and glycated haemoglobin levels, and were negatively correlated with high-density lipoprotein cholesterol levels. CRP levels were also higher in women, those at higher traditionally estimated cardiovascular risk and those with greater numbers of metabolic syndrome markers. Among patients without diabetes mellitus who were not receiving statin therapy, approximately 30% had CRP levels ?3 mg/L, and approximately 50% had CRP levels ?2 mg/L, including those at intermediate levels of traditionally estimated cardiovascular risk. Conclusions CRP levels are elevated in a large proportion of patients with at least one cardiovascular risk factor, without diabetes mellitus who are not receiving statin therapy, suggesting a higher level of cardiovascular risk than predicted according to conventional risk estimation systems. Trial registration ClinicalTrials.gov Identifier: NCT00882336 PMID:24564178

2014-01-01

186

Association of body mass index and aerobic physical fitness with cardiovascular risk factors in children?  

PubMed Central

Objective: To identify the association between both, body mass index and aerobic fitness, with cardiovascular disease risk factors in children. Methods: Cross-sectional study, carried out in Itaúna-MG, in 2010, with 290 school children ranging from 6 to 10 years-old of both sexes, randomly selected. Children from schools located in the countryside and those with medical restrctions for physical activity were not included. Blood sample was collected after a 12-hour fasting period. Blood pressure, stature and weight were evaluated in accordance with international standards. The following were considered as cardiovascular risk factors: high blood pressure, high total cholesterol, LDL, triglycerides and insulin levels, and low HDL. The statistical analysis included the Spearman's coefficient and the logistic regression, with cardiovascular risk factors as dependent variables. Results: Significant correlations were found, in both sexes, among body mass index and aerobic fitness with most of the cardiovascular risk factors. Children of both sexes with body mass index in the fourth quartile demonstrated increased chances of having high blood insulin and clustering cardiovascular risk factors. Moreover, girls with aerobic fitness in the first quartile also demonstrated increased chances of having high blood insulin and clustering cardiovascular risk factors. Conclusion: The significant associations and the increased chances of having cardiovascular risk factors in children with less aerobic fitness and higher levels of body mass index justify the use of these variables for health monitoring in Pediatrics.

Gonçalves, Reginaldo; Szmuchrowski, Leszek Antony; Damasceno, Vinícius Oliveira; de Medeiros, Marcelo Lemos; Couto, Bruno Pena; Lamounier, Joel Alves

2014-01-01

187

Chronic obstructive pulmonary disease and the risk of cardiovascular diseases  

Microsoft Academic Search

Previous large epidemiological studies reporting on the association between chronic obstructive pulmonary disease (COPD) and\\u000a cardiovascular diseases mainly focussed on prevalent diseases rather than on the incidence of newly diagnosed cardiovascular\\u000a outcomes. We used the UK-based General Practice Research Database (GPRD) to assess the prevalence and incidence of cardiovascular\\u000a diseases in COPD patients aged 40–79 between 1995 and 2005, and

Cornelia Schneider; Ulrich Bothner; Susan S. Jick; Christoph R. Meier

2010-01-01

188

Anxiety and cardiovascular risk: Review of Epidemiological and Clinical Evidence  

PubMed Central

An increasing body of evidence suggests that anxiety is an independent predictor of adverse cardiovascular (CV) events. Individuals with high levels of anxiety are at increased risk of coronary heart disease, congestive heart failure, stroke, fatal ventricular arrhythmias, and sudden cardiac death. Anxiety following a major cardiac event can impede recovery, and is associated with a higher morbidity and mortality. This linkage between anxiety and CV disease is further corroborated by evidence suggesting that treatment of anxiety may improve cardiac symptoms. However, the mechanisms underlying the observed associations are not entirely delineated. Several intermediary mechanisms have been suggested, including sympathetic activation, impaired vagal control, reduced heart rate variability, stimulation of the hypothalamic–pituitary axis, hyperventilation-induced coronary spasm, oxidative stress, increased inflammatory mediators, and unhealthy lifestyle. There is a need for several clinical trials to explicate the complex associations between anxiety and CV disease, which may be compounded by the involvement of other psychosocial factors. In this review, we examine the epidemiological evidence for the association between anxiety and CV disease, and discuss the proposed mechanisms that may be responsible for this association. PMID:21822473

Olafiranye, O; Jean-Louis, G; Zizi, F; Nunes, J; Vincent, MT

2011-01-01

189

Identification of effective screening strategies for cardiovascular disease prevention in a developing country: using cardiovascular risk-estimation and risk-reduction tools for policy recommendations  

PubMed Central

Background Recent increases in cardiovascular risk-factor prevalences have led to new national policy recommendations of universal screening for primary prevention of cardiovascular disease in Malaysia. This study assessed whether the current national policy recommendation of universal screening was optimal, by comparing the effectiveness and impact of various cardiovascular screening strategies. Methods Data from a national population based survey of 24 270 participants aged 30 to 74 was used. Five screening strategies were modelled for the overall population and by gender; universal and targeted screening (four age cut-off points). Screening strategies were assessed based on the ability to detect high cardiovascular risk populations (effectiveness), incremental effectiveness, impact on cardiovascular event prevention and cost of screening. Results 26.7% (95% confidence limits 25.7, 27.7) were at high cardiovascular risk, men 34.7% (33.6, 35.8) and women 18.9% (17.8, 20). Universal screening identified all those at high-risk and resulted in one high-risk individual detected for every 3.7 people screened, with an estimated cost of USD60. However, universal screening resulted in screening an additional 7169 persons, with an incremental cost of USD115,033 for detection of one additional high-risk individual in comparison to targeted screening of those aged ?35 years. The cost, incremental cost and impact of detection of high-risk individuals were more for women than men for all screening strategies. The impact of screening women aged ?45 years was similar to universal screening in men. Conclusions Targeted gender- and age-specific screening strategies would ensure more optimal utilisation of scarce resources compared to the current policy recommendations of universal screening. PMID:23442728

2013-01-01

190

Application of the tissue residue approach in ecological risk assessment.  

PubMed

The objective of this work is to present a critical review of the application of the tissue residue approach (TRA) in ecological risk and/or impact assessment (ERA) of chemical stressors and environmental criteria development. A secondary goal is to develop a framework for integrating the TRA into ecological assessments along with traditional, exposure concentration-based assessment approaches. Although widely recognized for its toxicological appeal, the utility of the TRA in specific applications will depend on numerous factors, such as chemical properties, exposure characteristics, assessment type, availability of tissue residue-response data, and ability to quantify chemical exposure. Therefore, the decision to use the TRA should include an evaluation of the relative strengths, limitations, and uncertainties among exposure and residue-based methods for characterizing toxicological effects. Furthermore, rather than supplanting exposure concentration-based toxicity assessments, the TRA can be highly effective for evaluating and reducing uncertainty when used in a complementary manner (e.g., when evaluating multiple lines of evidence in field studies). To address limitations with the available tissue residue-response data, approaches for extrapolating residue-based toxicity data across species, tissues, and exposure durations are discussed. Some of these approaches rely on predicted residue-response relationships or toxicological models that have an implicit residue-response basis (e.g., biotic ligand model). Because risk to an organism is a function of both its exposure potential and inherent sensitivity (i.e., on a residue basis), bioaccumulation models will be required not only for translating tissue residue criteria into corresponding water and sediment criteria, but also for defining the most vulnerable species in an assemblage (i.e., highly exposed and highly sensitive species). Application of the TRA in ecological assessments and criteria development are summarized for bioaccumulative organic chemicals, TBT, and in situ bioassays using bivalve molluscs. PMID:21184572

Sappington, Keith G; Bridges, Todd S; Bradbury, Steven P; Erickson, Russell J; Hendriks, A Jan; Lanno, Roman P; Meador, James P; Mount, David R; Salazar, Mike H; Spry, Doug J

2011-01-01

191

Indications for and utilization of angiotensin receptor II blockers in patients at high cardiovascular risk.  

PubMed

The worldwide burden of cardiovascular disease is growing. In addition to lifestyle changes, pharmacologic agents that can modify cardiovascular disease processes have the potential to reduce cardiovascular events. Antihypertensive agents are widely used to reduce the risk of cardiovascular events partly beyond that of blood pressure-lowering. In particular, the angiotensin II receptor blockers (ARBs), which antagonize the vasoconstrictive and proinflammatory/pro-proliferative effects of angiotensin II, have been shown to be cardio vascularly protective and well tolerated. Although the eight currently available ARBs are all indicated for the treatment of hypertension, they have partly different pharmacology, and their pharmacokinetic and pharmacodynamic properties differ. ARB trials for reduction of cardiovascular risk can be broadly categorized into those in patients with/without hypertension and additional risk factors, in patients with evidence of cardiovascular disease, and in patients with severe cardiovascular disease, such as heart failure. These differences have led to their indications in different populations. For hypertensive patients with left ventricular hypertrophy, losartan was approved to have an indication for stroke prevention, while for most patients at high-risk for cardiovascular events, telmisartan is an appropriate therapy because it has a cardiovascular preventive indication. Other ARBs are indicated for narrowly defined high-risk patients, such as those with hypertension or heart failure. Although in one analysis a possible link between ARBs and increased risks of cancer has surfaced, several meta-analyses, using the most comprehensive data available, have found no link between any ARB, or the class as a whole, and cancer. Most recently, the US Food and Drug Administration completed a review of the potential risk of cancer and concluded that treatment with an ARB medication does not increase the risk of developing cancer. This review discusses the clinical evidence supporting the different indications for each of the ARBs and the outstanding safety of this drug class. PMID:22102784

Farsang, Csaba

2011-01-01

192

Cardiovascular Risks Associated with Low Dose Ionizing Particle Radiation  

PubMed Central

Previous epidemiologic data demonstrate that cardiovascular (CV) morbidity and mortality may occur decades after ionizing radiation exposure. With increased use of proton and carbon ion radiotherapy and concerns about space radiation exposures to astronauts on future long-duration exploration-type missions, the long-term effects and risks of low-dose charged particle irradiation on the CV system must be better appreciated. Here we report on the long-term effects of whole-body proton (1H; 0.5 Gy, 1 GeV) and iron ion (56Fe; 0.15 Gy, 1GeV/nucleon) irradiation with and without an acute myocardial ischemia (AMI) event in mice. We show that cardiac function of proton-irradiated mice initially improves at 1 month but declines by 10 months post-irradiation. In AMI-induced mice, prior proton irradiation improved cardiac function restoration and enhanced cardiac remodeling. This was associated with increased pro-survival gene expression in cardiac tissues. In contrast, cardiac function was significantly declined in 56Fe ion-irradiated mice at 1 and 3 months but recovered at 10 months. In addition, 56Fe ion-irradiation led to poorer cardiac function and more adverse remodeling in AMI-induced mice, and was associated with decreased angiogenesis and pro-survival factors in cardiac tissues at any time point examined up to 10 months. This is the first study reporting CV effects following low dose proton and iron ion irradiation during normal aging and post-AMI. Understanding the biological effects of charged particle radiation qualities on the CV system is necessary both for the mitigation of space exploration CV risks and for understanding of long-term CV effects following charged particle radiotherapy. PMID:25337914

Yan, Xinhua; Sasi, Sharath P.; Gee, Hannah; Lee, JuYong; Yang, Yongyao; Mehrzad, Raman; Onufrak, Jillian; Song, Jin; Enderling, Heiko; Agarwal, Akhil; Rahimi, Layla; Morgan, James; Wilson, Paul F.; Carrozza, Joseph; Walsh, Kenneth; Kishore, Raj; Goukassian, David A.

2014-01-01

193

Modifiable cardiovascular risk factors in patients with ankylosing spondylitis.  

PubMed

The aim of this study was to evaluate whether modifiable cardiovascular disease (CVD) risk factors, e.g. atherogenic blood lipids, hypertension and lifestyle-related factors such as smoking, diet and physical inactivity, differ among patients with ankylosing spondylitis (AS) in comparison to the general population. Eighty-eight patients diagnosed with AS were identified by analysis of the databases of a previous community intervention programme, the Västerbotten intervention programme. The patients were compared with 351 controls matched for age, sex and study period. These databases include the results of blood samples analysed for cholesterol, triglycerides and plasma glucose, as well as data on hypertension, height, weight, smoking and dietary habits and physical activity. No significant differences were found between patients and controls regarding hypertension, body mass index, physical activity, diet or smoking. Levels of serum triglycerides (p?risk factors for CVD compared with the general population. Hence, the increased presence of CVD in patients with AS may be caused by other factors such as differences in metabolism and medication such as NSAID or the chronic low-grade inflammation present in the disease. PMID:24135890

Sundström, Björn; Johansson, Gunnar; Johansson, Ingegerd; Wållberg-Jonsson, Solveig

2014-01-01

194

Depression and cardiovascular disease: an update on how course of illness may influence risk.  

PubMed

Depression constitutes a novel and independent risk factor for cardiovascular disease, which despite extensive support in the literature has been underappreciated. While much of the evidence for depression as a risk factor for cardiovascular disease is based on studies following myocardial infarction, the elevated vascular risk conveyed by depression is not confined to periods following acute coronary syndromes. For that matter, the risk appears across mood disorders with evidence for even greater risk in bipolar disorder. This review summarizes the literature linking depressive disorders to cardiovascular mortality with a focus on how the course of illness of mood disorders may influence this risk. Mood disorders may influence risk over decades of illness in a dose-response to symptom burden, or the persistence of affective symptomatology. This may be mediated through changes in the activity of the autonomic nervous system, the hypothalamic-pituitary-adrenal axis, and inflammatory cytokines. Whether treatment of depression can mitigate this risk is not established although there are suggestions to support this contention, which could be better studied with more effective treatments of depression and larger standardized samples. Directions for future study of mechanisms and treatment are discussed. Regardless of causal mechanisms, persons with depressive disorders and other risk factors for vascular disease represent a neglected, high-risk group for cardiovascular events. In addition to the appropriate treatment for depression, screening and optimized management of traditional risk factors for cardiovascular diseases is necessary. PMID:25163592

Fiedorowicz, Jess G

2014-10-01

195

Sex differences in lifetime risk and first manifestation of cardiovascular disease: prospective population based cohort study  

PubMed Central

Objective To evaluate differences in first manifestations of cardiovascular disease between men and women in a competing risks framework. Design Prospective population based cohort study. Setting People living in the community in Rotterdam, the Netherlands. Participants 8419 participants (60.9% women) aged ?55 and free from cardiovascular disease at baseline. Main outcome measures First diagnosis of coronary heart disease (myocardial infarction, revascularisation, and coronary death), cerebrovascular disease (stroke, transient ischaemic attack, and carotid revascularisation), heart failure, or other cardiovascular death; or death from non-cardiovascular causes. Data were used to calculate lifetime risks of cardiovascular disease and its first incident manifestations adjusted for competing non-cardiovascular death. Results During follow-up of up to 20.1 years, 2888 participants developed cardiovascular disease (826 coronary heart disease, 1198 cerebrovascular disease, 762 heart failure, and 102 other cardiovascular death). At age 55, overall lifetime risks of cardiovascular disease were 67.1% (95% confidence interval 64.7% to 69.5%) for men and 66.4% (64.2% to 68.7%) for women. Lifetime risks of first incident manifestations of cardiovascular disease in men were 27.2% (24.1% to 30.3%) for coronary heart disease, 22.8% (20.4% to 25.1%) for cerebrovascular disease, 14.9% (13.3% to 16.6%) for heart failure, and 2.3% (1.6% to 2.9%) for other deaths from cardiovascular disease. For women the figures were 16.9% (13.5% to 20.4%), 29.8% (27.7% to 31.9%), 17.5% (15.9% to 19.2%), and 2.1% (1.6% to 2.7%), respectively. Differences in the number of events that developed over the lifespan in women compared with men (per 1000) were ?7 for any cardiovascular disease, ?102 for coronary heart disease, 70 for cerebrovascular disease, 26 for heart failure, and ?1 for other cardiovascular death; all outcomes manifested at a higher age in women. Patterns were similar when analyses were restricted to hard atherosclerotic cardiovascular disease outcomes, but absolute risk differences between men and women were attenuated for both coronary heart disease and stroke. Conclusions At age 55, though men and women have similar lifetime risks of cardiovascular disease, there are considerable differences in the first manifestation. Men are more likely to develop coronary heart disease as a first event, while women are more likely to have cerebrovascular disease or heart failure as their first event, although these manifestations appear most often at older ages. PMID:25403476

Leening, Maarten J G; Ferket, Bart S; Steyerberg, Ewout W; Kavousi, Maryam; Deckers, Jaap W; Nieboer, Daan; Heeringa, Jan; Portegies, Marileen L P; Hofman, Albert; Ikram, M Arfan; Hunink, M G Myriam; Franco, Oscar H; Witteman, Jacqueline C M; Roos-Hesselink, Jolien W

2014-01-01

196

Effects of thyroid hormones on major cardiovascular risk in acute coronary syndromes  

E-print Network

P1 Effects of thyroid hormones on major cardiovascular risk in acute coronary syndromes A Bayrak1 In this study we aimed to investigate the relationship between thyroid hormone abnormalities and major cardiac death and major cardiovascular events. The relationship between thyroid hormone levels and acute

197

Biomarkers of endothelial dysfunction, cardiovascular risk factors and atherosclerosis in rheumatoid arthritis  

Microsoft Academic Search

Cardiovascular event rates are markedly increased in rheumatoid arthritis (RA), and RA atherogenesis remains poorly understood. The relative contributions of traditional and nontraditional risk factors to cardiovascular disease in RA await elucidation. The present study comprises three components. First, we compared biomarkers of endothelial dysfunction (vascular cell adhesion molecule [VCAM]-1, intercellular adhesion molecule [ICAM]-1 and endothelial leucocyte adhesion molecule [ELAM]-1)

Patrick H Dessein; Barry I Joffe; Sham Singh

2005-01-01

198

Aortic Pulse Wave Velocity as a Marker of Cardiovascular Risk in Hypertensive Patients  

Microsoft Academic Search

Large artery damage is a major contributory factor to cardiovascular morbidity and mortality of patients with hypertension. Pulse wave velocity (PWV), a classic evaluation of arterial distensibility, has never been ascertained as a cardiovascular risk marker. To determine the factors influencing aortic PWV and the potential predictor role of this measurement, we studied a cohort of 710 patients with essential

Jacques Blacher; Roland Asmar; Saliha Djane; Gerard M. London; Michel E. Safar

199

Cardiovascular risk in the young type 1 diabetes population with a low 10-year, but high lifetime risk of cardiovascular disease.  

PubMed

Diabetes mellitus is associated with excess cardiovascular mortality that is evident in all age groups, but is most pronounced in young people with type 1 diabetes. Cardiovascular risk estimation models generally estimate the probability of future events over a 10-year time horizon. Due to the dependency on age, children and adolescents with type 1 diabetes would be considered at low short-term risk but high life-time risk of developing a cardiovascular event. Guidelines recommend screening particularly for microvascular complications including nephropathy and retinopathy beginning around puberty. Identification of early microvascular abnormalities in children and adolescents not only predict later development of long-term microvascular complications and further end-organ damage but are associated with an increased risk for future macrovascular events. This may be because of the fact that the same glycaemic mechanisms responsible for the occurrence of microvascular disease may also apply to the development of atherosclerosis. Alternatively, interventions that reduce the development of microvascular end-organ damage may also delay the development of associated macrovascular disease. Screening for subclinical atherosclerosis, especially in the coronary and carotid vessels, has been advocated as a means of detecting early atherosclerotic disease in asymptomatic individuals with the aim of potentially reclassifying cardiovascular risk and guiding therapeutic interventions. Currently there is no randomized clinical trial evidence that additional screening using non-invasive imaging techniques alters cardiovascular disease outcomes. We do not know the best approach or combination of approaches to assess risk and reduce cardiovascular disease burden in type 1 diabetes mellitus. All screening interventions carry harms as well as benefits and until further evidence becomes available additional screening using non-invasive imaging tests for the detection of subclinical atherosclerosis cannot be currently recommended for patients with type 1 diabetes. PMID:22998614

McVeigh, G E; Gibson, W; Hamilton, P K

2013-03-01

200

The Impact of C Reactive Protein on Global Cardiovascular Risk on Patients with Coronary Artery Disease  

PubMed Central

Introduction. Cardiovascular disease (CVD) is the major cause of premature death worldwide. Hundreds of risk factors have been associated with cardiovascular disease. Recent extensive evidence supports inflammation as a key pathogenetic mechanism in the development and progression of atherosclerosis and in triggering clinical atherothrombotic CVD events. C-reactive protein (CRP) is one possible marker of vascular inflammation and plays a direct role in promoting vascular inflammation, vessel damage and clinical CVD events. Material and method. The purpose of this study was to evaluate the correlation between CRP level and the global cardiovascular risk. We evaluated 100 patients with cardiovascular risk factors, using the systematic coronary risk evalution (SCORE) charts for high risk regions of Europe and we determined the CRP level, using the nephelometric method. Results. By their SCORE chart, 44% of the patients are in the moderate risk category, and almost 40% in the high risk category, the rest of them (16%) are in the low and very high risk category. A statistically significant p value (p<0.05) was observed between patients with CRP<10mg/L, who had a lower sistolic blood pressure than patients with CRP?10mg/L, Conclusion. The CRP level over 10mg/L is correlated with an over 4% risk of developing a fatal CVD in 10 years. The acute phase reactant, CRP, a simple downstream marker of inflammation, has now emerged as a major cardiovascular risk factor. PMID:24778862

Cozlea, D.L.; Farcas, D.M.; Nagy, A.; Keresztesi, A.A.; Tifrea, Ramona; Cozlea, L.; Carasca, E.

2013-01-01

201

Industrial Espionage from Residual Data: Risks and Countermeasures  

Microsoft Academic Search

This paper outlines the possible recovery of potentially sensitive corporate information from residual data. It outlines previous work on the recovery of information contained on second hand hard disks and handheld devices and discusses the risk of individuals conducting industrial espionage by targeting specific organizations. It examines the possible avenues for an attacker to obtain a storage device, then discusses

Iain Sutherland; Andrew Jones

2008-01-01

202

Multidisciplinary structured lifestyle intervention reduces the estimated risk of cardiovascular morbidity and mortality  

PubMed Central

Background Current guidelines for prevention and treatment of cardiovascular disease (CVD) emphasise the importance of a healthy lifestyle. However, successful lifestyle intervention is proving to be a challenge for healthcare professionals. Objectives Evaluation of the effect of lifestyle intervention on cardiovascular risk factors, on reaching treatment targets and on the estimated risk of cardiovascular morbidity and mortality. Methods The effect of a six-month multidisciplinary structured lifestyle intervention programme was assessed in 186 patients with and without a history of CVD. Results Multidisciplinary structured lifestyle intervention reduced the estimated ten-year risk of cardiovascular morbidity and mortality. The relative risk reduction was similar in patients with and without a history of CVD, the absolute risk reduction was higher in patients with a history of CVD. In both groups blood pressure and body weight decreased, and the maximal work rate and maximal oxygen uptake increased significantly. Blood levels of total cholesterol and cholesterol/HDL ratio decreased significantly in patients with a history of CVD. In addition, target levels for blood pressure and physical fitness were more frequently reached in both patient groups. Conclusion Multidisciplinary structured lifestyle intervention had beneficial effects on cardiovascular risk factors. Relative risk reduction was similar in patients with and without evidence of cardiovascular disease. Follow-up is needed to see how well these effects can be maintained.

Sprangers, R.L.H.; Stam, F.; Smid, H.E.C.; Stehouwer, C.D.A.; Hellemans, I.M.

2004-01-01

203

Longitudinal Genome-Wide Association of Cardiovascular Disease Risk Factors in the Bogalusa Heart Study  

E-print Network

Cardiovascular disease (CVD) is the leading cause of death worldwide. Recent genome-wide association (GWA) studies have pinpointed many loci associated with CVD risk factors in adults. It is unclear, however, if these loci ...

Peltonen, Leena

204

High-Oleic Ground Beef and Risk Factors for Cardiovascular Disease in Men and Postmenopausal Women  

E-print Network

of fatty acid composition of ground beef on selected cardiovascular disease risk indicators was evaluated with two primary goals. The first goal was to document effects of ground beef fatty acid composition on plasma lipoprotein concentrations, whereas...

Ghahramany, Ghazal

2012-07-16

205

Importance of cardiovascular disease risk management in patients with type 2 diabetes mellitus  

PubMed Central

Type 2 diabetes mellitus (T2DM) is commonly accompanied by other cardiovascular disease (CVD) risk factors, such as hypertension, obesity, and dyslipidemia. Furthermore, CVD is the most common cause of death in people with T2DM. It is therefore of critical importance to minimize the risk of macrovascular complications by carefully managing modifiable CVD risk factors in patients with T2DM. Therapeutic strategies should include lifestyle and pharmacological interventions targeting hyperglycemia, hypertension, dyslipidemia, obesity, cigarette smoking, physical inactivity, and prothrombotic factors. This article discusses the impact of modifying these CVD risk factors in the context of T2DM; the clinical evidence is summarized, and current guidelines are also discussed. The cardiovascular benefits of smoking cessation, increasing physical activity, and reducing low-density lipoprotein cholesterol and blood pressure are well established. For aspirin therapy, any cardiovascular benefits must be balanced against the associated bleeding risk, with current evidence supporting this strategy only in certain patients who are at increased CVD risk. Although overweight, obesity, and hyperglycemia are clearly associated with increased cardiovascular risk, the effect of their modification on this risk is less well defined by available clinical trial evidence. However, for glucose-lowering drugs, further evidence is expected from several ongoing cardiovascular outcome trials. Taken together, the evidence highlights the value of early intervention and targeting multiple risk factors with both lifestyle and pharmacological strategies to give the best chance of reducing macrovascular complications in the long term. PMID:24920930

Lorber, Daniel

2014-01-01

206

Differences in cardiovascular risk factors in rural, urban and rural-to-urban migrants in Peru  

Microsoft Academic Search

ObjectivesTo assess differences in cardiovascular risk profiles among rural-to-urban migrants and non-migrant groups.MethodsCross-sectional study in Ayacucho and Lima, Peru. Participants were: rural (n=201); rural-to-urban migrants (n=589); and urban (n=199). Cardiovascular risk factors were assessed according to migrant status (migrants vs non-migrants), age at first migration, length of residency in an urban area and lifetime exposure to an urban area.ResultsFor most

J Jaime Miranda; Robert H Gilman; Liam Smeeth

2011-01-01

207

Outcomes of National Community Organization Cardiovascular Prevention Programs for High-Risk Women  

Microsoft Academic Search

The purpose of this study was to reduce cardiovascular disease (CVD) risk in women by implementing a cardiovascular prevention\\u000a health promotion program in faith- and community-based sites. The primary outcomes were reducing obesity and increasing physical\\u000a activity. A longitudinal cohort of high-risk (age?>?40, ethnic minority) women (n?=?1,052) was enrolled at 32 sites across the USA. The pre- or post-educational intervention

Amparo C. Villablanca; Shavon Arline; Jacqui Lewis; Sekar Raju; Susan Sanders; Shannon Carrow

2009-01-01

208

Hypertension and Obesity as Cardiovascular Risk Factors among HIV Seropositive Patients in Western Kenya  

Microsoft Academic Search

BackgroundThere is increased risk of cardiovascular disease among HIV seropositive individuals. The prevalence of HIV is highest in sub-Saharan Africa; however, HIV-related cardiovascular risk research is largely derived from developed country settings. Herein, we describe the prevalence of hypertension and obesity in a large HIV treatment program in Kenya.MethodsWe performed a retrospective analysis of the electronic medical records of a

Gerald S. Bloomfield; Joseph W. Hogan; Alfred Keter; Edwin Sang; E. Jane Carter; Eric J. Velazquez; Sylvester Kimaiyo

2011-01-01

209

Individual social class, area-based deprivation, cardiovascular disease risk factors, and mortality: the Renfrew and Paisley Study  

Microsoft Academic Search

OBJECTIVE: To investigate the associations of individual and area-based socioeconomic indicators with cardiovascular disease risk factors and mortality. DESIGN: Prospective study. SETTING: The towns of Renfrew and Paisley in the west of Scotland. PARTICIPANTS: 6961 men and 7991 women included in a population-based cardiovascular disease screening study between 1972 and 1976. MAIN OUTCOME MEASURES: Cardiovascular disease risk factors and cardiorespiratory

G. D. Smith; C. Hart; G. Watt; D. Hole; V. Hawthorne

1998-01-01

210

Comorbidities and Cardiovascular Disease Risk in Older Breast Cancer Survivors  

PubMed Central

Objective To evaluate cardiovascular disease (CVD) risk factors in older breast cancer survivors compared with a group of women without breast cancer. Study Design The retrospective study included (1) women aged 65 or more years who were initially diagnosed with stage I or II breast cancer from 1990 to 1994 in 6 US health plans and who survived at least 5 years postdiagnosis (cases) and (2) a matched comparison group. They were followed for a maximum of 15 years. Methods Data sources included medical charts and electronic health records. Cases (n = 1361) were matched on age, health plan site, and enrollment year to women in the comparison group (n = 1361). Subjects were followed to the first CVD outcome, health plan disenrollment, death, or study end. We compared rates of CVD in these 2 groups and used Cox proportional hazard models to estimate the hazard ratio (HR), considering body mass index, smoking history, diabetes, and hypertension. Results The strongest predictors of CVD were smoking history (HR = 1.29; 95% confidence interval [CI], 1.15–1.46), diabetes (HR = 1.72; 95% CI, 1.48–1.99), and hypertension (HR = 1.48; 95% CI, 1.31–1.67) rather than breast cancer case-comparison status (HR = 0.97; 95% CI, 0.87–1.09). Conclusion Results suggest that long-term prognosis in breast cancer patients is affected by management of preexisting conditions. Assessment of comorbid conditions and effective management of diabetes and hypertension in older breast cancer survivors may lead to longer overall survival. PMID:24512167

Haque, Reina; Prout, Marianne; Geiger, Ann M.; Kamineni, Aruna; Thwin, Soe Soe; Avila, Chantal; Silliman, Rebecca A.; Quinn, Virginia; Yood, Marianne Ulcickas

2014-01-01

211

Audit of Cardiovascular Disease Risk Factors among Supported Adults with Intellectual Disability Attending an Ageing Clinic  

ERIC Educational Resources Information Center

Background: Little is known about the cardiovascular disease (CVD) risk factor profile for older adults with intellectual disability (ID). As many CVD risk factors are treatable by lifestyle changes, confirmation of the risk factor profile for older adults with ID could substantially impact upon preventive health practices for this group. Method:…

Wallace, Robyn A.; Schluter, Philip

2008-01-01

212

Determining cardiovascular disease risk in elementary school children: Developing a healthy heart score  

Microsoft Academic Search

At least 50% of children have one or more cardiovascular dis- ease (CVD) risk factor. We aimed to 1) determine the preva- lence of CVD risk factors in a sample of Canadian children, and 2) create a Healthy Heart Score that could be used in a school setting, to identify children with a greater number and severity of CVD risk

Kate E. Reed; Darren E. R. Warburton; Heather A. McKay

213

Harnessing Health IT for Improved Cardiovascular Risk Management  

Microsoft Academic Search

Robyn Whittaker and colleagues argue that IT-based programs can improve cardiovascular disease management and patient empowerment, but must be accompanied by supportive social and political environments and active patient and clinician engagement.

Sue Wells; Robyn Whittaker; Enid Dorey; Chris Bullen

2010-01-01

214

Novel Measures of Heart Rate Variability Predict Cardiovascular Mortality in Older Adults Independent of Traditional Cardiovascular Risk Factors  

PubMed Central

Novel HRV Predicts CV Mortality in the Elderly Background It is unknown whether abnormal heart rate turbulence (HRT) and abnormal fractal properties of heart rate variability identify older adults at increased risk of cardiovascular death (CVdth). Methods Data from 1,172 community-dwelling adults, ages 72 ± 5 (65–93) years, who participated in the Cardiovascular Health Study (CHS), a study of risk factors for CV disease in people ?65 years. HRT and the short-term fractal scaling exponent (DFA1) derived from 24-hour Holter recordings. HRT categorized as: normal (turbulence slope [TS] and turbulence onset [TO] normal) or abnormal (TS and/or TO abnormal). DFA1 categorized as low (?1) or high (>1). Cox regression analyses stratified by Framingham Risk Score (FRS) strata (low = <10, mid = 10–20, and high >20) and adjusted for prevalent clinical cardiovascular disease (CVD), diabetes, and quartiles of ventricular premature beat counts (VPCs). Results CVdths (N = 172) occurred over a median follow-up of 12.3 years. Within each FRS stratum, low DFA1+abnormal HRT predicted risk of CVdth (RR=7.7 for low FRS; 3.6, mid FRS; 2.8, high FRS). Among high FRS stratum participants, low DFA1 alone also predicted CVdth (RR = 2.0). VPCs in the highest quartile predicted CVdth, but only in the high FRS group. Clinical CV disease predicted CVdth at each FRS stratum (RR = 2.9, low; 2.6, mid; and 1.9, high). Diabetes predicted CVdth in the highest FRS group only (RR = 2.2). Conclusions The combination of low DFA1 + abnormal HRT is a strong risk factor for CVdth among older adults even after adjustment for conventional CVD risk measures and the presence of CVD. PMID:18631274

STEIN, PHYLLIS K.; BARZILAY, JOSHUA I.; CHAVES, PAULO H.M.; MISTRETTA, STEPHANIE Q.; DOMITROVICH, PETER P.; GOTTDIENER, JOHN S.; RICH, MICHAEL W.; KLEIGER, ROBERT E.

2013-01-01

215

Approach to Dyslipidemia, Lipodystrophy, and Cardiovascular Risk in Patients with HIV Infection  

PubMed Central

There is a significant prevalence (20%–80% depending on the population and the study) of lipid disorders and other cardiovascular risk factors in people living with HIV infection. This review focuses on HIV and HIV treatment–associated metabolic and cardiovascular concerns, including dyslipidemias, lipodystrophy syndromes, endothelial dysfunctions, and associated metabolic events such as insulin resistance. Emerging hypotheses of the underlying pathophysiology of these issues, with impact on selection of specific antiretroviral treatment (ART) strategies, therapy, and preventive approaches to decreasing cardiovascular risk and other problems associated with these syndromes are discussed. Screening for cardiovascular risk as part of the decision of starting antiretroviral therapy, and during care of patients with HIV regardless of ART therapy status, is suggested with particular areas of focus. Statins, other hyperlipidemic therapies, treatment for specific problems arising due to lipodystrophy, and implications on ART selection to avoid drug interactions and adverse effects are also discussed. PMID:21181310

2010-01-01

216

Cardiovascular disease risk in adult women with congenital adrenal hyperplasia due to 21-hydroxylase deficiency.  

PubMed

Congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency is a common autosomal recessive disorder characterized by impaired cortisol biosynthesis, with or without aldosterone deficiency, and androgen excess. Patients with the classic (severe) form also have epinephrine deficiency. Patients with CAH have an increased prevalence of risk factors for cardiovascular disease including obesity, hypertension, and insulin resistance. Androgen excess in women appears to be an additional risk factor for cardiovascular disease. Carotid intima-media thickness, a measure of subclinical atherosclerosis, also has been found to be increased in adults with CAH. The multiple hormonal imbalances present in the adult woman with CAH, in combination with chronic glucocorticoid therapy, contribute to cardiovascular disease risk. Further investigation of the predisposition to cardiovascular disease in women with CAH is warranted. Longitudinal studies are needed, and interventions targeting obesity, insulin resistance, hypertension, and hyperandrogenism may offer improved outcome. PMID:19530065

Kim, Mimi S; Merke, Deborah P

2009-07-01

217

When does cardiovascular risk start? Past and present socioeconomic circumstances and risk factors in adulthood  

PubMed Central

STUDY OBJECTIVES: To compare associations of childhood and adult socioeconomic position with cardiovascular risk factors measured in adulthood. To estimate the effects of adult socioeconomic position after adjustment for childhood circumstances. DESIGN: Cross sectional survey, using the relative index of inequality method to compare socioeconomic differences at different life stages. SETTING: The Whitehall II longitudinal study of men and women employed in London offices of the Civil Service at study baseline in 1985-88. PARTICIPANTS: 4774 men and 2206 women born in the period 1930-53 who were administered questions on early socioeconomic circumstances. MAIN RESULTS: Adult occupational position (employment grade) was inversely associated (high status-low risk) with current smoking and leisure time physical inactivity, with waist/height, and with metabolic risk factors HDL cholesterol, triglycerides, post-load glucose and fibrinogen. Associations of these variables with childhood socioeconomic position (father's Registrar General Social Class) were weaker or absent, with the exception of smoking in women. Childhood social position was associated with adult weight in both sexes and with current smoking, waist/height, HDL cholesterol and fibrinogen in women. Height, a measure of health capital or constitution, was weakly linked with father's social class and more strongly linked with own employment grade. The combination of childhood disadvantage (low father's class) together with a low status clerical occupation in men was particularly associated with higher body mass index as an adult (interaction test p < 0.001). Adjustment for earlier socioeconomic position--using father's class and own education level simultaneously--did not weaken the effects of adult socioeconomic position, except in the case of smoking in women, when the grade effect was reduced by 59 per cent. CONCLUSIONS: Cardiovascular risk factors in adulthood were in general more strongly related to adult than to childhood socioeconomic position. Among women but not men there was a strong but unexplained link between father's class and adult smoking habit. In both sexes degree of obesity was associated with both childhood and adulthood social position. These findings suggest that the socially patterned accumulation of health capital and cardiovascular risk begins in childhood and continues, according to socioeconomic position, during adulthood.   PMID:10656084

Brunner, E.; Shipley, M. J.; Blane, D.; Smith, G. D.; Marmot, M. G.

1999-01-01

218

Cardiovascular risk assessment in low-resource settings: a consensus document of the European Society of Hypertension Working Group on Hypertension and Cardiovascular Risk in Low Resource Settings  

PubMed Central

The Global Burden of Diseases, Injuries, and Risk Factors Study 2010 confirms ischemic heart disease and stroke as the leading cause of death and that hypertension is the main associated risk factor worldwide. How best to respond to the rising prevalence of hypertension in resource-deprived settings is a topic of ongoing public-health debate and discussion. In low-income and middle-income countries, socioeconomic inequality and cultural factors play a role both in the development of risk factors and in the access to care. In Europe, cultural barriers and poor communication between health systems and migrants may limit migrants from receiving appropriate prevention, diagnosis, and treatment. To use more efficiently resources available and to make treatment cost-effective at the patient level, cardiovascular risk approach is now recommended. In 2011, The European Society of Hypertension established a Working Group on ‘Hypertension and Cardiovascular risk in low resource settings’, which brought together cardiologists, diabetologists, nephrologists, clinical trialists, epidemiologists, economists, and other stakeholders to review current strategies for cardiovascular risk assessment in population studies in low-income and middle-income countries, their limitations, possible improvements, and future interests in screening programs. This report summarizes current evidence and presents highlights of unmet needs. PMID:24577410

Modesti, Pietro A.; Agostoni, Piergiuseppe; Agyemang, Charles; Basu, Sanjay; Benetos, Athanase; Cappuccio, Francesco P.; Ceriello, Antonio; Del Prato, Stefano; Kalyesubula, Robert; O'Brien, Eoin; Kilama, Michael O.; Perlini, Stefano; Picano, Eugenio; Reboldi, Gianpaolo; Remuzzi, Giuseppe; Stuckler, David; Twagirumukiza, Marc; Van Bortel, Luc M.; Watfa, Ghassan; Zhao, Dong; Parati, Gianfranco

2014-01-01

219

Cardiovascular risk assessment in low-resource settings: a consensus document of the European Society of Hypertension Working Group on Hypertension and Cardiovascular Risk in Low Resource Settings.  

PubMed

The Global Burden of Diseases, Injuries, and Risk Factors Study 2010 confirms ischemic heart disease and stroke as the leading cause of death and that hypertension is the main associated risk factor worldwide. How best to respond to the rising prevalence of hypertension in resource-deprived settings is a topic of ongoing public-health debate and discussion. In low-income and middle-income countries, socioeconomic inequality and cultural factors play a role both in the development of risk factors and in the access to care. In Europe, cultural barriers and poor communication between health systems and migrants may limit migrants from receiving appropriate prevention, diagnosis, and treatment. To use more efficiently resources available and to make treatment cost-effective at the patient level, cardiovascular risk approach is now recommended. In 2011, The European Society of Hypertension established a Working Group on 'Hypertension and Cardiovascular risk in low resource settings', which brought together cardiologists, diabetologists, nephrologists, clinical trialists, epidemiologists, economists, and other stakeholders to review current strategies for cardiovascular risk assessment in population studies in low-income and middle-income countries, their limitations, possible improvements, and future interests in screening programs. This report summarizes current evidence and presents highlights of unmet needs. PMID:24577410

Modesti, Pietro A; Agostoni, Piergiuseppe; Agyemang, Charles; Basu, Sanjay; Benetos, Athanase; Cappuccio, Francesco P; Ceriello, Antonio; Del Prato, Stefano; Kalyesubula, Robert; O'Brien, Eoin; Kilama, Michael O; Perlini, Stefano; Picano, Eugenio; Reboldi, Gianpaolo; Remuzzi, Giuseppe; Stuckler, David; Twagirumukiza, Marc; Van Bortel, Luc M; Watfa, Ghassan; Zhao, Dong; Parati, Gianfranco

2014-05-01

220

Snacking patterns, diet quality, and cardiovascular risk factors in adults  

PubMed Central

Background The relationship of snacking patterns on nutrient intake and cardiovascular risk factors (CVRF) in adults is unknown. The aim of this study was to examine the associations of snacking patterns with nutrient intake, diet quality, and a selection of CVRF in adults participating in the 2001-2008 National Health and Nutrition Examination Survey. Methods 24-hour dietary recalls were used to determine intake and cluster analysis was used to identify the snacking patterns. Height and weight were obtained and the health indices that were evaluated included diastolic and systolic blood pressure, high density lipoprotein-cholesterol, low density lipoprotein cholesterol, triacylglycerides, blood glucose, and insulin. Results The sample was participants (n = 18,988) 19+ years (50% males; 11% African-Americans; 72% white, 12% Hispanic-Americans, and 5% other). Cluster analyses generated 12 distinct snacking patterns, explaining 61% of the variance in snacking. Comparisons of snacking patterns were made to the no snack pattern. It was found that miscellaneous snacks constituted the most common snacking pattern (17%) followed by cakes/cookies/pastries (12%) and sweets (9%). Most snacking patterns were associated with higher energy intakes. Snacking patterns cakes/cookies/pastries, vegetables/legumes, crackers/salty snacks, other grains and whole fruit were associated with lower intakes of saturated fatty acids. Added sugars intakes were higher in the cakes/cookies/pastries, sweets, milk desserts, and soft drinks patterns. Five snack patterns (cakes/cookies/pastries, sweets, vegetable/legumes, milk desserts, soft drinks) were associated with lower sodium intakes. Several snack patterns were associated with higher intakes of potassium, calcium, fiber, vitamin A, and magnesium. Five snacking patterns (miscellaneous snacks; vegetables/legumes; crackers/salty snacks; other grains; and whole fruit) were associated with better diet quality scores. Alcohol was associated with a lower body mass index and milk desserts were associated with a lower waist circumference. No snack patterns were associated with other CVRF studied. Conclusions Overall, several snacking patterns were associated with better diet quality than those consuming no snacks. Yet, the majority of the snacking patterns were not associated with CVRF. Education is needed to improve snacking patterns in terms of nutrients to limit in the diet along with more nutrient-dense foods to be included in snacks. PMID:24754905

2014-01-01

221

Influence of the Flushing Response in the Relationship between Alcohol Consumption and Cardiovascular Disease Risk  

PubMed Central

Background The purpose of this study was to examine the relationship between cardiovascular disease risk and alcohol consumption according to facial flushing after drinking among Korean men. Methods The subjects were 1,817 Korean men (non-drinker group, 283 men; drinking-related facial flushing group, 662 men; non-flushing group, 872 men) >30 years who had undergone comprehensive health examinations at the health promotion center of a Chungnam National University Hospital between 2007 and 2009. Alcohol consumption and alcohol-related facial flushing were assessed through a questionnaire. Cardiovascular disease risk was investigated based on the 2008 Framingham Heart Study. With the non-drinker group as reference, logistic regression was used to analyze the relationship between weekly alcohol intake and cardiovascular disease risk within 10 years for the flushing and non-flushing groups, with adjustment for confounding factors such as body mass index, diastolic blood pressure, low density lipoprotein cholesterol, triglycerides, and exercise patterns. Results Individuals in the non-flushing group with alcohol consumption of ?4 standard drinks (1 standard drink = 14 g of alcohol) per week had significantly lower moderate or high cardiovascular disease risk than individuals in the nondrinker group (adjusted odds ratio, 0.51; 95% confidence interval, 0.37 to 0.71). However, no significant relationship between the drinking amount and cardiovascular disease risk was observed in the flushing group. Conclusion Cardiovascular disease risk is likely lowered by alcohol consumption among non-flushers, and the relationship between the drinking amount and cardiovascular disease risk may differ according to facial flushing after drinking, representing an individual's vulnerability. PMID:25426277

Suh, Hae Sun; Kim, Sung Soo; Jung, Jin Gyu; Yoon, Seok Jun; Ahn, Jae Bum

2014-01-01

222

Cost-Effectiveness of Aspirin Treatment in the Primary Prevention of Cardiovascular Disease Events in Subgroups Based on Age, Gender, and Varying Cardiovascular Risk  

Microsoft Academic Search

Background—Aspirin is effective for the primary prevention of cardiovascular events, but it remains unclear for which subgroups of individuals aspirin is beneficial. We assessed the cost-effectiveness of aspirin separately for men and women of different ages with various levels of cardiovascular disease risk. Methods and Results—A Markov model was developed to predict the number of cardiovascular events prevented, quality-adjusted life-years,

Jacoba P. Greving; Erik Buskens; Hendrik Koffijberg; Ale Algra

2010-01-01

223

Short-term versus lifetime risk assessment for cardiovascular disease: Pros, cons, and clinical implications  

Microsoft Academic Search

Atherosclerotic disease develops over decades, thus preceding end-organ events, myocardial infarction, and stroke by many\\u000a years. Identifying risk factors for atherosclerotic disease development is necessary to guide early primary prevention measures.\\u000a The most widely accepted risk estimation tools, 10-year risk profiles, may not adequately predict true future burden of cardiovascular\\u000a disease. Lifetime risk assessment estimates the chance of developing a

John T. Wilkins; Donald M. Lloyd-Jones

2009-01-01

224

Cardiovascular Disease Risk Factor Knowledge in Young Adults and 10-year Change in Risk Factors The Coronary Artery Risk Development in Young Adults (CARDIA) Study  

Microsoft Academic Search

This study's objective was assessment of cardiovascular disease (CVD) risk factor knowledge in young adults, its association with 10-year changes in risk factor levels, and variables related to risk factor knowledge. A total of 4,193 healthy persons (55% female, 48% Black; mean age ¼ 30 years) from four urban US communities were queried about risk factor knowledge in 1990-1991 and

Elizabeth B. Lynch; Kiang Liu; Catarina I. Kiefe; Philip Greenland

225

COLD AND THE RISK OF CARDIOVASCULAR DISEASES A review  

Microsoft Academic Search

The higher occurrence of cardiovascular diseases in winter is well known, and several explanatory mechanisms have been suggested based on increased blood pressure, haematological changes and res- piratory infections. Most investigations have used ecological data such as daily temperatures recorded at weather stations and mortality in the general population. Cause-specific mortality is the outcome mea- sure most commonly used. Local

Simo Näyhä

226

Who participates in cardiovascular disease risk factor screenings? Experience with a religious organization-based program.  

PubMed Central

Adult members who declined participation in cardiovascular disease risk factor screenings offered at religious organizations were randomly selected and asked to participate in screenings at their homes. Relationships between screening participation and sociodemographic, behavioral, and physiological measures were examined. Age, knowledge of cardiovascular disease risk factors, body mass index, current smoking status, previous report of elevated blood pressure, current diastolic blood pressure measurement, frequency of worship service attendance, and residential distance from the religious organization screening site were important predictors of screening response. Those with conspicuous risk factors appeared less likely to initially respond to religious organization site screening invitations. PMID:8279596

Wells, B L; Brown, C C; Horm, J W; Carleton, R A; Lasater, T M

1994-01-01

227

Landmark Risk Prediction of Residual Life for Breast Cancer Survival  

PubMed Central

The importance of developing personalized risk prediction estimates has become increasingly evident in recent years. In general, patient populations may be heterogenous and represent a mixture of different unknown subtypes of disease. When the source of this heterogeneity and resulting subtypes of disease are unknown, accurate prediction of survival may be difficult. However, in certain disease settings the onset time of an observable short term event may be highly associated with these unknown subtypes of disease and thus may be useful in predicting long term survival. One approach to incorporate short term event information along with baseline markers for the prediction of long term survival is through a landmark Cox model, which assumes a proportional hazards model for the residual life at a given landmark point. In this paper, we use this modeling framework to develop procedures to assess how a patient’s long term survival trajectory may change over time given good short term outcome indications along with prognosis based on baseline markers. We first propose time-varying accuracy measures to quantify the predictive performance of landmark prediction rules for residual life and provide resampling-based procedures to make inference about such accuracy measures. Simulation studies show that the proposed procedures perform well in finite samples. Throughout, we illustrate our proposed procedures using a breast cancer dataset with information on time to metastasis and time to death. In addition to baseline clinical markers available for each patient, a chromosome instability genetic score, denoted by CIN25, is also available for each patient and has been shown to be predictive of survival for various types of cancer. We provide procedures to evaluate the incremental value of CIN25 for the prediction of residual life and examine how the residual life profile changes over time. This allows us to identify an informative landmark point, t0, such that accurate risk predictions of the residual life could be made for patients who survive past t0 without metastasis. PMID:23494768

Parast, Layla; Cai, Tianxi

2013-01-01

228

Physical activity recommendations and cardiovascular disease risk factors in young Hispanic women  

Microsoft Academic Search

Despite the benefits associated with regular physical activity, there is little epidemiological evidence to support positive health outcomes when meeting physical activity guidelines in high-risk ethnic groups, such as Hispanic women. We compared cardiovascular disease risk factors between young Hispanic women who meet and those who do not meet current physical activity guidelines. Height, weight, waist circumference, and blood pressure

Chantal A. Vella; Diana Ontiveros; Raul Y. Zubia; Lance Dalleck

2011-01-01

229

Cardiovascular risk analysis by means of pulse morphology and clustering methodologies.  

PubMed

The purpose of this study was the development of a clustering methodology to deal with arterial pressure waveform (APW) parameters to be used in the cardiovascular risk assessment. One hundred sixteen subjects were monitored and divided into two groups. The first one (23 hypertensive subjects) was analyzed using APW and biochemical parameters, while the remaining 93 healthy subjects were only evaluated through APW parameters. The expectation maximization (EM) and k-means algorithms were used in the cluster analysis, and the risk scores (the Framingham Risk Score (FRS), the Systematic COronary Risk Evaluation (SCORE) project, the Assessing cardiovascular risk using Scottish Intercollegiate Guidelines Network (ASSIGN) and the PROspective Cardiovascular Münster (PROCAM)), commonly used in clinical practice were selected to the cluster risk validation. The result from the clustering risk analysis showed a very significant correlation with ASSIGN (r=0.582, p<0.01) and a significant correlation with FRS (r=0.458, p<0.05). The results from the comparison of both groups also allowed to identify the cluster with higher cardiovascular risk in the healthy group. These results give new insights to explore this methodology in future scoring trials. PMID:25023535

Almeida, Vânia G; Borba, J; Pereira, H Catarina; Pereira, Tânia; Correia, Carlos; Pêgo, Mariano; Cardoso, João

2014-11-01

230

Effect of Rosiglitazone on the Risk of Myocardial Infarction and Death from Cardiovascular Causes  

Microsoft Academic Search

Rosiglitazone was associated with a significant increase in the risk of myocardial infarction and with an increase in the risk of death from cardiovascular causes that had borderline significance. Our study was limited by a lack of access to original source data, which would have enabled time-to-event analysis. Despite these limita- tions, patients and providers should consider the potential for

Steven E. Nissen; Kathy Wolski

2007-01-01

231

A multilevel analysis of income inequality and cardiovascular disease risk factors  

Microsoft Academic Search

Recent research has suggested that inequality in the distribution of income is associated with increased mortality, even after accounting for average income levels. Using data from the Behavioral Risk Factor Surveillance System (BRFSS), we investigated whether inequality in the distribution of income within US states is related to the prevalence of four cardiovascular disease risk factors (body mass index (BMI),

Ana V. Diez-Roux; Bruce G. Link; Mary E. Northridge

2000-01-01

232

Daily egg consumption in hyperlipidemic adults - Effects on endothelial function and cardiovascular risk  

Microsoft Academic Search

BACKGROUND: Limiting consumption of eggs, which are high in cholesterol, is generally recommended to reduce risk of cardiovascular disease. However, recent evidence suggests that dietary cholesterol has limited influence on serum cholesterol or cardiac risk. OBJECTIVE: To assess the effects of egg consumption on endothelial function and serum lipids in hyperlipidemic adults. METHODS: Randomized, placebo-controlled crossover trial of 40 hyperlipidemic

Valentine Njike; Zubaida Faridi; Suparna Dutta; Anjelica L Gonzalez-Simon; David L Katz

2010-01-01

233

Therapy Insight: weight-loss surgery and major cardiovascular risk factors  

Microsoft Academic Search

Weight-loss surgery is an effective treatment for severe, medically complicated and refractory obesity. It reverses, eliminates or significantly ameliorates major cardiovascular risk factors related to obesity. In a large proportion of patients, the therapy produces significant weight loss, reduces the risk of disability and premature death, and improves quality of life. Surgical treatment by gastric-restrictive and malabsorptive procedures started several

Edward C Mun; George L Blackburn

2005-01-01

234

Risk factors for cardiovascular disease in a Brazilian population-based cohort study  

Microsoft Academic Search

Objective: Our aim was to investigate risk factors for cardiovascular disease (CVD) in a population-based Brazilian cohort. Design and methods: A cohort study was conducted with 1091 individuals identified through multi-stage probability sampling in Porto Alegre, Brazil. Risk factors were investigated among demographic and anthropometric characteristics, including education, smoking habits, income, alcoholic beverage consumption, and blood pressure. A fatal or

Renan Stoll Moraes; Flávio Danni Fuchs; Leila Beltrami Moreira; Mário Wiehe; Gerson Martins Pereira; Sandra Costa Fuchs

2003-01-01

235

Combination of BMI and Waist Circumference for Identifying Cardiovascular Risk Factors in Whites  

Microsoft Academic Search

Objective: BMI (kilograms per meters squared) and waist circumference (WC) (measured in centimeters) are each associated with the risk of developing cardiovascular disease (CVD). Therefore, a combination of the two may be more effective in identifying subjects at risk than either alone. The present study sought to identify the combination of BMI and WC that has the strongest association with

Shankuan Zhu; Stanley Heshka; ZiMian Wang; Wei Shen; David B. Allison; Robert Ross; Steven B. Heymsfield

2004-01-01

236

Cardiovascular risk factors in Mexican American adults: a transcultural analysis of NHANES III, 1988-1994.  

PubMed Central

OBJECTIVES: This study examined the extent to which cardiovascular disease risk factors differ among subgroups of Mexican Americans living in the United States. METHODS: Using data from a national sample (1988-1994) of 1387 Mexican American women and 1404 Mexican American men, aged 25 to 64 years, we examined an estimate of coronary heart disease mortality risk and 5 primary cardiovascular disease risk factors: systolic blood pressure, body mass index, cigarette smoking, non-high-density lipoprotein cholesterol, and type 2 diabetes mellitus. Differences in risk were evaluated by country of birth and primary language spoken. RESULTS: Estimated 10-year coronary heart disease mortality risk per 1000 persons, adjusted for age and education, was highest for US-born Spanish-speaking men and women (27.5 and 11.4, respectively), intermediate for US-born English-speaking men and women (22.5 and 7.0), and lowest for Mexican-born men and women (20.0 and 6.6). A similar pattern of higher risk among US-born Spanish-speaking men and women was demonstrated for each of the 5 cardiovascular disease risk factors. CONCLUSIONS: These findings illustrate the heterogeneity of the Mexican American population and identify a new group at substantial risk for cardiovascular disease and in need of effective heart disease prevention programs. PMID:10224985

Sundquist, J; Winkleby, M A

1999-01-01

237

Comparisons of Parent Cardiovascular Knowledge, Attitudes, and Behaviors Based on Screening and Perceived Child Risks  

Microsoft Academic Search

Questionnaire reports and universal screening procedures from 244 children (kindergarten, 5th grade, and 9th grade) were used to explore differences in parent health knowledge and attitudes of cardiovascular risks among children and parental involvement in promoting healthy lifestyles relative to whether their children were identified as being overweight or at risk of being overweight. The knowledge, attitudes, and behaviors of

Lesley A. Cottrell; Valerie Minor; Emily Murphy; Alyson Ward; Eloise Elliott; Georgianna Tillis; Malinda Turner; William A. Neal

2007-01-01

238

Using the Framingham Risk Score to Evaluate Immigrant Effect on Cardiovascular Disease Risk in Mexican Americans  

PubMed Central

Background This study uses the Framingham Risk Score (FRS) for 10-year cardiovascular disease (CVD) to evaluate differences between Mexican American immigrants and the U.S.-born population. Methods and Results Data from the Cameron County Hispanic Cohort (N=1,559). Average total risk scores were generated by age group for each gender. Regression analysis was conducted adjusting for covariates and interaction effects. Both women and men in the CCHC sample who were long-term immigrant residents (mean FRS scores women 4.2 with p<.001 vs. men 4.0 with p<.001) or born in the U.S. (mean FRS scores women 4.6 with p<.001 vs. men 3.3 with p<.001) had significantly higher risk scores than immigrants who had only been in this country for less than 10 years. The interaction model indicates that differences between immigrant and native-born Mexican Americans are most greatly felt at lowest levels of socioeconomic status for men in the CCHC. Conclusions This study suggests that in terms of immigrant advantage in CVD risk, on whom, where, and how the comparisons are being made have important implications for the degree of difference observed. PMID:22643615

Salinas, Jennifer J.; Abdelbary, Bassent; Wilson, Jeffrey; Hossain, Monir; Fisher-Hoch, Susan; McCormick, Joseph

2013-01-01

239

Reference frame for home pulse pressure based on cardiovascular risk in 6470 subjects from 5 populations.  

PubMed

The absence of an outcome-driven reference frame for self-measured pulse pressure (PP) limits its clinical applicability. In an attempt to derive an operational threshold for self-measured PP, we analyzed 6470 participants (mean age 59.3 years; 56.9% women; 22.5% on antihypertensive treatment) from 5 general population cohorts included in the International Database on HOme blood pressure in relation to Cardiovascular Outcome. During 8.3 years of follow-up (median), 294 cardiovascular deaths, 393 strokes and 336 cardiac events occurred. In 3285 younger subjects (<60 years), home PP only predicted all-cause and cardiovascular mortality (P?0.036), whereas in 3185 older subjects (?60 years) PP predicted total and cardiovascular mortality (P?0.0067) and all cardiovascular and coronary events (P?0.044). However, PP did not substantially refine risk prediction based on classical risk factors including mean blood pressure (generalized R(2) statistic ?0.20%). In older subjects, the adjusted hazard ratios expressing the risk in the upper decile of home PP (?76?mm?Hg) versus the average risk in whole population were 1.41 (95% confidence interval, 1.09-1.81; P=0.0081) for all-cause mortality, 1.62 (1.11-2.35; P=0.012) for cardiovascular mortality and 1.31 (1.00-1.70; P=0.047) for all fatal and nonfatal cardiovascular end points combined. The low number of events precluded an analysis by tenths of the PP distribution in younger participants. In conclusion, a home PP of ?76?mm?Hg predicted cardiovascular outcomes in the elderly with the exception of stroke, whereas in younger subjects no threshold could be established. PMID:24646650

Aparicio, Lucas S; Thijs, Lutgarde; Asayama, Kei; Barochiner, Jessica; Boggia, José; Gu, Yu-Mei; Cuffaro, Paula E; Liu, Yan-Ping; Niiranen, Teemu J; Ohkubo, Takayoshi; Johansson, Jouni K; Kikuya, Masahiro; Hozawa, Atsushi; Tsuji, Ichiro; Imai, Yutaka; Sandoya, Edgardo; Stergiou, George S; Waisman, Gabriel D; Staessen, Jan A

2014-07-01

240

Alcohol Consumption and Ankle-to-Brachial Index: Results from the Cardiovascular Risk Survey  

Microsoft Academic Search

Background and MethodologyA low ankle-to-brachial index (ABI) is a strong correlate of cardiovascular disease and subsequent mortality. The relationship between ABI and alcohol consumption remains unclear. Data are from the Cardiovascular Risk Survey (CRS), a multiple-ethnic, community-based, cross-sectional study of 14 618 Chinese people (5 757 Hans, 4 767 Uygurs, and 4 094 Kazakhs) aged 35 years and over at

Xiang Xie; Yi-Tong Ma; Yi-Ning Yang; Xiao-Mei Li; Fen Liu; Ding Huang; Zhen-Yan Fu; Xiang Ma; Bang-Dang Chen; Ying Huang; Gian Paolo Fadini

2010-01-01

241

Plant-based dietary patterns in the control of obesity and cardiovascular risk  

Microsoft Academic Search

Obesity and cardiovascular disease are uncommon in people consuming plant-based diets. In contrast, overweight and obesity\\u000a are surging in US children and adults, increasing their risk for cardiovascular disease and diabetes. Plant-based diets are\\u000a primarily comprised of whole plant foods that are rich in fiber and several beneficial phytochemicals and low to moderate\\u000a in fat. Plant-based dietary patterns have been

Antonella Dewell; Dean Ornish

2007-01-01

242

What are the basic self-monitoring components for cardiovascular risk management?  

Microsoft Academic Search

BACKGROUND: Self-monitoring is increasingly recommended as a method of managing cardiovascular disease. However, the design, implementation and reproducibility of the self-monitoring interventions appear to vary considerably. We examined the interventions included in systematic reviews of self-monitoring for four clinical problems that increase cardiovascular disease risk. METHODS: We searched Medline and Cochrane databases for systematic reviews of self-monitoring for: heart failure,

Alison M Ward; Carl Heneghan; Rafael Perera; Dan Lasserson; David Nunan; David Mant; Paul Glasziou

2010-01-01

243

Plasma Lipidomic Profiling of Treated HIV-Positive Individuals and the Implications for Cardiovascular Risk Prediction  

PubMed Central

Background The increased risk of coronary artery disease in human immunodeficiency virus (HIV) positive patients is collectively contributed to by the human immunodeficiency virus and antiretroviral-associated dyslipidaemia. In this study, we investigate the characterisation of the plasma lipid profiles of treated HIV patients and the relationship of 316 plasma lipid species across multiple lipid classes with the risk of future cardiovascular events in HIV- positive patients. Methods In a retrospective case-control study, we analysed plasma lipid profiles of 113 subjects. Cases (n?=?23) were HIV-positive individuals with a stored blood sample available 12 months prior to their diagnosis of coronary artery disease (CAD). They were age and sex matched to HIV-positive individuals without a diagnosis of CAD (n?=?45) and with healthy HIV-negative volunteers (n?=?45). Results Association of plasma lipid species and classes with HIV infection and cardiovascular risk in HIV were determined. In multiple logistic regression, we identified 83 lipids species and 7 lipid classes significantly associated with HIV infection and a further identified 74 lipid species and 8 lipid classes significantly associated with future cardiovascular events in HIV-positive subjects. Risk prediction models incorporating lipid species attained an area under the receiver operator characteristic curve (AUC) of 0.78 (0.775, 0.785)) and outperformed all other tested markers and risk scores in the identification of HIV-positive subjects with increased risk of cardiovascular events. Conclusions Our results demonstrate that HIV-positive patients have significant differences in their plasma lipid profiles compared with healthy HIV-negative controls and that numerous lipid species were significantly associated with elevated cardiovascular risk. This suggests a potential novel application for plasma lipids in cardiovascular risk screening of HIV-positive patients. PMID:24733512

Wong, Gerard; Trevillyan, Janine M.; Fatou, Benoit; Cinel, Michelle; Weir, Jacquelyn M.; Hoy, Jennifer F.; Meikle, Peter J.

2014-01-01

244

The optimal measure of microvascular function with velocity time integral for cardiovascular risk prediction.  

PubMed

Recent evidence suggests that microvascular function may be important in cardiovascular risk prediction. One measure of microvascular function is hyperaemic velocity time integral (VTI). We assessed whether the VTI of more than one beat of reactive hyperaemia would provide a stronger correlate to traditional cardiovascular risk factors using a subset of subjects from the Firefighters and Their Endothelium (FATE) study. Vascular function was assessed by measurement of hyperaemic blood velocity with high-resolution ultrasound of the brachial artery. We evaluated three measures in the current analysis: the VTI of the first beat, average VTI of 10 beats, and maximum VTI of 10 beats post-cuff release. A total of 399 male subjects (45.5 ± 10 years) were included in this analysis. Univariate correlations between the three end points and cardiovascular risk factors were calculated, and multivariable regression models constructed. Intra-observer variability was approximately equal for all VTI end points (coefficient of variation: first = 1.6%, average = 1.4%, maximum = 1.4%). Univariate correlations between VTI and cardiovascular risk factors were similar across all three end points. In multivariable analyses, there were no differences in the relationships between cardiovascular risk factors and the various VTI end points (R(2) from 0.090 to 0.102). Age, systolic blood pressure, and BMI were predictors of the three VTI end points (p < 0.05). In conclusion, the first beat of reactive hyperaemia remains the suitable measure of microvascular function. PMID:22815000

Lee, Vincent; Martin, Billie-Jean; Fung, Marinda; Anderson, Todd J

2012-10-01

245

Prevalence of left ventricular hypertrophy in patients with mild hypertension in primary care: impact of echocardiography on cardiovascular risk stratification  

Microsoft Academic Search

BackgroundLeft ventricular hypertrophy (LVH) is an important predictor of cardiovascular risk, and its detection contributes to risk stratification. The aims of the present study were to estimate the prevalence of echocardiographic LVH and to evaluate the influence of echocardiography (ECHO) on cardiovascular risk stratification in hypertensive patients presenting in primary care.

Teresa Sancho; Eduardo Armada; José M. Rubio; José L. Antón; Alberto Torre; Javier Palau; Paloma Seguido; Jaime Gallo; Isabel Saenz; Enrique Polo; Rosa Torres; José Oliver; Juan G. Puig

2003-01-01

246

Impact of cardiovascular risk factors on medical expenditure: evidence from epidemiological studies analysing data on health checkups and medical insurance.  

PubMed

Concerns have increasingly been raised about the medical economic burden in Japan, of which approximately 20% is attributable to cardiovascular disease, including coronary heart disease and stroke. Because the management of risk factors is essential for the prevention of cardiovascular disease, it is important to understand the relationship between cardiovascular risk factors and medical expenditure in the Japanese population. However, only a few Japanese epidemiological studies analysing data on health checkups and medical insurance have provided evidence on this topic. Patients with cardiovascular risk factors, including obesity, hypertension, and diabetes, may incur medical expenditures through treatment of the risk factors themselves and through procedures for associated diseases that usually require hospitalization and sometimes result in death. Untreated risk factors may cause medical expenditure surges, mainly due to long-term hospitalization, more often than risk factors preventively treated by medication. On an individual patient level, medical expenditures increase with the number of concomitant cardiovascular risk factors. For single risk factors, personal medical expenditure may increase with the severity of that factor. However, on a population level, the medical economic burden attributable to cardiovascular risk factors results largely from a single, particularly prevalent risk factor, especially from mildly-to-moderately abnormal levels of the factor. Therefore, cardiovascular risk factors require management on the basis of both a cost-effective strategy of treating high-risk patients and a population strategy for reducing both the ill health and medical economic burdens that result from cardiovascular disease. PMID:25070209

Nakamura, Koshi

2014-11-01

247

Impact of Cardiovascular Risk Factors on Medical Expenditure: Evidence From Epidemiological Studies Analysing Data on Health Checkups and Medical Insurance  

PubMed Central

Concerns have increasingly been raised about the medical economic burden in Japan, of which approximately 20% is attributable to cardiovascular disease, including coronary heart disease and stroke. Because the management of risk factors is essential for the prevention of cardiovascular disease, it is important to understand the relationship between cardiovascular risk factors and medical expenditure in the Japanese population. However, only a few Japanese epidemiological studies analysing data on health checkups and medical insurance have provided evidence on this topic. Patients with cardiovascular risk factors, including obesity, hypertension, and diabetes, may incur medical expenditures through treatment of the risk factors themselves and through procedures for associated diseases that usually require hospitalization and sometimes result in death. Untreated risk factors may cause medical expenditure surges, mainly due to long-term hospitalization, more often than risk factors preventively treated by medication. On an individual patient level, medical expenditures increase with the number of concomitant cardiovascular risk factors. For single risk factors, personal medical expenditure may increase with the severity of that factor. However, on a population level, the medical economic burden attributable to cardiovascular risk factors results largely from a single, particularly prevalent risk factor, especially from mildly-to-moderately abnormal levels of the factor. Therefore, cardiovascular risk factors require management on the basis of both a cost-effective strategy of treating high-risk patients and a population strategy for reducing both the ill health and medical economic burdens that result from cardiovascular disease. PMID:25070209

Nakamura, Koshi

2014-01-01

248

Cardiovascular multimorbidity: the effect of ethnicity on prevalence and risk factor management  

PubMed Central

Background Multimorbidity is common in primary care populations. Within cardiovascular disease, important differences in disease prevalence and risk factor management by ethnicity are recognised. Aim To examine the population burden of cardiovascular multimorbidity and the management of modifiable risk factors by ethnicity. Design and setting Cross-sectional study of general practices (148/151) in the east London primary care trusts of Tower Hamlets, City and Hackney, and Newham, with a total population size of 843 720. Method Using MIQUEST, patient data were extracted from five cardiovascular registers. Logistic regression analysis was used to examine the risk of being multimorbid by ethnic group, and the control of risk factors by ethnicity and burden of cardiovascular multimorbidity. Results The crude prevalence of cardiovascular multimorbidity among patients with at least one cardiovascular condition was 34%. People of non-white ethnicity are more likely to be multimorbid than groups of white ethnicity, with adjusted odds ratios of 2.04 (95% confidence interval [CI] = 1.94 to 2.15) for South Asians and 1.23 (95% CI = 1.18 to 1.29) for groups of black ethnicity. Achievement of targets for blood pressure, cholesterol, and glycated haemoglobin (HbA1c) was higher for patients who were multimorbid than unimorbid. For cholesterol and blood pressure, South Asian patients achieved better control than those of white and black ethnicity. For HbA1c levels, patients of white ethnicity had an advantage over other groups as the morbidity burden increased. Conclusion The burden of multiple disease varies by ethnicity. Risk factor management improves with increasing levels of cardiovascular multimorbidity, but clinically important differences by ethnicity remain and contribute to health inequalities. PMID:21619750

Mathur, Rohini; Hull, Sally A; Badrick, Ellena; Robson, John

2011-01-01

249

Impact of smoking and quitting on cardiovascular outcomes and risk advancement periods among older adults.  

PubMed

Smoking is an established risk factor for cardiovascular events, such as myocardial infarction, stroke and cardiovascular death. However, most pertinent studies primarily relied on middle aged adults. We aimed to provide empirical evidence on the association of smoking with cardiovascular events and the benefits of smoking cessation in people aged 50 years or older. In a German population-based cohort study detailed information on lifetime smoking history was obtained from 8,807 individuals aged 50-74 years, without previous myocardial infarction (MI) or stroke. Cox proportional hazards regression was applied to estimate the impact of smoking on MI, stroke and cardiovascular death (CVD) as well as on the combined outcome of major cardiovascular events (MI, stroke or CVD). In addition, the impact of smoking and the benefits of smoking cessation were quantified by risk advancement periods (RAP). The cohort included 17.2 % current smokers, 31.7 % former smokers and 51.1 % never smokers. During a mean follow-up of 9.1 years, 261 participants experienced a first MI, 456 had a primary stroke and 274 died of cardiovascular reasons. Compared to never smokers, adjusted hazard ratios (95 % confidence intervals) of current smokers were 2.25 (1.62-3.12), 2.12 (1.65-2.73) and 2.45 (1.76-3.42) and RAPs were 19.3, 9.8 and 8.4 years for MI, stroke and CVD, respectively. Strong dose-response relationships were seen with both current and life-time amount of smoking. Most of the excess risk and risk advancement disappeared within 5 years after smoking cessation. Smoking is a strong risk factor for cardiovascular events even at older age. Smoking cessation is highly and rapidly beneficial also at advanced age. PMID:23397516

Gellert, Carolin; Schöttker, Ben; Müller, Heiko; Holleczek, Bernd; Brenner, Hermann

2013-08-01

250

Interaction between renal function and microalbuminuria for cardiovascular risk in hypertension: the nordic diltiazem study.  

PubMed

We investigated whether renal function and microalbuminuria are independent predictors and whether any interaction exists between them, regarding future cardiovascular disease in hypertensive patients (n=10 881) followed for 4.5 years. The primary end points (PEs) were fatal and nonfatal myocardial infarction and stroke and other cardiovascular deaths. Creatinine and glomerular filtration rate (GFR), estimated using the formulas of the Modification of Diet in Renal Disease study group and Cockroft and Gault and in a subsample (n=4929) of microalbuminuria and interaction terms of microalbuminuria and renal function, were related to the risk of the PE using Cox proportional hazards model after full adjustment. Increased creatinine (P<0.001), decreased GFR from Cockroft and Gault (P=0.001), and decreased GFR from the Modification of Diet in Renal Disease study group (P=0.001) were all independent risk factors for the PE. Stepwise exclusion of patients with the poorest renal function excluded the possibility that the relationship between decreasing renal function and the PE was driven only by patients with severely impaired renal function. Microalbuminuria and all 3 of the indices of renal function predicted the PE independent of each other. There was a significant interaction between microalbuminuria and GFR from Cockroft and Gault (P=0.040) in prediction of the PE. Both renal function and microalbuminuria add independent prognostic information regarding cardiovascular risk in hypertensive patients. The cardiovascular risk associated with microalbuminuria increases with a decline in GFR, as demonstrated by a significant interaction between microalbuminuria and GFR from Cockroft and Gault. Because estimation of the total cardiovascular risk is essential for the aggressiveness of risk factor interventions, simultaneous inclusion of GFR and microalbuminuria in global cardiovascular risk assessment is essential. PMID:18504324

Färbom, Patrik; Wahlstrand, Björn; Almgren, Peter; Skrtic, Stanko; Lanke, Jan; Weiss, Lars; Kjeldsen, Sverre; Hedner, Thomas; Melander, Olle

2008-07-01

251

From oxidative stress to cardiovascular risk in obstructive sleep apnoea  

Microsoft Academic Search

Summary  Cumulative evidence demonstrates that obstructive sleep apnoea is associated with a higher incidence of cardiovascular morbidity than in the general population. The hallmark of sleep apnoea—the intermittent hypoxia—facilitates increased formation of reactive oxygen species (ROS), but antioxidant activity is also diminished. Consequently, oxidant-antioxidant balance is compromised and oxidative stress ensues. ROS are highly chemically reactive molecules, thus initiating and propagating

Lena Lavie; Rigler Sleep; Bruce Rappaport

2006-01-01

252

Cardiovascular Epidemiology and Characterization of Atherosclerotic Disease Risk Factors  

Microsoft Academic Search

\\u000a Over 80 million people in the United States exhibit one or more forms of cardiovascular disease (CVD), and atherosclerotic\\u000a CVD (mainly coronary heart disease and stroke) is, by far, the leading cause of death among men and women. More women die\\u000a from CVD in the United States each year than men. Atherosclerotic CVD has become a worldwide pandemic. While CVD

Kevin C. Maki; Martyn R. Rubin

253

Nutritionally Complete Prepared Meal Plan to Reduce Cardiovascular Risk Factors  

Microsoft Academic Search

Objective To compare a nutritionally complete prepared meal plan that meets national dietary guidelines to usual-care dietary therapy for hypertension, dyslipidemia, and glycemic control.Design Randomized, controlled trial.Subjects\\/setting Outpatients with hypertension, dyslipidemia, or diabetes mellitus (n=251) were recruited at 6 medical centers in the United States and Canada.Intervention The prepared meal plan, which was developed by university-based nutrition and cardiovascular scientists

R. BRIAN HAYNES; PENNY KRIS-ETHERTON; DAVID A McCARRON; SUZANNE OPARIL; ALAN CHAIT; LAWRENCE M RESNICK; CYNTHIA D MORRIS; SHARON CLARK; DANIEL C HATTON; JILL A METZ; MARGARET McMAHON; SCOTT HOLCOMB; GEOFFREY W SNYDER; F. XAVIER PI-SUNYER; JUDITH S STERN

1999-01-01

254

Erectile dysfunction in primary care: a focus on cardiometabolic risk evaluation and stratification for future cardiovascular events.  

PubMed

An association between erectile dysfunction (ED) and cardiovascular disease has long been recognized, and studies suggest that ED is an independent marker of cardiovascular disease risk and even further, a marker for the burden of both obstructive and non-obstructive coronary artery disease. Therefore, the primary care physician (PCP) must assess the presence or absence of ED in every man > 39 years of age, especially if that man is asymptomatic of signs and symptoms of coronary artery disease. Assessment and management of ED may help identify and reduce the risk of future cardiovascular events, particularly in younger middle-aged men. The initial ED evaluation should distinguish between predominantly vasculogenic ED and ED of other etiologies. For men believed to have predominantly vasculogenic ED, we recommend that initial cardiovascular risk stratification be based on the Framingham Risk Score. Management of men with ED who are at low risk for cardiovascular disease should focus on risk factor control; men at high risk, including those with cardiovascular symptoms, should be referred to a cardiologist. Intermediate risk men should undergo noninvasive evaluation for subclinical atherosclerosis. A growing body of evidence supports the use of selected prognostic markers to further understand cardiovascular risk in men with ED, particularly CT calcium scoring. In conclusion, we support cardiovascular risk stratification and risk factor management in all men with vasculogenic ED. PMID:24978630

Miner, Martin; Rosenberg, Matt T; Barkin, Jack

2014-06-01

255

Epigenetic programming and risk: the birthplace of cardiovascular disease?  

PubMed

Epigenetics, through control of gene expression circuitries, plays important roles in various physiological processes such as stem cell differentiation and self renewal. This occurs during embryonic development, in different tissues, and in response to environmental stimuli. The language of epigenetic program is based on specific covalent modifications of DNA and chromatin. Thus, in addition to the individual identity, encoded by sequence of the four bases of the DNA, there is a cell type identity characterized by its positioning in the epigenetic "landscape". Aberrant changes in epigenetic marks induced by environmental cues may contribute to the development of abnormal phenotypes associated with different human diseases such as cancer, neurological disorders and inflammation. Most of the epigenetic studies have focused on embryonic development and cancer biology, while little has been done to explore the role of epigenetic mechanisms in the pathogenesis of cardiovascular disease. This review highlights our current knowledge of epigenetic gene regulation and the evidence that chromatin remodeling and histone modifications play key roles in the pathogenesis of cardiovascular disease through (re)programming of cardiovascular (stem) cells commitment, identity and function. PMID:22773406

Vinci, Maria Cristina; Polvani, Gianluca; Pesce, Maurizio

2013-06-01

256

Cardiovascular Risks in Prediabetes: Preliminary Data on "Vasculopathy Triad"  

PubMed Central

Background: Subclinical cardiovascular disease is inherent in complications of diabetes mellitus. It occurs before the obvert manifestation of cardiovascular disease complication in diabetes, and involves vasculopathy triad or three major vascular events comprising stasis, endothelial dysfunction, and atherothrombosis. Aim: This study was to examine evidence of vasculopathy triad in prediabetes, biomarkers of stasis, endothelial dysfunction, and atherothrombosis in prediabetes were compared with apparently healthy group. Materials and Methods: Eighty-one participants with results for plasma D-dimer, homocysteine, and whole blood viscosity were selected from a research database. The participants consisted of control (n = 44) and prediabetes (n = 37) based on clinical history and laboratory results. Results: Multivariate analysis shows a significantly higher level of vasculopathy in prediabetes than in the control group (P > 0.0001). Blood viscosity (P < 0.04) and homocysteine (P < 0.03) are significantly higher in prediabetes than in controls. Average levels for plasma D-dimer are also higher in prediabetes than in control, but not statistically significant in this particular analysis. Conclusion: This study suggests a novel application of known idea, vasculopathy triad that could be used for assessment of subclinical cardiovascular disease in prediabetes. PMID:25077081

Nwose, Ezekiel U; Richards, Ross S; Bwititi, Phillip T

2014-01-01

257

Assessment of Cardiovascular Calcium: Interpretation, Prognostic Value, and Relationship to Lipids and Other Cardiovascular Risk Factors  

Microsoft Academic Search

\\u000a Cardiac risk assessment has traditionally been based on conventional risk factors; the shortcomings of this approach are all\\u000a too often highlighted by major cardiac events occurring in presumably low-risk people. The annual presentation of 650,000\\u000a previously asymptomatic patients with an acute coronary event as the initial manifestation of coronary artery disease (CAD)\\u000a [1] is a testimony to the failure of

Harvey S. Hecht

258

Fatty Acid Oxidation and Cardiovascular Risk during Menopause: A Mitochondrial Connection?  

PubMed Central

Menopause is a consequence of the normal aging process in women. This fact implies that the physiological and biochemical alterations resulting from menopause often blur with those from the aging process. It is thought that menopause in women presents a higher risk for cardiovascular disease although the precise mechanism is still under discussion. The postmenopause lipid profile is clearly altered, which can present a risk factor for cardiovascular disease. Due to the role of mitochondria in fatty acid oxidation, alterations of the lipid profile in the menopausal women will also influence mitochondrial fatty acid oxidation fluxes in several organs. In this paper, we propose that alterations of mitochondrial bioenergetics in the heart, consequence from normal aging and/or from the menopausal process, result in decreased fatty acid oxidation and accumulation of fatty acid intermediates in the cardiomyocyte cytosol, resulting in lipotoxicity and increasing the cardiovascular risk in the menopausal women. PMID:22496981

Oliveira, Paulo J.; Carvalho, Rui A.; Portincasa, Piero; Bonfrate, Leonilde; Sardao, Vilma A.

2012-01-01

259

Comparison of 24-hour cardiovascular and autonomic function in paraplegia, tetraplegia, and control groups: Implications for cardiovascular risk  

PubMed Central

Background Fluctuations in 24-hour cardiovascular hemodynamics, specifically heart rate (HR) and blood pressure (BP), are thought to reflect autonomic nervous system (ANS) activity. Persons with spinal cord injury (SCI) represent a model of ANS dysfunction, which may affect 24-hour hemodynamics and predispose these individuals to increased cardiovascular disease risk. Objective To determine 24-hour cardiovascular and ANS function among individuals with tetraplegia (n = 20; TETRA: C4–C8), high paraplegia (n = 10; HP: T2–T5), low paraplegia (n = 9; LP: T7–T12), and non-SCI controls (n = 10). Twenty-four-hour ANS function was assessed by time domain parameters of heart rate variability (HRV); the standard deviation of the 5-minute average R–R intervals (SDANN; milliseconds/ms), and the root-mean square of the standard deviation of the R–R intervals (rMSSD; ms). Subjects wore 24-hour ambulatory monitors to record HR, HRV, and BP. Mixed analysis of variance (ANOVA) revealed significantly lower 24-hour BP in the tetraplegic group; however, BP did not differ between the HP, LP, and control groups. Mixed ANOVA suggested significantly elevated 24-hour HR in the HP and LP groups compared to the TETRA and control groups (P < 0.05); daytime HR was higher in both paraplegic groups compared to the TETRA and control groups (P < 0.01) and nighttime HR was significantly elevated in the LP group compared to the TETRA and control groups (P < 0.01). Twenty-four-hour SDANN was significantly increased in the HP group compared to the LP and TETRA groups (P < 0.05) and rMSSD was significantly lower in the LP compared to the other three groups (P < 0.05). Elevated 24-hour HR in persons with paraplegia, in concert with altered HRV dynamics, may impart significant adverse cardiovascular consequences, which are currently unappreciated. PMID:21903013

Rosado-Rivera, Dwindally; Radulovic, M.; Handrakis, John P.; Cirnigliaro, Christopher M.; Jensen, A. Marley; Kirshblum, Steve; Bauman, William A.; Wecht, Jill Maria

2011-01-01

260

Retrospective assessment of the prevalence of cardiovascular risk factors among homeless individuals with schizophrenia in Shanghai  

PubMed Central

Background Cardiovascular diseases are increasingly important in China, but the prevalence of risk factors for cardiovascular diseases in the indigent mentally ill are unknown. Aim Assess the prevalence of four key risk factors for cardiovascular disease -- hypertension, hyperglycemia, hyperlipidemia and smoking – among homeless patients with schizophrenia and identify factors associated with the presence of these risk factors. Methods We reviewed medical charts of 181 homeless and 181 non-homeless patients with schizophrenia or schizophreniform disorder admitted to the Shanghai Jiading Mental Health Center between May 2007 and April 2013. Demographic characteristics and risk factors of cardiovascular events were compared between the two groups. Logistic regression models identified the factors that were associated with the presence of one or more of the four risk factors. Results The prevalence of hypertension and hyperlipidemia were 19 to 20% in both males and females in the two groups; these rates are similar to those reported in the general population. The prevalence of hyperglycemia ranged from 11 to 15% among males and females in the two groups. Smoking was highly prevalent in male patients (82% in homeless males and 78% in non-homeless males) but, like in China generally, much less prevalent in female patients (7% in homeless females and 5% in non-homeless females). The logistic regression analysis found that male gender, older age, and urban (vs. rural) residence were independently associated with the presence of one or more of the four cardiovascular risk factors. Homelessness was not associated with the presence of cardiovascular risk factors. Conclusion This study is the first known report on cardiovascular risk factors among homeless mentally ill in China. The study did not assess several important factors (such as the type, dose and duration of use of antipsychotic medication) but it was, nevertheless, able to show that, unlike in high-income countries, homelessness is not related to elevated risk of cardiovascular disease in Chinese individuals with mental illnesses. Prospective studies with the growing number of homeless individuals in China will be needed to get a clearer picture of the best ways to provide them with the health care services they need. PMID:25114489

CHEN, Qing; WAN, Min; BAN, Chunxia; GAO, Yafang

2014-01-01

261

Cardiovascular risk profile and lifestyle habits in a cohort of Italian cardiologists (from the SOCRATES Survey).  

PubMed

Cardiologists' cardiovascular profile and lifestyle habits are poorly known worldwide. To offer a snapshot of the personal health habits of Italian cardiologists, the Survey on Cardiac Risk Profile and Lifestyle Habits in a Cohort of Italian Cardiologists (SOCRATES) was undertaken. A Web-based electronic self-reported survey, accessible through a dedicated Web site, was used for data entry, and data were transferred through the Web to a central database. The survey was divided into 4 sections: baseline characteristics, medical illnesses and traditional cardiovascular risk factors, lifestyle habits, and selected medication use. The e-mail databases of 3 national scientific societies were used to survey a large and representative sample of Italian cardiologists. During the 3-month period of the survey, 1,770 of the 5,240 cardiologists contacted (33.7%) completed and returned ?1 sections of the questionnaire. More than 49% of the participants had 1 of the 5 classic risk factors (hypertension, hypercholesterolemia, active smoking, diabetes, and previous vascular events). More than 28% of respondents had 2 to 5 risk factors, and only 22.1% had none and therefore, according to age and gender, could be considered at low to intermediate risk. Despite the reported risk factors, >90% of cardiologists had a self-reported risk perception quantified as mild, such as low or intermediate. Furthermore, overweight and obesity, physical inactivity, and stress at work or at home were commonly reported, as well as limited use of cardiovascular drugs, such as statins or aspirin. In conclusion, the average cardiovascular profile of Italian cardiologist is unlikely to be considered ideal or even favorable according to recent statements and guidelines regarding cardiovascular risk. PMID:23587277

Temporelli, Pier Luigi; Zito, Giovanni; Faggiano, Pompilio

2013-07-15

262

Occupational Stress and Cardiovascular Risk Factors in High-Ranking Government Officials and Office Workers  

PubMed Central

Background: Cardiovascular diseases are among the most important sources of mortality and morbidity, and have a high disease burden. There are some major well-known risk factors, which contribute to the development of these diseases. Occupational stress is caused due to imbalance between job demands and individual’s ability, and it has been implicated as an etiology for cardiovascular diseases. Objectives: This study was conducted to evaluate the cardiovascular risk factors and different dimensions of occupational stress in high-ranking government officials, comparing an age and sex-matched group of office workers with them. Patients and Methods: We invited 90 high-ranking officials who managed the main governmental offices in a city, and 90 age and sex-matched office workers. The subjects were required to fill the occupational role questionnaire (Osipow) which evaluated their personal and medical history as well as occupational stress. Then, we performed physical examination and laboratory tests to check for cardiovascular risk factors. Finally, the frequency of cardiovascular risk factors and occupational stress of two groups were compared. Results: High-ranking officials in our study had less work experience in their current jobs and smoked fewer pack-years of cigarette, but they had higher waist and hip circumference, higher triglyceride level, more stress from role overload and responsibility, and higher total stress score. Our group of office workers had more occupational stress because of role ambiguity and insufficiency, but their overall job stress was less than officials. Conclusions: The officials have higher scores in some dimensions of occupational stress and higher overall stress score. Some cardiovascular risk factors were also more frequent in managers.

Mirmohammadi, Seyyed Jalil; Taheri, Mahmoud; Mehrparvar, Amir Houshang; Heydari, Mohammad; Saadati Kanafi, Ali; Mostaghaci, Mehrdad

2014-01-01

263

Cardiovascular and cognitive fitness at age 18 and risk of early-onset dementia.  

PubMed

Patients with early-onset dementia are a significantly under-recognized subgroup of patients with an increasing prevalence. Epidemiological studies are limited and studies of modifiable risk factors, such as physical fitness, are lacking. We aimed to investigate the associations between cardiovascular fitness individually and in combination with cognitive performance at age 18 and risk of early-onset dementia and mild cognitive impairment later in life. We performed a population-based cohort study of over 1.1 million Swedish, 18-year-old, male conscripts, who underwent conscription exams between 1968 and 2005. These males were then followed for up to 42 years. Objective data on cardiovascular fitness and cognitive performance were collected during conscription exams and were subsequently linked with hospital registries to calculate later risk of early-onset dementia and mild cognitive impairment using Cox proportional hazards models controlling for several confounders. The scores from the exams were divided into tertiles (low, medium, high) for the analyses. The mean follow-up time for the analyses was 25.7 years (standard deviation: 9.3) and the median was 27 years. In total, 30 195 315 person-years of follow-up were included in the study. In fully adjusted models, both low cardiovascular fitness and cognitive performance (compared to high) at age 18 were associated with increased risk for future early-onset dementia (cardiovascular fitness, n = 662 events: hazard ratio 2.49, 95%, confidence interval 1.87-3.32; cognitive performance, n = 657 events: hazard ratio 4.11, 95%, confidence interval 3.19-5.29) and mild cognitive impairment (cardiovascular fitness, n = 213 events: hazard ratio 3.57, 95%, confidence interval 2.23-5.74; cognitive performance, n = 212 events: hazard ratio 3.23, 95%, confidence interval 2.12-4.95). Poor performance on both cardiovascular fitness and cognitive tests was associated with a >7-fold (hazard ratio 7.34, 95%, confidence interval 5.08-10.58) and a >8-fold (hazard ratio 8.44, 95%, confidence interval 4.64-15.37) increased risk of early-onset dementia and early-onset mild cognitive impairment, respectively. In conclusion, lower cardiovascular fitness and cognitive performance in early adulthood were associated with an increased risk of early-onset dementia and mild cognitive impairment later in life, and the greatest risks were observed for individuals with a combination of low cardiovascular fitness and low cognitive performance. PMID:24604561

Nyberg, Jenny; Åberg, Maria A I; Schiöler, Linus; Nilsson, Michael; Wallin, Anders; Torén, Kjell; Kuhn, H Georg

2014-05-01

264

Glycerophospholipid and Sphingolipid Species and Mortality: The Ludwigshafen Risk and Cardiovascular Health (LURIC) Study  

PubMed Central

Vascular and metabolic diseases cause half of total mortality in Europe. New prognostic markers would provide a valuable tool to improve outcome. First evidence supports the usefulness of plasma lipid species as easily accessible markers for certain diseases. Here we analyzed association of plasma lipid species with mortality in the Ludwigshafen Risk and Cardiovascular Health (LURIC) study. Plasma lipid species were quantified by electrospray ionization tandem mass spectrometry and Cox proportional hazards regression was applied to assess their association with total and cardiovascular mortality. Overall no differences were detected between total and cardiovascular mortality. Highly polyunsaturated phosphatidylcholine species together with lysophosphatidylcholine species and long chain saturated sphingomyelin and ceramide species seem to be associated with a protective effect. The predominantly circulating phosphatidylcholine-based as well as phosphatidylethanolamine-based ether species and phosphatidylethanolamine species were positively associated with total and cardiovascular mortality. Saturated and monounsaturated phosphatidylcholine species, especially phosphatidylcholine 32?0 (most probably dipalmitoyl-phosphatidylcholine) and palmitate containing sphingomyelin and ceramide species showed together with 24?1 containing sphingomyelin and ceramide species strongest positive association with mortality. A quotient of the sums of the six most protective species and the six species with the strongest positive mortality association indicated an almost 3-fold increased risk of mortality, which was higher than the hazard ratio for known risk factors in our cohort. Plasma lipid species levels and especially ratios of certain species may be valuable prognostic marker for cardiovascular and total mortality. PMID:24465667

Sigruener, Alexander; Kleber, Marcus E.; Heimerl, Susanne; Liebisch, Gerhard; Schmitz, Gerd; Maerz, Winfried

2014-01-01

265

Cardiovascular Risk Factors Promote Brain Hypoperfusion Leading to Cognitive Decline and Dementia  

PubMed Central

Heart disease is the major leading cause of death and disability in the world. Mainly affecting the elderly population, heart disease and its main outcome, cardiovascular disease, have become an important risk factor in the development of cognitive decline and Alzheimer's disease (AD). This paper examines the evidence linking chronic brain hypoperfusion induced by a variety of cardiovascular deficits in the development of cognitive impairment preceding AD. The evidence indicates a strong association between AD and cardiovascular risk factors, including ApoE4, atrial fibrillation, thrombotic events, hypertension, hypotension, heart failure, high serum markers of inflammation, coronary artery disease, low cardiac index, and valvular pathology. In elderly people whose cerebral perfusion is already diminished by their advanced age, additional reduction of cerebral blood flow stemming from abnormalities in the heart-brain vascular loop ostensibly increases the probability of developing AD. Evidence also suggests that a neuronal energy crisis brought on by relentless brain hypoperfusion may be responsible for protein synthesis abnormalities that later result in the classic neurodegenerative lesions involving the formation of amyloid-beta plaques and neurofibrillary tangles. Insight into how cardiovascular risk factors can induce progressive cognitive impairment offers an enhanced understanding of the multifactorial pathophysiology characterizing AD and ways at preventing or managing the cardiovascular precursors of this dementia. PMID:23243502

de la Torre, Jack C.

2012-01-01

266

Reprint of "heated vegetable oils and cardiovascular disease risk factors".  

PubMed

Cardiovascular disease (CVD) is one of the leading major causes of morbidity and mortality worldwide. It may result from the interactions between multiple genetic and environmental factors including sedentary lifestyle and dietary habits. The quality of dietary oils and fats has been widely recognised to be inextricably linked to the pathogenesis of CVD. Vegetable oil is one of the essential dietary components in daily food consumption. However, the benefits of vegetable oil can be deteriorated by repeated heating that leads to lipid oxidation. The practice of using repeatedly heated cooking oil is not uncommon as it will reduce the cost of food preparation. Thermal oxidation yields new functional groups which may be potentially hazardous to cardiovascular health. Prolonged consumption of the repeatedly heated oil has been shown to increase blood pressure and total cholesterol, cause vascular inflammation as well as vascular changes which predispose to atherosclerosis. The harmful effect of heated oils is attributed to products generated from lipid oxidation during heating process. In view of the potential hazard of oxidation products, therefore this review article will provide an insight and awareness to the general public on the consumption of repeatedly heated oils which is detrimental to health. PMID:24846858

Ng, Chun-Yi; Leong, Xin-Fang; Masbah, Norliana; Adam, Siti Khadijah; Kamisah, Yusof; Jaarin, Kamsiah

2014-07-01

267

Fatherhood and the risk of cardiovascular mortality in the NIH-AARP Diet and Health Study  

PubMed Central

Background Fertility potential and reproductive fitness may reflect a man's future health, given that over one-third of the male human genome is involved in reproduction. We sought to determine if offspring number predicts cardiovascular death in the US men. Methods Using data from the NIH-AARP Diet and Health Study, 137 903 men (aged 50–71) without prior cardiovascular disease were followed-up for an average of 10.2 years. International Classification of Diseases, ninth edition, codes were used to establish the cause of death, and multivariable Cox proportional hazards modeling was used to estimate the association between offspring number and cardiovascular death while accounting for sociodemographic and lifestyle characteristics. Results Almost all (92%) participants had fathered at least one child and 50% had three or more offspring. A total of 3082 men died of cardiovascular causes during follow-up for an age-adjusted incidence rate of 2.70 per 1000 person-years. Compared with fathers, after adjusting for sociodemographic and lifestyle factors, childless men had a 17% [hazard ratio (HR): 1.17; 95% confidence interval (CI): 1.03–1.32] increased risk of death from cardiovascular disease contracted in the study period, and this elevated risk appeared to extend also to men with only one child. In comparison with fathers of five or more children, adjusted relative hazards for cardiovascular mortality of this sort were 1.06 (95% CI: 0.92–1.22) for four children, 1.02 (0.90–1.16) for three children, 1.02 (0.90–1.16) for two children, 1.11 (0.95–1.30) for one child and 1.21 (1.03–1.41) for no children. Conclusions Married men who have no children have a higher risk of dying from cardiovascular disease contracted after the age of 50 than men with two or more children. PMID:21946940

Eisenberg, Michael L.; Park, Yikyung; Hollenbeck, Albert R.; Lipshultz, Larry I.; Schatzkin, Arthur; Pletcher, Mark J.

2011-01-01

268

10-Year cardiovascular event risks for women who experienced hypertensive disorders in late pregnancy: the HyRAS study  

PubMed Central

Background Cardiovascular disease is the cause of death in 32% of women in the Netherlands. Prediction of an individual's risk for cardiovascular disease is difficult, in particular in younger women due to low sensitive and specific tests for these women. 10% to 15% of all pregnancies are complicated by hypertensive disorders, the vast majority of which develop only after 36 weeks of gestation. Preeclampsia and cardiovascular disease in later life show both features of "the metabolic syndrome" and atherosclerosis. Hypertensive disorders in pregnancy and cardiovascular disease may develop by common pathophysiologic pathways initiated by similar vascular risk factors. Vascular damage occurring during preeclampsia or gestational hypertension may contribute to the development of future cardiovascular disease, or is already present before pregnancy. At present clinicians do not systematically aim at the possible cardiovascular consequences in later life after a hypertensive pregnancy disorder at term. However, screening for risk factors after preeclampsia or gestational hypertension at term may give insight into an individual's cardiovascular risk profile. Methods/Design Women with a history of preeclampsia or gestational hypertension will be invited to participate in a cohort study 2 1/2 years after delivery. Participants will be screened for established modifiable cardiovascular risk indicators. The primary outcome is the 10-year cardiovascular event risk. Secondary outcomes include differences in cardiovascular parameters, SNP's in glucose metabolism, and neonatal outcome. Discussion This study will provide evidence on the potential health gains of a modifiable cardiovascular risk factor screening program for women whose pregnancy was complicated by hypertension or preeclampsia. The calculation of individual 10-year cardiovascular event risks will allow identification of those women who will benefit from primary prevention by tailored interventions, at a relatively young age. Trial registration The HYPITAT trial is registered in the clinical trial register as ISRCTN08132825. PMID:20515501

2010-01-01

269

Peroxisome Proliferator-Activated Receptor Agonists: Do They Increase Cardiovascular Risk?  

PubMed Central

Cardiovascular disease is a major cause of morbidity and mortality among people with type 2 diabetes mellitus. The peroxisome proliferator-activated receptor (PPAR) agonists have a significant role on glucose and fat metabolism. Thiazolidinediones (TZDs) are predominantly PPAR? agonists, and their primary benefit appears to be the prevention of diabetic complications by improving glycemic control and lipid profile. Recently, the cardiovascular safety of rosiglitazone was brought to center stage following meta analyses and the interim analysis of the RECORD trial. Current evidence points to rosiglitazone having a greater risk of myocardial ischemic events than placebo, metformin, or sulfonylureas. This review article discusses the mechanism of action of PPAR agonists and correlates it with clinical and laboratory outcomes in the published literature. In addition, this review article attempts to discuss some of the molecular mechanisms regarding the association between TZDs therapy and the nontraditional cardiovascular risks. PMID:19696948

Aljada, Ahmad; Shah, Kshitij Ashwin; Mousa, Shaker A.

2009-01-01

270

Air pollution exposure as a risk factor for cardiovascular disease morbidity and mortality.  

PubMed

There is growing evidence of an association between increasing exposure to air pollutants (both short-term and long-term exposures) and elevated risk of mortality and incidence of cardiovascular diseases in certain high-risk populations and throughout different geographic regions. The pathophysiologic mechanisms of air pollutant-induced cardiovascular morbidity and mortality are actively being studied, with autonomic system dysregulation and inflammatory pathway activation believed to be among the key culprits. Policy changes at the local and global levels are addressing the need for more stringent air pollution standards. These initiatives are projected to lower costs and improve health outcomes. In this review, we examine some major studies of the cardiovascular health impacts of air pollution. PMID:24304808

Koulova, Anna; Frishman, William H

2014-01-01

271

Circulating Adipocytokines in Obese Nondiabetic Patients in Relationship with Cardiovascular Risk Factors, Anthropometry and Resting-Energy Expenditure  

Microsoft Academic Search

Background: Obesity and insulin resistance are associated with cardiovascular risk factors, including altered levels of inflammatory markers and adipocytokines. The aim of the present study was to examine the relationship between circulating adipocytokines and cardiovascular risk factors. Subjects: A population of 95 obese, nondiabetic outpatients was analyzed prospectively. A complete nutritional evaluation was performed. Results: In the multivariate analysis, with

D. A. de Luis; M. Gonzalez Sagrado; R. Conde; R. Aller; O. Izaola; E. Romero

2007-01-01

272

Risk of idiopathic cardiovascular death and rionfatal venous thromboembolism in women using oral contraceptives with differing progestagen components  

Microsoft Academic Search

SummaryConcern about the risks of cardiovascular illness in women using combined oral contraceptives (OC) containing the progestagens desogestrel and gestodene prompted two studies of data from the UK General Practice Research Database. We compared the risks of certain cardiovascular illnesses in otherwise healthy women exposed to one of three OCs containing In the first study, based on some 470 general

H Jick; S. S Jick; M. W Myers; C Vasilakis; V Gurewich

1995-01-01

273

Type D Personality as a Cardiovascular Risk Marker in the General Population: Results from the Gutenberg Health Study  

Microsoft Academic Search

Background: Type D personality is considered as an independent risk factor for morbidity and mortality in cardiovascular patients and a vulnerability factor for distress in the general population. Because representative community studies are rare, we sought to determine the prevalence of type D personality and its relationship with demographic characteristics, different features of mental disorders, cardiovascular risk factors, health behavior,

M. E. Beutel; J. Wiltink; Y. Till; P. S. Wild; T. Münzel; F. M. Ojeda; T. Zeller; R. B. Schnabel; K. Lackner; M. Blettner; I. Zwiener; M. Michal

2012-01-01

274

Cardiovascular risk estimation in women with a history of hypertensive pregnancy disorders at term: a longitudinal follow-up study  

PubMed Central

Background Cardiovascular disease is associated with major morbidity and mortality in women in the Western world. Prediction of an individual cardiovascular disease risk in young women is difficult. It is known that women with hypertensive pregnancy complications have an increased risk for developing cardiovascular disease in later life and pregnancy might be used as a cardiovascular stress test to identify women who are at high risk for cardiovascular disease. In this study we assess the possibility of long term cardiovascular risk prediction in women with a history of hypertensive pregnancy disorders at term. Methods In a longitudinal follow-up study, between June 2008 and November 2010, 300 women with a history of hypertensive pregnancy disorders at term (HTP cohort) and 94 women with a history of normotensive pregnancies at term (NTP cohort) were included. From the cardiovascular risk status that was known two years after index pregnancy we calculated individual (extrapolated) 10-and 30-year cardiovascular event risks using four different risk prediction models including the Framingham risk score, the SCORE score and the Reynolds risk score. Continuous data were analyzed using the Student’s T test and Mann–Whitney U test and categorical data by the Chi-squared test. A poisson regression analysis was performed to calculate the incidence risk ratios and corresponding 95% confidence intervals for the different cardiovascular risk estimation categories. Results After a mean follow-up of 2.5 years, HTP women had significantly higher mean (SD) extrapolated 10-year cardiovascular event risks (HTP 7.2% (3.7); NTP 4.4% (1.9) (p<.001, IRR 5.8, 95% CI 1.9 to 19)) and 30-year cardiovascular event risks (HTP 11% (7.6); NTP 7.3% (3.5) (p<.001, IRR 2.7, 95% CI 1.6 to 4.5)) as compared to NTP women calculated by the Framingham risk scores. The SCORE score and the Reynolds risk score showed similar significant results. Conclusions Women with a history of gestational hypertension or preeclampsia at term have higher predicted (extrapolated) 10-year and 30-year cardiovascular event risks as compared to women with a history of uncomplicated pregnancies. Further large prospective studies have to evaluate whether hypertensive pregnancy disorders have to be included as an independent variable in cardiovascular risk prediction models for women. PMID:23734952

2013-01-01

275

Cardiovascular Disease (CVD) Risk: Should We Target College Women?  

Microsoft Academic Search

Recent changes by the American Heart Association identify screening guidelines for CVD risk factors for those in their early twenties. Research on CVD has focused on adult populations 40 and over. If risk is identified at an earlier age, then preventative behaviors can be established to prevent the onset and prevalence of CVD. This study was conducted to identify college

Devan R. Romero; Shari McMahan; Michelle Cathorall

2005-01-01

276

Association of cardiovascular disease risk factors with socioeconomic position during childhood and during adulthood.  

PubMed Central

OBJECTIVE: To investigate strength of associations between risk factors for cardiovascular disease and socioeconomic position during childhood and adulthood. DESIGN: Cross sectional analysis of status of cardiovascular risk factors and past and present social circumstances. SUBJECTS: 5645 male participants in the west of Scotland collaborative study, a workplace screening study. MAIN OUTCOME MEASURES: Strength of association between each risk factor for cardiovascular disease (diastolic blood pressure, serum cholesterol concentration, level of recreational physical exercise, cigarette smoking, body mass index, and FEV1 score (forced expiratory volume in one second as percentage of expected value) and social class during childhood (based on father's main occupation) and adulthood (based on own occupation at time of screening). RESULTS: All the measured risk factors were significantly associated with both father's and own social class (P < 0.05), apart from exercise and smoking (not significantly associated with father's social class) and body mass index (not significantly associated with own social class). For all risk factors except body mass index, the regression coefficient of own social class was larger than the regression coefficient of father's social class. The difference between the coefficients was significant for serum cholesterol concentration, cigarette smoking, body mass index, and FEV1 score (all P < 0.001). CONCLUSIONS: Subjects' status for behavioural risk factors (exercise and smoking) was associated primarily with current socioeconomic circumstances, while status for physiological risk factors (serum cholesterol, blood pressure, body mass index, and FEV1) was associated to varying extents with both past and present socioeconomic circumstances. PMID:8973230

Blane, D.; Hart, C. L.; Smith, G. D.; Gillis, C. R.; Hole, D. J.; Hawthorne, V. M.

1996-01-01

277

Reducing cardiovascular risk in spouses of cardiac patients: a randomized controlled trial.  

PubMed

Few studies have examined risk-reducing interventions in spouses of coronary artery bypass patients. This study examined the effects of the Partners Together in Health (PaTH) intervention versus usual care on cardiovascular risk factors. Spouses in the experimental group (n = 17/group) attended cardiac rehabilitation with patients and made the same physical activity and healthy eating changes as patients. Spouses in the usual care group attended educational classes with patients. Spouses' 30-year cardiovascular risk was calculated using the Lifetime Risk Scale before and after cardiac rehabilitation (3 months), and at 6 months. Spouses in both groups significantly reduced 30-year risk scores at 3 and 6 months. Exercise was the key ingredient in lowering risk. There was a trend toward reduction in systolic blood pressure and an increase in high-density lipoprotein cholesterol in both groups. Although there were no group differences, having spouses participate in cardiac rehabilitation with the patient was effective for reducing spouses' cardiovascular risk. PMID:25245113

Yates, Bernice C; Rowland, Sheri; Mancuso, Kerry; Kupzyk, Kevin A; Norman, Joseph F; Shurmur, Scott; Tesina, Karen

2015-01-01

278

Mass media approaches to reducing cardiovascular disease risk.  

PubMed Central

A key function of a basic and clinical biomedical research organization is to communicate the findings of clinical investigations so that people may apply the results to improve their health and well-being. To help communicate results from cardiovascular disease research, the National Heart, Lung, and Blood Institute has established a series of national health education programs. The authors describe a model for two of the five programs and discuss the role of communication media in supporting national goals for education programs. The research basis for the programs is reviewed, together with the process by which the Institute develops information materials for mass media, notably public service announcements. A description of two national health education campaigns, hypertension and cholesterol, illustrates how market research is used to identify appropriate target audiences, develop messages, and select channels of communication. Lessons learned about the role of mass media in a national health education campaign are summarized. PMID:2113682

Bellicha, T; McGrath, J

1990-01-01

279

Relationship between Anthropometric Measures and Cardiovascular Risk Factors in Children and Adolescents  

PubMed Central

Background Obesity has been identified as an important risk factor in the development of cardiovascular diseases; however, other factors, combined or not with obesity, can influence cardiovascular risk and should be considered in cardiovascular risk stratification in pediatrics. Objective To analyze the association between anthropometry measures and cardiovascular risk factors, to investigate the determinants to changes in blood pressure (BP), and to propose a prediction equation to waist circumference (WC) in children and adolescents. Methods We evaluated 1,950 children and adolescents, aged 7 to 18 years. Visceral fat was assessed by WC and waist hip relationship, BP and body mass index (BMI). In a randomly selected subsample of these volunteers (n = 578), total cholesterol, glucose and triglycerides levels were evaluated. Results WC was positively correlated with BMI (r = 0.85; p < 0.001) and BP (SBP r = 0.45 and DBP = 0.37; p < 0.001). Glycaemia and triglycerides showed a weak correlation with WC (r = 0.110; p = 0.008 e r = 0.201; p < 0.001, respectively). Total cholesterol did not correlate with any of the variables. Age, BMI and WC were significant predictors on the regression models for BP (p < 0.001). We propose a WC prediction equation for children and adolescents: boys: y = 17.243 + 0.316 (height in cm); girls: y = 25.197 + 0.256 (height in cm). Conclusion WC is associated with cardiovascular risk factors and presents itself as a risk factor predictor of hypertension in children and adolescents. The WC prediction equation proposed by us should be tested in future studies. PMID:23979777

Burgos, Miria Suzana; Burgos, Leandro Tibirica; Camargo, Marcelo Dias; Franke, Silvia Isabel Rech; Pra, Daniel; da Silva, Antonio Marcos Vargas; Borges, Tassia Silvana; Todendi, Pamela Ferreira; Reckziegel, Miriam Beatris; Reuter, Cezane Priscila

2013-01-01

280

Aspirin resistance as cardiovascular risk after kidney transplantation  

NASA Astrophysics Data System (ADS)

International surveys have shown that the leading cause of death after kidney transplantation has cardiovascular origin with a prevalence of 35-40%. As a preventive strategy these patients receive aspirin (ASA) therapy, even though their rate of aspirin resistance is still unknown. In our study, platelet aggregation measurements were performed between 2009 and 2012 investigating the laboratory effect of low-dose aspirin (100 mg) treatment using a CARAT TX4 optical aggregometer. ASA therapy was considered clinically effective in case of low ( i.e., below 40%) epinephrine-induced (10 ?M) platelet aggregation index. Rate of aspirin resistance, morbidity and mortality data of kidney transplanted patients (n = 255, mean age: 49 ± 12 years) were compared to a patient population with cardio- and cerebrovascular diseases (n = 346, mean age: 52.6 ± 11 years). Rate of aspirin resistance was significantly higher in the renal transplantation group (RT) compared to the positive control group (PC) (35.9% vs. 25.6%, p < 0.002). Morbidity analysis demonstrated significantly higher incidence of myocardial infarction, hypertension and diabetes mellitus in the RT group (p < 0.05). The subgroup analysis revealed significantly higher incidence of infarction and stroke in the ASA resistant RT group compared to the RT patients without ASA resistance (p < 0.05). Furthermore, the incidence of myocardial infarction and hypertension was significantly higher in the non-resistant RT group than in the group of PC patients without ASA resistance (p < 0.05). These results may suggest that the elevated rate of aspirin resistance contributes to the high cardiovascular mortality after kidney transplantation.

Sandor, Barbara; Varga, Adam; Rabai, Miklos; Toth, Andras; Papp, Judit; Toth, Kalman; Szakaly, Peter

2014-05-01

281

LACK OF EFFECT OF DRINKING WATER BARIUM ON CARDIOVASCULAR RISK FACTORS  

EPA Science Inventory

Higher cardiovascular mortality has been associated in a single epidemiological study with higher levels of barium in drinking water. he purpose of this study was to determine whether drinking water barium at levels found in some U.S. communities alters the known risk factors for...

282

Cardiovascular risk factors and cognitive and affective impairment in the elderly  

Microsoft Academic Search

In the last years several studies have highlighted the considerable importance of cardiovascular risk factors in cognitive performances. Particularly, arterial hypertension is associated not only with vascular dementia, but could be also one of the underlying factors in the pathology of late onset dementia of Alzheimer's type (LO-DAT).*In our hypertension ambulatory of Dept. of Internal Medicine and Aging, we evaluated

Marina Martorelli; Barbara Stagni; Gabriele Donati; Giancarlo Savorani; Debora Calderoni; Michela Mancini; Luigi Bolondi

2001-01-01

283

Arterial Stiffness in Children and Teenagers: An Emerging Cardiovascular Risk Factor  

Microsoft Academic Search

Arterial stiffness, the rigidity of the arterial wall, owes its significance to a direct relationship with impedance of the arterial system, and hence the left ventricular afterload. In adults, arterial stiffness has been considered as a marker of vascular disease and is emerging as an independent cardiovascular risk factor. There is accumulating evidence that this may also be true in

YF CHEUNG

2005-01-01

284

Waist-to-Height Ratio and Body Mass Index as Indicators of Cardiovascular Risk in Youth  

ERIC Educational Resources Information Center

Background: The purpose of this investigation was to determine if waist-to-height ratio (WHTR) or body mass index (BMI) is the better indicator of cardiovascular disease risk in children and adolescents of varying ages. Methods: Data from children and adolescents (N?=?2300) who were part of the 2003-2004 National Health and Nutrition Examination…

Keefer, Daniel J.; Caputo, Jennifer L.; Tseh, Wayland

2013-01-01

285

Role Models and the Psychological Characteristics That Buffer Low-Socioeconomic-Status Youth from Cardiovascular Risk  

ERIC Educational Resources Information Center

Little is understood about why some youth from low-socioeconomic-status (SES) environments exhibit good health despite adversity. This study tested whether role models and "shift-and-persist" approaches (reframing stressors more benignly while persisting with future optimism) protect low-SES youth from cardiovascular risk. A total of 163…

Chen, Edith; Lee, William K.; Cavey, Lisa; Ho, Amanda

2013-01-01

286

An Investigation of Cardiovascular Disease Risk Factors in an Adolescent Population.  

ERIC Educational Resources Information Center

A study was conducted to analyze high school students' self-reports and to determine biomedical cardiovascular disease risk factors in an adolescent population. Factors evaluated included smoking frequency, dietary fat intake, saturated fat intake, and cholesterol/high density lipoprotein ratio. (JN)

Wolfgang, James; Dennison, Darwin

1982-01-01

287

Aerobic interval training reduces cardiovascular risk factors more than a multitreatment approach in overweight adolescents  

Microsoft Academic Search

The aim of the present study was to compare the effects of a multidisciplinary approach (MTG) and aerobic interval training (AIT) on cardiovascular risk factors in overweight adolescents. A total of 62 overweight and obese adolescents from Trøndelag County in Norway, referred to medical treatment at St Olav's Hospital, Trondheim, Norway, were invited to participate. Of these, 54 adolescents (age,

Anja Bye; Marte Volden; Rønnaug Ødegård; Eirik Skogvoll; Ulrik Wisløff

2009-01-01

288

Trends in lifestyle cardiovascular risk factors in women: analysis from the Canadian National Population Health Survey  

Microsoft Academic Search

Cardiovascular disease (CVD) is the leading cause of death and disability among women. The present investigation analyzed data from the National Population Health Survey to examine the prevalence trends of self-reported lifestyle CVD risk factors in adult women. Results indicated an upward prevalence trend in physical activity and high blood pressure, and significant increased prevalence rates in obesity in the

Julia Wong; Shirley Wong

2002-01-01

289

Risk of Cardiovascular Events in Patients Receiving Celecoxib: A Meta-Analysis of Randomized Clinical Trials  

Microsoft Academic Search

Some nonsteroidal anti-inflammatory drugs (NSAIDs), including cyclooxygenase-2 selec- tive inhibitors, have been associated with increased cardiovascular (CV) events in recent clinical trials or observational studies. To determine whether the cyclooxygenase-2 selective inhibitor celecoxib affects CV risk, the incidence of CV events was analyzed in patients treated with celecoxib, placebo, or nonselective NSAIDs in the clinical trial database for celecoxib using

William B. White; Christine R. West; Jeffrey S. Borer; Philip B. Gorelick; Lisa Lavange; Sharon X. Pan; Ethan Weiner; Kenneth M. Verburg

290

Blood pressure, body mass index and risk of cardiovascular disease in Chinese men and women  

Microsoft Academic Search

BACKGROUND: It is still uncertain whether increased blood pressure (BP) has a stronger effect on the risk of cardiovascular disease (CVD) in lean persons than in obese persons. We tested it using a data set collected from a large cohort of Chinese adults. METHODS: Systolic and diastolic BP, body mass index (BMI) and other variables were measured in 169,871 Chinese

Hongwei Wang; Jie Cao; Jianxin Li; Jichun Chen; Xigui Wu; Xiufang Duan; Jianfeng Huang; Dongfeng Gu

2010-01-01

291

Low levels of cardiovascular risk factors and coronary heart disease in a UK Chinese population  

Microsoft Academic Search

OBJECTIVE: To compare the prevalence of cardiovascular risk factors and coronary heart disease in Chinese and Europid adults. DESIGN: Population based, cross sectional survey. SETTING: Newcastle upon Tyne, UK, 1991-93. SUBJECTS: Altogether 380 Chinese and 625 Europid adults, aged 25-64 years. MAIN OUTCOME MEASURES: Fasting lipid levels, blood pressure, body mass index (BMI), the proportions who smoked, and the prevalence

J O Harland; N Unwin; R S Bhopal; M White; B Watson; M Laker; K G Alberti

1997-01-01

292

Contextual socioeconomic determinants of cardiovascular risk factors in rural south-west China: a multilevel analysis  

Microsoft Academic Search

BACKGROUND: We examined independent influences of contextual variables on cardiovascular risk factors in Shilin county, Yunnan province, South-west China. METHODS: Three villages were selected from each of the ten townships based on probability proportional to size. In each selected village, 200 individuals aged ? 45 years were chosen based on simple random sampling method. From 6006 individuals, information on demographic

Cai Le; Virasakdi Chongsuvivatwong; Alan Geater

2007-01-01

293

Rural to urban migration and changes in cardiovascular risk factors in Tanzania: a prospective cohort study  

Microsoft Academic Search

BACKGROUND: High levels of rural to urban migration are a feature of most African countries. Our aim was to investigate changes, and their determinants, in cardiovascular risk factors on rural to urban migration in Tanzania. METHODS: Men and women (15 to 59 years) intending to migrate from Morogoro rural region to Dar es Salaam for at least 6 months were

Nigel Unwin; Peter James; Dorothy McLarty; Harun Machybia; Peter Nkulila; Bushiri Tamin; Mkay Nguluma; Richard McNally

2010-01-01

294

Community-Responsive Interventions to Reduce Cardiovascular Risk in American Indians  

ERIC Educational Resources Information Center

American Indian and Alaska Native (AI/AN) populations bear a heavy burden of cardiovascular disease (CVD), and they have the highest rates of risk factors for CVD, such as cigarette smoking, obesity, and diabetes, of any U.S. population group. Yet, few randomized controlled trials have been launched to test potential preventive interventions in…

Jobe, Jared B.; Adams, Alexandra K.; Henderson, Jeffrey A.; Karanja, Njeri; Lee, Elisa T.; Walters, Karina L.

2012-01-01

295

Obesity and Cardiovascular Disease Risk Factors in Firefighters: A Prospective Cohort Study  

Microsoft Academic Search

Objective: Obesity, despite being a significant determinant of fitness for duty, is reaching epidemic levels in the workplace. Firefighters’ fitness is important to their health and to public safety.Research Methods and Procedures: We examined the distribution of BMI and its association with major cardiovascular disease (CVD) risk factors in Massachusetts firefighters who underwent baseline (1996) and annual medical examinations through

Elpidoforos S. Soteriades; Russ Hauser; Ichiro Kawachi; Dimitrios Liarokapis; David C. Christiani; Stefanos N. Kales

2005-01-01

296

Cerebellar stroke in a low cardiovascular risk patient associated with sorafenib treatment for fibrolamellar hepatocellular carcinoma  

PubMed Central

Key Clinical Message Sorafenib is the standard treatment of hepatocellular carcinoma (HCC). However, fibrolamellar HCC was not included in sorafenib trials. The case is a 26-year-old man with fibrolamellar HCC, who had a cerebrovascular accident (CVA) while being treated with sorafenib. This illustrates a probable relationship between use of sorafenib and CVA in low cardiovascular risk patients. PMID:25356226

Vandewynckel, Yves-Paul; Geerts, Anja; Verhelst, Xavier; Van Vlierberghe, Hans

2014-01-01

297

Effect of weight loss on the cardiovascular risk profile of obese patients with psoriasis.  

PubMed

Psoriasis is associated with obesity and other cardiovascular risk factors including endothelial dysfunction. We aimed to investigate the effects of weight loss on the cardiovascular risk profile of obese patients with psoriasis. A randomised controlled study was conducted in which we measured the microvascular endothelial function with peripheral arterial tonometry (PAT), selected plasma markers of endothelial function, and traditional cardiovascular risk factors in 60 obese patients with psoriasis. The participants were randomised to either low-energy diet (n?=?30) providing 800-1,000 kcal/day for 8 weeks followed by 8 weeks of reduced food intake reaching 1,200 kcal/day or normal healthy foods (n?=?30) for 16 weeks. The intervention group lost significantly more weight than controls, which resulted in significant reductions of diastolic blood pressure, resting heart rate, total cholesterol, VLDL cholesterol, triglyceride, plasma glucose, glycated haemoglobin, and tissue plasminogen activator inhibitor. Microvascular endothelial function assessed by PAT remained unchanged. We conclude that certain components of the cardiovascular risk profile of obese patients with psoriasis can be significantly improved by weight reduction. PMID:24556829

Jensen, Peter; Zachariae, Claus; Christensen, Robin; Geiker, Nina R W; Schaadt, Bente K; Stender, Steen; Astrup, Arne; Hansen, Peter R; Skov, Lone

2014-10-23

298

Cardiovascular disease and risk factors in law enforcement personnel: a comprehensive review.  

PubMed

Law enforcement is a high-stress occupation that is prone to increasing the prevalence and incidence of cardiovascular disease. Epidemiological studies suggest that police officers and related public safety personnel have an increased risk of cardiovascular morbidity and mortality. Currently employed police personnel have a high prevalence of traditional risk factors, including hypertension, hyperlipidemia, metabolic syndrome, cigarette smoking, and a sedentary lifestyle. Obesity may be more common in police officers compared with civilians, whereas diabetes is present less frequently. Law enforcement personnel are also exposed to occupation-specific risk factors that include sudden physical exertion, acute and chronic psychological stress, shift work, and noise. Workplace programs to promote the health and fitness of police officers are commonly lacking, but can be an effective means for reducing cardiovascular risk. Physicians should be familiar with the essential job tasks required for police officers to determine whether the individual is fit for duty. Governmental agencies have established strategic goals to reduce cardiovascular complications and improve the health and wellness of public safety personnel. PMID:22314143

Zimmerman, Franklin H

2012-01-01

299

Motivational interviewing to reduce cardiovascular risk in African American and Latina women.  

PubMed

Cardiovascular disease (CVD) is the leading cause of death for women, and disproportionally so for African American and Latina women. CVD is largely preventable and many risks can be attributable to health behaviors, implementing and sustaining positive health behaviors is a challenge. Motivational interviewing is one promising intervention for initiating behavior change. The purpose of this review was to identify, synthesize, and critically analyze the existing literature on the use of motivational interviewing as a behavioral intervention to reduce CVD risk among African American and Latina women. Seven studies were identified that met inclusion criteria. Results of this review suggest that motivational interviewing has mixed results when used to reduce cardiovascular risk factors in African American and Latina women. More research using a standardized motivational interviewing approach is needed to definitively determine if it is an effective behavioral intervention to reduce CVD risk when used in populations of African American and Latina women. PMID:23797099

Witt, Dawn R; Lindquist, Ruth; Treat-Jacobson, Diane; Boucher, Jackie L; Konety, Suma H; Savik, Kay

2013-11-01

300

A global perspective on psychosocial risk factors for cardiovascular disease.  

PubMed

Worldwide, there is variation in the incidence CVD with the greater burden being borne by low and middle-income countries. Traditional risk factors do not fully explain the CVD risk in populations, and there is increasing awareness of the impact the social environment and psychological factors have on CVD incidence and outcomes. The measurement of psychosocial variables is uniquely complex as variables are difficult to define objectively and local understanding of psychosocial risk factors may be subject to cultural influences. Notwithstanding this, there is a growing evidence base for the independent role they play in the pathogenesis of CVD. Consistent associations have been seen for general psychological stress, work-related stress, locus of control and depression with CVD risk. Despite the strength of this association the results from behavioural and pharmacological interventions have not clearly resulted in improved outcomes. PMID:23621967

Neylon, Antoinette; Canniffe, Carla; Anand, Sonia; Kreatsoulas, Catherine; Blake, Gavin J; Sugrue, Declan; McGorrian, Catherine

2013-01-01

301

Cotinine-assessed second-hand smoke exposure and risk of cardiovascular disease in older adults  

Microsoft Academic Search

ObjectivesTo examine whether second-hand smoke (SHS) exposure measured by serum cotinine is associated with increased coronary heart disease (CHD) and stroke risk among contemporary older British adults.DesignProspective population-based study with self-reported medical history and health behaviours. Fasting blood samples were analysed for serum cotinine and cardiovascular disease (CVD) risk markers.SettingPrimary care centres in 25 British towns in 1998–2001.Patients8512 60–79-year-old men

B. J. Jefferis; D. A. Lawlor; S. Ebrahim; S. G. Wannamethee; C. Feyerabend; M. Doig; L. McMeekin; D. G. Cook; P. H. Whincup

2010-01-01

302

New Advances in Lipid-Modifying Therapies for Reducing Cardiovascular Risk  

Microsoft Academic Search

Over the last 30 years, several epidemiological and prospective studies have identified a number of risk factors for the development of cardiovascular disease. Lipid abnormalities are central among these risk factors, and their correction has been a major target for the medical community. The 3-hydroxy-3-methyl glutaryl coenzyme A reductase (HMG-CoA reductase) inhibitors (statins) are the most widely prescribed and best

Eric Bruckert

2002-01-01

303

Circadian affective, cardiopulmonary, and cortisol variability in depressed and nondepressed individuals at risk for cardiovascular disease  

Microsoft Academic Search

Depression is a risk factor for cardiovascular disease (CVD) perhaps mediated by hypothalamic–pituitary–adrenal (HPA) axis or vagal dysregulation. We investigated circadian mood variation and HPA-axis and autonomic function in older (?55 years) depressed and nondepressed volunteers at risk for CVD by assessing diurnal positive and negative affect (PA, NA), cortisol, and cardiopulmonary variables in 46 moderately depressed and 19 nondepressed

Ansgar Conrad; Frank H. Wilhelm; Walton T. Roth; David Spiegel; C. Barr Taylor

2008-01-01

304

Correlation between dietary glycemic index and cardiovascular disease risk factors among Japanese women  

Microsoft Academic Search

Objective: To examine the correlation between dietary glycemic index (GI) and cardiovascular disease (CVD) risk factors among subjects who consume white rice as a staple food.Design: A cross-sectional study was conducted to explore the associations between dietary GI, dietary glycemic load (GL) and dietary intakes, and CVD risk factors. Dietary GI and GL were calculated from a 3-day (including two

Y Amano; K Kawakubo; J S Lee; A C Tang; M Sugiyama; K Mori

2004-01-01

305

Effects of omega-3 fatty acids on serum markers of cardiovascular disease risk: A systematic review  

Microsoft Academic Search

Greater fish oil consumption has been associated with reduced CVD risk, although the mechanisms are unclear. Plant-source oil omega-3 fatty acids (ALA) have also been studied regarding their cardiovascular effect. We conducted a systematic review of randomized controlled trials that evaluated the effect of consumption of fish oil and ALA on commonly measured serum CVD risk factors, performing meta-analyses when

Ethan M. Balk; Alice H. Lichtenstein; Mei Chung; Bruce Kupelnick; Priscilla Chew; Joseph Lau

2006-01-01

306

Cocoa Consumption, Cocoa Flavonoids, and Effects on Cardiovascular Risk Factors: An Evidence-Based Review  

Microsoft Academic Search

There has been considerable interest in the health effects of cocoa products. Cocoa flavonoids have especially been associated\\u000a with cardiovascular disease (CVD) risk factors. We summarize the effects of total flavonoid and cocoa flavonoid consumption\\u000a on CVD endpoints in observational studies and intermediate risk factors in experimental designs. From an evidence-based review,\\u000a there is strong evidence that high cocoa intake

Scott R. Bauer; Eric L. Ding; Liesbeth A. Smit

2011-01-01

307

Effects of dietary animal and soy protein on cardiovascular disease risk factors  

Microsoft Academic Search

A growing body of research offers insight into the influence of dietary protein on cardiovascular disease (CVD) risk. Early\\u000a studies in rabbits indicated that animal protein was atherogenic; however, this has not been demonstrated in other animals\\u000a species (pig, primate) or humans. More recent studies have found that low-fat animal protein can effectively improve some\\u000a CVD risk factors. Soy protein

Kari D. Hecker

2001-01-01

308

Cardiovascular disease risk factors in habitual exercisers, lean sedentary men and abdominally obese sedentary men  

Microsoft Academic Search

OBJECTIVE:To investigate whether the favourable cardiovascular disease (CVD) risk factor profile of habitual exercisers is attributable to exercise or leanness.DESIGN:Cross-sectional study of 113 nonsmoking men aged 30–45 y. CVD risk factors were compared in exercisers (n=39) and sedentary men (n=74), and in subgroups of lean exercisers (n=37), lean sedentary men (n=46) and obese sedentary men (n=28). Waist girth was used

G O'Donovan; A Owen; E M Kearney; D W Jones; A M Nevill; K Woolf-May; S R Bird

2005-01-01

309

Milk Consumption and Cardiovascular Risk Factors in Older Chinese: The Guangzhou Biobank Cohort Study  

PubMed Central

Background Dairy products consumption is increasingly common globally. Most of the evidence concerning dairy products comes from observational studies in western populations which are inevitably open to confounding. To triangulate the evidence concerning dairy products, we examined the associations of whole cow's milk consumption with cardiovascular risk factors in a non-Western setting with a different pattern of milk consumption and cardiovascular diseases from Western populations. Methods We used multivariable censored linear or logistic regression to examine cross-sectionally the adjusted associations of whole cow's milk consumption (none (n?=?14892), 1–3/week (n?=?2689) and 3+/week (n?=?2754)) with cardiovascular risk factors in Chinese (?50 years) in the Guangzhou Biobank Cohort Study. Results Whole cow's milk consumption was negatively associated with systolic blood pressure (3+/week compared to none ?2.56 mmHg, 95% confidence interval (CI) ?3.63 to ?1.49), diastolic blood pressure (?1.32 mmHg, 95% CI ?1.87 to ?0.77) and triglycerides (?0.06 mmol/L, 95% CI ?0.11 to ?0.002), but was positively associated with HDL-cholesterol (0.02 mmol/L,95% CI 0.01 to 0.04) and fasting glucose (0.08 mmol/L, 95% CI 0.01 to 0.16) adjusted for age, sex, phase of study, socio-economic position, lifestyle (smoking, alcohol use and physical activity) and adiposity, but had no obvious association with LDL-cholesterol or the presence of diabetes. Conclusions Whole cow's milk consumption had heterogeneous associations with cardiovascular risk factors. Higher whole cow's milk consumption was associated with lower levels of specific cardiovascular risk factors which might suggest risk factor specific biological pathways with different relations to blood pressure and lipids than glucose. PMID:24416290

Sun, Yangbo; Jiang, Chaoqiang; Cheng, Kar Keung; Zhang, Weisen; Leung, Gabriel M.; Lam, Tai Hing; Schooling, C. Mary

2014-01-01

310

Cardiovascular disease risk factor knowledge in young adults and 10-year change in risk factors: the Coronary Artery Risk Development in Young Adults (CARDIA) Study  

Microsoft Academic Search

This study's objective was assessment of cardiovascular disease (CVD) risk factor knowledge in young adults, its association with 10-year changes in risk factor levels, and variables related to risk factor knowledge. A total of 4,193 healthy persons (55% female, 48% Black; mean age=30 years) from four urban US communities were queried about risk factor knowledge in 1990-1991 and were reexamined

Elizabeth B. Lynch; Kiang Liu; Catarina I. Kiefe; Philip Greenland

2006-01-01

311

A prospective study of positive early life psychosocial factors and favorable cardiovascular risk in adulthood  

PubMed Central

Background The American Heart Association’s national goals for cardiovascular health promotion emphasize that cardiovascular risk originates early in life, but little is known about child factors that may increase the likelihood of having favorable cardiovascular risk (FCR) in adulthood. We examined the prospective association between positive child factors and likelihood of midlife FCR. We also considered pathways through which child factors may influence FCR. Methods and Results We studied 415 adults (mean age=42.2 years) of the Collaborative Perinatal Project, a national cohort initiated in 1959–1966. We examined three positive child factors assessed at age 7 years: attention regulation (ability to stay focused), cognitive ability and positive home environment. 10.6% had FCR in midlife. Adjusting for demographics and child cardiovascular health, a one unit increase in child attention regulation, cognitive ability and positive home environment was associated with 2.4 (95%CI: 1.1 to 4.7), 1.8 (95%CI: 1.1 to 2.9), and 1.3 (95%CI: 1.1 to 1.6) higher respective odds of having midlife FCR. The association with child attention regulation was maintained when accounting for adult factors; education and diet partly explained the associations with child cognitive ability and home environment. The effect of each attribute was additive as those with high levels of each child factor had 4.3 higher odds (95%CI: 1.01 to 18.2) of midlife FCR compared to those low in all factors. Conclusions Positive child psychosocial factors may promote healthy adult cardiovascular functioning. Primordial prevention efforts aimed at preventing the development of cardiovascular risk should consider building on child psychosocial resources. PMID:23339873

Appleton, Allison A.; Buka, Stephen L.; Loucks, Eric B.; Rimm, Eric; Martin, Laurie T.; Kubzansky, Laura D.

2013-01-01

312

Type 1 diabetes, metabolic syndrome and cardiovascular risk.  

PubMed

Patients with type 1 diabetes mellitus (T1DM) traditionally had a low body mass index and microangiopathic complications were common, while macroangiopathy and the metabolic syndrome were exceptional. The Diabetes Control and Complications Trial, published in 1993, demonstrated that therapy aimed at maintaining HbA1c levels as close to normal as feasible reduced the incidence of microangiopathy. Since then, the use of intensive insulin therapy to optimize metabolic control became generalized. Improved glycemic control resulted in a lower incidence of microangiopathy; however, its side effects included a higher rate of severe hypoglycemia and increased weight gain. Approximately 50% of patients with T1DM are currently obese or overweight, and between 8% and 40% meet the metabolic syndrome criteria. The components of the metabolic syndrome and insulin resistance have been linked to chronic T1DM complications, and cardiovascular disease is now the leading cause of death in these patients. Therefore, new therapeutic strategies are required in T1DM subjects, not only to intensively lower glycemia, but to control all associated metabolic syndrome traits. PMID:24274980

Chillarón, Juan J; Flores Le-Roux, Juana A; Benaiges, David; Pedro-Botet, Juan

2014-02-01

313

Diabetes, cardiovascular disease, selected cardiovascular disease risk factors, and the 5-year incidence of age-related cataract and progression of lens opacities: the beaver dam eye study  

Microsoft Academic Search

PURPOSE: To describe the relationships of diabetes mellitus, cardiovascular disease, and selected cardiovascular disease risk factors to cumulative incidence of age-related cataract and to progression of lens opacities over a 5-year interval.METHODS: A follow-up examination of the Beaver Dam Eye Study cohort was performed 5 years after the baseline evaluation. Ages at the census prior to baseline ranged from 43

Barbara E. K Klein; Ronald Klein; Kristine E Lee

1998-01-01

314

Residual Antibiotics Disrupt Meat Fermentation and Increase Risk of Infection  

PubMed Central

ABSTRACT Fermented sausages, although presumed safe for consumption, sometimes cause serious bacterial infections in humans that may be deadly. Not much is known about why and when this is the case. We tested the hypothesis that residual veterinary antibiotics in meat can disrupt the fermentation process, giving pathogenic bacteria a chance to survive and multiply. We found that six commercially available starter cultures were susceptible to commonly used antibiotics, namely, oxytetracycline, penicillin, and erythromycin. In meat, statutorily tolerable levels of oxytetracycline and erythromycin inhibited fermentation performance of three and five of the six starter cultures, respectively. In model sausages, the disruption of meat fermentation enhanced survival of the pathogens Escherichia coli O157:H7 and Salmonella enterica serovar Typhimurium compared to successful fermentations. Our work reveals an overlooked risk associated with the presence of veterinary drugs in meat. PMID:22930338

Kjeldgaard, Jette; Cohn, Marianne T.; Casey, Pat G.; Hill, Colin; Ingmer, Hanne

2012-01-01

315

Estimates of Commercial Population at High Risk for Cardiovascular Events: Impact of Aggressive Cholesterol Reduction  

PubMed Central

Objectives To model the financial and health outcomes impact of intensive statin therapy compared with usual care in a high-risk working-age population (actively employed, commercially insured health plan members and their adult dependents). The target population consists of working-age people who are considered high-risk for cardiovascular disease events because of a history of coronary heart disease. Study Design Three-year event forecast for a sample population generated from the National Health and Nutrition Examination Survey data. Methods Using Framingham risk scoring system, the probability of myocardial infarction or stroke events was calculated for a representative sample population, ages 35 to 69 years, of people at high risk for cardiovascular disease, with a history of coronary heart disease. The probability of events for each individual was used to project the number of events expected to be generated for this population. Reductions in cardiovascular and stroke events reported in clinical trials with aggressive statin therapy were applied to these cohorts. We used medical claims data to model the cohorts' event costs. All results are adjusted to reflect the demographics of a typical working-age population. Results The high-risk cohort (those with coronary heart disease) comprises 4% of the 35- to 69-year-old commercially insured population but generates 22% of the risk for coronary heart disease and stroke. Reduced event rates associated with intensive statin therapy yielded a $58 mean medical cost reduction per treated person per month; a typical payer cost for a 30-day supply of intensive statin therapy is approximately $57. Conclusions Aggressive low-density lipoprotein cholesterol–lowering therapy for working-age people at high risk for cardiovascular events and with a history of heart disease appears to have a significant potential to reduce the rate of clinical events and is cost-neutral for payers. PMID:25126293

Fitch, Kathryn; Goldberg, Sara W.; Iwasaki, Kosuke; Pyenson, Bruce S.; Kuznik, Andreas; Solomon, Henry A.

2009-01-01

316

Risk of cardiovascular events in people prescribed glucocorticoids with iatrogenic Cushing's syndrome: cohort study  

PubMed Central

Objective To investigate whether there is an increased risk of cardiovascular events in people who exhibit iatrogenic Cushing’s syndrome during treatment with glucocorticoids. Design Cohort study. Setting 424 UK general practices contributing to The Health Improvement Network database. Participants People prescribed systemic glucocorticoids and with a diagnosis of iatrogenic Cushing’s syndrome (n=547) and two comparison groups: those prescribed glucocorticoids and with no diagnosis of iatrogenic Cushing’s syndrome (n=3231) and those not prescribed systemic glucocorticoids (n=3282). Main outcome measures Incidence of cardiovascular events within a year after diagnosis of iatrogenic Cushing’s syndrome or after a randomly selected date, and association between iatrogenic Cushing’s syndrome and risk of cardiovascular events. Results 417 cardiovascular events occurred in 341 patients. Taking into account only the first event by patient (coronary heart disease n=177, heart failure n=101, ischaemic stroke n=63), the incidence rates of cardiovascular events per 100 person years at risk were 15.1 (95% confidence interval 11.8 to 18.4) in those prescribed glucocorticoids and with a diagnosis of iatrogenic Cushing’s syndrome, 6.4 (5.5 to 7.3) in those prescribed glucocorticoids without a diagnosis of iatrogenic Cushing’s syndrome, and 4.1 (3.4 to 4.8) in those not prescribed glucocorticoids. In multivariate analyses adjusted for sex, age, intensity of glucocorticoid use, underlying disease, smoking status, and use of aspirin, diabetes drugs, antihypertensive drugs, lipid lowering drugs, or oral anticoagulant drugs, the relation between iatrogenic Cushing’s syndrome and cardiovascular events was strong (adjusted hazard ratios 2.27 (95% confidence interval 1.48 to 3.47) for coronary heart disease, 3.77 (2.41 to 5.90) for heart failure, and 2.23 (0.96 to 5.17) for ischaemic cerebrovascular events). The adjusted hazard ratio for any cardiovascular event was 4.16 (2.98 to 5.82) when the group prescribed glucocorticoids and with iatrogenic Cushing’s syndrome was compared with the group not prescribed glucocorticoids. Conclusion People who use glucocorticoids and exhibit iatrogenic Cushing’s syndrome should be aggressively targeted for early screening and management of cardiovascular risk factors. PMID:22846415

2012-01-01

317

Prevalence of cardiovascular risk factors and socioeconomic level among public-sector workers in Angola  

PubMed Central

Background Cardiovascular diseases are the leading cause of death in the majority of developed and developing countries. African countries are currently facing an increase in both cardiovascular and transmitted diseases. In addition, cardiovascular risk varies among different socioeconomic groups. Thus, we determined the prevalence of modifiable cardiovascular risk factors in apparently healthy public-sector workers and investigated possible relationships with socioeconomic status. Methods We employed a cross-sectional study comprising 42.2% (n = 615) of the public-sector workers at Agostinho Neto University, 48% (n = 294) male and 52% (n= 321) female, with ages between 20 and 72 years and from various socioeconomic groups. The study was conducted from February 2009 to December 2010. Personal, anthropometric, biochemical, hemodynamic, socioeconomic, and physical activity data were collected. Results The prevalence rates of cardiovascular risk factors were as follows: hypertension, 45.2% (men 46.3%, women 44.2%, P > 0.05); hypercholesterolemia, 11.1% (men 10.5%, women 11.5%, P > 0.05); low high-density lipoprotein (HDL) cholesterol, 50.1% (men 36.9%, women 62.3%; P < 0.05); hypertriglyceridemia, 10.6% (men 12.6%, women 8.7%, P > 0.05); smoking, 7.2% (men 10.2%, women 4.4%; P < 0.05); diabetes, 5.7% (men 5.5%, women 5.9%, P > 0.05); overweight, 29.3% (men 27.3%, women 31.2%, P > 0.05); obesity, 19.6% (men 9.2%, women 29.0%; P < 0.05); sedentary lifestyle, 87.2% (men 83.0%, women 91,0%, P < 0.05); and left ventricular hypertrophy, 20% (men 32.0%, women 9.0%; P < 0.05). At least one risk factor was present in 27.7% of the sample; 15.2% had two risk factors, and 31.4% had three or more risk factors. Among the individuals with low socioeconomic status, 41.0% had three or more risk factors. Conclusions The results of this study suggest the existence of a high prevalence of multiple risk factors for cardiovascular disease in apparently healthy public-sector workers in Angola. The workers in lower socioeconomic groups had higher incidences of hypertension, smoking, and left ventricular hypertrophy. PMID:23924306

2013-01-01

318

Cardiovascular disease risk score prediction models for women and its applicability to Asians  

PubMed Central

Purpose Although elevated cardiovascular disease (CVD) risk factors are associated with a higher risk of developing heart conditions across all ethnic groups, variations exist between groups in the distribution and association of risk factors, and also risk levels. This study assessed the 10-year predicted risk in a multiethnic cohort of women and compared the differences in risk between Asian and Caucasian women. Methods Information on demographics, medical conditions and treatment, smoking behavior, dietary behavior, and exercise patterns were collected. Physical measurements were also taken. The 10-year risk was calculated using the Framingham model, SCORE (Systematic COronary Risk Evaluation) risk chart for low risk and high risk regions, the general CVD, and simplified general CVD risk score models in 4,354 females aged 20–69 years with no heart disease, diabetes, or stroke at baseline from the third Australian Risk Factor Prevalence Study. Country of birth was used as a surrogate for ethnicity. Nonparametric statistics were used to compare risk levels between ethnic groups. Results Asian women generally had lower risk of CVD when compared to Caucasian women. The 10-year predicted risk was, however, similar between Asian and Australian women, for some models. These findings were consistent with Australian CVD prevalence. Conclusion In summary, ethnicity needs to be incorporated into CVD risk assessment. Australian standards used to quantify risk and treat women could be applied to Asians in the interim. The SCORE risk chart for low-risk regions and Framingham risk score model for incidence are recommended. The inclusion of other relevant risk variables such as obesity, poor diet/nutrition, and low levels of physical activity may improve risk estimation. PMID:24648770

Goh, Louise GH; Dhaliwal, Satvinder S; Welborn, Timothy A; Thompson, Peter L; Maycock, Bruce R; Kerr, Deborah A; Lee, Andy H; Bertolatti, Dean; Clark, Karin M; Naheed, Rakhshanda; Coorey, Ranil; Della, Phillip R

2014-01-01

319

Amlodipine/atorvastatin single pill for the management of hypertensive patients with additional cardiovascular risk factors.  

PubMed

Amlodipine besylate and atorvastatin calcium have been demonstrated in numerous clinical trials to be highly effective in lowering blood pressure and low-density lipoprotein cholesterol, respectively, and in reducing cardiovascular events. A novel single-pill therapy containing amlodipine and atorvastatin is currently available in the USA and has been approved for use in parts of Europe, Asia and Latin America. This medication retains the proven clinical safety and efficacy of amlodipine and atorvastatin when administered separately. However, it reduces the pill burden associated with coadministration of an antihypertensive agent and a statin for hypertensive patients with additional cardiovascular risk factors. This single-pill therapy may increase patient adherence to these medications and thus improve the simultaneous management of two important cardiovascular risk factors. This strategy may also improve clinical outcomes. An overview of the rationale for the development and use of amlodipine/atorvastatin single-pill therapy in hypertensive patients with multiple cardiovascular risk factors and the latest data from clinical trials are presented in this article. PMID:19804070

Blank, Roy

2006-03-01

320

Asymmetric dimethylarginine: a cardiovascular risk factor and a uremic toxin coming of age?  

PubMed

The idea that asymmetric dimethylarginine (ADMA) accumulation may be a cardiovascular risk factor in patients with end-stage renal disease was advanced by Vallance in 1992. During the last decade, the relationship between ADMA and adverse cardiovascular events, including death, in dialysis patients has been investigated thoroughly. Several studies have shown that, independently of other risk factors, ADMA is strongly associated with intima-media thickness of the carotid artery and left ventricular mass, particularly concentric left ventricular hypertrophy. Furthermore, cohort studies in both the general population and the dialysis population showed a strong and independent link between ADMA, all-cause mortality, and cardiovascular events. Circumstantial evidence indicates that norepinephrine and ADMA may be in the same causal pathway leading to cardiovascular complications in patients with end-stage renal disease. Several lines of evidence show that high ADMA levels may exert toxic effects in various cell types. High ADMA levels have been associated with alterations in the regulation of cerebral blood flow and neural function, with insulin resistance, thyroid dysfunction, and alterations in bone homeostasis, fertility, and erectile function. The clinical significance of decreasing plasma ADMA concentrations, if any, is unknown. Well-designed and carefully conducted studies are needed to further clarify the role of ADMA in the pathophysiological states of renal disease and explore possible treatment options to improve the prognosis of patients with elevated ADMA levels. ADMA may enable us to predict risk and follow up the course of renal diseases. PMID:16112037

Kielstein, Jan T; Zoccali, Carmine

2005-08-01

321

Prediction of Cardiovascular Risk Using Framingham, ASSIGN and QRISK2: How Well Do They Predict Individual Rather than Population Risk?  

PubMed Central

Background The objective of this study was to evaluate the performance of risk scores (Framingham, Assign and QRISK2) in predicting high cardiovascular disease (CVD) risk in individuals rather than populations. Methods and findings This study included 1.8 million persons without CVD and prior statin prescribing using the Clinical Practice Research Datalink. This contains electronic medical records of the general population registered with a UK general practice. Individual CVD risks were estimated using competing risk regression models. Individual differences in the 10-year CVD risks as predicted by risk scores and competing risk models were estimated; the population was divided into 20 subgroups based on predicted risk. CVD outcomes occurred in 69,870 persons. In the subgroup with lowest risks, risk predictions by QRISK2 were similar to individual risks predicted using our competing risk model (99.9% of people had differences of less than 2%); in the subgroup with highest risks, risk predictions varied greatly (only 13.3% of people had differences of less than 2%). Larger deviations between QRISK2 and our individual predicted risks occurred with calendar year, different ethnicities, diabetes mellitus and number of records for medical events in the electronic health records in the year before the index date. A QRISK2 estimate of low 10-year CVD risk (<15%) was confirmed by Framingham, ASSIGN and our individual predicted risks in 89.8% while an estimate of high 10-year CVD risk (?20%) was confirmed in only 48.6% of people. The majority of cases occurred in people who had predicted 10-year CVD risk of less than 20%. Conclusions Application of existing CVD risk scores may result in considerable misclassification of high risk status. Current practice to use a constant threshold level for intervention for all patients, together with the use of different scoring methods, may inadvertently create an arbitrary classification of high CVD risk. PMID:25271417

van Staa, Tjeerd-Pieter; Gulliford, Martin; Ng, Edmond S.-W.; Goldacre, Ben; Smeeth, Liam

2014-01-01

322

Cardiovascular Disease Risk Factor Profiling of Group C Employees in JIPMER, Puducherry  

PubMed Central

Background: Settings-based approach for health promotion includes conducting risk factor surveillance as one of its component. It was aimed to estimate the prevalence of CVD risk factors among group C employees of tertiary care hospital in south India. Materials and Methods: A cross-sectional survey was conducted among 400 group C employees aged ?20 years using the WHO “STEPwise approach to surveillance of non-communicable diseases” (STEPS) methodology. Standardized international protocols were used to measure behavioral risk factors (smoking, alcohol consumption, fruit and vegetable consumption, physical activity) and physical characteristics (weight, waist and hip circumferences, height, and blood pressure). Multivariate analysis was done to predict the factors, which carry independent risk of hypertension. Risk factor profiling of the staff was done using WHO/ISH risk prediction chart to calculate the 10-year risk of a fatal or non-fatal major cardiovascular events (myocardial infarction or stroke), according to age, gender, blood pressure, smoking status, and presence or absence of diabetes mellitus. Results: Mean age in years was 40.9 (±10.4), and men constituted 81.3% of study population. Prevalence of major cardiovascular risk factors was as follows: Current smokers 12.3% men, regular alcohol intake 33.2% among men, overweight (?23 kg/m2) 74.5%, central obesity 78.7%, hypertension 38.8%, and history of diabetes mellitus 13.2%. Age, gender, physical inactivity, obesity, and family history of hypertension were found to be independently associated with hypertension. Four percent participants had a >10% risk of developing CVD in next 10 years. Conclusion: The prevalence of CVD risk factors is high in the sample population. Employee wellness program should be started in the institute to combat the burden of cardiovascular diseases. PMID:25374865

Aswin, K; Ghorpade, Arun G.; Kar, Sitanshu Sekhar; Kumar, Ganesh

2014-01-01

323

Cardiovascular Risk Reduction. The Problems Facing Our Society.  

ERIC Educational Resources Information Center

Continued and expanded efforts to educate people as to what factors contribute to coronary heart disease will help to decrease its occurrence. Risk factors include: cholesterol, smoking, hypertension, obesity, heredity, psychological influences, and the taking of oral contraceptives or alcohol. (CJ)

Harrison, Donald C.; Winston, Mary

1982-01-01

324

Focus on high-density lipoproteins in reducing cardiovascular risk  

Microsoft Academic Search

Low high-density lipoprotein (HDL) cholesterol is associated with increased risk of coronary heart disease (CHD). Ongoing investigation into the mechanisms whereby HDL cholesterol might provide protection from atherosclerosis and clinical disease has resulted in improved understanding of the role of HDL in removal of cholesterol from the arterial wall and has suggested a number of strategies for augmenting the beneficial

H. Bryan Brewer

2004-01-01

325

Resting Heart Rate and Risk of Cardiovascular Diseases and All-Cause Death: The Kailuan Study  

PubMed Central

Background Resting heart rate (RHR) predicts both cardiovascular and noncardiovascular death in different populations. However, the results of the association between RHR and cardiovascular diseases (CVDs) are inconsistent, especially for each subtype of CVDs. Objective The aim of this study was to prospectively explore the relationship between RHR and CVDs including myocardial infarction (MI), ischemic stroke, and hemorrhagic stroke and all-cause death in a general population. Methods The Kailuan study is a prospective longitudinal cohort study on cardiovascular risk factors and cardiovascular or cerebrovascular events. Hazard ratio (HR) with 95% confidence intervals (CI) were calculated using Cox regression modeling. Results We analyzed 92,562 participants (18–98 years old) in the Kailuan Study. CVDs were developed in 1,903 people during follow-ups. In multivariate analysis with adjustment for major traditional cardiovascular risk factors, HRs of the highest quintile group compared with the lowest quintile group of RHR for all-cause CVDs, MI, any stroke, ischemic stroke, hemorrhagic stroke, and all-cause death were 1.03 (95% CI, 0.98–1.07), 1.10 (95% CI, 1.01–1.20), 1.01 (95% CI, 0.97–1.06), 1.02 (95% CI, 0.96–1.07), 1.01 (95% CI, 0.92–1.11) and 1.18, (95% CI, 1.13–1.23), respectively. Conclusions The elevated RHR was independently associated with the increased risk for MI and all-cause death, but not for all-cause CVDs, any stroke, ischemic stroke, nor hemorrhagic stroke. This indicates that the elevated RHR might be a risk marker for MI and all-cause death in general populations. PMID:25343354

Wang, Chunxue; Zhou, Yong; Wu, Yuntao; Xing, Aijun; Luo, Yanxia; Huang, Zhe; Liu, Xiaoxue; Guo, Xiuhua; Zhao, Xingquan; Wu, Shouling

2014-01-01

326

Does Apolipoprotein E genotype affect cardiovascular risk in subjects with acromegaly?  

PubMed

Acromegaly is a syndrome that results when the pituitary gland produces excess growth hormone after epiphyseal closure at puberty. Usually, subjects with acromegaly exhibit a 2- to 3-fold higher mortality rate from diseases that are associated with cardiovascular complications when compared to the normal population. In this study, we therefore aimed to evaluate whether a well-established cardiovascular risk factor, the Apolipoprotein E (Apo E) genotype, contributes to increased risk of cardiovascular complications in subjects with acromegaly. A total of 102 unrelated acromegaly subjects were prospectively included into this case-control association study and constituted our study group. The study group was comparable by age and gender with 200 unrelated healthy subjects constituting our control group. Genomic DNA was isolated from the peripheral blood leukocytes of all subjects and Apo E genotype (codon 112/158) was assessed by melting temperature analyses after using a real-time PCR protocol. The Apolipoprotein E4 allele was found at a significantly higher frequency in the study group when compared with the control group (P = 0.032). Subjects with the E2 allele, on the other hand, had significantly increased values in body mass index (P = 0.004), waist circumference (P = 0.001), C-reactive protein (CRP) (P < 0.001), and left-side carotid intima media thickness (P = 0.025). The Apolipoprotein E2 genotype might contribute to increased risk of cardiovascular complications in subjects with acromegaly since it is concurrently present with other cardiovascular risk factors such as the left-side carotid intima media thickness and CRP. PMID:22200909

Bozok Cetintas, Vildan; Zengi, Ayhan; Tetik, Asli; Karadeniz, Muammer; Ergonen, Faruk; Kucukaslan, Ali Sahin; Tamsel, Sadik; Kosova, Buket; Sahin, Serap Baydur; Sayg?l?, Fusun; Eroglu, Zuhal

2012-06-01

327

Antioxidant Micronutrients and Cardiovascular Risk in Patients with Diabetes: A Systematic Review  

PubMed Central

Background Inverse associations between micronutrient intake and cardiovascular outcomes have been previously shown, but did not focus on diabetic patients. Objective To systematically review the role of micronutrients in the development/presence of cardiovascular outcomes in patients with diabetes. Methods We searched Medline, Embase, and Scopus (January/1949-March/2012) for observational studies that evaluated micronutrients and cardiovascular outcomes in patients with diabetes, and then selected and extracted the data (two independent reviewers). Results From the 15 658 studies identified, five were included, comprising three case-control and two cohorts, with a follow-up of 7-15 years. A meta-analysis was not performed due to the different antioxidant micronutrients (types and measurement methods) and outcomes evaluated. The micronutrients assessed were vitamin C intake in diet and/ or supplementation, chromium and selenium in toenail samples, and ?-tocopherol and zinc in serum levels. Intake of > 300 mg of vitamin C through supplementation was associated with increased risk of cardiovascular disease, coronary artery disease (CAD), and stroke (RR 1.69-2.37). High levels of ?-tocopherol in serum were associated with 30% lower CAD risk in another study (HR 0.71; 95%CI 0.53-0.94). Among minerals (zinc, selenium, and chromium), an inverse association between zinc and CAD was observed; levels lower than 14.1 ?mol/L were associated with an increased risk for CAD (RR 1.70; 95%CI 1.21-2.38). Conclusion The information available on this issue is scarce. Further prospective studies are needed to elucidate the role of these nutrients in the cardiovascular risk of patients with diabetes. PMID:23877741

Sarmento, Roberta Aguiar; Silva, Flavia Moraes; Sbruzzi, Graciele; Schaan, Beatriz D'Agord; de Almeida, Jussara Carnevale

2013-01-01

328

Cardiovascular Risk with Non-steroidal Anti-inflammatory Drugs: Clinical Implications.  

PubMed

In February 2014, the US Food and Drug Administration (FDA) convened an advisory committee meeting to discuss the accumulated data relating to the cardiovascular risk of non-steroidal anti-inflammatory drugs (NSAIDs) and the potential implications on the class prescription labeling. The committee recommended, though not unanimously, that (1) the current data does not support the conclusion that naproxen has a lower risk of thrombotic events than other NSAIDs; (2) there is no latency period for the risk of cardiovascular thrombotic events; (3) there are some patient populations at increased risk for events; and (4) equipoise remains in the major ongoing trial designed to address these issues further. The clinical implications of the FDA deliberations as well as the recently published meta-analyses and observational studies are discussed. With the information available today, there is insufficient evidence to conclude that there are significant differences between the approved NSAIDs with regard to the potential for cardiovascular events. An approach for balancing the major risks associated with NSAIDs is suggested. Clinicians should continue to use the current FDA NSAID labeling language to guide their decision making for individual patients until such time as the FDA makes changes. PMID:25079141

Bello, Alfonso E; Holt, Robert J

2014-11-01

329

Eating patterns and cardiovascular disease risk in a Detroit Mexican American population.  

PubMed

The purpose of this study was to examine dietary patterns and cardiovascular risk factors in Hispanic adults living in Southwest Detroit. A descriptive design was used. Self-report baseline data were collected using The Rate Your Plate and Personal Health Risk Assessment questionnaires. A nonrandom sample of 32 Mexican American adults was recruited from a large Roman Catholic Church in Southwest Detroit. Participants were selected if they were enrolled in the larger parent research study to test the effects of a lay health educator intervention and planned to participate in the nutrition education portion of the intervention. Unhealthy eating patterns outnumbered heart healthy eating practices. The majority used higher fat salad dressings; ate fried foods, sweets, and high fat snacks; consumed greater than the desired amounts of regular cheese; drank whole milk; and ate few fruits and vegetables. Lack of physical activity, being overweight, and exposure to second-hand smoke were the most prevalent cardiovascular risk factors. The data suggest that effective community-based heart disease prevention programs that emphasize risk factor screening and cardiovascular risk reduction through heart healthy eating are needed. PMID:15363023

Artinian, Nancy T; Schim, Stephanie Myers; Vander Wal, Jillon S; Nies, Mary A

2004-01-01

330

Communicating cardiovascular disease risk: an interview study of General Practitioners' use of absolute risk within tailored communication strategies  

PubMed Central

Background Cardiovascular disease (CVD) prevention guidelines encourage assessment of absolute CVD risk - the probability of a CVD event within a fixed time period, based on the most predictive risk factors. However, few General Practitioners (GPs) use absolute CVD risk consistently, and communication difficulties have been identified as a barrier to changing practice. This study aimed to explore GPs’ descriptions of their CVD risk communication strategies, including the role of absolute risk. Methods Semi-structured interviews were conducted with a purposive sample of 25 GPs in New South Wales, Australia. Transcribed audio-recordings were thematically coded, using the Framework Analysis method to ensure rigour. Results GPs used absolute CVD risk within three different communication strategies: ‘positive’, ‘scare tactic’, and ‘indirect’. A ‘positive’ strategy, which aimed to reassure and motivate, was used for patients with low risk, determination to change lifestyle, and some concern about CVD risk. Absolute risk was used to show how they could reduce risk. A ‘scare tactic’ strategy was used for patients with high risk, lack of motivation, and a dismissive attitude. Absolute risk was used to ‘scare’ them into taking action. An ‘indirect’ strategy, where CVD risk was not the main focus, was used for patients with low risk but some lifestyle risk factors, high anxiety, high resistance to change, or difficulty understanding probabilities. Non-quantitative absolute risk formats were found to be helpful in these situations. Conclusions This study demonstrated how GPs use three different communication strategies to address the issue of CVD risk, depending on their perception of patient risk, motivation and anxiety. Absolute risk played a different role within each strategy. Providing GPs with alternative ways of explaining absolute risk, in order to achieve different communication aims, may improve their use of absolute CVD risk assessment in practice. PMID:24885409

2014-01-01

331

Personality, emotional adjustment, and cardiovascular risk: marriage as a mechanism.  

PubMed

A variety of aspects of personality and emotional adjustment predict the development and course of coronary heart disease (CHD), as do indications of marital quality (e.g., satisfaction, conflict, strain, disruption). Importantly, the personality traits and aspects of emotional adjustment that predict CHD are also related to marital quality. In such instances of correlated risk factors, traditional epidemiological and clinical research typically either ignores the potentially overlapping effects or examines independent associations through statistical controls, approaches that can misrepresent the key components and mechanisms of psychosocial effects on CHD. The interpersonal perspective in personality and clinical psychology provides an alternative and integrative approach, through its structural and process models of interpersonal behavior. We present this perspective on psychosocial risk and review research on its application to the integration of personality, emotional adjustment, and marital processes as closely interrelated influences on health and disease. PMID:24118013

Smith, Timothy W; Baron, Carolynne E; Grove, Jeremy L

2014-12-01

332

Association of Metabolic Syndrome and Albuminuria with Cardiovascular Risk in Occupational Drivers  

PubMed Central

Background and Aim Metabolic syndrome (MetS) and albuminuria increase cardiovascular risk. However, in occupational drivers, the clinical significance of albuminuria and its association with MetS remain unclear. We investigated the prevalence of MetS, albuminuria and cardiovascular risk, and its associated risk factors in occupational drivers; Methods 441 occupational drivers and 432 age- and sex-stratified matched counterpart controls were enrolled. MetS was defined using Adult Treatment Panel III for Asians. Albuminuria was defined as urine albumin-to-creatinine ratio ? 30 mg/g. Cardiovascular disease risk was evaluated by Framingham Risk Score (FRS); Results A significantly higher prevalence of MetS (43.1% vs. 25.5%, p < 0.001), albuminuria (12.0% vs. 5.6%, p = 0.001) and high FRS risk ? 10% of 10-year risk (46.9% vs. 35.2%, p < 0.001) was found in occupational drivers compared with their counterpart controls. Multiple logistic regression analysis showed that old age, a history of diabetes, gout and betel nut chewing, less exercise and albuminuria (odds ratio [OR], 2.75; p = 0.01) were risk factors for MetS, while a history of renal disease, diabetes and hypertension, and MetS (OR, 2.28; p = 0.01) were risk factors for albuminuria in occupational drivers; Conclusions Our study demonstrated that MetS and albuminuria were public health problems in occupational drivers. An education program for promoting healthy lifestyle and a regular occupational health visit for early detection and interventions should be established. PMID:24201129

Chen, Szu-Chia; Chang, Jer-Ming; Lin, Ming-Yen; Hou, Meng-Ling; Tsai, Jer-Chia; Hwang, Shang-Jyh; Chen, Hung-Chun

2013-01-01

333

Cardiovascular risks and socioeconomic status: differences between men and women in Finland.  

PubMed Central

STUDY OBJECTIVE--The study aimed to assess the association of different indicators of socioeconomic status with levels of cardiovascular disease risk factors in men and women aged 25-64 years. DESIGN--This was a cross sectional survey, using a community based random sample. SETTING--The provinces of North Karelia and Kuopio in eastern Finland and the cities of Turku and Loimaa and surrounding communities in southwestern Finland in 1987. PARTICIPANTS--Altogether 2164 men and 2182 women aged 25-64 years took part. MEASUREMENTS AND MAIN RESULTS--Data were collected using self administered questionnaires and the measurement of height, body weight, and blood pressure and blood sampling for lipid determinations were done at the survey site. The risk of cardiovascular disease was determined by calculating a simple risk factor score based on the observed values of HDL and total cholesterol, leisure time, physical activity, blood pressure, medication for hypertension, body mass index, and smoking. Indicators of socioeconomic position used were years of education, family income, marital status, and the person's occupation. Lower levels of education, occupation, and income were all significantly associated with an unfavorable risk factor profile in men and women. Education and occupation showed the strongest associations with the risk factor score in both men and women. The results changed little when adjusting for income and marital status. Family income was more strongly associated with the risk factor score in women than men. When adjusting for occupation and education, income was no longer significantly associated with the risk factor score in men. Marital status was not significantly associated with the risk factor score in either sex. CONCLUSIONS--Using the strength of the association with the cardiovascular risk factor score as the criterion for a good socioeconomic indicator, the present study suggests that education and occupation may be equally good indicators in both men and women. Family income may have some additional importance, especially in women. PMID:7964332

Luoto, R; Pekkanen, J; Uutela, A; Tuomilehto, J

1994-01-01

334

High Performance Lipoprotein Profiling for Cardiovascular Risk Assessment  

E-print Network

FRS Framingham Risk Score FWHM Full width half maximum HDL High density lipoprotein HDL-C High density lipoprotein cholesterol HMG-CoA 3-hydroxy-3-methylclutaryl-coenzyme A HPLDP High performance lipoprotein density profiling hs-CRP High...) recommended that lipid screening tests consisting of total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), and triglyceride (TG) measurements be performed as a standard health assessment.8 While...

Larner, Craig

2012-10-19

335

Hypertension and other cardiovascular risk factors in women  

Microsoft Academic Search

Coronary heart disease (CHD) is the leading cause of death in U.S. women, causing about 250,000 deaths annually. More than one-third of women aged 55 to 64 with CHD are disabled by their disease, and this increases to 55% in women 75 years and older. Risk factors are highly prevalent in U.S. women aged 20 to 74 years: >1\\/3 have

Nanette K. Wenger

1995-01-01

336

Unfavourable cardiovascular disease risk profiles in a cohort of Dutch and British haemophilia patients.  

PubMed

Cardiovascular disease (CVD) mortality is reported to be decreased in haemophilia patients, but reports on the prevalence of CVD risk factors are conflicting. A cross-sectional assessment of CVD risk profiles was performed in a large cohort of haemophilia patients. Baseline data on CVD risk factors of 709 Dutch and UK haemophilia patients aged ?30 years were analysed and compared with the general age-matched male population. CVD risk profiles were assessed using the QRISK®2-2011 and SCORE algorithms. Although QRISK® 2 was only validated in the UK, comparison with SCORE indicated similar properties of QRISK®2 in both Dutch and UK patients (correlation 0.86). Mean age was 49.8 years. Hypertension was more common in haemophilia patients than in the general population (49% vs. 40%), while the prevalences of obesity and hypercholesterolaemia were lower (15 vs. 20% and 44 vs. 68%, respectively), and those of diabetes and smoking were similar. The predicted 10-year QRISK®2 risk was significantly higher in haemophilia patients than in the general population (8.9 vs. 6.7%), indicating more unfavourable cardiovascular disease risk profiles. This increased risk became apparent after the age of 40 years. Our results indicate an increased prevalence of hypertension and overall more unfavourable CVD risk profiles in haemophilia patients compared with the general age-matched male population. PMID:23138324

Fransen van de Putte, Dietje E; Fischer, Kathelijn; Makris, Michael; Tait, R Campbell; Chowdary, Pratima; Collins, Peter W; Meijer, Karina; Roosendaal, Goris; Schutgens, Roger E G; Mauser-Bunschoten, Eveline P

2013-01-01

337

[Oral antidiabetic drugs. How to begin and combine without cardiovascular risk].  

PubMed

Diabetes is recognized to be a major cardiovascular risk factor, and cardiocerebrovascular disease is the main cause of death of diabetic patients. Over the past decade, randomized controlled trials in type 2 diabetes have failed to demonstrate a clear association between glycemic control and a reduction in cardiovascular events and mortality, and have actually suggested that reducing glycemia to near normal levels may be harmful in some patients, increasing overall mortality. A meta-analysis showed that one of the most promising drugs for the treatment of hyperglycemia in type 2 diabetics, namely rosiglitazone, increases the incidence of ischemic cardiovascular events, and this led to the drug's suspension in Europe and drastically restricted it's use in the US. Consequently, over the recent years, any new drug for the treatment of hyperglycemia is obliged to present pre-clinical studies that prove it's cardiovascular safety, besides its efficacy, in order to receive approval by the regulatory authorities. Hence, the issue of how to treat type 2 diabetes in a cardiovascular safe manner is a current and very relevant concern. PMID:23721975

Duarte, Rui

2013-04-01

338

The effect of a comprehensive lifestyle intervention on cardiovascular risk factors in pharmacologically treated patients with stable cardiovascular disease compared to usual care: a randomised controlled trial  

PubMed Central

Background The additional benefit of lifestyle interventions in patients receiving cardioprotective drug treatment to improve cardiovascular risk profile is not fully established. The objective was to evaluate the effectiveness of a target-driven multidisciplinary structured lifestyle intervention programme of 6 months duration aimed at maximum reduction of cardiovascular risk factors in patients with cardiovascular disease (CVD) compared with usual care. Methods A single centre, two arm, parallel group randomised controlled trial was performed. Patients with stable established CVD and at least one lifestyle-related risk factor were recruited from the vascular and cardiology outpatient departments of the university hospital. Blocked randomisation was used to allocate patients to the intervention (n?=?71) or control group (n?=?75) using an on-site computer system combined with allocations in computer-generated tables of random numbers kept in a locked computer file. The intervention group received the comprehensive lifestyle intervention offered in a specialised outpatient clinic in addition to usual care. The control group continued to receive usual care. Outcome measures were the lifestyle-related cardiovascular risk factors: smoking, physical activity, physical fitness, diet, blood pressure, plasma total/HDL/LDL cholesterol concentrations, BMI, waist circumference, and changes in medication. Results The intervention led to increased physical activity/fitness levels and an improved cardiovascular risk factor profile (reduced BMI and waist circumference). In this setting, cardiovascular risk management for blood pressure and lipid levels by prophylactic treatment for CVD in usual care was already close to optimal as reflected in baseline levels. There was no significant improvement in any other risk factor. Conclusions Even in CVD patients receiving good clinical care and using cardioprotective drug treatment, a comprehensive lifestyle intervention had a beneficial effect on some cardiovascular risk factors. In the present era of cardiovascular therapy and with the increasing numbers of overweight and physically inactive patients, this study confirms the importance of risk factor control through lifestyle modification as a supplement to more intensified drug treatment in patients with CVD. Trial registration ISRCTN69776211 at http://www.controlled-trials.com PMID:22962863

2012-01-01

339

Excess risk attributable to traditional cardiovascular risk factors in clinical practice settings across Europe - The EURIKA Study  

PubMed Central

Background Physicians involved in primary prevention are key players in CVD risk control strategies, but the expected reduction in CVD risk that would be obtained if all patients attending primary care had their risk factors controlled according to current guidelines is unknown. The objective of this study was to estimate the excess risk attributable, firstly, to the presence of CVD risk factors and, secondly, to the lack of control of these risk factors in primary prevention care across Europe. Methods Cross-sectional study using data from the European Study on Cardiovascular Risk Prevention and Management in Daily Practice (EURIKA), which involved primary care and outpatient clinics involved in primary prevention from 12 European countries between May 2009 and January 2010. We enrolled 7,434 patients over 50 years old with at least one cardiovascular risk factor but without CVD and calculated their 10-year risk of CVD death according to the SCORE equation, modified to take diabetes risk into account. Results The average 10-year risk of CVD death in study participants (N = 7,434) was 8.2%. Hypertension, hyperlipidemia, smoking, and diabetes were responsible for 32.7 (95% confidence interval 32.0-33.4), 15.1 (14.8-15.4), 10.4 (9.9-11.0), and 16.4% (15.6-17.2) of CVD risk, respectively. The four risk factors accounted for 57.7% (57.0-58.4) of CVD risk, representing a 10-year excess risk of CVD death of 5.66% (5.47-5.85). Lack of control of hypertension, hyperlipidemia, smoking, and diabetes were responsible for 8.8 (8.3-9.3), 10.6 (10.3-10.9), 10.4 (9.9-11.0), and 3.1% (2.8-3.4) of CVD risk, respectively. Lack of control of the four risk factors accounted for 29.2% (28.5-29.8) of CVD risk, representing a 10-year excess risk of CVD death of 3.12% (2.97-3.27). Conclusions Lack of control of CVD risk factors was responsible for almost 30% of the risk of CVD death among patients participating in the EURIKA Study. PMID:21923932

2011-01-01

340

Influence of risk behavior aggregation in different categories of physical activity on the occurrence of cardiovascular risk factors  

PubMed Central

Background We aimed to verify the association of risk behavior aggregation in different categories of physical activity (PA) with the presence of cardiovascular risk factors (RF) employees at a public university. Method We analyzed data of 376 employees, which were visited in their workplace for measurement of weight, height and questionnaires to identify the risk behaviors and risk factors. Chi-square test was used to analyze the association between the dependent and independent variables and binary logistic regression was used to construct a multivariate model for the observed associations. Results Associations were found between the aggregation of following risk behaviors: smoking, alcohol consumption and physical inactivity, considered in different categories of PA, and the increase in RF, except for the presence of hypertriglyceridemia. Individuals with two or more risk behaviors in occupational PA category are more likely to be hypertensive (3.04 times) and diabetes (3.44 times). For the free time PA category, these individuals were 3.18 times more likely to have hypercholesterolemia and for locomotion PA, more likely to be hypertensive (2.42 times) and obese (2.51 times). Conclusion There are association between the aggregation of two or more risk behaviors and the presence of cardiovascular RF. PMID:23800219

2013-01-01

341

Plasma and Dietary Antioxidant Status as Cardiovascular Disease Risk Factors: A Review of Human Studies  

PubMed Central

Extensive evidence has demonstrated that many antioxidants such as vitamin C, vitamin E, carotenoids and polyphenols have protective effects in preventing cardiovascular disease (CVD), a chronic disease that is mediated by oxidative stress and inflammation. This review focuses on evidence from prospective cohort studies and clinical trials in regard to the associations between plasma/dietary antioxidants and cardiovascular events. Long-term, large-scale, population-based cohort studies have found that higher levels of serum albumin, bilirubin, glutathione, vitamin E, vitamin C, and carotenoids were associated with a lower risk of CVD. Evidence from the cohort studies in regard to dietary antioxidants also supported the protective effects of dietary vitamin E, vitamin C, carotenoids, and polyphenols on CVD risk. However, results from large randomized controlled trials did not support long-term use of single antioxidant supplements for CVD prevention due to their null or even adverse effects on major cardiovascular events or cancer. Diet quality indexes that consider overall diet quality rather than single nutrients have been drawing increasing attention. Cohort studies and intervention studies that focused on diet patterns such as high total antioxidant capacity have documented protective effects on CVD risk. This review provides a perspective for future studies that investigate antioxidant intake and risk of CVD. PMID:23912327

Wang, Ying; Chun, Ock K.; Song, Won O.

2013-01-01

342

Precocious markers of cardiovascular risk and vascular damage in apparently healthy women with previous gestational diabetes  

PubMed Central

Previous gestational diabetes mellitus (pGDM) indicates future risk for type 2 diabetes (T2DM). Insulin resistance (IR) may precede T2DM in many years and is associated with an increased risk for cardiovascular diseases. Aim This study aims to identify endothelial dysfunction and cardiovascular risk factors in women with pGDM. Methods This cross-sectional analysis included 45 non diabetic women, 20 pGDM and 25 controls, at least one year after delivery. Body mass index (BMI), abdominal circumference (AC), blood pressure, serum lipids, liver enzymes, uric acid, nonesterified fatty acids, C-reactive protein and plasma glucose, insulin, fibrinogen and plasminogen activator inhibitor 1 were measured. HOMA IR and ? were calculated. Pre and post induced ischemia videocapillaroscopy was performed in hand nailfold to evaluate microvascular morphologic aspect and functional response. Results AC and fasting glucose were significantly higher in pGDM (p = 0.01 and p = 0.002 respectively). Women with pGDM and BMI < 25 kg/m2 had significantly higher levels of fasting insulin and HOMA IR than controls (p = 0.008 and 0.05 respectively). Abnormal morphologic findings were more frequent and papillae rectification were 3.3 times more prevalent in pGDM (p = 0.003). Other microvascular parameters did not differ between groups. Conclusion Cardiovascular risk factors and a microcirculation abnormality (papillae rectification) were significantly increased in young non-diabetic women with pGDM. PMID:24955136

2014-01-01

343

An Unexpected Effect of Proton Pump Inhibitors: Elevation of the Cardiovascular Risk Factor ADMA  

PubMed Central

Background Proton pump inhibitors (PPIs) are gastric acid suppressing agents widely prescribed for the treatment of gastro-esophageal reflux disease (GERD). Recently, several studies in patients with acute coronary syndrome (ACS) have raised the concern that use of PPIs in these patients may increase their risk of major adverse cardiovascular events (MACE). The mechanism of this possible adverse effect is not known. Whether the general population might also be at risk has not been addressed. Methods and Results Plasma ADMA is an endogenous inhibitor of nitric oxide synthase (NOS). Elevated plasma ADMA is associated with increased risk for cardiovascular disease, likely due to its attenuation of the vasoprotective effects of endothelial NOS. We find that PPIs elevate plasma asymmetric dimethylarginine (ADMA) level and reduce nitric oxide (NO) levels and endothelium-dependent vasodilation in a murine model and ex vivo human tissues. PPIs increase ADMA because they bind to, and inhibit dimethylarginine dimethylaminohydrolase (DDAH), the enzyme that degrades ADMA. Conclusions We present a plausible biological mechanism to explain the association of PPIs with increased MACE in patients with unstable coronary syndromes. Of concern, this adverse mechanism is also likely to extend to the general population using PPIs. This finding compels additional clinical investigations and pharmacovigilance directed toward understanding the cardiovascular risk associated with use of the PPIs in the general population. PMID:23825361

Ghebremariam, Yohannes T.; LePendu, Paea; Lee, Jerry C.; Erlanson, Daniel A.; Slaviero, Anna; Shah, Nigam H.; Leiper, James; Cooke, John P.

2013-01-01

344

Measurable urinary albumin predicts cardiovascular risk among normoalbuminuric patients with type 2 diabetes.  

PubMed

Micro- or macroalbuminuria is associated with increased cardiovascular risk factors among patients with type 2 diabetes, but whether albuminuria within the normal range predicts long-term cardiovascular risk is unknown. We evaluated the relationships between albuminuria and cardiovascular events in 1208 hypertensive, normoalbuminuric patients with type 2 diabetes from the BErgamo NEphrologic Diabetes Complication Trial (BENEDICT), all of whom received angiotensin-converting enzyme inhibitor (ACEI) therapy at the end of the trial and were followed for a median of 9.2 years. The main outcome was time to the first of fatal or nonfatal myocardial infarction; stroke; coronary, carotid, or peripheral artery revascularization; or hospitalization for heart failure. Overall, 189 (15.6%) of the patients experienced a main outcome event (2.14 events/100 patient-years); 24 events were fatal. Albuminuria independently predicted events (hazard ratio [HR], 1.05; 95% confidence interval [CI], 1.02-1.08). Second-degree polynomial multivariable analysis showed a continuous nonlinear relationship between albuminuria and events without thresholds. Considering the entire study population, even albuminuria at 1-2 ?g/min was significantly associated with increased risk compared with albuminuria <1 ?g/min (HR, 1.04; 95% CI, 1.02-1.07). This relationship was similar in the subgroup originally randomly assigned to non-ACEI therapy. Among those originally receiving ACEI therapy, however, the event rate was uniformly low and was not significantly associated with albuminuria. Taken together, among normoalbuminuric patients with type 2 diabetes, any degree of measurable albuminuria bears significant cardiovascular risk. The association with risk is continuous but is lost with early ACEI therapy. PMID:22935482

Ruggenenti, Piero; Porrini, Esteban; Motterlini, Nicola; Perna, Annalisa; Ilieva, Aneliya Parvanova; Iliev, Ilian Petrov; Dodesini, Alessandro Roberto; Trevisan, Roberto; Bossi, Antonio; Sampietro, Giuseppe; Capitoni, Enrica; Gaspari, Flavio; Rubis, Nadia; Ene-Iordache, Bogdan; Remuzzi, Giuseppe

2012-10-01

345

Estimation of the Long-term Cardiovascular Events Using UKPDS Risk Engine in Metabolic Syndrome Patients.  

PubMed

Long-term cardiovascular complications in metabolic syndrome are a major cause of mortality and morbidity in India and forecasted estimates in this domain of research are scarcely reported in the literature. The aim of present investigation is to estimate the cardiovascular events associated with a representative Indian population of patients suffering from metabolic syndrome using United Kingdom Prospective Diabetes Study risk engine. Patient level data was collated from 567 patients suffering from metabolic syndrome through structured interviews and physician records regarding the input variables, which were entered into the United Kingdom Prospective Diabetes Study risk engine. The patients of metabolic syndrome were selected according to guidelines of National Cholesterol Education Program - Adult Treatment Panel III, modified National Cholesterol Education Program - Adult Treatment Panel III and International Diabetes Federation criteria. A projection for 10 simulated years was run on the engine and output was determined. The data for each patient was processed using the United Kingdom Prospective Diabetes Study risk engine to calculate an estimate of the forecasted value for the cardiovascular complications after a period of 10 years. The absolute risk (95% confidence interval) for coronary heart disease, fatal coronary heart disease, stroke and fatal stroke for 10 years was 3.79 (1.5-3.2), 9.6 (6.8-10.7), 7.91 (6.5-9.9) and 3.57 (2.3-4.5), respectively. The relative risk (95% confidence interval) for coronary heart disease, fatal coronary heart disease, stroke and fatal stroke was 17.8 (12.98-19.99), 7 (6.7-7.2), 5.9 (4.0-6.6) and 4.7 (3.2-5.7), respectively. Simulated projections of metabolic syndrome patients predict serious life-threatening cardiovascular consequences in the representative cohort of patients in western India. PMID:24843193

Shivakumar, V; Kandhare, A D; Rajmane, A R; Adil, M; Ghosh, P; Badgujar, L B; Saraf, M N; Bodhankar, S L

2014-03-01

346

Preoperative Arrhythmias Such as Atrial Fibrillation: Cardiovascular Surgery Risk Factor  

PubMed Central

Atrial fibrillation is still the most common arrhythmia that occurs in heart surgery. However, there is few literature data on the manner in which preoperative atrial fibrillation may influence the postoperative outcome of various heart surgery procedures. The purpose of our research is to assess the effects of preoperative atrial fibrillation on patients having undergone different heart surgery procedures. The results of our research are a review of clinical data which were collected prospectively, over a 10-year period, from all the patients who had undergone heart surgery in our Institute. The study group included 1119 heart surgery patients, who were divided as follows: the preoperative AFib group (n = 226, 20.19%) and the sinus rhythm group (n = 893, 79.80%). Major postoperative complications and hospital mortality rates were analyzed. According to our statistical analysis, preoperative atrial fibrillation significantly increased the mortality risk (P = 0.001), the patients' mechanical ventilation needs (P = 0.022), the rate of occurrence of infectious complications (P < 0.5), the rate of occurrence of complications such as acute kidney failure (P = 0.012), and the time spent by the patients in the intensive care ward (P < 0.01). In conclusion, preoperative atrial fibrillation in heart surgery patients increases the mortality and major complication risk further to heart surgery. PMID:25105131

Anghel, Diana; Anghel, Radu; Corciova, Flavia; Enache, Mihail; Tinica, Grigore

2014-01-01

347

Adiponectin Provides Additional Information to Conventional Cardiovascular Risk Factors for Assessing the Risk of Atherosclerosis in Both Genders  

PubMed Central

Background This study evaluated the relation between adiponectin and atherosclerosis in both genders, and investigated whether adiponectin provides useful additional information for assessing the risk of atherosclerosis. Methods We measured serum adiponectin levels and other cardiovascular risk factors in 1033 subjects (454 men, 579 women) from the Korean Genomic Rural Cohort study. Carotid intima–media-thickness (CIMT) was used as measure of atherosclerosis. Odds ratios (ORs) with 95% confidence intervals (95% CI) were calculated using multiple logistic regression, and receiver operating characteristic curves (ROC), the category-free net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were calculated. Results After adjustment for conventional cardiovascular risk factors, such as age, waist circumference, smoking history, low-density and high-density lipoprotein cholesterol, triglycerides, systolic blood pressure and insulin resistance, the ORs (95%CI) of the third tertile adiponectin group were 0.42 (0.25–0.72) in men and 0.47 (0.29–0.75) in women. The area under the curve (AUC) on the ROC analysis increased significantly by 0.025 in men and 0.022 in women when adiponectin was added to the logistic model of conventional cardiovascular risk factors (AUC in men: 0.655 to 0.680, p?=?0.038; AUC in women: 0.654 to 0.676, p?=?0.041). The NRI was 0.32 (95%CI: 0.13–0.50, p<0.001), and the IDI was 0.03 (95%CI: 0.01–0.04, p<0.001) for men. For women, the category-free NRI was 0.18 (95%CI: 0.02–0.34, p?=?0.031) and the IDI was 0.003 (95%CI: ?0.002–0.008, p?=?0.189). Conclusion Adiponectin and atherosclerosis were significantly related in both genders, and these relationships were independent of conventional cardiovascular risk factors. Furthermore, adiponectin provided additional information to conventional cardiovascular risk factors regarding the risk of atherosclerosis. PMID:24116054

Yoon, Jin-Ha; Kim, Sung-Kyung; Choi, Ho-June; Choi, Soo-In; Cha, So-Youn; Koh, Sang-Baek

2013-01-01

348

Does high sugar consumption exacerbate cardiometabolic risk factors and increase the risk of type 2 diabetes and cardiovascular disease?  

PubMed Central

Consumption of sugar has been relatively high in the Nordic countries; the impact of sugar intake on metabolic risk factors and related diseases has been debated. The objectives were to assess the effect of sugar intake (sugar-sweetened beverages, sucrose and fructose) on association with type 2 diabetes, cardiovascular disease and related metabolic risk factors (impaired glucose tolerance, insulin sensitivity, dyslipidemia, blood pressure, uric acid, inflammation markers), and on all-cause mortality, through a systematic review of prospective cohort studies and randomised controlled intervention studies published between January 2000 and search dates. The methods adopted were as follows: the first search was run in PubMed in October 2010. A second search with uric acid as risk marker was run in April 2011. The total search strategy was rerun in April 2011 in SveMed+. An update was run in PubMed in January 2012. Two authors independently selected studies for inclusion from the 2,743 abstracts according to predefined eligibility criteria. The outcome was that out of the 17 studies extracted, 15 were prospective cohort studies and two were randomised controlled crossover trials. All of the studies included only adults. With respect to incident type 2 diabetes (nine studies), four of six prospective cohort studies found a significant positive association for sugar-sweetened beverage intake. In general, larger cohort studies with longer follow-up more often reported positive associations, and BMI seemed to mediate part of the increased risk. For other metabolic or cardiovascular risk factors or outcomes, too few studies have been published to draw conclusions. In conclusion, data from prospective cohort studies published in the years 2000–2011 suggest that sugar-sweetened beverages probably increase the risk of type 2 diabetes. For related metabolic risk factors, cardiovascular disease or all-cause mortality and other types of sugars, too few studies were available to draw conclusions. PMID:22855643

Sonestedt, Emily; ?verby, Nina Cecilie; Laaksonen, David E.; Birgisdottir, Bryndis Eva

2012-01-01

349

Risks and benefits of omega 3 fats for mortality, cardiovascular disease, and cancer: systematic review  

PubMed Central

Objective To review systematically the evidence for an effect of long chain and shorter chain omega 3 fatty acids on total mortality, cardiovascular events, and cancer. Data sources Electronic databases searched to February 2002; authors contacted and bibliographies of randomised controlled trials (RCTs) checked to locate studies. Review methods Review of RCTs of omega 3 intake for 3 6 months in adults (with or without risk factors for cardiovascular disease) with data on a relevant outcome. Cohort studies that estimated omega 3 intake and related this to clinical outcome during at least 6 months were also included. Application of inclusion criteria, data extraction, and quality assessments were performed independently in duplicate. Results Of 15 159 titles and abstracts assessed, 48 RCTs (36 913 participants) and 41 cohort studies were analysed. The trial results were inconsistent. The pooled estimate showed no strong evidence of reduced risk of total mortality (relative risk 0.87, 95% confidence interval 0.73 to 1.03) or combined cardiovascular events (0.95, 0.82 to 1.12) in participants taking additional omega 3 fats. The few studies at low risk of bias were more consistent, but they showed no effect of omega 3 on total mortality (0.98, 0.70 to 1.36) or cardiovascular events (1.09, 0.87 to 1.37). When data from the subgroup of studies of long chain omega 3 fats were analysed separately, total mortality (0.86, 0.70 to 1.04; 138 events) and cardiovascular events (0.93, 0.79 to 1.11) were not clearly reduced. Neither RCTs nor cohort studies suggested increased risk of cancer with a higher intake of omega 3 (trials: 1.07, 0.88 to 1.30; cohort studies: 1.02, 0.87 to 1.19), but clinically important harm could not be excluded. Conclusion Long chain and shorter chain omega 3 fats do not have a clear effect on total mortality, combined cardiovascular events, or cancer. PMID:16565093

Hooper, Lee; Thompson, Rachel L; Harrison, Roger A; Summerbell, Carolyn D; Ness, Andy R; Moore, Helen J; Worthington, Helen V; Durrington, Paul N; Higgins, Julian P T; Capps, Nigel E; Riemersma, Rudolph A; Ebrahim, Shah B J; Smith, George Davey

2006-01-01

350

Impact of Birth Weight and Early Infant Weight Gain on Insulin Resistance and Associated Cardiovascular Risk Factors in Adolescence  

Microsoft Academic Search

BackgroundLow birth weight followed by accelerated weight gain during early childhood has been associated with adverse metabolic and cardiovascular outcomes later in life. The aim of this study was to examine the impact of early infant weight gain on glucose metabolism and cardiovascular risk factors in adolescence and to study if the effect differed between adolescents born small for gestational

Signe Fabricius-Bjerre; Rikke Beck Jensen; Kristine Færch; Torben Larsen; Christian Mølgaard; Kim Fleischer Michaelsen; Allan Vaag; Gorm Greisen

2011-01-01

351

Plant Sterols as Dietary Adjuvants in the Reduction of Cardiovascular Risk: Theory and Evidence  

PubMed Central

Plant sterol-enriched foods are an effective dietary adjuvant in reducing cardiovascular risk by lowering total cholesterol and low density lipoprotein-cholesterol (LDL-C) in serum by up to ?15%. The mechanism of action of plant sterols is different from those of 3-hydroxy-3-methylglutaryl coenzyme A inhibitors (statins) and thus their effect is additive. Combining plant sterols with other dietary components known to reduce cholesterol in a portfolio approach has proven to be most effective for reduction of hypercholesterolemia and provide an alternative treatment option for clinicians. Plant sterol-enriched foods provides clinicians with a relatively cheap, safe, and effective way to help patients manage their cardiovascular risk. PMID:17319460

Patch, Craig S; Tapsell, Linda C; Williams, Peter G; Gordon, Michelle

2006-01-01

352

Use of pioglitazone in the treatment of diabetes: effect on cardiovascular risk  

PubMed Central

Pioglitazone and other thiazolidinediones (TZDs) initially showed great promise as unique receptor-mediated oral therapy for type 2 diabetes, but a host of serious side effects, primarily cardiovascular, have limited their utility. It is crucial at this point to perform a risk– benefit analysis to determine what role pioglitazone should play in our current treatment of type 2 diabetes and where the future of this class of drugs is headed. This review provides a comprehensive overview of the present literature. Clinical data currently available indicate that pioglitazone is an effective and generally well-tolerated treatment option for use in patients with type 2 diabetes. Pioglitazone can still reduce adverse cardiovascular risk. PMID:24023518

Zou, Cong; Hu, Honglin

2013-01-01

353

Prognostic value of adenosine stress cardiovascular magnetic resonance in patients with low-risk chest pain  

Microsoft Academic Search

BACKGROUND: Approximately 5% of patients with an acute coronary syndrome are discharged from the emergency room with an erroneous diagnosis of non-cardiac chest pain. Highly accurate non-invasive stress imaging is valuable for assessment of low-risk chest pain patients to prevent these errors. Adenosine stress cardiovascular magnetic resonance (AS-CMR) is an imaging modality with increasing application. The goal of this study

Stamatios Lerakis; Dalton S McLean; Athanasios V Anadiotis; Matthew Janik; John N Oshinski; Nikolaos Alexopoulos; Elisa Zaragoza-Macias; Emir Veledar; Arthur E Stillman

2009-01-01

354

Cardiovascular Disease and Risk Factors among Psoriasis Patients in Two US Healthcare Databases, 2001–2002  

Microsoft Academic Search

Background: Cardiovascular diseases or risk factors (CVDR) seem to be more common in psoriasis patients than in the general population. Objective: We assessed the relationship of psoriasis with CVDR by analysis of healthcare claims data using a cross-sectional, prevalence-based study design. Patients and Methods: The IMS Health and MarketScan® claims databases were used to identify adults with psoriasis diagnostic codes.

A. B. Kimball; Y. Wu; C. Guzzo; N. Yeilding; C. Paramore; K. Fraeman; M. Bala

2008-01-01

355

Reduction in Framingham cardiovascular risk with concomitant treatment of hypertension\\/dyslipidemia with amlodipine\\/atorvastatin  

Microsoft Academic Search

Although recent consensus guidelines have stressed the importance of simultaneous management of multiple cardiovascular risk factors, the actual effects of such strategies have not been adequately tested. The Respond study assessed the efficacy of concurrent treatment of concomitant hypertension\\/dyslipidemia.Respond is a double-blind, double-dummy, placebo-controlled trial undertaken in 15 countries, which randomized 1,660 patients with hypertension and dyslipidemia to 1 of

Richard A. Preston; Peter Harvey; Ottmar Herfert; Gary Dykstra; Franklin Sun; Jaman Maroni; David Gillen

2005-01-01

356

Paraoxonase 1 Polymorphism and Prenatal Pesticide Exposure Associated with Adverse Cardiovascular Risk Profiles at School Age  

PubMed Central

Background Prenatal environmental factors might influence the risk of developing cardiovascular disease later in life. The HDL-associated enzyme paraoxonase 1 (PON1) has anti-oxidative functions that may protect against atherosclerosis. It also hydrolyzes many substrates, including organophosphate pesticides. A common polymorphism, PON1 Q192R, affects both properties, but a potential interaction between PON1 genotype and pesticide exposure on cardiovascular risk factors has not been investigated. We explored if the PON1 Q192R genotype affects cardiovascular risk factors in school-age children prenatally exposed to pesticides. Methods Pregnant greenhouse-workers were categorized as high, medium, or not exposed to pesticides. Their children underwent a standardized examination at age 6-to-11 years, where blood pressure, skin folds, and other anthropometric parameters were measured. PON1-genotype was determined for 141 children (88 pesticide exposed and 53 unexposed). Serum was analyzed for insulin-like growth factor I (IGF-I), insulin-like growth factor binding protein 3 (IGFBP3), insulin and leptin. Body fat percentage was calculated from skin fold thicknesses. BMI results were converted to age and sex specific Z-scores. Results Prenatally pesticide exposed children carrying the PON1 192R-allele had higher abdominal circumference, body fat content, BMI Z-scores, blood pressure, and serum concentrations of leptin and IGF-I at school age than unexposed children. The effects were related to the prenatal exposure level. For children with the PON1 192QQ genotype, none of the variables was affected by prenatal pesticide exposure. Conclusion Our results indicate a gene-environment interaction between prenatal pesticide exposure and the PON1 gene. Only exposed children with the R-allele developed adverse cardiovascular risk profiles thought to be associated with the R-allele. PMID:22615820

Andersen, Helle R.; Wohlfahrt-Veje, Christine; Dalgård, Christine; Christiansen, Lene; Main, Katharina M.; Nellemann, Christine; Murata, Katsuyuki; Jensen, Tina K.; Skakkebæk, Niels E.; Grandjean, Philippe

2012-01-01

357

A reappraisal of the impact of dairy foods and milk fat on cardiovascular disease risk  

Microsoft Academic Search

Background  This review provides a reappraisal of the potential effects of dairy foods, including dairy fats, on cardiovascular disease\\u000a (CVD)\\/coronary heart disease (CHD) risk. Commodities and foods containing saturated fats are of particular focus as current\\u000a public dietary recommendations are directed toward reducing the intake of saturated fats as a means to improve the overall\\u000a health of the population. A conference

J. Bruce German; Robert A. Gibson; Ronald M. Krauss; Paul Nestel; Benoît Lamarche; Wija A. van Staveren; Jan M. Steijns; Lisette C. P. G. M. de Groot; Adam L. Lock; Frédéric Destaillats

2009-01-01

358

The Effects of Priming on a Public Health Campaign Targeting Cardiovascular Risks  

Microsoft Academic Search

Public health interventions are cost-effective methods to reduce heart disease. The present study investigated the impact\\u000a of a low-cost priming technique on a public health campaign targeting cardiovascular risk. Participants were 415 individuals\\u000a (66% female) ages 18 and older recruited through clinics and churches. The study consisted of three phases. In Phase I, participants\\u000a completed a brief survey to assess

Mindy Ma; Katherine M. Dollar; Jeffrey L. Kibler; Daniel Sarpong; Deanne Samuels

2011-01-01

359

Cardiovascular risks and socioeconomic status: differences between men and women in Finland  

Microsoft Academic Search

STUDY OBJECTIVE--The study aimed to assess the association of different indicators of socioeconomic status with levels of cardiovascular disease risk factors in men and women aged 25-64 years. DESIGN--This was a cross sectional survey, using a community based random sample. SETTING--The provinces of North Karelia and Kuopio in eastern Finland and the cities of Turku and Loimaa and surrounding communities

R Luoto; J Pekkanen; A Uutela; J Tuomilehto

1994-01-01

360

Genetic variants in novel pathways influence blood pressure and cardiovascular disease risk  

Microsoft Academic Search

Blood pressure is a heritable trait influenced by several biological pathways and responsive to environmental stimuli. Over one billion people worldwide have hypertension (>=140mmHg systolic blood pressure or>=90mmHg diastolic blood pressure). Even small increments in blood pressure are associated with an increased risk of cardiovascular events. This genome-wide association study of systolic and diastolic blood pressure, which used a multi-stage

Georg B. Ehret; Patricia B. Munroe; Kenneth M. Rice; Murielle Bochud; Andrew D. Johnson; Daniel I. Chasman; Albert V. Smith; Martin D. Tobin; Germaine C. Verwoert; Shih-Jen Hwang; Vasyl Pihur; Peter Vollenweider; Paul F. O'Reilly; Najaf Amin; Jennifer L. Bragg-Gresham; Alexander Teumer; Nicole L. Glazer; Lenore Launer; Jing Hua Zhao; Yurii Aulchenko; Simon Heath; Siim Sõber; Afshin Parsa; Jian'an Luan; Pankaj Arora; Abbas Dehghan; Feng Zhang; Gavin Lucas; Andrew A. Hicks; Anne U. Jackson; John F. Peden; Toshiko Tanaka; Sarah H. Wild; Igor Rudan; Wilmar Igl; Yuri Milaneschi; Alex N. Parker; Cristiano Fava; John C. Chambers; Ervin R. Fox; Meena Kumari; Min Jin Go; Pim van der Harst; Wen Hong Linda Kao; Marketa Sjögren; D. G. Vinay; Myriam Alexander; Yasuharu Tabara; Sue Shaw-Hawkins; Peter H. Whincup; Yongmei Liu; Gang Shi; Johanna Kuusisto; Bamidele Tayo; Mark Seielstad; Xueling Sim; Khanh-Dung Hoang Nguyen; Terho Lehtimäki; Giuseppe Matullo; Ying Wu; Tom R. Gaunt; N. Charlotte Onland-Moret; Matthew N. Cooper; Carl G. P. Platou; Rebecca Hardy; Santosh Dahgam; Jutta Palmen; Veronique Vitart; Peter S. Braund; Tatiana Kuznetsova; Cuno S. P. M. Uiterwaal; Adebowale Adeyemo; Walter Palmas; Harry Campbell; Barbara Ludwig; Maciej Tomaszewski; Ioanna Tzoulaki; Nicholette D. Palmer; Thor Aspelund; Melissa Garcia; Yen-Pei C. Chang; Jeffrey R. O'Connell; Nanette I. Steinle; Diederick E. Grobbee; Dan E. Arking; Sharon L. Kardia; Alanna C. Morrison; Dena Hernandez; Samer Najjar; Wendy L. McArdle; David Hadley; Morris J. Brown; John M. Connell; Aroon D. Hingorani; Ian N. M. Day; Debbie A. Lawlor; John P. Beilby; Robert W. Lawrence; Robert Clarke; Jemma C. Hopewell; Halit Ongen; Albert W. Dreisbach; Yali Li; J. Hunter Young; Joshua C. Bis; Mika Kähönen; Jorma Viikari; Linda S. Adair; Nanette R. Lee; Ming-Huei Chen; Matthias Olden; Cristian Pattaro; Judith A. Hoffman Bolton; Anna Köttgen; Sven Bergmann; Vincent Mooser; Nish Chaturvedi; Timothy M. Frayling; Muhammad Islam; Tazeen H. Jafar; Jeanette Erdmann; Smita R. Kulkarni; Stefan R. Bornstein; Jürgen Grässler; Leif Groop; Benjamin F. Voight; Johannes Kettunen; Philip Howard; Andrew Taylor; Simonetta Guarrera; Fulvio Ricceri; Valur Emilsson; Andrew Plump; Inês Barroso; Kay-Tee Khaw; Alan B. Weder; Steven C. Hunt; Yan V. Sun; Richard N. Bergman; Francis S. Collins; Lori L. Bonnycastle; Laura J. Scott; Heather M. Stringham; Leena Peltonen; Markus Perola; Erkki Vartiainen; Stefan-Martin Brand; Jan A. Staessen; Thomas J. Wang; Paul R. Burton; Maria Soler Artigas; Yanbin Dong; Harold Snieder; Xiaoling Wang; Haidong Zhu; Kurt K. Lohman; Megan E. Rudock; Susan R. Heckbert; Nicholas L. Smith; Kerri L. Wiggins; Ayo Doumatey; Daniel Shriner; Gudrun Veldre; Margus Viigimaa; Sanjay Kinra; Dorairaj Prabhakaran; Vikal Tripathy; Carl D. Langefeld; Annika Rosengren; Dag S. Thelle; Anna Maria Corsi; Andrew Singleton; Terrence Forrester; Gina Hilton; Colin A. McKenzie; Tunde Salako; Naoharu Iwai; Yoshikuni Kita; Toshio Ogihara; Takayoshi Ohkubo; Tomonori Okamura; Hirotsugu Ueshima; Satoshi Umemura; Susana Eyheramendy; Thomas Meitinger; H.-Erich Wichmann; Yoon Shin Cho; Hyung-Lae Kim; Jong-Young Lee; James Scott; Joban S. Sehmi; Weihua Zhang; Bo Hedblad; Peter Nilsson; George Davey Smith; Andrew Wong; Narisu Narisu; Alena Stancáková; Leslie J. Raffel; Jie Yao; Sekar Kathiresan; Christopher J. O'Donnell; Stephen M. Schwartz; M. Arfan Ikram; W. T. Longstreth Jr.; Thomas H. Mosley; Sudha Seshadri; Nick R. G. Shrine; Louise V. Wain; Mario A. Morken; Amy J. Swift; Jaana Laitinen; Inga Prokopenko; Paavo Zitting; Jackie A. Cooper; Steve E. Humphries; John Danesh; Asif Rasheed; Anuj Goel; Anders Hamsten; Hugh Watkins; Stephan J. L. Bakker; Wiek H. van Gilst; Charles S. Janipalli; K. Radha Mani; Chittaranjan S. Yajnik; Albert Hofman; Ben A. Oostra; Ayse Demirkan; Aaron Isaacs; Fernando Rivadeneira; Edward G. Lakatta; Marco Orru; Angelo Scuteri; Mika Ala-Korpela; Antti J. Kangas; Leo-Pekka Lyytikäinen; Pasi Soininen; Taru Tukiainen; Peter Würtz; Rick Twee-Hee Ong; Marcus Dörr; Heyo K. Kroemer; Uwe Völker; Henry Völzke; Pilar Galan; Serge Hercberg; Mark Lathrop; Diana Zelenika; Panos Deloukas; Massimo Mangino; Tim D. Spector; Guangju Zhai; James F. Meschia; Michael A. Nalls; Pankaj Sharma; Janos Terzic; M. V. Kranthi Kumar; Matthew Denniff; Ewa Zukowska-Szczechowska; Lynne E. Wagenknecht; F. Gerald R. Fowkes; Fadi J. Charchar; Peter E. H. Schwarz; Caroline Hayward; Xiuqing Guo; Charles Rotimi; Michiel L. Bots; Eva Brand; Nilesh J. Samani; Ozren Polasek; Philippa J. Talmud; Fredrik Nyberg; Diana Kuh; Maris Laan; Kristian Hveem; Lyle J. Palmer

2011-01-01

361

Cardiovascular risk factor assessment after pre-eclampsia in primary care  

PubMed Central

Background Pre-eclampsia is associated with an increased risk of development of cardiovascular disease later in life. It is not known how general practitioners in the Netherlands care for these women after delivery with respect to cardiovascular risk factor management. Methods Review of medical records of 1196 women in four primary health care centres, who were registered from January 2000 until July 2007 with an International Classification of Primary Care (ICPC) code indicating pregnancy. Records were searched for indicators of pre-eclampsia. Of those who experienced pre-eclampsia and of a random sample of 150 women who did not, the following information on cardiovascular risk factor management after pregnancy was extracted from the records: frequency and timing of blood pressure, cholesterol and glucose measurements - and vascular diagnoses. Additionally the sensitivity and specificity of ICPC coding for pre-eclampsia were determined. Results 35 women experienced pre-eclampsia. Blood pressure was more often checked after pregnancy in these women than in controls (57.1% vs. 12.0%, p < 0.001). In 50% of the cases blood pressure was measured within 3 months after delivery with no further follow-up visit. A check for glucose and cholesterol levels was rare, and equally frequent in PE and control women. 20% of the previously normotensive women in the PE group had hypertension at one or more occasions after three months post partum versus none in the control group. The ICPC coding for pre-eclampsia showed a sensitivity of 51.4% and a specificity of 100.0%. Conclusion Despite the evidence of increased risk of future cardiovascular disease in women with a history of pre-eclampsia, follow-up of these women is insufficient and undeveloped in primary care in the Netherlands. PMID:19995418

2009-01-01

362

Effect of BMI on cardiovascular and metabolic syndrome risk factors in an Appalachian pediatric population  

PubMed Central

Background The purpose of this study was to characterize cardiovascular risk factors in a rural pediatric population by body mass index (BMI) category and the presence of the metabolic syndrome. Methods Data on 13,018 children and adolescents (aged younger than 20 years) from West Virginia and Ohio in 2005–2006 were obtained from the C8 Health Project to determine the prevalence of overweight/obesity and the metabolic syndrome, which was then compared with National Health and Nutrition Examination Survey 2005–2006 data. Cardiovascular risk factors were assessed by age-standardized and sex-standardized BMI category (<85th, 85th–95th, >95th percentiles) and the presence of metabolic syndrome, defined as the presence of three or more of the following criteria: BMI >97th percentile, triglycerides >110 mg/dL, high-density lipoprotein cholesterol <40 mg/dL, and fasting blood glucose >110 mg/dL. Results The population was 51% male and 95% white. The prevalence of overweight/obesity was 38% and metabolic syndrome was 4.6% in the C8 population, compared with a prevalence of 30% and 3.4%, respectively, within the National Health and Nutrition Examination Survey population. In our Appalachian population, a significant adverse trend across BMI categories was observed for lipids, insulin, inflammatory markers, white blood cell count, and C-reactive protein. Significant differences in these risk factors were seen among those with metabolic syndrome compared with those without metabolic syndrome. Conclusion The increased prevalence of overweight/obesity and the metabolic syndrome along with the increase in cardiovascular risk factors in Appalachian children and adolescents, suggests a cohort that may develop earlier onset and possibly increased severity of cardiovascular disease and other complications associated with metabolic syndrome and obesity.

Weber, Katelynn E; Fischl, Andrea FR; Murray, Pamela J; Conway, Baqiyyah N

2014-01-01

363

Intermuscular adipose tissue rivals visceral adipose tissue in independent associations with cardiovascular risk  

Microsoft Academic Search

Background:The metabolic implications of intermuscular adipose tissue (IMAT) are poorly understood compared to those of visceral adipose tissue (VAT) even though the absolute quantities of both depots are similar in many individuals.Objective:The aim was to determine the independent relationship between whole-body IMAT and cardiovascular risk factor parameters.Design:Whole body magnetic resonance imaging (MRI) was used to quantify total skeletal muscle (SM),

J-E Yim; S Heshka; J Albu; S Heymsfield; P Kuznia; T Harris; D Gallagher

2007-01-01

364

Differential impact of milk fatty acid profiles on cardiovascular risk biomarkers in healthy men and women  

Microsoft Academic Search

Background\\/Objectives:The objective of this study was to evaluate the impact of three specific ruminant (R) milk fats resulting from modification of the cow's diet on cardiovascular risk factors in healthy volunteers. R-milk fats were characterized by increased content in total trans fatty acids (R-TFAs) and parallel decrease in saturated fatty acids (SFAs).Subjects\\/Methods:A total of 111 healthy, normolipemic men and women

C Malpuech-Brugère; J Mouriot; C Boue-Vaysse; N Combe; J-L Peyraud; P LeRuyet; G Chesneau; B Morio; J-M Chardigny

2010-01-01

365

Helicobacter pylori infection: relation with cardiovascular risk factors, ischaemic heart disease, and social class  

Microsoft Academic Search

OBJECTIVE--To determine whether Helicobacter pylori infection is associated with the development of ischaemic heart disease and whether such infection can explain the social class inequality in ischaemic heart disease. DESIGN--Cardiovascular risk factor levels, prevalence of ischaemic heart disease (Rose questionnaire angina, and\\/or a history of myocardial infarction), and serum antibodies to H pylori (enzyme linked immunosorbent assay) were assessed in

L. J. Murray; K. B. Bamford; D. P. OReilly; E. E. McCrum; A. E. Evans

1995-01-01

366

Lifestyle Variables, Nontraditional Cardiovascular Risk Factors, and the Metabolic Syndrome in an Aboriginal Canadian Population  

Microsoft Academic Search

Objective: To examine lifestyle factors associated with metabolic syndrome (MetS) and to explore the relationships between MetS and non-traditional cardiovascular disease risk factors [adiponectin, leptin, C-reactive protein (CRP), interleukin-6 (IL-6), and serum amyloid A (SAA)] in an isolated Aboriginal Canadian community.Research Methods and Procedures: Data were obtained from 360 non-diabetic adults participating in a population-based study of Aboriginal Canadians. Fasting

Juan Liu; T. Kue Young; Bernard Zinman; Stewart B. Harris; Philip W. Connelly; Anthony J. G. Hanley

2006-01-01

367

Relative influence of diet and physical activity on cardiovascular risk factors in urban Chinese adults  

Microsoft Academic Search

OBJECTIVE: The relative influence of dietary factors vs physical activity on cardiovascular risk factors are poorly understood. We investigated these factors in a population whose traditional diet may have both positive (high plant-based) and negative (high refined carbohydrate) aspects, and whose physical activity levels (PALs) vary widely.DESIGN: Cross-sectional study.SUBJECTS: A total of 130 weight stable adults aged 35–49 y (BMI

M Yao; A H Lichtenstein; S B Roberts; G Ma; S Gao; K L Tucker; M A McCrory

2003-01-01

368

C-reactive protein, adiposity and cardiovascular risk factors in a Mediterranean population  

Microsoft Academic Search

Background:Understanding the distribution of high-sensitivity C-reactive protein (CRP) and its relations with classic cardiovascular risk factors in specific populations is important for further diagnostic use.Methods:We studied 1157 adult subjects (652 women and 505 men) participating in the Health Study of Catalonia. CRP concentrations were measured with a high-sensitivity turbidimetric assay.Results:Median levels of CRP were 1.57 mg\\/l and 25% of both

P García-Lorda; M Bulló; R Balanzà; J Salas-Salvadó

2006-01-01

369

Prevalence of Cardiovascular Risk Factors in Older People With Intellectual Disability  

Microsoft Academic Search

The prevalence and correlates of cardiovascular risk factors in older adults with intellectual disability was examined. We conducted a cross-sectional study with 50- to 90-year-old clients (N 5 470) of three Dutch intellectual disability care providing organizations and found that healthy behavior was low, with 98.9% of the participants having an unhealthy diet and 68.3%, a lack of exercise. Smoking

Channa F. de Winter; Corine Penning; Heleen M. Evenhuis

2009-01-01

370

Health Literacy Associated With Blood Pressure but not Other Cardiovascular Disease Risk Factors Among Dialysis Patients  

Microsoft Academic Search

BackgroundLimited health literacy is prevalent and has been linked to adverse patient outcomes. We examined the relationship between health literacy and cardiovascular disease (CVD) risk factors, including blood pressure (BP) parameters, lipids, waist-to-hip ratio (WHR), body mass index (BMI), and tobacco utilization among dialysis patients.MethodsWe conducted a cross-sectional study of 72 participants in a prospective cohort study of vascular calcification

Gbemisola A. Adeseun; Christine C. Bonney; Sylvia E. Rosas

2012-01-01

371

Effects of dehydroepiandrosterone (DHEA) on cardiovascular risk factors in older women with frailty characteristics  

PubMed Central

Objective: this analysis was to investigate the effects of dehydroepiandrosterone (DHEA) on cardiovascular risk factors in older women with frailty characteristics. Design, setting and participants: the study was a double-blind, randomised, placebo-controlled trial of 99 women (mean 76.6 ± 6.0 year) with the low DHEA-S level and frailty. Intervention: participants received 50 mg/day DHEA or placebo for 6 months; all received calcium (1,000–1,200 mg/day diet) and supplement (combined) and cholecalciferol (1,000 IU/day). Women participated in 90-min twice weekly exercise regimens, either chair aerobics or yoga. Main outcome measures: assessment of outcome variables included hormone levels (DHEA-S, oestradiol, oestrone, testosterone and sex hormone-binding globulin (SHBG)), lipid profiles (total cholesterol, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol and triglycerides), body composition measured by dual energy absorptiometry, glucose levels and blood pressure (BP). Results: eighty-seven women (88%) completed 6 months of study; 88% were pre-frail demonstrating 1–2 frailty characteristics and 12% were frail with ?3 characteristics. There were significant changes in all hormone levels including DHEA-S, oestradiol, oestrone and testosterone and a decline in SHBG levels in those taking DHEA supplements. In spite of changes in hormone levels, there were no significant changes in cardiovascular risk factors including lipid profiles, body or abdominal fat, fasting glucose or BP. Conclusion: research to date has not shown consistent effects of DHEA on cardiovascular risk, and this study adds to the literature that short-term therapy with DHEA is safe for older women in relation to cardiovascular risk factors. This study is novel in that we recruited women with evidence of physical frailty. PMID:20484057

Boxer, R. S.; Kleppinger, A.; Brindisi, J.; Feinn, R.; Burleson, J. A.; Kenny, A. M.

2010-01-01

372

Biosensors for the detection of cardiovascular risk markers in human serum  

Microsoft Academic Search

This paper presents two affinity-based biosensor implementations for the detection and quantification of cardiovascular risk proteins\\/markers, such as C-reactive protein, myoglobin, TNF-alpha, serum amyloid, using specific antibodies. The first method is based on interdigitated microelectrodes while the other is based microarrays. The signal transduction in micro-IDEs from biological-signal to the electronic\\/electrical signal occurs via fringe fields and dielectric change, induced

Ozgur Gul; Sreenivasa S. Kallempudi; Huveyda Basaga; Ugur Sezerman; Yasar Gurbuz

2008-01-01

373

Excessive TV viewing and cardiovascular disease risk factors in adolescents. The AVENA cross-sectional study  

Microsoft Academic Search

BACKGROUND: Excessive television (TV) viewing might play an important role in the development of cardiovascular disease (CVD). The aim of this study was to examine the independent associations between TV viewing and CVD risk factors in adolescents. METHODS: A sample of 425 adolescents, aged 13- to 18.5-year-old, was included in this study. Body mass index (BMI), waist circumference (WC), glucose,

David Martinez-Gomez; J. Pablo Rey-López; Palma Chillón; Sonia Gómez-Martínez; Germán Vicente-Rodríguez; Miguel Martín-Matillas; Miguel Garcia-Fuentes; Manuel Delgado; Luis A Moreno; Oscar L Veiga; Joey C Eisenmann; Ascension Marcos

2010-01-01

374

Prevalence, detection, and management of cardiovascular risk factors in different ethnic groups in south London  

Microsoft Academic Search

ObjectiveTo assess the prevalence of cardiovascular risk factors and their level of detection and management in three ethnic groups.DesignPopulation based survey during 1994 to 1996.SettingFormer Wandsworth Health Authority in South London.Subjects1578 men and women, aged 40 to 59 years; 524 white, 549 of African descent, and 505 of South Asian origin.Main outcome measuresAge adjusted prevalence of hypertension, diabetes, obesity, raised

Francesco P Cappuccio; Derek G Cook; Richard W Atkinson; Pasquale Strazzullo

1997-01-01

375

Modifications of Metabolic and Cardiovascular Risk Factors after Weight Loss Induced by Laparoscopic Gastric Banding  

Microsoft Academic Search

Background: The well-known inverse relation between life expectancy and BMI, particularly in morbid obesity, is presumably\\u000a in large part due to multiple cardiovascular and metabolic comorbidities. Severely obese patients treated with laparoscopic\\u000a adjustable silicone gastric banding (LASGB) were evaluated for such risk factors before and 1 year after LASGB. Methods: 130\\u000a individuals (age 20-66, BMI 34-59 kg\\/m2) who underwent LASGB

Vincenzo Bacci; Maria Sole Basso; Francesco Greco; Romina Lamberti; Ugo Elmore; Angelo Restuccia; Nicola Perrotta; Gianfranco Silecchia; Antonello Bucci

2002-01-01

376

Effect of Folic Acid and B-Vitamins on Risk of Cardiovascular Events and Total Mortality among Women at High Risk for Cardiovascular Disease: A Randomized Trial  

PubMed Central

Context Recent randomized trials among patients with pre-existing cardiovascular disease (CVD) have failed to support benefits of B-vitamin supplementation on cardiovascular risk. Observational data suggest benefits may be greater among women, who have been underrepresented in published randomized trials. Objective To test whether a combination of folic acid, vitamin B6, and vitamin B12 lowers risk of CVD among high-risk women with and without CVD. Design, Setting, and Participants Within an ongoing randomized trial of antioxidant vitamins, 5,442 female US health professionals 42 years of age or older, with either a history of CVD or three or more coronary risk factors were randomized to a combination pill containing folic acid, vitamin B6, and vitamin B12 or a matching placebo and were followed for 7.3 years from April, 1998 until July, 2006. Intervention 2.5 mg of folic acid, 50 mg of vitamin B6, and 1 mg vitamin B12 Main Outcome Measures A composite outcome of myocardial infarction (MI), stroke, coronary revascularization, or CVD mortality. Results Compared to placebo, active treatment with the combination pill did not decrease the risk of the primary combined endpoint (226.9 per 10,000 person-years versus 219.2 per 10,000 person-years; relative risk =1.03; 95 percent confidence interval, 0.90–1.19, P=0.65), or any of the secondary outcomes including MI (34.5 per 10,000 person-years versus 39.5 per 10,000 person-years; relative risk =0.87; 95 percent confidence interval, 0.63–1.22), stroke (41.9 per 10,000 person-years versus 36.8 per 10,000 person-years in placebo; relative risk =1.14; 95 percent confidence interval, 0.82–1.57), and CVD mortality (50.3 per 10,000 person-years versus 49.6 per 10,000 person-years; relative risk =1.01; 95 percent confidence interval, 0.76–1.35). In a blood sub-study, geometric mean plasma homocysteine level was decreased by 18.5% (95% CI, 12.5–24.1; P<0.001) in the active arm (n=150) over that observed in the placebo arm (n=150) for a difference of 2.27 ?mol per liter (95% CI, 1.54 –2.96). CONCLUSION Over the longest follow-up recorded thus far, a combination of folic acid/vitamin B6/vitamin B12 did not reduce a combined endpoint of total cardiovascular events among high-risk women despite significant homocysteine lowering. Trial Registration clinicaltrials.gov Identifier: NCT00000541 PMID:18460663

Albert, Christine M.; Cook, Nancy R.; Gaziano, J. Michael; Zaharris, Elaine; MacFadyen, Jean; Danielson, Eleanor; Buring, Julie E.; Manson, JoAnn E.

2009-01-01

377

The Prevalence of Cardiovascular Disease Risk Factors and Obesity in Firefighters  

PubMed Central

Obesity is associated with increased risk of cardiovascular disease (CVD) mortality. CVD is the leading cause of duty-related death among firefighters, and the prevalence of obesity is a growing concern in the Fire Service. Methods. Traditional CVD risk factors, novel measures of cardiovascular health and a measurement of CVD were described and compared between nonobese and obese career firefighters who volunteered to participate in this cross-sectional study. Results. In the group of 116 men (mean age 43 ± 8?yrs), the prevalence of obesity was 51.7%. There were no differences among traditional CVD risk factors or the coronary artery calcium (CAC) score (criterion measure) between obese and nonobese men. However, significant differences in novel markers, including CRP, subendocardial viability ratio, and the ejection duration index, were detected. Conclusions. No differences in the prevalence of traditional CVD risk factors between obese and nonobese men were found. Additionally, CAC was similar between groups. However, there were differences in several novel risk factors, which warrant further investigation. Improved CVD risk identification among firefighters has important implications for both individual health and public safety. PMID:22888409

Smith, Denise L.; Fehling, Patricia C.; Frisch, Adam; Haller, Jeannie M.; Winke, Molly; Dailey, Michael W.

2012-01-01

378

Smoking cessation and the risk of cardiovascular disease outcomes predicted from established risk scores: Results of the Cardiovascular Risk Assessment among Smokers in Primary Care in Europe (CV-ASPIRE) Study  

PubMed Central

Background Smoking is a major risk factor for cardiovascular disease (CVD). This multicenter, cross-sectional survey was designed to estimate the cardiovascular (CV) risk attributable to smoking using risk assessment tools, to better understand patient behaviors and characteristics related to smoking, and characterize physician practice patterns. Methods 1,439 smokers were recruited from Europe during 2011. Smokers were ?40 years old, smoked > 10 cigarettes/day and had recent measurements on blood pressure and lipids. CV risk was calculated using the SCORE system, Framingham risk equations, and Progetto CUORE model. The CV risk attributable to smoking was evaluated using a simulated control (hypothetical non-smoker) with identical characteristics as the enrolled smoker. Risks assessed included CV mortality, coronary heart disease (CHD), CVD and hard CHD. Demographics, comorbidities, primary reasons for consultation, behavior towards previous attempts to quit, and interest in smoking cessation was assessed. Dependence on nicotine was evaluated using the Fagerström Test for Nicotine Dependence. GP practice patterns were assessed through a questionnaire. Results The prediction models consistently demonstrated a high CV risk attributable to smoking. For instance, the SCORE model demonstrated that this study population of smokers have a 100% increased probability of death due to cardiovascular disease in the next 10-years compared to non-smokers. A considerable amount of patients would like to hear from their GP about the different alternatives available to support their quitting attempt. Conclusions The findings of this study reinforce the importance of smoking as a significant predictor of long-term cardiovascular events. One of the best gains in health could be obtained by tackling the most important modifiable risk factors; these results suggest smoking is among the most important. PMID:23597191

2013-01-01

379

Human Research Program Human Health Countermeasures Element Cardiovascular Risks Standing Review Panel (SRP)  

NASA Technical Reports Server (NTRS)

The Cardiovascular Risk Standing Review Panel (SRP) evaluated several cardiovascular risks associated with space flight along with the ongoing and emerging plans to study these issues and potentially propose and/or develop countermeasures. The areas of focus included: 1) The risk of cardiac rhythm problems during prolonged space flight, and 2) Issues related to the risk of orthostatic intolerance during re-exposure to gravity. An emerging area of concern is radiation associated vascular injury. The risk of cardiac rhythm disturbances has emerged based on case reports only. No systematic study of this risk has been published. However, concerns about this risk are heightened by the age range of astronauts, the structural changes in the heart that occur during space flight, and the potential shifts in fluids and electrolytes. The current plan is to use prolonged Holter monitor EKG records made as part of the "Integrated Cardiovascular SMO" in space to determine more about the frequency and magnitude of this problem and to link this data to complementary data from the nutrition group on electrolytes. The SRP was supportive of this approach. The SRP also felt that any data related to cardiovascular risk in space should be better coordinated with the medical screening data that all astronauts undergo at regular intervals. Additionally, while there are potential privacy issues related to this suggestion, many of the current barriers to better coordination of experimental and clinical data appear to reflect longstanding cultural traditions at NASA that need rethinking. The risk of orthostatic intolerance during re-exposure to gravity was seen by the SRP as an area supported by a wealth of published physiological evidence. The SRP also felt that moving forward with the planned approach to countermeasures was reasonable and that extensive additional hypothesis testing on the physiology of orthostatic intolerance was not needed at this time. There was support for developing ground based models of limited (e.g. 1/6 th) G environments on Earth that generated a number of ideas for consideration by NASA investigators.

Joyner, Michael

2009-01-01

380

Perceived lifetime risk for cardiovascular disease (from the Dallas Heart Study).  

PubMed

Lifetime risk estimation for cardiovascular disease (CVD) has been proposed as a useful strategy to improve risk communication in the primary prevention setting. However, the perception of lifetime risk for CVD is unknown. We included 2,998 subjects from the Dallas Heart Study. Lifetime risk for developing CVD was classified as high (?39%) versus low (<39%) according to risk factor burden as described in our previously published algorithm. Perception of lifetime risk for myocardial infarction was assessed by way of a 5-point scale. Baseline characteristics were compared across levels of perceived lifetime risk. Multivariable logistic regression analyses were performed to determine the association of participant characteristics with level of perceived lifetime risk for CVD and with correctness of perceptions. Of the 2,998 participants, 64.8% (n = 1,942) were classified as having high predicted lifetime risk for CVD. There was significant discordance between perceived and predicted lifetime risk. After multivariable adjustment, family history of premature myocardial infarction, high self-reported stress, and low perceived health were all strongly associated with high perceived lifetime risk (odds ratio [OR] 2.37, 95% confidence interval [CI] 1.72 to 3.27; OR 2.17, 95% CI 1.66 to 2.83; and OR 2.71, 95% CI 2.09 to 3.53; respectively). However, the association between traditional CVD risk factors and high perceived lifetime risk was more modest. In conclusion, misperception of lifetime risk for CVD is common and frequently reflects the influence of factors other than traditional risk factor levels. These findings highlight the importance of effectively communicating the significance of traditional risk factors in determining the lifetime risk for CVD. PMID:24834788

Petr, Elisabeth Joye; Ayers, Colby R; Pandey, Ambarish; de Lemos, James A; Powell-Wiley, Tiffany M; Khera, Amit; Lloyd-Jones, Donald M; Berry, Jarett D

2014-07-01

381

Dulce Mothers: an intervention to reduce diabetes and cardiovascular risk in Latinas after gestational diabetes.  

PubMed

Latina women with prior gestational diabetes mellitus (GDM) are at elevated risk for type 2 diabetes mellitus and cardiovascular disease. Few primary prevention programs are designed for low socioeconomic status, Spanish-speaking populations. We examined the effectiveness of a Diabetes Prevention Program (DPP) translation in low-income Latinas with a history of GDM. Eighty-four Latinas, 18-45 years old with GDM in the past 3 years, underwent an 8-week peer-educator-led group intervention, with tailoring for Latino culture and recent motherhood. Lifestyle changes and diabetes and cardiovascular risk factors were assessed at study baseline, month 3 and month 6. Participants showed significant improvements in lipids, blood pressure, physical activity, dietary fat intake, and fatalistic and cultural diabetes beliefs (p?cardiovascular and diabetes risk in Latinas with GDM. PMID:24653773

Philis-Tsimikas, Athena; Fortmann, Addie L; Dharkar-Surber, Sapna; Euyoque, Johanna A; Ruiz, Monica; Schultz, James; Gallo, Linda C

2014-03-01

382

Relationship between adipocytokines and cardiovascular risk factors in patients with type 2 diabetes mellitus.  

PubMed

The aim of this study was to explore the relationship between serum profiles of adiponectin, leptin, resistin and visfatin and traditional and non-traditional cardiovascular risk factors in patients with type 2 diabetes mellitus (T2DM). A total of 85 patients with T2DM and 30 non-diabetic controls were enrolled in the study. Levels of adipocytokines (adiponectin, leptin, resistin and visfatin), lipids (total cholesterol, triglycerides), lipoproteins [HDL-cholesterol, LDL-cholesterol, lipoprotein (a)], apolipoproteins (Apo-A1 and Apo-B), non-traditional cardiovascular risk markers [asymmetric dimethylarginine (ADMA), homocysteine] and the inflammatory marker hs-CRP were measured, and anthropometric variables were determined. Serum adiponectin levels were decreased and leptin, resistin and visfatin levels were increased in T2DM patients compared to controls. They were associated with obesity (BMI), insulin resistance (HOMA-IR) and various markers of glucose/lipid profile, inflammation and endothelial dysfunction markers. These results suggest that decreased serum adiponectin and increased leptin, resistin and visfatin levels in T2DM may be novel biochemical risk factors for cardiovascular complications. PMID:23060933

Uslu, Sema; Kebapçi, Nur; Kara, Mehmet; Bal, Cengiz

2012-07-01

383

Gene polymorphisms in association with emerging cardiovascular risk markers in adult women  

PubMed Central

Background Evidence on the associations of emerging cardiovascular disease risk factors/markers with genes may help identify intermediate pathways of disease susceptibility in the general population. This population-based study is aimed to determine the presence of associations between a wide array of genetic variants and emerging cardiovascular risk markers among adult US women. Methods The current analysis was performed among the National Health and Nutrition Examination Survey (NHANES) III phase 2 samples of adult women aged 17 years and older (sample size n = 3409). Fourteen candidate genes within ADRB2, ADRB3, CAT, CRP, F2, F5, FGB, ITGB3, MTHFR, NOS3, PON1, PPARG, TLR4, and TNF were examined for associations with emerging cardiovascular risk markers such as serum C-reactive protein, homocysteine, uric acid, and plasma fibrinogen. Linear regression models were performed using SAS-callable SUDAAN 9.0. The covariates included age, race/ethnicity, education, menopausal status, female hormone use, aspirin use, and lifestyle factors. Results In covariate-adjusted models, serum C-reactive protein concentrations were significantly (P value controlling for false-discovery rate ? 0.05) associated with polymorphisms in CRP (rs3093058, rs1205), MTHFR (rs1801131), and ADRB3 (rs4994). Serum homocysteine levels were significantly associated with MTHFR (rs1801133). Conclusion The significant associations between certain gene variants with concentration variations in serum C-reactive protein and homocysteine among adult women need to be confirmed in further genetic association studies. PMID:20078877

2010-01-01

384

Effect of androgen deprivation therapy on cardiovascular risk factors in prostate cancer  

PubMed Central

Background: Androgen deprivation is the basis of treatment for advanced stages of prostate cancer. Cardiovascular disease may be a risk factor for mortality in prostate cancer. Therefore, we decided to evaluate the effect of androgen deprivation therapy (ADT) on the cardiovascular risk factors in patients with prostate cancer. Materials and Methods: In a cross-sectional study on 2011, 35 patients suffering from metastatic prostate cancer as candidates for ADT were enrolled. Serum levels of fasting blood sugar (FBS), triglyceride (TG) and total cholesterol (TC) were measured at the beginning and after the 5th month of ADT. Results: The mean level of TG increased significantly from 130.82 ± 41.57 mg/dl to 150.05 ± 48.29 mg/dl (P < 0.012). Furthermore, serum level of TC increased from 197.62 ± 40.71 mg/dl to 212.54 ± 38.25 mg/dl, which is statistically significant (P < 0.001). A non-significant increase in the serum level of FBS from 96.74 ± 14.04 mg/dl to 99.17 ± 15.23 mg/dl was also seen (P = 0.27). Conclusion: ADT in prostate cancer may lead to an increase in TG and TC levels. In patients with a high risk of cardiovascular disease patient's lipid profile should be considered during ADT. PMID:24516490

Roayaei, Mahnaz; Ghasemi, Sedighe

2013-01-01

385

Risk factors for recurrent and residual cholesteatoma in children determined by second stage operation  

Microsoft Academic Search

Objective: To clarify the risk factors for the development of recurrent and residual cholesteatoma in children. Methods: We studied 84 ears of 83 children aged 10 years or younger who underwent a second stage operation 1 year after primary surgery with a canal wall reconstruction procedure, and analyzed the clinical risk factors for recurrent and residual cholesteatoma. Results: Recurrent cholesteatoma

Yukiko Iino; Yukako Imamura; Chie Kojima; Sachiko Takegoshi; Jun-Ichi Suzuki

1998-01-01

386

Modifiable cardiovascular disease risk factors as predictors of dementia death: pooling of ten general population-based cohort studies  

PubMed Central

Background With drug treatment for dementia being of limited effectiveness, the role of primary prevention, in particular the predictive value of modifiable cardiovascular disease risk factors, may warrant exploration. The evidence base is, however, characterised by discordant findings and is modest in size. Accordingl