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1

Cardiovascular risk  

PubMed Central

Cardiovascular disease is a major, growing, worldwide problem. It is important that individuals at risk of developing cardiovascular disease can be effectively identified and appropriately stratified according to risk. This review examines what we understand by the term risk, traditional and novel risk factors, clinical scoring systems, and the use of risk for informing prescribing decisions. Many different cardiovascular risk factors have been identified. Established, traditional factors such as ageing are powerful predictors of adverse outcome, and in the case of hypertension and dyslipidaemia are the major targets for therapeutic intervention. Numerous novel biomarkers have also been described, such as inflammatory and genetic markers. These have yet to be shown to be of value in improving risk prediction, but may represent potential therapeutic targets and facilitate more targeted use of existing therapies. Risk factors have been incorporated into several cardiovascular disease prediction algorithms, such as the Framingham equation, SCORE and QRISK. These have relatively poor predictive power, and uncertainties remain with regards to aspects such as choice of equation, different risk thresholds and the roles of relative risk, lifetime risk and reversible factors in identifying and treating at-risk individuals. Nonetheless, such scores provide objective and transparent means of quantifying risk and their integration into therapeutic guidelines enables equitable and cost-effective distribution of health service resources and improves the consistency and quality of clinical decision making. PMID:22348281

Payne, Rupert A

2012-01-01

2

Cardiovascular risk.  

PubMed

Cardiovascular disease is a major, growing, worldwide problem. It is important that individuals at risk of developing cardiovascular disease can be effectively identified and appropriately stratified according to risk. This review examines what we understand by the term risk, traditional and novel risk factors, clinical scoring systems, and the use of risk for informing prescribing decisions. Many different cardiovascular risk factors have been identified. Established, traditional factors such as ageing are powerful predictors of adverse outcome, and in the case of hypertension and dyslipidaemia are the major targets for therapeutic intervention. Numerous novel biomarkers have also been described, such as inflammatory and genetic markers. These have yet to be shown to be of value in improving risk prediction, but may represent potential therapeutic targets and facilitate more targeted use of existing therapies. Risk factors have been incorporated into several cardiovascular disease prediction algorithms, such as the Framingham equation, SCORE and QRISK. These have relatively poor predictive power, and uncertainties remain with regards to aspects such as choice of equation, different risk thresholds and the roles of relative risk, lifetime risk and reversible factors in identifying and treating at-risk individuals. Nonetheless, such scores provide objective and transparent means of quantifying risk and their integration into therapeutic guidelines enables equitable and cost-effective distribution of health service resources and improves the consistency and quality of clinical decision making. PMID:22348281

Payne, Rupert A

2012-09-01

3

Molecular sources of residual cardiovascular risk, clinical signals, and innovative solutions: relationship with subclinical disease, undertreatment, and poor adherence: implications of new evidence upon optimizing cardiovascular patient outcomes  

PubMed Central

Residual risk, the ongoing appreciable risk of major cardiovascular events (MCVE) in statin-treated patients who have achieved evidence-based lipid goals, remains a concern among cardiologists. Factors that contribute to this continuing risk are atherogenic non-low-density lipoprotein (LDL) particles and atherogenic processes unrelated to LDL cholesterol, including other risk factors, the inherent properties of statin drugs, and patient characteristics, ie, genetics and behaviors. In addition, providers, health care systems, the community, public policies, and the environment play a role. Major statin studies suggest an average 28% reduction in LDL cholesterol and a 31% reduction in relative risk, leaving a residual risk of about 69%. Incomplete reductions in risk, and failure to improve conditions that create risk, may result in ongoing progression of atherosclerosis, with new and recurring lesions in original and distant culprit sites, remodeling, arrhythmias, rehospitalizations, invasive procedures, and terminal disability. As a result, identification of additional agents to reduce residual risk, particularly administered together with statin drugs, has been an ongoing quest. The current model of atherosclerosis involves many steps during which disease may progress independently of guideline-defined elevations in LDL cholesterol. Differences in genetic responsiveness to statin therapy, differences in ability of the endothelium to regenerate and repair, and differences in susceptibility to nonlipid risk factors, such as tobacco smoking, hypertension, and molecular changes associated with obesity and diabetes, may all create residual risk. A large number of inflammatory and metabolic processes may also provide eventual therapeutic targets to lower residual risk. Classically, epidemiologic and other evidence suggested that raising high-density lipoprotein (HDL) cholesterol would be cardioprotective. When LDL cholesterol is aggressively lowered to targets, low HDL cholesterol levels are still inversely related to MCVE. The efflux capacity, or ability to relocate cholesterol out of macrophages, is believed to be a major antiatherogenic mechanism responsible for reduction in MCVE mediated in part by healthy HDL. HDL cholesterol is a complex molecule with antioxidative, anti-inflammatory, anti-thrombotic, antiplatelet, and vasodilatory properties, among which is protection of LDL from oxidation. HDL-associated paraoxonase-1 has a major effect on endothelial function. Further, HDL promotes endothelial repair and progenitor cell health, and supports production of nitric oxide. HDL from patients with cardiovascular disease, diabetes, and autoimmune disease may fail to protect or even become proinflammatory or pro-oxidant. Mendelian randomization and other clinical studies in which raising HDL cholesterol has not been beneficial suggest that high plasma levels do not necessarily reduce cardiovascular risk. These data, coupled with extensive preclinical information about the functional heterogeneity of HDL, challenge the “HDL hypothesis”, ie, raising HDL cholesterol per se will reduce MCVE. After the equivocal AIM-HIGH (Atherothrombosis Intervention in Metabolic Syndrome With Low HDL/High Triglycerides: Impact on Global Health Outcomes) study and withdrawal of two major cholesteryl ester transfer protein compounds, one for off-target adverse effects and the other for lack of efficacy, development continues for two other agents, ie, anacetrapib and evacetrapib, both of which lower LDL cholesterol substantially. The negative but controversial HPS2-THRIVE (the Heart Protection Study 2-Treatment of HDL to Reduce the Incidence of Vascular Events) trial casts further doubt on the HDL cholesterol hypothesis. The growing impression that HDL functionality, rather than abundance, is clinically important is supported by experimental evidence highlighting the conditional pleiotropic actions of HDL. Non-HDL cholesterol reflects the cholesterol in all atherogenic particles containing apolipoprotein B, and has outperformed LDL cho

Kones, Richard

2013-01-01

4

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

5

Marathon run: cardiovascular adaptation and cardiovascular risk.  

PubMed

The first marathon run as an athletic event took place in the context of the Olympic Games in 1896 in Athens, Greece. Today, participation in a 'marathon run' has become a global phenomenon attracting young professional athletes as well as millions of mainly middle-aged amateur athletes worldwide each year. One of the main motives for these amateur marathon runners is the expectation that endurance exercise (EE) delivers profound beneficial health effects. However, with respect to the cardiovascular system, a controversial debate has emerged whether the marathon run itself is healthy or potentially harmful to the cardiovascular system, especially in middle-aged non-elite male amateur runners. In this cohort, exercise-induced increases in cardiac biomarkers-troponin and brain natriuretic peptide-and acute functional cardiac alterations have been observed and interpreted as potential cardiac damage. Furthermore, in the cohort of 40- to 65-year-old males engaged in intensive EE, a significant risk for the development of atrial fibrillation has been identified. Fortunately, recent studies demonstrated a normalization of the cardiac biomarkers and the functional alterations within a short time frame. Therefore, these alterations may be perceived as physiological myocardial reactions to the strenuous exercise and the term 'cardiac fatigue' has been coined. This interpretation is supported by a recent analysis of 10.9 million marathon runners demonstrating that there was no significantly increased overall risk of cardiac arrest during long-distance running races. In conclusion, intensive and long-lasting EE, e.g. running a full-distance Marathon, results in high cardiovascular strain whose clinical relevance especially for middle-aged and older athletes is unclear and remains a matter of controversy. Furthermore, there is a need for evidence-based recommendations with respect to medical screening and training strategies especially in male amateur runners over the age of 35 years engaged in regular and intensive EE. PMID:24408890

Predel, Hans-Georg

2014-11-21

6

Cardiovascular Risk in the Vietnamese Community  

E-print Network

.....................................................................................15 ii. Factors Associated With Cardiovascular Disease............................................16Cardiovascular Risk in the Vietnamese Community Formative Research from Houston, Texas U ...........................................................17 v. Perceptions of Heart Disease

Bandettini, Peter A.

7

Cardiovascular Risk in the Cambodian Community  

E-print Network

.....................................................................................13 ii. Factors Associated With Cardiovascular Disease............................................13Cardiovascular Risk in the Cambodian Community Formative Research from Lowell, Massachusetts U ...........................................................14 v. Perceptions of Heart Disease

Bandettini, Peter A.

8

Cardiovascular Risk in the Filipino Community  

E-print Network

.....................................................................................12 ii. Factors Associated With Cardiovascular Disease............................................12Cardiovascular Risk in the Filipino Community Formative Research from Daly City and San Francisco ...........................................................13 v. Perceptions of Heart Disease

Bandettini, Peter A.

9

Cardiovascular risk factors among Chamorros  

Microsoft Academic Search

BACKGROUND: Little is known regarding the cardiovascular disease risk factors among Chamorros residing in the United States. METHODS: The Chamorro Directory International and the CDC's Behavioral Risk Factor Surveillance System Questionnaire (BRFSS) were used to assess the health related practices and needs of a random sample of 228 Chamorros. RESULTS: Inactivity, hypertension, elevated cholesterol and diabetes mellitus were more prevalent

Binh Chiem; Victoria Nguyen; Phillis L Wu; Celine M Ko; Lee Ann Cruz; Georgia Robins Sadler

2006-01-01

10

Anabolic steroids and cardiovascular risk.  

PubMed

Recent reports from needle exchange programmes and other public health initiatives have suggested growing use of anabolic steroids (AS) in the UK and other countries. Data indicate that AS use is not confined to body-builders or high-level sportsmen. Use has spread to professionals working in emergency services, casual fitness enthusiasts and subelite sportsmen and women. Although the precise health consequences of AS use is largely undefined, AS use represents a growing public health concern. Data regarding the consequences of AS use on cardiovascular health are limited to case studies and a modest number of small cohort studies. Numerous case studies have linked AS use with a variety of cardiovascular disease (CVD) events or endpoints, including myocardial infarction, stroke and death. Large-scale epidemiological studies to support these links are absent. Consequently, the impact of AS use upon known CVD risk factors has been studied in relatively small, case-series studies. Data relating AS use to elevated blood pressure, altered lipid profiles and ECG abnormalities have been reported, but are often limited in scope, and other studies have often produced equivocal outcomes. The use of AS has been linked to the appearance of concentric left ventricular hypertrophy as well as endothelial dysfunction but the data again remains controversial. The mechanisms responsible for the negative effect of AS on cardiovascular health are poorly understood, especially in humans. Possibilities include direct effects on myocytes and endothelial cells, reduced intracellular Ca2+ levels, increased release of apoptogenic factors, as well as increased collagen crosslinks between myocytes. New data relating AS use to cardiovascular health risks are emerging, as novel technologies are developed (especially in non-invasive imaging) that can assess physiological structure and function. Continued efforts to fully document the cardiovascular health consequences of AS use is important to provide a clear, accurate, public health message to the many groups now using AS for performance and image enhancement. PMID:22229259

Angell, Peter; Chester, Neil; Green, Danny; Somauroo, John; Whyte, Greg; George, Keith

2012-02-01

11

Human immunodeficiency virus & cardiovascular risk.  

PubMed

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 availability 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

2011-12-01

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

Cardiovascular Risk in Patients with Psoriatic Arthritis  

PubMed Central

Psoriatic arthritis (PsA) is an inflammatory arthritis associated with psoriasis. In addition to skin and joint involvement, there is increasing evidence suggesting that patients with PsA also have an increase in risk of clinical and subclinical cardiovascular diseases, mostly due to accelerating atherosclerosis. Both conventional and nonconventional cardiovascular risk factors contribute to the increased cardiovascular risk in PsA. Chronic inflammation plays a pivotal role in the pathogenesis of atherosclerosis in PsA, acting independently and/or synergistically with the conventional risk factors. In this paper, we discuss the current literature indicating that patients with PsA are at risk of cardiovascular diseases. PMID:22645614

Zhu, Tracy Y.; Li, Edmund K.; Tam, Lai-Shan

2012-01-01

14

Cardiovascular risk in patients with psoriatic arthritis.  

PubMed

Psoriatic arthritis (PsA) is an inflammatory arthritis associated with psoriasis. In addition to skin and joint involvement, there is increasing evidence suggesting that patients with PsA also have an increase in risk of clinical and subclinical cardiovascular diseases, mostly due to accelerating atherosclerosis. Both conventional and nonconventional cardiovascular risk factors contribute to the increased cardiovascular risk in PsA. Chronic inflammation plays a pivotal role in the pathogenesis of atherosclerosis in PsA, acting independently and/or synergistically with the conventional risk factors. In this paper, we discuss the current literature indicating that patients with PsA are at risk of cardiovascular diseases. PMID:22645614

Zhu, Tracy Y; Li, Edmund K; Tam, Lai-Shan

2012-01-01

15

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

16

Cardiovascular risk and atherosclerosis prevention.  

PubMed

Until recently, coronary artery disease (CAD) was the leading cause of death in the developed countries. Its remarkable decline can be attributed to our knowledge of the major risk factors identified by several studies resulting in better prevention and treatment. Of the major risk factors, the ratio of apolipoprotein (apo) B/apo A1 followed by smoking, diabetes, and hypertension are the most important. A number of risk scores for men and women are now available to estimate the likelihood of development of CAD. However, because of the risk of CAD differs in various populations, some of the algorithms are more appropriate for some countries but not suitable for others. These risk assessment algorithms differ in the parameters they use. All the risk scores have some limitations such as different study populations; the age of the study is also different, and number of points awarded for age categories also differs among the various algorithms. In an effort to further improve the risk prediction, a number of biomarkers have been studied. In addition to plasma lipids, a lot of interest has focused on apo measurements; particularly of apo B. Another valuable biomarker is lipoprotein (a) [Lp(a)]. Lp(a) is not only atherogenic as low-density lipoprotein (LDL) but also prothrombotic, and several studies indicate that Lp(a) is an independent risk factor for CAD. The lipid profile provides a framework for appropriate management. This includes therapeutic lifestyle changes and medications. Lifestyle interventions are the cornerstone of CAD prevention strategies and are the first step in risk factor management. Of particular importance are smoking cessation, achievement and maintenance of ideal body weight, regular exercise, reduction in the intake of saturated fat and sugars, and decreasing level of stress. Of medications, lipid-lowering, anti-hypertensive, and anti-coagulant can be effectively used. The current strategies for risk assessment and prevention have been very successful contributing to the more than 50% decrease in CAD mortality over the last 20 years. Thus, in Canada, cardiovascular disease is no longer the leading cause of death. PMID:22502868

Frohlich, Jiri; Al-Sarraf, Ahmad

2013-01-01

17

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

18

Biomarkers of cardiovascular disease risk in women.  

PubMed

Cardiovascular disease (CVD), including coronary heart disease and stroke, is the leading cause of death among U.S. women and men. Established cardiovascular risk factors such as smoking, diabetes, hypertension, and elevated total cholesterol, and risk prediction models based on such factors, perform well but do not perfectly predict future risk of CVD. Thus, there has been much recent interest among cardiovascular researchers in identifying novel biomarkers to aid in risk prediction. Such markers include alternative lipids, B-type natriuretic peptides, high-sensitivity troponin, coronary artery calcium, and genetic markers. This article reviews the role of traditional cardiovascular risk factors, risk prediction tools, and selected novel biomarkers and other exposures in predicting risk of developing CVD in women. The predictive role of novel cardiovascular biomarkers for women in primary prevention settings requires additional study, as does the diagnostic and prognostic utility of cardiac troponins for acute coronary syndromes in clinical settings. Sex differences in the clinical expression and physiology of metabolic syndrome may have implications for cardiovascular outcomes. Consideration of exposures that are unique to, or more prevalent in, women may also help to refine cardiovascular risk estimates in this group. PMID:25487190

Manson, JoAnn E; Bassuk, Shari S

2015-03-01

19

Cardiovascular risk factor investigation: a pediatric issue  

PubMed Central

Objectives To correlate cardiovascular risk factors (e.g., hypertension, obesity, hypercholesterolemia, hypertriglyceridemia, hyperglycemia, sedentariness) in childhood and adolescence with the occurrence of cardiovascular disease. Sources A systematic review of books and selected articles from PubMed, SciELO and Cochrane from 1992 to 2012. Summary of findings Risk factors for atherosclerosis are present in childhood, although cardiovascular disease arises during adulthood. This article presents the main studies that describe the importance of investigating the risk factors for cardiovascular diseases in childhood and their associations. Significant rates of hypertension, obesity, dyslipidemia, and sedentariness occur in children and adolescents. Blood pressure needs to be measured in childhood. An increase in arterial blood pressure in young people predicts hypertension in adulthood. The death rate from cardiovascular disease is lowest in children with lower cholesterol levels and in individuals who exercise regularly. In addition, there is a high prevalence of sedentariness in children and adolescents. Conclusions Studies involving the analysis of cardiovascular risk factors should always report the prevalence of these factors and their correlations during childhood because these factors are indispensable for identifying an at-risk population. The identification of risk factors in asymptomatic children could contribute to a decrease in cardiovascular disease, preventing such diseases as hypertension, obesity, and dyslipidemia from becoming the epidemics of this century. PMID:23515212

Rodrigues, Anabel N; Abreu, Glaucia R; Resende, Rogério S; Goncalves, Washington LS; Gouvea, Sonia Alves

2013-01-01

20

HIV Infection, Antiretroviral Therapy and Cardiovascular Risk  

PubMed Central

In the last 15 years, highly active antiretroviral therapy (HAART) has determined a dramatic reduction of both morbidity and mortality in human immunodeficiency virus (HIV)-infected subjects, transforming this infection in a chronic and manageable disease. Patients surviving with HIV in the developed world, in larger number men, are becoming aged. As it would be expected for a population of comparable age, many HIV-infected individuals report a family history of cardiovascular disease, a small proportion have already experienced a cardiovascular event and an increasing proportion has diabetes mellitus. Smoking rate is very high while an increasing proportion of HIV-infected individuals have dyslipidaemia. Studies suggest that these traditional risk factors could play an important role in the development of cardiovascular disease in these patients as they do in the general population. Thus, whilst the predicted 10-year cardiovascular disease risk remains relatively low at present, it will likely increase in relation to the progressive aging of this patient population. Thus, the long-term follow-up of HIV infected patients has to include co-morbidity management such as cardiovascular disease prevention and treatment. Two intriguing aspects related to the cardiovascular risk in patients with HIV infection are the matter of current investigation: 1) while these subjects share many cardiovascular risk factors with the general population, HIV infection itself increases cardiovascular risk; 2) some HAART regimens too influence atherosclerotic profile, partly due to lipid changes. Although the mechanisms involved in the development of cardiovascular complications in HIV-infected patients remain to be fully elucidated, treatment guidelines recommending interventions to prevent cardiovascular disease in these individuals are already available; however, their application is still limited. PMID:21776340

de Gaetano Donati, Katleen; Cauda, Roberto; Iacoviello, Licia

2010-01-01

21

[Hypertension and cardiovascular risk: the J-curve concept].  

PubMed

The optimization of the pharmacologic treatment in hypertensive patients is encouraged by four reports: the high prevalence of hypertension and more particularly in the elderly, the lack of blood pressure control in more than half of patients, the frequency of the association to other cardiovascular risk factors and the existence of a residual risk under treatment. All these factors are combined to raise the cardiovascular risk in hypertensive patients. Several interventional studies highlighted a reduction of the cardiovascular risk proportional to the reduction of blood pressure under treatment. Thus arose the question of the optimal blood pressure: the guidelines propose values lower than 140/90 mmHg for the non-complicated essential hypertension and lower than 130/80 mmHg in secondary prevention, for the patients with diabetes or renal impairment. However, this strict blood pressure goal for the high cardiovascular risk patients is not confirmed by clinical trials, strict blood pressure goal being potentially deleterious. The concept of «the lower the better» tends to be abandoned. Since more than three decades, the assumption of a paradoxical increase of the cardiovascular morbidity and mortality associated with a high reduction of blood pressure (the «J-Curve» concept) remains the subject of many studies and controversies. PMID:21049440

Yannoutsos, A; Mourad, J-J; Blacher, Jacques; Safar, M

2010-11-01

22

Cardiovascular risk in chronic kidney disease  

Microsoft Academic Search

Cardiovascular risk in chronic kidney disease. National Kidney Foundation guidelines define chronic kidney disease (CKD) as persistent kidney damage (confirmed by renal biopsy or markers of kidney damage) and\\/or glomerular filtration rate (GFR) <60 mL\\/min\\/1.73m2 for greater than three months.Patients with CKD experience higher mortality and adverse cardiovascular (CV) event rates, which remains significant after adjustment for conventional coronary risk

Nagesh S. Anavekar; Marc A. Pfeffer

2004-01-01

23

Timely assessment of cardiovascular risk after preeclampsia.  

PubMed

Evaluation of: Cusimano MC, Pudwell J, Roddy M, Chan-Kyung JC, Smith GN. The maternal health clinic: an initiative for cardiovascular identification in women with pregnancy-related complications. Am. J. Obstet. Gynecol. 438, e1 (2014). Cardiovascular risk management, for men and women alike, is a preventative means to detect individuals' running an elevated risk of myocardial disorders, stroke and metabolic syndrome. Because age is an important factor in the risk assessment, especially young women almost always are classified in the low-risk category and therefore do not qualify for preventive treatment. A history of preeclampsia identifies women who have underlying cardiovascular risk factors. Approximately 6-8% of all pregnancies are complicated by hypertensive disorders, about 2% ends in preeclampsia. For that very reason, the Maternal Health Clinic at Kingston General Hospital in Kingston, Canada, was established to provide postpartum cardiovascular risk counseling or follow-up for women with the pregnancy-related complications. The outcomes were significant: 17% of the young target population with an average age of 33 years met criteria of metabolic syndrome and 85% revealed elevated lifetime cardiovascular disease risk. These figures are to be compared with control results of women with uncomplicated pregnancies: 7% metabolic syndrome and 46% non-optimal risk. It is concluded that the clinic may serve as a prolific and effective primary prevention strategy. PMID:25482481

Verbeek, André L M; Verbeek, Anna J M

2014-11-01

24

Cardiovascular disease and osteoporosis: Balancing risk management  

PubMed Central

In this narrative review of the current literature, we examine the traditional risk factors and patient profiles leading to cardiovascular disease and osteoporosis. We discuss the interrelationships between risk factors and common pathophysiological mechanisms for cardiovascular disease and osteoporosis. We evaluate the increasing evidence that supports an association between these disabling conditions. We reveal that vascular health appears to have a strong effect on skeletal health, and vice versa. We highlight the importance of addressing the risk benefit of preventative interventions in both conditions. We discuss how both sexes are affected by these chronic conditions and the importance of considering the unique risk of the individual. We show that habitual physical activity is an effective primary and secondary preventative strategy for both cardiovascular disease and osteoporosis. We highlight how a holistic approach to the prevention and treatment of these chronic conditions is likely warranted. PMID:18078019

Warburton, Darren ER; Nicol, Crystal Whitney; Gatto, Stephanie N; Bredin, Shannon SD

2007-01-01

25

Risk factors and cardiovascular disease in Turkey  

Microsoft Academic Search

Cardiovascular risk factors as well as morbidity and mortality from coronary heart disease among Turkish adults are herein reviewed. Lipids and lipoproteins are in focus, but other relevant risk factors are also discussed. Turks have distinctively low levels of total and high-density lipoprotein (HDL)-cholesterol, associated with high levels of hepatic lipase and fasting triglycerides. In addition, physical inactivity is common

Altan Onat

2001-01-01

26

Azithromycin and the Risk of Cardiovascular Death  

PubMed Central

BACKGROUND Although several macrolide antibiotics are proarrhythmic and associated with an increased risk of sudden cardiac death, azithromycin is thought to have minimal cardiotoxicity. However, published reports of arrhythmias suggest that azithromycin may increase the risk of cardiovascular death. METHODS We studied a Tennessee Medicaid cohort designed to detect an increased risk of death related to short-term cardiac effects of medication, excluding patients with serious noncardiovascular illness and person-time during and shortly after hospitalization. The cohort included patients who took azithromycin (347,795 prescriptions), propensity-score–matched persons who took no antibiotics (1,391,180 control periods), and patients who took amoxicillin (1,348,672 prescriptions), ciprofloxacin (264,626 prescriptions), or levofloxacin (193,906 prescriptions). RESULTS During 5 days of therapy, patients taking azithromycin, as compared with those who took no antibiotics, had an increased risk of cardiovascular death (hazard ratio, 2.88; 95% confidence interval [CI], 1.79 to 4.63; P<0.001) and death from any cause (hazard ratio, 1.85; 95% CI, 1.25 to 2.75; P = 0.002). Patients who took amoxicillin had no increase in the risk of death during this period. Relative to amoxicillin, azithromycin was associated with an increased risk of cardiovascular death (hazard ratio, 2.49; 95% CI, 1.38 to 4.50; P = 0.002) and death from any cause (hazard ratio, 2.02; 95% CI, 1.24 to 3.30; P = 0.005), with an estimated 47 additional cardiovascular deaths per 1 million courses; patients in the highest decile of risk for cardiovascular disease had an estimated 245 additional cardiovascular deaths per 1 million courses. The risk of cardiovascular death was significantly greater with azithromycin than with ciprofloxacin but did not differ significantly from that with levofloxacin. CONCLUSIONS During 5 days of azithromycin therapy, there was a small absolute increase in cardiovascular deaths, which was most pronounced among patients with a high baseline risk of cardiovascular disease. (Funded by the National Heart, Lung, and Blood Institute and the Agency for Healthcare Quality and Research Centers for Education and Research on Therapeutics.) PMID:22591294

Ray, Wayne A.; Murray, Katherine T.; Hall, Kathi; Arbogast, Patrick G.; Stein, C. Michael

2012-01-01

27

Hypertriglyceridemia as a Cardiovascular Risk Factor  

Microsoft Academic Search

To determine the relation between plasma triglyceride levels and the risk of incident cardiovascular disease, the semiquantitative techniques of meta-analysis were applied to 17 population-based prospective studies of triglyceride and cardiovascular disease. Sixteen of these studies represented 2,445 events among 46,413 Caucasian men followed for an average period of 8.4 years, and 5 studies represented 439 events among 10,864 Caucasian

Melissa A Austin; John E Hokanson; Karen L Edwards

1998-01-01

28

Emergent Biomarkers of Residual Cardiovascular Risk in Patients with Low HDL-c and/or High Triglycerides and Average LDL-c Concentrations: Focus on HDL Subpopulations, Oxidized LDL, Adiponectin, and Uric Acid  

PubMed Central

This study intended to determine the impact of HDL-c and/or TGs levels on patients with average LDL-c concentration, focusing on lipidic, oxidative, inflammatory, and angiogenic profiles. Patients with cardiovascular risk factors (n = 169) were divided into 4 subgroups, combining normal and low HDL-c with normal and high TGs patients. The following data was analyzed: BP, BMI, waist circumference and serum glucose, Total-c, TGs, LDL-c, oxidized-LDL, total HDL-c and HDL subpopulations, paraoxonase-1 (PON1) activity, hsCRP, uric acid, TNF-?, adiponectin, VEGF, and iCAM1. The two populations with increased TGs levels, regardless of the normal or low HDL-c, presented obesity and higher waist circumference, Total-c, LDL-c, Ox-LDL, and uric acid. Adiponectin concentration was significantly lower and VEGF was higher in the population with cumulative low values of HDL-c and high values of TGs, while HDL quality was reduced in the populations with impaired values of HDL-c and/or TGs, viewed by reduced large and increased small HDL subfractions. In conclusion, in a population with cardiovascular risk factors, low HDL-c and/or high TGs concentrations seem to be associated with a poor cardiometabolic profile, despite average LDL-c levels. This condition, often called residual risk, is better evidenced by using both traditional and nontraditional CV biomarkers, including large and small HDL subfractions, Ox-LDL, adiponectin, VEGF, and uric acid. PMID:24319364

Mascarenhas-Melo, Filipa; Sereno, José; Freitas, Isabel; Isabel-Mendonça, Maria; Pinto, Rui; Teixeira, Frederico

2013-01-01

29

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

30

HDL metabolism and the role of HDL in the treatment of high-risk patients with cardiovascular disease  

Microsoft Academic Search

Developing new therapeutic approaches to treating residual cardiovascular risk of recurrent clinical events in statin-treated\\u000a patients has been a major challenge for the cardiovascular field. Data from epidemiological evidence, animal models, and initial\\u000a clinical trials indicate that increasing high-density lipoprotein (HDL) may be an effective new target for treating residual\\u000a cardiovascular risk. Over the past several years, major advances have

H. Bryan Brewer Jr; H. Bryan

2007-01-01

31

NUTRIGENETICS, PLASMA LIPIDS AND CARDIOVASCULAR RISK  

Technology Transfer Automated Retrieval System (TEKTRAN)

Cardiovascular diseases (CVD) result from complex interactions between genetic and environmental factors. The evidence supports that gene-environment interactions modulate plasma lipid concentrations and potentially CVD risk. Several genes [i.e., APOA1, APOA4, APOE, and LIPC] are providing proof-of-...

32

Nutrigenetics, plasma lipids, and cardiovascular risk  

Technology Transfer Automated Retrieval System (TEKTRAN)

Cardiovascular disease (CVD) results from complex interactions between genetic and environmental factors. The evidence supports that gene-environment interactions modulate plasma lipid concentrations and potentially CVD risk. Several genes (eg, apolipoprotein A-I and A-IV, apolipoprotein E, and he...

33

COX-2 inhibitors and cardiovascular risk.  

PubMed

The development of drugs that selectively inhibit cyclooxygenase-2 (COX-2) demonstrates translational research from bench to bedside based on underlying knowledge of micro-cellular structure and function. However, theoretical concerns about potentially prothrombotic effects of selective COX-2 inhibitors coupled with observations of increased cardiovascular risk have produced significant consternation and lead to the withdrawal of two of these agents from the market. A number of questions remain unanswered. It appears clear that both selective and non-selective COX inhibitors are associated with increases in blood pressure. In addition, blood pressure is often increased after starting nonsteroidal therapy, and we know that even small increases in blood pressure in subjects with pre-existing vascular disease are associated with substantial increases in the risk of cardiovascular morbidity. Given this line of reasoning, one might hypothesize that the observed increases in the risk of cardiovascular events associated with COX-inhibitors are largely due to increases in blood pressure in populations of subjects who are already at high risk. But can we generalize that the adverse cardiovascular effects observed for rofecoxib and valdecoxib are sufficient to indict the entire class of COX-2 inhibitors, or is this not a class effect, but dependent upon the degree of COX-2 selectivity? In either case, it seems prudent to recommend that subjects who are at higher risk for a cardiovascular event and receiving a COX-inhibitor should also be treated with low dose ASA with close follow up of blood pressure and efficacious use of anti-hypertensive medications. Finally, modest dietary salt restriction may help lessen the effects of COX-inhibitors on blood pressure. PMID:17612050

Salzberg, Daniel J; Weir, Matthew R

2007-01-01

34

Perceptions of risk: understanding cardiovascular disease  

PubMed Central

Cardiovascular disease (CVD) is still the leading cause of death and disability worldwide despite the availability of well-established and effective preventive options. Accurate perception of a patient’s risk by both the patient and the doctors is important as this is one of the components that determine health-related behavior. Doctors tend to not use cardiovascular (CV) risk calculators and underestimate the absolute CV risk of their patients. Patients show optimistic bias when considering their own risk and consistently underestimate it. Poor patient health literacy and numeracy must be considered when thinking about this problem. Patients must possess a reasonably high level of understanding of numerical processes when doctors discuss risk, a level that is not possessed by large numbers of the population. In order to overcome this barrier, doctors need to utilize various tools including the appropriate use of visual aids to accurately communicate risk with their patients. Any intervention has been shown to be better than nothing in improving health understanding. The simple process of repeatedly conveying risk information to a patient has been shown to improve accuracy of risk perception. Doctors need to take responsibility for the accurate assessment and effective communication of CV risk in their patients in order to improve patient uptake of cardioprotective lifestyle choices and preventive medications. PMID:22312218

Webster, Ruth; Heeley, Emma

2010-01-01

35

CURRENT OPINION Lipoprotein(a) as a cardiovascular risk factor  

E-print Network

OPINION Lipoprotein(a) as a cardiovascular risk factor: current status Børge G. Nordestgaard1*, M. John(a)] as a cardiovascular risk factor and, second, to advise on screening for elevated plasma Lp(a), on desirable levels and increased cardiovascular disease (CVD)/cor- onary heart disease (CHD) risk, together with recent genetic

Paris-Sud XI, Université de

36

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

37

Cardiovascular risk in individuals with depression.  

PubMed

Depression and cardiovascular diseases (CVD) are both common illnesses. Several studies demonstrated that depressed individuals have higher mortality compared to age- and gender-matched population, with an excess of cardiovascular deaths. There is a bidirectional association between depression and CVD. Several factors can interact and influence this relationship: poverty and social inequality, reduced accessibility to health care, biological alterations (as reduced heart rate variability, endothelial dysfunction, increased inflammation and platelet function, and hyperactivity of hypothalamic-pituitary-adrenal axis), side effects of psychiatric medication, lower adherence to medical treatments, and higher frequency of cardiovascular risk factors (higher tobacco use, physical inactivity, obesity, diabetes mellitus). This article aims to update the current evidence of the possible mechanisms involved in the association between depression and CVD. PMID:23684214

Bivanco-Lima, Danielle; Souza Santos, Itamar de; Vannucchi, Ana Maria Cortez; Almeida Ribeiro, Manoel Carlos Sampaio de

2013-01-01

38

Psychosocial stress and cardiovascular risk : current opinion.  

PubMed

Cardiovascular disease (CVD) is a major cause of morbidity and mortality worldwide. Epidemiologic research of the last half-century has clearly shown that psychosocial factors related to the social environment, personality characteristics, and negative affect increase the risk of incident CVD and also impact prognosis of cardiac patients. Several mechanisms may explain this link, including a genetic predisposition, poor lifestyle choices, low adherence to health recommendations, and direct pathophysiologic perturbations. The latter include alteration of the hypothalamic-pituitary adrenal axis and autonomic dysfunction resulting in endothelial dysfunction, inflammation, and a prothrombotic state further downstream. Screening for psychosocial factors seems appropriate as part of the standard history and based on the clinician's knowledge of the patient and the purpose of the visit. Psychological interventions generally alleviate distress in cardiac patients, but whether they reduce the risk of hard cardiovascular endpoints and all-cause mortality is less evident. Cardiac patients with more severe depression may particularly profit from antidepressant medications. Due to their pharmacologic properties, selective serotonin reuptake inhibitors were shown to improve cardiovascular outcome. The most effective psychosocial treatment is multicomponent therapy that combines elements of cognitive behaviour therapy ("stress management") and changes in health behaviours, including the adoption of a regular exercise regimen. Gender-specific issues should probably be considered. The field of behavioural cardiology has accumulated a wealth of epidemiological, mechanistic and clinical knowledge that undoubtedly has furthered our understanding about the important role of psychosocial risk factors in patients with a heart disease. PMID:22271452

von Känel, Roland

2012-01-01

39

Waist-to-Height Ratio and Cardiovascular Risk Factors in Elderly Individuals at High Cardiovascular Risk  

Microsoft Academic Search

IntroductionSeveral anthropometric measurements have been associated with cardiovascular disease, type-2 diabetes mellitus and other cardiovascular risk conditions, such as hypertension or metabolic syndrome. Waist-to-height-ratio has been proposed as a useful tool for assessing abdominal obesity, correcting other measurements for the height of the individual. We compared the ability of several anthropometric measurements to predict the presence of type-2 diabetes, hyperglycemia,

Marta Guasch-Ferré; Mònica Bulló; Miguel Ángel Martínez-González; Dolores Corella; Ramon Estruch; María-Isabel Covas; Fernando Arós; Julia Wärnberg; Miquel Fiol; José Lapetra; Miguel Ángel Muñoz; Lluís Serra-Majem; Xavier Pintó; Nancy Babio; Andrés Díaz-López; Jordi Salas-Salvadó

2012-01-01

40

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

41

Age at onset of major depression and adulthood cardiovascular risk.  

PubMed

Childhood-onset compared to adulthood-onset of major depression is associated with increased rates of serious cardiovascular events, independently of cardiovascular risk factors. This could be explained by a longer duration of exposure to depression. Cardiovascular disease risk should be systematically assessed in individuals with long duration of major depression. PMID:25595335

Franco, Silvia; Hoertel, Nicolas; Peyre, Hugo; Mario Rodríguez-Fernández, Jorge; Limosin, Frédéric; Blanco, Carlos

2015-02-28

42

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

43

Cardiovascular Disease Risk Assessment: Insights from Framingham  

PubMed Central

SUMMARY Cardiovascular disease (CVD) is among the leading causes of death and disability worldwide. Since its beginning, the Framingham study has been a leader in identifying CVD risk factors. Clinical trials have demonstrated that when the modifiable risk factors are treated and corrected, the chances of CVD occurring can be reduced. The Framingham study also recognized that CVD risk factors are multifactorial and interact over time to produce CVD. In response, Framingham investigators developed the Framingham Risk Functions (also called Framingham Risk Scores) to evaluate the chance or likelihood of developing CVD in individuals. These functions are multivariate functions (algorithms) that combine the information in CVD risk factors such as sex, age, systolic blood pressure, total cholesterol, high-density lipoprotein cholesterol, smoking behavior, and diabetes status to produce an estimate (or risk) of developing CVD or a component of CVD (such as coronary heart disease, stroke, peripheral vascular disease, or heart failure) over a fixed time, for example, the next 10 years. These estimates of CVD risk are often major inputs in recommending drug treatments such as cholesterol-lowering drugs. PMID:23750335

Pencina, Michael J.; Massaro, Joseph M.; Coady, Sean

2013-01-01

44

Risk of cardiovascular diseases in seafarers.  

PubMed

Seafarers experience a lot of job-related risk factors for cardiovascular diseases (CVD). Considering the healthy-worker effect due to the biennial pre-employment examination and the periodical medical fitness tests, a (slightly) elevated risk for CVD among seafarers is assumed compared to the reference population ashore. In seafaring, the most important, influenceable risk factors for CVD refer to the ship-specific stress situation, the malnutrition and the lack of exercises on board. Furthermore, the prognosis of acute severe CVD often depends on the measures taken in the first few hours after occurrence of the symptoms. Owing to the lack of health professionals on board and the limited treatment options of events at sea, effective cardio-pulmonary resuscitation is often delayed and the outcome of cardiac events is worse compared to that ashore. PMID:25231325

Oldenburg, Marcus

2014-01-01

45

Waist-to-Height Ratio and Cardiovascular Risk Factors in Elderly Individuals at High Cardiovascular Risk  

PubMed Central

Introduction Several anthropometric measurements have been associated with cardiovascular disease, type-2 diabetes mellitus and other cardiovascular risk conditions, such as hypertension or metabolic syndrome. Waist-to-height-ratio has been proposed as a useful tool for assessing abdominal obesity, correcting other measurements for the height of the individual. We compared the ability of several anthropometric measurements to predict the presence of type-2 diabetes, hyperglycemia, hypertension, atherogenic dyslipidemia or metabolic syndrome. Materials and Methods In our cross-sectional analyses we included 7447 Spanish individuals at high cardiovascular risk, men aged 55–80 years and women aged 60–80 years, from the PREDIMED study. Logistic regression models were fitted to evaluate the odds ratio of presenting each cardiovascular risk factor according to various anthropometric measures. The areas under the receiver-operating characteristic curve (AUC) were used to compare the predictive ability of these measurements. Results In this relatively homogeneous cohort with 48.6% of type-2 diabetic individuals, the great majority of the studied anthropometric parameters were significantly and positively associated with the cardiovascular risk factors. No association was found between BMI and body weight and diabetes mellitus. The AUCs for the waist-to-height ratio and waist circumference were significantly higher than the AUCs for BMI or weight for type-2 diabetes, hyperglycemia, atherogenic dyslipidemia and metabolic syndrome. Conversely, BMI was the strongest predictor of hypertension. Conclusions We concluded that measures of abdominal obesity showed higher discriminative ability for diabetes mellitus, high fasting plasma glucose, atherogenic dyslipidemia and metabolic syndrome than BMI or weight in a large cohort of elderly Mediterranean individuals at high cardiovascular risk. No significant differences were found between the predictive abilities of waist-to-height ratio and waist circumference on the metabolic disease. PMID:22905246

Guasch-Ferré, Marta; Bulló, Mònica; Martínez-González, Miguel Ángel; Corella, Dolores; Estruch, Ramon; Covas, María-Isabel; Arós, Fernando; Wärnberg, Julia; Fiol, Miquel; Lapetra, José; Muñoz, Miguel Ángel; Serra-Majem, Lluís; Pintó, Xavier; Babio, Nancy; Díaz-López, Andrés; Salas-Salvadó, Jordi

2012-01-01

46

Sortilin and the risk of cardiovascular disease.  

PubMed

Plasma low-density lipoprotein cholesterol (LDL-C) levels are a key determinant of the risk of cardiovascular disease, which is why many studies have attempted to elucidate the pathways that regulate its metabolism. Novel latest-generation sequencing techniques have identified a strong association between the 1p13 locus and the risk of cardiovascular disease caused by changes in plasma LDL-C levels. As expected for a complex phenotype, the effects of variation in this locus are only moderate. Even so, knowledge of the association is of major importance, since it has unveiled a new metabolic pathway regulating plasma cholesterol levels. Crucial to this discovery was the work of three independent teams seeking to clarify the biological basis of this association, who succeeded in proving that SORT1, encoding sortilin, was the gene in the 1p13 locus involved in LDL metabolism. SORT1 was the first gene identified as determining plasma LDL levels to be mechanistically evaluated and, although the three teams used different, though appropriate, experimental methods, their results were in some ways contradictory. Here we review all the experiments that led to the identification of the new pathway connecting sortilin with plasma LDL levels and risk of myocardial infarction. The regulatory mechanism underlying this association remains unclear, but its discovery has paved the way for considering previously unsuspected therapeutic targets and approaches. PMID:23910371

Coutinho, Maria Francisca; Bourbon, Mafalda; Prata, Maria João; Alves, Sandra

2013-10-01

47

[Cardiovascular risk factors in Tlemcen (Algeria)].  

PubMed

Cardiovascular risk factors were studied in a random representative sample of the urban community of Tlemcen, aged 20 years or older. The study included 805 subjects (participation rate: 72%). This study showed a high prevalence of hypertension (32.7%), diabetes (16.1%), cigarette smoking (17.1%, but 36.8% among men), blood cholesterol levels > 6.2 mmol/L (6.3%) and obesity (19.2% and significantly higher in women than in men: 27.9% vs 10.5%). These results show that the prevalence of hypertension is very high among women, reaching levels observed in industrialized countries. PMID:18180216

Latifa, Boukli Hacène; Kaouel, Meguenni

2007-01-01

48

Women, lipoproteins and cardiovascular disease risk.  

PubMed

Atherosclerosis, lipoprotein structure, lipoprotein metabolism and role in atherogenesis, epidemiology of lipoproteins and coronary artery disease, and current public health guidelines for cholesterol control are described. Low density lipoprotein cholesterol levels rise with age in both men and women. High density lipoprotein (HDL) levels decline after menopause. Special aspects of coronary risk in women include the stronger role of diabetes, hypertriglyceridemia and HDL. In addition, the effects of exogenous hormone therapy, both in the form or oral contraceptives and post menopausal hormone replacement should be considered. Careful attention to these issues may reduce cardiovascular morbidity in adult women. PMID:2188715

LaRosa, J C

1990-05-01

49

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, Jozélio Freire

2014-01-01

50

Cardiovascular risk screening program in Australian community pharmacies  

Microsoft Academic Search

Objective To assess the suitability of Australian community pharmacies as cardiovascular disease risk profile screening centres and\\u000a evaluate whether community pharmacists can play an important role in detecting, educating and referring screened individuals\\u000a at high risk of cardiovascular disease. Setting 14 Australian community pharmacies. Method Opportunistic cardiovascular disease risk profiling for members of the public aged greater than 30 years with

Gregory M. PetersonKimbra; Kimbra D. Fitzmaurice; Helen Kruup; Shane L. Jackson; Rohan L. Rasiah

2010-01-01

51

Inflammation enhances cardiovascular risk and mortality in hemodialysis patients  

Microsoft Academic Search

Inflammation enhances cardiovascular risk and mortality in hemodialysis patients.BackgroundAtherosclerosis, a major problem in patients on chronic hemodialysis, has been characterized as an inflammatory disease. C-reactive protein (CRP), the prototypical acute phase protein in humans, is a predictor of cardiovascular mortality in the general population. We hypothesize that several of the classic, as well as nontraditional, cardiovascular risk factors may respond

JOSEF ZIMMERMANN; SILKE HERRLINGER; ANTJE PRUY; THOMAS METZGER; CHRISTOPH WANNER

1999-01-01

52

Evaluation of Cardiovascular Risk Scores Applied to NASA's Astronant Corps  

NASA Technical Reports Server (NTRS)

In an effort to improve cardiovascular disease (CVD) risk prediction, this analysis evaluates and compares the applicability of multiple CVD risk scores to the NASA Astronaut Corps which is extremely healthy at selection.

Jain, I.; Charvat, J. M.; VanBaalen, M.; Lee, L.; Wear, M. L.

2014-01-01

53

Simple anthropometric indexes and cardiovascular risk factors in Chinese  

Microsoft Academic Search

OBJECTIVE: Obesity is a major public health problem due to its associations with multiple cardiovascular risk factors. Although there are sophisticated methods, such as imaging, to document total body fat and its distributions, anthropometric measurements remain important in clinical practice. We examined the relationships between cardiovascular risk factors and the three commonest anthropometric measurements for obesity, body mass index (BMI),

GTC Ko; JCN Chan; J Woo; E Lau; VTF Yeung; C-C Chow; HPS Wai; JKY Li; W-Y So; CS Cockram; Gary TC Ko

1997-01-01

54

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

55

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

56

Risk Factors for Cardiovascular Disease in Homeless Adults  

Microsoft Academic Search

Background—Homeless people represent an extremely disadvantaged group in North America. Among older homeless men, cardiovascular disease (CVD) is the leading cause of death. The objective of this study was to examine cardiovascular risk factors in a representative sample of homeless adults and identify opportunities for improved risk factor modification. Methods and Results—Homeless persons were randomly selected at shelters for single

Tony C. Lee; John G. Hanlon; Jessica Ben-David; Gillian L. Booth; Warren J. Cantor; Philip W. Connelly; Stephen W. Hwang

2010-01-01

57

Uremia-related cardiovascular risk factors in chronic kidney disease  

Microsoft Academic Search

Cardiovascular disease is the leading cause of mortality in the dialysis population and a major cause of morbidity and mortality in patients with chronic renal failure. The conventional Framingham cardiovascular (CV) risk factors (ie, hypertension, smoking, age, hyper- cholesterolemia, and a family history of CV disease) have typically been the focus of risk stratification and subse- quent primary and\\/or secondary

Caroline E. Stigant

58

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

59

Reverse epidemiology of cardiovascular risk factors in maintenance dialysis patients  

Microsoft Academic Search

Reverse epidemiology of cardiovascular risk factors in maintenance dialysis patients. Conventional risk factors of cardiovascular disease and mortality in the general population such as body mass, serum cholesterol, and blood pressure are also found to relate to outcome in maintenance dialysis patients, but often in an opposite direction. Obesity, hypercholesterolemia, and hypertension appear to be protective features that are associated

Kamyar Kalantar-Zadeh; Gladys Block; Michael H. Humphreys; Joel D. Kopple

2003-01-01

60

Inflammation, the metabolic syndrome and cardiovascular risk.  

PubMed

Over the past ten years it has become clear that cardiovascular disease (CVD) and atherosclerosis have a 'microinflammatory' component and are often associated with low levels of inflammatory markers that are in the upper part of the 'normal' range. In particular, diseases that predispose to CVD, such as the metabolic syndrome and type 2 diabetes, appear to have a very strong inflammatory component. While the inflammatory process is very complicated, single measures, such as C-reactive protein (CRP) or fibrinogen, have clear benefits as they summarise many different parts of the inflammatory process and are easy to apply. However, it is important to remember that the process of inflammation includes coagulation, fibrinolysis, complement activation, antioxidation, immune response and hormonal regulation through the hypothalamic-pituitary-adrenal axis. Furthermore, genetic variation, differences in exposure to environmental influences and the mass of inflammation-producing tissue (e.g. adipose tissue) can all influence responses. Thus, the relationship between atherosclerosis, the metabolic syndrome and inflammation is extraordinarily complex. Inflammatory markers such as CRP exhibit strong CVD-risk prediction that is consistent across sexes and a number of different populations. They reflect risk not only for 'vulnerable plaque' and myocardial infarction (MI) but also for other cardiovascular diseases. In fact, inflammation is associated with several, if not all, of the chronic diseases of old age, and it is now clear that there are important links between inflammation and general metabolism. For instance, visceral adiposity exerts a major influence on inflammation status. Medications that affect atherosclerosis appear to do so at least in part by influencing inflammation (for instance, the emerging pleiotropic effects of statins), and this has far-reaching ramifications for chronic diseases of old age and their treatment. PMID:12793593

Tracy, Russell P

2003-03-01

61

Cardiac risk factors: environmental, sociodemographic, and behavioral cardiovascular risk factors.  

PubMed

Several environmental exposures are associated with increased risk of coronary heart disease (CHD). Exposure to secondhand smoke may increase the risk by as much as 25% to 30%. Exposure to third hand smoke, residual components of tobacco smoke that remain in the environment after a cigarette is extinguished, also appears to increase risk. These residual components can remain in rooms and automobiles for up to 30 years and enter the body through the skin or via inhalation or ingestion. Exposure to particulate matter air pollution from automobile emissions, power plants, and other sources is yet another environmental risk factor for CHD, resulting in tens of thousands of deaths annually in the United States. Exposure to other environmental toxins, particularly bisphenol A and phthalates, also has been linked to CHD. There are sociodemographic risks for CHD, with numerous studies showing that lower socioeconomic status is associated with higher risk. Behavioral risk factors include poor diet, such as frequent consumption of fast food and processed meals; sleep disturbance; and psychological stress, particularly related to marital or work issues. Finally, although high alcohol consumption is associated with increased CHD risk, moderate alcohol consumption (ie, less than 1 to 2 drinks/day), particularly of wine and possibly beer, appears to reduce the risk. PMID:24936715

Anthony, David; George, Paul; Eaton, Charles B

2014-06-01

62

Comorbidities and cardiovascular risk factors in patients with psoriasis*  

PubMed Central

BACKGROUND Psoriasis is a chronic inflammatory disease and its pathogenesis involves an interaction between genetic, environmental, and immunological factors. Recent studies have suggested that the chronic inflammatory nature of psoriasis may predispose to an association with other inflammatory diseases, especially cardiovascular diseases and metabolic disorders. OBJECTIVES To describe the demographic, clinical, epidemiological, and laboratory characteristics of a sample of psoriasis patients; to assess the prevalence of cardiovascular comorbidities in this group of patients; and to identify the cardiovascular risk profile using the Framingham risk score. METHODS We conducted a cross-sectional study involving the assessment of 190 patients. Participants underwent history and physical examination. They also completed a specific questionnaire about epidemiological data, past medical history, and comorbidities. The cardiovascular risk profile was calculated using the Framingham risk score. RESULTS Patients' mean age was 51.5 ± 14 years, and the predominant clinical presentation was plaque psoriasis (78.4%). We found an increased prevalence of systemic hypertension, type 2 diabetes, metabolic syndrome, and obesity. Increased waist circumference was also found in addition to a considerable prevalence of depression, smoking, and regular alcohol intake. Patients' cardiovascular risk was high according to the Framingham risk score, and 47.2% of patients had moderate or high risk of fatal and non-fatal coronary events in 10 years. CONCLUSIONS Patients had high prevalence of cardiovascular comorbidities, and high cardiovascular risk according to the Framingham risk score. Further epidemiological studies are needed in Brazil for validation of our results. PMID:25184912

Baeta, Isabela Guimarães Ribeiro; Bittencourt, Flávia Vasques; Gontijo, Bernardo; Goulart, Eugênio Marcos Andrade

2014-01-01

63

The interdependence between cardiovascular calcifications in different arterial beds and vascular risk factors in patients at high cardiovascular risk.  

PubMed

Objective: The objective was to explore the interdependence between cardiovascular risk factors and cardiovascular calcifications on the cardiac valves and in multiple vascular beds in the chest and abdomen in a high-risk population. Methods: 276 participants of the SMART study who received a CT scan of the chest and abdominal region within one year were evaluated for the presence of cardiovascular calcifications throughout the body. Cardiovascular calcifications were manually scored in the coronary arteries, the aorta, the supra aortic vessels, the infra aortic vessels, the aortic valve, the renal arteries and the splenic artery. The following clinical risk factors of cardiovascular disease were included in principal component analysis, body mass index, systolic blood pressure, glucose, total cholesterol and carotid intima media thickness (cIMT) as a marker of atherosclerosis. Results: Principal component analysis yielded three uncorrelated components. The first consisted of cardiovascular calcifications and cIMT (variance = 35.4%), the second contained BMI and glucose (variance = 11.1%), and the third component consisted of systolic blood pressure and cholesterol (variance = 9.0%). Combined these three components explained 56% of the total variance within the dataset. Strong associations were observed among vascular calcifications and cIMT, whereas the association between clinical risk factors and cardiovascular calcifications was weak. Conclusion: The results suggest a single systemic nature of cardiovascular calcifications throughout the body that do not cluster with traditional cardiovascular risk factors. PMID:25485737

Takx, Richard A P; Zanen, Pieter; Leiner, Tim; van der Graaf, Yolanda; de Jong, Pim A

2014-11-29

64

Prevalence of modifiable cardiovascular risk factors in German adolescents  

Microsoft Academic Search

Background The distribution and clustering of cardiovascular risk factors among German adolescents is only poorly understood.Objectives To describe the prevalence of major modifiable cardiovascular disease (CVD) risk factors and the clustering of risk factors in German adolescents aged 11–17 years.Design Cross-sectional study.Methods The German Health Interview and Examination Survey for Children and Adolescents was conducted between 2003 and 2006. The

Falk Müller-Riemenschneider; Marc Nocon; Stefan N. Willich

2010-01-01

65

Cardiovascular risk factors in patients with chronic kidney disease  

Microsoft Academic Search

Patients with chronic kidney disease have a higher burden of cardiovascular disease, which increases in a dose-dependent fashion with worsening kidney function. Traditional cardiovascular risk factors, including advanced age, diabetes mellitus, hypertension and dyslipidemia, have an important role in the progression of cardiovascular disease in patients who have a reduced glomerular filtration rate, especially in those with mild-to-moderate kidney disease.

Sarina van der Zee; Usman Baber; Sammy Elmariah; Jonathan Winston; Valentin Fuster

2009-01-01

66

Hypertension, concurrent cardiovascular risk factors and mortality: the Singapore Cardiovascular Cohort Study  

Microsoft Academic Search

The current hypertension (HTN) guidelines recommend the assessment of other cardiovascular disease (CVD) risk factors in individuals with HTN for further management. Few studies in Asian populations have been published to identify the outcome of individuals with HTN and other CVD risk factors. This study aims to assess the effect of HTN alone, and in combination with other CVD risk

J Lee; S Ma; D Heng; S K Chew; K Hughes; E S Tai

2008-01-01

67

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

68

Circulating Endothelial Progenitor Cells, Vascular Function, and Cardiovascular Risk  

Microsoft Academic Search

background Cardiovascular risk factors contribute to atherogenesis by inducing endothelial-cell injury and dysfunction. We hypothesized that endothelial progenitor cells derived from bone marrow have a role in ongoing endothelial repair and that impaired mobilization or depletion of these cells contributes to endothelial dysfunction and cardiovascular disease progression. methods We measured the number of colony-forming units of endothelial progenitor cells in

Jonathan M. Hill; Gloria Zalos; Julian P. J. Halcox; William H. Schenke; Myron A. Waclawiw; Arshed A. Quyyumi; Toren Finkel

2009-01-01

69

Metabolic Syndrome and Cardiovascular Risk: The Nurse's Role  

Microsoft Academic Search

A B S T R A C T Metabolic Syndrome (MS) is characterized by dysglycemia, arterial hypertension, atherogenic dyslipidemia and central obesity. Its presence has been associated with increased risk for the development of diabetes mellitus and cardiovascular disease. The main treatment goal is to lower the incidence of both MS and its cardiovascular sequelae and includes diet, exercise, weight

Dimitra Agelidou

2006-01-01

70

Autoantibodies and the Risk of Cardiovascular Events  

PubMed Central

OBJECTIVE Inflammation and autoimmunity are associated with increased cardiovascular (CV) risk in rheumatoid arthritis patients. This association may also be present in those without rheumatic diseases. The purpose of this study was to determine whether rheumatoid factor (RF), antinuclear antibody (ANA), and cyclic citrullinated peptide antibody (CCP) positivity are associated with increased risk of CV events and overall mortality in both those with and without rheumatic diseases. METHODS We performed a population-based cohort study of all subjects who had a RF and/or ANA test performed between 1/1/1990 and 1/1/2000, and/or CCP test performed between 9/1/2003 and 1/1/2005, with follow-up until 4/1/2007. Outcomes were ascertained using diagnostic indices from complete medical records, including: CV events [myocardial infarction (MI), heart failure (HF), and peripheral vascular disease (PVD)], and mortality. Cox models were used to analyze the data. RESULTS There were 6783 subjects with RF, 7852 with ANA, and 299 with CCP testing. Of these, 10.4%, 23.9% and 14.7% were positive for RF, ANA and CCP, respectively. Adjusting for age, sex, calendar year, comorbidity and rheumatic disease, RF and ANA positivity were significant predictors of CV events (HR 1.24 & 1.26) and death (HR 1.43 & 1.18). Adjusting for age, CCP positivity was associated with CV events but this association was not statistically significant (HR 3.1; 95% CI 0.8, 12.3). CONCLUSIONS RF and ANA positivity are significant predictors of CV events and mortality in both those with and without rheumatic diseases. These results support the role of immune dysregulation in the etiology of CV disease. PMID:19833748

Liang, Kimberly P.; Kremers, Hilal Maradit; Crowson, Cynthia S.; Snyder, Melissa R.; Therneau, Terry M.; Roger, Veronique L.; Gabriel, Sherine E.

2010-01-01

71

Obstructive Sleep Apnea and the Risk for Cardiovascular Disease  

PubMed Central

Obstructive sleep apnea (OSA) is a common disorder with major neurocognitive and cardiovascular sequelae. It is estimated that more than one quarter of the population is at risk for OSA, with increased prevalence noted in populations with hypertension, coronary artery disease, stroke, and atrial fibrillation. A number of epidemiologic and mechanistic studies have recently generated interest in the role of OSA in the pathophysiology of cardiovascular disease, a link that continues to require extensive investigation. This chapter reviews these epidemiologic studies, the current understanding of the mechanisms by which OSA may contribute to the progression of cardiovascular diseases, and the effects of OSA treatment on cardiovascular disease outcomes. PMID:21253882

Balachandran, Jay S.; Malhotra, Atul

2015-01-01

72

Arterial hypertension and cardiovascular risk in HIV-infected patients.  

PubMed

The dramatic change of the natural history of HIV-infected patients by highly active antiretroviral therapy (HAART) has exposed these patients to cardiovascular risk, including cardiovascular disease and hypertension. In HIV-infected patients, the development of arterial hypertension, at least in the medium-long term is an established feature, although recognized predictors of its development have not been clearly identified. In addition, conflicting data regarding the influence of antiretroviral therapy (ART) are reported. The presence of a proinflammatory state and oxidative stress-mediated endothelial dysfunction seem, however, to play a pathophysiologic role. In this review, we examine and provide a comprehensive, literature based, consideration of the pathophysiologic aspects of hypertension in these patients. HIV-infected patients, independently of the presence of hypertension, remain at very high cardiovascular risk due to the presence of the same cardiovascular risk factors recognized for the general population with, in addition, the indirect influence of the ART, essentially via its effect on lipid metabolism. This review based on the evidence from the literature, concludes that the management of HIV-infected patients in terms of cardiovascular prevention emerges as a priority. The consideration of cardiovascular risk in these patients should receive the same emphasis given for the general population at high cardiovascular risk, including adequate blood pressure control according to international guidelines. PMID:23807242

Calò, Lorenzo A; Caielli, Paola; Maiolino, Giuseppe; Rossi, Gianpaolo

2013-08-01

73

Cardiovascular Risk in Psoriatic Arthritis – a Cross-Sectional Study  

PubMed Central

ABSTRACT Objectives: The present study aims to estimate long term cardiovascular risk in psoriatic arthritis (PsA) patients and to identify clinical and/or laboratory features which influence this risk. Outcomes: The PsA group included 44 males and 59 females (p = 0.167) with an average age of 52 years (23-80). SCORE was significantly correlated with age of onset, BMI, triglycerides, FPG. Among these patients, males, smokers, those with axial involvement, with IHT, with AHT and those not treated with glucocorticoids had a significantly higher SCORE. The subgroup of 56 PsA women, age-matched with 56 normal women, had a significantly higher SCORE, even after controlling for covariates. Conclusions: Cardiovascular risk of PsA patients estimated on SCORE charts correlates with metabolic clinical and laboratory features and is associated with classical cardiovascular risk factors. The axial involvement in PsA is associated with a higher cardiovascular risk when compared to non-axial PsA. Women with PsA have a higher cardiovascular risk than normal women, which sustains the opinion that PsA may be considered an independent cardiovascular risk factor. PMID:25553121

POPESCU, Claudiu; PINTILIE, Ana Maria; BOJINCA, Violeta; BALANESCU, Andra; IONESCU, Ruxandra

2014-01-01

74

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

75

Association between simple anthropometric indices and cardiovascular risk factors  

Microsoft Academic Search

OBJECTIVE: To identify which of the three simple anthropometric indices, body mass index (BMI), waist-to-hip ratio (WHR) and waist circumference (WC), best predicts cardiovascular risk factors, and to determine if the association between the anthropometric indices and cardiovascular risk factors varies with gender.DESIGN AND METHODOLOGY: A cross-sectional population-based survey was carried out during 1995–1996. One thousand and ten Chinese people

SC Ho; YM Chen; JLF Woo; SSF Leung; TH Lam; ED Janus

2001-01-01

76

Blood pressure variability: cardiovascular risk integrator or independent risk factor?  

PubMed

Blood pressure (BP) variability is associated with several cardiovascular (CV) risk factors. Is BP variability measurement of any additive value, in terms of CV risk assessment strategies? To answer this question, we analyzed data from the SU.FOL.OM3 secondary prevention trial that included 2501 patients with background of CV disease history (coronary or cerebrovascular disease). BP was measured every year allowing calculation of variability of BP, expressed as s.d. and coefficient of variability (s.d./mean systolic BP) in 2157 patients. We found that systolic BP variability was associated with several CV risk factors: principally hypertension, age, and diabetes. Furthermore, all antihypertensives were positively associated with variability. Logistic regression analysis revealed that three factors were independent predictors of major CV event: coefficient of variability of systolic BP (OR=1.23 per s.d., 95% CI: 1.04-1.46, P=0.016), current smoking (OR=1.94, 95% CI: 1.03-3.66, P=0.039), and inclusion for cerebrovascular disease (OR=1.92, 95% CI: 1.29-2.87, P=0.001). Finally, when comparing logistic regression models characteristics without, and then with, inclusion of BP variability, there was a modest but statistically significant improvement (P=0.04). In conclusion, age, BP and diabetes were the major determinants of BP variability. Furthermore, BP variability has an independent prognostic value in the prediction of major CV events; but improvement in the prediction model was quite modest. This last finding is more in favor of BP variability acting as an integrator of CV risk than acting as a robust independent CV risk factor in this high-risk population. PMID:24990422

Blacher, J; Safar, M E; Ly, C; Szabo de Edelenyi, F; Hercberg, S; Galan, P

2015-02-01

77

RESIDUAL RISK ASSESSMENTS - RESIDUAL RISK ASSESSMENT FOR COKE OVENS  

EPA Science Inventory

This source category previously subjected to a technology-based standard will be examined to determine if health or ecological risks are significant enough to warrant further regulation for Coke Ovens. These assesments utilize existing models and data bases to examine the multi-m...

78

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

79

RESIDUAL RISK ASSESSMENT: HALOGENATED SOLVENTS  

EPA Science Inventory

This source category previously subjected to a technology-based standard will be examined to determine if health or ecological risks are significant enough to warrant further regulation for Halogenated Solvent Degreasing Facilities. These assessments utilize existing models and d...

80

Integrative Treatments to Reduce Risk for Cardiovascular Disease  

PubMed Central

Recognizing the contribution and interrelatedness of lipoprotein risk factors is critical to prioritizing treatment strategies for cardiovascular risk reduction. Lipoprotein factors still dominate risk for developing cardiovascular disease, including myocardial infarction. Some emerging risk factors such as C-reactive protein are gaining acceptance due to recent prospective clinical trials demonstrating clinical benefit in reducing these markers. Other emerging risk factors, including lipoprotein particle size, remain to be validated. In this second article of a 2-part series, we will begin with a review of formal risk assessment, discussing the contribution of multiple “risky” and “healthy” components that play a part in overall cardiovascular health. Following risk assessment, we will discuss evidence-based integrative therapies that can be used to modify any risky lipoprotein and inflammatory patient profiles, including medications, functional foods, supplements, and lifestyle approaches. The focus is on low-density lipoproteins, high-density lipoproteins, triglycerides, and C-reactive protein. Understanding the interrelatedness of lipoprotein risk factors, and finding efficient methods of treating multiple risk factors simultaneously, will not only improve the long-term health of patients but will also save on the expenditure of healthcare dollars for unnecessary testing and ineffective treatments. Integrative practitioners who understand the contribution of lifestyle factors, and who have numerous effective treatment options at their disposal, are well positioned to counsel patients on cardiovascular disease prevention. PMID:21461347

Bradley, Ryan; Oberg, Erica

2010-01-01

81

Assessment of cardiovascular risk in hypertensive patients: a comparison of commonly used risk scoring programs  

PubMed Central

Several calculation modalities are used today for cardiovascular risk assessment. Cardiovascular risk assessment should be performed in all hypertensive patients. Risk assessment methods being based on the population in which the patient lives and the inclusion of factors such as ethnicity variations, socioeconomic status, and medication use will contribute to improvements in risk assessments. The results should be shared with the patient, and modifiable risk factors must be effectively treated. PMID:25019017

Ulusoy, ?ükrü

2013-01-01

82

Cardiovascular Disorders Risk Factors in Different Industries of Iran  

PubMed Central

Background: Disorders of cardiovascular system can cause disability or death, screening is necessary specially in workers who maybe had risk factors. Hypertension, hyperlipidemia, obesity, smoking, genetic, exposure to chemicals, fumes, solvents, coldness are non occupational and occupational risk factors. Objective was comparison of cardiovascular disorders risk factors between workers in different industries of Iran. Methods: In a cross-sectional study, workers of automobile, food industries and light works had been selected and cardiovascular disorders risk factors had been gathered then data analyzed in SPSS with one-way ANOVA, Chi-2 and multi nominal logistic regression with P < 0.05. Results: 875 workers had been participated in the study, all of the cardiovascular disorders risk factors were in the normal range. Mean of high density lipoprotein (HDL) in food industry workers was 63.83 ± 17.42 mg/dl and it was protective, but in workers who work in automobile industry was 38.97 ± 11.08 mg/dl and the lowest, Also hypertension and hypertriglyceridemia were more prominent in this industry and after regression with P < 0.05, the differences were significant. Conclusions: Screening of cardiovascular disorders risk factors were important and helpful in industries specially automobile industry, that might be preventive method for these disorders in the future. PMID:23930194

Assadi, Seyedeh Negar

2013-01-01

83

Radiation as a risk factor for cardiovascular disease.  

PubMed

Abstract 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. PMID:21091078

Baker, John E; Moulder, John E; Hopewell, John W

2011-10-01

84

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

85

Comprehensive Nutrition Plan Improves Cardiovascular Risk Factors in Essential Hypertension  

Microsoft Academic Search

Increased arterial pressure is known to be influenced by a variety of nutrients. Compliance with dietary recommendations for risk reduction is often limited by the complexity of their implementation. In addition, how improvements in total diet, rather than single nutrients, influence concomitant cardiovascular risk factors has not been thoroughly explored. We assessed the effects of a nutritionally complete prepared meal

David A. McCarron; Suzanne Oparil; Lawrence M. Resnick; Alan Chait; R. Brian Haynes; Penny Kris-Etherton; F. Xavier Pi-Sunyer; Judith S. Stern; Cynthia D. Morris; Sharon Clark; Daniel C. Hatton; Jill A. Metz; Margaret McMahon; Scott Holcomb; Geoffrey W. Snyder

1998-01-01

86

Cardiovascular Risk In Adult Kidney Transplant Patients  

Microsoft Academic Search

More than 140,000 patients are living with a functioning kidney transplant in the United States. Although kidney transplantation confers relatively longer survival com- pared with any of the dialysis modalities, the life expectancy of kidney transplant recip- ients (KTRs) remains lower than that of the age- and sex-matched general population. 1 Cardiovascular (CV) disease is the single leading cause of

Reza Abdi; Jessamyn Bagley; Joseph V. Bonventre; Barry M. Brenner; Charles B. Carpenter; Anil K. Chandraker; David M. Charytan; Kenneth B. Christopher; Gary C. Curhan; Bradley M. Denker; John P. Forman; Markus H. Frank; M. D. Won; Kook Han; Dirk M. Hentschel; Li-Li Hsiao; Stephen Hsu; Benjamin D. Humphreys; John J. Iacomini; Takaharu Ichimura; Julie Lin; M. P. H. Colm; C. Magee; M. P. H. Edgar; L. Milford; David B. Mount; Nader Najafian; Shona Pendse; Martin R. Pollak; Stephen T. Reeders; Mohamed H. Sayegh; Julian L. Seifter; Jagesh V. Shah; Alice M. Sheridan; Ajay K. Singh; Theodore I. Steinman; Eric N. Taylor; Kathryn Tinckam; John K. Tucker; Wolfgang C. Winkelmayer; D. Xueli Yuan; D. Kambiz Zandi-Nejad; Jing Zhou

87

Homocysteine and Risk of Cardiovascular Disease  

Microsoft Academic Search

This pictorial introduction to homocysteine illustrates at a glance the nature of homocysteine and its role in cardiovascular disease by means of eight simple figures and an essential bibliography. Homocysteine is a sulfur-containing metabolite of methionine. Conversion back to methionine or transsulfuration to cysteine are the two major metabolic pathways that reduce total homocysteine (tHcy) concentrations in cells and blood.

Felicita Andreotti; Francesco Burzotta; Alessandro Manzoli; Killian Robinson

2000-01-01

88

Krill oil for cardiovascular risk prevention: is it for real?  

PubMed

Omega-3 fatty acids play an important role in cardiovascular health. Although it is suggested that individuals obtain these nutrients through diet, many prefer to rely on supplements. Fish oil supplements are widely used, yet large capsule sizes and tolerability make them less than ideal. Recently, krill oil has emerged as a potential alternative for omega-3 supplementation. This article will discuss what is known about krill oil and its potential use in cardiovascular risk prevention. PMID:25477562

Backes, James M; Howard, Patricia A

2014-11-01

89

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

90

Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults  

MedlinePLUS

... Force Recommendations Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults ... is peripheral artery disease? What is cardiovascular disease? Cardiovascular disease affects the heart and blood vessels. It is ...

91

Validity of Cardiovascular Risk Prediction Models in Kidney Transplant Recipients  

PubMed Central

Background. Predicting cardiovascular risk is of great interest in renal transplant recipients since cardiovascular disease is the leading cause of mortality. Objective. To conduct a systematic review to assess the validity of cardiovascular risk prediction models in this population. Methods. Five databases were searched (MEDLINE, EMBASE, SCOPUS, CINAHL, and Web of Science) and cohort studies with at least one year of follow-up were included. Variables that described population characteristics, study design, and prognostic performance were extracted. The Quality in Prognostic Studies (QUIPS) tool was used to evaluate bias. Results. Seven studies met the criteria for inclusion, of which, five investigated the Framingham risk score and three used a transplant-specific model. Sample sizes ranged from 344 to 23,575, and three studies lacked sufficient event rates to confidently reach conclusion. Four studies reported discrimination (as measured by c-statistic), which ranged from 0.701 to 0.75, while only one risk model was both internally and externally validated. Conclusion. The Framingham has underestimated cardiovascular events in renal transplant recipients, but these studies have not been robust. A risk prediction model has been externally validated at least on one occasion, but comprehensive validation in multiple cohorts and impact analysis are recommended before widespread clinical application is advocated. PMID:24977223

Stewart, Samuel Alan; Shoker, Ahmed

2014-01-01

92

Cardiovascular health informatics: risk screening and intervention.  

PubMed

Despite enormous efforts to prevent cardiovascular disease (CVD) in the past, it remains the leading cause of death in most countries worldwide. Around two-thirds of these deaths are due to acute events, which frequently occur suddenly and are often fatal before medical care can be given. New strategies for screening and early intervening CVD, in addition to the conventional methods, are therefore needed in order to provide personalized and pervasive healthcare. In this special issue, selected emerging technologies in health informatics for screening and intervening CVDs are reported. These papers include reviews or original contributions on 1) new potential genetic biomarkers for screening CVD outcomes and high-throughput techniques for mining genomic data; 2) new imaging techniques for obtaining faster and higher resolution images of cardiovascular imaging biomarkers such as the cardiac chambers and atherosclerotic plaques in coronary arteries, as well as possible automatic segmentation, identification, or fusion algorithms; 3) new physiological biomarkers and novel wearable and home healthcare technologies for monitoring them in daily lives; 4) new personalized prediction models of plaque formation and progression or CVD outcomes; and 5) quantifiable indices and wearable systems to measure them for early intervention of CVD through lifestyle changes. It is hoped that the proposed technologies and systems covered in this special issue can result in improved CVD management and treatment at the point of need, offering a better quality of life to the patient. PMID:22997187

Hartley, Craig J; Naghavi, Morteza; Parodi, Oberdan; Pattichis, Constantinos S; Poon, Carmen C Y; Zhang, Yuan-Ting

2012-09-01

93

Accumulating Brisk Walking for Fitness, Cardiovascular Risk, and Psychological Health.  

ERIC Educational Resources Information Center

Compared the effects of different patterns of regular brisk walking on fitness, cardiovascular disease risk factors, and psychological well-being in previously sedentary adults. Data on adults who completed either short-bout or long-bout walking programs found that three short bouts of brisk walking accumulated throughout the day were as effective…

Murphy, Marie; Nevill, Alan; Neville, Charlotte; Biddle, Stuart; Hardman, Adrianne

2002-01-01

94

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

95

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

96

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

97

Cardiovascular risk assessment before and after kidney transplantation.  

PubMed

Cardiovascular disease (CVD) is the leading cause of death in dialysis patients and the most common cause of death and allograft loss among kidney transplant recipients. End-stage renal disease (ESRD) is associated with an increased incidence and prevalence of a wide range of CVDs including coronary artery disease, stroke, congestive heart failure, atrial fibrillation, sudden cardiac death, pulmonary hypertension, and valvular heart disease. CVD risk factors are very common in patients with ESRD, and most patients have multiple risk factors. Kidney transplantation is the treatment of choice for patients with ESRD, as a successful transplant improves longevity and quality of life, primarily by decreasing the incidence and severity of CVD. Correction of the uremic state and improved glomerular filtration rate seem to be the major mechanism of this benefit. Transplant candidates should undergo cardiovascular assessment, usually echocardiography and exercise stress testing, and may require formal cardiology consultation. Higher risk candidates, including those aged >50 years, hypertension, diabetes, established coronary artery disease or peripheral vascular disease, left ventricular hypertrophy, and dialysis duration >1 year, should have repeat cardiovascular assessment every 1-2 years. Transplant candidates and recipients should have individualized treatment for CVD and risk factors such as hypertension, diabetes, hyperlipidemia, and obesity. Special consideration should be given for statin therapy, as its use is associated with decreased cardiovascular death in dialysis and transplant patients. Prospective randomized, controlled trials are needed to determine the optimal approach to diagnosis and treat CVD in the transplant candidate and recipient population. PMID:24896248

Glicklich, Daniel; Vohra, Parag

2014-01-01

98

Dietary Risk Factors and Their Modification in Cardiovascular Disease.  

ERIC Educational Resources Information Center

Provides an overview of dietary risk factors for cardiovascular disease, including diet sodium intake for hypertension and dietary fat and cholesterol for hypercholesterolemia, exacerbation of these conditions by obesity, and intervention strategies for their modification. Describes clinical strategies for modifying diet: education, skills…

Jeffery, Robert W.

1988-01-01

99

Waist Circumference and Cardiovascular Risk Factors in Prepubertal Children  

Microsoft Academic Search

Objective: Intra-abdominal fat has been identified as being the most clinically relevant type of fat in humans. Therefore, an assessment of body-fat distribution could possibly identify subjects with the highest risk of adverse lipid profile and hypertension. Few data on the relationship between body-fat distribution and cardiovascular risk factors are available in children, especially before puberty.Research Methods and Procedures: This

Claudio Maffeis; Angelo Pietrobelli; Alessandra Grezzani; Silvia Provera; Luciano Tatò

2001-01-01

100

Metabolic Risk: Primary Prevention of Cardiovascular Disease and Type 2 Diabetes  

MedlinePLUS

... The number of people at risk of developing cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) has ... years (or sooner). Metabolic Risk: Primary Prevention of Cardiovascular disease and type 2 diabetes What treatment is recommended ...

101

Intestinal Microbial Metabolism of Phosphatidylcholine and Cardiovascular Risk  

PubMed Central

BACKGROUND Recent studies in animals have shown a mechanistic link between intestinal microbial metabolism of the choline moiety in dietary phosphatidylcholine (lecithin) and coronary artery disease through the production of a proatherosclerotic metabolite, trimethylamine-N-oxide (TMAO). We investigated the relationship among intestinal microbiota-dependent metabolism of dietary phosphatidylcholine, TMAO levels, and adverse cardiovascular events in humans. METHODS We quantified plasma and urinary levels of TMAO and plasma choline and betaine levels by means of liquid chromatography and online tandem mass spectrometry after a phosphatidylcholine challenge (ingestion of two hard-boiled eggs and deuterium [d9]-labeled phosphatidylcholine) in healthy participants before and after the suppression of intestinal microbiota with oral broad-spectrum antibiotics. We further examined the relationship between fasting plasma levels of TMAO and incident major adverse cardiovascular events (death, myocardial infarction, or stroke) during 3 years of follow-up in 4007 patients undergoing elective coronary angiography. RESULTS Time-dependent increases in levels of both TMAO and its d9 isotopologue, as well as other choline metabolites, were detected after the phosphatidylcholine challenge. Plasma levels of TMAO were markedly suppressed after the administration of antibiotics and then reappeared after withdrawal of antibiotics. Increased plasma levels of TMAO were associated with an increased risk of a major adverse cardiovascular event (hazard ratio for highest vs. lowest TMAO quartile, 2.54; 95% confidence interval, 1.96 to 3.28; P<0.001). An elevated TMAO level predicted an increased risk of major adverse cardiovascular events after adjustment for traditional risk factors (P<0.001), as well as in lower-risk subgroups. CONCLUSIONS The production of TMAO from dietary phosphatidylcholine is dependent on metabolism by the intestinal microbiota. Increased TMAO levels are associated with an increased risk of incident major adverse cardiovascular events. (Funded by the National Institutes of Health and others.) PMID:23614584

Tang, W.H. Wilson; Wang, Zeneng; Levison, Bruce S.; Koeth, Robert A.; Britt, Earl B.; Fu, Xiaoming; Wu, Yuping; Hazen, Stanley L.

2013-01-01

102

Cardiovascular risk scores do not account for the effect of treatment: a review  

Microsoft Academic Search

ObjectiveTo compare the strengths and limitations of cardiovascular risk scores available for clinicians in assessing the global (absolute) risk of cardiovascular disease.DesignReview of cardiovascular risk scores.Data sourcesMedline (1966 to May 2009) using a mixture of MeSH terms and free text for the keywords ‘cardiovascular’, ‘risk prediction’ and ‘cohort studies’.Eligibility criteria for selecting studiesA study was eligible if it fulfilled the

S M Liew; J Doust; P Glasziou

2011-01-01

103

Impact of sex-specific body composition on cardiovascular risk factors: the Hong Kong Cardiovascular Risk Factor Study  

Microsoft Academic Search

The aim of the study was to analyze the effects of sex-specific distribution of adiposity, particularly emphasizing the independent contribution of waist and hip circumferences relative to body mass index (BMI), on cardiovascular risk factors in a Chinese population. Blood pressure and anthropometric and biochemical parameters were measured in 2510 population-based Chinese subjects. The relative contributions of waist and hip

G. Neil Thomas; Sarah M. McGhee; Mary Schooling; Sai Yin Ho; Karen S. L. Lam; Edward D. Janus; Tai Hing Lam

2006-01-01

104

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

105

Leptin as a cardiovascular risk factor  

PubMed Central

The role of leptin in humans is not yet precisely established. Nevertheless there is increasing evidence revealing that this molecule is involved in the pathogenesis of atherosclerosis as an independent risk factor. From another point of view, however, leptin is allready related to known traditional risk factors for accelerated atherogenesis, like obesity. We herein provide the experimental and clinical data concerning the association between leptin and atherosclerotic disease. Vascular stiffness and calcification, immune responce regulation, fibrinolysis, and oxidative stress, are the main fields to be investigated in relation to leptin in the present study. Additionally the discription of the main characteristics of leptin and its receptors is included in the introduction of this article, whereas in the end the main clinical data suggesting that this molecule represents an interesting risk factor for atherosclerotic disease are provided. PMID:19582187

Efstratiadis, G; Nikolaidou, C; Vergoulas, G

2007-01-01

106

Emerging noninvasive biochemical measures to predict cardiovascular risk.  

PubMed

New predictors of cardiovascular events are needed to improve the accuracy of risk stratification. Such predictors should be easily measurable in the population and potentially modifiable. This review reports on new biomarkers that are closely linked to the pathogenic mechanisms underlying the progression of the atherosclerotic plaque leading to rupture and thrombosis that ultimately precipitate acute clinical events, such as stroke and myocardial infarction. These risk factors have been associated with subclinical or clinical cardiovascular disease in large populations and include markers of lipoprotein and lipid metabolism, vitamin B12 metabolism, fibrinolysis, coagulation, inflammation, infection, endothelial dysfunction, the angiotensin system, and oxidative stress. For other key processes of atherosclerosis and cardiac disease, such as apoptosis or programmed cell death, there are currently no markers that can be measured noninvasively. Atherosclerosis is a multifactorial condition and possibly only a subset of factors are the main determinants of disease in a given patient. A better definition of the cardiovascular risk profile will help to better target primary and secondary prevention. Further epidemiological studies are needed to characterize the actual predictive and clinical value of these new emerging cardiovascular biomarkers. PMID:9989535

Pahor, M; Elam, M B; Garrison, R J; Kritchevsky, S B; Applegate, W B

1999-02-01

107

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

108

Younger age of escalation of cardiovascular risk factors in Asian Indian subjects  

Microsoft Academic Search

BACKGROUND: Cardiovascular risk factors start early, track through the young age and manifest in middle age in most societies. We conducted epidemiological studies to determine prevalence and age-specific trends in cardiovascular risk factors among adolescent and young urban Asian Indians. METHODS: Population based epidemiological studies to identify cardiovascular risk factors were performed in North India in 1999–2002. We evaluated major

Rajeev Gupta; Anoop Misra; Naval K Vikram; Dimple Kondal; Shaon Sen Gupta; Aachu Agrawal; RM Pandey

2009-01-01

109

HIGH CARDIOVASCULAR RISK IN AN ADULT POPULATION OF THE FRENCH WEST INDIES  

E-print Network

HIGH CARDIOVASCULAR RISK IN AN ADULT POPULATION OF THE FRENCH WEST INDIES: WIDE SOCIAL INEQUALITIES and the expression of multiple cardiovascular risk factors in an adult Caribbean population. Design and method sampling. The expression of multiple cardiovascular risk factors was defined by the presence of 3 or more

Paris-Sud XI, Université de

110

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

111

Endothelial damage and angiogenesis in hypertensive patients: relationship to cardiovascular risk factors and risk factor management  

Microsoft Academic Search

BackgroundHypertensive patients are at particular risk of cardiovascular complications, possibly related to endothelial damage or dysfunction, or to abnormal angiogenesis. These pathophysiologic processes are assessable by measurement of plasma levels of von Willebrand factor (vWf), and by vascular endothelial growth factor (VEGF) and its soluble receptor (sFlt-1). We hypothesized that these markers would correlate with the Framingham cardiovascular risk score

Dirk C. Felmeden; Charles G. C. Spencer; Funmi M. Belgore; Andrew D. Blann; D. Gareth Beevers; Gregory Y. H. Lip

2003-01-01

112

Genetic Profiling for Risk Reduction in Human Cardiovascular Disease  

PubMed Central

Cardiovascular disease is a major health concern affecting over 80,000,000 people in the U.S. alone. Heart failure, cardiomyopathy, heart rhythm disorders, atherosclerosis and aneurysm formation have significant heritable contribution. Supported by familial aggregation and twin studies, these cardiovascular diseases are influenced by genetic variation. Family-based linkage studies and population-based genome-wide association studies (GWAS) have each identified genes and variants important for the pathogenesis of cardiovascular disease. The advent of next generation sequencing has ushered in a new era in the genetic diagnosis of cardiovascular disease, and this is especially evident when considering cardiomyopathy, a leading cause of heart failure. Cardiomyopathy is a genetically heterogeneous disorder characterized by morphologically abnormal heart with abnormal function. Genetic testing for cardiomyopathy employs gene panels, and these panels assess more than 50 genes simultaneously. Despite the large size of these panels, the sensitivity for detecting the primary genetic defect is still only approximately 50%. Recently, there has been a shift towards applying broader exome and/or genome sequencing to interrogate more of the genome to provide a genetic diagnosis for cardiomyopathy. Genetic mutations in cardiomyopathy offer the capacity to predict clinical outcome, including arrhythmia risk, and genetic diagnosis often provides an early window in which to institute therapy. This discussion is an overview as to how genomic data is shaping the current understanding and treatment of cardiovascular disease. PMID:24705294

Puckelwartz, Megan J.; McNally, Elizabeth M.

2014-01-01

113

Comprehensive cardiovascular disease risk reduction in a cardiac rehabilitation setting.  

PubMed

Cardiac rehabilitation combines prescriptive exercise training with coronary artery disease (CAD) risk factor modification in patients with established CAD. As such, cardiac rehabilitation programs are ideally positioned to assume a pivotal role in the rendering of many components of comprehensive cardiovascular disease risk reduction in a secondary prevention setting. However, the extent to which traditional cardiac rehabilitation programs can successfully accomplish this goal is limited by low participation rates, inadequate emphasis on many of the essential aspects of secondary prevention, and lack of long-term follow-up of patients. To overcome these deficiencies, cardiac rehabilitation programs should evolve into cardiovascular risk reduction programs by implementing approaches that have been shown to be effective in randomized clinical trials. In this manuscript we describe one such approach, based on the Stanford Coronary Risk Intervention Project, which has been implemented in > 1,000 patients. Key components of this physician-supervised, nurse case-manager model include: (1) initial evaluation and risk assessment; (2) identification of specific goals for each CAD risk factor; (3) formulation and implementation of an individualized treatment plan that includes lifestyle modification and pharmacologic interventions for accomplishing specific risk reduction goals; (4) long-term follow-up to enhance compliance and revise the treatment plan as indicated; and (5) a mechanism for outcomes based long-term assessment of each patient. PMID:9373003

Gordon, N F; Haskell, W L

1997-10-30

114

Does Pomegranate intake attenuate cardiovascular risk factors in hemodialysis patients?  

PubMed Central

Background Atherosclerotic cardiovascular disease (CVD) is the most common cause of morbidity and mortality among hemodialysis (HD) patients. It has been attributed, among other causes, to hypertension and dyslipidemia. The aim of the present study was to investigate the effect of a year-long consumption of Pomegranate juice (PJ), on two traditional cardiovascular (CV) risk factors: hypertension and lipid profile, as well as on cardiovascular events. Methods 101 HD patients were randomized to receive 100 cc of PJ (0.7 mM polyphenols) or matching placebo juice, three times a week for one year. The primary endpoints were traditional CV risk factors; blood pressure and lipid profile. Systolic, diastolic and pulse pressure, plasma levels of triglycerides (TG), high density lipoprotein (HDL), low density lipoprotein (LDL) and total cholesterol were monitored quarterly during the study year. Secondary endpoint was incidence of cardiovascular events. Results PJ consumption yielded a significant time response improvement in systolic blood pressure, pulse pressure, triglycerides and HDL level; an improvement that was not observed in the placebo intake group. These beneficial outcomes were more pronounced among patients with hypertension, high level of triglycerides and low levels of HDL. Conclusion Regular PJ consumption by HD patients reduced systolic blood pressure and improved lipid profile. These favorable changes may reduce the accelerated atherosclerosis and high incidence of CVD among HD patients. Trial registration ClinicalTrials.gov registry, Identifier number: NCT00727519 PMID:24593225

2014-01-01

115

Testosterone deficiency: a risk factor for cardiovascular disease?  

PubMed

Male gender is a major risk factor for premature cardiovascular death, a relationship not yet explained. Low testosterone in men is a risk factor for the metabolic syndrome and type 2 diabetes and is associated independently with individual components of the metabolic syndrome--visceral obesity, insulin resistance, hyperglycemia, hypertension and dyslipidemia. Epidemiological studies report increased mortality in men with low testosterone. Testosterone replacement in the short-term reduces waist circumference, cholesterol and circulating pro-inflammatory cytokines and improves insulin sensitivity and glycemic control in diabetics. Testosterone also has beneficial effects on cardiac ischemia, angina and chronic heart failure. This manuscript reviews the current evidence supporting a link between low testosterone and cardiovascular disease, highlighting the need for larger, longer-term studies. PMID:20381374

Jones, T H

2010-08-01

116

[Salt consumption and cardiovascular risk : a plea for salt reduction].  

PubMed

High salt intake over long term is associated with increased incidence of arterial, predominantly systolic, hypertension and increased risk of cardiovascular diseases, e.g., stroke, heart failure, and renal insufficiency. High salt consumption is a vascular risk factor generating aortic stiffness and decreased vascular compliance leading to central blood pressure augmentation, higher cardiac load, and diminished diastolic perfusion. The development of heart failure can be a consequence of this sequelae. Randomized trials show a reduction in blood pressure with lower sodium intake. In long-term clinical trials, a reduction in cardiovascular morbidity and mortality has been demonstrated. Recommendations should emphasize the simultaneous reduction in sodium intake and increase in potassium intake. PMID:22086104

Middeke, M

2012-01-01

117

Four anthropometric indices and cardiovascular risk factors in Taiwan  

Microsoft Academic Search

OBJECTIVE: To examine the relationships between four anthropometric measurements and cardiovascular risk factors in Taiwan.DESIGN: The data was collected from four nationwide health screen centers in Taiwan from 1998 to 1999.SUBJECTS: A total of 38 556 subjects: 18 280 men and 20 276 women, mean age=37.0±11.1 y. None had any known major systemic diseases or were currently on medication.MEASUREMENTS: Individual

K-C Huang; W-Y Lin; L-T Lee; C-Y Chen; H Lo; H-H Hsia; I-L Liu; W-Y Shau; R-S Lin; Kuo-Chin Huang

2002-01-01

118

Risk Factors for Cardiovascular Disease in Systemic Lupus Erythematosus  

Microsoft Academic Search

Background—Cardiovascular disease (CVD) is overrepresented in patients with systemic lupus erythematosus (SLE). We determined the prevalence of traditional and nontraditional risk factors for CVD in SLE patients with and without CVD compared with controls. Methods and Results—Twenty-six women (aged 528.2 years) with SLE and a history of CVD (SLE cases) were compared with 26 age-matched women with SLE but without

Elisabet Svenungsson; Kerstin Jensen-Urstad; Mikael Heimbürger; Angela Silveira; Anders Hamsten; Joseph L. Witztum; Johan Frostegård

2010-01-01

119

Atherogenic Dyslipidemia and Cardiovascular Risk Factors in Obese Children  

PubMed Central

Childhood obesity when associated with serum lipoprotein changes triggers atherosclerosis. Evidences suggest that the atherosclerotic process begins in childhood and that the extent of early atherosclerosis of the aorta and coronary arteries can be associated with lipoprotein levels and obesity. Furthermore, many studies in childhood demonstrate an important relationship between parameters of insulin sensitivity, body fat distribution, and the development of lipid abnormalities. This review focuses on the most recent findings on the relationship between obesity, dyslipidemia, and cardiovascular risk in children.

D'Adamo, Ebe; Guardamagna, Ornella; Chiarelli, Francesco; Liccardo, Daniela; Ferrari, Federica; Nobili, Valerio

2015-01-01

120

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

121

Microalbuminuria and Chronic Kidney Disease as Cardiovascular Risk Factors  

Microsoft Academic Search

Retrospective analyses of data from outcome trial and large databases demonstrate that presence of either microalbuminuria\\u000a (MA) or a glomerular filtration rate (GFR) below 60 ml per min is associated with an increased risk for cardiovascular (CV)\\u000a events such as stroke or myocardial infarction. Presence of microalbuminuria does not imply presence of kidney disease although\\u000a a GFR below 60 ml

Pantelis A. Sarafidis; George L. Bakris

122

Ultrasonography for the Evaluation of Visceral Fat and Cardiovascular Risk  

Microsoft Academic Search

Visceral fat accumulation is associated with increased cardiovascular risk. Clinical evaluation of visceral fat is limited because of the lack of reliable and low-cost methods. To assess the correlation between ultrasonography and computed tomography (CT) for the evaluation of visceral fat, 101 obese women, age 50.567.7 years with a body mass index of 39.265.4 kg\\/m2, were submitted to ultrasonograph and

Fernando F. Ribeiro-Filho; Alessandra N. Faria; Sérgio Ajzen; Artur B. Ribeiro; Maria Teresa Zanella; Sandra R. G. Ferreira

123

Gender Differences in Cardiovascular Risk Factors in Incident Diabetes  

PubMed Central

Background Cardiovascular disease is a major cause of morbidity and mortality for women and men with diabetes. Previous cross-sectional studies of prevalent diabetes have found that women are less likely to meet ADA and AHA guidelines for control of cardiovascular risk factors (hemoglobin A1c, LDL cholesterol, and blood pressure), but have not studied the critical period immediately after diagnosis. Methods To assess gender differences in cardiovascular risk factors at the time of diabetes diagnosis (baseline) and one year later (follow-up), we conducted a retrospective cohort study of 6,547 individuals with incident diabetes in an integrated care delivery system. We assessed mean cardiovascular risk factor values by gender and adjusted odds ratios of attaining ADA goals. Findings Compared with men, at baseline women had lower hemoglobin A1c (7.9% vs. 8.2%, P<0.001), higher LDL cholesterol (118.9 vs. 111.5 mg/dL, P < 0.001), higher systolic blood pressure (131.9 vs. 130.5 mmHg, P<0.001), and lower diastolic blood pressure (79.1 vs. 79.7 mmHg, P=0.006). At follow-up, the hemoglobin A1c gender gap had closed (6.9% vs. 6.9%, P=0.39), and the gender gaps had decreased for blood pressure (129.8/77.0 vs. 128.9/77.6, P=0.009) and LDL cholesterol (104.0 vs 98.2 mg/dL, P<0.001). These associations varied by age. Adjusted odds ratios showed similar relationships. Conclusions In this cohort of individuals with incident diabetes, men and women had important differences in risk factor control at the time of diabetes diagnosis. These differences varied by age, and decreased over time. PMID:24439948

Schroeder, Emily B.; Bayliss, Elizabeth A.; Daugherty, Stacie L.; Steiner, John F.

2014-01-01

124

Prediction models for risk classification in cardiovascular disease.  

PubMed

Risk stratification is an increasingly important tool for the management of patients with different diseases and also for decision making in subjects not yet with overt disease but who are at risk of disease in the short or long term or during their lifetime. Careful risk assessment in the individual patient, based on clinical, laboratory and imaging data, can be helpful for making decisions about treatment or other prevention strategies. As regards cardiovascular disease, many models have been suggested and are available for the prediction of diagnosis and prognosis and there are several algorithms for risk prediction. However, current risk screening methods are not perfect. This review evaluates relative strengths and limitations of traditional and more recent methods for assessing the performance of prediction models. PMID:23053326

Petretta, Mario; Cuocolo, Alberto

2012-12-01

125

Predicting long-term cardiovascular risk using the mayo clinic cardiovascular risk score in a referral population.  

PubMed

Exercise testing provides valuable information but is rarely integrated to derive a risk prediction model in a referral population. In this study, we assessed the predictive value of conventional cardiovascular risk factors and exercise test parameters in 6,546 consecutive adults referred for exercise testing, who were followed for a period of 8.1 ± 3.7 years for incident myocardial infarction, coronary revascularization, and cardiovascular death. A risk prediction model was developed, and cross-validation of model was performed by splitting the data set into 10 equal random subsets, with model fitting based on 9 of the 10 subsets and testing in of the remaining subset, repeated in all 10 possible ways. The best performing model was chosen based on measurements of model discrimination and stability. A risk score was constructed from the final model, with points assigned for the presence of each predictor based on the regression coefficients. Using both conventional risk factors and exercise test parameters, a total of 9 variables were identified as independent and robust predictors and were included in a risk score. The prognostic ability of this model was compared with that of the Adult Treatment Panel III model using the net reclassification and integrated discrimination index. From the cross-validation results, the c statistic of 0.77 for the final model indicated strong predictive power. In conclusion, we developed, tested, and internally validated a novel risk prediction model using exercise treadmill testing parameters. PMID:25052544

Dhoble, Abhijeet; Lahr, Brian D; Allison, Thomas G; Bailey, Kent R; Thomas, Randal J; Lopez-Jimenez, Francisco; Kullo, Iftikhar J; Gupta, Bhanu; Kopecky, Stephen L

2014-09-01

126

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

127

Investigation on Cardiovascular Risk Prediction Using Physiological Parameters  

PubMed Central

Cardiovascular disease (CVD) is the leading cause of death worldwide. Early prediction of CVD is urgently important for timely prevention and treatment. Incorporation or modification of new risk factors that have an additional independent prognostic value of existing prediction models is widely used for improving the performance of the prediction models. This paper is to investigate the physiological parameters that are used as risk factors for the prediction of cardiovascular events, as well as summarizing the current status on the medical devices for physiological tests and discuss the potential implications for promoting CVD prevention and treatment in the future. The results show that measures extracted from blood pressure, electrocardiogram, arterial stiffness, ankle-brachial blood pressure index (ABI), and blood glucose carry valuable information for the prediction of both long-term and near-term cardiovascular risk. However, the predictive values should be further validated by more comprehensive measures. Meanwhile, advancing unobtrusive technologies and wireless communication technologies allow on-site detection of the physiological information remotely in an out-of-hospital setting in real-time. In addition with computer modeling technologies and information fusion. It may allow for personalized, quantitative, and real-time assessment of sudden CVD events. PMID:24489599

Lin, Wan-Hua; Zhang, Heye; Zhang, Yuan-Ting

2013-01-01

128

Predictive Utility of the Framingham General Cardiovascular Disease Risk Profile for Cognitive Function: Evidence from the Whitehall II Study  

E-print Network

1 Predictive Utility of the Framingham General Cardiovascular Disease Risk Profile for Cognitive of potentially relevant cardiovascular diseases, such as myocardial infarction, coronary insufficiency, angina, and peripheral artery disease. We used the recently developed Framingham General Cardiovascular Disease Risk

Paris-Sud XI, Université de

129

Endothelial function as a functional expression of cardiovascular risk factors.  

PubMed

Traditional cardiovascular risk (CV) factors based on the Framingham study have been used to estimate the risk of CV events and determine target cholesterol levels for primary prevention. Recently published systematic reviews have, however, demonstrated that the Framingham risk score is limited in certain cohorts and requires adjustment. Indeed, traditional CV risk factors fail to predict the development of coronary heart disease in 25-50% of cases. This underscores the complex interplay between traditional CV risk factors, genetic predisposition and other atheroprotective factors present in individuals of different populations in predicting CV events. Endothelial dysfunction, a functional expression of the inherent atherosclerotic risk representing an integrated index of both the overall CV risk-factor burden and the sum of all vasculoprotective factors in an individual, may serve as the missing link between CV risk factors and atherosclerotic disease. Endothelial function measurements may aid in future prediction of CV events and help identify high-risk patients for targeted therapy as well as provide a primary therapeutic end point for clinical follow-up of these patients. Recently introduced reactive hyperemia peripheral arterial tonometry is emerging as a promising tool in endothelial function measurement and CV risk stratification. PMID:20550469

Reriani, Martin K; Lerman, Lilach O; Lerman, Amir

2010-06-01

130

Mediterranean Diet and Cognitive Decline in Women with Cardiovascular1 Disease or Risk Factors2  

E-print Network

1 Mediterranean Diet and Cognitive Decline in Women with Cardiovascular1 Disease or Risk Factors2 3 INTRODUCTION7 Substantial evidence supports the role of cardiovascular disease (CVD) and coronary risk8 factors gave a written informed consent. None of the supplements were46 found to reduce cardiovascular disease

Paris-Sud XI, Université de

131

Vitamin E and Risk of Cardiovascular Diseases: A Review of Epidemiologic and Clinical Trial Studies  

Microsoft Academic Search

Cardiovascular diseases are the leading cause of worldwide mortality. There is strong epidemiologic evidence for a beneficial effect of vitamin E on cardiovascular disease risk. However, conflicting results have been reported by intervention studies. To assess the potential benefit of vitamin E intake on the risk of cardiovascular diseases, fifty-nine published reports from observational studies, retrospective and prospective, randomised clinical

Zorabel Cordero; Dagmar Drogan; Cornelia Weikert; Heiner Boeing

2010-01-01

132

Level of kidney function as a risk factor for cardiovascular outcomes in the elderly  

Microsoft Academic Search

Level of kidney function as a risk factor for cardiovascular outcomes in the elderly.BackgroundThere is a high prevalence of both reduced kidney function as well as cardiovascular disease (CVD) in the elderly. We evaluated whether the level of kidney function is an independent risk factor for CVD outcomes in the Cardiovascular Health Study (CHS), a cohort of subjects whose age

Guruprasad Manjunath; Hocine Tighiouart; Josef Coresh; Bonnie Macleod; Deeb N. Salem; John L. Griffith; Andrew S. Levey; Mark J. Sarnak

2003-01-01

133

Social distribution of cardiovascular disease risk factors: change among men in England 1984–1993  

Microsoft Academic Search

OBJECTIVETo investigate change in the social distribution of some of the main risk factors for cardiovascular disease in men in England during a period when inequality in cardiovascular disease mortality widenedDESIGNAge standardised comparison of the social distribution of seven known risk factors for cardiovascular disease (body mass index, waist to hip ratio, systolic and diastolic blood pressure, consumption of fresh

M Bartley; R Fitzpatrick; D Firth; M Marmot

2000-01-01

134

A Multidimensional Integrative Medicine Intervention to Improve Cardiovascular Risk  

PubMed Central

BACKGROUND Integrative medicine is an individualized, patient-centered approach to health, combining a whole-person model with evidence-based medicine. Interventions based in integrative medicine theory have not been tested as cardiovascular risk-reduction strategies. Our objective was to determine whether personalized health planning (PHP), an intervention based on the theories and principles underlying integrative medicine, reduces 10-year risk of coronary heart disease (CHD). METHODS We conducted a randomized, controlled trial among 154 outpatients age 45 or over, with 1 or more known cardiovascular risk factors. Subjects were enrolled from primary care practices near an academic medical center, and the intervention was delivered at a university Center for Integrative Medicine. Following a health risk assessment, each subject in the intervention arm worked with a health coach and a medical provider to construct a personalized health plan. The plan identified specific health behaviors important for each subject to modify; the choice of behaviors was driven both by cardiovascular risk reduction and the interests of each individual subject. The coach then assisted each subject in implementing her/his health plan. Techniques used in implementation included mindfulness meditation, relaxation training, stress management, motivational techniques, and health education and coaching. Subjects randomized to the comparison group received usual care (UC) without access to the intervention. Our primary outcome measure was 10-year risk of CHD, as measured by a standard Framingham risk score, and assessed at baseline, 5, and 10 months. Differences between arms were assessed by linear mixed effects modeling, with time and study arm as independent variables. RESULTS Baseline 10-year risk of CHD was 11.1% for subjects randomized to UC (n = 77), and 9.3% for subjects randomized to PHP (n = 77). Over 10 months of the intervention, CHD risk decreased to 9.8% for UC subjects and 7.8% for intervention subjects. Based on a linear mixed-effects model, there was a statistically significant difference in the rate of risk improvement between the 2 arms (P = 0.04). In secondary analyses, subjects in the PHP arm were found to have increased days of exercise per week compared with UC (3.7 vs 2.4, P = 0.002), and subjects who were overweight on entry into the study had greater weight loss in the PHP arm compared with UC (P = 0.06). CONCLUSIONS A multidimensional intervention based on integrative medicine principles reduced risk of CHD, possibly by increasing exercise and improving weight loss. PMID:16808774

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

2006-01-01

135

Management of cardiovascular risk: the importance of meeting lipid targets.  

PubMed

Strategies to reduce cardiovascular risk in primary and secondary prevention focus on optimization of low-density lipoprotein (LDL) cholesterol levels. Since the 2004 update of the Adult Treatment Panel (ATP) III guidelines, developments in the field of preventive cardiology have included new guidelines for women and for familial hypercholesterolemia; a risk assessment algorithm incorporating the inflammatory marker high-sensitivity C-reactive protein (hsCRP); and clinical trial data confirming the efficacy of aggressive lipid management. Within secondary prevention in particular, there is a need for more widespread use of intensive statin therapy to achieve low LDL cholesterol levels to reduce cardiovascular morbidity and mortality in patients at high risk for recurrent events. Within primary prevention, individuals with diabetes mellitus, mixed dyslipidemia, or elevated hsCRP also are at increased risk and may warrant treatment with aggressive lipid-modifying therapy. In this article, we provide an update on recent guidelines, risk algorithms, and trials related to the prevention and treatment of coronary artery disease. PMID:22697390

Gotto, Antonio M; Moon, Jennifer E

2012-07-01

136

Iron: Protector or Risk Factor for Cardiovascular Disease? Still Controversial  

PubMed Central

Iron is the second most abundant metal in the Earth’s crust. Despite being present in trace amounts, it is an essential trace element for the human body, although it can also be toxic due to oxidative stress generation by the Fenton reaction, causing organic biomolecule oxidation. This process is the basis of numerous pathologies, including cardiovascular diseases (CVD). The relationship between iron and cardiovascular disease was proposed in 1981 by Jerome Sullivan. Since then, numerous epidemiological studies have been conducted to test this hypothesis. The aim of this review is to present the main findings of the chief epidemiological studies published during the last 32 years, since Sullivan formulated his iron hypothesis, suggesting that this element might act as a risk factor for cardiovascular disease. We have analyzed 55 studies, of which 27 supported the iron hypothesis, 20 found no evidence to support it and eight were contrary to the iron hypothesis. Our results suggest that there is not a high level of evidence which supports the hypothesis that the iron may be associated with CVD. Despite the large number of studies published to date, the role of iron in cardiovascular disease still generates a fair amount of debate, due to a marked disparity in results. PMID:23857219

Muñoz-Bravo, Carlos; Gutiérrez-Bedmar, Mario; Gómez-Aracena, Jorge; García-Rodríguez, Antonio; Fernández-Crehuet Navajas, Joaquín

2013-01-01

137

[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

138

Cardiovascular risk in operators under radiofrequency electromagnetic radiation.  

PubMed

The aim of the study was to assess the long-term effects of radiofrequency electromagnetic radiation (EMR) on the cardiovascular system. Two groups of exposed operators (49 broadcasting (BC) station and 61 TV station operators) and a control group of 110 radiorelay station operators, matched by sex and age, with similar job characteristics except for the radiofrequency EMR were studied. The EMR exposure was assessed and the time-weighted average (TWA) was calculated. The cardiovascular risk factors arterial pressure, lipid profile, body mass index, waist/hip ratio, smoking, and family history of cardiovascular disease were followed. The systolic and diastolic blood pressure (SBP and DBP), total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) were significantly higher in the two exposed groups. It was found that the radiofrequency EMR exposure was associated with greater chance of becoming hypertensive and dyslipidemic. The stepwise multiple regression equations showed that the SBP and TWA predicted the high TC and high LDL-C, while the TC, age and abdominal obesity were predictors for high SBP and DBP. In conclusion, our data show that the radiofrequency EMR contributes to adverse effects on the cardiovascular system. PMID:16503299

Vangelova, Katia; Deyanov, Christo; Israel, Mishel

2006-03-01

139

[Changes in cardiovascular risk factors in developing countries].  

PubMed

As a result of progressive urbanization and westernization of their lifestyle, developing countries are now undergoing an epidemiological transition. These changes are leading to a new epidemiological situation in the world with a decline in infectious diseases and emergence of cardiovascular diseases in general and coronary artery disease in particular. From the current level of 16 millions deaths annually worldwide, mortality due to coronary heart disease is expected to double in the next 20 years with 80% of this increase occurring in developing countries. INTERHEART was a large international study designed to assess the importance of cardiovascular risk factors (CVRF) in terms of prevalence and coronary-related morbidity worldwide. The main modifiable CVRF, i.e., tobacco use, hypertension, diabetes, obesity, blood apolipoproteins, and psychosocial factors were strongly correlated with the risk for myocardial infarction (MI). The level of risk associated with these CVRF was the same in industrialized and developing countries. Globally tobacco use remains the most serious epidemiological risk in terms of prevalence of coronary artery disease whereas raised lipid level was the factor most strongly correlated with MI risk in terms of coronary morbidity particularly in Africa. The greatest impact of the strong increase in diabetes and hypertension with accompanying obesity was observed in countries in Southeast Asia and Africa. The emergence and rapid growth of CVRF in developing countries accounts for the strong increase in coronary-related morbidity/mortality predicted over the next two decades and further underlines the need for an epidemiological control plan aimed at preventing cardiovascular disease in developing countries.. PMID:18300515

Verdier, F; Fourcade, L

2007-12-01

140

CYCLOOXYGENASE POLYMORPHISMS AND RISK OF CARDIOVASCULAR EVENTS: THE ATHEROSCLEROSIS RISK IN COMMUNITIES (ARIC) STUDY  

Technology Transfer Automated Retrieval System (TEKTRAN)

Cyclooxygenase-derived prostaglandins modulate cardiovascular disease risk. We genotyped 2212 Atherosclerosis Risk in Communities study participants (1,023 incident coronary heart disease (CHD) cases; 270 incident ischemic stroke cases; 919 non-cases) with available DNA for polymorphisms in PTGS1 an...

141

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

E-print Network

About half of all deaths in developed countries are caused by cardiovascular disease. It is well known that cardiovascular disease (CVD) risk can be influenced by diet, but optimal dietary content of fatty acids continues to be debated. The effect...

Ghahramany, Ghazal

2012-07-16

142

Kidney Disease as a Risk Factor for Development of Cardiovascular Disease  

NSDL National Science Digital Library

This is a scientific statement on kidney disease as a risk factor for developing cardiovascular disease from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention.

2008-06-25

143

Cardiovascular Disease in CKD in Children: Update on Risk Factors, Risk Assessment, and Management  

PubMed Central

In young adults with onset of chronic kidney disease in childhood, cardiovascular disease is the most common cause of death. The likely reason for increased cardiovascular disease in these patients is high prevalence of traditional and uremia-related cardiovascular disease risk factors during childhood chronic kidney disease. Early markers of cardiomyopathy, such as left ventricular hypertrophy and left ventricular dysfunction and early markers of atherosclerosis, such as increased carotid artery intima-media thickness, carotid arterial wall stiffness and coronary artery calcification are frequently found in this patient population. The purpose of this review is to provide an update of recent advances in the understanding and management of cardiovascular disease risks in this population. PMID:19619845

Wilson, Amy C; Mitsnefes, Mark M

2009-01-01

144

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.; España-Romero, Vanesa; Sui, Xuemei; Church, Timothy S.; Blair, Steven N.

2012-01-01

145

Metabolic Abnormalities and Cardiovascular Risk Factors in Children with Myositis  

PubMed Central

Objective We studied children with myositis to characterize their metabolic abnormalities and risk factors for future cardiovascular disease. Methods Seventeen patients with severe juvenile myositis, primarily referred because of refractory disease, were assessed using standardized disease activity and damage measures. Body mass index (BMI), fasting insulin and lipids, 2-hour oral glucose tolerance test (OGTT), and cytokine levels were obtained. Results The majority (71%) had blood pressures > 75th percentile, 23.5% had hypertension, and BMI was > 85th percentile in 47%. Metabolic abnormalities were also frequent: 41.2% had an elevated fasting insulin level, 47.1% had hypertriglyceridemia and 25% met criteria for the metabolic syndrome. While insulin resistance was common (based on homeostasis model assessment (HOMA), and glucose: insulin (G:I) ratio), insulin secretion appeared to be unaffected. Thigh muscle damage assessed by magnetic resonance imaging (MRI) significantly correlated with fasting insulin, glucose and G:I ratio. Glucose indices also correlated with the pro-inflammatory cytokines IL-2 and IL-12 and inversely with anti-inflammatory cytokines IL-1RA and IL-10. Conclusions In this referral cohort of children with severe juvenile myositis, metabolic abnormalities and predictors of cardiovascular disease were common, suggesting an increased risk of future cardiovascular disease. Indicators of insulin resistance correlated with muscle damage on MRI and pro-inflammatory cytokines and inversely with anti-inflammatory cytokines. PMID:19643439

Coyle, Kathleen; Rother, Kristina I.; Weise, Martina; Ahmed, Alaa; Miller, Frederick W; Rider, Lisa G.

2010-01-01

146

Classical and Novel Biomarkers for Cardiovascular Risk Prediction in the United States  

PubMed Central

Cardiovascular risk prediction models based on classical risk factors identified in epidemiologic cohort studies are useful in primary prevention of cardiovascular disease in individuals. This article briefly reviews aspects of cardiovascular risk prediction in the United States and efforts to evaluate novel risk factors. Even though many novel risk markers have been found to be associated with cardiovascular disease, few appear to improve risk prediction beyond the powerful, classical risk factors. A recent US consensus panel concluded that clinical measurement of certain novel markers for risk prediction was reasonable, namely, hemoglobin A1c (in all adults), microalbuminuria (in patients with hypertension or diabetes), and C-reactive protein, lipoprotein-associated phospholipase, coronary calcium, carotid intima-media thickness, and ankle/brachial index (in patients deemed to be at intermediate cardiovascular risk, based on traditional risk factors). PMID:23604062

Folsom, Aaron R.

2013-01-01

147

Women's occupations, energy expenditure, and cardiovascular risk factors.  

PubMed

The purpose of this study was to examine the cardiovascular risk factors and energy expenditure of women from occupations that differ by physical activity level and socioeconomic level. Participants included 171 women randomly selected from employee lists at 10 employment sites. Measures included blood pressure, body mass index, levels of total and high-density lipoprotein (HDL) cholesterol, a submaximal aerobic fitness test on a bicycle ergometer, and a 12-month retrospective self-report of occupational, leisure time, and household energy expenditure. Women in active occupations had lower total cholesterol and higher HDL cholesterol than women in sedentary occupations. Women with higher occupational energy expenditure scores had higher HDL cholesterol and lower total cholesterol than women with lower occupational energy scores. Findings suggest that cardiovascular benefits, particularly for lipid profiles, may be derived from even small increases in occupational physical activity. The workplace may offer an environment for initiating policies to facilitate increased physical activity among women. PMID:10326992

Wilbur, J; Naftzger-Kang, L; Miller, A M; Chandler, P; Montgomery, A

1999-04-01

148

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

149

History of the Evolution of Cardiovascular Risk Factors and the Predictive Value of Traditional Risk-Factor-Based Risk Assessment  

Microsoft Academic Search

\\u000a The near epidemic rise in cardiovascular disease deaths in the early and middle twentieth century necessitated a more complete\\u000a understanding of the risk factors for these illnesses. Through histologic examinations, animal studies, clinical and geographical\\u000a observations and, ultimately, through large, prospective epidemiologic studies, the major traditional risk factors for cardiovascular\\u000a disease were discovered, which paved the way for successful public

Amit Khera

150

Migraine and the risk for stroke and cardiovascular disease.  

PubMed

Numerous data have pointed to an association between migraine and cardiovascular diseases. The majority of the available data have indicated that migraine with aura can be considered a risk factor for ischemic stroke, whereas migraine without aura cannot be reliably considered as such. High frequency of attacks and a recent onset of migraine have been related to an increased ischemic stroke risk. In addition, in young subjects with ischemic stroke migraine with aura represents an independent risk factor of overall recurrent vascular events and of recurrent ischemic stroke. Also the risk of transient ischemic attack seems to be increased in migraineurs, although this issue has not been extensively investigated. Several studies have also addressed the possible association between migraine and hemorrhagic stroke. Although the results of these individual studies were conflicting, their meta-analysis showed that migraine is associated with a 1.5-fold increase in the risk of hemorrhagic stroke (including intracerebral and subarachnoid hemorrhage). Some studies have identified migraine also as a possible risk factor for cardiac vascular events while others have yielded negative results. A meta-analysis did not show an increased risk of myocardial infarction in subjects with any migraine vs no migraine but subsequently, data has pointed to an association between any migraine with cardiac ischemic disease. Migraine has also been associated by some studies with vascular mortality and with vascular diseases in regions other than the brain and the heart. Several studies have also indicated that compared with nonmigraineurs, migraineurs have a higher burden of asymptomatic white matter brain lesions and, according to some studies, also infarct-like lesions at brain magnetic resonance. The mechanisms underlying the relationship between migraine and cardiovascular disease are still unclear. The possible explanation may rely on a peculiar vascular vulnerability of migraineurs that may contribute to the pathogenesis of migraine and, in the presence of some other unknown factors may also contribute, over time, to the development of cardiovascular disease. At the moment, there are no reliable features that may indicate which subjects, across the overall migraine population, will develop vascular events and so far, no drugs are recommended for the vascular prevention in migraineurs unless other clear indications are present. In general, the acute treatment and the secondary prevention measures of a patient with stroke who has a history of migraine do not differ from that of other stroke patients. There is currently no direct evidence to support that a migraine prophylactic treatment will reduce future stroke risk in secondary prevention. PMID:25059466

Sacco, Simona; Kurth, Tobias

2014-09-01

151

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

152

Prehypertension: a warning sign of future cardiovascular risk.  

PubMed

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

2014-03-01

153

Biomarkers for cardiovascular risk assessment in autoimmune diseases.  

PubMed

Autoimmune diseases, such as antiphospholipid syndrome, systemic lupus erythematosus, and rheumatoid arthritis, are characterized by a high prevalence of cardiovascular (CV) disease (CVD), which constitutes the leading causes of morbidity and mortality among such patients. Although such effects are partly explained by a higher prevalence of traditional CV risk factors, many studies indicate that such factors do not fully explain the enhanced CV risk in these patients. In addition, risk stratification algorithms based upon traditional CV risk factors are not as predictive in autoimmune diseases as in the general population. For these reasons, the timely and accurate assessment of CV risk in these high-risk populations still remains an unmet clinical need. An enhanced contribution of different inflammatory components of the immune response, as well as autoimmune elements (e.g. autoantibodies, autoantigens, and cellular response), has been proposed to underlie the incremental CV risk observed in these populations. Recent advances in proteomic tools have contributed to the discovery of proteins involved in CVDs, including some that may be suitable to be used as biological markers. In this review we summarize the main markers in the field of CVDs associated with autoimmunity, as well as the recent advances in proteomic technology and their application for biomarker discovery in autoimmune disease. PMID:25523513

Teixeira, Priscila Camillo; Ferber, Philippe; Vuilleumier, Nicolas; Cutler, Paul

2015-02-01

154

Breastfeeding in Infancy and Adult Cardiovascular Disease Risk Factors  

PubMed Central

Background Public health recommendations advocate breastfeeding in infancy as a means to reduce later-life obesity. Several prior studies relating breastfeeding to cardiovascular risk factors have been limited by lack of adjustment for maternal and participant confounding factors. Methods We ascertained breastfeeding history via questionnaire from mothers enrolled in the Framingham Offspring Study. In their young to middle-aged adult children enrolled in the Framingham Third Generation, we examined the relations between maternal breastfeeding history (yes, no) to cardiovascular risk factors, including: body mass index (BMI), HDL cholesterol, total cholesterol, triglycerides, fasting blood glucose, systolic and diastolic blood pressure. We applied Generalized estimating equations (GEE) to account for sibling correlations and adjusted for maternal and participant lifestyle, education and cardiovascular risk factors. Results In Third Generation participants (n=962, mean age=41 years, 54% women), 26% of their mothers reported breastfeeding. Compared to non-breastfed individuals, breastfed adult participants had lower multivariable-adjusted BMI [26.1 kg/m2 vs. 26.9 kg/m2, p=0.04] and higher HDL cholesterol levels [HDL 56.6 mg/dL vs. 53.7 mg/dL, p=0.01]. Upon additional adjustment for BMI the association between breastfeeding and HDL cholesterol was attenuated (p=0.09). Breastfeeding was not associated with total cholesterol, triglycerides, fasting blood glucose, systolic blood pressure or diastolic blood pressure. Conclusions Breastfeeding in infancy is inversely associated with adult BMI and positively associated with HDL cholesterol. Associations between breastfeeding and BMI may mediate the association between breastfeeding and HDL cholesterol. PMID:19559168

Parikh, Nisha I.; Hwang, Shih-Jen; Ingelsson, Erik; Benjamin, Emelia J.; Fox, Caroline S.; Vasan, Ramachandran S.; Murabito, Joanne M.

2009-01-01

155

[Evidence-based cardiology: practical applications from epidemiology. IV Cardiovascular risk prediction].  

PubMed

Cardiovascular risk assessment in patients without established disease allows to match the intensity of risk factor modification to the underlying hazard for cardiovascular events. The cardiologist needs to know the characteristics of current risk prediction algorithms, their advantages and limitations. PMID:22452869

Rodríguez-Escudero, Juan Pablo; López-Jiménez, Francisco; Trejo-Gutiérrez, Jorge F

2012-01-01

156

Weight gain and cardiovascular risk factors in the post-menopausal woman  

Microsoft Academic Search

Cardiovascular disease is the leading cause of mortality and morbidity in the post-menopausal woman. The natural menopause does not appear to be an independent risk factor (or a minor one) for coronary heart disease. Obesity, more precisely excessive intra-abdominal fat, is a cardiovascular risk factor especially with regard to the metabolic risk factors associated with this type of obesity. There

A. Colombel; B. Charbonnel

157

Cardiovascular risk factors in Turkish immigrants with type 2 diabetes mellitus: Comparison with Dutch patients  

Microsoft Academic Search

Background: Based on recent epidemiological studies the need for a similar approach towards management of cardiovascular risk factors in type 2 diabetics with different ethnic background can be questioned. We compared the prevalence of cardiovascular risk factors and 10-year absolute risk for a coronary heart disease between Turkish and Dutch type 2 diabetes patients. Methods: A cross-sectional study was performed

Paul J. M. Uitewaal; Alex N. Goudswaard; Lielith J. Ubnik-veltmaat; Marc A. Bruijnzeels; Arno W. Hoes; Siep Thomas

2004-01-01

158

C-reactive protein as a cardiovascular risk factor: more than an epiphenomenon ?  

Microsoft Academic Search

Background—Circulating levels of C-reactive protein (CRP) may constitute an independent risk factor for cardiovascular disease. How CRP as a risk factor is involved in cardiovascular disease is still unclear. Methods and Results—By reviewing available studies, we discuss explanations for the associations between CRP and cardiovascular disease. CRP levels within the upper quartile\\/quintile of the normal range constitute an increased risk

Wim K. Lagrand; Cees A. Visser; Willem T. Hermens; Hans W. M. Niessen; Freek W. A. Verheugt; Gert-Jan Wolbink; C. Erik Hack

1999-01-01

159

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

160

British Regional Heart Study: cardiovascular risk factors in middle-aged men in 24 towns  

Microsoft Academic Search

The British Regional Heart Study seeks to define risk factors for cardiovascular disease, to examine their interrelationships, and to explain the geographic variations in cardiovascular disease in Britain. A clinical survey of men aged 40-59 in 24 British towns was carried out and preliminary data from the survey analysed. On a town basis cardiovascular mortality was associated with mean systolic

A G Shaper; S J Pocock; M Walker; N M Cohen; C J Wale; A G Thomson

1981-01-01

161

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

162

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, Ástrid Camêlo; Leal, Adriana Amorim de F.; Ramos, Nathaly de Medeiros N.; de Alencar F., José; Simões, Mônica Oliveira da S.; Medeiros, Carla Campos M.

2013-01-01

163

Cardiovascular risk scores do not account for the effect of treatment: a review  

PubMed Central

Objective To compare the strengths and limitations of cardiovascular risk scores available for clinicians in assessing the global (absolute) risk of cardiovascular disease. Design Review of cardiovascular risk scores. Data sources Medline (1966 to May 2009) using a mixture of MeSH terms and free text for the keywords ‘cardiovascular’, ‘risk prediction’ and ‘cohort studies’. Eligibility criteria for selecting studies A study was eligible if it fulfilled the following criteria: (1) it was a cohort study of adults in the general population with no prior history of cardiovascular disease and not restricted by a disease condition; (2) the primary objective was the development of a cardiovascular risk score/equation that predicted an individual's absolute cardiovascular risk in 5–10?years; (3) the score could be used by a clinician to calculate the risk for an individual patient. Results 21 risk scores from 18 papers were identified from 3536 papers. Cohort size ranged from 4372 participants (SHS) to 1591209 records (QRISK2). More than half of the cardiovascular risk scores (11) were from studies with recruitment starting after 1980. Definitions and methods for measuring risk predictors and outcomes varied widely between scores. Fourteen cardiovascular risk scores reported data on prior treatment, but this was mainly limited to antihypertensive treatment. Only two studies reported prior use of lipid-lowering agents. None reported on prior use of platelet inhibitors or data on treatment drop-ins. Conclusions The use of risk-factor-modifying drugs—for example, statins—and disease-modifying medication—for example, platelet inhibitors—was not accounted for. In addition, none of the risk scores addressed the effect of treatment drop-ins—that is, treatment started during the study period. Ideally, a risk score should be derived from a population free from treatment. The lack of accounting for treatment effect and the wide variation in study characteristics, predictors and outcomes causes difficulties in the use of cardiovascular risk scores for clinical treatment decision. PMID:21474616

Doust, J; Glasziou, P

2011-01-01

164

Acrolein Exposure Is Associated With Increased Cardiovascular Disease Risk  

PubMed Central

Background Acrolein is a reactive aldehyde present in high amounts in coal, wood, paper, and tobacco smoke. It is also generated endogenously by lipid peroxidation and the oxidation of amino acids by myeloperoxidase. In animals, acrolein exposure is associated with the suppression of circulating progenitor cells and increases in thrombosis and atherogenesis. The purpose of this study was to determine whether acrolein exposure in humans is also associated with increased cardiovascular disease (CVD) risk. Methods and Results Acrolein exposure was assessed in 211 participants of the Louisville Healthy Heart Study with moderate to high (CVD) risk by measuring the urinary levels of the major acrolein metabolite—3?hydroxypropylmercapturic acid (3?HPMA). Generalized linear models were used to assess the association between acrolein exposure and parameters of CVD risk, and adjusted for potential demographic confounders. Urinary 3?HPMA levels were higher in smokers than nonsmokers and were positively correlated with urinary cotinine levels. Urinary 3?HPMA levels were inversely related to levels of both early (AC133+) and late (AC133?) circulating angiogenic cells. In smokers as well as nonsmokers, 3?HPMA levels were positively associated with both increased levels of platelet–leukocyte aggregates and the Framingham Risk Score. No association was observed between 3?HPMA and plasma fibrinogen. Levels of C?reactive protein were associated with 3?HPMA levels in nonsmokers only. Conclusions Regardless of its source, acrolein exposure is associated with platelet activation and suppression of circulating angiogenic cell levels, as well as increased CVD risk. PMID:25099132

DeJarnett, Natasha; Conklin, Daniel J.; Riggs, Daniel W.; Myers, John A.; O'Toole, Timothy E.; Hamzeh, Ihab; Wagner, Stephen; Chugh, Atul; Ramos, Kenneth S.; Srivastava, Sanjay; Higdon, Deirdre; Tollerud, David J.; DeFilippis, Andrew; Becher, Carrie; Wyatt, Brad; McCracken, James; Abplanalp, Wes; Rai, Shesh N.; Ciszewski, Tiffany; Xie, Zhengzhi; Yeager, Ray; Prabhu, Sumanth D.; Bhatnagar, Aruni

2014-01-01

165

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

Microsoft Academic Search

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

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

1999-01-01

166

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

167

Association of Lipoprotein Subfractions and Coronary Artery Calcium In Patient at Intermediate Cardiovascular Risk  

PubMed Central

More precise estimation of the atherogenic lipid parameters could improve identification of residual risk beyond what is possible using traditional lipid risk factors. The aim of the present study was to explore the association between advanced analysis of lipoprotein subfractions and the prevalence of coronary artery calcium. Consecutive participants at intermediate cardiovascular risk who were undergoing computed tomographic assessment of coronary calcium (calcium score) were included. Using a validated ultracentrifugation method (the vertical autoprofile II test), cholesterol in eluting lipoprotein subfractions [i.e., low- (LDL), very-low-, intermediate-, and high-density lipoprotein subclasses, lipoprotein (a), and predominant LDL distribution] was directly quantified. A total of 410 patients were included (29% women, mean age 57 years), of whom 297 (72.4%) had coronary artery calcium. LDL pattern B (predominance of small dense particles) emerged as an independent predictor of coronary calcium after adjustment for traditional risk factors (odds ratio 4.46, 95% confidence interval 1.19 to 16.7). However, after additional stratification for dyslipidemia, as defined by conventional lipid profiling, a statistically significant prediction was only retained for high-density lipoprotein subfraction 2 (odds ratio 3.45, 95% confidence interval 2.03 to 50.1) and “real” LDL (odds ratio 6.10, 95% confidence interval 1.26 to 23.41) in the normolipidemia group and for lipoprotein (a) (odds ratio 7.81, 95% confidence interval 1.41 to 43.5) in the dyslipidemic group. In conclusion, advanced assessment of the lipoprotein subfractions [i.e., LDL pattern B, high-density lipoprotein subfraction 2, “real” LDL, and lipoprotein (a)] using the vertical autoprofile II test provided additional information to that of conventional risk factors on the prevalence of coronary artery calcium in patients at intermediate cardiovascular risk. PMID:23141758

Jug, Borut; Papazian, Jenny; Lee, Robert; Budoff, Matthew J.

2014-01-01

168

Early or recurrent preterm birth and maternal cardiovascular disease risk  

PubMed Central

Purpose Preterm birth (PTB) has been associated with a later increased risk of maternal cardiovascular disease (CVD). We hypothesized a more pronounced relation between early or recurrent PTB and maternal CVD risk. Methods We related PTB severity (earlier gestational age at delivery) and recurrence (=2) among women with births from 1973–1983 in Denmark (n=427,765) to maternal CVD morbidity or mortality (1977–2006). Birth data were linked to CVD hospitalizations and deaths identified in national registers and data were analyzed using Cox proportional hazards models. Results Women with a prior PTB had excess CVD after adjustment for age, parity, and education (HR 1.36 [95% CI 1.31, 1.41]). This was only modestly attenuated when women with preeclampsia or small for gestational age births were excluded, and the relationship was stronger for CVD mortality (HR 1.98 [1.73, 2.26]). Recurrent PTB was associated with higher CVD morbidity compared to women with one PTB, particularly for ischemic events (HR 1.78 [1.40, 2.27] vs. 1.22 [1.09, 1.36]). Risk was similarly elevated among women with early, moderate, and late PTB. Sensitivity analysis suggested that confounding by smoking only partly explained these associations. Conclusions Women with PTB, especially recurrent PTB, were at increased risk for CVD, suggesting common causes of these conditions. PMID:20609340

Catov, Janet M; Wu, Chun Sen; Olsen, Jorn; Sutton-Tyrrell, Kim; Li, Jiong; Nohr, Ellen Aagaard

2010-01-01

169

Issues of Fish Consumption for Cardiovascular Disease Risk Reduction  

PubMed Central

Increasing fish consumption is recommended for intake of omega-3 (n-3) fatty acids and to confer benefits for the risk reduction of cardiovascular disease (CVD). Most Americans are not achieving intake levels that comply with current recommendations. It is the goal of this review to provide an overview of the issues affecting this shortfall of intake. Herein we describe the relationship between fish intake and CVD risk reduction as well as the other nutritional contributions of fish to the diet. Currently recommended intake levels are described and estimates of fish consumption at a food disappearance and individual level are reported. Risk and benefit factors influencing the choice to consume fish are outlined. The multiple factors influencing fish availability from global capture and aquaculture are described as are other pertinent issues of fish nutrition, production, sustainability, and consumption patterns. This review highlights some of the work that needs to be carried out to meet the demand for fish and to positively affect intake levels to meet fish intake recommendations for CVD risk reduction. PMID:23538940

Raatz, Susan K.; Silverstein, Jeffrey T.; Jahns, Lisa; Picklo, Matthew J.

2013-01-01

170

Issues of fish consumption for cardiovascular disease risk reduction.  

PubMed

Increasing fish consumption is recommended for intake of omega-3 (n-3) fatty acids and to confer benefits for the risk reduction of cardiovascular disease (CVD). Most Americans are not achieving intake levels that comply with current recommendations. It is the goal of this review to provide an overview of the issues affecting this shortfall of intake. Herein we describe the relationship between fish intake and CVD risk reduction as well as the other nutritional contributions of fish to the diet. Currently recommended intake levels are described and estimates of fish consumption at a food disappearance and individual level are reported. Risk and benefit factors influencing the choice to consume fish are outlined. The multiple factors influencing fish availability from global capture and aquaculture are described as are other pertinent issues of fish nutrition, production, sustainability, and consumption patterns. This review highlights some of the work that needs to be carried out to meet the demand for fish and to positively affect intake levels to meet fish intake recommendations for CVD risk reduction. PMID:23538940

Raatz, Susan K; Silverstein, Jeffrey T; Jahns, Lisa; Picklo, Matthew J

2013-04-01

171

Novel risk factors for cardiovascular disease in rheumatoid arthritis.  

PubMed

Since cardiovascular disease (CVD) is the most common cause of mortality in patients with rheumatoid arthritis (RA), we aimed to determine factors associated with such a complication in a large series of Colombian patients. This was a cross-sectional analytical study in which 800 consecutive Colombian patients with RA were assessed for variables associated with CVD. Furthermore, a systematic literature review was performed to address the state of the art about non-traditional risk factors for CVD in RA. The preferred reporting items for systematic reviews and meta-analyses guidelines were followed in data extraction, analysis, and reporting of articles selected. Hypercholesterolemia, type 2 diabetes mellitus, abnormal body mass index, abdominal obesity, and current smoking were all traditional risk factors significantly associated with CVD in Colombians. As non-traditional risk factors, familial autoimmunity, more than 10 years of duration of the disease, patients working on household duties, use of systemic steroids, and low education level were associated with CVD in the studied population. Out of a total of 9,812 articles identified in PubMed and Scopus databases, 140 fulfilled the eligibility criteria and were included. Through this systematic review, several factors and outcomes related to CVD were confirmed and identified. These were categorized into genetics, RA-related, and others. Traditional risk factors do not completely explain the high rates of CVD in patients with RA; thus, novel risk factors related to autoimmunity are now recognized predicting the presence of CVD as strong as traditional risk factors. Our results may assist health professionals and policymakers in making decisions about CVD in patients with RA. PMID:23584985

Amaya-Amaya, Jenny; Sarmiento-Monroy, Juan Camilo; Mantilla, Ruben-Dario; Pineda-Tamayo, Ricardo; Rojas-Villarraga, Adriana; Anaya, Juan-Manuel

2013-07-01

172

Kennedy space center cardiovascular disease risk reduction program evaluation  

PubMed Central

This program evaluation examined the Kennedy Space Center (KSC) Cardiovascular Disease (CVD) Risk Reduction Program which aims to identify CVD risk factors and reduce these risk factors through health education phone counseling. High risk participants (those having two or more elevated lipid values) are identified from monthly voluntary CVD screenings and counseled. Phone counseling consists of reviewing lab values with the participant, discussing dietary fat intake frequency using an intake questionnaire, and promoting the increase in exercise frequency. The participants are followed-up at two-months and five-months for relevant metrics including blood pressure, weight, body mass index (BMI), total cholesterol, high density lipoprotein (HDL) and low density lipoprotein (LDL) cholesterol, triglycerides, dietary fat intake, and exercise frequency. Data for three years of the KSC CVD Program included 366 participants, average age of 49 years, 75% male, and 25% female. For those with complete two and five month follow-up data, significant baseline to two-month follow-up comparisons included decreases in systolic blood pressure (p = 0.03); diastolic blood pressure (p = 0.002); total cholesterol, LDL cholesterol and dietary fat intake (all three at p < 0.0001) as well as a significant increase in exercise frequency (p = 0.04). Significant baseline to five-month follow-up comparisons included decreases in triglycerides (p = 0.05); and total cholesterol, LDL cholesterol and dietary intake (all three at p < 0.0001). These program evaluation results indicate that providing brief phone health education counseling and information at the worksite to high risk CVD participants may impact CVD risk factors. PMID:18561517

Calderon, Kristine S; Smallwood, Charles; Tipton, David A

2008-01-01

173

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

174

Adiposopathy and thyroid disease: tracing the pathway to cardiovascular risk.  

PubMed

Adiposopathy, defined as functionally disturbed adipose tissue mainly composed of large adipocytes and induced by chronic excess of food intake, has been associated with immune, metabolic and endocrine derangements promoting inflammation and, eventually, cardiovascular disease. Adiposopathy may positively influence thyrotropin-stimulating hormone, by raising leptin levels, and triggering autoimmunity. In this regard, it is hypothesized that the increased thyrotropin-stimulating hormone is independent of the negative regulation of the thyroid hormone, thereby constituting a secondary phenomenon and not a causal effect. Replacement therapy with thyroid hormones should therefore be applied following strict individualized consideration. Leptin is involved in the immune response and neuroendocrine appetite regulation, while leptin resistance may further promote autoimmune disease. The lipid derangement in adiposopathy may be aggravated in the presence of hypothyroidism and thus considerably augment cardiovascular risk. Lifestyle-modification counselling, including low-fat dietary intake and regular physical exercise, is today the cornerstone of adiposopathy treatment. Meanwhile, new drug formulations, such as leptin and leptin analogs, 5-HT2C-receptor agonist, and potent thyromimetics, currently comprise a promising armamentarium against adiposity and adiposopathy. PMID:22894634

Duntas, Leonidas; Micic, Dragan

2012-06-01

175

Telomeres and cardiovascular disease risk: an update 2013.  

PubMed

Leukocyte telomere length (LTL) has been regarded as a potential marker of biologic aging because it usually shortens in a predictable way with age. Recently, a growing interest in cardiovascular aging has led to a number of new epidemiologic studies investigating LTL in various disease conditions. Some methodological problems exist because there are different methods available to determine LTL, and standardization is much needed. For example, in the majority of studies, patients with early-onset coronary heart disease have been shown to have shorter LTL. In addition, patients with diabetes mellitus complications tend to have shorter LTL than control subjects. On the other hand, increased left ventricular hypertrophy or mass is associated with longer LTL, and studies investigating hypertension have reported both shorter and longer LTL than found in normotensive control subjects. There is, therefore, a need for longitudinal studies to elucidate these complicated relationships further, to provide estimations of telomere attrition rates, and to overcome analytical problems when only cross-sectional studies are used. The understanding of cardiovascular aging and telomere biology may open up new avenues for interventions, such as stem cell therapy or agents that could retard this aging process over and beyond conventional risk factor control. PMID:23748031

Nilsson, Peter M; Tufvesson, Hanna; Leosdottir, Margrét; Melander, Olle

2013-12-01

176

Dairy food intake is positively associated with cardiovascular health: findings from Observation of Cardiovascular Risk Factors in Luxembourg study.  

PubMed

Conflicting findings have been reported about dairy food consumption and risk for cardiovascular disease. Furthermore, few studies have examined dairy food intake in relation to cardiovascular health and the incorporation of lifestyle factors such as diet and physical activity. This study examined whether dairy food consumption was associated with cardiovascular health, recently defined by the American Heart Association. Data were analyzed from 1352 participants from the Observation of Cardiovascular Risk Factors in Luxembourg survey. A validated food frequency questionnaire was used to measure intakes of milk, yogurt, cheese, dairy desserts, ice cream, and butter. Seven cardiovascular health metrics were assessed: smoking, body mass index, physical activity, diet, total cholesterol, blood pressure, and fasting plasma glucose. A total cardiovascular health score (CHS) was determined by summing the total number of health metrics at ideal levels. It was hypothesized that greater dairy food consumption (both low fat and whole fat) would be associated with better global cardiovascular health, as indicated by a higher CHS. Total dairy food intake was positively associated with the CHS. Higher intakes of whole fat milk, yogurt, and cheese were associated with better cardiovascular health. Even when controlling for demographic and dietary variables, those who consumed at least 5 servings per week of these dairy products had a significantly higher CHS than those who consumed these products less frequently. Higher total whole fat dairy food intake was also associated with other positive health behaviors, including being a nonsmoker, consuming the suggested dietary intakes of recommended foods, and having a normal body mass index. Increased dairy food consumption was associated with better cardiovascular health. PMID:25476191

Crichton, Georgina E; Alkerwi, Ala'a

2014-12-01

177

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

PubMed Central

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

2014-01-01

178

Reclassification of European patients' cardiovascular risk using the updated Systematic Coronary Risk Evaluation algorithm.  

PubMed

Data from the European Study on Cardiovascular Risk Prevention and Management in Usual Daily Practice (EURIKA; ClinicalTrials.gov; NCT00882336) was used to assess the proportions of patients aged 50-65 years free of diabetes and not receiving lipid-lowering therapy (LLT) considered to be at low (<1%), intermediate (1% to <5%) and high (?5%) 10-year risk of cardiovascular mortality according to the Systematic Coronary Risk Evaluation (SCORE) algorithm and the updated algorithm that considers patients' total cholesterol and high-density lipoprotein cholesterol (HDL-C) levels as independent variables (SCORE-HDL). Of 2321 patients analysed, 19.3%, 60.7% and 20.0% were considered to be at low, intermediate and high cardiovascular risk respectively according to SCORE, and 25.7%, 57.2% and 17.1% respectively according to SCORE-HDL. Thus, there was an overall trend towards reclassification from higher to lower risk categories when SCORE-HDL was compared with SCORE. PMID:24092875

Halcox, Julian P; Tubach, Florence; Sazova, Ogün; Sweet, Stephen; Medina, Jesús

2015-02-01

179

The Burden of Cardiovascular Risk in Chronic Kidney Disease and Dialysis Patients (Cardiorenal Syndrome Type 4)  

Microsoft Academic Search

Type 4 cardiorenal syndrome is a growing societal problem as the aging population, with increasing incidence of chronic kidney disease (CKD), diabetes, obesity, hypertension, and other cardiovascular risks, leads to higher numbers of individuals suffering the complications of this bidirectional disorder. In this review, the immense burden of cardiovascular risk faced by patients on dialysis, as well as lesser degrees

Andrew A. House; Claudio Ronco

2011-01-01

180

Hyperinsulinemia and Insulin Resistance, Early Cardiovascular Risk Factors in Children with Chronic Kidney Disease  

Microsoft Academic Search

Background\\/Aims: Pediatric chronic kidney disease (CKD) is associated with increased risk of cardiovascular disease. Still, hyperinsulinemia and insulin resistance, common cardiovascular risk factors, are not extensively investigated in children with CKD. We hypothesize that insulin abnormalities are present also in pediatric mild to moderate CKD, and associated with inflammation and malnutrition. Methods: We enrolled 26 children with CKD, and 34

Ylva Tranæus Lindblad; Jonas Axelsson; Peter Bárány; Gianni Celsi; Bengt Lindholm; Abdul Rashid Qureshi; Alba Carrea; Alberto Canepa

2008-01-01

181

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

182

Hyperlipidemia as a Risk Factor for Cardiovascular Disease  

PubMed Central

Synopsis Elevated levels of blood lipids are well documented risk factors for cardiovascular disease. Current classification schemes and treatment levels for hyperlipidemia are based on the National Cholesterol Education Panel’s (NCEP) Adult Treatment Program-3 (ATP-III) guidelines. Statins are the preferred class of drugs to lower elevated low density lipoprotein cholesterol (LDL-C). There are other classes to augment or substitute for statins, such as ezetimibe, fibrates, niacin and dietary supplements. Extensive research over the last decade has raised the question whether or not ATP-III guidelines are sufficiently aggressive. New guidelines from ATP-IV are expected to be released in the near future, but in the meantime physicians are faced with uncertainty about how low to target LDL-C, whether to pharmacologically treat high density lipoprotein cholesterol (HDL-C) and triglyceride (TG) levels and how best to achieve target goals. PMID:23402469

Nelson, Robert H.

2012-01-01

183

Result of school-based intervention on cardiovascular risk factors  

PubMed Central

Abstract Objective. To assess the effectiveness of a two-year school-based intervention, consisting of integrated and replicable physical activity and nutritional education on weight, fat percentage, cardiovascular risk factors, and blood pressure. Design and setting. Six elementary schools in Reykjavik were randomly assigned to be either intervention (n = 3) or control (n = 3) schools. Seven-year-old children in the second grade in these schools were invited to participate (n = 321); 268 (83%) underwent some or all of the measurements. These 286 children were followed up for two years. Intervention. Children in intervention schools participated in an integrated and replicable physical activity programme, increasing to approximately 60 minutes of physical activity during school in the second year of intervention. Furthermore, they received special information about nutrition, and parents, teachers, and school food service staff were all involved in the intervention. Subjects. 321seven-year-old schoolchildren. Main outcome measures. Blood pressure, obesity, percentage of body fat, lipid profile, fasting insulin. Results. Children in the intervention group had a 2.3 mmHg increase in systolic blood pressure (SBP) and a 2.9 mmHg increase in diastolic blood pressure (DBP) over the two-year intervention period, while children in the control group increased SBP by 6.7 mmHg and DPB by 8.4 mmHg. These changes were not statistically significant. Furthermore there were no significant changes in percentage body fat, lipid profile, or fasting insulin between the intervention and control schools. Conclusion. A two-year school-based intervention with increased physical activity and healthy diet did not have a significant effect on common cardiovascular risk factors. PMID:25424464

Hrafnkelsson, Hannes; Magnusson, Kristjan Th.; Thorsdottir, Inga; Johannsson, Erlingur

2014-01-01

184

[Microalbuminuria: cardiovascular and renal risk factors underestimated in clinical practice].  

PubMed

Determination of microalbuminuria has been shown to be useful to identify patients with type 2 diabetes (DM2) at high risk of renal and cardiovascular (CV) diseases. The determination of the albumin/creatinine (Cr) ratio in an isolate sample of urine has been shown to be sufficient for the diagnosis as well as for the evaluation of the efficacy of the therapy employed to reduce microalbuminuria. Values of urinary albumin >30 mg/g of Cr or 3,4 mg/mmol of Cr are evidence of microalbuminuria. This condition is frequently associated with high blood pressure levels, which increases dramatically not only the progression of renal disease but also de risk of a CV event. Epidemiologic studies have demonstrated that the presence of microalbuminuria is predictive of higher morbi-mortality independent of the presence of other CV risk factors. It appears to reflect a generalized vascular lesion not confined to the glomeruli. The capacity of reducing blood pressure, intraglomerular pressure and the permeability of the glomerular membrane, which are important factors in the progression of renal disease, may explain the renoprotective effects of the angiotensin converting enzyme inhibitors (ACEIs) and the angiotensin II receptors blockers (ARBs). In the treatment of diabetic nephropathy, the control of blood pressure, which has to be maintained near or below 130/80 mmHg associated to the blockade of the renin-angiotensin system with ACEIs or BRAs are the best strategies to promote renal and CV protection. PMID:16767297

Zanella, Maria Teresa

2006-04-01

185

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

186

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

187

Exercise and cardiovascular risk in patients with hypertension.  

PubMed

Evidence for the benefits of regular exercise is irrefutable and increasing physical activity levels should be a major goal at all levels of health care. People with hypertension are less physically active than those without hypertension and there is strong evidence supporting the blood pressure-lowering ability of regular exercise, especially in hypertensive individuals. This narrative review discusses evidence relating to exercise and cardiovascular (CV) risk in people with hypertension. Comparisons between aerobic, dynamic resistance, and static resistance exercise have been made along with the merit of different exercise volumes. High-intensity interval training and isometric resistance training appear to have strong CV protective effects, but with limited data in hypertensive people, more work is needed in this area. Screening recommendations, exercise prescriptions, and special considerations are provided as a guide to decrease CV risk among hypertensive people who exercise or wish to begin. It is recommended that hypertensive individuals should aim to perform moderate intensity aerobic exercise activity for at least 30 minutes on most (preferably all) days of the week in addition to resistance exercises on 2-3 days/week. Professionals with expertise in exercise prescription may provide additional benefit to patients with high CV risk or in whom more intense exercise training is planned. Despite lay and media perceptions, CV events associated with exercise are rare and the benefits of regular exercise far outweigh the risks. In summary, current evidence supports the assertion of exercise being a cornerstone therapy in reducing CV risk and in the prevention, treatment, and control of hypertension. PMID:25305061

Sharman, James E; La Gerche, Andre; Coombes, Jeff S

2015-02-01

188

Cysteine is a cardiovascular risk factor in hyperlipidemic patients.  

PubMed

Several studies have reported that moderate hyperhomocysteinemia is related to an increased risk for atherosclerosis, but few data are available with regard to any other thiol compound having a potential vascular toxicity. Therefore, we measured both total cysteine and homocysteine plasma levels in patients with hyperlipidemia (242 males and 147 females, 41-65 years old). Homocysteine was higher in males than in females, 13.2+/-4.1 versus 11.1+/-3.4 micromol/l (P<0.0001). The mean cysteine level was 243.3+/-45.7 micromol/l in the whole study population. The subjects were split in two groups, symptomatic patients with cardiovascular disease (n = 106) and asymptomatic subjects (n = 283). Blood pressure, smoking status, total cholesterol, LDL-cholesterol and triglycerides did not statistically differ between groups, but the mean HDL-cholesterol level was lower in symptomatic patients (1.24+/-0.38 versus 1.42+/-0.41, P<0.0001). Cysteine levels were higher in patients with cardiovascular disease than in asymptomatic patients, respectively 254.7+/-47.7 versus 239.1+/-44.3 micromol/l (P = 0.003). A similar result was found for homocysteine, respectively 13.1+/-4.3 versus 12.2+/-3.9 micromol/l (P = 0.05). To analyse whether cysteine levels were related to atherosclerosis independently of age, adjusted levels were compared between asymptomatic patients with normal carotid arteries (n = 176), carotid atherosclerosis (n = 107) and symptomatic patients (n = 106). Age adjusted cysteine levels differed significantly between groups (P = 0.027) while the P-value was of borderline significance for homocysteine (P = 0.09). Odds ratios for having symptomatic cardiovascular disease were 1.81 (95% CI, 1.02-3.21) and 2.05 (95% CI, 1.16-3.60) for the mid and highest tertiles of cysteine using the lowest as the reference. After adjustment in a multivariate model including age, sex, and creatinine, the odds ratio for disease remained significant between the highest tertile versus the lowest (OR = 1.89). Adjusted odds ratios were found to be weaker when homocysteine tertiles were compared. Our data suggest that plasma total cysteine is a risk factor for atherosclerosis in hyperlipidemic patients. PMID:10487486

Jacob, N; Bruckert, E; Giral, P; Foglietti, M J; Turpin, G

1999-09-01

189

Plasma Lipid Composition and Risk of Developing Cardiovascular Disease  

PubMed Central

Aims We tested whether characteristic changes of the plasma lipidome in individuals with comparable total lipids level associate with future cardiovascular disease (CVD) outcome and whether 23 validated gene variants associated with coronary artery disease (CAD) affect CVD associated lipid species. Methods and Results Screening of the fasted plasma lipidome was performed by top-down shotgun analysis and lipidome compositions compared between incident CVD cases (n?=?211) and controls (n?=?216) from the prospective population-based MDC study using logistic regression adjusting for Framingham risk factors. Associations with incident CVD were seen for eight lipid species (0.21?q?0.23). Each standard deviation unit higher baseline levels of two lysophosphatidylcholine species (LPC), LPC16?0 and LPC20?4, was associated with a decreased risk for CVD (P?=?0.024–0.028). Sphingomyelin (SM) 38?2 was associated with increased odds of CVD (P?=?0.057). Five triglyceride (TAG) species were associated with protection (P?=?0.031–0.049). LPC16?0 was negatively correlated with the carotid intima-media thickness (P?=?0.010) and with HbA1c (P?=?0.012) whereas SM38?2 was positively correlated with LDL-cholesterol (P?=?0.0*10?6) and the q-values were good (q?0.03). The risk allele of 8 CAD-associated gene variants showed significant association with the plasma level of several lipid species. However, the q-values were high for many of the associations (0.015?q?0.75). Risk allele carriers of 3 CAD-loci had reduced level of LPC16?0 and/or LPC 20?4 (P?0.056). Conclusion Our study suggests that CVD development is preceded by reduced levels of LPC16?0, LPC20?4 and some specific TAG species and by increased levels of SM38?2. It also indicates that certain lipid species are intermediate phenotypes between genetic susceptibility and overt CVD. But it is a preliminary study that awaits replication in a larger population because statistical significance was lost for the associations between lipid species and future cardiovascular events when correcting for multiple testing. PMID:23967253

Fernandez, Celine; Sandin, Marianne; Sampaio, Julio L.; Almgren, Peter; Narkiewicz, Krzysztof; Hoffmann, Michal; Hedner, Thomas; Wahlstrand, Björn; Simons, Kai; Shevchenko, Andrej; James, Peter; Melander, Olle

2013-01-01

190

Cardiovascular risk factors of sirolimus compared with cyclosporine: early experience from two randomized trials in renal transplantation  

Microsoft Academic Search

IntroductionRenal transplant recipients are at a higher risk of cardiovascular events, including death. This paper examines cardiovascular risk factors in two phase II studies comparing cyclosporine (CsA) with sirolimus-based therapy.

C Legendre; J. M Campistol; J.-P Squifflet; J. T Burke

2003-01-01

191

[Cardiovascular risk factors on the Framingham Risk Score among hypertensive patients attended by family health teams].  

PubMed

The Framingham Risk Score (FRS) is used to stratify cardiovascular risk. This study sought to identify the prevalence of risk factors used in the FRS and the use of drugs that reduce cardiovascular risk among hypertensive patients attended by the Family Health Strategy (FHS). It is cross-sectional study, which evaluated a random sample of hypertensive patients in the FHS in northern Minas Gerais. Data were collected through interviews and from medical records. 505 hypertensive patients were evaluated in 9 municipalities of the region, with a predominance of women; 325 (64.4%), mean age of 66.4 years. In 90% of hypertensive patients there was at least one associated risk factor. The grouping of three or more factors occurred in 79 (15.7%) patients. Dyslipidemia was found in 188 (37.2%), diabetes in 101 (20%) and smoking in 36 (7.1%). The use of anti-hypertensive drugs was observed in 481 (95.2%) patients. The use of other cardioprotective drugs was higher among patients with 3 or more risk factors: 45.6% used antiplatelet and 27.8% used lipid-lowering drugs. The prevalence of risk factors from the FRS in the population studied was quite high and the use of cardioprotective drugs was seen to be restricted. Strategies to increase the use of FRS may improve the management of hypertension in the FHS. PMID:24897474

Pimenta, Henderson Barbosa; Caldeira, Antônio Prates

2014-06-01

192

Significant interactions between traditional risk factors affect cardiovascular risk prediction in healthy general population.  

PubMed

Aims. The aim was to carry out a systematic screening of interactions between the traditional risk factors and to evaluate which interactions are truly relevant for estimation of cardiovascular disease (CVD) risk. Methods. Cox regression was used in a meta-analysis of five independent, population-based health examination surveys (the National FINRISK Study). End-points were 10-year incidence of coronary heart disease (CHD), ischemic stroke (IS), and CVD in a population free of cardiovascular disease (n = 35,460). Results. In addition to expected age interactions, systolic blood pressure was found to be a markedly stronger risk factor for CVD (and for CHD) among subjects with normal BMI (BMI < 25: HR 1.42 [1.30-1.55] for one SD increase in systolic blood pressure) when compared to obese subjects (BMI > 30: HR 1.10 [1.01-1.19]) (P < 0.001 for interaction) and among subjects with highest high-density lipoprotein (HDL) (33% tertile: HR 1.43 [1.29-1.58]) when compared to subjects with low HDL (lowest 33% tertile: HR 1.20 [1.13-1.28]) (P < 0.001 for interaction). Interactions improved risk prediction of CVD (cross-validated continuous net reclassification improvement [NRI] 49.4% with 95% CI 44.7%-54.1%, P < 0.0001 and clinical NRI 4.7%, with 95% CI 2.8%-6.5%, P < 0.0001). The C-statistic improved from 0.8438 to 0.8455 (P = 0.010). No significant interaction was associated with the risk of IS. Conclusions. There are significant effect modifications between major risk factors, and accounting for them leads to significantly more accurate estimation of cardiovascular risk. PMID:25405541

Hernesniemi, Jussi A; Tynkkynen, Juho; Havulinna, Aki S; Oksala, Niku; Vartiainen, Erkki; Laatikainen, Tiina; Salomaa, Veikko

2014-11-18

193

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

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

2014-01-01

194

Type II diabetes mellitus and cardiovascular risk factors: Current therapeutic approaches  

PubMed Central

Worldwide, approximately 200 million people currently have type II diabetes mellitus (DM), a prevalence that has been predicted to increase to 366 million by 2030. Rates of cardiovascular disease (CVD) mortality and morbidity are particularly high in this population, representing a significant cost for health care systems. Type II DM patients generally carry a number of risk factors for CVD, including hyperglycemia, abnormal lipid profiles, alterations in inflammatory mediators and coagulation/thrombolytic parameters, as well as other ‘nontraditional’ risk factors, many of which may be closely associated with insulin resistance. Therefore, successful management of CVD associated with diabetes represents a major challenge to the clinicians. An effective way of tackling this problem is to detect the associated risk factors and to target treatment toward their improvement. Targeting hyperglycemia alone does not reduce the excess risk in diabetes, highlighting the need for aggressive treatment of other risk factors. Although the current use of statin therapy is effective at reducing low-density lipoprotein cholesterol, residual risk remains for other independent lipid and nonlipid factors. The peroxisome proliferator-activated receptor-? appears to be closely involved in regulating risk markers at multiple levels. A relatively new class of therapeutic agents that activate peroxisome proliferator-activated receptor-?, the thiazolidinedione insulin-sensitizing agents, is currently used to manage type II DM. These agents display a number of potential antiatherogenic properties, including effects on high-density lipoprotein cholesterol and triglycerides, as well as other beneficial nonlipid effects, such as regulating levels of mediators involved in inflammation and endothelial dysfunction. Research data suggest that simple strategies combining thiazolidinediones and statins could have complementary effects on CVD risk-factor profiles in diabetes, alongside the ability to control glycemia. PMID:18650975

Kalofoutis, Christos; Piperi, Christina; Kalofoutis, Anastasios; Harris, Fred; Phoenix, David; Singh, Jaipaul

2007-01-01

195

Olive oil intake and risk of cardiovascular disease and mortality in the PREDIMED Study  

PubMed Central

Background It is unknown whether individuals at high cardiovascular risk sustain a benefit in cardiovascular disease from increased olive oil consumption. The aim was to assess the association between total olive oil intake, its varieties (extra virgin and common olive oil) and the risk of cardiovascular disease and mortality in a Mediterranean population at high cardiovascular risk. Methods We included 7,216 men and women at high cardiovascular risk, aged 55 to 80 years, from the PREvención con DIeta MEDiterránea (PREDIMED) study, a multicenter, randomized, controlled, clinical trial. Participants were randomized to one of three interventions: Mediterranean Diets supplemented with nuts or extra-virgin olive oil, or a control low-fat diet. The present analysis was conducted as an observational prospective cohort study. The median follow-up was 4.8 years. Cardiovascular disease (stroke, myocardial infarction and cardiovascular death) and mortality were ascertained by medical records and National Death Index. Olive oil consumption was evaluated with validated food frequency questionnaires. Multivariate Cox proportional hazards and generalized estimating equations were used to assess the association between baseline and yearly repeated measurements of olive oil intake, cardiovascular disease and mortality. Results During follow-up, 277 cardiovascular events and 323 deaths occurred. Participants in the highest energy-adjusted tertile of baseline total olive oil and extra-virgin olive oil consumption had 35% (HR: 0.65; 95% CI: 0.47 to 0.89) and 39% (HR: 0.61; 95% CI: 0.44 to 0.85) cardiovascular disease risk reduction, respectively, compared to the reference. Higher baseline total olive oil consumption was associated with 48% (HR: 0.52; 95% CI: 0.29 to 0.93) reduced risk of cardiovascular mortality. For each 10 g/d increase in extra-virgin olive oil consumption, cardiovascular disease and mortality risk decreased by 10% and 7%, respectively. No significant associations were found for cancer and all-cause mortality. The associations between cardiovascular events and extra virgin olive oil intake were significant in the Mediterranean diet intervention groups and not in the control group. Conclusions Olive oil consumption, specifically the extra-virgin variety, is associated with reduced risks of cardiovascular disease and mortality in individuals at high cardiovascular risk. Trial registration This study was registered at controlled-trials.com (http://www.controlled-trials.com/ISRCTN35739639). International Standard Randomized Controlled Trial Number (ISRCTN): 35739639. Registration date: 5 October 2005. PMID:24886626

2014-01-01

196

Constipation and Risk of Cardiovascular Disease among Post-Menopausal Women  

PubMed Central

Background Constipation is common in Western societies, accounting for 2.5 million-physician visits/year in the US. Since many factors predisposing to constipation are also risk factors for cardiovascular disease, we hypothesized that constipation may be associated with increased risk of cardiovascular events. Methods We conducted a secondary analysis in 93,676 women enrolled in the observational arm of the Women’s Health Initiative. Constipation was evaluated at baseline by a self-administered questionnaire. Estimates of the risk of cardiovascular events (cumulative endpoint including mortality from coronary heart disease, myocardial infarction, angina, coronary revascularization, stroke and transient ischemic attack) were derived from Cox proportional hazards models adjusted for demographics, risk factors and other clinical variables (median follow-up: 6.9 years). Results The analysis included 73,047 women. Constipation was associated with increased age, African American and Hispanic descent, smoking, diabetes, high cholesterol, family history of myocardial infarction, hypertension, obesity, lower physical activity levels, lower fiber intake, and depression. Women with moderate and severe constipation experienced more cardiovascular events (14.2 and 19.1 events/1000 person-years, respectively) compared to women with no constipation (9.6/1000 person-years). After adjustment for demographics, risk factors, dietary factors, medications, frailty and other psychological variables, constipation was no longer associated with an increased risk of cardiovascular events except for the severe constipation group, which had a 23% higher risk of cardiovascular events. Conclusion In postmenopausal women, constipation is a marker for cardiovascular risk factors and increased cardiovascular risk. Since constipation is easily assessed, it may be a helpful tool to identify women with increased cardiovascular risk. PMID:21663887

Salmoirago-Blotcher, Elena; Crawford, Sybil; Jackson, Elizabeth; Ockene, Judith; Ockene, Ira

2011-01-01

197

Cardiovascular Risk Assessment of Bulgarian Urban Population: Cross-Sectional Study  

Microsoft Academic Search

Aim To assess the total cardiovascular risk of the Bulgarian urban popu- lation. Methods A representative sample of Bulgarian urban population (n = 3810, response rate 68.3%) from five Bulgarian cities was inlcuded in a cross-sectional observation study performed in the period 2005-2007. A detailed cardiovascular risk assessment was performed by general prac- titioners and a total 10-year risk of

Mariana Dyakova; Elena Shipkovenska; Peter Dyakov; Plamen Dimitrov; Svetla Torbova

2008-01-01

198

Is obesity predictive of cardiovascular dysfunction independent of cardiovascular risk factors?  

PubMed

Introduction:Obesity is thought to exert detrimental effects on the cardiovascular (CV) system. However, this relationship is impacted by the co-occurrence of CV risk factors, type 2 diabetes (T2DM) and overt disease. We examined the relationships between obesity, assessed by body mass index (BMI) and waist circumference (WC), and CV function in 102 subjects without overt CV disease. We hypothesized that obesity would be independently predictive of CV remodeling and functional differences, especially at peak exercise.Methods:Brachial (bSBP) and central (cSBP) systolic pressure, carotid-to-femoral pulse wave velocity (PWVcf) augmentation index (AGI; by SphygmoCor), and carotid remodeling (B-mode ultrasound) were examined at rest. Further, peak exercise cardiac imaging (Doppler ultrasound) was performed to measure the coupling between the heart and arterial system.Results:In backward elimination regression models, accounting for CV risk factors, neither BMI nor WC were predictors of carotid thickness or PWVcf; rather age, triglycerides and hypertension were the main determinants. However, BMI and WC predicted carotid cross-sectional area and lumen diameter. When examining the relationship between body size and SBP, BMI (?=0.32) and WC (?=0.25) were predictors of bSBP (P<0.05), whereas, BMI was the only predictor of cSBP (?=0.22, P<0.05) indicating a differential relationship between cSBP, bSBP and body size. Further, BMI (?=-0.26) and WC (?=-0.27) were independent predictors of AGI (P<0.05). As for resting cardiac diastolic function, WC seemed to be a better predictor than BMI. However, both BMI and WC were inversely and independently related to arterial-elastance (net arterial load) and end-systolic elastance (cardiac contractility) at rest and peak exercise.Conclusion:These findings illustrate that obesity, without T2DM and overt CV disease, and after accounting for CV risk factors, is susceptible to pathophysiological adaptations that may predispose individuals to an increased risk of CV events.International Journal of Obesity advance online publication, 22 July 2014; doi:10.1038/ijo.2014.111. PMID:24957486

DeVallance, E; Fournier, S B; Donley, D A; Bonner, D E; Lee, K; Frisbee, J C; Chantler, P D

2014-06-24

199

Cardiovascular Disease Prevalence and Risk Factors of Persons with Mental Retardation  

ERIC Educational Resources Information Center

This paper reviews the recent literature on cardiovascular disease (CVD) prevalence, CVD-related mortality, physiological CVD risk factors, and behavioral CVD risk factors in adults with mental retardation (MR). The literature on the potential influences of modifiable behavioral CVD risk factors and the physiological CVD risk factors are also…

Draheim, Christopher C.

2006-01-01

200

Metabolic risk factors for cardiovascular disease in a working population: A retrospective cohort study  

Microsoft Academic Search

Risk factors for cardiovascular disease (CVD) appear to cluster in individuals, possibly because of a single, underlying metabolic disorder. We describe the prevalence of metabolic risk factors for CVD in a young working population and the tendency for individuals with some risk factors to acquire additional factors. This was a retrospective three-year follow-up study of baseline CVD risk factors assessing

Barry Gumbiner; Elena M. Andresen; F. Terry Hearne; T. Erik Michaelson; Michael Bryson; Wayne M. Lednar; Roger Cass

1996-01-01

201

Carrying the burden of cardiovascular risk in old age: associations of weight and weight change with prevalent cardiovascular disease, risk factors, and health status in the Cardiovascular Health Study?3  

Microsoft Academic Search

Measured weight in old age, reported weight at age 50 y, and weight change from age 50 y to old age were studied in association with prevalent cardiovascular disease (CVD), CVD risk factors, and health status in a population of 4954 men and women aged ? 65 y in the Cardiovascular Health Study (CHS). Heavier weight (ie, generally weight in

Tamara B Harris; Peter J Savage; Grethe S Tell; Mary Haan; Shiriki Kumanyika; James C Lynch

202

Hypertriglyceridemia: a too long unfairly neglected major cardiovascular risk factor.  

PubMed

The existence of an independent association between elevated triglyceride (TG) levels, cardiovascular (CV) risk and mortality has been largely controversial. The main difficulty in isolating the effect of hypertriglyceridemia on CV risk is the fact that elevated triglyceride levels are commonly associated with concomitant changes in high density lipoprotein (HDL), low density lipoprotein (LDL) and other lipoproteins. As a result of this problem and in disregard of the real biological role of TG, its significance as a plausible therapeutic target was unfoundedly underestimated for many years. However, taking epidemiological data together, both moderate and severe hypertriglyceridaemia are associated with a substantially increased long term total mortality and CV risk. Plasma TG levels partially reflect the concentration of the triglyceride-carrying lipoproteins (TRL): very low density lipoprotein (VLDL), chylomicrons and their remnants. Furthermore, hypertriglyceridemia commonly leads to reduction in HDL and increase in atherogenic small dense LDL levels. TG may also stimulate atherogenesis by mechanisms, such excessive free fatty acids (FFA) release, production of proinflammatory cytokines, fibrinogen, coagulation factors and impairment of fibrinolysis. Genetic studies strongly support hypertriglyceridemia and high concentrations of TRL as causal risk factors for CV disease. The most common forms of hypertriglyceridemia are related to overweight and sedentary life style, which in turn lead to insulin resistance, metabolic syndrome (MS) and type 2 diabetes mellitus (T2DM). Intensive lifestyle therapy is the main initial treatment of hypertriglyceridemia. Statins are a cornerstone of the modern lipids-modifying therapy. If the primary goal is to lower TG levels, fibrates (bezafibrate and fenofibrate for monotherapy, and in combination with statin; gemfibrozil only for monotherapy) could be the preferable drugs. Also ezetimibe has mild positive effects in lowering TG. Initial experience with en ezetimibe/fibrates combination seems promising. The recently released IMPROVE-IT Trial is the first to prove that adding a non-statin drug (ezetimibe) to a statin lowers the risk of future CV events. In conclusion, the classical clinical paradigm of lipids-modifying treatment should be changed and high TG should be recognized as an important target for therapy in their own right. Hypertriglyceridemia should be treated. PMID:25471221

Tenenbaum, Alexander; Klempfner, Robert; Fisman, Enrique Z

2014-12-01

203

Influence of immune activation and inflammatory response on cardiovascular risk associated with the human immunodeficiency virus  

PubMed Central

Patients infected with the human immunodeficiency virus (HIV) have an increased cardiovascular risk. Although initially this increased risk was attributed to metabolic alterations associated with antiretroviral treatment, in recent years, the attention has been focused on the HIV disease itself. Inflammation, immune system activation, and endothelial dysfunction facilitated by HIV infection have been identified as key factors in the development and progression of atherosclerosis. In this review, we describe the epidemiology and pathogenesis of cardiovascular disease in patients with HIV infection and summarize the latest knowledge on the relationship between traditional and novel inflammatory, immune activation, and endothelial dysfunction biomarkers on the cardiovascular risk associated with HIV infection. PMID:25609975

Beltrán, Luis M; Rubio-Navarro, Alfonso; Amaro-Villalobos, Juan Manuel; Egido, Jesús; García-Puig, Juan; Moreno, Juan Antonio

2015-01-01

204

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

205

Social networks of health care providers and patients in cardiovascular risk management: a study protocol  

PubMed Central

Background In recent years, preventive and clinical interventions for cardiovascular risk management have been implemented widely in primary care in the Netherlands. Although this has enhanced quality and outcomes of cardiovascular risk management, further improvement remains possible. In the planned observational study, we aim to examine the role of social networks of healthcare providers and patients in quality and outcomes of cardiovascular risk management. Methods/Design In a longitudinal observational study, data on social networks of approximately 300 primary care providers from 30 general practices and 900 cardiovascular patients will be collected twice, with a six month interval, using a mix of measures. Social networks are documented with specifically designed questionnaires for patients, relatives, and healthcare professionals. For each included patient, we will extract from medical records to gather data on clinical processes and cardiovascular risk predictors. Data on self-management and psychosocial outcomes of patients will be collected using questionnaires for patients. The analysis focuses on identifying network characteristics, which are associated with (changes in) cardiovascular risk management or self-management. Discussion This research will provide insight into the role of social networks of patients and providers in cardiovascular risk management in primary practice. Trial registration Nederlands Trial Register NTR4069. PMID:24942555

2014-01-01

206

Interstate Variation in Modifiable Risk Factors and Cardiovascular Mortality in the United States  

PubMed Central

Objective We investigated the role of state-level differences in modifiable cardiovascular (CV) risk factors in contributing to state disparities in cardiovascular mortality rates in the US. Methods Adults aged 45–74 in 2010 were examined. We constructed a CV risk index summarizing state-level exposure to current smoking, obesity, physical inactivity, alcohol abstinence, hypertension, elevated cholesterol, and diabetes using the Behavioral Risk Factor Surveillance System. Outcomes were cardiovascular, coronary heart disease, and stroke mortality. Linear regression was used to estimate associations between the CV risk index and mortality outcomes. Models accounted for state-level socioeconomic characteristics and other potential confounders. Results Risk factors were highly correlated at the state-level (Cronbach's alpha 0.85 (men) and 0.92 (women). Each +1SD difference in the cardiovascular risk index was associated with higher adjusted cardiovascular mortality rates by 41.0 (95%CI?=?26.3, 55.7) and 33.3 (95%CI?=?24.4, 42.2) deaths per 100,000 for men and women, respectively. The index accounted for 8% (men) and 11% (women) of the variation in state-level cardiovascular mortality. Comparable associations were also observed for coronary heart disease and stroke mortality. Conclusions CV risk factors were highly correlated at the state-level and were independently associated with state CV mortality, suggesting the utility of generalized CV risk reduction. PMID:25003975

Patel, Shivani A.; Narayan, K. M. Venkat; Ali, Mohammed K.; Mehta, Neil K.

2014-01-01

207

Individualised multifactorial lifestyle intervention trial for high-risk cardiovascular patients in primary care.  

PubMed Central

BACKGROUND: The multiprofessional teams in Finnish health centres are well placed to carry out interventions aimed at the prevention of cardiovascular diseases. AIM: To evaluate the effectiveness of an individually tailored multifactorial lifestyle intervention in primary care for individuals at high risk for cardiovascular disease. DESIGN OF STUDY: A randomised controlled trial was conducted over 24 months with interim assessments at six and 12 months. SETTING: A health centre in Finland with a patient population of 11,000. METHOD: One hundred and fifty adults aged 18 to 65 years old with existing cardiovascular disease or multiple risk factors were randomised to active multiprofessional risk factor intervention or to standard care. The main outcome measure was a change in cardiovascular risk-factor score. Secondary outcomes were changes in blood pressure, weight, body-mass index, serum cholesterol, blood glucose, smoking cessation, and exercise habits. RESULTS: The cardiovascular risk score decreased by 28% in the intervention group (23% in the control group), body weight decreased by 3.7% (2%) and total cholesterol decreased by 10.8% (6.5%), while time engaged in exercise increased by 39% (43%). Differences were not significant. CONCLUSIONS: Cardiovascular risk levels of high-risk individuals decreased in both intervention and control groups. Primary care prevention should be targeted to high-risk persons. Long-term follow-up studies are needed. PMID:11458482

Ketola, E; Mäkelä, M; Klockars, M

2001-01-01

208

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

209

Burnout and Risk of Cardiovascular Disease: Evidence, Possible Causal Paths, and Promising Research Directions  

Microsoft Academic Search

Burnout is characterized by emotional exhaustion, physical fatigue, and cognitive weariness, resulting from prolonged exposure to work-related stress. The authors review the accumulated evidence suggesting that burnout and the related concept of vital exhaustion are associated with increased risk of cardiovascular disease and cardiovascular-related events. The authors present evidence supporting several potential mechanisms linking burnout with ill health, including the

Samuel Melamed; Arie Shirom; Sharon Toker; Shlomo Berliner; Itzhak Shapira

2006-01-01

210

Cardiovascular Risk Associated With Celecoxib in a Clinical Trial for Colorectal Adenoma Prevention  

Microsoft Academic Search

background Selective cyclooxygenase-2 (COX-2) inhibitors have come under scrutiny because of re- ports suggesting an increased cardiovascular risk associated with their use. Experimen- tal research suggesting that these drugs may contribute to a prothrombotic state pro- vides support for this concern. methods We reviewed all potentially serious cardiovascular events among 2035 patients with a history of colorectal neoplasia who were

Scott D. Solomon; John J. V. McMurray; Marc A. Pfeffer

2005-01-01

211

The Influence of a Vegetarian Diet on Haemostatic Risk Factors for Cardiovascular Disease in Africans  

Microsoft Academic Search

Dietary habits have been implicated in the occurrence of cardiovascular diseases. Elevated plasma fibrinogen levels and decreased fibrinolytic activity have been identified as major independent cardiovascular risk factors. In this study, we compared the blood pressure, plasma fibrinogen concentration, and fibrinolytic activity of 40 nonvegetarians (NON-VEGs) with 36 vegetarians (8 VEGs and 28 SEMI-VEGs). The latter group consisted of students

A. A Famodu; O Osilesi; Y. O Makinde; O. A Osonuga; T. A Fakoya; E. O Ogunyemi; I. E Egbenehkhuere

1999-01-01

212

Describing an Academic and Nonprofit Organization Partnership to Educate At-Risk Adolescents about Cardiovascular Health  

ERIC Educational Resources Information Center

There is emerging evidence to suggest community-based interventions can change community-wide behaviors and attitudes toward cardiovascular health. This article describes a partnership between an academic institution and a community nonprofit organization to develop and implement a cardiovascular health promotion program targeting at risk high…

Palazzo, Steven J.; Skager, Cherie; Kraiger, Anneliese

2014-01-01

213

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

214

Early Infantile Growth and Cardiovascular Risks in Adolescent Japanese Women  

PubMed Central

Objective: Early life events connected with the risk of later disease can occur not only in utero, but also in infancy. In study of the developmental origins of health and disease, the relationship between infantile growth patterns and adolescent body mass index and blood pressure is one of the most important issues to verify. Materials and Methods: We analyzed the correlation of current body mass index and systolic blood pressure of 168 female college students with their growth patterns in utero and in infancy. Results: Body mass index and systolic blood pressure in adolescence showed positive correlations with changes in weight-for-age z scores between 1 and 18 months but not with those between 18 and 36 months. Stepwise multiple regression analysis showed that both change in weight-for-age z scores from 1 to 18 months and body mass index at 1 month were significantly and independently associated with systolic blood pressure in adolescence. Body mass index at 36 months was positively correlated with body mass index in adolescence, while body mass index at birth was negatively correlated with body mass index in adolescence. Conclusion: Our findings shows that restricted growth in utero and accelerated weight gain in early infancy are associated with the cardiovascular risk factors of high systolic blood pressure and high body mass index in adolescence. In Japan, an increasing proportion of low birth weight infants and accelerated catch-up growth after birth have been observed in recent decades. This might be an alarming harbinger of an increase in diseases related to the developmental origins of health and disease in Japan.

Ohmi, Hiroki; Kato, Chieko; Meadows, Martin; Terayama, Kazuyuki; Suzuki, Fumiaki; Ito, Michiko; Mochizuki, Yoshikatsu; Hata, Akira

2013-01-01

215

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

216

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

E-print Network

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...

Harland, J O; Unwin, Nigel; Bhopal, Raj; White, M; Watson, B; Laker, M; Alberti, K G

1997-01-01

217

Effects of a High Oleic Acid Beef Diet on Cardiovascular Disease Risk Factors of Human Subjects  

E-print Network

The consumption of high-fat hamburger enriched with saturated fatty acids (SFA) and trans-fatty acids (TFA) may increase risk factors for cardiovascular disease, whereas hamburger enriched with monounsaturated fatty acids (MUFA) may have...

Adams, Thaddeus Hunter

2012-10-19

218

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

219

A study of cardiovascular risk factors and its knowledge among school children of Delhi  

PubMed Central

Background Data on the knowledge of cardiovascular risk factors among Indian school children are limited. Aim of the study was to assess the prevalence of cardiovascular risk factors and its knowledge among school children of Delhi. Methods We performed a cross-sectional survey among 485 school children studying in classes 6, 7 and 8 in two government and one private school in New Delhi using convenience sampling. Cardiovascular risk factors (physical activity, diet and smoking), knowledge about risk factors and family profile were assessed using a structured self report questionnaire. Weight, height and blood pressure measurements were taken. Results The mean age of the studied school children was 12.8 ± 1.6 years. The prevalence of overweight and obesity was 9.5% and 11.5% respectively. The prevalence of prehypertension, stage 1 hypertension and stage 2 hypertension was 12.4%, 6.8% and 1.4% respectively. Of the total, 43.8% were physically active for at least 1 hour per day on all 7 days of the previous week. Daily consumption of fruits and vegetables was reported by 42% and 76% of the school children respectively. Nearly 5% of the school children reported to have used any form of tobacco. One fifth of the school children had a family history of cardiovascular disease. Of the total, 25.4% had adequate knowledge regarding cardiovascular risk factors. Conclusion Cardiovascular risk factors are highly prevalent among school children. Importantly, school children lack adequate knowledge regarding cardiovascular risk factors. School based interventions are required for cardiovascular risk reduction in childhood. PMID:24973830

George, Grace Mary; Sharma, Kamlesh Kumari; Ramakrishnan, Sivasubramaniam; Gupta, Sanjeev Kumar

2014-01-01

220

Sexual Dimorphism in Body Fat Distribution and Risk for Cardiovascular Diseases  

Microsoft Academic Search

The prevalence of obesity has dramatically increased over the past decade along with the cardiovascular and other health risks\\u000a it encompasses. Adipose tissue, which is distributed in the abdominal viscera, carries a greater risk for cardiovascular disorders\\u000a than adipose tissue subcutaneously. There is a sex difference in the regional fat distribution. Women have more subcutaneous\\u000a fat, whereas men have more

Thekkethil P. Nedungadi; Deborah J. Clegg

2009-01-01

221

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

222

Changes in cardiovascular risk factors among adolescents from 1995 to 2004 in the Republic of Karelia, Russia  

Microsoft Academic Search

Background: In Russia, cardiovascular mortality is among the highest in the world. Behaviours related to the development of cardiovascular disease are usually adopted in childhood and adolescence. Very little information exists on prevalence and trends of risk factors among Russian youth. This study aims to investigate changes in the prevalence of cardiovascular risk factors among adolescents in the Republic of

Anastasiya Rogacheva; Tiina Laatikainen; Kerttu Tossavainen; Tiina Vlasoff; Vladimir Panteleev; Erkki Vartiainen

2007-01-01

223

The relationship between calcium intake, obesity, and cardiovascular disease risk factors: the jackson heart study  

Technology Transfer Automated Retrieval System (TEKTRAN)

Cardiovascular disease (CVD) is a major health risk in the United States. Major indicators of CVD risk include obesity, blood lipids, and blood pressure. Modifiable risk factors associated with CVD include body composition (body mass index and waist circumference), serum lipids, and blood pressure. ...

224

Use of BNP and CRP as biomarkers in assessing cardiovascular disease: diagnosis versus risk.  

PubMed

Biomarkers are used in medicine to facilitate diagnosis, assess risk, direct therapy and determine efficacy of treatment. Sensitivity and specificity are essential in order for a biomarker to be useful. Brain natriuretic peptide (BNP) and C-reactive protein (CRP) are considered biomarkers of cardiovascular disease. However, they differ in function, sensitivity and specificity. BNP is released from the myocardium in response to myocardial stretch, a clear cause and effect relationship; therefore, it is useful in the diagnosis of heart failure when patients present with dyspnea of unknown origin and to assess treatment in high risk patients with diagnosed heart failure. Sex and age based reference ranges and partition values are established from clinical trials and from populations screened for the absence of cardiovascular disease. Highly sensitive and reproducible methods are also available to measure CRP. However, although CRP is associated with adverse cardiovascular events, unlike BNP, multiple stimuli increase production of CRP. Therefore, elevation in CRP is not specific to cardiovascular disease. Partition values for CRP and cardiovascular risk based on epidemiological studies predict risk for populations but may not always be useful when used alone to predict individual risk or to direct therapy. Given the non-specific stimuli which affect circulating concentrations of CRP, using CRP to monitor treatment to reduce cardiovascular risk may provide little benefit without understanding or targeting the underlying causes for its elevation. PMID:17266610

Miller, Virginia M; Redfield, Margaret M; McConnell, Joseph P

2007-01-01

225

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

226

HDL Cholesterol, Apolipoproteins, and Cardiovascular Risk in Hemodialysis Patients.  

PubMed

High concentrations of HDL cholesterol are considered to indicate efficient reverse cholesterol transport and to protect from atherosclerosis. However, HDL has been suggested to be dysfunctional in ESRD. Hence, our main objective was to investigate the effect of HDL cholesterol on outcomes in maintenance hemodialysis patients with diabetes. Moreover, we investigated the associations between the major protein components of HDL (apoA1, apoA2, and apoC3) and end points. We performed an exploratory, post hoc analysis with 1255 participants (677 men and 578 women) of the German Diabetes Dialysis study. The mean age was 66.3 years and the mean body mass index was 28.0 kg/m(2). The primary end point was a composite of cardiac death, myocardial infarction, and stroke. The secondary end point included all-cause mortality. The mean duration of follow-up was 3.9 years. A total of 31.3% of the study participants reached the primary end point and 49.1% died from any cause. HDL cholesterol and apoA1 and apoC3 quartiles were not related to end points. However, there was a trend toward an inverse association between apoA2 and all-cause mortality. The hazard ratio for death from any cause in the fourth quartile compared with the first quartile of apoA2 was 0.63 (95% confidence interval, 0.40 to 0.89). The lack of an association between HDL cholesterol and cardiovascular risk may support the concept of dysfunctional HDL in hemodialysis. The possible beneficial effect of apoA2 on survival requires confirmation in future studies. PMID:25012163

Silbernagel, Günther; Genser, Bernd; Drechsler, Christiane; Scharnagl, Hubert; Grammer, Tanja B; Stojakovic, Tatjana; Krane, Vera; Ritz, Eberhard; Wanner, Christoph; März, Winfried

2015-02-01

227

Prevalence of cardiovascular risk factors in patients with psoriatic arthritis.  

PubMed

Psoriatic arthritis (PsA) is a chronic T cell-mediated inflammatory spondyloarthropathy affecting 10-40 % of psoriasis (PSO) patients (0.3-1.0 % of the general population). Recent epidemiological studies have shown an increased prevalence of cardiovascular (CV) risk factors and/or morbidity among PSO or PsA patients as compared to control individuals. The aim of this study is to describe the CV profile of PsA patients in Newfoundland, Canada. The possible impact of duration of chronic inflammation on CV variables was also explored. PsA patients were selected from a registry of PSO and PsA patients in Newfoundland. PsA patients diagnosed as per the CASPAR criteria are entered in the registry at the time of diagnosis, questioned on their medical history, and are followed indefinitely. Based on the duration since PsA diagnosis patients were classified as having early (<2 years) or established (?2 years) PsA. CV risk was assessed using both conventional (hypertension, hypercholesterolemia, diabetes, obesity) and non-conventional (markers of chronic inflammation) factors. A total of 196 PsA patients were included; 42.9 % had early PsA and 57.1 % had established PsA. The prevalence of hypercholesterolemia, obesity, hypertension, diabetes mellitus, anxiety/depression, and coronary heart disease was 61.6, 59.7, 32.7, 13.8, 13.8, and 8.7 %, respectively. The prevalence of comorbidities was generally comparable between cohorts with exception of anxiety/depression, which was considerably higher in patients with established PsA compared to early PsA and obesity which was more common among male patients with established PsA. However, upon adjusting for age and gender differences, no statistically significant between-group differences were observed. Overall, these results suggest that PsA, even at early stages, is associated with significant CV comorbidity. These conditions should be taken into consideration when assessing the PsA burden of illness in epidemiological and health outcomes studies. Furthermore, early detection and management of these conditions could improve the patients' disability and quality of life. PMID:25034080

Khraishi, Majed; Aslanov, Rana; Rampakakis, Emmanouil; Pollock, Clare; Sampalis, John S

2014-10-01

228

A Survey of Needs of Texas Biology Teachers Relative to Teaching Cardiovascular Diseases and Associated Risk Factors.  

ERIC Educational Resources Information Center

The data show that biology teachers spend relatively little time on diseases of the cardiovascular system. Approximately one period per year is spent on each of eight given cardiovascular disease risk factors. (MP)

White, Robert C.; And Others

1978-01-01

229

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

230

Projections of preventable risks for cardiovascular disease in Canada to 2021: a microsimulation modelling approach  

PubMed Central

Background Reductions in preventable risks associated with cardiovascular disease have contributed to a steady decrease in its incidence over the past 50 years in most developed countries. However, it is unclear whether this trend will continue. Our objective was to examine future risk by projecting trends in preventable risk factors in Canada to 2021. Methods We created a population-based microsimulation model using national data on births, deaths and migration; socioeconomic data; cardiovascular disease risk factors; and algorithms for changes in these risk factors (based on sociodemographic characteristics and previous cardiovascular disease risk). An initial population of 22.5 million people, representing the Canadian adult population in 2001, had 13 characteristics including the risk factors used in clinical risk prediction. There were 6.1 million potential exposure profiles for each person each year. Outcome measures included annual prevalence of risk factors (smoking, obesity, diabetes, hypertension and lipid levels) and of co-occurring risks. Results From 2003 to 2009, the projected risks of cardiovascular disease based on the microsimulation model closely approximated those based on national surveys. Except for obesity and diabetes, all risk factors were projected to decrease through to 2021. The largest projected decreases were for the prevalence of smoking (from 25.7% in 2001 to 17.7% in 2021) and uncontrolled hypertension (from 16.1% to 10.8%). Between 2015 and 2017, obesity was projected to surpass smoking as the most prevalent risk factor. Interpretation Risks of cardiovascular disease are projected to decrease modestly in Canada, leading to a likely continuing decline in its incidence. PMID:25077135

Manuel, Douglas G.; Tuna, Meltem; Hennessy, Deirdre; Okhmatovskaia, Anya; Finès, Philippe; Tanuseputro, Peter; Tu, Jack V.; Flanagan, William

2014-01-01

231

Oral hygiene status of individuals with cardiovascular diseases and associated risk factors.  

PubMed

Dentist and oral health screening may be the latest weapon in identifying persons at risk of cardiovascular disease. Oral infections, specifically periodontitis, may confer independent risks for different systemic conditions. The risk factors associated with cardiovascular diseases also suggest that the relationship between periodontal disease and diabetes works in both ways. The aim of this study was to support and strengthen the association and relationship between oral hygiene status of individuals with cardiovascular diseases and its associated risk factors. A simple random sampling was carried out in 200 inhabitants of Western Utter Pradesh, India. An oral health visit and examination was made for an equal number of males and females of different age groups with cardiovascular diseases. Evaluation of the oral status was made by means of an oral hygiene index, community periodontal index of treatment needs and loss of attachment. Evaluation of oral status in patients with cardiovascular diseases and in the control group has shown a statistically significant low level of oral health in patients with cardiovascular diseases as compared to control. Prevalence of systemic diseases in different age groups significantly correlated with the prevalence of severe periodontal diseases. Treating gum disease may reduce the risk of heart disease and improve health outcomes for patients with periodontal disease and vascular heart problems. PMID:24765485

Shetty, Divya; Dua, Mahima; Kumar, Kiran; Dhanapal, Raghu; Astekar, Madhusudan; Shetty, Devi Charan

2012-10-12

232

Glucokinase-activating GCKR polymorphisms increase plasma levels of triglycerides and free fatty acids, but do not elevate cardiovascular risk in the Ludwigshafen Risk and Cardiovascular Health Study.  

PubMed

Two strongly correlated polymorphisms located within the gene of the glucokinase regulator protein (GKRP), rs780094 and rs1260326, are associated with increased plasma triglyceride levels and provide a genetic model for the long-term activation of hepatic glucokinase. Because pharmacological glucokinase activators are evaluated for the treatment of diabetes, the aim of the study was to assess if these polymorphisms could provide evidence for an increased cardiovascular risk of long-term glucokinase activation. Therefore, these polymorphisms were tested in 3 500 patients of the Ludwigshafen Risk and Cardiovascular Health study, which was designed to assess cardiovascular risk factors. The two variants were associated with a significant increase of both plasma triglycerides (p<0.0001) and VLDL triglyceride levels (p<0.0001). Plasma free fatty acid concentrations were also significantly elevated (p<0.0078). LDL and HDL cholesterol levels were unchanged. No association was found with respect to coronary stenosis, myocardial infarction, left ventricular wall hypertrophy, and hypertension. In conclusion, long-term genetic glucokinase activation by the GKRP polymorphisms was not associated with an increased cardiovascular risk in the study population. PMID:20352598

Kozian, D H; Barthel, A; Cousin, E; Brunnhöfer, R; Anderka, O; März, W; Böhm, B; Winkelmann, B; Bornstein, S R; Schmoll, D

2010-06-01

233

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

234

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

235

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

236

Magnesium Modifies the Cardiovascular Mortality Risk Associated with Hyperphosphatemia in Patients Undergoing Hemodialysis: A Cohort Study  

PubMed Central

Background In vitro studies have shown inhibitory effects of magnesium (Mg) on phosphate-induced calcification of vascular smooth muscle cells, raising the possibility that maintaining a high Mg level may be useful for reducing cardiovascular risks of patients with hyperphosphatemia. We examined how serum Mg levels affect the association between serum phosphate levels and the risk of cardiovascular mortality in patients undergoing hemodialysis. Methods A nationwide register-based cohort study was conducted using database of the Renal Data Registry of the Japanese Society for Dialysis Therapy in 2009. We identified 142,069 patients receiving in-center hemodialysis whose baseline serum Mg and phosphate levels were available. Study outcomes were one-year cardiovascular and all-cause mortality. Serum Mg levels were categorized into three groups (lower, <2.7 mg/dL; intermediate, ?2.7, <3.1 mg/dL; and higher, ?3.1 mg/dL). Results During follow-up, 11,401 deaths occurred, out of which 4,751 (41.7%) were ascribed to cardiovascular disease. In multivariable analyses, an increase in serum phosphate levels elevated the risk of cardiovascular mortality in the lower- and intermediate-Mg groups, whereas no significant risk increment was observed in the higher-Mg group. Moreover, among patients with serum phosphate levels of ?6.0 mg/dL, the cardiovascular mortality risk significantly decreased with increasing serum Mg levels (adjusted odds ratios [95% confidence intervals] of the lower-, intermediate-, and higher-Mg groups were 1.00 (reference), 0.81 [0.66–0.99], and 0.74 [0.56–0.97], respectively.). An interaction between Mg and phosphate on the risk of cardiovascular mortality was statistically significant (P?=?0.03). Conclusion Serum Mg levels significantly modified the mortality risk associated with hyperphosphatemia in patients undergoing hemodialysis. PMID:25545498

Sakaguchi, Yusuke; Fujii, Naohiko; Shoji, Tatsuya; Hayashi, Terumasa; Rakugi, Hiromi; Iseki, Kunitoshi; Tsubakihara, Yoshiharu; Isaka, Yoshitaka

2014-01-01

237

Dietary fibre intake and risk of cardiovascular disease: systematic review and meta-analysis  

PubMed Central

Objective To investigate dietary fibre intake and any potential dose-response association with coronary heart disease and cardiovascular disease. Design Systematic review of available literature and dose-response meta-analysis of cohort studies using random effects models. Data sources The Cochrane Library, Medline, Medline in-process, Embase, CAB Abstracts, ISI Web of Science, BIOSIS, and hand searching. Eligibility criteria for studies Prospective studies reporting associations between fibre intake and coronary heart disease or cardiovascular disease, with a minimum follow-up of three years and published in English between 1 January 1990 and 6 August 2013. Results 22 cohort study publications met inclusion criteria and reported total dietary fibre intake, fibre subtypes, or fibre from food sources and primary events of cardiovascular disease or coronary heart disease. Total dietary fibre intake was inversely associated with risk of cardiovascular disease (risk ratio 0.91 per 7 g/day (95% confidence intervals 0.88 to 0.94)) and coronary heart disease (0.91 (0.87 to 0.94)). There was evidence of some heterogeneity between pooled studies for cardiovascular disease (I2=45% (0% to 74%)) and coronary heart disease (I2=33% (0% to 66%)). Insoluble fibre and fibre from cereal and vegetable sources were inversely associated with risk of coronary heart disease and cardiovascular disease. Fruit fibre intake was inversely associated with risk of cardiovascular disease. Conclusions Greater dietary fibre intake is associated with a lower risk of both cardiovascular disease and coronary heart disease. Findings are aligned with general recommendations to increase fibre intake. The differing strengths of association by fibre type or source highlight the need for a better understanding of the mode of action of fibre components. PMID:24355537

2013-01-01

238

Challenges and Opportunities for Extracting Cardiovascular Risk Biomarkers from Imaging Data  

NASA Astrophysics Data System (ADS)

Complications attributed to cardiovascular diseases (CDV) are the leading cause of death worldwide. In the United States, sudden heart attack remains the number one cause of death and accounts for the majority of the 280 billion burden of cardiovascular diseases. In spite of the advancements in cardiovascular imaging techniques, the rate of deaths due to unpredicted heart attack remains high. Thus, novel computational tools are of critical need, in order to mine quantitative parameters from the imaging data for early detection of persons with a high likelihood of developing a heart attack in the near future (vulnerable patients). In this paper, we present our progress in the research of computational methods for the extraction of cardiovascular risk biomarkers from cardiovascular imaging data. In particular, we focus on the methods developed for the analysis of intravascular ultrasound (IVUS) data.

Kakadiaris, I. A.; Mendizabal-Ruiz, E. G.; Kurkure, U.; Naghavi, M.

239

The U-shaped Relationship of Traditional Cardiovascular Risk Factors and Adverse Outcomes in Later Life  

PubMed Central

With advancing age traditional cardiovascular risk factors follow a U-shaped relationship with survival outcomes. This relationship has been described as reverse metabolism. The mechanism of such relationship is unclear. However, it appears that malnutrition, inflammation and functional decline are characteristics shared by populations exhibiting the U-shaped risk. Thus, frailty or decline in functional reserve may be the main confounding factor of the relationship between cardiovascular risk factors and adverse outcomes in older patients. Clinical implication of this is not yet clear but more attention should be focused on optimal management of undernutrition and weight loss by improving feeding and maintaining physical activity. PMID:23251851

Abdelhafiz, Ahmed H; Loo, Boon Eng; Hensey, Nicola; Bailey, Claire; Sinclair, Alan

2012-01-01

240

Waist circumference and cardiovascular risk factors among rural older adults: gender differences  

Technology Transfer Automated Retrieval System (TEKTRAN)

Overweight and obese patients present with a greater risk for CVD. The purpose of this study was to explore how weight status relates to cardiovascular risk factor in older adults in the Geisinger Rural Aging Study (114 male, 158 female mean age 78. 5). Anthropometric and health data, along with a f...

241

Prevalence of cardiovascular disease risk factors among older Puerto Rican adults living in Massachusetts  

Technology Transfer Automated Retrieval System (TEKTRAN)

There remains limited research on cardiovascular disease (CVD) risk factors in Puerto Rican adults. We compared lifestyle and CVD risk factors in Puerto Rican men and women with normal fasting glucose (NFG), impaired fasting glucose (IFG), or type 2 diabetes (T2D), and investigated achievement of Am...

242

A Cardiovascular Risk Reduction Program for American Indians with Metabolic Syndrome: The Balance Study  

ERIC Educational Resources Information Center

The Balance Study is a randomized controlled trial designed to reduce cardiovascular disease (CVD) risk in 200 American Indian (AI) participants with metabolic syndrome who reside in southwestern Oklahoma. Major risk factors targeted include weight, diet, and physical activity. Participants are assigned randomly to one of two groups, a guided or a…

Lee, Elisa T.; Jobe, Jared B.; Yeh, Jeunliang; Ali, Tauqeer; Rhoades, Everett R.; Knehans, Allen W.; Willis, Diane J.; Johnson, Melanie R.; Zhang, Ying; Poolaw, Bryce; Rogers, Billy

2012-01-01

243

Level of kidney function as a risk factor for atherosclerotic cardiovascular outcomes in the community  

Microsoft Academic Search

ObjectivesThe goal of this study was to determine whether the level of kidney function is an independent risk factor for atherosclerotic cardiovascular disease (ASCVD) outcomes in the Atherosclerosis Risk in Communities (ARIC) study, a prospective cohort study of subjects aged 45 to 64 years.

Guruprasad Manjunath; Hocine Tighiouart; Hassan Ibrahim; Bonnie MacLeod; Deeb N Salem; John L Griffith; Josef Coresh; Andrew S Levey; Mark J Sarnak

2003-01-01

244

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

245

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

246

Cardiovascular risk factors in men: The role of gonadal steroids and sex hormone-binding globulin  

Microsoft Academic Search

Males have higher risk of cardiovascular disease (CVD) than premenopausal females. Gonadal steroids are probably involved in the gender difference in CVD, but previous results have been conflicting. We investigated the associations between CVD risk factors and sex hormones in a cross-sectional designed study of 508 healthy males, aged 41 to 72 years. We determined total testosterone (T), sex hormone-binding

Jesper Gyllenborg; Susanne L. Rasmussen; Knut Borch-Johnsen; Berit L. Heitmann; Anders Juul

2001-01-01

247

Hypertension risk factors and cardiovascular reactivity to mental stress in young men  

Microsoft Academic Search

Hypertension risk may be associated with increased pressor response to mental stress. However, studies using family history as a predictor of reactivity have obtained mixed results. We assessed cardiovascular responses to mental arithmetic stress (a 5-min serial subtraction task) in male medical students (n = 220) at three levels of hypertension risk based on parental history and the subject's systolic

Mustafa al'Absi; Susan A. Everson; William R. Lovallo

1995-01-01

248

Menthol cigarettes and the cardiovascular risks of people living with HIV.  

PubMed

The possibility that menthol cigarettes add to the deleterious cardiovascular effects of smoking has been barely discussed. Although cardiovascular diseases (CVD) are at the forefront of medical concerns of people living with HIV (PLWH), an important, yet unknown, issue for clinicians and public health authorities is whether use of menthol-flavored cigarettes heightens CVD risk factors. Our study aims to assess traditional (10-year risk using the Framingham Risk Model) and nontraditional CVD risk factors and to contrast the effects of menthol-flavored versus non-menthol-flavored cigarettes on these risk factors. Compared to controls, menthol smokers were twice as likely to have hypertension. Users of menthol-flavored cigarettes had higher body mass index values, and increased risk of abdominal obesity. Multivariate analyses indicated that menthol smokers doubled the odds of having moderate to high CVD risk. This finding is highly significant given the widespread use of menthol-flavored cigarettes, particularly among women, minorities, and PLWH. PMID:24581861

Míguez-Burbano, María José; Vargas, Mayra; Quiros, Clery; Lewis, John E; Espinoza, Luis; Deshratan, Asthana

2014-01-01

249

Depressive symptoms, physical inactivity and risk of cardiovascular mortality in older adults: the Cardiovascular Health Study  

Microsoft Academic Search

BackgroundDepressed older individuals have a higher mortality than older persons without depression. Depression is associated with physical inactivity, and low levels of physical activity have been shown in some cohorts to be a partial mediator of the relationship between depression and cardiovascular events and mortality.MethodsA cohort of 5888 individuals (mean 72.8±5.6 years, 58% female, 16% African-American) from four US communities

Sithu Win; Kapil Parakh; Chete M Eze-Nliam; John S Gottdiener; Willem J Kop; Roy C Ziegelstein

2011-01-01

250

Dietary magnesium intake is inversely associated with mortality in adults at high cardiovascular disease risk.  

PubMed

The relation between dietary magnesium intake and cardiovascular disease (CVD) or mortality was evaluated in several prospective studies, but few of them have assessed the risk of all-cause mortality, which has never been evaluated in Mediterranean adults at high cardiovascular risk. The aim of this study was to assess the association between magnesium intake and CVD and mortality risk in a Mediterranean population at high cardiovascular risk with high average magnesium intake. The present study included 7216 men and women aged 55-80 y from the PREDIMED (Prevención con Dieta Mediterránea) study, a randomized clinical trial. Participants were assigned to 1 of 2 Mediterranean diets (supplemented with nuts or olive oil) or to a control diet (advice on a low-fat diet). Mortality was ascertained by linkage to the National Death Index and medical records. We fitted multivariable-adjusted Cox regressions to assess associations between baseline energy-adjusted tertiles of magnesium intake and relative risk of CVD and mortality. Multivariable analyses with generalized estimating equation models were used to assess the associations between yearly repeated measurements of magnesium intake and mortality. After a median follow-up of 4.8 y, 323 total deaths, 81 cardiovascular deaths, 130 cancer deaths, and 277 cardiovascular events occurred. Energy-adjusted baseline magnesium intake was inversely associated with cardiovascular, cancer, and all-cause mortality. Compared with lower consumers, individuals in the highest tertile of magnesium intake had a 34% reduction in mortality risk (HR: 0.66; 95% CI: 0.45, 0.95; P < 0.01). Dietary magnesium intake was inversely associated with mortality risk in Mediterranean individuals at high risk of CVD. This trial was registered at controlled-trials.com as ISRCTN35739639. PMID:24259558

Guasch-Ferré, Marta; Bulló, Mònica; Estruch, Ramon; Corella, Dolores; Martínez-González, Miguel A; Ros, Emilio; Covas, Maribel; Arós, Fernando; Gómez-Gracia, Enrique; Fiol, Miquel; Lapetra, José; Muñoz, Miguel Ángel; Serra-Majem, Lluís; Babio, Nancy; Pintó, Xavier; Lamuela-Raventós, Rosa M; Ruiz-Gutiérrez, Valentina; Salas-Salvadó, Jordi

2014-01-01

251

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

252

Rheumatoid arthritis versus diabetes as a risk factor for cardiovascular disease: a cross-sectional study, the CARRÉ Investigation  

Microsoft Academic Search

Objectives:Patients with rheumatoid arthritis (RA) have an increased cardiovascular risk, but the magnitude of this risk is not known precisely. A study was undertaken to investigate the associations between RA and type 2 diabetes (DM2), a well-established cardiovascular risk factor, on the one hand, and cardiovascular disease (CVD) on the other.Methods:The prevalence of CVD (coronary, cerebral and peripheral arterial disease)

V P van Halm; M. J. L. Peters; A. E. Voskuijl; M. Boers; W. F. Lems; M. Visser; C. D. A. Stehouwer; A. M. W. Spijkerman; J. M. Dekker; G Nijpels; R. J. Heine; L. M. Bouter; Y. M. Smulders; B. A. C. Dijkmans; M. T. Nurmohamed

2009-01-01

253

Cutaneous stigmata associated with insulin resistance and increased cardiovascular risk.  

PubMed

Certain cutaneous conditions have been reported to be associated with diabetes mellitus, insulin resistance, and metabolic syndrome. In this novel review paper, the evidence linking various cutaneous phenomena (e.g. skin tags, acanthosis nigricans, ear lobe creases, and xanthelasma) and metabolic syndrome and cardiovascular disease is examined, and explanations for these associations are proposed. PMID:24697530

Schilling, William H K; Crook, Martin A

2014-09-01

254

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

255

Cardiorespiratory fitness and physical activity as risk predictors of future atherosclerotic cardiovascular diseases  

Microsoft Academic Search

Physical fitness and activity status are well-documented risk predictors of cardiovascular and total mortality. The purpose\\u000a of this article is to show how cardiorespiratory fitness predicts atherosclerotic cardiovascular diseases. Measurement of\\u000a maximum oxygen consumption (VO2max), defined with or without ventilatory gas analysis during exercise testing, can provide a good estimate for cardiorespiratory\\u000a fitness, which is an independent marker of the

Jari A. Laukkanen; Sudhir Kurl; Jukka T. Salonen

2002-01-01

256

C-reactive protein and risk of cardiovascular disease: Evidence and clinical application  

Microsoft Academic Search

Prospective epidemiologic data consistently show that elevated C-reactive protein (CRP) levels are associated with an increased\\u000a risk of subsequent cardiovascular events in apparently healthy populations, and accumulating laboratory research is uncovering\\u000a possible mechanisms by which CRP may influence the development of atherothrombotic disease. CRP is a stronger predictor of\\u000a cardiovascular disease than is low-density lipoprotein (LDL) cholesterol. CRP adds prognostic

Paul M. Ridker; Shari S. Bassuk; Peter P. Toth

2003-01-01

257

Vegetarian Dietary Patterns as a Means to Achieve Reduction in Cardiovascular Disease and Diabetes Risk Factors  

Microsoft Academic Search

Cardiovascular disease and type 2 diabetes are uncommon in people consuming vegetarian and vegan diets. Vegetarian and vegan\\u000a dietary patterns tend to result in lower body weight and better nutritional profiles than conventional healthy eating patterns\\u000a and have been shown to be an effective tool for management of cardiovascular disease and diabetes risk. The consistency of\\u000a observed beneficial outcomes with

Amy Joy Lanou; Barbara Svenson

2010-01-01

258

Inequalities in cardiovascular disease mortality: the role of behavioural, physiological and social risk factors  

Microsoft Academic Search

BackgroundWhile the relationship between socio-economic disadvantage and cardiovascular disease (CVD) is well established, the role that traditional cardiovascular risk factors play in this association remains unclear. The authors examined the association between education attainment and CVD mortality and the extent to which behavioural, social and physiological factors explained this relationship.MethodsAdults (n=38 355) aged 40–69 years living in Melbourne, Australia were

Alison Beauchamp; Anna Peeters; Rory Wolfe; Gavin Turrell; Linton R Harriss; Graham G Giles; Dallas R English; John McNeil; Dianna Magliano; Stephen Harrap; Danny Liew; David Hunt; Andrew Tonkin

2009-01-01

259

Associations between socioeconomic status and cardiovascular risk factors in an urban population in China.  

PubMed Central

INTRODUCTION: In developed countries socioeconomic status has been proven to be an important factor in the progression of cardiovascular disease. The present article reports the results of a cross-sectional assessment to investigate the association between socioeconomic status and cardiovascular risk factors in a Chinese urban population. METHODS: In 1996, a behavioural risk factor survey was carried out in Tianjin, the third largest city in China. A sample of 4000 people aged 15-69 years, stratified by sex and 10-year age groups, was drawn randomly from urban areas of the city. The present study covers respondents aged 25-69 years (1615 men and 1592 women). Four socioeconomic indicators (education, occupation, income, and marital status), blood pressure, body mass index, and cigarette smoking were determined in the survey. RESULTS: Educational level seemed to be the most important measure of the four socioeconomic indicators in relation to the cardiovascular risk factors in the study population. People with lower socioeconomic status had higher levels of cardiovascular risk factors. The association between socioeconomic status and cardiovascular risk factors was more consistent among women than men. DISCUSSION: Our findings do not seem to differ from those observed in developed countries. PMID:11143189

Yu, Z.; Nissinen, A.; Vartiainen, E.; Song, G.; Guo, Z.; Zheng, G.; Tuomilehto, J.; Tian, H.

2000-01-01

260

Probabilistic networks of blood metabolites in healthy subjects as indicators of latent cardiovascular risk.  

PubMed

The complex nature of the mechanisms behind cardiovascular diseases prevents the detection of latent early risk conditions. Network representations are ideally suited to investigate the complex interconnections between the individual components of a biological system that underlies complex diseases. Here, we investigate the patterns of correlations of an array of 29 metabolites identified and quantified in the plasma of 864 healthy blood donors and use a systems biology approach to define metabolite probabilistic networks specific for low and high latent cardiovascular risk. We adapted methods based on the likelihood of correlation and methods from information theory and combined them with resampling techniques. Our results show that plasma metabolite networks can be defined that associate with latent cardiovascular disease risk. The analysis of the networks supports our previous finding of a possible association between cardiovascular risk and impaired mitochondrial activity and highlights post-translational modifications (glycosilation and oxidation) of lipoproteins as a possible target-mechanism for early detection of latent cardiovascular risk. PMID:25428344

Saccenti, Edoardo; Suarez-Diez, Maria; Luchinat, Claudio; Santucci, Claudio; Tenori, Leonardo

2015-02-01

261

Cardiovascular risk assessment in prediabetes and undiagnosed diabetes mellitus study: international collaboration research overview.  

PubMed

The study aims to develop a screening protocol for the risk of future cardiovascular disease and diabetes mellitus in people with prediabetes and undiagnosed diabetes; and to establish a framework for early identification and intervention of prediabetes including strategies for holistic management and monitoring of progression. The first phase is to identify prediabetes and undiagnosed diabetes in volunteers who are ?18-years-old for 5 years. Point-of-care testing and questionnaire will be used to screen for prediabetes and cardiovascular disease. We anticipate screening more than 2000 individuals of both genders by the end of first phase. The second and third phases which shall run for 5-10 years will be longitudinal study involving participants identified in the first phase as having prediabetes without dyslipidaemia, or clinically established cardiovascular disease. The second phase shall focus on preventive management of risk of progress to diabetes with explicit diagnosis of cardiovascular disease. Oxidative stress measurements will be performed cum evaluation of the use of antioxidants, exercise, and nutrition. The third phase will include probing the development of diabetes and cardiovascular disease. Binomial logistic regression would be performed to generate and propose a model chart for the assessment of cardiovascular disease risk in prediabetes. PMID:24404539

Nwose, Ezekiel Uba; Richards, Ross Stuart; Digban, Kester; Bwititi, Philip Taderera; Ennis, Gretchen; Yee, Kwang Choon; Oguoma, Victor Maduabuchi; Liberato, Selma

2013-11-01

262

Cardiovascular Risk Assessment in Prediabetes and Undiagnosed Diabetes Mellitus Study: International Collaboration Research Overview  

PubMed Central

The study aims to develop a screening protocol for the risk of future cardiovascular disease and diabetes mellitus in people with prediabetes and undiagnosed diabetes; and to establish a framework for early identification and intervention of prediabetes including strategies for holistic management and monitoring of progression. The first phase is to identify prediabetes and undiagnosed diabetes in volunteers who are ?18-years-old for 5 years. Point-of-care testing and questionnaire will be used to screen for prediabetes and cardiovascular disease. We anticipate screening more than 2000 individuals of both genders by the end of first phase. The second and third phases which shall run for 5-10 years will be longitudinal study involving participants identified in the first phase as having prediabetes without dyslipidaemia, or clinically established cardiovascular disease. The second phase shall focus on preventive management of risk of progress to diabetes with explicit diagnosis of cardiovascular disease. Oxidative stress measurements will be performed cum evaluation of the use of antioxidants, exercise, and nutrition. The third phase will include probing the development of diabetes and cardiovascular disease. Binomial logistic regression would be performed to generate and propose a model chart for the assessment of cardiovascular disease risk in prediabetes. PMID:24404539

Nwose, Ezekiel Uba; Richards, Ross Stuart; Digban, Kester; Bwititi, Philip Taderera; Ennis, Gretchen; Yee, Kwang Choon; Oguoma, Victor Maduabuchi; Liberato, Selma

2013-01-01

263

Increased microvascular vasodilation and cardiovascular risk following a pre-eclamptic pregnancy.  

PubMed

Women who develop pre-eclampsia are at high-risk for premature cardiovascular disease and death. The aim of this study was to assess microvascular function and cardiovascular risk in the early postpartum period for women who did/did not have a pregnancy complicated by pre-eclampsia. Peripheral microvascular function was assessed in women in the third trimester of uncomplicated pregnancies, with re-evaluation at 2 and 6 months postpartum. The effect of pre-eclampsia on postpartum microvascular function was assessed 2 and 6 months after delivery. Never-pregnant, naturally cycling women served for comparison. Cutaneous microvascular reactivity to acetylcholine and sodium nitroprusside, delivered locally by iontophoresis, was measured by laser Doppler flowmetry. 30-year and lifetime risk estimates for cardiovascular disease were established. Acetylcholine-mediated vasodilation was enhanced by normotensive pregnancy, and declined to nonpregnant levels by 6 months postpartum. Acetylcholine-mediated vasodilation remained high in pre-eclamptic subjects from 2 to 6 months postpartum compared to normotensive and never-pregnant controls. Pre-eclamptic subjects exhibited elevated 30-year and lifetime risk at 6 months postpartum. This study provides in vivo evidence of microvascular and cardiovascular risk implications of pre-eclampsia as early as 6 months postpartum, and suggests that the development of pre-eclampsia may be used to identify women at risk and eligible for risk screening and intervention. PMID:25428950

Murphy, Malia S Q; Vignarajah, Meera; Smith, Graeme N

2014-11-01

264

Increased microvascular vasodilation and cardiovascular risk following a pre?eclamptic pregnancy  

PubMed Central

Abstract Women who develop pre?eclampsia are at high?risk for premature cardiovascular disease and death. The aim of this study was to assess microvascular function and cardiovascular risk in the early postpartum period for women who did/did not have a pregnancy complicated by pre?eclampsia. Peripheral microvascular function was assessed in women in the third trimester of uncomplicated pregnancies, with re?evaluation at 2 and 6 months postpartum. The effect of pre?eclampsia on postpartum microvascular function was assessed 2 and 6 months after delivery. Never?pregnant, naturally cycling women served for comparison. Cutaneous microvascular reactivity to acetylcholine and sodium nitroprusside, delivered locally by iontophoresis, was measured by laser Doppler flowmetry. 30?year and lifetime risk estimates for cardiovascular disease were established. Acetylcholine?mediated vasodilation was enhanced by normotensive pregnancy, and declined to nonpregnant levels by 6 months postpartum. Acetylcholine?mediated vasodilation remained high in pre?eclamptic subjects from 2 to 6 months postpartum compared to normotensive and never?pregnant controls. Pre?eclamptic subjects exhibited elevated 30?year and lifetime risk at 6 months postpartum. This study provides in vivo evidence of microvascular and cardiovascular risk implications of pre?eclampsia as early as 6 months postpartum, and suggests that the development of pre?eclampsia may be used to identify women at risk and eligible for risk screening and intervention. PMID:25428950

Murphy, Malia S. Q.; Vignarajah, Meera; Smith, Graeme N.

2014-01-01

265

A new Web-based medical tool for assessment and prevention of comprehensive cardiovascular risk  

PubMed Central

Background: Multifactor cardiovascular disease is the leading cause of death; besides well-known cardiovascular risk factors, several emerging factors such as mental stress, diet type, and physical inactivity, have been associated to cardiovascular disease. To date, preventive strategies are based on the concept of absolute risk calculated by different algorithms and scoring systems. However, in general practice the patient’s data collection represents a critical issue. Design: A new multipurpose computer-based program has been developed in order to:1) easily calculate and compare the absolute cardiovascular risk by the Framingham, Procam, and Progetto Cuore algorithms; 2) to design a web-based computerized tool for prospective collection of structured data; 3) to support the doctor in the decision-making process for patients at risk according to recent international guidelines. Methods: During a medical consultation the doctor utilizes a common computer connected by Internet to a medical server where all the patient’s data and software reside. The program evaluates absolute and relative cardiovascular risk factors, personalized patient’s goals, and multiparametric trends, monitors critical parameter values, and generates an automated medical report. Results: In a pilot study on 294 patients (47% males; mean age 60 ± 12 years [±SD]) the global time to collect data at first consultation was 13 ± 11 minutes which declined to 8 ± 7 minutes at the subsequent consultation. In 48.2% of cases the program revealed 2 or more primary risk factor parameters outside guideline indications and gave specific clinical suggestions to return altered parameters to target values. Conclusion: The web-based system proposed here may represent a feasible and flexible tool for clinical management of patients at risk of cardiovascular disease and for epidemiological research. PMID:21445280

Franchi, Daniele; Cini, Davide; Iervasi, Giorgio

2011-01-01

266

Is global cardiovascular risk considered in current practice? Treatment and control of hypertension, hyperlipidemia, and diabetes according to patients’ risk level  

PubMed Central

Objectives To assess the pharmacological treatment and the control of major modifiable cardiovascular risk factors in everyday practice according to the patients’ cardiovascular risk level. Methods In a cross-sectional study general practitioners (GPs) had to identify a random sample of their patients with cardiovascular risk factors or diseases and collect essential data on the pharmacological treatment and control of hypertension, hyperlipidemia, and diabetes according to the patients’ cardiovascular risk level and history of cardiovascular disease. Participants were subjects of both sexes, aged 40–80 years, with at least one known cardiovascular risk factor or a history of cardiovascular diseases. Results From June to December 2000, 162 Italian GPs enrolled 3120 of their patients (2470 hypertensives, 1373 hyperlipidemics, and 604 diabetics). Despite the positive association between the perceived level of global cardiovascular risk and lipid-lowering drug prescriptions in hyperlipidemic subjects (from 26% for lowest risk to 56% for highest risk p < 0.0001) or the prescription of combination therapy in hypertensives (from 41% to 70%, p < 0.0001) and diabetics (from 24% to 43%, p = 0.057), control was still inadequate in 48% of diabetics, 77% of hypertensives, and 85% of hyperlipidemics, with no increase in patients at highest risk. Trends for treatment and control were similar in patients with cardiovascular diseases. Conclusions Even in high-risk patients, despite a tendency towards more intensive treatment, pharmacological therapy is still under used and the degree of control of blood pressure, cholesterol level and diabetes is largely unsatisfactory. PMID:17323606

Roccatagliata, Daria; Avanzini, Fausto; Monesi, Lara; Caimi, Vittorio; Lauri, Davide; Longoni, Paolo; Marchioli, Roberto; Tombesi, Massimo; Tognoni, Gianni; Roncaglioni, Maria Carla

2006-01-01

267

Simulating the Impact of Improved Cardiovascular Risk Interventions on Clinical and Economic Outcomes in Russia  

PubMed Central

Objectives Russia faces a high burden of cardiovascular disease. Prevalence of all cardiovascular risk factors, especially hypertension, is high. Elevated blood pressure is generally poorly controlled and medication usage is suboptimal. With a disease-model simulation, we forecast how various treatment programs aimed at increasing blood pressure control would affect cardiovascular outcomes. In addition, we investigated what additional benefit adding lipid control and smoking cessation to blood pressure control would generate in terms of reduced cardiovascular events. Finally, we estimated the direct health care costs saved by treating fewer cardiovascular events. Methods The Archimedes Model, a detailed computer model of human physiology, disease progression, and health care delivery was adapted to the Russian setting. Intervention scenarios of achieving systolic blood pressure control rates (defined as systolic blood pressure <140 mmHg) of 40% and 60% were simulated by modifying adherence rates of an antihypertensive medication combination and compared with current care (23.9% blood pressure control rate). Outcomes of major adverse cardiovascular events; cerebrovascular event (stroke), myocardial infarction, and cardiovascular death over a 10-year time horizon were reported. Direct health care costs of strokes and myocardial infarctions were derived from official Russian statistics and tariff lists. Results To achieve systolic blood pressure control rates of 40% and 60%, adherence rates to the antihypertensive treatment program were 29.4% and 65.9%. Cardiovascular death relative risk reductions were 13.2%, and 29.6%, respectively. For the current estimated 43,855,000-person Russian hypertensive population, each control-rate scenario resulted in an absolute reduction of 1.0 million and 2.4 million cardiovascular deaths, and a reduction of 1.2 million and 2.7 million stroke/myocardial infarction diagnoses, respectively. Averted direct costs from current care levels ($7.6 billion [in United States dollars]) were $1.1 billion and $2.6 billion, respectively. PMID:25141122

Shum, Kenny; Alperin, Peter; Shalnova, Svetlana; Boytsov, Sergey; Kontsevaya, Anna; Vigdorchik, Alexey; Guetz, Adam; Eriksson, Jennifer; Hughes, David

2014-01-01

268

[Cardiovascular risk factor assessment in a rural Brazilian population].  

PubMed

This cross-sectional study assessed cardiovascular health in 863 adults in rural communities in the Jequitinhonha Valley, Minas Gerais State, Brazil, focusing on seven factors, four of which behavioral (diet, physical activity, smoking, and body weight) and three biological (total cholesterol, fasting blood glucose, and arterial pressure), classified as ideal, intermediate, or poor. Men showed better results in behavioral factors (p = 0.01), with more men displaying 2 or 3 factors at ideal levels (48.5 and 25.8%, respectively), when compared to women (44.2 and 19.8%, respectively) (p = 0.01). Women presented more biological factors at ideal levels (19.1%) when compared to men (7.9%) (p < 0.001). Only three participants (0.4%) showed all seven factors at ideal levels. Prevalence of ideal indices was very low, showing the need for strategies to improve cardiovascular health in this population. PMID:25099042

Felisbino-Mendes, Mariana Santos; Jansen, Ann Kristine; Gomes, Crizian Saar; Velásquez-Meléndez, Gustavo

2014-06-01

269

Flavonoids from fruit and vegetables: a focus on cardiovascular risk factors.  

PubMed

Epidemiological studies suggest that high intakes of dietary flavonoids are associated with decreased cardiovascular disease mortality and risk factors. Less is known about the cardioprotective effects of flavonoids from fruit and vegetables. This review summarizes data from studies which examine the effects of commonly consumed fruit and vegetables on cardiovascular disease risk biomarkers in healthy volunteers or at-risk individuals. Although flavonoids from apples, berries, and onions appear to impact positively on blood pressure, vascular function, and serum lipid levels, further research is required to find out the optimal quantity and food matrix for conferring substantial clinical benefit. The benefits from citrus flavonoids are still inconclusive. Further robust, longer-term dietary intervention studies, with the inclusion of placebo or control arms, are required to improve the credibility of the findings and confirm current observations. An improved understanding of the impact of flavonoids from fruit and vegetables can help one make discerning food choices for optimal cardiovascular health. PMID:24091782

Toh, J Y; Tan, Verena M H; Lim, Paul C Y; Lim, S T; Chong, Mary F F

2013-12-01

270

Angiotensin-converting enzyme gene polymorphism as a cardiovascular risk factor in children.  

PubMed

A family history of cardiovascular disease predicts cardiovascular risk in the next generation, which is either the result of inherited traits or certain living habits in some families. The aim of our study was to evaluate both variables and particularly the role of one of the possible genetic risk factors--angiotensin-converting enzyme (ACE) gene polymorphism. History and anthropometric and biochemical parameters, ACE gene polymorphism and carotid wall thickness--intima media thickness (IMT) were studied in two groups of children: in children whose parents had a stroke before the age of 45 years and in children without a positive family history. The preliminary results of the present study failed to confirm our hypothesis that ACE gene polymorphism is a cardiovascular risk factor in children of parents with premature stroke. PMID:10653133

Varda, N M; Peterlin, B; Umek Bradac, S; Gregoric, A; Milanez, T

2000-01-01

271

Macronutrient Intake and Metabolic Syndrome in Subjects at High Cardiovascular Risk  

Microsoft Academic Search

Background: The effect of macronutrient intake on the metabolic syndrome (MS) is still controversial. Our aim in this study was to assess the relationships between macronutrient intake and the risk of developing the MS in subjects at high cardiovascular risk. Methods: In this cross-sectional study, 967 high-risk men and women (55–80 years) were assessed according to the MS criteria defined

Elizabeth Cabello-Saavedra; Maira Bes-Rastrollo; Jose Alfredo Martinez; Javier Diez-Espino; Pilar Buil-Cosiales; Manuel Serrano-Martinez; Miguel Angel Martinez-Gonzalez

2010-01-01

272

Does calcium intake affect cardiovascular risk factors and/or events?  

PubMed Central

Dietary intervention is an important approach in the prevention of cardiovascular disease. Over the last decade, some studies have suggested that a calcium-rich diet could help to control body weight, with anti-obesity effects. The potential mechanism underlying the impact of calcium on body fat has been investigated, but it is not fully understood. Recent evidence has also suggested that a calcium-rich diet could have beneficial effects on other cardiovascular risk factors, such as insulin resistance, dyslipidemia, hypertension and inflammatory states. In a series of studies, it was observed that a high intake of milk and/or dairy products (the main sources of dietary calcium) is associated with a reduction in the relative risk of cardiovascular disease. However, a few studies suggest that supplemental calcium (mainly calcium carbonate or citrate) may be associated with an increased risk of cardiovascular events. This review will discuss the available evidence regarding the relationship between calcium intake (dietary and supplemental) and different cardiovascular risk factors and/or events. PMID:22892932

Torres, Márcia Regina Simas Gonçalves; Sanjuliani, Antonio Felipe

2012-01-01

273

Remediation of TENORM residues: risk communication in practice.  

PubMed

Despite several decades of studies on the risk assessment and risk perception of ionising radiation, risk management of radioactive materials remains a challenging issue. This is also true for wastes containing technologically enhanced naturally occurring radioactive materials. The present work focuses on the underlying reasons for communication problems between experts and affected members of the public. Exploring the case of a German remediation site with residual radioactive contamination in a residential area, the experts' as well as the residents' perspectives were studied by conducting qualitative interviews. Our results indicate a variety of reasons for communication problems on different levels of risk management and risk communication: the regulatory, the communicative and the moral levels. In the observed case, four salient causes for problems in risk communication and risk management emerged: the mismatch in understanding the residents' values, the issue of risk communication in an unforeseen situation, the problem of the regulatory gap between radiation protection and soil protection in regard to legacies with naturally occurring radioactive material in Germany, and the challenge of communicating a highly complex scientific issue to non-scientists. Moreover, one (at least partial) solution could be seen: the introduction of an external mediator. The results indicate that coordination of different health and environment protection disciplines-in this case radiation protection relating to soil protection-is possible and urgently needed. The opportunity to put, at least natural, radioactive material in line with other conventional industrial materials should be taken. PMID:24983208

König, C; Drögemüller, C; Riebe, B; Walther, C

2014-09-01

274

Use of varenicline for smoking cessation and risk of serious cardiovascular events: nationwide cohort study  

PubMed Central

Objective To investigate whether varenicline is associated with an increased risk of serious cardiovascular events compared with another drug used for smoking cessation, bupropion. Design Nationwide historical cohort study. Setting Denmark, 2007-10. Participants New users of varenicline (n=17?926) and bupropion (n=17?926). Main outcome measures Individual level data on dispensed drug prescriptions, cardiovascular events, and potential confounders were linked between registries. Cox regression was used to estimate hazard ratios of cardiovascular events in analyses matched for propensity score. The primary outcomes at six months after start of treatment were acute coronary syndrome, ischaemic stroke, and cardiovascular death analysed individually and as a composite of any major event. Results There were 57 major cardiovascular events among varenicline users (6.9 cases per 1000 person years) compared with 60 events among bupropion users (7.1 cases per 1000 person years); the hazard ratio for any major event was 0.96 (95% confidence interval 0.67 to 1.39). Varenicline use was not associated with an increased risk of acute coronary syndrome (1.20, 0.75 to 1.91), ischaemic stroke (0.77, 0.40 to 1.48), and cardiovascular death (0.51, 0.13 to 2.02). In subgroup analyses, the risk of any major cardiovascular event was not significantly different between patients with and without a history of cardiovascular disease (1.24 (0.72 to 2.12) and 0.83 (0.51 to 1.36), respectively; P=0.29). Conclusions This cohort study found no increased risk of major cardiovascular events associated with use of varenicline compared with bupropion for smoking cessation. On the basis of the upper confidence limit, the data allowed the exclusion of a 40% increased risk of the composite outcome of any major cardiovascular event. While the estimates were less precise for specific outcomes, any differences would be small in absolute terms. PMID:23138033

2012-01-01

275

Effect of Race and Socioeconomic Status on Cardiovascular Risk Factor Burden: The Cooper Center Longitudinal Study  

PubMed Central

Objectives This study examines the prevalence of cardiovascular risk factors and chronic disease burden among African Americans compared to Caucasians in a population of higher socioeconomic status. Design The current study is a cross-sectional, secondary data analysis of the Cooper Center Longitudinal Study. Setting Patients with a medical examination from 1970-2010 at the Cooper Clinic. Participants 762 African Americans and 40,051 Caucasians who met the criteria. Outcome Measures Racial differences in cardiovascular risk factors/burden of disease between African Americans and Caucasians. Results African Americans had higher prevalence of evaluated cardiovascular risk factors than did Caucasians after controlling for obesity, tobacco use, and physical fitness. Caucasians had greater likelihood of no risk factors while African Americans were more likely to have all three risk factors. Race was typically predictive of cardiovascular risk factors in African Americans compared to Caucasians. Conclusions Findings suggest that health differences persist despite greater socioeconomic status, and further investigations of biopsychosocial causes are warranted. (Ethn Dis. 2013;23[1]:35-42) PMID:23495620

Frierson, Gorita M.; Howard, Erica N.; DeFina, Laura F.; Powell-Wiley, Tiffany M.; Willis, Benjamin L.

2014-01-01

276

New insights on the risk for cardiovascular disease in african americans: the role of added sugars.  

PubMed

African Americans are at increased risk for cardiovascular and metabolic diseases, including obesity, high BP, diabetes, CKD, myocardial infarction, and stroke. Here we summarize the current risks and provide an overview of the underlying risk factors that may account for these associations. By reviewing the relationship between cardiovascular and renal diseases and the African-American population during the early 20th century, the historic and recent associations of African heritage with cardiovascular disease, and modern population genetics, it is possible to assemble strong hypotheses for the primary underlying mechanisms driving the increased frequency of disease in African Americans. Our studies suggest that underlying genetic mechanisms may be responsible for the increased frequency of high BP and kidney disease in African Americans, with particular emphasis on the role of APOL1 polymorphisms in causing kidney disease. In contrast, the Western diet, particularly the relatively high intake of fructose-containing sugars and sweetened beverages, appears to be the dominant force driving the increased risk of diabetes, obesity, and downstream complications. Given that intake of added sugars is a remediable risk factor, we recommend clinical trials to examine the reduction of sweetened beverages as a primary means for reducing cardiovascular risk in African Americans. PMID:25090991

Saab, Karim R; Kendrick, Jessica; Yracheta, Joseph M; Lanaspa, Miguel A; Pollard, Maisha; Johnson, Richard J

2015-02-01

277

TRC150094 attenuates progression of nontraditional cardiovascular risk factors associated with obesity and type 2 diabetes in obese ZSF1 rats  

PubMed Central

Chronic overnutrition and consequential visceral obesity is associated with a cluster of risk factors for cardiovascular disease and type 2 diabetes mellitus. Moreover, individuals who have a triad of hypertension, dysglycemia, and elevated triglycerides along with reduced high-density lipoprotein cholesterol have a greater residual cardiovascular risk even after factoring for the traditional risk factors such as age, smoking, diabetes, and elevated low-density lipoprotein cholesterol. In our previous study we demonstrated that TRC150094, when administered to rats receiving a high-fat diet, stimulated mitochondrial fatty acid oxidation (FAO) and reduced visceral adiposity, opening an interesting perspective for a possible clinical application. In the present study, oral administration of TRC150094 to obese Zucker spontaneously hypertensive fatty rats (obese ZSF1) improved glucose tolerance and glycemic profile as well as attenuated a rise in blood pressure. Obese ZSF1 rats treated with TRC150094 also showed reduced hepatic steatosis, reduced progression of nephropathy, and improved skeletal muscle function. At the cellular level, TRC150094 induced a significant increase in mitochondrial respiration as well as an increased FAO in liver and skeletal muscle, ultimately resulting in reduced hepatic as well as total body fat accumulation, as evaluated by magnetic resonance spectroscopy and magnetic resonance imaging, respectively. If reproduced in humans, these results could confirm that TRC150094 may represent an attractive therapeutic agent to counteract multiple residual cardiovascular risk components. PMID:21448317

Zambad, Shitalkumar P; Munshi, Siralee; Dubey, Amita; Gupta, Ram; Busiello, Rosa Anna; Lanni, Antonia; Goglia, Fernando; Gupta, Ramesh C; Chauthaiwale, Vijay; Dutt, Chaitanya

2011-01-01

278

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

279

Overview of saxagliptin efficacy and safety in patients with type 2 diabetes and cardiovascular disease or risk factors for cardiovascular disease  

PubMed Central

Most individuals with type 2 diabetes mellitus have or will develop multiple independent risk factors for cardiovascular disease, particularly coronary artery disease (CAD). CAD is the leading cause of morbidity and mortality among individuals with type 2 diabetes mellitus, and treating these patients is challenging. The risk of hypoglycemia, weight gain, or fluid retention with some diabetes medications should be considered when developing a treatment plan for individuals with a history of CAD or at risk for CAD. Dipeptidyl peptidase-4 inhibitors are oral antihyperglycemic agents that inhibit the breakdown of the incretin hormones glucagon-like peptide-1 and glucose-dependent insulinotropic polypeptide, resulting in increased glucose-dependent insulin secretion and suppression of glucagon secretion. Saxagliptin is a potent and selective dipeptidyl peptidase-4 inhibitor that improves glycemic control and is generally well tolerated when used as monotherapy and as add-on therapy to other antihyperglycemic medications. This review summarizes findings from recently published post hoc analyses of saxagliptin clinical trials that have been conducted in patients with and without a history of cardiovascular disease and in patients with and without various risk factors for cardiovascular disease. The results show that saxagliptin was generally well tolerated and consistently improved glycemic control, as assessed by reductions from baseline in glycated hemoglobin, fasting plasma glucose concentration, and postprandial glucose concentration, regardless of the presence or absence of baseline cardiovascular disease, hypertension, statin use, number of cardiovascular risk factors, or high Framingham 10-year cardiovascular risk score.

Toth, Peter P

2015-01-01

280

Association of sympathovagal imbalance with cardiovascular risks in patients with polycystic ovary syndrome.  

PubMed

Abstract Polycystic ovary syndrome (PCOS) is associated with cardiovascular risks like obesity, insulin resistance, dyslipidemia that can lead to sympathovagal imbalance (SVI). The study was designed to assess the cardiovascular risk in PCOS and link of metabolic derangements to SVI. Thirty-five newly diagnosed PCOS patients and 32 age-matched controls were recruited. Waist-hip ratio, body mass index (BMI), basal cardiovascular parameters such as basal heart rate (BHR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and rate pressure product (RPP) were recorded. Autonomic functions were assessed using short-term heart rate variability (HRV) analysis, heart rate and blood pressure response to standing (30:15 ratio), deep breathing (E:I ratio) and isometric handgrip (?DBPihg). Fasting plasma glucose, insulin, lipid profile and testosterone were assayed. Insulin resistance (HOMA-IR) and lipid risk factors were calculated. The cases had increased BHR, BMI, SBP, DBP, MAP and RPP. The ratio of low-frequency to high-frequency (LF-HF) of HRV, the marker of SVI was significantly increased in cases. 30:15 ratio and ?DBPihg were increased and E:I ratio was decreased in the cases. HOMA-IR, lipid risk factors and testosterone were significantly elevated in cases. There was a significant correlation of LF-HF with BMI, BHR, RPP, insulin resistance and lipid risk factors. On regression analysis, insulin resistance and lipid risk factors had independent association with LF-HF. PCOS patients have SVI, decreased HRV and increased RPP and the potential cardiovascular risks. The insulin resistance and dyslipidemia contribute to SVI and cardiovascular risks in PCOS patients. PMID:24866562

Kuppusamy, Saranya; Pal, Gopal Krushna; Habeebullah, Syed; Ananthanarayanan, P H; Pal, Pravati

2015-01-01

281

2013 ACC/AHA cholesterol treatment guideline: Paradigm shifts in managing atherosclerotic cardiovascular disease risk.  

PubMed

The 2013 American College of Cardiology/American Heart Association Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults represents a major shift from prior cholesterol management guidelines. The new guidelines include data from individual randomized trials as well as the most comprehensive meta-analyses, and introduce several major paradigm shifts, which include: aiming for ASCVD risk reduction as opposed to targeting LDL-C levels, advocating for the use of evidence-based doses of statins as first line therapy, and utilizing a new risk calculator and risk cut point to guide initiation of statin therapy. These major changes have created controversy and confusion among the medical community, with some clinicians hesitant to embrace the shift. We review the evidence that forms the basis for these major changes, compare them to other major lipid guidelines, and recommend an integrated approach to managing dyslipidemia to decrease atherosclerotic cardiovascular disease risk. PMID:25435519

Finkel, Jonathan B; Duffy, Danielle

2014-10-28

282

The differential impact of subjective and objective aspects of social engagement on cardiovascular risk factors  

PubMed Central

Background This article provides new insights into the impact of social engagement on CVD risk factors in older adults. We hypothesized that objective (social participation, social ties and marital status) and subjective (emotional support) aspects of social engagement are independently associated with objective measures of cardiovascular risk. Methods Data from the English Longitudinal Study on Ageing (ELSA) were analyzed. The effects of social participation, social ties, marital status, and emotional support on hypertension, obesity, high sensitivity C-reactive protein, and fibrinogen were estimated by logistic regression controlling for age, sex, education, physical function, depression, cardiovascular disease, other chronic diseases, physical activity, and smoking. Results Social participation is a consistent predictor of low risk for four risk factors, even after controlling for a wide range of covariates. Being married is associated with lower risk for hypertension. Social ties and emotional support are not significantly associated with any of the cardiovascular risk factors. Conclusion Our analysis suggests that participation in social activities has a stronger association with CV risk factors than marital status, social ties or emotional support. Different forms of social engagement may therefore have different implications for the biological risk factors involved. PMID:21044327

2010-01-01

283

Interactions of grapefruit juice and cardiovascular medications: A potential risk of toxicity  

PubMed Central

Recently, drug interactions with grapefruit juice (GFJ) have received considerable attention from basic scientists, physicians, industry and drug regulatory agencies. GFJ has been shown to inhibit cytochrome P-450 3A4 isoenzyme and P-glycoprotein transporters in the intestine and liver. The GFJ-induced inhibitory effects are considered to be responsible for alterations in drug bioavailability, and pharmacokinetic and pharmacodynamic changes when drugs are ingested concurrently with GFJ. However, little or no interaction is observed when GFJ is taken concomitantly with parentally administered drugs. It is well known that risk factors for cardiovascular disease increase with advancing age, while hepatic metabolic activity decreases in elderly individuals. It is, therefore, possible that the combination of GFJ and cardiovascular medications may pose a health risk, especially in elderly patients. A number of studies have shown interactions of GFJ with cardiovascular drugs such as calcium-channel blockers, angiotensin II receptor antagonists, beta-blockers, and statins. Such interactions are likely to change the pharmacokinetics and pharmacodynamics of these drugs, consequently causing undesirable health effects. Therefore, health care professionals and the public need to be advised of the potential risks associated with the concomitant use of GFJ and interacting medications, especially cardiovascular drugs and agents with a narrow therapeutic index. This review focuses on the adverse interactions of GFJ and cardiovascular medications, and the proposed underlying mechanisms of such interactions. PMID:19641658

Lim, Gareth E; Li, Timao; Buttar, Harpal S

2003-01-01

284

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

285

Methylmercury-induced inhibition of paraoxonase-1 (PON1)-implications for cardiovascular risk.  

PubMed

Methylmercury (MeHg) has been associated with increased risk for cardiovascular disease in some but not all epidemiology studies. These inconsistent results may stem from the fact that exposure typically occurs in the context of fish consumption, which is also associated with cardioprotective factors such as omega-3 fatty acids. Mechanistic information may help to understand whether MeHg represents a risk to cardiovascular health. MeHg is a pro-oxidant that inactivates protein sulfhydryls. These biochemical effects may diminish critical antioxidant defense mechanism(s) involved in protecting against atherosclerosis. One such defense mechanism is paraoxonase-1 (PON1), an enzyme present on high-density lipoproteins and that prevents the oxidation of blood lipids and their deposition in vascular endothelium. PON1 is potentially useful as a clinical biomarker of cardiovascular risk, as well as a critical enzyme in the detoxification of certain organophosphate oxons. MeHg and other metals are known to inhibit PON1 activity in vitro. MeHg is associated with lowered serum PON1 activity in a fish-eating population. The implications of lowering PON1 are evaluated by predicting the shift in PON1 population distribution induced by various doses of MeHg. An MeHg dose of 0.3 ?g/kg/d is estimated to decrease the population average PON1 level by 6.1% and to increase population risk of acute cardiovascular events by 9.7%. This evaluation provides a plausible mechanism for MeHg-induced cardiovascular risk and suggests means to quantify the risk. This case study exemplifies the use of upstream disease biomarkers to evaluate the additive effect of chemical toxicity with background disease processes in assessing human risk. PMID:25072822

Ginsberg, G; Sonawane, B; Nath, R; Lewandowski, P

2014-01-01

286

Circulating Progenitor Cell Count for Cardiovascular Risk Stratification: A Pooled Analysis  

PubMed Central

Background Circulating progenitor cells (CPC) contribute to the homeostasis of the vessel wall, and a reduced CPC count predicts cardiovascular morbidity and mortality. We tested the hypothesis that CPC count improves cardiovascular risk stratification and that this is modulated by low-grade inflammation. Methodology/Principal Findings We pooled data from 4 longitudinal studies, including a total of 1,057 patients having CPC determined and major adverse cardiovascular events (MACE) collected. We recorded cardiovascular risk factors and high-sensitive C-reactive protein (hsCRP) level. Risk estimates were derived from Cox proportional hazard analyses. CPC count and/or hsCRP level were added to a reference model including age, sex, cardiovascular risk factors, prevalent CVD, chronic renal failure (CRF) and medications. The sample was composed of high-risk individuals, as 76.3% had prevalent CVD and 31.6% had CRF. There were 331 (31.3%) incident MACE during an average 1.7±1.1 year follow-up time. CPC count was independently associated with incident MACE even after correction for hsCRP. According to C-statistics, models including CPC yielded a non-significant improvement in accuracy of MACE prediction. However, the integrated discrimination improvement index (IDI) showed better performance of models including CPC compared to the reference model and models including hsCRP in identifying MACE. CPC count also yielded significant net reclassification improvements (NRI) for CV death, non-fatal AMI and other CV events. The effect of CPC was independent of hsCRP, but there was a significant more-than-additive interaction between low CPC count and raised hsCRP level in predicting incident MACE. Conclusions/Significance In high risk individuals, a reduced CPC count helps identifying more patients at higher risk of MACE over the short term, especially in combination with a raised hsCRP level. PMID:20634884

Fadini, Gian Paolo; Maruyama, Shoichi; Ozaki, Takenori; Taguchi, Akihiko; Meigs, James; Dimmeler, Stefanie; Zeiher, Andreas M.; de Kreutzenberg, Saula; Avogaro, Angelo; Nickenig, Georg; Schmidt-Lucke, Caroline; Werner, Nikos

2010-01-01

287

Cardiovascular risk scores in the prediction of subclinical atherosclerosis in young adults: Evidence from the Cardiovascular Risk in Young Finns Study  

PubMed Central

Aims To study the utility of risk scores in prediction of subclinical atherosclerosis in young adults. Methods and results Participants were 2,204 healthy Finnish adults aged 24–39 years in 2001 from population-based follow-up study Cardiovascular Risk in Young Finns. We examined the performance of the Framingham, Reynolds, SCORE (Systematic Coronary Risk Evaluation), PROCAM, and Finrisk cardiovascular risk scores to predict subclinical atherosclerosis, i.e. carotid artery intima-media thickness(IMT) and plaque, carotid artery distensibility (CDist) and brachial artery flow-mediated dilatation (FMD) 6 years later. In 6-year prediction of high IMT (highest decile or plaque), areas under the receiver operating characteristic curves (AUC) for baseline Finrisk (0.733), SCORE (0.726), PROCAM (0.712) and Reynolds (0.729) risk scores were similar as for Framingham risk score (0.728, P always ?0.15). All risk scores had similar discrimination in predicting low CDist (lowest decile) (0.652, 0.642, 0.639, 0.658, 0.652 respectively, P always ?0.41). In prediction of low FMD (lowest decile), Finrisk, PROCAM, Reynolds and Framingham scores had similar AUCs (0.578, 0.594, 0.582, 0.568, P always ?0.08) and SCORE discriminated slightly better (AUC=0.596, P<0.05). Prediction of subclinical outcomes was consistent when estimated from other statistical measures of discrimination, reclassification, and calibration. Conclusions CVD risk scores had equal performance in predicting subclinical atherosclerosis measured by IMT and CDist in young adults. SCORE was more accurate at predicting low FMD than Framingham risk score. PMID:20354441

Raiko, Juho R.H.; Magnussen, Costan G.; Kivimäki, Mika; Taittonen, Leena; Laitinen, Tomi; Kähönen, Mika; Hutri-Kähönen, Nina; Jula, Antti; Loo, Britt-Marie; Thomson, Russell J.; Lehtimäki, Terho; Viikari, Jorma S.A.; Raitakari, Olli T.; Juonala, Markus

2010-01-01

288

Birth weight and risk of cardiovascular disease in a cohort of women followed up since 1976.  

PubMed Central

OBJECTIVE: To examine the association between birth weight and non-fatal adult cardiovascular disease while controlling for potential confounders such as socioeconomic group and adult lifestyle. DESIGN: Retrospective self report of birth weight in an ongoing longitudinal cohort of nurses followed up by postal questionnaire every two years. SETTING: Nurses' health study, a cohort of 121700 women followed up since 1976. MAIN OUTCOME MEASURES: Non-fatal cardiovascular disease, including myocardial infarction, coronary revascularisation, and stroke. RESULTS: Among the 70297 women free of cardiovascular disease at baseline who reported birth weight in the 1992 questionnaire there were 1309 first cases of non-fatal cardiovascular disease. Increasing birth weight was associated with decreasing risk of non-fatal cardiovascular disease. There were 1216 first cases of non-fatal cardiovascular disease among women who were singletons and had been born full term; their relative risks adjusted for several cardiovascular risk factors were 1.49 (95% confidence interval 1.05 to 2.10) for birth weight < 2268 g (< 5 lb 0 oz); 1.25 (0.98 to 1.61) for birth weight 2268-2495 g (5 lb 0 oz to 5 lb 8 oz); 1.12 (0.98 to 1.27) for birth weight > 2495-3175 g (> 5 lb 8 oz to 7 lb 0 oz); 1.00 (referent) for birth weight > 3175-3856 g (> 7 lb 0 oz to 8 lb 8 oz); 0.96 (0.80 to 1.15) for birth weight > 3856-4536 g (> 8 lb 8 oz to 10 lb 0 oz); and 0.68 (0.46 to 1.00) for birth weight > 4536 g (> 10 lb 0 oz) (P value for trend = 0.0004). The inverse trend was apparent for both coronary heart disease and stroke. CONCLUSIONS: These data provide strong evidence of an association between birth weight and adult coronary heart disease and stroke. PMID:9277603

Rich-Edwards, J. W.; Stampfer, M. J.; Manson, J. E.; Rosner, B.; Hankinson, S. E.; Colditz, G. A.; Willett, W. C.; Hennekens, C. H.

1997-01-01

289

High prevalence of cardiovascular risk factors in Gerona, Spain, a province with low myocardial infarction incidence. REGICOR Investigators  

Microsoft Academic Search

STUDY OBJECTIVE: To establish the prevalence of main cardiovascular risk factors in the province of Gerona, where the incidence of myocardial infarction is known to be low. DESIGN: This was a cross sectional study of prevalence of cardiovascular risk factors conducted on a large random population sample. SETTING: The province of Gerona, Spain. PARTICIPANTS: Two thousand four hundred and four

R. Masia; A. Pena; J. Marrugat; J. Sala; J. Vila; M. Pavesi; M. Covas; C. Aubo; R. Elosua

1998-01-01

290

Altering dietary lysine: arginine ratio has little effect on cardiovascular risk factors and vascular reactivity in moderately hypercholesterolemic adults  

Technology Transfer Automated Retrieval System (TEKTRAN)

Background: The effect of dietary protein type on cardiovascular risk factors and vascular reactivity, with specific focus on the lysine to arginine (Lys:Arg) ratio, has been studied sporadically. Objective: Determine effect of dietary Lys:Arg ratio on cardiovascular risk factors and vascular reacti...

291

Effect of red wine and red grape extract on blood lipids, haemostatic factors, and other risk factors for cardiovascular disease  

Microsoft Academic Search

Objective:Some epidemiological studies found a lower risk of cardiovascular disease among wine drinkers than among drinkers of other types of ethanol. This difference might be due to an effect of nonalcohol compounds in wine on important cardiovascular risk factors. The objective of this study was to compare the effect of red wine, nonalcohol compounds of red wine and placebo on

A S Hansen; P Marckmann; L O Dragsted; I-L Finné Nielsen; S E Nielsen; M Grønbæk; Grønbæk

2005-01-01

292

Residue and risk assessment of pyridaben in cabbage.  

PubMed

The dissipation and residue of pyridaben in cabbage under field conditions were investigated. A sensitive, simple, and fast method for determining pyridaben in cabbage was established by high-performance liquid chromatography tandem mass spectrometry. The average recoveries were in the range of 90.29-95.00% with relative standard deviations ranging from 1.72% to 6.39%. The field results showed that pyridaben dissipated rapidly in cabbage and had a half-life of 2.8-3.5 d. During harvest, the terminal residues of pyridaben were 0.01-0.80 mg/kg. Given that no maximum residue limit (MRL) has been set for pyridaben in cabbage, risk assessment was evaluated by using the risk quotient (RQ). Results indicated that the RQ value was significantly lower than RQ = 1. Thus, the effect of pyridaben in cabbage at the recommended dosage was negligible to humans. This study could provide guidance for the safe and reasonable use of pyridaben as a broad-spectrum acaricide and serve as a reference for the establishment of an MRL in China. PMID:24295701

Liu, Congyun; Lu, Dahai; Wang, Youcheng; Huang, Jianxiang; Wan, Kai; Wang, Fuhua

2014-04-15

293

Arterial Hypertension and other risk factors associated with cardiovascular diseases among adults1  

PubMed Central

OBJECTIVE: to identify the prevalence of arterial hypertension and its association with cardiovascular risk factors among adults. METHOD: cross-sectional, population-based, descriptive study conducted with 408 adult individuals. Data were collected through a questionnaire and measurements of weight, height and waist circumference. Person's Chi-square and multiple logistic regression were used in the data analysis. RESULTS: 23.03% of the individuals reported hypertension with a higher prevalence among women. Odds Ratio indicated that smoking, body mass index, waist circumference, diabetes mellitus and dyslipidemia were positively associated with arterial hypertension. CONCLUSION: high self-reported hypertension and its association with other cardiovascular risk factors such as diabetes, obesity and dyslipidemia show the need for specific nursing interventions and the implementation of protocols focused on minimizing complications arising from hypertension, as well as to prevent the emergence of other cardiovascular diseases. PMID:25296137

Radovanovic, Cremilde Aparecida Trindade; dos Santos, Lucimary Afonso; Carvalho, Maria Dalva de Barros; Marcon, Sonia Silva

2014-01-01

294

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

PubMed Central

Objectives To assess differences in cardiovascular risk profiles among rural-to-urban migrants and non-migrant groups. Design Cross-sectional study. Setting Ayacucho and Lima, Peru Participants rural (n=201); rural-urban migrants (n=589) and urban (n=199). Main outcome measures 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. Results For most risk factors, the migrant group had intermediate levels of risk between those observed for the rural and urban groups. Prevalences, for rural, migrant and urban groups, was 3%, 20% and 33% for obesity and 0.8%, 3% and 6% for type-2 diabetes. This gradient of risk was not observed uniformly across all risk factors. Blood pressure did not show a clear gradient of difference between groups. The migrant group had similar systolic blood pressure (SBP) but lower diastolic blood pressure (DBP) than the rural group. The urban group had higher SBP but similar DBP than rural group. Hypertension was more prevalent among the urban (29%) compared to both rural and migrant groups (11% and 16% respectively). For HbA1c, although the urban group had higher levels, the migrant and rural groups were similar to each other. No differences were observed in triglycerides between the three groups. Within migrants, those who migrated when aged older than 12 years had higher odds of diabetes, impaired fasting glucose and metabolic syndrome compared to people who migrated at younger ages. Adjustment for age, sex and socioeconomic indicators had little impact on the patterns observed. Conclusions The impact of rural to urban migration on cardiovascular risk profile is not uniform across different risk factors, and is further influenced by the age at which migration occurs. A gradient in levels was observed for some risk factors across study groups. This observation indicates that urbanization is indeed detrimental to cardiovascular health. PMID:21478383

Miranda, J. Jaime; Gilman, Robert H.; Smeeth, Liam

2011-01-01

295

Obesity-related cardiovascular risk factors after long- term resistance training and ginger supplementation  

PubMed Central

Obesity and its metabolic consequences are major risk factors for cardiovascular morbidity and mortality. However, lifestyle interventions, including exercise training and dietary components may decrease cardiovascular risk. Hence, this study was conducted to assess the effects of ginger supplementation and progressive resistance training on some cardiovascular risk factors in obese men. In a randomized double-blind design, 32 obese Iranian men (BMI ? 30) were assigned in to one of four groups: Placebo (PL, n = 8); ginger group (GI, n = 8) that consumed 1 gr ginger/d for 10 wk; resistance training plus placebo (RTPL, n = 8); and 1gr ginger plus resistance exercise (RTGI, n = 8). Progressive resistance training was performed three days per week for 10 weeks and included eight exercises. At baseline and after 10 weeks, body composition and anthropometric indices were measured. To identify other risk factors, venous blood samples were obtained before and 48-72 hours after the last training session for measurement of blood lipids (LDL-C, HDL-C, TG), systemic inflammation (CRP), and insulin resistance (HOMA-IR). After 10 weeks both RTGI and RTPL groups showed significant decreases in waist circumference (WC), waist-to-hip ratio (WHR), body fat percent, body fat mass, total cholesterol, and insulin resistance (p < 0.05) and a significant increase in fat free mass (FFM) (p < 0.05), while it remained unchanged in PL and GI. Further, significant decreases in the mean values of CRP were observed in all groups except PL (p < 0.05). Our results reveal that resistance training is an effective therapeutic strategy to reduce cardiovascular risk in obese Iranian men. Further, ginger supplementation alone or in combination with resistance training, also reduces chronic inflammation. However more research on the efficacy of this supplement to reduce cardiovascular risk in humans is required. Key points Long- term resistance training reduced cardiovascular risk factors in obese men. Ginger supplementation can also decrease chronic low grade inflammation in obese men. More researches are warranted to elicit the effects of these interventions on cardiovascular risk factors in humans. PMID:24149559

Atashak, Sirvan; Peeri, Maghsoud; Azarbayjani, Mohammad Ali; Stannard, Stephen Robert; Haghighi, Marjan Mosalman

2011-01-01

296

RESIDUAL RISK ASSESSMENTS - FINAL RESIDUAL RISK ASSESSMENT FOR SECONDARY LEAD SMELTERS  

EPA Science Inventory

This source category previously subjected to a technology-based standard will be examined to determine if health or ecological risks are significant enough to warrant further regulation for Secondary Lead Smelters. These assesments utilize existing models and data bases to examin...

297

Explaining the cardiovascular risk associated with rheumatoid arthritis: traditional risk factors versus markers of rheumatoid arthritis severity  

Microsoft Academic Search

BackgroundCardiovascular (CV) disease has a major impact on patients with rheumatoid arthritis (RA), however, the relative contributions of traditional CV risk factors and markers of RA severity are unclear. The authors examined the relative importance of traditional CV risk factors and RA markers in predicting CV events.MethodsA prospective longitudinal cohort study was conducted in the setting of the CORRONA registry

Daniel H Solomon; Joel Kremer; Jeffrey R Curtis; Marc C Hochberg; George Reed; Peter Tsao; Michael E Farkouh; Soko Setoguchi; Jeffrey D Greenberg

2010-01-01

298

Impact of tobacco smoking and smoking cessation on cardiovascular risk and disease.  

PubMed

Despite declines in smoking prevalence in many Western countries, tobacco use continues to grow in global importance as a leading preventable cause of cardiovascular disease. Tobacco smoke is both prothrombotic and atherogenic, increasing the risks of acute myocardial infarction, sudden cardiac death, stroke, aortic aneurysm and peripheral vascular disease. Even very low doses of exposure increase the risk of acute myocardial infarction. However, smoking cessation and second-hand smoke avoidance swiftly reduce this risk. While promising new agents are emerging, proven cost-effective and safe cessation interventions already exist, such as brief physician advice, counseling and nicotine replacement therapy. These should be routinely offered, where available, to all smokers. This is especially important for those at risk of, or with established and even acute, cardiovascular disease. Clinicians must play a more active role than ever before in supporting complete cessation in patients who smoke and in advocating for stronger tobacco control measures. PMID:18570625

Bullen, Christopher

2008-07-01

299

The Evolution and Refinement of Traditional Risk Factors for Cardiovascular Disease  

PubMed Central

Traditional risk factors for premature cardiovascular disease such as systemic hypertension and hypercholesterolemia, all described more than half a century ago, are relatively few in number. Efforts to expand the epidemiological canon have met with limited success due to the high hurdle of causality. Fortunately, another solution to current deficiencies in risk assessment – in particular, the underestimation of risk both before and after initiation of pharmacotherapy – may exist. Parallel to the investigation of novel biomarkers, such as high-sensitivity C-reactive protein, ongoing research has yielded improved metrics of known causative conditions. This evolution of traditional risk factors, heralded by measures such as ambulatory blood pressure, central hemodynamics, low density lipoprotein particle concentration, genetic testing, and “vascular age,” may better address the detection gap in cardiovascular disease. PMID:22183062

deGoma, Emil M.; Knowles, Joshua W.; Angeli, Fabio; Budoff, Matthew J.; Rader, Daniel J.

2011-01-01

300

Fatty acid desaturase gene variants, cardiovascular risk factors, and myocardial infarction in the costa rica study  

Technology Transfer Automated Retrieval System (TEKTRAN)

Genetic variation in fatty acid desaturases (FADS) has previously been linked to long-chain polyunsaturated fatty acids (PUFAs) in adipose tissue and cardiovascular risk. The goal of our study was to test associations between six common FADS polymorphisms (rs174556, rs3834458, rs174570, rs2524299, r...

301

Burnout and Risk of Cardiovascular Disease: Evidence, Possible Causal Paths, and Promising Research Directions  

ERIC Educational Resources Information Center

Burnout is characterized by emotional exhaustion, physical fatigue, and cognitive weariness, resulting from prolonged exposure to work-related stress. The authors review the accumulated evidence suggesting that burnout and the related concept of vital exhaustion are associated with increased risk of cardiovascular disease and…

Melamed, Samuel; Shirom, Arie; Toker, Sharon; Berliner, Shlomo; Shapira, Itzhak

2006-01-01

302

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

303

A Community Health Advisor Program to Reduce Cardiovascular Risk among Rural African-American Women  

ERIC Educational Resources Information Center

The Uniontown, Alabama Community Health Project trained and facilitated Community Health Advisors (CHAs) in conducting a theory-based intervention designed to reduce the risk for cardiovascular disease (CVD) among rural African-American women. The multiphased project included formative evaluation and community organization, CHA recruitment and…

Cornell, C. E.; Littleton, M. A.; Greene, P. G.; Pulley, L.; Brownstein, J. N.; Sanderson, B. K.; Stalker, V. G.; Matson-Koffman, D.; Struempler, B.; Raczynski, J. M.

2009-01-01

304

[Cardiovascular risk of haloperidol vs. atypical anti-psychotic drugs in schizophrenia treatment].  

PubMed

The present study examined the safety of the atypical antipsychotic drugs sertindol, olanzapine and quetiapine used in the treatment of schizophrenia. Haloperidol, a typical antipsychotic drug, was used for comparison. These data may account for the different therapeutic effects and side-effect profiles (cardiovascular risk) of typical and atypical antipsychotic drugs in schizophrenia. PMID:21243790

Dobrin, Irina; Dobrin, R P; Chele, Gabriela; Stef?nescu, C; Knieling, A; Chiri??, Roxana

2010-01-01

305

Cardiovascular Disease in Systemic Lupus Erythematosus: The Role of Traditional and Lupus Related Risk Factors  

PubMed Central

Atherosclerosis is a chronic inflammatory disorder characterized by immune cell activation, inflammation driven plaque formation and subsequent destabilization. In other disorders of an inflammatory nature, the chronic inflammatory state per se has been linked to acceleration of the atherosclerotic process which is underlined by an increased incidence of cardiovascular disease (CVD) in disorders such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA) and antiphopholipid (Hughes) syndrome (APS). SLE is an autoimmune disease that may affect any organ. Premature coronary heart disease has emerged as a major cause of morbidity and mortality in SLE. In addition to mortality, cardiovascular morbidity is also markedly increased in these patients, compared with the general population. The increased cardiovascular risk can be explained only partially by an increased prevalence of classical risk factors for cardiovascular disease; it also appears to be related to inflammation. Inflammation is increasingly being considered central to the pathogenesis of atherosclerosis and an important risk factor for vascular disease. Recent epidemiologic and pathogenesis studies have suggested a great deal in common between the pathogenesis of prototypic autoimmune disease such as SLE and that of atherosclerosis. We will review traditional risk factors for CVD in SLE. We will also discuss the role of inflammation in atherosclerosis, as well as possible treatment strategies in these patients. PMID:19936286

Zeller, Carlos Borelli; Appenzeller, Simone

2008-01-01

306

Hair mercury (signature of fish consumption) and cardiovascular risk in Munduruku and Kayabi Indians of Amazonia  

Microsoft Academic Search

Fish is an important natural resource in the diet of inhabitants of the Amazon rain forest and a marker of its consumption (hair Hg) was used to compare selected cardiovascular risk parameters between tribes of Eastern Amazonia. Three Munduruku (Terra Preta, Kaburuá, Cururu) villages and one Kayabi village at the banks of head rivers (Tapajós, Tropas, Kabitutu, Cururu, Curuzinho, Teles

José G. Dórea; Jurandir R. de Souza; Patricia Rodrigues; Íris Ferrari; Antonio C. Barbosa

2005-01-01

307

Cardiovascular Risk Factors in the Elderly: The Tehran Lipid and Glucose Study  

Microsoft Academic Search

Background Coronary artery disease is becoming more prevalent in developing countries, particularly in urban areas. Because the proportion of elderly individuals in the population is on the rise, this study was conducted to determine the prevalence of cardiovascular risk factors among the Tehran urban elderly population.Design and methods Among 15005 urban individuals of 3 years old and over who had

Fereidoun Azizi; Habib Emami; Payam Salehi; Arash Ghanbarian; Parvin Mirmiran; Mohammadreza Mirbolooki; Tohid Azizi

2003-01-01

308

Managing cardiovascular and renal risk: the potential of direct renin inhibition  

Microsoft Academic Search

Aliskiren is the first direct renin inhibitor for the treatment of hypertension. Clinical experience from studies in over 14,000 patients has shown that aliskiren, alone or in combination with other antihypertensive therapies, provides effective blood pressure lowering with a good safety and tolerability profile. The ultimate aim of antihypertensive therapy, however, is to reduce the risk of adverse cardiovascular and

Peter S Sever; Alan H Gradman; Michel Azizi

2009-01-01

309

[Influence of body fat and its distribution on cardiovascular risk factors in healthy subjects].  

PubMed

The aim of this work was to study the association between obesity and body fat distribution with known cardiovascular risk factors. Seven hundred eighty two healthy individuals, 634 men and 148 female age 44 +/- 10 years were studied. Multiple stepwise regression models were performed in which cardiovascular risk factors (total, LDL and HDL cholesterol, triglycerides, fasting and postprandial blood glucose, systolic and diastolic blood pressure) were considered as the dependent variable and age, sex, smoking habits, body mass index (BMI), waist circumference (WC), waist hip ratio (WHR), subscapular/tricipital skinfold ratio (STR) and percentage of total body fat (%BF), derived from the sum of four skinfolds, as the independent variables. Among anthropometric variables, WC was the principal predictor of total cholesterol and basal blood glucose, WHR was the principal predictor of HDL cholesterol (inverse relationship) and triglycerides; BMI was the principal predictor of systolic and diastolic blood pressure; %BF was the principal predictor of post prandial blood glucose. Performing the same analysis in a subgroup of patients with a BMI between 21 and 24, measures of fat distribution continued to be predictors of cardiovascular risk factors. It is concluded that both total body fat and its distribution are related to cardiovascular risk factors and, in some cases, may have an additive effect and should be measured in preventive medical examinations. PMID:8085075

Bunout, D; Rueda, E; Aicardi, V; Hidalgo, C; Kauffmann, R

1994-02-01

310

Identifying Risk Factors for the Prediction of Hospital Readmission among Older Persons with Cardiovascular Disease.  

ERIC Educational Resources Information Center

Older persons (55 years and older) with cardiovascular disease are at increased risk for hospital readmission when compared to other subgroups of our population. This issue presents an economic problem, a concern for the quality and type of care provided, and an urgent need to implement innovative strategies designed to reduce the rising cost of…

Middleton, Renee Annette

311

Relationship between Visceral Fat and Cardiovascular Disease Risk Factors: The Tanno and Sobetsu Study  

Microsoft Academic Search

We assessed the amount of visceral fat using ultrasonography (US) and studied its relationship to cardiovascular disease risk factors, particularly blood pressure. The subjects in the first study were 45 male and 61 female outpatients. We measured the visceral fat area (VFA) of each subject using abdominal CT and waist circumference (WC), and visceral fat distance (VFD) using US. The

Yu Chiba; Shigeyuki Saitoh; Satoru Takagi; Hirofumi Ohnishi; Nobuo Katoh; Junichi Ohata; Motoya Nakagawa; Kazuaki Shimamoto

2007-01-01

312

Pulse pressure and risk of cardiovascular events in the systolic hypertension in the elderly program  

Microsoft Academic Search

Pulse pressure has been related to higher risk of cardiovascular events in older persons. Isolated systolic hypertension is common among the elderly and is accompanied by elevated pulse pressure. Treatment of isolated systolic hypertension may further increase pulse pressure if diastolic pressure is lowered to a greater extent than systolic pressure. Little is known regarding pulse pressure as a predictor

Viola Vaccarino; Alan K Berger; Jerome Abramson; Henry R Black; John F Setaro; Janice A Davey; Harlan M Krumholz

2001-01-01

313

Cardiovascular Risk in Midlife and Psychological Well-being Among Older Men  

Microsoft Academic Search

Background:Negativeandpositiveaffectsinfluencethe prognosis in the elderly, but underlying mechanisms are obscure. We investigated whether cardiovascular dis- ease risk in midlife is related to psychological well- being in older men (aged 69-84 years old). Methods: A socioeconomically homogeneous volun- teer sample of men, born from 1919 through 1934, was followed up for 29 years. At baseline in 1974, they were healthy but

Timo E. Strandberg; Arto Y. Strandberg; Kaisu H. Pitkala; Veikko V. Salomaa; Reijo S. Tilvis; Tatu A. Miettinen

314

Therapies for type 2 diabetes: lowering HbA1c and associated cardiovascular risk factors  

Microsoft Academic Search

OBJECTIVES: To summarize data supporting the effects of antidiabetes agents on glucose control and cardiovascular risk factors in patients with type 2 diabetes. METHODS: Studies reporting on the effects of antidiabetes agents on glycemic control, body weight, lipid levels, and blood pressure parameters are reviewed and summarized for the purpose of selecting optimal therapeutic regimens for patients with type 2

L. Romayne Kurukulasuriya; James R Sowers

2010-01-01

315

POLYMORPHISMS IN CYTOPLASMIC SERINE HYDROXYMETHYLTRANSFERASE AND METHYLENETETRAHYDROFOLATE REDUCTASE AFFECT THE RISK OF CARDIOVASCULAR DISEASE IN MEN  

Technology Transfer Automated Retrieval System (TEKTRAN)

Genetic variation in folate-regulating enzymes contributes to the risk of cardiovascular disease (CVD). The cytoplasmic serine hydroxymethyltransferase (cSHMT) enzyme is proposed to regulate a key metabolic intersection in folate metabolism. We hypothesized that a variant in cSHMT (cSHMT 1420CT) aff...

316

Genetic Determinants of Risk Factors for Cardiovascular Disease in a Population from Rural Brazil  

Microsoft Academic Search

We investigate the heritability of and pleiotropic relationships among triglycerides and cholesterol lipoproteins that have long been considered traditional risk factors for cardiovascular disease. Quantitative lipid and lipoprotein phenotypes were determined for a cross-sectional sample of a community in Jequitinhonha valley in northern Minas Gerais state, Brazil. The sample consisted primarily of subsistence farmers. Two hundred sixty-nine individuals (128 males

Gustavo. Velásquez-Meléndez; Flavia C. Parra; Andrea. Gazzinelli; Sarah. Williams-Blangero; Rodrigo. Correa-Oliveira

2007-01-01

317

MIGRATION HISTORY, HEALTH BEHAVIORS, AND CARDIOVASCULAR DISEASE RISK FACTORS IN OVERWEIGHT MEXICAN-AMERICAN WOMEN  

Technology Transfer Automated Retrieval System (TEKTRAN)

This research examined whether the migration history of overweight Mexican-American women had an independent effect on cardiovascular risk factors, or whether it was mediated by health behavior changes. Cross-sectional data from 390 overweight, non-diabetic Mexican-American women (aged 18 to 65 year...

318

Genetic influences on blood lipids and cardiovascular disease risk: tools for primary prevention  

Technology Transfer Automated Retrieval System (TEKTRAN)

Genetic polymorphism in the human population is part of the evolutionary process that results from the interaction between the environment and the human genome. Recent changes in diet have upset this equilibrium, potentially influencing the risk of most common morbidities such as cardiovascular dise...

319

The impact of school socioenvironmental factors on cardiovascular risk in a multiethnic sample of adolescents  

Microsoft Academic Search

Socioenvironmental factors, such as chronic exposure to stress and lack of resources, may play a role in explaining ethnic differences in health. Past studies have focused on the impact of socioeconomic stress (SES) on health in adolescents using individual measures of SES such as parental income, occupation, and\\/or education. The impact of school and community variables on cardiovascular risk factors

Jocelyn Winzer

2004-01-01

320

Resting Energy Expenditure, Cardiovascular Risk Factors and Insulin Resistance in Obese Patients  

Microsoft Academic Search

Objective: The aim of our study was to determine whether energy expenditure modified by increasing body mass over the wide range of body mass index (BMI) was related to insulin resistance, cardiovascular risk factors and dietary intakes. Subjects and Methods: A population of 87 obese non-diabetic outpatients was analyzed prospectively. Indirect calorimetry, tetrapolar electrical bioimpedance, serial assessment of nutritional intake

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

2005-01-01

321

Association between Physical Activity and Cardiovascular Risk in Chinese Youth Independent of Age and Pubertal Stage  

Microsoft Academic Search

BACKGROUND: Childhood and adolescence are critical periods of habit formation with substantial tracking of lifestyle and cardiovascular risk into adulthood. There are various guidelines on recommended levels of physical activity in youth of school-age. Despite the epidemic of obesity and diabetes in China, there is a paucity of data in this regard in Chinese youth. We examined the association of

Alice PS Kong; Kai-Chow Choi; Albert MC Li; Stanley SC Hui; Michael HM Chan; YK Wing; Ronald CW Ma; Christopher WK Lam; Joseph TF Lau; Wing Yee So; Gary TC Ko; Juliana CN Chan

2010-01-01

322

The Experience of Daily Hassles, Cardiovascular Reactivity and Adolescent Risk Taking and Self-Esteem  

ERIC Educational Resources Information Center

Based on Boyce and Ellis's model on "context" and "biological sensitivity to the context", this article analyzes the interaction between the experience of daily hassles and experimentally induced cardiovascular reactivity as an indicator of stress reactivity, in explaining risk taking and self-esteem. This study found, in a sample of 599…

Vermeersch, Hans; T'Sjoen, Guy; Kaufman, Jean-Marc; Vincke, John; Bracke, Piet

2010-01-01

323

Dietary Trans Fatty Acids and Cardiovascular Disease Risk: Past and Present  

Technology Transfer Automated Retrieval System (TEKTRAN)

Dietary trans double bond fatty acids have been associated with increased risk of cardiovascular disease. There are two main sources of dietary trans fatty acids: meat and dairy fats, and partially-hydrogenated oils. Due to a number of factors, including changes in federal labeling requirements fo...

324

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

325

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

326

Biomarkers, erectile dysfunction, and cardiovascular risk prediction: the latest of an evolving concept.  

PubMed

A number of circulating and imaging biomarkers are robustly associated with cardiovascular (CV) risk. The overall expectation from a biomarker in the erectile dysfunction (ED) setting is to enhance the optimal management of a man with this disorder but no clinical atherosclerosis. Evidence demonstrating that these biomarkers enhance risk prediction for individuals with ED is at this stage still limited for most of them. A better identification of the subsets of the ED population that require further risk stratification, as well as the initiation of randomized trials that will formally test the ability of biomarkers to predict CV risk, could make biomarker-guided prevention an attainable goal. PMID:25412676

Vlachopoulos, Charalambos; Ioakeimidis, Nikolaos; Stefanadis, Christodoulos

2015-01-01

327

Biomarkers, erectile dysfunction, and cardiovascular risk prediction: the latest of an evolving concept  

PubMed Central

A number of circulating and imaging biomarkers are robustly associated with cardiovascular (CV) risk. The overall expectation from a biomarker in the erectile dysfunction (ED) setting is to enhance the optimal management of a man with this disorder but no clinical atherosclerosis. Evidence demonstrating that these biomarkers enhance risk prediction for individuals with ED is at this stage still limited for most of them. A better identification of the subsets of the ED population that require further risk stratification, as well as the initiation of randomized trials that will formally test the ability of biomarkers to predict CV risk, could make biomarker-guided prevention an attainable goal. PMID:25412676

Vlachopoulos, Charalambos; Ioakeimidis, Nikolaos; Stefanadis, Christodoulos

2015-01-01

328

Glucose Levels Predict Hospitalization for Congestive Heart Failure in Patients at High Cardiovascular Risk  

Microsoft Academic Search

Background—Patients with diabetes mellitus (DM) are at high risk of developing congestive heart failure (CHF). However, the relationships between glucose levels and CHF in people with or without a history of DM have not been well characterized. Methods and Results—We evaluated the associations between fasting plasma glucose and risk of hospitalization for CHF during follow-up in patients at high cardiovascular

C. Held; H. C. Gerstein; S. Yusuf; F. Zhao; L. Hilbrich; C. Anderson; P. Sleight; K. Teo

2007-01-01

329

Global approach to cardiovascular risk in chronic kidney disease: Reality and opportunities for intervention  

Microsoft Academic Search

The current implementation into nephrology clinical practice of guidelines on treatment of cardiovascular (CV) risk factors in chronic kidney disease (CKD) is unknown. We designed a cross-sectional analysis to evaluate the prevalence and treatment of eight modifiable CV risk factors in 1058 predialysis CKD patients (stage 3: n=486; stage 4: n=430, stage 5: n=142) followed for at least 1 year

L De Nicola; R Minutolo; P Chiodini; C Zoccali; P Castellino; C Donadio; M Strippoli; F Casino; M Giannattasio; F Petrarulo; M Virgilio; E Laraia; B R Di Iorio; V Savica; G Conte

2006-01-01

330

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

331

Evaluation of the performance of existing non-laboratory based cardiovascular risk assessment algorithms  

PubMed Central

Background The high burden and rising incidence of cardiovascular disease (CVD) in resource constrained countries necessitates implementation of robust and pragmatic primary and secondary prevention strategies. Many current CVD management guidelines recommend absolute cardiovascular (CV) risk assessment as a clinically sound guide to preventive and treatment strategies. Development of non-laboratory based cardiovascular risk assessment algorithms enable absolute risk assessment in resource constrained countries. The objective of this review is to evaluate the performance of existing non-laboratory based CV risk assessment algorithms using the benchmarks for clinically useful CV risk assessment algorithms outlined by Cooney and colleagues. Methods A literature search to identify non-laboratory based risk prediction algorithms was performed in MEDLINE, CINAHL, Ovid Premier Nursing Journals Plus, and PubMed databases. The identified algorithms were evaluated using the benchmarks for clinically useful cardiovascular risk assessment algorithms outlined by Cooney and colleagues. Results Five non-laboratory based CV risk assessment algorithms were identified. The Gaziano and Framingham algorithms met the criteria for appropriateness of statistical methods used to derive the algorithms and endpoints. The Swedish Consultation, Framingham and Gaziano algorithms demonstrated good discrimination in derivation datasets. Only the Gaziano algorithm was externally validated where it had optimal discrimination. The Gaziano and WHO algorithms had chart formats which made them simple and user friendly for clinical application. Conclusion Both the Gaziano and Framingham non-laboratory based algorithms met most of the criteria outlined by Cooney and colleagues. External validation of the algorithms in diverse samples is needed to ascertain their performance and applicability to different populations and to enhance clinicians’ confidence in them. PMID:24373202

2013-01-01

332

Antipsychotic Medication–Induced Weight Gain and Risk for Diabetes and Cardiovascular Disease  

Microsoft Academic Search

Compared with the general population, individuals with schizophrenia demonstrate an increased hprevalence of obesity, type\\u000a 2 diabetes mellitus (T2DM), and cardiovascular disease (CVD), with related increases in mortality. Increased adiposity is\\u000a associated with decreases in insulin sensitivity, leading to increased risk of hyperglycemia and hyperlipidemia. Current evidence\\u000a supports the hypothesis that treatment with antipsychotic medications is associated with increased risk

John W. Newcomer

333

Sex-specific risk of cardiovascular disease and cognitive decline: pregnancy and menopause  

PubMed Central

Understanding the biology of sex differences is integral to personalized medicine. Cardiovascular disease and cognitive decline are two related conditions, with distinct sex differences in morbidity and clinical manifestations, response to treatments, and mortality. Although mortality from all-cause cardiovascular diseases has declined in women over the past five years, due in part to increased educational campaigns regarding the recognition of symptoms and application of treatment guidelines, the mortality in women still exceeds that of men. The physiological basis for these differences requires further research, with particular attention to two physiological conditions which are unique to women and associated with hormonal changes: pregnancy and menopause. Both conditions have the potential to impact life-long cardiovascular risk, including cerebrovascular function and cognition in women. This review draws on epidemiological, translational, clinical, and basic science studies to assess the impact of hypertensive pregnancy disorders on cardiovascular disease and cognitive function later in life, and examines the effects of post-menopausal hormone treatments on cardiovascular risk and cognition in midlife women. We suggest that hypertensive pregnancy disorders and menopause activate vascular components, i.e., vascular endothelium and blood elements, including platelets and leukocytes, to release cell-membrane derived microvesicles that are potential mediators of changes in cerebral blood flow, and may ultimately affect cognition in women as they age. Research into specific sex differences for these disease processes with attention to an individual’s sex chromosomal complement and hormonal status is important and timely. PMID:23537114

2013-01-01

334

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

335

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

336

Cardiorespiratory fitness, cardiovascular workload and risk factors among cleaners; a cluster randomized worksite intervention  

PubMed Central

Background Prevalence of cardiovascular risk factors is unevenly distributed among occupational groups. The working environment, as well as lifestyle and socioeconomic status contribute to the disparity and variation in prevalence of these risk factors. High physical work demands have been shown to increase the risk for cardiovascular disease and mortality, contrary to leisure time physical activity. High physical work demands in combination with a low cardiorespiratory fitness infer a high relative workload and an excessive risk for cardiovascular mortality. Therefore, the aim of this study is to examine whether a worksite aerobic exercise intervention will reduce the relative workload and cardiovascular risk factors by an increased cardiorespiratory fitness. Methods/design A cluster-randomized controlled trial is performed to evaluate the effect of the worksite aerobic exercise intervention on cardiorespiratory fitness and cardiovascular risk factors among cleaners. Cleaners are eligible if they are employed???20?hours/week, at one of the enrolled companies. In the randomization, strata are formed according to the manager the participant reports to. The clusters will be balanced on the following criteria: Geographical work location, gender, age and seniority. Cleaners are randomized to either I) a reference group, receiving lectures concerning healthy living, or II) an intervention group, performing worksite aerobic exercise “60 min per week”. Data collection will be conducted at baseline, four months and 12?months after baseline, at the worksite during working hours. The data collection will consist of a questionnaire-based interview, physiological testing of health and capacity-related measures, and objective diurnal measures of heart rate, physical activity and blood pressure. Primary outcome is cardiorespiratory fitness. Discussion Information is lacking about whether an improved cardiorespiratory fitness will affect the cardiovascular health, and additionally decrease the objectively measured relative workload, in a population with high physical work demands. Previous intervention studies have lacked robust objective measurements of the relative workload and physical work demands. This study will monitor the relative workload and general physical activity before, during after the intervention, and contribute to the understanding of the previously observed opposing effects on cardiovascular health and mortality from occupational and leisure time physical activity. Trial registration The study is registered as ISRCTN86682076. PMID:22888833

2012-01-01

337

The effect of different cardiovascular risk presentation formats on intentions, understanding and emotional affect: a randomised controlled trial using a web-based risk formatter (protocol)  

Microsoft Academic Search

BACKGROUND: The future risk of heart disease can be predicted with increasing precision. However, more research is needed into how this risk is conveyed and presented. The aim of this study is to compare the effects of presenting cardiovascular risk in different formats on individuals' intention to change behaviour to reduce risk, understanding of risk information and emotional affect. METHODS\\/DESIGN:

Cherry-Ann Waldron; John Gallacher; Trudy van der Weijden; Robert Newcombe; Glyn Elwyn

2010-01-01

338

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

339

Socio-economic and Ethnic Disparities in Cardiovascular Risk In the United States, 2001-2006  

PubMed Central

Purpose To quantify socioeconomic status and ethnic differences in risk for coronary heart disease (CHD) accrued from major risk factors, in the United States (US). Methods Data came from the National Health and Nutrition Examination Survey 2001-2006. Outcomes examined were a) 10-year risk for CHD events as predicted by the National Cholesterol Education Program Adult Treatment Panel III 2004 Updated guidelines, and b) the prevalence of the metabolic syndrome and overt diabetes mellitus (a CHD risk-equivalent). Results Strong inverse socioeconomic gradients with risk were present in all race/ethnicity groups except foreign-born Mexican American men, and were attenuated by controls for physical activity, smoking, and abdominal obesity. In contrast, race/ethnicity disparities were seen in some but not all socioeconomic strata, with some Non-Hispanic Blacks and US-born Mexican Americans having higher risk and some Foreign-born Mexican Americans having lower risk. Conclusions Disparities in cardiovascular risk in the United States are primarily related to SES, and less to race/ethnicity. Socioeconomically disadvantaged individuals should be targeted for lifestyle counseling and early screening for risk factors, regardless of race/ethnicity, to reduce social disparities in cardiovascular outcomes. PMID:20609342

Karlamangla, Arun S; Merkin, Sharon Stein; Crimmins, Eileen M; Seeman, Teresa E

2010-01-01

340

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

341

High-sensitivity troponin T and cardiovascular events in systolic blood pressure categories: atherosclerosis risk in communities study.  

PubMed

Based on observational studies, there is a linear increase in cardiovascular risk with higher systolic blood pressure (SBP), yet clinical trials have not shown benefit across all SBP categories. We assessed whether troponin T measured using high-sensitivity assay was associated with cardiovascular disease within SBP categories in 11 191 Atherosclerosis Risk in Communities study participants. Rested sitting SBP by 10-mm Hg increments and troponin categories were identified. Incident heart failure hospitalization, coronary heart disease, and stroke were ascertained for a median of 12 years after excluding individuals with corresponding disease. Approximately 53% of each type of cardiovascular event occurred in individuals with SBP<140 mm Hg and troponin T ?3 ng/L. Higher troponin T was associated with increasing cardiovascular events across most SBP categories. The association was strongest for heart failure and least strong for stroke. There was no similar association of SBP with cardiovascular events across troponin T categories. Individuals with troponin T ?3 ng/L and SBP <140 mm Hg had higher cardiovascular risk compared with those with troponin T <3 ng/L and SBP 140 to 159 mm Hg. Higher troponin T levels within narrow SBP categories portend increased cardiovascular risk, particularly for heart failure. Individuals with lower SBP but measurable troponin T had greater cardiovascular risk compared with those with suboptimal SBP but undetectable troponin T. Future trials of systolic hypertension may benefit by using high-sensitivity troponin T to target high-risk patients. PMID:25350984

Pokharel, Yashashwi; Sun, Wensheng; de Lemos, James A; Taffet, George E; Virani, Salim S; Ndumele, Chiadi E; Mosley, Thomas H; Hoogeveen, Ron C; Coresh, Josef; Wright, Jacqueline D; Heiss, Gerardo; Boerwinkle, Eric A; Bozkurt, Biykem; Solomon, Scott D; Ballantyne, Christie M; Nambi, Vijay

2015-01-01

342

Bad marriage, broken heart? Age and gender differences in the link between marital quality and cardiovascular risks among older adults.  

PubMed

Working from a life course perspective, we develop hypotheses about age and gender differences in the link between marital quality and cardiovascular risk and test them using data from the first two waves of the National Social Life, Health, and Aging Project. The analytic sample includes 459 married women and 739 married men (aged 57-85 in the first wave) who were interviewed in both waves. We apply Heckman-type corrections for selection bias due to mortality and marriage. Cardiovascular risk is measured as hypertension, rapid heart rate, C-reactive protein, and general cardiovascular events. Results suggest that changes in marital quality and cardiovascular risk are more closely related for older married people than for their younger counterparts and that the link between marital quality and cardiovascular risk is more pronounced among women than among men at older ages. These findings fit with the gendered life course perspective and cumulative disadvantage framework. PMID:25413802

Liu, Hui; Waite, Linda

2014-12-01

343

Bad Marriage, Broken Heart? Age and Gender Differences in the Link between Marital Quality and Cardiovascular Risks among Older Adults  

PubMed Central

Working from a life course perspective, we develop hypotheses about age and gender differences in the link between marital quality and cardiovascular risk and test them using data from the first two waves of the National Social Life, Health, and Aging Project. The analytic sample includes 459 married women and 739 married men (aged 57–85 in the first wave) who were interviewed in both waves. We apply Heckman-type corrections for selection bias due to mortality and marriage. Cardiovascular risk is measured as hypertension, rapid heart rate, C-reactive protein, and general cardiovascular events. Results suggest that changes in marital quality and cardiovascular risk are more closely related for older married people than for their younger counterparts; and that the link between marital quality and cardiovascular risk is more pronounced among women than among men at older ages. These findings fit with the gendered life course perspective and cumulative disadvantage framework. PMID:25413802

Liu, Hui; Waite, Linda

2015-01-01

344

Frailty and cardiovascular disease: potential role of gait speed in surgical risk stratification in older adults  

PubMed Central

Frailty is a state of late life decline and vulnerability, typified by physical weakness and decreased physiologic reserve. The epidemiology and pathophysiology of frailty share features with those of cardiovascular disease. Gait speed can be used as a measure of frailty and is a powerful predictor of mortality. Advancing age is a potent risk factor for cardiovascular disease and has been associated with an increased risk of adverse outcomes. Older adults comprise approximately half of cardiac surgery patients, and account for nearly 80% of the major complications and deaths following surgery. The ability of traditional risk models to predict mortality and major morbidity in older patients being considered for cardiac surgery may improve if frailty, as measured by gait speed, is included in their assessment. It is possible that in the future frailty assessment may assist in choosing among therapies (e.g., surgical vs. percutaneous aortic valve replacement for patients with aortic stenosis).

Chen, Michael A.

2015-01-01

345

The impact of ethnicity and cardiovascular risk on the pharmacologic management of osteoarthritis: a US perspective.  

PubMed

Abstract Many individuals with osteoarthritis (OA) also have other chronic, comorbid conditions, such as obesity, hypertension and diabetes, which can compound the risk for developing cardiovascular adverse events that have been associated with specific analgesics, most notably nonselective nonsteroidal anti-inflammatory drugs (NSAIDs) and selective cyclooxygenase-2 inhibitor NSAIDs. Pharmacotherapy may be further complicated by genetic factors that may influence drug metabolism in certain individuals. These risks may vary according to race and ethnicity. Black and Hispanic populations are known to have a higher prevalence of cardiovascular risk factors and disease, and a substantial proportion of black and Hispanic individuals possess genotypes of the cytochrome P450 (CYP) 2C9 enzyme involved in the metabolism of many NSAIDs and the CYP2D6 enzyme involved in metabolism of the dual opioid agonist/norepinephrine-serotonin reuptake inhibitor tramadol. As a result, the efficacy and safety of available analgesics may vary between patients in different racial and ethnic groups. This review article focuses on racial and ethnic differences in cardiovascular risk and genetic factors altering drug efficacy and safety and evaluates the pharmacologic options that can be used for the management of OA in these populations. Particular emphasis is given to the place of topical NSAIDs and capsaicin in the management of OA patients for whom systemic exposure to available pharmacotherapy poses particular risk. Evidence-based guidelines in OA management, as they relate to appropriate patient-specific pharmacotherapy, are also examined. PMID:25584932

Balmaceda, Casilda M

2015-01-01

346

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

347

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

348

Calcium Intake and Serum Concentration in Relation to Risk of Cardiovascular Death in NHANES III  

PubMed Central

Background Evidence for an association between calcium intake and risk of cardiovascular death remains controversial. By assessing dietary intake, use of supplements, and serum levels of calcium, we aimed to disentangle this link in the third National Health and Nutrition Examination Survey (NHANES III). Methods Mortality linkage of NHANES III to death certificate data for those aged 17 years or older (n?=?20,024) was used to estimate risk of overall cardiovascular death as well as death from ischemic heart disease (IHD), acute myocardial infarction (AMI), heart failure (HF), and cerebrovascular disease (CD) with multivariate Cox proportional hazards regression analysis. Results About 10.0% of the population died of cardiovascular disease and the majority (5.4%) died of IHD. There was increased risk of overall CVD death for those in the bottom 5% of serum calcium compared to those in the mid 90% (HR: 1.51 (95% CI: 1.03–2.22)). For women there was a statistically significant increased risk of IHD death for those with serum calcium levels in the top 5% compared to those in the mid 90% (HR: 1.72 (95%CI: 1.13–2.61)), whereas in men, low serum calcium was related to increased IHD mortality (HR: 2.32 (95% CI 1.14–3.01), Pinteraction: 0.306). No clear association with CVD death was observed for dietary or supplemental calcium intake. Conclusions Calcium as assessed by serum concentrations is involved in cardiovascular health, though differential effects by sex may exist. No clear evidence was found for an association between dietary or supplementary intake of calcium and cardiovascular death. PMID:23593383

Van Hemelrijck, Mieke; Michaelsson, Karl; Linseisen, Jakob; Rohrmann, Sabine

2013-01-01

349

Long?term Cardiovascular Risks Associated With an Elevated Heart Rate: The Framingham Heart Study  

PubMed Central

Background Higher heart rate has been associated with an adverse prognosis, but most prior studies focused on individuals with known cardiovascular disease or examined a limited number of outcomes. We sought to examine the association of baseline heart rate with both fatal and nonfatal outcomes during 2 decades of follow?up. Methods and Results Our study included 4058 Framingham Heart Study participants (mean age 55 years, 56% women). Cox models were performed with multivariable adjustment for clinical risk factors and physical activity. A total of 708 participants developed incident cardiovascular disease (303 heart failure, 343 coronary heart disease, and 216 stroke events), 48 received a permanent pacemaker, and 1186 died. Baseline heart rate was associated with incident cardiovascular disease (hazard ratio [HR] 1.15 per 1 SD [11 bpm] increase in heart rate, 95% CI 1.07 to 1.24, P=0.0002), particularly heart failure (HR 1.32, 95% CI 1.18 to 1.48, P<0.0001). Higher heart rate was also associated with higher all?cause (HR 1.17, 95% CI 1.11 to 1.24, P<0.0001) and cardiovascular mortality (HR 1.18, 95% CI 1.04 to 1.33, P=0.01). Spline analyses did not suggest a lower threshold beyond which the benefit of a lower heart rate abated or increased. In contrast, individuals with a higher heart rate had a lower risk of requiring permanent pacemaker placement (HR 0.55, 95% CI 0.38 to 0.79, P=0.001). Conclusions Individuals with a higher heart rate are at elevated long?term risk for cardiovascular events, in particular, heart failure, and all?cause death. On the other hand, a higher heart rate is associated with a lower risk of future permanent pacemaker implantation. PMID:24811610

Ho, Jennifer E.; Larson, Martin G.; Ghorbani, Anahita; Cheng, Susan; Coglianese, Erin E.; Vasan, Ramachandran S.; Wang, Thomas J.

2014-01-01

350

Peripheral Endothelial Function and Cardiovascular Events in High?Risk Patients  

PubMed Central

Background Endothelial dysfunction is a key component of vascular vulnerability. Reactive hyperemia index (RHI), as assessed by the peripheral arterial tonometry, can noninvasively evaluate endothelial function. This study was designed to determine the additional prognostic value of endothelial function to the Synergy Between PCI With Taxus and Cardiac Surgery Score (SYNTAXsc) and the Framingham Risk Score (FRS) in predicting cardiovascular events in high?risk patients. Methods and Results We undertook a two?center prospective study in 528 stable patients at high?risk for cardiovascular events from the years 2006–2011. The RHI was measured before coronary angiography and coronary complexity was assessed by SYNTAXsc. After optimal therapies including coronary revascularization, there was follow?up with patients until August 2012. Cardiovascular events consist of cardiovascular death, myocardial infarction, unstable angina, ischemic stroke, coronary revascularization, heart failure?induced hospitalization, aortic disease, and peripheral arterial disease. During 1468 person?years of follow?up, 105 patients developed cardiovascular events. Multivariate Cox proportional hazards analysis identified B?type natriuretic peptide (BNP), SYNTAXsc, and RHI as independent cardiovascular event predictors (hazard ratio [95% confidence interval]: natural logarithm of BNP per 0.1: 1.019 [1.002 to 1.037]; P=0.023, SYNTAXsc per tertile: 2.426 [1.825 to 3.225]; P<0.0001, RHI per 0.1: 0.761 [0.673 to 0.859]; P<0.0001). When RHI was added to the FRS, BNP, and SYNTAXsc, net reclassification index was significantly improved (27.5%; P<0.0001), with a significant increase in the C?statistic (from 0.728 [0.679 to 0.778] to 0.766 [0.726 to 0.806]; P=0.031). Conclusions Advanced endothelial dysfunction significantly correlated with near future cardiovascular events in high?risk patients. This physiological vascular measurement improved risk discrimination when added to the FRS, BNP, and SYNTAXsc. Clinical Trial Registration URL: clinicaltrials.gov (http://www.clinicaltrials.gov). Unique identifier: NCT00737945. PMID:24275629

Matsuzawa, Yasushi; Sugiyama, Seigo; Sumida, Hitoshi; Sugamura, Koichi; Nozaki, Toshimitsu; Ohba, Keisuke; Matsubara, Junichi; Kurokawa, Hirofumi; Fujisue, Koichiro; Konishi, Masaaki; Akiyama, Eiichi; Suzuki, Hiroyuki; Nagayoshi, Yasuhiro; Yamamuro, Megumi; Sakamoto, Kenji; Iwashita, Satomi; Jinnouchi, Hideaki; Taguri, Masataka; Morita, Satoshi; Matsui, Kunihiko; Kimura, Kazuo; Umemura, Satoshi; Ogawa, Hisao

2013-01-01

351

Nonalcoholic fatty liver disease (NAFLD): a new risk factor for adverse cardiovascular events in dialysis patients.  

PubMed

Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in Western countries. Today it is believed that NAFLD is a hepatic manifestation of metabolic syndrome, and thus it is closely related to the cardiovascular morbidity and mortality. Cardiovascular diseases (CVD) are the leading cause of morbidity and mortality in patients with end-stage-renal disease (ESRD). NAFLD and ESRD share some important cardiometabolic risk factors and possible common pathophyisiological mechanisms, and are linked to an increased risk of incident CVD events. We hypothesize that the coexistence of these two conditions could lead to much faster progress of the aterogenic process. Furthermore, patients with ESRD who suffer from NAFLD have a much higher risk for the development of adverse CVD events. Given the high prevalence of NAFLD, and its tight association with other manifestations of the metabolic syndrome and thus cardiovascular complications, it is important to recognize and aggressively treat this condition in ESRD patients. To evaluate this hypothesis, we propose the use of non-invasive methods such as transient elastography (TE) (Fibroscan-CAP) for the detection and quantification of liver steatosis and fibrosis, as well as an abdominal ultrasound for detecting liver steatosis. We focus on their correlation with carotid intima-media thickness (IMT) and plaque as surrogate measures of increased cardiovascular risk in HD patients in order to investigate the association of NAFLD and increase risk of adverse CVD events. This evaluation will prove useful in assessing the risk in HD patients with NAFLD for increase CVD mortality. PMID:24365277

Mikolasevic, I; Racki, S; Zaputovic, L; Lukenda, V; Milic, S; Orlic, L

2014-02-01

352

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

353

Lack of cardiovascular risk assessment in inflammatory arthritis and systemic lupus erythematosus patients at a tertiary care center  

Microsoft Academic Search

The purpose of this study is to evaluate cardiovascular risk assessment at a Canadian rheumatology center and describe the\\u000a cardiovascular risk of inflammatory arthritis (IA) and systemic lupus erythematosus (SLE) patients using the Framingham risk\\u000a score. A retrospective chart review of 504 patients attending nine rheumatology practices at the University of Alberta Hospital\\u000a was performed. A pre-specified case report form

Stephanie O. Keeling; Michelle Teo; Daisy Fung

354

Modifiable cardiovascular risk factors among individuals in low socioeconomic communities and homeless shelters.  

PubMed

To understand cardiovascular health in low socioeconomic populations, we analyzed the data from 426 low socioeconomic community-dwelling males and females and 287 homeless males in Philadelphia. Despite higher prevalence of smoking and hypertension, the proportion of homeless participants at increased risk for coronary heart disease was comparable with that of low socioeconomic community-dwelling participants. Among various characteristics, emotional stress was significantly associated with coronary heart disease risk in low socioeconomic community-dwelling participants only, suggestive of a differential psychosocial effect of stress. Our findings suggest that low socioeconomic populations are heterogeneous with respect to their risk factors and needs for interventions. PMID:18794634

Kim, Dae Hyun; Daskalakis, Constantine; Plumb, James D; Adams, Suzanne; Brawer, Rickie; Orr, Nicole; Hawthorne, Katie; Toto, Erin Cunningham; Whellan, David J

2008-01-01

355

Educational status and cardiovascular risk profile in Indians  

PubMed Central

The inverse graded relationship of education and risk factors of coronary heart disease (CHD) has been reported from Western populations. To examine whether risk factors of CHD are predicted by level of education and influenced by the level of urbanization in Indian industrial populations, a cross-sectional survey (n = 19,973; response rate, 87.6%) was carried out among employees and their family members in 10 medium-to-large industries in highly urban, urban, and periurban regions of India. Information on behavioral, clinical, and biochemical risk factors of CHD was obtained through standardized instruments, and educational status was assessed in terms of the highest educational level attained. Data from 19,969 individuals were used for analysis. Tobacco use and hypertension were significantly more prevalent in the low- (56.6% and 33.8%, respectively) compared with the high-education group (12.5% and 22.7%, respectively; P < 0.001). However, dyslipidemia prevalence was significantly higher in the high-education group (27.1% as compared with 16.9% in the lowest-education group; P < 0.01). When stratified by the level of urbanization, industrial populations located in highly urbanized centers were observed to have an inverse graded relationship (i.e., higher-education groups had lower prevalence) for tobacco use, hypertension, diabetes, and overweight, whereas in less-urbanized locations, we found such a relationship only for tobacco use and hypertension. This study indicates the growing vulnerability of lower socioeconomic groups to CHD. Preventive strategies to reduce major CHD risk factors should focus on effectively addressing these social disparities. PMID:17923677

Reddy, K. Srinath; Prabhakaran, Dorairaj; Jeemon, Panniyammakal; Thankappan, K. R.; Joshi, Prashant; Chaturvedi, Vivek; Ramakrishnan, Lakshmy; Ahmed, Farooque

2007-01-01

356

Risk Factors Associated With Cardiovascular Events During Testosterone Administration in Older Men With Mobility Limitation  

PubMed Central

Background. Testosterone in Older Men with Mobility Limitations Trial found an increased incidence of cardiovascular events in men randomized to testosterone, resulting in enrollment cessation by trial's Data and Safety Monitoring Board. We evaluated changes in gonadal hormones and markers of inflammation and coagulation to elucidate risk factors associated with cardiovascular events. Methods. Men aged 65 years or more, with mobility limitation, total testosterone 100–350 ng/dL, or free testosterone less than 50 pg/mL, were randomized to placebo or 10 g testosterone gel daily for 6 months. Changes in total and free testosterone, estradiol and estrone, C-reactive protein, interleukin 6, fibrinogen, plasminogen activator inhibitor-1, and pro-brain naturetic peptide were compared between groups and within the testosterone group between subjects who experienced cardiovascular events and those who did not. Results. Of 209 men randomized (mean age 74 years), gonadal hormones and biomarkers were available in 179 men. Baseline body mass index, gonadal hormones, lipids, Framingham risk scores, and other biomarkers were similar in the two treatment groups. Within the testosterone group, the 6-month increase in free testosterone was significantly greater in men who experienced cardiovascular events than in those who did not [mean (95% confidence interval), 10.6 (4.6–16.7) vs 5.2 (3.0–7.5) ng/dL, p = .05]. In multivariable logistic regression analysis, the change in the serum levels of free testosterone was associated with cardiovascular events. Conclusion. Mobility-limited older men who experienced cardiovascular events had greater increases in serum free testosterone levels than those who did not. PMID:22562960

Davda, Maithili N.; Travison, Thomas G.; Ulloor, Jagadish; Singh, Ravinder; Bhasin, Shalender

2013-01-01

357

Trends in the Risk for Cardiovascular Disease among Adults with Diabetes in Oman  

PubMed Central

Objectives: This study aimed to investigate trends in the estimated 10-year risk for developing cardiovascular disease (CVD) among adults with diagnosed diabetes in Oman. In addition, the effect of hypothetical risk reductions in this population was examined. Methods: Data from 1,077 Omani adults aged ?40 years with diagnosed diabetes were collected and analysed from three national surveys conducted in 1991, 2000 and 2008 across all regions of Oman. The estimated 10-year CVD risk and hypothetical risk reductions were calculated using risk prediction algorithms from the Systematic COronary Risk Evaluation (SCORE), Diabetes Epidemiology Collaborative Analysis of Diagnostic Criteria in Europe (DECODE) and World Health Organization/International Society of Hypertension (WHO/ISH) risk tools. Results: Between 1991 and 2008, the estimated 10-year risk of CVD increased significantly in the total sample and among both genders, regardless of the risk prediction algorithm that was used. Hypothetical risk reduction models for three scenarios (eliminating smoking, controlling systolic blood pressure and reducing total cholesterol) identified that reducing systolic blood pressure to ?130 mmHg would lead to the largest reduction in the 10-year risk of CVD in subjects with diabetes. Conclusion: The estimated 10-year risk for CVD among adults with diabetes increased significantly between 1991 and 2008 in Oman. Focused public health initiatives, involving recognised interventions to address behavioural and biological risks, should be a national priority. Improvements in the quality of care for diabetic patients, both at the individual and the healthcare system level, are required.

Al-Lawati, Jawad; Morsi, Magdi; Al-Riyami, Asya; Mabry, Ruth; El-Sayed, Medhat; El-Aty, Mahmoud Abd; Al-Lawati, Hawra

2015-01-01

358

A Critical Dialogue: Communicating with Type 2 Diabetes Patients about Cardiovascular Risk  

PubMed Central

Patients with type 2 diabetes mellitus (DM) are at increased risk for cardiovascular disease (CVD), and many patients are inadequately treated for risk factors such as hyperglycemia, hyperlipidemia, hypertension, and smoking. Providing individualized risk information in a clear and engaging manner may serve to encourage both patients and their physicians to intensify risk-reducing behaviors and therapies. This review outlines simple and effective methods for making CVD risk infomation understandable to persons of all levels of literacy and mathematical ability. To allow the patient to understand what might happen and how, personal risk factors should be clearly communicated and the potential consequences of a CVD event should be presented in a graphic but factual manner. Risk calculation software can provide CVD risk estimates, and the resulting information can be made understandable by assigning risk severity (eg, “high”) by comparing clinical parameters with accepted treatment targets and by comparing the individual's risk with that of the “average” person. Patients must also be informed about how they might reduce their CVD risk and be supported in these efforts. Thoughtful risk communication using these techniques can improve access to health information for individuals of low literacy, especially when interactive computer technology is employed. Research is needed to find the best methods for communicating risk in daily clinical practice. PMID:17315602

Roach, Paris; Marrero, David

2005-01-01

359

Marked smoking-associated increase of cardiovascular risk in childhood type 1 diabetes.  

PubMed

Type 1 diabetes is a generally accepted atherogenic risk factor, and diabetic patients who smoke markedly accelerate the atherosclerotic process. The main intentions of our investigation were to ascertain differences between juvenile active/passive smokers and non-smokers with type 1 diabetes regarding the number and spectrum of cardiovascular risk factors and their associations with smoking. Ninety-two patients were enrolled comprising 19 active/passive smokers (median age 15.9 years) and 73 non-smokers (median age 12.3 years). To determine age-dependent influences we compared age- and gender-matched groups of 12 smokers with 12 non-smokers. Smokers had significantly higher HbA1c, fructosamine, total cholesterol, LDL cholesterol, apolipoprotein B, serum P-selectin, and lower serum L-selectin than non-smokers. However, L-selectin levels were not different between the age-matched smoker and non-smoker groups. A significant positive relation (Spearman rank correlation) was found between smoking and age, HbAlc, fructosamine, total cholesterol, apolipoprotein B, and P-selectin; a negative relationship between smoking and L-selectin. We conclude that smoking in children and adolescents with type 1 diabetes increases the cardiovascular risk through the deterioration of glucose metabolism, lipid profile, and endothelial function. Therefore, smoking diabetic juveniles may increase their number of cardiovascular risk factors from 1, diabetes, by another four factors, i.e. smoking, hyperglycemia, dyslipidemia, and endothelial perturbation. PMID:19097567

Schwab, Karl Otfried; Doerfer, Jürgen; Hallermann, Kristiane; Krebs, Andreas; Schorb, Elisabeth; Krebs, Kristin; Winkler, Karl

2008-01-01

360

Predicting the Thirty-year Risk of Cardiovascular Disease: The Framingham Heart Study  

PubMed Central

Background Present cardiovascular disease (CVD) risk prediction algorithms were developed for the 10-year or shorter period. Clustering of risk factors at younger ages and increasing life expectancy suggest the need for longer term risk prediction tools. Methods and Results We prospectively followed 4506 participants (2333 women) of the Framingham Offspring cohort aged 20–59 and free of CVD and cancer at baseline examination in 1971–1974 for the development of `hard' CVD (coronary death, myocardial infarction, stroke). We used modified Cox model that allows adjustment for competing risk of non-cardiovascular death to construct prediction algorithm for 30-year risk of hard CVD. Cross-validated survival c statistic and calibration chi-square were used to assess model performance. The 30-year hard CVD event rates adjusted for the competing risk of death were 7.6% for women and 18.3% for men. Standard risk factors (male sex, blood pressure and antihypertensive treatment, total and HDL cholesterol, smoking, diabetes) measured at baseline, were significantly related to the incidence of hard CVD and remained significant when regularly updated on follow-up. Body mass index was associated with 30-year risk of hard CVD only in models which did not update risk factors. Model performance was excellent as indicated by cross-validated discrimination c = 0.803 and calibration chi-square = 4.25 (p-value=0.894). In contrast, thirty-year risk predictions based on different applications of 10-year functions proved inadequate. Conclusions Standard risk factors remain strong predictors of hard CVD over extended follow-up. 30-year functions offer additional risk burden information that complements that of 10-year functions. PMID:19506114

Pencina, Michael J.; D'Agostino, Ralph B.; Larson, Martin G.; Massaro, Joseph M.; Vasan, Ramachandran S.

2009-01-01

361

Quality improvement programme for cardiovascular disease risk factor recording in primary care  

PubMed Central

Objectives—Evaluation of the effect of a quality improvement programme on cardiovascular disease (CVD) risk factor recording and risk factor levels in a controlled study at two primary health care centres serving 26 000 inhabitants in Northern Helsinki. Methods—From a random sample of patient records from 1995 (n=1066), 1996 (n=1042), and 1997 (n=1040) the frequency of CVD risk factor recording was measured and the changes in mean levels of total cholesterol, blood glucose, blood pressure, and body weight were monitored during the follow up period. The intervention programme (1995–1996) consisted of lectures and meetings of multiprofessional teams, development of local guidelines, and introduction of a structured risk factor recording sheet as part of the patient records. Results—After the quality improvement period all risk factors were better recorded at the intervention station than at the control station (p<0.001). More high risk CVD patients were detected from the general population at the intervention station. The mean values of most measured risk factors changed during the intervention. During the follow up period differences were observed between the two health stations in the time trends for body weight, body mass index (BMI), total cholesterol, and glucose levels. Risk factor levels of high risk patients receiving CVD treatment decreased during the intervention. Conclusions—A simple quality improvement programme improved the practice of recording risk factors for CVD which resulted in earlier detection of patients with a high risk of developing the disease. Key Words: quality improvement; cardiovascular disease; risk factor recording; primary health care PMID:10980078

Ketola, E.; Sipila, R.; Makela, M.; Klockars, M.

2000-01-01

362

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

363

Prevalence of Metabolic Syndrome: Association with Risk Factors and Cardiovascular Complications in an Urban Population  

PubMed Central

Introduction Metabolic syndrome (MS) is a set of cardiovascular risk factors and type 2 diabetes, responsible for a 2.5-fold increased cardiovascular mortality and a 5-fold higher risk of developing diabetes. Objectives 1-to evaluate the prevalence of MS in individuals over 18 years associated with age, gender, socioeconomic status, educational levels, body mass index (BMI), HOMA index and physical activity; moreover, to compare it to other studies; 2-to compare the prevalence of elevated blood pressure (BP), high triglycerides and plasma glucose levels, low HDL cholesterol and high waist circumference among individuals with MS also according to gender; 3-to determine the number of risk factors in subjects with MS and prevalence of complications in individuals with and without MS aged over 40 years. Methods A cross-sectional study of 1369 Individuals, 667 males (48.7%) and 702 females (51.3%) was considered to evaluate the prevalence of MS and associated factors in the population. Results The study showed that 22.7% (95% CI: 19.4% to 26.0%) of the population has MS, which increases with age, higher BMI and sedentary lifestyle. There was no significant difference between genders until age ?70 years and social classes. Higher prevalence of MS was observed in lower educational levels and higher prevalence of HOMA positive among individuals with MS. The most prevalent risk factors were elevated blood pressure (85%), low HDL cholesterol (83.1%) and increased waist circumference (82.5%). The prevalence of elevated BP, low HDL cholesterol and plasma glucose levels did not show significant difference between genders. Individuals with MS had higher risk of cardiovascular complications over 40 years. Conclusion The prevalence of MS found is similar to that in developed countries, being influenced by age, body mass index, educational levels, physical activity, and leading to a higher prevalence of cardiovascular complications after the 4th decade of life. PMID:25180496

Moreira, Gisela Cipullo; Cipullo, José Paulo; Ciorlia, Luiz Alberto Souza; Cesarino, Cláudia Bernardi; Vilela-Martin, José Fernando

2014-01-01

364

Measurable Urinary Albumin Predicts Cardiovascular Risk among Normoalbuminuric Patients with Type 2 Diabetes  

PubMed Central

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

2012-01-01

365

Metabolic syndrome affects cardiovascular risk profile and response to treatment in hypertensive postmenopausal women.  

PubMed

Metabolic syndrome is increasingly recognized as an important cardiovascular risk factor in hypertension, but its influence on the cardiovascular risk profile in hypertensive postmenopausal women has not been studied. The aim of the present study was to investigate the impact of metabolic syndrome on the cardiovascular risk profile and the response to treatment. We enrolled 350 hypertensive postmenopausal women, 55+/-6 years of age (range 47 to 60 years of age). Patients were divided into 2 groups according to the presence of metabolic syndrome. Compared with those without, women with metabolic syndrome had higher waist circumference, body mass index, and levels of glucose, triglycerides, and HDL cholesterol, as would be expected, based on definition. In addition, patients with metabolic syndrome had a cardiovascular risk profile less favorable, characterized by a significantly higher highly sensitive C-reactive protein (2.2+/-0.6 versus 1.7+/-0.7 ng/L; P<0.01), a more compromised endothelial function (flow-mediated vasodilation 2.4+/-2.2 versus 4.4+/-2.5%; P=0.01), and a significantly higher left ventricular mass (44+/-15 versus 41+/-16 g/m(2.7)). Also, antihypertensive treatment induced a more modest improvement of both endothelial dysfunction and subclinical inflammation in women with metabolic syndrome. The results of our study show that in postmenopausal women, there are 2 different forms of hypertension: that which is isolated, and that which is associated with metabolic syndrome. This last form is related to a more severe risk profile, and response to therapy is less favorable. PMID:18852391

Rossi, Rosario; Nuzzo, Annachiara; Origliani, Giorgia; Modena, Maria Grazia

2008-11-01

366

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

PubMed Central

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.

2014-01-01

367

Is interpregnancy interval associated with cardiovascular risk factors in later life? A cohort study  

PubMed Central

Objectives Pregnancy represents a metabolic challenge to women; in a normal pregnancy, transient metabolic changes occur that support the needs of the growing fetus. It is possible that repeating this challenge within a relatively short amount of time may result in lasting damage to the woman's cardiovascular health. Conversely, it is also possible that a long interpregnancy interval (IPI) may reflect subfertility, which has been found to be associated with cardiovascular disease (CVD). We examine the associations of short and long IPI with measures of cardiovascular health. Design Prospective cohort. Setting Mothers of the Avon Longitudinal Study of Parents and Children (ALSPAC). Participants Women with two live births in order to control for confounding by parity. Outcome measures Arterial distensibility, common carotid intima, adiposity, blood pressure, lipids, glucose, insulin, proinsulin, triglycerides, C reactive protein. Results 25% (n=3451) of ALSPAC mothers had provided sufficient data to determine full reproductive history—of these, 1477 had two live births, with 54% mothers having non-missing data on all variables required for our analyses. A total of 1268 mothers with IPI (interbirth interval minus 9?months’ gestation) had CVD risk factors measured/imputed at mean age 48?years. After adjusting for confounding, we found no association of either short (?15?months) or long (>27?months) IPI and increased levels of cardiovascular risk factors. There was some suggestion that women with long and short IPIs had a more favourable lipid profile compared with women whose IPI was 16–27?months; however, the differences were small in magnitude and imprecisely estimated. Conclusions This study does not support the hypothesis that either long or short IPI is a risk factor for later cardiovascular health. PMID:24647446

Knipe, Duleeka W; Fraser, Abigail; Lawlor, Debbie A; Howe, Laura D

2014-01-01

368

British Regional Heart Study: cardiovascular risk factors in middle-aged men in 24 towns.  

PubMed Central

The British Regional Heart Study seeks to define risk factors for cardiovascular disease, to examine their interrelationships, and to explain the geographic variations in cardiovascular disease in Britain. A clinical survey of men aged 40-59 in 24 British towns was carried out and preliminary data from the survey analysed. On a town basis cardiovascular mortality was associated with mean systolic blood pressure and the prevalence of heavy cigarette smoking and heavy alcohol consumption. No such association was seen for body mass index or mean serum total cholesterol or high-density-lipoprotein cholesterol concentration. Cigarette smoking and alcohol intake and, to a less degree, systolic blood pressure were related to the social class (percentage of manual workers) of a town, and these factors may determine to some extent the increased risk of cardiovascular disease in manual workers. Blood pressure in individual subjects was affected predominantly by age, body mass index, and alcohol intake. Body mass index appeared to affect blood pressure to a greater extent than alcohol intake and did so with a consistent and positive linear trend. Nevertheless, the differences between towns in mean blood pressure readings appeared to be more closely associated with variations in the prevalence of heavy drinking than with variations in body mass index. Alcohol intake and body mass index explained only a part of the striking differences between towns in mean blood pressure readings, and some important "town"factors remained unexplained. PMID:6789956

Shaper, A G; Pocock, S J; Walker, M; Cohen, N M; Wale, C J; Thomson, A G

1981-01-01

369

Endothelin-A Receptor Antagonism Modifies Cardiovascular Risk Factors in CKD  

PubMed Central

Arterial stiffness and impaired nitric oxide (NO) bioavailability contribute to the high risk for cardiovascular disease in CKD. Both asymmetric dimethylarginine (ADMA), an endogenous inhibitor of NO production, and endothelin-1 (ET-1) oppose the actions of NO, suggesting that ET-1 receptor antagonists may have a role in cardiovascular protection in CKD. We conducted a randomized, double-blind, three-way crossover study in 27 patients with proteinuric CKD to compare the effects of the ETA receptor antagonist sitaxentan, nifedipine, and placebo on proteinuria, BP, arterial stiffness, and various cardiovascular biomarkers. After 6 weeks of treatment, placebo and nifedipine did not affect plasma urate, ADMA, or urine ET-1/creatinine, which reflects renal ET-1 production; in contrast, sitaxentan led to statistically significant reductions in all three of these biomarkers. No treatment affected plasma ET-1. Reductions in proteinuria and BP after sitaxentan treatment was associated with increases in urine ET-1/creatinine, whereas reduction in pulse-wave velocity, a measure of arterial stiffness, was associated with a decrease in ADMA. Taken together, these data suggest that ETA receptor antagonism may modify risk factors for cardiovascular disease in CKD. PMID:23243212

Melville, Vanessa; Blackwell, Scott; Talwar, Dinesh K.; Johnston, Neil R.; Goddard, Jane; Webb, David J.

2012-01-01

370

Endothelin-A receptor antagonism modifies cardiovascular risk factors in CKD.  

PubMed

Arterial stiffness and impaired nitric oxide (NO) bioavailability contribute to the high risk for cardiovascular disease in CKD. Both asymmetric dimethylarginine (ADMA), an endogenous inhibitor of NO production, and endothelin-1 (ET-1) oppose the actions of NO, suggesting that ET-1 receptor antagonists may have a role in cardiovascular protection in CKD. We conducted a randomized, double-blind, three-way crossover study in 27 patients with proteinuric CKD to compare the effects of the ET(A) receptor antagonist sitaxentan, nifedipine, and placebo on proteinuria, BP, arterial stiffness, and various cardiovascular biomarkers. After 6 weeks of treatment, placebo and nifedipine did not affect plasma urate, ADMA, or urine ET-1/creatinine, which reflects renal ET-1 production; in contrast, sitaxentan led to statistically significant reductions in all three of these biomarkers. No treatment affected plasma ET-1. Reductions in proteinuria and BP after sitaxentan treatment was associated with increases in urine ET-1/creatinine, whereas reduction in pulse-wave velocity, a measure of arterial stiffness, was associated with a decrease in ADMA. Taken together, these data suggest that ET(A) receptor antagonism may modify risk factors for cardiovascular disease in CKD. PMID:23243212

Dhaun, Neeraj; Melville, Vanessa; Blackwell, Scott; Talwar, Dinesh K; Johnston, Neil R; Goddard, Jane; Webb, David J

2013-01-01

371

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

372

Adding social deprivation and family history to cardiovascular risk assessment: the ASSIGN score from the Scottish Heart Health Extended Cohort (SHHEC)  

Microsoft Academic Search

Objective: To improve equity in cardiovascular disease prevention by developing a cardiovascular risk score including social deprivation and family history.Design: The ASSIGN score was derived from cardiovascular outcomes in the Scottish Heart Health Extended Cohort (SHHEC). It was tested against the Framingham cardiovascular risk score in the same database.Setting: Random-sample, risk-factor population surveys across Scotland 1984–87 and North Glasgow 1989,

Mark Woodward; Peter Brindle; Hugh Tunstall-Pedoe

2007-01-01

373

Effects of Ramadan fasting on cardiovascular risk factors: a prospective observational study  

PubMed Central

Background Previous research has shown that Ramadan fasting has beneficial effects on cardiovascular risk factors, however there are controversies. In the present study, the effect of Ramadan fasting on cardiovascular risk factors has been investigated. Method This is a prospective observational study that was carried out in a group of patients with at least one cardiovascular risk factor (including history of documented previous history of either coronary artery disease (CAD), metabolic syndrome or cerebro-vascular disease in past 10 y). Eighty two volunteers including 38 male and 44 female, aged 29–70 y, mean 54.0?±?10 y, with a previous history of either coronary artery disease, metabolic syndrome or cerebro-vascular disease were recruited. Subjects attended the metabolic unit after at least 10?h fasting, before and after Ramadan who were been fasting for at least 10?days. A fasting blood sample was obtained, blood pressure was measured and body mass index (BMI) was calculated. Lipids profile, fasting blood sugar (FBS) and insulin, homocysteine (hcy), high-sensitivity C-reactive protein (hs-CRP) and complete blood count (CBC) were analyzed on all blood samples. Results A significant improvement in 10?years coronary heart disease risk (based on Framingham risk score) was found (13.0?±?8 before Ramadan and 10.8 ±7 after Ramadan, P <0.001, t test).There was a significant higher HDL-c, WBC, RBC and platelet count (PLT), and lower plasma cholesterol, triglycerides, LDL-c, VLDL-c, systolic blood pressure, body mass index and waist circumference after Ramadan (P <0.05, t test). The changes in FBS, insulin,Homeostasis Model Assessment Insulin Resistance (HOMA-IR), hcy, hs-CRP and diastolic blood pressure before and after Ramadan were not significant (P >0.05, t test). Conclusions This study shows a significant improvement in 10?years coronary heart disease risk score and other cardiovascular risk factors such as lipids profile, systolic blood pressure, weight, BMI and waist circumference in subjects with a previous history of cardiovascular disease. PMID:22963582

2012-01-01

374

Risk-based surveillance of antimicrobial residues in pigs--identification of potential risk indicators.  

PubMed

Around 20,000 samples are analysed each year for the presence of antibacterial residues in Danish finisher pigs, and between zero and five samples are detected positive above the maximum residue level (MRL). The intention was to develop a risk-based surveillance programme involving fewer samples while ensuring equal sensitivity. Therefore, risk indicators were searched for. Data were obtained from the Danish slaughterhouse database covering the period from July 2010 to December 2012. Residues were found or suspected in 17 incidents. In nine of these, the farmer had called in to prevent the pigs from being slaughtered. Hence, eight suspect cases were found through the surveillance programme, and two of these were above MRL. For these eight case herds, the number of pigs slaughtered and the number in which each of the following lesions were found were included in a statistical analysis: chronic pleuritis, tail bite, chronic pericarditis, chronic pneumonia, chronic peritonitis, osteomyelitis, abscess in hindquarters, abscess in leg/toe and abscess in forequarters. Only chronic pleuritis was associated with the presence of residues. Next, data from all herds delivering pigs for slaughter to the same abattoir were included covering a 3-month period prior to the residue finding. The prevalence of chronic pleuritis was on average 1.7 times higher in the eight case herds compared to all other herds. In two herds, the prevalence was significantly higher (P?0.05), and in one herd substantially higher, but only borderline significant (P=0.1). In the remaining herds, the prevalence did not differ from the other herds delivering pigs to the abattoir. This indicates that chronic pleuritis might be considered as a risk indicator for use in surveillance. Other risk indicators/factors - reported in the cases where the farmers called in - were inadequate marking of treated animals and incorrect use of medication dispensers. These factors are not suited for use in surveillance and should be dealt with otherwise. PMID:24582122

Alban, Lis; Pacheco, Goncalo; Petersen, Jesper Valentin

2014-05-01

375

Biological variation of cardiovascular risk factors in patients with diabetes.  

PubMed

Biological variation refers to the natural fluctuations found when repeated measurements are made in a biological system. Generally, biological variation remains within narrow boundaries in health, but may differ in pathological states, with implications for the diagnosis and monitoring of disease processes. In disease, biological variation may alter such that any subsequent measurement may need to have a greater difference compared with a healthy control to be biologically relevant. Treatments such as insulin or anti-hypertensive therapy have been shown to reduce biological variability closer to normal levels and theoretically this may help prevent complication development or progression in conditions such as diabetes. This article reviews how biological variation can influence our identification and assessment of vascular risk factors in a person with diabetes. The role of biological variation in the diagnosis of diabetes (glucose and HbA1c) is then examined. Finally, the influence that common treatments in diabetes have in modifying biological variation is described. PMID:23413821

Dawson, A J; Sathyapalan, T; Atkin, S L; Kilpatrick, E S

2013-10-01

376

Dietary fat and cardiovascular disease risk: quantity or quality?  

PubMed

When considering dietary fat quantity, there are two main factors to consider, impact on body weight and plasma lipoprotein profiles. Data supporting a major role of dietary fat quantity in determining body weight are weak and may be confounded by differences in energy density, dietary fiber, and dietary protein. With respect to plasma lipoprotein profiles, relatively consistent evidence indicates that under isoweight conditions, decreasing the total fat content of the diet causes an increase in triglyceride and decrease in high-density lipoprotein (HDL) cholesterol levels. When considering dietary fat quality, current evidence suggests that saturated fatty acids tend to increase low-density lipoprotein (LDL) cholesterol levels, whereas monounsaturated and polyunsaturated fatty acids tend to decrease LDL cholesterol levels. Long-chain omega-3 fatty acids, eicosapentaenoic acid (EPA) (20:5n-3) and docosahexaenoic acid (DHA) (22:6n-3), are associated with decreased triglyceride levels in hypertriglyceridemic patients and decreased risk of developing coronary heart disease (CHD). Dietary trans-fatty acids are associated with increased LDL cholesterol levels. Hence, a diet low in saturated and trans-fatty acids, with adequate amounts of monounsaturated and polyunsaturated fatty acids, especially long-chain omega-3 fatty acids, would be recommended to reduce the risk of developing CHD. Additionally, the current data suggest it is necessary to go beyond dietary fat, regardless of whether the emphasis is on quantity or quality, and consider lifestyle. This would include encouraging abstinence from smoking, habitual physical activity, avoidance of weight gain with age, and responsible limited alcohol intake (one drink for females and two drinks for males per day). PMID:12737709

Lichtenstein, Alice H

2003-03-01

377

Traditional cardiovascular risk factors and severity of angiographic coronary artery disease in the elderly.  

PubMed

Over 80% of annual coronary heart disease mortality occurs in the elderly, a rapidly expanding subset of the population. The authors retrospectively examined the relationship between traditional cardiovascular risk factors and atherosclerotic coronary artery disease burden in a cohort of 631 elderly patients undergoing angiography. Age and male sex but not hypertension or dyslipidemia were predictors of presence of obstructive coronary artery disease (Duke score >or=2). Only diabetes mellitus emerged as an independent predictor of obstructive coronary artery disease burden. Smoking was found to be predictive of left main coronary artery disease. In summary, severity of angiographic disease in the elderly as assessed by Duke Myocardial Jeopardy scoring appears to correlate poorly with prevalence of established traditional cardiovascular risk factors. PMID:20626669

Veeranna, Vikas; Pradhan, Jyotiranjan; Niraj, Ashutosh; Fakhry, Hesham; Afonso, Luis

2010-01-01

378

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

379

Dietary soy intake is not associated with risk of cardiovascular disease mortality in Singapore Chinese adults.  

PubMed

Although soy food has been recommended because of its presumed cardiovascular benefits, the long-term prospective association between habitual soy food intake and cardiovascular disease mortality remains unclear. This study aimed to evaluate the relation of soy protein and isoflavone intake with the risk of cardiovascular disease mortality in middle-aged and older Chinese adults residing in Singapore. The Singapore Chinese Health Study is a population-based study that recruited 63,257 Chinese adults aged 45-74 y from 1993 to 1998. Usual diet was measured at recruitment by using a validated semiquantitative food-frequency questionnaire, and mortality information was identified via registry linkage until 31 December 2011. Cox proportional hazards models were used to calculate HRs, with adjustment for potential confounders. The median intake was 5.2 g/d for soy protein, 15.8 mg/d for soy isoflavones, and 87.4 g/d for soy expressed as tofu equivalents. We documented 4780 cardiovascular deaths during 890,473 person-years of follow-up. After adjustment for sociodemographic, lifestyle, and other dietary factors, soy protein intake was not significantly associated with cardiovascular disease mortality: HRs (95% CIs) were 1.00 (reference), 1.02 (0.94, 1.11), 1.02 (0.93, 1.11), and 1.06 (0.97, 1.17) for increasing quartiles of soy protein (P-trend = 0.24). Similarly, no significant association was observed for soy isoflavones and total tofu equivalents and when deaths from coronary heart disease (n = 2697) and stroke (n = 1298) were considered separately. When stratified by sex, HRs for cardiovascular disease mortality across quartiles of soy protein were 1.00, 1.00, 1.05, and 1.16 (95% CI: 1.03, 1.31) in men (P-trend = 0.02) and 1.00, 1.01, 0.96, and 0.95 (95% CI: 0.81, 1.10) in women (P-trend = 0.31), although the interaction was not significant (P-interaction = 0.12). In conclusion, soy intake was not significantly associated with risk of cardiovascular disease mortality in the Chinese population. However, a slightly increased risk associated with high soy protein intake in men cannot be excluded and requires further investigation. PMID:24699802

Talaei, Mohammad; Koh, Woon-Puay; van Dam, Rob M; Yuan, Jian-Min; Pan, An

2014-06-01

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

Cardiovascular risk estimation in 2012: lessons learned and applicability to the HIV population.  

PubMed

Cardiovascular disease (CVD) risk assessment tools such as the Framingham Risk Functions, often called Framingham Risk Scores, are common in the evaluation of the CVD risk among individuals in the general population. These functions are multivariate risk algorithms that combine data on CVD risk factors, such as sex, age, systolic blood pressure, total cholesterol level, high-density lipoprotein cholesterol level, smoking behavior, and diabetes status, to produce an estimate (or risk) of developing CVD or a component of it (such as coronary heart disease, stroke, peripheral vascular disease, and heart failure) over a fixed period (eg, the next 10 years). These estimates of CVD risk are often major inputs in recommending drug treatments, such as agents to reduce cholesterol level. The Framingham Risk Functions are valid in diverse populations, at times requiring a calibration adjustment for proper applicability. With the realization that individuals with human immunodeficiency virus (HIV) infection often have elevated CVD risk factors, the evaluation of CVD risk for these individuals becomes a serious concern. Researchers have recently developed new CVD risk functions specifically for HIV-infected patients and have also examined the extension of existing Framingham Risk Functions to the HIV-infected population. This article first reviews briefly the Framingham Study and risk functions, covering their objectives, their components, evaluation of their performance, and transportability and validity on non-Framingham populations. It then reviews the development of CVD risk functions for HIV-infected individuals and comments on the usefulness of extending the Framingham risk equation to the HIV-infected population and the need to develop more-specific risk prediction equations uniquely tailored to this population. PMID:22577209

D'Agostino, Ralph B

2012-06-01

382

Comparative assessment of absolute cardiovascular disease risk characterization from non-laboratory-based risk assessment in South African populations  

PubMed Central

Background All rigorous primary cardiovascular disease (CVD) prevention guidelines recommend absolute CVD risk scores to identify high- and low-risk patients, but laboratory testing can be impractical in low- and middle-income countries. The purpose of this study was to compare the ranking performance of a simple, non-laboratory-based risk score to laboratory-based scores in various South African populations. Methods We calculated and compared 10-year CVD (or coronary heart disease (CHD)) risk for 14,772 adults from thirteen cross-sectional South African populations (data collected from 1987 to 2009). Risk characterization performance for the non-laboratory-based score was assessed by comparing rankings of risk with six laboratory-based scores (three versions of Framingham risk, SCORE for high- and low-risk countries, and CUORE) using Spearman rank correlation and percent of population equivalently characterized as ‘high’ or ‘low’ risk. Total 10-year non-laboratory-based risk of CVD death was also calculated for a representative cross-section from the 1998 South African Demographic Health Survey (DHS, n = 9,379) to estimate the national burden of CVD mortality risk. Results Spearman correlation coefficients for the non-laboratory-based score with the laboratory-based scores ranged from 0.88 to 0.986. Using conventional thresholds for CVD risk (10% to 20% 10-year CVD risk), 90% to 92% of men and 94% to 97% of women were equivalently characterized as ‘high’ or ‘low’ risk using the non-laboratory-based and Framingham (2008) CVD risk score. These results were robust across the six risk scores evaluated and the thirteen cross-sectional datasets, with few exceptions (lower agreement between the non-laboratory-based and Framingham (1991) CHD risk scores). Approximately 18% of adults in the DHS population were characterized as ‘high CVD risk’ (10-year CVD death risk >20%) using the non-laboratory-based score. Conclusions We found a high level of correlation between a simple, non-laboratory-based CVD risk score and commonly-used laboratory-based risk scores. The burden of CVD mortality risk was high for men and women in South Africa. The policy and clinical implications are that fast, low-cost screening tools can lead to similar risk assessment results compared to time- and resource-intensive approaches. Until setting-specific cohort studies can derive and validate country-specific risk scores, non-laboratory-based CVD risk assessment could be an effective and efficient primary CVD screening approach in South Africa. PMID:23880010

2013-01-01

383

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

384

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

385

Epidemiology of cardiovascular risk factors in Greece: aims, design and baseline characteristics of the ATTICA study  

PubMed Central

Background In an attempt to evaluate the levels of several cardiovascular risk factors in Greece we conducted a population-based health and nutrition survey, the "ATTICA study". In this work we present the design and the methodology of the study, as well as the status of various baseline characteristics of the participants. Methods From May 2001 to December 2002 we randomly enrolled 1514 adult men and 1528 adult women, stratified by age – gender (census 2000), from the greater area of Athens. More than 300 demographic, lifestyle, behavioral, dietary, clinical and biochemical variables have been recorded. Results Regarding the frequency of the classical cardiovascular risk factors we observed that 51% of men and 39% of women reported smokers (p < 0.05), 37% of men and 25% of women were defined as hypertensives (p < 0.05), 46% of men and 40% of women had total serum cholesterol levels above 200 mg/dl (p < 0.05) and 8% of men and 6% of women had history of diabetes mellitus. Moreover, 20% of men and 15% of women were obese (p < 0.05), while men were more physically active as compared to women (42% vs. 39%, p < 0.05). 19% of men and 38% of women had mild to severe depressive symptoms (p < 0.01). Finally, 72 men (5%) and 45 (3%) women reported history of coronary heart disease at entry evaluation. Conclusions The prevalence of the common cardiovascular risk factors in our population seems high. As a consequence a considerable proportion of Greek adults are at "high-risk" for future cardiovascular events. PMID:14567760

Pitsavos, Christos; Panagiotakos, Demosthenes B; Chrysohoou, Christina; Stefanadis, Christodoulos

2003-01-01

386

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. PMID:25285020

Weber, Katelynn E; Fischl, Andrea FR; Murray, Pamela J; Conway, Baqiyyah N

2014-01-01

387

Prevalence of Cardiovascular Risk Factors in Hemodialysis Patients - The CORDIAL Study  

PubMed Central

Background There are scarce epidemiological data on cardiovascular risk profile of chronic hemodialysis patients in Brazil. Objective The CORDIAL study was designed to evaluate cardiovascular risk factors and follow up a hemodialysis population in a Brazilian metropolitan city. Methods All patients undergoing regular hemodialysis for chronic renal failure in all fifteen nephrology centers of Porto Alegre were considered for inclusion in the baseline phase of the CORDIAL study. Clinical, laboratory and demographic data were obtained in medical records and in structured individual interviews performed in all patients by trained researchers. Results A total of 1215 patients were included (97.3% of all hemodialysis patients in the city of Porto Alegre). Their average age was 58.3 years old, 59.5% were male and 62.8% were white. The prevalence of cardiovascular risk factors observed was 87.5% for hypertension, 84.7% for dyslipidemia, 73.1% for sedentary lifestyle, 53.7% for tobacco use, and 35.8% for diabetes. In a multivariate adjusted analysis, we found that sedentary lifestyle (p = 0.032, PR 1.08 - 95%CI: 1.01-1.15), dyslipidemia (p = 0.019, PR 1.08 - 95%CI: 1.01-1.14), and obesity (p < 0.001, PR 1.96 - 95%CI: 1.45-2.63) were more frequent in women; and hypertension (p = 0.018, PR 1.06 - 95%CI: 1.01-1.11) and tobacco use (p = 0.006, PR 2.7 - 95%CI: 1.79-4.17) were more often found among patients under 65 years old. Sedentary lifestyle was independently associated with time in dialysis less than 12 months (p < 0.001, PR 1.23 - 95% CI: 1.14-1.33). Conclusion Hemodialysis patients in this southern metropolitan Brazilian city have a high prevalence of cardiovascular risk factors resembling many northern countries. PMID:24759948

Burmeister, Jayme Eduardo; Mosmann, Camila Borges; Costa, Veridiana Borges; Saraiva, Ramiro Tubino; Grandi, Renata Rech; Bastos, Juliano Peixoto; Gonçalves, Luiz Felipe; Rosito, Guido Aranha

2014-01-01

388

Comparison of Dietary Risk Factors for Cardiovascular Disease in African-American and White Women  

Microsoft Academic Search

Objective To compare African-American and white women's knowledge, attitudes, and energy and nutrient intakes related to cardiovascular disease risk.Design The 1989 through 1991 Continuing Survey of Food Intakes by Individuals and the Diet and Health Knowledge Survey (DHKS).Subjects A nationally representative sample of 2,684 white and 449 African-American women who completed the DHKS and provided 3 days of dietary information.Statistical

GALL GATES; MARY McDONALD

1997-01-01

389

Dietary Monounsaturated Fatty Acids Are Protective Against Metabolic Syndrome and Cardiovascular Disease Risk Factors  

Microsoft Academic Search

Over 50 years of research has sought to define the role dietary fat plays in cardiovascular disease (CVD) risk. Although optimal\\u000a dietary fat quantity has been keenly pursued over past decades, attention has recently centered on the value of dietary fat\\u000a quality. The purpose of the present review is to provide a critical assessment of the current body of evidence surrounding

Leah G. Gillingham; Sydney Harris-Janz; Peter J. H. Jones

2011-01-01

390

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

391

Is adiposity at normal body weight relevant for cardiovascular disease risk?  

Microsoft Academic Search

OBJECTIVE: To examine the relation between adiposity and risk factors for cardiovascular disease (CVD) in normal weight (NW) individuals.METHODS: Cross-sectional study using the sample of white people, aged from 17 to 60 y from the Québec Family Study and the Heritage Family Study. NW subjects with a body mass index (BMI) between 18.5 and 25 kg\\/m2 (181 males and 265

S Tanaka; K Togashi; T Rankinen; L Pérusse; AS Leon; DC Rao; JS Skinner; JH Wilmore; C Bouchard; C Bouchard

2002-01-01

392

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

393

Cardiovascular Risk Profile and Type of Alcohol Beverage Consumption: A Population-Based Study  

Microsoft Academic Search

Aims: To determine the association between several cardiovascular risk factors with total alcohol and types of alcoholic beverage consumption. Methods: The subjects were Spanish men (n = 2,383) and women (n = 2,535) aged 25–74 years who were examined in 1994–1995 and 1999–2000, in two population-based cross-sectional surveys in the north-east of Spain (Gerona). Information of total amount and type

Helmut Schröder; Olivia Ferrández; Jordi Jimenez Conde; Jaume Marrugat

2005-01-01

394

When Are Type 1 Diabetic Patients at Risk for Cardiovascular Disease?  

Microsoft Academic Search

This discussion of increased cardiovascular risk in patients with type 1 diabetes reviews recent data concerning glycemia\\u000a and the role of glycemic control in type 1 diabetes, as well as observations of an association with haptoglobin genotype and\\u000a coronary artery disease events. This genetic predisposition also leads to oxidative damage and appears to be associated with\\u000a profound high-density lipoprotein dysfunction.

Trevor J. Orchard; Tina Costacou

2010-01-01

395

Major dietary patterns and cardiovascular risk factors among young Brazilian adults  

Microsoft Academic Search

Purpose  Diet is one of the most important modifiable risk factors for cardiovascular diseases. The scientific literature has consistently\\u000a shown the effects of certain diets on health; however, given the variety of cultures and dietary habits across the world,\\u000a it is likely that much remains to be learned about dietary patterns and health outcomes. We assessed the associations between\\u000a main dietary

Maria Teresa A. OlintoDenise; Denise P. Gigante; Bernardo Horta; Vera Silveira; Isabel Oliveira; Walter Willett

396

Prevalence of metabolic syndrome and cardiovascular risk level in a vulnerable population.  

PubMed

This study examined the prevalence of metabolic syndrome and the risk level of cardiovascular disease (CVD) in a vulnerable population of 407 subjects in Korea. This descriptive study was a part of the Tailed Health Visiting Service Program, using baseline data from public health centres in Suwon, Korea. The definition of metabolic syndrome was based on the National Cholesterol Education Program criteria, and risk of CVD was estimated according to the Framingham study equation. This study demonstrated that the prevalence of metabolic syndrome was 40.8% higher and the risk of CVD was significantly 3.1 times higher among those with metabolic syndrome than among those without it. Of those with metabolic syndrome, 50.6% overall and 81.1% of men had a high risk for CVD. These findings suggest a need to screen and prevent the risk of CVD in vulnerable populations with metabolic syndrome. PMID:24666551

Kim, Chun-Ja; Park, Jeewon; Kang, Se-Won

2014-03-26

397

Relation of Adiponectin to Glucose Tolerance Status, Adiposity, and Cardiovascular Risk Factor Load  

PubMed Central

Objective. Adiponectin has anti-atherogenic and anti-inflammatory properties. We investigated the influence of adiponectin on glucose tolerance status, adiposity and cardiovascular risk factors (CVRFs). Design and Patients. Study consisted of 107 subjects: 55 with normal glucose tolerance (NGT) and 52 with impaired glucose regulation (IGR) who were divided into two groups: 24 subjects with impaired fasting glucose (IFG Group) and 28 patients with type 2 diabetes mellitus (DM Group). In additional analysis, study participants were divided into two groups, according to CVRFs: low and high risk. Measurements: Patients were evaluated for glucose, HbA1C, insulin, lipids, CRP, HOMA-IR and adiponectin. Measurements. Patients were evaluated for glucose, HbA1C, insulin, lipids, CRP, HOMA-IR and adiponectin. Results. Adiponectin was significantly higher in NGT group than in IFG (P = 0.003) and DM (P = 0.01) groups. Adiponectin was significantly, positively associated with HDL and inversely associated with glucose, HbA1c, ALT, AST, TG, HOMA-IR. Patients with higher CVRFs load have lesser adiponectin compared to patients with low cardiovascular risk P < 0.0001). Adiponectin was inversely associated with the number of risk factors (r = ?0.430, P = 0.0001). Conclusions. Circulating adiponectin was significantly lower in subjects with different degree of IGR compared to subjects with normal glucose homeostasis. Adiponectin was significantly lower in high risk group than low risk group and decreased concurrently with increased number of CVRFs. PMID:22253614

Wolfson, N.; Gavish, D.; Matas, Z.; Boaz, M.; Shargorodsky, M.

2012-01-01

398

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

399

A Comparison of Cardiovascular Disease Risk Factor Biomarkers in African Americans and Yoruba Nigerians  

PubMed Central

Objective Classical risk factors for coronary artery disease are changing in the developing world while rates of cardiovascular disease are increasing in these populations. Newer risk factors have been identified for cardiovascular disease, but these have been rarely examined in elderly populations and not those of developing countries. Methods This study was a cross-sectional comparison from a longitudinal, observational, epidemiologic study in which participants are interviewed at three-year intervals. The sample included 1510 African Americans from Indianapolis, Indiana, and 1254 Yoruba from Ibadan, Nigeria. We compared anthropomorphic measurements; biomarkers of endothelial dysfunction (plasminogen activator inhibitor type 1 [PAI-1] and E-selectin), inflammation (C-reactive protein), and lipid oxidation (8-isoprostane); and levels of lipids, homocysteine, folate, and vitamin B12. Results Cholesterol, triglycerides, and low-density lipoprotein cholesterol levels were higher in African Americans. For markers of endothelial dysfunction, E-selectin and homocysteine differed between men, and PAI-1 was higher in the Yoruba. C-reactive protein differed only in women, but 8-isoprostane was higher in the Yoruba. Conclusion Higher lipid levels in African Americans are consistent with their Western diet and lifestyle. Oxidative stress appears to be higher in the Yoruba than in African Americans, which may be secondary to dietary differences. Whether these differences in classical and emerging risk factors account for the different rates of cardiovascular disease, dementia, or other morbidities in these two populations remains to be determined. PMID:19157246

Deeg, M.; Baiyewu, O.; Gao, S.; Ogunniyi, A.; Shen, J.; Gureje, O.; Taylor, S.; Murrell, J.; Unverzagt, F.; Smith-Gamble, V.; Evans, R.; Dickens, J.; Hendrie, H.; Hall, K.

2009-01-01

400

Lipid Metabolism and Cardiovascular Risk in HIV-1 Infection and HAART: Present and Future Problems  

PubMed Central

Many infections favor or are directly implicated with lipid metabolism perturbations and/or increased risk of coronary heart disease (CHD). HIV itself has been shown to increase lipogenesis in the liver and to alter the lipid profile, while the presence of unsafe habits, addiction, comorbidities, and AIDS-related diseases increases substantially the risk of cardiovascular disease (CVD) in the HIV-infected population. Antiretroviral therapy reduces such stimuli but many drugs have intrinsic toxicity profiles impacting on metabolism or potential direct cardiotoxicity. In a moment when the main guidelines of HIV therapy are predating the point when to start treating, we mean to highlight the contribution of HIV-1 to lipid alteration and inflammation, the impact of antiretroviral therapy, the decisions on what drugs to use to reduce the probability of having a cardiovascular event, the increasing use of statins and fibrates in HIV-1 infected subjects, and finally the switch strategies, that balance effectiveness and toxicity to move the decision to change HIV drugs. Early treatment might reduce the negative effect of HIV on overall cardiovascular risk but may also evidence the impact of drugs, and the final balance (reduction or increase in CHD and lipid abnormalities) is not known up to date. PMID:21490912

Melzi, Sara; Carenzi, Laura; Cossu, Maria Vittoria; Passerini, Simone; Capetti, Amedeo; Rizzardini, Giuliano

2010-01-01