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  1. Chronic kidney disease increases cardiovascular unfavourable outcomes in outpatients with heart failure

    PubMed Central

    2009-01-01

    Background Chronic heart failure (CHF) has a high morbidity and mortality. Chronic kidney disease (CKD) has consistently been found to be an independent risk factor for unfavorable cardiovascular (CV) outcomes. Early intervention on CKD reduces the progression of CHF, hospitalizations and mortality, yet there are very few studies about CKD as a risk factor in the early stages of CHF. The aims of our study were to assess the prevalence and the prognostic importance of CKD in patients with systolic CHF stages B and C. Methods This is a prospective cohort study, dealing with prognostic markers for CV endpoints in patients with systolic CHF (ejection fraction ≤ 45%). Results CKD was defined as estimated glomerular filtration rate <60 mL/min/1.73 m2 and CV endpoints as death or hospitalization due to CHF, in 12 months follow-up. Eighty three patients were studied, the mean age was 62.7 ± 12 years, and 56.6% were female. CKD was diagnosed in 49.4% of the patients, 33% of patients with CHF stage B and 67% in the stage C. Cardiovascular endpoints were observed in 26.5% of the patients. When the sample was stratified into stages B and C of CHF, the occurrence of CKD was associated with 100% and 64.7%, respectively, of unfavorable CV outcomes. After adjustments for all other prognostic factors at baseline, it was observed that the diagnosis of CKD increased in 3.6 times the possibility of CV outcomes (CI 95% 1.04-12.67, p = 0.04), whereas higher ejection fraction (R = 0.925, IC 95% 0.862-0.942, p = 0.03) and serum sodium (R = 0.807, IC 95% 0.862-0.992, p = 0.03) were protective. Conclusion In this cohort of patients with CHF stages B and C, CKD was prevalent and independently associated with increased risk of hospitalization and death secondary to cardiac decompensation, especially in asymptomatic patients. PMID:19843342

  2. Enhanced complement activation is part of the unfavourable cardiovascular risk profile in South Asians

    PubMed Central

    Siezenga, M A; Chandie Shaw, P K; van der Geest, R N; Mollnes, T E; Daha, M R; Rabelink, T J; Berger, S P

    2009-01-01

    South Asian immigrants in western societies exhibit a high burden of diabetes and subsequent vascular complications. Diabetic vascular complications are associated with vascular inflammation. We hypothesize that enhanced complement activation is involved. Therefore, levels of complement C3 and SC5b-9 – the soluble end product of complement activation – in a group of 200 South Asians were compared with an age- and sex-matched control group of native Caucasians. In addition, the association between complement levels and albuminuria, an indicator of renal damage and a cardiovascular risk marker, was assessed in the diabetic South Asian group. Compared with native Caucasians, South Asians had significantly higher levels of both serum C3 and plasma SC5b-9, even when only non-diabetic South Asians were considered. Diabetic South Asians had significantly higher C3 levels compared with non-diabetic South Asians. In diabetic South Asians, higher levels of SC5b-9 were associated with an increased prevalence of albuminuria (odds ratio 5·4, 95% confidence interval 1·8–15·8). These results suggest that enhanced complement activation is part of the unfavourable cardiovascular risk profile in South Asians. PMID:19659775

  3. Unfavourable results in hypospadias

    PubMed Central

    Agrawal, Karoon; Misra, Anshumali

    2013-01-01

    Hypospadias urethroplasty is considered difficult as the complications and unfavourable results are not uncommon. At the turn of the century, due to a better understanding of applied anatomy of hypospadias, new techniques were developed which significantly brought down the complication rate. However unfavourable results are still disturbing. An algorithm for selection of surgery has been presented. Forty three secondary surgeries were performed over 3 years for correction of unfavourable results. The urethrocutaneous fistula was the most common (21%) followed by meatal stenosis (14%) and narrow neourethra (14%). Common unfavourable results have been discussed. On the basis of experience with a large number of hypospadias urethroplasty ‘tips to avoid or minimise unfavourable results’ have been presented. However, one should assess the final outcome of urethroplasty using hypospadias objective scoring evaluation. PMID:24501477

  4. Unfavourable results in pollicisation

    PubMed Central

    Thatte, Mukund R.; Nehete, Sushil; Garude, Kirti; Mehta, Rujuta

    2013-01-01

    Pollicisation of the index finger is perhaps one of the most complex and most rewarding operations in hand and plastic surgery. It however has a steep learning curve and demands very high skill levels and experience. There are multiple pitfalls and each can result in an unfavourable result. In essence we need to: Shorten the Index, recreate the carpo metacarpal joint from the metacarpo phalangeal (MP) joint, rotate the digit by about 120° for pulp to pulp pinch, palmarly abduct by 40-50° to get a new first web gap, Shorten and readjust the tension of the extensors, re attach the intrinsics to form a thenar eminence capable of positioning the new thumb in various functional positions and finally close the flaps forming a new skin envelope. The author has performed over 75 pollicisations personally and has personal experience of some of the issues raised there. The steps mentioned therefore are an algorithm for helping the uninitiated into these choppy waters. PMID:24501467

  5. Increased cardiovascular mortality following early bilateral oophorectomy

    PubMed Central

    Rivera, Cathleen M.; Grossardt, Brandon R.; Rhodes, Deborah J.; Brown, Robert D.; Roger, Véronique L.; Melton, L. Joseph; Rocca, Walter A.

    2008-01-01

    Objective To investigate the mortality associated with cardiovascular diseases and the effect of estrogen treatment in women who underwent unilateral or bilateral oophorectomy before menopause. Design We conducted a cohort study with long-term follow-up of women in Olmsted County, MN, who underwent either unilateral or bilateral oophorectomy before the onset of menopause from 1950 through 1987. Each member of the oophorectomy cohort was matched by age to a referent woman from the same population who had not undergone any oophorectomy. We studied the mortality associated with cardiovascular disease in a total of 1,274 women with unilateral oophorectomy, 1,091 women with bilateral oophorectomy, and 2,383 referent women. Results Women who underwent unilateral oophorectomy experienced a reduced mortality associated with cardiovascular disease compared with referent women (hazard ratio [HR], 0.82; 95% confidence interval [CI], 0.67–0.99; P = 0.04). By contrast, women who underwent bilateral oophorectomy before age 45 years experienced an increased mortality associated with cardiovascular disease compared with referent women (HR, 1.44; 95% CI, 1.01–2.05; P = 0.04). Within this age stratum, the HR for mortality was significantly elevated in women who were not treated with estrogen through age 45 years or longer (HR, 1.84; 95% CI, 1.27–2.68; P = 0.001) but not in women treated (HR, 0.65; 95% CI, 0.30–1.41; P = 0.28; test of interaction, P = 0.01). Mortality was further increased after excluding deaths associated with cerebrovascular causes. Conclusions Bilateral oophorectomy performed before age 45 years is associated with increased cardiovascular mortality, especially with cardiac mortality. However, estrogen treatment may reduce this risk. PMID:19034050

  6. Mechanisms by which diabetes increases cardiovascular disease

    PubMed Central

    Gleissner, Christian A.; Galkina, Elena; Nadler, Jerry L.; Ley, Klaus

    2008-01-01

    Diabetes mellitus is one of the major risk factors for cardiovascular disease which is the leading cause of death in the U.S. Increasing prevalence of diabetes and diabetic atherosclerosis makes identification of molecular mechanisms by which diabetes promotes atherogenesis an important task. Targeting common pathways may ameliorate both diseases. This review focuses on well known as well as newly discovered mechanisms which may represent promising therapeutic targets. PMID:18695749

  7. Unfavourable outcomes in orthognathic surgery

    PubMed Central

    Bonanthaya, Krishnamurthy; Anantanarayanan, P.

    2013-01-01

    Unfavourable outcomes are part and parcel of performing surgeries of any kind. Unfavourable outcomes are results of such work, which the patient and or the clinician does not like. This is an attempt to review various causes for unfavorable outcomes in orthognathic surgery and discuss them in detail. All causes for unfavorable outcomes may be classified as belonging to one of the following periods A) Pre- Treatment B) During treatment Pre-Treatment: In orthognathic surgery- as in any other discipline of surgery- which involves changes in both aesthetics and function, the patient motivation for seeking treatment is a very important input which may decide, whether the outcome is going to be favorable or not. Also, inputs in diagnosis and plan for treatment and its sequencing, involving the team of the surgeon and the orthodontist, will play a very important role in determining whether the outcome will be favorable. In other words, an unfavorable outcome may be predetermined even before the actual treatment process starts. During Treatment: Good treatment planning itself does not guarantee favorable results. The execution of the correct plan could go wrong at various stages which include, Pre-Surgical orthodontics, Intra and Post-Operative periods. A large number of these unfavorable outcomes are preventable, if attention is paid to detail while carrying out the treatment plan itself. Unfavorable outcomes in orthognathic surgery may be minimized If pitfalls are avoided both, at the time of treatment planning and execution. PMID:24501454

  8. Shipping emissions associated with increased cardiovascular hospitalizations

    NASA Astrophysics Data System (ADS)

    Tian, Linwei; Ho, Kin-fai; Louie, Peter K. K.; Qiu, Hong; Pun, Vivian C.; Kan, Haidong; Yu, Ignatius T. S.; Wong, Tze Wai

    2013-08-01

    Previous studies have suggested nickel (Ni) and vanadium (V) as the likely constituents that are partially responsible for health effects associated with particulate matter pollution. The authors aimed to examine the effects of Ni and V in PM10, the indices of shipping emissions, on emergency hospitalizations for cardiovascular diseases (CVD) in Hong Kong. Daily PM10 speciation data across six monitoring stations in Hong Kong during 1998-2007 were collected. Generalized additive Poisson models with single-day lags were used to estimate the excess risks of emergency hospital admissions for CVD associated with Ni and V, after adjusted for major PM10 chemical species and criteria gaseous pollutants. The excess risks for inter-quartile range (IQR) increases of Ni and V on the same day and previous six days (lag0 ˜ lag6) were estimated. Ni in PM10 was associated with a 1.25% (95%CI: 0.81-1.68%) increase of total emergency CVD admissions on the same day, while lag0 V was associated with a 0.95% (95%CI: 0.55-1.35%) elevated CVD admissions. The associations were not sensitive to the further adjustment for co-pollutants. Ni appeared to correspond better than V to cardiovascular health. Controlling shipping emissions from residual oil combustion in the port cities like Hong Kong is particularly important.

  9. Unfavourable results in thumb reconstruction

    PubMed Central

    Kumta, Samir M.

    2013-01-01

    The history of thumb reconstruction parallels the history of hand surgery. The attributes that make the thumb unique, and that the reconstructive surgeon must assess and try to restore when reconstructing a thumb, are: Position, stability, strength, length, motion, sensibility and appearance. Deficiency in any of these attributes can reduce the utility of the reconstructed thumb. A detailed assessment of the patient and his requirements needs to be performed before embarking on a thumb reconstruction. Most unsatisfactory results can be attributed to wrong choice of procedure. Component defects of the thumb are commonly treated by tissue from adjacent fingers, hand or forearm. With refinements in microsurgery, the foot has become a major source of tissue for component replacement in the thumb. Bone lengthening, osteoplastic reconstruction, pollicisation, and toe to hand transfers are the commonest methods of thumb reconstruction. Unfavourable results can be classified as functional and aesthetic. Some are common to all types of procedures. However each type of reconstruction has its own unique set of problems. Meticulous planning and execution is essential to give an aesthetic and functionally useful thumb. Secondary surgeries like tendon transfers, bone grafting, debulking, arthrodesis, may be required to correct deficiencies in the reconstruction. Attention needs to be paid to the donor site as well. PMID:24501466

  10. Avoiding unfavourable outcomes in liposuction.

    PubMed

    Khanna, Atul; Filobbos, George

    2013-05-01

    The origin of liposuction can be traced to an adverse event by Dujarrier in 1921 when he used a uterine curette to remove fat from the knees of a ballerina ending in an amputation secondary to damage of the femoral artery. The history of liposuction since then has been one of avoiding complications and optimising outcome. After this adverse event, liposuction was abandoned until the 1960's when Schrudde revived the practice using small stab incisions and sharp curettage with the secondary suction to aspirate the freed tissue. This technique was associated with a high incidence of complications especially seroma and skin necrosis. Illouz then replaced the curette with a blunt cannula connected to vacuum pump thus avoiding the complications of a sharp curette. Despite the presence of various techniques for liposuction, suction assisted liposuction (SAL) is still the standard technique of liposuction. This article aims to discuss literature regarding the various aspects of liposuction (SAL) and to highlight the salient points in the literature and in the senior author's experience in order to avoid unfavourable outcomes in liposuction. A literature review on avoiding complication is in liposuction including some of the seminal papers on liposuction. Liposuction is generally a safe procedure with reproducible outcome. Just like any surgical procedure it should be treated with the utmost care. Illouz published 10 commandments for liposuction in 1989 and we review these commandments to demonstrate how liposuction has evolved.

  11. Avoiding unfavourable outcomes in liposuction

    PubMed Central

    Khanna, Atul; Filobbos, George

    2013-01-01

    The origin of liposuction can be traced to an adverse event by Dujarrier in 1921 when he used a uterine curette to remove fat from the knees of a ballerina ending in an amputation secondary to damage of the femoral artery. The history of liposuction since then has been one of avoiding complications and optimising outcome. After this adverse event, liposuction was abandoned until the 1960's when Schrudde revived the practice using small stab incisions and sharp curettage with the secondary suction to aspirate the freed tissue. This technique was associated with a high incidence of complications especially seroma and skin necrosis. Illouz then replaced the curette with a blunt cannula connected to vacuum pump thus avoiding the complications of a sharp curette. Despite the presence of various techniques for liposuction, suction assisted liposuction (SAL) is still the standard technique of liposuction. This article aims to discuss literature regarding the various aspects of liposuction (SAL) and to highlight the salient points in the literature and in the senior author's experience in order to avoid unfavourable outcomes in liposuction. A literature review on avoiding complication is in liposuction including some of the seminal papers on liposuction. Liposuction is generally a safe procedure with reproducible outcome. Just like any surgical procedure it should be treated with the utmost care. Illouz published 10 commandments for liposuction in 1989 and we review these commandments to demonstrate how liposuction has evolved. PMID:24501475

  12. [Ankylosing spondylitis is associated with increased cardiovascular morbidity and mortality].

    PubMed

    Madsen, Ole Rintek; Lindhardsen, Jesper

    2011-05-23

    Ankylosing spondylitis is an inflammatory disorder primarily affecting the axial skeleton. The disease is associated with increased cardiovascular morbidity and mortality. Structural changes in the heart, and arteriosclerosis secondary to inflammation may be of importance. The role of traditional cardiovascular risk factors and of anti-inflammatory treatment is unclear. Tumor necrosis factor inhibitors seem to increase cholesterol levels. Evaluation of the cardiovascular risk in these patients should be considered. Cardiovascular risk factors should be managed according to ordinary guidelines.

  13. Unfavourable results with distraction in craniofacial skeleton

    PubMed Central

    Agarwal, Rajiv

    2013-01-01

    Distraction osteogenesis has revolutionised the management of craniofacial abnormalities. The technique however requires precise planning, patient selection, execution and follow-up to achieve consistent and positive results and to avoid unfavourable results. The unfavourable results with craniofacial distraction stem from many factors ranging from improper patient selection, planning and use of inappropriate distraction device and vector. The present study analyses the current standards and techniques of distraction and details in depth the various errors and complications that may occur due to this technique. The commonly observed complications of distraction have been detailed along with measures and suggestions to avoid them in clinical practice. PMID:24501455

  14. Unfavourable outcomes of liposuction and their management

    PubMed Central

    Dixit, Varun V.; Wagh, Milind S.

    2013-01-01

    Liposuction is one of the most popular cosmetic surgery procedures currently performed by plastic surgeons around the world. It must be clear at the outset that liposuction is not primarily a modality for weight loss, it is meant to be a body contouring procedure and therefore the inherent limitations and safety issues related to this must always be respected if complications and unfavourable results are to be avoided as far as possible. PMID:24501474

  15. Cannabis use: signal of increasing risk of serious cardiovascular disorders.

    PubMed

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

    2014-04-23

    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. 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. 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.

  16. Nocturnal indicators of increased cardiovascular risk in depressed adolescent girls.

    PubMed

    Waloszek, Joanna M; Woods, Michael J; Byrne, Michelle L; Nicholas, Christian L; Bei, Bei; Murray, Greg; Raniti, Monika; Allen, Nicholas B; Trinder, John

    2016-04-01

    Depression is an independent risk factor for cardiovascular disease in adults, and recent literature suggests preclinical signs of cardiovascular risk are also present in depressed adolescents. No study has examined the effect of clinical depression on cardiovascular factors during sleep. This study examined the relationship between clinical depression and nocturnal indicators of cardiovascular risk in depressed adolescent girls from the general community (13-18 years old; 11 clinically depressed, eight healthy control). Continuous beat-to-beat finger arterial blood pressure and heart rate were monitored via Portapres and electrocardiogram, respectively. Cardiovascular data were averaged over each hour for the first 6 h of sleep, as well as in 2-min epochs of stable sleep that were then averaged within sleep stages. Data were also averaged across 2-min epochs of pre-sleep wakefulness and the first 5 min of continuous non-rapid eye movement sleep to investigate the blood pressure dipping response over the sleep-onset period. Compared with controls, depressed adolescents displayed a similar but significantly elevated blood pressure profile across sleep. Depressed adolescents had significantly higher systolic and diastolic blood pressure and mean arterial pressures across the entire night (P < 0.01), as well as during all sleep stages (P < 0.001). Depressed adolescents also had higher blood pressure across the sleep-onset period, but the groups did not differ in the rate of decline across the period. Higher blood pressure during sleep in depressed adolescent females suggests that depression has a significant association with cardiovascular functioning during sleep in adolescent females, which may increase risk for future cardiovascular pathology. © 2015 European Sleep Research Society.

  17. [New populations at increased cardiovascular risk: Cardiovascular disease in dermatological diseases].

    PubMed

    Godoy-Gijón, Elena; Meseguer-Yebra, Carmen; Palacio-Aller, Lucía; Godoy-Rocati, Diego Vicente; Lahoz-Rallo, Carlos

    2016-01-01

    The increased cardiovascular risk in some dermatological diseases has been demonstrated in recent decades. Diseases such as psoriasis and systemic lupus erythematosus are currently included in the guidelines for prevention of cardiovascular disease. Other diseases such as androgenic alopecia, polycystic ovary syndrome, hidradenitis suppurativa or lichen planus have numerous studies that point to an increased risk, however, they have not been included in these guidelines. In this article we review the evidence supporting this association, in order to alert the clinician to the need for greater control in cardiovascular risk factors in these patients. Copyright © 2015 Sociedad Española de Arteriosclerosis. Published by Elsevier España. All rights reserved.

  18. Cannabis Use: Signal of Increasing Risk of Serious Cardiovascular Disorders

    PubMed Central

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

    2014-01-01

    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

  19. Uric acid increases erythrocyte aggregation: Implications for cardiovascular disease.

    PubMed

    Sloop, Gregory D; Bialczak, Jessica K; Weidman, Joseph J; St Cyr, J A

    2016-10-05

    Uric acid may be a risk factor for atherosclerotic cardiovascular disease, although the data conflict and the mechanism by which it may cause cardiovascular disease is uncertain. This study was performed to test the hypothesis that uric acid, an anion at physiologic pH, can cause erythrocyte aggregation, which itself is associated with cardiovascular disease. Normal erythrocytes and erythrocytes with a positive direct antiglobulin test for surface IgG were incubated for 15 minutes in 14.8 mg/dL uric acid. Erythrocytes without added uric acid were used as controls. Erythrocytes were then examined microscopically for aggregation. Aggregates of up to 30 erythrocytes were noted when normal erythrocytes were incubated in uric acid. Larger aggregates were noted when erythrocytes with surface IgG were incubated in uric acid. Aggregation was negligible in controls. These data show that uric acid causes erythrocyte aggregation. The most likely mechanism is decreased erythrocyte zeta potential. Erythrocyte aggregates will increase blood viscosity at low shear rates and increase the risk of atherothrombosis. In this manner, hyperuricemia and decreased zeta potential may be risk factors for atherosclerotic cardiovascular disease.

  20. Circadian misalignment increases cardiovascular disease risk factors in humans.

    PubMed

    Morris, Christopher J; Purvis, Taylor E; Hu, Kun; Scheer, Frank A J L

    2016-03-08

    Shift work is a risk factor for hypertension, inflammation, and cardiovascular disease. This increased risk cannot be fully explained by classic risk factors. One of the key features of shift workers is that their behavioral and environmental cycles are typically misaligned relative to their endogenous circadian system. However, there is little information on the impact of acute circadian misalignment on cardiovascular disease risk in humans. Here we show-by using two 8-d laboratory protocols-that short-term circadian misalignment (12-h inverted behavioral and environmental cycles for three days) adversely affects cardiovascular risk factors in healthy adults. Circadian misalignment increased 24-h systolic blood pressure (SBP) and diastolic blood pressure (DBP) by 3.0 mmHg and 1.5 mmHg, respectively. These results were primarily explained by an increase in blood pressure during sleep opportunities (SBP, +5.6 mmHg; DBP, +1.9 mmHg) and, to a lesser extent, by raised blood pressure during wake periods (SBP, +1.6 mmHg; DBP, +1.4 mmHg). Circadian misalignment decreased wake cardiac vagal modulation by 8-15%, as determined by heart rate variability analysis, and decreased 24-h urinary epinephrine excretion rate by 7%, without a significant effect on 24-h urinary norepinephrine excretion rate. Circadian misalignment increased 24-h serum interleukin-6, C-reactive protein, resistin, and tumor necrosis factor-α levels by 3-29%. We demonstrate that circadian misalignment per se increases blood pressure and inflammatory markers. Our findings may help explain why shift work increases hypertension, inflammation, and cardiovascular disease risk.

  1. Circadian misalignment increases cardiovascular disease risk factors in humans

    PubMed Central

    Morris, Christopher J.; Purvis, Taylor E.; Hu, Kun; Scheer, Frank A. J. L.

    2016-01-01

    Shift work is a risk factor for hypertension, inflammation, and cardiovascular disease. This increased risk cannot be fully explained by classic risk factors. One of the key features of shift workers is that their behavioral and environmental cycles are typically misaligned relative to their endogenous circadian system. However, there is little information on the impact of acute circadian misalignment on cardiovascular disease risk in humans. Here we show—by using two 8-d laboratory protocols—that short-term circadian misalignment (12-h inverted behavioral and environmental cycles for three days) adversely affects cardiovascular risk factors in healthy adults. Circadian misalignment increased 24-h systolic blood pressure (SBP) and diastolic blood pressure (DBP) by 3.0 mmHg and 1.5 mmHg, respectively. These results were primarily explained by an increase in blood pressure during sleep opportunities (SBP, +5.6 mmHg; DBP, +1.9 mmHg) and, to a lesser extent, by raised blood pressure during wake periods (SBP, +1.6 mmHg; DBP, +1.4 mmHg). Circadian misalignment decreased wake cardiac vagal modulation by 8–15%, as determined by heart rate variability analysis, and decreased 24-h urinary epinephrine excretion rate by 7%, without a significant effect on 24-h urinary norepinephrine excretion rate. Circadian misalignment increased 24-h serum interleukin-6, C-reactive protein, resistin, and tumor necrosis factor-α levels by 3–29%. We demonstrate that circadian misalignment per se increases blood pressure and inflammatory markers. Our findings may help explain why shift work increases hypertension, inflammation, and cardiovascular disease risk. PMID:26858430

  2. [Importance of increased physical activity in ambulatory cardiovascular prevention].

    PubMed

    Huonker, M; Halle, M; Frey, I; Schmidt-Trucksäss, A; Sorichter, S; Keul, J; Berg, A

    1998-11-01

    Current trends in public health provided potential arguments to, first, intensify the recommendations of a physically active lifestyle in the primary prevention of atherosclerosis and, second, to prescribe a supervised outpatient exercise training program for secondary prevention of cardiovascular diseases. Regular physical exercise may positively influence cardiovascular risk factors (overweight, hypertension, hyperlipoproteinaemia, insulin resistance, hemostatic markers). Physical conditioning modifies the body composition in favor of an increased skeletal muscle mass, changes the eating habits, and other life style characteristics. The dietary modifications characterized by a low-fat, more vegetarian food supports the weight control and the adjustment of the other metabolic risk factors. All these changes are suitable to reduce the manifestation of atherosclerosis and to minimize the risk of an acute thromboembolic arterial occlusion. Physical conditioning on one's own initiative in primary prevention or an exercise training program supervised by health professionals in secondary prevention of atherosclerosis should predominantly include a low intensive aerobic endurance exercise training. Lactate concentration in capillary blood can be measured to objectify and regulate exercise intensity. The additional energy turnover should amount to a minimum of 1,000 kcal and a maximum of 3,500 kcal weekly. This energy expenditure could be realized either with an increased physical activity level in daily routine (e.g., stair climbing, go for a walk, gardening) or by a regular leisure-time physical exercise. A turnover of 300 kcal per session should be prescribed. In long-term clinical trials investigating the benefit of primary and secondary cardiovascular prevention a reduction of the cardiovascular mortality of about 20-30% has been demonstrated.

  3. Determinants of increased cardiovascular disease in obesity and metabolic syndrome.

    PubMed

    Vazzana, N; Santilli, F; Sestili, S; Cuccurullo, C; Davi, G

    2011-01-01

    Obesity is associated with an increased mortality and morbidity for cardiovascular disease (CVD) and adipose tissue is recognised as an important player in obesity-mediated CVD. The diagnosis of the metabolic syndrome (MS) appears to identify substantial additional cardiovascular risk above and beyond the individual risk factors, even though the pathophysiology underlying this evidence is still unravelled. The inflammatory response related to fat accumulation may influence cardiovascular risk through its involvement not only in body weight homeostasis, but also in coagulation, fibrinolysis, endothelial dysfunction, insulin resistance (IR) and atherosclerosis. Moreover, there is evidence that oxidative stress may be a mechanistic link between several components of MS and CVD, through its role in inflammation and its ability to disrupt insulin-signaling. The cross-talk between impaired insulin-signaling and inflammatory pathways enhances both metabolic IR and endothelial dysfunction, which synergize to predispose to CVD. Persistent platelet hyperreactivity/activation emerges as the final pathway driven by intertwined interactions among IR, adipokine release, inflammation, dyslipidemia and oxidative stress and provides a pathophysiological explanation for the excess risk of atherothrombosis in this setting. Despite the availability of multiple interventions to counteract these metabolic changes, including appropriate diet, regular exercise, antiobesity drugs and bariatric surgery, relative failure to control the incidence of MS and its complications reflects both the multifactorial nature of these diseases as well as the scarce compliance of patients to established strategies. Evaluation of the impact of these therapeutic strategies on the pathobiology of atherothrombosis, as discussed in this review, will translate into an optimized approach for cardiovascular prevention.

  4. Tissue expansion: Concepts, techniques and unfavourable results

    PubMed Central

    Wagh, Milind S.; Dixit, Varun

    2013-01-01

    The phenomenon of tissue expansion is observed in nature all the time. The same properties of the human skin to stretch and expand and yield extra skin if placed under continuous stress over a prolonged period of time has been utilised for reconstructive purposes with the help of a silicon balloon inserted under the skin and progressively filled with saline. The technique of tissue expansion is now more than three decades old and has been a value addition to our armamentarium in reconstructive surgery in all parts of the body. However, it still requires careful patient selection, meticulous planning and faultless execution to successfully carry out the process, which usually lasts for more than 8-12 weeks and involves two sittings of surgery. Any compromise in this process can lead to unfavourable results and complications, some minor, which allow continuance of the process to attain the expected goal and others major, which force abandonment of the process without reaching the expected goal. This article seeks to highlight the intricacies of the concept of tissue expansion, the technique related to flawless execution of the process and likely complications with emphasis on their management. We also present our results from a personal series of 138 patients operated over a period of 18 years between 1994 and 2012. PMID:24501470

  5. Masked first name priming increases effort-related cardiovascular reactivity.

    PubMed

    Silvia, Paul J; Jones, Hannah C; Kelly, Casey S; Zibaie, Alireza

    2011-06-01

    Recent research on motivational intensity has shown that explicit manipulations of self-focused attention (e.g., mirrors and video cameras) increase effort-related cardiovascular responses during active coping. An experiment examined whether masked first name priming, an implicit manipulation of self-focused attention, had similar effects. Participants (n=52 young adults) performed a self-paced cognitive task, in which they were told to get as many trials correct as possible within 5min. During the task, the participant's first name was primed for 0%, 33%, 67%, or 100% of the trials. First name priming, regardless of its frequency, significantly increased cardiovascular reactivity, particularly systolic blood pressure (SBP) reactivity. Furthermore, the priming manipulation interacted with individual differences in trait self-focus: trait self-focus predicted higher SBP reactivity in the 0% condition, but first name priming eliminated the effects of individual differences. Implications for self-awareness research and for the emerging interest in priming effects on effort are considered.

  6. [Calcium supplementation and the possible increase in cardiovascular risk].

    PubMed

    Montero Sáez, Abelardo; Formiga, Francesc; Pujol Farriols, Ramón

    2013-01-01

    The primary goal of osteoporosis treatment is to prevent the occurrence of fragility fractures, and thereby reduce morbidity and mortality. Among the various approaches to the treatment of this disease include ensuring proper calcium intake and to obtain adequate levels of vitamin D. Virtually all clinical trials with drugs used to treat osteoporosis systematically include calcium and vitamin D supplements. In light of the recent publication of clinical trials and meta-analyses, a possible increase in cardiovascular risk, particularly in the form of a myocrdial infarction, is hypothesised in patients taking calcium supplements. However, data published to date are inconclusive. Until the development of new scientific evidence, it seems reasonable to recommend, whenever practicable and individualized for each patient, increasing calcium intake with food and reserve supplements for patients with very low calcium intake in the diet. It would also be advisable for the administration of total daily dose to be fractionated throughout the day and with meals, and to obtain appropriate levels of vitamin D (25-hydroxycholecalciferol or calcidiol), along with the basic treatment for osteoporosis that is decided to be prescribed to patients.

  7. Exercise Increases the Cardiovascular Stimulus Provided by Artificial Gravity

    NASA Technical Reports Server (NTRS)

    Howarth, M. S.; Moore, F. B.; Hinghofer-Szalkay, H.; Jezova, D.; Diedrich, A.; Ferris, M. B.; Schlegel, T. T.; Pathwardhan, A. R.; Knapp, C. F.; Evans, J. M.

    2008-01-01

    We investigated fluid shifts and regulatory responses to variations of posture, exercise, Gz level and radius of rotation in subjects riding NASA Ames 20G centrifuge. Results are from 4 protocols that address radius and exercise effects only. Protocol A: After 10 min supine control, 12 healthy men (35 plus or minus 9 yr, 82.8 plus or minus 7.9 kg) were exposed to rotational 1 Gz (2.5 m radius) for 2 min followed by 20 min alternating between 1 and 1.25 Gz. Blood samples were taken pre and post spin. Protocol B: Same as A, but lower limb exercise (70% V02max) preceded ramps to 1.25 Gz. Protocol C: Same as A but radius of rotation 8.3 m. Protocol D: Same as B but at 8.3 m. The 8 subjects who completed all protocols, increased heart rate (HR) from control, on average, by: A: 5, B: 39, C: 11, D: 44 bpm. For thoracic fluid volume, (bioimpedance), the 8 subjects changed from control, on average: A: -394, B: -548, C: -537, D: -708 mL. For thigh fluid volume, changes from control, on average, were: A: -137, B: 129, C: -75, D: 159 mL. Hematocrit changes from control were: A: 2.3, B: 3.5, C: 2.3, D: 4.3 %. Radius effects were mild and included greater loss of fluid from the thorax, less fluid loss from the thigh and increased heart rate at the longer radius. Pre-acceleration exercise effects were more dramatic and included additional loss of fluid from the chest, increased fluid volume of the thigh, increased hematocrit and greater heart rate increases. We propose that short bouts of intense exercise can be used to magnify the cardiovascular stress delivered by artificial gravity (AG) training and the combination of AG with exercise training can be fine-tuned to preserve orthostatic tolerance of astronauts during spaceflight.

  8. Exercise Increases the Cardiovascular Stimulus Provided by Artificial Gravity

    NASA Technical Reports Server (NTRS)

    Howarth, M. S.; Moore, F. B.; Hinghofer-Szalkay, H.; Jezova, D.; Diedrich, A.; Ferris, M. B.; Schlegel, T. T.; Pathwardhan, A. R.; Knapp, C. F.; Evans, J. M.

    2008-01-01

    We investigated fluid shifts and regulatory responses to variations of posture, exercise, Gz level and radius of rotation in subjects riding NASA Ames 20G centrifuge. Results are from 4 protocols that address radius and exercise effects only. Protocol A: After 10 min supine control, 12 healthy men (35 plus or minus 9 yr, 82.8 plus or minus 7.9 kg) were exposed to rotational 1 Gz (2.5 m radius) for 2 min followed by 20 min alternating between 1 and 1.25 Gz. Blood samples were taken pre and post spin. Protocol B: Same as A, but lower limb exercise (70% V02max) preceded ramps to 1.25 Gz. Protocol C: Same as A but radius of rotation 8.3 m. Protocol D: Same as B but at 8.3 m. The 8 subjects who completed all protocols, increased heart rate (HR) from control, on average, by: A: 5, B: 39, C: 11, D: 44 bpm. For thoracic fluid volume, (bioimpedance), the 8 subjects changed from control, on average: A: -394, B: -548, C: -537, D: -708 mL. For thigh fluid volume, changes from control, on average, were: A: -137, B: 129, C: -75, D: 159 mL. Hematocrit changes from control were: A: 2.3, B: 3.5, C: 2.3, D: 4.3 %. Radius effects were mild and included greater loss of fluid from the thorax, less fluid loss from the thigh and increased heart rate at the longer radius. Pre-acceleration exercise effects were more dramatic and included additional loss of fluid from the chest, increased fluid volume of the thigh, increased hematocrit and greater heart rate increases. We propose that short bouts of intense exercise can be used to magnify the cardiovascular stress delivered by artificial gravity (AG) training and the combination of AG with exercise training can be fine-tuned to preserve orthostatic tolerance of astronauts during spaceflight.

  9. Acrolein Exposure Is Associated With Increased Cardiovascular Disease Risk

    PubMed Central

    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

    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

  10. Cardiovascular risk may be increased in women with unexplained infertility

    PubMed Central

    Yildiz Zeyrek, Fadile; Zebitay, Ali Galip; Akyol, Hurkan

    2017-01-01

    Objective Growing evidence suggests that increased cardiovascular disease (CVD) risk is associated with female infertility caused by conditions such as polycystic ovarian disease, obesity, thyroid dysfunction, and endometriosis. The aim of this study was to evaluate whether any relationship exists between CVD and unexplained infertility. Methods Sixty-five women with unexplained infertility and 65 fertile controls were enrolled in the study. CVD risk markers such as low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC), triglycerides (TG), insulin resistance (defined by the homeostasis model assessment ratio), and high-sensitivity C-reactive protein (hs-CRP) were assessed. Results TG, TC, LDL, and hs-CRP levels were higher and HDL levels were lower in patients with unexplained infertility than in fertile controls (p<0.05 for all). Positive associations were found between unexplained infertility and TG, TC, LDL, and hs-CRP levels, and a negative correlation was found for HDL (p<0.05 for all). Multivariate logistic regression analysis showed that TG, HDL, and hs-CRP were independent variables associated with unexplained infertility. Conclusion Our study showed that women with unexplained infertility had an atherogenic lipid profile and elevated hs-CRP levels, suggesting a higher risk of developing CVD in the future. Further studies with larger groups are needed to investigate the nature of this link. PMID:28428941

  11. Cardiovascular risk may be increased in women with unexplained infertility.

    PubMed

    Verit, Fatma Ferda; Yildiz Zeyrek, Fadile; Zebitay, Ali Galip; Akyol, Hurkan

    2017-03-01

    Growing evidence suggests that increased cardiovascular disease (CVD) risk is associated with female infertility caused by conditions such as polycystic ovarian disease, obesity, thyroid dysfunction, and endometriosis. The aim of this study was to evaluate whether any relationship exists between CVD and unexplained infertility. Sixty-five women with unexplained infertility and 65 fertile controls were enrolled in the study. CVD risk markers such as low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC), triglycerides (TG), insulin resistance (defined by the homeostasis model assessment ratio), and high-sensitivity C-reactive protein (hs-CRP) were assessed. TG, TC, LDL, and hs-CRP levels were higher and HDL levels were lower in patients with unexplained infertility than in fertile controls (p<0.05 for all). Positive associations were found between unexplained infertility and TG, TC, LDL, and hs-CRP levels, and a negative correlation was found for HDL (p<0.05 for all). Multivariate logistic regression analysis showed that TG, HDL, and hs-CRP were independent variables associated with unexplained infertility. Our study showed that women with unexplained infertility had an atherogenic lipid profile and elevated hs-CRP levels, suggesting a higher risk of developing CVD in the future. Further studies with larger groups are needed to investigate the nature of this link.

  12. Experimental Fault Reactivation on Favourably and Unfavourably Oriented Faults

    NASA Astrophysics Data System (ADS)

    Mitchell, T. M.; Renner, J.; Sibson, R. H.

    2011-12-01

    In this study, we assess the loading of faults to failure under different stress regimes in a triaxial deformation apparatus, both in dry and saturated conditions. We explore experimentally the reshear of an existing fault in various orientations for particular values of (σ_1 - σ_3) and σ_3' for contrasting loading systems - load-strengthening (equivalent to a thrust fault) with σ1' increasing at constant σ_3', versus load-weakening (equivalent to a normal fault) with reducing σ_3' under constant σ_1'. Experiments are conducted on sawcut granite samples with fault angles at a variety of orientations relative to σ_1, ranging from an optimal orientation for reactivation to lockup angles where new faults are formed in preference to reactivating the existing sawcut orientation. Prefailure and postfailure behaviour is compared in terms of damage zone development via monitoring variations in ultrasonic velocity and acoustic emission behaviour. For example, damage surrounding unfavourably oriented faults is significantly higher than that seen around favourably orientated faults due to greater maximum stresses attained prior to unstable slip, which is reflected by the increased acoustic emission activity leading up to failure. In addition, we explore reshear conditions under an initial condition of (σ_1' = σ_3'), then inducing reshear on the existing fault first by increasing σ_1'(load-strengthening), then by decreasing σ_3' (load-weakening), again comparing relative damage zone development and acoustic emission levels. In saturated experiments, we explore the values of pore fluid pressure (P_f) needed for re-shear to occur in preference to the formation of a new fault. Typically a limiting factor in conventional triaxial experiments performed in compression is that P_f cannot exceed the confining pressure (σ_2 and σ_3). By employing a sample assembly that allows deformation while the loading piston is in extension, it enables us to achieve pore pressures in

  13. Women with cardiovascular disease have increased risk of osteoporotic fracture.

    PubMed

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

    2011-01-01

    This study investigated whether women with cardiovascular disease (CVD) would have an increased risk of fractures as osteoporosis and CVD share many common risk factors. From February 2006 to January 2007, 17,033 women aged ≥50 years (mean 71.8, range 50-106) were recruited by 1,248 primary care practitioners and interviewed by trained nurses. For each woman, 10-year probability of a future major osteoporotic fracture was estimated using the World Health Organization Fracture Risk Assessment Tool (FRAX). The study showed that the 10-year probability of a major osteoporotic fracture was higher for 6,219 CVD women compared to 10,814 non-CVD women after adjustment for age, BMI, current smoking, and alcohol use (adjusted geometric means 14.3 and 13.8%, respectively; P < 0.001). With regard to high risk of fracture (i.e., 10-year probability ≥ 20%), the adjusted odds ratio for CVD was 1.23 (95% CI 1.13-1.35, P < 0.001). However, compared to non-CVD women, CVD women were more likely to report a previous fracture, to have a secondary osteoporosis, and to use glucocorticoids. Among the 4,678 women who were classified as having a high fracture risk, current use rate of bone-related medications (i.e., any one of bisphosphonates, raloxifene, PTH, vitamin D, calcium, or hormone therapy) was 50.2% in the CVD group and 56.9% in the non-CVD group. Women with CVD were at increased risk of fracture partly due to bone-specific risk factors such as history of previous fracture, use of glucocorticoids, and secondary osteoporosis. This risk is not being treated appropriately by primary health physicians.

  14. Increased cardiovascular risk in South African patients with Addison's disease.

    PubMed

    Ross, I L; Bergthorsdottir, R; Levitt, N S; Schatz, D A; Johannsson, G; Marais, A D

    2013-11-01

    Patients with Addison's disease (AD) are believed to be at risk for cardiovascular disease (CVD). South Africa, like the rest of the developing world is experiencing an increase in CVD and patients with AD may be at double the risk of their peers. We wished to explore AD patients' CVD risk factors. A cross-sectional nationwide study in South Africa of patients with AD was conducted. A cohort of 147 patients with AD and 147 healthy control subjects were matched by age, gender, ethnicity, and BMI as far as was possible. Lipoproteins and highly-sensitive C-reactive-protein (hs-CRP) were the main outcome measures. AD patients had significantly higher triglycerides; (p=0.001), lower HDLC (p<0.001), higher hs-CRP (p<0.001), and more small dense LDL; (p=0.002) than controls. Nonesterified fatty acids were lower in patients (p<0.001). Approximately 65% [95% confidence interval (CI 55.6-72.4%)] had hypercholesterolaemia, 75% (CI 64.8-81.2%) had low HDLC, and 75% (CI 68.0-84.1%) had a higher LDLC. Thirteen percent of AD patients had diabetes mellitus, but none of the risk factors differed from the nondiabetics. Only HDLC correlated positively with daily hydrocortisone dose (r=0.32; p=0.005). In conclusion dyslipidaemia is common in South African AD patients; CVD risk assessment and intervention are probably warranted in the management of these patients. © Georg Thieme Verlag KG Stuttgart · New York.

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

    PubMed Central

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

    2013-01-01

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

  16. Increased cardiovascular risk associated with diabetes in Dallas County.

    PubMed

    Das, Sandeep R; Vaeth, Patrice A C; Stanek, Harold G; de Lemos, James A; Dobbins, Robert L; McGuire, Darren K

    2006-05-01

    Diabetes mellitus is a major public health problem in the United States. We assess the prevalence of diabetes in Dallas County, quantify the association between diabetes and subclinical cardiovascular disease, and assess the use of evidence-based cardiovascular disease risk-modifying therapies. This study uses data from 3392 participants aged 30 to 65 years from the Dallas Heart Study, a probability-based, multiethnic sample of residents living in Dallas County, Texas. Three primary outcomes were examined: (1) diabetes prevalence, (2) adjusted odds ratios for detectable coronary calcium stratified by diabetes diagnosis status, and (3) rates of use of evidence-based cardiovascular disease risk-modifying therapies among subjects with diabetes stratified by diabetes diagnosis status. The estimated prevalence of diabetes in Dallas County was 7.8%, with >40% of diabetic patients undiagnosed before participation in the Dallas Heart Study. Both previously diagnosed and previously undiagnosed diabetes were independently associated with the presence of coronary artery calcium (diagnosed: OR 3.55, 95% CI 1.56-8.05) (undiagnosed: OR 2.98, 95% CI 1.39-6.39). The rates of use of aspirin, angiotensin-converting enzyme inhibitors, and statins were suboptimal, and blood pressure and low-density lipoprotein cholesterol targets were rarely met, especially among subjects with previously undiagnosed diabetes. Diabetes is prevalent and is associated with subclinical cardiovascular disease; this association is present even at the time of diagnosis. Despite the cardiovascular risk associated with diabetes, evidence-based risk-modifying therapies continue to be underused, and therapeutic targets remain unmet, especially among people unaware of their diabetes diagnosis.

  17. Thoracic aorta calcification but not inflammation is associated with increased cardiovascular disease risk: results of the CAMONA study.

    PubMed

    Blomberg, Björn A; de Jong, Pim A; Thomassen, Anders; Lam, Marnix G E; Vach, Werner; Olsen, Michael H; Mali, Willem P T M; Narula, Jagat; Alavi, Abass; Høilund-Carlsen, Poul F

    2017-02-01

    Arterial inflammation and vascular calcification are regarded as early prognostic markers of cardiovascular disease (CVD). In this study we investigated the relationship between CVD risk and arterial inflammation ((18)F-FDG PET/CT imaging), vascular calcification metabolism (Na(18)F PET/CT imaging), and vascular calcium burden (CT imaging) of the thoracic aorta in a population at low CVD risk. Study participants underwent blood pressure measurements, blood analyses, and (18)F-FDG and Na(18)F PET/CT imaging. In addition, the 10-year risk for development of CVD, based on the Framingham risk score (FRS), was estimated. CVD risk was compared across quartiles of thoracic aorta (18)F-FDG uptake, Na(18)F uptake, and calcium burden on CT. A total of 139 subjects (52 % men, mean age 49 years, age range 21 - 75 years, median FRS 6 %) were evaluated. CVD risk was, on average, 3.7 times higher among subjects with thoracic aorta Na(18)F uptake in the highest quartile compared with those in the lowest quartile of the distribution (15.5 % vs. 4.2 %; P < 0.001). CVD risk was on average, 3.7 times higher among subjects with a thoracic aorta calcium burden on CT in the highest quartile compared with those in the lowest two quartiles of the distribution (18.0 % vs. 4.9 %; P < 0.001). CVD risk was similar in subjects in all quartiles of thoracic aorta (18)F-FDG uptake. Our findings indicate that an unfavourable CVD risk profile is associated with marked increases in vascular calcification metabolism and vascular calcium burden of the thoracic aorta, but not with arterial inflammation.

  18. Chronic vitamin C deficiency increases the risk of cardiovascular diseases.

    PubMed

    Ginter, E

    2007-01-01

    The studies on experimental animals (guinea pigs, monkeys, fish) have confirmed the important role of ascorbic acid deficiency in the development of hypercholesterolemia and atherosclerosis, but the clinical experience is not quite uniform. Metaanalyses of randomized controlled trials performed on subjects without established vitamin C-deficiency conclud that the evidence of the presence or absence of benefits derived from the ability of ascorbic acid to prevent cardiovascular diseases is not sufficient. This review is an outline of numerous clinical, epidemiological and prospective studies that have found a positive role of vitamin C in the prevention of atherosclerosis. If we admit the possibility that vitamin C deficiency is a significant risk factor of atherogenesis, due to ethical reasons it is impossible to perform long-term controlled trials on subjects with proved vitamin C deficiency, to recommend them not to change their nutrition and lifestyle, and to administer placebo to the control group. Therefore the proof of atherogenic effect of chronic vitamin C deficiency is limited to indirect evidence only. In this review many new data on the positive effects of ascorbic acid on human cardiovascular system are summarized and the mechanisms of its protective influence on blood vessels are discussed (Fig.5, Ref. 45). Full Text (Free, PDF) www.bmj.sk.

  19. Favourable and Unfavourable Conditions for Children's Confidence Judgments

    ERIC Educational Resources Information Center

    Roebers, Claudia M.; von der Linden, Nicole; Howie, Pauline

    2007-01-01

    Two studies are presented in which favourable and unfavourable conditions for children's meta-cognitive monitoring processes are examined. Previously reported findings have shown that especially children's uncertainty monitoring (in contrast to certainty monitoring) poses specific problems for children in their elementary school years. When…

  20. Experimental Fault Reactivation on Favourably and Unfavourably Oriented Faults

    NASA Astrophysics Data System (ADS)

    Mitchell, T. M.; Sibson, R. H.; Renner, J.; Toy, V. G.; di Toro, G.; Smith, S. A.

    2010-12-01

    In this study, we introduce work which aims assess the loading of faults to failure under different stress regimes in a triaxial deformation apparatus. We explore experimentally the reshear of an existing fault in various orientations for particular values of (σ1 - σ3) and σ3' for contrasting loading systems - load-strengthening (equivalent to a thrust fault) with σ1' increasing at constant σ3', versus load-weakening (equivalent to a normal fault) with reducing σ3' under constant σ1'. Experiments are conducted on sawcut granite samples with fault angles at a variety of orientations relative to σ1 , ranging from an optimal orientation for reactivation to lockup angles where new faults are formed in preference to reactivating the existing sawcut orientation. Prefailure and postfailure behaviour is compared in terms of damage zone development via monitoring variations in ultrasonic velocity and acoustic emission behaviour. For example, damage surrounding unfavourably oriented faults is significantly higher than that seen around favourably orientated faults due to greater maximum stresses attained prior to unstable slip, which is reflected by the increased acoustic emission activity leading up to failure. In addition, we also experimentally explore the reshear of natural pseudotachylytes (PSTs) from two different fault zones; the Gole Larghe Fault, Adamello, Italy in which the PSTs are in relatively isotropic Tonalite (at lab sample scale) and the Alpine Fault, New Zealand in which the PSTs are in highly anisotropic foliated shist. We test whether PSTs will reshear in both rock types under the right conditions, or whether new fractures in the wall rock will form in preference to reactivating the PST (PST shear strength is higher than that of the host rock). Are PSTs representative of one slip event?

  1. More americans living longer with cardiovascular disease will increase costs while lowering quality of life.

    PubMed

    Pandya, Ankur; Gaziano, Thomas A; Weinstein, Milton C; Cutler, David

    2013-10-01

    In the past several decades, some risk factors for cardiovascular disease have improved, while others have worsened. For example, smoking rates have dropped and treatment rates for cardiovascular disease have increased-factors that have made the disease less fatal. At the same time, Americans' average body mass index and incidence of diabetes have increased as the population continues to live longer-factors that have made cardiovascular disease more prevalent. To assess the aggregate impact of these opposing trends, we used the nine National Health and Nutrition Examination Survey waves from 1973 to 2010 to forecast total cardiovascular disease risk and prevalence from 2015 to 2030. We found that continued improvements in cardiovascular disease treatment and declining smoking rates will not outweigh the influence of increasing population age and obesity on cardiovascular disease risk. Given an aging population, an obesity epidemic, and declining mortality from the disease, the United States should expect to see a sharp rise in the health care costs, disability, and reductions in quality of life associated with increased prevalence of cardiovascular disease. Policies that target the treatment of high blood pressure and cholesterol and the reduction of obesity will be necessary to curb the imminent spike in cardiovascular disease prevalence.

  2. Cardiovascular

    NASA Image and Video Library

    Overview of Cardiovascular research which addresses risks of space flight, including adaptive changes to the cephalad fluid shift (such as reduced circulating blood volume), potential for heart rhy...

  3. Evaluation of the modifying effects of unfavourable genotypes on classical clinical risk factors for ischaemic stroke

    PubMed Central

    Szolnoki, Z; Somogyvari, F; Kondacs, A; Szabo, M; Fodor, L; Bene, J; Melegh, B

    2003-01-01

    Objectives: Ischaemic stroke is a frequent heterogeneous multifactorial disease that is affected by a number of genetic mutations and environmental factors. We hypothesised the clinical importance of the interactions between common, unfavourable genetic mutations and clinical risk factors in the development of ischaemic stroke. Methods: The Factor V Leiden G1691A (Leiden V), the prothrombin G20210A, the methylenetetrahydrofolate reductase C677T (MTHFR C677T) mutations, the angiotensin converting enzyme I/D (ACE I/D), and apolipoprotein allele e4 (APO e4) genotypes were examined by the polymerase chain reaction (PCR) technique in 867 ischaemic stroke patients and 743 healthy controls. Logistic regression models were used to estimate the roles of the co-occurrences of the clinical risk factors and common genetic mutations in ischaemic stroke. Results: The Leiden V mutation in combination with hypertension or diabetes mellitus increased the risk of ischaemic stroke. We found synergistic effects between the ACE D/D and MTHFR 677TT genotypes and drinking or smoking. The presence of the APO e4 greatly facilitated the unfavourable effects of hypertension, diabetes mellitus, smoking, or drinking on the incidence of ischaemic stroke. Conclusion: In certain combinations, pairing of common unfavourable genetic factors, which alone confer only minor or non-significant risk, with clinical risk factors can greatly increase the susceptibility to ischaemic stroke. PMID:14638877

  4. Hepatitis C virus coinfection independently increases the risk of cardiovascular disease in HIV-positive patients.

    PubMed

    Fernández-Montero, J V; Barreiro, P; de Mendoza, C; Labarga, P; Soriano, V

    2016-01-01

    Patients infected with HIV are at increased risk for cardiovascular disease despite successful antiretroviral therapy. Likewise, chronic hepatitis C virus (HCV) infection is associated with extrahepatic complications, including cardiovascular disease. However the risk of cardiovascular disease has not been formally examined in HIV/HCV-coinfected patients. A retrospective study was carried out to assess the influence of HCV coinfection on the risk of cardiovascular events in a large cohort of HIV-infected patients recruited since year 2004. A composite event of cardiovascular disease was used as an endpoint, including myocardial infarction, angina pectoris, stroke or death due to any of them. A total of 1136 patients (567 HIV-monoinfected, 70 HCV-monoinfected and 499 HIV/HCV-coinfected) were analysed. Mean age was 42.7 years, 79% were males, and 46% were former injection drug users. Over a mean follow-up of 79.4 ± 21 months, 3 patients died due to cardiovascular disease, whereas 29 suffered a first episode of coronary ischaemia or stroke. HIV/HCV-coinfected patients had a greater incidence of cardiovascular disease events and/or death than HIV-monoinfected individuals (4% vs 1.2%, P = 0.004) and HCV-monoinfected persons (4% vs 1.4%, P = 0.5). After adjusting for demographics, virological parameters and classical cardiovascular disease risk factors (smoking, hypertension, diabetes, high LDL cholesterol), both HIV/HCV coinfection (HR 2.91; CI 95%: 1.19-7.12; P = 0.02) and hypertension (HR 3.65; CI 95%: 1.34-9.94; P = 0.01) were independently associated with cardiovascular disease events and/or death in HIV-infected patients. Chronic hepatitis C and hypertension are independently associated with increased cardiovascular disease risk in HIV-infected patients. Therefore, treatment of chronic hepatitis C should be prioritized in HIV/HCV-coinfected patients regardless of any liver fibrosis staging.

  5. A comparison of four methods of ripening the unfavourable cervix.

    PubMed

    Wilson, P D

    1978-12-01

    A comparison was made between four methods of ripening the unfavourable cervix (extra-amniotic prostaglandin E2 gel, oral prostaglandin E2, intravaginal prostaglandin E2 and intravenous oxytocin) in a clinical trial involving 60 primigravidae. In all groups there was an improvement in cervical status. This was significantly greater in those patients who received extra-amniotic prostaglandin gel and they also showed significant decreases in the mean induction-delivery interval and in the incidence of Caesarean section.

  6. Repeated administration of adenosine increases its cardiovascular effects in rats.

    PubMed

    Vidrio, H; García-Márquez, F; Magos, G A

    1987-01-20

    Hypotensive and negative chronotropic responses to adenosine in anesthetized rats increased after previous administration of the nucleoside. Bradycardia after adenosine in the isolated perfused rat heart was also potentiated after repeated administration at short intervals. This self-potentiation could be due to extracellular accumulation of adenosine and persistent stimulation of receptors caused by saturation or inhibition of cellular uptake of adenosine.

  7. Genetic predisposition to higher blood pressure increases risk of incident hypertension and cardiovascular diseases in Chinese.

    PubMed

    Lu, Xiangfeng; Huang, Jianfeng; Wang, Laiyuan; Chen, Shufeng; Yang, Xueli; Li, Jianxin; Cao, Jie; Chen, Jichun; Li, Ying; Zhao, Liancheng; Li, Hongfan; Liu, Fangcao; Huang, Chen; Shen, Chong; Shen, Jinjin; Yu, Ling; Xu, Lihua; Mu, Jianjun; Wu, Xianping; Ji, Xu; Guo, Dongshuang; Zhou, Zhengyuan; Yang, Zili; Wang, Renping; Yang, Jun; Yan, Weili; Gu, Dongfeng

    2015-10-01

    Although multiple genetic markers associated with blood pressure have been identified by genome-wide association studies, their aggregate effect on risk of incident hypertension and cardiovascular disease is uncertain, particularly among East Asian who may have different genetic and environmental exposures from Europeans. We aimed to examine the association between genetic predisposition to higher blood pressure and risk of incident hypertension and cardiovascular disease in 26 262 individuals in 2 Chinese population-based prospective cohorts. A genetic risk score was calculated based on 22 established variants for blood pressure in East Asian. We found the genetic risk score was significantly and independently associated with linear increases in blood pressure and risk of incident hypertension and cardiovascular disease (P range from 4.57×10(-3) to 3.10×10(-6)). In analyses adjusted for traditional risk factors including blood pressure, individuals carrying most blood pressure-related risk alleles (top quintile of genetic score distribution) had 40% (95% confidence interval, 18-66) and 26% (6-45) increased risk for incident hypertension and cardiovascular disease, respectively, when compared with individuals in the bottom quintile. The genetic risk score also significantly improved discrimination for incident hypertension and cardiovascular disease and led to modest improvements in risk reclassification for cardiovascular disease (all the P<0.05). Our data indicate that genetic predisposition to higher blood pressure is an independent risk factor for blood pressure increase and incident hypertension and cardiovascular disease and provides modest incremental information to cardiovascular disease risk prediction. The potential clinical use of this panel of blood pressure-associated polymorphisms remains to be determined. © 2015 American Heart Association, Inc.

  8. Acute exercise in elite rugby players increases the circulating level of the cardiovascular biomarker GDF-15.

    PubMed

    Galliera, Emanuela; Lombardi, Giovanni; Marazzi, Monica G; Grasso, Dalila; Vianello, Elena; Pozzoni, Roberto; Banfi, Giuseppe; Corsi Romanelli, Massimiliano M

    2014-09-01

    Intense training can lead to a pathophysiological change in serum concentration of a variety of biomarkers. Traditional biomarkers of cardiac injury are very useful in monitoring CVD patients, but in healthy subjects or athletes they cannot be informative enough about the cardiovascular risk, because in these cases their serum levels do not increase over the pathological limit. Therefore novel cardiovascular biomarkers are required in order to allow a better monitoring of sport performance, prediction of overtraining and diagnosis of sport-related cardiac injuries. Growth differentiation factor-15 (GDF-15) is emerging as a powerful cardiovascular injury risk indicator. In this study we investigate the effect of intense physical training of on the circulating levels of GDF-15 in rugby professional players. Serum GDF-15, Erythropoietin, IL-6, the cardiovascular parameter ST-2, NT-proBNP and routine hematological parameters were measured in a group of 30 rugby players before and after a session of intense training. While ST-2, IL-6 and hsCRP displayed no significant changes after intense training, NT-proBNP and GDF-15 showed a significant increase, even without reaching the pathological level. The measure of GDF-15 in professional rugby players could be a useful tool to monitoring their cardiovascular status during training and competition session in order to prevent the onset of collateral cardiovascular adverse event due to the intense training and, in the case of cardiac injury, it could possibly allow a very early diagnosis at the beginning of the pathogenic process.

  9. Extra-amniotic prostaglandin E2 and the unfavourable cervix.

    PubMed

    Shepherd, J; Sims, C; Craft, I

    1976-10-02

    A small dose of prostaglandin E2 suspended in a viscous medium was instilled as a single application into the extra-amniotic space of patients with unfavourable induction features the day before planned induction in an attempt to improve the condition of the cervix. Two groups of 15 patients were studied, one receiving prostaglandin E2 250 mug suspended in methyl ethyl cellulose ('Tylose') 6% solution, and the other tylose alone. Cervical status did not change in those receiving tylose alone, whereas a significant improvement occurred in 14 out of 15 patients receiving the prostaglandin. Labour began before formal induction in 1 patient receiving tylose and in 8 receiving prostaglandin.

  10. How could we improve the increased cardiovascular mortality in patients with overt and subclinical hyperthyroidism?

    PubMed

    Biondi, Bernadette

    2012-09-01

    Over the past five years several meta-analyses have evaluated the cardiovascular mortality in patients with hyperthyroidism. They assessed various studies in which different inclusion criteria were used for the analysis of the cardiovascular mortality. More selective criteria have been used in recent meta-analyses. Only prospective cohort studies were included and only cohorts using second and third generation TSH assays were chosen. In addition, only the studies where the TSH evaluation was repeated during the follow-up were selected. The results of these recent meta-analyses provide evidence that overt and subclinical hyperthyroidism, particularly in patients with undetectable serum TSH, may increase the cardiovascular mortality. However, still today, the results remain inconclusive and not sufficient enough to recommend treatment for patients with low-detectable serum TSH. The high cardiovascular risk and mortality in presence of thyroid hormone excess suggest that this dysfunction is an important health problem and requires guidelines for the treatment of patients at high cardiovascular risk. Rigorous studies are necessary to evaluate the effects of the various causes of hyperthyroidism on the clinical outcomes. Randomized controlled clinical trials are needed to assess the benefits of treatment to improve the cardiovascular mortality and morbidity of mild and overt hyperthyroidism.

  11. Venous cerebral blood volume increase during voluntary locomotion reflects cardiovascular changes.

    PubMed

    Huo, Bing-Xing; Greene, Stephanie E; Drew, Patrick J

    2015-09-01

    Understanding how changes in the cardiovascular system contribute to cerebral blood flow (CBF) and volume (CBV) increases is critical for interpreting hemodynamic signals. Here we investigated how systemic cardiovascular changes affect the cortical hemodynamic response during voluntary locomotion. In the mouse, voluntary locomotion drives an increase in cortical CBF and arterial CBV that is localized to the forelimb/hindlimb representation in the somatosensory cortex, as well as a diffuse venous CBV increase. To determine if the heart rate increases that accompany locomotion contribute to locomotion-induced CBV and CBF increases, we occluded heart rate increases with the muscarinic cholinergic receptor antagonist glycopyrrolate, and reduced heart rate with the β1-adrenergic receptor antagonist atenolol. We quantified the effects of these cardiovascular manipulations on CBV and CBF dynamics by comparing the hemodynamic response functions (HRF) to locomotion across these conditions. Neither the CBF HRF nor the arterial component of the CBV HRF was significantly affected by pharmacological disruption of the heart rate. In contrast, the amplitude and spatial extent of the venous component of the CBV HRF were decreased by atenolol. These results suggest that the increase in venous CBV during locomotion was partially driven by peripheral cardiovascular changes, whereas CBF and arterial CBV increases associated with locomotion reflect central processes. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. The polypill: An effective approach to increasing adherence and reducing cardiovascular event risk.

    PubMed

    Bramlage, Peter; Sims, Helen; Minguet, Joan; Ferrero, Carmen

    2017-02-01

    Background Despite a wide range of medications being available for the prevention of cardiovascular events such as stroke, myocardial infarction and mortality in both a primary and secondary setting, patient adherence to complex therapy regimens involving different drug classes remains low worldwide. Combining antiplatelet, antihypertensive, lipid-lowering and potentially further drugs into one 'polypill' has the potential to increase adherence, thereby reducing risk factors to a greater extent and for a longer duration. The World Health Organization has recently highlighted increased adherence as a key development need for reducing cardiovascular disease. Methods Recent clinical trial data regarding adherence, reductions in cardiovascular risk and outcomes, safety and tolerability and the cost-effectiveness of the polypill approach are summarised and reviewed. In addition, ongoing trials and the questions they intend to answer are considered. References were retrieved from a PubMed literature search (date range 1990-2016) using the terms 'polypill', 'cardiovascular events' and 'adherence', and selected based on relevance. The website www.clinicaltrials.gov was also consulted for the identification of ongoing trials. Conclusions To date, the polypill approach has been conclusively shown to increase adherence relative to usual care in all patients, with those in a primary care setting or with poor baseline adherence potentially standing to benefit most. Concomitant risk factor reductions have also been suggested. However, whether this translates into a reduction in cardiovascular events and generates good cost-effectiveness in a given healthcare environment is currently under further investigation.

  13. Increased Peripheral Proinflammatory T Helper Subsets Contribute to Cardiovascular Complications in Diabetic Patients

    PubMed Central

    Zhao, Ru-xing; Li, Wen-juan; Lu, Yi-ran; Qin, Jun; Wu, Chuan-long; Tian, Meng; He, Tian-yi; Yi, Shou-nan; Tang, Dong-qi; Sun, Lei; Chen, Li

    2014-01-01

    Background. Coronary atherosclerotic heart disease (CHD) is one of the major concerns in type 2 diabetes (T2D). The systemic chronic inflammation has been postulated to bridge the increased risk of cardiovascular disease and T2D. We formulated that increased peripheral proinflammatory T helper subsets contributed to the development of cardiovascular complications in diabetic patients. Methods. The frequencies of peripheral total CD4+ T helper cells, proinflammatory Th1, Th17, and Th22 subsets were determined by flow cytometry in diabetic patients with or without CHD (n = 42 and 67, resp.). Results. Both peripheral frequencies and total numbers of Th1, Th17, and Th22 cells were further increased in diabetic patients with CHD. Logistic regression and categorical cross-table analysis further confirmed that increased proinflammatory Th subsets, especially Th22, were independent risk factors of cardiovascular complication in diabetes. Elevated Th subsets also correlated with increased CRP levels and the atherogenic index of plasma. Moreover, Th1 frequency and Th22 numbers demonstrated remarkable potential in predicting CHD in diabetes. Conclusions. Increased peripheral proinflammatory T helper subsets act in concert and contribute to the increased prevalence of diabetic cardiovasculopathy. The recently identified Th22 cells might play an independent role in CHD and represent a novel proxy for cardiovascular risks in diabetes. PMID:24803740

  14. A role for the central histaminergic system in the leptin-mediated increase in cardiovascular dynamics.

    PubMed

    Rao, Sumangala P; Dunbar, Joseph C

    2005-01-15

    The central nervous system (CNS) histaminergic neurons have been shown to regulate feeding behavior and are a target of leptin in the brain. The present study aimed to examine the involvement of the histaminergic system in the leptin-mediated regulation of cardiovascular dynamics. We investigated the cardiovascular responses to the CNS administration of histamine, leptin and alpha-melanocyte stimulating hormone (alpha-MSH) both in the presence and absence of the histamine H1 antagonist, chlorpheniramine. The intracerebroventricular (i.c.v.) administration of histamine resulted in an immediate increase in both mean arterial pressure (MAP) and heart rate (HR) and vasoconstricted the iliac, renal and superior mesenteric vessels. The i.c.v. pretreatment with chlorpheniramine attenuated the histamine-induced increase in MAP, HR and decreased vascular conductance. The i.c.v. administration of leptin increased MAP and HR and decreased vascular conductance. The i.c.v. pretreatment with chlorpheniramine decreased the leptin-induced increase in MAP and the leptin-mediated iliac vasoconstriction. The i.c.v. administration of alpha-MSH also increased MAP, HR and decreased vascular conductance. However, pretreatment with chlorpheniramine did not influence the central alpha-MSH-mediated increase in MAP, HR and decreased vascular conductance. These results indicate that the central histaminergic system mediated by H1 receptors have a role in the central signaling pathway and is involved in leptin's regulation of cardiovascular dynamics. It appears that leptin directly or indirectly stimulates histaminergic neurons that lead to increased cardiovascular activity.

  15. Cardiovascular responses during orthostasis - Effect of an increase in maximal O2 uptake

    NASA Technical Reports Server (NTRS)

    Convertino, V. A.; Montgomery, L. D.; Greenleaf, J. E.

    1984-01-01

    A study is described which tests the hypothesis that changes in aerobic activity (increases in maximum oxygen uptake) will reduce the effectiveness of cardiovascular reflexes to regulate blood pressure during orthostasis. The hypothesis was tested by measuring heart rate, blood pressure and blood volume responses in eight healthy male subjects before and after an eight-day endurance regimen. The results of the study suggest that the physiologic responses to orthostasis are dependent upon the rate of plasma volume loss and pooling, and are associated with training-induced hypervolemia. It is indicated that endurance type exercise training enhances cardiovascular adjustments during tilt. The implications of these results for the use of exercise training as a countermeasure and/or therapeutic method for the prevention of cardiovascular instability during orthostatic stress are discussed.

  16. Cardiovascular responses during orthostasis - Effect of an increase in maximal O2 uptake

    NASA Technical Reports Server (NTRS)

    Convertino, V. A.; Montgomery, L. D.; Greenleaf, J. E.

    1984-01-01

    A study is described which tests the hypothesis that changes in aerobic activity (increases in maximum oxygen uptake) will reduce the effectiveness of cardiovascular reflexes to regulate blood pressure during orthostasis. The hypothesis was tested by measuring heart rate, blood pressure and blood volume responses in eight healthy male subjects before and after an eight-day endurance regimen. The results of the study suggest that the physiologic responses to orthostasis are dependent upon the rate of plasma volume loss and pooling, and are associated with training-induced hypervolemia. It is indicated that endurance type exercise training enhances cardiovascular adjustments during tilt. The implications of these results for the use of exercise training as a countermeasure and/or therapeutic method for the prevention of cardiovascular instability during orthostatic stress are discussed.

  17. Hourly peak PM2.5 concentration associated with increased cardiovascular mortality in Guangzhou, China.

    PubMed

    Lin, Hualiang; Liu, Tao; Xiao, Jianpeng; Zeng, Weilin; Guo, Lingchuan; Li, Xing; Xu, Yanjun; Zhang, Yonghui; Chang, Jen Jen; Vaughn, Michael G; Qian, Zhengmin Min; Ma, Wenjun

    2016-11-02

    Hourly peak concentration may capture health effects of ambient fine particulate matter pollution (PM2.5) better than daily averages. We examined the associations of hourly peak concentration of PM2.5 with cardiovascular mortality in Guangzhou, China. We obtained daily data on cardiovascular mortality and hourly PM2.5 concentrations in Guangzhou from 19 January 2013 through 30 June 2015. Generalized additive models were applied to evaluate the associations with adjustment for potential confounding factors. Significant associations were found between hourly peak concentrations of PM2.5 and cardiovascular mortality, particularly from ischemic heart diseases (IHD) and cerebrovascular diseases (CBD). Every 10 μg/m(3) increment of hourly peak PM2.5 at lag 03 day was associated with a 1.15% (95% CI: 0.67%, 1.63%); 1.02% (95% CI: 0.30%, 1.74%) and 1.09% (95% CI: 0.27%, 1.91%) increase in mortalities from total cardiovascular diseases, IHD and CBD, respectively. The effects remained after adjustment for daily mean PM2.5 and gaseous air pollutants, though there was a high correlation between PM2.5 peak and PM2.5 mean (correlation coefficient=0.95). No significant association was observed for acute myocardial infarction (AMI). In addition to daily mean concentration of PM2.5, hourly peak concentration of PM2.5 might be one important risk factor of cardiovascular mortality and should be considered as an important air pollution indicator when assessing the possible cardiovascular effects of PM2.5.Journal of Exposure Science and Environmental Epidemiology advance online publication, 2 November 2016; doi:10.1038/jes.2016.63.

  18. Not only cardiovascular, but also coordinative exercise increases hippocampal volume in older adults

    PubMed Central

    Niemann, Claudia; Godde, Ben; Voelcker-Rehage, Claudia

    2014-01-01

    Cardiovascular activity has been shown to be positively associated with gray and white matter volume of, amongst others, frontal and temporal brain regions in older adults. This is particularly true for the hippocampus, a brain structure that plays an important role in learning and memory, and whose decline has been related to the development of Alzheimer’s disease. In the current study, we were interested in whether not only cardiovascular activity but also other types of physical activity, i.e., coordination training, were also positively associated with the volume of the hippocampus in older adults. For this purpose we first collected cross-sectional data on “metabolic fitness” (cardiovascular fitness and muscular strength) and “motor fitness” (e.g., balance, movement speed, fine coordination). Second, we performed a 12-month randomized controlled trial. Results revealed that motor fitness but not metabolic fitness was associated with hippocampal volume. After the 12-month intervention period, both, cardiovascular and coordination training led to increases in hippocampal volume. Our findings suggest that a high motor fitness level as well as different types of physical activity were beneficial to diminish age-related hippocampal volume shrinkage or even increase hippocampal volume. PMID:25165446

  19. Increased risk of cardiovascular complications in chronic kidney disease: a possible role of leptin.

    PubMed

    Korolczuk, Agnieszka; Dudka, Jaroslaw

    2014-01-01

    Leptin is a small peptide hormone (16 kDa), a product of the obesity gene (Ob), and is mainly synthesized and secreted by adipocytes. It is removed from the blood by the kidneys. The kidney is not only a site of leptin clearance, but also a target organ for its action in different pathophysiological states. Several studies have documented a strong relationship between chronic kidney disease (CKD) and accelerated cardiovascular disease (CVD) defined as a cardiorenal syndrome. Patients with stage 3 and 4 CKD develop cardiovascular complications and are at increased risk of death from CVD. Renal dysfunction promotes several mechanisms responsible for exacerbation of cardiovascular disease. These include activation of the renin-angiotensin system, oxidative stress, elevated asymmetric dimethylarginine (ADMA), low-grade inflammation with increased circulating cytokines, and dyslipidemia. Recently, it has been observed that plasma leptin level is elevated in patients with cardiorenal syndrome. In obesity, hyperleptinemia combined with selective leptin resistance appear to have a critical role in the development and progression of kidney disease, CVD and metabolic syndrome. This has clinical implications for the treatment of obesity-related hypertension and kidney disease. In this paper the role of leptin in chronic kidney disease and accelerated cardiovascular disease is out lined. The link between hyperleptinemia and development and progression of morphologic changes that effect kidney in obese patients is also discussed.

  20. Why are kids with lupus at an increased risk of cardiovascular disease?

    PubMed

    Quinlan, Catherine; Marks, Stephen D; Tullus, Kjell

    2016-06-01

    Juvenile-onset systemic lupus erythematosus (SLE) is an aggressive multisystem autoimmune disease. Despite improvements in outcomes for adult patients, children with SLE continue to have a lower life expectancy than adults with SLE, with more aggressive disease, a higher incidence of lupus nephritis and there is an emerging awareness of their increased risk of cardiovascular disease (CVD). In this review, we discuss the evidence for an increased risk of CVD in SLE, its pathogenesis, and the clinical approach to its management.

  1. Electrical stimulation of unloaded muscles causes cardiovascular exercise by increasing oxygen demand.

    PubMed

    Banerjee, Prithwish; Clark, Andrew; Witte, Klaus; Crowe, Louis; Caulfield, Brian

    2005-10-01

    The development of new strategies to encourage increased levels of physical activity can help to reduce the incidence of cardiovascular disease. A new system of electrical muscle stimulation (EMS) has been developed that attempts to cause an increase in energy expenditure by mimicking the action of shivering in the body. The purpose of this study was to show that this form of EMS is capable of eliciting a cardiovascular exercise response in healthy adults. An observational study. Ten healthy volunteers completed a maximal treadmill test and four EMS sessions using a hand-held EMS device that delivered current to the body via five silicone rubber electrodes on each leg. At each session subjects completed 3 min stimulation at each of four stimulation outputs (10, 20, 30 and 40% of maximum output) while cardiopulmonary gas exchange and heart rate (HR) were measured. Physiological responses at increasing levels of stimulation were evaluated. Average (+/-SD) HR and oxygen consumption (VO2) levels of 67+/-11 bpm and 4.7+/-1.2 ml/kg per min at rest, respectively, were increased to 186+/-10 bpm and 44.9+/-9.8 ml/kg per min at peak exercise intensity on treadmill testing. The electrical stimulation was generally well tolerated by the subjects. Subjects demonstrated statistically significant increases in all physiological variables measured with successive increases in stimulation intensity. Peak HR and VO2 at 40% stimulation intensity were 101+/-12 bpm and 14.9+/-4.3 ml/kg per min, respectively. These results demonstrate that this form of EMS is capable of producing a physiological response consistent with cardiovascular exercise at mild to moderate intensities. It achieves this without producing gross movement of the limbs or loading of the joints. This EMS-induced cardiovascular exercise response could be used to promote increased levels of physical activity in populations unable to participate in voluntary exercise.

  2. Increasing pulse wave velocity in a realistic cardiovascular model does not increase pulse pressure with age

    PubMed Central

    Mohiuddin, Mohammad W.; Rihani, Ryan J.; Laine, Glen A.

    2012-01-01

    The mechanism of the well-documented increase in aortic pulse pressure (PP) with age is disputed. Investigators assuming a classical windkessel model believe that increases in PP arise from decreases in total arterial compliance (Ctot) and increases in total peripheral resistance (Rtot) with age. Investigators assuming a more sophisticated pulse transmission model believe PP rises because increases in pulse wave velocity (cph) make the reflected pressure wave arrive earlier, augmenting systolic pressure. It has recently been shown, however, that increases in cph do not have a commensurate effect on the timing of the reflected wave. We therefore used a validated, large-scale, human arterial system model that includes realistic pulse wave transmission to determine whether increases in cph cause increased PP with age. First, we made the realistic arterial system model age dependent by altering cardiac output (CO), Rtot, Ctot, and cph to mimic the reported changes in these parameters from age 30 to 70. Then, cph was theoretically maintained constant, while Ctot, Rtot, and CO were altered. The predicted increase in PP with age was similar to the observed increase in PP. In a complementary approach, Ctot, Rtot, and CO were theoretically maintained constant, and cph was increased. The predicted increase in PP was negligible. We found that increases in cph have a limited effect on the timing of the reflected wave but cause the system to degenerate into a windkessel. Changes in PP can therefore be attributed to a decrease in Ctot. PMID:22561301

  3. Preventing Heart Attacks and Strokes: Increasing Awareness of the Adverse Cardiovascular Health Impacts of Air Pollution

    EPA Science Inventory

    Summary: Chronic cardiovascular disease imposes a significant health and economic burden on individuals and communities. Despite decades of improvement in cardiovascular mortality, cardiovascular disease and stroke remain the leading cause of death in the U.S. and disparities i...

  4. Increased 10-year cardiovascular disease and mortality risk scores in asymptomatic patients with calcium oxalate urolithiasis.

    PubMed

    Aydin, Hasan; Yencilek, Faruk; Erihan, Ismet Bilger; Okan, Binnur; Sarica, Kemal

    2011-12-01

    Both the prevalence of cardiovascular risk factors and event rate are increased in patients with urolithiasis. Screening is recommended to all patients who have high cardiovascular risk. The aim of this study was to document 10-year risk of cardiovascular disease and mortality in asymptomatic patients with urolithiasis. Consecutive 200 patients with calcium oxalate urolithiasis were compared with 200 age- and sex-matched healthy controls. Ten-year cardiovascular disease risk was calculated with the Framingham Risk Score and mortality risk with SCORE risk score. Calcium, oxalate, and citrate excretion were studied as urinary stone risk factors. The results indicate that patients with urolithiasis had higher total cholesterol (p < 0.0001), lower HDL-cholesterol (p < 0.0001), and higher systolic blood pressure (p < 0.0001) and hsCRP (p < 0.0001) compared with controls. Patients with urolithiasis had a higher Framingham Risk Scores [OR 8.36 (95% CI 3.81-18.65), p = 0.0001] and SCORE risk score [OR 3.02 (95% CI 1.30-7.02), p = 0.0006] compared with controls. The Framingham and SCORE risk score were significantly correlated with urinary calcium (p = 0.0001, r = 0.460, and p = 0.005, r = 0.223, respectively) and oxalate excretion (p = 0.0001, r = 0.516, p = 0.001, r = 0.290, respectively). In multiple linear regression analysis, urinary calcium and oxalate excretion, age, sex, total cholesterol, HDL-cholesterol, hsCRP and smoking were the independent predictors of 10-year cardiovascular disease risk and urinary calcium and oxalate excretion, age, sex, total cholesterol, fasting blood glucose for 10-year cardiovascular mortality. In conclusion, patients with calcium oxalate urolithiasis carry high risk of cardiovascular disease and mortality. All patients should be screened at the initial diagnosis of urolithiasis for the risk factors.

  5. Increasing Prescription Length Could Cut Cardiovascular Disease Burden And Produce Savings In South Africa.

    PubMed

    Gaziano, Thomas; Cho, Sylvia; Sy, Stephen; Pandya, Ankur; Levitt, Naomi S; Steyn, Krisela

    2015-09-01

    South Africa's rates of statin use are among the world's lowest, despite statins' demonstrated effectiveness for people with a high blood cholesterol level or history of cardiovascular disease. Almost 5 percent of the country's total mortality has been attributed to high cholesterol levels, fueled in part by low levels of statin adherence. Drawing upon experience elsewhere, we used a microsimulation model of cardiovascular disease to investigate the health and economic impacts of increasing prescription length from the standard thirty days to either sixty or ninety days, for South African adults on a stable statin regimen. Increasing prescription length to sixty or ninety days could save 1,694 or 2,553 lives per million adults, respectively. In addition, annual per patient costs related to cardiovascular disease would decrease by $152.41 and $210.29, respectively. Savings would largely accrue to patients in the form of time savings and reduced transportation costs, as a result of less frequent trips to the pharmacy. Increasing statin prescription length would both save resources and improve health outcomes in South Africa. Project HOPE—The People-to-People Health Foundation, Inc.

  6. Increasing Prescription Length Could Cut Cardiovascular Disease Burden And Produce Savings In South Africa

    PubMed Central

    Gaziano, Thomas; Cho, Sylvia; Sy, Stephen; Pandya, Ankur; Levitt, Naomi S.; Steyn, Krisela

    2016-01-01

    South Africa's rates of statin use are among the world's lowest, despite statins’ demonstrated effectiveness for people with a high blood cholesterol level or history of cardiovascular disease. Almost 5 percent of the country's total mortality has been attributed to high cholesterol levels, fueled in part by low levels of statin adherence. Drawing upon experience elsewhere, we used a microsimulation model of cardiovascular disease to investigate the health and economic impacts of increasing prescription length from the standard thirty days to either sixty or ninety days, for South African adults on a stable statin regimen. Increasing prescription length to sixty or ninety days could save 1,694 or 2,553 lives per million adults, respectively. In addition, annual per patient costs related to cardiovascular disease would decrease by $152.41 and $210.29, respectively. Savings would largely accrue to patients in the form of time savings and reduced transportation costs, as a result of less frequent trips to the pharmacy. Increasing statin prescription length would both save resources and improve health outcomes in South Africa. PMID:26355061

  7. High Thyroid-stimulating Hormone Levels Increase Proinflammatory and Cardiovascular Markers in Patients with Extreme Obesity.

    PubMed

    Gómez-Zamudio, Jaime Héctor; Mendoza-Zubieta, Victoria; Ferreira-Hermosillo, Aldo; Molina-Ayala, Marío Antonio; Valladares-Sálgado, Adán; Suárez-Sánchez, Fernando; de Jesús Peralta-Romero, Jose; Cruz, Miguel

    2016-08-01

    Obesity is an important health problem worldwide and many studies have suggested a relationship between obesity and thyroid function, with controversial results. Interestingly, high TSH levels have been involved with the presence of inflammatory state and risk for developing cardiovascular diseases in hypothyroid and obese patients. The aim in this work was to determine the prevalence of hypothyroidism in patients with extreme obesity and to determine whether their TSH levels were related to increased serum levels of inflammatory and cardiovascular markers. A cross-sectional study in 101 patients with extreme obesity (BMI ≥40) was performed. Anthropometric (weight, height and waist circumference) and biochemical (fasting glucose, glycosylated hemoglobin, triglycerides, total cholesterol, LDL-C, HDL-C and insulin) parameters were measured. TSH and FT4 levels as well as clinical exploration for diagnosis of hypothyroidism were carried out. Serum concentration of IL-10, IL-6, adiponectin, resistin, leptin, ICAM-1, VCAM-1 and E-selectin were determined. A high prevalence for diabetes (37.6%), prediabetes (50.5%), dyslipidemia (74.3%), hypertension (61.4%) and hypothyroidism (48.5%) was observed in patients with extreme obesity. The presence of hypothyroidism increased serum concentration of proinflammatory cytokines IL-6 and leptin and decreased the antiinflammatory cytokine adiponectin. In addition, serum TSH levels showed a correlation for waist circumference, weight, BMI, A1c, insulin, IL-6, leptin, ICAM-1 and E-selectin. There is a high prevalence for hypothyroidism in patients with extreme obesity. High levels of TSH contribute to elevate proinflammatory and cardiovascular risk markers, increasing the risk for development of cardiovascular diseases. Copyright © 2016 IMSS. Published by Elsevier Inc. All rights reserved.

  8. Controversy regarding the association of high calcium intake and increased risk for cardiovascular disease.

    PubMed

    Chrysant, Steven G; Chrysant, George S

    2014-08-01

    Calcium intake has been shown to be associated with beneficial effects regarding hypertension, coronary heart disease (CHD), vascular disease, and stroke by several prospective cohort studies. However, recent studies have questioned the beneficial cardiovascular effects of calcium intake and instead have shown that high calcium intake is associated with an increased risk for CHD and stroke. These findings have created controversy and concern among physicians, because calcium is consumed by a large number of older men and women to prevent osteoporosis and bone fractures. Based on the methods of patient self-reporting of calcium intake and cardiovascular events, the conclusions drawn from the studies may not be entirely valid. Therefore, until more confirmatory data are available, physicians should not be dissuaded from prescribing calcium supplements to their patients. The best candidates are patients with low calcium intake, but their calcium supplementation should not exceed the recommended 1200 mg/d to 1500 mg/d. © 2014 Wiley Periodicals, Inc.

  9. [Cardiovascular effects of omega-3-fatty acids and alternatives to increase their intake].

    PubMed

    Carrero, J J; Martín-Bautista, E; Baró, L; Fonollá, J; Jiménez, J; Boza, J J; López-Huertas, E

    2005-01-01

    Cardiovascular diseases are the main mortality cause in Europe, the USA and a great extent of Asia. There are several risk factors associated with cardiovascular diseases, such as increased total cholesterol, homocysteine and triglycerides, hypertension, diabetes, and reduced levels of HDL-cholesterol. Many of these risk factors are diet influenced. In spite of the great amount of foods enriched with n-3 fatty acids available at the market, the knowledge about the effects produced by regular intake of these foods still is a challenge in the majority of cases. It appears that intake of foods enriches with n-3 polyunsatured fatty acids is an option that may be effective in reducing risk factors for diseases, by substituting supplements without modifying consumer's alimentary habits. Also shown are the outcomes from a nutritional study undergone with a functional milk-bases food that contains n-3 fatty acids, oleic acid and vitamins.

  10. Increased risk of acute cardiovascular events after partner bereavement: a matched cohort study.

    PubMed

    Carey, Iain M; Shah, Sunil M; DeWilde, Stephen; Harris, Tess; Victor, Christina R; Cook, Derek G

    2014-04-01

    IMPORTANCE The period immediately after bereavement has been reported as a time of increased risk of cardiovascular events. However, this risk has not been well quantified, and few large population studies have examined partner bereavement. OBJECTIVE To compare the rate of cardiovascular events between older individuals whose partner dies with those of a matched control group of individuals whose partner was still alive on the same day. DESIGN, SETTING, AND PARTICIPANTS Matched cohort study using a UK primary care database containing availale data of 401 general practices from February 2005 through September 2012. In all, 30 447 individuals aged 60 to 89 years at study initiation who experienced partner bereavement during follow-up were matched by age, sex, and general practice with the nonbereaved control group (n = 83 588) at the time of bereavement. EXPOSURES Partner bereavement. MAIN OUTCOMES AND MEASURES The primary outcome was occurrence of a fatal or nonfatal myocardial infarction (MI) or stroke within 30 days of bereavement. Secondary outcomes were non-MI acute coronary syndrome and pulmonary embolism. All outcomes were compared between the groups during prespecified periods after bereavement (30, 90, and 365 days). Incidence rate ratios (IRRs) from a conditional Poisson model were adjusted for age, smoking status, deprivation, and history of cardiovascular disease. RESULTS Within 30 days of their partner's death, 50 of the bereaved group (0.16%) experienced an MI or a stroke compared with 67 of the matched nonbereaved controls (0.08%) during the same period (IRR, 2.20 [95% CI, 1.52-3.15]). The increased risk was seen in bereaved men and women and attenuated after 30 days. For individual outcomes, the increased risk was found separately for MI (IRR, 2.14 [95% CI, 1.20-3.81]) and stroke (2.40 [1.22-4.71]). Associations with rarer events were also seen after bereavement, including elevated risk of non-MI acute coronary syndrome (IRR, 2.20 [95% CI, 1

  11. Hypertension caused by primary hyperaldosteronism: increased heart damage and cardiovascular risk.

    PubMed

    Abad-Cardiel, María; Alvarez-Álvarez, Beatriz; Luque-Fernandez, Loreto; Fernández, Cristina; Fernández-Cruz, Arturo; Martell-Claros, Nieves

    2013-01-01

    Primary hyperaldosteronism is the most common cause of secondary hypertension. Elevated aldosterone levels cause heart damage and increase cardiovascular morbidity and mortality. Early diagnosis could change the course of this entity. The objective of this report was to study the clinical characteristics, cardiac damage and cardiovascular risk associated with primary hyperaldosteronism. We studied 157 patients with this diagnosis. We analyzed the reason for etiological investigation, and the routinely performed tests, including echocardiography. We used a cohort of 720 essential hypertensive patients followed in our unit for comparison. Compared with essential hypertensive patients, those with hyperaldosteronism were younger (56.9 [11.7] years vs 60 [14.4] years; P<.001), had higher blood pressure prior to the etiological diagnosis (136 [20.6] mmHg vs 156 [23.2] mmHg), more frequently had a family history of early cardiovascular disease (25.5% vs 2.2%; P<.001), and had a higher prevalence of concentric left ventricular hypertrophy (69% vs 25.7%) and higher cardiovascular risk. Specific treatment resulted in optimal control of systolic and diastolic blood pressures (from 150.7 [23.0] mmHg and 86.15 [14.07] mmHg to 12.69 [15.3] mmHg and 76.34 [9.7] mmHg, respectively). We suspected the presence of hyperaldosteronism because of resistant hypertension (33.1%), hypokalemia (38.2%), and hypertensive crises (12.7%). Only 4.6% of these patients had been referred from primary care with a suspected diagnosis of hyperaldosteronism. Hyperaldosteronism should be suspected in cases of resistant hypertension, hypokalemia and hypertensive crises. The diagnosis of hyperaldosteronism allows better blood pressure control. The most prevalent target organ damage is left ventricular hypertrophy. Copyright © 2012 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  12. Bupropion response on sleep quality in patients with depression: implications for increased cardiovascular disease risk

    PubMed Central

    Schramm, Preetam J.; Poland, Russell E.; Rao, Uma

    2013-01-01

    Depression could be an independent risk factor for cardiovascular disease. We assessed bupropion response in depressed patients by polysomnography (PSG) and cardiopulmonary coupling (CPC) variables. Nineteen subjects participated in a two-session, two consecutive night PSG protocol. Participants received either placebo or bupropion-SR 150 mg, orally, in a randomized, double-blind cross-over fashion on night two. Outcome variables were: sleep stages, REM latency, stable, unstable sleep and very low frequency coupling (VLFC). CPC analysis uses heart rate variability and the electrocardiogram’s R-wave amplitude fluctuations associated with respiration to generate frequency maps. Bupropion increased REM latency (p=0.043) but did not impact PSG sleep continuity, architecture and CPC variables. A trend (p=0.092) was observed towards increasing VLFC duration. Bupropion increased the number of stable-unstable sleep transitions (p=0.036). Moderate to strong correlations between PSG and CPC variables were found on placebo and bupropion nights. Limitations include a small sample size, limited power to detect CPC changes and lack of normal controls for comparison. Increased stable-unstable sleep transitions and VLFC duration may indicate vulnerability to cardiovascular disease due to their association with low heart rate variability that has been associated with increased mortality raising the question whether the beneficial effects of the antidepressant medication outweighs the impact on cardiopulmonary dynamics. PMID:24239431

  13. Bupropion response on sleep quality in patients with depression: implications for increased cardiovascular disease risk.

    PubMed

    Schramm, Preetam J; Poland, Russell E; Rao, Uma

    2014-02-01

    Depression could be an independent risk factor for cardiovascular disease. We assessed bupropion response in depressed patients by polysomnography (PSG) and cardiopulmonary coupling (CPC) variables. Nineteen subjects participated in a two-session, two consecutive night PSG protocol. Participants received either placebo or bupropion-SR 150 mg, orally, in a randomized, double-blind cross-over fashion on night two. Outcome variables were: sleep stages, REM latency, stable, unstable sleep and very low frequency coupling (VLFC). CPC analysis uses heart rate variability and the electrocardiogram's R-wave amplitude fluctuations associated with respiration to generate frequency maps. Bupropion increased REM latency (p=0.043) but did not impact PSG sleep continuity, architecture and CPC variables. A trend (p=0.092) was observed towards increasing VLFC duration. Bupropion increased the number of stable-unstable sleep transitions (p=0.036). Moderate to strong correlations between PSG and CPC variables were found on placebo and bupropion nights. Limitations include a small sample size, limited power to detect CPC changes and lack of normal controls for comparison. Increased stable-unstable sleep transitions and VLFC duration may indicate vulnerability to cardiovascular disease due to their association with low heart rate variability that has been associated with increased mortality raising the question whether the beneficial effects of the antidepressant medication outweighs the impact on cardiopulmonary dynamics. © 2013 Elsevier B.V. and ECNP All rights reserved.

  14. Vascular Health in American Football Players: Cardiovascular Risk Increased in Division III Players

    PubMed Central

    Feairheller, Deborah L.; Aichele, Kristin R.; Oakman, Joyann E.; Neal, Michael P.; Cromwell, Christina M.; Lenzo, Jessica M.; Perez, Avery N.; Bye, Naomi L.; Santaniello, Erica L.; Hill, Jessica A.; Evans, Rachel C.; Thiele, Karla A.; Chavis, Lauren N.; Getty, Allyson K.; Wisdo, Tia R.; McClelland, JoAnna M.; Sturgeon, Kathleen; Chlad, Pam

    2016-01-01

    Studies report that football players have high blood pressure (BP) and increased cardiovascular risk. There are over 70,000 NCAA football players and 450 Division III schools sponsor football programs, yet limited research exists on vascular health of athletes. This study aimed to compare vascular and cardiovascular health measures between football players and nonathlete controls. Twenty-three athletes and 19 nonathletes participated. Vascular health measures included flow-mediated dilation (FMD) and carotid artery intima-media thickness (IMT). Cardiovascular measures included clinic and 24 hr BP levels, body composition, VO2 max, and fasting glucose/cholesterol levels. Compared to controls, football players had a worse vascular and cardiovascular profile. Football players had thicker carotid artery IMT (0.49 ± 0.06 mm versus 0.46 ± 0.07 mm) and larger brachial artery diameter during FMD (4.3 ± 0.5 mm versus 3.7 ± 0.6 mm), but no difference in percent FMD. Systolic BP was significantly higher in football players at all measurements: resting (128.2 ± 6.4 mmHg versus 122.4 ± 6.8 mmHg), submaximal exercise (150.4 ± 18.8 mmHg versus 137.3 ± 9.5 mmHg), maximal exercise (211.3 ± 25.9 mmHg versus 191.4 ± 19.2 mmHg), and 24-hour BP (124.9 ± 6.3 mmHg versus 109.8 ± 3.7 mmHg). Football players also had higher fasting glucose (91.6 ± 6.5 mg/dL versus 86.6 ± 5.8 mg/dL), lower HDL (36.5 ± 11.2 mg/dL versus 47.1 ± 14.8 mg/dL), and higher body fat percentage (29.2 ± 7.9% versus 23.2 ± 7.0%). Division III collegiate football players remain an understudied population and may be at increased cardiovascular risk. PMID:26904291

  15. Vascular Health in American Football Players: Cardiovascular Risk Increased in Division III Players.

    PubMed

    Feairheller, Deborah L; Aichele, Kristin R; Oakman, Joyann E; Neal, Michael P; Cromwell, Christina M; Lenzo, Jessica M; Perez, Avery N; Bye, Naomi L; Santaniello, Erica L; Hill, Jessica A; Evans, Rachel C; Thiele, Karla A; Chavis, Lauren N; Getty, Allyson K; Wisdo, Tia R; McClelland, JoAnna M; Sturgeon, Kathleen; Chlad, Pam

    2016-01-01

    Studies report that football players have high blood pressure (BP) and increased cardiovascular risk. There are over 70,000 NCAA football players and 450 Division III schools sponsor football programs, yet limited research exists on vascular health of athletes. This study aimed to compare vascular and cardiovascular health measures between football players and nonathlete controls. Twenty-three athletes and 19 nonathletes participated. Vascular health measures included flow-mediated dilation (FMD) and carotid artery intima-media thickness (IMT). Cardiovascular measures included clinic and 24 hr BP levels, body composition, VO2 max, and fasting glucose/cholesterol levels. Compared to controls, football players had a worse vascular and cardiovascular profile. Football players had thicker carotid artery IMT (0.49 ± 0.06 mm versus 0.46 ± 0.07 mm) and larger brachial artery diameter during FMD (4.3 ± 0.5 mm versus 3.7 ± 0.6 mm), but no difference in percent FMD. Systolic BP was significantly higher in football players at all measurements: resting (128.2 ± 6.4 mmHg versus 122.4 ± 6.8 mmHg), submaximal exercise (150.4 ± 18.8 mmHg versus 137.3 ± 9.5 mmHg), maximal exercise (211.3 ± 25.9 mmHg versus 191.4 ± 19.2 mmHg), and 24-hour BP (124.9 ± 6.3 mmHg versus 109.8 ± 3.7 mmHg). Football players also had higher fasting glucose (91.6 ± 6.5 mg/dL versus 86.6 ± 5.8 mg/dL), lower HDL (36.5 ± 11.2 mg/dL versus 47.1 ± 14.8 mg/dL), and higher body fat percentage (29.2 ± 7.9% versus 23.2 ± 7.0%). Division III collegiate football players remain an understudied population and may be at increased cardiovascular risk.

  16. Dyslipidemia and Diabetes Increase the OPG/TRAIL Ratio in the Cardiovascular System.

    PubMed

    Toffoli, Barbara; Fabris, Bruno; Bartelloni, Giacomo; Bossi, Fleur; Bernardi, Stella

    2016-01-01

    Background. Dyslipidemia and diabetes are two of the most well established risk factors for the development of cardiovascular disease (CVD). Both of them usually activate a complex range of pathogenic pathways leading to organ damage. Here we hypothesized that dyslipidemia and diabetes could affect osteoprotegerin (OPG) and TNF-related apoptosis-inducing ligand (TRAIL) expression in the vessels and the heart. Materials and Methods. Gene and protein expression of OPG, TRAIL, and OPG/TRAIL ratio were quantified in the aorta and the hearts of control mice, dyslipidemic mice, and diabetic mice. Results. Diabetes significantly increased OPG and the OPG/TRAIL ratio expression in the aorta, while dyslipidemia was the major determinant of the changes observed in the heart, where it significantly increased OPG and reduced TRAIL expression, thus increasing cardiac OPG/TRAIL ratio. Conclusions. This work shows that both dyslipidemia and diabetes affect OPG/TRAIL ratio in the cardiovascular system. This could contribute to the changes in circulating OPG/TRAIL which are observed in patients with diabetes and CVD. Most importantly, these changes could mediate/contribute to atherosclerosis development and cardiac remodeling.

  17. Adiponectin plasma levels are increased by atorvastatin treatment in subjects at high cardiovascular risk.

    PubMed

    Blanco-Colio, Luis M; Martín-Ventura, Jose L; Gómez-Guerrero, Carmen; Masramon, Xavier; de Teresa, Eduardo; Farsang, Csaba; Gaw, Allan; Gensini, GianFranco; Leiter, Lawrence A; Langer, Anatoly; Egido, Jesús

    2008-05-31

    Adiponectin can suppress atherogenesis by inhibiting the adherence of monocytes, reducing their phagocytic activity, and suppressing the accumulation of modified lipoproteins in the vascular wall. Contradictory data have been reported about the effect of statins on adiponectin plasma levels. In this work, adiponectin plasma levels were measured in 102 statin-free subjects from the Spanish population of the Achieve Cholesterol Targets Fast with Atorvastatin Stratified Titration (ACTFAST) study, a 12-week, prospective, multi-centre, open-label trial which enrolled subjects with coronary heart disease, coronary heart disease-equivalent or a 10-year coronary heart disease risk >20%. Subjects were assigned to atorvastatin (10-80 mg/day) based on low-density lipoprotein (LDL)-cholesterol concentration at screening. For comparison, age and gender-matched blood donors (N=40) were used as controls. Control subjects did not present hypertension, hypercholesterolemia, diabetes, metabolic syndrome and history of cardiovascular diseases. Adiponectin levels were diminished in patients at high cardiovascular risk compared with control subjects [4166 (3661-4740) vs 5806 (4764-7075) ng/ml respectively; geometric mean (95% CI); P<0.0001]. In the whole population, atorvastatin treatment increased adiponectin levels [9.7 (3.2-16.7);% Change (95% CI); P=0.003]. This increment was in a dose-dependent manner; maximal effect observed with atorvastatin 80 mg/d [24.7 (5.7-47.1); P=0.01]. Adiponectin concentrations were positively correlated with high-density lipoprotein-cholesterol both before and after atorvastatin treatment. No association was observed between adiponectin and LDL-cholesterol before and after atorvastatin treatment. In conclusion, atorvastatin increased adiponectin plasma levels in subjects at high cardiovascular risk, revealing a novel anti-inflammatory effect of this drug.

  18. Paradoxical Association of Enhanced Cholesterol Efflux With Increased Incident Cardiovascular Risks

    PubMed Central

    Li, Xin-Min; Tang, Wai Hong Wilson; Mosior, Marian K.; Huang, Ying; Wu, Yuping; Matter, William; Gao, Vivian; Schmitt, David; DiDonato, Joseph A.; Fisher, Edward A.; Smith, Jonathan D.; Hazen, Stanley L.

    2013-01-01

    Objective Diminished cholesterol efflux activity of apolipoprotein B (apoB)–depleted serum is associated with prevalent coronary artery disease, but its prognostic value for incident cardiovascular events is unclear. We investigated the relationship of cholesterol efflux activity with both prevalent coronary artery disease and incident development of major adverse cardiovascular events (death, myocardial infarction, or stroke). Approach and Results Cholesterol efflux activity from free cholesterol–enriched macrophages was measured in 2 case– control cohorts: (1) an angiographic cohort (n=1150) comprising stable subjects undergoing elective diagnostic coronary angiography and (2) an outpatient cohort (n=577). Analysis of media from cholesterol efflux assays revealed that the high-density lipoprotein fraction (1.063increase in prospective (3 years) risk of myocardial infarction/stroke (adjusted hazard ratio, 2.19; 95% confidence interval, 1.02–4.74) and major adverse cardiovascular events (adjusted hazard ratio, 1.85; 95% confidence interval, 1.11–3.06). Conclusions Heightened cholesterol efflux to apoB-depleted serum was paradoxically associated with increased prospective risk for myocardial

  19. Ulcerative Colitis and Crohn's Disease Are Associated with Decreased Serum Selenium Concentrations and Increased Cardiovascular Risk.

    PubMed

    Castro Aguilar-Tablada, Teresa; Navarro-Alarcón, Miguel; Quesada Granados, Javier; Samaniego Sánchez, Cristina; Rufián-Henares, José Ángel; Nogueras-Lopez, Flor

    2016-12-01

    The incidence of inflammatory bowel disease (IBD) and associated oxidative stress is increasing. The antioxidant mineral selenium (Se) was measured in serum samples from 106 IBD patients (53 with ulcerative colitis (UC) and 53 with Crohn's disease (CD)) and from 30 healthy controls. Serum Se concentrations were significantly lower in UC and CD patients than in healthy controls (p < 0.001) and significantly lower in CD patients than in UC patients (p = 0.006). Se concentrations in patients were significantly influenced by sex, body mass index (BMI), the inflammatory biomarker α-1-antitrypsin, surgery, medical treatment, the severity, extent, and form of the disease and the length of time since onset (p < 0.05). Se concentrations in IBD patients were positively and linearly correlated with nutritional (protein, albumin, prealbumin, cholinesterase and total cholesterol) and iron status-related (hemoglobin, Fe and hematocrit) parameters (p < 0.05). A greater impairment of serum Se and cardiovascular status was observed in CD than in UC patients. An adequate nutritional Se status is important in IBD patients to minimize the cardiovascular risk associated with increased inflammation biomarkers, especially in undernourished CD patients, and is also related to an improved nutritional and body iron status.

  20. A high dietary glycemic index increases total mortality in a Mediterranean population at high cardiovascular risk.

    PubMed

    Castro-Quezada, Itandehui; Sánchez-Villegas, Almudena; Estruch, Ramón; Salas-Salvadó, Jordi; Corella, Dolores; Schröder, Helmut; Alvarez-Pérez, Jacqueline; Ruiz-López, María Dolores; Artacho, Reyes; Ros, Emilio; Bulló, Mónica; Covas, María-Isabel; Ruiz-Gutiérrez, Valentina; Ruiz-Canela, Miguel; Buil-Cosiales, Pilar; Gómez-Gracia, Enrique; Lapetra, José; Pintó, Xavier; Arós, Fernando; Fiol, Miquel; Lamuela-Raventós, Rosa María; Martínez-González, Miguel Ángel; Serra-Majem, Lluís

    2014-01-01

    Different types of carbohydrates have diverse glycemic response, thus glycemic index (GI) and glycemic load (GL) are used to assess this variation. The impact of dietary GI and GL in all-cause mortality is unknown. The objective of this study was to estimate the association between dietary GI and GL and risk of all-cause mortality in the PREDIMED study. The PREDIMED study is a randomized nutritional intervention trial for primary cardiovascular prevention based on community-dwelling men and women at high risk of cardiovascular disease. Dietary information was collected at baseline and yearly using a validated 137-item food frequency questionnaire (FFQ). We assigned GI values of each item by a 5-step methodology, using the International Tables of GI and GL Values. Deaths were ascertained through contact with families and general practitioners, review of medical records and consultation of the National Death Index. Cox regression models were used to estimate multivariable-adjusted hazard ratios (HR) and their 95% CI for mortality, according to quartiles of energy-adjusted dietary GI/GL. To assess repeated measures of exposure, we updated GI and GL intakes from the yearly FFQs and used Cox models with time-dependent exposures. We followed 3,583 non-diabetic subjects (4.7 years of follow-up, 123 deaths). As compared to participants in the lowest quartile of baseline dietary GI, those in the highest quartile showed an increased risk of all-cause mortality [HR = 2.15 (95% CI: 1.15-4.04); P for trend  = 0.012]. In the repeated-measures analyses using as exposure the yearly updated information on GI, we observed a similar association. Dietary GL was associated with all-cause mortality only when subjects were younger than 75 years. High dietary GI was positively associated with all-cause mortality in elderly population at high cardiovascular risk.

  1. Plasma prolylcarboxypeptidase (angiotensinase C) is increased in obesity and diabetes mellitus and related to cardiovascular dysfunction.

    PubMed

    Xu, Shengyuan; Lind, Lars; Zhao, Linshu; Lindahl, Bertil; Venge, Per

    2012-07-01

    Prolylcarboxypeptidase (PRCP) (angiotensinase C) has 3 major targets, angiotensin II, prekallikrein, and α-melanocyte stimulating hormone(1-13). The truncation of the latter leads to loss in appetite regulation and obesity in experimental animals. The objectives of this study were to purify PRCP from a native source, establish a sensitive immunoassay for PRCP, and relate plasma PRCP concentrations to signs and symptoms of obesity, diabetes mellitus, and cardiovascular dysfunction. Purification of PRCP from human neutrophils and establishment of a sensitive ELISA was carried out with the use of samples from study participants. Three cohorts were studied: healthy individuals (n = 40); a chest pain cohort (Fast Assessment of Thoracic Pain by Neural Networks) (n = 165); and a community-based cohort [Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS)] (n = 1004). PRCP was purified to homogeneity. Mean (SD) plasma concentrations in healthy individuals were 12.9 (3.2) μg/L and were increased in patients with chest pain and in patients with obesity and/or diabetes mellitus (P < 0.0001). In the PIVUS cohort the concentrations were related to several measures of arterial plaque formation, thickness of arterial intima media and posterior wall of the heart (P = 0.04-0.000005); the Framingham score (r = 0.14, P < 0.0001); and concentrations of C-reactive protein (r = 0.16, P < 0.0001) and N-terminal pro B-type natriuretic peptide (r = -0.13, P < 0.0001). Plasma concentrations of PRCP may be used to reflect metabolic conditions in individuals with obesity and diabetes mellitus. The associations of PRCP concentrations with signs of cardiovascular dysfunction and cardiovascular abnormalities suggest a pivotal role of the enzyme in disease.

  2. Arterial Stiffness Is Increased in Patients With Type 1 Diabetes Without Cardiovascular Disease

    PubMed Central

    Llauradó, Gemma; Ceperuelo-Mallafré, Victòria; Vilardell, Carme; Simó, Rafael; Freixenet, Núria; Vendrell, Joan; González-Clemente, José Miguel

    2012-01-01

    OBJECTIVE To investigate the relationship between arterial stiffness and low-grade inflammation in subjects with type 1 diabetes without clinical cardiovascular disease. RESEARCH DESIGN AND METHODS Sixty-eight patients with type 1 diabetes and 68 age- and sex-matched healthy subjects were evaluated. Arterial stiffness was assessed by aortic pulse wave velocity (aPWV). Serum concentrations of high-sensitivity C-reactive protein (hsCRP), interleukin (IL)-6, and soluble fractions of tumor necrosis factor-α receptors 1 and 2 (sTNFαR1 and sTNFαR2, respectively) were measured. All statistical analyses were stratified by sex. RESULTS Subjects with diabetes had a higher aPWV compared with healthy control subjects (men: 6.9 vs. 6.3 m/s, P < 0.001; women: 6.4 vs. 6.0 m/s, P = 0.023). These differences remained significant after adjusting for cardiovascular risk factors. Men with diabetes had higher concentrations of hsCRP (1.2 vs. 0.6 mg/L; P = 0.036), IL-6 (0.6 vs. 0.3 pg/mL; P = 0.002), sTNFαR1 (2,739 vs. 1,410 pg/mL; P < 0.001), and sTNFαR2 (2,774 vs. 2,060 pg/mL; P < 0.001). Women with diabetes only had higher concentrations of IL-6 (0.6 vs. 0.4 pg/mL; P = 0.039). In men with diabetes, aPWV correlated positively with hsCRP (r = 0.389; P = 0.031) and IL-6 (r = 0.447; P = 0.008), whereas in women with diabetes no significant correlation was found. In men, multiple linear regression analysis showed that the following variables were associated independently with aPWV: age, BMI, type 1 diabetes, and low-grade inflammation (R2 = 0.543). In women, these variables were age, BMI, mean arterial pressure, and type 1 diabetes (R2 = 0.550). CONCLUSIONS Arterial stiffness assessed as aPWV is increased in patients with type 1 diabetes without clinical cardiovascular disease, independently of classical cardiovascular risk factors. In men with type 1 diabetes, low-grade inflammation is independently associated with arterial stiffness. PMID:22357186

  3. Increased Waist-to-height Ratio May Contribute to Age-related Increase in Cardiovascular Risk Factors

    PubMed Central

    Akhlaghi, Masoumeh; Kamali, Majid; Dastsouz, Farideh; Sadeghi, Fatemeh; Amanat, Sassan

    2016-01-01

    Background: The risk of cardiovascular diseases (CVDs) increases with age. The objective was to determine whether lifestyle and dietary behaviors and anthropometric measures, which are affected by these behaviors, contribute to the increase of CVD risk factors across age categories of 20–50-year-old. Methods: In a cross-sectional design, 437 adults aged 20–50-year-old were selected from households living in Shiraz. Risk factors of CVD, including body mass index (BMI), waist-to-height ratio (WHtR), blood pressure, fasting blood glucose (FBG), serum triglycerides, total cholesterol, and low- and high-density lipoprotein cholesterol (LDL-C and HDL-C, respectively) as well as lifestyle behaviors (physical activity and smoking), dietary habits, and food intakes were assessed across the age categories of 20–29, 30–39, and 40–50 years. Linear regression was used to examine the contribution of different variables to the age-related increase of CVD risk factors. Results: All CVD risk factors, except for HDL-C, significantly increased across age categories. Older subjects had healthier dietary habits and food intakes, but they possessed nonsignificantly lower physical activity and higher smoking rate compared to younger adults. Adjusting for physical activity, smoking, and BMI did not change the significant positive association between age and CVD risk factors but adjusting for WHtR disappeared associations for blood pressure, triglycerides, and metabolic syndrome although significant associations remained for FBG and total and LDL-C. Conclusions: Age-related increase of CVD risk factors occurred independent of lifestyle habits. WHtR, but not BMI, may partially contribute to the age-related increase in CVD risk factors. PMID:27195100

  4. Age-related increase of thromboxane B2 and risk of cardiovascular disease in atrial fibrillation

    PubMed Central

    Farcomeni, Alessio; Nocella, Cristina; Bartimoccia, Simona; Carnevale, Roberto; Violi, Francesco

    2016-01-01

    Aging is strictly associated with an increased incidence of cardiovascular events (CVEs) in the general population. Mechanisms underlying the risk of CVEs are still unclear. Platelet activation contributes to the onset of cardiovascular complications. The incidence of atrial fibrillation (AF) increases with age, and the natural history of AF is often complicated by CVEs. We prospectively investigated the relationship between age, urinary thromboxane (Tx) B2, which reflects platelet activation, and CVEs in 833 AF patients. Median TxB2 level was 120 [66-200] ng/mg of urinary creatinine. At multivariable linear regression analysis, age (B: 0.097, p=0.005) and previous MI/CHD (B: 0.069, p=0.047) were associated with log-TxB2 levels. When we divided our population into age classes (i.e. < 60, 60-69, 70-79, ≥ 80 years), we found a significant difference in TxB2 levels across classes (p=0.005), with a significant elevation at 74.6 years. During a mean follow-up of 40.9 months, 128 CVEs occurred; the rate of CVEs significantly increased with age classes (Log-rank test, p < 0.001). TxB2 levels were higher in patients with, compared to those without, CVEs in patients aged 70-79 (p < 0.001) and ≥ 80 (p = 0.020) years. In conclusion, TxB2 levels enhance by increasing age, suggesting that platelet activation contributes to CVEs in elderly patients with AF. PMID:27270651

  5. Increased Klk9 Urinary Excretion Is Associated to Hypertension-Induced Cardiovascular Damage and Renal Alterations

    PubMed Central

    Blázquez-Medela, Ana M.; García-Sánchez, Omar; Quirós, Yaremi; Blanco-Gozalo, Victor; Prieto-García, Laura; Sancho-Martínez, Sandra M.; Romero, Miguel; Duarte, Juan M.; López-Hernández, Francisco J.; López-Novoa, José M.; Martínez-Salgado, Carlos

    2015-01-01

    Abstract Early detection of hypertensive end-organ damage and secondary diseases are key determinants of cardiovascular prognosis in patients suffering from arterial hypertension. Presently, there are no biomarkers for the detection of hypertensive target organ damage, most outstandingly including blood vessels, the heart, and the kidneys. We aimed to validate the usefulness of the urinary excretion of the serine protease kallikrein-related peptidase 9 (KLK9) as a biomarker of hypertension-induced target organ damage. Urinary, plasma, and renal tissue levels of KLK9 were measured by the Western blot in different rat models of hypertension, including angiotensin-II infusion, DOCA-salt, L-NAME administration, and spontaneous hypertension. Urinary levels were associated to cardiovascular and renal injury, assessed by histopathology. The origin of urinary KLK9 was investigated through in situ renal perfusion experiments. The urinary excretion of KLK9 is increased in different experimental models of hypertension in rats. The ACE inhibitor trandolapril significantly reduced arterial pressure and the urinary level of KLK9. Hypertension did not increase kidney, heart, liver, lung, or plasma KLK9 levels. Hypertension-induced increased urinary excretion of KLK9 results from specific alterations in its tubular reabsorption, even in the absence of overt nephropathy. KLK9 urinary excretion strongly correlates with cardiac hypertrophy and aortic wall thickening. KLK9 appears in the urine in the presence of hypertension as a result of subtle renal handling alterations. Urinary KLK9 might be potentially used as an indicator of hypertensive cardiac and vascular damage. PMID:26469898

  6. Increased Cardiovascular Events and Subclinical Atherosclerosis in Rheumatoid Arthritis Patients: 1 Year Prospective Single Centre Study

    PubMed Central

    Ruscitti, Piero; Cipriani, Paola; Masedu, Francesco; Romano, Silvio; Berardicurti, Onorina; Liakouli, Vasiliki; Carubbi, Francesco; Di Benedetto, Paola; Alvaro, Saverio; Penco, Maria; Valenti, Marco; Giacomelli, Roberto

    2017-01-01

    Objectives Several studies showed the close relationship between Rheumatoid Arthritis (RA) and cerebro-cardiovascular events (CVEs) and subclinical atherosclerosis. In this study, we investigated the occurrence of CVEs and subclinical atherosclerosis during the course of RA and we evaluated the possible role of both traditional cardiovascular (CV) and disease related risk factors to predict the occurrence of new CVEs and the onset of subclinical atherosclerosis. Methods We designed a single centre, bias-adjusted, prospective, observational study to investigate, in a homogeneous subset of RA patients, the occurrence of new onset of CVEs and subclinical atherosclerosis. Statistical analyses were performed to evaluate the role of traditional CV and disease-related risk factors to predict the occurrence of new CVEs and subclinical atherosclerosis. Results We enrolled 347 RA patients prospectively followed for 12 months. An increased percentage of patients experienced CVEs, developed subclinical atherosclerosis and was affected by systemic arterial hypertension (SAH), type 2 diabetes mellitus and metabolic syndrome (MS), at the end of follow up. Our analysis showed that the insurgence of both SAH and MS, during the follow up, the older age, the CVE familiarity and the lack of clinical response, were associated with a significantly increased risk to experience CVEs and to develop subclinical atherosclerosis. Conclusions Our study quantifies the increased expected risk for CVEs in a cohort of RA patients prospectively followed for 1 year. The occurrence of both new CVEs and subclinical atherosclerosis in RA patients may be explained by inflammatory burden as well as traditional CV risk factors. PMID:28103312

  7. (Sub)clinical cardiovascular disease is associated with increased bone loss and fracture risk; a systematic review of the association between cardiovascular disease and osteoporosis

    PubMed Central

    2011-01-01

    Introduction Both cardiovascular disease and osteoporosis are important causes of morbidity and mortality in the elderly. The co-occurrence of cardiovascular disease and osteoporosis prompted us to review the evidence of an association between cardiovascular (CV) disease and osteoporosis and potential shared common pathophysiological mechanisms. Methods A systematic literature search (Medline, Pubmed and Embase) was conducted to identify all clinical studies that investigated the association between cardiovascular disease and osteoporosis. Relevant studies were screened for quality according to guidelines as proposed by the Dutch Cochrane Centre and evidence was summarized. Results Seventy studies were included in this review. Due to a large heterogeneity in study population, design and outcome measures a formal meta-analysis was not possible. Six of the highest ranked studies (mean n = 2,000) showed that individuals with prevalent subclinical CV disease had higher risk for increased bone loss and fractures during follow-up compared to persons without CV disease (range of reported risk: hazard ratio (HR) 1.5; odds ratio (OR) 2.3 to 3.0). The largest study (n = 31,936) reported a more than four times higher risk in women and more than six times higher risk in men. There is moderate evidence that individuals with low bone mass had higher CV mortality rates and incident CV events than subjects with normal bone mass (risk rates 1.2 to 1.4). Although the shared common pathophysiological mechanisms are not fully elucidated, the most important factors that might explain this association appear to be, besides age, estrogen deficiency and inflammation. Conclusions The current evidence indicates that individuals with prevalent subclinical CV disease are at increased risk for bone loss and subsequent fractures. Presently no firm conclusions can be drawn as to what extent low bone mineral density might be associated with increased cardiovascular risk. PMID:21241491

  8. A High Dietary Glycemic Index Increases Total Mortality in a Mediterranean Population at High Cardiovascular Risk

    PubMed Central

    Castro-Quezada, Itandehui; Sánchez-Villegas, Almudena; Estruch, Ramón; Salas-Salvadó, Jordi; Corella, Dolores; Schröder, Helmut; Álvarez-Pérez, Jacqueline; Ruiz-López, María Dolores; Artacho, Reyes; Ros, Emilio; Bulló, Mónica; Covas, María-Isabel; Ruiz-Gutiérrez, Valentina; Ruiz-Canela, Miguel; Buil-Cosiales, Pilar; Gómez-Gracia, Enrique; Lapetra, José; Pintó, Xavier; Arós, Fernando; Fiol, Miquel; Lamuela-Raventós, Rosa María; Martínez-González, Miguel Ángel; Serra-Majem, Lluís

    2014-01-01

    Objective Different types of carbohydrates have diverse glycemic response, thus glycemic index (GI) and glycemic load (GL) are used to assess this variation. The impact of dietary GI and GL in all-cause mortality is unknown. The objective of this study was to estimate the association between dietary GI and GL and risk of all-cause mortality in the PREDIMED study. Material and Methods The PREDIMED study is a randomized nutritional intervention trial for primary cardiovascular prevention based on community-dwelling men and women at high risk of cardiovascular disease. Dietary information was collected at baseline and yearly using a validated 137-item food frequency questionnaire (FFQ). We assigned GI values of each item by a 5-step methodology, using the International Tables of GI and GL Values. Deaths were ascertained through contact with families and general practitioners, review of medical records and consultation of the National Death Index. Cox regression models were used to estimate multivariable-adjusted hazard ratios (HR) and their 95% CI for mortality, according to quartiles of energy-adjusted dietary GI/GL. To assess repeated measures of exposure, we updated GI and GL intakes from the yearly FFQs and used Cox models with time-dependent exposures. Results We followed 3,583 non-diabetic subjects (4.7 years of follow-up, 123 deaths). As compared to participants in the lowest quartile of baseline dietary GI, those in the highest quartile showed an increased risk of all-cause mortality [HR = 2.15 (95% CI: 1.15–4.04); P for trend  = 0.012]. In the repeated-measures analyses using as exposure the yearly updated information on GI, we observed a similar association. Dietary GL was associated with all-cause mortality only when subjects were younger than 75 years. Conclusions High dietary GI was positively associated with all-cause mortality in elderly population at high cardiovascular risk. PMID:25250626

  9. Cardiovascular responses to lead are biphasic, while methylmercury, but not inorganic mercury, monotonically increases blood pressure in rats.

    PubMed

    Wildemann, Tanja M; Mirhosseini, Naghmeh; Siciliano, Steven D; Weber, Lynn P

    2015-02-03

    Cardiovascular diseases, such as heart attack and stroke, are the major cause of death worldwide. It is well known that a high number of environmental and physiological risk factors contribute to the development of cardiovascular diseases. Although risk factors are additive, increased blood pressure (hypertension) is the greatest risk factor. Over the last two decades, a growing number of epidemiological studies associate environmental exposure to lead or mercury species with hypertension. However, cardiovascular effects beyond blood pressure are rarely studied and thresholds for effect are not yet clear. To explore effects of lead or mercury species on the cardiovascular system, normal male Wistar rats were exposed to a range of doses of lead, inorganic mercury or methylmercury through the drinking water for four weeks. High-resolution ultrasound was used to measure heart and vascular function (carotid artery blood flow) at baseline and at the end of the exposure, while blood pressure was measured directly in the femoral artery at the end of the 4-week exposure. After 4 weeks, blood pressure responses to lead were biphasic. Low lead levels decreased blood pressure, dilated the carotid artery and increased cardiac output. At higher lead doses, rats had increased blood pressure. In contrast, methylmercury-exposed rats had increased blood pressure at all doses despite dilated carotid arteries. Inorganic mercury did not show any significant cardiovascular effects. Based on the current study, the benchmark dose level 10% (BMDL10s) for systolic blood pressure for lead, inorganic mercury and methylmercury are 1.1, 1.3 and 1.0 μg/kg-bw/d, respectively. However, similar total mercury blood levels attributed to inorganic mercury or methylmercury produced strikingly different results with inorganic mercury having no observable effect on the cardiovascular system but methylmercury increasing systolic and pulse pressures. Therefore, adverse cardiovascular effects cannot be

  10. Therapy for triggered acute risk prevention in subjects at increased cardiovascular risk.

    PubMed

    Tofler, Geoffrey H; Spinaze, Monica; Shaw, Elizabeth; Buckley, Thomas

    2013-06-15

    Heavy physical exertion, emotional stress, heavy meals, and respiratory infection transiently increase the risk of myocardial infarction, sudden cardiac death, and stroke; however, it remains uncertain how to use this information for disease prevention. We determined whether it was feasible for those with either risk factors for cardiovascular disease (CVD) or known CVD to take targeted medication for the hazard duration of the triggering activity to reduce their risk. After a run-in of 1 month, 20 subjects (12 women and 8 men) aged 68.6 years (range 58 to 83) recorded for 2 months all episodes of physical and emotional stress, heavy meal consumption, and respiratory infection. For each episode, the subjects were instructed to take either aspirin 100 mg and propranolol 10 mg (for physical exertion and emotional stress) or aspirin 100 mg alone (for respiratory infection and heavy meal consumption) and to record their adherence. Adherence with taking the appropriate medication was 86% according to the diary entries, with 15 of 20 subjects (75%) achieving ≥80% adherence. Propranolol taken before exertion reduced the peak heart rate compared with similar exercise during the run-in period (118 ± 21 vs 132 ± 16 beats/min, p = 0.016). Most subjects (85%) reported that it was feasible to continue taking the medication in this manner. In conclusion, it is feasible for those with increased CVD risk to identify potential triggers of acute CVD and to take targeted therapy at the time of these triggers.

  11. Insulin Therapy Increases Cardiovascular Risk: Time for a Sea of Change in Type 2 Diabetes Treatment.

    PubMed

    Herman, Mary E; O'Keefe, James H; Bell, David S H; Schwartz, Stanley S

    2017-09-25

    Insulin therapy increased cardiovascular (CV) risk and mortality among type 2 diabetes (T2D) patients in several recently reported clinical outcomes trials. To assess whether this association is causative or coincidental, PubMed searches were used to query the effects of insulin therapy for T2D on CV health and longevity from large-scale outcomes trials, meta-analyses, and patient registry studies, as well as basic research on insulin's direct and pleiotropic actions. Although several old studies provided conflicting results, the majority of large observational studies show strong dose-dependent associations for injected insulin with increased CV risk and worsened mortality. Insulin clearly causes weight gain, recurrent hypoglycemia, and, other potential adverse effects, including iatrogenic hyperinsulinemia. This over-insulinization with use of injected insulin predisposes to inflammation, atherosclerosis, hypertension, dyslipidemia, heart failure (HF), and arrhythmias. These associations support the findings of large-scale evaluations that strongly suggest that insulin therapy has a poorer short- and long-term safety profile than that found to many other anti-T2D therapies. The potential adverse effects of insulin therapy should be weighed against proven CV benefits noted for select other therapies for T2D as reported in recent large randomized controlled trials. Copyright © 2017. Published by Elsevier Inc.

  12. Increased consumption of fruit and vegetables for the primary prevention of cardiovascular diseases.

    PubMed

    Hartley, Louise; Igbinedion, Ewemade; Holmes, Jennifer; Flowers, Nadine; Thorogood, Margaret; Clarke, Aileen; Stranges, Saverio; Hooper, Lee; Rees, Karen

    2013-06-04

    There is increasing evidence that high consumption of fruit and vegetables is beneficial for cardiovascular disease (CVD) prevention. The primary objective is to determine the effectiveness of i) advice to increase fruit and vegetable consumption ii) the provision of fruit and vegetables to increase consumption, for the primary prevention of CVD.  We searched the following electronic databases: The Cochrane Library (2012, issue 9-CENTRAL, HTA, DARE, NEED), MEDLINE (1946 to week 3 September 2012); EMBASE (1980 to 2012 week 39) and the Conference Proceedings Citation Index - Science on ISI Web of Science (5 October 2012). We searched trial registers, screened reference lists and contacted authors for additional information where necessary. No language restrictions were applied. Randomised controlled trials with at least three months follow-up (follow-up was considered to be the time elapsed since the start of the intervention) involving healthy adults or those at high risk of CVD. Trials investigated either advice to increase fruit and vegetable intake (via any source or modality) or the provision of fruit and vegetables to increase intake. The comparison group was no intervention or minimal intervention. Outcomes of interest were CVD clinical events (mortality (CVD and all-cause), myocardial infarction (MI), coronary artery bypass grafting (CABG) or percutaneous transluminal coronary angioplasty (PTCA), angiographically-defined angina pectoris, stroke, carotid endarterectomy, peripheral arterial disease (PAD)) and major CVD risk factors (blood pressure, blood lipids, type 2 diabetes). Trials involving multifactorial lifestyle interventions (including different dietary patterns, exercise) or where the focus was weight loss were excluded to avoid confounding. Two review authors independently selected trials for inclusion, extracted data and assessed the risk of bias. Trials of provision of fruit and vegetables were analysed separately from trials of dietary advice

  13. Cardiovascular risk factors are associated with increased lesion burden and brain atrophy in multiple sclerosis.

    PubMed

    Kappus, Natalie; Weinstock-Guttman, Bianca; Hagemeier, Jesper; Kennedy, Cheryl; Melia, Rebecca; Carl, Ellen; Ramasamy, Deepa P; Cherneva, Mariya; Durfee, Jacqueline; Bergsland, Niels; Dwyer, Michael G; Kolb, Channa; Hojnacki, David; Ramanathan, Murali; Zivadinov, Robert

    2016-02-01

    Cardiovascular (CV) risk factors have been associated with changes in clinical outcomes in patients with multiple sclerosis (MS). To investigate the frequency of CV risks in patients with MS and their association with MRI outcomes. In a prospective study, 326 patients with relapsing-remitting MS and 163 patients with progressive MS, 61 patients with clinically isolated syndrome (CIS) and 175 healthy controls (HCs) were screened for CV risks and scanned on a 3T MRI scanner. Examined CV risks included hypertension, heart disease, smoking, overweight/obesity and type 1 diabetes. MRI measures assessed lesion volumes (LVs) and brain atrophy. Association between individual or multiple CV risks and MRI outcomes was examined adjusting for age, sex, race, disease duration and treatment status. Patients with MS showed increased frequency of smoking (51.7% vs 36.5%, p = 0.001) and hypertension (33.9% vs 24.7%, p=0.035) compared with HCs. In total, 49.9% of patients with MS and 36% of HCs showed ≥ 2 CV risks (p = 0.003), while the frequency of ≥ 3 CV risks was 18.8% in the MS group and 8.6% in the HCs group (p = 0.002). In patients with MS, hypertension and heart disease were associated with decreased grey matter (GM) and cortical volumes (p < 0.05), while overweight/obesity was associated with increased T1-LV (p < 0.39) and smoking with decreased whole brain volume (p = 0.049). Increased lateral ventricle volume was associated with heart disease (p = 0.029) in CIS. Patients with MS with one or more CV risks showed increased lesion burden and more advanced brain atrophy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  14. Cardiovascular Risk Factors Are Associated With Increased Arterial Stiffness in Youth With Type 1 Diabetes

    PubMed Central

    Dabelea, Dana; Talton, Jennifer W.; D’Agostino, Ralph; Wadwa, R. Paul; Urbina, Elaine M.; Dolan, Lawrence M.; Daniels, Stephen R.; Marcovina, Santica M.; Hamman, Richard F.

    2013-01-01

    OBJECTIVE To evaluate if presence of cardiovascular (CV) risk factors and their clustering as metabolic syndrome (MetS) is associated with increased arterial stiffness and accelerated progression over time among youth with type 1 diabetes. RESEARCH DESIGN AND METHODS Longitudinal study of 298 youth with type 1 diabetes (age 14.5 years; 46.3% female; duration 4.8 years), with two research visits conducted 5 years apart. CV factors included: waist circumference, blood pressure (BP), fasting lipids (HDL cholesterol, LDL cholesterol [LDL-c], triglycerides), albumin/creatinine ratio, and HbA1c. MetS was based on Adult Treatment Panel III criteria modified for youth. Pulse wave velocity (PWV) in the carotid–femoral segment was measured by tonometry. Mixed models were used to assess the rate of progression in PWV and the association between CV factors and PWV over time. RESULTS PWV increased significantly over time (0.145 m/s/year; P < 0.0001). MetS (P = 0.0035), large waist (P < 0.0001), and elevated BP (P = 0.0003) at baseline were each associated with worse PWV over time. These baseline factors, however, did not significantly influence the rate of progression. Increases in waist circumference (P < 0.0001), LDL-c levels (P = 0.0156), and declining glucose control (HbA1c; P = 0.0419) were independently associated with higher PWV over time. CONCLUSIONS Presence, clustering, and worsening of CV risk factors are associated with increased arterial stiffness over time in youth with type 1 diabetes. Whether improvement in CV risk factors early in life will slow the progression of arterial stiffness and reduce the burden of CV disease in this population requires further study. PMID:24101697

  15. Breast cancer in neurofibromatosis type 1: overrepresentation of unfavourable prognostic factors

    PubMed Central

    Uusitalo, Elina; Kallionpää, Roope A; Kurki, Samu; Rantanen, Matti; Pitkäniemi, Janne; Kronqvist, Pauliina; Härkönen, Pirkko; Huovinen, Riikka; Carpen, Olli; Pöyhönen, Minna; Peltonen, Sirkku; Peltonen, Juha

    2017-01-01

    Background: An increased breast cancer incidence and poor survival have been reported for women with neurofibromatosis 1 (NF1). To explain the poor survival, we aimed to link the histopathology and clinical characteristics of NF1-associated breast cancers. Methods: The Finnish Cancer Registry and the Finnish NF Registry were cross-referenced to identify the NF1 patients with breast cancer. Archival NF1 breast cancer specimens were retrieved for histopathological typing and compared with matched controls. Results: A total of 32 breast cancers were diagnosed in 1404 NF1 patients during the follow-up. Women with NF1 had an estimated lifetime risk of 18.0% for breast cancer, and this is nearly two-fold compared with that of the general Finnish female population (9.74%). The 26 successfully retrieved archival NF1 breast tumours were more often associated with unfavourable prognostic factors, such as oestrogen and progesterone receptor negativity and HER2 amplification. However, survival was worse in the NF1 group (P=0.053) even when compared with the control group matched for age, diagnosis year, gender and oestrogen receptor status. Scrutiny of The Cancer Genome Atlas data set showed that NF1 mutations and deletions were associated with similar characteristics in the breast cancers of the general population. Conclusions: These results emphasise the role of the NF1 gene in the pathogenesis of breast cancer and a need for active follow-up for breast cancer in women with NF1. PMID:27931045

  16. Breast cancer in neurofibromatosis type 1: overrepresentation of unfavourable prognostic factors.

    PubMed

    Uusitalo, Elina; Kallionpää, Roope A; Kurki, Samu; Rantanen, Matti; Pitkäniemi, Janne; Kronqvist, Pauliina; Härkönen, Pirkko; Huovinen, Riikka; Carpen, Olli; Pöyhönen, Minna; Peltonen, Sirkku; Peltonen, Juha

    2017-01-17

    An increased breast cancer incidence and poor survival have been reported for women with neurofibromatosis 1 (NF1). To explain the poor survival, we aimed to link the histopathology and clinical characteristics of NF1-associated breast cancers. The Finnish Cancer Registry and the Finnish NF Registry were cross-referenced to identify the NF1 patients with breast cancer. Archival NF1 breast cancer specimens were retrieved for histopathological typing and compared with matched controls. A total of 32 breast cancers were diagnosed in 1404 NF1 patients during the follow-up. Women with NF1 had an estimated lifetime risk of 18.0% for breast cancer, and this is nearly two-fold compared with that of the general Finnish female population (9.74%). The 26 successfully retrieved archival NF1 breast tumours were more often associated with unfavourable prognostic factors, such as oestrogen and progesterone receptor negativity and HER2 amplification. However, survival was worse in the NF1 group (P=0.053) even when compared with the control group matched for age, diagnosis year, gender and oestrogen receptor status. Scrutiny of The Cancer Genome Atlas data set showed that NF1 mutations and deletions were associated with similar characteristics in the breast cancers of the general population. These results emphasise the role of the NF1 gene in the pathogenesis of breast cancer and a need for active follow-up for breast cancer in women with NF1.

  17. Increasing aspirin use among persons at risk for cardiovascular events in Oklahoma.

    PubMed

    Mallonee, Sue; Daniels, Carrie G; Mold, James W; Cline, Terry L

    2010-07-01

    Cardiovascular disease (CVD), including coronary heartdisease (CHD)and stroke, is the leading cause of death in the United States and in Oklahoma; Oklahoma ranks 48th worst in CVD deaths.This paper will present Oklahoma-specific data and review current recommendations regarding aspirin use for the prevention of CVD events. Average annual age-adjusted death rates were calculated. Oklahoma Behavioral Risk Factor Surveillance System (BRFSS) data were used to determine past history of CHD, risk factors for CHD and stroke, and aspirin use among persons 45 years and older. A literature review of recommendations regarding aspirin use was conducted. Between 2005-2008, 14.8% of Oklahomans 45 years of age and older reported a history of coronary heart disease and 6.4% a history of stroke. Approximately 50% of Oklahomans 45 years and older reported a history of hypertension and hypercholesterolemia; 21.5% were current smokers and 16.0% had diabetes. Nearly 10,000 Oklahomans die annually from CHD or stroke. The United States Preventive Services Task Force recommends 81mg per day of aspirin for men 45 to 79 and women 55 to 79 years of age unless they are at risk for bleeding complications. Daily aspirin use in Oklahoma was 44-57% among those with risk factors but no history of CHD or stroke. Fewer than 50% of Oklahomans 45-79 years reported being counseled by a health professional to take aspirin. Among those persons without a history of CVD who were counseled by a healthcare professional regarding aspirin, 79% were taking daily aspirin compared to 18% among persons not counseled. Aspirin sales increased significantly in Stephens County following a multifaceted community-based aspirin campaign. Low-dose aspirin is being underutilized as a strategy for reducing the excessive numbers of cardiovascular events and deaths in Oklahoma. Health professionals play an important role in educating patients about appropriate use of low-dose aspirin. Community-based interventions can also be

  18. Increased cardiovascular disease risk in Swedish persons with paraplegia: The Stockholm spinal cord injury study.

    PubMed

    Wahman, Kerstin; Nash, Mark S; Lewis, John E; Seiger, Ake; Levi, Richard

    2010-05-01

    Comparison of prevalence of cardiovascular disease risks in persons with chronic traumatic paraplegia with those in the general population. Cross-sectional comparative study. A total of 135 individuals, age range 18-79 years, with chronic (> or = 1 year) traumatic paraplegia. The prevalences of diabetes mellitus, dyslipidaemia, hypertension, overweight, and smoking, were assessed in the study population and were compared with an age- and gender-matched sample of the general population in the region under study. History of myocardial infarction and medication for dyslipidaemia, hypertension, and diabetes mellitus were also recorded. chi2 tests were used to compare the paraplegic cohort with the general population sample. Significantly more persons with paraplegia reported a history of myocardial infarction (5.9%) than those in the comparison group (0.7%). The prevalences of diabetes mellitus (5.9%), dyslipidaemia (11.1%), and hypertension (14.1%) were also significantly higher in the paraplegic group, as were drug treatment for these disorders. Persons with paraplegia report increased prevalences of diabetes mellitus, hypertension, and dyslipidaemia, in particular, compared with the general population. Population-based screening and therapeutic counter-measures for these conditions may therefore be particularly indicated for this patient group.

  19. Increased risk of community-acquired pneumonia in COPD patients with comorbid cardiovascular disease

    PubMed Central

    Lin, Sheng-Hao; Perng, Diahn-Warng; Chen, Ching-Pei; Chai, Woei-Horng; Yeh, Chin-Shui; Kor, Chew-Teng; Cheng, Shih-Lung; Chen, Jeremy JW; Lin, Ching-Hsiung

    2016-01-01

    Background and objective COPD patients with community-acquired pneumonia (CAP) have worse clinical outcomes, as compared to those without COPD. Cardiovascular disease (CVD) is a common comorbidity for COPD patients. Whether COPD with comorbid CVD will increase the risk of CAP is not well investigated. The incidence and factors associated with CAP in COPD patients with and without CVD were analyzed. Methods The medical records of patients with newly diagnosed COPD between 2007 and 2010 were reviewed. The patients’ characteristics, medical history of CVD, occurrence of CAP, and type of medication were recorded. Kaplan–Meier curves were used to assess the differences in cumulative incidence of CAP. Cox’s proportional hazards regression model was used to determine the adjusted hazard ratios with 95% confidence intervals in relation to factors associated with CAP in COPD patients with and without CVD. Results Among 2,440 patients, 475 patients (19.5%) developed CAP during the follow-up period. COPD patients who developed CAP were significantly older, had lower forced expiratory volume in 1 second, frequent severe exacerbation and comorbid CVD, as well as received inhaled corticosteroid (ICS)-containing therapy than those without CAP. The cumulative incidence of CAP was higher in COPD patients with CVD compared to those without CVD. Patients who received ICS-containing therapy had significantly increased risk of developing CAP compared to those who did not. Conclusion For patients with COPD, comorbid CVD is an independent risk factor for developing CAP. ICS-containing therapy may increase the risk of CAP among COPD patients. PMID:27980402

  20. Effects of red orange juice intake on endothelial function and inflammatory markers in adult subjects with increased cardiovascular risk.

    PubMed

    Buscemi, Silvio; Rosafio, Giuseppe; Arcoleo, Gioacchina; Mattina, Alessandro; Canino, Baldassare; Montana, Maria; Verga, Salvatore; Rini, Giovanbattista

    2012-05-01

    Oxidative and inflammatory stresses are involved in the pathogenesis of atherosclerosis. The consumption of fruit and vegetables is associated with improved health and reduced cardiovascular risk. Red oranges have a high content of antioxidant and antiinflammatory substances, but there is a paucity of data concerning their effects on cardiovascular biomarkers in subjects with increased cardiovascular risk. We investigated the effect of red orange juice intake on endothelial function, oxidative stress, and markers of inflammation in subjects with increased cardiovascular risk. Nineteen nondiabetic subjects with increased cardiovascular risk (aged 27-56 y) were included in a randomized, placebo-controlled, single-blind crossover study and compared with 12 healthy, nonobese control subjects. In 2 periods of 7 d each with a 3-d interval, each participant alternatively received 500 mL red orange juice/d and 500 mL placebo/d in a random sequence. All measurements were performed in the morning after overnight fasting. Endothelial function, which was measured as flow-mediated dilation, significantly improved and was normalized (5.7% compared with 7.9%; P < 0.005) after 1 wk of red orange juice consumption. Similarly, concentrations of high-sensitivity C-reactive protein, IL-6, and TNF-α significantly decreased (P < 0.001). Red orange juice had no significant effect on nitric oxide plasma concentrations. A 7-d consumption of red orange juice ameliorates endothelial function and reduces inflammation in nondiabetic subjects with increased cardiovascular risk. This trial was registered at biomedcentral.com as ISRCTN39987296.

  1. Impact of increases in high-density lipoprotein cholesterol on cardiovascular outcomes during the armed forces regression study.

    PubMed

    Devendra, Ganesh P; Whitney, Edwin J; Krasuski, Richard A

    2010-12-01

    high-density lipoprotein (HDL) cholesterol is a well-established inverse risk factor for cardiovascular disease. The extent to which cardiovascular risk can be modified through changes in HDL, however, is less clear. We further examined the role of aggressive HDL raising therapy on cardiovascular outcomes in the 143 patients enrolled in the Armed Forces Regression Study (AFREGS). reanalysis of the AFREGS population. Patients with stable coronary disease were randomized to receive gemfibrozil, niacin, and cholestyramine in combination or matching placebos, on top of aggressive dietary and exercise modification for a 30-month period. Blood work was performed at baseline and repeated after 1 year of therapy. patients were divided into 3 groups based on their therapeutic response: no HDL increase, mild HDL increase, and large HDL increase (% change in HDL ≤ 0, ≤ the lower 2 tertiles of HDL increase, and > the upper tertile of HDL increase, respectively). A progressive decrease in cardiovascular events was noted across these groups (30.4%, 19.4%, and 3.2%, respectively, P = .01). Kaplan-Meier analysis according to percentage change in HDL demonstrated a similar improvement in event-free survival (P = .01). Proportional hazards modeling also demonstrated that increasing HDL predicted a lower hazard of cardiovascular events, even after adjusting for changes in low-density lipoprotein ([LDL] P < .01). For every 1% increase in HDL achieved, a 2% decrease in events was recognized. these data suggest that in a population of patients with stable atherosclerosis, the greater the percentage increase in HDL achieved, the greater the cardioprotective benefit. This further supports HDL raising as a beneficial therapeutic strategy.

  2. Smoking increases the risk of all-cause and cardiovascular mortality in patients with chronic kidney disease.

    PubMed

    Nakamura, Koshi; Nakagawa, Hideaki; Murakami, Yoshitaka; Kitamura, Akihiko; Kiyama, Masahiko; Sakata, Kiyomi; Tsuji, Ichiro; Miura, Katsuyuki; Ueshima, Hirotsugu; Okamura, Tomonori

    2015-11-01

    Little is known about the magnitude and nature of the combined effect of chronic kidney disease (CKD) and smoking on cardiovascular diseases. We studied this in a Japanese population using a pooled analysis of 15,468 men and 19,154 women aged 40-89 years enrolled in 8 cohort studies. The risk of mortality from all-causes and cardiovascular disease was compared in 6 gender-specific categories of baseline CKD status (non-CKD or CKD) and smoking habits (lifelong never smoked, former smokers, or currently smoking). CKD was defined as a decreased level of estimated glomerular filtration rate (under 60 ml/min per 1.73 m(2)) and/or dipstick proteinuria. Hazard ratios were estimated for each category, relative to never smokers without CKD. During the follow-up period (mean 14.8 years), there were 6771 deaths, 1975 of which were due to cardiovascular diseases. In both men and women, current or former smokers with CKD had the first or second highest crude mortality rates from all-cause and cardiovascular diseases among the 6 categories. After adjustment for age and other major cardiovascular risk factors, the hazard ratios in male and female current smokers with CKD were 2.26 (95% confidence interval, 1.95-2.63) and 1.78 (1.36-2.32) for all-causes, and 2.66 (2.04-3.47) and 1.71 (1.10-2.67) for cardiovascular diseases, respectively. Thus, coexistence of CKD and smoking may markedly increase the risk of all-cause and cardiovascular mortality.

  3. Arsenic exposure through drinking water increases the risk of liver and cardiovascular diseases in the population of West Bengal, India

    PubMed Central

    2012-01-01

    Background Arsenic is a natural drinking water contaminant affecting 26 million people in West Bengal, India. Chronic arsenic exposure causes cancer, cardiovascular disease, liver disease, neuropathies and ocular diseases. The aims of the present study were to assess bioindicators of hepatocellular injury as indicated by the levels of liver enzymes, to determine the auto immune status, as indicated by the amounts of anti-nuclear antibodies (ANA) and anti-dsDNA antibodies in their serum, and to predict cardiovascular risk in the arsenic exposed population. Methods Effect of chronic arsenic exposure on liver was determined by liver function tests. Autoimmune status was measured by measuring ANA and anti-dsDNA in serum. Inflammatory cytokines associated with increased cardiovascular disease risk, IL6, IL8 and MCP-1 were determined. Results Our results indicated that serum levels of bilirubin, alanine transaminase, aspartate transaminase, alkaline phosphatase and ANA were increased in the arsenic exposed population. Serum levels of IL6 and IL8 also increased in the arsenic exposed group. Conclusions Chronic arsenic exposure causes liver injury, increases the serum levels of autoimmune markers and imparts increased cardiovascular risk. PMID:22883023

  4. Arsenic exposure through drinking water increases the risk of liver and cardiovascular diseases in the population of West Bengal, India.

    PubMed

    Das, Nandana; Paul, Somnath; Chatterjee, Debmita; Banerjee, Nilanjana; Majumder, Niladri S; Sarma, Nilendu; Sau, Tanmoy J; Basu, Santanu; Banerjee, Saptarshi; Majumder, Papiya; Bandyopadhyay, Apurba K; States, J Christopher; Giri, Ashok K

    2012-08-10

    Arsenic is a natural drinking water contaminant affecting 26 million people in West Bengal, India. Chronic arsenic exposure causes cancer, cardiovascular disease, liver disease, neuropathies and ocular diseases. The aims of the present study were to assess bioindicators of hepatocellular injury as indicated by the levels of liver enzymes, to determine the auto immune status, as indicated by the amounts of anti-nuclear antibodies (ANA) and anti-dsDNA antibodies in their serum, and to predict cardiovascular risk in the arsenic exposed population. Effect of chronic arsenic exposure on liver was determined by liver function tests. Autoimmune status was measured by measuring ANA and anti-dsDNA in serum. Inflammatory cytokines associated with increased cardiovascular disease risk, IL6, IL8 and MCP-1 were determined. Our results indicated that serum levels of bilirubin, alanine transaminase, aspartate transaminase, alkaline phosphatase and ANA were increased in the arsenic exposed population. Serum levels of IL6 and IL8 also increased in the arsenic exposed group. Chronic arsenic exposure causes liver injury, increases the serum levels of autoimmune markers and imparts increased cardiovascular risk.

  5. Intravenous Ferric Chloride Hexahydrate Supplementation Induced Endothelial Dysfunction and Increased Cardiovascular Risk among Hemodialysis Patients

    PubMed Central

    Kuo, Ko-Lin; Hung, Szu-Chun; Lin, Yao-Ping; Tang, Ching-Fang; Lee, Tzong-Shyuan; Lin, Chih-Pei; Tarng, Der-Cherng

    2012-01-01

    Background The association between intravenous (IV) iron administration and outcomes in hemodialysis (HD) patients is still debated. Therefore, this study was aimed to assess the relationship between the IV administration of ferric chloride hexahydrate (Atofen®) and cardiovascular (CV) outcome and the interaction between iron-induced oxidative stress and endothelial dysfunction in chronic HD patients. Methodology/Principal Findings A cohort of 1239 chronic HD patients was recruited. In a follow-up of 12 months, Kaplan-Meier survival curves showed that higher doses of IV Atofen associated with higher risks for CV events and deaths in HD patients. In multivariate Cox models, compared to no iron supplementation, IV Atofen administration was an independent predictor for CV events and overall mortality. However, the nature of the observational cohort study possibly bears selection bias. We further found that IV Atofen enhanced the superoxide production of mononuclear cells (MNCs), the levels of circulating soluble adhesion molecules, and the adhesion of MNCs to human aortic endothelial cells (HAECs). In vitro experiments showed that Atofen increased the expression of intracellular cell adhesion molecule-1 and vascular cell adhesion molecule-1 in HAECs and aggravated the endothelial adhesiveness in a dose-dependent manner. These iron-induced changes were significantly attenuated by the co-treatment of HAECs with N-acetylcysteine and inhibitors of NADPH oxidase, nuclear factor κB, and activator protein-1. Conclusion A cumulative dose of IV Atofen >800 mg within 6 months was associated with an adverse CV outcome and a higher mortality among chronic HD patients. The detrimental effects of IV iron supplementation were partly due to the increased oxidative stress and induction of MNC adhesion to endothelial cells, a pivotal index of early atherogenesis. PMID:23227165

  6. A high-fat meal increases cardiovascular reactivity to psychological stress in healthy young adults.

    PubMed

    Jakulj, Fabijana; Zernicke, Kristin; Bacon, Simon L; van Wielingen, Laura E; Key, Brenda L; West, Sheila G; Campbell, Tavis S

    2007-04-01

    The consumption of high levels of saturated fat over the course of several weeks may lead to exaggerated cardiovascular reactivity. The consumption of a single high-fat meal has been associated with a transient impairment of vascular function. In a randomized, repeated measures, crossover study we tested whether the consumption of a single high-fat meal by healthy, normotensive participants would affect cardiovascular reactivity when compared with an isocaloric, low-fat meal. Thirty healthy participants ate a high-fat (42 g) and a low-fat (1 g) meal on 2 separate occasions, and their cardiovascular response to 2 standard laboratory stressors was measured. Systolic blood pressure, diastolic blood pressure, and total peripheral resistance were greater in participants following the consumption of the high-fat meal relative to the low-fat meal. The findings of the present study are consistent with the hypothesis that even a single high-fat meal may be associated with heightened cardiovascular reactivity to stress and offer insight into the pathways through which a high-fat diet may affect cardiovascular function.

  7. A prospective randomized trial comparing Foley catheter, oxytocin, and combination Foley catheter-oxytocin for labour induction with unfavourable cervix.

    PubMed

    El Khouly, Nabih I

    2016-12-06

    The purpose of this study was to evaluate the effectiveness and safety of transcervical Foley catheter with and without oxytocin versus oxytocin alone for labour induction with unfavourable cervix. This trial enrolled 108 women with singleton pregnancies presented for labour induction with unfavourable cervix. Patients were randomly assigned to receive Foley catheter alone (I), Foley catheter plus oxytocin (II) or oxytocin alone (III). Outcomes were analysed in terms of success of induction, induction delivery interval, route of delivery, dose and duration of oxytocin, and complications. Successful normal vaginal delivery was more common in group I (p = .02) compared to group III. Induction delivery time was statistically shorter in group II and group III (p < .001). Patients in group I required significantly less oxytocin dose and duration (p < .001). This led to our conclusion that induction of labour with Foley catheter without oxytocin increases success rate of normal vaginal delivery; however, it has a longer induction delivery interval with similar complications.

  8. Long driving time is associated with haematological markers of increased cardiovascular risk in taxi drivers

    PubMed Central

    Chen, J; Chen, Y; Chang, W; Christiani, D

    2005-01-01

    Aims: To examine the association between driving time and changes in haematological markers of increased risks for cardiovascular diseases (CVD). Methods: The authors conducted a cross sectional analysis of baseline data from the Taxi Drivers' Health Study cohort in Taipei, Taiwan. They retrieved information on comorbidity, laboratory tests, age, and anthropometric measures from medical records of 1157 subjects (mean age 44.6 (SD 8.6) years). Whole blood cell (WBC) count was used as the primary haematological marker for increased CVD risk, and platelet count and haematocrit as the secondary markers. Standardised questionnaires were implemented to collect information on demographics, lifestyle, work related physical and psychosocial factors, and driving time profiles. Multiple regression was used to estimate the adjusted effects of driving time on three haematological markers. Results: The mean measured hematological marker was 6656 (SD 1656) cells x106/l for WBC, 47.2 (SD 3.5) % for hematocrit, and 243 (SD 52) cells x109/l for platelets. The driving time was 264 (SD 76) hours/month. Compared with drivers who drove ⩽208 hours/month (1st quartile cut off), drivers who drove >208 hours/month had a higher WBC count (by 317 x106/l; 95% CI 99 to 535), haematocrit (by 0.8%; 95% CI 0.3 to 1.2), and platelets (7.9 x109/l; 95% CI 1.0 to 14.8). After adjusting for conventional CVD risk factors (age, sex, smoking, hypertension, diabetes, and hypercholesterolaemia), obesity, alcohol drinking, regular exercise, and sociodemographics (education, marital status, income, and so on), long driving time was still associated with significant increases in WBC and platelets, whereas the effect on haematocrit was diminished and became statistically non-significant. Additional controls for physical workload, self-perceived job stress, and job dissatisfaction did not alter the associations with increased WBC and platelets. Conclusions: Longitudinal studies are needed to confirm the

  9. Digoxin treatment is associated with increased total and cardiovascular mortality in anticoagulated patients with atrial fibrillation.

    PubMed

    Pastori, Daniele; Farcomeni, Alessio; Bucci, Tommaso; Cangemi, Roberto; Ciacci, Paolo; Vicario, Tommasa; Violi, Francesco; Pignatelli, Pasquale

    2015-02-01

    Some evidences suggest that the use of digoxin may be harmful inatrial fibrillation (AF) patients. The aim of the study was to investigate in a "real world" of AF patients receiving vitamin K antagonists (VKAs), the relationship between digoxin use and mortality. Prospective single-center observational study including 815 consecutive non-valvular AF patients treated with VKAs. Total mortality was the primary outcome of the study. We also performed a sub-analysis considering only cardiovascular (CV) deaths. Time in therapeutic range (TTR) was used for anticoagulation quality. Median follow-up was 33.2months (2460 person-years); 171 (21.0%) patients were taking digoxin. Compared to those without, patients on digoxin were older (p=0.007), with a clinical history of HF (p<0.001) and at higher risk of thromboembolic events (p<0.001). No difference in TTR between the two groups was registered (p=0.598). During the follow-up, 85 deaths occurred: 47 CV and 38 non-CV deaths; 35 deaths occurred in digoxin users (20.6%). A significant increased rate of total mortality was observed in digoxin-treated patients (p<0.001). Multivariable analysis showed that digoxin was associated with total mortality (hazard ratio [HR]: 2.224, p<0.001) and CV death (HR: 4.686, p<0.001). A propensity score-matched analysis confirmed that digoxin was associated with total mortality (HR: 2.073, p=0.0263) and CV death (HR: 4.043, p=0.004). In AF patients on good anticoagulation control with VKAs, digoxin use was associated with a higher rate of total and CV mortality. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  10. Neonatal Handling Increases Cardiovascular Reactivity to Contextual Fear Conditioning in Borderline Hypertensive Rats (BHR)

    PubMed Central

    Sanders, Brian J.; Knoepfler, Jonathan

    2008-01-01

    Much research has demonstrated that events occurring in early life can have a profound influence on future biobehavioral responses to stressful and emotion provoking situations. The purpose of these studies was to determine the effects of an early environmental manipulation, handling (HAN) on cardiovascular (CV) reactivity, freezing behavior and corticosterone (CORT) responses to contextual fear conditioning in the borderline hypertensive rat (BHR), which is susceptible to environmental stressors. HAN subjects were separated from the nest for 15 min/day on post-natal days 1–14, while non-handled (NON-HAN) controls remained in the home cage. Adult subjects were exposed to the contextual fear conditioning procedure and returned to the chamber 24 h later for a 10 min test period. HAN subjects displayed significantly more freezing behavior compared to NON-HAN(92%±2.2 vs 80.7%±5.7, p < .05). Although resting MAP did not differ between groups, HAN subjects had increased MAP reactivity when re-exposed to the chamber. In addition, HAN subjects had significantly lower CORT levels at the end of the 10 min test period (174.2±9 ng/ml vs 237.2±12.9 ng/ml, p < .05). In the second experiment, CORT responses to 60 min of restraint stress and recovery following return to the home cage were assessed in separate groups of HAN and NON-HAN subjects. HAN subjects showed reduced CORT levels in response to acute restraint stress. These results indicate that neonatal handling can modulate biobehavioral responses to contextual fear conditioning in BHR and may suggest a useful model with which to study emotionality and susceptibility to CV disease. PMID:18538802

  11. Increased cardiovascular disease mortality associated with excessive exercise in heart attack survivors.

    PubMed

    Williams, Paul T; Thompson, Paul D

    2014-09-01

    To test whether greater exercise is associated with progressively lower mortality after a cardiac event. We used Cox proportional hazard analyses to examine mortality vs estimated energy expended by running or walking measured as metabolic equivalents (3.5 mL O2/kg per min per day or metabolic equivalent of task-h/d [MET-h/d]) in 2377 self-identified heart attack survivors, where 1 MET-h/d is the energy equivalent of running 1 km/d. Mortality surveillance via the National Death Index included January 1991 through December 2008. A total of 526 deaths occurred during an average prospective follow-up of 10.4 years, 376 (71.5%) of which were related to cardiovascular disease (CVD) (International Statistical Classification of Diseases, 10th Revision codes I00-I99). CVD-related mortality compared with the lowest exercise group decreased by 21% for 1.07 to 1.8 MET-h/d of running or walking (P=.11), 24% for 1.8 to 3.6 MET-h/d (P=.04), 50% for 3.6 to 5.4 MET-h/d (P=.001), and 63% for 5.4 to 7.2 MET-h/d (P<.001) but decreased only 12% for ≥7.2 MET-h/d (P=.68). These data represent a 15% average risk reduction per MET-h/d for CVD-related mortality through 7.2 MET-h/d (P<.001) and a 2.6-fold risk increase above 7.2 MET-h/d (P=.009). Relative to the risk reduction at 7.2 MET-h/d, the risk for ≥7.2 MET-h/d increased 3.2-fold (P=.006) for all ischemic heart disease (IHD)-related mortalities but was not significantly increased for non-IHD-CVD, arrhythmia-related CVD, or non-CVD-related mortalities. Running or walking decreases CVD mortality risk progressively at most levels of exercise in patients after a cardiac event, but the benefit of exercise on CVD mortality and IHD deaths is attenuated at the highest levels of exercise (running: above 7.1 km/d or walking briskly: 10.7 km/d). Copyright © 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  12. A common NOS1AP genetic polymorphism is associated with increased cardiovascular mortality in users of dihydropyridine calcium channel blockers

    PubMed Central

    Becker, Matthijs L; Visser, Loes E; Newton-Cheh, Christopher; Hofman, Albert; Uitterlinden, André G; Witteman, Jacqueline C M; Stricker, Bruno H Ch

    2009-01-01

    AIM Recently, a polymorphism in the NOS1AP gene (rs10494366), a regulator of neuronal nitric oxide synthase (nNOS), was associated with QTc prolongation. Both nNOS and calcium channel blockers (CCBs) regulate intracellular calcium levels and have an important role in cardiovascular homeostasis. The aim was to investigate whether this polymorphism is associated with cardiovascular mortality in users of CCBs. METHODS The data from the Rotterdam study, a population-based closed cohort study of Caucasian individuals of ≥55 years of age, were used. We identified 1113 participants in the Rotterdam Study who were prescribed CCBs for the first time between 1991 and 2005. All-cause and cardiovascular mortality was assessed in participants who were prescribed CCBs with different NOS1AP rs10494366 genotypes using Cox proportional hazard models. RESULTS In participants starting on dihydropyridine CCBs (amlodipine, nifedipine and others) all-cause mortality (n = 79) risks were higher in participants with the TG [hazard ratio (HR) 2.57, 95% confidence interval (CI) 1.24, 5.34] or the GG genotype (HR 3.18, 95% CI 1.18, 8.58) than in participants with the referent TT genotype. Cardiovascular mortality (n = 54) risks were 3.51 (95% CI 1.41, 8.78) for the TG genotype and 6.00 (95% CI 1.80, 20.0) for the GG genotype. No differences in all-cause mortality or cardiovascular mortality were seen in participants starting with the nondihydropyridine CCBs verapamil or diltiazem. CONCLUSION The minor G allele of rs10494366 in the NOS1AP gene is associated with increased all-cause and cardiovascular mortality in Caucasian users of dihydropyridine CCBs. The mechanism underlying the observed association is unknown. PMID:19076153

  13. Dust Storms in the United States are Associated with Increased Cardiovascular Mortality

    EPA Science Inventory

    Background: Extreme weather events such as dust storms are predicted to become more frequent as the global climate warms through the 21st century. Studies of Asian, Saharan, Arabian, and Australian dust storms have found associations with cardiovascular and total non-accidental...

  14. Dust Storms in the United States are Associated with Increased Cardiovascular Mortality

    EPA Science Inventory

    Background: Extreme weather events such as dust storms are predicted to become more frequent as the global climate warms through the 21st century. Studies of Asian, Saharan, Arabian, and Australian dust storms have found associations with cardiovascular and total non-accidental...

  15. Increased insulin-like growth factor-1 in relation to cardiovascular function in polycystic ovary syndrome: friend or foe?

    PubMed

    Desai, Namrata Ajaykumar; Patel, Snehal S

    2015-10-01

    The incidence of cardiovascular disease (CVD) in patients with polycystic ovary syndrome (PCOS) is very high and conventional risk factors only partially explain excessive risk of developing CVD in patients of PCOS. The pathophysiology of PCOS is very unique, and several hormonal and metabolic changes occur. Several observations suggest that serum IGF-1 levels decrease in insulin resistance, which results in IGF-1 deficiency. In patient of PCOS, close relationships have been demonstrated between insulin resistance and serum IGF-1 levels. Hyperinsulinemic insulin resistance results in a general augmentation of steroidogenesis and LH release in PCOS. The action of IGF-1 varies in different tissues possibly via autocrine or paracrine mechanisms. The increase or decrease in IGF-1 in different tissues results in differential outcomes. Several studies suggest that lowered circulating IGF-1 levels play important role in the initiation of the cardiac hypertrophic response which results in the risk of cardiovascular disease. While recent results suggests that individual with elevated IGF-1 is protected against cardiovascular disease. Thus IGF-1 shows versatile pleiotropic actions. This review provides a current perspective on increased level of IGF-1 in PCOS and also adds to the current controversy regarding the roles of IGF-1 in cardiovascular disease.

  16. Antioxidative Diet Supplementation Reverses High-Fat Diet-Induced Increases of Cardiovascular Risk Factors in Mice

    PubMed Central

    Vargas-Robles, Hilda; Rios, Amelia; Arellano-Mendoza, Monica; Escalante, Bruno A.; Schnoor, Michael

    2015-01-01

    Obesity is a worldwide epidemic that is characterized not only by excessive fat deposition but also by systemic microinflammation, high oxidative stress, and increased cardiovascular risk factors. While diets enriched in natural antioxidants showed beneficial effects on oxidative stress, blood pressure, and serum lipid composition, diet supplementation with synthetic antioxidants showed contradictive results. Thus, we tested in C57Bl/6 mice whether a daily dosage of an antioxidative mixture consisting of vitamin C, vitamin E, L-arginine, eicosapentaenoic acid, and docosahexaenoic acid (corabion) would affect cardiovascular risk factors associated with obesity. Obese mice showed increased serum triglyceride and glucose levels and hypertension after eight weeks of being fed a high-fat diet (HFD). Importantly, corabion ameliorated all of these symptoms significantly. Oxidative stress and early signs of systemic microinflammation already developed after two weeks of high-fat diet and were significantly reduced by daily doses of corabion. Of note, the beneficial effects of corabion could not be observed when applying its single antioxidative components suggesting that a combination of various nutrients is required to counteract HFD-induced cardiovascular risk factors. Thus, daily consumption of corabion may be beneficial for the management of obesity-related cardiovascular complications. PMID:25922641

  17. Orthostatic hypotension does not increase cardiovascular risk in the elderly at a population level.

    PubMed

    Casiglia, Edoardo; Tikhonoff, Valérie; Caffi, Sandro; Boschetti, Giovanni; Giordano, Nunzia; Guidotti, Federica; Segato, Federico; Mazza, Alberto; Grasselli, Carla; Saugo, Mario; Rigoni, Giulio; Guglielmi, Francesco; Martini, Bortolo; Palatini, Paolo

    2014-01-01

    The general belief that orthostatic hypotension (OH) predisposes to cardiovascular events is based on sparse and contradictory data, rarely derived from population studies. A total of 1,016 men and women aged ≥65 years was studied in a 12-year epidemiological population-based study. Cardiovascular events were detected in subjects with and without OH (blood pressure (BP) decrease ≥20mm Hg for systolic or ≥10mm Hg for diastolic), and Cox analysis was performed including OH as an independent variable. In univariate analysis, coronary (20.2% vs. 13.1%, P = 0.05), cerebrovascular (13.1% vs. 8.4%, P = 0.05), and heart failure (HF) events (20.2% vs. 13.8%, P = 0.03) were apparently more incidental in subjects with OH than in those without OH. Nevertheless, after adjusting for age, gender, and systolic BP as confounders, OH did not act as a cardiovascular predictor (relative risk for cerebrovascular events 1.33, 95% confidence interval (CI), 0.78-2.2, for coronary events 1.25, CI 0.82-1.88, for HF 1.07, CI 0.71-1.62, for arrhythmias 0.82, CI 0.40-1.37, and for syncope 0.58, CI 0.13-2.71). Although OH seems to be a predictor of coronary, cerebrovascular, and HF events, no predictive role was found in models that include biological confounders. Independent of the cause of OH, age and systolic BP, which are positively associated with OH, fully explain the greater incidence of cardiovascular events and the greater cardiovascular risk observed in subjects with OH.

  18. Increased risk of cardiovascular events in patients with herpes zoster: a population-based study.

    PubMed

    Wu, Po-yuan; Lin, Cheng-Li; Sung, Fung-Chang; Chou, Tzu-Chieh; Lee, Yuan-Teh

    2014-05-01

    The association between herpes zoster and cardiovascular complications remains vague with limited study on the association between these two disorders. This study evaluated the risk of cardiovascular diseases in patients with herpes zoster. From insurance claims data of Taiwan, 19,483 patients with herpes zoster diagnosed in 1998-2008 and 77,932 subjects without herpes zoster were identified in this study. Both cohorts were followed up until the end of 2010 to measure the incidence of arrhythmia and coronary artery disease. The incidence rate ratio and adjusted hazard ratio (HR) of the cardiovascular complications with 95% confidence interval (CI) were estimated. The incidence of arrhythmia was 1.17-fold greater in the herpes zoster cohort than in the non-herpes zoster cohort (13.2 vs. 11.3 per 1,000 person-years), with an adjusted HR of 1.16 (P < 0.01). The coronary artery disease incidence in the herpes zoster cohort was 1.16-fold higher than that in the non-herpes zoster cohort (9.02 vs. 7.83 per 1,000 person-years), with an adjusted HR of 1.11 (P < 0.01). Over the stratified follow-up years, adjusted HRs were 1.22 (95% CI = 1.12-1.34) for arrhythmia and 1.14 (95% CI = 1.02-1.28) for coronary artery disease within 2 years after herpes zoster diagnosis. The risk measured for these disorders declined over time. Comorbidities of hypertension, diabetes, and hyperlipidemia also contributed to these cardiovascular disorders with greater extent. It is concluded that the contribution of herpes zoster to the risk of arrhythmia and cardiovascular diseases is less strong than that of hypertension, diabetes, and hyperlipidemia.

  19. Quantifying the contribution of foods with unfavourable nutrient profiles to nutritionally adequate diets.

    PubMed

    Maillot, Matthieu; Drewnowski, Adam; Vieux, Florent; Darmon, Nicole

    2011-04-01

    That 'all foods can fit' into a healthy diet is a long-standing principle of dietetic practice. The present study quantified the relative contributions of foods to encourage and foods to limit, using new techniques of individual diet optimisation and nutrient profiling. Individual foods from every food group were assigned to four nutrient profile classes based on the French SAIN,LIM system. Foods with the most favourable nutrient profiles were in class 1, and foods with the least favourable nutrient profiles were in class 4. An optimised diet that met the recommendations for thirty-two nutrients and that respected the existing eating habits was designed for each adult in the nationally representative 'Enquête Individuelle et Nationale sur les Consommations Alimentaires 1' dietary survey (n 1171). The relative proportions of the four nutrient profiling classes were assessed before and after the optimisation process. The contribution of fruits and vegetables, whole grains, milk and fish was significantly increased, whereas the contribution of refined grains, meats, mixed dishes, sugars and fats was decreased. The optimised diets derived more energy (30 v. 21 % in the observed diets) from class 1 foods and less energy (41 v. 56 %) from class 4 foods. They also derived a higher amount of class 1 foods (61 v. 51 %) and a lower amount of class 4 foods (22 v. 32 %). Thus, nutrient adequacy was compatible with the consumption of foods with an unfavourable nutrient profile (one-fifth the basket weight), provided that the diet also contained almost two-thirds of foods with the most favourable profile. Translating these results into concrete and quantified advice may have very tangible public health implications.

  20. Myocardial dysfunction in treated adult hypopituitarism: a possible explanation for increased cardiovascular mortality.

    PubMed Central

    Shahi, M; Beshyah, S A; Hackett, D; Sharp, P S; Johnston, D G; Foale, R A

    1992-01-01

    showed normal coronary arteries. Exercise-induced ST segment depression was not related to the severity or duration of growth hormone deficiency or serum cholesterol concentration. CONCLUSIONS--This study suggests that left ventricular mass and the rate-pressure product are related to the degree of growth hormone deficiency, that left ventricular diastolic dysfunction is frequently seen in hypopituitarism, and that these patients may have ischaemic-like ST segment changes during exercise testing. These findings may explain the increased cardiovascular mortality in patients with hypopituitarism and may also have implications for growth hormone replacement therapy in adults. Images PMID:1739534

  1. [The methodological basis of expert assessment of unfavourable outcomes of the stomatological treatment in the framework of civil law proceedings].

    PubMed

    Pigolkin, Iu I; Murzova, T V; Mirzoev, Kh M

    2011-01-01

    The authors discuss peculiarities of the performance of forensic medical expertise in the cases of unfavourable outcomes of the stomatological treatment. The methodological basis of expert assessment has been created to be applied in situations related to the unfavourable outcomes of dental care.

  2. Multiple adipose depots increase cardiovascular risk via local and systemic effects

    PubMed Central

    Karastergiou, Kalypso; Fried, Susan K.

    2014-01-01

    Adipose tissue modifies the development of cardiovascular disease in a complex manner: obesity is a major risk factor, but particularly when accompanied with a central fat distribution. For that reason the characteristics of visceral adipose tissue attracted the majority of research interest thus far and measurement of waist circumference is now recommended for everyday clinical practice. However, the direct, causative role of visceral fat in cardiometabolic disease remains to be established. Epidemiological and clinical studies show that accumulation of fat subcutaneously, in the gluteo-femoral area, is protective for cardiovascular disease, but the exact molecular mechanisms remain again unclear. In the last few years, imaging allowed the study of smaller fat depots that may interact locally with important tissues: epicardial fat with the myocardium, perivascular fat with the vessel wall and the developing atherosclerotic plaque, renal sinus fat with the renal artery. Unraveling the heterogeneous fat distribution and metabolic phenotypes in human obesity will facilitate optimal assessment of cardiovascular risk in overweight and obese individuals. PMID:23982264

  3. The relationship between pediatric nonalcoholic fatty liver disease and cardiovascular risk factors and increased risk of atherosclerosis in obese children.

    PubMed

    Gökçe, Selim; Atbinici, Zehra; Aycan, Zehra; Cınar, Hasibe Gökçe; Zorlu, Pelin

    2013-02-01

    To investigate the relationship between nonalcoholic fatty liver disease and cardiovascular risk factors and increased risk of atherosclerosis in obese children. The study included 80 consecutive obese children who were stratified into group 1 [ultrasonographically diagnosed with NAFLD (n = 50)] and group 2 [not diagnosed with NAFLD (n = 30)]. The control group included 30 healthy children. The groups were compared in terms of clinical cardiovascular risk factors and carotid intimal medial thickness (CIMT) (as a marker of atherosclerosis) measured using B-mode ultrasound. Mean body mass index (BMI) and blood pressure (BP), as well as the frequency of dyslipidemia, metabolic syndrome (MetS), and insulin resistance (IR), were similar in groups 1 and 2. Mean BMI and triglyceride (TG) levels, and the frequency of IR and MetS, increased significantly as the grade of steatosis increased. Mean CIMT in group 1 was significantly greater than that in the control group (P < 0.01). There was a positive correlation between CIMT and age, BP, and BMI in groups 1 and 2. In addition, CIMT was correlated with TG, low high-density lipoprotein (HDL) cholesterol, MetS, and IR only in group 1. Linear regression analysis between CIMT and age, BP, BMI, TG level, HDL cholesterol level, IR, MetS, and grade of steatosis yielded a significant difference only for grade of steatosis. Cardiovascular risk factors are more impressive and CIMT was significantly higher in group 1 than in group 2 and the control group, indicating that they are associated with greater risk of atherosclerosis and future adverse cardiovascular events.

  4. Protection from Cardiovascular Disease Due to Increased High-Density Lipoprotein Cholesterol in African Black Populations: Myth or Reality?

    PubMed

    Woudberg, Nicholas J; Goedecke, Julia H; Lecour, Sandrine

    2016-10-20

    The burden of cardiovascular disease (CVD) in sub-Saharan Africa has increased over the last decade. Despite this, African Black populations present with relatively low incidences of coronary heart disease and ischemic heart disease, which may be attributed to their lower total cholesterol, triglycerides and low-density lipoprotein cholesterol concentrations, compared with White populations. Commensurate with these lower lipid levels, it was believed that high-density lipoprotein cholesterol (HDL-C) concentrations would be higher in Black populations compared with their White counterparts. This is based on data from previous studies of African and African American populations; however, recent studies conducted in Africa found similar or lower HDL-C concentrations in Black compared with White individuals. Current research, therefore, suggests that HDL-C may not be a good indicator of cardiovascular risk and future research should focus on HDL quality (vs quantity), by measuring HDL functionality and subclass.

  5. Does Simulation-Based Training Increase Athletic Training Students' Clinical Confidence and Competence in Performing a Cardiovascular Screening?

    PubMed

    Doherty-Restrepo, Jennifer L; Harrelson, K Erin; Swinnie, Tazjanne; Montalvo, Alicia M

    2017-01-01

    The incidence of sudden cardiac death (SCD) in athletes is higher than previously estimated. The need for increased screening to detect cardiac diseases in preparticipation physical examinations (PPE) has become a focus in athletic training. The use of simulation-based training in healthcare professionals' education has increased clinical confidence and competence, but research is limited. To examine if a simulation-based educational intervention can increase athletic training students' self-reported confidence and clinical competence in conducting a cardiovascular screening. Pretest-posttest design. 25 first-year athletic training students in a professional master's program participated. The intervention consisted of a standardized cardiovascular curriculum consisting of a 45-minute, interactive instructor-led session and a 45-minute audio session which included repetitions of heart murmurs. Learner self-reported confidence scale, multiple-choice knowledge exam, and objective structured clinical examination (OSCE) of cardiovascular assessment skills and auditory recognition of heart murmurs were recorded. Self-reported confidence increased significantly from 4.4±2.1 to 9.2±3.0 post-intervention (F=78.7, p<0.001) with a moderately high effect size (n2=0.789). Knowledge exam scores increased significantly from 11.0±2.5 to 13.6±4.0 post-intervention (F=5.3, p=0.031) with a low effect size (n2=0.191). The history-taking assessment of the OSCE increased significantly from 2.6±1.6 to 5.7±1.7 post-intervention (F=70.1, p<0.001) with a moderately high effect size (n2=0.751). The clinical skills assessment of the OSCE increased significantly from 4.1±2.8 to 15.6±1.6 post-intervention (F=415.4, p<0.001) with a high effect size (n2=0.952). Simulation-based training is an effective tool for increasing athletic training students' self-reported confidence and competence in conducting a cardiovascular screening.

  6. Increased serum renalase in peritoneal dialysis patients: Is it related to cardiovascular disease risk?

    PubMed

    Gok Oguz, Ebru; Akoglu, Hadim; Ulusal Okyay, Gulay; Karaveli Gursoy, Guner; Yildirim, Tolga; Merhametsiz, Ozgur; Cimen, Tolga; Canbakan, Basol; Yeter, Ekrem; Ayli, M Deniz

    Renalase, with possible monoamine oxidase activity, is implicated in degradation of catecholamines; which suggests novel mechanisms of cardiovascular complications in patients with chronic kidney diseases. Epicardial adipose tissue (EAT) has been found to correlate with cardiovascular diseases (CVD) in dialysis patients. The present study aimed to evaluate the association of serum renalase levels with EAT thickness and other CVD risk factors in peritoneal dialysis (PD) patients. The study included 40 PD patients and 40 healthy controls. All subjects underwent blood pressure and anthropometric measurements. Serum renalase was assessed by using a commercially available assay. Transthoracic echocardiography was used to measure EAT thickness and left ventricular mass index (LVMI) in all subjects. The median serum renalase level was significantly higher in the PD patients than in the control group [176.5 (100-278.3) vs 122 (53.3-170.0)ng/ml] (p=0.001). Renalase was positively correlated with C-reactive protein (r=0.705, p<0.001) and negatively correlated with RRF (r=-0.511, p=0.021). No correlation was observed between renalase and EAT thickness or LVMI. There was a strong correlation between EAT thickness and LVMI in both the PD patients and the controls (r=0.848, p<0.001 and r=0.640, p<0.001 respectively). This study indicates that renalase is associated with CRP and residual renal function but not with EAT thickness as CVD risk factors in PD patients. Copyright © 2016 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

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

    PubMed Central

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

    2012-01-01

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

  8. [Increased risk of type II diabetes mellitus and cardiovascular disease after gestational diabetes mellitus: a systematic review].

    PubMed

    Hopmans, Tara-Eileen J P; van Houten, Chantal B; Kasius, Annemieke; Kouznetsova, Ouliana I; Nguyen, Ly A; Rooijmans, Sanne V; Voormolen, Daphne N; van Vliet, Elvira O G; Franx, Arie; Koster, M P H Wendy

    2015-01-01

    To determine the long-term risk of developing type II diabetes (T2D) and cardiovascular disease (CVD) for women with a history of gestational diabetes mellitus. Systematic review and meta-analysis. Two search strategies were used in PubMed and Embase to determine the long-term risks of developing T2D and CVD after a pregnancy complicated by gestational diabetes mellitus. After critical appraisal of the papers found, 11 papers were included, involving a total of 328,423 patients. Absolute and relative risks (RRs) were calculated. Eight studies (n=276,829) reported on the long-term risk of T2D and 4 (n=141,048) on the long-term risk of CVD. Follow-up ranged from 3.5 to 11.5 years for T2D and from 1.2 to 74.0 years for CVD. Women with gestational diabetes had a risk of T2D varying between 9.5% and 37.0% and a risk of CVD of between 0.28% and 15.5%. Women with gestational diabetes were at increased risk of T2D (weighted RR: 13.2; 95% CI: 8.5-20.7) and CVD (weighted RR: 2.0; 95% CI: 1.1-3.7) compared to women without gestational diabetes. Women with prior gestational diabetes mellitus have a significantly increased risk of developing T2D and CVD. It is very important that gestational diabetes is recognised as a cardiovascular risk factor in daily practice. It would be desirable to screen this group of women for the presence of hyperglycaemia and other cardiovascular risk factors. Further research is required to be able to specify the long-term risk of T2D and CVD and to demonstrate whether such screening is cost-effective.

  9. Association of the PPARγ2 Pro12Ala polymorphism with increased risk of cardiovascular diseases.

    PubMed

    Li, Y; Zhu, J; Ding, J Q

    2015-12-29

    This meta-analysis investigated the correlation between the PPARγ2 Pro12Ala polymorphism and cardiovascular disease (CVD). Electronic database and manual searches were conducted to retrieve studies published relevant to the PPARγ2 Pro12Ala polymorphism and CVD. Rigorous inclusion and exclusion criteria were employed for selection of high-quality patients-control studies. Statistical data analyses on allelic, dominant, homozygous, heterozygous, and recessive inheritance models were performed using the R 3.1.0 and Stata 12.0 software. We enrolled 12 case-control studies consisting of 10,189 patients with CVD [1070 with myocardial infarction (MI), 7849 with coronary artery disease (CAD), and 1270 with acute coronary syndromes (ACS)] and 17,899 controls. The results of meta-analyses revealed that the PPARγ2 Pro12Ala (rs1801282) polymorphism was correlated with a higher risk of CVD under both allelic and dominant models, while no statistical significance was found under homozygous, heterozygous, or recessive models. Subgroup analysis based on disease showed that the PPARγ2 Pro12Ala (rs1801282) polymorphism was correlated with a higher risk of MI under both allelic and dominant models, while no statistical significance was found for association with CAD or ACS under allele or dominant models. Furthermore, under homozygous, heterozygous, and recessive models, the PPARγ2 Pro12Ala (rs1801282) polymorphism had no statistically significant association with MI, CAD, or ACS. The results of this meta-analysis suggest that the PPARγ2 Pro12Ala (rs1801282) polymorphism might be correlated with a higher risk of CVD, particularly MI, and could serve as an important early indicator for CVD.

  10. Increased risks of cardiovascular diseases and insulin resistance among the Orang Asli in Peninsular Malaysia.

    PubMed

    Tuan Abdul Aziz, Tuan Azlin; Teh, Lay Kek; Md Idris, Muhd Hanis; Bannur, Zakaria; Ashari, Lydiatul Shima; Ismail, Adzrool Idzwan; Ahmad, Aminuddin; Isa, Kamarudzaman Md; Nor, Fadzilah Mohd; Rahman, Thuhairah Hasrah Abdul; Shaari, Syahrul Azlin Binti; Jan Mohamed, Hamid Jan; Mohamad, Nornazliya; Salleh, Mohd Zaki

    2016-03-24

    Despite the strategic development plan by the authorities for the Orang Asli, there are six subtribes of which their population numbers are small (less than 700). These minorities were not included in most of the health related studies published thus far. A comprehensive physiological and biomedical updates on these small subtribes in comparison to the larger subtribes and the urban Malay population is timely and important to help provide appropriate measures to prevent further reduction in the numbers of the Orang Asli. A total of 191 Orang Asli from different villages in Peninsular Malaysia and 115 healthy urban Malays were recruited. Medical examinations and biochemical analyses were conducted. Framingham risk scores were determined. Data was analyzed using IBM SPSS Statistics, Version 20.0. A higher percentage of the Orang Asli showed high insulin levels and hsCRP compared to the healthy Malays denoting possible risk of insulin resistance. High incidences of low HDL-c levels were observed in all the Orang Asli from the six subtribes but none was detected among the urban Malays. A higher percentage of inlanders (21.1% of the males and 4.2% of the females) were categorized to have high Framingham Risk Score. Orang Asli staying both in the inlands and peripheries are predisposed to cardiovascular diseases and insulin resistance diabetes mellitus. The perception of Orang Asli being healthier than the urban people no longer holds. We believed that this information is important to the relevant parties in strategizing a healthier community of the Orang Asli to avoid the vanishing of the vulnerable group(s).

  11. Heat transfer in fish: are short excursions between habitats a thermoregulatory behaviour to exploit resources in an unfavourable thermal environment?

    PubMed

    Pépino, Marc; Goyer, Katerine; Magnan, Pierre

    2015-11-01

    Temperature is the primary environmental factor affecting physiological processes in ectotherms. Heat-transfer models describe how the fish's internal temperature responds to a fluctuating thermal environment. Specifically, the rate coefficient (k), defined as the instantaneous rate of change in body temperature in relation to the difference between ambient and body temperature, summarizes the combined effects of direct thermal conduction through body mass, passive convection (intracellular and intercellular fluids) and forced convective heat transfer (cardiovascular system). The k-coefficient is widely used in fish ecology to understand how body temperature responds to changes in water temperature. The main objective of this study was to estimate the k-coefficient of brook charr equipped with internal temperature-sensitive transmitters in controlled laboratory experiments. Fish were first transferred from acclimation tanks (10°C) to tanks at 14, 19 or 23°C (warming experiments) and were then returned to the acclimation tanks (10°C; cooling experiments), thus producing six step changes in ambient temperature. We used non-linear mixed models to estimate the k-coefficient. Model comparisons indicated that the model incorporating the k-coefficient as a function of absolute temperature difference (dT: 4, 9 and 13°C) best described body temperature change. By simulating body temperature in a heterogeneous thermal environment, we provide theoretical predictions of maximum excursion duration between feeding and resting areas. Our simulations suggest that short (i.e. <60 min) excursions could be a common thermoregulatory behaviour adopted by cold freshwater fish species to sustain body temperature below a critical temperature threshold, enabling them to exploit resources in an unfavourable thermal environment. © 2015. Published by The Company of Biologists Ltd.

  12. Ulcerative Colitis and Crohn’s Disease Are Associated with Decreased Serum Selenium Concentrations and Increased Cardiovascular Risk

    PubMed Central

    Castro Aguilar-Tablada, Teresa; Navarro-Alarcón, Miguel; Quesada Granados, Javier; Samaniego Sánchez, Cristina; Rufián-Henares, José Ángel; Nogueras-Lopez, Flor

    2016-01-01

    The incidence of inflammatory bowel disease (IBD) and associated oxidative stress is increasing. The antioxidant mineral selenium (Se) was measured in serum samples from 106 IBD patients (53 with ulcerative colitis (UC) and 53 with Crohn’s disease (CD)) and from 30 healthy controls. Serum Se concentrations were significantly lower in UC and CD patients than in healthy controls (p < 0.001) and significantly lower in CD patients than in UC patients (p = 0.006). Se concentrations in patients were significantly influenced by sex, body mass index (BMI), the inflammatory biomarker α-1-antitrypsin, surgery, medical treatment, the severity, extent, and form of the disease and the length of time since onset (p < 0.05). Se concentrations in IBD patients were positively and linearly correlated with nutritional (protein, albumin, prealbumin, cholinesterase and total cholesterol) and iron status-related (hemoglobin, Fe and hematocrit) parameters (p < 0.05). A greater impairment of serum Se and cardiovascular status was observed in CD than in UC patients. An adequate nutritional Se status is important in IBD patients to minimize the cardiovascular risk associated with increased inflammation biomarkers, especially in undernourished CD patients, and is also related to an improved nutritional and body iron status. PMID:27916926

  13. Association between adult atopic dermatitis, cardiovascular disease, and increased heart attacks in three population-based studies.

    PubMed

    Silverberg, J I

    2015-10-01

    Adults with eczema are more likely to smoke cigarettes, consume alcohol, and have sedentary lifestyle. We sought to determine whether adult eczema is associated with increased cardiovascular and cerebrovascular disease. Data from the 2005-2006 National Health and Nutrition Examination Survey (NHANES) (n = 4970) and 2010 (n = 27 157) and 2012 (n = 34 525) National Health Interview Survey (NHIS). History of coronary artery disease (CAD), angina, heart attack, stroke, and peripheral vascular disease (PVD) were determined. In NHANES, flexural eczema in the past year was associated with significantly higher odds of CAD (P ≤ 0.04), heart attack (P ≤ 0.01), and congestive heart failure (P ≤ 0.02), but not with stroke (P ≥ 0.37), in survey-weighted multivariate logistic regression models that controlled for socio-demographics, comorbid asthma, and hay fever. Similarly, in NHIS 2010 and 2012, 1-year history of eczema was associated with significantly higher odds of CAD (P ≤ 0.02), angina (P ≤ 0.02), heart attack (P ≤ 0.047), other heart disease (P < 0.0001), stroke (P ≤ 0.02), and PVD (<0.0001) in multivariate models. Adults with atopic dermatitis may have increased cardiovascular disease, heart attack, and stroke. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Children under the age of seven with diabetes are increasing their cardiovascular risk by their food choices.

    PubMed

    Sundberg, F; Augustsson, M; Forsander, G; Cederholm, U; Axelsen, M

    2014-04-01

    Early-onset diabetes increases the risk of cardiovascular disease. This study examined the eating habits of children under 7 years of age with diabetes to see whether their diet increased that risk even further. A total of 24 children with type 1 diabetes (mean age 4.5 years) and 27 healthy controls (mean age 4.6 years) participated in this cross-sectional study. Food intake was assessed by two 4-day food records. Children with type 1 diabetes had a higher energy intake from protein (18 vs 15%, p < 0.05) and fat (35 vs 31%, p < 0.05) but lower intake from carbohydrates (47 vs 54%, p < 0.05), than the healthy control group. Intake of saturated fat was higher than recommended in both groups, and consumption of fruit and vegetables was lower than recommended, but similar, in both the diabetes and control groups (191 vs 207 g per day). Total intake of fat was negatively correlated with intake of fruit and vegetables (r = -0.74 p < 0.05) in children with type 1 diabetes. Children under 7 years of age with type 1 diabetes eat too much saturated fat and not enough fruit and vegetables. Their diet should be improved to reduce their cardiovascular risk. ©2013 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  15. Endothelial progenitor cells in mothers of low-birthweight infants: a link between defective placental vascularization and increased cardiovascular risk?

    PubMed

    King, Thomas F J; Bergin, David A; Kent, Etaoin M; Manning, Fiona; Reeves, Emer P; Dicker, Patrick; McElvaney, Noel G; Sreenan, Seamus; Malone, Fergal D; McDermott, John H

    2013-01-01

    Offspring birthweight is inversely associated with future maternal cardiovascular mortality, a relationship that has yet to be fully elucidated. Endothelial progenitor cells (EPCs) are thought to play a key role in vasculogenesis, and EPC numbers reflect cardiovascular risk. Our objective was to ascertain whether EPC number or function was reduced in mothers of low-birthweight infants. This was a prospective cohort study in a general antenatal department of a university maternity hospital. Twenty-three mothers of small for gestational age (SGA) infants (birthweight < 10th centile) and 23 mothers of appropriate for gestational age (AGA) infants (birthweight ≥ 10th centile) were recruited. Maternal EPC number and function, conventional cardiovascular risk markers, and cord blood adiponectin were measured. Median EPC count was lower (294 vs. 367, P = 0.005) and EPC migration was reduced (0.91 vs. 1.59, P < 0.001) in SGA compared with AGA infants, with no difference in EPC adhesion (0.221 vs. 0.284 fluorescence units, P = 0.257). Maternal triglyceride levels were higher in SGA than AGA infants (0.98 vs. 0.78 mmol/liter, P = 0.006), but there was no difference in cholesterol, glucose, insulin, glycosylated hemoglobin, adiponectin, or blood pressure. There was a moderate monotone (increasing) relationship between birthweight and umbilical cord blood adiponectin (r = 0.475, P = 0.005). Giving birth to an SGA infant was associated with lower maternal EPC number and reduced migratory function. Cord blood adiponectin was significantly correlated with birthweight.

  16. The role of conventional and novel mechanisms in explaining increased risk of cardiovascular events in offspring with positive parental history.

    PubMed

    Hamer, Mark; Chida, Yoichi; Stamatakis, Emmanuel

    2009-10-01

    Parental history is a widely accepted risk factor for offspring cardiovascular events, although the mechanisms remain unclear. We examined the contribution of conventional and novel risk factors in explaining the excess risk of cardiovascular events in offspring with positive parental history (PH+). We collected conventional (blood pressure, cholesterol, adiposity), lifestyle, and novel (C-reactive protein, CRP) risk factors at baseline in participants from the Scottish Health Surveys (n = 5946, 44.5% men, aged 53.6 +/- 12.4 years), who were followed up over an average of 7.1 years for cardiovascular disease (CVD) events (a composite of fatal and nonfatal events incorporating acute myocardial infarction, coronary artery bypass surgery, percutaneous coronary angioplasty, stroke, heart failure). Younger PH+ participants (<65 years) were at higher risk of incident CVD events [age-adjusted and sex-adjusted hazard ratio = 1.91, 95% confidence interval (CI) 1.21-3.00] compared with PH-. Despite an association of PH+ with blood pressure, total and high-density lipoprotein cholesterol, CRP, and physical activity, less than 15% of the excess risk was explained through conventional and novel risk factors. However, the greatest risk of CVD was observed in PH+ participants with elevated CRP (> or =3 mg/l) (hazard ratio = 2.99, 95% CI 2.15-4.16) or hypertension (hazard ratio = 2.87, 95% CI 2.07-3.99). Only a small amount of the excess CVD risk associated with PH+ is accounted for by conventional and novel mechanisms. However, the combination of elevated CRP or hypertension with PH+ substantially increases the risk of CVD.

  17. ANGPTL2 is associated with an increased risk of cardiovascular events and death in diabetic patients.

    PubMed

    Gellen, Barnabas; Thorin-Trescases, Nathalie; Sosner, Philippe; Gand, Elise; Saulnier, Pierre-Jean; Ragot, Stéphanie; Fraty, Mathilde; Laugier, Stéphanie; Ducrocq, Grégory; Montaigne, David; Llaty, Pierre; Rigalleau, Vincent; Zaoui, Philippe; Halimi, Jean-Michel; Roussel, Ronan; Thorin, Eric; Hadjadj, Samy

    2016-11-01

    A high serum angiopoietin-like 2 (ANGPTL2) concentration is an independent risk factor for developing diabetes and is associated with insulin resistance and atherosclerosis. In this work, we have examined the impact of serum ANGPTL2 on improving cardiovascular (CV) risk stratification in patients with type 2 diabetes. A prospective, monocentric cohort of consecutive type 2 diabetes patients (the SURDIAGENE cohort; total of 1353 type 2 diabetes patients; 58% men, mean ± SD age 64 ± 11 years) was followed for a median of 6.0 years for death as primary endpoint and major adverse CV events (MACE; i.e. CV death, myocardial infarction or stroke) as a secondary endpoint. Patients with end-stage renal disease, defined as a requirement for dialysis or a history of kidney transplantation, were excluded. Patients were grouped into quartiles according to ANGPTL2 concentrations at inclusion: <11.2 (Q1), 11.2-14.7 (Q2), 14.8-19.5 (Q3) or >19.5 (Q4) ng/ml. During follow up, 367 patients (representing 4.5% of the total person-years) died and 290 patients (representing 3.7% of the total person-years) presented with MACE. Both the survival and MACE-free survival rates were significantly different between ANGPTL2 quartiles (logrank 82.12, p < 0.0001 for death; and logrank 65.14, p < 0.0001 for MACE). Patients with ANGPTL2 concentrations higher than 19.5 ng/ml (Q4) had a significantly higher risk of death and MACE than those with ANGPTL2 levels of 19.5 ng/ml or less (Q1-3) (HR for death 2.44 [95% CI 1.98, 3.00], p < 0.0001; HR for MACE 2.43 [95% CI 1.92, 3.06], p < 0.0001) after adjustment for sex, age and established CV risk factors. Using ANGPTL2 concentrations, prediction of the risk of mortality, as assessed by integrated discrimination improvement (IDI), was significantly improved (IDI 0.006 ± 0.002, p = 0.0002). In patients with type 2 diabetes, serum ANGPTL2 concentrations were independently associated with death and MACE. Therefore

  18. Midlife Ankylosing Spondylitis Increases the Risk of Cardiovascular Diseases in Males 5 Years Later

    PubMed Central

    Hung, Yao-Min; Chang, Wei-Pin; Wei, James Cheng-Chung; Chou, Pesus; Wang, Paul Yung-Pou

    2016-01-01

    Abstract There are limited studies describing the association between ankylosing spondylitis (AS) and cardiovascular disease (CVD) in patients over 40 years old. We aimed to focus on the incident AS patients in those aged 40 years or older and to investigate whether events of CVD occurred more than the general population. We conducted a nationwide cohort study between 2000 and 2005 using the Taiwan National Health Insurance Research Database. The risk of newly diagnosed CVD was compared between incident AS patients and matched age- and sex-matched subjects without AS. Events of CVDs were classified into 1 of 5 subcategories: hypertensive heart disease, coronary heart disease, congestive heart failure, cerebrovascular disease, or “other” CVD according to the ICD-9-CM codes. Cumulative incidences and hazard ratios (HRs) were calculated after adjusting for demographic and comorbid medical disorders. Multivariate analyses were performed using Cox proportional hazards model. We compared 537 AS and 2685 non-AS patients and found that the cumulative incidence rate of CVD during follow-up period was higher in the AS cohort than the non-AS cohort. The crude HR of CVD for the AS group was 1.24 [95% confidence interval (95% CI), 1.05–1.46; P = 0.01] and the adjusted HR was 1.20 with 95% CI 1.02 to 1.42 (P = 0.03). When stratified by age, AS cohort at age 60 to 69 years exhibited a significantly higher HR for all CVD than the general population cohort (adjusted HR 1.48, 95% CI 1.06–2.08, P < 0.05). When stratified by gender, male AS group had a significantly higher HR for all CVD than the general population cohort with the adjusted HR 1.28 (95% CI 1.01–1.63, P < 0.05). There was no statistically significant difference for females. Patients with AS, especially age 60 to 69 years male patients, had a higher risk of CVDs than non-AS controls. PMID:27149491

  19. A 16-Month Community-Based Intervention to Increase Aspirin Use for Primary Prevention of Cardiovascular Disease

    PubMed Central

    Duval, Sue; Luepker, Russell V.; Finnegan, John R.; LaMarre, Heather; Peterson, Kevin A.; Zantek, Nicole D.; Jacobs, Ginny; Straka, Robert J.; Miller, Karen H.; Hirsch, Alan T.

    2014-01-01

    Introduction Cardiovascular diseases are the leading causes of disability and death in the United States. Primary prevention of these events may be achieved through aspirin use. The ability of a community-based intervention to increase aspirin use has not been evaluated. The objective of this study was to evaluate an educational intervention implemented to increase aspirin use for primary prevention of cardiovascular disease in a small city in Minnesota. Methods A community-based intervention was implemented during 16 months in a medium-sized community in Minnesota. Messages for aspirin use were disseminated to individuals, health care professionals, and the general population. Independent cross-sectional samples of residents (men aged 45–79, women aged 55–79) were surveyed by telephone to identify candidates for primary prevention aspirin use, examine their characteristics, and determine regular aspirin use at baseline and after the campaign at 4 months and 16 months. Results In primary prevention candidates, regular aspirin use rates increased from 36% at baseline to 54% at 4 months (odds ratio = 2.05; 95% confidence interval, 1.09–3.88); the increase was sustained at 52% at 16 months (odds ratio = 1.89; 95% confidence interval, 1.02–3.49). The difference in aspirin use rates at 4 months and 16 months was not significant (P = .77). Conclusion Aspirin use rates for primary prevention remain low. A combined public health and primary care approach can increase and sustain primary prevention aspirin use in a community setting. PMID:24831287

  20. Trends in cardiovascular risk factors across levels of education in a general population: is the educational gap increasing? The Tromsø study 1994-2008.

    PubMed

    Eggen, Anne Elise; Mathiesen, Ellisiv B; Wilsgaard, Tom; Jacobsen, Bjarne K; Njølstad, Inger

    2014-08-01

    To describe trends in cardiovascular risk factors and change over time across education levels, and study the influence from medicine use and gender. Data from participants (30-74 years) of the Tromsø Study in 1994-1995 (n=22 108) and in 2007-2008 (n=11 565). Blood samples, measurements and self-reported educational level and medicine use were collected. Differences in risk factor levels across education groups were persistent for all risk factors over time, with a more unfavourable pattern in the lowest education group. The exception was cholesterol, with the reduction being largest in the lowest educated, resulting in weakened educational trends over time. While a significant educational trend in cholesterol persisted among the non-users of lipid-lowering drugs (LLD), no educational trend in cholesterol was found among the LLD users in 2007-2008. The strongest educational trends were found for daily smoking and Body Mass Index (BMI). In 2007-2008 the odds for being a smoker were five times higher among the lowest educated compared to the highest educated. In men, the odds for being in the highest quintile of the BMI distribution were, in 2007-2008, almost doubled in the lowest compared to the highest educated. The lowest educated women had 6.2 mm Hg higher mean systolic blood pressure than the highly educated, mean BMI of 26.4 kg/m 2 and smoking prevalence of 37.7%. The difference across education groups for cholesterol levels decreased, while the educational gap persisted over time for the other risk factors. Use of LLD seemed to contribute to the reduction of social differences in cholesterol levels. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  1. Preparation for induction of labour of the unfavourable cervix with Foley catheter compared with vaginal prostaglandin.

    PubMed

    Thomas, I L; Chenoweth, J N; Tronc, G N; Johnson, I R

    1986-02-01

    Ripening of the unfavourable cervix prior to induction of labour using traction on a Foley catheter (32 patients) was compared with 40 mg of prostaglandin F2 alpha in Tylose gel applied to the external cervical os and held in place for 12 hours with a vaginal diaphragm (25 patients). Each patient in the above groups had a modified Bishop score of 0-3 and was randomly allocated to one or other group. Comparison was made with a further 25 patients in whom the cervical score was 4-6. Timing of amniotomy and commencement of Syntocinon infusion were equivalent for all patients. Prostaglandins conferred no advantage over Foley catheter in terms of amniotomy-delivery interval, operative delivery rate, and condition of the baby one minute after birth. The disadvantages of prostaglandins for cervical ripening are a longer preparation-delivery interval, and cost ($77 versus $4.75 for the Foley catheter). Currently, prostaglandins are not officially approved for use in Australia for induction of labour. It is suggested, therefore, that the Foley catheter is preferable for ripening the unfavourable cervix as a prelude to amniotomy.

  2. Increased levels of circulating platelet-derived microparticles in psoriasis: Possible implications for the associated cardiovascular risk

    PubMed Central

    Papadavid, Evangelia; Diamanti, Konstantina; Spathis, Aris; Varoudi, Maria; Andreadou, Ioanna; Gravanis, Kostas; Theodoropoulos, Kostas; Karakitsos, Petros; Lekakis, John; Rigopoulos, Dimitrios; Ikonomidis, Ignatios

    2016-01-01

    AIM To evaluate platelet activation markers in psoriasis patients, compared to controls, and investigate their association with the inflammatory burden of psoriasis. METHODS Forty psoriatic patients without cardiovascular disease, and 12 healthy controls were subjected to measurement of baseline platelet CD62P, CD63 and CD42b expression, platelet-leukocyte complexes, i.e., platelet-monocyte complexes (PMC), platelet-neutrophil complexes (PNC) and platelet-lymphocyte complexes, and concentrations of platelet-derived microparticles (PMPs) using flow cytometry. Both larger-size (0.5-0.9 μm) and smaller-size (< 0.5 μm) PMPs were determined. Serum interleukin (IL)-12 and IL-17 levels were also measured by enzyme-linked immunosorbent assay. The severity of psoriasis was evaluated by the Psoriasis Area Severity Index (PASI). RESULTS PMP concentrations were significantly higher in psoriasis patients than controls [mean ± standard error of mean (SEM): 22 ± 5/μL vs 11 ± 6/μL; P = 0.018), for both smaller-size (10 ± 2/μL vs 4 ± 2/μL; P = 0.033) and larger-size (12 ± 3/μL vs 6 ± 4/μL; P = 0.014) PMPs. Platelet CD62P, CD63 and CD42b expression and circulating PMC and PNC were similar between the two groups. Lower circulating PLC were observed in psoriasis patients compared to controls (mean ± SEM: 16% ± 3% vs 23% ± 6%; P = 0.047). Larger-size PMPs were related with IL-12 levels (P < 0.001) and smaller-size PMPs with both IL-12 and IL-17 levels (P < 0.001). Total PMPs also correlated with IL-12 (P < 0.001). CD63 expression was positively correlated with both IL-12 and IL-17 (P < 0.05). Increased PASI score was associated with increased levels of larger-size PMPs (r = 0.45; P = 0.011) and increased CD63 expression (r = 0.47; P < 0.01). CONCLUSION PMPs, known to be predictive of cardiovascular outcomes, are increased in psoriasis patients, and associated with high inflammatory disease burden. Enhanced platelet activation may be the missing link leading to

  3. No effect of increased water intake on blood viscosity and cardiovascular risk factors.

    PubMed

    Tonstad, Serena; Klemsdal, Tor Ole; Landaas, Sverre; Høieggen, Aud

    2006-12-01

    Observational data have suggested that increased water intake decreases the risk of CHD. A postulated mechanism is that increased water ingestion reduces blood viscosity. The aim of the present study was to assess the effect of increased fluid intake on blood viscosity. Men (n 67) and postmenopausal women (n 27) with one or more risk factors for CVD who reported intake of < or =0.5 litres water daily were randomised to a control group (n 31), an intervention group (n 32) that increased their daily water intake by 1 litre/d and an intervention group (n 31) that ingested 1 litre blueberry juice/d. All were encouraged to continue their usual diet and lifestyle. Whole-blood viscosity and blood and urine chemistries were measured by standard techniques after 2 and 4 weeks. Urine volume increased (by a median of 872 and 725 ml in the water and blueberry juice groups, respectively, v. 10 ml in the control group; P< or =0.002), confirming the subjects' adherence to the protocol. Urine osmolality and urinary levels of Na, K and creatinine decreased in the water and blueberry juice groups v. the controls (P<0.05). No change was seen in whole-blood viscosity or in levels of fibrinogen, total protein, lipids, glucose, insulin, C-peptide or other chemistry and haematology variables. In conclusion, a postulated protective effect of increased water or fluid intake is not explained by a change in blood viscosity and increased fluid intake does not influence CVD risk factors in the short term.

  4. Ameliorating hypertension and insulin resistance in subjects at increased cardiovascular risk: effects of acetyl-L-carnitine therapy.

    PubMed

    Ruggenenti, Piero; Cattaneo, Dario; Loriga, Giacomina; Ledda, Franca; Motterlini, Nicola; Gherardi, Giulia; Orisio, Silvia; Remuzzi, Giuseppe

    2009-09-01

    Insulin resistance, a key component of the metabolic syndrome, is a risk factor for diabetes mellitus and cardiovascular disease. Acetyl-L-carnitine infusion acutely ameliorated insulin sensitivity in type 2 diabetics with insulin resistance. In this sequential off-on-off pilot study, we prospectively evaluated the effects of 24-week oral acetyl-L-carnitine (1 g twice daily) therapy on the glucose disposal rate (GDR), assessed by hyperinsulinemic euglycemic clamps, and components of the metabolic syndrome in nondiabetic subjects at increased cardiovascular risk a priori segregated into 2 groups with GDR < or =7.9 (n=16) or >7.9 (n=16) mg/kg per minute, respectively. Baseline GDR and systolic blood pressure were negatively correlated (n=32; P=0.001; r=-0.545), and patients with GDR < or =7.9 mg/kg per minute had higher systolic/diastolic blood pressure than those with higher GDR. Acetyl-L-carnitine increased GDR from 4.89+/-1.47 to 6.72+/-3.12 mg/kg per minute (P=0.003, Bonferroni-adjusted) and improved glucose tolerance in patients with GDR < or =7.9 mg/kg per minute, whereas it had no effects in those with higher GDRs. Changes in GDR were significantly different between groups (P=0.017, ANCOVA). Systolic blood pressure decreased from 144.0+/-13.6 to 135.1+/-8.4 mm Hg and from 130.8+/-12.4 to 123.8+/-10.8 mm Hg in the lower and higher GDR groups, respectively (P<0.05 for both; P<0.001 overall) and progressively recovered toward baseline over 8 weeks posttreatment. Total and high molecular weight adiponectin levels followed specular trends. Diastolic blood pressure significantly decreased only in those with higher GDRs. Treatment was well tolerated in all of the patients. Acetyl-L-carnitine safely ameliorated arterial hypertension, insulin resistance, impaired glucose tolerance, and hypoadiponectinemia in subjects at increased cardiovascular risk. Whether these effects may translate into long-term cardioprotection is worth investigating.

  5. Moderately increased albuminuria is an independent risk factor of cardiovascular events in the general Japanese population under 75 years of age: the Watari study.

    PubMed

    Konno, Satoshi; Munakata, Masanori

    2015-01-01

    Moderately increased albuminuria (formerly called microalbuminuria) is widely recognized as a predictor of cardiovascular disease. However, it is not clear whether this observation is applicable to the Asian population, as studies leading to this conclusion were conducted on Western populations. The aim of this study was to examine the hypothesis if moderately increased albuminuria could be an independent predictor of cardiovascular mortality and morbidity in the Japanese population. The study population consisted of 3093 inhabitants of Watari, Miyagi Prefecture, who participated in an annual health check-up in 2009. We examined anthropometry, sitting blood pressure, fasting blood sample, and urine albumin-to-creatinine ratio (UACR). After baseline assessment, subjects were followed prospectively for up to 60 months. The incidence of major cardiovascular events (stroke, myocardial infarction, revascularization, and cardiovascular death) was determined based on death certificate records or medical claims sent to the National Health Insurance of Japan. Follow-up was discontinued for those who reached 75 years of age because they were moved to a different medical insurance system. We observed 57 cardiovascular events during a mean follow-up period of 47.8 months. The cumulative incidence rate for major cardiovascular events was significantly higher in patients with moderately increased albuminuria (UACR 30-299 mg/gCr) than in those with normoalbuminuria (UACR <30 mg/gCr) (6.4% vs. 2.2%, p = 0.0002 by log-rank test). Multivariate Cox proportional hazards analyses have revealed that moderately increased albuminuria is an independent predictor of cardiovascular events (HR 2.386, 95% CI: 1.120-4.390). Moderately increased albuminuria is an independent predictor of cardiovascular events in the general Japanese population under 75 years of age.

  6. Pulmonary instillation of MWCNT increases lung permeability, decreases gp130 expression in the lungs, and initiates cardiovascular IL-6 transsignaling

    PubMed Central

    Thompson, Leslie C.; Holland, Nathan A.; Snyder, Ryan J.; Luo, Bin; Becak, Daniel P.; Odom, Jillian T.; Harrison, Benjamin S.; Brown, Jared M.; Gowdy, Kymberly M.

    2015-01-01

    Pulmonary instillation of multiwalled carbon nanotubes (MWCNT) has the potential to promote cardiovascular derangements, but the mechanisms responsible are currently unclear. We hypothesized that exposure to MWCNT would result in increased epithelial barrier permeability by 24 h postexposure and initiate a signaling process involving IL-6/gp130 transsignaling in peripheral vascular tissue. To test this hypothesis we assessed the impact of 1 and 10 μg/cm2 MWCNT on transepithelial electrical resistance (TEER) and expression of barrier proteins and cell activation in vitro using normal human bronchial epithelial primary cells. Parallel studies using male Sprague-Dawley rats instilled with 100 μg MWCNT measured bronchoalveolar lavage (BAL) differential cell counts, BAL fluid total protein, and lung water-to-tissue weight ratios 24 h postexposure and quantified serum concentrations of IL-6, soluble IL-6r, and soluble gp130. Aortic sections were examined immunohistochemically for gp130 expression, and gp130 mRNA/protein expression was evaluated in rat lung, heart, and aortic tissue homogenates. Our in vitro findings indicate that 10 μg/cm2 MWCNT decreased the development of TEER and zonula occludens-1 expression relative to the vehicle. In rats MWCNT instillation increased BAL protein, lung water, and induced pulmonary eosinophilia. Serum concentrations of soluble gp130 decreased, aortic endothelial expression of gp130 increased, and expression of gp130 in the lung was downregulated in the MWCNT-exposed group. We propose that pulmonary exposure to MWCNT can manifest as a reduced epithelial barrier and activator of vascular gp130-associated transsignaling that may promote susceptibility to cardiovascular derangements. PMID:26589480

  7. Stochastic resonance whole body vibration increases perceived muscle relaxation but not cardiovascular activation: A randomized controlled trial

    PubMed Central

    Elfering, Achim; Burger, Christian; Schade, Volker; Radlinger, Lorenz

    2016-01-01

    AIM To investigate the acute effects of stochastic resonance whole body vibration (SR-WBV), including muscle relaxation and cardiovascular activation. METHODS Sixty-four healthy students participated. The participants were randomly assigned to sham SR-WBV training at a low intensity (1.5 Hz) or a verum SR-WBV training at a higher intensity (5 Hz). Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR) and self-reported muscle relaxation were assessed before and immediately after SR-WBV. RESULTS Two factorial analyses of variance (ANOVA) showed a significant interaction between pre- vs post-SR-WBV measurements and SR-WBV conditions for muscle relaxation in the neck and back [F(1,55) = 3.35, P = 0.048, η2 = 0.07]. Muscle relaxation in the neck and back increased in verum SR-WBV, but not in sham SR-WBV. No significant changes between pre- and post-training levels of SBD, DBD and HR were observed either in sham or verum SR-WBV conditions. With verum SR-WBV, improved muscle relaxation was the most significant in participants who reported the experience of back, neck or shoulder pain more than once a month (P < 0.05). CONCLUSION A single session of SR-WBV increased muscle relaxation in young healthy individuals, while cardiovascular load was low. An increase in musculoskeletal relaxation in the neck and back is a potential mediator of pain reduction in preventive worksite SR-WBV trials. PMID:27900274

  8. Rheumatoid arthritis patients are not at increased risk for 30-day cardiovascular events, infections, or mortality after total joint arthroplasty

    PubMed Central

    2013-01-01

    Introduction Serious infection, cardiovascular disease, and mortality are increased in rheumatoid arthritis (RA). Whether RA affects the risk for these complications after total joint arthroplasty (TJA) is unknown, we hypothesize that it does. We compared the occurrence of 30-day postoperative complications and mortality in a large cohort of RA and osteoarthritis (OA) patients undergoing hip or knee TJA. Methods Analyses included 7-year data from the Veterans Affairs Surgical Quality Improvement Program. The 30-day complications were compared by diagnosis by using logistic regression, and long-term mortality was examined by using Cox proportional hazards regression. All analyses were adjusted for age, sex, and clustering by surgical site. Additional covariates included sociodemographics, comorbidities, health behaviors, and operative risk factors. Results The 34,524 patients (839 RA, 33,685 OA) underwent knee (65.9%) or hip TJA. Patients were 95.7% men with a mean (SD) age of 64.4 (10.7) years and had 3,764 deaths over a mean follow-up of 3.7 (2.3) years. Compared with OA patients, those with RA were significantly more likely to require a return to the operating room (odds ratio (OR), 1.45 (95% CI, 1.08 to 1.94), but had similar rates of 30-day postoperative infection, OR 1.02 (0.72 to 1.47), cardiovascular events, OR 0.69 (0.37 to 1.28), and mortality, OR 0.94 (0.38 to 2.33). RA was associated with a significantly higher long-term mortality; hazard ratio (HR), 1.22 (1.00 to 1.49). Conclusion In this study of US veterans, RA patients were not at an increased risk for short-term mortality or other major complications after TJA, although they returned to the operating room more often and had increased long-term mortality. PMID:24252350

  9. Pulmonary instillation of MWCNT increases lung permeability, decreases gp130 expression in the lungs, and initiates cardiovascular IL-6 transsignaling.

    PubMed

    Thompson, Leslie C; Holland, Nathan A; Snyder, Ryan J; Luo, Bin; Becak, Daniel P; Odom, Jillian T; Harrison, Benjamin S; Brown, Jared M; Gowdy, Kymberly M; Wingard, Christopher J

    2016-01-15

    Pulmonary instillation of multiwalled carbon nanotubes (MWCNT) has the potential to promote cardiovascular derangements, but the mechanisms responsible are currently unclear. We hypothesized that exposure to MWCNT would result in increased epithelial barrier permeability by 24 h postexposure and initiate a signaling process involving IL-6/gp130 transsignaling in peripheral vascular tissue. To test this hypothesis we assessed the impact of 1 and 10 μg/cm(2) MWCNT on transepithelial electrical resistance (TEER) and expression of barrier proteins and cell activation in vitro using normal human bronchial epithelial primary cells. Parallel studies using male Sprague-Dawley rats instilled with 100 μg MWCNT measured bronchoalveolar lavage (BAL) differential cell counts, BAL fluid total protein, and lung water-to-tissue weight ratios 24 h postexposure and quantified serum concentrations of IL-6, soluble IL-6r, and soluble gp130. Aortic sections were examined immunohistochemically for gp130 expression, and gp130 mRNA/protein expression was evaluated in rat lung, heart, and aortic tissue homogenates. Our in vitro findings indicate that 10 μg/cm(2) MWCNT decreased the development of TEER and zonula occludens-1 expression relative to the vehicle. In rats MWCNT instillation increased BAL protein, lung water, and induced pulmonary eosinophilia. Serum concentrations of soluble gp130 decreased, aortic endothelial expression of gp130 increased, and expression of gp130 in the lung was downregulated in the MWCNT-exposed group. We propose that pulmonary exposure to MWCNT can manifest as a reduced epithelial barrier and activator of vascular gp130-associated transsignaling that may promote susceptibility to cardiovascular derangements. Copyright © 2016 the American Physiological Society.

  10. Increased Air Velocity Reduces Thermal and Cardiovascular Strain in Young and Older Males during Humid Exertional Heat Stress.

    PubMed

    Wright Beatty, Heather E; Hardcastle, Stephen G; Boulay, Pierre; Flouris, Andreas D; Kenny, Glen P

    2015-01-01

    Older adults have been reported to have a lower evaporative heat loss capacity than younger adults during exercise when full sweat evaporation is permitted. However, it is unclear how conditions of restricted evaporative and convective heat loss (i.e., high humidity, clothing insulation) alter heat stress. to the purpose of this study was to examine the heat stress responses of young and older males during and following exercise in a warm/humid environment under two different levels of air velocity. Ten young (YOUNG: 24±2 yr) and 10 older (OLDER: 59±3 yr) males, matched for body surface area performed 4×15-min cycling bouts (15-min rest) at a fixed rate of heat production (400 W) in warm/humid conditions (35°C, 60% relative humidity) under 0.5 (Low) and 3.0 (High) m·s(-1) air velocity while wearing work coveralls. Rectal (Tre) and mean skin (MTsk) temperatures, heart rate (HR), local sweat rate, % max skin blood flow (SkBF) (recovery only), and blood pressure (recovery only) were measured. High air velocity reduced core and skin temperatures (p < 0.05) equally in YOUNG and OLDER males (p > 0.05) but was more effective in reducing cardiovascular strain (absolute and % max HR; p < 0.05) in YOUNG males (p < 0.05). Greater increases in local dry heat loss responses (% max SkBF and cutaneous vascular conductance) were detected across time in OLDER than YOUNG males in both conditions (p < 0.05). Local dry heat loss responses and cardiovascular strain were attenuated during the High condition in YOUNG compared to OLDER (p < 0.05). High air velocity reduced the number of males surpassing the 38.0°C Tre threshold from 90% (Low) to 50% (High). Despite age-related local heat loss differences, YOUNG and OLDER males had similar levels of heat stress during intermittent exercise in warm and humid conditions while wearing work coveralls. Increased air velocity was effective in reducing heat stress equally, and cardiovascular strain to a greater extent, in YOUNG and OLDER

  11. Ventral Lamina Terminalis Mediates Enhanced Cardiovascular Responses of RVLM Neurons During Increased Dietary Salt

    PubMed Central

    Adams, Julye M.; Bardgett, Megan E.; Stocker, Sean D.

    2009-01-01

    Increased dietary salt enhances sympathoexcitatory and sympathoinhibitory responses evoked from the rostral ventrolateral medulla (RVLM). The purpose of the present study was to determine whether neurons of the forebrain lamina terminalis (LT) mediated these changes in the RVLM. Male Sprague-Dawley rats with and without LT lesions were fed normal chow and given access to water or 0.9% NaCl for 14-15 days. Unilateral injection of L-glutamate into the RVLM produced significantly larger increases in renal sympathetic nerve activity (SNA) and arterial blood pressure (ABP) of sham rats ingesting 0.9% NaCl versus water. However, these differences were not observed between ventral LT-lesioned rats drinking 0.9% NaCl versus water. Similar findings were observed when angiotensin II or GABA were injected into the RVLM. Interestingly, a subset of animals drinking 0.9% but with damage restricted to the organum vasculosum of the lamina terminalis did not show enhanced responses to L-glutamate or GABA. In marked contrast, RVLM injection of L-glutamate or GABA produced exaggerated SNA and ABP responses in animals drinking 0.9% NaCl versus water after an acute ventral LT lesion or chronic lesion of the subfornical organ. Additional experiments demonstrate plasma sodium concentration and osmolality were increased at night in rats ingesting 0.9% NaCl. These findings suggest that neurons of the ventral LT mediate the ability of increased dietary salt to enhance the responsiveness of RVLM sympathetic neurons. PMID:19506102

  12. AN INCREASE IN RISK FACTORS FOR CARDIOVASCULAR DISEASE IN YOGYAKARTA, INDONESIA: A COMPARISON OF TWO CROSS-SECTIONAL SURVEYS.

    PubMed

    Dewi, F S T; Stenlund, H; Hakimi, M; Weinehall, L

    2015-07-01

    This paper aims to describe changes in risk factors for cardiovascular disease (CVD) over a five year period in urban Indonesia. In 2004 (n = 3,205) and 2009 (n = 2,467) we conducted cross-sectional surveys of residents in Yogjakarta City, Indonesia evaluating risk factors for CVD. Smoking habits, fruit and vegetable intake, physical activity, blood pressure, weight, and height were recorded. The results of these 2 surveys conducted 5 years apart were then compared. The risk for having a CVD event was also calculated. Behavioral CVD risk factors were more common among men. The predicted risk of having a CVD event increased from 8.4% to 11.3% among men between 2004 and 2009. Effective measures need to be taken to change these behaviors among men in Yogyakarta, Indonesia.

  13. The many facets of cardiovascular magnetic resonance imaging: review of background, clinical utility, and increasing use in the community hospital.

    PubMed

    Gore, Thomas B; Rollings, Robert C; Gore, Andrew W

    2009-07-01

    Cardiovascular magnetic resonance imaging (CMR or cardiac MRI) has advanced dramatically in the last ten years and has been proven a reliable and flexible method for cardiac diagnosis. Stress perfusion MRI is a new technique that accurately detects coronary heart disease with high sensitivity and specificity. The role of CMR is also increasing for the evaluation of congestive heart failure and cardiomyopathy. Late gadolinium enhancement highlights areas of myocardial scar and helps predict prognosis. CMR usually complements, but does not fully replace, other diagnostic modalities. Careful patient selection is required to ensure safety in the presence of this powerful magnetic field. MRI gives unique tissue characterization without ionizing radiation. No longer used just for esoteric conditions, CMR is becoming common in the community hospital.

  14. Association Between Thoracic Aorta Calcium and Thoracic Aorta Geometry in a Cohort of Asymptomatic Participants at Increased Cardiovascular Risk.

    PubMed

    Craiem, Damian; Alsac, Jean-Marc; Casciaro, Mariano E; El Batti, Salma; Mousseaux, Elie; Sirieix, Marie-Emmanuelle; Simon, Alain

    2016-09-01

    Thoracic aorta calcium detection is known to improve cardiovascular risk prediction for cardiac and noncardiac events beyond traditional risk factors. We investigated the influence of thoracic aorta morphometry on the presence and extent of aortic calcifications. Nonenhanced computed tomography heart scans were performed in 970 asymptomatic participants at increased cardiovascular risk. An automated algorithm estimated the geometry of the entire thoracic aorta and quantified the aortic calcium Agatston score. A nonparametric model was used to analyze the percentiles of calcium score by age. Logistic regression models were calculated to identify anatomical associations with calcium levels. Calcifications were concentrated in the aortic arch and descending portions. Higher amounts of calcium were associated with an enlarged, unfolded, less tapered and more tortuous aorta. The size of the ascending aorta was not correlated with aortic calcium score, whereas enlargement of the descending aorta had the strongest association: the risk of having a global calcium score > 90th percentile was 3.62 times higher (confidence interval, 2.30-5.91; P < .001) for each 2.5-mm increase in descending aorta diameter. Vessel taper, tortuosity, unfolding and aortic arch and descending volumes were also correlated with higher amounts of calcium. Thoracic aorta calcium was predominantly found at the arch and descending aorta and was positively associated with the size of the descending aorta and the aortic arch, but not with the size of the ascending aorta. These findings suggest that aortic dilatation may have different mechanisms and may consequently require different preventive strategies according to the considered segments. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  15. Suppression in growth hormone during overeating ameliorates the increase in insulin resistance and cardiovascular disease risk

    PubMed Central

    Cornford, Andrea S.; Barkan, Ariel L.; Hinko, Alexander

    2012-01-01

    Previously, we reported that overeating for only a few days markedly suppressed the secretion of growth hormone (GH). The purpose of the present study was to determine the role of this reduction in GH concentration on key metabolic adaptations that occur during 2 wk of overeating. Nine nonobese, healthy adults were admitted to the hospital for 2 wk, during which time they ate ∼4,000 kcal/day (70 kcal·kg fat-free mass−1·day−1; 50% carbohydrate, 35% fat, and 15% protein), and their plasma GH concentration was allowed to decline naturally (control). An additional eight subjects underwent the same overeating intervention and received exogenous GH treatment (GHT) administered in four daily injections to mimic physiological GH secretion throughout the 2-wk overeating period. We measured plasma insulin and glucose concentrations in the fasting and postprandial state as well as fasting lipolytic rate, proteolytic rate, and fractional synthetic rate (FSR) using stable-isotope tracer methods. GHT prevented the fall in plasma GH concentration, maintaining plasma GH concentration at baseline levels (1.2 ± 0.2 ng/ml), which increased fasting and postprandial assessments of insulin resistance (P < 0.05) and increased fasting lipidemia (all P < 0.05 vs. control). In addition, preventing the suppression in GH with overeating also blunted the increase in systemic proteolysis (P < 0.05 GHT vs. control). However, GHT did not alter lipolysis or FSR in response to overeating. In conclusion, our main findings suggest that the suppression in GH secretion that naturally occurs during the early stages of overeating may help attenuate the insulin resistance and hyperlipidemia that typically accompany overeating. PMID:23011065

  16. Coronary fluorine-18-sodium fluoride uptake is increased in healthy adults with an unfavorable cardiovascular risk profile: results from the CAMONA study.

    PubMed

    Blomberg, Björn A; Thomassen, Anders; de Jong, Pim A; Lam, Marnix G E; Diederichsen, Axel C P; Olsen, Michael H; Mickley, Hans; Mali, Willem P T M; Alavi, Abass; Høilund-Carlsen, Poul F

    2017-09-04

    Coronary artery fluorine-18-sodium fluoride (F-NaF) uptake reflects coronary artery calcification metabolism and is considered to be an early prognostic marker of coronary heart disease. This study evaluated the relationship between coronary artery F-NaF uptake and cardiovascular risk in healthy adults at low cardiovascular risk. Study participants underwent blood pressure measurements, blood analyses, and coronary artery F-NaF PET/CT imaging. In addition, the 10-year risk for the development of cardiovascular disease, on the basis of the Framingham Risk Score, was estimated. Multivariable linear regression evaluated the dependence of coronary artery F-NaF uptake on cardiovascular risk factors. We recruited 89 (47 men, 42 women) healthy adults aged 21-75 years. Female sex (0.34 kBq/ml; P=0.009), age (0.16 kBq/ml per SD; P=0.002), and BMI (0.42 kBq/ml per SD; P<0.001) were independent determinants of increased coronary artery F-NaF uptake (adjusted R=0.21; P<0.001). Coronary artery F-NaF uptake increased linearly according to the number of cardiovascular risk factors present (P<0.001 for a linear trend). The estimated 10-year risk for the development of cardiovascular disease was on average 2.4 times higher in adults with coronary artery F-NaF uptake in the highest quartile compared with those in the lowest quartile of the distribution (8.0 vs. 3.3%, P<0.001). Our findings indicate that coronary artery F-NaF PET/CT imaging is feasible in healthy adults at low cardiovascular risk and that an unfavorable cardiovascular risk profile is associated with a marked increase in coronary artery F-NaF uptake.

  17. Vegan proteins may reduce risk of cancer, obesity, and cardiovascular disease by promoting increased glucagon activity.

    PubMed

    McCarty, M F

    1999-12-01

    Amino acids modulate the secretion of both insulin and glucagon; the composition of dietary protein therefore has the potential to influence the balance of glucagon and insulin activity. Soy protein, as well as many other vegan proteins, are higher in non-essential amino acids than most animal-derived food proteins, and as a result should preferentially favor glucagon production. Acting on hepatocytes, glucagon promotes (and insulin inhibits) cAMP-dependent mechanisms that down-regulate lipogenic enzymes and cholesterol synthesis, while up-regulating hepatic LDL receptors and production of the IGF-I antagonist IGFBP-1. The insulin-sensitizing properties of many vegan diets--high in fiber, low in saturated fat--should amplify these effects by down-regulating insulin secretion. Additionally, the relatively low essential amino acid content of some vegan diets may decrease hepatic IGF-I synthesis. Thus, diets featuring vegan proteins can be expected to lower elevated serum lipid levels, promote weight loss, and decrease circulating IGF-I activity. The latter effect should impede cancer induction (as is seen in animal studies with soy protein), lessen neutrophil-mediated inflammatory damage, and slow growth and maturation in children. In fact, vegans tend to have low serum lipids, lean physiques, shorter stature, later puberty, and decreased risk for certain prominent 'Western' cancers; a vegan diet has documented clinical efficacy in rheumatoid arthritis. Low-fat vegan diets may be especially protective in regard to cancers linked to insulin resistance--namely, breast and colon cancer--as well as prostate cancer; conversely, the high IGF-I activity associated with heavy ingestion of animal products may be largely responsible for the epidemic of 'Western' cancers in wealthy societies. Increased phytochemical intake is also likely to contribute to the reduction of cancer risk in vegans. Regression of coronary stenoses has been documented during low-fat vegan diets

  18. Associations between Unhealthy Diet and Lifestyle Behaviours and Increased Cardiovascular Disease Risk in Young Overweight and Obese Women.

    PubMed

    Whatnall, Megan C; Collins, Clare E; Callister, Robin; Hutchesson, Melinda J

    2016-08-19

    Unhealthy lifestyle behaviours are known modifiable risk factors for cardiovascular disease (CVD). This cross-sectional analysis aimed to describe lifestyle behaviours and CVD risk markers in young overweight and obese Australian women and explore associations between individual and combined lifestyle behaviours with CVD risk markers. Lifestyle behaviours assessed were diet quality, alcohol intake, physical activity, sitting time and smoking status, and were combined to generate a Healthy Lifestyle Score (HLS) (0-5). Objectively measured CVD risk markers were body mass index (BMI), %body fat, waist circumference, blood pressure, and plasma cholesterol and triglycerides. Analysis included 49 women aged 18-35 years, with BMI 25.0 to 34.9 kg/m². The mean ± SD Australian Recommended Food Score was 33.5 ± 9.3 points, alcohol 3.3 ± 2.4 standard drinks/day, physical activity 207 ± 225 min/week and sitting time 578 ± 213 min/day. All participants were non-smokers. The proportion of participants outside normal reference ranges was 83.7% for waist circumference (n = 41), blood pressure 0% (n = 0), total cholesterol 26.2% (n = 11), HDL cholesterol 38.6% (n = 17), LDL cholesterol 22.7% (n = 10), and triglycerides 4.2% (n = 2). Physical activity was inversely associated with body fat (β = -0.011%, p = 0.005), diastolic blood pressure (β = -0.010 mmHg, p = 0.031) and waist circumference (β = -0.013 cm, p = 0.029). Most participants (59.2%, n = 29) had a HLS ≤ 2. No significant associations were found between HLS and CVD risk markers. Insufficient physical activity was the primary lifestyle factor associated with increased CVD risk markers, which suggests interventions targeting physical activity in young women may potentially improve cardiovascular health.

  19. Evidence Linking Hypoglycemic Events to an Increased Risk of Acute Cardiovascular Events in Patients With Type 2 Diabetes

    PubMed Central

    Johnston, Stephen S.; Conner, Christopher; Aagren, Mark; Smith, David M.; Bouchard, Jonathan; Brett, Jason

    2011-01-01

    OBJECTIVE This retrospective study examined the association between ICD-9-CM–coded outpatient hypoglycemic events (HEs) and acute cardiovascular events (ACVEs), i.e., acute myocardial infarction, coronary artery bypass grafting, revascularization, percutaneous coronary intervention, and incident unstable angina, in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS Data were derived from healthcare claims for individuals with employer-sponsored primary or Medicare supplemental insurance. A baseline period (30 September 2006 to 30 September 2007) was used to identify eligible patients and collect information on their clinical and demographic characteristics. An evaluation period (1 October 2007 to 30 September 2008) was used to identify HEs and ACVEs. Patients aged ≥18 years with type 2 diabetes were selected for analysis by a modified Healthcare Effectiveness Data and Information Set algorithm. Data were analyzed with multiple logistic regression and backward stepwise selection (maximum P = 0.01) with adjustment for important confounding variables, including age, sex, geography, insurance type, comorbidity scores, cardiovascular risk factors, diabetes complications, total baseline medical expenditures, and prior ACVEs. RESULTS Of the 860,845 patients in the analysis set, 27,065 (3.1%) had ICD-9-CM–coded HEs during the evaluation period. The main model retained 17 significant independent variables. Patients with HEs had 79% higher regression-adjusted odds (HE odds ratio [OR] 1.79; 95% CI 1.69–1.89) of ACVEs than patients without HEs; results in patients aged ≥65 years were similar to those for the entire population (HE OR 1.78, 95% CI 1.65–1.92). CONCLUSIONS ICD-9-CM–coded HEs were independently associated with an increased risk of ACVEs. Further studies of the relationship between hypoglycemia and the risk of ACVEs are warranted. PMID:21421802

  20. Associations between Unhealthy Diet and Lifestyle Behaviours and Increased Cardiovascular Disease Risk in Young Overweight and Obese Women

    PubMed Central

    Whatnall, Megan C.; Collins, Clare E.; Callister, Robin; Hutchesson, Melinda J.

    2016-01-01

    Unhealthy lifestyle behaviours are known modifiable risk factors for cardiovascular disease (CVD). This cross-sectional analysis aimed to describe lifestyle behaviours and CVD risk markers in young overweight and obese Australian women and explore associations between individual and combined lifestyle behaviours with CVD risk markers. Lifestyle behaviours assessed were diet quality, alcohol intake, physical activity, sitting time and smoking status, and were combined to generate a Healthy Lifestyle Score (HLS) (0–5). Objectively measured CVD risk markers were body mass index (BMI), %body fat, waist circumference, blood pressure, and plasma cholesterol and triglycerides. Analysis included 49 women aged 18–35 years, with BMI 25.0 to 34.9 kg/m2. The mean ± SD Australian Recommended Food Score was 33.5 ± 9.3 points, alcohol 3.3 ± 2.4 standard drinks/day, physical activity 207 ± 225 min/week and sitting time 578 ± 213 min/day. All participants were non-smokers. The proportion of participants outside normal reference ranges was 83.7% for waist circumference (n = 41), blood pressure 0% (n = 0), total cholesterol 26.2% (n = 11), HDL cholesterol 38.6% (n = 17), LDL cholesterol 22.7% (n = 10), and triglycerides 4.2% (n = 2). Physical activity was inversely associated with body fat (β = −0.011%, p = 0.005), diastolic blood pressure (β = −0.010 mmHg, p = 0.031) and waist circumference (β = −0.013 cm, p = 0.029). Most participants (59.2%, n = 29) had a HLS ≤ 2. No significant associations were found between HLS and CVD risk markers. Insufficient physical activity was the primary lifestyle factor associated with increased CVD risk markers, which suggests interventions targeting physical activity in young women may potentially improve cardiovascular health. PMID:27548243

  1. Collective cell migration of thyroid carcinoma cells: a beneficial ability to override unfavourable substrates.

    PubMed

    Lobastova, Liudmila; Kraus, Dominik; Glassmann, Alexander; Khan, Dilaware; Steinhäuser, Christian; Wolff, Christina; Veit, Nadine; Winter, Jochen; Probstmeier, Rainer

    2017-02-01

    Tumor cell invasion and metastasis are life threatening events. Invasive tumor cells tend to migrate as collective sheets. In the present in vitro study we aimed to (i) assess whether collective tumor cells gain benefits in their migratory potential compared to single cells and (ii) to identify its putative underlying molecular mechanisms. The migratory potential of single and collective carcinoma cells was assessed using video time lapse microscopy and cell migration assays in the absence and presence of seven potential gap junction inhibitors or the Rac1 inhibitor Z62954982. The perturbation of gap junctions was assessed using a dye diffusion assay. In addition, LDH-based cytotoxicity and RT-PCR-based expression analyses were performed. Whereas single breast, cervix and thyroid carcinoma cells were virtually immobile on unfavourable plastic surfaces, we found that they gained pronounced migratory capacities as collectives under comparable conditions. Thyroid carcinoma cells, that were studied in more detail, were found to express specific subsets of connexins and to form active gap junctions as revealed by dye diffusion analysis. Although all potential gap junction blockers suppressed intercellular dye diffusion in at least one of the cell lines tested, only two of them were found to inhibit collective cell migration and none of them to inhibit single cell migration. In the presence of the Rac1 inhibitor Z62954982 collective migration, but not single cell migration, was found to be reduced up to 20 %. Our data indicate that collective migration enables tumor cells to cross otherwise unfavourable substrate areas. This capacity seems to be independent of intercellular communication via gap junctions, whereas Rac1-dependent intracellular signalling seems to be essential.

  2. Migrating zooids allow the dispersal of Fredericella sultana (Bryozoa) to escape from unfavourable conditions and further spreading of Tetracapsuloides bryosalmonae.

    PubMed

    Gorgoglione, Bartolomeo; Kotob, Mohamed H; El-Matbouli, Mansour

    2016-10-01

    Fredericella sultana (Bryozoa: Phylactolaemata) is a primary host in the two-host life cycle of the myxozoan parasite Tetracapsuloides bryosalmonae, the etiological agent of Proliferative Kidney Disease (PKD) in salmonids. Overtly infected F. sultana colonies were collected from River Kamp (Lower Austria), following the first PKD outbreak affecting autochthonous brown trout (Salmo trutta) in Austria. Zooids cultured under unfavourable conditions, e.g. hypertrophication or sudden temperature changes, disconnected their funiculus from the bottom of the body wall, contracted their retractor muscle and packed all organs into a pear-shaped capsule. Migrating zooids dislocated from larger dying branches by separating from the degenerating zooecial tube. After attaching to a new substrate, a new colony could grow rapidly, similar to newly hatched zooids from statoblasts. This is the first observation of an adaptive dispersal mechanism undertaken by adult viable bryozoan zooids to escape from colony deterioration upon adverse summer-like conditions. The evidence of migrating zooids for F. sultana colonization of new habitats increases their intrinsic capacity of spreading infective T. bryosalmonae malacospores. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Threshold conditions for transitions to I-mode and H-mode with unfavourable ion grad B drift direction

    NASA Astrophysics Data System (ADS)

    Hubbard, A. E.; Whyte, D. G.; Churchill, R. M.; Dominguez, A.; Hughes, J. W.; Ma, Y.; Marmar, E. S.; Lin, Y.; Reinke, M. L.; White, A. E.

    2012-11-01

    Transitions from the L-mode regime to the I-mode regime, with an energy transport barrier, and to the H-mode regime with both an energy and particle transport barrier are studied on the Alcator C-Mod tokamak. Steady I-mode plasmas have been produced over a wide range of plasma field (3-6 T), current (0.8-1.35 MA), density and shaping in the unfavourable ion B × ∇B configuration. The power threshold for the L-I transition is higher than scalings for the L-H transition with favourable drift, and increases with plasma current as well as density. Threshold conditions for the I-H transition are more variable. In some conditions I-mode is maintained up to the maximum available ICRF power of 5 MW, nearly a factor of two above the L-I threshold, giving a robust operating window. Edge Te at the L-I transition is in the range 250-450 eV, over a range of current and density, about a factor of two higher than with favourable drift, while at the I-H transition it can be much higher (up to 1.1 keV) but is again widely variable. Heat pulses due to sawteeth may play a role in transitions. Controlled I-L back transitions indicate little power hysteresis.

  4. The role of cone beam computed tomography in the management of unfavourable fractures following sagittal split mandibular osteotomy.

    PubMed

    Lloyd, Timothy E; Drage, Nicholas A; Cronin, Andrew J

    2011-03-01

    Cone beam computed tomography (CBCT) has been at the forefront of recent technological advances within the maxillofacial region. CBCT is useful in the accurate assessment and planning of patients undergoing orthognathic surgery. We propose that it also has a role in the post-operative evaluation of a subgroup of patients who have suffered complications at the time of surgery. We present two cases where unfavourable splits occurred during a bilateral sagittal split osteotomy (BSSO) of the mandible. Both cases were investigated post-operatively with CBCT with the aim of identifying the potential cause of the unfavourable split and to establish accurate localization of the condyle in the glenoid fossa following intra-operative attempts at proximal segment control. CBCT should be considered for evaluation of the mandible following an unfavourable split where it is deemed that plain radiographs would not provide adequate information.

  5. Effect of increased potassium intake on cardiovascular risk factors and disease: systematic review and meta-analyses

    PubMed Central

    Hanson, Sara; Gutierrez, Hialy; Hooper, Lee; Elliott, Paul; Cappuccio, Francesco P

    2013-01-01

    Objective To conduct a systematic review of the literature and meta-analyses to fill the gaps in knowledge on potassium intake and health. Data sources Cochrane Central Register of Controlled Trials, Medline, Embase, WHO International Clinical Trials Registry Platform, Latin American and Caribbean Health Science Literature Database, and the reference lists of previous reviews. Study selection Randomised controlled trials and cohort studies reporting the effects of potassium intake on blood pressure, renal function, blood lipids, catecholamine concentrations, all cause mortality, cardiovascular disease, stroke, and coronary heart disease were included. Data extraction and synthesis Potential studies were independently screened in duplicate, and their characteristics and outcomes were extracted. When possible, meta-analysis was done to estimate the effects (mean difference or risk ratio with 95% confidence interval) of higher potassium intake by using the inverse variance method and a random effect model. Results 22 randomised controlled trials (including 1606 participants) reporting blood pressure, blood lipids, catecholamine concentrations, and renal function and 11 cohort studies (127 038 participants) reporting all cause mortality, cardiovascular disease, stroke, or coronary heart disease in adults were included in the meta-analyses. Increased potassium intake reduced systolic blood pressure by 3.49 (95% confidence interval 1.82 to 5.15) mm Hg and diastolic blood pressure by 1.96 (0.86 to 3.06) mm Hg in adults, an effect seen in people with hypertension but not in those without hypertension. Systolic blood pressure was reduced by 7.16 (1.91 to 12.41) mm Hg when the higher potassium intake was 90-120 mmol/day, without any dose response. Increased potassium intake had no significant adverse effect on renal function, blood lipids, or catecholamine concentrations in adults. An inverse statistically significant association was seen between potassium intake and risk of

  6. Effect of increased potassium intake on cardiovascular risk factors and disease: systematic review and meta-analyses.

    PubMed

    Aburto, Nancy J; Hanson, Sara; Gutierrez, Hialy; Hooper, Lee; Elliott, Paul; Cappuccio, Francesco P

    2013-04-03

    To conduct a systematic review of the literature and meta-analyses to fill the gaps in knowledge on potassium intake and health. Cochrane Central Register of Controlled Trials, Medline, Embase, WHO International Clinical Trials Registry Platform, Latin American and Caribbean Health Science Literature Database, and the reference lists of previous reviews. Randomised controlled trials and cohort studies reporting the effects of potassium intake on blood pressure, renal function, blood lipids, catecholamine concentrations, all cause mortality, cardiovascular disease, stroke, and coronary heart disease were included. Potential studies were independently screened in duplicate, and their characteristics and outcomes were extracted. When possible, meta-analysis was done to estimate the effects (mean difference or risk ratio with 95% confidence interval) of higher potassium intake by using the inverse variance method and a random effect model. 22 randomised controlled trials (including 1606 participants) reporting blood pressure, blood lipids, catecholamine concentrations, and renal function and 11 cohort studies (127,038 participants) reporting all cause mortality, cardiovascular disease, stroke, or coronary heart disease in adults were included in the meta-analyses. Increased potassium intake reduced systolic blood pressure by 3.49 (95% confidence interval 1.82 to 5.15) mm Hg and diastolic blood pressure by 1.96 (0.86 to 3.06) mm Hg in adults, an effect seen in people with hypertension but not in those without hypertension. Systolic blood pressure was reduced by 7.16 (1.91 to 12.41) mm Hg when the higher potassium intake was 90-120 mmol/day, without any dose response. Increased potassium intake had no significant adverse effect on renal function, blood lipids, or catecholamine concentrations in adults. An inverse statistically significant association was seen between potassium intake and risk of incident stroke (risk ratio 0.76, 0.66 to 0.89). Associations between

  7. Increased cardiovascular disease risk in the HIV-positive population on ART: potential role of HIV-Nef and Tat.

    PubMed

    Wang, Ting; Yi, Ru; Green, Linden Ann; Chelvanambi, Sarvesh; Seimetz, Michael; Clauss, Matthias

    2015-01-01

    With effective antiretroviral therapy (ART), many HIV-infected people die of diseases other than acquired immune deficiency syndrome (AIDS). In particular, coronary artery disease has emerged as one of most critical complications of HIV infection and a major cause of morbidity and mortality. Although reportedly antiretroviral combination therapy itself may accelerate atherosclerosis by enhancing dyslipidemia, most recent epidemiological studies support the notion that HIV infection itself contributes to cardiovascular disease. However, it is still a mystery how the virus can contribute to cardiovascular disease development even while suppressed by ARTs. This review discusses the current understanding of interactions between HIV infection and cardiovascular diseases in both clinical and experimental studies with special focus on those viral proteins that are still produced by HIV. This will help infectious disease/vascular biology experts to gain insights into the pathophysiological mechanisms of HIV-associated cardiovascular disease and new trends to treat and prevent cardiovascular disease in the HIV-infected population.

  8. Effects of incremental increases in silt load on the cardiovascular performance of riverine and lacustrine rock bass, Ambloplites rupestris.

    PubMed

    Bunt, Christopher M; Cooke, Steven J; Schreer, Jason F; Philipp, David P

    2004-01-01

    Rock bass (Ambloplites rupestris) are a widespread centrarchid species with both riverine and lacustrine populations. After precipitation events, rivers often carry elevated silt loads, where as lakes generally remain free from suspended silt and sediment. To examine the physiological effects of silt on rock bass, we conducted a series of experiments using fish from Lake Opinicon and the Grand River in Ontario. Ultrasonic Doppler flow probes were surgically affixed around the ventral aorta to monitor cardiovascular performance. After recovery from surgery replicated treatment groups were exposed to incremental increases in silt load (made from bentonite slurry), while cardiac output and its two components, heart rate and stroke volume, were measured simultaneously. Although both groups of rock bass responded significantly to low concentrations of silt (10 NTU), the response by riverine rock bass was rapidly extinguished by acclimation or physiological adjustment. Compensatory mechanisms to minimize cardiac (and respiratory) disruption attributable to increases in suspended silt appear to be inherent in rock bass of riverine origin. These fish appear to fully compensate for interference in gas exchange at the gill surfaces 60 min after initial exposure. In contrast, individual lacustrine rock bass were highly variable in their response to elevated silt concentrations. Changes in stroke volume and cardiac output suggested no clear compensatory mechanism or strategy to cope with increased silt levels.

  9. Cardiovascular health, growth and gonadal function in children and adolescents with congenital adrenal hyperplasia.

    PubMed

    Mooij, Christiaan F; Webb, Emma A; Claahsen van der Grinten, Hedi L; Krone, Nils

    2017-06-01

    After the introduction of replacement therapy with glucocorticoids and mineralocorticoids in the 1950s, congenital adrenal hyperplasia (CAH) is no longer a life-limiting condition. However, due to the successful introduction of medical steroid hormone replacement, CAH has become a chronic condition, with associated comorbidities and long-term health implications. The aim of treatment is the replacement of mineralocorticoids and glucocorticoids and the normalisation of elevated androgen concentrations. Long-term consequences of the condition and current treatment regimens include unfavourable changes in the cardiovascular risk profile, impaired growth, testicular adrenal rest tumours (TART) in male and subfertility in both male and female patients with CAH. Optimising replacement therapy in patients with CAH remains challenging. On one hand, treatment with supraphysiological doses of glucocorticoids might be required to normalise androgen concentrations and decrease size or presence of TARTs. On the other hand, treatment with supraphysiological doses of glucocorticoids is associated with an increased prevalence of unfavourable cardiovascular and metabolic risk profiles as well as impaired longitudinal growth and gonadal function. Therefore, treatment of children and adults with CAH requires an individualised approach. Careful monitoring for early signs of complications is already warranted during paediatric healthcare provision to prevent and reduce the impact of comorbidities in later life. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  10. Erythropoietin-mediated protection in kidney transplantation: nonerythropoietic EPO derivatives improve function without increasing risk of cardiovascular events.

    PubMed

    van Rijt, Willem G; van Goor, Harry; Ploeg, Rutger J; Leuvenink, Henri G D

    2014-03-01

    The protective, nonerythropoietic effects of erythropoietin (EPO) have become evident in preclinical models in renal ischaemia/reperfusion injury and kidney transplantation. However, four recently published clinical trials using high-dose EPO treatment following renal transplantation did not reveal any protective effect for short-term renal function and even reported an increased risk of thrombosis. This review focusses on the current status of protective pathways mediated by EPO, the safety concerns using high EPO dosage and discusses the discrepancies between pre-clinical and clinical studies. The protective effects are mediated by binding of EPO to a heteromeric receptor complex consisting of two β-common receptors and two EPO receptors. An important role for the activation of endothelial nitric oxide synthase is proposed. EPO-mediated cytoprotection still has enormous potential. However, only nonerythropoietic EPO derivatives may induce protection without increasing the risk of cardiovascular events. In preclinical models, nonerythropoietic EPO derivatives, such as carbamoylated EPO and ARA290, have been tested. These EPO derivatives improve renal function and do not affect erythropoiesis. Therefore, nonerythropoietic EPO derivatives may be able to render EPO-mediated cytoprotection useful and beneficial for clinical transplantation.

  11. Is greater acculturation associated with an increased prevalence of cardiovascular risk factors among Latinos in South Florida?

    PubMed

    Chang, Aileen; Kenya, Sonjia; Ilangovan, Kumar; Li, Hua; Koru-Sengul, Tulay; Alonzo, Yisel; Carrasquillo, Olveen

    2015-05-01

    To examine the association of acculturation with various cardiovascular risk factors (CRFs) among Latinos with diabetes in South Florida. In a cross-sectional analysis of data collected from 300 Latinos with poorly controlled diabetes we measured acculturation using the Marin Short Acculturation Scale. We examined correlations between acculturation and the following 7 CRFs: hemoglobin A1C, low-density lipoprotein, systolic blood pressure, body mass index, smoking status, physical activity, and fruit and vegetable intake. Cubans made up 38% of our population; no other Latino subgroup represented over 17% of the sample. Of the 8 outcomes examined, only smoking was associated with increased acculturation; 12% of Latinos in the 2 lowest acculturation groups were current smokers versus 25% in the highest acculturation group (P=0.02). Furthermore, Cuban Americans from our sample had over double the prevalence of smoking compared with non-Cubans in both the lowest and highest acculturation groups. With the exception of smoking, our data does not support a link between increased acculturation and higher prevalence of CRFs in Latinos with diabetes. Smoking prevention and cessation programs targeting Latinos and particularly among Cubans are needed.

  12. Testosterone Threshold for Increased Cardiovascular Risk in Middle-Aged and Elderly Men: A Locally Weighted Regression Analysis.

    PubMed

    Liao, Pin-Wen; Wu, Chia-Chang; Chen, Kuan-Chou; Jaw, Fu-Shan; Yu, Hong-Jeng; Liu, Shih-Ping; Ho, Chen-Hsun

    2016-12-01

    Although testosterone deficiency has a well-known association with increased risk of cardiovascular disease (CVD), the threshold remains to be determined. To investigate whether there is a discriminatory testosterone level below which the CVD risk increases. The study included 876 men 45 to 74 years old who underwent a general health checkup. The Framingham Risk Score was used to estimate the 10-year CVD risk; a high-sensitivity C-reactive protein (hsCRP) level of at least 1 mg/L was considered an indicator of increased CVD risk. Aging symptoms and sexual function were evaluated with the Aging Males' Symptom Scale. Locally weighted regression was performed to determine the testosterone threshold for Framingham CVD risk and increased hsCRP. The mean age was 56.6 ± 7.0 years. The mean total testosterone level was 394.3 ± 115.7 ng/dL. The mean 10-year Framingham CVD risk was 16.6 ± 10.7%, and 169 (19.3%) had increased hsCRP. The locally weighted regression showed that total testosterone levels of 440 and 480 ng/dL were associated with increased Framingham CVD risk and an increased probability of increased hsCRP, respectively. Men with sexual dysfunction (poor sexual performance, decreased morning erection, and loss of libido) had significantly greater CVD risk. Their risk appeared to increase at a relatively higher testosterone level, and it reached a plateau at a testosterone level of 300 to 350 ng/dL. In contrast, the risk in those with no or less sexual dysfunction remained low at a higher testosterone level, and a threshold level of 425 to 475 ng/dL was associated with increased CVD risk. A similar pattern and threshold were identified in the analyses of the relation between testosterone and hsCRP. These data showed that a testosterone threshold of 440 ng/dL was associated with increased Framingham 10-year CVD risk in middle-aged and elderly men. Poor sexual performance, decreased morning erection, and loss of libido had an impact on the testosterone threshold

  13. Perioperative hypothermia (33 degrees C) does not increase the occurrence of cardiovascular events in patients undergoing cerebral aneurysm surgery: findings from the Intraoperative Hypothermia for Aneurysm Surgery Trial.

    PubMed

    Nguyen, Hoang P; Zaroff, Jonathan G; Bayman, Emine O; Gelb, Adrian W; Todd, Michael M; Hindman, Bradley J

    2010-08-01

    Perioperative hypothermia has been reported to increase the occurrence of cardiovascular complications. By increasing the activity of sympathetic nervous system, perioperative hypothermia also has the potential to increase cardiac injury and dysfunction associated with subarachnoid hemorrhage. The Intraoperative Hypothermia for Aneurysm Surgery Trial randomized patients undergoing cerebral aneurysm surgery to intraoperative hypothermia (n = 499, 33.3 degrees +/- 0.8 degrees C) or normothermia (n = 501, 36.7 degrees +/- 0.5 degrees C). Cardiovascular events (hypotension, arrhythmias, vasopressor use, myocardial infarction, and others) were prospectively followed until 3-month follow-up and were compared in hypothermic and normothermic patients. A subset of 62 patients (hypothermia, n = 33; normothermia, n = 29) also had preoperative and postoperative (within 24 h) measurement of cardiac troponin-I and echocardiography to explore the association between perioperative hypothermia and subarachnoid hemorrhage-associated myocardial injury and left ventricular function. There was no difference between hypothermic and normothermic patients in the occurrence of any single cardiovascular event or in composite cardiovascular events. There was no difference in mortality (6%) between groups, and there was only a single primary cardiovascular death (normothermia). There was no difference between hypothermic and normothermic patients in postoperative versus preoperative left ventricular regional wall motion or ejection fraction. Compared with preoperative values, hypothermic patients had no postoperative increase in cardiac troponin-I (median change 0.00 microg/l), whereas normothermic patients had a small postoperative increase (median change + 0.01 microg/l, P = 0.038). In patients undergoing cerebral aneurysm surgery, perioperative hypothermia was not associated with an increased occurrence of cardiovascular events.

  14. Increased Mortality in Schizophrenia Due to Cardiovascular Disease – A Non-Systematic Review of Epidemiology, Possible Causes, and Interventions

    PubMed Central

    Ringen, Petter Andreas; Engh, John A.; Birkenaes, Astrid B.; Dieset, Ingrid; Andreassen, Ole A.

    2014-01-01

    Background: Schizophrenia is among the major causes of disability worldwide and the mortality from cardiovascular disease (CVD) is significantly elevated. There is a growing concern that this health challenge is not fully understood and efficiently addressed. Methods: Non-systematic review using searches in PubMed on relevant topics as well as selection of references based on the authors’ experience from clinical work and research in the field. Results: In most countries, the standardized mortality rate in schizophrenia is about 2.5, leading to a reduction in life expectancy between 15 and 20 years. A major contributor of the increased mortality is due to CVD, with CVD mortality ranging from 40 to 50% in most studies. Important causal factors are related to lifestyle, including poor diet, lack of physical activity, smoking, and substance abuse. Recent findings suggest that there are overlapping pathophysiology and genetics between schizophrenia and CVD-risk factors, further increasing the liability to CVD in schizophrenia. Many pharmacological agents used for treating psychotic disorders have side effects augmenting CVD risk. Although several CVD-risk factors can be effectively prevented and treated, the provision of somatic health services to people with schizophrenia seems inadequate. Further, there is a sparseness of studies investigating the effects of lifestyle interventions in schizophrenia, and there is little knowledge about effective programs targeting physical health in this population. Discussion: The risk for CVD and CVD-related deaths in people with schizophrenia is increased, but the underlying mechanisms are not fully known. Coordinated interventions in different health care settings could probably reduce the risk. There is an urgent need to develop and implement effective programs to increase life expectancy in schizophrenia, and we argue that mental health workers should be more involved in this important task. PMID:25309466

  15. High-Intensity Progressive Resistance Training Increases Strength With No Change in Cardiovascular Function and Autonomic Neural Regulation in Older Adults.

    PubMed

    Kanegusuku, Hélcio; Queiroz, Andréia C; Silva, Valdo J; de Mello, Marco T; Ugrinowitsch, Carlos; Forjaz, Cláudia L

    2015-07-01

    The effects of high-intensity progressive resistance training (HIPRT) on cardiovascular function and autonomic neural regulation in older adults are unclear. To investigate this issue, 25 older adults were randomly divided into two groups: control (CON, N = 13, 63 ± 4 years; no training) and HIPRT (N = 12, 64 ± 4 years; 2 sessions/week, 7 exercises, 2–4 sets, 10–4 RM). Before and after four months, maximal strength, quadriceps cross-sectional area (QCSA), clinic and ambulatory blood pressures (BP), systemic hemodynamics, and cardiovascular autonomic modulation were measured. Maximal strength and QCSA increased in the HIPRT group and did not change in the CON group. Clinic and ambulatory BP, cardiac output, systemic vascular resistance, stroke volume, heart rate, and cardiac sympathovagal balance did not change in the HIPRT group or the CON group. In conclusion, HIPRT was effective at increasing muscle mass and strength without promoting changes in cardiovascular function or autonomic neural regulation.

  16. Abnormal glucose tolerance and increased risk for cardiovascular disease in Japanese-Americans with normal fasting glucose.

    PubMed

    Liao, D; Shofer, J B; Boyko, E J; McNeely, M J; Leonetti, D L; Kahn, S E; Fujimoto, W Y

    2001-01-01

    To compare the American Diabetes Association (ADA) fasting glucose and the World Health Organization (WHO) oral glucose tolerance test (OGTT) criteria for diagnosing diabetes and detecting people at increased risk for cardiovascular disease (CVD). Study subjects were 596 Japanese-Americans. Fasting insulin, lipids, and C-peptide levels; systolic and diastolic blood pressures (BPs); BMI (kg/m2); and total and intra-abdominal body fat distribution by computed tomography (CT) were measured. Study subjects were categorized by ADA criteria as having normal fasting glucose (NFG), impaired fasting glucose (IFG), and diabetic fasting glucose and by WHO criteria for a 75-g OGTT as having normal glucose tolerance (NGT), impaired glucose tolerance (IGT), and diabetic glucose tolerance (DGT). Of 503 patients with NFG, 176 had IGT and 20 had DGT These patients had worse CVD risk factors than those with NGT . The mean values for NGT, IGT, and DGT, respectively, and analysis of covariance P values, adjusted for age and sex, are as follows; intra-abdominal fat area by CT 69.7, 95.0, and 101.1 cm2 (P < 0.0001); total CT fat area 437.7, 523.3, and 489.8 cm2 (P < 0.0001); fasting triglycerides 1.40, 1.77, and 1.74 mmol/l (P = 0.002); fasting HDL cholesterol 1.56, 1.50, and 1.49 mmol/l (P = 0.02); C-peptide 0.80, 0.90, 0.95 nmol/l (P = 0.002); systolic BP 124.9, 132.4, and 136.9 mmHg (P = 0.0035); diastolic BP 74.8, 77.7, and 78.2 mmHg (P = 0.01). NFG patients who had IGT or DGT had more intra-abdominal fat and total adiposity; higher insulin, C-peptide, and triglyceride levels; lower HDL cholesterol levels; and higher BPs than those with NGT. Classification by fasting glucose misses many Japanese-Americans with abnormal glucose tolerance and less favorable cardiovascular risk profiles.

  17. Do restless legs syndrome (RLS) and periodic limb movements of sleep (PLMS) play a role in nocturnal hypertension and increased cardiovascular risk of renally impaired patients?

    PubMed

    Portaluppi, Francesco; Cortelli, Pietro; Buonaura, Giovanna Calandra; Smolensky, Michael H; Fabbian, Fabio

    2009-08-01

    Hypertension can cause or promote renal failure and is related to cardiovascular mortality, the major cause of death in patients with renal impairment. Changes in the circadian BP pattern, particularly the blunting or reversal of the nocturnal decline in BP, are common in chronic renal failure. These changes in turn are among the major determinants of left ventricular hypertrophy. Using a chronobiological approach, it is possible to obtain better insight into the reciprocal relationship between hypertension, renal disease, and increased cardiovascular risk of renal patients. Disruption of the normal circadian rhythm of rest/activity may be hypothesized to underlie the high cardiovascular morbidity and mortality of such patients. Epidemiological studies reveal that hemodialysis patients experience poor subjective sleep quality and insomnia and, in comparison to healthy persons, are more likely to show shorter sleep duration and lower sleep efficiency. Sleep apnea may be present and is usually investigated in these patients; however, the prevalence of restless legs syndrome (RLS), which is high in dialysis patients and which has been associated with increased risk for cardiovascular disease in the general population, could also play a role in the pathogenesis of sleep-time hypertension in renal patients. Careful assessment of sleep quality, in particular, diagnostic screening for RLS and periodic limb movements (PLM) in renal patients, is highly recommended. In renal failure, attention to sleep quality and related perturbations of the sleep/wake cycle may help prevent the occurrence and progression of cardiovascular disease.

  18. Skin advanced glycation end products in HIV infection are increased and predictive of development of cardiovascular events.

    PubMed

    Sprenger, Herman G; Bierman, Wouter F; Martes, Melanie I; Graaff, Reindert; van der Werf, Tjip S; Smit, Andries J

    2017-01-14

    HIV-1 infection is associated with an increased cardiovascular disease (CVD) risk. Advanced glycation end products are formed as stable markers of glycaemic and oxidative stress. Skin autofluorescence (SAF) as marker of accumulated advanced glycation end products is increased and predictive of CVD events in diabetes mellitus, chronic kidney disease (CKD), and preexisting CVD. We determined SAF levels in HIV-1 infected patients, testing the hypothesis that SAF predicts CVD events in HIV infection. Single-centre prospective cohort study. In 2010-2011, SAF was measured in 91 patients. Development of CVD events was monitored during a median follow-up of 4.8 years. SAF values of the patients were expressed as a ratio (rSAF) to expected SAF levels in age-matched healthy volunteers. Seventy-nine men and 12 women were included, mean age 47 years; 81 patients were on combination antiretroviral therapy. With a mean rSAF of 1.155, SAF levels in patients were 15.5% higher than predicted for their age (95% confidence interval, 10.0-20.0; P < 0.001). In multivariate regression analysis, rSAF was associated with nadir CD4 cell count less than 200 cells/μl (β -0.274; P = 0.01), smoking (β 0.240; P = 0.03), and men who have sex with men (MSM) (β 0.202; P = 0.07). CVD events occurred in six patients (7%). In Cox regression analysis including age, SAF, smoking, diabetes, hypertension and CKD, SAF (P = 0.01), and (Wet Medisch-wetenschappelijk Onderzoek met mensen; WMO) CKD (P = 0.03) remained as independent predictors of CVD events. SAF is increased in HIV-infected patients, and related with smoking, low nadir CD4 cell count, and MSM. Larger studies are needed to confirm whether SAF is an independent predictor of CVD events.

  19. Medical and psychosocial factors and unfavourable low-density lipoprotein cholesterol control in coronary patients.

    PubMed

    Munkhaugen, John; Sverre, Elise; Otterstad, Jan E; Peersen, Kari; Gjertsen, Erik; Perk, Joep; Gullestad, Lars; Moum, Torbjørn; Dammen, Toril; Husebye, Einar

    2017-01-01

    Objective Understanding the determinants of low-density lipoprotein cholesterol (LDL-C) control constitutes the basis of modelling interventions for optimal lipid control and prognosis. We aim to identify medical and psychosocial (study) factors associated with unfavourable LDL-C control in coronary patients. Methods A cross-sectional explorative study used logistic and linear regression analysis to investigate the association between study factors and LDL-C in 1095 patients, hospitalized with myocardial infarction and/or a coronary revascularization procedure. Data were collected from hospital records, a comprehensive self-report questionnaire, clinical examination and blood samples after 2-36 months follow-up. Results Fifty-seven per cent did not reach the LDL-C target of 1.8 mmol/l at follow-up. Low socioeconomic status and psychosocial factors were not associated with failure to reach the LDL-C target. Statin specific side-effects (odds ratio 3.23), low statin adherence (odds ratio 3.07), coronary artery by-pass graft operation as index treatment (odds ratio 1.95), ≥ 1 coronary event prior to the index event (odds ratio 1.81), female gender (odds ratio 1.80), moderate- or low-intensity statin therapy (odds ratio 1.62) and eating fish < 3 times/week (odds ratio 1.56) were statistically significantly associated with failure to reach the LDL-C target, in adjusted analyses. Only side-effects (standardized β 0.180), low statin adherence ( β 0.209) and moderate- or low-intensity statin therapy ( β 0.228) were associated with LDL-C in continuous analyses. Conclusions Statin specific side-effects, low statin adherence and moderate- or low-intensity statin therapy were the major factors associated with unfavourable LDL-C control. Interventions to improve LDL-C should ensure adherence and prescription of sufficiently potent statins, and address side-effects appropriately.

  20. Association of Osteoarthritis With Increased Risk of Cardiovascular Diseases in the Elderly: Findings From the Progetto Veneto Anziano Study Cohort.

    PubMed

    Veronese, Nicola; Trevisan, Caterina; De Rui, Marina; Bolzetta, Francesco; Maggi, Stefania; Zambon, Sabina; Musacchio, Estella; Sartori, Leonardo; Perissinotto, Egle; Crepaldi, Gaetano; Manzato, Enzo; Sergi, Giuseppe

    2016-05-01

    The possible relevance of osteoarthritis (OA) as a cardiovascular disease (CVD) risk factor is still debated. The aim of this study was to investigate the association between OA and the onset of CVD in older individuals. Among a sample of 3,099 elderly subjects, 2,158 were identified as having no CVD at baseline and were followed up for a mean ± SD 4.4 ± 1.2 years. OA was defined using a standardized algorithm that investigated disease history, medical documentation (including radiographic reports), symptoms, and physical examination of the joints. Incident CVD was defined as the onset of coronary artery disease, heart failure, stroke/transient ischemic attack, peripheral artery disease, and CVD-related hospitalization or mortality. At baseline, 1,336 (61.9%) of the 2,158 study participants had OA. Participants with OA had more potential CVD risk factors, including obesity, hypertension, high levels of low-density lipoprotein, greater severity of inflammation, and worse renal function, than did those without OA. During the follow-up, 47.8% of the subjects with OA developed a new CVD event, compared to 41.3% of those without OA. Using an adjusted Cox regression analysis, the presence of OA significantly increased the risk of CVD (hazard ratio 1.22, 95% confidence interval 1.02-1.49; P = 0.04). The association between OA and CVD was stronger when the hip or knee was affected, and also was stronger in women than in men and when ≥2 joints were involved. Considering single CVD outcomes, the presence of OA significantly increased the risk of new coronary artery disease, heart failure, and hospitalization for CVD. OA may be a significant predictor of the onset of CVD in elderly individuals, particularly in women with OA and when OA affects the lower limbs or ≥2 joints are involved. © 2016, American College of Rheumatology.

  1. Increased Serum Uric Acid Levels Blunt the Antihypertensive Efficacy of Lifestyle Modifications in Children at Cardiovascular Risk.

    PubMed

    Viazzi, Francesca; Rebora, Paola; Giussani, Marco; Orlando, Antonina; Stella, Andrea; Antolini, Laura; Valsecchi, Maria Grazia; Pontremoli, Roberto; Genovesi, Simonetta

    2016-05-01

    Primary hypertension is a growing concern in children because of the obesity epidemic largely attributable to western lifestyles. Serum uric acid is known to be influenced by dietary habits, correlates with obesity, and could represent a risk factor for hypertension. Preliminary studies in children highlighted uric acid as a potentially modifiable risk factor for the prevention and treatment of hypertension. The effect of lifestyle changes (increase of physical activity and dietary modifications) on blood pressure values, weight status, and serum uric acid levels in a cohort of 248 children referred for cardiovascular risk assessment were evaluated over a mean 1.5-year follow-up. At baseline, 48% of children were obese and 50% showed blood pressure values >90th percentile. At follow-up, a significant improvement in weight class (24% obese;P<0.0001) and blood pressure category (22% >90th percentile;P<0.0001) was found. Systolic blood pressure z-score (P<0.0001), uric acid value (P=0.0056), and puberty at baseline (P=0.0048) were independently associated with higher systolic blood pressure z-score at follow-up, whereas a negative association was observed with body mass index z-score decrease during follow-up (P=0.0033). The risk of hypertension at follow-up was associated with body mass index (P=0.0025) and systolic blood pressure (P<0.0001) z-score at baseline and inversely related to delta body mass index (P=0.0002), whereas the risk of showing hypertension ≥99th percentile was more than doubled for each baseline 1 mg/dL increase of serum uric acid (P=0.0130). Uric acid is a powerful determinant of blood pressure over time, independent of lifestyle modifications. © 2016 American Heart Association, Inc.

  2. Unfavourable family characteristics and their associations with childhood obesity: a cross-sectional study.

    PubMed

    Moens, Ellen; Braet, Caroline; Bosmans, Guy; Rosseel, Yves

    2009-07-01

    This cross-sectional study explores the influence of multiple familial factors on children's weight status and the interaction between parenting stress and unfavourable family characteristics. A total of 197 families with children between 6 and 14 years participated in this study. Of this group, 97 families had a child with normal weight and 100 families had a child with overweight. Parents reported on seven family factors (maternal BMI, number of children, family structure, socioeconomic position, life events, parental psychopathology and parenting stress). Families with overweight children experience more parenting stress. A regression analysis revealed that familial factors explain 27% in the variance in child's weight status. The hypothesis that a combination of familial factors will be more able to explain child's adiposity could not be confirmed. Familial factors have moderate ability to predict children's weight status. There is a need to identify other familial mechanisms taking into account developmental and temporal evolutions over the past decade. 2009 John Wiley & Sons, Ltd and Eating Disorders Association

  3. Gastro-omental free flap in the reconstruction of the unfavourable hypopharyngeal defects: a functional assessment.

    PubMed

    Chahine, Karim A; Chaffanjon, Philippe; Bettega, Georges; Lebeau, Jacques; Reyt, Emile; Righini, Christian A

    2009-11-01

    Reconstruction flaps following major head and neck cancer surgery should consider the state of tissue at the recipient site. This study presents the cumulative experience of the use of the gastro-omental free flap (GOFF) for pharyngeal reconstruction in cases with unfavourable recipient site conditions. The GOFF reconstruction procedure and postoperative follow-up are described in details, and the functional results are analysed retrospectively. Fifteen patients underwent GOFF reconstruction. Previous treatments included radiotherapy, chemotherapy and surgery. Postoperatively, two patients (13%) developed partial flap necrosis, and four (27%) patients developed fistula and flap stenosis. On the functional level, eight (53%) patients developed oesophageal speech at different levels of audibility, and all patients developed oral alimentation ranging from a mixed diet with supplements to a regular oral diet. The GOFF is characterised by multiple survival advantages that favour its use in the presence of inhospitable recipient site conditions. (c) 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  4. Perception of students' intelligence malleability and potential for future success: Unfavourable beliefs towards girls.

    PubMed

    Verniers, Catherine; Martinot, Delphine

    2015-09-01

    Endorsing an entity theory of intelligence has negative effects on students' academic trajectories. Research focused on students' personal theories of intelligence has shown that girls are more likely than boys to hold an entity theory of intelligence. However, no study has examined the possibility of a gender stereotype basis for this belief. We examined whether secondary school students are knowledgeable about others' beliefs describing female students' intelligence as less malleable than male students' intelligence. A sample of 85 French ninth graders were asked to rate to what extent others perceived: (1) female or male students' intelligence as malleable and fixed; (2) female or male students as making efforts for their current achievement; and (3) female or male students as having potential for future success. Participants reported that others perceived girls' intelligence as less malleable than boys' intelligence. Moreover, the relationship between current efforts and potential for future achievement depended on the target's gender. The more hardworking a female student was perceived to be in school, the less she was considered to have potential to succeed in the future, whereas such a link was not observed for a male student. Secondary school students seem to be knowledgeable about a gender stereotype regarding intelligence and potential for academic success which is unfavourable for female students. Implications for students' academic trajectories are discussed. © 2015 The British Psychological Society.

  5. Playful Interventions Increase Knowledge about Healthy Habits and Cardiovascular Risk Factors in Children: The CARDIOKIDS Randomized Study

    PubMed Central

    Cecchetto, Fátima H.; Pena, Daniela B.; Pellanda, Lucia C.

    2017-01-01

    Background Childhood obesity is an important health problem worldwide. In this context, there is a need for the development and evaluation of innovative educational interventions targeting prevention and formation of health habits. Objectives To ascertain the impact of ludic workshops on children’s knowledge, self-care, and body weight. Methods This was a randomized, clinical study with 79 students aged 7-11 years, conducted from March to November 2012. Anthropometric measurements were collected and two questionnaires (Typical Day of Physical Activities and Food Intake, in Portuguese, and the CARDIOKIDS, a questionnaire of knowledge about cardiovascular risk factors) were applied at baseline, at the end of intervention, and three months thereafter. The intervention consisted of eight playful workshops, which involved the presentation of a play. Results Seventy-nine students were randomized to the intervention (n = 40) or the control group (n = 39). Mean age was 10.0 ± 1.1 years. After eight weeks, the intervention group showed significant improvement in the knowledge score (p < 0.001). There was an increase in physical activity scores in both groups, but with no difference between the groups at the end of intervention (p = 0.209). A reduction in the BMI percentile was observed in the intervention group, but there was no significant statistical difference between the two groups after the intervention. Conclusions Playful interventions may improve knowledge and physical activity levels in children and, when combined with other strategies, may be beneficial to prevent child obesity and improve self-care. PMID:28746521

  6. Elevated lactate dehydrogenase activity and increased cardiovascular mortality in the arsenic-endemic areas of southwestern Taiwan

    SciTech Connect

    Liao, Ya-Tang; Chen, Chien-Jen; Li, Wan-Fen; Hsu, Ling-I; Tsai, Li-Yu; Huang, Yeou-Lih; Sun, Chien-Wen; Chen, Wei J.; Wang, Shu-Li

    2012-08-01

    Arsenic ingestion has been linked to increasing global prevalence of and mortality from cardiovascular disease (CVD); arsenic can be removed from drinking water to reduce related health effects. Lactate dehydrogenase (LDH) is used for the evaluation of acute arsenic toxicity in vivo and in vitro, but it is not validated for the evaluation of long-term, chronic arsenic exposure. The present study examined the long-term effect of chronic arsenic exposure on CVD and serum LDH levels, after consideration of arsenic metabolism capacity. A total of 380 subjects from an arseniasis-endemic area and 303 from a non-endemic area of southwestern Taiwan were recruited in 2002. Various urinary arsenic species were analyzed using high-performance liquid chromatography (HPLC) and hydride generation systems. Fasting serum was used for quantitative determination of the total LDH activity. A significant dose–response relationship was observed between arsenic exposure and LDH elevation, independent of urinary arsenic profiles (P < 0.001). Furthermore, abnormal LDH elevation was associated with CVD mortality after adjustment for Framingham risk scores for 10-year CVD and arsenic exposure (hazard ratio, 3.98; 95% confidence interval, 1.07–14.81). LDH was elevated in subjects with arsenic exposure in a dose-dependent manner. LDH is a marker of arsenic toxicity associated with CVD mortality. Results of this study have important implications for use in ascertaining long-term arsenic exposure risk of CVD. -- Highlights: ► We showed that arsenic exposure was correlated with LDH elevation. ► LDH elevation was related to arsenic methylation capacity. ► Abnormal LDH elevation can be a marker of susceptibility to CVD mortality.

  7. Enhanced lipid peroxidation and platelet activation as potential contributors to increased cardiovascular risk in the low-HDL phenotype.

    PubMed

    Vazzana, Natale; Ganci, Antonina; Cefalù, Angelo Baldassare; Lattanzio, Stefano; Noto, Davide; Santoro, Nicole; Saggini, Raoul; Puccetti, Luca; Averna, Maurizio; Davì, Giovanni

    2013-04-04

    Low high-density lipoprotein (HDL) levels are major predictors of cardiovascular (CV) events, even in patients on statin treatment with low-density lipoprotein (LDL) at target. In animal models HDLs protect LDL from oxidation and blunt platelet activation. Our study aimed to examine whether HDL levels are related to in vivo oxidative stress and platelet activation, as determinants of atherothrombosis. Urinary 8-iso-PGF2α and 11-dehydro-TXB2, in vivo markers of oxidative stress and platelet activation, respectively, were measured in 65 coronary heart disease (CHD) normocholesterolemic patients with HDL ≤35 mg/dL, and in 47 CHD patients with HDL >35 mg/dL. The 2 eicosanoids were also measured before and after an intensive exercise program in sedentary people (n=18) and before and after fenofibrate treatment in otherwise healthy subjects with low HDL (n=10). Patients with HDL ≤35 mg/dL showed significantly higher urinary 8-iso-PGF2α (median [25th to 75th percentiles]: 289 [189 to 380] versus 216 [171 to 321] pg/mg creatinine, P=0.019) and 11-dehydro-TXB2 (563 [421 to 767] versus 372 [249 to 465] pg/mg creatinine, P=0.0001) than patients with higher HDL. A direct correlation was found between urinary 8-iso-PGF2α and 11-dehydro-TXB2 in the entire group of patients (ρ=0.77, P<0.0001). HDL levels were inversely related to both 8-iso-PGF2α (ρ=-0.32, P=0.001) and 11-dehydro-TXB2 (ρ=-0.52, P<0.0001). On multiple regression, only 8-iso-PGF2α (β=0.68, P<0.0001) and HDL level (β=-0.29, P<0.0001) were associated with urinary 11-dehydro-TXB2 excretion, independent of sex, age, smoking, hypertension, diabetes, previous myocardial infarction, total cholesterol, LDL, and triglycerides. Both intensive exercise and fenofibrate treatment significantly reduced the 2 eicosanoids in healthy subjects, in parallel with an HDL increase. A low HDL phenotype, both in CHD patients and in healthy subjects, is associated with increased lipid peroxidation and platelet activation

  8. Playful Interventions Increase Knowledge about Healthy Habits and Cardiovascular Risk Factors in Children: The CARDIOKIDS Randomized Study.

    PubMed

    Cecchetto, Fátima H; Pena, Daniela B; Pellanda, Lucia C

    2017-07-20

    Childhood obesity is an important health problem worldwide. In this context, there is a need for the development and evaluation of innovative educational interventions targeting prevention and formation of health habits. To ascertain the impact of ludic workshops on children's knowledge, self-care, and body weight. This was a randomized, clinical study with 79 students aged 7-11 years, conducted from March to November 2012. Anthropometric measurements were collected and two questionnaires (Typical Day of Physical Activities and Food Intake, in Portuguese, and the CARDIOKIDS, a questionnaire of knowledge about cardiovascular risk factors) were applied at baseline, at the end of intervention, and three months thereafter. The intervention consisted of eight playful workshops, which involved the presentation of a play. Seventy-nine students were randomized to the intervention (n = 40) or the control group (n = 39). Mean age was 10.0 ± 1.1 years. After eight weeks, the intervention group showed significant improvement in the knowledge score (p < 0.001). There was an increase in physical activity scores in both groups, but with no difference between the groups at the end of intervention (p = 0.209). A reduction in the BMI percentile was observed in the intervention group, but there was no significant statistical difference between the two groups after the intervention. Playful interventions may improve knowledge and physical activity levels in children and, when combined with other strategies, may be beneficial to prevent child obesity and improve self-care. A obesidade infantil é um importante problema de saúde no mundo. Nesse contexto, há uma necessidade para o desenvolvimento e a avaliação de intervenções educativas inovadoras que objetivem a prevenção e a formação de hábitos saudáveis. Avaliar o impacto de workshops lúdicos sobre o conhecimento, autocuidado, e peso corporal de crianças. Esse foi um estudo clínico randomizado, com 79 estudantes com

  9. Discontinuation of anti-hypertensive drugs increases 11-year cardiovascular mortality risk in community-dwelling elderly (the Bambuí Cohort Study of Ageing)

    PubMed Central

    2014-01-01

    Background Hypertension remains a major public health problem whose management is hampered by poor persistence with pharmacological therapy. The aim of this study was to evaluate the association between discontinuing antihypertensive drugs (AHDs) and the risk of cardiovascular mortality in the elderly. Methods A population-based prospective cohort study of all of the ≥60-year-old residents in Bambuí city (Brazil) enrolled 1606 subjects (92.2%), of whom 1494 (93.0%) were included in this study. The use of AHDs was ascertained annually in a real-clinical context, and time-varying AHD exposure was categorised as non-use, current use or stopped. The predicted cardiovascular mortality rates were estimated using interval Poisson models for ungrouped person-time data, taking into account current levels of systolic blood pressure (BP). Results The overall adjusted cardiovascular mortality risk ratio of AHD stoppers vs current users was 3.12 (95% CI: 2.35-4.15). There was a significant interaction with BP levels: the association between discontinuing AHDs and the risk of cardiovascular mortality was stronger at higher systolic BP levels. The estimates of the risk of cardiovascular mortality over the follow-up period were similar in AHD users and non-users, for whom AHDs were never prescribed. Conclusion Discontinuing AHDs increases the risk of cardiovascular mortality in the elderly. Misconceptions about symptoms or drug-related adverse effects could underlie a subject’s decision to discontinue AHDs. Greater attention should be paid to the choice of AHDs and informative action. PMID:25030357

  10. Cardiovascular Effects Caused by Increasing Concentrations of Diesel Exhaust in Middle-Aged Healthy GSTM1 Null Human Volunteers

    EPA Science Inventory

    ABSTRACT Objectives: Epidemiological studies have shown an association between the incidence of adverse cardiovascular effects and exposure to ambient particulate matter (PM). Diesel exhaust (DE) is a major contributor to ambient PM in urban areas. This study was designed to e...

  11. Does vitamin D deficiency contribute to increased rates of cardiovascular disease and type 2 diabetes among African Americans?

    USDA-ARS?s Scientific Manuscript database

    African Americans have higher rates of type 2 diabetes and some forms of cardiovascular disease (CVD) compared with European Americans. They also have much higher rates of vitamin D deficiency. There is emerging evidence that vitamin D deficiency may be a risk factor for hypertension, type 2 diabete...

  12. Cardiovascular Effects Caused by Increasing Concentrations of Diesel Exhaust in Middle-Aged Healthy GSTM1 Null Human Volunteers

    EPA Science Inventory

    ABSTRACT Objectives: Epidemiological studies have shown an association between the incidence of adverse cardiovascular effects and exposure to ambient particulate matter (PM). Diesel exhaust (DE) is a major contributor to ambient PM in urban areas. This study was designed to e...

  13. A candidate probiotic with unfavourable effects in subjects with irritable bowel syndrome: a randomised controlled trial

    PubMed Central

    2010-01-01

    Background Some probiotics have shown efficacy for patients with irritable bowel syndrome (IBS). Lactobacillus (L.) plantarum MF1298 was found to have the best in vitro probiotic properties of 22 strains of lactobacilli. The aim of this study was to investigate the symptomatic effect of L. plantarum MF1298 in subjects with IBS. Primary outcome was treatment preference and secondary outcomes were number of weeks with satisfactory relief of symptoms and IBS sum score. Methods The design was a randomised double blind placebo-controlled crossover trial. 16 subjects with IBS underwent two three-week periods of daily intake of one capsule of 1010 CFU L. plantarum MF 1298 or placebo separated by a four-week washout period. Results Thirteen participants (81%; 95% CI 57% to 93%; P = 0.012) preferred placebo to L. plantarum MF1298 treatment. The mean (SD) number of weeks with satisfactory relief of symptoms in the periods with L. plantarum MF1298 and placebo were 0.50 (0.89) and 1.44 (1.26), respectively (P = 0.006). IBS sum score was 6.44 (1.81) in the period with L. plantarum MF1298 treatment compared with 5.35 (1.77) in the period with placebo (P = 0.010). With a clinically significant difference in the IBS sum score of 2 in disfavour of active treatment, the number needed to harm was 3.7, 95% CI 2.3 to 10.9. Conclusions This trial shows for the first time an unfavourable effect on symptoms in subjects with IBS after intake of a potential probiotic. The trial registration number Clinical trials NCT00355810. PMID:20144246

  14. The effect of unfavourable and favourable social comparisons on paranoid ideation: An experimental study.

    PubMed

    Ascone, Leonie; Jaya, Edo S; Lincoln, Tania M

    2017-09-01

    Low social rank is associated with paranoia, but there is a lack of evidence for causality. We tested the effects of social comparisons on negative affect and paranoia with an online social rank paradigm, and whether striving to avoid inferiority or fears of social rejection moderated paranoid reactions. Female students (N = 172) were randomly exposed to one of two validated online profiles depicting a same-aged, high (unfavourable comparison) vs. low rank (favourable comparison) female student. Moderators were assessed at baseline. Social rank, anxiety, sadness and paranoia were assessed pre and post profile-exposure. There was a large effect of the experimental manipulation on social rank (p < 0.001, η(2)partial = 0.191). The manipulations had no effects on anxiety and paranoia (p > 0.38). Sadness was significantly altered (p = 0.016, η(2)partial = 0.033). There were significant moderation effects between the experimental conditions and insecure striving (trend-level) as well as fears of rejection. Our findings may be biased (overestimation of effects) as students are likely to be more competitive compared to the general population. Our rank manipulations did not alter paranoia. This suggests that changes in the cognitive representation of social rank alone - without triggering a strong emotional response - do not suffice to evoke paranoia. Although our results do not support the notion that threats to social rank cause paranoid symptoms, they suggest that threats to social rank are more likely to trigger paranoid states in those who are insecure in regard to their social position. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Smoking modifies the associated increased risk of future cardiovascular disease by genetic variation on chromosome 9p21.

    PubMed

    Hamrefors, Viktor; Hedblad, Bo; Hindy, George; Smith, J Gustav; Almgren, Peter; Engström, Gunnar; Sjögren, Marketa; Gränsbo, Klas; Orho-Melander, Marju; Melander, Olle

    2014-01-01

    Genetic predisposition for cardiovascular disease (CVD) is likely to be modified by environmental exposures. We tested if the associated risk of CVD and CVD-mortality by the single nucleotide polymorphism rs4977574 on chromosome 9p21 is modified by life-style factors. A total of 24,944 middle-aged subjects (62% females) from the population-based Malmö-Diet-and-Cancer-Cohort were genotyped. Smoking, education and physical activity-levels were recorded. Subjects were followed for 15 years for incidence of coronary artery disease (CAD; N = 2309), ischemic stroke (N = 1253) and CVD-mortality (N = 1156). Multiplicative interactions between rs4977574 and life-style factors on endpoints were tested in Cox-regression-models. We observed an interaction between rs4977574 and smoking on incident CAD (P = 0.035) and CVD-mortality (P = 0.012). The hazard ratios (HR) per risk allele of rs4977574 were highest in never smokers (N = 9642) for CAD (HR = 1.26; 95% CI 1.13-1.40; P<0.001) and for CVD-mortality (HR = 1.40; 95% CI 1.20-1.63; P<0.001), whereas the risk increase by rs4977574 was attenuated in current smokers (N = 7000) for both CAD (HR = 1.05; 95%CI 0.95-1.16; P = 0.326) and CVD-mortality (HR = 1.08; 95%CI 0.94-1.23; P = 0.270). A meta-analysis supported the finding that the associated increased risk of CAD by the risk-allele was attenuated in smokers. Neither education nor physical activity-levels modified the associated risk of CAD, ischemic stroke and CVD mortality conferred by rs4977574. Smoking may modify the associated risk of CAD and CVD-mortality conferred by genetic variation on chromosome 9p21. Whether the observed attenuation of the genetic risk reflects a pathophysiological mechanism or is a result of smoking being such a strong risk-factor that it may eliminate the associated genetic effect, requires further investigation.

  16. Significantly Increased Risk of Cardiovascular Disease among Patients with Gallstone Disease: A Population-Based Cohort Study

    PubMed Central

    Olaiya, Muideen Tunbosun; Chiou, Hung-Yi; Jeng, Jiann-Shing; Lien, Li-Ming; Hsieh, Fang-I

    2013-01-01

    Objective To investigate whether gallstone disease (GD) increases the risk of developing cardiovascular disease (CVD) in a large population-based cohort. Methods A study population including 6,981 patients with GD was identified from The Taiwan National Health Insurance Research Database between 2004 and 2005. GD patients were defined as patients with principal discharge diagnoses of cholelithiasis using the ICD-9-CM code 574. 27,924 patients without GD were randomly selected and matched for age and gender. All patients were followed for 6 years or until diagnosis for CVD. Cox proportional hazards regression model was used to assess the risk of developing CVD with adjustment for age, gender and co-morbid conditions. Results During the six years follow-up period, 935 patients with GD and 2,758 patients without GD developed CVD. Patients with GD had an elevated risk of CVD (HR, 1.32; 95% CI, 1.22-1.43) when compared with those without GD. Similar relationship was observed when CVD was categorized i.e. stroke (HR, 1.15; 95% CI, 1.01-1.32), coronary heart disease (HR, 1.42; 95% CI, 1.28-1.58) and heart failure (HR, 1.31; 95% CI, 1.00-1.73). When GD was classified according to the level of severity, using patients without GD as reference, the risks of CVD were elevated in patients with non-severe GD (HR, 1.34; 95% CI, 1.24-1.46) as well as those with severe GD (HR, 1.20, 95% CI, 1.02-1.40), after adjusting for age, gender and comorbidities. In age-stratified analysis, patients aged 18-40 years with GD were at higher risk of developing CVD (HR, 1.42; 95% CI, 1.09-1.84) than older GD patients. Conclusion This study found an increased risk of CVD in patients diagnosed with GD. The excess risk was particularly high in younger GD patients. Prevention of GD could help reduce the risk of developing CVD, and the better effect could be achieved for the younger age groups. PMID:24098504

  17. Association between excessive BMI increase during puberty and risk of cardiovascular mortality in adult men: a population-based cohort study.

    PubMed

    Ohlsson, Claes; Bygdell, Maria; Sondén, Arvid; Rosengren, Annika; Kindblom, Jenny M

    2016-12-01

    Being overweight during childhood and adolescence is associated with increased risk of cardiovascular disease in adulthood, but the relative contribution of prepubertal childhood BMI and BMI change during puberty to adult mortality due to cardiovascular disease is unknown. We assessed the contribution of these two distinct developmental BMI parameters for cardiovascular mortality in adult men. As a part of the ongoing population-based BMI Epidemiology Study (BEST) in Gothenburg, Sweden, men born between 1945 and 1961 with information on both their childhood BMI at age 8 years and BMI change during puberty were included in the study and followed up until December, 2013. Participants who died or emigrated before age 20 years were excluded from the analysis. BMI was collected from paediatric growth charts and mandatory military conscription tests. Childhood overweight (BMI of ≥17·9 kg/m(2)) was defined according to the Centers for Disease Control and Prevention's cutoff at 8 years of age, and BMI change during puberty was defined as the difference between young adult BMI and childhood BMI (BMI at age 20 years minus BMI at age 8 years). Information on mortality was retrieved from high quality national registers with the participants' ten-digit personal identity number. We used Cox proportional hazard regression to analyse the association between exposures and mortality. The ethics committee of the University of Gothenburg, Sweden, approved the study and waived the requirement for written informed consent. We followed 37 672 Swedish men from age 20 years for a mean of 37·8 years (1 422 185 person-years follow-up). 3188 all-cause deaths and 710 cardiovascular deaths occurred during follow-up. The correlation between childhood BMI and BMI change during puberty was marginal (r=0·06). BMI change during puberty, but not childhood BMI, was independently associated with adult all-cause and cardiovascular mortality in men. Boys that became overweight during puberty

  18. Flow cytometric DNA hypertetraploidy is associated with unfavourable prognostic features in breast cancer.

    PubMed Central

    Pinto, A E; André, S; Nogueira, M; Mendonça, E; Soares, J

    1997-01-01

    cytometric DNA hypertetraploidy is related to clinicopathological features of breast cancer usually associated with unfavourable prognosis. Images PMID:9306941

  19. Does smoking increase the risk of progression of nephropathy and/or cardiovascular disease in type 2 diabetic patients with albuminuria and those without albuminuria?

    PubMed Central

    Bentata, Yassamine; Karimi, Ilham; Benabdellah, Nawal; Alaoui, Fatiha El; Haddiya, Intissar; Abouqal, Redouane

    2016-01-01

    Diabetic nephropathy is the primary cause of chronic kidney disease and is associated with increased cardiovascular mortality. Cigarette smoking is probably the most complex and the least understood among the risk factors for chronic kidney disease and cardiovascular disease in diabetic patients. The aim of this study was to determine the impact of smoking on progression of nephropathy and cardiovascular disease in type 2 diabetic patients with albuminuria and those without albuminuria. Methods: This is a prospective study. The Ethics Committee of Morocco’s Mohammed V University in Rabat approved the study protocol. Inclusion criteria targeted patients who were type 2 diabetics and who had nephrology follow up for at least 36 months. Results: A total of 671 cases of T2D were included. Mean age of all patients was 65 ± 11 years and 12.1% were smokers. There was no statistically significant difference between T2D patients with albuminuria according to absence of presence of smoking at the time of enrollment, at 1 year and 3 years of follow-up, concerning the median albumin excretion rate (mg/day): 98 [56-281] vs. 124 [56-323] (p=0.59); 98 [56-281] vs. 124 [56-323] (p=0.15) and 98 [56-281] vs. 124 [56-323] (p=0.52) respectively. There was a statistically significant difference between T2D patients with albuminuria according to absence or presence of smoking at the time of enrollment and the end of follow-up, concerning cardiovascular events: 56 (12.3%) vs. 19 (28.4%) (p<0.001) and 66 (14.5%) vs. 19 (28.4%) (p=0.004) respectively. Conclusion: Smoking remains one of the most important modifiable risk factors for progression of renal and cardiovascular disease in diabetic patients, thus adding to the burden of morbimortality. PMID:27335692

  20. Pollen mixing in pollen generalist solitary bees: a possible strategy to complement or mitigate unfavourable pollen properties?

    PubMed

    Eckhardt, Michael; Haider, Mare; Dorn, Silvia; Müller, Andreas

    2014-05-01

    Generalist herbivorous insects, which feed on plant tissue that is nutritionally heterogeneous or varies in its content of secondary metabolites, often benefit from dietary mixing through more balanced nutrient intake or reduced exposure to harmful secondary metabolites. Pollen is similarly heterogeneous as other plant tissue in its content of primary and secondary metabolites, suggesting that providing their offspring with mixed pollen diets might be a promising strategy for pollen generalist bees to complement nutrient imbalances or to mitigate harmful secondary metabolites of unfavourable pollen. In the present study, we compared larval performance of the pollen generalist solitary bee species Osmia cornuta (Megachilidae) on five experimental pollen diets that consisted of different proportions of unfavourable pollen diet of Ranunculus acris (Ranunculaceae) and favourable pollen diet of Sinapis arvensis (Brassicaceae). In addition, we microscopically analysed the pollen contained in the scopal brushes of field-collected females of O. cornuta and three closely related species to elucidate to what degree these pollen generalist bees mix pollen of different hosts in their brood cells. In striking contrast to a pure Ranunculus pollen diet, which had a lethal effect on most developing larvae of O. cornuta, larval survival, larval development time and adult body mass of both males and females remained nearly unaffected by the admixture of up to 50% of Ranunculus pollen diet to the larval food. Between 42% and 66% of all female scopal pollen loads analysed contained mixtures of pollen from two to six plant families, indicating that pollen mixing is a common behaviour in O. cornuta and the three related bee species. The present study provides the first evidence that the larvae of pollen generalist bees can benefit from the nutrient content of unfavourable pollen without being negatively affected by its unfavourable chemical properties if such pollen is mixed with

  1. Assessment of the Possible Association of Air Pollutants PM10, O3, NO2 With an Increase in Cardiovascular, Respiratory, and Diabetes Mortality in Panama City

    PubMed Central

    Zúñiga, Julio; Tarajia, Musharaf; Herrera, Víctor; Urriola, Wilfredo; Gómez, Beatriz; Motta, Jorge

    2016-01-01

    Abstract In recent years, Panama has experienced a marked economic growth, and this, in turn, has been associated with rapid urban development and degradation of air quality. This study is the first evaluation done in Panama on the association between air pollution and mortality. Our objective was to assess the possible association between monthly levels of PM10, O3, and NO2, and cardiovascular, respiratory, and diabetes mortality, as well as the seasonal variation of mortality in Panama City, Panama. The study was conducted in Panama City, using air pollution data from January 2003 to December 2013. We utilized a Poisson regression model based on generalized linear models, to evaluate the association between PM10, NO2, and O3 exposure and mortality from diabetes, cardiovascular, and respiratory diseases. The sample size for PM10, NO2, and O2 was 132, 132, and 108 monthly averages, respectively. We found that levels of PM10, O3, and NO2 were associated with increases in cardiovascular, respiratory, and diabetes mortality. For PM10 levels ≥ 40 μg/m3, we found an increase in cardiovascular mortality of 9.7% (CI 5.8–13.6%), and an increase of 12.6% (CI 0.2–24.2%) in respiratory mortality. For O3 levels ≥ 20 μg/m3 we found an increase of 32.4% (IC 14.6–52.9) in respiratory mortality, after a 2-month lag period following exposure in the 65 to <74 year-old age group. For NO2 levels ≥20 μg/m3 we found an increase in respiratory mortality of 11.2% (IC 1.9–21.3), after a 2-month lag period following exposure among those aged between 65 and <74 years. There could be an association between the air pollution in Panama City and an increase in cardiovascular, respiratory, and diabetes mortality. This study confirms the urgent need to improve the measurement frequency of air pollutants in Panama. PMID:26765444

  2. Negative statin-related news stories decrease statin persistence and increase myocardial infarction and cardiovascular mortality: a nationwide prospective cohort study.

    PubMed

    Nielsen, Sune Fallgaard; Nordestgaard, Børge Grønne

    2016-03-14

    We tested the hypothesis that statin-related news stories, cardiovascular disease, diabetes, statin dose, calendar year, and socio-demographic status are associated with early statin discontinuation. We also examined frequency and consequences of early statin discontinuation. From the entire Danish population, we studied 674 900 individuals aged 40 or older who were initiated on statin therapy in 1995-2010, and followed them until 31 December 2011. Individuals on statins increased from <1% in 1995 to 11% in 2010, while early statin discontinuation increased from 6% in 1995 to 18% in 2010. The odds ratios for early statin discontinuation vs. continued use were 1.09 (95% confidence interval, 1.06-1.12) for negative statin-related news stories, 1.04 (1.02-1.07) per increasing calendar year, 1.04 (1.02-1.06) per increasing defined daily dose of statin, 1.05 (1.03-1.06) for male sex, 1.13 (1.11-1.15) for living in cities, 1.67 (1.63-1.71) for other ethnicity than Danish, 0.92 (0.90-0.94) for positive statin-related news stories, 0.73 (0.72-0.74) for baseline cardiovascular disease, and 0.91 (0.90-0.93) for baseline diabetes. During follow-up, the hazard ratios for individuals with vs. without early statin discontinuation were 1.26 (1.21-1.30) for myocardial infarction and 1.18 (1.14-1.23) for death from cardiovascular disease. Early statin discontinuation increased with negative statin-related news stories, calendar year, statin dose, male sex, living in cities, and with other ethnicity than Danish, while the opposite was true for positive statin-related news stories and for baseline cardiovascular disease and diabetes. Early statin discontinuation was also associated with increased risk of myocardial infarction and death from cardiovascular disease. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

  3. Childhood maltreatment and unfavourable clinical outcomes in bipolar disorder: a systematic review and meta-analysis.

    PubMed

    Agnew-Blais, Jessica; Danese, Andrea

    2016-04-01

    , 3010 participants; 1·89, 1·45-2·48, p<0·0001), greater number of manic episodes (seven studies, 3909 participants; 1·26, 1·09-1·47, p=0·003), greater number of depressive episodes (eight studies, 4025 participants; 1·38, 1·07-1·79, p=0·013), and higher risk of suicide attempt (13 studies, 3422 participants; 2·25, 1·88-2·70, p<0·0001) compared with those with bipolar disorder without childhood maltreatment. Overall, these associations were not explained by publication bias, undue effects of individual studies, or variation in study quality. Childhood maltreatment predicts unfavourable clinical features and course of illness in patients with bipolar disorder. None. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Advanced chronic kidney disease populations have elevated trimethylamine N-oxide levels associated with increased cardiovascular events.

    PubMed

    Kim, Richard B; Morse, Bridget L; Djurdjev, Ognjenka; Tang, Mila; Muirhead, Norman; Barrett, Brendan; Holmes, Daniel T; Madore, Francois; Clase, Catherine M; Rigatto, Claudio; Levin, Adeera

    2016-05-01

    Cardiovascular disease is more common in patients with chronic kidney disease (CKD), and traditional risk factors do not adequately predict those at risk for cardiovascular (CV) events. Recent evidence suggests elevated trimethylamine N-oxide (TMAO), created by gut microflora from dietary L-carnitine and choline, is associated with CV events. We investigated the relationship of TMAO levels in patients with stages 3b and 4 CKD to ischemic CV events using the CanPREDDICT cohort, a Canada-wide observational study with prospective 3-year follow-up of adjudicated CV events. Baseline samples were obtained for 2529 CKD patients. TMAO, choline, and L-carnitine levels were measured using tandem mass spectrometry. Baseline median TMAO level was high for the whole cohort (20.41 μM; interquartile range [IQR]: 12.82-32.70 μM). TMAO was independently associated with CV events (hazard ratio 1.23; 95% confidence interval: 1.06-1.42 / 1 SD lnTMAO) after adjusting for all potential CV risk factors. Those in the highest TMAO quartile had significantly higher risk of CV events (adjusted hazard ratio 1.59; 95% confidence interval: 1.04-2.43; P = 0.0351) in the analysis of recurring ischemic events. Among those with stage 3b CKD (hazard ratio 1.45; 95% confidence interval: 1.12-1.87 / 1 SD lnTMAO), independent of kidney function, TMAO levels identified those at highest risk for events. Our results suggest that TMAO may represent a new potentially modifiable CV risk factor for CKD patients. Further studies are needed to determine sources of variability and if lowering of TMAO reduces CV risk in CKD.

  5. Caryocar brasiliense oil improves cardiac function by increasing Serca2a/PLB ratio despite no significant changes in cardiovascular risk factors in rats.

    PubMed

    Oliveira, Lidiane Guedes; Moreno, Lauane Gomes; Melo, Dirceu Sousa; Costa-Pereira, Liliane Vanessa; Carvalho, Mayara Medeiros de Freitas; Silva, Paulo Henrique Evangelista; Alves, Ana Maria; Magalhães, Flávio de Castro; Dias-Peixoto, Marco Fabrício; Esteves, Elizabethe Adriana

    2017-02-08

    Caryocar brasiliense (pequi) oil is high in monounsaturated fat acids (MUFA), especially oleic, and in carotenoids, which have been associated with protection against cardiovascular disease. However, this food is poorly studied in this context, especially in the cardiac function. Therefore, we investigated the effects of a long-term intake of pequi oil in systemic cardiovascular risk factors and in the ex vivo cardiac function of rats. Previously, we determined fatty acids and carotenoids in pequi oil. Next, male rats were divided in C - control group feed a standard diet, and PO - pequi oil group fed the same diet added pequi oil (+2.25 g.100 g(-1)). After 15 weeks, plasma lipids, glucose, insulin, blood pressure, heart rate, hepatic lipids were accessed and visceral fat pads were harvested. Hearts were used for the ex vivo cardiac function, histologic assays, SERCA2a and phospholanban (PLB) determinations. In agreement with scientific data, pequi oil had expressive amounts MUFA, especially oleic acid, and carotenoids. Hepatic triglycerides (TG) were reduced by pequi oil intake (p < 0.05). All others cardiovascular risk factors were not changed. The intrinsic heart rate was lower in PO group (p < 0.05). SERCA2a content was higher in this group (p < 0.05), without affecting PLB. Also, SERCA2a/PLB ratio increased in PO group (p < 0.05). Pequi oil intake improved cardiac function ex vivo, despite no significant changes in systemic cardiovascular risk factors. The higher lipid offer in pequi oil diet, its composition in oleic acid and carotenoids could be related to those effects.

  6. Prevention of unfavourable effects of cigarette smoke on flap viability using botulinum toxin in random pattern flaps: An experimental study

    PubMed Central

    Karayel, Hikmet; Kaya, Burak; Caydere, Muzaffer; Terzioğlu, Ahmet; Aslan, Gürcan

    2015-01-01

    BACKGROUND: There are numerous clinical and experimental studies reporting unfavourable effects of cigarette smoke on skin flaps. OBJECTIVE: To investigate whether unfavourable effects of cigarette smoke on flap survival could be reduced by botulinum toxin type A. METHODS: Twenty-eight male Wistar albino rats (15 months of age, mean weight 210 g [range 180 g to 230 g]) were included. They were divided into four groups of seven animals each. The control group underwent the surgical procedure alone. Surgical procedure was performed after administration of botulinum toxin type A in the botulinum toxin (BTX) group, after exposure to cigarette smoke in the cigarette smoke (CS) group, and after BTX type A administration and exposure to CS in the CS+BTX (CS+BTX) group. Random pattern cutaneous flaps (3 cm × 9 cm) were elevated from the dorsum of all rats. Necrosis area was calculated in percentages (%) using Image J computer software. Tissue samples were examined histopathologically. RESULTS: The mean necrotic area in the control group (26%) and in the BTX group (21%) were similar (P=0.497), whereas administration of BTX type A significantly decreased flap necrosis area in the rats exposed to CS (the mean necrosis areas were 41.5% in the CS group, and 26% in the CS+BTX group; P<0.001). Histopathological examination findings corroborated the unfavourable effects of CS and preventive effects of BTX type A. CONCLUSION: Preoperative administration of BTX significantly enhanced flap viability in the rats exposed to CS. Further human studies are warranted to verify whether BTX type A could be used as an agent to reduce the risk of flap necrosis in patients who smoke. PMID:26361625

  7. Do unfavourable working conditions explain mental health inequalities between ethnic groups? Cross-sectional data of the HELIUS study.

    PubMed

    Nieuwenhuijsen, Karen; Schene, Aart H; Stronks, Karien; Snijder, Marieke B; Frings-Dresen, Monique H W; Sluiter, Judith K

    2015-08-20

    Ethnic inequalities in mental health have been found in many high-income countries. The purpose of this study is to test whether mental health inequalities between ethnic groups are mediated by exposure to unfavourable working conditions. Workers (n = 6278) were selected from baseline data of the multi-ethnic HELIUS study. Measures included two indices of unfavourable working conditions (lack of recovery opportunities, and perceived work stress), and two mental health outcomes (generic mental health: MCS-12 and depressive symptoms: PHQ-9). Mediation of the relationships between ethnicity and mental health by unfavourable working conditions was tested using the bias-corrected bootstrap confidence intervals technique. Linear models with and without the mediators included, and adjusted for gender and age. Attenuation was calculated as the change in B between the models with and without mediators. The sample comprised Dutch (1355), African Surinamese (1290), South-Asian Surinamese (1121), Turkish (1090), Ghanaian (729), and Moroccan (693) workers. After controlling for age and gender, all ethnic minorities had a higher risk of mental health problems as compared to the Dutch host population, with the exception of Ghanaians in the case of depressive symptoms, and African Surinamese workers with regard to both outcomes. The Turkish group stands out with the lowest mental health on both mental health indices, followed by Moroccan and South-Asian Surinamese workers. A lack of recovery opportunities mediated the relationship between ethnic group and a higher risk of mental health problems. Perceived work stress did not contribute to the explanation of ethnic inequalities. The higher risk of mental health problems in ethnic minority groups can be partly accounted for by a lack of recovery opportunities at work, but not by perceived work stress. This may imply that workplace prevention targeting recovery opportunities have the potential to reduce ethnic inequalities, but

  8. Health Outcomes of Population-Based Pharmacy Outreach to Increase Statin Use for Prevention of Cardiovascular Disease in Patients with Diabetes.

    PubMed

    Grembowski, David; Ralston, James D; Anderson, Melissa L

    2016-08-01

    In 2003, Group Health implemented a pharmacy-based, systemwide outreach effort to increase the preventive use of statins and angiotensin-converting enzyme inhibitors in enrollees at risk for cardiovascular disease, including all enrollees with diabetes. To estimate the associations between the use of statins and major vascular events and the total costs in 2006-2010 for enrollees with diabetes, using a pharmacy-based, systemwide outreach. In a 14-year (1997-2010) longitudinal cohort study design, the study population consisted of 6,975 Group Health enrollees with type 1 or type 2 diabetes, who were enrolled continuously and had no statin use before the Group Health outreach in 1997-2002. Health outcomes were all-cause mortality, cardiovascular mortality, myocardial infarction, and stroke. Statin exposure was measured by cumulative statin use since 2003, weighted by the effect of the statin type and dose on the lowering of low-density lipoprotein levels. Regression models estimated associations between cumulative statin use, health outcomes, and total costs in 2006-2010. Among enrollees with no statin use before outreach began in 2003, about half had no or low exposure to statins by the end of 2005. In 2006-2010, cumulative statin use was greater among enrollees with risk factors for cardiovascular disease. Greater statin use was related to lower cardiovascular deaths and incidence of stroke and myocardial infarction, greater but nonsignificant all-cause mortality, and unrelated to total costs. Population-based pharmacy outreach increased statin use for eligible enrollees with diabetes, which was related to better cardiovascular outcomes. Generally, statin use was unrelated to all-cause mortality and total costs. This study was funded by Grant No. R21 HS019501 from the Agency for Healthcare Research and Quality (AHRQ) and was conducted as part of the AHRQ announcement Optimizing Prevention and Healthcare Management for the Complex Patient (R21; RFA-HS-10

  9. Patients with Cushing's syndrome have increased intimal media thickness at different vascular levels: comparison with a population matched for similar cardiovascular risk factors.

    PubMed

    Albiger, N; Testa, R M; Almoto, B; Ferrari, M; Bilora, F; Petrobelli, F; Pagnan, A; Mantero, F; Scaroni, C

    2006-06-01

    Cushing's syndrome (CS) is associated with high cardiovascular risk. The aim of this study was to analyze intimal media thickness (IMT) in patients with CS and compare them with subjects matched for similar conventional and independent cardiovascular risk factors. Twenty eight patients with CS (mean age: 40.7 +/- 2.5 y) and 28 subjects (mean age: 41.1 +/- 14 y) matched for sex, age, smoking habit, body mass index, blood pressure levels, glucose and lipid metabolism were evaluated. IMT was measured at right and left common carotid (CC), carotid bulb (BC), aorta (Ao) and femoral (F) levels by B-echo-Doppler ultrasonography. Although parameters of cardiovascular risk factors did not differ statistically between patients and controls, IMT was significantly increased (right and left CC-IMT, p < 0.05; right and left BC-IMT, p < 0.01, Ao-IMT p < 0.05) and wall plaques were more common (14.2 % VS. 7.1 %) in patients. In CS patients, CC-IMT and F-IMT correlated positively and significantly with fasting glucose (right CC-IMT: r (2) = 0.37, p = 0.05; left CC-IMT: r (2) = 0.43, p = 0.02; right F-IMT: r (2) = 0.57; p < 0.01; left F-IMT: r (2) = 0.47, p = 0.01) and HOMA index (left CC-IMT: r (2) = 0.64, p < 0.01 and left F-IMT: r (2) = 0.48, p < 0.05). The CS patients' waist-to-hip ratio (WHR) was evaluated and correlated positively and significantly with CC-IMT (right: r (2) = 0.53, p = 0.01 and left: r (2) = 0.44, p = 0.05). No correlation was found between IMT and cortisol levels, however. In conclusion, patients with CS have more severe atherosclerotic damage than a population matched for similar cardiovascular risk factors. Multiple events related to long-term cortisol effects on metabolism and at vascular and endothelial sites may increase the risk of cardiovascular damage in patients with CS.

  10. Is a family history of diabetes associated with an increased level of cardiovascular risk factors? Studies in healthy people and in subjects with different degree of glucose intolerance.

    PubMed

    Quatraro, A; Giugliano, D; De Rosa, N; Minei, A; Ettorre, M; Donzella, C; Saccomanno, F; Ceriello, A

    1993-01-01

    In order to evaluate whether the presence of a positive family history of diabetes (PFH) may have a negative impact on both glucose metabolism and cardiovascular risk factors, we studied parameters of carbohydrate metabolism (fasting and 2h-plasma glucose, HbA1c) and beta-cell function (fasting insulin and C-peptide), as well as the levels of some established cardiovascular risk factors (total cholesterol and triglycerides, HDL-cholesterol, blood pressure) in 729 subjects who were seen within the frame of a Regional Health Program in Taranto, South Italy. According to the NDDG criteria, 147 men and 235 women had normal glucose tolerance, 54 men and 66 women non-diagnostic OGTT, 65 men and 79 women impaired glucose tolerance, and 45 men and 58 women newly-diagnosed Type 2 diabetes. There was a continuous increase of PFH across the categories of glucose intolerance (p < 0.001). Subjects with PFH were younger (4 years on the average) than subjects without PFH. After adjustment for age, there was no difference in the clinical and metabolic parameters considered across the categories of glucose tolerance between subjects with or without PFH. Only in OGTT-diagnosed diabetics, was the presence of PFH associated with significantly greater levels of total cholesterol and 2h-plasma glucose, as well as a trend for triglycerides and HbA1c to be higher. There was a continuous increase in fasting glucose, HbA1c, insulin and C-peptide across the categories; however, the C-peptide/insulin molar ratio was lowest in OGTT-diagnosed diabetics. There was a graded and significant increase in the levels of cardiovascular risk factors across the categories.(ABSTRACT TRUNCATED AT 250 WORDS)

  11. Increased Cardiovascular Reactivity to Acute Stress and Salt-Loading in Adult Male Offspring of Fat Fed Non-Obese Rats

    PubMed Central

    Rudyk, Olena; Makra, Péter; Jansen, Eugene; Shattock, Michael J.; Poston, Lucilla; Taylor, Paul D.

    2011-01-01

    Diet-induced obesity in rat pregnancy has been shown previously to be associated with consistently raised blood pressure in the offspring, attributed to sympathetic over-activation, but the relative contributions to this phenotype of maternal obesity versus raised dietary fat is unknown. Sprague-Dawley female rats were fed either a control (4.3% fat, n = 11) or lard-enriched (23.6% fat, n = 16) chow 10 days prior to mating, throughout pregnancy and lactation. In conscious adult (9-month-old) offspring cardiovascular parameters were measured (radiotelemetry). The short period of fat-feeding did not increase maternal weight versus controls and the baseline blood pressure was similar in offspring of fat fed dams (OF) and controls (OC). However, adult male OF showed heightened cardiovascular reactivity to acute restraint stress (p<0.01; Δ systolic blood pressure (SBP) and Δheart rate (HR)) with a prolonged recovery time compared to male OC. α1/β-adrenergic receptor blockade normalised the response. Also, after dietary salt-loading (8%-NaCl ad libitum for 1 week) male OF demonstrated higher SBP (p<0.05) in the awake phase (night-time) and increased low/high frequency ratio of power spectral density of HR variability versus OC. Baroreflex gain and basal power spectral density components of the heart rate or blood pressure were similar in male OF and OC. Minor abnormalities were evident in female OF. Fat feeding in the absence of maternal obesity in pregnant rats leads to altered sympathetic control of cardiovascular function in adult male offspring, and hypertension in response to stressor stimuli. PMID:22043281

  12. Increasing the percentage of energy from dietary sugar, fats, and alcohol in adults is associated with increased energy intake but has minimal association with biomarkers of cardiovascular risk.

    PubMed

    Austin, Gregory L; Krueger, Patrick M

    2013-10-01

    The optimal diet composition to prevent obesity and its complications is unknown. Study aims were to determine the association of diet composition with energy intake, homeostatic model assessment-insulin resistance (HOMA-IR), and C-reactive protein (CRP). Data were from the NHANES for eligible adults aged 20-74 y from 2005 to 2006 (n = 3073). Energy intake and diet composition were obtained by dietary recall. HOMA-IR was calculated from fasting insulin and glucose concentrations, and CRP was measured directly. Changes for a 1-point increase in percentage of sugar, saturated fatty acids (SFAs), monounsaturated fatty acids (MUFAs), polyunsaturated fatty acids (PUFAs), and alcohol were determined across their means in exchange for a 1-point decrease in percentage of nonsugar carbohydrates. Regression analyses were performed, and means ± SEs were estimated. Increasing the percentage of sugar was associated with increased energy intake in men (23 ± 5 kcal; P < 0.001) and women (12 ± 3 kcal; P = 0.002). In men, increasing percentages of SFAs (58 ± 13 kcal; P = 0.001) and PUFAs (66 ± 19 kcal; P < 0.001) were associated with increased energy intake. In women, increasing percentages of SFAs (27 ± 10 kcal; P = 0.02), PUFAs (43 ± 6 kcal; P < 0.001), and MUFAs (36 ± 13 kcal; P = 0.01) were associated with increased energy intake. Increasing the percentage of alcohol was associated with increased energy intake in men (38 ± 7 kcal; P < 0.001) and women (25 ± 8 kcal; P = 0.001). Obesity was associated with increased HOMA-IR and CRP in both genders (all P ≤ 0.001). Increasing PUFAs was associated with decreasing CRP in men (P = 0.02). In conclusion, increasing the percentage of calories from sugar, fats, and alcohol was associated with substantially increased energy intake but had minimal association with HOMA-IR and CRP.

  13. Are Sitting Occupations Associated with Increased All-Cause, Cancer, and Cardiovascular Disease Mortality Risk? A Pooled Analysis of Seven British Population Cohorts

    PubMed Central

    Stamatakis, Emmanuel; Chau, Josephine Y.; Pedisic, Zeljko; Bauman, Adrian; Macniven, Rona; Coombs, Ngaire; Hamer, Mark

    2013-01-01

    Background There is mounting evidence for associations between sedentary behaviours and adverse health outcomes, although the data on occupational sitting and mortality risk remain equivocal. The aim of this study was to determine the association between occupational sitting and cardiovascular, cancer and all-cause mortality in a pooled sample of seven British general population cohorts. Methods The sample comprised 5380 women and 5788 men in employment who were drawn from five Health Survey for England and two Scottish Health Survey cohorts. Participants were classified as reporting standing, walking or sitting in their work time and followed up over 12.9 years for mortality. Data were modelled using Cox proportional hazard regression adjusted for age, waist circumference, self-reported general health, frequency of alcohol intake, cigarette smoking, non-occupational physical activity, prevalent cardiovascular disease and cancer at baseline, psychological health, social class, and education. Results In total there were 754 all-cause deaths. In women, a standing/walking occupation was associated with lower risk of all-cause (fully adjusted hazard ratio [HR] = 0.68, 95% CI 0.52–0.89) and cancer (HR = 0.60, 95% CI 0.43–0.85) mortality, compared to sitting occupations. There were no associations in men. In analyses with combined occupational type and leisure-time physical activity, the risk of all-cause mortality was lowest in participants with non-sitting occupations and high leisure-time activity. Conclusions Sitting occupations are linked to increased risk for all-cause and cancer mortality in women only, but no such associations exist for cardiovascular mortality in men or women. PMID:24086292

  14. Are sitting occupations associated with increased all-cause, cancer, and cardiovascular disease mortality risk? A pooled analysis of seven British population cohorts.

    PubMed

    Stamatakis, Emmanuel; Chau, Josephine Y; Pedisic, Zeljko; Bauman, Adrian; Macniven, Rona; Coombs, Ngaire; Hamer, Mark

    2013-01-01

    There is mounting evidence for associations between sedentary behaviours and adverse health outcomes, although the data on occupational sitting and mortality risk remain equivocal. The aim of this study was to determine the association between occupational sitting and cardiovascular, cancer and all-cause mortality in a pooled sample of seven British general population cohorts. The sample comprised 5380 women and 5788 men in employment who were drawn from five Health Survey for England and two Scottish Health Survey cohorts. Participants were classified as reporting standing, walking or sitting in their work time and followed up over 12.9 years for mortality. Data were modelled using Cox proportional hazard regression adjusted for age, waist circumference, self-reported general health, frequency of alcohol intake, cigarette smoking, non-occupational physical activity, prevalent cardiovascular disease and cancer at baseline, psychological health, social class, and education. In total there were 754 all-cause deaths. In women, a standing/walking occupation was associated with lower risk of all-cause (fully adjusted hazard ratio [HR] = 0.68, 95% CI 0.52-0.89) and cancer (HR = 0.60, 95% CI 0.43-0.85) mortality, compared to sitting occupations. There were no associations in men. In analyses with combined occupational type and leisure-time physical activity, the risk of all-cause mortality was lowest in participants with non-sitting occupations and high leisure-time activity. Sitting occupations are linked to increased risk for all-cause and cancer mortality in women only, but no such associations exist for cardiovascular mortality in men or women.

  15. Does exposure to aircraft noise increase the mortality from cardiovascular disease in the population living in the vicinity of airports? Results of an ecological study in France.

    PubMed

    Evrard, Anne-Sophie; Bouaoun, Liacine; Champelovier, Patricia; Lambert, Jacques; Laumon, Bernard

    2015-01-01

    The impact of aircraft noise on health is of growing concern. We investigated the relationship between this exposure and mortality from cardiovascular disease, coronary heart disease, myocardial infarction, and stroke. We performed an ecological study on 161 communes (commune being the smallest administrative unit in France) close to the following three major French airports: Paris-Charles de Gaulle, Lyon Saint-Exupéry, and Toulouse-Blagnac. The mortality data were provided by the French Center on Medical Causes of Death for the period 2007-2010. Based on the data provided by the French Civil Aviation Authority, a weighted average exposure to aircraft noise (L den AEI) was computed at the commune level. A Poisson regression model with commune-specific random intercepts, adjusted for potential confounding factors including air pollution, was used to investigate the association between mortality rates and L den AEI. Positive associations were observed between L den AEI and mortality from cardiovascular disease [adjusted mortality rate ratio (MRR) per 10 dB(A) increase in L den AEI = 1.18; 95% confidence interval (CI): 1.11-1.25], coronary heart disease [MRR = 1.24 (1.12-1.36)], and myocardial infarction [MRR = 1.28 (1.11-1.46]. Stroke mortality was more weakly associated with L den AEI [MRR = 1.08 (0.97-1.21]. These significant associations were not attenuated after the adjustment for air pollution. The present ecological study supports the hypothesis of an association between aircraft noise exposure and mortality from cardiovascular disease, coronary heart disease, and myocardial infarction. However, the potential for ecological bias and the possibility that this association could be due to residual confounding cannot be excluded.

  16. Does exposure to aircraft noise increase the mortality from cardiovascular disease in the population living in the vicinity of airports? Results of an ecological study in France

    PubMed Central

    Evrard, Anne-Sophie; Bouaoun, Liacine; Champelovier, Patricia; Lambert, Jacques; Laumon, Bernard

    2015-01-01

    The impact of aircraft noise on health is of growing concern. We investigated the relationship between this exposure and mortality from cardiovascular disease, coronary heart disease, myocardial infarction, and stroke. We performed an ecological study on 161 communes (commune being the smallest administrative unit in France) close to the following three major French airports: Paris-Charles de Gaulle, Lyon Saint-Exupéry, and Toulouse-Blagnac. The mortality data were provided by the French Center on Medical Causes of Death for the period 2007-2010. Based on the data provided by the French Civil Aviation Authority, a weighted average exposure to aircraft noise (Lden AEI) was computed at the commune level. A Poisson regression model with commune-specific random intercepts, adjusted for potential confounding factors including air pollution, was used to investigate the association between mortality rates and Lden AEI. Positive associations were observed between Lden AEI and mortality from cardiovascular disease [adjusted mortality rate ratio (MRR) per 10 dB(A) increase in Lden AEI = 1.18; 95% confidence interval (CI): 1.11-1.25], coronary heart disease [MRR = 1.24 (1.12-1.36)], and myocardial infarction [MRR = 1.28 (1.11-1.46]. Stroke mortality was more weakly associated with Lden AEI [MRR = 1.08 (0.97-1.21]. These significant associations were not attenuated after the adjustment for air pollution. The present ecological study supports the hypothesis of an association between aircraft noise exposure and mortality from cardiovascular disease, coronary heart disease, and myocardial infarction. However, the potential for ecological bias and the possibility that this association could be due to residual confounding cannot be excluded. PMID:26356375

  17. [Vitamin D and cardiovascular risk].

    PubMed

    Mayer, Otto

    2012-05-01

    The pathogenesis of cardiovascular disease is without any doubt multifactorial, and it is generally accepted, that conventional risk factors determined only about 80% of cardiovascular risk. There is accumulating evidence that vitamin D exerts important pathophysiological effects on cardiovascular system. Low vitamin D was associated with increased cardiovascular risk in several reports. This review summarizes recent epidemiological evidence and possible pathophysiological mechanism for a role of low vitamin D in cardiovascular diseases. Moreover, available data concerning vitamin D supplementation are depicted.

  18. Higher serum triglyceride to high-density lipoprotein cholesterol ratio was associated with increased cardiovascular mortality in female patients on peritoneal dialysis.

    PubMed

    Wu, H; Xiong, L; Xu, Q; Wu, J; Huang, R; Guo, Q; Mao, H; Yu, X; Yang, X

    2015-08-01

    High serum triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio has been found to be an independent predictor for cardiovascular events in the general population. We aimed to evaluate whether a high TG/HDL-C ratio was associated with an increased risk of mortality in patients on continuous ambulatory peritoneal dialysis (CAPD). In this single-center retrospective cohort study, 1170 incident patients on peritoneal dialysis (PD) from 1 January 2007 to 31 December 2011 were recruited and followed up until 31 December 31 2013. The mean age was 47.4 ± 15.2 years, and 24.7% were diabetic. During a median of the 34.5-month follow-up period, 213 (18.2%) deaths occurred, 121 of which (56.8%) were caused by cardiovascular disease (CVD). The serum median TG/HDL-C ratio at baseline was 2.57 (range: 0.06-39.39). On multivariate Cox regression analysis, the highest quartile of the TG/HDL-C ratio (≥4.19) was associated with increased risk of all-cause mortality (hazard ratio (HR) 1.98, 95% confidence interval (CI), 1.17-3.36; P = 0.011) and CVD mortality (HR 2.28, 95% CI, 1.16-4.47; P = 0.017). For female patients, each one-unit higher baseline TG/HDL-C was associated with 13% (95% CI 1.06-1.22; P = 0.001) increased risk of CVD mortality, whereas such an association was not observed for male patients, (HR 1.00, 95% CI 0.92-1.08; P = 0.977). A higher serum TG/HDL-C ratio was associated with an increased risk of all-cause and CVD mortality in PD patients. Moreover, the increased risk of CVD mortality was significantly higher in female than male PD patients. Copyright © 2015 Elsevier B.V. All rights reserved.

  19. Design and baseline characteristics of the PerfectFit study: a multicenter cluster-randomized trial of a lifestyle intervention in employees with increased cardiovascular risk.

    PubMed

    Kouwenhoven-Pasmooij, Tessa A; Djikanovic, Bosiljka; Robroek, Suzan J W; Helmhout, Pieter; Burdorf, Alex; Hunink, M G Myriam

    2015-07-28

    , physical activity, stress management) and body mass index. Furthermore, a process evaluation and an economic analysis will be performed. Additional coaching using MI is expected to be a key factor for success of the web-based HRA in employees with increased cardiovascular risk. This "blended care"-approach may be an essential strategy for effective health promotion activities. Dutch Trial Register by registration number NTR4894 , 14/11/2014.

  20. [Psoriasis and cardiovascular disease].

    PubMed

    Torres, Tiago; Sales, Rita; Vasconcelos, Carlos; Selores, Manuela

    2013-01-01

    Psoriasis is a common, chronic and systemic inflammatory disease associated with several comorbidities, such as obesity, hypertension, diabetes, dyslipidaemia and metabolic syndrome, but also with an increased risk of cardiovascular disease, like myocardial infarction or stroke. The chronic inflammatory nature of psoriasis has been suggested to be a contributing and potentially independent risk factor for the development of cardiovascular comorbidities and precocious atherosclerosis. Aiming at alerting clinicians to the need of screening and monitoring cardiovascular diseases and its risk factors in psoriatic patients, this review will focus on the range of cardiometabolic comorbidities and increased risk of cardiovascular disease associated with psoriasis.

  1. Reduced brachial flow-mediated vasodilation in young adult ex extremely low birth weight preterm: a condition predictive of increased cardiovascular risk?

    PubMed

    Bassareo, P P; Fanos, V; Puddu, M; Demuru, P; Cadeddu, F; Balzarini, M; Mercuro, G

    2010-10-01

    Sporadic data present in literature report how preterm birth and low birth weight constitute the risk factors for the development of cardiovascular diseases in later life. To assess the presence of potential alterations to endothelial function in young adults born preterm at extremely low birth weight (<1000 g; ex ELBW). Thirty-two ex-ELBW subjects (10 males [M] and 22 females [F], aged 17-28 years, mean [+/- DS] 20.1 +/- 2.5 years) were compared with 32 healthy, age-matched subjects born at term (C, 9 M and 23 F). 1) pathological conditions known to affect endothelial function; 2) administration of drugs known to affect endothelial function. Endothelial function was assessed by non-invasive finger plethysmography, previously validated by the US Food and Drug Administration (Endopath; Itamar Medical Ltd., Cesarea, Israel). Endothelial function was significantly reduced in ex-ELBW subjects compared to C (1.94 +/- 0.37 vs. 2.68 +/- 0.41, p < 0.0001). Moreover, this function correlated significantly with gestational age (r = 0.56, p < 0.0009) and birth weight (r = 0.63, p < 0.0001). The results obtained reveal a significant decrease in endothelial function of ex-ELBW subjects compared to controls, underlining a probable correlation with preterm birth and low birth weight. Taken together, these results suggest that an ELBW may underlie the onset of early circulatory dysfunction predictive of increased cardiovascular risk.

  2. Relationship between office and home blood pressure with increasing age: The International Database of HOme blood pressure in relation to Cardiovascular Outcome (IDHOCO).

    PubMed

    Ntineri, Angeliki; Stergiou, George S; Thijs, Lutgarde; Asayama, Kei; Boggia, José; Boubouchairopoulou, Nadia; Hozawa, Atsushi; Imai, Yutaka; Johansson, Jouni K; Jula, Antti M; Kollias, Anastasios; Luzardo, Leonella; Niiranen, Teemu J; Nomura, Kyoko; Ohkubo, Takayoshi; Tsuji, Ichiro; Tzourio, Christophe; Wei, Fang-Fei; Staessen, Jan A

    2016-08-01

    Home blood pressure (HBP) measurements are known to be lower than conventional office blood pressure (OBP) measurements. However, this difference might not be consistent across the entire age range and has not been adequately investigated. We assessed the relationship between OBP and HBP with increasing age using the International Database of HOme blood pressure in relation to Cardiovascular Outcome (IDHOCO). OBP, HBP and their difference were assessed across different decades of age. A total of 5689 untreated subjects aged 18-97 years, who had at least two OBP and HBP measurements, were included. Systolic OBP and HBP increased across older age categories (from 112 to 142 mm Hg and from 109 to 136 mm Hg, respectively), with OBP being higher than HBP by ∼7 mm Hg in subjects aged >30 years and lesser in younger subjects (P=0.001). Both diastolic OBP and HBP increased until the age of ∼50 years (from 71 to 79 mm Hg and from 66 to 76 mm Hg, respectively), with OBP being consistently higher than HBP and a trend toward a decreased OBP-HBP difference with aging (P<0.001). Determinants of a larger OBP-HBP difference were younger age, sustained hypertension, nonsmoking and negative cardiovascular disease history. These data suggest that in the general adult population, HBP is consistently lower than OBP across all the decades, but their difference might vary between age groups. Further research is needed to confirm these findings in younger and older subjects and in hypertensive individuals.

  3. Diabetes Drugs and Cardiovascular Safety.

    PubMed

    Bae, Ji Cheol

    2016-06-01

    Diabetes is a well-known risk factor of cardiovascular morbidity and mortality, and the beneficial effect of improved glycemic control on cardiovascular complications has been well established. However, the rosiglitazone experience aroused awareness of potential cardiovascular risk associated with diabetes drugs and prompted the U.S. Food and Drug Administration to issue new guidelines about cardiovascular risk. Through postmarketing cardiovascular safety trials, some drugs demonstrated cardiovascular benefits, while some antidiabetic drugs raised concern about a possible increased cardiovascular risk associated with drug use. With the development of new classes of drugs, treatment options became wider and the complexity of glycemic management in type 2 diabetes has increased. When choosing the appropriate treatment strategy for patients with type 2 diabetes at high cardiovascular risk, not only the glucose-lowering effects, but also overall benefits and risks for cardiovascular disease should be taken into consideration.

  4. Diabetes Drugs and Cardiovascular Safety

    PubMed Central

    2016-01-01

    Diabetes is a well-known risk factor of cardiovascular morbidity and mortality, and the beneficial effect of improved glycemic control on cardiovascular complications has been well established. However, the rosiglitazone experience aroused awareness of potential cardiovascular risk associated with diabetes drugs and prompted the U.S. Food and Drug Administration to issue new guidelines about cardiovascular risk. Through postmarketing cardiovascular safety trials, some drugs demonstrated cardiovascular benefits, while some antidiabetic drugs raised concern about a possible increased cardiovascular risk associated with drug use. With the development of new classes of drugs, treatment options became wider and the complexity of glycemic management in type 2 diabetes has increased. When choosing the appropriate treatment strategy for patients with type 2 diabetes at high cardiovascular risk, not only the glucose-lowering effects, but also overall benefits and risks for cardiovascular disease should be taken into consideration. PMID:27302713

  5. Hyper-coagulable profile with elevated pro-thrombotic biomarkers and increased cerebro- and cardio-vascular disease risk exist among healthy dyslipidemic women.

    PubMed

    Ferreira, Cláudia N; Carvalho, Maria G; Reis, Helton J; Gomes, Karina B; Sousa, Marinez O; Palotás, András

    2014-05-01

    Dyslipidemia is one of the pathognomonic elements of athero-genesis, as well as cerebro- and cardio-vascular disease (CCVD). Hemostatic factors are also involved in athero-sclerosis and ischemic changes, however their relationship with disrupted lipid homeostasis is not well characterized. The aim of this study was to determine the coagulation state of dyslipidemic patients and to evaluate their association with CCVD risk factors. Biochemical and hematological parameters, as well as neuro-psychiatric profile of 109 dyslipidemic subjects and 107 normo-lipidic healthy volunteers were assessed. Serum bio-marker levels and cognitive performance generally did not differ in the groups, but prothrombin fragment 1+2 (F1+2) and D-dimer concentrations were markedly higher among women. Hyper-coagulability was not associated with dyslipidemia, but was correlated with the female gender, which might pose an increased thromboembolic risk in asymptomatic women.

  6. Cardiovascular hospitalizations and associations with environmental quality

    EPA Science Inventory

    Cardiovascular disease has been identified as a condition that may be associated with environmental factors. Air pollution in particular has been demonstrated to be associated with cardiovascular disease and atherosclerosis, which can increase the likelihood of cardiovascular eve...

  7. Vivir Con Un Corazón Saludable: a Community-Based Educational Program Aimed at Increasing Cardiovascular Health Knowledge in High-Risk Hispanic Women.

    PubMed

    Romero, Daniela C; Sauris, Aileen; Rodriguez, Fátima; Delgado, Daniela; Reddy, Ankita; Foody, JoAnne M

    2016-03-01

    Hispanic women suffer from high rates of cardiometabolic risk factors and an increasingly disproportionate burden of cardiovascular disease (CVD). Particularly, Hispanic women with limited English proficiency suffer from low levels of CVD knowledge associated with adverse CVD health outcomes. Thirty-two predominantly Spanish-speaking Hispanic women completed, Vivir Con un Corazón Saludable (VCUCS), a culturally tailored Spanish language-based 6-week intensive community program targeting CVD health knowledge through weekly interactive health sessions. A 30-question CVD knowledge questionnaire was used to assess mean changes in CVD knowledge at baseline and postintervention across five major knowledge domains including CVD epidemiology, dietary knowledge, medical information, risk factors, and heart attack symptoms. Completion of the program was associated with a statistically significant (p < 0.001) increase in total mean CVD knowledge scores from 39 % (mean 11.7/30.0) to 66 % (mean 19.8/30.0) postintervention consistent with a 68 % increase in overall mean CVD scores. There was a statistically significant (p < 0.001) increase in mean knowledge scores across all five CVD domains. A culturally tailored Spanish language-based health program is effective in increasing CVD awareness among high CVD risk Hispanic women with low English proficiency and low baseline CVD knowledge.

  8. Paroxetine markedly increases plasma concentrations of ophthalmic timolol; CYP2D6 inhibitors may increase the risk of cardiovascular adverse effects of 0.5% timolol eye drops.

    PubMed

    Mäenpää, Jukka; Volotinen-Maja, Marjo; Kautiainen, Hannu; Neuvonen, Mikko; Niemi, Mikko; Neuvonen, Pertti J; Backman, Janne T

    2014-12-01

    Although ophthalmic timolol is generally well tolerated, a significant fraction of topically administered timolol can be systemically absorbed. We investigated the effect of the strong CYP2D6 inhibitor paroxetine on the pharmacokinetics of timolol after ophthalmic administration. In a four-phase crossover study, 12 healthy volunteers ingested either paroxetine (20 mg) or placebo daily for 3 days. In phases 1-2, timolol 0.1% gel, and in phases 3-4, timolol 0.5% drops were administered to both eyes. Paroxetine increased the plasma concentrations of timolol with both timolol formulations to a similar degree. The geometric mean ratio (95% confidence interval) of timolol peak concentration was 1.53-fold (1.23-1.91) with 0.1% timolol and 1.49-fold (0.94-2.36) with 0.5% timolol, and that of timolol area under the plasma concentration-time curve (AUC) from time 0 to 12 hours was 1.61-fold (1.26- to 2.06-fold) and 1.78-fold (1.21-2.62), respectively. During paroxetine administration, six subjects on 0.5% timolol drops, but none on 0.1% timolol gel, had plasma timolol concentrations exceeding 0.7 ng/ml, which can cause systemic adverse effects in patients at risk. There was a positive correlation between the AUC from time 0 to 13 hours of paroxetine and the placebo phase AUC from time 0 to infinity of timolol after timolol 0.5% drops (P < 0.05), and a nonsignificant trend after timolol 0.1% gel, consistent with the role of CYP2D6 in the metabolism of both agents. In the orthostatic test, heart rate immediately after upright standing was significantly lower (P < 0.05) during the paroxetine phase than during the placebo phase at 1 and 3 hours after 0.5% timolol dosing. In conclusion, paroxetine and other CYP2D6 inhibitors can have a clinically important interaction with ophthalmic timolol, particularly when patients are using 0.5% timolol formulations.

  9. A mobile phone intervention increases physical activity in people with cardiovascular disease: Results from the HEART randomized controlled trial.

    PubMed

    Maddison, Ralph; Pfaeffli, Leila; Whittaker, Robyn; Stewart, Ralph; Kerr, Andrew; Jiang, Yannan; Kira, Geoffrey; Leung, William; Dalleck, Lance; Carter, Karen; Rawstorn, Jonathan

    2015-06-01

    To determine the effectiveness and cost-effectiveness of a mobile phone intervention to improve exercise capacity and physical activity behaviour in people with ischaemic heart disease (IHD). In this single-blind, parallel, two-arm, randomized controlled trial adults (n = 171) with IHD were randomized to receive a mobile phone delivered intervention (HEART; n = 85) plus usual care, or usual care alone (n = 86). Adult participants aged 18 years or more, with a diagnosis of IHD, were clinically stable as outpatients, able to perform exercise, able to understand and write English, and had access to the Internet. The HEART (Heart Exercise And Remote Technologies) intervention involved a personalized, automated package of text messages and a secure website with video messages aimed at increasing exercise behaviour, delivered over 24 weeks. All participants were able to access usual community-based cardiac rehabilitation, which involves encouragement of physical activity and an offer to join a local cardiac support club. All outcomes were assessed at baseline and 24 weeks and included peak oxygen uptake (PVO2; primary outcome), self-reported physical activity, health-related quality of life, self-efficacy and motivation (secondary outcomes). Results showed no differences in PVO2 between the two groups (difference -0.21 ml kg(-1)min(-1), 95% CI: -1.1, 0.7; p = 0.65) at 24 weeks. However significant treatment effects were observed for selected secondary outcomes, including leisure time physical activity (difference 110.2 min/week, 95% CI: -0.8, 221.3; p = 0.05) and walking (difference 151.4 min/week, 95% CI: 27.6, 275.2; p = 0.02). There were also significant improvements in self-efficacy to be active (difference 6.2%, 95% CI: 0.2, 12.2; p = 0.04) and the general health domain of the SF36 (difference 2.1, 95% CI: 0.1, 4.1; p = 0.03) at 24 weeks. The HEART programme was considered likely to be cost-effective for leisure time activity and walking. A mobile phone intervention

  10. An Increase of Plasma Advanced Oxidation Protein Products Levels Is Associated with Cardiovascular Risk in Incident Peritoneal Dialysis Patients: A Pilot Study

    PubMed Central

    Gonzalez, Elena; Bajo, Maria-Auxiliadora; Carrero, Juan J.; Lindholm, Bengt; Grande, Cristina; Sánchez-Villanueva, Rafael; Del Peso, Gloria; Díaz-Almirón, Mariana; Iglesias, Pedro; Díez, Juan J.; Selgas, Rafael

    2015-01-01

    Advanced oxidation protein products (AOPPs) are considered as markers and even mediators of the proinflammatory effect of oxidative stress in uremia. We hypothesized that an increase of oxidative stress associated with peritoneal dialysis (PD), estimated by the variation of plasma AOPPs over time, might be associated with cardiovascular (CV) risk and overall prognosis. In 48 PD patients, blood samples were collected on two occasions: the first one in the first six months after starting PD therapy and the second one, one year after. The plasma AOPPs level variation over the first year on PD was significantly associated with CV antecedents and also with CV prognosis. In those patients in whom the AOPPs levels increased more than 50% above the baseline value, a significant association with past and future CV disease was confirmed. These patients had 4.7 times greater risk of suffering later CV disease than those with a smaller increase, even after adjusting for previous CV history. Our data suggest that the increase of AOPPs plasma level over the first year on PD is conditioned by CV antecedents but also independently predicts CV prognosis. AOPPs plasma levels seem to represent the CV status of PD patients with sufficient sensitivity to identify those with a clearly sustained higher CV risk. PMID:26581178

  11. The effects of socioeconomic status and increased body mass index on cardiovascular disease in African-American women.

    PubMed

    Hill, M; Calvin, R L; Bangura, T; Moore, A N; Maston, K; Azoro, C; Brown, B; Boyd, C

    2001-12-01

    Today within the United States, CVD is the leading cause of death in women with the highest mortality being seen in African-American women. A review of literature revealed that over the last decade, within the United States, there has been an overall reduction in the death rate due to CVD. However, the rate of decline has been less for women than for men and less for African-American women than for White women. Findings from some studies indicate that African-American women have increased risk factors as compared to other ethnic groups for CVD based upon conditions and behaviors affecting lifestyle. Fortunately, most of the CVD risk factors are modifiable and their occurrence can be widely prevented. Therefore, it is imperative that health care providers approach the issue of risk factors for CVD in African-American women as a heart disease epidemic. This approach is necessary if the United States is going to improve the health of all Americans, eliminate disparities, and improve the quality of life.

  12. β-Blocker premedication does not increase the frequency of allergic reactions from coronary CT angiography: Results from the Advanced Cardiovascular Imaging Consortium.

    PubMed

    Aggarwal, Anshul; Smith, James L; Chinnaiyan, Kavitha M; Mehta, Neesurg; Boura, Judith; Khoury Abdulla, Rami; Lauter, Carl B; Raff, Gilbert L

    2015-01-01

    β-Blockers are often used for heart rate control during coronary CT angiography (CTA). Increased frequency and severity of allergic reactions to radiocontrast media (RCM) have been reported with concomitant use of β-blockers. The objectives of this study were to determine whether there is a higher incidence of allergic reactions to low-osmolar nonionic RCM in patients undergoing coronary CTA with concomitant β-blockers and to define the overall incidence and severity of allergic reactions in patients undergoing coronary CTA with and without a history of allergy to RCM. Patients undergoing coronary CTA at 47 institutions participating in the Advanced Cardiovascular Imaging Consortium registry were analyzed. The incidence and severity of allergic reactions were compared between those patients who did and those who did not receive β-blockers, as well as in subgroups of patients with and without a history of prior allergy to RCM. The incidence of allergic reaction in patients who received β-blockers was 45 of 23,867 (0.19%) compared with those who did not receive β-blockers, which was 9 of 5232 (0.17%; P = .84; odds ratio = 1.1). Of the patients with history of allergy to RCM, 4 of 706 patients (0.6%) on β-blockers experienced allergic reactions compared to 1 of 77 patients (1.3%) without β-blockers (P = .40; odds ratio = 0.43). β-Blocker pretreatment had no effect on the frequency or severity of allergic reaction in patients undergoing coronary CTA, even in patients with a past history of allergy to RCM. Copyright © 2015 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

  13. Myocardial extracellular volume fraction quantified by cardiovascular magnetic resonance is increased in hypertension and associated with left ventricular remodeling.

    PubMed

    Wang, Shuli; Hu, Hongjie; Lu, Minjie; Sirajuddin, Arlene; Li, Jinghui; An, Jing; Chen, Xiuyu; Yin, Gang; Lan, Tian; Dai, Linlin; Zhang, Yan; Yin, Xiaorong; Song, Lei; Dang, Aimin; Kellman, Peter; Arai, Andrew E; Zhao, Shihua

    2017-04-24

    To determine whether extracellular volume fraction (ECV) quantification by cardiac magnetic resonance (CMR) can demonstrate left ventricle (LV) abnormalities and relationship between ECV and LV remodeling in hypertension (HTN) patients METHODS: ECV quantification was prospectively performed in 134 consecutive HTN patients and 97 healthy subjects. Individual and regional ECV were compared to the regions on late gadolinium enhancement (LGE) images. Statistical analysis of the relationship between LV global functional parameters and ECV was carried out using Pearson's correlation, Student's t test and multiple regressions. In the HTN group, 70.1% (94/134) were LGE negative and 29.9% (40/134) LGE positive. The mean ECV after adjusting for age, sex, BMI, diabetes, smoking and dyslipidaemia in healthy controls and LGE-negative patients were 26.9 ± 2.67% and 28.5 ± 2.9% (p < 0.001), respectively. The differences in ECV reached statistical significance among the regions of LGE, LGE-Peri, LGE remote and the normal area between the control and LGE-positive subgroup (all p < 0.05). Global ECV significantly correlated with LVEF (r = -0.466, p < 0 .001) and LV hypertrophy (r = 0.667, p < 0.001). ECV can identify LV abnormalities at an early stage in HTN patients without LGE. These abnormalities may reflect an increase in diffuse myocardial fibrosis and are associated with LV remodeling. • Diffuse myocardial fibrosis may develop in hypertensive cardiomyopathy before conventional MRI detectable LGE. • ECV can identify myocardial fibrosis at an early stage in hypertensive patients. • Elevated ECV is associated with decreased LV global function and LV remodeling in hypertension.

  14. Effect of secular trends on age-related trajectories of cardiovascular risk factors: the Whitehall II longitudinal study 1985–2009

    PubMed Central

    Hulmán, Adam; Tabák, Adam G; Nyári, Tibor A; Vistisen, Dorte; Kivimäki, Mika; Brunner, Eric J; Witte, Daniel R

    2014-01-01

    Background: Secular trends in cardiovascular risk factors have been described, but few studies have examined simultaneously the effects of both ageing and secular trends within the same cohort. Methods: Development of cardiovascular risk factors over the past three decades was analysed using serial measurements from 10 308 participants aged from 35 to 80 years over 25 years of follow-up from five clinical examination phases of the Whitehall II study. Changes of body mass index, waist circumference, blood pressure and total and high-density lipoprotein cholesterol distribution characteristics were analysed with quantile regression models in the 57–61 age group. Age-related trajectories of risk factors were assessed by fitting mixed-effects models with adjustment for year of birth to reveal secular trends. Results: Average body mass index and waist circumference increased faster with age in women than in men, but the unfavourable secular trend was more marked in men. Distributions showed a fattening of the right tail in each consecutive phase, meaning a stronger increase in higher percentiles. Despite the higher obesity levels in younger birth cohorts, total cholesterol decreased markedly in the 57–61 age group along the entire distribution rather than in higher extremes only. Conclusion: The past three decades brought strong and heterogeneous changes in cardiovascular risk factor distributions. Secular trends appear to modify age-related trajectories of cardiovascular risk factors, which may be a source of bias in longitudinal analyses. PMID:24464190

  15. Blunted sleep-time relative blood pressure decline increases cardiovascular risk independent of blood pressure level--the "normotensive non-dipper" paradox.

    PubMed

    Hermida, Ramón C; Ayala, Diana E; Mojón, Artemio; Fernández, José R

    2013-03-01

    Numerous studies have consistently shown an association between blunted sleep-time relative blood pressure (BP) decline (non-dipping) and increased cardiovascular disease (CVD) risk in hypertension. Normotensive persons with a non-dipper BP profile also have increased target organ damage, namely, increased left ventricular mass and relative wall thickness, reduced myocardial diastolic function, increased urinary albumin excretion, increased prevalence of diabetic retinopathy, and impaired glucose tolerance. It remains a point of contention, however, whether the non-dipper BP pattern or just elevated BP, alone, is the most important predictor of advanced target organ damage and future CVD events. Accordingly, we investigated the role of dipping status and ambulatory BP level as contributing factors for CVD morbidity and mortality in the MAPEC (Monitorización Ambulatoria para Predicción de Eventos Cardiovasculares, i.e., Ambulatory Blood Pressure Monitoring for Prediction of Cardiovascular Events) study. We prospectively studied 3344 individuals (1718 men/1626 women), 52.6 ± 14.5 (mean ± SD) yrs of age, during a median follow-up of 5.6 yrs. BP was measured by ambulatory monitoring (ABPM) for 48 h at baseline, and again annually or more frequently (quarterly) if treatment adjustment was required in treated hypertensive patients. At baseline, those with ABPM-substantiated hypertension were randomized to one of two treatment-time regimen groups: (i) ingestion of all prescribed hypertension medications upon awakening or (ii) ingestion of the entire dose of ≥1 of them at bedtime. Those found to be normotensive at baseline were untreated but followed and evaluated by repeated ABPM like the hypertensive patients. Participants were divided into four investigated categories on the basis of dipping status and ambulatory BP: (i) dipper vs. non-dipper, and (ii) normal ambulatory BP if the awake systolic (SBP)/diastolic (DBP) BP means were <135/85 mm Hg and the

  16. Medium-Term Outcomes Following Endovascular Repair of Infrarenal Abdominal Aortic Aneurysms with an Unfavourable Proximal Neck

    SciTech Connect

    Saha, Prakash Hughes, John Patel, Ashish S. Donati, Tommaso Sallam, Morad Patel, Sanjay D. Bell, Rachel E.; Katsanos, Konstantinos; Modarai, Bijan Zayed, Hany A.

    2015-08-15

    PurposeThe purpose of this study was to evaluate medium-term outcomes following endovascular repair of abdominal aortic aneurysms (EVAR) with unfavourable neck anatomy using stent grafts with a 36 mm or larger proximal diameter.Materials and MethodsA retrospective review of 27 patients who underwent elective EVAR between 2006 and 2008 using a stent graft with a 36 mm or larger proximal diameter was carried out. All patients had computed tomography angiography (CTA) for procedure planning, and detailed assessment of the aneurysm neck was performed using a three-dimensional CTA workstation. Patients were followed up with CTA at 3 and 12 months and annual duplex thereafter.ResultsThe median aneurysm diameter was 7 cm, and the median aneurysm neck diameter was 31 mm. Cook Zenith stent grafts were used in all patients, with a proximal diameter of 36 mm (n = 25) and 40 mm (n = 2). Primary and assisted primary technical success rates were 74 and 93 %, respectively. The follow-up period ranged from 62 to 84 months, with a median of 72 months. 15 patients died during follow-up. Two patients died from aortic rupture, and the remaining patients died from cardiac disease (n = 4), chest sepsis (n = 6), cancer (n = 2) and renal failure (n = 1). Complications included type I endoleak (n = 5), limb occlusion (n = 2), limb stenosis (n = 2), limb kinking (n = 1), dissection of an artery (n = 1), occlusion of a femorofemoral cross-over graft (n = 1) and poor attachment of a distal limb (n = 1).ConclusionsEVAR using stent grafts in the presence of an unfavourable neck has a high risk of complications. Medium-term survival in this group is low but mainly due to patient co-morbidities.

  17. Acute and chronic effects of morphine on cardiovascular system and the baroreflexes sensitivity during severe increase in blood pressure in rats.

    PubMed

    Shanazari, Ali Asghar Pour; Aslani, Zahra; Ramshini, Efat; Alaei, Hojatolah

    2011-01-01

    This study aimed to determine the role and effects of baroreflexes during acute increase in blood pressure (BP) after severe and long-term infusion of morphine. This experimental study was conducted on male desert rats. They were assigned into 4 groups and the rats of the case group received morphine in the short and long term periods, whereas the control rats received normal saline for the same duration. Then, the rats were anesthetized, and their femoral artery and vein were cannulated for the injection of phenylephrine and naloxone, respectively. The injection of phenylephrine was performed by the device after a period of recording BP, mean arterial pressure (MAP), heart rate (HR) and baroreflex sensitivity (BRS) in order to induce acute hypertension before and after injecting naloxone. The Student t-test and analysis of variance (ANOVA) were used for statistical analysis. The obtained results suggested that acute and chronic injections of morphine may cause significant reduction in systolic and diastolic arterial BP as well as the mean arterial pressure; moreover, it significantly increased the sensitivity of baroreflexes. Furthermore, the increased baroreflex sensitivity was observed after acute injection of morphine, whereas chronic morphine injection caused reduction in baroreflex sensitivity. It seems that the details of the opiates' effects on the body including cardiovascular system depend on the type of opioids and consequently, on the type of stimulated receptor.

  18. Increased pericardial fat accumulation is associated with increased intramyocardial lipid content and duration of highly active antiretroviral therapy exposure in patients infected with human immunodeficiency virus: a 3T cardiovascular magnetic resonance feasibility study.

    PubMed

    Diaz-Zamudio, Mariana; Dey, Damini; LaBounty, Troy; Nelson, Michael; Fan, Zhaoyang; Szczepaniak, Lidia S; Hsieh, Bill Pei-Chin; Rajani, Ronak; Berman, Daniel; Li, Debiao; Dharmakumar, Rohan; Hardy, W David; Conte, Antonio Hernandez

    2015-10-31

    The aim of the current study was to examine whether the use of highly active antiretroviral therapy (HAART) in patients with HIV is associated with changes in pericardial fat and myocardial lipid content measured by cardiovascular magnetic resonance (CMR). In this prospective case-control study, we compared 27 HIV seropositive (+) male subjects receiving HAART to 22 control male subjects without HIV matched for age, ethnicity and body mass index. All participants underwent CMR imaging for determination of pericardial fat [as volume at the level of the origin of the left main coronary artery (LM) and at the right ventricular free wall] and magnetic resonance spectroscopy (MRS) for evaluation of intramyocardial lipid content (% of fat to water in a single voxel at the interventricular septum). All measurements were made by two experienced readers blinded to the clinical history of the study participants. Two-sample t-test, Spearman's correlation coefficient or Pearson's correlation coefficient and multivariable logistic regression were used for statistical analysis. Pericardial fat volume at the level of LM origin was higher in HIV (+) subjects (33.4 cm(3) vs. 27.4 cm(3), p = 0.03). On multivariable analysis adjusted for age, Framingham risk score (FRS) and waist/hip ratio, pericardial fat remained significantly associated to HIV-status (OR 1.09, p = 0.047). For both HIV (+) and HIV (-) subjects, pericardial fat volume showed strong correlation with intramyocardial lipid content (r = 0.58, p < 0.0001) and FRS (r = 0.53, p = 0.0002). Among HIV (+) subjects, pericardial fat was significantly higher in patients with lipo-accumulation (37 cm(3) vs. 27.1 cm(3), p = 0.03) and showed significant correlation with duration of both HIV infection (r = 0.5, p = 0.01) and HAART (r = 0.46, p = 0.02). Pericardial fat content is increased in HIV (+) subjects on chronic HAART (>5 years), who demonstrate HAART-related lipo

  19. How much can diptera-borne viruses persist over unfavourable seasons?

    PubMed

    Charron, Maud V P; Balenghien, Thomas; Seegers, Henri; Langlais, Michel; Ezanno, Pauline

    2013-01-01

    Diptera are vectors of major human and animal pathogens worldwide, such as dengue, West-Nile or bluetongue viruses. In seasonal environments, vector-borne disease occurrence varies with the seasonal variations of vector abundance. We aimed at understanding how diptera-borne viruses can persist for years under seasonal climates while vectors overwinter, which should stop pathogen transmission during winter. Modeling is a relevant integrative approach for investigating the large panel of persistence mechanisms evidenced through experimental and observational studies on specific biological systems. Inter-seasonal persistence of virus may occur in hosts due to viremia duration, chronic infection, or vertical transmission, in vector resistance stages, and due to a low continuous transmission in winter. Using a generic stochastic modeling framework, we determine the parameter ranges under which virus persistence could occur via these different mechanisms. The parameter ranges vary according to the host demographic regime: for a high host population turnover, persistence increases with the mechanism parameter, whereas for a low turnover, persistence is maximal for an optimal range of parameter. Persistence in hosts due to long viremia duration in a few hosts or due to vertical transmission is an effective strategy for the virus to overwinter. Unexpectedly, a low continuous transmission during winter does not give rise to certain persistence, persistence barely occurring for a low turnover of the susceptible population. We propose a generic framework adaptable to most diptera-borne diseases. This framework allows ones to assess the plausibility of each persistence mechanism in real epidemiological situations and to compare the range of parameter values theoretically allowing persistence with the range of values determined experimentally.

  20. How Much Can Diptera-Borne Viruses Persist over Unfavourable Seasons?

    PubMed Central

    Charron, Maud V. P.; Balenghien, Thomas; Seegers, Henri; Langlais, Michel; Ezanno, Pauline

    2013-01-01

    Diptera are vectors of major human and animal pathogens worldwide, such as dengue, West-Nile or bluetongue viruses. In seasonal environments, vector-borne disease occurrence varies with the seasonal variations of vector abundance. We aimed at understanding how diptera-borne viruses can persist for years under seasonal climates while vectors overwinter, which should stop pathogen transmission during winter. Modeling is a relevant integrative approach for investigating the large panel of persistence mechanisms evidenced through experimental and observational studies on specific biological systems. Inter-seasonal persistence of virus may occur in hosts due to viremia duration, chronic infection, or vertical transmission, in vector resistance stages, and due to a low continuous transmission in winter. Using a generic stochastic modeling framework, we determine the parameter ranges under which virus persistence could occur via these different mechanisms. The parameter ranges vary according to the host demographic regime: for a high host population turnover, persistence increases with the mechanism parameter, whereas for a low turnover, persistence is maximal for an optimal range of parameter. Persistence in hosts due to long viremia duration in a few hosts or due to vertical transmission is an effective strategy for the virus to overwinter. Unexpectedly, a low continuous transmission during winter does not give rise to certain persistence, persistence barely occurring for a low turnover of the susceptible population. We propose a generic framework adaptable to most diptera-borne diseases. This framework allows ones to assess the plausibility of each persistence mechanism in real epidemiological situations and to compare the range of parameter values theoretically allowing persistence with the range of values determined experimentally. PMID:24023929

  1. Effect of temperature under unfavourable conditions on oxygen uptake of larval herring, Clupea harengus

    NASA Astrophysics Data System (ADS)

    Yin, Ming-Cheng; Batty, R. S.

    1995-09-01

    Oxygen uptake under starvation and short periods of sudden temperature change was measured for larval herring ( Clupea harengus L.) reared at average temperature of 7.3, 11 and 12.9°C. Larval stages between first feeding and premetamorphosis were used. For comparison, the routine oxygen uptake (ROU) was also investigated and followed the relationship Q=0.974+0.174 tW -0.210, where Q is in μg/(mg·h), W is dry body weight in mg and t is temperature in °C. The oxygen uptake under starvation (SOU, deprived of food for 24 h) was different from the routine when the larval dry weight was less than 0.6 0.8 mg; it increased with temperature and body weight giving the relationship Q=1.568+0.110 tW 0.380; if the larval dry weight was more than 0.6 0.8 mg, it reverted to the norm ( Q=1.704+0.078 tW -0.349). The oxygen uptake was tested in short periods (3 h) of sudden temperature changes in six groups: 7.3 to 11, 7.3 to 12.9, 11 to 7.3, 11 to 12.9, 12.9 to 7.3 and 1.29 to 11°C. The oxygen uptake in the 7.3 to 12.9 and 12.9 to 7.3°C groups varied in a way similar to that of the larvae under starvation. The other four groups' oxygen uptake were more or less normal.

  2. Expression of the polycomb‐group gene BMI1 is related to an unfavourable prognosis in primary nodal DLBCL

    PubMed Central

    van Galen, Joost C; Muris, Jettie J F; Oudejans, Joost J; Vos, Wim; Giroth, Cindy P E; Ossenkoppele, Gert J; Otte, Arie P; Raaphorst, Frank M; Meijer, Chris J L M

    2007-01-01

    Background Clinical outcome in patients with diffuse large B cell lymphomas (DLBCL) is highly variable and poorly predictable. Microarray studies showed that patients with DLBCL with a germinal centre B cell‐like (GCB) phenotype have a better prognosis than those with an activated B cell‐like (ABC) phenotype. The BMI1 proto‐oncogene was identified as one of the genes present in the signature of the ABC type of DLBCL, associated with a poor prognosis. Objectives (1) To investigate, in primary nodal DLBCL, the expression of BMI1 and its association with clinical outcome and DLBCL signature; (2) to look for an association between BMI1 expression and the expression of its putative downstream targets p14ARF and p16INK4a. Results BMI1 expression was found to be associated with poor clinical outcome, but not clearly with an ABC‐like phenotype of DLBCL. Expression of BMI1 was frequently, but not always, related to low levels of expression of p14ARF and p16INK4a. Conclusion Expression of BMI1 is associated with an unfavourable clinical outcome of primary nodal DLBCL. PMID:16837630

  3. Evolutionary process of Bos taurus cattle in favourable versus unfavourable environments and its implications for genetic selection

    PubMed Central

    O'Neill, Christopher J; Swain, David L; Kadarmideen, Haja N

    2010-01-01

    The evolutionary processes that have enabled Bos taurus cattle to establish around the globe are at the core to the future success of livestock production. Our study focuses on the history of cattle domestication including the last 60 years of B. taurus breeding programmes in both favourable and unfavourable environments and its consequences on evolution and fitness of cattle. We discuss the emergence of ‘production diseases’ in temperate production systems and consider the evolutionary genetics of tropical adaptation in cattle and conclude that the Senepol, N'Dama, Adaptaur and Criollo breeds, among others with similar evolutionary trajectories, would possess genes capable of improving the productivity of cattle in challenging environments. Using our own experimental evidence from northern Australia, we review the evolution of the Adaptaur cattle breed which has become resistant to cattle tick. We emphasize that the knowledge of interactions between genotype, environment and management in the livestock systems will be required to generate genotypes for efficient livestock production that are both economically and environmentally sustainable. Livestock producers in the 21st century will have less reliance on infrastructure and veterinary products to alleviate environmental stress and more on the animal's ability to achieve fitness in a given production environment. PMID:25567936

  4. Evolutionary process of Bos taurus cattle in favourable versus unfavourable environments and its implications for genetic selection.

    PubMed

    O'Neill, Christopher J; Swain, David L; Kadarmideen, Haja N

    2010-09-01

    The evolutionary processes that have enabled Bos taurus cattle to establish around the globe are at the core to the future success of livestock production. Our study focuses on the history of cattle domestication including the last 60 years of B. taurus breeding programmes in both favourable and unfavourable environments and its consequences on evolution and fitness of cattle. We discuss the emergence of 'production diseases' in temperate production systems and consider the evolutionary genetics of tropical adaptation in cattle and conclude that the Senepol, N'Dama, Adaptaur and Criollo breeds, among others with similar evolutionary trajectories, would possess genes capable of improving the productivity of cattle in challenging environments. Using our own experimental evidence from northern Australia, we review the evolution of the Adaptaur cattle breed which has become resistant to cattle tick. We emphasize that the knowledge of interactions between genotype, environment and management in the livestock systems will be required to generate genotypes for efficient livestock production that are both economically and environmentally sustainable. Livestock producers in the 21st century will have less reliance on infrastructure and veterinary products to alleviate environmental stress and more on the animal's ability to achieve fitness in a given production environment.

  5. Ginsenosides Have a Suppressive Effect on c-Fos Expression in Brain and Reduce Cardiovascular Responses Increased by Noxious Stimulation to the Rat Tooth

    PubMed Central

    Jung, Ji-Yeon; Seong, Kyung-Joo; Moon, In-Ohk; Cho, Jin-Hyoung; Kim, Sun-Hun

    2013-01-01

    The purpose of this study is to investigate the antinociceptive effects of ginsenosides on toothache. c-Fos immunoreactive (IR) neurons were examined after noxious intrapulpal stimulation (NS) by intrapulpal injection of 2 M KCl into upper and lower incisor pulps exposed by bone cutter in Sprague Dawley rats. The number of Fos-IR neurons was increased in the trigeminal subnucleus caudalis (Vc) and the transitional region between Vc and subnucleus interpolaris (Vi) by NS to tooth. The intradental NS raised arterial blood pressure (BP) and heart rate (HR). The number of Fos-IR neurons was also enhanced in thalamic ventral posteromedial nucleus (VPMN) and centrolateral nucleus (CLN) by NS to tooth. The intradental NS increased the number of Fos-IR neurons in the nucleus tractus solitarius (NTS) and rostral ventrolateral medulla (RVLM), hypothalamic supraoptic nucleus (SON) and paraventricular nucleus (PVN), central cardiovascular regulation centers. Ginsenosides reduced the number of c-Fos-IR increased by NS to tooth in the trigeminal Vc and thalamic VPMN and CLN. Naloxone, an opioid antagonist, did not block the effect of ginsenoside on the number of Fos-IR neurons enhanced by NS to tooth in the trigeminal Vc and thalamic VPMN and CLN. Ginsenosides ameliorated arterial BP and HR raised by NS to tooth and reduced the number of Fos-IR neurons increased by NS to tooth in the NTS, RVLM, hypothalamic SON, and PVN. These results suggest that ginsenosides have an antinociceptive effect on toothache through non-opioid system and attenuates BP and HR increased by NS to tooth. PMID:23626473

  6. Distribution of ideal cardiovascular health by educational levels from 1978 to 2006: a time trend study from the capital region of Denmark.

    PubMed

    Olsen, Gitte S; Holm, Ann-Sofie S; Jørgensen, Torben; Borglykke, Anders

    2014-09-01

    The focus on improvements in ideal cardiovascular health is a relatively new approach and to our knowledge nobody has published the trend in regard to educational difference. Time trend analysis from six cross-sectional studies in 1978-2006 from the south-western part of the capital region of Denmark. This analysis included 16,935 individuals aged 30-64 years. Ideal cardiovascular health was achieved if all of the following criteria were met: no established cardiovascular disease, no diabetes, no antihypertensive or lipid-lowering treatment, non-smoker, body mass index <25 kg/m(2), blood pressure ≤120/80 mmHg and total cholesterol ≤5 mmol/l. Results are presented adjusted for age and stratified according to sex and educational level as length of vocational training. The proportion of women with ideal cardiovascular health increased from 2% in 1978 to 13% in 2006. From 1991, an educational difference occurred, increasing to a 5-fold difference in 2006 between the highest and lowest educated women. For men, a less pronounced increase occurred from 1% in 1978 to 5% in 2006; a change which was only significant among the highest educated. An educational difference occurred from 1986 to 1999 between the highest and lowest educated men, but was no longer present in 2006. The trend for women shows an increasing proportion in ideal cardiovascular health with a more unfavourable risk profile among women with a low educational level. For men, the educational difference was less pronounced probably because very few men reached an ideal cardiovascular risk profile. This stresses the importance for preventive efforts targeting low educated groups, and men in particular. © Authors 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  7. Increases in Plasma Tryptophan Are Inversely Associated with Incident Cardiovascular Disease in the Prevención con Dieta Mediterránea (PREDIMED) Study.

    PubMed

    Yu, Edward; Ruiz-Canela, Miguel; Guasch-Ferré, Marta; Zheng, Yan; Toledo, Estefania; Clish, Clary B; Salas-Salvadó, Jordi; Liang, Liming; Wang, Dong D; Corella, Dolores; Fitó, Montse; Gómez-Gracia, Enrique; Lapetra, José; Estruch, Ramón; Ros, Emilio; Cofán, Montserrat; Arós, Fernando; Romaguera, Dora; Serra-Majem, Lluis; Sorlí, Jose V; Hu, Frank B; Martinez-Gonzalez, Miguel A

    2017-03-01

    Background: During development of cardiovascular disease (CVD), interferon-γ-mediated inflammation accelerates degradation of tryptophan into downstream metabolites. A Mediterranean diet (MedDiet) consisting of a high intake of extra-virgin olive oil (EVOO), nuts, fruits, vegetables, and cereals has been demonstrated to lower the risk of CVD. The longitudinal relation between tryptophan and its downstream metabolites and CVD in the context of a MedDiet is unstudied.Objective: We sought to investigate the relation between metabolites in the tryptophan-kynurenine pathway and CVD in the context of a MedDiet pattern.Methods: We used a case-cohort design nested in the Prevención con Dieta Mediterránea randomized controlled trial. There were 231 CVD cases (stroke, myocardial infarction, cardiovascular death) among 985 participants over a median of 4.7 y of follow-up [mean ± SD age: 67.6 ± 6.1 y; 53.7% women; mean ± SD body mass index (in kg/m(2)): 29.7 ± 3.7]. We assessed plasma tryptophan, kynurenine, kynurenic acid, 3-hydroxyanthranilic acid, and quinolinic acid concentrations at baseline and after 1 y of intervention with a MedDiet. We combined these metabolites in a kynurenine risk score (KRS) by weighting each metabolite by the adjusted coefficient of its associations with CVD. Cox models were used in the primary analysis.Results: Increases in tryptophan after 1 y were associated with a lower risk of composite CVD (HR per SD: 0.79; 95% CI: 0.63, 0.98). The baseline kynurenic acid concentration was associated with a higher risk of myocardial infarction and coronary artery disease death but not stroke. A higher KRS was more strongly associated with CVD in the control group than in the 2 intervention groups (P-interaction = 0.003). Adjustment for changes in plasma tryptophan attenuated the inverse association between MedDiet+EVOO and CVD.Conclusions: An increase in the plasma tryptophan concentration was significantly associated with a decreased risk of CVD. A

  8. Cardiovascular Risk Factors Increase the Risks of Diabetic Peripheral Neuropathy in Patients With Type 2 Diabetes Mellitus: The Taiwan Diabetes Study.

    PubMed

    Yang, Chun-Pai; Lin, Cheng-Chieh; Li, Chia-Ing; Liu, Chiu-Shong; Lin, Wen-Yuan; Hwang, Kai-Lin; Yang, Sing-Yu; Chen, Hsuan-Ju; Li, Tsai-Chung

    2015-10-01

    This study aimed to examine whether poor glycemic control, measured by glycated hemoglobin A1C (HbA1c) and other cardiovascular risk factors, can predict diabetic peripheral neuropathy (DPN) in patients with type 2 diabetes mellitus (DM).Patients aged ≥30 years with type 2 DM, enrolled in the National Diabetes Care Management Program, and free of DPN (n = 37,375) in the period 2002 to 2004 were included and followed up until 2011. The related factors were analyzed using Cox proportional hazards regression models.For an average follow-up of 7.00 years, 8379 cases of DPN were identified, with a crude incidence rate of 32.04/1000 person-years. After multivariate adjustment, patients with HbA1c levels 7 to 8%, 8 to 9%, 9 to 10%, and ≥10% exhibited higher risk of DPN (adjusted HR: 1.11 [1.04-1.20], 1.30 [1.21-1.40], 1.32 [1.22-1.43], and 1.62 [1.51-1.74], respectively) compared with patients with HbA1c level 6 to 7%. There was a significant linear trend in DPN incidence with increasing HbA1c (P < 0.001) and significant HRs of DPN for patients with HbA1c level ≥7%, blood pressure ≥130/85 mm Hg, triglycerides (TG) ≥150 mg/dL, high density of lipoprotein-cholesterol (HDL-C) <40 mg/dL in males and <50 mg/dL in females, low density of lipoprotein-cholesterol (LDL-C) ≥100 mg/dL, and estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m.Patients with type 2 DM and HbA1c ≥7.0% exhibit increased risk of DPN, demonstrating a linear relationship. The incidence of DPN is also associated with poor glucose control and cardiovascular risk factors like hypertension, hyper-triglyceridemia, low HDL-C, high LDL-C, and decreased eGFR.

  9. Radiation Dose Associated with Renal Failure Mortality: A Potential Pathway to Partially Explain Increased Cardiovascular Disease Mortality Observed after Whole-Body Irradiation

    PubMed Central

    Adams, Michael Jacob; Grant, Eric J.; Kodama, Kazunori; Shimizu, Yukiko; Kasagi, Fumiyoshi; Suyama, Akihiko; Sakata, Ritsu; Akahoshi, Masazumi

    2012-01-01

    Whole-body and thoracic ionizing radiation exposure are associated with increased cardiovascular disease (CVD) risk. In atomic bomb survivors, radiation dose is also associated with increased hypertension incidence, suggesting that radiation dose may be associated with chronic renal failure (CRF), thus explaining part of the mechanism for increased CVD. Multivariate Poisson regression was used to evaluate the association of radiation dose with various definitions of chronic kidney disease (CKD) mortality in the Life Span Study (LSS) of atomic bomb survivors. A secondary analysis was performed using a subsample for whom self-reported information on hypertension and diabetes, the two biggest risk factors for CRF, had been collected. We found a significant association between radiation dose and only our broadest definition of CRF among the full cohort. A quadratic dose excess relative risk model [ERR/Gy2 = 0.091 (95% CI: 0.05, 0.198)] fit minimally better than a linear model. Within the subsample, association was also observed only with the broadest CRF definition [ERR/Gy2 = 0.15 (95% CI: 0.02, 0.32)]. Adjustment for hypertension and diabetes improved model fit but did not substantially change the ERR/Gy2 estimate, which was 0.17 (95% CI: 0.04, 0.35). We found a significant quadratic dose relationship between radiation dose and possible chronic renal disease mortality that is similar in shape to that observed between radiation and incidence of hypertension in this population. Our results suggest that renal dysfunction could be part of the mechanism causing increased CVD risk after whole-body irradiation, a hypothesis that deserves further study. PMID:22149958

  10. Comparison of first-line chemotherapy including escalated BEACOPP versus chemotherapy including ABVD for people with early unfavourable or advanced stage Hodgkin lymphoma.

    PubMed

    Skoetz, Nicole; Will, Andrea; Monsef, Ina; Brillant, Corinne; Engert, Andreas; von Tresckow, Bastian

    2017-05-25

    There are two different international standards for the treatment of early unfavourable and advanced stage Hodgkin lymphoma (HL): chemotherapy with escalated BEACOPP (bleomycin/etoposide/doxorubicin/cyclophosphamide/vincristine/procarbazine/prednisone) regimen and chemotherapy with ABVD (doxorubicin/bleomycin/vinblastine/dacarbazine) regimen. To determine the advantages and disadvantages of chemotherapy including escalated BEACOPP compared to chemotherapy including ABVD in the treatment of early unfavourable or advanced stage HL as first-line treatment. We searched for randomised controlled trials in MEDLINE, CENTRAL and conference proceedings (January 1985 to July 2013 and for the update to March 2017) and Embase (1985 to November 2008). Moreover we searched trial registries (March 2017; www.controlled-trials.com, www.clinicaltrialsregister.eu/ctr-search/search, clinicaltrials.gov, www.eortc.be, www.ghsg.org, www.ctc.usyd.edu.au, www.trialscentral.org/index.html) SELECTION CRITERIA: We included randomised controlled trials examining chemotherapy including at least two cycles of escalated BEACOPP regimens compared with chemotherapy including at least four cycles of ABVD regimens as first-line treatment for patients with early unfavourable stage or advanced stage HL. The effect measures we used were hazard ratios (HRs) for overall survival (OS), progression-free survival (PFS) and freedom from first progression.We used risk ratios (RRs) relative risks to analyse harms: treatment-related mortality, secondary malignancies (including myeloid dysplastic syndrome (MDS) or acute myeloid leukaemia (AML)), infertility and adverse events.Quality of life was not reported in any trial, therefore not analysed. Two review authors independently extracted data and assessed quality of trials. We screened 1796 records and identified five eligible trials in total i.e. one trial could be added on the previous review. These trials included only adults (16 to 65 years of age). We

  11. Fatty liver is associated with an increased risk of diabetes and cardiovascular disease - Evidence from three different disease models: NAFLD, HCV and HIV

    PubMed Central

    Lonardo, Amedeo; Ballestri, Stefano; Guaraldi, Giovanni; Nascimbeni, Fabio; Romagnoli, Dante; Zona, Stefano; Targher, Giovanni

    2016-01-01

    Fatty liver, which frequently coexists with necro-inflammatory and fibrotic changes, may occur in the setting of nonalcoholic fatty liver disease (NAFLD) and chronic infections due to either hepatitis C virus (HCV) or human immunodeficiency virus (HIV). These three pathologic conditions are associated with an increased prevalence and incidence of cardiovascular disease (CVD) and type 2 diabetes (T2D). In this multidisciplinary clinical review, we aim to discuss the ever-expanding wealth of clinical and epidemiological evidence supporting a key role of fatty liver in the development of T2D and CVD in patients with NAFLD and in those with HCV or HIV infections. For each of these three common diseases, the epidemiological features, pathophysiologic mechanisms and clinical implications of the presence of fatty liver in predicting the risk of incident T2D and CVD are examined in depth. Collectively, the data discussed in this updated review, which follows an innovative comparative approach, further reinforce the conclusion that the presence of fatty/inflamed/fibrotic liver might be a shared important determinant for the development of T2D and CVD in patients with NAFLD, HCV or HIV. This review may also open new avenues in the clinical and research arenas and paves the way for the planning of future, well-designed prospective and intervention studies. PMID:27956792

  12. Elevated parathyroid hormone, but not vitamin D deficiency, is associated with increased risk of heart failure in older men with and without cardiovascular disease.

    PubMed

    Wannamethee, S Goya; Welsh, Paul; Papacosta, Olia; Lennon, Lucy; Whincup, Peter H; Sattar, Naveed

    2014-09-01

    Hyperparathyroidism and low vitamin D status have been implicated in the pathogenesis of heart failure (HF). We examined the prospective associations between parathyroid hormone (PTH), circulating 25-hydroxyvitamin D, and markers of mineral metabolism and risk of incident HF in older men with and without established cardiovascular disease. Prospective study of 3731 men aged 60 to 79 years with no prevalent HF followed up for a mean period of 13 years, in whom there were 287 incident HF cases. Elevated PTH (≥55.6 pg/mL; top quarter) was associated with significantly higher risk of incident HF after adjustment for lifestyle characteristics, diabetes mellitus, blood lipids, blood pressure, lung function, heart rate, renal dysfunction, atrial fibrillation, forced expiratory volume in 1 second, and C-reactive protein (hazards ratio, 1.66; 95% confidence interval, 1.30-2.13). The increased risk was seen in both men with and without previous myocardial infarction or stroke (hazards ratio, 1.72; 95% confidence interval, 1.07-2.76; hazards ratio, 1.70; 95% confidence interval, 1.25-2.30, respectively). Elevated PTH was significantly associated with N-terminal probrain natriuretic peptide, a marker of left ventricular wall stress. By contrast, 25-hydroxyvitamin D and other markers of mineral metabolism including serum calcium and phosphate showed no significant association with incident HF after adjustment for age. Elevated PTH, but not 25-hydroxyvitamin D or other markers of mineral metabolism, is associated with increased risk of HF in both older men with and without myocardial infarction/stroke. This increased risk was not explained by its association with known risk factors for HF. Further studies are now needed to elucidate the mechanisms underlying this association. © 2014 American Heart Association, Inc.

  13. Cardiovascular Deconditioning

    NASA Technical Reports Server (NTRS)

    Charles, John B.; Fritsch-Yelle, Janice M.; Whitson, Peggy A.; Wood, Margie L.; Brown, Troy E.; Fortner, G. William

    1999-01-01

    Spaceflight causes adaptive changes in cardiovascular function that may deleteriously affect crew health and safety. Over the last three decades, symptoms of cardiovascular changes have ranged from postflight orthostatic tachycardia and decreased exercise capacity to serious cardiac rhythm disturbances during extravehicular activities (EVA). The most documented symptom of cardiovascular dysfunction, postflight orthostatic intolerance, has affected a significant percentage of U.S. Space Shuttle astronauts. Problems of cardiovascular dysfunction associated with spaceflight are a concern to NASA. This has been particularly true during Shuttle flights where the primary concern is the crew's physical health, including the pilot's ability to land the Orbiter, and the crew's ability to quickly egress and move to safety should a dangerous condition arise. The study of astronauts during Shuttle activities is inherently more difficult than most human research. Consequently, sample sizes have been small and results have lacked consistency. Before the Extended Duration Orbiter Medical Project (EDOMP), there was a lack of normative data on changes in cardiovascular parameters during and after spaceflight. The EDOMP for the first time allowed studies on a large enough number of subjects to overcome some of these problems. There were three primary goals of the Cardiovascular EDOMP studies. The first was to establish, through descriptive studies, a normative data base of cardiovascular changes attributable to spaceflight. The second goal was to determine mechanisms of cardiovascular changes resulting from spaceflight (particularly orthostatic hypotension and cardiac rhythm disturbances). The third was to evaluate possible countermeasures. The Cardiovascular EDOMP studies involved parallel descriptive, mechanistic, and countermeasure evaluations.

  14. Socioeconomic position in childhood and adult cardiovascular risk factors, vascular structure, and function: cardiovascular risk in young Finns study.

    PubMed

    Kivimäki, M; Smith, G Davey; Juonala, M; Ferrie, J E; Keltikangas-Järvinen, L; Elovainio, M; Pulkki-Råback, L; Vahtera, J; Leino, M; Viikari, J S A; Raitakari, O T

    2006-04-01

    To examine the association of childhood socioeconomic position (SEP) with adult cardiovascular risk factors, vascular structure, and vascular function in a contemporary population of young adults. Population based prospective cohort study with baseline assessment in 1980. Finland. 856 men and 1066 women whose childhood SEP was determined by parental occupational status (manual, lower non-manual, upper non-manual) at age 3-18 years. Cardiovascular risk factors, carotid artery intima-media thickness, and brachial artery flow mediated vasodilatation, assessed at age 24-39 years. After adjustment for age and adult SEP, systolic pressure was 2.3 mm Hg higher (p = 0.0002), high density lipoprotein (HDL) cholesterol 0.03 mmol/l lower (p = 0.02), and insulin resistance score (homeostasis model assessment index) 0.12 units greater (p = 0.05) among men; and systolic pressure was 1.3 mm Hg higher (p = 0.02), diastolic pressure 1.1 mm Hg higher (p = 0.01), and height 1.1 cm lower (p < 0.0001) among women for each step down the childhood SEP hierarchy. Lower childhood SEP was associated with a 20% increase in the odds of having a waist circumference > 102 cm in men and > 88 cm in women (overall p = 0.05). Childhood SEP was not associated with intima-media thickness, flow mediated vasodilatation, the metabolic syndrome, low density lipoprotein cholesterol, triglycerides, body mass index, alcohol consumption, or smoking. Among adults under 40, low childhood SEP predicted higher blood pressure and central obesity and, among men, unfavourable HDL cholesterol and insulin resistance, independent of current SEP. No independent effects were found on adult vascular structure, vascular function, or health related behaviours at this life stage.

  15. Consumption of ready-made meals and increased risk of obesity: findings from the Observation of Cardiovascular Risk Factors in Luxembourg (ORISCAV-LUX) study.

    PubMed

    Alkerwi, Ala'a; Crichton, Georgina E; Hébert, James R

    2015-01-28

    The consumption of ready-made meals, such as pre-packaged dishes, available at grocery stores and fast-food restaurants, is a habit related to our modern fast-paced lives. No study has examined the association of daily ready-made meal consumption with diet quality or health-related outcomes. The present study aimed to investigate the association between self-reported ready-made meal consumption and diet quality, as measured by compliance with dietary recommendations and with a set of adiposity measures, in a nationally representative sample of 1352 subjects, aged 18-69 years, participating in the nationwide population-based ORISCAV-LUX (Observation of Cardiovascular Risk Factors in Luxembourg) survey. The daily consumption of ready-made meals was calculated as follows: frequency of consumption × portion size × number of portions consumed. The sum of the daily consumption values of the eleven pre-packaged dishes included in the FFQ represented the total daily consumption of ready-made meals (g/d) for each participant. About 97% of the participants reported daily consumption of ready-made meals. The intake was highly prevalent in men living alone and varied according to education level. Ready-made meal consumption provided >7% of total daily energy. The fractions (%) of macro- and micronutrients derived from daily consumption of ready-made meals varied from 10% for total cholesterol to 0.65% for total fibre. Increased consumption of ready-made meals was found to be independently associated with abdominal obesity. On controlling for age, sex, socio-economic status and lifestyle factors, daily consumption of ready-made meals was found to be associated with higher energy intake and with poor compliance with national nutritional recommendations, and hence it could plausibly increase the risk of central obesity and fat deposition.

  16. Insufficient and excessive amounts of sleep increase the risk of premature death from cardiovascular and other diseases: the Multiethnic Cohort Study

    PubMed Central

    Kim, Yeonju; Wilkens, Lynne R.; Schembre, Susan M.; Henderson, Brian E.; Kolonel, Laurence N.; Goodman, Marc T.

    2014-01-01

    Objective To explore an independent association between self-reported sleep duration and cause-specific mortality. Methods Data were obtained from the Multiethnic Cohort Study conducted in Los Angeles and Hawaii. Results Among 61,936 men and 73,749 women with no history of cancer, heart attack or stroke, 19,335 deaths occurred during an average 12.9 year follow-up. Shorter (≤5 h/day) and longer (≥9 h/day) sleepers of both sexes (vs. 7 h/day) had an increased risk of all-cause and cardiovascular disease (CVD) mortality, but not of cancer mortality. Multivariable hazard ratios for CVD mortality were 1.13 (95% CI 1.00-1.28) for ≤5 h/day and 1.22 (95% CI 1.09-1.35) for ≥9 h/day among men; and 1.20 (95% CI 1.05-1.36) for ≤5 h/day and 1.29 (95% CI 1.13-1.47) for ≥9 h/day among women. This risk pattern was not heterogeneous across specific causes of CVD death among men (Phetero 0.53) or among women (Phetero 0.72). The U-shape association for all-cause and CVD mortality was observed in all five ethnic groups included in the study and by subgroups of age, smoking status, and body mass index. Conclusion Insufficient or excessive amounts of sleep were associated with increased risk of mortality from CVD and other diseases in a multiethnic population. PMID:23811525

  17. The non-alcoholic fraction of beer increases stromal cell derived factor 1 and the number of circulating endothelial progenitor cells in high cardiovascular risk subjects: a randomized clinical trial.

    PubMed

    Chiva-Blanch, Gemma; Condines, Ximena; Magraner, Emma; Roth, Irene; Valderas-Martínez, Palmira; Arranz, Sara; Casas, Rosa; Martínez-Huélamo, Miriam; Vallverdú-Queralt, Anna; Quifer-Rada, Paola; Lamuela-Raventos, Rosa M; Estruch, Ramon

    2014-04-01

    Moderate alcohol consumption is associated with a decrease in cardiovascular risk, but fermented beverages seem to confer greater cardiovascular protection due to their polyphenolic content. Circulating endothelial progenitor cells (EPC) are bone-marrow-derived stem cells with the ability to repair and maintain endothelial integrity and function and are considered as a surrogate marker of vascular function and cumulative cardiovascular risk. Nevertheless, no study has been carried out on the effects of moderate beer consumption on the number of circulating EPC in high cardiovascular risk patients. To compare the effects of moderate consumption of beer, non-alcoholic beer and gin on the number of circulating EPC and EPC-mobilizing factors. In this crossover trial, 33 men at high cardiovascular risk were randomized to receive beer (30 g alcohol/d), the equivalent amount of polyphenols in the form of non-alcoholic beer, or gin (30 g alcohol/d) for 4 weeks. Diet and physical exercise were carefully monitored. The number of circulating EPC and EPC-mobilizing factors were determined at baseline and after each intervention. After the beer and non-alcoholic beer interventions, the number of circulating EPC significantly increased by 8 and 5 units, respectively, while no significant differences were observed after the gin period. In correlation, stromal cell derived factor 1 increased significantly after the non-alcoholic and the beer interventions. The non-alcoholic fraction of beer increases the number of circulating EPC in peripheral blood from high cardiovascular risk subjects. http://www.controlled-trials.com/ISRCTN95345245 ISRCTN95345245. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. Introduction: Cardiovascular physics

    NASA Astrophysics Data System (ADS)

    Wessel, Niels; Kurths, Jürgen; Ditto, William; Bauernschmitt, Robert

    2007-03-01

    The number of patients suffering from cardiovascular diseases increases unproportionally high with the increase of the human population and aging, leading to very high expenses in the public health system. Therefore, the challenge of cardiovascular physics is to develop high-sophisticated methods which are able to, on the one hand, supplement and replace expensive medical devices and, on the other hand, improve the medical diagnostics with decreasing the patient's risk. Cardiovascular physics-which interconnects medicine, physics, biology, engineering, and mathematics-is based on interdisciplinary collaboration of specialists from the above scientific fields and attempts to gain deeper insights into pathophysiology and treatment options. This paper summarizes advances in cardiovascular physics with emphasis on a workshop held in Bad Honnef, Germany, in May 2005. The meeting attracted an interdisciplinary audience and led to a number of papers covering the main research fields of cardiovascular physics, including data analysis, modeling, and medical application. The variety of problems addressed by this issue underlines the complexity of the cardiovascular system. It could be demonstrated in this Focus Issue, that data analyses and modeling methods from cardiovascular physics have the ability to lead to significant improvements in different medical fields. Consequently, this Focus Issue of Chaos is a status report that may invite all interested readers to join the community and find competent discussion and cooperation partners.

  19. Slow breathing and cardiovascular disease

    PubMed Central

    Chaddha, Ashish

    2015-01-01

    Cardiovascular disease is the leading cause of death for both men and women worldwide. Much emphasis has been placed on the primary and secondary prevention of cardiovascular disease. While depression and anxiety increase the risk of developing cardiovascular disease, cardiovascular disease also increases the risk of developing anxiety and depression. Thus, promoting optimal mental health may be important for both primary and secondary prevention of cardiovascular disease. Like lowering blood pressure, lipids, and body weight, lowering anger and hostility and improving depression and anxiety may also be an important intervention in preventive cardiology. As we strive to further improve cardiovascular outcomes, the next bridge to cross may be one of offering patients nonpharmacologic means for combating daily mental stress and promoting mental health, such as yoga and pranayama. Indeed, the best preventive cardiovascular medicine may be a blend of both Western and Eastern medicine. PMID:26170595

  20. Slow breathing and cardiovascular disease.

    PubMed

    Chaddha, Ashish

    2015-01-01

    Cardiovascular disease is the leading cause of death for both men and women worldwide. Much emphasis has been placed on the primary and secondary prevention of cardiovascular disease. While depression and anxiety increase the risk of developing cardiovascular disease, cardiovascular disease also increases the risk of developing anxiety and depression. Thus, promoting optimal mental health may be important for both primary and secondary prevention of cardiovascular disease. Like lowering blood pressure, lipids, and body weight, lowering anger and hostility and improving depression and anxiety may also be an important intervention in preventive cardiology. As we strive to further improve cardiovascular outcomes, the next bridge to cross may be one of offering patients nonpharmacologic means for combating daily mental stress and promoting mental health, such as yoga and pranayama. Indeed, the best preventive cardiovascular medicine may be a blend of both Western and Eastern medicine.

  1. Cardiovascular risk factors in overweight German children and adolescents: relation to gender, age and degree of overweight.

    PubMed

    Reinehr, Thomas; Andler, Werner; Denzer, Christian; Siegried, Wolfgang; Mayer, H; Wabitsch, Martin

    2005-06-01

    So far in Europe, no large studies have been published on the frequencies of the cardiovascular risk factors hypertension and dyslipidaemia in overweight children. Diagnosis of hypertension, decreased HDL-cholesterol, increased triglycerides, total and LDL-cholesterol were documented for 1004 overweight children and adolescents (aged 4-8 years, 52% girls, BMI-SDS in median 2.43) referred to four obesity centres. Hypertension and dyslipidaemia were defined by cut off points above the 95th percentile of healthy children. Multivariate linear regression was conducted for the dependent variables systolic and diastolic blood pressure, triglycerides, HDL-, LDL-, and total cholesterol, including gender, degree of overweight (SDS-BMI) and age as independent variables. Thirty-seven percent of the children studied suffered from hypertension, 27% displayed increased total cholesterol, 26% increased LDL-cholesterol, 20% increased triglycerides and 18% decreased HDL-cholesterol. Seventy percent of all children had at least one unfavourable cardiovascular risk factor. Hypertension and dyslipidaemia were observed in any age group and in any degree of overweight at least twofold above the suspected rate of 5%. SDS-BMI was significantly related to blood pressure (systolic: coefficient 7.26, p < 0.001, diastolic: coefficient 3.21, p < 0.001), weakly to triglycerides (coefficient 0.12, p = 0.007), slightly negatively to HDL-cholesterol (coefficient -0.06, p = 0.001) and not related to total and LDL-cholesterol. Age was positively related to blood pressure (systolic: coefficient 2.436, p < 0.001, diastolic: coefficient 0.54, p < 0.001) and negatively to HDL cholesterol (coefficient -0.02, p < 0.001). Cardiovascular risk factors were frequently present in a large collective of overweight European children and adolescents. They occurred mostly independently of age, gender and degree of overweight. Therefore, screening for cardiovascular risk factors seems meaningful at any age and degree

  2. Gonadal and adrenal androgen deficiencies as independent predictors of increased cardiovascular mortality in men with type II diabetes mellitus and stable coronary artery disease.

    PubMed

    Ponikowska, Beata; Jankowska, Ewa A; Maj, Jolanta; Wegrzynowska-Teodorczyk, Kinga; Biel, Bartosz; Reczuch, Krzysztof; Borodulin-Nadzieja, Ludmila; Banasiak, Waldemar; Ponikowski, Piotr

    2010-09-03

    Age-related decline in circulating androgens in men is associated with poor cardiovascular (CV) outcome. Men with type II diabetes mellitus (DM) are prone to develop androgen deficiency. We studied the prevalence and prognostic consequences of deficiencies in circulating total and free testosterone (TT, FT) and dehydroepiandrosterone sulphate (DHEAS) in type II DM men with coronary artery disease (CAD). We examined 153 diabetic men with stable CAD (age: 65±9 years). Serum levels of FT were estimated (eFT) from TT and sex hormone binding globulin levels. TT, eFT and DHEAS deficiencies (serum levels≤the 10th percentile of healthy peers) were found in 22%, 33% and 77% of DM men with CAD, being more frequent than in healthy peers (all p<0.001). During follow-up (median: 19 months), there were 43 (28%) CV deaths. We identified 4 independent predictors of CV mortality: testosterone (TT, eFT) and DHEAS deficiencies, high plasma N-terminal pro-B-type natriuretic peptide (≥2661 pg/mL, upper quartile), high serum high sensitivity C-reactive protein (≥6.58 mg/L, upper quartile) (all p<0.01). There was a graded relation between the number of risk factors and increased CV mortality: hazard risk (95% confidence interval) for 1, 2, 3-4 vs. no risk factors, respectively: 5.9 (0.8-45.6), p=0.09, 9.2 (1.2-69.2), 63.0 (8.0-498.7), p<0.0001 (χ(2)=42.23, p<0.0001). In diabetic men with stable CAD, testosterone and DHEAS deficiencies are common and related to high CV mortality. Whether an androgen substitution would improve prognosis in androgen deficient men with type II diabetes and stable CAD, requires further studies. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

  3. Sexual dysfunction is frequent in premenopausal women with diabetes, obesity, and hypothyroidism, and correlates with markers of increased cardiovascular risk. A preliminary report.

    PubMed

    Veronelli, Annamaria; Mauri, Chiara; Zecchini, Barbara; Peca, Maria Grazia; Turri, Olivia; Valitutti, Maria Teresa; dall'Asta, Chiara; Pontiroli, Antonio E

    2009-06-01

    Female sexual dysfunction (FSD) is characterized by reduced sexual appetite and altered psychologic and physiologic response to sexual intercourse; it is reported to be frequent in diabetes mellitus, but no data have been reported in thyroid disorders. To compare the prevalence of FSD in diabetic, in obese, and in hypothyroid women vs. healthy women, and to correlate FSD with endocrine and metabolic profiles. We evaluated, through a questionnaire (Female Sexual Function Index [FSFI]), the prevalence of FSD in 91 women affected by diabetes mellitus, obesity, or hypothyroidism, and in 36 healthy women, all aged 22-51 years and in premenopausal state. FSFI score, endocrine and metabolic parameters (triglycerides, high-density lipoprotein [HDL] and low-density lipoprotein [LDL] cholesterol, free-triiodothyronine (FT3), free-thyroxine (FT4), thyroid stimulating hormone [TSH], 17-beta-estradiol, testosterone, glycated hemoglobin 1c (HbA1c), thyroid autoantibodies, E-selectin, P-selectin, intercellular adhesion molecule-1 [ICAM-1], plasminogen-activator inhibitor-1 [PAI-1]), and anthropometric parameters (body mass index, waist, blood pressure [BP]). A reduced FSFI score was more frequent in diabetic, obese, and hypothyroid women vs. healthy women (P < 0.01). In the different groups of women, FSFI score was inversely correlated (pairwise correlation) with at least one of the following: HbA1c, TSH, LDL-cholesterol, PAI-1, diastolic BP, presence of thyroid Ab, and directly correlated with HDL-cholesterol (always P < 0.05 or less). At stepwise regression analysis, HDL-cholesterol (protective) and HbA1c, LDL-cholesterol, PAI-1, and diastolic BP (negatively) predicted reduced FSFI score. These data indicate an increased prevalence of sexual dysfunction in diabetic, in obese, and in hypothyroid women, associated with markers of cardiovascular risk.

  4. The Leu7Pro polymorphism of preproNPY is associated with decreased insulin secretion, delayed ghrelin suppression, and increased cardiovascular responsiveness to norepinephrine during oral glucose tolerance test.

    PubMed

    Jaakkola, Ulriikka; Kuusela, Tom; Jartti, Tuomas; Pesonen, Ullamari; Koulu, Markku; Vahlberg, Tero; Kallio, Jaana

    2005-06-01

    Neuropeptide Y (NPY) plays a role in angiogenesis, cardiovascular regulation, and hormone secretion. The leucine7 to proline7 (Leu7Pro) polymorphism of preproNPY is associated with vascular diseases and has an impact on hormone levels in healthy subjects. The current study investigated the role of the Leu7Pro polymorphism in metabolic and cardiovascular autonomic regulation. A 5-h oral glucose tolerance test was performed on 27 healthy volunteers representing two preproNPY genotypes (Leu7/Pro7 and Leu7/Leu7) matched for age, sex, body mass index and physical activity. Simultaneously we performed cardiovascular autonomic function tests and plasma measurements of sympathetic transmitters, glucose, insulin, and ghrelin. The subjects with Leu7/Pro7 genotype had decreased plasma NPY, norepinephrine (NE), and insulin concentrations and insulin to glucose ratios. The suppression of ghrelin concentrations after glucose ingestion was delayed in these subjects. They also had increased heart rate variability indices and baroreflex sensitivity. However, they displayed significant negative association of NE concentration with variability of low-frequency R-R-intervals and with baroreflex sensitivity. The Leu7Pro polymorphism of preproNPY is related to decreased level of basal sympathetic activity, decreased insulin secretion, and delayed ghrelin suppression during oral glucose tolerance test. The increased responsiveness of autonomic functions to NE associated with the polymorphism may be connected to increased cardiovascular vulnerability.

  5. Increased cardiovascular disease, resource use, and costs before the clinical diagnosis of diabetes in veterans in the southeastern U.S.

    PubMed

    Olson, Darin E; Zhu, Ming; Long, Qi; Barb, Diana; Haw, Jeehea S; Rhee, Mary K; Mohan, Arun V; Watson-Williams, Phyllis I; Jackson, Sandra L; Tomolo, Anne M; Wilson, Peter W F; Narayan, K M Venkat; Lipscomb, Joseph; Phillips, Lawrence S

    2015-06-01

    Screening for diabetes might be more widespread if adverse associations with cardiovascular disease (CVD), resource use, and costs were known to occur earlier than conventional clinical diagnosis. The purpose of this study was to determine whether adverse effects associated with diabetes begin prior to clinical diagnosis. Veterans with diabetes were matched 1:2 with controls by follow-up, age, race/ethnicity, gender, and VA facility. CVD was obtained from ICD-9 codes, and resource use and costs from VA datasets. VA facilities in SC, GA, and AL. Patients with and without diagnosed diabetes. Diagnosed CVD, resource use, and costs. In this study, the 2,062 diabetic patients and 4,124 controls were 63 years old on average, 99 % male, and 29 % black; BMI was 30.8 in diabetic patients vs. 27.8 in controls (p<0.001). CVD prevalence was higher and there were more outpatient visits in Year -4 before diagnosis through Year +4 after diagnosis among diabetic vs. control patients (all p<0.01); in Year -2, CVD prevalence was 31 % vs. 24 %, and outpatient visits were 22 vs. 19 per year, respectively. Total VA costs/year/veteran were higher in diabetic than control patients from Year -4 ($4,083 vs. $2,754) through Year +5 ($8,347 vs. $5,700) (p<0.003) for each, reflecting underlying increases in outpatient, inpatient, and pharmacy costs (p<0.05 for each). Regression analysis showed that diabetes contributed an average of $1,748/year to costs, independent of CVD (p<0.001). VA costs per veteran are higher--over $1,000/year before and $2,000/year after diagnosis of diabetes--due to underlying increases in outpatient, inpatient, and pharmacy costs, greater number of outpatient visits, and increased CVD. Moreover, adverse associations with veterans' health and the VA healthcare system occur early in the natural history of the disease, several years before diabetes is diagnosed. Since adverse associations begin before diabetes is recognized, greater consideration should be given to

  6. Caffeine and cardiovascular health.

    PubMed

    Turnbull, Duncan; Rodricks, Joseph V; Mariano, Gregory F; Chowdhury, Farah

    2017-10-01

    This report evaluates the scientific literature on caffeine with respect to potential cardiovascular outcomes, specifically relative risks of total cardiovascular disease (CVD), coronary heart disease (CHD) and acute myocardial infarction (AMI), effects on arrhythmia, heart failure, sudden cardiac arrest, stroke, blood pressure, hypertension, and other biomarkers of effect, including heart rate, cerebral blood flow, cardiac output, plasma homocysteine levels, serum cholesterol levels, electrocardiogram (EKG) parameters, heart rate variability, endothelial/platelet function and plasma/urine catecholamine levels. Caffeine intake has been associated with a range of reversible and transient physiological effects broadly and cardiovascular effects specifically. This report attempts to understand where the delineations exist in caffeine intake and corresponding cardiovascular effects among various subpopulations. The available literature suggests that cardiovascular effects experienced by caffeine consumers at levels up to 600 mg/day are in most cases mild, transient, and reversible, with no lasting adverse effect. The point at which caffeine intake may cause harm to the cardiovascular system is not readily identifiable in part because data on the effects of daily intakes greater than 600 mg is limited. However, the evidence considered within this review suggests that typical moderate caffeine intake is not associated with increased risks of total cardiovascular disease; arrhythmia; heart failure; blood pressure changes among regular coffee drinkers; or hypertension in baseline populations. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  7. Different outcomes among favourable and unfavourable intermediate-risk prostate cancer patients treated with hypofractionated radiotherapy and androgen deprivation therapy.

    PubMed

    Bracci, Stefano; Osti, Mattia F; Agolli, Linda; Bertaccini, Luca; De Sanctis, Vitaliana; Valeriani, Maurizio

    2016-06-08

    to evaluate the role of a risk stratification system in intermediate-risk prostate cancer (PCa) treated with hypofractionated radiotherapy (HyRT). 131 patients affected by intermediate-risk PCa were treated with HyRT at the total dose of 54,75 Gy in 15 fraction plus 9 months of androgen deprivation therapy (ADT). Patients were classified as favourable risk (FIR) if they had a single NCCN intermediate-risk factor (IRF), a Gleason score ≤3 + 4 = 7, and <50 % of biopsy cores containing cancer (PBCC). If these criteria were not met were classified as unfavourable risk (UIR). Univariate and multivariate analyses using Cox proportional hazards model were calculated for biochemical recurrence-free survival (bRFS), the risk of local recurrence and metastasis-free survival (MFS). After a median follow-up of 56.7 months (range 9.8 to 93.7 months), 11 patients (8.4 %) died, of whom 2 (1.5 %) for PCa. In the univariate analysis, Gleason score, PPBCs, IRFs and PSA at first follow-up were prognostic factors for bRFS and LF while Gleason score, PPBCs and PSA at first follow-up were significant predictor for MFS. In the multivariate analysis only the PSA at first follow-up resulted a prognostic factor for bRFS and MFS. Patients with a value of PSA at first follow-up <0.7 ng/mL respect to those with PSA ≥0,7 ng/mL had a 5y-bRFS of 93.3 % vs. 57.5 %, 5y-MFS of 99.0 % vs. 78.9 % and 5y-LF of 5.8 % vs. 38.3 %. Patients in the UIR PCa group with a PSA value <0.7 ng/mL at first follow-up had significant better bRFS, LF and MFS. Risk factors currently not included in the guidelines are useful to stratify patients with intermediate-risk PCa in two groups of different prognosis even when HyRT is delivered. PSA at first follow-up is useful in UIR PCa to guide the overall length of ADT.

  8. Increased levels of anti-heat-shock protein 60 (anti-Hsp60) indicate endothelial dysfunction, atherosclerosis and cardiovascular diseases in patients with mixed connective tissue disease.

    PubMed

    Bodolay, Edit; Prohászka, Zoltan; Paragh, Gyorgy; Csipő, Istvan; Nagy, Gabor; Laczik, Renata; Demeter, Nora; Zöld, Eva; Nakken, Britt; Szegedi, Gyula; Szodoray, Peter

    2014-10-01

    Heat-shock protein 60 (Hsp60) has been shown to provoke inflammation, and anti-Hsp60 may facilitate the development of atherosclerosis. In this study, we have investigated 30 patients with mixed connective tissue disease (MCTD) and assessed anti-Hsp60 and their relationship to cardiovascular diseases (CVD). Out of 30 patients with MCTD, 15 had CVDs. Anti-Hsp60 antibody was determined by enzyme-linked immunosorbent assay. Since endothelial dysfunction and accelerated atherosclerosis are characteristic to MCTD, a wide array of MCTD-, endothelial dysfunction- and CVD-associated parameters was investigated: serum lipid levels, paraoxonase activity (PON1), rich nuclear ribonucleoprotein U1 (anti-U1RNP), anti-endothelial cell antibodies, anti-cardiolipin and anti-β2-glycoprotein I antibody isotypes (anti-CL and anti-β2GPI), endothelin-1 (ET-1) levels, also intima-media thickness (IMT), a quantitative indicator of atherosclerosis. In MCTD, anti-Hsp60 antibody levels were significantly higher than in healthy individuals (p < 0.02). MCTD patients with CVD had significantly higher levels of anti-Hsp60 compared to MCTD without CVD (p = 0.001). Patients with MCTD had significantly lower high-density lipoprotein cholesterol (p = 0.02) and PON activity (p < 0.001), and significantly increased systolic (p < 0.0002) and diastolic (p < 0.001) blood pressure compared to healthy individuals. Anti-U1RNP levels (p < 0.002) and IMT were higher in patients compared to controls (p = 0.002). The CVD-positive MCTD patients had increased anti-Hsp60 (p < 0.0013), anti-CL IgG (p = 0.0005), ET-1 serum concentration (p < 0.05) and IMT levels (p < 0.001) compared to MCTD patients without CVD. Anti-Hsp60 showed a strong correlation with anti-oxLDL (r = 0.36, p = 0.01) and serum ET-1 (r = 0.62, p < 0.001) and negative correlation with PON activity (r = -0.47, p = 0.01). Anti-Hsp60 indicates endothelial injury, CVD, and can function as a novel atherosclerotic

  9. Large Doses of Vitamin D Fail to Increase 25-Hydroxyvitamin D Levels or to Alter Cardiovascular Risk Factors in Obese Adolescents: A Pilot Study.

    PubMed

    Shah, Sejal; Wilson, Darrell M; Bachrach, Laura K

    2015-07-01

    Vitamin D deficiency and cardiometabolic risk factors are common in obese adolescents. Observational studies demonstrate an inverse relationship among serum 25-hydroxyvitamin D (25OHD) and obesity, insulin resistance, and inflammatory cytokines. This pilot study explores if vitamin D supplementation could reduce serum concentrations of inflammatory cytokines (interleukin [IL] 6, IL-10, tumor necrosis factor α), adiponectin, lipids, hemoglobin A1C, and high-sensitivity C-reactive protein (hs-CRP). A secondary aim was to determine the associations between baseline serum 25OHD concentrations and body mass index (BMI), hs-CRP, inflammatory cytokines, and lipids. Overweight and obese adolescents enrolled in this 24-week, randomized, double-blind study were given 150,000 IU ergocalciferol or placebo at baseline and 12 weeks. Outcome measurements included serum 25OHD, inflammatory cytokines, adiponectin, hs-CRP, lipids, hemoglobin A1C, and BMI at baseline, 12, and 24 weeks. Of 40 participants, 31 (78%) completed the study. Mean ± standard error 25OHD levels were similar in vitamin D and placebo groups at baseline (19.6 ± 5.3 vs. 25.8 ± 10.8 ng/mL) and 24 weeks (20.1 ± 3.4 vs. 24.6 ± 8.4 ng/mL). Inflammatory and cardiovascular markers were not significantly different between groups at 24 weeks. Serum 25OHD at baseline was associated with BMI (r = -.44 [95% confidence interval, -.66 to -.15]) but not with other outcome measures. Supplementation with vitamin D at 150,000 IU every 3 months failed to increase serum 25OHD or alter inflammatory markers and lipids in overweight and obese youth. Further studies are needed to establish the dose of vitamin D required to increase 25OHD and determine potential effects on metabolic risk factors in obese teens. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  10. Effect of increased consumption of whole-grain foods on blood pressure and other cardiovascular risk markers in healthy middle-aged persons: a randomized controlled trial.

    PubMed

    Tighe, Paula; Duthie, Garry; Vaughan, Nicholas; Brittenden, Julie; Simpson, William G; Duthie, Susan; Mutch, William; Wahle, Klaus; Horgan, Graham; Thies, Frank

    2010-10-01

    Three daily portions of whole-grain foods could lower cardiovascular disease risk, but a comprehensive intervention trial was needed to confirm this recommendation. We aimed to assess the effects of consumption of 3 daily portions of whole-grain foods (provided as only wheat or a mixture of wheat and oats) on markers of cardiovascular disease risk in relatively high-risk individuals. This was a randomized controlled dietary trial in middle-aged healthy individuals. After a 4-wk run-in period with a refined diet, we randomly allocated volunteers to a control (refined diet), wheat, or wheat + oats group for 12 wk. The primary outcome was a reduction of cardiovascular disease risk factors by dietary intervention with whole grains, which included lipid and inflammatory marker concentrations, insulin sensitivity, and blood pressure. We recruited a total of 233 volunteers; 24 volunteers withdrew, and 3 volunteers were excluded. Systolic blood pressure and pulse pressure were significantly reduced by 6 and 3 mm Hg, respectively, in the whole-grain foods groups compared with the control group. Systemic markers of cardiovascular disease risk remained unchanged apart from cholesterol concentrations, which decreased slightly but significantly in the refined group. Daily consumption of 3 portions of whole-grain foods can significantly reduce cardiovascular disease risk in middle-aged people mainly through blood pressure-lowering mechanisms. The observed decrease in systolic blood pressure could decrease the incidence of coronary artery disease and stroke by ≥15% and 25%, respectively. This trial was registered at clinicaltrials.gov as ISRCTN27657880.

  11. Triglycerides and cardiovascular disease.

    PubMed

    Nordestgaard, Børge G; Varbo, Anette

    2014-08-16

    After the introduction of statins, clinical emphasis first focussed on LDL cholesterol-lowering, then on the potential for raising HDL cholesterol, with less focus on lowering triglycerides. However, the understanding from genetic studies and negative results from randomised trials that low HDL cholesterol might not cause cardiovascular disease as originally thought has now generated renewed interest in raised concentrations of triglycerides. This renewed interest has also been driven by epidemiological and genetic evidence supporting raised triglycerides, remnant cholesterol, or triglyceride-rich lipoproteins as an additional cause of cardiovascular disease and all-cause mortality. Triglycerides can be measured in the non-fasting or fasting states, with concentrations of 2-10 mmol/L conferring increased risk of cardiovascular disease, and concentrations greater than 10 mmol/L conferring increased risk of acute pancreatitis and possibly cardiovascular disease. Although randomised trials showing cardiovascular benefit of triglyceride reduction are scarce, new triglyceride-lowering drugs are being developed, and large-scale trials have been initiated that will hopefully provide conclusive evidence as to whether lowering triglycerides reduces the risk of cardiovascular disease. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Cardiovascular disease risk in women with migraine.

    PubMed

    Rockett, Fernanda Camboim; Perla, Alexandre da Silveira; Perry, Ingrid D Schweigert; Chaves, Márcia L Fagundes

    2013-09-06

    Studies suggest a higher prevalence of unfavourable cardiovascular risk factors amongst migraineurs, but results have been conflicting. The aim of this study was to investigate traditional and newly recognized risk factors as well as other surrogate markers of cardiovascular risk in obese and normal weight women with migraine. Fifty-nine adult female probands participated in this case-control study. The sample was divided into normal weight and obese migraineurs and age- and body mass index-matched control groups. The following cardiovascular risk factors were analyzed: serum levels of lipids, fasting glucose, and insulin; insulin resistance; blood pressure; smoking (categorized as current, past or never); Framingham 10-year risk of general cardiovascular disease score; C-reactive protein; family history of cardiovascular disease; physical activity; sleep disturbances; depression; and bioelectrical impedance phase angle. The means of continuous variables were compared using Student's t-test for independent samples or the Mann-Whitney U-test (for 2 groups) and ANOVA or the Kruskal-Wallis test (for 4 groups) depending on the distribution of data. All migraineurs were sedentary irrespective of nutritional status. Migraineurs had higher depression scores and shorter sleep duration, and obese migraineurs, in particular, had worse sleep quality scores. Insulin resistance and insulinaemia were associated with obesity, and obese migraineurs had lower HDL-c than normal weight controls and migraineurs. Also, the Framingham risk score was higher in obese migraineurs. These findings suggest that female migraineurs experience marked inactivity, depression, and some sleep disturbance, that higher insulin resistance and insulinaemia are related to obesity, and that obesity and migraine probably exert overlapping effects on HDL-c levels and Framingham 10-year cardiovascular risk.

  13. Cardiovascular disease risk in women with migraine

    PubMed Central

    2013-01-01

    Background Studies suggest a higher prevalence of unfavourable cardiovascular risk factors amongst migraineurs, but results have been conflicting. The aim of this study was to investigate traditional and newly recognized risk factors as well as other surrogate markers of cardiovascular risk in obese and normal weight women with migraine. Methods Fifty-nine adult female probands participated in this case–control study. The sample was divided into normal weight and obese migraineurs and age- and body mass index-matched control groups. The following cardiovascular risk factors were analyzed: serum levels of lipids, fasting glucose, and insulin; insulin resistance; blood pressure; smoking (categorized as current, past or never); Framingham 10-year risk of general cardiovascular disease score; C-reactive protein; family history of cardiovascular disease; physical activity; sleep disturbances; depression; and bioelectrical impedance phase angle. The means of continuous variables were compared using Student’s t-test for independent samples or the Mann–Whitney U-test (for 2 groups) and ANOVA or the Kruskal-Wallis test (for 4 groups) depending on the distribution of data. Results All migraineurs were sedentary irrespective of nutritional status. Migraineurs had higher depression scores and shorter sleep duration, and obese migraineurs, in particular, had worse sleep quality scores. Insulin resistance and insulinaemia were associated with obesity, and obese migraineurs had lower HDL-c than normal weight controls and migraineurs. Also, the Framingham risk score was higher in obese migraineurs. Conclusion These findings suggest that female migraineurs experience marked inactivity, depression, and some sleep disturbance, that higher insulin resistance and insulinaemia are related to obesity, and that obesity and migraine probably exert overlapping effects on HDL-c levels and Framingham 10-year cardiovascular risk. PMID:24011175

  14. The Canadian HIV and aging cohort study - determinants of increased risk of cardio-vascular diseases in HIV-infected individuals: rationale and study protocol.

    PubMed

    Durand, Madeleine; Chartrand-Lefebvre, Carl; Baril, Jean-Guy; Trottier, Sylvie; Trottier, Benoit; Harris, Marianne; Walmsley, Sharon; Conway, Brian; Wong, Alexander; Routy, Jean-Pierre; Kovacs, Colin; MacPherson, Paul A; Monteith, Kenneth Marc; Mansour, Samer; Thanassoulis, George; Abrahamowicz, Michal; Zhu, Zhitong; Tsoukas, Christos; Ancuta, Petronela; Bernard, Nicole; Tremblay, Cécile L

    2017-09-11

    With potent antiretroviral drugs, HIV infection is becoming a chronic disease. Emergence of comorbidities, particularly cardiovascular disease (CVD) has become a leading concern for patients living with the infection. We hypothesized that the chronic and persistent inflammation and immune activation associated with HIV disease leads to accelerated aging, characterized by CVD. This will translate into higher incidence rates of CVD in HIV infected participants, when compared to HIV negative participants, after adjustment for traditional CVD risk factors. When characterized further using cardiovascular imaging, biomarkers, immunological and genetic profiles, CVD associated with HIV will show different characteristics compared to CVD in HIV-negative individuals. The Canadian HIV and Aging cohort is a prospective, controlled cohort study funded by the Canadian Institutes of Health Research. It will recruit patients living with HIV who are aged 40 years or older or have lived with HIV for 15 years or more. A control population, frequency matched for age, sex, and smoking status, will be recruited from the general population. Patients will attend study visits at baseline, year 1, 2, 5 and 8. At each study visit, data on complete medical and pharmaceutical history will be captured, along with anthropometric measures, a complete physical examination, routine blood tests and electrocardiogram. Consenting participants will also contribute blood samples to a research biobank. The primary outcome is incidence of a composite of: myocardial infarction, coronary revascularization, stroke, hospitalization for angina or congestive heart failure, revascularization or amputation for peripheral artery disease, or cardiovascular death. Preplanned secondary outcomes are all-cause mortality, incidence of the metabolic syndrome, incidence of type 2 diabetes, incidence of renal failure, incidence of abnormal bone mineral density and body fat distribution. Patients participating to the

  15. Cardiovascular pharmacogenetics.

    PubMed

    Myburgh, Renier; Hochfeld, Warren E; Dodgen, Tyren M; Ker, James; Pepper, Michael S

    2012-03-01

    Human genetic variation in the form of single nucleotide polymorphisms as well as more complex structural variations such as insertions, deletions and copy number variants, is partially responsible for the clinical variation seen in response to pharmacotherapeutic drugs. This affects the likelihood of experiencing adverse drug reactions and also of achieving therapeutic success. In this paper, we review key studies in cardiovascular pharmacogenetics that reveal genetic variations underlying the outcomes of drug treatment in cardiovascular disease. Examples of genetic associations with drug efficacy and toxicity are described, including the roles of genetic variability in pharmacokinetics (e.g. drug metabolizing enzymes) and pharmacodynamics (e.g. drug targets). These findings have functional implications that could lead to the development of genetic tests aimed at minimizing drug toxicity and optimizing drug efficacy in cardiovascular medicine.

  16. Assessment of the Possible Association of Air Pollutants PM10, O3, NO2 With an Increase in Cardiovascular, Respiratory, and Diabetes Mortality in Panama City: A 2003 to 2013 Data Analysis.

    PubMed

    Zúñiga, Julio; Tarajia, Musharaf; Herrera, Víctor; Urriola, Wilfredo; Gómez, Beatriz; Motta, Jorge

    2016-01-01

    In recent years, Panama has experienced a marked economic growth, and this, in turn, has been associated with rapid urban development and degradation of air quality. This study is the first evaluation done in Panama on the association between air pollution and mortality. Our objective was to assess the possible association between monthly levels of PM10, O3, and NO2, and cardiovascular, respiratory, and diabetes mortality, as well as the seasonal variation of mortality in Panama City, Panama.The study was conducted in Panama City, using air pollution data from January 2003 to December 2013. We utilized a Poisson regression model based on generalized linear models, to evaluate the association between PM10, NO2, and O3 exposure and mortality from diabetes, cardiovascular, and respiratory diseases. The sample size for PM10, NO2, and O2 was 132, 132, and 108 monthly averages, respectively.We found that levels of PM10, O3, and NO2 were associated with increases in cardiovascular, respiratory, and diabetes mortality. For PM10 levels ≥ 40 μg/m3, we found an increase in cardiovascular mortality of 9.7% (CI 5.8-13.6%), and an increase of 12.6% (CI 0.2-24.2%) in respiratory mortality. For O3 levels ≥ 20 μg/m3 we found an increase of 32.4% (IC 14.6-52.9) in respiratory mortality, after a 2-month lag period following exposure in the 65 to <74 year-old age group. For NO2 levels ≥20 μg/m3 we found an increase in respiratory mortality of 11.2% (IC 1.9-21.3), after a 2-month lag period following exposure among those aged between 65 and <74 years.There could be an association between the air pollution in Panama City and an increase in cardiovascular, respiratory, and diabetes mortality. This study confirms the urgent need to improve the measurement frequency of air pollutants in Panama.

  17. Gender, ethnicity, and cardiovascular disease.

    PubMed

    Allen, Jerilyn; Szanton, Sarah

    2005-01-01

    Although the influence of gender and ethnicity on cardiovascular disease has been understudied, cardiovascular nurse researchers have contributed significantly to the existing body of knowledge. This article distinguishes between the constructs of "gender versus sex'' and "ethnicity versus race,'' acknowledging that the terms are often used interchangeably in research. A sampling of the substantial contributions of cardiovascular nurse researchers related to gender and ethnicity in the areas of symptoms of cardiovascular disease; risk factors and prevention; delay in seeking care, diagnosis, and treatment; recovery and outcomes; and cardiac rehabilitation is highlighted. Recommendations for future research include publishing research data by gender and ethnicity subgroups even though statistical comparisons may not be feasible, and increasing cardiovascular disease research in minority populations such as Asian Americans, Pacific Islanders, Native Americans, and Hispanics. Finally, we challenge cardiovascular nurse researchers to shift from the documentation of disparities toward designing and testing of interventions to eliminate health disparities.

  18. Vitamin D and cardiovascular disease.

    PubMed

    Giovannucci, Edward

    2009-11-01

    Recent studies indicate that deficient vitamin D status may increase risk of both ischemic and nonischemic cardiovascular diseases independently of established cardiovascular risk factors. The role of vitamin D in potentially regulating many functions in the cardiovascular system is just beginning to be understood. Among the potentially relevant mechanisms for cardiovascular diseases, vitamin D may influence blood pressure through the renin-angiotensin system, parathyroid hormone levels, myocardial function, inflammation, and vascular calcification. Cardiovascular risk appears especially elevated at 25-hydroxy-vitamin D levels below 10 or 15 ng/mL, and optimal levels may be at least 30 ng/mL. Among individuals who are not receiving substantial exposure to sun, intakes of 1000 to 2000 IU may be needed to achieve levels of at least 30 ng/mL. Further study, including properly designed randomized control trials, is required to further establish the role of vitamin D on cardiovascular diseases.

  19. Sleep apnea and cardiovascular disease.

    PubMed

    Logan, Alexander G; Bradley, T Douglas

    2010-06-01

    Cardiovascular disease is still the leading cause of death in North America. To improve outcomes, it will likely be necessary to identify new potentially treatable conditions. Sleep apnea affects approximately 50% of patients with cardiovascular disease and is associated with increased cardiovascular risk. Continuous positive airway pressure is currently the treatment of choice and has many short-term favorable effects. The long-term benefits, however, remain elusive. Further, it may not be the ideal treatment for central sleep apnea, and the benefits of alternatives such adaptive servo-ventilation are currently being tested. Randomized controlled trials are now needed to determine whether treating sleep apnea will improve survival and reduce cardiovascular disease risk. Until better evidence becomes available, testing for sleep apnea cannot be recommended as part of the routine cardiovascular disease risk assessment, nor can its treatment be recommended for the prevention or management of cardiovascular disease in asymptomatic patients.

  20. [Sleep rhythm and cardiovascular diseases].

    PubMed

    Maemura, Koji

    2012-07-01

    Sleep disturbance is a common problem in general adult population. Recent evidence suggests the link between the occurrence of cardiovascular events and several sleep disturbances including sleep apnea syndrome, insomnia and periodic limb movements during sleep. Sleep duration may affect the cardiovascular outcome. Shift work also may increase the risk of ischemic heart disease. Normalization of sleep rhythm has a potential to be a therapeutic target of ischemic heart diseases, although further study is required to evaluate the preventive effect on cardiovascular events. Here we describe the current understandings regarding the roles of sleep disorders during the pathogenesis of cardiovascular events.

  1. Cardiovascular risk

    PubMed Central

    Payne, Rupert A

    2012-01-01

    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

  2. Cardiovascular Disease

    USDA-ARS?s Scientific Manuscript database

    Cardiovascular disease (CVD), particularly CHD (coronary heart disease) and stroke, remain the leading causes of death of women in America and most developed countries. In recent years the rate of CVD has declined in men but not in women. This is contributed to by an under-recognition of women’s C...

  3. Cardiovascular risk in rheumatoid arthritis.

    PubMed

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

    2014-07-01

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

  4. Neuropeptides in cardiovascular control.

    PubMed

    Ganong, W F

    1984-12-01

    Neuropeptides can affect cardiovascular function in various ways. They can serve as cotransmitters in the autonomic nervous system; for example, vasoactive intestinal peptide (VIP) is released with acetylcholine and neuropeptide Y with norepinephrine from postganglionic neurons. Substance P and, presumably, other peptides can can affect cardiovascular function when released near blood vessels by antidromically conducted impulses in branches of stimulated sensory neurons. In the central nervous system, many different neuropeptides appear to function as transmitters or contransmittes in the neural pathways that regulate the cardiovascular system. In addition neuropeptides such as vasopressin and angiotensin II also circulate as hormones that are involved in cardiovascular control. Large doses of exogenous vasopressin are required to increase blood pressure in normal animals because the increase in total peripheral resistance produced by the hormones is accompanied by a decrease in cardiac output. However, studies with synthetic peptides that selectively antagonize the vasopressor action of vasopressin indicate that circulating vasopressin is important in maintaining blood pressure when animals are hypovolemic due to dehydration, haemorrhage or adrenocortical insufficiency. VIP dilates blood vessels and stimulates renin secretion by a direct action on the juxtaglomerular cells. Renin secretion is stimulated when the concentration of VIP in plasma exceeds 75 pmol/litre, and higher values are seen in a number of conditions. Neostigmine, a drug which increases the secretion of endogenous VIP, also increases renin secretion, and this increase is not blocked by renal denervation or propranolol. Thus, VIP may be a physiologically significant renin stimulating hormone.(ABSTRACT TRUNCATED AT 250 WORDS)

  5. Noninvasive cardiovascular imaging.

    PubMed

    Hartman, Robert J

    2014-01-01

    Over the past 2 decades, use of noninvasive cardiovascular imaging has increased dramatically. This article provides a brief synopsis of the current state of several technologies-- echocardiography, cardiac magnetic resonance imaging, and cardiac computed tomography--as well as a glimpse at future possibilities in cardiac imaging.

  6. [Cardiovascular prevention: begin young].

    PubMed

    Visseren, Frank L J

    2009-01-01

    Atherosclerotic vascular disease is rare in the young. Nevertheless, the foundations for atherosclerotic disease in later life are laid early by a harmful lifestyle including overweight and smoking. Adolescents who are overweight or have the metabolic syndrome are at increased cardiovascular risk later in life.

  7. Psoriasis and cardiovascular risk factors: increased serum myeloperoxidase and corresponding immunocellular overexpression by Cd11b+ CD68+ macrophages in skin lesions

    PubMed Central

    Cao, Lauren Y; Soler, David C; Debanne, Sarah M; Grozdev, Ivan; Rodriguez, Myriam E; Feig, Rivka L; Carman, Teresa L; Gilkeson, Robert C; Orringer, Carl E; Kern, Elizabeth F; McCormick, Thomas S; Cooper, Kevin D; Korman, Neil J

    2014-01-01

    Background: Recent studies report independent associations between psoriasis, cardiovascular (CV) events and risk factors. Blood Myeloperoxidase (MPO) from activated myeloid cells is associated with CV risk mainly through lipid oxidation, induction of endothelial dysfunction and release of IL-12 from macrophages. Objectives: To elucidate associations between psoriasis and conventional CV risk factors. Methods: We performed a cross-sectional study of 100 psoriasis patients and 53 controls, group matched on age, gender and body mass index, to assess levels of MPO in serum, as well as immunohistochemical staining from psoriasis skin lesions, psoriasis uninvolved skin, and normal skin. Results: Although the groups did not differ on waist circumference, glucose, cholesterol, triglycerides, creatinine or personal history of CV events, psoriasis patients had significantly higher waist-to-hip ratios, blood pressures, proportion of current smokers, and lower high density lipoprotein level than controls. Serum MPO level was elevated 2.5 fold (P<0.001) in psoriasis patients, even after adjusting for the CV risk factors on which the groups differed. MPO did correlate with coronary artery calcification, carotid plaque, carotid intima media thickness and flow mediated dilation, but did not correlate with psoriasis severity. However, MPO was highly expressed in lesional psoriatic skin and colocalized predominantly with CD45+ CD11b+ leukocytes. CD11b+ cell density correlated with circulation MPO levels. Conclusion: Lesional skin CD11b+ leukocytes activated to generate MPO may contribute to serum levels of MPO. Lesional CD11b+ cell activity may be an alternative measure of disease burden to PASI that underlies the MPO biomarker for systemic inflammation related to Cardiovascular Disease. PMID:24349618

  8. Tea and Cardiovascular Disease

    PubMed Central

    Deka, Apranta; Vita, Joseph A.

    2011-01-01

    There is increasing evidence for a protective effect of tea consumption against cardiovascular disease. This review summarizes the available epidemiological data providing evidence for and against such an effect. We also review observational and intervention studies that investigated an effect of tea and tea extracts on cardiovascular risk factors, including blood pressure, serum lipids, diabetes mellitus, and obesity. Finally, we review potential mechanisms of benefit, including anti-inflammatory, anti-oxidant, and anti-proliferative effects, as well as favorable effects on endothelial function. Overall, the observational data suggest a benefit, but results are mixed and likely confounded by lifestyle and background dietary factors. The weight of evidence indicates favorable effects on risk factors and a number of plausible mechanisms have been elucidated in experimental and translational human studies. Despite the growing body evidence, it remains uncertain whether tea consumption should be recommended to the general population or to patients as a strategy to reduce cardiovascular risk. PMID:21477653

  9. [Peculiarities of cardiovascular system pathology depending on psychological profile in patients of senior age groups].

    PubMed

    Prokhorenko, I O

    2013-01-01

    Interrelations between peculiarities of psychological profile of patients of senior age groups (according to Cattel), level of stress hormones in blood and background pathology of cardiovascular system were studied. Levels of catecholamine and corticosteroids in dynamics, rate of magnesium in erythrocytes and calcium in plaques of coronary arteries as well as fats, Holter ECG, daily profiles of blood pressure, vasomotor function of endothelium and microcirculation were analysed. It is established that stress hormones indirectly determine original form of stress reaction depending on patients' psychological profile. This contributes to the development of one or another form of cardiovascular system pathology. Excessive alcohol intake also promotes progression of cardiovascular system pathology. Depression, being a reflection of disbalance of stress hormones levels, can be used as a marker of unfavourable course of cardiovascular pathology.

  10. Rheumatoid cachexia and cardiovascular disease.

    PubMed

    Summers, Gregory D; Metsios, Giorgos S; Stavropoulos-Kalinoglou, Antonios; Kitas, George D

    2010-08-01

    Both cachexia and cardiovascular disease are strongly associated with rheumatoid arthritis (RA) and linked to the chronic inflammatory process. Typically, rheumatoid cachexia occurs in individuals with normal or increased BMI (reduced muscle mass and increased fat mass). Classic cachexia (reduced muscle mass and reduced fat mass) is rare in RA but is associated with high inflammatory activity and aggressive joint destruction in patients with a poor cardiovascular prognosis. Conversely, obesity is linked to hypertension and dyslipidemia but, paradoxically, lower RA disease activity and less cardiovascular disease-related mortality. Rheumatoid cachexia might represent the 'worst of both worlds' with respect to cardiovascular outcome, but until diagnostic criteria for this condition are agreed upon, its effect on cardiovascular disease risk remains controversial.

  11. Indian poverty and cardiovascular disease.

    PubMed

    Ramaraj, Radhakrishnan; Alpert, Joseph Stephen

    2008-07-01

    Cardiovascular disease is among the world's leading causes of death, and nearly 80% of deaths occur in developing countries. Cardiovascular disease is becoming a major health problem in India, where life expectancy has increased with decreases in infectious disease and childhood mortality. It is well established that this population experiences coronary artery disease at a younger age than other populations. With infectious diseases still endemic, noncommunicable diseases are a lower priority for the governments of developing countries. There is a clear progression to degenerative and lifestyle-related diseases such as cardiovascular disease as a result of current social and economic change. The lack of a public response to the increasing risk for cardiovascular disease thus far is due mostly to a perception among policy makers and the public that cardiovascular disease is largely a problem of the urban rich. In conclusion, this review addresses the imminent threats and ways to tackle the epidemic in India.

  12. [Cardiovascular pharmacogenomics].

    PubMed

    Scibona, Paula; Angriman, Federico; Simonovich, Ventura; Heller, Martina M; Belloso, Waldo H

    2014-01-01

    Cardiovascular disease remains a major cause of morbidity and mortality worldwide. Current medical practice takes into account information based on population studies and benefits observed in large populations or cohorts. However, individual patients present great differences in both toxicity and clinical efficacy that can be explained by variations in adherence, unknown drug to drug interactions and genetic variability. The latter seems to explain from 20% up to 95% of patient to patient variability. Treating patients with cardiovascular disorders faces the clinician with the challenge to include genomic analysis into daily practice. There are several examples within cardiovascular disease of treatments that can vary in toxicity or clinical usefulness based on genetic changes. One of the main factors affecting the efficacy of Clopidogrel is the phenotype associated with polymorphisms in the gene CYP 2C9. Furthermore, regarding oral anticoagulants, changes in CYP2C9 and VKORC1 play an important role in changing the clinical response to anticoagulation. When analyzing statin treatment, one of their main toxicities (myopathy) can be predicted by the SLCO1B1 polymorphism. The potential for prediction of toxicity and clinical efficacy from the use of genetic analysis warrants further studies aiming towards its inclusion in daily clinical practice.

  13. [Cardiovascular system and aging].

    PubMed

    Saner, H

    2005-12-01

    Aging is one of the most important cardiovascular risk factors. Age-related morphologic changes in large resistance vessels include an intima-media-thickening and increased deposition of matrix substance, ultimately leading to a reduced compliance and an increased stiffness of the vessels. Aging of the heart is mainly characterized by an increase of the left ventricular mass in relation to the chamber volume and a decrease of diastolic function. There is some controversy in regard to the question if these changes in the vessel wall are the consequence of aging or if a decrease in physical activity is a major contributor of this process. With age the cardiovascular profile is changing. Whereas smoking is less prominent, arterial hypertension and diabetes mellitus are more often encountered. Primary and secondary prevention through cardiovascular risk factor management is also very important in the aging population due to the increased risk of acute vascular complications with age. Preventive measures have to include life style factor interventions as well as optimized drug therapy. There is no scientific evidence that vascular aging can be prevented by administration of supplements such as antioxidant vitamins. Aspirin is effective for cardiovascular prevention up to a higher age. Betablockers and ACE-inhibitors are generally underused in older patients after myocardial infarctions. Statins are effective in reducing cardiovascular complications up to an age of 80 years. Myocardial infarction in elderly patients is often characterized by atypical symptoms and may be even silent. Interventional therapy in elderly patients is as successful as in younger patients but has an increased complication rate. Ambulatory cardiac rehabilitation in elderly patients leads to significant improvements of physical capacity, well-being and quality of life and may help to prevent social isolation.

  14. Multiple aberrations in shared inflammatory and oxidative & nitrosative stress (IO&NS) pathways explain the co-association of depression and cardiovascular disorder (CVD), and the increased risk for CVD and due mortality in depressed patients.

    PubMed

    Maes, Michael; Ruckoanich, Piyanuj; Chang, Young Seun; Mahanonda, Nithi; Berk, Michael

    2011-04-29

    There is evidence that there is a bidirectional relationship between major depression and cardiovascular disorder (CVD): depressed patients are a population at risk for increased cardiac morbidity and mortality, and depression is more frequent in patients who suffer from CVD. There is also evidence that inflammatory and oxidative and nitrosative stress (IO&NS) pathways underpin the common pathophysiology of both CVD and major depression. Activation of these pathways may increase risk for both disorders and contribute to shared risk. The shared IO&NS pathways that may contribute to CVD and depression comprise the following: increased levels of pro-inflammatory cytokines, like interleukin-1β (IL-1β), IL-2, IL-6, IL-8, IL-12, tumor necrosis factor-α, and interferon-γ; T cell activation; increased acute phase proteins, like C-reactive protein, haptoglobin, fibrinogen and α1-antitrypsin; complement factors; increased LPS load through bacterial translocation and subsequent gut-derived inflammation; induction of indoleamine 2,3-dioxygenase with increased levels of tryptophan catabolites; decreased levels of antioxidants, like coenzyme Q10, zinc, vitamin E, glutathione and glutathione peroxidase; increased O&NS characterized by oxidative damage to low density lipoprotein (LDL) and phospholipid inositol, increased malondialdehyde, and damage to DNA and mitochondria; increased nitrosative stress; and decreased ω3 polyunsaturated fatty acids (PUFAs). The complex interplay between the abovementioned IO&NS pathways in depression results in pro-atherogenic effects and should be regarded as a risk factor to future clinical CVD and due mortality. We suggest that major depression should be added as a risk factor to the Charlson "comorbidity" index. It is advised that patients with (sub)chronic or recurrent major depression should routinely be assessed by serology tests to predict if they have an increased risk to cardiovascular disorders.

  15. Seropositivity for Anti-HCV Core Antigen is Independently Associated With Increased All-Cause, Cardiovascular, and Liver Disease-Related Mortality in Hemodialysis Patients

    PubMed Central

    Ohsawa, Masaki; Kato, Karen; Tanno, Kozo; Itai, Kazuyoshi; Fujishima, Yosuke; Okayama, Akira; Turin, Tanvir Chowdhury; Onoda, Toshiyuki; Suzuki, Kazuyuki; Nakamura, Motoyuki; Kawamura, Kazuko; Akiba, Takashi; Sakata, Kiyomi; Fujioka, Tomoaki

    2011-01-01

    Background It is not known whether chronic or past hepatitis C virus (HCV) infection contributes to the high mortality rate in hemodialysis patients. Methods This prospective study of 1077 adult hemodialysis patients without hepatitis B virus infection used Poisson regression analysis to estimate crude and sex- and age-adjusted rates (per 1000 patient-years) of all-cause, cardiovascular, infectious disease-related and liver disease-related mortality in patients negative for HCV antibody (group A), patients positive for HCV antibody and negative for anti-HCV core antigen (group B), and patients positive for anti-HCV core antigen (group C). The relative risks (RRs) for each cause of death in group B vs group C as compared with those in group A were also estimated by Poisson regression analysis after multivariate adjustment. Results A total of 407 patients died during the 5-year observation period. The sex- and age-adjusted mortality rate was 71.9 in group A, 80.4 in group B, and 156 in group C. The RRs (95% CI) for death in group B vs group C were 1.23 (0.72 to 2.12) vs 1.60 (1.13 to 2.28) for all-cause death, 0.75 (0.28 to 2.02) vs 1.64 (0.98 to 2.73) for cardiovascular death, 1.64 (0.65 to 4.15) vs 1.58 (0.81 to 3.07) for infectious disease-related death, and 15.3 (1.26 to 186) vs 28.8 (3.75 to 221) for liver disease-related death, respectively. Conclusions Anti-HCV core antigen seropositivity independently contributes to elevated risks of all-cause and cause-specific death. Chronic HCV infection, but not past HCV infection, is a risk for death among hemodialysis patients. PMID:22001541

  16. Non-invasive quick diagnosis of cardiovascular problems from visible and invisible abnormal changes with increased cardiac troponin I appearing on cardiovascular representation areas of the eyebrows, left upper lip, etc. of the face & hands: beneficial manual stimulation of hands for acute anginal chest pain, and important factors in safe, effective treatment.

    PubMed

    Omura, Yoshiaki; Jones, Marilyn K; Duvvi, Harsha; Shimotsuura, Yasuhiro; Ohki, Motomu; Rodriques, Aaron

    2014-01-01

    Our previous study indicated that there are at least 7 cardiovascular representation areas on the face, including the "Eyebrows", both sides of the "Nose", "Lelt Upper Lip" and the "Outside of the corner of both sides of the mouth," in addition to 2 areas in each hand. When there are cardiovascular problems, some of the heart representation areas of these areas often show the following changes: 1) Most distinctive visible changes such as the initial whitening with or without long white hair, then hair loss and complete disappearance of the hairs of the heart representation area of "Eyebrows" 2) Invisible biochemical changes that happen in heart representation areas at the "Left Upper Lips", 3) "Nose" below eye level as well as 4) "3rd segment of Middle Finger of Hands." Most distinctive visible & invisible changes are found in heart representation areas on the "Eyebrow", located nearest to the midline of face, where the color of the hairs becomes white compared with the rest of the Eyebrow. Then the cardiovascular problem advances, and hair starts disappearing. When there are no hairs at the heart representation areas of the Eyebrow, usually Cardiac Troponin I is increased to a very serious, abnormal high value. Most of the cardiovascular representation areas of the face show, regardless of presence or absence of visible change. When there is a cardiovascular problem, not only simple Bi-Digital O-Ring Test can detect without using any instrument in several minutes but also, corresponding biochemical changes of abnormally increased Cardiac Troponin I level can often be detected non-invasively from these Organ Representation Areas of Face & Hands, although changes in Eyebrows, L-Upper Lip & 3rd segment of middle fingers are clinically the most reliable changes & easy to identify the locations. Manual Stimulation of Hand's heart representation areas often eliminated acute anginal chest pain before medical help became available. Important factors for safe, effective

  17. [Preeclampsia as cardiovascular risk factor].

    PubMed

    Heida, Karst Y; Franx, Arie; Bots, Michiel L

    2013-01-01

    Cardiovascular diseases (CVD) are the primary cause of death in women. Guidelines for identifying high-risk individuals have been developed, e.g. the Dutch Guideline on Cardiovascular Risk Management. In the most recent version of this guideline, diabetes mellitus (DM) and rheumatoid arthritis (RA) are cited as cardiovascular risk factors; therefore, individuals with these conditions are identified as being at high risk. As with DM and RA, there is strong evidence that the experience of having a hypertensive disorder during pregnancy is a cardiovascular risk factor. This is particularly the case for early preeclampsia, which constitutes a 7-fold increased risk of ischemic heart disease. However, in the Netherlands, there are no guidelines and there is no consensus on how to screen or treat these women. Trial evidence is therefore urgently needed to substantiate the value of cardiovascular risk management for those women with a history of hypertension during pregnancy.

  18. [Cardiovascular screening].

    PubMed

    Pellizzari, Barbara; Siddu, Andrea; Ferro, Antonio; Colonna, Manuela; Mantovani, William; Valsecchi, Massimo; Marensi, Lorenzo; Moro, Alessandro; Brusaferro, Silvio; Cinquetti, Sandro

    2014-01-01

    To evaluate, through active call, lifestyles of an asymptomatic population in order to identify hyperglycaemic subjects and/or high-blood pressure sufferers to dispatch to their GP to perform suitable checking, and subjects to invite to a cardiovascular disease prevention programme because of their lifestyles. Between April 2011 and March 2013, all healthy residents in 6 Local Health Authorities of Regione Veneto aged 45-59 years were invited to join a cardiovascular disease prevention programme. All participants were evaluated through an administered lifestyle questionnaire. Parameters such as blood pressure (BP), glycemia, waist circumference and body mass index were collected and recorded. Participants also received counseling, informational materials on lifestyle and were invited to individual or group health promotion initiatives in relation to personal risk factors. Among the invited, 60.84%(10,346/17,004) adhered. Subjects without risks factors were 23.95%. Subjects with lifestyle risk factors but normal BP and glycemia were 56.59%, while those with altered values for BP and glycemia were 13.9%. The 5.55% of the respondents was not eligible for the study. The results confirmthat a preventive programme based on the citizens active call by the Department of prevention could be an effective tool to identify asymptomatic individuals with unknown hypertension and/or hyperglycaemia and to offer lifestyle interventions to lower the risk of cardiovascular diseases. Since the results were positive, the the Regional Veneto Centre for Disease Prevention and Control (CCMR - Veneto) presented a similar project to the Ministry of Health, involving 12 Italian Regions.

  19. Cardiovascular manifestations of phaeochromocytoma.

    PubMed

    Prejbisz, Aleksander; Lenders, Jacques W M; Eisenhofer, Graeme; Januszewicz, Andrzej

    2011-11-01

    Clinical expression of phaeochromocytoma may involve numerous cardiovascular manifestations, but usually presents as sustained or paroxysmal hypertension associated with other signs and symptoms of catecholamine excess. Most of the life-threatening cardiovascular manifestations of phaeochromocytoma, such as hypertensive emergencies, result from a rapid and massive release of catecholamines from the tumour. More rarely, patients with phaeochromocytoma present with low blood pressure or even shock that may then precede multisystem crisis. Sinus tachycardia, with palpitations as the presenting symptom, is the most prevalent abnormality of cardiac rhythm in phaeochromocytoma, but tumours can also be associated with more serious ventricular arrhythmias or conduction disturbances. Reversible dilated or hypertrophic cardiomyopathy are well established cardiac manifestations of phaeochromocytoma, with more recent attention to an increasing number of cases with Takotsubo cardiomyopathy. This review provides an update on the cause, clinical presentation and treatment of the cardiovascular manifestations of phaeochromocytoma. As the cardiovascular complications of phaeochromocytoma can be life-threatening, all patients who present with manifestations that even remotely suggest excessive catecholamine secretion should be screened for the disease.

  20. Marathon run: cardiovascular adaptation and cardiovascular risk.

    PubMed

    Predel, Hans-Georg

    2014-11-21

    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

  1. Cardiovascular group

    NASA Technical Reports Server (NTRS)

    Blomqvist, Gunnar

    1989-01-01

    As a starting point, the group defined a primary goal of maintaining in flight a level of systemic oxygen transport capacity comparable to each individual's preflight upright baseline. The goal of maintaining capacity at preflight levels would seem to be a reasonable objective for several different reasons, including the maintenance of good health in general and the preservation of sufficient cardiovascular reserve capacity to meet operational demands. It is also important not to introduce confounding variables in whatever other physiological studies are being performed. A change in the level of fitness is likely to be a significant confounding variable in the study of many organ systems. The principal component of the in-flight cardiovascular exercise program should be large-muscle activity such as treadmill exercise. It is desirable that at least one session per week be monitored to assure maintenance of proper functional levels and to provide guidance for any adjustments of the exercise prescription. Appropriate measurements include evaluation of the heart-rate/workload or the heart-rate/oxygen-uptake relationship. Respiratory gas analysis is helpful by providing better opportunities to document relative workload levels from analysis of the interrelationships among VO2, VCO2, and ventilation. The committee felt that there is no clear evidence that any particular in-flight exercise regimen is protective against orthostatic hypotension during the early readaptation phase. Some group members suggested that maintenance of the lower body muscle mass and muscle tone may be helpful. There is also evidence that late in-flight interventions to reexpand blood volume to preflight levels are helpful in preventing or minimizing postflight orthostatic hypotension.

  2. PET Radiotracers of the Cardiovascular System.

    PubMed

    Gropler, Robert J

    2009-01-01

    Cardiovascular PET provides exquisite measurements of key aspects of the cardiovascular system and as a consequence it plays central role in cardiovascular investigation. Moreover, PET is now playing an ever increasing role in the management of the cardiac patient. Central to the success of PET is the development and use of novel radiotracers that permit measurements of key aspects of cardiovascular health such as myocardial perfusion, metabolism, and neuronal function. Moreover, the development of molecular imaging radiotracers is now permitting the interrogation of cellular and sub cellular processes. This article highlights these various radiotracers and their role in both cardiovascular research and potential clinical applications.

  3. IMPACT OF IMPROVED FAT-MEAT PRODUCTS CONSUMPTION ON ANTHROPOMETRIC MARKERS AND NUTRIENT INTAKES OF MALE VOLUNTEERS AT INCREASED CARDIOVASCULAR RISK.

    PubMed

    Celada, Paloma; Delgado-Pando, Gonzalo; Olmedilla-Alonso, Begoña; Jiménez-Colmenero, Francisco; Ruperto, Mar; Sánchez-Muniz, Francisco J

    2015-08-01

    Introducción: la carne es una matriz adecuada para la inclusión de ingredientes funcionales. En un estudio no secuencial controlado y aleatorio se evaluó el impacto del consumo de productos cárnicos, en los que se sustituyó la grasa animal por una combinación de aceite de oliva, de linaza y de pescado, sobre la ingesta de energía y nutrientes y sobre los marcadores antropométricos. Métodos: dieciocho voluntarios con elevado riesgo cardiovascular consumieron semanalmente 200 g de salchichas tipo frankfurt y 250 g de paté durante tres períodos sucesivos de 4 semanas (bajo en grasa (RF); enriquecidos en n-3 (n-3RF), y grasa normal (NF)), separados por un lavado de 4 semanas. Se evaluó la ingesta de nutrientes y energía, el índice de alimentación saludable (HEI) y los cambios antropométricos. Resultados: hubo diferencias significativas entre períodos para las tasas de cambio de la grasa corporal y de la relación cintura/cadera (p = 0,018 y p = 0,031, respectivamente), disminuyendo la masa grasa, el perímetro de la cintura y la relación cintura/cadera en el periodo RF, e incrementándose la grasa corporal en el periodo NF (todos p = 0,05). En el período n-3RF las tasas de cambio de IMC y del peso ideal correlacionaron inversa y significativamente (p = 0.003 y p = 0.006, respectivamente) con el cociente hidratos de carbono/AGS. El HEI inicial de las dietas fue muy bajo (valor medio < 60). La contribución energética de carbohidratos, grasa y proteínas fue 40%, 41% y 16%, respectivamente. Más del 33% de los voluntarios no cubrían al inicio el 70% de las RDA para minerales y vitaminas. La intervención mejoró en todos los períodos la ingesta de Zn, Ca, equivalentes de retinol, folatos y vitamina B12. En el período n-3RF incrementó los AGPn-3 y redujo el cociente n-6/n-3. Conclusión: los productos cárnicos con menos grasa o enriquecidos en AGP n-3 son alimentos funcionales para personas con sobrepeso/obesidad, ya que su consumo mejora los

  4. A Fatal Case of Acute Butane-Propane Poisoning in a Prisoner Under Psychiatric Treatment: Do These 2 Factors Have an Arrhythmogenic Interaction, Thus Increasing the Cardiovascular Risk Profile?

    PubMed

    Gioia, Sara; Lancia, Massimo; Bacci, Mauro; Suadoni, Fabio

    2015-12-01

    Sudden death due to inhalation of aliphatic hydrocarbons such as butane and propane is well described in the literature. The main mechanism involved is the induction of a fatal cardiac arrhythmia. This phenomenon is frequently associated with prisoners who accidentally die while sniffing these volatile substances with an abuse purpose. Furthermore, such prisoners are often under psychiatric treatment; specific drugs belonging to this pharmacological class lead to a drug-related QT interval prolongation, setting the stage for torsade de pointes. In this article, we present the case of a prisoner died after sniffing a butane-propane gas mixture from a prefilled camping stove gas canister. The man was under psychiatric drugs due to mental disorders. He was constantly subjected to electrocardiogram to monitor the QTc (corrected QT interval), which was 460 milliseconds long. Toxicological analysis on cadaveric samples was performed by means of gas chromatography (head space) and revealed the presence of butane and propane at low levels. The aim of this article was to discuss a possible arrhythmogenic interaction of QT interval prolongation induced by psychiatric drugs and butane-propane inhalations, increasing the cardiovascular risk profile. In other words, evidence may suggest that prisoners, under these circumstances, are more likely to experience cardiovascular adverse effects. We believe that this study underlines the need to take this hypothesis into account to reduce death risk in prison and any medical-related responsibilities. Further studies are needed to validate the hypothesis.

  5. Increased Levels of Oxidative Stress Markers, Soluble CD40 Ligand, and Carotid Intima-Media Thickness Reflect Acceleration of Atherosclerosis in Male Patients with Ankylosing Spondylitis in Active Phase and without the Classical Cardiovascular Risk Factors

    PubMed Central

    Cholewka, Armand; Sieroń, Karolina; Sieroń, Aleksander

    2017-01-01

    Objective The primary aim of the study was to assess levels of oxidative stress markers, soluble CD40 ligand (sCD40L), serum pregnancy-associated plasma protein-A (PAPP-A), and placental growth factor (PlGF) as well as carotid intima-media thickness (IMT) in patients with ankylosing spondylitis (AS) with active phase without concomitant classical cardiovascular risk factors. Material and methods The observational study involved 96 male subjects: 48 AS patients and 48 healthy ones, who did not differ significantly regarding age, BMI, comorbid disorders, and distribution of classical cardiovascular risk factors. In both groups, we estimated levels of oxidative stress markers, lipid profile, and inflammation parameters as well as sCD40L, serum PAPP-A, and PlGF. In addition, we estimated carotid IMT in each subject. Results The study showed that markers of oxidative stress, lipid profile, and inflammation, as well as sCD40L, PlGF, and IMT, were significantly higher in the AS group compared to the healthy group. Conclusion Our results demonstrate that ankylosing spondylitis may be associated with increased risk for atherosclerosis. PMID:28883908

  6. Therapeutic implications of selecting the SCORE (European) versus the D'AGOSTINO (American) risk charts for cardiovascular risk assessment in hypertensive patients

    PubMed Central

    Gómez-Marcos, Manuel A; Martínez-Salgado, Carlos; Martin-Cantera, Carlos; Recio-Rodríguez, José I; Castaño-Sánchez, Yolanda; Giné-Garriga, Maria; Rodriguez-Sanchez, Emiliano; García-Ortiz, Luis

    2009-01-01

    Background No comparisons have been made of scales estimating cardiovascular mortality and overall cardiovascular morbidity and mortality. The study objectives were to assess the agreement between the Framingham-D'Agostino cardiovascular risk (CVR) scale and the chart currently recommended in Europe (SCORE) with regard to identification of patients with high CVR, and to describe the discrepancies between them and the attendant implications for the treatment of hypertension and hyperlipidaemia. Methods A total of 474 hypertensive patients aged 40–65 years monitored in primary care were enrolled into the study. CVR was assessed using the Framingham-D'Agostino scale, which estimates the overall cardiovascular morbidity and mortality risk, and the SCORE chart, which estimates the cardiovascular mortality risk. Cardiovascular risk was considered to be high for values ≥ 20% and ≥ 5% according to the Framingham-D'Agostino and SCORE charts respectively. Kappa statistics was estimated for agreement in classification of patients with high CVR. The therapeutic recommendations in the 2007 European Guidelines on Cardiovascular Disease Prevention were followed. Results Mean patient age was 54.1 (SD 7.3), and 58.4% were males. A high CVR was found in 17.5% using the SCORE chart (25.3% males, 6.6% females) and in 32.7% using the D'Agostino method (56.9% males, 12,7% females). Kappa coefficient was 0.52, and increased to 0.68 when the high CVR threshold was established at 29% according to D'Agostino. Hypertensive patients with high SCORE and non-high D'Agostino (1.7%) were characterized by an older age, diabetes, and a lower atherogenic index, while the opposite situation (16.9%) was associated to males, hyperlipidaemia, and a higher atherogenic index. Variables with a greater weight in discrepancies were sex and smoking. A 32.0% according to SCORE and 33.5% according to D'Agostino would be candidates to receive antihypertensive treatment, and 15.8% and 27.3% respectively to

  7. Improvements to cardiovascular gene ontology.

    PubMed

    Lovering, Ruth C; Dimmer, Emily C; Talmud, Philippa J

    2009-07-01

    Gene Ontology (GO) provides a controlled vocabulary to describe the attributes of genes and gene products in any organism. Although one might initially wonder what relevance a 'controlled vocabulary' might have for cardiovascular science, such a resource is proving highly useful for researchers investigating complex cardiovascular disease phenotypes as well as those interpreting results from high-throughput methodologies. GO enables the current functional knowledge of individual genes to be used to annotate genomic or proteomic datasets. In this way, the GO data provides a very effective way of linking biological knowledge with the analysis of the large datasets of post-genomics research. Consequently, users of high-throughput methodologies such as expression arrays or proteomics will be the main beneficiaries of such annotation sets. However, as GO annotations increase in quality and quantity, groups using small-scale approaches will gradually begin to benefit too. For example, genome wide association scans for coronary heart disease are identifying novel genes, with previously unknown connections to cardiovascular processes, and the comprehensive annotation of these novel genes might provide clues to their cardiovascular link. At least 4000 genes, to date, have been implicated in cardiovascular processes and an initiative is underway to focus on annotating these genes for the benefit of the cardiovascular community. In this article we review the current uses of Gene Ontology annotation to highlight why Gene Ontology should be of interest to all those involved in cardiovascular research.

  8. [Dietary habits and cardiovascular diseases].

    PubMed

    Nola, Iskra Alexandra; Doko Jelinić, Jagoda; Bergovec, Mijo; Ruzić, Alen; Persić, Viktor

    2010-05-01

    Cardiovascular diseases are a major public health problem worldwide. They are the main cause of death in industrialized countries, while the mortality associated with cardiovascular disease is increasing in less developed countries. The modifiable risk factors for cardiovascular disease are cigarette smoking, hypertension, hyperlipidemia, diabetes mellitus and obesity. Obesity has been recorded in 10%-25% of the population, indicating that poor or inappropriate diet is one of the most common causes of cardiovascular disease. Unhealthy dietary habits including place and way of taking meals, number of daily meals and excessive salt intake from processed foods also contribute to body mass gain. In the present study, dietary habits were assessed in cardiovascular patients versus control group by use of Dietary Habits Questionnaire. Study results showed a statistically significantly higher (P < 0.05) prevalence of inappropriate eating habits in cardiovascular patients (lower number of daily meals, more often skipping breakfast and having dinner) than in control group. In conclusion, many lifestyle and individual behavior modifications are needed in most patients with or at a high risk of cardiovascular disease.

  9. Youth screen-time behaviour is associated with cardiovascular risk in young adulthood: the European Youth Heart Study.

    PubMed

    Grøntved, Anders; Ried-Larsen, Mathias; Møller, Niels Christian; Kristensen, Peter Lund; Wedderkopp, Niels; Froberg, Karsten; Hu, Frank B; Ekelund, Ulf; Andersen, Lars B

    2014-01-01

    We prospectively examined the association of TV viewing, computer use, and total screen time in adolescence, and change in these behaviours, with cardiovascular disease (CVD) risk factors in young adulthood. This was a prospective cohort study among Danish men and women (n = 435) followed for up to 12 years. Adiposity, blood pressure (BP), triglycerides, high-density lipoprotein (HDL), glucose, insulin, and self-reported TV viewing and computer use were obtained in adolescence and in young adulthood. A continuous metabolic syndrome z-score was calculated as the sum of standardized values of each risk factor (inverse of HDL). In multivariable-adjusted analyses, TV viewing and total screen time in adolescence were positively associated with adiposity, triglycerides, and metabolic syndrome z-score in young adulthood (p < 0.05). Individuals who increased their TV viewing, computer use, or total screen time with more than 2 hours/day from adolescence to young adulthood had 0.90 (95% CI 0.12 to 1.69), 0.95 (95% CI 0.01 to 1.88), and 1.40 (95% CI 0.28 to 2.51) kg/m(2) higher body mass index, respectively, in young adulthood compared with individuals who remained stable or decreased their viewing time. Insulin and metabolic syndrome z-scores were also higher among individuals who increased their TV viewing, computer use, or total screen time more than 2 hours/day compared with individuals who remained stable or decreased their viewing time (p < 0.05). Prolonged TV viewing and total screen time during leisure time in adolescence, and increases in these behaviours, are associated with unfavourable levels of several cardiovascular risk factors in young adulthood.

  10. Depression and cardiovascular disease.

    PubMed

    Glassman, A

    2008-11-01

    This manuscript reviews the evidence that depression is associated with increased risk of mortality and explores the evidence that treating depression reduces that risk. The thought that depression and death are linked is ancient, but scientifically it has been difficult to prove. After the World War II, type "A" personality appeared capable of identifying cardiac patients at increased risk of death. By the mid 1970s that evidence appeared to weaken and may have been altered by the changing treatment of cardiovascular disease. At the same time, research began to focus on a diagnosis of depression as a predictor but it was 25 years before the association was firmly established. Originally examined in medically healthy in-dividuals followed for long periods of time, in the early 1990s epidemiological research began examining the influence of depression in patients with overt cardiovascular disease. That focus has been primarily on post-MI depression and the obvious question was if treating depression would reduce the risk. Such studies require a very large sample and initially there was no safety data available with any antidepressant drug. Gradually evidence has accumulated that SSRI antidepressants were safe and effective and there is a suggestion that they reduce not only depression but medical adverse events as well. However, that evidence is not definitive and the reason behind the association between depression and cardiovascular morbidity and mortality remains uncertain.

  11. Cardiovascular adaptation to spaceflight

    NASA Technical Reports Server (NTRS)

    Hargens, A. R.; Watenpaugh, D. E.

    1996-01-01

    This article reviews recent flight and ground-based studies of cardiovascular adaptation to spaceflight. Prominent features of microgravity exposure include loss of gravitational pressures, relatively low venous pressures, headward fluid shifts, plasma volume loss, and postflight orthostatic intolerance and reduced exercise capacity. Many of these short-term responses to microgravity extend themselves during long-duration microgravity exposure and may be explained by altered pressures (blood and tissue) and fluid balance in local tissues nourished by the cardiovascular system. In this regard, it is particularly noteworthy that tissues of the lower body (e.g., foot) are well adapted to local hypertension on Earth, whereas tissues of the upper body (e.g., head) are not as well adapted to increase in local blood pressure. For these and other reasons, countermeasures for long-duration flight should include reestablishment of higher, Earth-like blood pressures in the lower body.

  12. Cardiovascular adaptation to spaceflight

    NASA Technical Reports Server (NTRS)

    Hargens, A. R.; Watenpaugh, D. E.

    1996-01-01

    This article reviews recent flight and ground-based studies of cardiovascular adaptation to spaceflight. Prominent features of microgravity exposure include loss of gravitational pressures, relatively low venous pressures, headward fluid shifts, plasma volume loss, and postflight orthostatic intolerance and reduced exercise capacity. Many of these short-term responses to microgravity extend themselves during long-duration microgravity exposure and may be explained by altered pressures (blood and tissue) and fluid balance in local tissues nourished by the cardiovascular system. In this regard, it is particularly noteworthy that tissues of the lower body (e.g., foot) are well adapted to local hypertension on Earth, whereas tissues of the upper body (e.g., head) are not as well adapted to increase in local blood pressure. For these and other reasons, countermeasures for long-duration flight should include reestablishment of higher, Earth-like blood pressures in the lower body.

  13. The rice Osmyb4 gene enhances tolerance to frost and improves germination under unfavourable conditions in transgenic barley plants.

    PubMed

    Soltész, Alexandra; Vágújfalvi, Attila; Rizza, Fulvia; Kerepesi, Ildikó; Galiba, Gábor; Cattivelli, Luigi; Coraggio, Immacolata; Crosatti, Cristina

    2012-05-01

    The Osmyb4 rice gene, coding for a transcription factor, proved to be efficient against different abiotic stresses as a trans(cis)gene in several plant species, although the effectiveness was dependent on the host genomic background. Eight barley transgenic lines carrying the rice Osmyb4 gene under the control of the Arabidopsis cold inducible promoter cor15a were produced to test the efficiency of this gene in barley. After a preliminary test, the best performing lines were subjected to freezing at -11°C and -12°C. Frost tolerance was assessed measured the F(v)/F(m) parameter widely used to indicate the maximum quantum yield of photosystem II photochemistry in the dark adapted state. Three transgenic lines showed significantly increased tolerance. These selected lines were further studied under a complex stress applying cold and hypoxia at germinating stage. In these conditions the three selected transgenic lines outperformed the wild type barley in terms of germination vigour. The transgenic plants also showed a significant modification of their metabolism under cold/hypoxia conditions as demonstrated through the assessment of the activity of key enzymes involved in anoxic stress response. None of the transgenic lines showed dwarfism, just a slight retarded growth. These results provide evidence that the cold dependent expression of Osmyb4 can efficiently improved frost tolerance and germination vigour at low temperature without deleterious effect on plant growth.

  14. Erectile dysfunction in the cardiovascular patient.

    PubMed

    Vlachopoulos, Charalambos; Jackson, Graham; Stefanadis, Christodoulos; Montorsi, Piero

    2013-07-01

    Erectile dysfunction is common in the patient with cardiovascular disease. It is an important component of the quality of life and it also confers an independent risk for future cardiovascular events. The usual 3-year time period between the onset of erectile dysfunction symptoms and a cardiovascular event offers an opportunity for risk mitigation. Thus, sexual function should be incorporated into cardiovascular disease risk assessment for all men. A comprehensive approach to cardiovascular risk reduction (comprising of both lifestyle changes and pharmacological treatment) improves overall vascular health, including sexual function. Proper sexual counselling improves the quality of life and increases adherence to medication. This review explores the critical connection between erectile dysfunction and cardiovascular disease and evaluates how this relationship may influence clinical practice. Algorithms for the management of patient with erectile dysfunction according to the risk for sexual activity and future cardiovascular events are proposed.

  15. Effectiveness and safety of vaginal misoprostol for induction of labour in unfavourable cervix in 3rd trimester.

    PubMed

    Abbasi, Nasreen; Danish, Nargis; Shakoor, Farah; Parveen, Zahida; Bilal, Syed Ahmad

    2008-01-01

    The use of prostaglandin preparations with or without oxytocin infusion, is widely recognized and accepted as a standard method of induction of labour. It has been shown to reduce induction time and the risk of failed induction. The objective of this quasi-experimental observational study was to determine the effectiveness and safety of Misoprostol administered vaginally for induction of labour to achieve vaginal delivery. This study was conducted from October 2004 to October 2007. The study was conducted at Shaheena Jamil Teaching Hospital, Frontier Medical College, Abbottabad and Women and Children Hospital Abbottabad. A total of 6299 obstetric patients were received for delivery and 946 patients had to undergo induction of labour. Primary outcome measures were to address clinical effectiveness (delivery within 24-hours) and safety (uterine hyper-stimulation, Caesarean Section and serious Maternal Morbidity). Secondary outcome measures included neonatal outcome. Out of 946 cases, successful vaginal deliveries were achieved in 843 (89.1%) cases. Time interval between induction and delivery was 4-24 hours. Oxytocin was required in 107 (12%) patients. Caesarean Section had to be done in 103 (10.8%) cases. The indications for Caesarean Section were foetal distress in 42 (40%), occipito-posterior position in 8 (7.7%), abruptioplacentae 2 (1.9%), cord around the neck 9 (7%), uterine hyperstimulation 6 (5.8%) and failure to progress in 20 (19%) cases. Admission to NICU was 28 (3.3%) and Neonatal deaths were 5 (0.5%). Postpartum Haemorrhage (PPH) was observed in 22 (2.3%) patients. There was no case of rupture uterus. Vaginal Misoprostol appears to be safe and effective for cervical ripening in 3rd Trimester. It helps vaginal delivery within 24 hours, does not increase incidence of Caesarean Section and has no adverse effect on foetal outcome. It could also be used in circumstances where extensive monitoring techniques are not available though close observation and

  16. Hormone, metabolic peptide, and nutrient levels in the earliest phases of rheumatoid arthritis-contribution of free fatty acids to an increased cardiovascular risk during very early disease.

    PubMed

    Tang, Man Wai; Koopman, Frieda A; Visscher, Jan P M; de Hair, Maria J; Gerlag, Danielle M; Tak, Paul Peter

    2017-02-01

    Rheumatoid arthritis (RA) is a chronic autoimmune disease associated with changes in several hormones and metabolic peptides. Crosstalk between these factors and the immune system may be important for homeostasis during inflammation. Here, we studied the levels of hormones, metabolic peptides, and nutrients in individuals at risk for developing RA (at risk). In total, 18 hormones, metabolic peptides, and nutrients were measured in fasting serum samples from 45 autoantibody-positive individuals at risk, 22 RA patients, and 16 healthy subjects. Triglyceride (TG) levels were also measured in an independent validation cohort of 32 individuals at risk, 20 early arthritis patients, and 20 healthy controls. We found an elevated TG level in individuals at risk and significantly higher TG levels in RA patients compared to healthy controls. These results were confirmed in the validation cohort. Similarly, free fatty acid (FFA) levels showed an increase in individuals at risk and were significantly higher in RA patients compared to healthy controls. In RA patients, FFA levels were positively correlated with disease activity. Pancreatic polypeptide (PP) and norepinephrine levels were highly significantly increased in individuals at risk and RA patients compared to healthy controls. TG and FFA levels are increased in RA patients and positively correlated with disease activity parameters. The results presented here suggest a role for FFAs in the pathogenesis of RA. Furthermore, PP and norepinephrine may be a biomarker that could assist in the identification of individuals at risk.

  17. Prevalence of cardiovascular risk factors in relation to metabolic syndrome in the Roma population compared with the non-Roma population in the eastern part of Slovakia.

    PubMed

    Fedacko, Ján; Pella, Daniel; Jarcuska, Peter; Siegfried, Leonard; Janicko, Martin; Veselíny, Eduard; Pella, Jozef; Sabol, Frantisek; Jarcuska, Pavol; Mareková, Mária; Gecková, Andrea Madarasová; Pazinka, Peter; Jankajová, Monika; Kmec, Ján; Babcák, Marián; Kalanin, Peter; Drazilová, Sylvia; Babinská, Ingrid; Cecetková, Beáta

    2014-03-01

    Obesity-induced metabolic syndrome is a multiple risk factor for cardiovascular (CV) risk factors and type 2 diabetes, and ethnic minorities seem to have unfavourable medical risk factors in general more frequently than majority populations. The aim of this study was to evaluate the prevalence of cardiovascular risk factors in relation to metabolic syndrome in the Roma population compared with the non-Roma population residing in the eastern part of Slovakia. 123 Roma and 79 non-Roma patients with metabolic syndrome were evaluated. Men between 40-55 years of age had 4.76-times higher odds and women 5.26-times higher odds for metabolic sydrome compared with the younger population. We found statistically significant higher waist circumference in the Roma subpopulation and higher body mass index as well, although in selected population with metabolic syndrome. HDL cholesterol was significantly lower in both Roma men and women, and LDL cholesterol was not significant in men and women with metabolic syndrome. Triglycerides levels were significantly higher in non-Roma women only. High-sensitivity C-reactive protein (hsCRP) values were not in correlation with age but were associated with the increasing number of fulfilled criteria for metabolic syndrome in both subgroups (Roma, non-Roma), independently of gender. Our study confirmed higher prevalence of obesity, metabolic syndrome and other CV risk factors associated with metabolic syndrome among younger Roma population, which may be associated with increased cardiovascular disease (CVD) morbidity and mortality among elderly Roma compared with non-Roma.

  18. Neuropeptide Y polymorphism increases the risk for asthma in overweight subjects; protection from atherosclerosis in asthmatic subjects--the cardiovascular risk in young Finns study.

    PubMed

    Jaakkola, U; Kakko, T; Juonala, M; Lehtimäki, T; Viikari, J; Jääskeläinen, A E; Mononen, N; Kähönen, M; Koskinen, T; Keltikangas-Järvinen, L; Raitakari, O; Kallio, J

    2012-12-01

    The role of neuropeptide Y (NPY) and its gene polymorphisms in the development of atherosclerosis has become increasingly evident. In asthma, NPY has been shown to be involved as immunomodulator. In this study, we investigated the role of two functional NPY polymorphisms, NPY-Leu7Pro (rs16139) and NPY-399C/T (rs16147) and obesity for the development of asthma as well as atherosclerosis in asthmatic and non-asthmatic subjects. Also, we measured heart rate variability (HRV) and NPY in serum since these might contribute through these polymorphisms to both diseases. Thousand hundred and seventy six Finnish young adults were genotyped and three groups (G1-G3) were formed based on the observed diplotypes. The NPY-Pro7 allele always co-existed with the NPY-399T allele indicating complete linkage disequilibrium. Here we show that overweight (BMI≥25kg/m2) was associated with 2.5-fold increased risk for asthma in subjects with the NPY-399T allele without NPY-Pro7 allele (G2, n=716). Overweight was also associated with increased atherosclerosis determined by carotid intima media thickness (cIMT), but asthma seemed to be more significant determinant than overweight in determing cIMT having a decreasing effect. NPY concentration in serum was diplotype-driven (G1=792.2(29.5), G2=849.0(18.9), G3=873.9(45.2) pg/ml) and correlated positively with cIMT in the group having NPY-Pro7 allele (G3, n=142). However, the subjects with asthma had a negative NPY-cIMT relationship. Total HRV was increased in asthma and correlated negatively with cIMT irrespective of the NPY genotype. Overweight together with the NPY-399T allele without NPY-Pro7 allele was associated with increased risk for asthma. Atherosclerosis was decreased in subjects with asthma depending on the NPY genotype. The results reveal novel insights into the genetics and biology of the relationship of atherosclerosis and asthma. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. Association of BMI and fasting insulin with cardiovascular disease risk factors in seven-year-old Icelandic children.

    PubMed

    Hrafnkelsson, Hannes; Magnusson, Kristjan T H; Sigurdsson, Emil L; Johannsson, Erlingur

    2009-01-01

    . To look at overweight and common cardiovascular disease (CVD) risk factors, and associations with body mass index (BMI) and fasting insulin in seven-year-old schoolchildren in Reykjavik, Iceland. Cross-sectional study of seven-year-old schoolchildren. Six elementary schools in Reykjavik. All children attending second grade in these six schools were invited to participate. Overweight, fasting serum insulin, CVD risk factors. Some 14% of the participating children were classified as overweight. Overweight children had higher fasting insulin, higher fasting glucose, and higher systolic and diastolic blood pressure. Furthermore, they had significantly lower total cholesterol (TC), lower high-density lipoprotein (HDL), and lower low-density lipoprotein (LDL) but a similar TC/LDL ratio to normal-weight children. The factors that were strongly associated with BMI were serum fasting insulin, systolic blood pressure (SBP), HDL and fasting glucose, while the sum of four skinfolds, triglycerides, glucose, and LDL were highly associated with fasting insulin. Overweight children are likelier to have unfavourable levels of common CVD risk factors included in metabolic syndrome, but surprisingly had lower LDL and TC. Skinfold thickness, higher triglyceride and glucose levels, and being female were associated with increased serum insulin.

  20. Behaviour of Saccharomyces cerevisiae wine strains during adaptation to unfavourable conditions of fermentation on synthetic medium: cell lipid composition, membrane integrity, viability and fermentative activity.

    PubMed

    Mannazzu, Ilaria; Angelozzi, Daniele; Belviso, Simona; Budroni, Marilena; Farris, Giovanni Antonio; Goffrini, Paola; Lodi, Tiziana; Marzona, Mario; Bardi, Laura

    2008-01-15

    During must fermentation wine strains are exposed to a variety of biotic and abiotic stresses which, when prevailing over the cellular defence systems, can affect cell viability with negative consequences on the progression of the fermentative process. To investigate the ability of wine strains to survive and adapt to unfavourable conditions of fermentation, the lipid composition, membrane integrity, cell viability and fermentative activity of three strains of Saccharomyces cerevisiae were analysed during hypoxic growth in a sugar-rich medium lacking lipid nutrients. These are stressful conditions, not unusual during must fermentation, which, by affecting lipid biosynthesis may exert a negative effect on yeast viability. The results obtained showed that the three strains were able to modulate cell lipid composition during fermentation. However, only two of them, which showed highest viability and membrane integrity at the end of the fermentation process, reached a fatty acid composition which seemed to be optimal for a successful adaptation. In particular, C16/TFA and UFA/TFA ratios, more than total lipid and ergosterol contents, seem to be involved in yeast adaptation.

  1. Clinical and laboratory characterization of 114 cases of Castleman disease patients from a single centre: paraneoplastic pemphigus is an unfavourable prognostic factor.

    PubMed

    Dong, Yujun; Wang, Mingyue; Nong, Lin; Wang, Lihong; Cen, Xinan; Liu, Wei; Zhu, Sainan; Sun, Yuhua; Liang, Zeyin; Li, Yuan; Ou, Jinping; Qiu, Zhixiang; Ren, Hanyun

    2015-06-01

    This study retrospectively collected the clinical and laboratory data of 114 patients with Castleman disease (CD) from a single medical centre. Clinical classification identified 62 patients (54·4%) with unicentric Castleman disease and 52 (45·6%) with multi-centric Castleman disease. Pathological classification revealed 68 cases (59·6%) of hyaline vascular variant, 16 (14·1%) mixed cellular variant (Mix) and 30 (26·3%) plasmacytic variant. Clinical complications occurred in 69 CD patients, including 37 cases of paraneoplastic pemphigus (PNP) and 25 cases with renal complications. Haematological involvement, pleural effusion and/or ascites and POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy and skin changes) were also found. Univariate analysis showed that presence of clinical complications and PNP were both risk factors relating to CD patient survival. Prognostic factors showing P < 0·15 in univariate analysis and those with clinical significance were subjected to multivariate analysis using a Cox regression model. PNP presence and age over 40 years both significantly adversely affected survival. Thus, only presence of PNP was identified as an independent unfavourable survival risk factor in both univariate and multivariate analyses. Overall, the present data provide a panoramic description of CD cases and emphasize that the presence of PNP is an adverse prognostic factor. © 2015 John Wiley & Sons Ltd.

  2. Acral lentiginous melanoma - a skin cancer with unfavourable prognostic features. A study of the German Central Malignant Melanoma Registry (CMMR) in 2050 patients.

    PubMed

    Teramoto, Y; Keim, U; Gesierich, A; Schuler, G; Fiedler, E; Tüting, T; Ulrich, C; Wollina, U; Hassel, J C; Gutzmer, R; Goerdt, S; Zouboulis, C; Leiter, U; Eigentler, T K; Garbe, C

    2017-07-14

    Acral lentiginous melanoma (ALM) is one of the four major subtypes in cutaneous melanoma (CM). Although ALM has a poorer prognosis than other CM subtypes, the prognostic factors of ALM have been verified only in small-sized cohorts because of the low incidence of ALM worldwide. To investigate clinical characteristics of ALM and to evaluate their prognostic values based on a large dataset from the Central Malignant Melanoma Registry (CMMR) of the German Dermatologic Society. The Kaplan-Meier method was used to estimate the potential influence of clinical and histological parameters on ALM disease-specific survival (DSS) curves, which were compared using log-rank test. A cox proportional hazards model was used to identify independent prognostic factors for DSS. 2,050 ALM patients were identified from 58,949 CM patients recorded by CMMR with follow-up data. In multivariate analyses, age (p=0.006), ulceration (p = 0.013), tumour thickness (p < 0.001) and tumour spread (p < 0.001) turned out to be significant prognostic factors for DSS in ALM whereas gender, nevus association and level of invasion were not independent factors. Acral lentiginous melanoma has the same prognostic factors as the other subtypes of melanoma. Unfavourable prognosis probably derives from the delay of diagnosis in comparison to other melanoma subtypes. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  3. The fetal cardiovascular response to increased placental vascular impedance to flow determined with four-dimensional ultrasound using spatiotemporal image correlation and virtual organ computer-aided analysis

    PubMed Central

    Hamill, Neil; Romero, Roberto; Hassan, Sonia; Lee, Wesley; Myers, Stephen A.; Mittal, Pooja; Kusanovic, Juan Pedro; Balasubramaniam, Mamtha; Chaiworapongsa, Tinnakorn; Vaisbuch, Edi; Espinoza, Jimmy; Gotsch, Francesca; Goncalves, Luis F.; Mazaki-Tovi, Shali; Erez, Offer; Hernandez-Andrade, Edgar; Yeo, Lami

    2014-01-01

    Objective To determine if increased placental vascular impedance to flow is associated with changes in fetal cardiac function using spatiotemporal image correlation (STIC) and Virtual Organ Computer-aided AnaLysis (VOCAL). Study Design A cross-sectional study was performed in fetuses with an umbilical artery pulsatility index > 95th percentile (ABN). Ventricular volume (end-systole, end-diastole), stroke volume (SV), cardiac output (CO), adjusted CO, and ejection fraction (EF) were compared to those of 184 normal fetuses (NL). Results 1) 34 fetuses were evaluated at a median gestational age of 28.3 (range 20.6 – 36.9) weeks; 2) mean ventricular volumes were lower for ABN than NL (end-systole, end-diastole) with a proportionally greater decrease for left ventricular volume (vs. right); 3) mean left and right SV, CO, and adjusted CO were lower for ABN (vs. NL); 4) right ventricular volume, SV, CO, and adjusted CO exceeded the left in ABN fetuses; 5) mean EF was greater for ABN than NL; and 6) median left EF was greater (vs. right) in ABN fetuses. Conclusion Increased placental vascular impedance to flow is associated with changes in fetal cardiac function. PMID:23220270

  4. Hostility and cognitive control: Evidence of increased cardiovascular reactivity as a function of exposure to affective stress using a dichotic listening paradigm.

    PubMed

    Holland, Alissa K; Mitchell, Gina A; Steele, Angela; Bunting, Jessica; Harrison, David W

    2017-09-07

    Indices of cognitive control were examined in men with high and low levels of trait hostility as a function of exposure to affective and cognitive stress. A dual concurrent task paradigm was used whereby participants intentionally directed focus to the left or right ear under dichotic listening conditions before and after exposure to angry infant vocalizations. Analysis of the behavioral data supports the prediction of reduced right frontal regulatory control in men with high levels of hostility as indicated by diminished capacity to suppress report of phonemes presented to the language dominant left hemisphere (right ear) in the Focus Left condition. This diminishment in the capacity to suppress report of phonemes presented to the right ear in the Focus Left condition is suggestive of reduced cognitive control. With respect to the neurophysiological data, heart rate increased for only men with high levels of hostility in the Focus Left condition, and this was especially evident in the post-affective stress condition. This increase in right hemisphere arousal provides additional evidence of reduced cognitive control and support for the capacity model of hostility by implicating poor right frontal regulatory control over right posterior cerebral regions under dual task conditions. The results are discussed in terms of integrating the construct of cognitive control into the capacity model as well as providing implications regarding reductions in the capacity to suppress predominant aggressive responses in domestic settings. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Cardiovascular effects of air pollution.

    PubMed

    Bourdrel, Thomas; Bind, Marie-Abèle; Béjot, Yannick; Morel, Olivier; Argacha, Jean-François

    2017-07-20

    Air pollution is composed of particulate matter (PM) and gaseous pollutants, such as nitrogen dioxide and ozone. PM is classified according to size into coarse particles (PM10), fine particles (PM2.5) and ultrafine particles. We aim to provide an original review of the scientific evidence from epidemiological and experimental studies examining the cardiovascular effects of outdoor air pollution. Pooled epidemiological studies reported that a 10μg/m(3) increase in long-term exposure to PM2.5 was associated with an 11% increase in cardiovascular mortality. Increased cardiovascular mortality was also related to long-term and short-term exposure to nitrogen dioxide. Exposure to air pollution and road traffic was associated with an increased risk of arteriosclerosis, as shown by premature aortic and coronary calcification. Short-term increases in air pollution were associated with an increased risk of myocardial infarction, stroke and acute heart failure. The risk was increased even when pollutant concentrations were below European standards. Reinforcing the evidence from epidemiological studies, numerous experimental studies demonstrated that air pollution promotes a systemic vascular oxidative stress reaction. Radical oxygen species induce endothelial dysfunction, monocyte activation and some proatherogenic changes in lipoproteins, which initiate plaque formation. Furthermore, air pollution favours thrombus formation, because of an increase in coagulation factors and platelet activation. Experimental studies also indicate that some pollutants have more harmful cardiovascular effects, such as combustion-derived PM2.5 and ultrafine particles. Air pollution is a major contributor to cardiovascular diseases. Promotion of safer air quality appears to be a new challenge in cardiovascular disease prevention. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  6. Stress and atherosclerotic cardiovascular disease.

    PubMed

    Inoue, Nobutaka

    2014-01-01

    Recent major advances in medical science have introduced a wide variety of treatments against atherosclerosis-based cardiovascular diseases, which has led to a significant reduction in mortality associated with these diseases. However, atherosclerosis-based cardiovascular disease remains a leading cause of death. Furthermore, progress in medical science has demonstrated the pathogenesis of cardiovascular disease to be complicated, with a wide variety of underlying factors. Among these factors, stress is thought to be pivotal. Several types of stress are involved in the development of cardiovascular disease, including oxidative stress, mental stress, hemodynamic stress and social stress. Accumulating evidence indicates that traditional risk factors for atherosclerosis, including diabetes, hyperlipidemia, hypertension and smoking, induce oxidative stress in the vasculature. Oxidative stress is implicated in the pathogenesis of endothelial dysfunction, atherogenesis, hypertension and remodeling of blood vessels. Meanwhile, mental stress is a well-known major contributor to the development of cardiovascular disease. The cardiovascular system is constantly exposed to hemodynamic stress by the blood flow and/or pulsation, and hemodynamic stress exerts profound effects on the biology of vascular cells and cardiomyocytes. In addition, social stress, such as that due to a lack of social support, poverty or living alone, has a negative impact on the incidence of cardiovascular disease. Furthermore, there are interactions between mental, oxidative and hemodynamic stress. The production of reactive oxygen species is increased under high levels of mental stress in close association with oxidative stress. These stress responses and their interactions play central roles in the pathogenesis of atherosclerosis-based cardiovascular disease. Accordingly, the pathophysiological and clinical implications of stress are discussed in this article.

  7. Age-associated increase in abdominal obesity and insulin resistance, and usefulness of AHA/NHLBI definition of metabolic syndrome for predicting cardiovascular disease in Japanese elderly with type 2 diabetes mellitus.

    PubMed

    Sakurai, Takashi; Iimuro, Satoshi; Araki, Atsushi; Umegaki, Hiroyuki; Ohashi, Yasuo; Yokono, Koichi; Ito, Hideki

    2010-01-01

    Management of metabolic syndrome (MetS) seems to constitute an efficient strategy to attain successful ageing. Although the clinical entity of MetS in patients with diabetes mellitus has been discussed, there is very little information on MetS-type cardiometabolic risk factor clustering in diabetic elderly. To determine the relationship among age-associated changes in obesity, insulin resistance, and clustering of MetS-type risk factors, in association with vascular complications, in Japanese elderly with type 2 diabetes. A cross-sectional study was conducted of 812 diabetic elderly enrolled in the Japanese Elderly Diabetes Intervention Trial. Information on diabetes, blood examinations and complications was obtained. Abdominal obesity, insulin resistance and prevalence of MetS risk factor clustering, defined by three sets of criteria from the International Diabetes Federation (IDF), the Japanese Society of Internal Medicine (JSIM), and the American Heart Association and the National Heart, Lung, and Blood Institute (AHA/NHLBI), were analyzed. Waist circumference and insulin resistance estimated by homeostasis model assessment insulin resistance (HOMA-IR) increased with age, followed by a partial decrease at age 80 and over. Prevalence of IDF-MetS and JSIM-MetS also increased with age at least until the age of 80, whereas the incidence of AHA/NHLBI-MetS did not show any apparent age changes. There was a significant crude linear association between waist circumference and HOMA-IR, which was highly elevated in IDF and AHA/NHLBI overlapping with MetS, and also elevated in AHA/NHLBI without abdominal obesity. Although IDF-MetS and JSIM-MetS, which specify abdominal obesity, did not always appear to be associated with cardiovascular diseases, AHA/NHLBI-MetS, comprising both abdominal obesity and non-abdominal obesity, independently correlated with coronary heart disease and stroke after adjustment for other risk factors of atherosclerotic diseases. There was an age

  8. Effect of Pioglitazone and Ramipril on Biomarkers of Low-Grade Inflammation and Vascular Function in Nondiabetic Patients with Increased Cardiovascular Risk and an Activated Inflammation: Results from the PIOace Study

    PubMed Central

    Pfützner, Andreas; Hanefeld, Markolf; Dekordi, Lida A; Müller, Jürgen; Kleine, Iris; Fuchs, Winfried; Forst, Thomas

    2011-01-01

    Aims This study investigated the effects of pioglitazone (PIO), ramipril (RAM), or their combination (PIRA) on low-grade inflammation in nondiabetic hypertensive patients with increased cardiovascular risk. Methods and Results Patients enrolled in this placebo-controlled, double-blind, randomized, parallel trial (72 male, 77 female, aged 60 ± 9 years, body mass index 30.4 ± 4.7 kg/m2, duration of hypertension 9 ± 8 years) were treated with either 30/45 mg PIO (dose titration), 2.5/5 mg RAM, or their combination for 12 weeks. A reduction in high-sensitivity C-reactive protein was observed with PIO (−0.89 ± 1.98 mg/liter; -25%) and PIRA (−0.49 ± 2.11 mg/liter; -16%), while an increase was seen with RAM (0.58 ± 2.13 mg/liter; +20%, p < .05 vs PIO and PIRA). The 24-hour blood pressure profile showed a small increase with both monotherapies but a decrease with PIRA (p < .05 vs PIO). Improvements in biomarkers of chronic systemic inflammation and insulin resistance (IR) were observed in the PIO and PIRA arms only [PIO/RAM/PIRA: homeostasis model of assessment of IR: -0.78 ± 1.39 (−29%)/0.15 ± 1.03 (+5%)/ -1.44 ± 2.83 (−40%); adiponectin: 8.51 ± 5.91 (+104%)/ 0.09 ± 2.63 (+1%)/ 8.86 ± 6.37 mg/liter (+107%); matrix metallo-proteinase-9: -48 ± 127 (−12%)/-1 ± 224 (0%)/-60 ± 210 ng/ml (−13%), p < .05 for RAM vs PIO or PIRA in all cases]. Conclusions Our 3-month study in nondiabetic hypertensive patients showed a decrease in biomarkers of IR and chronic systemic inflammation with the PIO monotherapy and the PIRA combination only, which may help to explain some findings in other cardiovascular outcome trials. PMID:21880242

  9. Risk factors for unfavourable postoperative outcome in patients with Crohn's disease undergoing right hemicolectomy or ileocaecal resection An international audit by ESCP and S-ECCO.

    PubMed

    2017-09-15

    Patient and disease-related factors, as well as operation technique all have the potential to impact on postoperative outcome in Crohn's disease. The available evidence is based on small series and often displays conflicting results. To investigate the effect of pre- and intra-operative risk factors on 30-day postoperative outcome in patients undergoing surgery for Crohn's disease. International prospective snapshot audit including consecutive patients undergoing right hemicolectomy or ileocaecal resection. This study analysed a subset of patients who underwent surgery for Crohn's disease. The primary outcome measure was the overall Clavien-Dindo postoperative complication rate. The key secondary outcomes were anastomotic leak, re-operation, surgical site infection and length of stay at hospital. Multivariable binary logistic regression analyses were used to produce odds ratios (OR) and 95% confidence intervals (CI). Three hundred and seventy five resections in 375 patients were included. The median age was 37 and 57.1% were female. In multivariate analyses, postoperative complications were associated with preoperative parenteral nutrition (OR 2.36 95% CI 1.10-4.97)], urgent/expedited surgical intervention (OR 2.00, 95% CI 1.13-3.55) and unplanned intraoperative adverse events (OR 2.30, 95% CI 1.20-4.45). The postoperative length of stay in hospital was prolonged in patients who received preoperative parenteral nutrition (OR 31, CI [1.08-1.61]) and those who had urgent/expedited operations (OR 1.21, CI [1.07-1.37]). Preoperative parenteral nutritional support, urgent/expedited operation and unplanned intraoperative adverse events were associated with unfavourable postoperative outcome. Enhanced preoperative optimization and improved planning of operation pathways and timings may improve outcomes for patients. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  10. Evaluation of stability of allergen extracts for sublingual immunotherapy during transport under unfavourable temperature conditions with an innovative thermal insulating packaging.

    PubMed

    Puccinelli, P; Natoli, V; Dell'albani, I; Scurati, S; Incorvaia, C; Barbieri, S; Masieri, S; Frati, F

    2013-10-01

    Many pharmaceutical and biotechnological products are temperature-sensitive and should normally be kept at a controlled temperature, particularly during transport, in order to prevent the loss of their stability and activity. Therefore, stability studies should be performed for temperature-sensitive products, considering product characteristics, typical environmental conditions, and anticipating environmental extremes that may occur during product transport in a specific country. Staloral products for sublingual immunotherapy are temperature sensitive and are labelled for maintenance under refrigerated conditions (2-8°C). Given the peculiar climatic context of Italy and the great temperature fluctuations that may occur during transport, this study was aimed at evaluating the impact of a new engineered thermal insulating packaging for Staloral. In particular, the purpose was to assess whether the new packaging could create a container condition able to preserve the stability and immunological activity of the product during the transport phase throughout Italy. The results showed that the range of temperatures that can affect the product, in the area surrounding the product packaging, may reach a peak of 63°C during transport under the most unfavourable climatic conditions, i.e. in a non-refrigerated van during the summer season, from the site of production in France to the patient's house in Catania, the city with the highest temperatures in Italy. However, the highest temperature reached inside the vaccine did not exceed 45°C over a period of about 2 h. The ELISA inhibition test on samples subjected to the extreme temperature conditions previously defined (45°C) showed an immunological activity higher than 75% of that initially measured and was comparable to those obtained with samples stored at controlled temperature (5°C). This means that, even in the worst case scenario, the structure of the allergen extracts is not influenced and the vaccine potency is

  11. The Applicability of Nonlinear Systems Dynamics Chaos Measures to Cardiovascular Physiology Variables

    NASA Technical Reports Server (NTRS)

    Hooker, John C.

    1991-01-01

    Three measures of nonlinear chaos (fractal dimension, Approximate Entropy (ApEn), and Lyapunov exponents) were studied as potential measures of cardiovascular condition. It is suggested that these measures have potential in the assessment of cardiovascular condition in environments of normal cardiovascular stress (normal gravity on the Earth surface), cardiovascular deconditioning (microgravity of space), and increased cardiovascular stress (lower body negative pressure (LBNP) treatments).

  12. Increased risk of cardiovascular disease (CVD) with age in HIV-positive men: a comparison of the D:A:D CVD risk equation and general population CVD risk equations.

    PubMed

    Petoumenos, K; Reiss, P; Ryom, L; Rickenbach, M; Sabin, C A; El-Sadr, W; d'Arminio Monforte, A; Phillips, A N; De Wit, S; Kirk, O; Dabis, F; Pradier, C; Lundgren, J D; Law, M G

    2014-11-01

    The aim of the study was to statistically model the relative increased risk of cardiovascular disease (CVD) per year older in Data collection on Adverse events of anti-HIV Drugs (D:A:D) and to compare this with the relative increased risk of CVD per year older in general population risk equations. We analysed three endpoints: myocardial infarction (MI), coronary heart disease (CHD: MI or invasive coronary procedure) and CVD (CHD or stroke). We fitted a number of parametric age effects, adjusting for known risk factors and antiretroviral therapy (ART) use. The best-fitting age effect was determined using the Akaike information criterion. We compared the ageing effect from D:A:D with that from the general population risk equations: the Framingham Heart Study, CUORE and ASSIGN risk scores. A total of 24 323 men were included in analyses. Crude MI, CHD and CVD event rates per 1000 person-years increased from 2.29, 3.11 and 3.65 in those aged 40-45 years to 6.53, 11.91 and 15.89 in those aged 60-65 years, respectively. The best-fitting models included inverse age for MI and age + age(2) for CHD and CVD. In D:A:D there was a slowly accelerating increased risk of CHD and CVD per year older, which appeared to be only modest yet was consistently raised compared with the risk in the general population. The relative risk of MI with age was not different between D:A:D and the general population. We found only limited evidence of accelerating increased risk of CVD with age in D:A:D compared with the general population. The absolute risk of CVD associated with HIV infection remains uncertain. © 2014 British HIV Association.

  13. ASICs and cardiovascular homeostasis.

    PubMed

    Abboud, François M; Benson, Christopher J

    2015-07-01

    In this review we address primarily the role of ASICs in determining sensory signals from arterial baroreceptors, peripheral chemoreceptors, and cardiopulmonary and somatic afferents. Alterations in these sensory signals during acute cardiovascular stresses result in changes in sympathetic and parasympathetic activities that restore cardiovascular homeostasis. In pathological states, however, chronic dysfunctions of these afferents result in serious sympatho-vagal imbalances with significant increases in mortality and morbidity. We identified a role for ASIC2 in the mechano-sensitivity of aortic baroreceptors and of ASIC3 in the pH sensitivity of carotid bodies. In spontaneously hypertensive rats, we reported decreased expression of ASIC2 in nodose ganglia neurons and overexpression of ASIC3 in carotid bodies. This reciprocal expression of ASIC2 and ASIC3 results in reciprocal changes in sensory sensitivity of baro- and chemoreceptors and a consequential synergistic exaggeration sympathetic nerve activity. A similar reciprocal sensory dysautonomia prevails in heart failure and increases the risk of mortality. There is also evidence that ASIC heteromers in skeletal muscle afferents contribute significantly to the exercise pressor reflex. In cardiac muscle afferents of the dorsal root ganglia, they contribute to nociception and to the detrimental sympathetic activation during ischemia. Finally, we report that an inhibitory influence of ASIC2-mediated baroreceptor activity suppresses the sympatho-excitatory reflexes of the chemoreceptors and skeletal muscle afferents, as well as the ASIC1a-mediated excitation of central neurons during fear, threat, or panic. The translational potential of activation of ASIC2 in cardiovascular disease states may be a beneficial sympatho-inhibition and parasympathetic activation. This article is part of the Special Issue entitled 'Acid-Sensing Ion Channels in the Nervous System'.

  14. HIV and General Cardiovascular Risk

    PubMed Central

    Capili, Bernadette; Anastasi, Joyce K.; Ogedegbe, Olugbenga

    2011-01-01

    The incidence of cardiovascular disease (CVD) is increasing in HIV-infected people. Risk factors such as hyperlipidemia, impaired glucose tolerance, and insulin resistance have become common. CVD in HIV may also be related to non-traditional risk factors including accumulation of visceral fat, inflammation secondary to HIV, and effects of some antiretroviral drugs. This cross-sectional study described the CVD risk factors of 123 adults living with HIV and calculated the 10-year estimate for general cardiovascular risk score. Results showed that approximately 25% of the participants were considered to be at high risk for developing CVD in the next 10 years. Increased waist circumference and longer duration of smoking habit were associated with elevated general cardiovascular risk scores. Similar to the general population, most of the identified risks could be modified through lifestyle management. PMID:21277230

  15. Preeclampsia: exposing future cardiovascular risk in mothers and their children.

    PubMed

    Anderson, Cindy M

    2007-01-01

    There is an increased risk for future cardiovascular disease in women who have had preeclampsia. In infants born to mothers with preeclampsia, there is growing evidence of increased risk for both cardiovascular disease and preeclampsia. Epidemiologic and experimental data provide a strong link between intrauterine exposure to preeclampsia and subsequent risk for the development of cardiovascular disease in women.

  16. An international model to predict recurrent cardiovascular disease.

    PubMed

    Wilson, Peter W F; D'Agostino, Ralph; Bhatt, Deepak L; Eagle, Kim; Pencina, Michael J; Smith, Sidney C; Alberts, Mark J; Dallongeville, Jean; Goto, Shinya; Hirsch, Alan T; Liau, Chiau-Suong; Ohman, E Magnus; Röther, Joachim; Reid, Christopher; Mas, Jean-Louis; Steg, Ph Gabriel

    2012-07-01

    Prediction models for cardiovascular events and cardiovascular death in patients with established cardiovascular disease are not generally available. Participants from the prospective REduction of Atherothrombosis for Continued Health (REACH) Registry provided a global outpatient population with known cardiovascular disease at entry. Cardiovascular prediction models were estimated from the 2-year follow-up data of 49,689 participants from around the world. A developmental prediction model was estimated from 33,419 randomly selected participants (2394 cardiovascular events with 1029 cardiovascular deaths) from the pool of 49,689. The number of vascular beds with clinical disease, diabetes, smoking, low body mass index, history of atrial fibrillation, cardiac failure, and history of cardiovascular event(s) <1 year before baseline examination increased risk of a subsequent cardiovascular event. Statin (hazard ratio 0.75; 95% confidence interval, 0.69-0.82) and acetylsalicylic acid therapy (hazard ratio 0.90; 95% confidence interval, 0.83-0.99) also were significantly associated with reduced risk of cardiovascular events. The prediction model was validated in the remaining 16,270 REACH subjects (1172 cardiovascular events, 494 cardiovascular deaths). Risk of cardiovascular death was similarly estimated with the same set of risk factors. Simple algorithms were developed for prediction of overall cardiovascular events and for cardiovascular death. This study establishes and validates a risk model to predict secondary cardiovascular events and cardiovascular death in outpatients with established atherothrombotic disease. Traditional risk factors, burden of disease, lack of treatment, and geographic location all are related to an increased risk of subsequent cardiovascular morbidity and cardiovascular mortality. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. [Psychological disorders and cardiovascular diseases].

    PubMed

    Monami, Matteo; Marchionni, Niccolò

    2007-06-01

    The present review is aimed at critically analyzing the available literature on the relationship between psycho-emotional disorders and cardiovascular disease, and the effects of antidepressant and antianxiety drugs on clinically relevant outcomes. An extensive Medline search has been conducted between January 1966 and December 2006 using "coronary artery disease", "cardiac disease", "depression", "anxiety", and "emotional disorders" in all their possible combinations as search terms. Among patients with cardiovascular disease, depression and/or anxiety are very common, with a prevalence ranging from 15% to 50%. Many epidemiological studies with extended periods of follow-up have shown that psycho-emotional disorders (in particular, depressive disorders) are associated with increased risk of incident cardiovascular events, rehospitalization, all-cause and cardiovascular mortality both in patients with overt cardiac disease and in the general population. Pathophysiologic reasons supporting this association are represented by unhealthy lifestyle (i.e. persistent smoking habits, inadequate adherence to medical prescriptions, etc.) associated with psycho-emotional disorders, and also by functional alterations of the hypothalamic-pituitary-adrenal axis, platelets, and autonomic nervous system. Some observational studies and clinical trials with small numbers of patients included suggest that these alterations are effectively antagonized by some antidepressant/antianxiety drugs. However, no randomized clinical trial has yet demonstrated that such drugs can reduce the increased risk of unfavorable clinical events associated with psycho-emotional disorders. Despite a proven association of psycho-emotional disorders with an increased cardiovascular risk, and the demonstration that several antidepressant/antianxiety pharmacological agents favorably affect the pathophysiologic alterations associated with such disorders, randomized clinical trials with adequately large sample

  18. Cardiovascular Disease and Diabetes

    MedlinePlus

    ... loud and clear that there is a strong correlation between cardiovascular disease (CVD) and diabetes. At least ... has been strongly associated with insulin resistance. Weight loss can improve cardiovascular risk, decrease insulin concentration and ...

  19. Framingham Risk Score underestimates cardiovascular disease risk in severe psoriatic patients: implications in cardiovascular risk factors management and primary prevention of cardiovascular disease.

    PubMed

    Torres, Tiago; Sales, Rita; Vasconcelos, Carlos; Martins da Silva, Berta; Selores, Manuela

    2013-11-01

    Severe psoriasis has been associated with increase cardiovascular mortality, due to a higher prevalence of traditional cardiovascular risk factors and premature atherosclerosis, as a consequence of its systemic inflammation. Recently, it has been estimated that severe psoriasis may confer an increased 6.2% on long-term risk of cardiovascular disease based on Framingham Risk Score, which can have practical implications in the treatment of cardiovascular risk factors and primary prevention of cardiovascular disease, as treatment guidelines account for the risk of cardiovascular disease in treatment goals. The aim of this study was to analyze the influence of the attributable risk of severe psoriasis on long-term risk of cardiovascular disease and its implication on the correct treatment of cardiovascular risk factors and primary prevention of cardiovascular disease on a real-world cohort of patients. One hundred severe psoriasis patients without psoriatic arthritis or previous cardiovascular disease were evaluated and it was found that more than half of the patients were reclassified to a higher cardiovascular risk category with important clinical implications on the correct management of their cardiovascular risk factors and primary prevention of cardiovascular disease, as a considerable proportion of patients with hypertension, hypercholesterolemia and coronary heart disease equivalent risk were not being correctly managed.

  20. [Thyroid and cardiovascular system].

    PubMed

    Gallowitsch, Hans-Jürgen

    2005-10-01

    The cardiocirculatory changes in hyperthyroidism seem to be an accommodation to the increased metabolic demands and lead to an increased perfusion of the peripheral tissues. Due to the influence of elevated thyroid hormone levels, contractility, stroke volume, resting heart rate, and contraction and relaxation velocity of the left ventricle increase. Caused by direct effect on the smooth vascular muscle, systemic vascular resistance is decreased with the consequence of a diminished afterload and an increased cardiac efficiency. The activation of the renin-angiotensin-aldosteron system and the increased production of erythropoietin additionally lead to an increased blood volume, which increases cardiac preload together with the increased venous backflow. Manifest hypothyroidism is characterized by bradycardia and diastolic dysfunction in rest and systolic dysfunction at stress. Despite a slight increase of diastolic blood pressure due to an increased systemic vascular resistance, blood pressure remains nearly stable because of diminished cardiac output. Hypercholesterinaemia and diastolic hypertension in hypothyroid patients can lead to the development of arteriosclerosis and coronary heart disease (CHD). Also subclinical hypothyroidism is associated with a significantly higher risk for arteriosclerosis and CHD, whereas subclinical hyperthyroidism seems to be associated with an increased mortality for all reasons, especially for cardiovascular diseases.

  1. Infection and Cardiovascular Disease

    ClinicalTrials.gov

    2016-02-17

    Cardiovascular Diseases; Coronary Disease; Cerebrovascular Accident; Heart Diseases; Myocardial Infarction; Infection; Chlamydia Infections; Cytomegalovirus Infections; Helicobacter Infections; Atherosclerosis

  2. Cardiovascular and other effects of salt consumption

    PubMed Central

    Cappuccio, Francesco P

    2013-01-01

    Salt is one of the most important determinants of high blood pressure and increased cardiovascular risk worldwide. However, a high salt intake has other adverse effects beyond those involving the cardiovascular system, so that there is renewed interest in the relationships between high salt intake and other diseases. PMID:25019010

  3. Cardiovascular Complications of Pregnancy

    PubMed Central

    Gongora, Maria Carolina; Wenger, Nanette K.

    2015-01-01

    Pregnancy causes significant metabolic and hemodynamic changes in a woman’s physiology to allow for fetal growth. The inability to adapt to these changes might result in the development of hypertensive disorders of pregnancy (hypertension, preeclampsia or eclampsia), gestational diabetes and preterm birth. Contrary to previous beliefs these complications are not limited to the pregnancy period and may leave permanent vascular and metabolic damage. There is in addition, a direct association between these disorders and increased risk of future cardiovascular disease (CVD, including hypertension, ischemic heart disease, heart failure and stroke) and diabetes mellitus. Despite abundant evidence of this association, women who present with these complications of pregnancy do not receive adequate postpartum follow up and counseling regarding their increased risk of future CVD. The postpartum period in these women represents a unique opportunity to intervene with lifestyle modifications designed to reduce the development of premature cardiovascular complications. In some cases it allows early diagnosis and treatment of chronic hypertension or diabetes mellitus. The awareness of this relationship is growing in the medical community, especially among obstetricians and primary care physicians, who play a pivotal role in detecting these complications and assuring appropriate follow up. PMID:26473833

  4. Arsenic and cardiovascular disease.

    PubMed

    States, J Christopher; Srivastava, Sanjay; Chen, Yu; Barchowsky, Aaron

    2009-02-01

    Chronic arsenic exposure is a worldwide health problem. Although arsenic-induced cancer has been widely studied, comparatively little attention has been paid to arsenic-induced vascular disease. Epidemiological studies have shown that chronic arsenic exposure is associated with increased morbidity and mortality from cardiovascular disease. In addition, studies suggest that susceptibility to arsenic-induced vascular disease may be modified by nutritional factors in addition to genetic factors. Recently, animal models for arsenic-induced atherosclerosis and liver sinusoidal endothelial cell dysfunction have been developed. Initial studies in these models show that arsenic exposure accelerates and exacerbates atherosclerosis in apolipoprotein E-knockout mice. Microarray studies of liver mRNA and micro-RNA abundance in mice exposed in utero suggest that a permanent state of stress is induced by the arsenic exposure. Furthermore, the livers of the arsenic-exposed mice have activated pathways involved in immune responses suggesting a pro-hyperinflammatory state. Arsenic exposure of mice after weaning shows a clear dose-response in the extent of disease exacerbation. In addition, increased inflammation in arterial wall is evident. In response to arsenic-stimulated oxidative signaling, liver sinusoidal endothelium differentiates into a continuous endothelium that limits nutrient exchange and waste elimination. Data suggest that nicotinamide adenine dinucleotide phosphate oxidase-derived superoxide or its derivatives are essential second messengers in the signaling pathway for arsenic-stimulated vessel remodeling. The recent findings provide future directions for research into the cardiovascular effects of arsenic exposure.

  5. Cardiovascular Complications of Pregnancy.

    PubMed

    Gongora, Maria Carolina; Wenger, Nanette K

    2015-10-09

    Pregnancy causes significant metabolic and hemodynamic changes in a woman's physiology to allow for fetal growth. The inability to adapt to these changes might result in the development of hypertensive disorders of pregnancy (hypertension, preeclampsia or eclampsia), gestational diabetes and preterm birth. Contrary to previous beliefs these complications are not limited to the pregnancy period and may leave permanent vascular and metabolic damage. There is in addition, a direct association between these disorders and increased risk of future cardiovascular disease (CVD, including hypertension, ischemic heart disease, heart failure and stroke) and diabetes mellitus. Despite abundant evidence of this association, women who present with these complications of pregnancy do not receive adequate postpartum follow up and counseling regarding their increased risk of future CVD. The postpartum period in these women represents a unique opportunity to intervene with lifestyle modifications designed to reduce the development of premature cardiovascular complications. In some cases it allows early diagnosis and treatment of chronic hypertension or diabetes mellitus. The awareness of this relationship is growing in the medical community, especially among obstetricians and primary care physicians, who play a pivotal role in detecting these complications and assuring appropriate follow up.

  6. Cardiovascular Implications of Preeclampsia.

    PubMed

    Burgess, Adriane; Founds, Sandra

    2016-01-01

    Cardiovascular disease (CVD) is the leading cause of death of women in the United States. Many healthcare providers are unaware of sex-specific factors that affect the development of CVD. Nursing care for women with a history of preeclampsia and their children is presented. Preeclampsia affects 4% to 8% of all pregnancies. Rates have increased by 25% over the past 2 decades. Research supports the link between preeclampsia and risk of future CVD in women and the children of affected pregnancies. Appropriate preconception, prenatal and postpartum education, and surveillance are necessary to improve the long-term health of both mother and infant. Currently, there are no evidence-based interventions specific to the prevention of CVD for women and their children who have been affected by preeclampsia. However, women who have had preeclampsia may require yearly risk factor assessment and education regarding cardiovascular prevention strategies such as smoking cessation, increased physical activity, importance of a healthy diet, and maintenance of a healthy weight. Preeclampsia should be acknowledged by healthcare providers as a CVD risk factor. Appropriate monitoring, education, and CVD preventive strategies need to be implemented with this population and their children.

  7. Physiological Changes to the Cardiovascular System at High Altitude and Its Effects on Cardiovascular Disease.

    PubMed

    Riley, Callum James; Gavin, Matthew

    2017-06-01

    Riley, Callum James, and Matthew Gavin. Physiological changes to the cardiovascular system at high altitude and its effects on cardiovascular disease. High Alt Med Biol. 18:102-113, 2017.-The physiological changes to the cardiovascular system in response to the high altitude environment are well understood. More recently, we have begun to understand how these changes may affect and cause detriment to cardiovascular disease. In addition to this, the increasing availability of altitude simulation has dramatically improved our understanding of the physiology of high altitude. This has allowed further study on the effect of altitude in those with cardiovascular disease in a safe and controlled environment as well as in healthy individuals. Using a thorough PubMed search, this review aims to integrate recent advances in cardiovascular physiology at altitude with previous understanding, as well as its potential implications on cardiovascular disease. Altogether, it was found that the changes at altitude to cardiovascular physiology are profound enough to have a noteworthy effect on many forms of cardiovascular disease. While often asymptomatic, there is some risk in high altitude exposure for individuals with certain cardiovascular diseases. Although controlled research in patients with cardiovascular disease was largely lacking, meaning firm conclusions cannot be drawn, these risks should be a consideration to both the individual and their physician.

  8. Unravelling cardiovascular disease using four dimensional flow cardiovascular magnetic resonance.

    PubMed

    Kamphuis, Vivian P; Westenberg, Jos J M; van der Palen, Roel L F; Blom, Nico A; de Roos, Albert; van der Geest, Rob; Elbaz, Mohammed S M; Roest, Arno A W

    2016-11-25

    Knowledge of normal and abnormal flow patterns in the human cardiovascular system increases our understanding of normal physiology and may help unravel the complex pathophysiological mechanisms leading to cardiovascular disease. Four-dimensional (4D) flow cardiovascular magnetic resonance (CMR) has emerged as a suitable technique that enables visualization of in vivo blood flow patterns and quantification of parameters that could potentially be of prognostic value in the disease process. In this review, current image processing tools that are used for comprehensive visualization and quantification of blood flow and energy distribution in the heart and great vessels will be discussed. Also, imaging biomarkers extracted from 4D flow CMR will be reviewed that have been shown to distinguish between normal and abnormal flow patterns. Furthermore, current applications of 4D flow CMR in the heart and great vessels will be discussed, showing its potential as an additional diagnostic modality which could aid in disease management and timing of surgical intervention.

  9. [Risk factors for cardiovascular diseases in the descendants of patients after early myocardial infarction].

    PubMed

    Mateřánková, Markéta; Karnosová, Petra; Mlíková Seidlerová, Jitka; Filipovský, Jan; Mayer, Otto

    2017-01-01

    The cardiovascular diseases (CVDs) developing as the result of atherosclerosis are among the most frequent causes of morbidity and mortality within the Czech Republic and elsewhere. Genetic predisposition for cardiovascular diseases is amplified in the presence of routine risk factors which can be influenced. Our aim was to establish whether the level of the risk factors for ICHS already differs in the population of healthy descendants of the patients after early myocardial infarction, as opposed to the control group of examined individuals. We approached adult children (n = 127; age 28.7 ± 6.5 years) of the patients with early manifestation of ICHS, who were examined within the study EUROASPIRE IV. The examination of both the descendants and the control group (n = 199; age 28.9 ± 5.3 years) focused on identifying the risk factors for ICHS. Descendants presented arterial hypertension more often (18.9 vs 8.0 %, p = 0.003) and there were more smokers among them compared to the control group (37 vs 24.1 %, p = 0.01). The levels of triglycerides (1.13 vs 0.99 mmol/l, p = 0.05) and LDL-cholesterol (2.7 vs 2.45 mmol/l, p = 0.01) were higher in the descendant group, HDL-cholesterol was similar in both groups (1.6 vs 1.67 mmol/l, p = 0.17). Increased fasting glycemia occurred more frequent in the descendant group (5.5 vs 1.5 %, p = 0.05). None of the examined participants met the criteria for the diagnosis of diabetes mellitus. Aortic stiffness was higher in the descendant group as opposed to the control group (6.2 vs 5.8 m/s, p = 0.001). The total calculated cardiovascular risk based on the SCORE system was also higher in the descendant group as compared to the control group - the current risk related to the age of 40 years: 0.35 (0.19-0.64) vs 0.20 (0.13-0.47), p < 0.0001 and the risk related to the age of 60 years: 3.35 (2.23-5.36) vs 2.40 (1.58-4.11), p < 0.0001. The population of the descendants includes, based on our results, a greater number of smokers and

  10. [Animal models of cardiovascular disease].

    PubMed

    Chorro, Francisco J; Such-Belenguer, Luis; López-Merino, Vicente

    2009-01-01

    The use of animal models to study cardiovascular disease has made a substantial contribution to increasing our understanding of disease pathogenesis, has led to the development of diagnostic techniques, and has made it possible to verify the effectiveness of different preventative and therapeutic approaches, whether pharmacological or interventional. The main limitations stem from differences between human and experimentally induced pathology, in terms of both genetic regulatory mechanisms and factors that influence cardiovascular function. The experimental models and preparations used in cardiovascular research include those based on isolated cells or tissues or structures immersed in organ baths. The Langendorff system enables isolated perfused hearts to be studied directly under conditions of either no load or controlled loading. In small mammals, a number of models have been developed of cardiovascular conditions that result from spontaneous genetic mutations or, alternatively, that may be induced by specific genomic modification. One of the techniques employed is gene transfer, which can involve the controlled induction of mutations that result in the expression of abnormalities associated with the development of a broad range of different types of cardiovascular disease. Larger animals are used in experimental models in which it is important that physiological regulatory and homeostatic mechanisms are present.

  11. PPARs and the Cardiovascular System

    PubMed Central

    Hamblin, Milton; Chang, Lin; Fan, Yanbo; Zhang, Jifeng

    2009-01-01

    Abstract Peroxisome proliferator-activated receptors (PPARs) belong to the nuclear hormone-receptor superfamily. Originally cloned in 1990, PPARs were found to be mediators of pharmacologic agents that induce hepatocyte peroxisome proliferation. PPARs also are expressed in cells of the cardiovascular system. PPARγ appears to be highly expressed during atherosclerotic lesion formation, suggesting that increased PPARγ expression may be a vascular compensatory response. Also, ligand-activated PPARγ decreases the inflammatory response in cardiovascular cells, particularly in endothelial cells. PPARα, similar to PPARγ, also has pleiotropic effects in the cardiovascular system, including antiinflammatory and antiatherosclerotic properties. PPARα activation inhibits vascular smooth muscle proinflammatory responses, attenuating the development of atherosclerosis. However, PPARδ overexpression may lead to elevated macrophage inflammation and atherosclerosis. Conversely, PPARδ ligands are shown to attenuate the pathogenesis of atherosclerosis by improving endothelial cell proliferation and survival while decreasing endothelial cell inflammation and vascular smooth muscle cell proliferation. Furthermore, the administration of PPAR ligands in the form of TZDs and fibrates has been disappointing in terms of markedly reducing cardiovascular events in the clinical setting. Therefore, a better understanding of PPAR-dependent and -independent signaling will provide the foundation for future research on the role of PPARs in human cardiovascular biology. Antioxid. Redox Signal. 11, 1415–1452. PMID:19061437

  12. PPARs and the cardiovascular system.

    PubMed

    Hamblin, Milton; Chang, Lin; Fan, Yanbo; Zhang, Jifeng; Chen, Y Eugene

    2009-06-01

    Peroxisome proliferator-activated receptors (PPARs) belong to the nuclear hormone-receptor superfamily. Originally cloned in 1990, PPARs were found to be mediators of pharmacologic agents that induce hepatocyte peroxisome proliferation. PPARs also are expressed in cells of the cardiovascular system. PPAR gamma appears to be highly expressed during atherosclerotic lesion formation, suggesting that increased PPAR gamma expression may be a vascular compensatory response. Also, ligand-activated PPAR gamma decreases the inflammatory response in cardiovascular cells, particularly in endothelial cells. PPAR alpha, similar to PPAR gamma, also has pleiotropic effects in the cardiovascular system, including antiinflammatory and antiatherosclerotic properties. PPAR alpha activation inhibits vascular smooth muscle proinflammatory responses, attenuating the development of atherosclerosis. However, PPAR delta overexpression may lead to elevated macrophage inflammation and atherosclerosis. Conversely, PPAR delta ligands are shown to attenuate the pathogenesis of atherosclerosis by improving endothelial cell proliferation and survival while decreasing endothelial cell inflammation and vascular smooth muscle cell proliferation. Furthermore, the administration of PPAR ligands in the form of TZDs and fibrates has been disappointing in terms of markedly reducing cardiovascular events in the clinical setting. Therefore, a better understanding of PPAR-dependent and -independent signaling will provide the foundation for future research on the role of PPARs in human cardiovascular biology.

  13. Sex differences in cardiovascular ageing.

    PubMed

    Merz, Allison A; Cheng, Susan

    2016-06-01

    Despite recent progress in identifying and narrowing the gaps in cardiovascular outcomes between men and women, general understanding of how and why cardiovascular disease presentations differ between the sexes remains limited. Sex-specific patterns of cardiac and vascular ageing play an important role and, in fact, begin very early in life. Differences between the sexes in patterns of age-related cardiac remodelling are associated with the relatively greater prevalence in women than in men of heart failure with preserved ejection fraction. Similarly, sex variation in how vascular structure and function change with ageing contributes to differences between men and women in how coronary artery disease manifests typically or atypically over the adult life course. Both hormonal and non-hormonal factors underlie sex differences in cardiovascular ageing and the development of age-related disease. The midlife withdrawal of endogenous oestrogen appears to augment the age-related increase in cardiovascular risk seen in postmenopausal compared with premenopausal women. However, when compared with intrinsic biological differences between men and women that are present throughout life, this menopausal transition may not be as substantial an actor in determining cardiovascular outcomes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  14. Hormonal contraception and cardiovascular system.

    PubMed

    Brito, Milena Bastos; Nobre, Fernando; Vieira, Carolina Sales

    2011-04-01

    Hormonal contraception is the most widely used method to prevent unplanned pregnancies. The literature has shown an association between cardiovascular risk and use of hormone therapy. With the purpose of providing better guidelines on contraception methods for women with risk factors for cardiovascular disease, we have reviewed the literature on the subject. This review describes the latest data from the scientific literature concerning the influence of hormonal contraceptives on arterial thrombosis, venous thrombosis and systemic high blood pressure, which are diseases that have become increasingly prevalent among young females.

  15. Fetal origins of cardiovascular disease.

    PubMed

    Barker, D J

    1999-04-01

    Low birthweight, thinness and short body length at birth are now known to be associated with increased rates of cardiovascular disease and non-insulin dependent diabetes in adult life. The fetal origins hypothesis proposes that these diseases originate through adaptations which the fetus makes when it is undernourished. These adaptations may be cardiovascular, metabolic or endocrine. They permanently change the structure and function of the body. Prevention of the diseases may depend on prevention of imbalances in fetal growth or imbalances between prenatal and postnatal growth, or imbalances in nutrient supply to the fetus.

  16. Aquaporins in Cardiovascular System.

    PubMed

    Tie, Lu; Wang, Di; Shi, Yundi; Li, Xuejun

    2017-01-01

    Recent studies have shown that some aquaporins (AQPs ), including AQP1, AQP4, AQP7 and AQP9, are expressed in endothelial cells, vascular smooth muscle cells and heart of cardiovascular system. These AQPs are involved in the cardiovascular function and in pathological process of related diseases, such as cerebral ischemia , congestion heart failure , hypertension and angiogenesis. Therefore, it is important to understand the accurate association between AQPs and cardiovascular system, which may provide novel approaches to prevent and treat related diseases. Here we will discuss the expression and physiological function of AQPs in cardiovascular system and summarize recent researches on AQPs related cardiovascular diseases.

  17. Social factors and cardiovascular morbidity.

    PubMed

    Brunner, Eric John

    2017-03-01

    Recent progress in population health at aggregate level, measured by life expectancy, has been accompanied by lack of progress in reducing the difference in health prospects between groups defined by social status. Cardiovascular disease is an important contributor to this undesirable situation. The stepwise gradient of higher risk with lower status is accounted for partly by social gradients in health behaviors. The psychosocial hypothesis provides a stronger explanation, based on social patterning of living and working environments and psychological assets that individuals develop during childhood. Three decades of research based on Whitehall II and other cohort studies provide evidence for psychosocial pathways leading to cardiovascular morbidity and mortality. Job stress is a useful paradigm because exposure is long term and depends on occupational status. Studies of social-biological translation implicate autonomic and neuroendocrine function among the biological systems that mediate between chronic adverse psychosocial exposures and increased cardiometabolic risk and cardiovascular disease incidence.

  18. [Cardiovascular manifestations of human toxocariasis].

    PubMed

    Bolívar-Mejía, Adrián; Rodríguez-Morales, Alfonso J; Paniz-Mondolfi, Alberto E; Delgado, Olinda

    2013-01-01

    Toxocariasis is a parasitic infection produced by helminths that cannot reach their adult stage in humans. For their etiological species (Toxocara canis and Toxocara cati), man is a paratenic host. Infection by such helminths can produce a variety of clinical manifestations, such as: visceral larvae migrans syndrome, ocular larvae migrans syndrome and covert toxocariasis. In the visceral larvae migrans syndrome, the organs that are mainly involved include liver, lungs, skin, nervous system, muscles, kidneys and the heart. Regarding the latter, the importance of cardiovascular manifestations in toxocariasis, as well as its clinical relevance, has increasingly begun to be recognized. The current article is based on a systematic information search, focused mainly on the clinical and pathological aspects of cardiovascular manifestations in toxocariasis, including its pathophysiology, laboratory findings, diagnosis and therapeutical options, with the objective of highlighting its importance as a zoonosis and its relevance to the fields of cardiovascular medicine in adults and children.

  19. Sympathetic rhythms and cardiovascular oscillations.

    PubMed

    Montano, N; Cogliati, C; Dias da Silva, V J; Gnecchi-Ruscone, T; Malliani, A

    2001-07-20

    Spectral analysis of heart rate and arterial pressure variabilities is a powerful noninvasive tool, which is increasingly used to infer alterations of cardiovascular autonomic regulation in a variety of physiological and pathophysiological conditions, such as hypertension, myocardial infarction and congestive heart failure. A most important methodological issue to properly interpret the results obtained by the spectral analysis of cardiovascular variability signals is represented by the attribution of neurophysiological correlates to these spectral components. In this regard, recent applications of spectral techniques to the evaluation of the oscillatory properties of sympathetic efferent activity in animals, as well as in humans, offer a new approach to a better understanding of the relationship between cardiovascular oscillations and autonomic regulation.

  20. Cardiovascular risks of antiretroviral therapies.

    PubMed

    Mondy, Kristin; Tebas, Pablo

    2007-01-01

    The use of highly active antiretroviral therapy (HAART) has resulted in sustained reductions in mortality from HIV infection. In recent years, HAART has also been associated with metabolic complications that may increase patients' cardiovascular disease risk. Recent studies have begun to support a more complex interaction between HAART, HIV infection itself, and other traditional social and immunologic factors that may predispose patients to premature cardiovascular disease. Substantial progress has been made in the development of newer antiretroviral therapies that have a better metabolic profile with respect to dyslipidemia, hyperglycemia, and lipodystrophy. Optimal selection of metabolically neutral antiretroviral therapies, together with aggressive management of other modifiable coronary risk factors, may improve cardiovascular disease risk in the long term.

  1. Optimization in Cardiovascular Modeling

    NASA Astrophysics Data System (ADS)

    Marsden, Alison L.

    2014-01-01

    Fluid mechanics plays a key role in the development, progression, and treatment of cardiovascular disease. Advances in imaging methods and patient-specific modeling now reveal increasingly detailed information about blood flow patterns in health and disease. Building on these tools, there is now an opportunity to couple blood flow simulation with optimization algorithms to improve the design of surgeries and devices, incorporating more information about the flow physics in the design process to augment current medical knowledge. In doing so, a major challenge is the need for efficient optimization tools that are appropriate for unsteady fluid mechanics problems, particularly for the optimization of complex patient-specific models in the presence of uncertainty. This article reviews the state of the art in optimization tools for virtual surgery, device design, and model parameter identification in cardiovascular flow and mechanobiology applications. In particular, it reviews trade-offs between traditional gradient-based methods and derivative-free approaches, as well as the need to incorporate uncertainties. Key future challenges are outlined, which extend to the incorporation of biological response and the customization of surgeries and devices for individual patients.

  2. Resveratrol and Cardiovascular Diseases

    PubMed Central

    Bonnefont-Rousselot, Dominique

    2016-01-01

    The increased incidence of cardiovascular diseases (CVDs) has stimulated research for substances that could improve cardiovascular health. Among them, resveratrol (RES), a polyphenolic compound notably present in grapes and red wine, has been involved in the “French paradox”. RES is known for its antioxidant and anti-inflammatory properties and for its ability to upregulate endothelial NO synthase (eNOS). RES was able to scavenge •OH/O2•− and peroxyl radicals, which can limit the lipid peroxidation processes. Moreover, in bovine aortic endothelial cells (BAEC) under glucose-induced oxidative stress, RES restored the activity of dimethylargininedimethylaminohydrolase (DDAH), an enzyme that degrades an endogenous inhibitor of eNOS named asymmetric dimethylarginine (ADMA). Thus, RES could improve •NO availability and decrease the endothelial dysfunction observed in diabetes. Preclinical studies have made it possible to identify molecular targets (SIRT-1, AMPK, Nrf2, NFκB…); however, there are limited human clinical trials, and difficulties in the interpretation of results arise from the use of high-dose RES supplements in research studies, whereas low RES concentrations are present in red wine. The discussions on potential beneficial effects of RES in CVDs (atherosclerosis, hypertension, stroke, myocardial infarction, heart failure) should compare the results of preclinical studies with those of clinical trials. PMID:27144581

  3. Laser therapy in cardiovascular disease

    NASA Astrophysics Data System (ADS)

    Rindge, David

    2009-02-01

    Cardiovascular disease is the number one cause of death worldwide. It is broadly defined to include anything which adversely affects the heart or blood vessels. One-third of Americans have one or more forms of it. By one estimate, average human life expectancy would increase by seven years if it were eliminated. The mainstream medical model seeks mostly to "manage" cardiovascular disease with pharmaceuticals or to surgically bypass or reopen blocked vessels via angioplasty. These methods have proven highly useful and saved countless lives. Yet drug therapy may be costly and ongoing, and it carries the risk of side effects while often doing little or nothing to improve underlying health concerns. Similarly, angioplasty or surgery are invasive methods which entail risk. Laser therapy1 regenerates tissue, stimulates biological function, reduces inflammation and alleviates pain. Its efficacy and safety have been increasingly well documented in cardiovascular disease of many kinds. In this article we will explore the effects of laser therapy in angina, atherosclerosis, coronary artery disease, hypertension, hyperlipidemia, myocardial infarction, stroke and other conditions. The clinical application of various methods of laser therapy, including laserpuncture and transcutaneous, supravascular and intravenous irradiation of blood will be discussed. Implementing laser therapy in the treatment of cardiovascular disease offers the possibility of increasing the health and wellbeing of patients while reducing the costs and enhancing safety of medical care.

  4. Cardiovascular Surgery in the Elderly.

    PubMed

    Yaffee, David W; Williams, Mathew R

    2016-01-01

    The elderly population is the fastest growing demographic in Western countries. As the population ages, the incidence of age-related comorbidities such as diabetes mellitus, chronic obstructive pulmonary disease, peripheral vascular disease, renal disease, cerebrovascular disease, and cardiovascular disease increases. With cardiovascular disease occurring in approximately one-quarter of the population over the age of 75 years and more than half of all cardiac procedures performed on this age group, the number of potential elderly surgical candidates is increasing. However, data suggest that old age is associated with increased morbidity and mortality following cardiac surgery. Over the past 2 decades, improvements in myocardial protection, extracorporeal circulation, anesthesia, and surgical techniques have significantly reduced the morbidity and mortality associated with cardiac surgery. Although most prospective studies exclude elderly patients, data from large retrospective studies and subgroup analyses suggest that cardiac surgery is a viable option for many elderly patients with cardiovascular disease, with good outcomes observed in reasonable-risk candidates; moreover, there are a growing number of available less-invasive options for them when surgical risk becomes prohibitive. In this article, we discuss the current state of cardiovascular surgery in the elderly as well as emerging technologies on the horizon. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Effect of increased convective clearance by on-line hemodiafiltration on all cause and cardiovascular mortality in chronic hemodialysis patients – the Dutch CONvective TRAnsport STudy (CONTRAST): rationale and design of a randomised controlled trial [ISRCTN38365125

    PubMed Central

    Penne, E Lars; Blankestijn, Peter J; Bots, Michiel L; van den Dorpel, Marinus A; Grooteman, Muriel P; Nubé, Menso J; van der Tweel, Ingeborg; ter Wee, Piet M

    2005-01-01

    Background The high incidence of cardiovascular disease in patients with end stage renal disease (ESRD) is related to the accumulation of uremic toxins in the middle and large-middle molecular weight range. As online hemodiafiltration (HDF) removes these molecules more effectively than standard hemodialysis (HD), it has been suggested that online HDF improves survival and cardiovascular outcome. Thus far, no conclusive data of HDF on target organ damage and cardiovascular morbidity and mortality are available. Therefore, the CONvective TRAnsport STudy (CONTRAST) has been initiated. Methods CONTRAST is a Dutch multi-center randomised controlled trial. In this trial, approximately 800 chronic hemodialysis patients will be randomised between online HDF and low-flux HD, and followed for three years. The primary endpoint is all cause mortality. The main secondary outcome variables are fatal and non-fatal cardiovascular events. Conclusion The study is designed to provide conclusive evidence whether online HDF leads to a lower mortality and less cardiovascular events as compared to standard HD. PMID:15907201

  6. Effect of increased convective clearance by on-line hemodiafiltration on all cause and cardiovascular mortality in chronic hemodialysis patients - the Dutch CONvective TRAnsport STudy (CONTRAST): rationale and design of a randomised controlled trial [ISRCTN38365125].

    PubMed

    Penne, E Lars; Blankestijn, Peter J; Bots, Michiel L; van den Dorpel, Marinus A; Grooteman, Muriel P; Nubé, Menso J; van der Tweel, Ingeborg; Ter Wee, Piet M

    2005-05-20

    BACKGROUND: The high incidence of cardiovascular disease in patients with end stage renal disease (ESRD) is related to the accumulation of uremic toxins in the middle and large-middle molecular weight range. As online hemodiafiltration (HDF) removes these molecules more effectively than standard hemodialysis (HD), it has been suggested that online HDF improves survival and cardiovascular outcome. Thus far, no conclusive data of HDF on target organ damage and cardiovascular morbidity and mortality are available. Therefore, the CONvective TRAnsport STudy (CONTRAST) has been initiated. METHODS: CONTRAST is a Dutch multi-center randomised controlled trial. In this trial, approximately 800 chronic hemodialysis patients will be randomised between online HDF and low-flux HD, and followed for three years. The primary endpoint is all cause mortality. The main secondary outcome variables are fatal and non-fatal cardiovascular events. CONCLUSION: The study is designed to provide conclusive evidence whether online HDF leads to a lower mortality and less cardiovascular events as compared to standard HD.

  7. Hepatitis C virus and cardiovascular: A review.

    PubMed

    Petta, Salvatore

    2017-03-01

    Chronic hepatitis C virus (HCV) infection is a systemic disease that leads to increased risks of cirrhosis and its complications, as well as extrahepatic disturbances, including immune-related disorders and metabolic alterations such as insulin resistance and steatosis. Recent accumulating evidence suggests that HCV infection can increase cardiovascular risk, and that viral eradication can improve cardiovascular outcomes in the clinical setting. These data are strengthened by evidence identifying potential mechanisms (in)directly linking HCV infection to vascular damage. However, the high prevalence of both HCV infection and cardiovascular alterations, as well as the presence of contrasting results not identifying any association between HCV infection and cardiovascular dysfunction, provides uncertainty about a direct association of HCV infection with cardiovascular risk. Further studies are needed to clarify definitively the role of HCV infection in cardiovascular alterations, as well as the impact of viral eradication on cardiovascular outcomes. These features are now more attractive, considering the availability of new, safe, and very effective interferon-free antiviral agents for the treatment of HCV infection. This review aims to discuss carefully available data on the relationship between HCV infection and cardiovascular risk.

  8. Non-cardiovascular effects associated with statins

    PubMed Central

    Martin, Seth S; Blumenthal, Roger S

    2014-01-01

    Statins form the pharmacologic cornerstone of the primary and secondary prevention of atherosclerotic cardiovascular disease. In addition to beneficial cardiovascular effects, statins seem to have multiple non-cardiovascular effects. Although early concerns about statin induced hepatotoxicity and cancer have subsided owing to reassuring evidence, two of the most common concerns that clinicians have are myopathy and diabetes. Randomized controlled trials suggest that statins are associated with a modest increase in the risk of myositis but not the risk of myalgia. Severe myopathy (rhabdomyolysis) is rare and often linked to a statin regimen that is no longer recommended (simvastatin 80 mg). Randomized controlled trials and meta-analyses suggest an increase in the risk of diabetes with statins, particularly with higher intensity regimens in people with two or more components of the metabolic syndrome. Other non-cardiovascular effects covered in this review are contrast induced nephropathy, cognition, cataracts, erectile dysfunction, and venous thromboembolism. Currently, systematic reviews and clinical practice guidelines indicate that the cardiovascular benefits of statins generally outweigh non-cardiovascular harms in patients above a certain threshold of cardiovascular risk. Literature is also accumulating on the potential non-cardiovascular benefits of statins, which could lead to novel applications of this class of drug in the future. PMID:25035309

  9. Dietary Echium Oil Increases Long-Chain n–3 PUFAs, Including Docosapentaenoic Acid, in Blood Fractions and Alters Biochemical Markers for Cardiovascular Disease Independently of Age, Sex, and Metabolic Syndrome12

    PubMed Central

    Kuhnt, Katrin; Fuhrmann, Claudia; Köhler, Melanie; Kiehntopf, Michael; Jahreis, Gerhard

    2014-01-01

    Dietary supplementation with echium oil (EO) containing stearidonic acid (SDA) is a plant-based strategy to improve long-chain (LC) n–3 (ω-3) polyunsaturated fatty acid (PUFA) status in humans. We investigated the effect of EO on LC n–3 PUFA accumulation in blood and biochemical markers with respect to age, sex, and metabolic syndrome. This double-blind, parallel-arm, randomized controlled study started with a 2-wk run-in period, during which participants (n = 80) were administered 17 g/d run-in oil. Normal-weight individuals from 2 age groups (20–35 and 49–69 y) were allotted to EO or fish oil (FO; control) groups. During the 8-wk intervention, participants were administered either 17 g/d EO (2 g SDA; n = 59) or FO [1.9 g eicosapentaenoic acid (EPA); n = 19]. Overweight individuals with metabolic syndrome (n = 19) were recruited for EO treatment only. During the 10-wk study, the participants followed a dietary n–3 PUFA restriction, e.g., no fish. After the 8-wk EO treatment, increases in the LC n–3 metabolites EPA (168% and 79%) and docosapentaenoic acid [DPA (68% and 39%)] were observed, whereas docosahexaenoic acid (DHA) decreased (−5% and −23%) in plasma and peripheral blood mononuclear cells, respectively. Compared with FO, the efficacy of EO to increase EPA and DPA in blood was significantly lower (∼25% and ∼50%, respectively). A higher body mass index (BMI) was associated with lower relative and net increases in EPA and DPA. Compared with baseline, EO significantly reduced serum cholesterol, LDL cholesterol, oxidized LDL, and triglyceride (TG), but also HDL cholesterol, regardless of age and BMI. In the FO group, only TG decreased. Overall, daily intake of 15–20 g EO increased EPA and DPA in blood but had no influence on DHA. EO lowered cardiovascular risk markers, e.g., serum TG, which is particularly relevant for individuals with metabolic syndrome. Natural EO could be a noteworthy source of n–3 PUFA in human nutrition. This trial

  10. Dietary echium oil increases long-chain n-3 PUFAs, including docosapentaenoic acid, in blood fractions and alters biochemical markers for cardiovascular disease independently of age, sex, and metabolic syndrome.

    PubMed

    Kuhnt, Katrin; Fuhrmann, Claudia; Köhler, Melanie; Kiehntopf, Michael; Jahreis, Gerhard

    2014-04-01

    Dietary supplementation with echium oil (EO) containing stearidonic acid (SDA) is a plant-based strategy to improve long-chain (LC) n-3 (ω-3) polyunsaturated fatty acid (PUFA) status in humans. We investigated the effect of EO on LC n-3 PUFA accumulation in blood and biochemical markers with respect to age, sex, and metabolic syndrome. This double-blind, parallel-arm, randomized controlled study started with a 2-wk run-in period, during which participants (n = 80) were administered 17 g/d run-in oil. Normal-weight individuals from 2 age groups (20-35 and 49-69 y) were allotted to EO or fish oil (FO; control) groups. During the 8-wk intervention, participants were administered either 17 g/d EO (2 g SDA; n = 59) or FO [1.9 g eicosapentaenoic acid (EPA); n = 19]. Overweight individuals with metabolic syndrome (n = 19) were recruited for EO treatment only. During the 10-wk study, the participants followed a dietary n-3 PUFA restriction, e.g., no fish. After the 8-wk EO treatment, increases in the LC n-3 metabolites EPA (168% and 79%) and docosapentaenoic acid [DPA (68% and 39%)] were observed, whereas docosahexaenoic acid (DHA) decreased (-5% and -23%) in plasma and peripheral blood mononuclear cells, respectively. Compared with FO, the efficacy of EO to increase EPA and DPA in blood was significantly lower (∼25% and ∼50%, respectively). A higher body mass index (BMI) was associated with lower relative and net increases in EPA and DPA. Compared with baseline, EO significantly reduced serum cholesterol, LDL cholesterol, oxidized LDL, and triglyceride (TG), but also HDL cholesterol, regardless of age and BMI. In the FO group, only TG decreased. Overall, daily intake of 15-20 g EO increased EPA and DPA in blood but had no influence on DHA. EO lowered cardiovascular risk markers, e.g., serum TG, which is particularly relevant for individuals with metabolic syndrome. Natural EO could be a noteworthy source of n-3 PUFA in human nutrition.

  11. Sodium intake and cardiovascular health.

    PubMed

    O'Donnell, Martin; Mente, Andrew; Yusuf, Salim

    2015-03-13

    Sodium is an essential nutrient. Increasing sodium intake is associated with increasing blood pressure, whereas low sodium intake results in increased renin and aldosterone levels. Randomized controlled trials have reported reductions in blood pressure with reductions in sodium intake, to levels of sodium intake <1.5 g/d, and form the evidentiary basis for current population-wide guidelines recommending low sodium intake. Although low sodium intake (<2.0 g/d) has been achieved in short-term feeding clinical trials, sustained low sodium intake has not been achieved by any of the longer term clinical trials (>6-month duration). It is assumed that the blood pressure-lowering effects of reducing sodium intake to low levels will result in large reductions in cardiovascular disease globally. However, current evidence from prospective cohort studies suggests a J-shaped association between sodium intake and cardiovascular events, based on studies from >300 000 people, and suggests that the lowest risk of cardiovascular events and death occurs in populations consuming an average sodium intake range (3-5 g/d). The increased risk of cardiovascular events associated with higher sodium intake (>5 g/d) is most prominent in those with hypertension. A major deficit in the field is the absence of large randomized controlled trials to provide definitive evidence on optimal sodium intake for preventing cardiovascular events. Pending such trials, current evidence would suggest a recommendation for moderate sodium intake in the general population (3-5 g/d), with targeting the lower end of the moderate range among those with hypertension.

  12. The programming of cardiovascular disease.

    PubMed

    Thornburg, K L

    2015-10-01

    In spite of improving life expectancy over the course of the previous century, the health of the U.S. population is now worsening. Recent increasing rates of type 2 diabetes, obesity and uncontrolled high blood pressure predict a growing incidence of cardiovascular disease and shortened average lifespan. The daily >$1billion current price tag for cardiovascular disease in the United States is expected to double within the next decade or two. Other countries are seeing similar trends. Current popular explanations for these trends are inadequate. Rather, increasingly poor diets in young people and in women during pregnancy are a likely cause of declining health in the U.S. population through a process known as programming. The fetal cardiovascular system is sensitive to poor maternal nutritional conditions during the periconceptional period, in the womb and in early postnatal life. Developmental plasticity accommodates changes in organ systems that lead to endothelial dysfunction, small coronary arteries, stiffer vascular tree, fewer nephrons, fewer cardiomyocytes, coagulopathies and atherogenic blood lipid profiles in fetuses born at the extremes of birthweight. Of equal importance are epigenetic modifications to genes driving important growth regulatory processes. Changes in microRNA, DNA methylation patterns and histone structure have all been implicated in the cardiovascular disease vulnerabilities that cross-generations. Recent experiments offer hope that detrimental epigenetic changes can be prevented or reversed. The large number of studies that provide the foundational concepts for the developmental origins of disease can be traced to the brilliant discoveries of David J.P. Barker.

  13. Cardiovascular magnetic resonance artefacts

    PubMed Central

    2013-01-01

    The multitude of applications offered by CMR make it an increasing popular modality to study the heart and the surrounding vessels. Nevertheless the anatomical complexity of the chest, together with cardiac and respiratory motion, and the fast flowing blood, present many challenges which can possibly translate into imaging artefacts. The literature is wide in terms of papers describing specific MR artefacts in great technical detail. In this review we attempt to summarise, in a language accessible to a clinical readership, some of the most common artefacts found in CMR applications. It begins with an introduction of the most common pulse sequences, and imaging techniques, followed by a brief section on typical cardiovascular applications. This leads to the main section on common CMR artefacts with examples, a short description of the mechanisms behind them, and possible solutions. PMID:23697969

  14. Erectile dysfunction in patients with cardiovascular disease

    PubMed Central

    Ophuis, A.J.M. Oude; Nijeholt, A.A.B. Lycklama à

    2006-01-01

    Erectile dysfunction is a highly prevalent disease, especially in cardiovascular-compromised men. Many of the well-established risk factors for cardiovascular disease are also risk factors for erectile dysfunction. A correlation between erectile dysfunction and endothelial dysfunction is well established. It is postulated that erectile dysfunction with an arteriovascular aetiology can predate and be an indicator of potential coronary artery disease. In this paper we will attempt to increase awareness among cardiologists for the predictive value of erectile dysfunction for future cardiovascular disease in order to optimise cardiovascular risk management. The treatment of erectile dysfunction and cardiovascular interactions is also discussed in detail. ImagesFigure 1AFigure 1B PMID:25696612

  15. Clinical Pharmacology and Cardiovascular Safety of Naproxen.

    PubMed

    Angiolillo, Dominick J; Weisman, Steven M

    2017-04-01

    The voluntary withdrawal of Vioxx (rofecoxib) from the market in 2004, as well as the 2005 and 2014 US FDA Advisory Committee meetings about non-steroidal anti-inflammatory drugs (NSAIDs) and cardiovascular risk, have raised questions surrounding the use of NSAIDs in at-risk populations. This paper discusses the cardiovascular safety profile of naproxen in the context of the NSAID class. The balance of evidence suggests that cardiovascular risk correlates with cyclooxygenase (COX)-2 selectivity, and the low COX-2 selectivity of naproxen results in a lower cardiovascular risk than that of other NSAIDs. The over-the-counter (OTC) use of naproxen is expected to pose minimal cardiovascular risk; however, the benefit-risk ratio and appropriate use should be considered at an individual patient level, particularly to assess underlying conditions that may increase the risk of events. Likewise, regulatory authorities should revisit label information periodically to ensure labeling reflects the current understanding of benefits and risks.

  16. Vitamin D and cardiovascular disease.

    PubMed

    Zittermann, Armin

    2014-09-01

    It has long been known from case series that vitamin D excess can lead to atherosclerosis and vascular calcification in humans. In the 1980s, ecological studies provided data that deficient human vitamin D status may also increase the risk of developing cardiovascular disease (CVD). The assumption of a biphasic vitamin D effect on CVD is supported by experimental studies: Numerous studies have demonstrated positive effects of the vitamin D hormone (1,25-dihydroxyviramin D) on the cardiovascular system. However, the effects and mechanisms that lead to vascular calcification by vitamin D excess could also be confirmed. Large prospective observational studies support the hypothesis of a U-shaped association between vitamin D and CVD. These studies indicate that deficient circulating 25-hydroxyvitamin D levels (<30 nmol/l) are independently-associated with increased CVD morbidity and mortality. They also suggest that those circulating 25-hydroxyvitamin D levels, which have long been considered to be safe (100-150 nmol/l), are associated with an increased CVD risk. Meanwhile, numerous randomized controlled trials have investigated the effects of vitamin D supplements or ultraviolet B radiation on biochemical cardiovascular risk markers, cardiovascular physiology, and cardiovascular outcomes. Overall, results are mixed with the majority of studies reporting neither beneficial nor adverse vitamin D effects. Several limitations in the study design, which may have prevented beneficial vitamin D effects, are discussed. In conclusion, it must be stated that the role of vitamin D in the prevention and management of CVD as well as the dose-response relationship of potentially harmful effects still remain to be established.

  17. Lipoprotein metabolism indicators improve cardiovascular risk prediction

    USDA-ARS?s Scientific Manuscript database

    Background: Cardiovascular disease risk increases when lipoprotein metabolism is dysfunctional. We have developed a computational model able to derive indicators of lipoprotein production, lipolysis, and uptake processes from a single lipoprotein profile measurement. This is the first study to inves...

  18. Evaluation of a Cardiovascular Education Pilot Program.

    ERIC Educational Resources Information Center

    Fang, Wei Li

    1980-01-01

    A Virginia elementary-secondary school blood pressure education program is described and evaluated. Evidence presented indicates that participants' cardiovascular knowledge levels increased significantly as a result of program participation. (JMF)

  19. Unmet Needs for Cardiovascular Care in Indonesia

    PubMed Central

    Maharani, Asri; Tampubolon, Gindo

    2014-01-01

    Background In the past twenty years the heaviest burden of cardiovascular diseases has begun to shift from developed to developing countries. However, little is known about the real needs for cardiovascular care in these countries and how well those needs are being met. This study aims to investigate the prevalence and determinants of unmet needs for cardiovascular care based on objective assessment. Methods and Findings Multilevel analysis is used to analyse the determinants of met needs and multilevel multiple imputation is applied to manage missing data. The 2008 Indonesian Family Life Survey (IFLS4) survey is the source of the household data used in this study, while district data is sourced from the Ministry of Health and Ministry of Finance. The data shows that nearly 70% of respondents with moderate to high cardiovascular risk failed to receive cardiovascular care. Higher income, possession of health insurance and residence in urban areas are significantly associated with met needs for cardiovascular care, while health facility density and physician density show no association with them. Conclusions The prevalence of unmet needs for cardiovascular care is considerable in Indonesia. Inequality persists as a factor in meeting needs for cardiovascular care as the needs of people with higher incomes and those living in urban areas are more likely to be met. Alleviation of poverty, provision of health care insurance for the poor, and improvement in the quality of healthcare providers are recommended in order to meet this ever-increasing need. PMID:25148389

  20. Cardiovascular reactivity, stress, and physical activity

    PubMed Central

    Huang, Chun-Jung; Webb, Heather E.; Zourdos, Michael C.; Acevedo, Edmund O.

    2013-01-01

    Psychological stress has been proposed as a major contributor to the progression of cardiovascular disease (CVD). Acute mental stress can activate the sympathetic-adrenal-medullary (SAM) axis, eliciting the release of catecholamines (NE and EPI) resulting in the elevation of heart rate (HR) and blood pressure (BP). Combined stress (psychological and physical) can exacerbate these cardiovascular responses, which may partially contribute to the elevated risk of CVD and increased proportionate mortality risks experienced by some occupations (e.g., firefighting and law enforcement). Studies have supported the benefits of physical activity on physiological and psychological health, including the cardiovascular response to acute stress. Aerobically trained individuals exhibit lower sympathetic nervous system (e.g., HR) reactivity and enhanced cardiovascular efficiency (e.g., lower vascular reactivity and decreased recovery time) in response to physical and/or psychological stress. In addition, resistance training has been demonstrated to attenuate cardiovascular responses and improve mental health. This review will examine stress-induced cardiovascular reactivity and plausible explanations for how exercise training and physical fitness (aerobic and resistance exercise) can attenuate cardiovascular responses to stress. This enhanced functionality may facilitate a reduction in the incidence of stroke and myocardial infarction. Finally, this review will also address the interaction of obesity and physical activity on cardiovascular reactivity and CVD. PMID:24223557

  1. Unmet needs for cardiovascular care in Indonesia.

    PubMed

    Maharani, Asri; Tampubolon, Gindo

    2014-01-01

    In the past twenty years the heaviest burden of cardiovascular diseases has begun to shift from developed to developing countries. However, little is known about the real needs for cardiovascular care in these countries and how well those needs are being met. This study aims to investigate the prevalence and determinants of unmet needs for cardiovascular care based on objective assessment. Multilevel analysis is used to analyse the determinants of met needs and multilevel multiple imputation is applied to manage missing data. The 2008 Indonesian Family Life Survey (IFLS4) survey is the source of the household data used in this study, while district data is sourced from the Ministry of Health and Ministry of Finance. The data shows that nearly 70% of respondents with moderate to high cardiovascular risk failed to receive cardiovascular care. Higher income, possession of health insurance and residence in urban areas are significantly associated with met needs for cardiovascular care, while health facility density and physician density show no association with them. The prevalence of unmet needs for cardiovascular care is considerable in Indonesia. Inequality persists as a factor in meeting needs for cardiovascular care as the needs of people with higher incomes and those living in urban areas are more likely to be met. Alleviation of poverty, provision of health care insurance for the poor, and improvement in the quality of healthcare providers are recommended in order to meet this ever-increasing need.

  2. Optimizing cardiovascular outcomes in diabetes mellitus.

    PubMed

    Sobel, Burton E

    2007-09-01

    This article presents a series of take-home statements, compiled by a multidisciplinary steering committee, concerning significant aspects of macrovascular disease in patients with diabetes mellitus, including the extent of risk, pathogenetic mechanisms, and optimal management for risk reduction. The discussion focuses in particular on the impact of diabetes medications beyond blood glucose control. In summary, these statements are as follows: (1) Patients with diabetes have an increased risk for cardiovascular disease that contributes to decreased life expectancy; (2) prognosis after a cardiovascular event is poorer in patients with diabetes; (3) pathogenetic mechanisms include insulin resistance, endothelial dysfunction, dyslipidemia, chronic inflammation, procoagulability, and impaired fibrinolysis; (4) management of established cardiovascular risk factors, for example with 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) and antihypertensive therapy, reduces cardiovascular event rates in diabetes; (5) correction of hyperglycemia can reduce macrovascular event rates, but the coupling to hyperglycemia is less tight for macrovascular events than it is for reduction of microvascular complications; (6) patients with diabetes should be screened for additional cardiovascular risk factors and appropriate interventions should be initiated; (7) results of observational and interventional studies have indicated that some insulin sensitizers appear to reduce the incidence of cardiovascular events and improve survival; (8) thiazolidinediones have beneficial effects on metabolism that may improve cardiovascular risk, and a randomized clinical trial in patients with advanced atherosclerosis indicates that addition of pioglitazone to therapy for hyperglycemia may reduce the incidence of cardiovascular events such as myocardial infarction and stroke.

  3. Cadmium Exposure and Incident Cardiovascular Disease

    PubMed Central

    Tellez-Plaza, Maria; Guallar, Eliseo; Howard, Barbara V.; Umans, Jason G.; Francesconi, Kevin A.; Goessler, Walter; Silbergeld, Ellen K.; Devereux, Richard B.; Navas-Acien, Ana

    2014-01-01

    Background Cadmium is a widespread toxic metal with potential cardiovascular effects, but no studies have evaluated cadmium and incident cardiovascular disease. We evaluated the association of urine cadmium concentration with cardiovascular disease incidence and mortality in a large population-based cohort. Methods We conducted a prospective cohort study of 3,348 American Indian adults aged 45–74 years from Arizona, Oklahoma and North and South Dakota who participated in the Strong Heart Study in 1989–1991. Urine cadmium was measured using inductively coupled plasma mass spectrometry. Follow-up extended through 31 December 2008. Results The geometric mean cadmium level in the study population was 0.94 μg/g (95% confidence interval= 0.92 – 0.93). We identified 1,084 cardiovascular events, including 400 deaths. After adjustment for sociodemographic and cardiovascular risk factors, the hazard ratios (comparing the 80th to the 20th percentile of urine cadmium concentrations) was 1.43 for cardiovascular mortality (95% confidence interval=1.21 – 1.70), and 1.34 for coronary heart disease mortality (1.10 – 1.63). The corresponding hazard ratios for incident cardiovascular disease, coronary heart disease, stroke, and heart failure were 1.24 (1.11 – 1.38), 1.22 (1.08 – 1.38), 1.75 (1.17 – 2.59) and 1.39 (1.01 – 1.94), respectively. The associations were similar in most study subgroups including never-smokers. Conclusions Urine cadmium, a biomarker of long-term exposure, was associated with increased cardiovascular mortality and with increased incidence of cardiovascular disease. These findings support that cadmium exposure is a cardiovascular risk factor. PMID:23514838

  4. Exosomes and Cardiovascular Protection.

    PubMed

    Davidson, Sean M; Takov, Kaloyan; Yellon, Derek M

    2017-02-01

    Most, if not all, cells of the cardiovascular system secrete small, lipid bilayer vesicles called exosomes. Despite technical challenges in their purification and analysis, exosomes from various sources have been shown to be powerfully cardioprotective. Indeed, it is possible that much of the so-called "paracrine" benefit in cardiovascular function obtained by stem cell therapy can be replicated by the injection of exosomes produced by stem cells. However, exosomes purified from plasma appear to be just as capable of activating cardioprotective pathways. We discuss the potential roles of endogenous exosomes in the cardiovascular system, how this is perturbed in cardiovascular disease, and evaluate their potential as therapeutic agents to protect the heart.

  5. Association between trans fatty acid intake and cardiovascular risk factors in Europe: the TRANSFAIR study.

    PubMed

    van de Vijver, L P; Kardinaal, A F; Couet, C; Aro, A; Kafatos, A; Steingrimsdottir, L; Amorim Cruz, J A; Moreiras, O; Becker, W; van Amelsvoort, J M; Vidal-Jessel, S; Salminen, I; Moschandreas, J; Sigfússon, N; Martins, I; Carbajal, A; Ytterfors, A; Poppel, G

    2000-02-01

    High intakes of trans fatty acids (TFA) have been found to exert an undesirable effect on serum lipid profiles, and thus may increase the risk for cardiovascular disease. Investigation of the association between TFA intake and serum lipids. Cross-sectional study in eight European countries (Finland, France, Greece, Iceland, The Netherlands, Portugal, Spain, Sweden) among 327 men and 299 women (50-65 y). Using a dietary history method, food consumption was assessed and TFA intake was calculated with recent figures on TFA levels of foods, collected in the TRANSFAIR study. Mean (+/-s.d.) TFA intake was 2.40+/-1.53 g/day for men and 1.98+/-1.49 g/day for women (0.87+/-0.48% and 0. 95+/-0.55% of energy, respectively), with the highest consumption in Iceland and the lowest in the Mediterranean countries. No associations were found between total TFA intake and LDL, HDL or LDL/HDL ratio after adjustment for cardiovascular risk factors. Additional adjustment for other fatty acid clusters resulted in a significant inverse trend between total TFA intake and total cholesterol (Ptrend<0.03). The most abundantly occurring TFA isomer, C18:1 t, contributed substantially to this inverse association. The TFA isomers C14:1 t9, C16:1 t9 and C22:1 t were not associated or were positively associated with LDL or total cholesterol. From this study we conclude that at the current European intake levels of trans fatty acids they are not associated with an unfavourable serum lipid profile. Unilever Research Laboratorium, the Dutch Dairy Foundation on Nutrition and Health, Cargill BV, the Institute of Food Research Norwich Laboratory, the Nutrition Branch of the Ministry of Agriculture, Fisheries and Food, the International Fishmeal and Oil Manufacturers' Association, Kraft Foods, NV Vandemoortele Coordination Center, Danone Group, McDonalds Deutschland Inc, Danish Veterinary and Food Administration, Valio Ltd, Raisio Group. European Journal of Clinical Nutrition (2000) 54, 126-135

  6. Exercise and the cardiovascular system.

    PubMed

    Golbidi, Saeid; Laher, Ismail

    2012-01-01

    There are alarming increases in the incidence of obesity, insulin resistance, type II diabetes, and cardiovascular disease. The risk of these diseases is significantly reduced by appropriate lifestyle modifications such as increased physical activity. However, the exact mechanisms by which exercise influences the development and progression of cardiovascular disease are unclear. In this paper we review some important exercise-induced changes in cardiac, vascular, and blood tissues and discuss recent clinical trials related to the benefits of exercise. We also discuss the roles of boosting antioxidant levels, consequences of epicardial fat reduction, increases in expression of heat shock proteins and endoplasmic reticulum stress proteins, mitochondrial adaptation, and the role of sarcolemmal and mitochondrial potassium channels in the contributing to the cardioprotection offered by exercise. In terms of vascular benefits, the main effects discussed are changes in exercise-induced vascular remodeling and endothelial function. Exercise-induced fibrinolytic and rheological changes also underlie the hematological benefits of exercise.

  7. The aged cardiovascular risk patient.

    PubMed

    Priebe, H J

    2000-11-01

    It is mostly acknowledged that 'normal' or 'healthy' ageing of the cardiovascular system is distinct from the increasing incidence and severity of cardiovascular disease with advancing age (e.g. hypertension, ischaemic heart disease and congestive heart failure). It is also recognized that chronological and biological age may differ considerably. Nevertheless, even in the absence of overt coexisting disease, advanced age is always accompanied by a general decline in organ function, and specifically by alterations in structure and function of the heart and vasculature that will ultimately affect cardiovascular performance. Actual biological age is thus the net result of the interaction between age-related and concomitant disease-associated changes in organ function. As cardiovascular performance at a given moment is the net result of interactions between heart rate, intrinsic contractility, diastolic and systolic function, ventricular afterload and coronary perfusion, it is important to be aware of the age-related changes in each of these variables, independent of disease, as they determine cardiac performance at rest and its response to stress in the elderly. The most relevant age-related changes in cardiovascular performance for perioperative management are the stiffened myocardium and vasculature, blunted beta-adrenoceptor responsiveness and impaired autonomic reflex control of heart rate. These changes are of little clinical relevance at rest, but may have considerable consequences during superimposed cardiovascular stress. Such stress can take the form of increased flow demand (as in exercise or postoperatively), demand for acute autonomic reflex control (as in change of posture) or severe disease (as during myocardial ischaemia, tachyarrhythmias or uncontrolled hypertension). It may interfere with diastolic relaxation (i.e. ventricular filling), systolic contraction (i.e. ventricular emptying) and vasomotor control (i.e. arterial pressure homeostasis). Three

  8. Smokeless tobacco and prevalence of cardiovascular disease.

    PubMed

    Mushtaq, Nasir; Beebe, Laura A; Thompson, David M; Skaggs, Valerie J

    2010-01-01

    Few studies have examined the possible increased risk of cardiovascular disease with smokeless tobacco. Existing studies have yielded inconsistent results and have been based on limited populations. The purpose of this study was to assess whether the use of smokeless tobacco increases the risk of cardiovascular disease and to identify higher risk groups. Data from the Behavioral Risk Factor Surveillance System (BRFSS) from 1999 to 2001 for the state of Oklahoma were analyzed. We analyzed 10332 complete records to assess association of any use of smokeless tobacco (over the respondent's life time) with cardiovascular disease. Similarly, the association between cardiovascular disease and individual socio-demographic covariates such as age, gender, smoking, and BMI was checked. As a secondary analysis we explored associations among three categories for smokeless tobacco users, current, former, and never users, with cardiovascular disease. Logistic regression models, which controlled for age, sex, race-ethnicity, obesity, and smoking, estimated the odds of having cardiovascular disease were 1.18 (95% CI: 0.96, 1.45) times higher among smokeless tobacco users. This odds ratio was more than two fold in the Non-White/Hispanic group (O.R. 2.31, 95% CI: 1.42, 3.73). Similarly the odds of cardiovascular disease were higher among female ST users than among females who were non-users of ST (O.R. 1.72 95% CI: 1.12, 2.65). A modest increase in the odds of cardiovascular disease was associated with smokeless tobacco. Two risk groups were identified, females and Non-Whites/Hispanics, whose odds of cardiovascular disease increased with the use of smokeless tobacco.

  9. Seasonal Influenza Infections and Cardiovascular Disease Mortality

    PubMed Central

    Nguyen, Jennifer L.; Yang, Wan; Ito, Kazuhiko; Matte, Thomas D.; Shaman, Jeffrey; Kinney, Patrick L.

    2016-01-01

    IMPORTANCE Cardiovascular deaths and influenza epidemics peak during winter in temperate regions. OBJECTIVES To quantify the temporal association between population increases in seasonal influenza infections and mortality due to cardiovascular causes and to test if influenza incidence indicators are predictive of cardiovascular mortality during the influenza season. DESIGN, SETTING, AND PARTICIPANTS Time-series analysis of vital statistics records and emergency department visits in New York City, among cardiovascular deaths that occurred during influenza seasons between January 1, 2006, and December 31, 2012. The 2009 novel influenza A(H1N1) pandemic period was excluded from temporal analyses. EXPOSURES Emergency department visits for influenza-like illness, grouped by age (≥0 years and ≥65 years) and scaled by laboratory surveillance data for viral types and subtypes, in the previous 28 days. MAIN OUTCOMES AND MEASURES Mortality due to cardiovascular disease, ischemic heart disease, and myocardial infarction. RESULTS Among adults 65 years and older, who accounted for 83.0% (73 363 deaths) of nonpandemic cardiovascular mortality during influenza seasons, seasonal average influenza incidence was correlated year to year with excess cardiovascular mortality (Pearson correlation coefficients ≥0.75, P≤.05 for 4 different influenza indicators). In daily time-series analyses using 4 different influenza metrics, interquartile range increases in influenza incidence during the previous 21 days were associated with an increase between 2.3% (95% CI, 0.7%–3.9%) and 6.3% (95% CI, 3.7%–8.9%) for cardiovascular disease mortality and between 2.4% (95% CI, 1.1%–3.6%) and 6.9% (95% CI, 4.0%–9.9%) for ischemic heart disease mortality among adults 65 years and older. The associations were most acute and strongest for myocardial infarction mortality, with each interquartile range increase in influenza incidence during the previous 14 days associated with mortality

  10. Fetal Programming and Cardiovascular Pathology

    PubMed Central

    Alexander, Barbara T.; Dasinger, John Henry; Intapad, Suttira

    2016-01-01

    Low birth weight serves as a crude proxy for impaired growth during fetal life and indicates a failure for the fetus to achieve its full growth potential. Low birth weight can occur in response to numerous etiologies that include complications during pregnancy, poor prenatal care, parental smoking, maternal alcohol consumption or stress. Numerous epidemiological and experimental studies demonstrate that birth weight is inversely associated with blood pressure and coronary heart disease. Sex and age impact the developmental programming of hypertension. In addition, impaired growth during fetal life also programs enhanced vulnerability to a secondary insult. Macrosomia, which occurs in response to maternal obesity, diabetes and excessive weight gain during gestation, is also associated with increased cardiovascular risk. Yet, the exact mechanisms that permanently change the structure, physiology and endocrine health of an individual across their lifespan following altered growth during fetal life are not entirely clear. Transmission of increased risk from one generation to the next in the absence of an additional prenatal insult indicates an important role for epigenetic processes. Experimental studies also indicate that the sympathetic nervous system, the renin angiotensin system, increased production of oxidative stress and increased endothelin play an important role in the developmental programming of blood pressure in later life. Thus, this review will highlight how adverse influences during fetal life and early development program an increased risk for cardiovascular disease including high blood pressure and provide an overview of the underlying mechanisms that contribute to the fetal origins of cardiovascular pathology. PMID:25880521

  11. Anabolic steroids and cardiovascular risk.

    PubMed

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

    2012-02-01

    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

  12. Bradykinin-mediated cardiovascular protective actions of ACE inhibitors. A new dimension in anti-ischaemic therapy?

    PubMed

    Remme, W J

    1997-01-01

    In addition to being accepted therapy in hypertension and heart failure, ACE inhibitors may well offer a new dimension in anti-ischaemic therapy. Currently, anti-ischaemic properties have been demonstrated by ACE inhibitors in selected patient groups, including patients with left ventricular dysfunction with or without a direct temporal relationship with myocardial infarction. Anti-ischaemic effects of ACE inhibitors become apparent late after initiation of treatment and suggest a structural rather than a functional effect. Underlying mechanisms may include a reduction in ventricular dilatation and (abnormal) cardiac hypertrophy, leading to less myocardial oxygen demand and, possibly, improved subendocardial blood supply, and vasculoprotective effects, i.e. anti-atherosclerotic and antiremodelling properties, a beneficial effect on the fibrinolytic system and an improvement in abnormal endothelial vasodilator function. The latter aspect is most probably the pivotal mode of action where the anti-ischaemic profile of ACE inhibition is concerned. An improvement in endothelial dysfunction has been shown in patients with mild to moderate coronary artery disease [Trial on Reversing ENdothelial Dysfunction (TREND)]. It is of importance that, in both clinical experiments and human studies, the role of bradykinin appears central in the structural and functional cardiovascular effects of ACE inhibition. This is particularly true for the improvement of impaired endothelial function. Myocardial ischaemia evokes vasoconstrictor neurohormonal activation, which may lead to coronary vasoconstriction in diseased coronary segments. The subsequent abnormal endothelial function leads to diminished coronary flow and also increases systemic vasotone and afterload, thus unfavourably altering the myocardial oxygen supply/demand ratio. Under laboratory conditions, acute ACE inhibition counteracts this activation in humans. However, it is speculated that this anti-ischaemic mechanism may

  13. Animal models of cardiovascular diseases.

    PubMed

    Zaragoza, Carlos; Gomez-Guerrero, Carmen; Martin-Ventura, Jose Luis; Blanco-Colio, Luis; Lavin, Begoña; Mallavia, Beñat; Tarin, Carlos; Mas, Sebastian; Ortiz, Alberto; Egido, Jesus

    2011-01-01

    Cardiovascular diseases are the first leading cause of death and morbidity in developed countries. The use of animal models have contributed to increase our knowledge, providing new approaches focused to improve the diagnostic and the treatment of these pathologies. Several models have been developed to address cardiovascular complications, including atherothrombotic and cardiac diseases, and the same pathology have been successfully recreated in different species, including small and big animal models of disease. However, genetic and environmental factors play a significant role in cardiovascular pathophysiology, making difficult to match a particular disease, with a single experimental model. Therefore, no exclusive method perfectly recreates the human complication, and depending on the model, additional considerations of cost, infrastructure, and the requirement for specialized personnel, should also have in mind. Considering all these facts, and depending on the budgets available, models should be selected that best reproduce the disease being investigated. Here we will describe models of atherothrombotic diseases, including expanding and occlusive animal models, as well as models of heart failure. Given the wide range of models available, today it is possible to devise the best strategy, which may help us to find more efficient and reliable solutions against human cardiovascular diseases.

  14. Ghrelin and the cardiovascular system.

    PubMed

    Tokudome, Takeshi; Kishimoto, Ichiro; Miyazato, Mikiya; Kangawa, Kenj

    2014-01-01

    Ghrelin is a peptide that was originally isolated from the stomach. It exerts potent growth hormone (GH)-releasing and orexigenic activities. Several studies have highlighted the therapeutic benefits of ghrelin for the treatment of cardiovascular disease. In animal models of chronic heart failure, the administration of ghrelin improved cardiac function and remodeling; these findings were replicated in human patients with heart failure. Moreover, in an animal study, ghrelin administration effectively reduced pulmonary hypertension induced by chronic hypoxia. In addition, repeated administration of ghrelin to cachectic patients with chronic obstructive pulmonary disease had positive effects on overall body function, including muscle wasting, functional capacity and sympathetic activity. The administration of ghrelin early after myocardial infarction (MI) reduced fatal arrhythmia and related mortality. In ghrelin-deficient mice, both exogenous and endogenous ghrelin were protective against fatal arrhythmia and promoted remodeling after MI. Although the mechanisms underlying the effects of ghrelin on the cardiovascular system remain unclear, there are indications that its beneficial effects are mediated through both direct physiological actions, including increased GH levels, improved energy balance and direct actions on cardiovascular cells, and regulation of autonomic nervous system activity. Therefore, ghrelin is a promising novel therapeutic agent for cardiovascular disease.

  15. Metabolic and cardiovascular adjustments during psychological stress and carotid artery intima-media thickness in youth

    USDA-ARS?s Scientific Manuscript database

    Objective: Absolute systolic blood pressure during exercise and a greater increase above baseline, or reactivity, in systolic blood pressure during psychological stress are correlated with an increased risk for cardiovascular disease. Most studies hypothesize that increased cardiovascular responses...

  16. Hypoxia Stress Test Reveals Exaggerated Cardiovascular Effects in Hypertensive Rats after Exposure to the Air Pollutant Acrolein

    EPA Science Inventory

    Exposure to air pollution increases the risk of cardiovascular morbidity and mortality, especially in susceptible populations with cardiovascular disease. Stress tests are useful in assessing cardiovascular risk and manifesting latent effects of exposure. The goal of this study w...

  17. Hypoxia Stress Test Reveals Exaggerated Cardiovascular Effects in Hypertensive Rats after Exposure to the Air Pollutant Acrolein

    EPA Science Inventory

    Exposure to air pollution increases the risk of cardiovascular morbidity and mortality, especially in susceptible populations with cardiovascular disease. Stress tests are useful in assessing cardiovascular risk and manifesting latent effects of exposure. The goal of this study w...

  18. Frequent Consumption of Sugar- and Artificially Sweetened Beverages and Natural and Bottled Fruit Juices Is Associated with an Increased Risk of Metabolic Syndrome in a Mediterranean Population at High Cardiovascular Disease Risk.

    PubMed

    Ferreira-Pêgo, Cíntia; Babio, Nancy; Bes-Rastrollo, Maira; Corella, Dolores; Estruch, Ramon; Ros, Emilio; Fitó, Montserrat; Serra-Majem, Lluís; Arós, Fernando; Fiol, Miguel; Santos-Lozano, José Manuel; Muñoz-Bravo, Carlos; Pintó, Xavier; Ruiz-Canela, Miguel; Salas-Salvadó, Jordi

    2016-08-01

    The relation between the consumption of sweetened beverages and metabolic syndrome (MetS) is controversial. This analysis evaluated the associations between intakes of sugar-sweetened beverages (SSBs), artificially sweetened beverages, and natural and bottled fruit juices and the incidence of MetS in elderly individuals at high risk of cardiovascular disease (CVD) and without MetS at baseline. We prospectively examined 1868 participants free of MetS at baseline from the PREDIMED (PREvención con DIeta MEDiterránea) study. MetS was defined by using the updated harmonized criteria of the International Diabetes Federation, the American Heart Association, and National Heart, Lung, and Blood Institute. Energy and nutrient intakes were evaluated at baseline and then yearly by using a validated 137-item food-frequency questionnaire. Multivariable-adjusted HRs for MetS and its components were estimated from mean intakes during follow-up. We compared the 2 highest consumption categories (1-5 and >5 servings/wk) with the lowest category (<1 serving/wk). A total of 930 incident cases of MetS were documented during a median follow-up of 3.24 y. When we compared consumption of >5 servings/wk with consumption of <1 serving/wk, multivariable HRs (95% CIs) for MetS incidence were 1.43 (1.00, 2.15), 1.74 (1.26, 2.41), 1.30 (1.00, 1.69), and 1.14 (1.04, 1.65) for SSBs, artificially sweetened beverages, natural fruit juices, and bottled fruit juices, respectively. The occasional consumption of SSBs and artificially sweetened beverages (1-5 servings/wk) was not associated with the incidence of MetS in middle-aged and elderly individuals at high risk of CVD. The consumption of >5 servings/wk of all of the types of beverages analyzed was associated with an increased risk of MetS and some of its components. However, for SSBs and bottled fruit juices these associations must be interpreted with caution because of the low frequency of consumption in this population. This trial was

  19. Cardiovascular effects of calcium supplements.

    PubMed

    Reid, Ian R

    2013-07-05

    Calcium supplements reduce bone turnover and slow the rate of bone loss. However, few studies have demonstrated reduced fracture incidence with calcium supplements, and meta-analyses show only a 10% decrease in fractures, which is of borderline statistical and clinical significance. Trials in normal older women and in patients with renal impairment suggest that calcium supplements increase the risk of cardiovascular disease. To further assess their safety, we recently conducted a meta-analysis of trials of calcium supplements, and found a 27%-31% increase in risk of myocardial infarction, and a 12%-20% increase in risk of stroke. These findings are robust because they are based on pre-specified analyses of randomized, placebo-controlled trials and are consistent across the trials. Co-administration of vitamin D with calcium does not lessen these adverse effects. The increased cardiovascular risk with calcium supplements is consistent with epidemiological data relating higher circulating calcium concentrations to cardiovascular disease in normal populations. There are several possible pathophysiological mechanisms for these effects, including effects on vascular calcification, vascular cells, blood coagulation and calcium-sensing receptors. Thus, the non-skeletal risks of calcium supplements appear to outweigh any skeletal benefits, and are they appear to be unnecessary for the efficacy of other osteoporosis treatments.

  20. The prevalence of metabolic syndrome increases with serum high sensitivity C-reactive protein concentration in individuals without a history of cardiovascular disease: a report from a large Persian cohort.

    PubMed

    Kazemi-Bajestani, Seyyed Mr; Tayefi, Maryam; Ebrahimi, Mahmoud; Heidari-Bakavoli, Ali R; Moohebati, Mohsen; Parizadeh, Seyyed Mr; Esmaeili, Habibollah; Ferns, Gordon Aa; Ghayour-Mobarhan, Majid

    2017-01-01

    Background Metabolic syndrome is defined by a clustering of cardiovascular risk factors and is associated with a heightened inflammatory state. A raised serum high-sensitivity C-reactive protein, a marker of inflammation, is also known to associate with cardiovascular risk. We have investigated the relationship between the presence of metabolic syndrome and serum high-sensitivity C-reactive protein concentration in a large representative Persian population cohort without a history of cardiovascular disease. Methods The MASHAD study population cohort comprised 9778 subjects, who were recruited from the city of Mashhad, Iran, between 2007 and 2008. Several cardiovascular risk factors were measured in this population without cardiovascular disease. Individuals were categorized into quartiles of serum high-sensitivity C-reactive protein concentration: first quartile - 0.72 (0.59-0.85) (median [range]) mg/L, second quartile - 1.30 (1.14-1.4) mg/L, third quartile - 2.29 (1.92-2.81) mg/L and fourth quartile - 6.63 (4.61-11.95) mg/L, respectively. The prevalence of metabolic syndrome in each quartile was determined using either International Diabetes Federation or Adult Treatment Panel III criteria. Results The prevalence of metabolic syndrome was highest in the fourth quartile for serum high-sensitivity C-reactive protein (1220 subjects [50.0%]), and significantly higher than that in the first quartile (reference group) (634 subjects [25.9%]) ( P < 0.001). A positive smoking habit (OR, 1.47 [1.26-1.70], P < 0.001) and the presence of either metabolic syndrome-International Diabetes Federation (OR, 1.35 [1.18-1.55], P < 0.001) or metabolic syndrome-ATPIII (OR, 1.40 [1.18-1.50], P < 0.001) were strong predictors of a fourth quartile for serum high-sensitivity C-reactive protein concentration. Conclusions There was a significant association between high concentrations of serum high-sensitivity C-reactive protein and the presence of metabolic syndrome among

  1. Cardiovascular adaptations to resistance training.

    PubMed

    Fleck, S J

    1988-10-01

    The cross-sectional and longitudinal data available indicate that the following conclusions are warranted concerning the effects of resistance training on the cardiovascular system. Resistance training causes increased absolute left ventricular wall thickness and left ventricular mass. These increases are not as evident when expressed relative to body surface area or lean body mass. There is little or no change in left ventricular internal dimensions, in absolute terms or relative to body surface area, resting heart rate, resting blood pressure, and diastolic function of the left ventricle due to resistance training. No change or slight positive effects are noted in systolic function of the left ventricle with training. During resistance training exercises, a large pressor response occurs and is attenuated in resistance trained athletes as compared to control subjects. Resistance training does result in adaptations of the cardiovascular system, with further research needed to elucidate its nature.

  2. The Supply and Demand of the Cardiovascular Workforce

    PubMed Central

    Narang, Akhil; Sinha, Shashank S.; Rajagopalan, Bharath; Ijioma, Nkechinyere N.; Jayaram, Natalie; Kithcart, Aaron P.; Tanguturi, Varsha K.; Cullen, Michael W.

    2017-01-01

    As the burden of cardiovascular disease in the United States continues to increase, uncertainty remains on how well-equipped the cardiovascular workforce is to meet the challenges that lie ahead. In a time when health care is rapidly shifting, numerous factors affect the supply and demand of the cardiovascular workforce. This Council Commentary critically examines several factors that influence the cardiovascular workforce. These include current workforce demographics and projections, evolving health care and practice environments, and the increasing burden of cardiovascular disease. Finally, we propose 3 strategies to optimize the workforce. These focus on cardiovascular disease prevention, the effective utilization of the cardiovascular care team, and alterations to the training pathway for cardiologists. PMID:27712782

  3. Managing cardiovascular risk in patients with inflammatory arthritis: practical considerations

    PubMed Central

    Tournadre, Anne; Mathieu, Sylvain; Soubrier, Martin

    2016-01-01

    Patients with inflammatory arthritis, such as rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis, have higher rates of cardiovascular mortality. While the increased cardiovascular risk is only explained to some extent, a lot of research is currently conducted to improve our understanding of its pathogenesis, risk stratification, and optimal cardiovascular risk management. This review sought to report epidemiological data pertaining to the cardiovascular disease burden in patients with inflammatory arthritis, underlying mechanisms accounting for excessive cardiovascular risk, along with recommendations regarding risk assessment and management in this patient population. PMID:27721904

  4. Erectile dysfunction and cardiovascular disease

    PubMed Central

    Jackson, Graham

    2013-01-01

    The link between erectile dysfunction (ED) and cardiovascular disease (CVD) is reviewed by assessing original papers, current consensus, previous reviews and meta-analyses. The link between these conditions is confirmed, and the evaluation and assessment summarised with a new evidence-based algorithm. ED, especially in younger men, is a marker of an increased risk of CVD, and ED needs to be incorporated into all risk-screening programmes. PMID:26558084

  5. Potassium in hypertension and cardiovascular disease.

    PubMed

    Castro, Hector; Raij, Leopoldo

    2013-05-01

    The increased prevalence of hypertension and cardiovascular disease in industrialized societies undoubtedly is associated with the modern high-sodium/low-potassium diet. Extensive experimental and clinical data strongly link potassium intake to cardiovascular outcome. Most studies suggest that the sodium-to-potassium intake ratio is a better predictor of cardiovascular outcome than either nutrient individually. A high-sodium/low-potassium environment results in significant abnormalities in central hemodynamics, leading to potential target organ damage. Altered renal sodium handling, impaired endothelium-dependent vasodilatation, and increased oxidative stress are important mediators of this effect. It remains of paramount importance to reinforce consumption of a low-sodium/high-potassium diet as a critical strategy for prevention and treatment of hypertension and cardiovascular disease. Published by Elsevier Inc.

  6. Update on cardiovascular disease in lupus.

    PubMed

    Lewandowski, Laura B; Kaplan, Mariana J

    2016-09-01

    Atherosclerotic cardiovascular disease confers significant morbidity and mortality in patients with systemic lupus erythematosus (SLE) and cannot be fully explained by traditional cardiovascular risk factors. Recent immunologic discoveries have outlined putative pathways in SLE that may also accelerate the development of atherosclerosis. Aberrant innate and adaptive immune responses implicated in lupus pathogenesis may also contribute to the development of accelerated atherosclerosis in these patients. Defective apoptosis, abnormal lipoprotein function, autoantibodies, aberrant neutrophil responses, and a dysregulated type I interferon pathway likely contribute to endothelial dysfunction. SLE macrophages have an inflammatory phenotype that may drive progression of plaque. Recent discoveries have placed increased emphasis on the immunology of atherosclerotic cardiovascular disease. Understanding the factors that drive the increased risk for cardiovascular disease in SLE patients may provide selective therapeutic targets for reducing inflammation and improving outcomes in atherosclerosis.

  7. Factors associated with an unfavourable outcome after Salter innominate osteotomy in patients with unilateral developmental dysplasia of the hip: does occult dysplasia of the contralateral hip affect the outcome?

    PubMed

    Kaneko, H; Kitoh, H; Mishima, K; Matsushita, M; Kadono, I; Ishiguro, N; Hattori, T

    2014-10-01

    Salter innominate osteotomy is an effective reconstructive procedure for the treatment of developmental dysplasia of the hip (DDH), but some children have a poor outcome at skeletal maturity. In order to investigate factors associated with an unfavourable outcome, we assessed the development of the contralateral hip. We retrospectively reviewed 46 patients who underwent a unilateral Salter osteotomy at between five and seven years of age, with a mean follow-up of 10.3 years (7 to 20). The patients were divided into three groups according to the centre-edge angle (CEA) of the contralateral hip at skeletal maturity: normal (> 25°, 22 patients), borderline (20° to 25°, 17 patients) and dysplastic (< 20°, 7 patients). The CEA of the affected hip was measured pre-operatively, at eight to nine years of age, at 11 to 12 years of age and at skeletal maturity. The CEA of the affected hip was significantly smaller in the borderline and dysplastic groups at 11 and 12 years of age (p = 0.012) and at skeletal maturity (p = 0.017) than in the normal group. Severin group III was seen in two (11.8%) and four hips (57.1%) of the borderline and dysplastic groups, respectively (p < 0.001). Limited individual development of the acetabulum was associated with an unfavourable outcome following Salter osteotomy. ©2014 The British Editorial Society of Bone & Joint Surgery.

  8. Improving cardiovascular protection: focus on a cardiovascular polypill.

    PubMed

    Barrios, Vivencio; Escobar, Carlos

    2016-03-01

    Lack of adherence may explain, at least in part, the poor cardiovascular risk factors control observed in patients with ischemic heart disease, increasing the risk of developing new events. Polypill improves medication adherence, which may actually reduce blood pressure and LDL cholesterol compared with the drugs given separately. The fixed combination of acetylsalicylic acid 100 mg + ramipril 2.5, 5, or 10 mg + either simvastatin 40 mg or atorvastatin 20 mg is the unique cardiovascular polypill that has been registered in 22 countries worldwide. The polypill-containing simvastatin has been specifically tested in a clinical trial including only patients with ischemic heart disease. The FOCUS study showed that patients treated with the polypill showed a higher adherence compared with those receiving separate medications.

  9. Cardiovascular risk factor investigation: a pediatric issue

    PubMed Central

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

    2013-01-01

    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

  10. Cocoa, blood pressure, and cardiovascular health.

    PubMed

    Ferri, Claudio; Desideri, Giovambattista; Ferri, Livia; Proietti, Ilenia; Di Agostino, Stefania; Martella, Letizia; Mai, Francesca; Di Giosia, Paolo; Grassi, Davide

    2015-11-18

    High blood pressure is an important risk factor for cardiovascular disease and cardiovascular events worldwide. Clinical and epidemiological studies suggest that cocoa-rich products reduce the risk of cardiovascular disease. According to this, cocoa has a high content in polyphenols, especially flavanols. Flavanols have been described to exert favorable effects on endothelium-derived vasodilation via the stimulation of nitric oxide-synthase, the increased availability of l-arginine, and the decreased degradation of NO. Cocoa may also have a beneficial effect by protecting against oxidative stress alterations and via decreased platelet aggregation, decreased lipid oxidation, and insulin resistance. These effects are associated with a decrease of blood pressure and a favorable trend toward a reduction in cardiovascular events and strokes. Previous meta-analyses have shown that cocoa-rich foods may reduce blood pressure. Long-term trials investigating the effect of cocoa products are needed to determine whether or not blood pressure is reduced on a chronic basis by daily ingestion of cocoa. Furthermore, long-term trials investigating the effect of cocoa on clinical outcomes are also needed to assess whether cocoa has an effect on cardiovascular events. A 3 mmHg systolic blood pressure reduction has been estimated to decrease the risk of cardiovascular and all-cause mortality. This paper summarizes new findings concerning cocoa effects on blood pressure and cardiovascular health, focusing on putative mechanisms of action and "nutraceutical " viewpoints.

  11. Visualizing novel concepts of cardiovascular calcification.

    PubMed

    Hjortnaes, Jesper; New, Sophie E P; Aikawa, Elena

    2013-04-01

    Cardiovascular calcification is currently viewed as an active disease process similar to embryonic bone formation. Cardiovascular calcification mainly affects the aortic valve and arteries and is associated with increased mortality risk. Aortic valve and arterial calcification share similar risk factors, including age, gender, diabetes, chronic renal disease, and smoking. However, the exact cellular and molecular mechanism of cardiovascular calcification is unknown. Late-stage cardiovascular calcification can be visualized with conventional imaging modalities such as echocardiography and computed tomography. However, these modalities are limited in their ability to detect the development of early calcification and the progression of calcification until advanced tissue mineralization is apparent. Due to the subsequent late diagnosis of cardiovascular calcification, treatment is usually comprised of invasive interventions such as surgery. The need to understand the process of calcification is therefore warranted and requires new imaging modalities which are able to visualize early cardiovascular calcification. This review focuses on the use of new imaging techniques to visualize novel concepts of cardiovascular calcification. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. Relationships of different types of event to cardiovascular death in trials of antihypertensive treatment: an aid to definition of total cardiovascular disease risk in hypertension.

    PubMed

    Zambon, Antonella; Arfè, Andrea; Corrao, Giovanni; Zanchetti, Alberto

    2014-03-01

    Guidelines for management of cardiovascular diseases stratify absolute cardiovascular risk into categories with a high-risk threshold defined at a 20% cardiovascular events risk in 10 years, but it is unclear whether only major events or the Framingham-extended definition should be considered. The 2013 ESH-ESC hypertension guidelines, instead, define cardiovascular risk as a risk of cardiovascular death in 10 years, as in the SCORE model, setting the threshold for high risk at the 5% level. It would be therefore convenient to know the quantitative relationship between the risks of the different outcomes adopted by the different guidelines, especially because some outcome definitions include serious nonfatal cardiovascular events relevant in cardiovascular prevention. We have therefore analysed these relationships in trials of antihypertensive therapy as an aid to defining total cardiovascular risk in hypertensive patients. Sixty-one trials were identified, and 51 retained for analysis of the relationship of cardiovascular death to the incidence of all-cause death, major cardiovascular events and inclusive (Framingham) cardiovascular events. The relationship between cardiovascular death rates and each type of event rates was explored by fitting flexible regression models. The included trials provided 15164 cardiovascular deaths and 1674427 patient-years. The relation of each event rate to cardiovascular death rate was best explained by a model considering the logarithm of each event rate as a dependent variable and the logarithm of cardiovascular death rate as a predictor. Mean patients' age and treatment were also predictors, but to a minor extent. The increase of the incidence rates of all types of events was less steep the higher the CV death rate: the rate ratios of all-cause death to cardiovascular death were 2.2, 1.9 and 1.8 at low-moderate (cardiovascular death <5% in 10 years), high (cardiovascular death 5% to <10%) and very high risk (cardiovascular death

  13. Cardiovascular involvement in celiac disease

    PubMed Central

    Ciaccio, Edward J; Lewis, Suzanne K; Biviano, Angelo B; Iyer, Vivek; Garan, Hasan; Green, Peter H

    2017-01-01

    Celiac disease (CD) is an autoimmune response to ingestion of gluten protein, which is found in wheat, rye, and barley grains, and results in both small intestinal manifestations, including villous atrophy, as well as systemic manifestations. The main treatment for the disease is a gluten-free diet (GFD), which typically results in the restoration of the small intestinal villi, and restoration of other affected organ systems, to their normal functioning. In an increasing number of recently published studies, there has been great interest in the occurrence of alterations in the cardiovascular system in untreated CD. Herein, published studies in which CD and cardiovascular terms appear in the title of the study were reviewed. The publications were categorized into one of several types: (1) articles (including cohort and case-control studies); (2) reviews and meta-analyses; (3) case studies (one to three patient reports); (4) letters; (5) editorials; and (6) abstracts (used when no full-length work had been published). The studies were subdivided as either heart or vascular studies, and were further characterized by the particular condition that was evident in conjunction with CD. Publication information was determined using the Google Scholar search tool. For each publication, its type and year of publication were tabulated. Salient information from each article was then compiled. It was determined that there has been a sharp increase in the number of CD - cardiovascular studies since 2000. Most of the publications are either of the type “article” or “case study”. The largest number of documents published concerned CD in conjunction with cardiomyopathy (33 studies), and there have also been substantial numbers of studies published on CD and thrombosis (27), cardiovascular risk (17), atherosclerosis (13), stroke (12), arterial function (11), and ischemic heart disease (11). Based on the published research, it can be concluded that many types of cardiovascular

  14. Cardiovascular drift during heat stress: implications for exercise prescription.

    PubMed

    Wingo, Jonathan E; Ganio, Matthew S; Cureton, Kirk J

    2012-04-01

    Cardiovascular drift, the progressive increase in heart rate and decrease in stroke volume that begins after approximately 10 min of prolonged moderate-intensity exercise, is associated with decreased maximal oxygen uptake, particularly during heat stress. Consequently, the increased heart rate reflects an increased relative metabolic intensity during prolonged exercise in the heat when cardiovascular drift occurs, which has implications for exercise prescription.

  15. Coffee Consumption and Cardiovascular Health.

    PubMed

    Chrysant, Steven G

    2015-09-01

    Coffee is the most widely consumed beverage worldwide and is only second to water drinking and is consumed by 83% of adults in the United States. The long-held controversy regarding the association of coffee consumption with an increased incidence of cardiovascular diseases (CVDs) and hypertension has been reversed by several recent prospective cohort studies and meta-analyses, which have demonstrated that coffee consumption is not associated with increased incidence of CVDs and hypertension and instead it could have a beneficial effect. To get a better understanding of the effects of coffee consumption on cardiovascular health, a Medline search of the English language literature was conducted from 2010 to early 2015 and 25 pertinent reports with information on the effects of coffee drinking, the incidence of CVDs, and hypertension and its mechanism of action were selected for inclusion in this commentary. These studies have shown either a neutral or beneficial effect of coffee on cardiovascular health. In conclusion, coffee is safe to drink by both normal subjects and by those with preexisting CVDs and hypertension.

  16. Cocoa antioxidants and cardiovascular health.

    PubMed

    Keen, Carl L; Holt, Roberta R; Oteiza, Patricia I; Fraga, César G; Schmitz, Harold H

    2005-01-01

    An increasing body of epidemiologic evidence supports the concept that diets rich in fruits and vegetables can promote health and attenuate, or delay, the onset of various diseases. Epidemiologic data support the idea that these health benefits are causally linked to the consumption of certain flavonoids present in fruit and vegetables. In the context of cardiovascular health, a particular group of flavonoids, namely, the flavan-3-ols (flavanols), has received attention. Flavanol-rich, plant-derived foods and beverages include wine, tea, and various fruits and berries, as well as cocoa and cocoa products. Numerous dietary intervention studies in humans and animals indicate that flavanol-rich foods and beverages might exert cardioprotective effects with respect to vascular function and platelet reactivity. This review discusses the bioactivity of flavanols in the context of cardiovascular health, with respect to their bioavailability, their antioxidant properties, and their vascular effects.

  17. Vitamin D and Cardiovascular Disease.

    PubMed

    Wang, Thomas J

    2016-01-01

    Vitamin D is best known for its influence on skeletal health. There is growing recognition, however, that vitamin D has nonskeletal actions, which could have important implications for understanding the consequences of vitamin D deficiency. In epidemiologic studies, vitamin D deficiency has been consistently associated with an increased risk for cardiovascular disease and hypertension. Disruption of vitamin D signaling in animal models promotes hypertension, cardiac hypertrophy, and atherosclerosis. This evidence has led to the initiation of prospective randomized trials of vitamin D supplementation in individuals at risk for cardiovascular disease. The results of these trials should help to guide strategies for screening and management of vitamin D deficiency in the clinic and at the population level.

  18. [Cooperative Cardiovascular Disease Research Network (RECAVA)].

    PubMed

    García-Dorado, David; Castro-Beiras, Alfonso; Díez, Javier; Gabriel, Rafael; Gimeno-Blanes, Juan R; Ortiz de Landázuri, Manuel; Sánchez, Pedro L; Fernández-Avilés, Francisco

    2008-01-01

    Today, cardiovascular disease is the principal cause of death and hospitalization in Spain, and accounts for an annual healthcare budget of more than 4000 million euros. Consequently, early diagnosis, effective prevention, and the optimum treatment of cardiovascular disease present a significant social and healthcare challenge for the country. In this context, combining all available resources to increase the efficacy and healthcare benefits of scientific research is a priority. This rationale prompted the establishment of the Spanish Cooperative Cardiovascular Disease Research Network, or RECAVA (Red Temática de Investigación Cooperativa en Enfermedades Cardiovasculares), 5 years ago. Since its foundation, RECAVA's activities have focused on achieving four objectives: a) to facilitate contacts between basic, clinical and epidemiological researchers; b) to promote the shared use of advanced technological facilities; c) to apply research results to clinical practice, and d) to train a new generation of translational cardiovascular researchers in Spain. At present, RECAVA consists of 41 research groups and seven shared technological facilities. RECAVA's research strategy is based on a scientific design matrix centered on the most important cardiovascular processes. The level of RECAVA's research activity is reflected in the fact that 28 co-authored articles were published in international journals during the first six months of 2007, with each involving contributions from at least two groups in the network. Finally, RECAVA also participates in the work of the Spanish National Center for Cardiovascular Research, or CNIC (Centro Nacional de Investigación Cardiovascular), and some established Biomedical Research Network Centers, or CIBER (Centros de Investigación Biomédica en RED), with the aim of consolidating the development of a dynamic multidisciplinary research framework that is capable of meeting the growing challenge that cardiovascular disease will present

  19. Cardiovascular disease risk reduction with sleep apnea treatment

    PubMed Central

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

    2014-01-01

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

  20. Vitamin E and cardiovascular disease.

    PubMed

    Saremi, Adonis; Arora, Rohit

    2010-01-01

    The objective of this article is to review the role of vitamin E in cardiovascular disease. We begin by describing the general characteristics and metabolism of vitamin E and the pathogenesis of atherosclerosis as it relates to oxidation. We also discuss key in vitro studies, animal studies, observational studies, and clinical trials regarding the potentially cardioprotective effect of vitamin E. Lastly, we outline the current recommendations regarding vitamin E in the prevention and treatment of cardiovascular disease as stated by the American Heart Association. Vitamin E is a fat-soluble antioxidant vitamin and alpha-tocopherol is its most naturally abundant and active form. Oxidation is a key step in atherogenesis. Oxidized low-density lipoprotein stimulates endothelial cells to produce inflammatory markers, is involved in foam cell formation, has cytotoxic effects on endothelial cells, inhibits the motility of tissue macrophages, and inhibits nitric oxide-induced vasodilatation. Vitamin E has been shown to increase oxidative resistance in vitro and prevent atherosclerotic plaque formation in mouse models. Consumption of foods rich in vitamin E has been associated with lower risk of coronary heart disease in middle-aged to older men and women. Clinical studies at large have not demonstrated a benefit of vitamin E in the primary and secondary prevention of cardiovascular disease. Vitamin E supplementation might be associated with an increase in total mortality, heart failure, and hemorrhagic stroke. The American Heart Association does not support the use of vitamin E supplements to prevent cardiovascular disease, but does recommend the consumption of foods abundant in antioxidant vitamins and other nutrients.

  1. Cocaine and Cardiovascular Events.

    ERIC Educational Resources Information Center

    Cantwell, John D.; Rose, Fred D.

    1986-01-01

    The case of a 21-year-old man who suffered a myocardial infarction after using cocaine and amphetamines is reported. A brief literature review provides evidence of cocaine's potential cardiovascular effects. (Author/MT)

  2. Autophagy in cardiovascular biology

    PubMed Central

    Lavandero, Sergio; Chiong, Mario; Rothermel, Beverly A.; Hill, Joseph A.

    2015-01-01

    Cardiovascular disease is the leading cause of death worldwide. As such, there is great interest in identifying novel mechanisms that govern the cardiovascular response to disease-related stress. First described in failing hearts, autophagy within the cardiovascular system has been widely characterized in cardiomyocytes, cardiac fibroblasts, endothelial cells, vascular smooth muscle cells, and macrophages. In all cases, a window of optimal autophagic activity appears to be critical to the maintenance of cardiovascular homeostasis and function; excessive or insufficient levels of autophagic flux can each contribute to heart disease pathogenesis. In this Review, we discuss the potential for targeting autophagy therapeutically and our vision for where this exciting biology may lead in the future. PMID:25654551

  3. Cardiovascular modeling and diagnostics

    SciTech Connect

    Kangas, L.J.; Keller, P.E.; Hashem, S.; Kouzes, R.T.

    1995-12-31

    In this paper, a novel approach to modeling and diagnosing the cardiovascular system is introduced. A model exhibits a subset of the dynamics of the cardiovascular behavior of an individual by using a recurrent artificial neural network. Potentially, a model will be incorporated into a cardiovascular diagnostic system. This approach is unique in that each cardiovascular model is developed from physiological measurements of an individual. Any differences between the modeled variables and the variables of an individual at a given time are used for diagnosis. This approach also exploits sensor fusion to optimize the utilization of biomedical sensors. The advantage of sensor fusion has been demonstrated in applications including control and diagnostics of mechanical and chemical processes.

  4. [Cardiovascular syphilis: diagnosis, treatment].

    PubMed

    Carrada-Bravo, Teodoro

    2006-01-01

    Cardiovascular tertiary syphilis may lead to aortitis, aortic aneurism, coronary stenosis, aortic insufficiency and, rarely, to myocarditis. The physician must be familiar with the clinical presentations of this process, including the asymptomatic variety and must be able to have an organized plan for the diagnosis and evaluation to establish or exclude the presence of cardiovascular pathology and the differential diagnosis with other entities. Once the etiologic and topographic diagnosis is established, the patient should be treated with penicillin, doxicycline and other antibiotics, and the consequences of the disorder, both actual and potential, should be considered before deciding weather to recommend surgical intervention. Although late syphilis can be prevented by appropriate therapy of early syphilis, this is a cardiovascular disease that most likely will continue to be diagnosed lately. Understanding of the pathology and pathophysiology of the disease, is most important for its prompt recognition and subsequent management. This paper reviews the natural history, diagnosis and therapy of cardiovascular syphilis.

  5. Cardiovascular Effects of Weightlessness

    NASA Technical Reports Server (NTRS)

    Short, K.

    1985-01-01

    Physiological changes resulting from long term weightlessness are reviewed and activities conducted to study cardiovascular deconditioning at NASA Ames are discussed. Emphasis is on using monkeys in chair rest, water immersion, and tilt table studies to simulate space environment effects.

  6. Understanding cardiovascular disease

    MedlinePlus

    ... of plaque. Narrow arteries reduce or block blood flow. When blood and oxygen can't get to the legs, it can injure nerves and tissue. High blood pressure (hypertension) is a cardiovascular disease that ...

  7. Cocaine and Cardiovascular Events.

    ERIC Educational Resources Information Center

    Cantwell, John D.; Rose, Fred D.

    1986-01-01

    The case of a 21-year-old man who suffered a myocardial infarction after using cocaine and amphetamines is reported. A brief literature review provides evidence of cocaine's potential cardiovascular effects. (Author/MT)

  8. Low levels of high-density lipoprotein cholesterol and increased risk of cardiovascular events in stable ischemic heart disease patients: A post-hoc analysis from the COURAGE Trial (Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation).

    PubMed

    Acharjee, Subroto; Boden, William E; Hartigan, Pamela M; Teo, Koon K; Maron, David J; Sedlis, Steven P; Kostuk, William; Spertus, John A; Dada, Marcin; Chaitman, Bernard R; Mancini, G B John; Weintraub, William S

    2013-11-12

    This study sought to assess the independent effect of high-density lipoprotein-cholesterol (HDL-C) level on cardiovascular risk in patients with stable ischemic heart disease (SIHD) who were receiving optimal medical therapy (OMT). Although low HDL-C level is a powerful and independent predictor of cardiovascular risk, recent data suggest that this may not apply when low-density lipoprotein-cholesterol (LDL-C) is reduced to optimal levels using intensive statin therapy. We performed a post-hoc analysis in 2,193 men and women with SIHD from the COURAGE trial. The primary outcome measure was the composite of death from any cause or nonfatal myocardial infarction (MI). The independent association between HDL-C levels measured after 6 months on OMT and the rate of cardiovascular events after 4 years was assessed. Similar analyses were performed separately in subjects with LDL-C levels below 70 mg/dl (1.8 mmol/l). In the overall population, the rate of death/MI was 33% lower in the highest HDL-C quartile as compared with the lowest quartile, with quartile of HDL-C being a significant, independent predictor of death/MI (p = 0.05), but with no interaction for LDL-C category (p = 0.40). Among subjects with LDL-C levels <70 mg/dl, those in the highest quintile of HDL-C had a 65% relative risk reduction in death or MI as compared with the lowest quintile, with HDL-C quintile demonstrating a significant, inverse predictive effect (p = 0.02). In this post-hoc analysis, patients with SIHD continued to experience incremental cardiovascular risk associated with low HDL-C levels despite OMT during long-term follow-up. This relationship persisted and appeared more prominent even when LDL-C was reduced to optimal levels with intensive dyslipidemic therapy. (Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation; NCT00007657). Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  9. Discontinued drugs in 2012: cardiovascular drugs.

    PubMed

    Zhao, Hong-Ping; Jiang, Hong-Min; Xiang, Bing-Ren

    2013-11-01

    The continued high rate of cardiovascular morbidity and mortality has attracted wide concern and great attention of pharmaceutical industry. In order to reduce the attrition of cardiovascular drug R&D, it might be helpful recapitulating previous failures and identifying the potential factors to success. This perspective mainly analyses the 30 cardiovascular drugs dropped from clinical development in 2012. Reasons causing the termination of the cardiovascular drugs in the past 5 years are also tabulated and analysed. The analysis shows that the attrition is highest in Phase II trials and financial and strategic factors and lack of clinical efficacy are the principal reasons for these disappointments. To solve the four problems (The 'better than the Beatles' problem, the 'cautious regulator' problem, the 'throw money at it' tendency and the 'basic researchbrute force' bias) is recommended as the main measure to increase the number and quality of approvable products.

  10. Evidence for central organization of cardiovascular rhythms.

    PubMed

    Montano, N; Porta, A; Malliani, A

    2001-06-01

    Spectral analysis of heart rate and arterial pressure variabilities is a powerful noninvasive tool that is increasingly used to infer alterations of cardiovascular autonomic regulation in a variety of physiological and pathophysiological conditions such as hypertension, myocardial infarction, and congestive heart failure. A most important methodological issue to properly interpret the results obtained by the spectral analysis of cardiovascular variability signals is represented by the attribution of neurophysiological correlates to these spectral components. In this regard, recent application of spectral techniques to the evaluation of the oscillatory properties of sympathetic efferent activity in animals as well as in humans offers a new approach to a better understanding of the relationship between cardiovascular oscillations and autonomic regulation. The data so far collected seem to suggest the presence of a centrally organized neural code, characterized by excitatory and inhibitory neural mechanisms subserving the genesis and the regulation of cardiovascular oscillations concerning the major variables of autonomic regulation.