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Sample records for cardiovascular risk assessment

  1. Assessment of cardiovascular risk.

    LENUS (Irish Health Repository)

    Cooney, Marie Therese

    2010-10-01

    Atherosclerotic cardiovascular disease (CVD) is the most common cause of death worldwide. Usually atherosclerosis is caused by the combined effects of multiple risk factors. For this reason, most guidelines on the prevention of CVD stress the assessment of total CVD risk. The most intensive risk factor modification can then be directed towards the individuals who will derive the greatest benefit. To assist the clinician in calculating the effects of these multiple interacting risk factors, a number of risk estimation systems have been developed. This review address several issues regarding total CVD risk assessment: Why should total CVD risk be assessed? What risk estimation systems are available? How well do these systems estimate risk? What are the advantages and disadvantages of the current systems? What are the current limitations of risk estimation systems and how can they be resolved? What new developments have occurred in CVD risk estimation?

  2. Total cardiovascular disease risk assessment: a review.

    LENUS (Irish Health Repository)

    Cooney, Marie Therese

    2011-09-01

    The high risk strategy for the prevention of cardiovascular disease (CVD) requires an assessment of an individual\\'s total CVD risk so that the most intensive risk factor management can be directed towards those at highest risk. Here we review developments in the assessment and estimation of total CVD risk.

  3. Cardiovascular risk assessment in women - an update.

    Science.gov (United States)

    Collins, P; Webb, C M; de Villiers, T J; Stevenson, J C; Panay, N; Baber, R J

    2016-08-01

    Cardiovascular disease is the leading cause of morbidity and mortality in postmenopausal women. Although it is a disease of aging, vascular disease initiates much earlier in life. Thus, there is a need to be aware of the potential to prevent the development of the disease from an early age and continue this surveillance throughout life. The menopausal period and early menopause present an ideal opportunity to assess cardiovascular risk and plan accordingly. Generally in this period, women will be seen by primary health-care professionals and non-cardiovascular specialists. This review addresses female-specific risk factors that may contribute to the potential development of cardiovascular disease. It is important for all health-care professionals dealing with women in midlife and beyond to be cognisant of these risk factors and to initiate female-specific preventative measures or to refer to a cardiovascular specialist. PMID:27327421

  4. Method and apparatus for assessing cardiovascular risk

    Science.gov (United States)

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

    1998-01-01

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

  5. Assessment of cardiovascular risk in diabetes: Risk scoresand provocative testing

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Cardiovascular disease (CVD) is the leading cause ofmorbidity and mortality among patients with diabetesmellitus, who have a risk of cardiovascular mortalitytwo to four times that of people without diabetes. Anindividualised approach to cardiovascular risk estimationand management is needed. Over the past decades,many risk scores have been developed to predict CVD.However, few have been externally validated in adiabetic population and limited studies have examinedthe impact of applying a prediction model in clinicalpractice. Currently, guidelines are focused on testingfor CVD in symptomatic patients. Atypical symptomsor silent ischemia are more common in the diabeticpopulation, and with additional markers of vasculardisease such as erectile dysfunction and autonomicneuropathy, these guidelines can be difficult to interpret.We propose an algorithm incorporating cardiovascularrisk scores in combination with typical and atypical signsand symptoms to alert clinicians to consider furtherinvestigation with provocative testing. The modalities forinvestigation of CVD are discussed.

  6. Assessment of Cardiovascular Disease Risk in South Asian Populations

    Directory of Open Access Journals (Sweden)

    S. Monira Hussain

    2013-01-01

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

  7. Cardiovascular risk assessment in Italy: the CUORE Project risk score and risk chart

    Directory of Open Access Journals (Sweden)

    Simona Giampaoli

    2007-06-01

    Full Text Available

    Aim: Risk charts and risk score, based on the global absolute risk, are key tools for CVD risk assessment. When applied to the population from which they derive, they provide the best estimate of CVD risk. That is why the CUORE Project has among its objectives the assessment of the Italian population’s cardiovascular risk, identifying the model for the prediction of coronary and cerebrovascular events in 10 years.

    Methods: Data fromdifferent cohorts enrolled in the North, Centre and South of Italy between the 1980s and the 1990s were used. From the 7,056 men and 12,574 women aged 35-69 years, free of cardiovascular disease at base-line and followed up for a mean time of 10 years for total and cause-specific mortality and non fatal cerebrovascular and coronary events, 894 major cardiovascular events (596 coronary and 298 cerebrovascular were identified and validated. To assess 10-year cardiovascular risk, the risk score and risk chart were developed for men and women separately, considering the first major coronary or cerebrovascular event as the endpoint.

    Results: The risk score is applied tomen andwomen aged 35-69 years and includes age, systolic blood pressure, total cholesterol, HDL-cholesterol, smoking habit, diabetes and hypertension treatment using continuous values when possible. The risk chart is applied to persons aged 40-69 years and includes the same risk factors as risk score, except for HDL-cholesterol and hypertension treatment, and uses categorical values for all variables.

    Conclusions: The risk score and risk chart are easy-to-use tools which enable general practitioners and specialists to achieve an objective evaluation of the absolute global cardiovascular risk of middle-aged persons in primary prevention.

  8. New Cardiovascular Risk Factors and Their Use for an Accurate Cardiovascular Risk Assessment in Hypertensive Patients

    Science.gov (United States)

    TAUTU, Oana-Florentina; DARABONT, Roxana; ONCIUL, Sebastian; DEACONU, Alexandru; COMANESCU, Ioana; ANDREI, Radu Dan; DRAGOESCU, Bogdan; CINTEZA, Mircea; DOROBANTU, Maria

    2014-01-01

    Objectives: To analyze the predictive value of new cardiovascular (CV) risk factors for CV risk assessment in the adult Romanian hypertensive (HT) population. Methods: Hypertensive adults aged between 40-65 years of age, identified in national representative SEPHAR II survey were evaluated by anthropometric, BP and arterial stiffness measurements: aortic pulse wave velocity (PWVao), aortic augmentation index (AIXao), revers time (RT) and central systolic blood pressure (SBPao), 12 lead ECGs and laboratory workup. Values above the 4th quartile of mean SBP' standard deviation (s.d.) defined increased BP variability. Log(TG/HDL-cholesterol) defined atherogenic index of plasma (AIP). Serum uric acid levels above 5.70 mg/dl for women and 7.0 mg/dl for males defined hyperuricemia (HUA). CV risk was assessed based on SCORE chart for high CV risk countries. Binary logistic regression using a stepwise likelihood ratio method (adjustments for major confounders and colliniarity analysis) was used in order to validate predictors of high and very high CV risk class. Results: The mean SBP value of the study group was 148.46±19.61 mmHg. Over forty percent of hypertensives had a high and very high CV risk. Predictors of high/very high CV risk category validated by regression analysis were: increased visit-to-visit BP variability (OR: 2.49; 95%CI: 1.67-3.73), PWVao (OR: 1.12; 95%CI: 1.02-1.22), RT (OR: 0.95; 95% CI: 0.93-0.98), SBPao (OR: 1.01; 95%CI: 1.01-1.03) and AIP (OR: 7.08; 95%CI: 3.91-12.82). Conclusion: The results of our study suggests that the new CV risk factors such as increased BP variability, arterial stiffness indices and AIP are useful tools for a more accurate identification of hypertensives patients at high and very high CV risk. PMID:25705267

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

    Science.gov (United States)

    ... Force Recommendations Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults The ... Recommendation | 1 Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults Potential ...

  10. Assessment of Cardiovascular Risk in Collegiate Football Players and Nonathletes

    Science.gov (United States)

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

    2010-01-01

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

  11. Assessment of high cardiovascular risk profiles for the clinician.

    Science.gov (United States)

    Whayne, Thomas F

    2013-07-01

    Diabetes mellitus (DM) is a major cardiovascular (CV) risk factor. General Framingham Risk Profile (GFRP) and World Health Organization/International Society of Hypertension (WHO/ISH) charts were used to assess CV risk in DM in Oman. The GFRP identified more patients with medium-risk DM; GFRP and WHO/ISH identified essentially equal numbers at very high risk. These were then used to evaluate statin usage in Oman, including economics. Google lists innumerable tools from organizations, hospitals, practitioners, magazines, societies, clinics, and medical associations. The GFRP and WHO/ISH calculations provided useful DM assessment of populations in Oman. Other major risk models are Adult Treatment Panel III, based on Framingham, and Reynolds Risk Score; the latter incorporates other factors such as family history, high-sensitivity C-reactive protein, and hemoglobin A(1c) (in DM). These models are useful in assessing specific populations. Individual practitioners with limited time may just evaluate patients as low, medium, and high CV risk based on general knowledge and then treat. PMID:23299171

  12. Multi-parametric prediction for cardiovascular risk assessment.

    Science.gov (United States)

    Henriques, Jorge; de Carvalho, Paulo; Rocha, Teresa; Paredes, Simão; Morais, João

    2016-01-01

    The employment of personal health systems (pHealth) is a valuable concept in the management of chronic diseases, particularly in the context of cardiovascular diseases. By means of a continuous monitoring of the patient it is possible to seamless access multiple sources of data, including physiological signals, providing professionals with a global and reliable view of the patient's status. In practice, it is possible the prompt diagnosis of events, the early prediction of critical events and the implementation of personalized therapies. Furthermore, the information collected during long periods creates new opportunities in the diagnosis of a disease, in its evolution, and in the prediction of possible complications. The focus of this work is the research and implementation of multi-parametric algorithms for data analysis in pHealth context, including data mining techniques as well as physiological signal modelling and processing. In particular, fusion strategies for cardiovascular status evaluation (namely cardiovascular risk assessment and cardiac function estimation) and multi-parametric prediction algorithms for the early detection of cardiovascular events (such as hypertension, syncope and heart failure decompensation) will be addressed. PMID:27225547

  13. Assessment of cardiovascular risks and overall risks for noncardiac surgery.

    Science.gov (United States)

    Chung, O Y; Beattie, C; Friesinger, G C

    1999-02-01

    Appropriate care of the elderly patient requires a concerted multi-disciplinary approach before, during, and after surgery to optimize functional outcomes, with the principal focus placed on improving quality of life and strategies for risk reduction. Perioperative physicians must be able to assess the biologic, not the chronologic, age of geriatric patients and their capacity for independent function. Physicians need to understand alterations in the physiology of elderly patients attributable to the normal aging process as well as the prevalence of concurrent pathologic conditions that necessitate special precautions. Maintaining autonomy and function as a result of an acute surgical intervention may be the most important outcome to the elderly patient. Most of the data available and guidelines promulgated do not specifically address the elderly population. It is important to collect data prospectively and use sophisticated methods for analyses to develop better management algorithms for these (often complicated) clinical issues in the elderly. PMID:10093774

  14. Diabetes Mellitus, Arterial Wall, and Cardiovascular Risk Assessment

    Science.gov (United States)

    Kozakova, Michaela; Palombo, Carlo

    2016-01-01

    Diabetes mellitus is an independent risk factor for atherothrombotic cardiovascular disease. Adults with diabetes are two to four times more likely to develop heart disease or stroke than adults without diabetes. The two major features of diabetes, i.e., hyperglycemia and insulin-resistance, trigger arterial stiffening and increase the susceptibility of the arterial wall to atherosclerosis at any given age. These pathological changes in the arterial wall may provide a functional and structural background for cardiovascular events. The present paper provides a critical overview of the clinical evidence linking diabetes-related metabolic abnormalities to cardiovascular risk, debates the pathophysiologic mechanisms through which insulin resistance and hyperglycemia may affect the arterial wall, and discusses the associations between vascular biomarkers, metabolic abnormalities and cardiovascular events. PMID:26861377

  15. [Assessment of cardiovascular risk in hypertensive patients: comparison among scores].

    Science.gov (United States)

    Del Colle, Sara; Rabbia, Franco; Mulatero, Paolo; Veglio, Franco

    2004-09-01

    At present, a correct and thorough risk evaluation represents the best prognostic and therapeutic approach for hypertensive patients. Recent European and American guidelines recommend a global stratification of the cardiovascular risk of hypertensive patients, based on the evaluation of risk factors, organ damage, and the clinical conditions associated with hypertension. A similar approach uses numerical risk scores that transform the percentage risk, calculated from large populations, into absolute values. These scores have been calculated by different research groups and scientific organizations with the aim of better defining the real risk of a given population over time. Many of these risk scores have been conceived by American and European scientific groups on the basis of the epidemiology of different risk variables in the respective populations; in general, north American hypertensives are exposed to a higher cardiovascular risk compared to Europeans and some European countries have a higher risk than others. The present review underlines the pivotal role of a correct risk evaluation of hypertension as reported in the guidelines. We briefly analyze the principal studies on risk scores: we compare the advantages and disadvantages of the different scores, as well as the similarities and differences, in order to demonstrate not only their utility, but also the possible equivalence of the different parameters considered. PMID:15568607

  16. Cardiovascular risk assessment - From individual risk prediction to estimation of global risk and change in risk in the population

    OpenAIRE

    Batsis John A; Lopez-Jimenez Francisco

    2010-01-01

    Abstract Background Cardiovascular disease is the most common cause of death and risk prediction formulae such as the Framingham Risk Score have been developed to easily identify patients at high risk that may require therapeutic interventions. Discussion Using cardiovascular risk formulae at a population level to estimate and compare average cardiovascular risk among groups has been recently proposed as a way to facilitate surveillance of net cardiovascular risk and target public health inte...

  17. Diabetes Mellitus, ArterialWall, and Cardiovascular Risk Assessment

    OpenAIRE

    Michaela Kozakova; Carlo Palombo

    2016-01-01

    Diabetes mellitus is an independent risk factor for atherothrombotic cardiovascular disease. Adults with diabetes are two to four times more likely to develop heart disease or stroke than adults without diabetes. The two major features of diabetes, i.e., hyperglycemia and insulin-resistance, trigger arterial stiffening and increase the susceptibility of the arterial wall to atherosclerosis at any given age. These pathological changes in the arterial wall may provide a functional and structura...

  18. Predictive Value of Cardiovascular Risk Factors for Risk Assessment in Cohort of Shiraz Heart Study

    Directory of Open Access Journals (Sweden)

    MJ ZibaeeNezhad

    2010-03-01

    Full Text Available Background: Risk assessment for fast growing burden of cardiovascular diseases is very important and dif- ficult. As a response to this challenge, in particular, genetic risk factors which potentially modify risk, we conducted a survey of primary data registry of Shiraz Heart Study on integration and application of family history data in prevention of cardiovascular disorders.Method: This study is a longitudinal cohort project to be extended from subpopulations of different job groups to the community.Results: Parental family history of MI, diabetes mellitus (DM, hyperlipidemia (HPL, hypertension (HTN was reported more frequently among females than males. Histories of MI, DM, HPL, and HTN in both parents were respectively positive in 2.6%, 2%, 4.6%, and 7.9 % of the participants. Odd ratios (OR for risk of MI from family history of MI were 2.7; risk of DM from family history of DM 4.5; risk of HPL from family history of HPL 2.04; and risk of HTN from family history HTN 4.7. Also, family history of MI modifies risk of HPL (OR=1.7, P<0.0001; and family history of DM modifies risk of HPL (OR=2.04, P<0.0001.Conclusion: Our primary result shows potent application of family history data in risk assessment of cardiovascular outcome. In particular, HTN appears as a silent and leading risk modifier. In regard to the course of continuing Shiraz Heart Study integration of family history of risk factors crucial in public health we suggest to adopt a network of electronic health records from the “Health House” to the “Heart House”.

  19. Assessment of cardiovascular risk in rheumatoid arthritis: impact of the new EULAR recommendations on the score cardiovascular risk index.

    Science.gov (United States)

    Gómez-Vaquero, Carmen; Robustillo, Montserrat; Narváez, Javier; Rodríguez-Moreno, Jesús; González-Juanatey, Carlos; Llorca, Javier; Nolla, Joan Miquel; González-Gay, Miguel Angel

    2012-01-01

    To assess the impact of the application of the European League against Rheumatism (EULAR) task force recommendations in the cardiovascular (CV) risk of a series of Spanish patients diagnosed with rheumatoid arthritis (RA). Two hundred consecutive RA patients seen at the rheumatology outpatient clinics of Bellvitge Hospital, Barcelona, were studied. Information on clinical features of the disease, classic CV risk factors, and history of CV events was assessed. Both the systematic coronary risk evaluation (SCORE) CV risk index and the modified SCORE (mSCORE) according to the last EULAR recommendations were calculated. Based on the classic CV risk factors, the mean ± standard deviation SCORE was 2.1 ± 2.3% (median, 2; interquartile range [IQR], 1-3). Twenty-three (11%) patients were above the threshold of high CV risk for the Spanish population (≥5%). Following the EULAR recommendations, a change in the score was required in 119 (59%) patients. Therefore, the mean mSCORE was 2.7 ± 2.9% (median, 2; IQR, 1-3) and, due to this, 28 (14%) patients were above the threshold of high CV risk. Nine (5%) had at least one ischemic CV event. Patients with CV events were older and had more CV risk factors and higher SCORE and mSCORE than those without CV events. Although a large proportion of patients from this series fulfilled the criteria for the application of the EULAR recommendations, the final impact on the calculated CV risk was low and clinically significant in only a few patients. However, an association between the mSCORE and the presence of ischemic CV events was observed. PMID:21567119

  20. [Risk assessment and management of exodontia perioperative patients with cardiovascular diseases].

    Science.gov (United States)

    Wang, W Y

    2016-07-01

    The number of tooth extraction patients with cardiovascular disease in our country is increasing year by year. Safety is essential for those patients and there is no uniform standard of risk assessment and management for tooth extraction patients with cardiovascular disease during perioperative period. By referring to literatures and with the clinical experience, the author summarized the risk assessment methods for tooth extraction patients with cardiovascular disease during perioperative period. Blood pressure control, cardiac function determination, arrhythmia recognition, blood glucose management, oral antiplatelet or anticoagulant medicine use, etc, were proposed in this article. PMID:27480428

  1. One risk assessment tool for cardiovascular disease, type 2 diabetes, and chronic kidney disease

    NARCIS (Netherlands)

    M. Alssema (Marjan); R.S. Newson (Rachel); S.J.L. Bakker (Stephan); C.D. Stehouwer (Coen); M.W. Heymans (Martijn); M.G.A.A.M. Nijpels (Giel); H.L. Hillege (Hans); A. Hofman (Albert); J.C.M. Witteman (Jacqueline); R.T. Gansevoort; J.M. Dekker (Jacqueline)

    2012-01-01

    textabstractOBJECTIVE - Individuals at high risk for chronic cardiometabolic disease (cardiovascular disease [CVD], type 2 diabetes, and chronic kidney disease [CKD]) share many risk factors and would benefit from early intervention. We developed a nonlaboratory-based risk-assessment tool for identi

  2. One Risk Assessment Tool for Cardiovascular Disease, Type 2 Diabetes, and Chronic Kidney Disease

    NARCIS (Netherlands)

    Alssema, Marjan; Newson, Rachel S.; Bakker, Stephan J. L.; Stehouwer, Coen D. A.; Heymans, Martijn W.; Nijpels, Giel; Hillege, Hans L.; Hofman, Albert; Witteman, Jacqueline C. M.; Gansevoort, Ron T.; Dekker, Jacqueline M.

    2012-01-01

    OBJECTIVE-Individuals at high risk for chronic cardiometabolic disease (cardiovascular disease [CVD], type 2 diabetes, and chronic kidney disease [CKDD]) share many risk factors and would benefit from early intervention. We developed a nonlaboratory-based risk-assessment tool for identification of p

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

    OpenAIRE

    Wilson, Amy C.; Mitsnefes, Mark M.

    2009-01-01

    In young adults with onset of chronic kidney disease in childhood, cardiovascular disease is the most common cause of death. The likely reason for increased cardiovascular disease in these patients is high prevalence of traditional and uremia-related cardiovascular disease risk factors during childhood chronic kidney disease. Early markers of cardiomyopathy, such as left ventricular hypertrophy and left ventricular dysfunction and early markers of atherosclerosis, such as increased carotid ar...

  4. HIV infection does not contribute to increased cardiovascular risk as assessed by Framingham risk score

    Directory of Open Access Journals (Sweden)

    I Ramsay

    2012-11-01

    significant predictors. The overall mean cfPWV for the HIV cohort (n=47 was 9.09±2.13 m/s compared to 11.95±2.37 m/s in the control group (n=46(p<0.01. HIV infection does not contribute to increased cardiovascular risk as assessed by Framingham risk score or carotid-femoral pulse wave velocity. This may be due to good control of traditional cardiovascular risk factors and a healthy lifestyle in this cohort.

  5. 74. Cardiovascular risk assessment for Saudi university employees and their families: Developing a framework for provision of an evidence-based cardiovascular disease preventative programme

    OpenAIRE

    R. Alzeidan; F. Rabiee; A. Hersi; A. Mandil

    2016-01-01

    In the Kingdom of Saudi Arabia (KSA), cardiovascular diseases (CVDs) are the primary cause of death among adults, representing 46% of total mortality in 2014. This study’s objectives were to assess the prevalence of cardiovascular risk factors (CVRFs), and calculate the cardiovascular risk (CVR) among King Saud University employees and their families. Moreover, it aimed at assessing the possible effects of living in KSA on the heart health of expatriate employees and their families. A cross-s...

  6. 26. Cardiovascular risk assessment for Saudi university employees and their families: developing a framework for provision of an evidence-based cardiovascular disease preventative programme.

    OpenAIRE

    R. Alzeidan; F. Rabiee; A. Hersi; A. Mandil

    2016-01-01

    In the Kingdom of Saudi Arabia (KSA), cardiovascular diseases (CVDs) are the primary cause of death among adults, representing 46% of total mortality in 2014. This study’s objectives were to assess the prevalence of cardiovascular risk factors (CVRFs), and calculate the cardiovascular risk (CVR) among King Saud University employees and their families. Moreover, it aimed at assessing the possible effects of living in KSA on the heart health of expatriate employees and their families.A cross-se...

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

    Directory of Open Access Journals (Sweden)

    Ezekiel Uba Nwose

    2013-01-01

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

  8. Assessing Framingham cardiovascular risk scores in subjects with diabetes and their correlation with diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Deepali R Damkondwar

    2012-01-01

    Full Text Available Aim: To study the Framingham cardiovascular risk assessment scores in subjects with diabetes and their association with diabetic retinopathy in subjects with diabetes. Materials and Methods: In this population-based prospective study, subjects with diabetes were recruited (n=1248; age ≥40 years. The Framingham cardiovascular risk scores were calculated for 1248 subjects with type 2 diabetes. The scores were classified as high risk (>10%, and low risk (<10%. Results: Out of the 1248 subjects, 830 (66.5% patients had a low risk of developing cardiovascular disease (CVD in 10 years and 418 (33.5% had a high risk of developing CVD in 10 years. The risk of developing CVD was more in males than females (56.8% vs. 7% The prevalence of both diabetic retinopathy and sight-threatening retinopathy was more in the high-risk group (21% and 4.5%, respectively. The risk factors for developing diabetic retinopathy were similar in both the groups (low vs. high - duration of diabetes (OR 1.14 vs. 1.08, higher HbA1c (OR 1.24 vs. 1.22, presence of macro- and microalbuminuria (OR 10.17 vs. 6.12 for macro-albuminuria and use of insulin (OR 2.06 vs. 4.38. The additional risk factors in the high-risk group were presence of anemia (OR 2.65 and higher serum high density lipoprotein (HDL cholesterol (OR 1.05. Conclusion: Framingham risk scoring, a global risk assessment tool to predict the 10-year risk of developing CVD, can also predict the occurrence and type of diabetic retinopathy. Those patients with high CVD scores should be followed up more frequently and treated adequately. This also warrants good interaction between the treating physician/cardiologist and the ophthalmologist.

  9. Assessment of Cardiovascular Disease Risk by using Framingham Risk Equation amongst the Residents of Ahmedabad City

    Directory of Open Access Journals (Sweden)

    Sonal Parikh, Manish Patel, Hemant Tiwari, D V Bala, Bhavin Joshi

    2013-01-01

    Results: The median 10-year probability of CHD was 2.9% (5.6% for men and 1.8% for women. One third (33.4% population above 30 years had CVD risk 20% or more. Males had significantly higher CVD risk as compared to females (20% of males & 4.5% of female had high CVD risk. Cardiovascular disease risk was also person with inadequate sleep & in executives. Conclusion- Higher risk in males & unskilled worker was mainly due to tobacco addiction while in executives it was mainly due to diabetes & obesity.

  10. Assessment of some cardiovascular risk factors in predialysis chronic kidney disease patients in Southern Nigeria

    Directory of Open Access Journals (Sweden)

    Oluseyi A Adejumo

    2015-01-01

    Full Text Available Background: Cardiovascular risk factors are responsible for cardiovascular disease and rapid progression of chronic kidney disease (CKD to end-stage renal disease. Prompt evaluation, modification, and treatment of these factors in predialysis patients will reduce morbidity and mortality. This study assessed some cardiovascular risk factors in predialysis CKD patients in a tertiary hospital in Southern Nigeria. Patients and Methods: This was a case–control study that involved 76 consecutive predialysis CKD patients and 38 age-and sex-matched controls without CKD over 1 year period. Both groups were assessed for cardiovascular risk factors, and comparisons were made. A P value of <0.05 was taken as significant. Results: The mean ages of the CKD versus control group were 48.00 ± 15.28 versus 45.34 ± 15.35 years. The male:female ratio was 1.7:1 for both groups. The common etiologies of CKD in this study were hypertension 30 (39.5%, diabetes mellitus 23 (30.3%, and chronic glomerulonephritis 19 (25%. There were 38 (50% in CKD stage 3, 31 (40.8% in CKD stage 4, and 7 (9.2% in CKD stage 5. The common cardiovascular risk factors found in the CKD versus control were hypertension (96.1% vs. 42.1%, anemia (96.1% vs. 23.7%, left ventricular hypertrophy (77.6% vs. 23.7%, dyslipidemia (67.1% vs. 39.5%, hypocalcemia (60.1% vs. 18.5%, hyperphosphatemia (63.2% vs. 0%, and hyperuricemia (57.9% vs. 15.8%. These risk factors were significantly higher in CKD group. Hyperphosphatemia and hypoalbuminemia significantly increased across CKD stages 3–5. Anemia was significantly more common in males whereas dyslipidemia was more common in female CKD patients. Conclusion: Cardiovascular risk factors were highly prevalent in predialysis CKD subjects even in early stages. Hypoalbuminemia and hyperphosphatemia significantly increased across the CKD stages 3–5 whereas anemia and dyslipidemia showed significant gender differences. Cardiovascular risk factors should be

  11. Assessment of cardiovascular risk of new drugs for the treatment of diabetes mellitus: risk assessment vs. risk aversion.

    Science.gov (United States)

    Zannad, Faiez; Stough, Wendy Gattis; Lipicky, Raymond J; Tamargo, Juan; Bakris, George L; Borer, Jeffrey S; Alonso García, Maria de Los Angeles; Hadjadj, Samy; Koenig, Wolfgang; Kupfer, Stuart; McCullough, Peter A; Mosenzon, Ofri; Pocock, Stuart; Scheen, André J; Sourij, Harald; Van der Schueren, Bart; Stahre, Christina; White, William B; Calvo, Gonzalo

    2016-07-01

    The Food and Drug Administration issued guidance for evaluating the cardiovascular risk of new diabetes mellitus drugs in 2008. Accumulating evidence from several completed trials conducted within this framework raises questions as to whether requiring safety outcome studies for all new diabetes mellitus therapies remains justified. Given the burden of cardiovascular disease in patients with diabetes, the focus should shift towards cardiovascular outcome studies designed to evaluate efficacy (i.e. to determine the efficacy of a drug over placebo or standard care) rather than demonstrating that risk is not increased by a pre-specified safety margin. All stakeholders are responsible for ensuring that new drug approvals occur under conditions of appropriate safety and effectiveness. It is also a shared responsibility to avoid unnecessary hurdles that may compromise access to useful drugs and threaten the sustainability of health systems. It is critical to renew this debate so that stakeholders can collectively determine the optimal approach for developing new drugs to treat type 2 diabetes mellitus. PMID:27418973

  12. Cardiovascular risk assessment in hypertensive patients Evaluación del riesgo cardiovascular en hipertensos Avaliação do risco cardiovascular em hipertensos

    Directory of Open Access Journals (Sweden)

    Elaine Amaral de Paula

    2013-06-01

    Full Text Available OBJECTIVE: to assess cardiovascular risk by means of the traditional Framingham score and the version modified through the incorporation of emerging risk factors, such as family history of acute myocardial infarction, metabolic syndrome and chronic kidney disease. METHOD: participants were 50 hypertensive patients under outpatient treatment. The clinical data were collected through a semi-structured interview and the laboratory data from patients' histories. RESULTS: it was verified that the traditional Framingham score was predominantly low (74%, with 14% showing medium risk and 12% high risk. After the inclusion of emerging risk factors, the chance of a coronary event was low in 22% of the cases, medium in 56% and high in 22%. CONCLUSIONS: the comparison between the traditional Framingham risk score and the modified version demonstrated a significant difference in the cardiovascular risk classification, whose correlation shows discreet agreement between the two scales. Lifestyle elements seem to play a determinant role in the increase in cardiovascular risk levels. OBJETIVO: evaluar el riesgo cardiovascular utilizando el puntaje de Framingham tradicional y el modificado por la incorporación de factores de riesgo emergentes como historia familiar de infarto agudo del miocardio, síndrome metabólico y enfermedad renal crónica. MÉTODO: participaron 50 hipertensos que hacen tratamiento en ambulatorio. Los datos clínicos fueron obtenidos por medio de entrevista semiestructurada y los de laboratorio fueron obtenidos de fichas. RESULTADOS: se verificó que el puntaje de Framingham tradicional fue predominantemente bajo (74%, 14% presentó riesgo medio y 12% riesgo alto. Tras la inclusión de factores de riesgo emergentes, la probabilidad de ocurrir un evento coronario fue baja en 22% de los casos, media en 56% y alta en 22% de los casos. CONCLUSIONES: la comparación entre el puntaje de riesgo de Framingham tradicional y el modificado demostr

  13. Cardiovascular risk assessment in the treatment of nonalcoholic steatohepatitis: a secondary analysis of the MOZART trial

    Science.gov (United States)

    Lin, Steven C.; Ang, Brandon; Hernandez, Carolyn; Bettencourt, Ricki; Jain, Rashmi; Salotti, Joanie; Richards, Lisa; Kono, Yuko; Bhatt, Archana; Aryafar, Hamed; Lin, Grace Y.; Valasek, Mark A.; Sirlin, Claude B.; Brouha, Sharon; Loomba, Rohit

    2016-01-01

    Background: Nonalcoholic steatohepatitis (NASH) is associated with increased cardiovascular risk and mortality. No US Food and Drug Administration (FDA) approved therapies for NASH are available; clinical trials to date have not yet systematically assessed for changes in cardiovascular risk. This study examines the prospective utility of cardiovascular risk assessments, the Framingham risk score (FRS) and coronary artery calcium (CAC) score, as endpoints in a NASH randomized clinical trial, and assesses whether histologic improvements lead to lower cardiovascular risk. Methods: Secondary analysis of a 24-week randomized, double-blind, placebo-controlled trial (MOZART) in which 50 biopsy-proven NASH patients received oral ezetimibe 10 mg daily (n = 25) versus placebo (n = 25). Biochemical profiling, FRS, CAC scores, liver biopsies were obtained at baseline and endpoint. Results: Ezetimibe improved FRS whereas placebo did not (4.4 ± 6.2 to 2.9 ± 4.8, p = 0.038; 3.0 ± 4.4 to 2.9 ± 4.2, p = 0.794). CAC scores did not change with ezetimibe or placebo (180.4 ± 577.2 to 194.1 ± 623.9, p = 0.293; 151.4 ± 448.9 to 183.3 ± 555.7, p = 0.256). Ezetimibe improved FRS and CAC scores in more patients than placebo (48% versus 23%, p = 0.079, and 21% versus 0%, p = 0.090, respectively), though not significantly. No differences were noted in cardiovascular risk scores among histologic responders versus nonresponders. Conclusions: Ezetimibe improved FRS whereas placebo did not. FRS and CAC scores improved in a greater proportion of patients with ezetimibe; this trend did not reach significance. These findings indicate the utility and feasibility of monitoring cardiovascular risk in a NASH trial. The utility of CAC scores may be higher in trials of longer duration (⩾52 weeks) and with older patients (age ⩾45). ClinicalTrials.gov registration: NCT01766713. PMID:26929777

  14. Assessment of total cardiovascular risk using WHO/ISH risk prediction charts in three low and middle income countries in Asia

    OpenAIRE

    Otgontuya, Dugee; Oum, Sophal; Buckley, Brian S; Bonita, Ruth

    2013-01-01

    Background Recent research has used cardiovascular risk scores intended to estimate “total cardiovascular disease (CVD) risk” in individuals to assess the distribution of risk within populations. The research suggested that the adoption of the total risk approach, in comparison to treatment decisions being based on the level of a single risk factor, could lead to reductions in expenditure on preventive cardiovascular drug treatment in low- and middle-income countries. So that the patient bene...

  15. Cardiovascular risk assessment in rheumatoid arthritis – controversies and the new approach

    Science.gov (United States)

    Głuszko, Piotr

    2016-01-01

    The current methods of cardiovascular (CV) risk assessment in the course of inflammatory connective tissue diseases are a subject of considerable controversy. Comparing different methods of CV risk assessment in current rheumatoid arthritis (RA) guidelines, only a few of them recommend the use of formal risk calculators. These are the EULAR guidelines suggesting the use of SCORE and the British Society for Rheumatology guidelines performed in collaboration with NICE preferring the use of QRISK-2. Analyzing the latest American and British reports, two main concepts could be identified. The first one is to focus on risk calculators developed for the general population taking into account RA, and the calculator that might fulfill this role is the new QRISK-2 presented by NICE in 2014. The second concept is to create RA-specific risk calculators, such as the Expanded Cardiovascular Risk Prediction Score for RA. In this review we also discuss the efficiency of a new Pooled Cohort Equation and other calculators in the general and RA population. PMID:27504023

  16. Cardiovascular risk assessment in rheumatoid arthritis - controversies and the new approach.

    Science.gov (United States)

    Bonek, Krzysztof; Głuszko, Piotr

    2016-01-01

    The current methods of cardiovascular (CV) risk assessment in the course of inflammatory connective tissue diseases are a subject of considerable controversy. Comparing different methods of CV risk assessment in current rheumatoid arthritis (RA) guidelines, only a few of them recommend the use of formal risk calculators. These are the EULAR guidelines suggesting the use of SCORE and the British Society for Rheumatology guidelines performed in collaboration with NICE preferring the use of QRISK-2. Analyzing the latest American and British reports, two main concepts could be identified. The first one is to focus on risk calculators developed for the general population taking into account RA, and the calculator that might fulfill this role is the new QRISK-2 presented by NICE in 2014. The second concept is to create RA-specific risk calculators, such as the Expanded Cardiovascular Risk Prediction Score for RA. In this review we also discuss the efficiency of a new Pooled Cohort Equation and other calculators in the general and RA population. PMID:27504023

  17. Assessment of cardiovascular risk factors in a rural community in the Brazilian state of Bahia

    Directory of Open Access Journals (Sweden)

    André Costa Matos

    2003-09-01

    Full Text Available OBJECTIVE: To assess the frequency of cardiovascular risk factors in the rural community of Cavunge, in the Brazilian state of Bahia. METHODS: A cross-sectional study was carried out with 160 individuals (age > 19 years randomly drawn from those listed in the population census of the Cavunge Project. The following parameters were studied: arterial hypertension, dyslipidemia, diabetes, obesity, smoking, waist-hip ratio (WHR, physical activity, and overall cardiovascular risk classified according to the Framingham score. The assessing parameters used were those established by the III Brazilian Consensus on Hypertension and the II Brazilian Consensus on Dyslipidemia. RESULTS: Of the randomly drawn individuals, 126 with a mean age of 46.6 + 19.7 years were included in the study, 43.7% of whom were males. The frequency of arterial hypertension was 36.5%; 20.4% of the individuals had cholesterol levels >240 mg/dL; 31.1% of the individuals had LDL-C levels > 130 mg/dL; 4% were diabetic; and 39.7% had a high-risk Framingham score. Abdominal obesity was observed in 41.3% of the population and in 57.7% of the females. High caloric-expenditure (HCE physical activities were performed by 56.5% of the individuals. The HCE group had a greater frequency of normal triglyceride levels (63% vs 44%; P=0.05, no diabetes, and WHR tending towards normal (46% vs 27%, P=0.08 as compared with those in the low caloric-expenditure group. CONCLUSION: Cardiovascular risk factors, such as hypertension and hypercholesterolemia, are frequently found in rural communities. The greatest frequency of normal triglyceride levels and normal WHR in the HCE group reinforces the association between greater caloric expenditure and a better risk profile.

  18. Step On It! Workplace Cardiovascular Risk Assessment of New York City Yellow Taxi Drivers.

    Science.gov (United States)

    Gany, Francesca; Bari, Sehrish; Gill, Pavan; Ramirez, Julia; Ayash, Claudia; Loeb, Rebecca; Aragones, Abraham; Leng, Jennifer

    2016-02-01

    Multiple factors associated with taxi driving can increase the risk of cardiovascular disease (CVD) in taxi drivers. This paper describes the results of Step On It!, which assessed CVD risk factors among New York City taxi drivers at John F. Kennedy International Airport. Drivers completed an intake questionnaire and free screenings for blood pressure, glucose and body mass index (BMI). 466 drivers participated. 9 % had random plasma glucose values >200 mg/dl. 77 % had elevated BMIs. Immigrants who lived in the US for >10 years had 2.5 times the odds (CI 1.1-5.9) of having high blood pressure compared to newer immigrants. Abnormalities documented in this study were significant, especially for immigrants with greater duration of residence in the US, and underscore the potential for elevated CVD risk in this vulnerable population, and the need to address this risk through frameworks that utilize multiple levels of intervention. PMID:25680879

  19. Value and limitations of existing scores for the assessment of cardiovascular risk: a review for clinicians.

    LENUS (Irish Health Repository)

    Cooney, Marie Therese

    2009-09-29

    Atherosclerotic cardiovascular diseases (CVDs) are the biggest causes of death worldwide. In most people, CVD is the product of a number of causal risk factors. Several seemingly modest risk factors may, in combination, result in a much higher risk than an impressively raised single factor. For this reason, risk estimation systems have been developed to assist clinicians to assess the effects of risk factor combinations in planning management strategies. In this article, the performances of the major risk estimation systems are reviewed. Most perform usably well in populations that are similar to the one used to derive the system, and in other populations if calibrated to allow for different CVD mortality rates and different risk factor distributions. The effect of adding "new" risk factors to age, sex, smoking, lipid status, and blood pressure is usually small, but may help to appropriately reclassify some of those patients who are close to a treatment threshold to a more correct "treat\\/do not treat" category. Risk estimation in the young and old needs more research. Quantification of the hoped-for benefits of the multiple risk estimation approach in terms of improved outcomes is still needed. But, it is likely that the widespread use of such an approach will help to address the issues of both undertreatment and overtreatment.

  20. THE IMPACT OF SEVERITY OF DIABETIC RETINOPATHY IN CARDIOVASCULAR DISEASE RISK ASSESSMENT USING FRAMINGHAM RISK SCORE - A PILOT STUDY

    Directory of Open Access Journals (Sweden)

    Nidhi

    2015-08-01

    Full Text Available Diabetic retinopathy (DR is the most common micro vascular complications of diabetes, estimated to affect approximately 100 million people worldwide, while cardiovascular disease (CVD is the leading cause of death in individuals with type II diabetes. There is limited Indian data reporting the association of Diabetic retinopathy and its severity with CVD. AIM : To study the relation between the severity of DR and risk of CVD in cen tral Indian subjects. MATERIALS AND METHODS : The subjects consisted of 50 patients with Diabetes mellitus type II having varying grades of diabetic retinopathy attending eye OPD of a tertiary care hospital in central India. 10 year risk of developing CVD was estimated using the Framingham Risk Score. RESULTS : The number of subjects with an increased risk of developing CVD increased with advancing age (28.57% in 40 - 49 years to 61 .53% in > 60 years age group. The risk of CVD was slightly more in males (55. 55% compared to females (43.47%. Out of the 30 patients having sight threatening diabetic retinopathy, 13 had low risk of developing CVD while 17 had high risk of developing CVD. The prevalence of sight threatening retinopathy was more in the high risk group (56.67% when compared to the low - risk group (40%. DISCUSSION : We found that more subjects having high risk of developing CVD had sight - threatening DR compared to those having low risk. CONCLUSION : Diabetic retinopathy may contribute to CVD risk in Indian population too. A careful cardiovascular assessment and follow - up may be required in individuals with diabetic retinopathy, using a larger sample size

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

    OpenAIRE

    Daniele Franchi; Davide Cini; Giorgio Iervasi

    2011-01-01

    Daniele Franchi1,2, Davide Cini1, Giorgio Iervasi11Istituto di Fisiologia Clinica, CNR, Pisa, Italy; 2Dipartimento di Oncologia, dei Trapianti e delle Nuove Tecnologie in Medicina, Università di Pisa, Pisa, ItalyBackground: Multifactor cardiovascular disease is the leading cause of death; besides well-known cardiovascular risk factors, several emerging factors such as mental stress, diet type, and physical inactivity, have been associated to cardiovascular disease. To date, prevent...

  2. Adiponectin provides additional information to conventional cardiovascular risk factors for assessing the risk of atherosclerosis in both genders.

    Directory of Open Access Journals (Sweden)

    Jin-Ha Yoon

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

  3. Prospective validation and assessment of cardiovascular and offspring risk models for pregnant women with congenital heart disease

    NARCIS (Netherlands)

    Balci, A.; Sollie-Szarynska, K.M.; Bijl, A.G. van der; Ruys, T.P.; Mulder, B.J.; Roos-Hesselink, J.W.; Dijk, A.P.J. van; Wajon, E.M.; Vliegen, H.W.; Drenthen, W.; Hillege, H.L.; Aarnoudse, J.G.; Veldhuisen, D.J. van; Pieper, P.G.

    2014-01-01

    OBJECTIVES: Adequate prepregnancy prediction of maternal cardiovascular and offspring risk is important for counselling and management of pregnancy in women with congenital heart disease (CHD). Therefore we performed a study to identify the optimal assessment strategy for estimating the risk of preg

  4. Prospective validation and assessment of cardiovascular and offspring risk models for pregnant women with congenital heart disease

    NARCIS (Netherlands)

    Balci, Ali; Sollie-Szarynska, Krystyna M.; van der Bijl, Antoinette G. L.; Ruys, Titia P. E.; Mulder, Barbara J. M.; Roos-Hesselink, Jolien W.; van Dijk, Arie P. J.; Wajon, Elly M. C. J.; Vliegen, Hubert W.; Drenthen, Willem; Hillege, Hans L.; Aarnoudse, Jan G.; van Veldhuisen, Dirk J.; Pieper, Petronella G.

    2014-01-01

    Objectives Adequate prepregnancy prediction of maternal cardiovascular and offspring risk is important for counselling and management of pregnancy in women with congenital heart disease (CHD). Therefore we performed a study to identify the optimal assessment strategy for estimating the risk of pregn

  5. Assessing perinatal depression as an indicator of risk for pregnancy-associated cardiovascular disease.

    Science.gov (United States)

    Nicholson, Lauren; Lecour, Sandrine; Wedegärtner, Sonja; Kindermann, Ingrid; Böhm, Michael; Sliwa, Karen

    2016-01-01

    Cardiovascular conditions associated with pregnancy are serious complications. In general, depression is a well-known risk indicator for cardiovascular disease (CVD). Mental distress and depression are associated with physiological responses such as inflammation and oxidative stress. Both inflammation and oxidative stress have been implicated in the pathophysiology of CVDs associated with pregnancy. This article discusses whether depression could represent a risk indicator for CVDs in pregnancy, in particular in pre-eclampsia and peripartum cardiomyopathy (PPCM). PMID:27213860

  6. Seasonality of cardiovascular risk factors

    DEFF Research Database (Denmark)

    Marti-Soler, Helena; Gubelmann, Cédric; Aeschbacher, Stefanie;

    2014-01-01

    OBJECTIVE: To assess the seasonality of cardiovascular risk factors (CVRF) in a large set of population-based studies. METHODS: Cross-sectional data from 24 population-based studies from 15 countries, with a total sample size of 237 979 subjects. CVRFs included Body Mass Index (BMI) and waist...

  7. Effects of the Multidisciplinary Risk Assessment and Management Program for Patients with Diabetes Mellitus (RAMP-DM) on biomedical outcomes, observed cardiovascular events and cardiovascular risks in primary care: a longitudinal comparative study

    OpenAIRE

    Jiao, Fang Fang; Fung, Colman Siu Cheung; Wong, Carlos King Ho; Wan, Yuk Fai; Dai, Daisy; Kwok, Ruby; Lam, Cindy Lo Kuen

    2014-01-01

    Background To assess whether the Multidisciplinary Risk Assessment and Management Program for Patients with Diabetes Mellitus (RAMP-DM) led to improvements in biomedical outcomes, observed cardiovascular events and predicted cardiovascular risks after 12-month intervention in the primary care setting. Methods A random sample of 1,248 people with diabetes enrolled to RAMP-DM for at least 12 months was selected and 1,248 people with diabetes under the usual primary care were matched by age, sex...

  8. Impact of Replacing the Pooled Cohort Equation With Other Cardiovascular Disease Risk Scores on Atherosclerotic Cardiovascular Disease Risk Assessment (from the Multi-Ethnic Study of Atherosclerosis [MESA]).

    Science.gov (United States)

    Qureshi, Waqas T; Michos, Erin D; Flueckiger, Peter; Blaha, Michael; Sandfort, Veit; Herrington, David M; Burke, Gregory; Yeboah, Joseph

    2016-09-01

    The increase in statin eligibility by the new cholesterol guidelines is mostly driven by the Pooled Cohort Equation (PCE) criterion (≥7.5% 10-year PCE). The impact of replacing the PCE with either the modified Framingham Risk Score (FRS) or the Systematic Coronary Risk Evaluation (SCORE) on assessment of atherosclerotic cardiovascular disease (ASCVD) risk assessment and statin eligibility remains unknown. We assessed the comparative benefits of using the PCE, FRS, and SCORE for ASCVD risk assessment in the Multi-Ethnic Study of Atherosclerosis. Of 6,815 participants, 654 (mean age 61.4 ± 10.3; 47.1% men; 37.1% whites; 27.2% blacks; 22.3% Hispanics; 12.0% Chinese-Americans) were included in analysis. Area under the curve (AUC) and decision curve analysis were used to compare the 3 risk scores. Decision curve analysis is the plot of net benefit versus probability thresholds; net benefit = true positive rate - (false positive rate × weighting factor). Weighting factor = Threshold probability/1 - threshold probability. After a median of 8.6 years, 342 (6.0%) ASCVD events (myocardial infarction, coronary heart disease death, fatal or nonfatal stroke) occurred. All 4 risk scores had acceptable discriminative ability for incident ASCVD events; (AUC [95% CI] PCE: 0.737 [0.713 to 0.762]; FRS: 0.717 [0.691 to 0.743], SCORE (high risk) 0.722 [0.696 to 0.747], and SCORE (low risk): 0.721 [0.696 to 0.746]. At the ASCVD risk threshold recommended for statin eligibility for primary prevention (≥7.5%), the PCE provides the best net benefit. Replacing the PCE with the SCORE (high), SCORE (low) and FRS results in a 2.9%, 8.9%, and 17.1% further increase in statin eligibility. The PCE has the best discrimination and net benefit for primary ASCVD risk assessment in a US-based multiethnic cohort compared with the SCORE or the FRS. PMID:27445216

  9. Assessing Physical Activity and its Relationship to Cardiovascular Risk Factors: NHANES 2003-2006

    Directory of Open Access Journals (Sweden)

    Cao Guichan

    2011-05-01

    Full Text Available Abstract Background Levels of physical activity (PA in the general population are difficult to characterize. Historically measurement has been based on self-report, which can be subject to bias. PA monitor use has created opportunities to improve surveillance and analytic research on activity and health. The aims of the current study were to investigate the associations between objectively measured PA and cardiovascular disease risk factors and obesity. Methods Data on PA from accelerometers, demographics, blood pressure, plasma glucose and lipids, self-reported hypertension and diabetes were obtained for adults, ages 20-65, in the NHANES surveys, 2003-2006. Outcomes were assessed as levels of moderate and vigorous activity, percentage of participants meeting recommended guidelines, and the correlations between activity and cardiovascular risk factors. Accelerometry data were available on 3,370 adults. Based on standard algorithms, activity levels were extremely low in all age-gender-race/ethnic groups, with an average of only 1 bout of vigorous activity lasting longer than 1 minute/day. Results Men spent 35 minutes in moderate activity/day, women 21 minutes; >75% of this activity was accumulated in 1-minute bouts. Levels of activity declined sharply after age 50 in all groups. Negative associations were observed between minutes of combined moderate and vigorous activity and systolic blood pressure, blood glucose, diabetes, hypertension, body mass index and obesity, and a positive association was seen with HDL-cholesterol (all P ≤ 0.03, suggesting valid rank ordering of participants by activity level. Conclusion The magnitude of the gap between self-report and accelerometry activity must be a result of either a vast social acceptability bias in reporting or inaccurate measurement with accelerometry. Therefore, due to the low validity of self reported PA data for epidemiologic research, it is pertinent to encourage the use of valid, objective

  10. Assessment of Risk Factor for Cardiovascular Disease Using Heart Rate Variability in Postmenopausal Women: A Comparative Study between Urban and Rural Indian Women

    OpenAIRE

    Mirajkar, Amrit M.; Shailaja Moodithaya; Harsha Halahalli; Nikhil Narayanaswamy

    2013-01-01

    Cardiovascular diseases are important causes of morbidity and mortality in postmenopausal women. A major determinant of cardiovascular health is the status of autonomic nervous system and assessment of Heart Rate Variability (HRV). Heart Rate Variability is a noninvasive and sensitive technique to evaluate cardiovascular autonomic control. Reduced HRV is an independent risk factor for the development of heart disease. This study evaluated the risk factors for cardiovascular diseases using HRV...

  11. Assessment of potential cardiovascular risks of methylphenidate in comparison with sibutramine: do we need a SCOUT (trial)?

    Science.gov (United States)

    Antel, Jochen; Albayrak, Özgür; Heusch, Gerd; Banaschewski, Tobias; Hebebrand, Johannes

    2015-04-01

    With the recent approval of methylphenidate (MPH) for treating attention-deficit/hyperactivity disorder (ADHD) in adults, the number of patients exposed will increase tremendously. The ongoing debate on the cardiovascular safety of MPH has triggered two large retrospective cohort studies in children and adolescents as well as in young to middle-aged adults. These studies looked into serious cardiovascular events (sudden cardiac death, acute myocardial infarction and stroke) as primary endpoints and concluded that MPH was safe after a mean duration of 2.1 years of follow-up in children and adolescents and mean duration of 0.33 years of current use in adults. The results are encouraging with respect to the short- and medium-term use of MPH. Without the inherent limitations of retrospective cohort studies, a prospective randomized, double-blind, placebo-controlled, multicenter trial in individuals stratified for cardiovascular risk factors would allow for an optimized risk assessment. With many millions of patients treated per year and drawing parallels to the lately discovered risks of sibutramine, another sympathomimetic with an overlapping mode of action and similar side effects on heart rate and blood pressure, we hypothesize that such a trial might be a dedicated risk mitigation strategy for public health. A critical assessment of cardiovascular side effects of MPH appears particularly warranted, because ADHD is associated with obesity, smoking and poor health in general. We summarize recent findings with the focus on cardiovascular risks of MPH in humans; we additionally analyze the limited number of rodent studies that have addressed cardiovascular risks of MPH. PMID:25149468

  12. How artificial intelligence tools can be used to assess individual patient risk in cardiovascular disease: problems with the current methods

    Directory of Open Access Journals (Sweden)

    Grossi Enzo

    2006-05-01

    Full Text Available Abstract Background In recent years a number of algorithms for cardiovascular risk assessment has been proposed to the medical community. These algorithms consider a number of variables and express their results as the percentage risk of developing a major fatal or non-fatal cardiovascular event in the following 10 to 20 years Discussion The author has identified three major pitfalls of these algorithms, linked to the limitation of the classical statistical approach in dealing with this kind of non linear and complex information. The pitfalls are the inability to capture the disease complexity, the inability to capture process dynamics, and the wide confidence interval of individual risk assessment. Artificial Intelligence tools can provide potential advantage in trying to overcome these limitations. The theoretical background and some application examples related to artificial neural networks and fuzzy logic have been reviewed and discussed. Summary The use of predictive algorithms to assess individual absolute risk of cardiovascular future events is currently hampered by methodological and mathematical flaws. The use of newer approaches, such as fuzzy logic and artificial neural networks, linked to artificial intelligence, seems to better address both the challenge of increasing complexity resulting from a correlation between predisposing factors, data on the occurrence of cardiovascular events, and the prediction of future events on an individual level.

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

    Directory of Open Access Journals (Sweden)

    Daniele Franchi

    2011-02-01

    Full Text Available Daniele Franchi1,2, Davide Cini1, Giorgio Iervasi11Istituto di Fisiologia Clinica, CNR, Pisa, Italy; 2Dipartimento di Oncologia, dei Trapianti e delle Nuove Tecnologie in Medicina, Università di Pisa, Pisa, ItalyBackground: Multifactor cardiovascular disease is the leading cause of death; besides well-known cardiovascular risk factors, several emerging factors such as mental stress, diet type, and physical inactivity, have been associated to cardiovascular disease. To date, preventive strategies are based on the concept of absolute risk calculated by different algorithms and scoring systems. However, in general practice the patient's data collection represents a critical issue.Design: A new multipurpose computer-based program has been developed in order to:1 easily calculate and compare the absolute cardiovascular risk by the Framingham, Procam, and Progetto Cuore algorithms; 2 to design a web-based computerized tool for prospective collection of structured data; 3 to support the doctor in the decision-making process for patients at risk according to recent international guidelines.Methods: During a medical consultation the doctor utilizes a common computer connected by Internet to a medical server where all the patient's data and software reside. The program evaluates absolute and relative cardiovascular risk factors, personalized patient's goals, and multiparametric trends, monitors critical parameter values, and generates an automated medical report.Results: In a pilot study on 294 patients (47% males; mean age 60 ± 12 years [± SD] the global time to collect data at first consultation was 13 ± 11 minutes which declined to 8 ± 7 minutes at the subsequent consultation. In 48.2% of cases the program revealed 2 or more primary risk factor parameters outside guideline indications and gave specific clinical suggestions to return altered parameters to target values.Conclusion: The web-based system proposed here may represent a feasible and

  14. Cardiovascular risk factor assessment after pre-eclampsia in primary care

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    Numans Mattijs E

    2009-12-01

    Full Text Available Abstract Background Pre-eclampsia is associated with an increased risk of development of cardiovascular disease later in life. It is not known how general practitioners in the Netherlands care for these women after delivery with respect to cardiovascular risk factor management. Methods Review of medical records of 1196 women in four primary health care centres, who were registered from January 2000 until July 2007 with an International Classification of Primary Care (ICPC code indicating pregnancy. Records were searched for indicators of pre-eclampsia. Of those who experienced pre-eclampsia and of a random sample of 150 women who did not, the following information on cardiovascular risk factor management after pregnancy was extracted from the records: frequency and timing of blood pressure, cholesterol and glucose measurements - and vascular diagnoses. Additionally the sensitivity and specificity of ICPC coding for pre-eclampsia were determined. Results 35 women experienced pre-eclampsia. Blood pressure was more often checked after pregnancy in these women than in controls (57.1% vs. 12.0%, p Conclusion Despite the evidence of increased risk of future cardiovascular disease in women with a history of pre-eclampsia, follow-up of these women is insufficient and undeveloped in primary care in the Netherlands.

  15. Implications of Cardiovascular Disease Risk Assessment Using the WHO/ISH Risk Prediction Charts in Rural India

    Science.gov (United States)

    Raghu, Arvind; Praveen, Devarsetty; Peiris, David; Tarassenko, Lionel; Clifford, Gari

    2015-01-01

    Cardiovascular disease (CVD) risk in India is currently assessed using the World Health Organization/International Society for Hypertension (WHO/ISH) risk prediction charts since no population-specific models exist. The WHO/ISH risk prediction charts have two versions—one with total cholesterol as a predictor (the high information (HI) model) and the other without (the low information (LI) model). However, information on the WHO/ISH risk prediction charts including guidance on which version to use and when, as well as relative performance of the LI and HI models, is limited. This article aims to, firstly, quantify the relative performance of the LI and HI WHO/ISH risk prediction (for WHO-South East Asian Region D) using data from rural India. Secondly, we propose a pre-screening (simplified) point-of-care (POC) test to identify patients who are likely to benefit from a total cholesterol (TC) test, and subsequently when the LI model is preferential to HI model. Analysis was performed using cross-sectional data from rural Andhra Pradesh collected in 2005 with recorded blood cholesterol measurements (N = 1066). CVD risk was computed using both LI and HI models, and high risk individuals who needed treatment(THR) were subsequently identified based on clinical guidelines. Model development for the POC assessment of a TC test was performed through three machine learning techniques: Support Vector Machine (SVM), Regularised Logistic Regression (RLR), and Random Forests (RF) along with a feature selection process. Disagreement in CVD risk predicted by LI and HI WHO/ISH models was 14.5% (n = 155; p<0.01) overall and comprised 36 clinically relevant THR patients (31% of patients identified as THR by using either model). Using two patient-specific parameters (age, systolic blood pressure), our POC assessment can pre-determine the benefit of TC testing and choose the appropriate risk model (out-of-sample AUCs:RF-0.85,SVM-0.84,RLR:0.82 and maximum sensitivity-98%). The

  16. Implications of Cardiovascular Disease Risk Assessment Using the WHO/ISH Risk Prediction Charts in Rural India.

    Directory of Open Access Journals (Sweden)

    Arvind Raghu

    Full Text Available Cardiovascular disease (CVD risk in India is currently assessed using the World Health Organization/International Society for Hypertension (WHO/ISH risk prediction charts since no population-specific models exist. The WHO/ISH risk prediction charts have two versions-one with total cholesterol as a predictor (the high information (HI model and the other without (the low information (LI model. However, information on the WHO/ISH risk prediction charts including guidance on which version to use and when, as well as relative performance of the LI and HI models, is limited. This article aims to, firstly, quantify the relative performance of the LI and HI WHO/ISH risk prediction (for WHO-South East Asian Region D using data from rural India. Secondly, we propose a pre-screening (simplified point-of-care (POC test to identify patients who are likely to benefit from a total cholesterol (TC test, and subsequently when the LI model is preferential to HI model. Analysis was performed using cross-sectional data from rural Andhra Pradesh collected in 2005 with recorded blood cholesterol measurements (N = 1066. CVD risk was computed using both LI and HI models, and high risk individuals who needed treatment(THR were subsequently identified based on clinical guidelines. Model development for the POC assessment of a TC test was performed through three machine learning techniques: Support Vector Machine (SVM, Regularised Logistic Regression (RLR, and Random Forests (RF along with a feature selection process. Disagreement in CVD risk predicted by LI and HI WHO/ISH models was 14.5% (n = 155; p<0.01 overall and comprised 36 clinically relevant THR patients (31% of patients identified as THR by using either model. Using two patient-specific parameters (age, systolic blood pressure, our POC assessment can pre-determine the benefit of TC testing and choose the appropriate risk model (out-of-sample AUCs:RF-0.85,SVM-0.84,RLR:0.82 and maximum sensitivity-98%. The

  17. Effects on cardiovascular disease risk of a web-based health risk assessment with tailored health advice: A follow-up study

    NARCIS (Netherlands)

    E.B. Colkesen (Ersen); B.S. Ferket (Bart); J.G.P. Tijssen (Jan); R.A. Kraaijenhagen (Roderik); C.K. Kalken (Coenraad); R.J. Peters (Ron)

    2011-01-01

    textabstractIntroduction: A large proportion of the cardiovascular disease (CVD) burden can potentially be prevented by primary prevention programs addressing major causal risk factors. A Web- based health risk assessment (HRA) with tailored feedback for individual health promotion is a promising st

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

    OpenAIRE

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

    2010-01-01

    Objectives To examine whether second-hand smoke (SHS) exposure measured by serum cotinine is associated with increased coronary heart disease (CHD) and stroke risk among contemporary older British adults. Design Prospective population-based study with self-reported medical history and health behaviours. Fasting blood samples were analysed for serum cotinine and cardiovascular disease (CVD) risk markers. Setting Primary care centres in 25 British towns in 1998–2001. Patients 8512 60–79-year-ol...

  19. Risk of cardiovascular disease

    DEFF Research Database (Denmark)

    Gejl, Michael; Starup-Linde, Jakob; Thomsen, Jan Lykke Scheel;

    2015-01-01

    AIMS: Type 2 diabetes (DM) increases the risk of cardiovascular disease. We investigated the effects of antidiabetic drugs on the composite endpoint (CE) of ischemic heart disease, heart failure or stroke in DM patients. METHODS: We conducted a nested case-control study. Cases were DM patients who......% CI: 16.88-24.12), neuropathy (OR=1.39, 95% CI: 1.05-1.85) and peripheral artery disease (OR=1.31, 95% CI: 1.02-1.69) increased the risk of CE. Biguanides (OR=0.62 95% CI; 0.54-0.71) and liraglutide (OR=0.48 95% CI; 0.38-0.62) significantly decreased the risk of CE as did statin treatment (OR=0.63, 95...

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

    OpenAIRE

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

    2013-01-01

    The study aims to develop a screening protocol for the risk of future cardiovascular disease and diabetes mellitus in people with prediabetes and undiagnosed diabetes; and to establish a framework for early identification and intervention of prediabetes including strategies for holistic management and monitoring of progression. The first phase is to identify prediabetes and undiagnosed diabetes in volunteers who are ≥18-years-old for 5 years. Point-of-care testing and questionnaire will be us...

  1. Assessment of Polycystic Ovarian Syndrome Patients' Perception for Different Cardiovascular Risk Factors using Questionnaire

    OpenAIRE

    Gateva, Antoaneta; Kamenov, Zdravko

    2012-01-01

    Aim: The aim of the present study was to investigate the perception for the presence of cardiovascular risk factors in Bulgarian patients with PCOS and/or obesity. Study Design: Clinic of endocrinology, Alexandrovska University Hospital, Sofia, Bulgaria between January 2010 and December 2011. Methodology: One hundred women (30 obese, 50 nonobese PCOS and 20 obese PCOS) aged 18-45 years were included in the study. They were asked to fill a questionnaire, containing questions about common and p...

  2. Effects on cardiovascular disease risk of a web-based health risk assessment with tailored health advice: A follow-up study

    OpenAIRE

    Colkesen, Ersen; Ferket, Bart; Tijssen, Jan; Kraaijenhagen, Roderik; Kalken, Coenraad; Peters, Ron

    2011-01-01

    textabstractIntroduction: A large proportion of the cardiovascular disease (CVD) burden can potentially be prevented by primary prevention programs addressing major causal risk factors. A Web- based health risk assessment (HRA) with tailored feedback for individual health promotion is a promising strategy. We evaluated the effect on CVD risk of such a program among employees of a Dutch worksite. Methods: We conducted a prospective follow-up study among 368 employees who voluntarily participat...

  3. Investigating patients' and general practitioners' views of computerised decision support software for the assessment and management of cardiovascular risk

    Directory of Open Access Journals (Sweden)

    Anne Wilson

    2007-01-01

    Conclusion Computer decision support programs are becoming more prevalent, but little is known about their usability and acceptability to both health professionals and consumers. The complexities of cardiovascular risk assessment and management can be adequately managed with such programs. As a contemporary report this study contributes to the growing knowledge required for developers of medical software and decision support systems to better understand the needs of endusers.

  4. Assessment of the risk of cardiovascular disease in patients with rosacea

    DEFF Research Database (Denmark)

    Egeberg, Alexander; Hansen, Peter R; Gislason, Gunnar H;

    2016-01-01

    BACKGROUND: Recent studies have shown a higher prevalence of cardiovascular (CV) risk factors in patients with rosacea. However, it remains unknown whether rosacea represents an independent CV risk factor. OBJECTIVE: We evaluated the risk of myocardial infarction, stroke, CV death, major adverse CV...... events, and all-cause mortality, respectively. METHODS: Between January 1, 1997, and December 31, 2012, a total of 4948 patients with rosacea were identified and matched with 23,823 control subjects. We used Poisson regression to calculate incidence rate ratios. RESULTS: Adjusted incidence rate ratios......-cause mortality. LIMITATIONS: We were unable to distinguish between the different subtypes and severities of rosacea. CONCLUSIONS: In this population-based study, rosacea was not associated with increased risk of adverse CV outcomes or death....

  5. The Addition of Vascular Calcification Scores to Traditional Risk Factors Improves Cardiovascular Risk Assessment in Patients with Chronic Kidney Disease

    OpenAIRE

    Liabeuf, Sophie; Desjardins, Lucie; Diouf, Momar; Temmar, Mohamed; Renard, Cédric; Choukroun, Gabriel; Massy, Ziad A.

    2015-01-01

    Background Although a variety of non-invasive methods for measuring cardiovascular (CV) risk (such as carotid intima media thickness, pulse wave velocity (PWV), coronary artery and aortic calcification scores (measured either by CT scan or X-ray) and the ankle brachial index (ABI)) have been evaluated separately in chronic kidney disease (CKD) cohorts, few studies have evaluated these methods simultaneously. Here, we looked at whether the addition of non-invasive methods to traditional risk f...

  6. Cheese and cardiovascular disease risk

    DEFF Research Database (Denmark)

    Hjerpsted, Julie Bousgaard; Tholstrup, Tine

    2016-01-01

    Abstract Currently, the effect of dairy products on cardiovascular risk is a topic with much debate and conflicting results. The purpose of this review is to give an overview of the existing literature regarding the effect of cheese intake and risk of cardiovascular disease (CVD). Studies included...

  7. Microalbuminuria: a Cardiovascular Risk Factor

    OpenAIRE

    ERCAN, Ertuğrul

    2010-01-01

    Albumin is a protein which is charged negatively. By correcting for the daily excretion of creatinine, the albumin creatinin ratio implicates the daily excretion of albumin in spot urine. Albuminuria is a cardiovascular risk factor in patients with diabetes, hypertension, and the general population. Urinary albumin excretion is independently associated with an increased risk of cardiovascular events, even after adjustment for risk factors. Risk has been shown to increase continuously with inc...

  8. Role of Cystatin-C in assessing the cardiovascular risk among overweight and obese individuals

    Directory of Open Access Journals (Sweden)

    Deepa Krishna

    2012-01-01

    Full Text Available Background: Cystatin C is a naturally occurring protease inhibitor that protects the host tissue from Cysteine protease Cathepsins, which is a pro-atherogenic factor. Cystatin C is a reliable marker of renal functions and its plasma concentration is dependent completely on Glomerular Filtration Rate, and has emerged as a biomarker of cardiovascular risk . The main objective of present study is to estimate the serum levels of Cystatin C in individuals with normal BMI, overweight and obese, aged between 20 and 39 years and to correlate the levels of serum Cystatin C with cardiovascular risk factors. Materials and Methods: The study population was taken from healthy volunteers of Mysore city, aged between 20 and 39 years of either sex. The study population was divided into three groups based on BMI. The sample size in each group was 20. Fasting serum sample was analyzed for glucose, HDL cholesterol, creatinine by enzymatic method and serum Cystatin C by immunoturbidimetric method using autoanalyser. Results: The serum Cystatin C levels was significantly increased in overweight and obese groups, P value <0.001. The mean serum Cystatin C levels in normal BMI group was 0.7 ± 0.03, in overweight group 0.91 ± 0.009 and in obese group was 1.15 ± 0.09. In the study, serum Cystatin C showed a positive correlation with serum total cholesterol ( r = 0.71, LDL cholesterol ( r = 0.69, total CHOL: HDL ( r = 0.77, HDL: LDL ( r = 0.75, serum glucose ( r = 0.61 and negative correlation with serum HDL ( r = -0.52. Conclusion: Serum Cystatin C can serve as a good predictive marker of preclinical cardiovascular disease and chronic kidney disease in overweight and obese individuals.

  9. Assessment of the Body Composition and Parameters of the Cardiovascular Risk in Juvenile Idiopathic Arthritis

    Directory of Open Access Journals (Sweden)

    Ewa Jednacz

    2015-01-01

    Full Text Available The study was aimed to evaluate cardiovascular risk parameters, body mass index (BMI centiles for sex and age, and body fat percentage using the electric bioimpedance method in children with juvenile idiopathic arthritis (JIA. 30 children with JIA participated in the study. A control group included 20 children. Patients were well matched for the age and sex. The body mass and body fat percentage were determined using the segmental body composition analyser; the BMI centiles were determined. All patients had the following parameters determined: lipid profile, hsCRP, homocysteine, and IL-6. The intima media thickness (IMT was measured. Patients with JIA had significantly lower body weight, BMI, and the BMI centile compared to the control group. The IL-6 levels were significantly higher in patients with JIA compared to the control group. There were no differences between two groups with regard to the lipid profile, % content of the fat tissue, homocysteine levels, hsCRP, and IMT. Further studies are necessary to search for reasons for lower BMI and BMI centile in children with JIA and to attempt to answer the question of whether lower BMI increases the cardiovascular risk in these patients, similarly as in patients with rheumatoid arthritis (RA.

  10. Perspectives on Some Controversies in Cardiovascular Disease Risk Assessment in the Pharmaceutical Development of Glucose-Lowering Medications.

    Science.gov (United States)

    Hoogwerf, Byron J; Manner, David H; Fu, Haoda; Moscarelli, Elena; Gaydos, Brenda L; Heine, Robert J

    2016-08-01

    The U.S. Food and Drug Administration (FDA) issued guidance on requirements to assess cardiovascular disease (CVD) risk with drugs being developed for approval for clinical use. The guidance was triggered by a meta-analysis published by Nissen and Wolski that suggested an increased risk for myocardial infarction with the use of rosiglitazone. This article discusses controversies around CVD trials in diabetes beginning with the University Group Diabetes Program. This is followed by a brief description of the FDA guidance for evaluating CVD risk with glucose-lowering medications. Limitations of meta-analyses of data from phase 2 and 3 (phase 2/3) trials to inform CVD risk are highlighted. These include the differences between patient characteristics in phase 2/3 trials and those in cardiovascular outcome trials (CVOTs) and the relatively short exposure time in phase 2/3 trials. The differences may partly explain the observed disparity between phase 2/3 meta-analyses and the results of completed CVOTs. Approaches to understanding CVD risk with a new medication should get to the answer about risk as efficiently as possible to minimize any potential harm to patients. In that context, we discuss options for clinical trial design and an alternative approach for statistical analyses. PMID:27440836

  11. CARDIOVASCULAR RISK ASSESSMENT IN PATIENTS WITH EARLY RHEUMATOID ARTHRITIS WITHIN THE REMARCA STUDY: PRELIMINARY DATA

    Directory of Open Access Journals (Sweden)

    D. S. Novikova

    2015-01-01

    Full Text Available Most patients with early rheumatoid arthritis (RA have a high or very high cardiovascular risk (CVR before therapy with disease-modifying antirheumatic drugs (DMARDs. Objective: to evaluate the impact of antirheumatic therapy performed in accordance with the Treat-to-Target strategy on the progression of atherosclerosis and CVR in patients with early RA. Subjects and methods. This investigation enrolled 74 patients (72% women; median age, 56 years with early RA having moderate to high activity (median DAS28, 5.6 who had not previously received DMARDs and glucocorticoids (GCs. All patients were anticyclic citrullinated peptide antibody-positive and 87% of the patients were rheumatoid factor-positive. All patients received methotrexate (MT subcutaneously with dose escalation up to 25–30 mg/week, in case of its inefficiency at 3 months a biological agent (BA was added. After 6 months, 39% of the patients achieved remission; 19% had low; 35 and 7% had moderate and high disease activity, respectively. The majority (n = 20 (69% who achieved remission received MT monotherapy; 9 (31% – MT + BA whereas among the patients who did not achieve remission 15 (33% and 30 (67% respectively. At baseline and after 6 months of treatment, traditional CVR factors were assessed in all patients, by determining the total coronary risk by the SCORE scale, including that modified by EULAR (mSCORE, carotid artery atherosclerosis (CAA by duplex scanning data, coronary calcification (CC by multislice spiral computed tomography and by estimating the degree of CVR.Results and discussion. The rates of hypertension, overweight, abdominal obesity, low activity, smoking, and type 2 diabetes mellitus did not change significantly after 6 months. There were increases in the levels of total cholesterol by 7% (p < 0.05, low-density lipoprotein cholesterol by 9% (p<0.01, high-density lipoprotein cholesterol by 26% (p < 0.005, and body mass index (BMI by 1% (p < 0.01 and a decrease

  12. Cardiovascular Risk Assessment with Vascular Function, Carotid Atherosclerosis and the UKPDS Risk Engine in Korean Patients with Newly Diagnosed Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Choon Sik Seon

    2011-12-01

    Full Text Available BackgroundPatients with type 2 diabetes have an increased risk of cardiovascular disease. Few studies have evaluated the cardiovascular disease (CVD risk simultaneously using the United Kingdom Prospective Diabetes Study (UKPDS risk engine and non-invasive vascular tests in patients with newly diagnosed type 2 diabetes.MethodsParticipants (n=380; aged 20 to 81 years with newly diagnosed type 2 diabetes were free of clinical evidence of CVD. The 10-year coronary heart disease (CHD and stroke risks were calculated for each patient using the UKPDS risk engine. Carotid intima media thickness (CIMT, flow mediated dilation (FMD, pulse wave velocity (PWV and augmentation index (AI were measured. The correlations between the UKPDS risk engine and the non-invasive vascular tests were assessed using partial correlation analysis, after adjusting for age, and multiple regression analysis.ResultsThe mean 10-year CHD and 10-year stroke risks were 14.92±11.53% and 4.03±3.95%, respectively. The 10-year CHD risk correlated with CIMT (P<0.001, FMD (P=0.017, and PWV (P=0.35 after adjusting for age. The 10-year stroke risk correlated only with the mean CIMT (P<0.001 after adjusting for age. FMD correlated with age (P<0.01 and systolic blood pressure (P=0.09. CIMT correlated with age (P<0.01, HbA1c (P=0.05, and gender (P<0.01.ConclusionThe CVD risk is increased at the onset of type 2 diabetes. CIMT, FMD, and PWV along with the UKPDS risk engine should be considered to evaluate cardiovascular disease risk in patients with newly diagnosed type 2 diabetes.

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

    Directory of Open Access Journals (Sweden)

    Giné-Garriga Maria

    2009-05-01

    Full Text Available Abstract 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

  14. Marathon run: cardiovascular adaptation and cardiovascular risk.

    Science.gov (United States)

    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

  15. Pulmonary Arterial Hypertension: Use of Delayed Contrast-Enhanced Cardiovascular Magnetic Resonance in Risk Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Bessa, Luiz Gustavo Pignataro, E-mail: lgpignataro@ig.com.br; Junqueira, Flávia Pegado; Bandeira, Marcelo Luiz da Silva; Garcia, Marcelo Iorio; Xavier, Sérgio Salles; Lavall, Guilherme; Torres, Diego; Waetge, Daniel [Hospital Universitário Clementino Fraga Filho, Ilha do Fundão, RJ (Brazil)

    2013-10-15

    Pulmonary arterial hypertension is a severe and progressive disease. Its early diagnosis is the greatest clinical challenge. To evaluate the presence and extension of the delayed myocardial contrast-enhanced cardiovascular magnetic resonance, as well as to verify if the percentage of the myocardial fibrosis mass is a severity predictor. Cross-sectional study with 30 patients with pulmonary arterial hypertension of groups I and IV, subjected to clinical, functional and hemodynamic evaluation, and to cardiac magnetic resonance. The mean age of patients was 52 years old, with female predominance (77%). Among the patients, 53% had right ventricular failure at diagnosis, and 90% were in functional class II/III. The mean of the 6-minute walk test was 395m. In hemodynamic study with right catheterism, the mean average pulmonary arterial pressure was 53.3mmHg, of the cardiac index of 2.1L/ min.m{sup 2}, and median right atrial pressure was 13.5 mmHg. Delayed myocardial contrast enhanced cardiovascular magnetic resonance was found in 28 patients. The mean fibrosis mass was 9.9 g and the median percentage of fibrosis mass was 6.17%. The presence of functional class IV, right ventricular failure at diagnosis, 6-minute walk test < 300 meters and right atrial pressure ≥ 15 mmHg, with cardiac index < 2.0 L/ min.m{sup 2}, there was a relevant association with the increased percentage of myocardial fibrosis. The percentage of the myocardial fibrosis mass indicates a non-invasive marker with promising perspectives in identifying patients with high risk factors for pulmonary hypertension.

  16. Pulmonary Arterial Hypertension: Use of Delayed Contrast-Enhanced Cardiovascular Magnetic Resonance in Risk Assessment

    International Nuclear Information System (INIS)

    Pulmonary arterial hypertension is a severe and progressive disease. Its early diagnosis is the greatest clinical challenge. To evaluate the presence and extension of the delayed myocardial contrast-enhanced cardiovascular magnetic resonance, as well as to verify if the percentage of the myocardial fibrosis mass is a severity predictor. Cross-sectional study with 30 patients with pulmonary arterial hypertension of groups I and IV, subjected to clinical, functional and hemodynamic evaluation, and to cardiac magnetic resonance. The mean age of patients was 52 years old, with female predominance (77%). Among the patients, 53% had right ventricular failure at diagnosis, and 90% were in functional class II/III. The mean of the 6-minute walk test was 395m. In hemodynamic study with right catheterism, the mean average pulmonary arterial pressure was 53.3mmHg, of the cardiac index of 2.1L/ min.m2, and median right atrial pressure was 13.5 mmHg. Delayed myocardial contrast enhanced cardiovascular magnetic resonance was found in 28 patients. The mean fibrosis mass was 9.9 g and the median percentage of fibrosis mass was 6.17%. The presence of functional class IV, right ventricular failure at diagnosis, 6-minute walk test < 300 meters and right atrial pressure ≥ 15 mmHg, with cardiac index < 2.0 L/ min.m2, there was a relevant association with the increased percentage of myocardial fibrosis. The percentage of the myocardial fibrosis mass indicates a non-invasive marker with promising perspectives in identifying patients with high risk factors for pulmonary hypertension

  17. Proactive multifactorial intervention strategy reduces the risk of cardiovascular disease estimated with region-specific risk assessment models in Pacific Asian patients participating in the CRUCIAL trial.

    Science.gov (United States)

    Cho, Eun Joo; Kim, Jae Hyung; Sutradhar, Santosh; Yunis, Carla; Westergaard, Mogens

    2013-12-01

    Despite race, ethnic, and regional differences in cardiovascular disease risk, many worldwide hypertension management guidelines recommend the use of the Framingham coronary heart disease (CHD) risk equation to guide treatment decisions. This subanalysis of the recently published CRUCIAL trial compared the treatment-related reductions in calculated CHD and stroke risk among Pacific Asian (PA) patients using a variety of region-specific risk assessment models. As a result, greater reductions in systolic and diastolic blood pressure, low-density lipoprotein cholesterol, and triglycerides were observed in the proactive multifactorial intervention (PMI) arm compared with the usual care arm at Week 52 for PA patients. The relative percentage change in 10-yr CHD risk between baseline and Week 52 in the PMI versus usual care arms was greatest using the NIPPON DATA80 fatal CHD model (LS [least square] mean difference -42.6%), and similar in the SCORE fatal CHD and Framingham total CHD models (LS mean difference -29.4% and -30.8%, respectively). The single-pill based PMI approach is consistently effective in reducing cardiovascular disease risk, evaluated using a variety of risk assessment models. (ClinicalTrials.gov registration number: NCT00407537). PMID:24339703

  18. Assessment and comparison of cardiovascular risk factors among smokers and tobacco chewers

    International Nuclear Information System (INIS)

    Many adverse health effects have been reported with the use of tobacco (smokeless) in populations, including CVDs, buccal cavity cancers, soft tissue lesions of mouth and gum recession, The purpose of Present study is to evaluate and compare specific cardiovascular risk factors, in individuals using smoked and smokeless tobacco products, Total of 220 age matched, male subjects were selected to participate in the study, who had a history of smoking or tobacco chewing or both, Base line history was collected through a questionnaire and anti coagulated venous blood samples were collected and analyzed for plasma glucose, lipid profile and blood glutathione levels. Results showed that in Pakistan middle class socioeconomic group has high 'prevalence of both forms of tobacco use. Mean BMI and prevalence of obesity were low in three tobacco groups. Systolic and diastolic BP were high in tobacco users but prevalence of hypertension was more in subjects using both forms of tobacco. Marked lipid profile and glutathione variations were present in all tobacco users. Plasma glucose concentrations also showed a non significant increase in three experimental groups as compared to controls. (author)

  19. Cardiovascular risk factors in men

    DEFF Research Database (Denmark)

    Gyllenborg, J; Rasmussen, S L; Borch-Johnsen, Knut;

    2001-01-01

    Males have higher risk of cardiovascular disease (CVD) than premenopausal females. Gonadal steroids are probably involved in the gender difference in CVD, but previous results have been conflicting. We investigated the associations between CVD risk factors and sex hormones in a cross...

  20. Space radiation and cardiovascular disease risk.

    Science.gov (United States)

    Boerma, Marjan; Nelson, Gregory A; Sridharan, Vijayalakshmi; Mao, Xiao-Wen; Koturbash, Igor; Hauer-Jensen, Martin

    2015-12-26

    Future long-distance space missions will be associated with significant exposures to ionizing radiation, and the health risks of these radiation exposures during manned missions need to be assessed. Recent Earth-based epidemiological studies in survivors of atomic bombs and after occupational and medical low dose radiation exposures have indicated that the cardiovascular system may be more sensitive to ionizing radiation than was previously thought. This has raised the concern of a cardiovascular disease risk from exposure to space radiation during long-distance space travel. Ground-based studies with animal and cell culture models play an important role in estimating health risks from space radiation exposure. Charged particle space radiation has dense ionization characteristics and may induce unique biological responses, appropriate simulation of the space radiation environment and careful consideration of the choice of the experimental model are critical. Recent studies have addressed cardiovascular effects of space radiation using such models and provided first results that aid in estimating cardiovascular disease risk, and several other studies are ongoing. Moreover, astronauts could potentially be administered pharmacological countermeasures against adverse effects of space radiation, and research is focused on the development of such compounds. Because the cardiovascular response to space radiation has not yet been clearly defined, the identification of potential pharmacological countermeasures against cardiovascular effects is still in its infancy. PMID:26730293

  1. Statins but not aspirin reduce thrombotic risk assessed by thrombin generation in diabetic patients without cardiovascular events: the RATIONAL trial.

    Directory of Open Access Journals (Sweden)

    Alejandro Macchia

    Full Text Available BACKGROUND: The systematic use of aspirin and statins in patients with diabetes and no previous cardiovascular events is controversial. We sought to assess the effects of aspirin and statins on the thrombotic risk assessed by thrombin generation (TG among patients with type II diabetes mellitus and no previous cardiovascular events. METHODOLOGY/PRINCIPAL FINDINGS: Prospective, randomized, open, blinded to events evaluation, controlled, 2×2 factorial clinical trial including 30 patients randomly allocated to aspirin 100 mg/d, atorvastatin 40 mg/d, both or none. Outcome measurements included changes in TG levels after treatment (8 to 10 weeks, assessed by a calibrated automated thrombogram. At baseline all groups had similar clinical and biochemical profiles, including TG levels. There was no interaction between aspirin and atorvastatin. Atorvastatin significantly reduced TG measured as peak TG with saline (85.09±55.34 nmol vs 153.26±75.55 nmol for atorvastatin and control groups, respectively; p = 0.018. On the other hand, aspirin had no effect on TG (121.51±81.83 nmol vs 116.85±67.66 nmol, for aspirin and control groups, respectively; p = 0.716. The effects of treatments on measurements of TG using other agonists were consistent. CONCLUSIONS/SIGNIFICANCE: While waiting for data from ongoing large clinical randomized trials to definitively outline the role of aspirin in primary prevention, our study shows that among diabetic patients without previous vascular events, statins but not aspirin reduce thrombotic risk assessed by TG. TRIAL REGISTRATION: ClinicalTrials.gov NCT00793754.

  2. Assessment of total cardiovascular risk using WHO/ISH risk prediction charts in three low and middle income countries in Asia

    Science.gov (United States)

    2013-01-01

    Background Recent research has used cardiovascular risk scores intended to estimate “total cardiovascular disease (CVD) risk” in individuals to assess the distribution of risk within populations. The research suggested that the adoption of the total risk approach, in comparison to treatment decisions being based on the level of a single risk factor, could lead to reductions in expenditure on preventive cardiovascular drug treatment in low- and middle-income countries. So that the patient benefit associated with savings is highlighted. Methods This study used data from national STEPS surveys (STEPwise Approach to Surveillance) conducted between 2005 and 2010 in Cambodia, Malaysia and Mongolia of men and women aged 40–64 years. The study compared the differences and implications of various approaches to risk estimation at a population level using the World Health Organization/International Society of Hypertension (WHO/ISH) risk score charts. To aid interpretation and adjustment of scores and inform treatment in individuals, the charts are accompanied by practice notes about risk factors not included in the risk score calculations. Total risk was calculated amongst the populations using the charts alone and also adjusted according to these notes. Prevalence of traditional single risk factors was also calculated. Results The prevalence of WHO/ISH “high CVD risk” (≥20% chance of developing a cardiovascular event over 10 years) of 6%, 2.3% and 1.3% in Mongolia, Malaysia and Cambodia, respectively, is in line with recent research when charts alone are used. However, these proportions rise to 33.3%, 20.8% and 10.4%, respectively when individuals with blood pressure > = 160/100 mm/Hg and/or hypertension medication are attributed to “high risk”. Of those at “moderate risk” (10- < 20% chance of developing a cardio vascular event over 10 years), 100%, 94.3% and 30.1%, respectively are affected by at least one risk-increasing factor. Of all individuals, 44

  3. Genetic risks for cardiovascular diseases

    OpenAIRE

    Zafarmand, M. H.

    2008-01-01

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

  4. Relationship between Conventional Cardiovascular Disease Risk Assessment and Coronary Artery Calcification in Group Exposed to Inorganic Dusts

    International Nuclear Information System (INIS)

    The purpose of this study is to determine the relationship between the coronary artery calcification (CAC) and the conventional cardiovascular disease risk assessment (CCDRA). This study included 101 subjects who were exposed to inorganic dusts and underwent CAC scoring by multidetector CT (MDCT), laboratory tests, and a standardized questionnaire for CCDRA, after being approved from the Institutional Review Board and providing informed consent. All subjects were divided as either non-calcified group (< 1, 55.4%) or calcified group (≥ 1, 44.6%) from total CAC, and evaluated by CCDRA, such as Framingham risk score (FRS) and National Cholesterol Education Program (NCEP). Receiver operating characteristic (ROC) area of FRS was generated for predicting CAC risk using SPSS program (ver. 19.0, Chicago, IL, USA). Total CAC was significantly correlated with FRS (r = 0.283, p = 0.004). Crude odds ratio for CAC risk was 3.64 [95% confidence interval (CI) 1.39-9.52] in FRS ≥ 20%, and 2.87 (95% CI 1.24-6.65) in the high risk group of NCEP. Subjects with pneumoconiosis showed higher values of CAC (p 0.541) and FRS (p = 0.035) scores compared with subjects without pneumoconiosis. ROC area of FRS was 0.69 (95% CI 0.59-0.79) with a cutoff point of 13.5%. CAC measured MDCT is significantly correlated with FRS than other CCDRA

  5. Relationship between Conventional Cardiovascular Disease Risk Assessment and Coronary Artery Calcification in Group Exposed to Inorganic Dusts

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Won Jeong; Park, So Young [Occupational Lung Diseases Institute, KCOMWEL, Ansan (Korea, Republic of)

    2013-03-15

    The purpose of this study is to determine the relationship between the coronary artery calcification (CAC) and the conventional cardiovascular disease risk assessment (CCDRA). This study included 101 subjects who were exposed to inorganic dusts and underwent CAC scoring by multidetector CT (MDCT), laboratory tests, and a standardized questionnaire for CCDRA, after being approved from the Institutional Review Board and providing informed consent. All subjects were divided as either non-calcified group (< 1, 55.4%) or calcified group ({>=} 1, 44.6%) from total CAC, and evaluated by CCDRA, such as Framingham risk score (FRS) and National Cholesterol Education Program (NCEP). Receiver operating characteristic (ROC) area of FRS was generated for predicting CAC risk using SPSS program (ver. 19.0, Chicago, IL, USA). Total CAC was significantly correlated with FRS (r = 0.283, p = 0.004). Crude odds ratio for CAC risk was 3.64 [95% confidence interval (CI) 1.39-9.52] in FRS {>=} 20%, and 2.87 (95% CI 1.24-6.65) in the high risk group of NCEP. Subjects with pneumoconiosis showed higher values of CAC (p 0.541) and FRS (p = 0.035) scores compared with subjects without pneumoconiosis. ROC area of FRS was 0.69 (95% CI 0.59-0.79) with a cutoff point of 13.5%. CAC measured MDCT is significantly correlated with FRS than other CCDRA.

  6. Cardiovascular risk factors among Chamorros

    Directory of Open Access Journals (Sweden)

    Wu Phillis L

    2006-12-01

    Full Text Available Abstract Background Little is known regarding the cardiovascular disease risk factors among Chamorros residing in the United States. Methods The Chamorro Directory International and the CDC's Behavioral Risk Factor Surveillance System Questionnaire (BRFSS were used to assess the health related practices and needs of a random sample of 228 Chamorros. Results Inactivity, hypertension, elevated cholesterol and diabetes mellitus were more prevalent in this Chamorro sample compared to the US average. Participants who were 50-and-older or unemployed were more likely to report hypertension, diabetes and inactivity, but they were also more likely to consume more fruits and vegetables than their younger and employed counterparts. Women were more likely to report hypertension and diabetes, whereas men were more likely to have elevated BMI and to have never had their blood cholesterol checked. Conclusion The study provides data that will help healthcare providers, public health workers and community leaders identify where to focus their health improvement efforts for Chamorros and create culturally competent programs to promote health in this community.

  7. Effects on cardiovascular disease risk of a web-based health risk assessment with tailored health advice: a follow-up study

    Directory of Open Access Journals (Sweden)

    Ersen B Colkesen

    2011-02-01

    Full Text Available Ersen B Colkesen1,2, Bart S Ferket2,3, Jan GP Tijssen1, Roderik A Kraaijenhagen2, Coenraad K van Kalken2, Ron JG Peters11Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; 2NDDO Institute for Prevention and Early Diagnostics (NIPED, Amsterdam, the Netherlands; 3Department of Epidemiology, Erasmus Medical Center, Rotterdam, the NetherlandsIntroduction: A large proportion of the cardiovascular disease (CVD burden can potentially be prevented by primary prevention programs addressing major causal risk factors. A Web-based health risk assessment (HRA with tailored feedback for individual health promotion is a promising strategy. We evaluated the effect on CVD risk of such a program among employees of a Dutch worksite.Methods: We conducted a prospective follow-up study among 368 employees who voluntarily participated in a Web-based HRA program at a single Dutch worksite in 2008. The program included a multicomponent HRA through a Web-based electronic questionnaire, biometrics, and laboratory evaluation. The results were combined with health behavior change theory to generate tailored motivational and educational health advice. On request, a health counseling session with the program physician was available. Follow-up data on CVD risk were collected 1 year after initial participation. The primary outcome was a change in Framingham CVD risk at 6 months relative to baseline. We checked for a possible background effect of an increased health consciousness as a consequence of program introduction at the worksite by comparing baseline measurements of early program participants with baseline measurements of participants who completed the program 6 months later.Results: A total of 176 employees completed follow-up measurements after a mean of 7 months. There was a graded relation between CVD risk changes and baseline risk, with a relative reduction of 17.9% (P = 0.001 in the high-risk category (baseline

  8. Valoración del riesgo cardiovascular de pacientes en Hemodiálisis Assessment of cardiovascular risk in haemodialysis patients

    Directory of Open Access Journals (Sweden)

    Cristina Mendías Benítez

    2010-06-01

    Full Text Available Las complicaciones cardiovasculares son la principal causa de enfermedad renal crónica, y a su vez uno de los principales factores de riesgo cardiovascular. Por otro lado, la enfermedad cardiovascular está íntimamente relacionada con la obesidad central o androide. Nuestro objetivo es determinar los factores de riesgo cardiovascular presentes en nuestros pacientes en tratamiento sustitutivo de hemodiálisis para elaborar una hoja de seguimiento que nos sirva de apoyo para valorar la progresión o regresión de los factores de riesgo. Se diseñó un estudio descriptivo transversal prospectivo y abierto, la población de referencia se determinó por una muestra de los pacientes en tratamiento hemodialítico en nuestros centros. Analizados los 14 factores de riesgo cardiovascular presentes en el estudio, encontramos una media de factores presentes de 5,11 ± 2,15. La población estudiada presentaba: valores altos en cuanto a sobrepeso, uno de cada cuatro pacientes del estudio presentaba Síndrome Metabólico, niveles mayores de troponina basal en pacientes con más tiempo en hemodiálisis, encontramos una variedad entre 0 y 9 factores de riesgo presentes de los 14 analizados en el estudio, no encontramos correlación entre el tiempo en hemodiálisis y aumento de los factores de riesgo o entre la presencia de síndrome metabólico y el tiempo en hemodiálisis.Cardiovascular complications are the main cause of the Chronic Kidney Disease and also one of the main cardiovascular risk factors. On the other hand, a cardiovascular disease is directly related to android or central obesity. Our goal is to define cardiovascular risk factors on our patients receiving haemodialysis therapy, in order to provide a follow-up form as a support to estimate the progression or regression of risk factors. A transversal descriptive study, prospective and opened, has been elaborated. Reference population has been determined by a simple of our patients in haemodialysis

  9. [Psoriasis and cardiovascular risk factors].

    Science.gov (United States)

    Tal, Roy; Pavlovsky, Lev; David, Michael

    2012-10-01

    Psoriasis is a common inflammatory skin disease which may dramatically affect patients' lives. This chronic disease is characterized by a protracted course of alternating remissions and relapses. In recent years, the attention of researchers has focused on the association between psoriasis and cardiovascular disease risk factors. This review summarizes the literature on this topic with an emphasis on research conducted in Israel. PMID:23316664

  10. European Practice Assessment of Cardiovascular risk management (EPA Cardio: protocol of an international observational study in primary care

    Directory of Open Access Journals (Sweden)

    van Lieshout Jan

    2009-01-01

    Full Text Available Abstract Background Despite important improvements in available prevention and treatment, cardiovascular diseases (CVD remain an important cause of morbidity and mortality. Not all high-risk patients and patients with CVD have healthy lifestyles and receive the best possible healthcare. Internationally comparative data are needed to compare cardiovascular risk management in different countries, and to examine the impact of improvement programs and others factors. Objectives This study aims to provide internationally comparative data on cardiovascular risk management provided in primary care and on health-related lifestyles of patients in Europe. The study will also explore the views of doctors and patients on innovative preventive services for CVDs. Design and methods An observational cross-sectional study is planned. In 10 European countries, stratified samples of 36 practices per country will be recruited. In each practice, three samples of 15 patients each will be sampled: patients with coronary heart disease, patients at high risk for CVD, and healthy adult patients. The quality of cardiovascular risk management has been specified in terms of 44 performance indicators that resulted from an international Delphi-procedure with general practitioners. Most indicators are based on medical records, and some on a structured interview with a contact person of the practice. Lifestyle (smoking, physical exercise, diet will be measured with previously validated questionnaires that are completed by patients. Additional measures include practice characteristics and exposure to programs to improve cardiovascular care.

  11. Abacavir and cardiovascular risk

    NARCIS (Netherlands)

    G.M.N. Behrens; P. Reiss

    2010-01-01

    Purpose of review This review focuses on current studies addressing the association of abacavir (ABC) therapy and myocardial risk in HIV-infected patients, discusses potential pathogenetic mechanisms, and suggests a preliminary algorithm for decision making regarding ABC therapy in daily clinical pr

  12. The new concept of total cardiovascular risk management

    OpenAIRE

    Gino Seravalle; Guido Grassi; Giuseppe Mancia

    2013-01-01

    Introduction: Cardiovascular risk factors, such as hypertension, hypercholesterolemia, and diabetes mellitus, often cluster together and can also be seen with other pathophysiological conditions that greatly increase an individual’s risk for cardiovascular morbidity and death. Aim of the study: This article emphasizes the importance of assessing and managing the total cardiovascular risk in an individual patient. Materials and methods: Suggestions and recommendations from the most current hyp...

  13. Abacavir and cardiovascular risk

    OpenAIRE

    Behrens, G.M.N.; Reiss, P

    2010-01-01

    Purpose of review This review focuses on current studies addressing the association of abacavir (ABC) therapy and myocardial risk in HIV-infected patients, discusses potential pathogenetic mechanisms, and suggests a preliminary algorithm for decision making regarding ABC therapy in daily clinical practise. Recent findings The D:A:D study was the first to reveal an increased rate of myocardial infarction in patients recently treated with ABC. Subsequent analyses of both cohort studies as well ...

  14. Cardiovascular risk factors in subjects with psoriasis

    DEFF Research Database (Denmark)

    Jensen, Peter; Thyssen, Jacob P; Zachariae, Claus;

    2012-01-01

    Background Epidemiological data have established an association between cardiovascular disease and psoriasis. Only one general population study has so far compared prevalences of cardiovascular risk factors among subjects with psoriasis and control subjects. We aimed to determine the prevalence of...... cardiovascular risk factors in subjects with and without psoriasis in the general population. Methods During 2006-2008, a cross-sectional study was performed in the general population in Copenhagen, Denmark. A total of 3471 subjects participated in a general health examination that included assessment of current...... smoking status, weight, height, waist and hip circumferences, systolic and diastolic blood pressures, resting heart rate, and plasma lipids, hemoglobin A1c, fasting glucose, and insulin levels. Results Physician-diagnosed psoriasis was reported by 238 (7.1%) of 3374 participants. There were no differences...

  15. Personalized prevention approach with use of a web-based cardiovascular risk assessment with tailored lifestyle follow-up in primary care practice - a pilot study

    NARCIS (Netherlands)

    van den Brekel-Dijkstra, Karolien; Rengers, Antonia H; Niessen, Maurice Aj; de Wit, NJ; Kraaijenhagen, Roderik A

    2015-01-01

    AIMS: The aim of this prospective implementation study is to evaluate feasibility of a personalized prevention approach with use of a web-based health risk assessment for cardiovascular diseases combined with tailored lifestyle feedback and interventions in the community setting. METHODS: A random s

  16. Cardiovascular risk assessment in type 2 diabetes mellitus: comparison of the World Health Organization/International Society of Hypertension risk prediction charts versus UK Prospective Diabetes Study risk engine

    Directory of Open Access Journals (Sweden)

    Herath HMM

    2015-11-01

    Full Text Available Herath M Meththananda Herath, Thilak Priyantha Weerarathna, Dilini Umesha Department of Medicine, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka Introduction: Patients with type 2 diabetes mellitus (T2DM are at higher risk of developing cardiovascular diseases, and assessment of their cardiac risk is important for preventive strategies. Purpose: The Ministry of Health of Sri Lanka has recommended World Health Organization/International Society of Hypertension (WHO/ISH charts for cardiac risk assessment in individuals with T2DM. However, the most suitable cardiac risk assessment tool for Sri Lankans with T2DM has not been studied. This study was designed to evaluate the performance of two cardiac risk assessments tools; WHO/ISH charts and UK Prospective Diabetes Study (UKPDS risk engine. Methods: Cardiac risk assessments were done in 2,432 patients with T2DM attending a diabetes clinic in Southern Sri Lanka using the two risk assessment tools. Validity of two assessment tools was further assessed by their ability to recognize individuals with raised low-density lipoprotein (LDL and raised diastolic blood pressure in a cohort of newly diagnosed T2DM patients (n=332. Results: WHO/ISH charts identified 78.4% of subjects as low cardiac risk whereas the UKPDS risk engine categorized 52.3% as low cardiac risk (P<0.001. In the risk categories of 10%–<20%, the UKPDS risk engine identified higher proportions of patients (28% compared to WHO/ISH charts (7%. Approximately 6% of subjects were classified as low cardiac risk (<10% by WHO/ISH when UKPDS recognized them as cardiac risk of >20%. Agreement between the two tools was poor (κ value =0.144, P<0.01. Approximately 82% of individuals categorized as low cardiac risk by WHO/ISH had higher LDL cholesterol than the therapeutic target of 100 mg/dL. Conclusion: There is a significant discrepancy between the two assessment tools with WHO/ISH risk chart recognizing higher proportions of patients

  17. Cardiovascular Risk Factors and Cardiovascular Hyperreactivity in Young Venezuelans

    OpenAIRE

    Sady Montes Amador; Mikhail Benet Rodríguez; Lenia Ramos Rodríguez; Esther Cano Andino; Erick Andrés Pérez Martín

    2015-01-01

    Background: cardiovascular hyperreactivity in young people has been associated with different risk factors and a family history of hypertension. Objective: to determine the association between a family history of hypertension and cardiovascular risk factors with cardiovascular hyperreactivity. Method: a correlational, cross-sectional study was conducted in a universe of 77 young individuals aged 18 to 40 years from the Churuguara parish of the Falcon State in Venezuela. The variables were: ag...

  18. Issues and challenges in the assessment, diagnosis and treatment of cardiovascular risk factors: Assessing the needs of cardiologists

    Directory of Open Access Journals (Sweden)

    Dupuis Martin

    2008-05-01

    Full Text Available Abstract Background This needs assessment, initiated by the Academy for Healthcare Education Inc. in cooperation with AXDEV Group Inc., explored the knowledge, attitudes, behavior, and skills of community-based and academic-affiliated U.S. cardiologists in the area of CV risk assessment, treatment, and management from July 2006 to December 2006. Methods The needs assessment used a multistage, mixed-method approach to collect, analyze, and verify data from two independent sources. The exploratory phase collected data from a representative sampling of U.S. cardiologists by means of qualitative panel meetings, one-on-one interviews, and quantitative questionnaires. In the validation phase, 150 cardiologists from across the United States completed a quantitative online questionnaire. Data were analyzed with standardized statistical methods. Results The needs assessment found that cardiologists have areas of weakness pertaining to their interpersonal skills, which may influence patient-physician communication and patient adherence. Cardiologists appeared to have little familiarity with or lend little credence to the concept of relative CV risk. In daily clinical practice, they faced challenges with regard to optimal patient outcome in areas of patient referral from primary-care providers, CV risk assessment and treatment, and patient monitoring. Community-based and academic-affiliated cardiologists appeared to be only moderately interested in educational interventions that pertain to CV risk-reduction strategies. Conclusion Educational interventions that target cardiologists' interpersonal skills to enhance their efficacy may benefit community-based and academic-affiliated specialists. Other desirable educational initiatives should address gaps in the patient referral process, improve patient knowledge and understanding of their disease, and provide supportive educational tools and materials to enhance patient-physician communication.

  19. Development of a community-wide cardiovascular risk reduction assessment tool for small rural employers in upstate New York.

    Science.gov (United States)

    Goetzel, Ron Z; Liss-Levinson, Rivka C; Goodman, Nanette; Kennedy, James X

    2009-04-01

    Employers are implementing workplace health promotion programs that address modifiable health risk factors such as overweight and obesity, smoking, high blood pressure, high cholesterol, physical inactivity, poor diet, and high stress. Research with large employers has found that these programs can improve workers' health and decrease the costs associated with medical care, absenteeism, and presenteeism. Despite their promise, health promotion programs are not widely embraced by small businesses, especially those in rural communities. This article reviews the barriers encountered by small and rural businesses in implementing health promotion programs. We describe an approach developed in cooperation with the New York State Department of Health's Healthy Heart Program and the Cayuga Community Health Network to engage small businesses in health promotion. We review the development and implementation of an assessment tool created to evaluate current workplace health promotion programs, policies, and practices targeting cardiovascular disease among small, rural employers in upstate New York. Potential benefits of the assessment tool are discussed, and the instrument is made available for the public. PMID:19289008

  20. Does Sufficient Evidence Exist to Support a Causal Association between Vitamin D Status and Cardiovascular Disease Risk? An Assessment Using Hill’s Criteria for Causality

    OpenAIRE

    Weyland, Patricia G.; Grant, William B; Jill Howie-Esquivel

    2014-01-01

    Serum 25-hydroxyvitamin D (25(OH)D) levels have been found to be inversely associated with both prevalent and incident cardiovascular disease (CVD) risk factors; dyslipidemia, hypertension and diabetes mellitus. This review looks for evidence of a causal association between low 25(OH)D levels and increased CVD risk. We evaluated journal articles in light of Hill’s criteria for causality in a biological system. The results of our assessment are as follows. Strength of association: many randomi...

  1. Cardiovascular risk assessment in type 2 diabetes mellitus: comparison of the World Health Organization/International Society of Hypertension risk prediction charts versus UK Prospective Diabetes Study risk engine

    OpenAIRE

    Herath HMM; Weerarathna TP; Umesha D

    2015-01-01

    Herath M Meththananda Herath, Thilak Priyantha Weerarathna, Dilini Umesha Department of Medicine, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka Introduction: Patients with type 2 diabetes mellitus (T2DM) are at higher risk of developing cardiovascular diseases, and assessment of their cardiac risk is important for preventive strategies. Purpose: The Ministry of Health of Sri Lanka has recommended World Health Organization/International Society of Hypertension (WHO/ISH) charts f...

  2. Assessment of the Cardiovascular Risk and Physical Activity of Individuals Exercising at a Public Park in the City of São Paulo

    Directory of Open Access Journals (Sweden)

    Cláudia L. M. Forjaz

    2002-07-01

    Full Text Available OBJECTIVE: Physical exercise helps to prevent cardiovascular disorders. Campaigns promoting exercise have taken many people to the parks of our city. The most appropriate exercise for preventing cardiovascular disorders is the aerobic modality; inappropriate exercise acutely increases cardiovascular risk, especially in individuals at higher risk. Therefore, assessing the cardiovascular risk of these individuals and their physical activities is of practical value. METHODS: In the Parque Fernando Costa, we carried out the project "Exercício e Coração" (Exercise and Heart involving 226 individuals. Assessment of the cardiovascular risk and of the physical activity practiced by the individuals exercising at that park was performed with a questionnaire and measurement of the following parameters: blood pressure, weight, height, and waist/hip ratio. The individuals were lectured on the benefits provided by exercise and how to correctly exercise. Each participant received a customized exercise prescription. RESULTS: In regard to risk, 43% of the individuals had health problems and 7% of the healthy individuals had symptoms that could be attributed to heart disorders. High blood pressure was observed in a large amount of the population. In regard to the adequacy of the physical activity, the individuals exercised properly. The project was well accepted, because the participants not only appreciated the initiative, but also reported altering their exercise habits after taking part in the project. CONCLUSION: Data obtained in the current study point to the need to be more careful in assessing the health of individuals who exercise at parks, suggesting that city parks should have a sector designated for assessing and guiding physical activity.

  3. Cardiovascular risk assessment in type 2 diabetes mellitus: comparison of the World Health Organization/International Society of Hypertension risk prediction charts versus UK Prospective Diabetes Study risk engine

    Science.gov (United States)

    Herath, Herath M Meththananda; Weerarathna, Thilak Priyantha; Umesha, Dilini

    2015-01-01

    Introduction Patients with type 2 diabetes mellitus (T2DM) are at higher risk of developing cardiovascular diseases, and assessment of their cardiac risk is important for preventive strategies. Purpose The Ministry of Health of Sri Lanka has recommended World Health Organization/International Society of Hypertension (WHO/ISH) charts for cardiac risk assessment in individuals with T2DM. However, the most suitable cardiac risk assessment tool for Sri Lankans with T2DM has not been studied. This study was designed to evaluate the performance of two cardiac risk assessments tools; WHO/ISH charts and UK Prospective Diabetes Study (UKPDS) risk engine. Methods Cardiac risk assessments were done in 2,432 patients with T2DM attending a diabetes clinic in Southern Sri Lanka using the two risk assessment tools. Validity of two assessment tools was further assessed by their ability to recognize individuals with raised low-density lipoprotein (LDL) and raised diastolic blood pressure in a cohort of newly diagnosed T2DM patients (n=332). Results WHO/ISH charts identified 78.4% of subjects as low cardiac risk whereas the UKPDS risk engine categorized 52.3% as low cardiac risk (P20%. Agreement between the two tools was poor (κ value =0.144, P<0.01). Approximately 82% of individuals categorized as low cardiac risk by WHO/ISH had higher LDL cholesterol than the therapeutic target of 100 mg/dL. Conclusion There is a significant discrepancy between the two assessment tools with WHO/ISH risk chart recognizing higher proportions of patients having low cardiac risk than the UKPDS risk engine. Risk assessment by both assessment tools demonstrated poor sensitivity in identifying those with treatable levels of LDL cholesterol and diastolic blood pressure. PMID:26622181

  4. Benefit-Risk Assessment of Fish Oil in Preventing Cardiovascular Disease.

    Science.gov (United States)

    Lands, Bill

    2016-09-01

    Cardiovascular disease (CVD) is a preventable disease, which combines two general processes: chronic vascular inflammation and acute thrombosis. Both are amplified with positive feedback signals by n-6 eicosanoids derived from food-based n-6 highly unsaturated fatty acids (n-6 HUFA). This amplification is lessened by competing actions of n-3 HUFA. Death results from fatal interactions of the vascular wall with platelets and clotting proteins. The benefits of fish oil interventions are confounded by complex details in pharmacokinetics, pharmacodynamics, adverse events, timescale factors, topology, financial incentives and people's sense of cause and effect. Two basic aspects of n-3 HUFA that are overlooked in CVD dynamics are saturable, hyperbolic responses of the enzymes continually supplying n-6 HUFA and hard-to-control positive feedback receptor signals by excessive n-6 HUFA-based mediators. Multiple feedback loops in inflammation and thrombosis have diverse mediators, and reducing one mediator that occurs above its rate-limiting levels may not reduce the pathophysiology. Clinicians have developed some successful interventions that decrease CVD deaths in the form of secondary prevention. However, the current high CVD prevalence in the USA remains unchanged, and successful primary prevention of CVD remains uncertain. This review weighs the available evidence to help clinicians, the biomedical community and the public put the use of fish oil supplements into a balanced perspective. PMID:27412006

  5. Utility of genetic determinants of lipids and cardiovascular events in assessing risk.

    Science.gov (United States)

    Holmes, Michael V; Harrison, Seamus; Talmud, Philippa J; Hingorani, Aroon D; Humphries, Steve E

    2011-04-01

    The prevention of coronary heart disease (CHD) is a major public-health goal, but disease architecture is such that a larger proportion of clinical events occur among the average majority than among the high-risk minority--the prevention paradox. Genetic findings over the past few years have resulted in the reopening of the old debate on whether an individualized or a population-based approach to prevention is preferable. Genetic testing is an attractive tool for CHD risk prediction because it is a low-cost, high-fidelity technology with multiplex capability. Moreover, by contrast with nongenetic markers, genotype is invariant and determined from conception, which eliminates biological variability and makes prediction from early life possible. Mindful of the prevention paradox, this Review examines the potential applications and challenges of using genetic information for predicting CHD, focusing on lipid risk factors and drawing on experience in the evaluation of nongenetic risk factors as screening tests for CHD. Many of the issues we discuss hold true for any late-onset common disease with modifiable risk factors and proven preventative strategies. PMID:21321562

  6. Adverse Outcome Analyses of Observational Data: Assessing Cardiovascular Risk in HIV Disease

    OpenAIRE

    Triant, V. A.; Josephson, F.; Rochester, C. G.; Althoff, K. N.; Marcus, K; Munk, R.; Cooper, C.; D’Agostino, R. B.; Costagliola, D; Sabin, C.A.; Williams, P. L.; Hughes, S.; Post, W. S.; Chandra-Strobos, N.; Guaraldi, G.

    2011-01-01

    Clinical decision making often relies on observational data analyses. Attention to 7 readily understood statistical factors will assist in understanding observational studies. Responsible public access to de-identified source data, if feasible, is recommended to assess methodological limitations.

  7. Toxic urban waste's assault on cardiovascular risk

    Directory of Open Access Journals (Sweden)

    M.L. De Rosa

    2015-03-01

    Full Text Available A cardiovascular health survey of 1203 persons in households located near the hazardous waste disposal sites and in a reference community, was conducted from 2009 until today to assess whether rates of adverse cardiovascular health outcomes were elevated among persons living near the sites. Data included medical records of reported cardiovascular disease certificates and hospital admission for cardiovascular diseases from hospital database. The study areas appeared similar with respect to mortality, cancer incidence, and pregnancy outcomes. In contrast, rate ratios were greater than 1.5 for 2 of 19 reported diseases, i.e., angina pectoris, and strokes. The apparent broad-based elevation in reported diseases and symptoms may reflect increased perception or recall of conditions by respondents living near the sites. Our study found that cardiovascular risk is associated only with PM2.5 concentrations, derived from uncontrolled burning of municipal solid waste in particular sites of our country. Their analysis demonstrated a relationship between increased levels of eventual fine particulate pollution and higher rates of death and complications from cardiovascular and cerebrovascular diseases. Management of solid waste releases a number of toxic substances, most in small quantities and at extremely low levels. Because of the wide range of pollutants, the different pathways of exposure, long-term low-level exposure, and the potential for synergism among the pollutants, concerns remain about potential health effects but there are many uncertainties involved in the assessment. Future community-based health studies should include medical and psychosocial assessment instruments sufficient to distinguish between changes in health status and effects of resident reporting tendency.

  8. Risk of cardiovascular disease following radiation exposure

    International Nuclear Information System (INIS)

    Excess radiation-induced cardiac mortalities have been reported among radiotherapy patients. Many case reports describe the occurrence of atherosclerosis following radiotherapy for Hodgkin's disease and breast cancer. Some case reports describe the cerebral infarction following radiotherapy to neck region, and of peripheral vascular disease of the lower extremities following radiotherapy to the pelvic region. The association of atomic bomb radiation and cardiovascular disease has been examined recently by incidence studies and prevalence studies of various endpoints of atherosclerosis; all endpoints indicated an increase of cardiovascular disease in the exposed group. It is almost certain that the cardiovascular disease is higher among atomic bomb survivors. However, since a heavy exposure of 10-40 Gy is delivered in radiotherapy and the bomb survivors were exposed to radiation at high dose and dose-rate, the question is whether the results can be extrapolated to individuals exposed to lower levels of radiation. Some recent epidemiological studies on occupationally exposed workers and population living near Chernobyl have provided the evidence for cardiovascular disease being a significant late effect at relatively low doses of radiation. However, the issue of non-cancer mortality from radiation is complicated by lack of adequate information on doses, and many other confounding factors (e.g., smoking habits or socio-economic status). This presentation will evaluate possible radiobiological mechanisms for radiation-induced cardiovascular disease, and will address its relevance to radiation protection management at low doses and what the impact might be on future radiation risk assessments. (authors)

  9. The BioImage Study: novel approaches to risk assessment in the primary prevention of atherosclerotic cardiovascular disease--study design and objectives

    DEFF Research Database (Denmark)

    Muntendam, Pieter; McCall, Carol; Sanz, Javier;

    2010-01-01

    eligibility criteria were randomized to a telephonic health survey only (survey only: n = 865), standard risk assessment (Framingham only: n = 718), or comprehensive risk assessment in a dedicated mobile facility equipped with advanced imaging tools (n = 6,104). Baseline examination included assessment of...... cardiovascular risk factors and screening for subclinical (asymptomatic) atherosclerosis with quantification of coronary artery calcification by computed tomography (CT), measurement of intima-media thickness, presence of carotid atherosclerotic plaques and abdominal aortic aneurysm by ultrasound, and ankle......The identification of asymptomatic individuals at risk for near-term atherothrombotic events to ensure optimal preventive treatment remains a challenging goal. In the BioImage Study, novel approaches are tested in a typical health-plan population. Based on certain demographic and risk...

  10. Metabolic syndrome and cardiovascular risk

    Directory of Open Access Journals (Sweden)

    Abdullah M Alshehri

    2010-11-01

    Full Text Available The constellation of dyslipidemia (hypertriglyceridemia and low levels of high-density lipoprotein cholesterol, elevated blood pressure, impaired glucose tolerance, and central obesity is now classified as metabolic syndrome, also called syndrome X. In the past few years, several expert groups have attempted to set forth simple diagnostic criteria for use in clinical practice to identify patients who manifest the multiple components of the metabolic syndrome. These criteria have varied somewhat in specific elements, but in general, they include a combination of multiple and metabolic risk factors. The most widely recognized of the metabolic risk factors are atherogenic dyslipidemia, elevated blood pressure, and elevated plasma glucose. Individuals with these characteristics, commonly manifest a prothrombotic state as well as and a proinflammatory state. Atherogenic dyslipidemia consists of an aggregation of lipoprotein abnormalities including elevated serum triglyceride and apolipoprotein B (apoB, increased small LDL particles, and a reduced level of HDL cholesterol (HDL-C. The metabolic syndrome is often referred to as if it were a discrete entity with a single cause. Available data suggest that it truly is a syndrome, ie, a grouping of atherosclerotic cardiovascular disease (ASCVD risk factors, that probably has more than one cause. Regardless of cause, the syndrome identifies individuals at an elevated risk for ASCVD. The magnitude of the increased risk can vary according to the components of the syndrome present as well as the other, non-metabolic syndrome risk factors in a particular person.

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

    OpenAIRE

    Guasch-Ferre, M. (Marta); Hu, F.B.; Martinez-Gonzalez, M. A.; Fito, M. (Montserrat); Bullo, M. (Mónica); Estruch, R.; Ros, E.; D. Corella; Recondo, J. (Javier); Gomez-Gracia, E. (Enrique); Fiol, M; Lapetra, J.; L. Serra-Majem; Muñoz, M. A.; Pinto, X. (Xavier)

    2014-01-01

    Background It is unknown whether individuals at high cardiovascular risk sustain a benefit in cardiovascular disease from increased olive oil consumption. The aim was to assess the association between total olive oil intake, its varieties (extra virgin and common olive oil) and the risk of cardiovascular disease and mortality in a Mediterranean population at high cardiovascular risk. Methods We included 7,216 men and women at high cardiovascular risk, aged 55 to 80 years, from the PREvención ...

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

    OpenAIRE

    Guasch-Ferré, Marta; Hu, Frank B; Martínez-González, Miguel A; Fitó, Montserrat; Bulló, Mònica; Estruch, Ramon; Ros, Emilio; Corella, Dolores; Recondo, Javier; Gómez-Gracia, Enrique; Fiol, Miquel; Lapetra, José; Serra-Majem, Lluís; Muñoz, Miguel A.; Pintó, Xavier

    2014-01-01

    Background: It is unknown whether individuals at high cardiovascular risk sustain a benefit in cardiovascular disease from increased olive oil consumption. The aim was to assess the association between total olive oil intake, its varieties (extra virgin and common olive oil) and the risk of cardiovascular disease and mortality in a Mediterranean population at high cardiovascular risk. Methods: We included 7,216 men and women at high cardiovascular risk, aged 55 to 80 years, from the PREvenció...

  13. Simplifying cardiovascular risk estimation using resting heart rate.

    LENUS (Irish Health Repository)

    Cooney, Marie Therese

    2010-09-01

    Elevated resting heart rate (RHR) is a known, independent cardiovascular (CV) risk factor, but is not included in risk estimation systems, including Systematic COronary Risk Evaluation (SCORE). We aimed to derive risk estimation systems including RHR as an extra variable and assess the value of this addition.

  14. Risk assessment for cardiovascular and respiratory mortality due to air pollution and synoptic meteorology in 10 Canadian cities

    International Nuclear Information System (INIS)

    Synoptic weather and ambient air quality synergistically influence human health. We report the relative risk of mortality from all non-accidental, respiratory-, and cardiovascular-related causes, associated with exposure to four air pollutants, by weather type and season, in 10 major Canadian cities for 1981 through 1999. We conducted this multi-city time-series study using Poisson generalized linear models stratified by season and each of six distinctive synoptic weather types. Statistically significant relationships of mortality due to short-term exposure to carbon monoxide, nitrogen dioxide, sulphur dioxide, and ozone were found, with significant modifications of risk by weather type, season, and mortality cause. In total, 61% of the respiratory-related mortality relative risk estimates were significantly higher than for cardiovascular-related mortality. The combined effect of weather and air pollution is greatest when tropical-type weather is present in the spring or summer. -- Air pollution has a greater influence on acute human mortality than weather type, with significant differences in risk from exposure to gaseous air pollution based on cause of death

  15. Framingham risk score with cardiovascular events in chronic kidney disease.

    Directory of Open Access Journals (Sweden)

    Szu-Chia Chen

    Full Text Available The Framingham Risk Score (FRS was developed to predict coronary heart disease in various populations, and it tended to under-estimate the risk in chronic kidney disease (CKD patients. Our objectives were to determine whether FRS was associated with cardiovascular events, and to evaluate the role of new risk markers and echocardiographic parameters when they were added to a FRS model. This study enrolled 439 CKD patients. The FRS is used to identify individuals categorically as "low" (4.7 cm, left ventricular hypertrophy or left ventricular ejection fraction<50% to the FRS model significantly improves the predictive values for cardiovascular events. In CKD patients, "high" risk categorized by FRS predicts cardiovascular events. Novel biomarkers and echocardiographic parameters provide additional predictive values for cardiovascular events. Future study is needed to assess whether risk assessment enhanced by using these biomarkers and echocardiographic parameters might contribute to more effective prediction and better care for patients.

  16. Waist-to-height ratio and cardiovascular risk factors in elderly individuals at high cardiovascular risk.

    Directory of Open Access Journals (Sweden)

    Marta Guasch-Ferré

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

  17. Subclinical organ damage and cardiovascular risk prediction

    DEFF Research Database (Denmark)

    Sehestedt, Thomas; Olsen, Michael H

    2010-01-01

    measuring subclinical organ damage. We have (i) reviewed recent studies linking markers of subclinical organ damage in the heart, blood vessels and kidney to cardiovascular risk; (ii) discussed the evidence for improvement in cardiovascular risk prediction using markers of subclinical organ damage; (iii...

  18. Progestins and cardiovascular risk markers.

    Science.gov (United States)

    Sitruk-Ware, R

    2000-01-01

    Several risks are attributed to progestins as a class-effect; however, the progestins used in hormone replacement therapy (HRT) have varying pharmacologic properties and do not induce the same side effects. Natural progesterone (P) and some of its derivatives, such as the 19-norprogesterones, do not exert any androgenic effect and, hence, have no negative effect on the lipids. On the other hand, the 19-nortestosterone derivatives and even some 17-hydroxyprogesterones have a partial androgenic effect, which may explain some of the negative effects observed on surrogate markers of cardiovascular risk. The relevance of the lipid changes induced by sex steroids has been questioned, and studies in the female cynomolgous monkey have not shown a direct relationship to atherosclerosis. Results suggest that estrogens (E) have antiatherogenic effects and that P does not reverse the beneficial effect of estradiol. Also, sex hormones modulate the vasomotor response of the main arteries. E preserves the normal endothelium-mediated dilation of coronary arteries, and P does not reverse this potential cardioprotective mechanism. In the same animal model, the addition of cyclic or continuous medroxyprogesterone acetate (MPA) to E inhibited vasodilatation by 50%, while nomegestrol acetate did not diminish the E-induced vasodilatation. Not all progestins act similarly on vasomotion or affect cardiovascular risk factors in the same way. Progestins, such as MPA or norethisterone acetate (NETA), exert a partial detrimental effect on the beneficial actions of estrogens with regard to lipid changes, atheroma development, or vasomotion. In contrast, progesterone itself does not have this inhibitory effect on lipid changes and vascular reactivity in animal models or on exercise-induced myocardial ischemia in humans. Nonandrogenic molecules of P itself and of derivatives, such as 19-norprogesterones, would appear neutral on the vessels. Several ongoing randomized controlled trials of HRT are

  19. Cardiovascular risk age: concepts and practicalities.

    LENUS (Irish Health Repository)

    Cooney, Marie Therese

    2012-06-01

    A young person with many risk factors may have the same level of risk as an older person with no risk factors. Thus a high-risk 40-year-old may have a risk age of 60 years or more. The aim of the study was to derive a generic equation for risk age, construct risk age charts, and explore the hypothesis that risk age is similar regardless of the cardiovascular disease (CVD) end point used.

  20. RED AND PROCESSED MEAT AND CARDIOVASCULAR RISK FACTOR

    OpenAIRE

    Atalić, Bruno; TOTH, JURICA; ATALIĆ, VLASTA; RADANOVIĆ, DANIJELA; Miškulin, Maja; LUČIN, ANA

    2014-01-01

    Aims: The British National Diet and Nutrition 2000/1 Survey data set records on 1,724 respondents (766 males and 958 females) were analyzed in order to assess the potential influences of red and processed meat intakes on cardiovascular risk factors. Methods: Linear regression of the associations of the red, processed, combination of red and processed, and total meat intakes with body mass index (BMI), systolic blood pressure and plasma total cholesterol as cardiovascular risk factors was cond...

  1. The new concept of total cardiovascular risk management

    Directory of Open Access Journals (Sweden)

    Gino Seravalle

    2013-03-01

    Full Text Available Introduction: Cardiovascular risk factors, such as hypertension, hypercholesterolemia, and diabetes mellitus, often cluster together and can also be seen with other pathophysiological conditions that greatly increase an individual’s risk for cardiovascular morbidity and death. Aim of the study: This article emphasizes the importance of assessing and managing the total cardiovascular risk in an individual patient. Materials and methods: Suggestions and recommendations from the most current hypertension management guidelines have been integrated with results from the major clinical trials published in the last decade. Results: Based on a review of the epidemiological data on cardiovascular disease, this paper expands the concept of stratification of hypertensive patients according to the approximate added risk of major cardiovascular events in the next 10 years and stresses the importance of subclinical target-organ damage. Conclusions: Although common in clinical practice, high-risk patients are often undiagnosed. Intensive hypertensive therapy is recommended for high-risk patients, and this treatment strategy will require combination therapy to control or reverse subclinical organ damage and prevent the progression of cardiovascular risk in subjects at low risk or medium risk.

  2. Cardiovascular Risk in Patients with Psoriatic Arthritis

    Directory of Open Access Journals (Sweden)

    Tracy Y. Zhu

    2012-01-01

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

  3. Echocardiographic assessment of the impact of cardiovascular risk factors on left ventricular systolic function in patients with acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Vijay Kumar Verma

    2014-06-01

    Conclusion: Since the proportion of patients with LV systolic dysfunction in patients with AMI remains relatively high, LV systolic function variables such as LVEF and LVESV should be echocardiographically evaluated in all patients with AMI. Since the post-infarction LV systolic function remains the single most important determinant of survival, treatment of AMI patients should be aimed at limitation of infarct size and prevention of ventricular dilation. Moreover, cardiovascular risk factors such as diabetes mellitus and smoking have a significant impact on the likelihood of impairment of LV systolic function in patients with AMI and hence could influence long-term prognosis. [Int J Res Med Sci 2014; 2(3.000: 1101-1106

  4. Serum triglycerides and risk of cardiovascular disease.

    NARCIS (Netherlands)

    Boullart, I.; Graaf, J. de; Stalenhoef, A.F.H.

    2012-01-01

    Dyslipidemia, especially elevated serum levels of cholesterol, is causally related to cardiovascular disease. The specific role of triglycerides has long been controversial. In this article we discuss the role of serum triglycerides in relation to the risk of cardiovascular disease. First, the (path

  5. Coffee and cardiovascular risk; an epidemiological study

    NARCIS (Netherlands)

    A.A.A. Bak (Annette)

    1990-01-01

    textabstractThis thesis comprises several studies on the effect of coffee and caffeine on cardiovascular risk in general, and the effect on serum lipids, blood pressure and selected hemostatic variables in particular. The association between coffee use and cardiovascular morbidity and mortality was

  6. Risk assessment

    DEFF Research Database (Denmark)

    Pedersen, Liselotte; Rasmussen, Kirsten; Elsass, Peter

    2010-01-01

    International research suggests that using formalized risk assessment methods may improve the predictive validity of professionals' predictions of risk of future violence. This study presents data on forensic psychiatric patients discharged from a forensic unit in Denmark in year 2001-2002 (n=107......). All patients were assessed for risk of future violence utilizing a structured professional judgment model: the Historical-Clinical-Risk Management-20 (HCR-20) violence risk assessment scheme. After a follow-up period of 5.6 years, recidivism outcome were obtained from the Danish National Crime...... predictive of violent recidivism compared to static items. In sum, the findings support the use of structured professional judgment models of risk assessment and in particular the HCR-20 violence risk assessment scheme. Findings regarding the importance of the (clinical) structured final risk judgment and...

  7. Risk assessment

    International Nuclear Information System (INIS)

    The radiation hormesis hypothesis is discussed claiming that low dose ionizing radiation shows positive biological effects. The hypothesis could not be demonstrably proved. In the last decade, new disciplines have been developing, such as risk assessment and risk management that, on the basis of proven results and the consideration of all circumstances quantitatively assess and test possible risks. (M.D.). 1 fig

  8. Cardiovascular Risk Factors and Cardiovascular Hyperreactivity in Young Venezuelans

    Directory of Open Access Journals (Sweden)

    Sady Montes Amador

    2015-07-01

    Full Text Available Background: cardiovascular hyperreactivity in young people has been associated with different risk factors and a family history of hypertension. Objective: to determine the association between a family history of hypertension and cardiovascular risk factors with cardiovascular hyperreactivity. Method: a correlational, cross-sectional study was conducted in a universe of 77 young individuals aged 18 to 40 years from the Churuguara parish of the Falcon State in Venezuela. The variables were: age, sex, skin color, family history of hypertension, medical history of hypertension, diabetes mellitus, alcohol consumption, salt intake, physical activity and body mass index. The diastolic and systolic blood pressure before and after the pressor response elicited by an isometric exercise were determined as hemodynamic variables. Results: thirteen percent of the participants developed vascular reactivity after the hand-held weight test. Cardiovascular hyperreactivity is three times higher in individuals with a family history of hypertension. Sixty percent of those with a body mass index greater than or equal to 27 kg/m2 are hyperreactive. There is a higher cardiovascular response to the hand-held weight test as the consumption of alcohol increases. Thirty three point three percent of the participants who smoke are hyperreactive. Conclusions: there is a significant association between a family history of hypertension, obesity, salt intake, alcohol consumption and vascular hyperreactivity.

  9. Lipoprotein metabolism indicators improve cardiovascular risk prediction

    Science.gov (United States)

    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...

  10. Insulin Resistance and Risk of Cardiovascular Disease in Postmenopausal Women

    DEFF Research Database (Denmark)

    Schmiegelow, Michelle D; Hedlin, Haley; Stefanick, Marcia L;

    2015-01-01

    BACKGROUND: Insulin resistance is associated with diabetes mellitus, but it is uncertain whether it improves cardiovascular disease (CVD) risk prediction beyond traditional cardiovascular risk factors. METHODS AND RESULTS: We identified 15,288 women from the Women's Health Initiative Biomarkers....../HDL-C, or impaired fasting glucose (serum glucose ≥110 mg/dL) to traditional risk factors in separate Cox multivariable analyses and assessed risk discrimination and reclassification. The study end point was major CVD events (nonfatal and fatal coronary heart disease and ischemic stroke) within 10 years, which...

  11. Cardiovascular risk prediction in the Netherlands

    NARCIS (Netherlands)

    Dis, van S.J.

    2011-01-01

    Background: In clinical practice, Systematic COronary Risk Evaluation (SCORE) risk prediction functions and charts are used to identify persons at high risk for cardiovascular diseases (CVD), who are considered eligible for drug treatment of elevated blood pressure and serum cholesterol. These funct

  12. Does Sufficient Evidence Exist to Support a Causal Association between Vitamin D Status and Cardiovascular Disease Risk? An Assessment Using Hill’s Criteria for Causality

    Directory of Open Access Journals (Sweden)

    Patricia G. Weyland

    2014-09-01

    Full Text Available Serum 25-hydroxyvitamin D (25(OHD levels have been found to be inversely associated with both prevalent and incident cardiovascular disease (CVD risk factors; dyslipidemia, hypertension and diabetes mellitus. This review looks for evidence of a causal association between low 25(OHD levels and increased CVD risk. We evaluated journal articles in light of Hill’s criteria for causality in a biological system. The results of our assessment are as follows. Strength of association: many randomized controlled trials (RCTs, prospective and cross-sectional studies found statistically significant inverse associations between 25(OHD levels and CVD risk factors. Consistency of observed association: most studies found statistically significant inverse associations between 25(OHD levels and CVD risk factors in various populations, locations and circumstances. Temporality of association: many RCTs and prospective studies found statistically significant inverse associations between 25(OHD levels and CVD risk factors. Biological gradient (dose-response curve: most studies assessing 25(OHD levels and CVD risk found an inverse association exhibiting a linear biological gradient. Plausibility of biology: several plausible cellular-level causative mechanisms and biological pathways may lead from a low 25(OHD level to increased risk for CVD with mediators, such as dyslipidemia, hypertension and diabetes mellitus. Experimental evidence: some well-designed RCTs found increased CVD risk factors with decreasing 25(OHD levels. Analogy: the association between serum 25(OHD levels and CVD risk is analogous to that between 25(OHD levels and the risk of overall cancer, periodontal disease, multiple sclerosis and breast cancer. Conclusion: all relevant Hill criteria for a causal association in a biological system are satisfied to indicate a low 25(OHD level as a CVD risk factor.

  13. Cardiovascular risk and hippocampal thickness in Alzheimer's disease.

    Science.gov (United States)

    Donix, Markus; Scharf, Maria; Marschner, Kira; Werner, Annett; Sauer, Cathrin; Gerner, Antje; Nees, Josef A; Meyer, Shirin; Donix, Katharina L; Von Kummer, Rüdiger; Holthoff, Vjera A

    2013-01-01

    Cardiovascular risk factors influence onset and progression of Alzheimer's disease. Among cognitively healthy people, changes in brain structure and function associated with high blood pressure, diabetes, or other vascular risks suggest differential regional susceptibility to neuronal damage. In patients with Alzheimer's disease, hippocampal and medial temporal lobe atrophy indicate early neuronal loss preferentially in key areas for learning and memory. We wanted to investigate whether this regional cortical thinning would be modulated by cardiovascular risk factors. We utilized high-resolution magnetic resonance imaging and a cortical unfolding technique to determine the cortical thickness of medial temporal subregions in 30 patients with Alzheimer's disease. Cardiovascular risk was assessed using a sex-specific multivariable risk score. Greater cardiovascular risk was associated with cortical thinning in the hippocampus CA2/3/dentate gyrus area but not other hippocampal and medial temporal subregions. APOE genotype, a family history of Alzheimer's disease, and age did not influence cortical thickness. Alzheimer's disease-related atrophy could mask the influence of genetic risk factors or age on regional cortical thickness in medial temporal lobe regions, whereas the impact of vascular risk factors remains detectable. This highlights the importance of cardiovascular disease prevention and treatment in patients with Alzheimer's disease. PMID:24228185

  14. Cardiovascular Risk and Hippocampal Thickness in Alzheimer’s Disease

    Directory of Open Access Journals (Sweden)

    Markus Donix

    2013-01-01

    Full Text Available Cardiovascular risk factors influence onset and progression of Alzheimer’s disease. Among cognitively healthy people, changes in brain structure and function associated with high blood pressure, diabetes, or other vascular risks suggest differential regional susceptibility to neuronal damage. In patients with Alzheimer’s disease, hippocampal and medial temporal lobe atrophy indicate early neuronal loss preferentially in key areas for learning and memory. We wanted to investigate whether this regional cortical thinning would be modulated by cardiovascular risk factors. We utilized high-resolution magnetic resonance imaging and a cortical unfolding technique to determine the cortical thickness of medial temporal subregions in 30 patients with Alzheimer’s disease. Cardiovascular risk was assessed using a sex-specific multivariable risk score. Greater cardiovascular risk was associated with cortical thinning in the hippocampus CA2/3/dentate gyrus area but not other hippocampal and medial temporal subregions. APOE genotype, a family history of Alzheimer’s disease, and age did not influence cortical thickness. Alzheimer’s disease-related atrophy could mask the influence of genetic risk factors or age on regional cortical thickness in medial temporal lobe regions, whereas the impact of vascular risk factors remains detectable. This highlights the importance of cardiovascular disease prevention and treatment in patients with Alzheimer’s disease.

  15. Risk of bleeding related to antithrombotic treatment in cardiovascular disease

    DEFF Research Database (Denmark)

    Sørensen, Rikke; Olesen, Jonas B; Charlot, Mette;

    2012-01-01

    Antithrombotic therapy is a cornerstone of treatment in patients with cardiovascular disease with bleeding being the most feared complication. This review describes the risk of bleeding related to different combinations of antithrombotic drugs used for cardiovascular disease: acute coronary...... syndrome (ACS), atrial fibrillation (AF), cerebrovascular (CVD) and peripheral arterial disease (PAD). Different risk assessment schemes and bleeding definitions are compared. The HAS-BLED risk score is recommended in patients with AF and in ACS patients with AF. In patients with ACS with or without...

  16. Cloud-Based Smart Health Monitoring System for Automatic Cardiovascular and Fall Risk Assessment in Hypertensive Patients.

    Science.gov (United States)

    Melillo, P; Orrico, A; Scala, P; Crispino, F; Pecchia, L

    2015-10-01

    The aim of this paper is to describe the design and the preliminary validation of a platform developed to collect and automatically analyze biomedical signals for risk assessment of vascular events and falls in hypertensive patients. This m-health platform, based on cloud computing, was designed to be flexible, extensible, and transparent, and to provide proactive remote monitoring via data-mining functionalities. A retrospective study was conducted to train and test the platform. The developed system was able to predict a future vascular event within the next 12 months with an accuracy rate of 84 % and to identify fallers with an accuracy rate of 72 %. In an ongoing prospective trial, almost all the recruited patients accepted favorably the system with a limited rate of inadherences causing data losses (risk assessment of vascular events and falls. PMID:26276015

  17. Lifestyle dominates cardiovascular risks in Malaysia

    Directory of Open Access Journals (Sweden)

    Khalib A. Latiff

    2008-03-01

    Full Text Available Cardiovascular problem is one of the leading cause of death in Malaysia and now invaded to the sub-urban and rural areas. To prevent and control of this problem, several main risk factors needed to be known and shall be reexamined and ranked according to the priority. The objectives of this research paper was to identify several dominant risk factor related to cardiovascular problem. A cross sectional study was carried out from March 2000 – June 2001 on a total of 8159 rural population aged 18 and above to measure the prevalence of the common cardiovascular risk factors. Those risk factors are systolic blood pressure, diastolic blood pressure, serum cholesterol level, obesity index, blood glucose level, smoking, physical activity and mental stress. Overall prevalence of common cardiovascular risk factors were higher, dominated by physical inactivity (65.7%, hypercholesterolemia – TC:HC (62.3%, mental stress (55.5% and obesity (53.7%. Smoking was also high at 49.9% especially among men. However systolic hypertension, diastolic hypertension and diabetes mellitus; although increased by age, its prevalence is relatively low at 23.7%, 19.2%, and 6.3% respectively. Cardiovascular risk factors related to lifestyle are much evidenced as compared to risk factors related to the biological influence. Therefore, all initiatives in community health intervention should be mobilized specifically on prevention and control of lifestyle-related risk factors. (Med J Indones 2008; 17: 50-6Keywords: cardiovascular problem, community intervention, lifestyle-linked risk factors

  18. Blood pressure and control of cardiovascular risk

    Directory of Open Access Journals (Sweden)

    Judith A Whitworth

    2005-10-01

    Full Text Available Judith A WhitworthJohn Curtin School of Medical Research, Australian National University, Canberra, ACT, AustraliaAbstract: Two key early 20th century notions, the first the primacy of diastolic pressure in determining risk, and the second that hypertension is a discrete disorder, have proved to be incorrect. We now recognize the primacy of systolic pressure as a risk factor for cardiovascular disease and that hypertension is an arbitrary definition. In the early 21st century, we are moving away from a dichotomous approach to risk classification, and away from notions of hypertension and normotension towards an appreciation that blood pressure-related risk is continuous. In parallel, there has been a paradigm shift from a single risk factor approach to comprehensive cardiovascular disease risk prevention. Accordingly, prevention of cardiovascular disease requires a focus on lowering of blood pressure and modification of associated risk factors rather than simply treatment of hypertension. This emphasis is reflected in the World Health Organization (WHO – International Society of Hypertension (ISH 2003 statement on management of hypertension.Keywords: blood pressure, hypertension, cardiovascular risk, treatment

  19. Cardiovascular risk, effectiveness and mortality

    Directory of Open Access Journals (Sweden)

    Juan Gérvas

    2011-11-01

    Full Text Available Dice la Ley de Hierro de la Epidemiología que todo el que nace muere. Por ello el fin de la Medicina no es evitar la muerte en sí, sino evitar las muertes, las enfermedades y el sufrimiento médicamente evitables.Al final, todos nuestros pacientes morirán – y nosotros mismos moriremos también, obviamente. “Los cuerpos encuentran una forma de morir” y si la causa no es el hambre ni la deshidratación, ni es congénita, ni infecciosa, ni por lesiones, ni por cáncer, ni por suicidio, tenemos que esperar que sea por ‘causa cardiovascular’, enfermedad pulmonar, insuficiencia renal o hepática, demencia u otras enfermedades degenerativas. Pero de algo tenemos que morir.Morir por causa cardiovascular ni es deshonroso, ni implica defectuosa atención clínica. Que la primera causa de muerte sea la cardiovascular no dice nada respecto a los cuidados clínicos, ni debería asustar.Sin embargo, son evitables muchas muertes de causa cardiovascular. Así, se puede evitar mucha mortalidad cardiovascular disminuyendo la desigualdad social, por ejemplo (con mejor re-distribución de la riqueza, mejor educación y demás. Los médicos saben que los factores adversos psicosociales asociados a la pertenencia a la clase baja responden del 35% del riesgo atribuible a la hipertensión en la incidencia del infarto de miocardio (en otra formulación, que pertenecer a la clase baja multiplica por 2,7 dicho riesgo1.También deberíamos saber que contra las muertes cardiovasculares no hay nada como las políticas de salud pública sobre el tabaquismo (restricciones de lugares en los que fumar, aumento del precio del tabaco, campañas de información, y demás.En lo clínico, las muertes cardiovasculares evitables se deben ver en perspectiva, según lo que se puede lograr2. Así, por 100.000 habitantes y año, el tratamiento con inhibidores de la enzima convertidora de angiotensina (IECA en la insuficiencia cardíaca puede evitar 308 muertes; el consejo m

  20. Assessment of cardiovascular risks due to methylphenidate in six months of treatment in children with attention deficit and hyperactivity disorder

    OpenAIRE

    mehmet emre ari; ibrahim ilker cetin; filiz ekici; abdullah kocabas; sancar eminoglu; esra guney; onder ozturk; gulser senses dinc; zeynep goker

    2014-01-01

    Objectives: Cardiovascular adverse effects can be seen rarely in patients receiving methylphenidate for attention deficit and hyperactivity disorder (ADHD). In this study, we planned to investigate the effects of methylphenidate on the cardiovascular system in ADHD patients. Methods: One hundred and forty-one patients, who were diagnosed with ADHD and started on methylphenidate treatment between May 2011 and May 2012, were investigated. A cardiologic evaluation was performed on all of the ...

  1. Cardiovascular Reactivity and its Association with the Risk of Cardiovascular Morbidity

    Directory of Open Access Journals (Sweden)

    Milagros Lisset León Regal

    2016-06-01

    Full Text Available Background: there are no studies that confirm the association between cardiovascular hyperreactivity and the risk of cardiovascular morbidity. Objective: to determine the association between cardiovascular hyperreactivity and the risk of cardiovascular morbidity in normotensive individuals. Methods: a cross-sectional, correlational study was conducted. The universe consisted of the population aged 15 to 74 years in Cienfuegos municipality; the sample included 644 people. The variables were: sex, skin color, age, total cholesterol, HDL cholesterol, fasting blood glucose, smoking, baseline systolic blood pressure, cardiovascular reactivity, and risk of cardiovascular morbidity. The risk of cardiovascular morbidity was calculated by applying the Framingham Risk Functions. The Pearson’s Chi-square test and the prevalence ratio were used with a 95 % confidence interval. The direction of the relationship between cardiovascular reactivity, age, and systolic blood pressure was analyzed considering the Eta value. Results: the prevalence of cardiovascular hyperreactivity was higher among people aged 65 to 74 years and males. A higher risk of cardiovascular morbidity was observed in cardiovascular hyperreactive individuals. There is an association between non-optimal systolic blood pressure, increasing age, and high risk of cardiovascular morbidity in cardiovascular hyperreactive people. Conclusions: the risk of cardiovascular morbidity is higher in cardiovascular hyperreactive individuals than in normoreactive people. Age and systolic blood pressure showed greater association with high risk of cardiovascular morbidity.

  2. Credit scores, cardiovascular disease risk, and human capital.

    Science.gov (United States)

    Israel, Salomon; Caspi, Avshalom; Belsky, Daniel W; Harrington, HonaLee; Hogan, Sean; Houts, Renate; Ramrakha, Sandhya; Sanders, Seth; Poulton, Richie; Moffitt, Terrie E

    2014-12-01

    Credit scores are the most widely used instruments to assess whether or not a person is a financial risk. Credit scoring has been so successful that it has expanded beyond lending and into our everyday lives, even to inform how insurers evaluate our health. The pervasive application of credit scoring has outpaced knowledge about why credit scores are such useful indicators of individual behavior. Here we test if the same factors that lead to poor credit scores also lead to poor health. Following the Dunedin (New Zealand) Longitudinal Study cohort of 1,037 study members, we examined the association between credit scores and cardiovascular disease risk and the underlying factors that account for this association. We find that credit scores are negatively correlated with cardiovascular disease risk. Variation in household income was not sufficient to account for this association. Rather, individual differences in human capital factors—educational attainment, cognitive ability, and self-control—predicted both credit scores and cardiovascular disease risk and accounted for ∼45% of the correlation between credit scores and cardiovascular disease risk. Tracing human capital factors back to their childhood antecedents revealed that the characteristic attitudes, behaviors, and competencies children develop in their first decade of life account for a significant portion (∼22%) of the link between credit scores and cardiovascular disease risk at midlife. We discuss the implications of these findings for policy debates about data privacy, financial literacy, and early childhood interventions. PMID:25404329

  3. Cardiovascular Update: Risk, Guidelines, and Recommendations.

    Science.gov (United States)

    Pearson, Tamera

    2015-09-01

    This article provides an update of the current status of cardiovascular disease (CVD) in the United States, including a brief review of the underlying pathophysiology and epidemiology. This article presents a discussion of the latest American Heart Association guidelines that introduce the concept of promoting ideal cardiovascular health, defined by seven identified metrics. Specific CVD risk factors and utilization of the 10-year CVD event prediction calculator are discussed. In addition, current management recommendations of health-related conditions that increase risk for CVD, such as hypertension and hypercholesterolemia, are provided. Finally, a discussion of detailed evidence-based lifestyle recommendations to promote cardiovascular health and reduce CVD risks concludes the update. PMID:26156147

  4. Risk of Cardiovascular Disease Using Framingham Risk Score in Korean Cancer Survivors

    Science.gov (United States)

    So, Ji-Hyun; Shin, Jin-Young; Park, Wan

    2016-01-01

    Background Cardiovascular disease is an important cause of morbidity and mortality in cancer survivors. The aim of this study was to investigate the modifiable cardiovascular disease risk factors and 10-year probability of the disease based on the Framingham risk score in cancer survivors, compared with the general population. Methods A total of 1,225 cancer survivors and 5,196 non-cancer controls who participated in the 2007–2013 Korea National Health and Nutrition Examination Surveys were enrolled. We assessed modifiable cardiovascular disease risk factors including smoking, body mass index, physical inactivity, high blood pressure, high cholesterol, and elevated blood glucose level. The 10-year probability of cardiovascular disease was determined by applying the Framingham cardiovascular disease risk equation among cancer survivors and non-cancer controls, ranging from 30 to 74 years old who had no overt cardiovascular diseases. Results The proportion of subjects who had higher fasting glucose levels, hemoglobin A1c levels, systolic blood pressure, and low density lipoprotein cholesterol levels, and those who had lower high density lipoprotein cholesterol levels was significantly higher in the cancer survivors than in the non-cancer controls. The average 10-year probability of cardiovascular disease among the cancer survivors was higher than that in the non-cancer controls in both men and women. The average 10-year probability of cardiovascular disease in relation to the cancer type was significantly higher in patients with hepatic, colon, lung, breast, and gastric cancer. Conclusion Cancer survivors have a higher cardiovascular disease risk and 10-year probability of cardiovascular disease than non-cancer controls. Control of cardiovascular disease risk factors and implementation of a well-defined cardiovascular disease prevention program are needed for treating cancer survivors. PMID:27468342

  5. Cardiovascular risk prediction: the old has given way to the new but at what risk-benefit ratio?

    Directory of Open Access Journals (Sweden)

    Yeboah J

    2014-10-01

    Full Text Available Joseph Yeboah Heart and Vascular Center of Excellence, Wake Forest University School of Medicine, Winston-Salem, NC, USA Abstract: The ultimate goal of cardiovascular risk prediction is to identify individuals in the population to whom the application or administration of current proven lifestyle modifications and medicinal therapies will result in reduction in cardiovascular disease events and minimal adverse effects (net benefit to society. The use of cardiovascular risk prediction tools dates back to 1976 when the Framingham coronary heart disease risk score was published. Since then a lot of novel risk markers have been identified and other cardiovascular risk prediction tools have been developed to either improve or replace the Framingham Risk Score (FRS. In 2013, the new atherosclerotic cardiovascular disease risk estimator was published by the American College of Cardiology and the American Heart Association to replace the FRS for cardiovascular risk prediction. It is too soon to know the performance of the new atherosclerotic cardiovascular disease risk estimator. The risk-benefit ratio for preventive therapy (lifestyle modifications, statin +/− aspirin based on cardiovascular disease risk assessed using the FRS is unknown but it was assumed to be a net benefit. Should we also assume the risk-benefit ratio for the new atherosclerotic cardiovascular disease risk estimator is also a net benefit? Keywords: risk prediction, prevention, cardiovascular disease

  6. Lifestyle dominates cardiovascular risks in Malaysia

    OpenAIRE

    Khalib A. Latiff; Khairul H. Yusof

    2008-01-01

    Cardiovascular problem is one of the leading cause of death in Malaysia and now invaded to the sub-urban and rural areas. To prevent and control of this problem, several main risk factors needed to be known and shall be reexamined and ranked according to the priority. The objectives of this research paper was to identify several dominant risk factor related to cardiovascular problem. A cross sectional study was carried out from March 2000 – June 2001 on a total of 8159 rural population aged 1...

  7. The Wild Wild West: A Framework to Integrate mHealth Software Applications and Wearables to Support Physical Activity Assessment, Counseling and Interventions for Cardiovascular Disease Risk Reduction.

    Science.gov (United States)

    Lobelo, Felipe; Kelli, Heval M; Tejedor, Sheri Chernetsky; Pratt, Michael; McConnell, Michael V; Martin, Seth S; Welk, Gregory J

    2016-01-01

    Physical activity (PA) interventions constitute a critical component of cardiovascular disease (CVD) risk reduction programs. Objective mobile health (mHealth) software applications (apps) and wearable activity monitors (WAMs) can advance both assessment and integration of PA counseling in clinical settings and support community-based PA interventions. The use of mHealth technology for CVD risk reduction is promising, but integration into routine clinical care and population health management has proven challenging. The increasing diversity of available technologies and the lack of a comprehensive guiding framework are key barriers for standardizing data collection and integration. This paper reviews the validity, utility and feasibility of implementing mHealth technology in clinical settings and proposes an organizational framework to support PA assessment, counseling and referrals to community resources for CVD risk reduction interventions. This integration framework can be adapted to different clinical population needs. It should also be refined as technologies and regulations advance under an evolving health care system landscape in the United States and globally. PMID:26923067

  8. Assessment of cardiovascular risks due to methylphenidate in six months of treatment in children with attention deficit and hyperactivity disorder

    Directory of Open Access Journals (Sweden)

    mehmet emre ari

    2014-01-01

    Conclusions: In ADHD patients, the elongation of QTc duration and increase in the systolic and diastolic blood pressures were statistically significant during 6 months of methylphenidate treatment. However, all these changes remained within normal limits. All patients receiving this drug should be monitored carefully for cardiovascular side effects.

  9. Estimation of Cardiovascular Risk in Patients with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Belkis Vicente Sánchez

    2015-09-01

    Full Text Available Background: diabetes mellitus accelerates atherosclerotic changes throughout the vascular tree and consequently increases the risk of developing fatal acute events. Objective: to estimate the global cardiovascular risk in patients with type 2 diabetes mellitus. Method: a cross-sectional study of a series of type 2 diabetic patients from the People's Council of Constancia, Abreus municipality, Cienfuegos province was conducted from July to December 2012. The universe comprised the 180 people with diabetes in the area. Variables studied were: age, sex, body mass index, nutritional assessment, blood pressure, toxic habits, associated chronic diseases, blood levels of glucose, lipids (total cholesterol and triglycerides and microalbuminuria. World Health Organization/International Society of Hypertension prediction charts specific to the region of the Americas, in which Cuba is included, were used to estimate the cardiovascular risk. Results: mean age was 61.63 years and females predominated. Relevant risk factors were hypertension followed by obesity, smoking and dyslipidemia. Mean body mass index was 27.66kg/m2; waist circumference was 94.45 cm in women and 96.86 cm in men. Thirty point six percent had more than two uncontrolled risk factors and 28.3 % of the total presented a high to very high cardiovascular risk. Conclusions: cardiovascular risk prediction charts are helpful tools for making clinical decisions, but their interpretation must be flexible and allow the intervention of clinical reasoning.

  10. Lifestyle factors and risk of cardiovascular diseases

    NARCIS (Netherlands)

    Hoevenaar-Blom, M.P.

    2013-01-01

     Background Evidence is accumulating that lifestyle factors influence the incidence of fatal and non-fatal cardiovascular diseases (CVD). A healthy diet, being physically active, moderate alcohol consumption and not smoking are associated with a lower CVD risk. In addition to

  11. AGE, ARTERIAL STIFFNESS AND CARDIOVASCULAR RISK

    Institute of Scientific and Technical Information of China (English)

    蒋雄京; 刘国仗; 刘力生

    2001-01-01

    The recent researches on the structure and function of large artery find that increasing pulse pressure is associated with greater cardiovascular risk, especially risk of coronary events. Such risk is not explicable on the basis of increasing systolic pressure with age, and is apparent even when the major reason for increased pulse pressure is a relative decrease of diastolic pressure. The finding challenges the conventional approach to arterial pressure where diastolic pressure is traditionally viewed as the most robust indicator of caridovascular risk. An explanation is available. This is based on the perception of Harriet Dustan that hypertension in the older popula-

  12. Hypertriglyceridemia and Cardiovascular Risk Reduction

    Science.gov (United States)

    Elevated triglyceride (TG) levels are prevalent among the US population, often occurring in persons who are overweight or obese, or who have type 2 diabetes or the metabolic syndrome. Meta-analysis indicates that elevated TG levels may be a significant independent risk factor for coronary heart dise...

  13. Estimation of serum insulin, Homeostasis model assessment-insulin resistance and C-peptide can help identify possible cardiovascular disease risk in thyroid disorder patients

    Directory of Open Access Journals (Sweden)

    Purvi Purohit

    2012-01-01

    Full Text Available Aim: We aimed at evaluating the cardiovascular disease (CVD risk of thyroid disorder patients at diagnosis, using the traditional lipid profile, apo-B and apo-A1 in correlation with serum insulin and insulin resistance (IR and C-peptide. Background: With an ever increasing incidence of CVD in most urban populations, there has been a demand for newer techniques that could help in the early detection of the risk of this disease complex. Materials and Methods: The present study was conducted on 100 healthy controls and 150 hypothyroid and 70 hyperthyroid patients, coming for the first time to our OPDs. The patients were selected on the basis of symptomatology and serum T3, T4, thyroid stimulating hormone (TSH evaluations. They were then analyzed for body mass index (BMI, blood pressure (BP, serum insulin, homeostasis model assessment-insulin resistance (HOMA-IR, C-peptide, lipid profile and apo-B and -A1. Statistical analysis was done using Student′s "t" test and Spearman′s coefficient of correlation. Results: The hypothyroid patients presented with high BMI, diastolic hypertension, dyslipidemia, hyperinsulinemia, IR and raised serum C-peptide. There was highly significant correlation of serum insulin, HOMA-IR and C-peptide with lipid fractions and CVD risk ratios, T. chol/HDLc and apo-B/apo-A1, in hypothyroid patients. The hyperthyroid patients presented with systolic hypertension and a significant correlation of T. chol/HDLc with HOMA-IR. Hyperthyroid patients also had hyperinsulinemia, but reduced serum C-peptide levels. Conclusion: We conclude that the estimation of traditional lipid profile along with serum insulin, IR, C-peptide, apo-A1 and apo-B would not only help assess the thyroid status, but can also help in the early evaluation of a possible risk of CVD.

  14. [Prognostic assessment for formation of a group of cardiovascular high risk among personnel participating in atomic submarines utilization].

    Science.gov (United States)

    Sosiukin, A E; Vasiliuk, V B; Ivanchenko, A V; Saenko, S A; Semenchuk, O A; Dokhov, M A; Verveda, A B

    2014-01-01

    Ultrasound scanning of main vessels (common carotid, internal carotid, common and superficial femoral, posterior tibial arteries) in staffers of shipyard "Nerpa"--branch of JSC "Shipbuilding center Zvezdochka" (Snezhnogorsk city Murmansk region)--engaged into atomic submarines utilization. Findings are atherosclerotic changes in common carotid and common femoral arteries--increased thickness of intima-media complex over the reference values or atherosclerotic plaque formation. The changes were maximal in a group of males aged over 50 with length of service over 25 years. Discriminant analysis helped to suggest a mathematic model to forecast cardiovascular diseases in personnel of "Nerpa" shipyard. PMID:25845142

  15. The Finnish Cardiovascular Study (FINCAVAS: characterising patients with high risk of cardiovascular morbidity and mortality

    Directory of Open Access Journals (Sweden)

    Niemi Mari

    2006-03-01

    Full Text Available Abstract Background The purpose of the Finnish Cardiovascular Study (FINCAVAS is to construct a risk profile – using genetic, haemodynamic and electrocardiographic (ECG markers – of individuals at high risk of cardiovascular diseases, events and deaths. Methods and design All patients scheduled for an exercise stress test at Tampere University Hospital and willing to participate have been and will be recruited between October 2001 and December 2007. The final number of participants is estimated to reach 5,000. Technically successful data on exercise tests using a bicycle ergometer have been collected of 2,212 patients (1,400 men and 812 women by the end of 2004. In addition to repeated measurement of heart rate and blood pressure, digital high-resolution ECG at 500 Hz is recorded continuously during the entire exercise test, including the resting and recovery phases. About 20% of the patients are examined with coronary angiography. Genetic variations known or suspected to alter cardiovascular function or pathophysiology are analysed to elucidate the effects and interactions of these candidate genes, exercise and commonly used cardiovascular medications. Discussion FINCAVAS compiles an extensive set of data on patient history, genetic variation, cardiovascular parameters, ECG markers as well as follow-up data on clinical events, hospitalisations and deaths. The data enables the development of new diagnostic and prognostic tools as well as assessments of the importance of existing markers.

  16. Cardiovascular risk in pulmonary alveolar proteinosis.

    Science.gov (United States)

    Manali, Effrosyni D; Papadaki, Georgia; Konstantonis, Dimitrios; Tsangaris, Iraklis; Papaioannou, Andriana I; Kolilekas, Likurgos; Schams, Andrea; Kagouridis, Konstantinos; Karakatsani, Anna; Orfanos, Stylianos; Griese, Matthias; Papiris, Spyros A

    2016-02-01

    We hypothesized that cardiovascular events and/or indices of cardiac dysfunction may be increased in pulmonary alveolar proteinosis (PAP). Systemic and pulmonary arterial hypertension, arrhythmias, pulmonary embolism, stroke and ischemic heart attack were reported. Patients underwent serum anti-GM-CSF antibodies, disease severity score (DSS), Doppler transthoracic echocardiograph, glucose, thyroid hormones, lipids, troponin and pro-Brain natriuretic peptide (BNP) examination. Thirteen patients (8 female) were studied, median age of 47. Pro-BNP inversely related to DLCO% and TLC%; troponin directly related to DSS, age, P(A-a)O2, left atrium-, left ventricle-end-diastole diameter and BMI. On multiple regression analysis DSS was the only parameter significantly and strongly related with troponin (R(2) = 0.776, p = 0.007). No cardiovascular event was reported during follow-up. In PAP cardiovascular risk indices relate to lung disease severity. Therefore, PAP patients could be at increased risk for cardiovascular events. Quantitation of its magnitude and potential links to lungs' physiologic derangement will be addressed in future studies. PMID:26558331

  17. [Helicobacter pylori: a new cardiovascular risk factor?].

    Science.gov (United States)

    Martínez Torres, Alejandra; Martínez Gaensly, Miguel

    2002-06-01

    There is increasing evidence that certain microbial agents may have an etiopathogenic role in the development of atherothrombosis. Helicobacter pylori, a bacterium that causes peptic ulcer disease, has been suggested as one of the microbes involved in the development of atherothrombosis. This hypothesis is based on the following observations: a) a higher prevalence of Helicobacter pylori infection in patients with coronary artery disease, myocardial infarction, or cerebrovascular disease; b) the coincidence of Helicobacter pylori infection and cardiovascular risk factors, such as serum cholesterol and triglyceride concentrations and plasma fibrinogen; c) Helicobacter pylori seropositivity correlates with acute-phase proteins associated with higher risk of coronary disease, such as C-reactive protein, and d) controversial PCR studies indicating the presence of Helicobacter pylori in atheromas. Analysis of the scientific evidence suggests that Helicobacter pylori infection could indirectly contribute to the development and severity of atherothrombosis and cardiovascular disease. PMID:12113724

  18. Periodontitis and Calculated Risk of Cardiovascular Mortality

    OpenAIRE

    Boutouyrie, P.; P. Bouchard; C. Mattout; Bourgeois, D.

    2008-01-01

    Epidemiological studies have reported associations between periodontitis and vascular disease in Europe. The aim of this multi-centric study was to evaluate the relationship between periodontitis and the calculated risk of cardiovascular death in the French adult population. The survey employed 2144 dentate adult subjects of the First National Periodontal and Systemic Examination Survey (NPASES I). This nationally representative sample was obtained by a quota method. The subjects had a compl...

  19. CARDIOVASCULAR RISK FACTORS IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

    Directory of Open Access Journals (Sweden)

    Ye. D. Bazdyrev

    2014-11-01

    Full Text Available Objective: to detect previously undiagnosed arterial hypertension in patients with chronic obstructive pulmonary disease (COPD as a risk factor for cardiovascular mortality.Materials and methods. 43 patients with stage I–II of COPD and the absence of clinical signs of cardiovascular diseases were examined. Spirometry, body plethysmography and diffusing lung capacity (DLCO were included in the respiratory system assessment. The cardiovascular system was assessed with echocardiography and ambulatory blood pressure monitoring (ABPM.Results. Despite the absence of obvious signs of cardiovascular lesions (an increase of office blood pressure, intracardiac hemodynamic changes, the following cardiovascular risk factors were identified: age (58.2 ± 2.0 years, male gender, smoking, hypercholesterolemia and dyslipidemia (total cholesterol 5.9 ± 0.9 mmol / l, low density lipoproteins 3.8 ± 0.5 mmol / l, triglycerides 1.8 ± 0.2 mmol / l. Correlation analysis has revealed the relation between several respiratory parameters and the severity of dyspnea and quality of life in patients with COPD, as well as its relation with lipid levels.Conclusion. The patients with COPD have a large number of risk factors for CVD. According to ABPM data, arterial hypertension was verified in 18 (41.9 % of 43 patients with COPD at normal level of office blood pressure; moreover, 51.2 % of patients demonstrated low reduction of blood pressure during the night-time that nowadays, is considered to be a predictor of cardiovascular disease and sudden death.

  20. Epigenetic Changes in Diabetes and Cardiovascular Risk.

    Science.gov (United States)

    Keating, Samuel T; Plutzky, Jorge; El-Osta, Assam

    2016-05-27

    Cardiovascular complications remain the leading causes of morbidity and premature mortality in patients with diabetes mellitus. Studies in humans and preclinical models demonstrate lasting gene expression changes in the vasculopathies initiated by previous exposure to high glucose concentrations and the associated overproduction of reactive oxygen species. The molecular signatures of chromatin architectures that sensitize the genome to these and other cardiometabolic risk factors of the diabetic milieu are increasingly implicated in the biological memory underlying cardiovascular complications and now widely considered as promising therapeutic targets. Atherosclerosis is a complex heterocellular disease where the contributing cell types possess distinct epigenomes shaping diverse gene expression. Although the extent that pathological chromatin changes can be manipulated in human cardiovascular disease remains to be established, the clinical applicability of epigenetic interventions will be greatly advanced by a deeper understanding of the cell type-specific roles played by writers, erasers, and readers of chromatin modifications in the diabetic vasculature. This review details a current perspective of epigenetic mechanisms of macrovascular disease in diabetes mellitus and highlights recent key descriptions of chromatinized changes associated with persistent gene expression in endothelial, smooth muscle, and circulating immune cells relevant to atherosclerosis. Furthermore, we discuss the challenges associated with pharmacological targeting of epigenetic networks to correct abnormal or deregulated gene expression as a strategy to alleviate the clinical burden of diabetic cardiovascular disease. PMID:27230637

  1. Physical inactivity : A cardiovascular risk factor

    Directory of Open Access Journals (Sweden)

    Prasad D

    2009-01-01

    Full Text Available Evidence regarding health benefits of physical activity is overwhelming and plays a critical role in both the primary and secondary prevention of coronary artery disease (CAD. Epidemiological investigations show approximately half the incidence of CAD in active compared to sedentary persons. A sedentary lifestyle is considered by various national and international organizations to be one of the most important modifiable risk factors for cardiovascular morbidity and mortality. Fortunately, a moderate level of occupational or recreational activity appears to confer a significant protective effect. Once coronary artery disease has become manifest, exercise training can clearly improve the functional capacity of patients and reduce overall mortality by decreasing the risk of sudden death. Well-designed clinical investigations, supported by basic animal studies, have demonstrated that the beneficial effects of exercise are related to direct and indirect protective mechanisms. These benefits may result from an improvement in cardiovascular risk factors, enhanced fibrinolysis, improved endothelial function, decreased sympathetic tone, and other as-yet-undetermined factors. Hence physical fitness, more than the absence of ponderosity or other factors, is the major determinant of cardiovascular and metabolic risk and long-term disease-free survival, in effect linking health span to life span. It is obviously in every individual′s interest to assume the responsibility for his or her own health and embrace this extremely effective, safe, and inexpensive treatment modality. The need for a comprehensive review of this particular topic has arisen in view of the high prevalence of physical inactivity and overwhelming evidence regarding CVD risk reduction with regular physical activity.

  2. Association Between Leisure Time Physical Activity, Cardiopulmonary Fitness, Cardiovascular Risk Factors, and Cardiovascular Workload at Work in Firefighters

    OpenAIRE

    Clare C. W. Yu; Au, Chun T.; Lee, Frank Y.F.; So, Raymond C.H.; Wong, John P.S.; Mak, Gary Y.K.; Chien, Eric P.; Alison M. McManus

    2015-01-01

    Background Overweight, obesity, and cardiovascular disease risk factors are prevalent among firefighters in some developed countries. It is unclear whether physical activity and cardiopulmonary fitness reduce cardiovascular disease risk and the cardiovascular workload at work in firefighters. The present study investigated the relationship between leisure-time physical activity, cardiopulmonary fitness, cardiovascular disease risk factors, and cardiovascular workload at work in firefighters i...

  3. Oral contraception and cardiovascular risk factors during adolescence

    OpenAIRE

    Paulus, Dominique; Saint-Remy, Annie; JeanJean, Michel

    2000-01-01

    The objective of the present study was to analyze the pattern of oral contraceptive (OC) use in teenagers and to examine the relationship between OC use and other cardiovascular risk factors. The study was conducted in 24 Belgian secondary schools. Most students (1526 adolecents aged 12-17 years) agreed to participate (participation rate: 83.6%). Smoking, physical activity habits, menarche, and OC use were assessed by a self-administered questionnaire. Total cholesterol level, blood press...

  4. Use of Chronic Kidney Disease to Enhance Prediction of Cardiovascular Risk in Those at Medium Risk

    OpenAIRE

    Chia, Yook Chin; Lim, Hooi Min; Ching, Siew Mooi

    2015-01-01

    Based on global cardiovascular (CV) risk assessment for example using the Framingham risk score, it is recommended that those with high risk should be treated and those with low risk should not be treated. The recommendation for those of medium risk is less clear and uncertain. We aimed to determine whether factoring in chronic kidney disease (CKD) will improve CV risk prediction in those with medium risk. This is a 10-year retrospective cohort study of 905 subjects in a primary care clinic s...

  5. Development of a Community-Wide Cardiovascular Risk Reduction Assessment Tool for Small Rural Employers in Upstate New York

    OpenAIRE

    Liss-Levinson, Rivka C.; Goetzel, Ron Z.; Goodman, Nanette; Kennedy, James X.

    2009-01-01

    Employers are implementing workplace health promotion programs that address modifiable health risk factors such as overweight and obesity, smoking, high blood pressure, high cholesterol, physical inactivity, poor diet, and high stress. Research with large employers has found that these programs can improve workers' health and decrease the costs associated with medical care, absenteeism, and presenteeism. Despite their promise, health promotion programs are not widely embraced by small busines...

  6. Community Based Assessment of Biochemical Risk Factors for Cardiovascular Diseases in Rural and Tribal Area of Himalayan Region, India

    OpenAIRE

    Ashok Kumar Bhardwaj; Dinesh Kumar; Sunil Kumar Raina; Pradeep Bansal; Satya Bhushan; Vishav Chander

    2013-01-01

    Context. Evident change in nutrition and lifestyle among individuals of urban and rural areas raises suspicion for similar change in tribal area population of India. Aim. To study the biochemical risk factor for CVDs in rural and tribal population of Sub-Himalayan state of India. Settings and Design. Cross-sectional study in rural (low altitude) and tribal (high altitude) area of Himachal Pradesh, India. Methodology. Blood lipid profile using standard laboratory methods. Statistical Analysis....

  7. Cardiovascular risk and cardiometabolic protection: role of glitazones.

    Science.gov (United States)

    Petrazzi, Luisa; Grassi, Davide; Polidoro, Lorella; D'Aurelio, Azzurra; Croce, Giuseppe; Properzi, Giuliana; Tiberti, Sergio; Desideri, Giovambattista; Ferri, Claudio

    2008-01-01

    Thiazolidinediones (TZDs) are widely used in the type 2 diabetes mellitus (DMT2) treatment but have also been tested in cardiovascular prevention. DMT2 is associated with a marked increment in cardiovascular risk, and its prevention represents a main target in cardiometabolic protection. Both Troglitazone (Troglitazone in Prevention of Diabetes study) and Rosiglitazone (Diabetes Reduction Assessment with Ramipril and Rosiglitazone Medication study) significantly reduced new-onset diabetes. A similar topic will be investigated with pioglitazone (Actos Now for Prevention of Diabetes). In the Prospective Pioglitazone Clinical Trial in Macrovascular events the primary end point (all-cause mortality, nonfatal myocardial infarction, stroke, acute coronary syndromes, endovascular or surgical intervention in the coronary/leg arteries and amputation above ankles) was unaffected, whereas the secondary one (all-cause mortality, nonfatal myocardial infarction and stroke) was reduced by pioglitazone (-16%, p=0.027) compared to placebo in 5,238 patients with DMT2 and macrovascular disease. In contrast, a meta-analysis (Nissen and Wolski, N Engl J Med. 2007;356:2457-2471) reported that rosiglitazone treatment is associated with a significant increase in myocardial infarction risk (p=0.03) and a borderline significant increase in the risk of death from cardiovascular causes (p=0.06). Nevertheless, the possibility that rosiglitazone might affect cardiovascular events should be evaluated by the ongoing trial Rosiglitazone Evaluated for Cardiac Outcomes and Regulation of Glycemia in Diabetes (RECORD). Interim findings early from RECORD did not show significant differences between the rosiglitazone and the control group regarding myocardial infarction and death from cardiovascular and any cause. Additional large-scale trials are awaited to clarify the of role TZDs in cardiovascular outcomes. PMID:19034866

  8. Overweight in Childhood, Adolescence and Adulthood and Cardiovascular Risk in Later Life: Pooled Analysis of Three British Birth Cohorts

    OpenAIRE

    Park, MH; Sovio, U.; Viner, RM; Hardy, RJ; Kinra, S.

    2013-01-01

    BACKGROUND Overweight and obesity in adulthood are established risk factors for adverse cardiovascular outcomes, but the contribution of overweight in childhood to later cardiovascular risk is less clear. Evidence for a direct effect of childhood overweight would highlight early life as an important target for cardiovascular disease prevention. The aim of this study was to assess whether overweight and obesity in childhood and adolescence contribute to excess cardiovascular risk in adults. ...

  9. Early cardiovascular risk markers and cardiac function in children with chronic kidney disease

    OpenAIRE

    Tranæus Lindblad, Ylva

    2016-01-01

    Children with advanced chronic kidney disease (CKD) have an increased risk of premature death, foremost due to cardiovascular disease (CVD). The cardiovascular (CV) morbidity starts early in the disease process and renal transplanted children (CKD-T) are also at risk. Aims: The overall aim of this thesis was to study CV morbidity and potential risk factors in pediatric CKD and CKD-T patients. The prevalence of various known biomarkers associated with increased risk of CVD was assessed ...

  10. Cardiovascular risk assessment in diabetes mellitus: comparison of the general Framingham risk profile versus the World Health Organization/International Society of Hypertension risk prediction charts in Arabs--clinical implications.

    Science.gov (United States)

    Al-Lawati, Jawad A; Barakat, Mohammed N; Al-Lawati, Najla A; Al-Maskari, Masoud Y; Elsayed, Medhat K; Mikhailidis, Dimitri P; Al-Zakwani, Ibrahim S

    2013-07-01

    We estimated the prevalence of cardiovascular disease (CVD) risk and its clinical implications among 1 110 Omani patients with type 2 diabetes mellitus (DM) using 2 different CVD risk tools: the general Framingham risk profile (GFRP) and the joint World Health Organization/International Society of Hypertension (WHO/ISH) risk prediction charts. The GFRP tool identified higher proportion of patients compared with joint WHO/ISH tool at 10-year CVD risk 10% to GFRP identified almost double the number of men eligible for aspirin treatment at CVD risk thresholds of ≥10% (86% vs 43%). In women, the proportions were, 66% and 45%, respectively. For statins, the figures were, 60% and 37%, for men and 28% and 36%, for women. In conclusion, the GFRP overestimates the number of patients eligible for primary prevention of CVD compared with the joint WHO/ISH method. PMID:22942129

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

    OpenAIRE

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

    2005-01-01

    Objective: 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. Design: Population based prospective cohort study with baseline assessment in 1980. Setting: Finland. Participants: 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. Mai...

  12. DETERMINING CARDIOVASCULAR DISEASE RISK IN ELEMENTARY SCHOOL CHILDREN:

    Directory of Open Access Journals (Sweden)

    Kate E. Reed

    2007-03-01

    Full Text Available At least 50% of children have one or more cardiovascular disease (CVD risk factor. We aimed to 1 determine the prevalence of CVD risk factors in a sample of Canadian children, and 2 create a Healthy Heart Score that could be used in a school setting, to identify children with a greater number and severity of CVD risk factors. Children (n = 242, 122M, 120F, aged 9-11 years were assessed for cardiovascular fitness, physical activity, systolic/diastolic blood pressure, and body mass index (BMI. Biological values were converted to age and sex specific percentiles and allocated a score. Healthy Heart Scores could range between 5 and 18, with lower scores suggesting a healthier cardiovascular profile. Seventy-seven children volunteered for blood samples in order to assess the relationship between the Healthy Heart Score and (total cholesterol (TC, high and low-density lipoprotein cholesterol (HDL, LDL and triglycerides (TG. Fifty eight percent of children had elevated scores for at least 1 risk factor. The group mean Healthy Heart Score was 8 (2.2. The mean score was significantly higher in boys (9 (2.2 compared with girls (8 (2.1, p < 0.01. A high score was significantly associated with a low serum HDL, a high TC:HDL and a high TG concentration. Our results support other studies showing a high prevalence of CVD risk factors in children. Our method of allocation of risk score, according to percentile, allows for creation of an age and sex specific CVD risk profile in children, which takes into account the severity of the elevated risk factor

  13. Cardiovascular Risk Factors of Taxi Drivers.

    Science.gov (United States)

    Elshatarat, Rami Azmi; Burgel, Barbara J

    2016-06-01

    In the United States (U.S.), cardiovascular disease (CVD) is a major leading cause of death. Despite the high mortality rate related to CVD, little is known about CVD risk factors among urban taxi drivers in the U.S. A cross-sectional design was used to identify the predictors of high cardiovascular risk factors among taxi drivers. Convenience sampling method was used to recruit 130 taxi drivers. A structured questionnaire was used to obtain the data. The sample was male (94 %), age mean (45 ± 10.75) years, married (54 %), born outside of the USA (55 %), had some college or below (61.5 %), night drivers (50.8 %), and driving on average 9.7 years and 41 h/week. About 79 % of them were eligible for CVD prevention, and 35.4 % had high CVD risk factors (4-9 risk factors). A CVD high-risk profile had a significant relationship with the subjects who were ≥55 years old; had hypertension, diabetes, or hyperlipidemia; were drinking alcohol ≥2 times/week; and had insufficient physical activity. Subjects who worked as a taxi driver for more than 10 years (OR 4.37; 95 % CI 1.82, 10.50) and had mental exertion from cab driving >5 out of 10 (OR 2.63; 95 % CI 1.05, 6.57) were more likely to have a CVD high-risk profile. As a conclusion, system-level or worksite interventions include offering healthy food at taxi dispatching locations, creating a work culture of frequent walking breaks, and interventions focusing on smoking, physical activity, and weight management. Improving health insurance coverage for this group of workers is recommended. PMID:27151321

  14. Atherosclerotic plaque volume and composition in symptomatic carotid arteries assessed with multidetector CT angiography; relationship with severity of stenosis and cardiovascular risk factors

    OpenAIRE

    Rozie, S.; de Weert, T. T.; de Monyé, C.; Homburg, P. J.; Tanghe, H L J; Dippel, D W J; van der Lugt, A.

    2009-01-01

    The purpose of this study was to examine the volume and the composition of atherosclerotic plaque in symptomatic carotid arteries and to investigate the relationship between these plaque features and the severity of stenosis and the presence of cardiovascular risk factors. One hundred patients with cerebrovascular symptoms underwent CT angiography. We measured plaque volume (PV) and the relative contribution of plaque components (calcifications, fibrous tissue, and lipid) in the symptomatic a...

  15. Assessing salivary C-reactive protein: Longitudinal associations with systemic inflammation and cardiovascular disease risk in women exposed to intimate partner violence

    OpenAIRE

    Out, Dorothée; Hall, Rosalie J.; Granger, Douglas A.; Page, Gayle G.; Woods, Stephanie J.

    2012-01-01

    This study evaluated individual differences in levels of C-reactive protein (CRP) measured in saliva, cross-sectionally and prospectively, in relation to systemic inflammation and risk for cardiovascular disease (CVD). Plasma and saliva samples, later assayed for CRP, were collected multiple times from an ethnically diverse group of women seeking help from domestic violence crisis shelters-agencies (N = 107; mean age at study start = 34 years). Plasma and saliva CRP levels were moderately ass...

  16. Lifestyle Decreases Risk Factors for Cardiovascular Diseases

    OpenAIRE

    Slavíček, Jaroslav; Kittnar, Otomar; Fraser, Gary E.; Medová, Eva; Konečná, Jana; Žižka, Robert; Dohnalová, Alena; Novák, Vladimír

    2008-01-01

    The morbidity and mortality of the cardiovascular diseases is high in the developed countries. The lifestyle changes are capable to decrease it by 50%. The aim of the present study was to measure the parameters of some risk factors before and after a one-week NEW START rehabilitative retreat. 1,349 volunteers, 320 men, 1,029 woman, mean age 51±14.5 (SD) years participated in 30 rehabilitative retreats from 1999–2006 in the Czech Republic, using a low-fat, low-energy, lacto-ovo-vegetarian diet...

  17. Atherosclerotic plaque volume and composition in symptomatic carotid arteries assessed with multidetector CT angiography; relationship with severity of stenosis and cardiovascular risk factors

    International Nuclear Information System (INIS)

    The purpose of this study was to examine the volume and the composition of atherosclerotic plaque in symptomatic carotid arteries and to investigate the relationship between these plaque features and the severity of stenosis and the presence of cardiovascular risk factors. One hundred patients with cerebrovascular symptoms underwent CT angiography. We measured plaque volume (PV) and the relative contribution of plaque components (calcifications, fibrous tissue, and lipid) in the symptomatic artery. The contribution of different components was measured as the number of voxels within defined ranges of HU values (calcification >130 HU, fibrous tissue 60-130 HU, lipid core <60 HU). Fifty-seven patients had atherosclerotic plaque in the symptomatic carotid artery. The severity of stenosis and PV were moderately correlated. Age and smoking were independently related to PV. Patients with hypercholesterolemia had significantly less lipid and more calcium in their plaques than patients without hypercholesterolemia. Other cardiovascular risk factors were not significantly related to PV or plaque composition. Luminal stenosis of the carotid artery partly reflects the amount of atherosclerotic carotid disease. Plaque volume and plaque composition are associated with cardiovascular risk factors. (orig.)

  18. Atherosclerotic plaque volume and composition in symptomatic carotid arteries assessed with multidetector CT angiography; relationship with severity of stenosis and cardiovascular risk factors

    Energy Technology Data Exchange (ETDEWEB)

    Rozie, S.; Weert, T.T. de; Monye, C. de; Homburg, P.J.; Tanghe, H.L.J.; Lugt, A. van der [Erasmus MC, University Medical Center Rotterdam, Departments of Radiology, Rotterdam (Netherlands); Dippel, D.W.J. [Erasmus MC, University Medical Center Rotterdam, Department of Neurology, PO Box 2040, Rotterdam (Netherlands)

    2009-09-15

    The purpose of this study was to examine the volume and the composition of atherosclerotic plaque in symptomatic carotid arteries and to investigate the relationship between these plaque features and the severity of stenosis and the presence of cardiovascular risk factors. One hundred patients with cerebrovascular symptoms underwent CT angiography. We measured plaque volume (PV) and the relative contribution of plaque components (calcifications, fibrous tissue, and lipid) in the symptomatic artery. The contribution of different components was measured as the number of voxels within defined ranges of HU values (calcification >130 HU, fibrous tissue 60-130 HU, lipid core <60 HU). Fifty-seven patients had atherosclerotic plaque in the symptomatic carotid artery. The severity of stenosis and PV were moderately correlated. Age and smoking were independently related to PV. Patients with hypercholesterolemia had significantly less lipid and more calcium in their plaques than patients without hypercholesterolemia. Other cardiovascular risk factors were not significantly related to PV or plaque composition. Luminal stenosis of the carotid artery partly reflects the amount of atherosclerotic carotid disease. Plaque volume and plaque composition are associated with cardiovascular risk factors. (orig.)

  19. Risk assessment

    International Nuclear Information System (INIS)

    The report is in sections, entitled: preface; summary and conclusions; introduction (historical and organizational); estimating engineering risks (techniques of risk estimation and forms of expression of risk); laboratory experiments for estimation of biological risks; estimation of risk from observations on man (travel, medical procedures; occupations; sport); the perception of risks; (as an example of attitudes towards a single hazard, studies of nuclear power are considered among other topics in this section); risk management (estimation; perception; acceptability, analysis of risk, costs and benefits; safety standards; decision-making process; possible guidelines). (U.K.)

  20. Retinal vascular calibres are significantly associated with cardiovascular risk factors

    DEFF Research Database (Denmark)

    von Hanno, T.; Bertelsen, G.; Sjølie, Anne K.;

    2014-01-01

    . Association between retinal vessel calibre and the cardiovascular risk factors was assessed by multivariable linear and logistic regression analyses. Results: Retinal arteriolar calibre was independently associated with age, blood pressure, HbA1c and smoking in women and men, and with HDL cholesterol in men......Purpose: To describe the association between retinal vascular calibres and cardiovascular risk factors. Methods: Population-based cross-sectional study including 6353 participants of the TromsO Eye Study in Norway aged 38-87years. Retinal arteriolar calibre (central retinal artery equivalent) and...... retinal venular calibre (central retinal vein equivalent) were measured computer-assisted on retinal photographs. Data on blood pressure, body mass index (BMI), high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, glycosylated haemoglobin (HbA1c) and smoking were collected...

  1. Mediterranean Diet and Cardiovascular Risk: Beyond Traditional Risk Factors.

    Science.gov (United States)

    Delgado-Lista, Javier; Perez-Martinez, Pablo; Garcia-Rios, Antonio; Perez-Caballero, Ana I; Perez-Jimenez, Francisco; Lopez-Miranda, Jose

    2016-04-01

    A strict adherence to the Mediterranean Diet (MedDiet) has repeatedly been linked to a low risk of cardiovascular disease in several situations. Initially, the mechanisms considered as possible causes of this were based on the effects of this dietary pattern on the so-called traditional risk factors (especially lipids and blood pressure). However, the high relative reduction in the prevalence of cardiovascular morbidity and mortality were not proportional to the limited findings about regulation of those traditional risk factors. In addition to several studies confirming the above effects, current research on the MedDiet is being focused on defining its effects on non-traditional risk factors, such as endothelial function, inflammation, oxidative stress, or on controlling the conditions which predispose people to cardiovascular events, such as obesity, metabolic syndrome or type 2 diabetes mellitus. In the current article, after briefly reviewing the known effects of the MedDiet on the traditional risk factors, we will mainly focus on reviewing the current evidence about the effects that this dietary pattern exerts on alternative factors, including postprandial lipemia or coagulation, among others, as well as providing a short review on future directions. PMID:25118147

  2. Cardiovascular risk in carotid disease: assessment of doppler sonography and biomarker results Risco cardiovascular e doença carotídea: avaliação de resultados de doppler e biomarcadores

    Directory of Open Access Journals (Sweden)

    Rogério Jorge Barbosa de Oliveira

    2013-02-01

    Full Text Available INTRODUCTION: Atherosclerosis and correlated cardiovascular problems, whose mechanical and physiological disorders cause thickening and hardening of blood vessels, are among the main causes of death worldwide. OBJECTIVE: To assess plasma concentrations of biomarkers from the lipid metabolism and carotid doppler sonography results by correlating them with atherogenic carotid disease. METHODS: the study comprised 66 patients aged 57.5 ± 15.5 years (20-77, from which 63% were female. Serum markers and doppler sonography images were used to evaluate the association with atherogenic carotid disease (ACD. RESULTS: There was a higher prevalence of ACD among females (33% vs. 15%, age range 56-65, showing a relative risk (RR of 1.56 among females (p 40 mg/dl and 19% had HDL-C ≥ 40 mg/dl. The prevalence of HDL-C > 40 mg/dl at levels II, III and IV was considerable. There was no difference in HDL-C among the groups (p = 0.4910; unpaired t test. Furthermore, there was no difference in paraoxonase (PON1 activity when stratified to HDL-C > and 0.05. CONCLUSION: The female group displayed higher ACD prevalence at 56-65 age range, with RR of 1.56 times higher. These findings substantiate the importance of analyzing this group and age range carefully, inasmuch as the absence of hormonal protection may increase ACD risk and ultimately influence HDL antioxidant activity due to its direct action on PON1. Triglycerides (TG/HDL-C ratio indicates cardiovascular risk and impaired reverse cholesterol transport.INTRODUÇÃO: Complicações da aterosclerose agregam as principais causas de morte no mundo por problemas cardiovasculares relativos a distúrbio da condição mecânica e fisiológica que promove espessamento e endurecimento nas artérias. OBJETIVO: Avaliar as concentrações plasmáticas de biomarcadores do metabolismo lipídico e os resultados de doppler de carótidas, relacionando-os com a doença aterogênica de carótidas. MÉTODOS: Foram acompanhados 66

  3. Effects on cardiovascular disease risk of a web-based health risk assessment with tailored health advice: a follow-up study

    OpenAIRE

    Colkesen, Ersen B; Ferket, Bart S; Jan GP Tijssen; et al.

    2011-01-01

    Ersen B Colkesen1,2, Bart S Ferket2,3, Jan GP Tijssen1, Roderik A Kraaijenhagen2, Coenraad K van Kalken2, Ron JG Peters11Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; 2NDDO Institute for Prevention and Early Diagnostics (NIPED), Amsterdam, the Netherlands; 3Department of Epidemiology, Erasmus Medical Center, Rotterdam, the NetherlandsIntroduction: A large proportion of the cardiovascular disease (CVD) burden can potentially be prevente...

  4. Lifestyle decreases risk factors for cardiovascular diseases.

    Science.gov (United States)

    Slavícek, Jaroslav; Kittnar, Otomar; Fraser, Gary E; Medová, Eva; Konecná, Jana; Zizka, Robert; Dohnalová, Alena; Novák, Vladimir

    2008-12-01

    The morbidity and mortality of cardiovascular diseases is high in the developed countries. The lifestyle changes are capable to decrease it by 50%. The aim of the present study was to measure the parameters of some risk factors before and after a one-week NEW START rehabilitative retreat. 1349 volunteers, 320 men, 1029 woman, mean age 51 +/- 14.5 (SD) years participated in 30 rehabilitative retreats from 1999-2006 in the Czech Republic, using a low-fat, low-energy, lacto-ovo-vegetarian diet and exercise, in a stress-free environment. Body weight, height, BMI, blood pressure, heart rate, serum cholesterol and blood glucose were measured. Body weight decreased in 1223 measured persons from 71.2 +/- 14.38 (SD) to 70.6 +/- 14.02 kg (placto-ovo vegetarians and Seventh-day Adventists than in controls who never observed the diet and avail the lifestyle programs. The parameters were nonsignificantly changed one year after finishing the retreat in the sample of 68 persons showing the positive effect of retreats. Our results showed, that the intake of a low-fat, low-energy diet, over the course of one week in a stress-free environment, had positive impact on the risk factors of cardiovascular diseases. PMID:19256282

  5. Patients with psoriasis have an increased risk of cardiovascular diseases

    DEFF Research Database (Denmark)

    Ahlehoff, Ole; Gislason, Gunnar; Lindhardsen, Jesper; Skov, Lone; Hansen, Peter Riis

    2012-01-01

    Psoriasis is a chronic immunoinflammatory disease that affects 2-3% of the population and shares pathophysiologic mechanisms and risk factors with cardiovascular diseases. Studies have suggested psoriasis as an independent risk factor for cardiovascular disease and Danish guidelines on...... cardiovascular risk factor modification in patients with psoriasis and psoriatic arthritis have recently been published. We provide a short review of the current evidence and the Danish guidelines....

  6. Relationship between Sarcopenic Obesity and Cardiovascular Disease Risk as Estimated by the Framingham Risk Score

    OpenAIRE

    Kim, Jeong-Hyeon; Cho, Jung Jin; Park, Yong Soon

    2015-01-01

    This study was conducted to assess the association between sarcopenic obesity and cardiovascular disease (CVD) risk in Korean adults (n=3,320; ≥40 yr) who participated in the 5th Korean National Health and Nutrition Examination Survey in 2010. The appendicular skeletal muscle mass divided by body weight was calculated for each participant; participants with values

  7. Epigenetics and cardiovascular risk in childhood.

    Science.gov (United States)

    Martino, Francesco; Magenta, Alessandra; Pannarale, Giuseppe; Martino, Eliana; Zanoni, Cristina; Perla, Francesco M; Puddu, Paolo E; Barillà, Francesco

    2016-08-01

    Cardiovascular disease (CVD) can arise at the early stages of development and growth. Genetic and environmental factors may interact resulting in epigenetic modifications with abnormal phenotypic expression of genetic information without any change in the nucleotide sequence of DNA. Maternal dietary imbalance, inadequate to meet the nutritional needs of the fetus can lead to intrauterine growth retardation, decreased gestational age, low birth weight, excessive post-natal growth and metabolic alterations, with subsequent appearance of CVD risk factors. Fetal exposure to high cholesterol, diabetes and maternal obesity is associated with increased risk and progression of atherosclerosis. Maternal smoking during pregnancy and exposure to various environmental pollutants induce epigenetic alterations of gene expression relevant to the onset or progression of CVD. In children with hypercholesterolemia and/or obesity, oxidative stress activates platelets and monocytes, which release proinflammatory and proatherogenic substances, inducing endothelial dysfunction, decreased Doppler flow-mediated dilation and increased carotid intima-media thickness. Primary prevention of atherosclerosis should be implemented early. It is necessary to identify, through screening, high-risk apparently healthy children and take care of them enforcing healthy lifestyle (mainly consisting of Mediterranean diet and physical activity), prescribing nutraceuticals and eventual medications, if required by a high-risk profile. The key issue is the restoration of endothelial function in the reversible stage of atherosclerosis. Epigenetics may provide new markers for an early identification of children at risk and thereby develop innovative therapies and specific nutritional interventions in critical times. PMID:27367935

  8. Assessment of the relationship between selected cardiovascular risk factors and the indices of intima-media thickness and coronary artery calcium score in various stages of chronic kidney disease.

    Science.gov (United States)

    Szarejko-Paradowska, Anna; Gluba-Brzózka, Anna; Pietruszyński, Robert; Rysz, Jacek

    2015-12-01

    Renal diseases pose a growing epidemiological and health problem worldwide. Cardiovascular diseases are the leading cause of deaths among patients with chronic kidney disease. Increased risk of atherosclerosis in these patients results from the occurrence of traditional and non-traditional risk factors. The aim of this study was to assess the relationship between selected risk factors for cardiovascular diseases (age, sex, dyslipidemia, hypertension, etc.), intima-media thickness and coronary artery calcium score in patients with chronic kidney disease stages 2, 3 and 4. This study included 60 patients with chronic kidney disease divided into 3 groups on the basis of disease stage and control group consisting of 20 individuals without diagnosed chronic kidney disease and cardiovascular diseases. Blood analysis and blood pressure measurements were taken. All patients underwent carotid artery ultrasound with the assessment of the intima-media thickness, and heart CT scan in order to assess the index of coronary artery calcification. Logistic regression analysis revealed statistically significant correlation between blood vessels calcification and age--the increase in age by 1 year was associated with the increase in the risk of coronary artery calcification by 6.7 %. The increase in IMT by about 0.1 mm raises the risk of calcification by about 2 %. Second logistic regression model revealed that one-year increase in age was associated with an increase in the risk of intima-media thickening by 6.5 %. Occurrence of hypertension was associated with a ninefold increase in intima-media thickening risk in comparison with patients with normal blood pressure. To sum up, age and hypertension were associated with the growth of IMT in CKD patients, while age and exposure to tobacco smoke were associated with the increase in coronary artery calcium score. The relationship between thickening of IMT and the increase in calcification index in patients was also observed in study

  9. Incidence of cardiovascular events after kidney transplantation and cardiovascular risk scores: study protocol

    Directory of Open Access Journals (Sweden)

    Lorenzo-Aguiar Dolores

    2011-01-01

    Full Text Available Abstract Background Cardiovascular disease (CVD is the major cause of death after renal transplantation. Not only conventional CVD risk factors, but also transplant-specific risk factors can influence the development of CVD in kidney transplant recipients. The main objective of this study will be to determine the incidence of post-transplant CVD after renal transplantation and related factors. A secondary objective will be to examine the ability of standard cardiovascular risk scores (Framingham, Regicor, SCORE, and DORICA to predict post-transplantation cardiovascular events in renal transplant recipients, and to develop a new score for predicting the risk of CVD after kidney transplantation. Methods/Design Observational prospective cohort study of all kidney transplant recipients in the A Coruña Hospital (Spain in the period 1981-2008 (2059 transplants corresponding to 1794 patients. The variables included will be: donor and recipient characteristics, chronic kidney disease-related risk factors, pre-transplant and post-transplant cardiovascular risk factors, routine biochemistry, and immunosuppressive, antihypertensive and lipid-lowering treatment. The events studied in the follow-up will be: patient and graft survival, acute rejection episodes and cardiovascular events (myocardial infarction, invasive coronary artery therapy, cerebral vascular events, new-onset angina, congestive heart failure, rhythm disturbances and peripheral vascular disease. Four cardiovascular risk scores were calculated at the time of transplantation: the Framingham score, the European Systematic Coronary Risk Evaluation (SCORE equation, and the REGICOR (Registre Gironí del COR (Gerona Heart Registry, and DORICA (Dyslipidemia, Obesity, and Cardiovascular Risk functions. The cumulative incidence of cardiovascular events will be analyzed by competing risk survival methods. The clinical relevance of different variables will be calculated using the ARR (Absolute Risk

  10. Ezetimibe, cardiovascular risk and atherogenic dyslipidaemia.

    Science.gov (United States)

    Rizzo, Manfredi; Battista Rini, Giovam

    2011-02-01

    Ezetimibe is a selective cholesterol absorption inhibitor with an excellent side-effect profile, able to reduce low-density lipoprotein (LDL) cholesterol by 15-25% from baseline in monotherapy and on top of statins and fibrates. Yet, it seems that ezetimibe produces quantitative rather than qualitative changes in LDL, with small net effects on atherogenic dyslipidaemia. This is supported by findings from the Ezetimibe and Simvastatin in Hypercholesterolemia Enhances Atherosclerosis Regression (ENHANCE) study on atherosclerosis progression, where the addition of ezetimibe to simvastatin in patients with heterozygous familial hypercholesterolaemia did not affect the mean change in carotid intima-media thickness, although a significant reduction in LDL cholesterol levels was observed. The Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study has further shown that combination treatment with simvastatin significantly reduced LDL cholesterol levels in patients with aortic stenosis, but did not affect the primary end point of aortic valve and cardiovascular events, although a significant reduction in the risk of ischaemic events was reported. Formal cardiovascular outcome trials are underway and these will provide additional insights into the long-term effects of ezetimibe on clinical events as well as on atherogenic dyslipidaemia, beyond LDL cholesterol levels. PMID:22291726

  11. Impact of 4 different definitions used for the assessment of the prevalence of the Metabolic Syndrome in primary healthcare:The German Metabolic and Cardiovascular Risk Project (GEMCAS

    Directory of Open Access Journals (Sweden)

    Wasem Jürgen

    2007-09-01

    Full Text Available Abstract Background The metabolic syndrome (MetSyn places individuals at increased risk for type 2 diabetes and cardiovascular disease. Prevalence rates of the population of the MetSyn are still scarce. Moreover, the impact of different definitions of the MetSyn on the prevalence is unclear. Aim here is to assess the prevalence of the MetSyn in primary health care and to investigate the impact of four different definitions of the MetSyn on the determined prevalence with regard to age, gender and socio-economic status. Methods The German-wide cross-sectional study was conducted during two weeks in October 2005 in 1.511 randomly selected general practices. Blood samples were analyzed, blood pressure and waist circumference assessed, data on lifestyle, medication, chronic disorders, and socio-demographic characteristics collected. MetSyn prevalence was estimated according to the definitions of NCEP ATP III (2001, AHA/NHLBI (2004, 2005, and IDF (2005. Descriptive statistics and prevalence rate ratios using the PROG GENMOD procedure, were calculated. Cohen's kappa was used as measure for interreliability between the different prevalence estimates. Results Data of 35,869 patients (age range: 18–99, women 61.1% were included. The prevalence was lowest using the NCEP ATP III- (all: 19.8%, men 22.7%, women: 18.0%, highest according to the IDF-definition (32.7%, 40.3%, 28.0%. The increase in prevalence with recent definitions was more pronounced for men than for women, and was particularly high for men and women aged 60–79 years. The IDF-definition resulted in a higher prevalence especially in those with the highest educational status. Agreement (kappa between the NCEP ATP III- and IDF-definition was 0.68 (men 0.61, women 0.74, between the updated the AHA/NHLBI- (2005 and IDF-definition 0.85 (men 0.79, women 0.89. Conclusion The prevalence of metabolic syndrome is associated with age, gender, and educational status and increases considerably with each

  12. Use of Chronic Kidney Disease to Enhance Prediction of Cardiovascular Risk in Those at Medium Risk.

    Directory of Open Access Journals (Sweden)

    Yook Chin Chia

    Full Text Available Based on global cardiovascular (CV risk assessment for example using the Framingham risk score, it is recommended that those with high risk should be treated and those with low risk should not be treated. The recommendation for those of medium risk is less clear and uncertain. We aimed to determine whether factoring in chronic kidney disease (CKD will improve CV risk prediction in those with medium risk. This is a 10-year retrospective cohort study of 905 subjects in a primary care clinic setting. Baseline CV risk profile and serum creatinine in 1998 were captured from patients record. Framingham general cardiovascular disease risk score (FRS for each patient was computed. All cardiovascular disease (CVD events from 1998-2007 were captured. Overall, patients with CKD had higher FRS risk score (25.9% vs 20%, p = 0.001 and more CVD events (22.3% vs 11.9%, p = 0.002 over a 10-year period compared to patients without CKD. In patients with medium CV risk, there was no significant difference in the FRS score among those with and without CKD (14.4% vs 14.6%, p = 0.84 However, in this same medium risk group, patients with CKD had more CV events compared to those without CKD (26.7% vs 6.6%, p = 0.005. This is in contrast to patients in the low and high risk group where there was no difference in CVD events whether these patients had or did not have CKD. There were more CV events in the Framingham medium risk group when they also had CKD compared those in the same risk group without CKD. Hence factoring in CKD for those with medium risk helps to further stratify and identify those who are actually at greater risk, when treatment may be more likely to be indicated.

  13. Use of Chronic Kidney Disease to Enhance Prediction of Cardiovascular Risk in Those at Medium Risk.

    Science.gov (United States)

    Chia, Yook Chin; Lim, Hooi Min; Ching, Siew Mooi

    2015-01-01

    Based on global cardiovascular (CV) risk assessment for example using the Framingham risk score, it is recommended that those with high risk should be treated and those with low risk should not be treated. The recommendation for those of medium risk is less clear and uncertain. We aimed to determine whether factoring in chronic kidney disease (CKD) will improve CV risk prediction in those with medium risk. This is a 10-year retrospective cohort study of 905 subjects in a primary care clinic setting. Baseline CV risk profile and serum creatinine in 1998 were captured from patients record. Framingham general cardiovascular disease risk score (FRS) for each patient was computed. All cardiovascular disease (CVD) events from 1998-2007 were captured. Overall, patients with CKD had higher FRS risk score (25.9% vs 20%, p = 0.001) and more CVD events (22.3% vs 11.9%, p = 0.002) over a 10-year period compared to patients without CKD. In patients with medium CV risk, there was no significant difference in the FRS score among those with and without CKD (14.4% vs 14.6%, p = 0.84) However, in this same medium risk group, patients with CKD had more CV events compared to those without CKD (26.7% vs 6.6%, p = 0.005). This is in contrast to patients in the low and high risk group where there was no difference in CVD events whether these patients had or did not have CKD. There were more CV events in the Framingham medium risk group when they also had CKD compared those in the same risk group without CKD. Hence factoring in CKD for those with medium risk helps to further stratify and identify those who are actually at greater risk, when treatment may be more likely to be indicated. PMID:26496190

  14. Feasibility of Development of a Cohort in a Rural Area of Sub-Himalayan Region of India to Assess the Emergence of Cardiovascular Diseases Risk Factors

    OpenAIRE

    Ashok Kumar Bhardwaj; Dinesh Kumar; Sunil Kumar Raina; Satya Bhushan; Vishav Chander; Sushant Sharma

    2014-01-01

    Introduction. Rural area of India is facing epidemiological transitions due to growth and development, warranting a longitudinal study to assess the development of CVDs risk factors. Objective. Feasibility of setting up a rural cohort for the assessment and development of biochemical risk factors for CVDs. Methodology. In Himachal Pradesh, house-to-house surveys were carried out in six villages for anthropometry and assessment of lipid profile. All the information was stored in specifically d...

  15. Hyperhomocysteinemia and cardiovascular risks in hemodialysis patients.

    Science.gov (United States)

    Sagheb, Mohammad Mahdi; Ostovan, Mohammad Ali; Sohrabi, Zahra; Atabati, Elham; Raisjalai, Ghanbar Ali; Roozbeh, Jamshid

    2010-09-01

    The risk of premature and progressive occlusive vascular disease is high in chronic uremic patients, and it accounts for more than 40% of the mortality in dialysis patients. End stage renal failure (ESRF) patients exhibit elevated plasma homocystein levels, about four fold as much as those in the controls, and it is now considered as a causative factor for increased risk of cardiovascular death among these patients. The aim of this study was to evaluate the relationship of total plasma homocysteine level and echocardiographic abnormalities as a surrogate of cardiac disease outcome in hemodialysis patients. 123 adult patients on maintenance hemodialysis and having echocardiography done during January till November 2006 were enrolled in this cross-sectional study. Plasma homocysteine level was directly related to the presence of aortic regurgitation r= 0.27 P= 0.009. There were negative correlations between ejection fraction (EF), left ventricular systolic dimension (LV.S) (r= - 0.71, P= 0.0001), left ventricular diastolic dimension (LV.D) (r= -0.23 p= 0.01) and age (r= - 0.021 P= 0.02). In conclusion we did not find the paradoxical reverse epidemiology in our patients and plasma total homocysteine level was in direct correlation with cardiac risk factors such as left ventricular mass index and aortic regurgitation. PMID:20814121

  16. Hyperhemocysteinemia and cardiovascular risks in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Sagheb Mohammad

    2010-01-01

    Full Text Available The risk of premature and progressive occlusive vascular disease is high in chronic uremic patients, and it accounts for more than 40% of the mortality in dialysis patients. End stage renal failure (ESRF patients exhibit elevated plasma homocystein levels, about four fold as much as those in the controls, and it is now considered as a causative factor for increased risk of cardiovascular death among these patients. The aim of this study was to evaluate the relationship of total plasma homocysteine level and echocardiographic abnormalities as a surrogate of cardiac disease outcome in hemodialysis patients. 123 adult patients on maintenance hemodialysis and having echocardiography done during January till November 2006 were enrolled in this cross-sectional study. Plasma homocysteine level was directly related to the presence of aortic regur-gitation r= 0.27 P= 0.009. There were negative correlations between ejection fraction (EF, left ventricular systolic dimension (LV.S (r= - 0.71, P= 0.0001, left ventricular diastolic dimension (LV.D (r= -0.23 p= 0.01 and age (r= - 0.021 P= 0.02. In conclusion we did not find the para-doxical reverse epidemiology in our patients and plasma total homocysteine level was in direct correlation with cardiac risk factors such as left ventricular mass index and aortic regurgitation.

  17. Estimation of the Cardiovascular Risk Using World Health Organization/International Society of Hypertension (WHO/ISH) Risk Prediction Charts in a Rural Population of South India

    OpenAIRE

    Arun Gangadhar Ghorpade; Saurabh RamBihariLal Shrivastava; Sitanshu Sekhar Kar; Sonali Sarkar; Sumanth Mallikarjuna Majgi; Gautam Roy

    2015-01-01

    Background World Health Organization/International Society of Hypertension (WHO/ISH) charts have been employed to predict the risk of cardiovascular outcome in heterogeneous settings. The aim of this research is to assess the prevalence of Cardiovascular Disease (CVD) risk factors and to estimate the cardiovascular risk among adults aged >40 years, utilizing the risk charts alone, and by the addition of other parameters. Methods A cross-sectional study was performed in two o...

  18. Special Diabetes Program for Indians: Retention in Cardiovascular Risk Reduction

    Science.gov (United States)

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

    2011-01-01

    Purpose: This study examined the associations between participant and site characteristics and retention in a multisite cardiovascular disease risk reduction project. Design and Methods: Data were derived from the Special Diabetes Program for Indians Healthy Heart Demonstration Project, an intervention to reduce cardiovascular risk among American…

  19. Quantifying cardiovascular disease risk factors in patients with psoriasis

    DEFF Research Database (Denmark)

    Miller, I M; Skaaby, T; Ellervik, C;

    2013-01-01

    BACKGROUND: In a previous meta-analysis on categorical data we found an association between psoriasis and cardiovascular disease and associated risk factors. OBJECTIVES: To quantify the level of cardiovascular disease risk factors in order to provide additional data for the clinical management...

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

    Science.gov (United States)

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

    2014-01-01

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

  1. Coconut oil consumption and cardiovascular risk factors in humans.

    Science.gov (United States)

    Eyres, Laurence; Eyres, Michael F; Chisholm, Alexandra; Brown, Rachel C

    2016-04-01

    Coconut oil is being heavily promoted as a healthy oil, with benefits that include support of heart health. To assess the merits of this claim, the literature on the effect of coconut consumption on cardiovascular risk factors and outcomes in humans was reviewed. Twenty-one research papers were identified for inclusion in the review: 8 clinical trials and 13 observational studies. The majority examined the effect of coconut oil or coconut products on serum lipid profiles. Coconut oil generally raised total and low-density lipoprotein cholesterol to a greater extent than cis unsaturated plant oils, but to a lesser extent than butter. The effect of coconut consumption on the ratio of total cholesterol to high-density lipoprotein cholesterol was often not examined. Observational evidence suggests that consumption of coconut flesh or squeezed coconut in the context of traditional dietary patterns does not lead to adverse cardiovascular outcomes. However, due to large differences in dietary and lifestyle patterns, these findings cannot be applied to a typical Western diet. Overall, the weight of the evidence from intervention studies to date suggests that replacing coconut oil with cis unsaturated fats would alter blood lipid profiles in a manner consistent with a reduction in risk factors for cardiovascular disease. PMID:26946252

  2. Telehealth for patients at high risk of cardiovascular disease: pragmatic randomised controlled trial

    OpenAIRE

    Salisbury, Chris; O’Cathain, Alicia; Thomas, Clare; Edwards, Louisa; Gaunt, Daisy; Dixon, Padraig; Hollinghurst, Sandra; Nicholl, Jon; Large, Shirley; Yardley, Lucy; Fahey, Tom; Foster, Alexis; Garner, Katy; Horspool, Kimberley; Man, Mei-See

    2016-01-01

    Objective To assess whether non-clinical staff can effectively manage people at high risk of cardiovascular disease using digital health technologies. Design Pragmatic, multicentre, randomised controlled trial. Setting 42 general practices in three areas of England. Participants Between 3 December 2012 and 23 July 2013 we recruited 641 adults aged 40 to 74 years with a 10 year cardiovascular disease risk of 20% or more, no previous cardiovascular event, at least one modifiable risk factor (sy...

  3. The MyHealthCheckup study: Training graduate students to implement cardiovascular risk screening programs in community pharmacies

    OpenAIRE

    Banack, Hailey R.; Grover, Samuel; Kaouche, Mohammed; Marchand, Sylvie; Lowensteyn, Ilka

    2012-01-01

    Background: Hypertension is a major risk factor for cardiovascular morbidity and mortality. Despite this fact and the development of effective antihypertensive drug therapy, hypertension is often poorly controlled. Community pharmacies are an ideal site for the management of hypertension and other modifiable cardiovascular risk factors. The purpose of the current study was to develop and assess a pharmacy-based cardiovascular risk screening program implemented by graduate students.

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

    Science.gov (United States)

    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. PMID:26383179

  5. Prevalence of Cardiovascular disease risk among Medical Students in South India

    OpenAIRE

    Biswajit Paul; Vidhyaa Nayaaki; Mousumi Sen; Rita Isaac

    2015-01-01

    Background: Cardiovascular diseases (CVDs) are global epidemic and contribute to double burden in developing countries. Individual’s dietary habits and risk behavior influence the onset and progression of CVDs. Medical students are future role models of the society and their knowledge, habits and behavior can influence their practice in prevention of CVDs in general population. Aims & Objectives: To assess the prevalence of common cardiovascular risk factors among a sample of medical stud...

  6. Major dietary patterns and cardiovascular risk factors among young Brazilian adults

    OpenAIRE

    Olinto, Maria Teresa A.; Gigante, Denise P.; Horta, Bernardo; Silveira, Vera; OLIVEIRA, ISABEL; Willett, Walter C.

    2011-01-01

    Purpose: Diet is one of the most important modifiable risk factors for cardiovascular diseases. The scientific literature has consistently shown the effects of certain diets on health; however, given the variety of cultures and dietary habits across the world, it is likely that much remains to be learned about dietary patterns and health outcomes. We assessed the associations between main dietary patterns and cardiovascular risk factors among 4,202 young Brazilian adults in a cross-sectional ...

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

    OpenAIRE

    2000-01-01

    INTRODUCTION: In developed countries socioeconomic status has been proven to be an important factor in the progression of cardiovascular disease. The present article reports the results of a cross-sectional assessment to investigate the association between socioeconomic status and cardiovascular risk factors in a Chinese urban population. METHODS: In 1996, a behavioural risk factor survey was carried out in Tianjin, the third largest city in China. A sample of 4000 people aged 15-69 years, st...

  8. Prevalence of Vitamin D Deficiency in Singapore: Its Implications to Cardiovascular Risk Factors

    OpenAIRE

    Bi, Xinyan; Tey, Siew Ling; Leong, Claudia; Quek, Rina; Henry, Christiani Jeyakumar

    2016-01-01

    Objective Vitamin D deficiency is a global health challenge and has been linked to type 2 diabetes and other chronic diseases. However, the relationship between vitamin D status, body composition, and cardiovascular risks has not been well characterized in Asian populations. The objectives of this study were to examine the factors associated with the low vitamin D levels in a sunny tropical region and to assess the role of vitamin D status in cardiovascular risk factors. Design and Methods Th...

  9. 衡阳市城区老年人群心血管事件风险预测及评估管理%Prediction,Assessment and Management of Risk of Cardiovascular Events in Urban Older Adults in Hengyang City

    Institute of Scientific and Technical Information of China (English)

    刘赞; 曾颖

    2014-01-01

    目的了解衡阳市城区老年人心血管疾病危险因素及心血管事件10年风险情况,为老年人心血管疾病预防提供依据。方法采取方便抽样法,于2011年10月5日~2012年3月30日抽取在衡阳市南华大学附一、附二医院进行健康体检的1200名城区老年人为调查对象,有效问卷1120份,采用自行设计的老年人社会人口学及体检一般项目问卷进行调查与分析,采用WHO/ISH《心血管疾病预防指南》进行心血管风险评估(心血管事件10年风险评估)。结果衡阳市城区老年人心血管疾病危险因素的控制不理想:高血压、高血脂、高血糖患病率分别为37.5%、36.2%、18.9%,服药率分别为:43.6%、7.6%、16.4%;冠心病、脑卒中等心血管疾病发病率男性高于女性;衡阳市城区老年人心血管事件10年风险较高:心血管风险<10%222人(19.8%),心血管风险10%~40%的510人(45.5%),心血管风险≥40%388人(34.6%)。结论衡阳市城区老年人心血管疾病危险因素控制不理想,心血管风险水平较高,应针对老年人群积极开展心血管疾病预防与干预。%Objective To describe the current situation of cardiovascular risk factors and assess the 10 years'risk of car-diovascular events in older adults in Hengyang city. Methods A cross-sectional descriptive study was made. 1 200 older adults were included by a cluster random sampling method,who were consecutively admitted to the health examination centers of the first and the second affiliated hospitals of University of South China. Socio-demographic data and cardiovascular risk factors of disease were collected by face-to-face interviews using two self-designed questionnaires. The cardiovascular risk of the older adults was assessed using the 2008 WHO/ISH Pocket Guide for cardiovascular risk assessment and management. Results The control of CVD risk factors of the older adults was not ideal in Hengyang City. The prevalence of

  10. Association of sympathovagal imbalance with cardiovascular risks in overt hypothyroidism

    Directory of Open Access Journals (Sweden)

    Avupati Naga Syamsunder

    2013-01-01

    Full Text Available Background: Cardiovascular morbidities have been reported in hypothyroidism. Aims: The objective of this study is to investigate the link of sympathovagal imbalance (SVI to cardiovascular risks (CVRs and the plausible mechanisms of CVR in hypothyroidism. Materials and Methods: Age-matched 104 females (50 controls, 54 hypothyroids were recruited and their body mass index (BMI, cardiovascular parameters, autonomic function tests by spectral analysis of heart rate variability (HRV, heart rate response to standing, deep breathing and blood pressure response to isometric handgrip were studied. Thyroid profile, lipid profile, immunological and inflammatory markers were estimated and their association with low-frequency to the high-frequency ratio (LF-HF of HRV, the marker of SVI was assessed by multivariate regression. Results: Increased diastolic pressure, decreased HRV, increased LF-HF, dyslipidemia and increased high-sensitive C-reactive protein (hsCRP were observed in hypothyroid patients and all these parameters had significant correlation with LF-HF. BMI had no significant association with LF-HF. Atherogenic index (β 1.144, P = 0.001 and hsCRP (b 0.578, P = 0.009 had independent contribution to LF-HF. LF-HF could significantly predict hypertension status (odds ratio 2.05, confidence interval 1.110-5.352, P = 0.008 in hypothyroid subjects. Conclusions: SVI due to sympathetic activation and vagal withdrawal occurs in hypothyroidism. Dyslipidemia and low-grade inflammation, but not obesity contribute to SVI and SVI contributes to cardiovascular risks.

  11. A comparative assessment of non-laboratory-based versus commonly used laboratory-based cardiovascular disease risk scores in the NHANES III population.

    Directory of Open Access Journals (Sweden)

    Ankur Pandya

    Full Text Available BACKGROUND: National and international primary CVD risk screening guidelines focus on using total CVD risk scores. Recently, we developed a non-laboratory-based CVD risk score (inputs: age, sex, smoking, diabetes, systolic blood pressure, treatment of hypertension, body-mass index, which can assess risk faster and at lower costs compared to laboratory-based scores (inputs include cholesterol values. We aimed to assess the exchangeability of the non-laboratory-based risk score to four commonly used laboratory-based scores (Framingham CVD [2008, 1991 versions], and Systematic COronary Risk Evaluation [SCORE] for low and high risk settings in an external validation population. METHODS AND FINDINGS: Analyses were based on individual-level, score-specific rankings of risk for adults in the Third National Health and Nutrition Examination Survey (NHANES III aged 25-74 years, without history of CVD or cancer (n = 5,999. Risk characterization agreement was based on overlap in dichotomous risk characterization (thresholds of 10-year risk >10-20% and Spearman rank correlation. Risk discrimination was assessed using receiver operator characteristic curve analysis (10-year CVD death outcome. Risk characterization agreement ranged from 91.9-95.7% and 94.2-95.1% with Spearman correlation ranges of 0.957-0.980 and 0.946-0.970 for men and women, respectively. In men, c-statistics for the non-laboratory-based, Framingham (2008, 1991, and SCORE (high, low functions were 0.782, 0.776, 0.781, 0.785, and 0.785, with p-values for differences relative to the non-laboratory-based score of 0.44, 0.89, 0.68 and 0.65, respectively. In women, the corresponding c-statistics were 0.809, 0.834, 0.821, 0.792, and 0.792, with corresponding p-values of 0.04, 0.34, 0.11 and 0.09, respectively. CONCLUSIONS: Every score discriminated risk of CVD death well, and there was high agreement in risk characterization between non-laboratory-based and laboratory-based risk scores, which

  12. Inflammation, Infection, and Future Cardiovascular Risk

    Science.gov (United States)

    2016-03-15

    Cardiovascular Diseases; Coronary Disease; Cerebrovascular Accident; Myocardial Infarction; Venous Thromboembolism; Heart Diseases; Infection; Chlamydia Infections; Cytomegalovirus Infections; Helicobacter Infections; Herpesviridae Infections; Inflammation

  13. Cardiovascular disease risk in adults with spastic bilateral cerebral palsy

    OpenAIRE

    Slot, Wilma; Roebroeck, Marij; Nieuwenhuijsen, Channah; Bergen, Michael; Stam, Henk; Burdorf, Alex; Berg-Emons, Rita

    2013-01-01

    textabstractObjective: To explore: (i) cardiovascular disease risk factors and the 10-year clustered risk of a fatal cardiovascular event in adults with spastic bilateral cerebral palsy; and (ii) relationships between the 10-year risk and body fat, aerobic fitness and physical activity. Design: Cross-sectional study. Subjects: Forty-three adults with spastic bilateral cerebral palsy without severe cognitive impairment (mean age 36.6 years (standard deviation 6); 27 men). Methods: Biological a...

  14. Cardiovascular Risk in Malaysia: causes, consequences and prevention

    OpenAIRE

    Selvarajah, S.

    2012-01-01

    Cardiovascular disease forms the highest morbidity and mortality worldwide and disproportionately affects low and middle-income developing countries. In developing countries, cardiovascular morbidity and mortality tend to affect the (younger) working adults. This poses a significant burden to the economy. This thesis attempts to investigate the burden of cardiovascular risk factors and disease, and its’ prevention in Malaysia, a middle-income developing country. We described the clustering of...

  15. 30. Cardiovascular risk factors burden in Saudi Arabia: The africa middle east cardiovascular epidemiological (ace study

    Directory of Open Access Journals (Sweden)

    A. Ahmed

    2016-07-01

    Full Text Available Limited data exit on the epidemiology of cardiovascular risk factors in Saudi Arabia particularly in relation to the differences between local citizens and expatriates. The aim of this analysis is to describe the current prevalence of cardiovascular risk factors among patients attending general practice clinics in Saudi Arabia. In a cross- sectional epidemiological study, the presence of cardiovascular risk factors (hypertension, diabetes, dyslipidaemia, obesity, smoking, and abdominal obesity was evaluated in stable adult outpatients attending primary care clinics in Saudi Arabia. Groups comparison were made between local Saudi patients and expatriates. A total of 550 participant were enrolled form different clinics in Saudi Arabia (71% were male, mean age was 43 ± 10 years. Nearly half of the study cohort had more than two cardiovascular risk factors (49.6%. Dyslipidemia had the highest prevalence (68.4%. Furthermore, prevalence of hypertension (47.5% vs. 31.4%, dyslipidaemia (75.2% vs. 55.1% and abdominal obesity (63.9% vs. 52.2% were higher among expatriates compare to Saudis (p-value < 0.001. This analysis clearly shows that there is a high prevalence of cardiovascular risk factors prevalence in Saudi population. In addition, a significant proportion of patients with risk factors have poor overall control. Programmed community based screening is needed for all cardiovascular risk factors in Saudi Arabia. Increased awareness and improved primary care services may decrease incidence of coronary artery disease and improve overall quality of life.

  16. Cardiovascular Risk Screening Options in Diabetes: Framework for Selective Adoption

    Directory of Open Access Journals (Sweden)

    Ezekiel Uba Nwose

    2016-06-01

    Full Text Available "Background: There exist several models for assessment of risk of cardiovascular disease (CVD, including different criteria for diag-nosis of obesity, of which a major disparity is and lsquo;definition of waist circumference'. Case reports and comparative reviews are hereby presented to exemplify that one cap and lsquo;model' does not fit all. Cases: First case illustrates how very slim person with BMI of 17 may possess cardiovascular risk and #8805;22.7% compared to an obese in-dividual who has a BMI of 39 with CVD risk and #8804;8.0%. Second case review illustrates how the same BMI and lipid models vary in outcomes depending on gender. Third case report shows how different and lsquo;definitions of waist circumference' impacts on identification of obesity, which in turn affect decision about metabolic syndrome. Conclusion: The needs for paradigm shift and 5-step framework are briefly highlighted. [Natl J Community Med 2016; 7(6.000: 540-544

  17. Yoga, Anxiety, and Some Cardiovascular Risk Factors in Women

    Directory of Open Access Journals (Sweden)

    Asim CENGIZ

    2015-06-01

    Full Text Available This study aimed to examine the effects of a yoga program on anxiety, and some cardiovascular risk factors. Forty - six elderly participants aged 40 – 51 years women. The yoga program was based on 3 times/week for 10 weeks a set of yoga techniques, in the form of asana (postures and deep relaxation technique, pranayama (breathing techniques and meditation three for 60 minutes three times a week. The level of anxiety and decreased the risk factors for cardiovascular disease risk factors (CVD. The yoga program reduced the level of anxiety and decreased the risk factors for cardiovascular disease risk factors (CVD in the experimental group. After 8 weeks of the yoga program. SBP, DBP, B MI, HR and WC values were improved. It is likely that the yoga practices of controlling body, mind, and spirit combine to provide useful physiological effects for healthy people and for people compromised by cardiovascular disease.

  18. Cardiovascular risk during hormonal treatment in patients with prostate cancer

    International Nuclear Information System (INIS)

    The objective of this review is to provide information on cardiovascular risk following androgen-deprivation therapy (ADT) in prostate cancer patients and to suggest potential prevention and management strategies. Androgen deprivation therapy can cause peripheral insulin resistance, increase fat mass and low-density lipoprotein cholesterol, and induce type 2 diabetes. While recent studies have reported an association in patients with prostate cancer between ADT and increased risk of cardiovascular events, other studies have not detected the association. However, at this time, it is plausible that ADT could increase cardiovascular risk because of the adverse effect of ADT on risk factors for cardiovascular disease. It is advisable that prostate cancer patients in whom ADT is initiated be referred to their physician, who will carefully monitor them for potential metabolic effects. Therefore, physicians should be informed about these potential side effects. This especially applies to men aged >65 years and those with pre-existing cardiovascular comorbidities. Adopting a healthy lifestyle including a balanced diet and regular physical activity is recommended. Patients with cardiovascular disease should receive appropriate preventive therapies, including lipid-lowering, antihypertensive, glucose-lowering, and antiplatelet therapy. ADT should preferably not be unnecessarily administered to prostate cancer patients with pre-existing cardiovascular disease, certainly not to those in whom the risk of prostate cancer-specific mortality is low. The physician should carefully weigh the potential benefits of ADT against the possible risks in individual patients with prostate cancer

  19. Hormone therapy and cardiovascular risk markers and disease

    DEFF Research Database (Denmark)

    Pedersen, Susan H; Lokkegaard, Ellen; Ottesen, Bent

    2006-01-01

    cardiovascular outcomes. Recent, large-scale, randomized clinical studies did not confirm a beneficial cardiovascular effect of HT. On the contrary, an increased risk was found with continuous combined estrogen-progestagen regimens. The progestagen used in these trials was medroxyprogesterone acetate and other...

  20. Moderate alcohol consumption and cardiovascular risk reduction: open issues

    Directory of Open Access Journals (Sweden)

    Simona Costanzo

    2006-06-01

    Full Text Available

    Background: The inverse relationship between low to moderate alcohol consumption and several favorable health outcomes has been well established in many epidemiological studies and meta-analyses. However, several questions still remain controversial.

    Aims: To discuss a number of open questions relating to the healthy effect of a moderate intake of alcohol (especially wine on cardiovascular disease and total mortality. This will be based on findings from the literature, with a particular emphasis on meta-analyses.

    Results and Conclusion: The role of different alcoholic beverages, age and sex, confounding, former drinkers and study design has been discussed. Whether wine is better than beer or spirits, though suggestive, remains to be established. Cardiovascular morbidity and total mortality is significantly reduced both in men and women who are regular drinkers of low amounts of alcohol; however, the predicted protection in women disappears at lower doses than in men. The primary protection of alcohol decreases after adjustment for known variables, thus confirming the importance of confounding in assessing drinking effects, but it remains significant and of undoubted public health value. As the cardiovascular protection by moderate alcohol consumption might have been unduly overestimated by inclusion in control groups of former drinkers, we compared studies that used as a reference group the category of no alcohol intake and/or formally excluded former drinkers with studies which did not: the protection was indeed somewhat lower in the former than in the latter studies, but was still statistically significant. We conclude that the dose-response relationship between alcohol intake and cardiovascular risk or total mortality, consistently described by J-shaped curves, can be reasonably attributed to a combination of both real beneficial (at lower doses and harmful (at higher doses

  1. A review of ground-based heavy-ion radiobiology relevant to space radiation risk assessment. Part II: Cardiovascular and immunological effects

    Science.gov (United States)

    Blakely, Eleanor A.; Chang, Polly Y.

    The future of manned space flight depends on an analysis of the numerous potential risks of travel into deep space. Currently no radiation dose limits have been established for these exploratory missions. To set these standards more information is needed about potential acute and late effects on human physiology from appropriate radiation exposure scenarios, including pertinent radiation types and dose rates. Cancer risks have long been considered the most serious late effect from chronic daily relatively low-dose exposures to the complex space radiation environment. However, other late effects from space radiation exposure scenarios are under study in ground-based accelerator facilities and have revealed some unique particle radiation effects not observed with conventional radiations. A comprehensive review of pertinent literature that considers tissue effects of radiation leading to functional detriments in specific organ systems has recently been published (NCRP National Council on Radiation Protection and Measurements. Information Needed to Make Radiation Protection Recommendations for Space Missions Beyond Low-Earth Orbit. Report #153, Bethesda, MD, 2006). This paper highlights the review of two non-cancer concerns from this report: cardiovascular and immunological effects.

  2. A review of ground-based heavy-ion radiobiology relevant to space radiation risk assessment: Part II. Cardiovascular and immunological effects

    Energy Technology Data Exchange (ETDEWEB)

    Blakely, Eleanor A.; Chang, Polly Y.

    2007-02-26

    The future of manned space flight depends on an analysis of the numerous potential risks of travel into deep space. Currently no radiation dose limits have been established for these exploratory missions. To set these standards more information is needed about potential acute and late effects on human physiology from appropriate radiation exposure scenarios, including pertinent radiation types and dose rates. Cancer risks have long been considered the most serious late effect from chronic daily relatively low-dose exposures to the complex space radiation environment. However, other late effects from space radiation exposure scenarios are under study in ground-based accelerator facilities and have revealed some unique particle radiation effects not observed with conventional radiations. A comprehensive review of pertinent literature that considers tissue effects of radiation leading to functional detriments in specific organ systems has recently been published (NCRP National Council on Radiation Protection and Measurements, Information Needed to Make Radiation Protection Recommendations for Space Missions Beyond Low-Earth Orbit, Report 153, Bethesda, MD, 2006). This paper highlights the review of two non-cancer concerns from this report: cardiovascular and immunological effects.

  3. Hepatitis Risk Assessment

    Science.gov (United States)

    ... visit this page: About CDC.gov . Hepatitis Risk Assessment Recommend on Facebook Tweet Share Compartir Viral Hepatitis. ... at risk? Take this 5 minute Hepatitis Risk Assessment developed by the CDC and get a personalized ...

  4. Risk of solid cancer, cardiovascular disease, anaphylaxis, osteoporosis and fractures in patients with systemic mastocytosis

    DEFF Research Database (Denmark)

    Broesby-Olsen, Sigurd; Farkas, Dóra Körmendiné; Vestergaard, Hanne;

    2016-01-01

    In patients with systemic mastocytosis (SM), several aspects of morbidity remain poorly understood. We assessed the risk of solid cancers, cardiovascular disease, anaphylaxis, osteoporosis, and fractures in SM patients. Using Danish medical registries, we conducted a nationwide population.......2 (95% CI 0.9-1.6) and the 10-year AR was 5.9% (95% CI 3.9-8.4). SM patients are at increased risk of solid cancers - especially melanoma and NMSC-and cardiovascular disease. The risk of anaphylaxis and osteoporosis is clearly increased in SM, though absolute risk was low in this population-based study...

  5. [Association of influenza, influenza vaccination and cardiovascular risk].

    Science.gov (United States)

    Jiang, Y M; Zhang, Y

    2016-02-01

    Cardiovascular risk and related medical burden due to influenza in patients with chronic disease were higher than those of healthy subjects. As a result, influenza vaccination is recommended as a strategy for secondary prevention in cardiovascular disease by major cardiovascular organizations, but the prevalence of influenza vaccination in these population is still low. Whether influenza vaccine can prevent cardiovascular events such as myocardial infarction and death is still controversial based on current evidences from observational studies and case-control studies, which may result from study desion,subjects selection,outcome definition and sample size issues. Recent meta-analysis showed that influenza vaccination may reduce cardiovascular risk, but large-scale random controlled trials with adequately power should be conducted to confirm these findings as well as the target population for this strategy further. PMID:26926716

  6. Imaging of cardiovascular risk in patients with Turner's syndrome.

    Science.gov (United States)

    Marin, A; Weir-McCall, J R; Webb, D J; van Beek, E J R; Mirsadraee, S

    2015-08-01

    Turner's syndrome is a disorder defined by an absent or structurally abnormal second X chromosome and affects around 1 in 2000 newborn females. The standardised mortality ratio in Turner's syndrome is around three-times higher than in the general female population, mainly as a result of cardiovascular disorders. Most striking is the early age at which Turner's syndrome patients develop the life-threatening complications of cardiovascular disorders compared to the general population. The cardiovascular risk stratification in Turner's syndrome is challenging and imaging is not systematically used. The aim of this article is to review cardiovascular risks in this group of patients and discuss a systematic imaging approach for early identification of cardiovascular disorders in these patients. PMID:25917542

  7. Polycystic Ovary Syndrome and the Relationship of Cardiovascular Disease Risk

    Directory of Open Access Journals (Sweden)

    Evrim Çakır

    2013-06-01

    Full Text Available Polycystic ovary syndrome (PCOS is a common endocrine disorder affecting at least 5-10% of women of reproductive age. PCOS is characterized by hyperandrogenism, menstrual disturbance, anovulation, infertility and obesity and, also associated with increased number of cardiovascular risk factors and early atherosclerosis. Hyperinsulinemia is a frequent finding in PCOS patients and has cause-and-effect relationship with low-grade chronic inflammation and increased risk of cardiovascular disease. Turk Jem 2013; 17: 33-7

  8. Characterisation of cardiovascular risk in adults with Turner Syndrome.

    OpenAIRE

    Ostberg, J. E.

    2006-01-01

    Turner Syndrome (TS) results from the complete or partial absence of one X chromosome in females. Short stature and gonadal dysgenesis are characteristic, with increased risks of cardiovascular disease, diabetes and obesity. This thesis investigates the prevalence and pathogenesis of factors contributing to cardiovascular risk. Because women with TS differ from normals in terms of their X-chromosome defect and oestrogen deficiency, they were compared to similarly-aged normal women, and a seco...

  9. Guidelines for managing cardiovascular risk: an evolving area

    DEFF Research Database (Denmark)

    Currier, Judith S; Lundgren, Jens

    2008-01-01

    PURPOSE OF REVIEW: To reflect on the need for guidelines to assist clinicians in the management of cardiovascular risk in HIV-infected patients. RECENT FINDINGS: Over the past eight years guidelines for the management of dyslipidemia and metabolic complications of HIV infection have been developed...... and revised as new information becomes available. SUMMARY: Current guidelines for managing cardiovascular risk in HIV patients are limited by the currently available data, but nonetheless provide a useful approach to assist clinicians....

  10. Polycystic Ovary Syndrome and the Relationship of Cardiovascular Disease Risk

    OpenAIRE

    Evrim Çakır; Erman Çakal; Mustafa Özbek; Mustafa Şahin; Tuncay Delibaşı

    2013-01-01

    Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting at least 5-10% of women of reproductive age. PCOS is characterized by hyperandrogenism, menstrual disturbance, anovulation, infertility and obesity and, also associated with increased number of cardiovascular risk factors and early atherosclerosis. Hyperinsulinemia is a frequent finding in PCOS patients and has cause-and-effect relationship with low-grade chronic inflammation and increased risk of cardiovascular disease...

  11. Sensitivity of cardiovascular risk factors, as part of the campaign of healthy companies and their essential contribution to the safety of a nuclear installation

    International Nuclear Information System (INIS)

    Prevention campaigns are essential to curb the incidence of cardiovascular disease, to plan prevention programs, discovering, assessing and treating risk factors, affecting asymptomatic subjects, threaten, is the most effective and efficient measure to reduce cardiovascular disease. (Author)

  12. Factores de riesgo cardiovascular en estudiantes universitarios chilenos Cardiovascular risk factors in Chilean university students

    Directory of Open Access Journals (Sweden)

    María Teresa Chiang-Salgado

    1999-12-01

    cardiovasculares en la vida adulta de los jóvenes.OBJECTIVE: To study the prevalence of cardiovascular risk factors in asymptomatic university students of both sexes, aged 18 to 25 years. MATERIAL AND METHODS: Serum lipid levels were measured in a subsample of 293 subjects, using a Hitachi 717 chemical analyzer. Obesity was classified using Body Mass Index (BMI measurements. A self-applied questionnaire was used to collect data on sedentary life style, family history of cardiovascular disease and cigarette smoking. Statistical associations of lipid levels with lipidic and non-lipidic risk factors were assessed using Pearson´s chi² test and multiple regression. RESULTS: We found lipid risk levels in 29.2% for Total Cholesterol (CT, 16.2% for Low Density Lipoproteins (C-LDL and 5% for High Density Lipoproteins (C-HDL. The main non-lipidic factors were smoking (46.1% and sedentarism (60.8%. Obesity, hypertension and parental history of myocardial infarction were present in 1.9%, 4.6% and 11%, respectively. We observed an association of a lipid risk profile with obesity, cigarette smoking and family history. CONCLUSIONS: The results show that sedentarism and smoking are associated with a lipid risk profile. These results call for the need to develop appropriate behavior strategies for the successful prevention of cardiovascular disease.

  13. Prediction of Cardiovascular Disease Risk among Low-Income Urban Dwellers in Metropolitan Kuala Lumpur, Malaysia

    OpenAIRE

    Tin Tin Su; Mohammadreza Amiri; Farizah Mohd Hairi; Nithiah Thangiah; Awang Bulgiba; Hazreen Abdul Majid

    2015-01-01

    We aimed to predict the ten-year cardiovascular disease (CVD) risk among low-income urban dwellers of metropolitan Malaysia. Participants were selected from a cross-sectional survey conducted in Kuala Lumpur. To assess the 10-year CVD risk, we employed the Framingham risk scoring (FRS) models. Significant determinants of the ten-year CVD risk were identified using General Linear Model (GLM). Altogether 882 adults (≥30 years old with no CVD history) were randomly selected. The classic FRS mode...

  14. Cardiovascular risk factors in patients with rheumatoid arthritis in combination with hypertension depending on body weight

    Directory of Open Access Journals (Sweden)

    Sіrenko O.Yu.

    2014-11-01

    Full Text Available The objective was to evaluate the frequency of cardiovascular risk factors and hypertension in patients with rheumatoid arthritis depending on body weight. The study involved 100 patients with rheumatoid arthritis and stably selected therapy for more than 6 months at the age from 45 to 65 years (mean age 53,19 ± 5,40 years. Traditional cardiovascular risk was assessed, taking into account risk factors by SCORE scale and amended for patients with RA. The levels of total cholesterol, triglycerides, C-reactive protein, serum creatinine, body mass index, body area index were determined. Arterial hypertension was diagnosed in 41 (41% patients with rheuma¬toid arthritis and was associated with traditional risk factors (age, obesity, rheumatoid factor, hyperuricemia and the duration of glucocorticoid therapy. Obesity and excess body mass occurred in the majority of patients with rheumatoid arthritis, herewith the highest level of inflammation indicators and risk of cardiovascular events was in overweight patients. Obesity was associated with duration of rheumatoid arthritis, the activity of the inflammatory process, the duration of glucocorticoids taking. It is found that the traditional SCORE scale does not fully reflect the risk of cardiovascular events in rheumatoid arthritis. Identification of hypertension and obesity increases the information content of the risk assessment of cardiovascular events in rheumatoid arthritis.

  15. Clinical Assessment of Cardiovascular and Autonomic Function

    Directory of Open Access Journals (Sweden)

    Diego Benitez

    2004-10-01

    Full Text Available This paper presents a non-invasive virtual medical instrument for the clinical assessment of cardiovascular and autonomic function. The virtual instrument was developed with the aim of analysing and understanding the physiological changes that occurs in the heart and circulation during vasovagal blackout attacks. The automated virtual instrument allows impedance cardiography analysis, time and frequency heart rate and blood pressure variability analysis, invasive and non-invasive baroreflex sensitivity assessment and forearm blood flow measurements. Using this virtual instrument five control subjects (3 male, mean age 30.6 ± 5.4 and five vasovagal syncope suffers (2 male, mean age 38.6 ± 6.3 were used in a study to try to identify the differences between the two groups to tilt induced syncope. The results obtained suggest that there are fundamental differences in the physiological responses to orthostatic stress between vasovagal patients and controls, which are evident before the onset of major haemodynamic changes.

  16. Association between Birth Weight and Cardiovascular Risk Factors in Adolescents

    Energy Technology Data Exchange (ETDEWEB)

    Sousa, Maria Amenaide Carvalho Alves de, E-mail: amenaidecarvalho@gmail.com [Escola Bahiana de Medicina e Saúde Pública, Salvador, BA (Brazil); Guimarães, Isabel Cristina Britto; Daltro, Carla [Universidade Federal da Bahia, Salvador, BA (Brazil); Guimarães, Armênio Costa [Escola Bahiana de Medicina e Saúde Pública, Salvador, BA (Brazil)

    2013-07-15

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

  17. Association between Birth Weight and Cardiovascular Risk Factors in Adolescents

    International Nuclear Information System (INIS)

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

  18. The Impact of NSAID Treatment on Cardiovascular Risk

    DEFF Research Database (Denmark)

    Olsen, A. M. S.; Fosbol, E. L.; Gislason, Gunnar H.

    2014-01-01

    This MiniReview describes the present evidence for the relationship between cardiovascular risk and use of non-steroidal anti-inflammatory drugs (NSAIDs) with special focus using Danish register-based data. NSAIDs are among the most widely used drugs worldwide and mainly used for management of pain...... and inflammatory conditions. Through the past decade, much attention has been given to the cardiovascular safety of these drugs, and several studies have shown increased risk of adverse cardiovascular effects associated with NSAID use. Current guidelines discourage any use of NSAIDs in patients with...... cardiovascular disease, yet over a period of 8-10 years, 35-44% of patients with myocardial infarction or heart failure were exposed to NSAIDs in Denmark. Furthermore, NSAID use was associated with an increased risk of death or myocardial infarction by up to 5 times that of non-users. There was also a clear...

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

    OpenAIRE

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

    2011-01-01

    Cardiovascular risk factors in children are increasing at an alarming rate in the western world. However, there is limited information regarding these in the South Asian children. This review attempts at summarizing such evidence. South Asians are remarkable for the earlier onset of adult cardiovascular disease (CVD) by almost a decade compared to the Caucasians. We identified published literature, mainly on PubMed, Embase and Cochrane library using specific search terms such as lipid abnorma...

  20. Psychosocial job factors and biological cardiovascular risk factors in Mexican workers

    OpenAIRE

    Garcia-Rojas, IJ; Choi, B; Krause, N.

    2015-01-01

    © 2015 Wiley Periodicals, Inc. Background: Psychosocial job factors (PJF) have been implicated in the development of cardiovascular disease. The paucity of data from developing economies including Mexico hampers the development of worksite intervention efforts in those regions. Methods: This cross-sectional study of 2,330 Mexican workers assessed PJF (job strain [JS], social support [SS], and job insecurity [JI]) and biological cardiovascular disease risk factors [CVDRF] by questionnaire and ...

  1. Cardiovascular risks and brain function: a functional magnetic resonance imaging study of executive function in older adults

    OpenAIRE

    Chuang, Yi-Fang; Eldreth, Dana; Kirk I Erickson; Varma, Vijay; Harris, Gregory; Fried, Linda P.; Rebok, George W.; Tanner, Elizabeth K.; Carlson, Michelle C.

    2013-01-01

    Cardiovascular (CV) risk factors, such as hypertension, diabetes, and hyperlipidemia are associated with cognitive impairment and risk of dementia in older adults. However, the mechanisms linking them are not clear. This study aims to investigate the association between aggregate CV risk, assessed by the Framingham general cardiovascular risk profile, and functional brain activation in a group of community-dwelling older adults. Sixty participants (mean age: 64.6 years) from the Brain Health ...

  2. Preventing renal and cardiovascular risk by renal function assessment: Insights from a cross-sectional study in low-income countries and the USA

    OpenAIRE

    Cravedi, P.; Sharma, S. K.; R.F. Bravo; Islam, N; I. Tchokhonelidze; M. Ghimire; B Pahari; S. Thapa; A. Basnet; A. Tataradze; D. Tinatin; L. Beglarishvili; C. Fwu; Kopp, J B; P. Eggers

    2012-01-01

    Objective To assess the prevalence of microalbuminuria and kidney dysfunction in low-income countries and in the USA. Design Cross-sectional study of screening programmes in five countries. Setting Screening programmes in Nepal, Bolivia, the USA (National Health and Nutrition Examination Survey (NHANES) 2005–2008) Bangladesh and Georgia. Participants General population in Nepal (n=20 811), Bolivia (n=3436) and in the USA (n=4299) and high-risk subjects in Bangladesh (n=1518) and Georgia (n=15...

  3. Congenital cerebral palsy, child sex and parent cardiovascular risk.

    Directory of Open Access Journals (Sweden)

    Elani Streja

    Full Text Available OBJECTIVE: Genes associated with cardiovascular disease may also be risk factors for congenital cerebral palsy (CP and these associations may be modified by sex, since there is an increased risk of CP in male children. We investigated the association between CP of the child with cardiovascular disease in parents, taking sex of the child into consideration. METHODS: All parents of non-adopted singletons born in Denmark between 1973 and 2003 were included. Parents of a child with CP, confirmed by the Danish National CP registry, were considered exposed. Cox proportional hazards regressions were used to model risk of cardiovascular outcomes for exposed parents compared to all other parents beginning at the child's 10(th birthday. RESULTS: We identified 733,730 mothers and 666,652 fathers among whom 1,592 and 1,484, respectively, had a child with CP. The mean age for mothers at end of follow up was 50 ± 8 years. After adjustment for maternal age, parental education, child's sex, child's residence, child being small for gestational age and maternal hypertensive disorder during pregnancy, mothers of CP male children had an excess risk of cardiovascular disease (HR: 1.52, 95% CI: 1.16-2.00, attributable mostly to an increased incidence of hypertension and cerebrovascular disease. After additional adjustment for preterm birth, the association was markedly attenuated for cardiovascular disease (1.34, 95%CI: 1.02 - 1.76, became nonsignificant for hypertension, but remained significant for cerebrovascular disease (HR: 2.73, 95% CI: 1.45- 5.12. There was no increased risk of cardiovascular events in mothers of female CP children, or fathers of CP children of any sex. CONCLUSIONS: Women that have a male child with CP are at increased risk for premature cardiovascular disease. Part of this association may be related to risk factors for preterm births.

  4. Lowering triglycerides to modify cardiovascular risk: will icosapent deliver?

    Directory of Open Access Journals (Sweden)

    Scherer DJ

    2015-03-01

    Full Text Available Daniel J Scherer,1 Stephen J Nicholls2 1Cardiovascular Investigation Unit, Royal Adelaide Hospital, 2South Australian Health and Medical Research Institute, University of Adelaide, Adelaide, SA, Australia Abstract: Despite the clinical benefits of lowering levels of low-density lipoprotein cholesterol, many patients continue to experience cardiovascular events. This residual risk suggests that additional risk factors require aggressive modification to result in more effective prevention of cardiovascular disease. Hypertriglyceridemia has presented a considerable challenge with regard to understanding its role in the promotion of cardiovascular risk. Increasing evidence has established a clear causal role for elevated triglyceride levels in vascular risk. As a result, there is increasing interest in the development of specific therapeutic strategies that directly target hypertriglyceridemia. This has seen a resurgence in the use of omega-3 fatty acids for the therapeutic lowering of triglyceride levels. The role of these agents and other emerging strategies to reduce triglyceride levels in order to decrease vascular risk are reviewed. Keywords: hypertriglyceridemia, omega-3 fatty acid, fish oil, cardiovascular risk, lipids

  5. Diabetes Mellitus and Cardiovascular Risk : epidemiology, etiology and intervention

    OpenAIRE

    Rautio, Aslak

    2016-01-01

    Background: The Framingham Study from 1988 showed a heavy impact of diabetes mellitus (DM) on the risk and prognosis of cardiovascular disease (CVD). Several other studies have confirmed that DM is an independent risk factor for coronary heart disease (CHD) and that patients with DM have a poor prognosis. However, the strength of DM as a risk factor is debated. Some studies indicate that DM, as a risk factor for a coronary event, is comparable to already known or established CHD. Also, mechan...

  6. Cancer therapy and cardiovascular risk: focus on bevacizumab

    International Nuclear Information System (INIS)

    Recognition and management of treatment-related cardiovascular toxicity, defined as either an acute cardiac event or a chronic condition, has been tightly integrated into routine cancer care and has become an important component in treatment selection. Several chemotherapeutic agents, such as anthracyclines, are traditionally characterized as cardiotoxic, but cardiovascular adverse events are also associated with commonly used molecular targeted therapies. In the past decade, bevacizumab, a monoclonal humanized antibody against vascular endothelial growth factor, has been introduced in the treatment of a variety of metastatic malignancies. Despite its efficacy, bevacizumab has been associated with significant risk of cardiovascular complications, such as hypertension, cardiac ischemia, and congestive heart failure. This review will focus on the cardiovascular toxicity of bevacizumab, providing the latest evidence on the incidence, clinical spectrum, risk factors, and responsible mechanisms

  7. A novel risk score to predict cardiovascular disease risk in national populations (Globorisk)

    DEFF Research Database (Denmark)

    Hajifathalian, Kaveh; Ueda, Peter; Lu, Yuan;

    2015-01-01

    , diabetes, and total cholesterol, and allowed the effects of sex and age on cardiovascular disease to vary between cohorts or countries. We developed risk equations for fatal cardiovascular disease and for fatal plus non-fatal cardiovascular disease. We validated the risk equations internally and also using...... regions (China, Czech Republic, Denmark, England, Iran, Japan, Malawi, Mexico, South Korea, Spain, and USA). FINDINGS: The risk score discriminated well in internal and external validations, with C statistics generally 70% or more. At any age and risk factor level, the estimated 10 year fatal....... Conversely, the proportion of people at high risk of fatal cardiovascular disease was largest in China and Mexico. In China, 33% of men and 28% of women had a 10-year risk of fatal cardiovascular disease of 10% or more, whereas in Mexico, the prevalence of this high risk was 16% for men and 11% for women...

  8. Management of Cardiovascular Risk in Patients with Chronic Inflammatory Diseases

    DEFF Research Database (Denmark)

    Lindhardsen, Jesper; Kristensen, Søren Lund; Ahlehoff, Ole

    2016-01-01

    An increased risk of cardiovascular disease (CVD) has been observed in a range of chronic inflammatory diseases (CID), including rheumatoid arthritis (RA), psoriasis, inflammatory bowel diseases (IBD), and systemic lupus erythematosus (SLE). The increased risk of CVDs and reduced life expectancy in...... gained considerable interest in recent years. We briefly summarize the current level of evidence of the association between CIDs and CVD and cardiovascular risk management recommendations. Perspectives of ongoing and planned trials are discussed in consideration of potential ways to improve primary and...

  9. Heart Attack Risk Assessment

    Science.gov (United States)

    ... Pressure Tools & Resources Stroke More Heart Attack Risk Assessment Updated:May 31,2016 We're sorry, but ... Can You Recognize a Heart Attack? Quiz Risk Assessment Patient Information Sheets: Heart Attack Heart Attack Personal ...

  10. Cardiovascular Disease Risk Factors among Emerging Adults in College

    Science.gov (United States)

    Abshire, Demetrius Alexander

    2014-01-01

    The purpose of this dissertation was to examine factors associated with cardiovascular disease (CVD) risk among emerging adults in college aged 18-25 years. CVD risks that develop during this period often persist into adulthood making it an ideal time to target CVD prevention. The specific aims of this dissertation were to 1) explore perceptions…

  11. Apolipoprotein E genotype, cardiovascular biomarkers and risk of stroke

    DEFF Research Database (Denmark)

    Khan, Tauseef A; Shah, Tina; Prieto, David;

    2013-01-01

    At the APOE gene, encoding apolipoprotein E, genotypes of the ε2/ε3/ε4 alleles associated with higher LDL-cholesterol (LDL-C) levels are also associated with higher coronary risk. However, the association of APOE genotype with other cardiovascular biomarkers and risk of ischaemic stroke is less c...

  12. Dietary epicatechin intake and 25-y risk of cardiovascular mortality

    NARCIS (Netherlands)

    Dower, James I.; Geleijnse, Johanna M.; Hollman, Peter C.H.; Soedamah-Muthu, Sabita S.; Kromhout, Daan

    2016-01-01

    Background: Prospective cohort studies have shown that the consumption of cocoa and tea is associated with lower risk of cardiovascular diseases (CVDs), and cocoa and tea have been shown to improve CVD risk factors in randomized controlled trials. Cocoa and tea are major dietary sources of the fl

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

    Science.gov (United States)

    Backes, James M; Howard, Patricia A

    2014-11-01

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

  14. Krill Oil for Cardiovascular Risk Prevention: Is It for Real?

    OpenAIRE

    Backes, James M; Howard, Patricia A.

    2014-01-01

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

  15. Paternal Metabolic and Cardiovascular Risk Factors for Fetal Growth Restriction

    OpenAIRE

    Hillman, Sara; Peebles, Donald M.; Williams, David J.

    2013-01-01

    OBJECTIVE Fathers of low–birth weight offspring are more likely to have type 2 diabetes and cardiovascular disease in later life. We investigated whether paternal insulin resistance and cardiovascular risk factors were evident at the time that fetal growth–restricted offspring were born. RESEARCH DESIGN AND METHODS We carried out a case-control study of men who fathered pregnancies affected by fetal growth restriction, in the absence of recognized fetal disease (n = 42), compared with men who...

  16. Rosuvastatin: Role in Cardiovascular High-risk Patient

    Directory of Open Access Journals (Sweden)

    John E Feliciano-Alfonso

    2013-01-01

    Full Text Available Statins are the lipid-lowering drug family of first choice in situations of hypercholesterolemia or mixed dyslipidemia with predominant increase in cholesterol. The evidence shows conclusively that each one of the commercially available statins have proven benefits on outcomes of cardiovascular morbidity and mortality. However, rosuvastatin has certain pharmacokinetic efficacy and cost-effectiveness characteristics that make it an attractive molecule to be the statin of choice in patients at high cardiovascular risk.

  17. Type 2 diabetes: postprandial hyperglycemia and increased cardiovascular risk

    OpenAIRE

    Aryangat, Ajikumar V; Gerich, John E.

    2010-01-01

    Ajikumar V Aryangat, John E GerichUniversity of Rochester, Rochester, New York, USAAbstract: Hyperglycemia is a major risk factor for both the microvascular and macrovascular complications in  patients with type 2 diabetes. This review summarizes the cardiovascular results of large outcomes trials in diabetes and presents new evidence on the role of hyperglycemia, with particular emphasis on postprandial hyperglycemia, in adverse cardiovascular outcomes in patients with type 2 diabet...

  18. Cardiovascular Disease Risk Factors in Older People with Intellectual Disabilities

    OpenAIRE

    Winter, Channa

    2014-01-01

    markdownabstract__Abstract__ Chapter 1 General introduction There is an increasing group of older people with intellectual disability in The Netherlands, reaching almost the same life expectancy as the general population. Age-related diseases, such as cardiovascular disease, cancer and dementia are now the most encountered diseases and causes of death in older people with intellectual disabilities. Although cardiovascular disease is a major risk for older people with intellectual disabilities...

  19. Genetically Low Antioxidant Protection and Risk of Cardiovascular Disease and Heart Failure in Diabetic Subjects

    DEFF Research Database (Denmark)

    Kobylecki, Camilla J; Afzal, Shoaib; Nordestgaard, Børge G

    2015-01-01

    risk of cardiovascular disease and heart failure. METHODS: We used the prospective Copenhagen General Population Study and Copenhagen City Heart Study and genotyped 95,871 individuals for the rs1799895 R213G variation in the SOD3 gene, of which 4498 had diabetes. We used national hospitalization and...... death registers to assess cardiovascular disease and heart failure. FINDINGS: Out of 95,871 individuals, we identified 93,521 R213G non-carriers (213RR, 97.5%), 2336 heterozygotes (213RG, 2.4%) and 14 homozygotes (213GG, 0.01%). In diabetic subjects, the hazard ratio for cardiovascular disease in R213G.......49-0.92) in non-diabetic subjects (p for interaction < 0.001). INTERPRETATION: Risk of cardiovascular disease and heart failure was higher in R213G heterozygotes versus non-carriers in diabetic subjects, but not in non-diabetic subjects....

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

    OpenAIRE

    Folsom, Aaron R.

    2013-01-01

    Cardiovascular risk prediction models based on classical risk factors identified in epidemiologic cohort studies are useful in primary prevention of cardiovascular disease in individuals. This article briefly reviews aspects of cardiovascular risk prediction in the United States and efforts to evaluate novel risk factors. Even though many novel risk markers have been found to be associated with cardiovascular disease, few appear to improve risk prediction beyond the powerful, classical risk f...

  1. Implementation of cardiovascular risk factor recording in a rheumatology outpatient clinic

    OpenAIRE

    2013-01-01

    Background: The high cardiovascular (CV) risk in patients with rheumatoid arthritis (RA) is under-recognized and under-assessed in both primary and secondary health care. Our aim was to evaluate the quality of CV risk recording in rheumatology outpatient clinics and to evaluate strategies for optimizing CV risk factor screening in RA patients. Methods: RA patients (n=1142) who visited the rheumatology outpatient clinic at the Hospital of Southern Norway in 2012, either attended the regul...

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

    OpenAIRE

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

    2008-01-01

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

  3. Novel risk factors for cardiovascular disease in rheumatoid arthritis.

    Science.gov (United States)

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

    2013-07-01

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

  4. Assessment of cardiovascular system in subclinical hyperthyroidosis

    International Nuclear Information System (INIS)

    from 3.97+/- 1.2 to 3.75 +/-1,3 1/min, P=NS. There were no statistical differences in global and regional perfusion before and after treatment on summed images. In 12 patients after the treatment we observed the improved perfusion on end-diastolic images. The group with end-diastolic perfusion changes had a higher FT4 and FT3 (pyper. The major cardiovascular findings in patients with SH coupled with undetectable TSH are a higher heart rate and a higher risk of supraventricular arrhythmias. The most consistent cardiac abnormality is a significant increase in left ventricular mass with unchanged or increased at-rest systolic function and, usually, impaired diastolic function . Moreover, reduced systolic performance on effort and decreased exercise tolerance has been reported in patients with SH who had a greater increase in left ventricular mass. Thyroid hormone-induced hypertrophy in SH is due primarily to the cardiac response induced by the increased cardiac workload. This is accordance with cardiac hypertrophy induced in rats by thyroid hormone excess. Moreover, the significant increase in left ventricular mass with a tendency towards LV concentric remodelling reported in patients with long-standing SH may counter act the favourable effect acutely exerted by thyroid hormone on diastolic performance, and so lead to impaired ventricular relaxation and systolic dysfunction during effort. The altered passive elasticity of the ventricle (chamber stiffness) determined by the presence of myocardial hypertrophy is the major determinant of diastolic dysfunction in patients with subclinical hyperthyroidism. However, the increase in heart rate and in left ventricular mass usually precedes the onset of more severe cardiovascular disease, and is an independent risk factor for increased cardiovascular morbidity and mortality in the general population. Conclusion: It was found that excess of thyroid hormones during endogenic subclinical hyperhyreosis affects cardiovascular system on

  5. Cardiovascular risk factors in workers at Health Centre in Beočin

    Directory of Open Access Journals (Sweden)

    Petrović Biljana

    2008-01-01

    Full Text Available Most cardiovascular diseases are caused by atherosclerosis, which is a result of interactions between risk factors such as gender, age, blood lipid concentrations, blood pressure, glucose tolerance, adiposity, physical activity and cigarette smoking. Identification of risk factors is the first step in cardiovascular disease prevention. As health workers contribute significantly to cardiovascular morbidity, the aim of our study was to analyze prevalence of cardiovascular risk factors and to assess the level of mentioned risk in health workers employed in Health Centre Beočin. The study group consisted of 50 health workers. Obesity was evaluated according to BMI and body fat (BF% values, while central obesity was defined using waist circumference. Serum lipid concentrations and glycaemia were used in metabolic profile definition. The level of physical activity was assessed using IPAQ, and information about smoking status and family history of cardiovascular diseases was obtained from self-report. Framingham point-scoring system was used to predict the risk for development of coronary heart disease in the 10-year period. Overweight was found in 36%, and obesity in 18% subjects. 42% of examined subjects had higher fat mass, while 24% of them had obesity. Central fat accumulation was observed in 50% subjects. We registered 56% smokers, 70% subjects with positive family history, 28% subjects with hypertension, and 56% subjects with dyslipidemia. According to IPAQ results 20% of exanimate subjects were minimally active and 70% were insufficiently active. Estimated risk of coronary heart disease was 7.38%, and 10% subjects had risk over 20%. In spite of lower cardiovascular risk level, our results showed high prevalence of overweight, smoking and physical inactivity in health workers, which suggests the importance of their own lifestyle modification. It should be the first step in increasing motivation of their patients.

  6. Expanding the definition of hypertension to incorporate global cardiovascular risk.

    Science.gov (United States)

    Khosla, Nitin; Black, Henry R

    2006-10-01

    Recent epidemiologic analyses have changed the way that hypertension is viewed. Cardiovascular risk has been found to be elevated at levels of blood pressure previously believed to be normal and not imparting additional risk. Furthermore, the approach to hypertension has been shifted from viewing and treating it in isolation to a more comprehensive approach that incorporates a focus on global cardiovascular risk and the risk factors commonly associated with having an elevated blood pressure. However, control rates not only for hypertension but also for associated risk factors, such as hyperlipidemia and diabetes, remain abysmal, providing an even greater challenge to providers of care. To change this alarming trend, physicians must become aggressive in using the available armamentarium of lifestyle modifications and drugs in treating hypertension and other risk factors that increase the burden of atherosclerosis. PMID:16965724

  7. Congenital cerebral palsy, child sex and parent cardiovascular risk

    DEFF Research Database (Denmark)

    Streja, Elani; Wu, Chunsen; Uldall, Peter Vilhelm;

    2013-01-01

    OBJECTIVE: Genes associated with cardiovascular disease may also be risk factors for congenital cerebral palsy (CP) and these associations may be modified by sex, since there is an increased risk of CP in male children. We investigated the association between CP of the child with cardiovascular...... disease in parents, taking sex of the child into consideration. METHODS: All parents of non-adopted singletons born in Denmark between 1973 and 2003 were included. Parents of a child with CP, confirmed by the Danish National CP registry, were considered exposed. Cox proportional hazards regressions were...... used to model risk of cardiovascular outcomes for exposed parents compared to all other parents beginning at the child's 10(th) birthday. RESULTS: We identified 733,730 mothers and 666,652 fathers among whom 1,592 and 1,484, respectively, had a child with CP. The mean age for mothers at end of follow...

  8. Patients’ experiences managing cardiovascular disease and risk factors in prison

    OpenAIRE

    Thomas, Emily H.; Wang, Emily A.; Curry, Leslie A.; Chen, Peggy G.

    2016-01-01

    Background Despite greater risk of cardiovascular disease (CVD) mortality in patients with a history of incarceration, little is known about how prisons manage CVD risk factors (CVD-RF) to mitigate this risk. Methods We conducted in-depth interviews with individuals with CVD-RF who had been recently released from prison (n = 26). These individuals were recruited through community flyers and a primary care clinic in Connecticut. Using a grounded theory approach and the constant comparative met...

  9. Adverse Pregnancy Outcomes and Cardiovascular Risk Factor Management

    OpenAIRE

    Mehta, Puja K.; Minissian, Margo; Merz, C. Noel Bairey

    2015-01-01

    Cardiovascular disease (CVD) is the leading health threat to American women. In addition to established risk factors for hypertension, hyperlipidemia, diabetes, smoking, and obesity, adverse pregnancy outcomes (APOs) including pre-eclampsia, eclampsia, and gestational diabetes are now recognized as factors that increase a woman’s risk for future CVD. CVD risk factor burden is disproportionately higher in those of low socioeconomic status and in ethnic/racial minority women. Since younger wome...

  10. Risk of Cardiovascular Disease in a Traditional African Population with a High Infectious Load: A Population-Based Study

    OpenAIRE

    Koopman J.J.; van Bodegom D.; Jukema J.W.; Westendorp R.G.

    2012-01-01

    BACKGROUND: To test the inflammatory origin of cardiovascular disease, as opposed to its origin in western lifestyle. Population-based assessment of the prevalences of cardiovascular risk factors and cardiovascular disease in an inflammation-prone African population, including electrocardiography and ankle-arm index measurement. Comparison with known prevalences in American and European societies. METHODOLOGY/PRINCIPAL FINDINGS: Traditional population in rural Ghana, characterised by adverse ...

  11. Hypoglycemia and Cardiovascular Risk: Is There a Major Link?

    Science.gov (United States)

    Hanefeld, Markolf; Frier, Brian M; Pistrosch, Frank

    2016-08-01

    Severe hypoglycemia is recognized to be one of the strongest predictors of macrovascular events, adverse clinical outcomes, and mortality in patients with type 2 diabetes. However, it is uncertain whether a direct pathophysiological link exists or whether hypoglycemia is primarily a marker of vulnerability to these events. Large clinical trials have reported an increased hazard ratio for all-cause mortality and cardiovascular events in patients with type 2 diabetes and severe hypoglycemia, but such an association has not been demonstrated in prospective trials of people with type 1 diabetes. Several cardiovascular effects occur during hypoglycemia either as a result of low blood glucose levels per se or through activation of the sympathoadrenal response: hemodynamic changes with an increase in cardiac work load and potential attenuation of myocardial perfusion, electrophysiological changes that may be arrhythmogenic, induction of a prothrombotic state, and release of inflammatory markers. Although the potential for a causal relationship has been demonstrated in mechanistic studies, the evidence from large prospective studies that hypoglycemia is a major causal contributor to cardiovascular events is limited to date. Other preexisting cardiovascular risk factors in addition to hypoglycemia may be the major link to the final cardiovascular event, but a low blood glucose level can trigger these events in patients with a high cardiovascular risk. PMID:27440834

  12. Should We Use PPAR Agonists to Reduce Cardiovascular Risk?

    Directory of Open Access Journals (Sweden)

    Jennifer G. Robinson

    2008-01-01

    Full Text Available Trials of peroxisome proliferator-activated receptor (PPAR agonists have shown mixed results for cardiovascular prevention. Fibrates are PPAR- agonists that act primarily to improve dyslipidemia. Based on low- and high-density lipoprotein cholesterol (LDL and HDL effects, gemfibrozil may be of greater cardiovascular benefit than expected, fenofibrate performed about as expected, and bezafibrate performed worse than expected. Increases in both cardiovascular and noncardiovascular serious adverse events have been observed with some fibrates. Thiazolidinediones (TZDs are PPAR- agonists used to improve impaired glucose metabolism but also influence lipids. Pioglitazone reduces atherosclerotic events in diabetic subjects, but has no net cardiovascular benefit due to increased congestive heart failure risk. Rosiglitazone may increase the risk of atherosclerotic events, and has a net harmful effect on the cardiovascular system when congestive heart failure is included. The primary benefit of TZDs appears to be the prevention of diabetic microvascular complications. Dual PPAR-/ agonists have had unacceptable adverse effects but more selective agents are in development. PPAR- and pan-agonists are also in development. It will be imperative to prove that future PPAR agonists not only prevent atherosclerotic events but also result in a net reduction on total cardiovascular events without significant noncardiovascular adverse effects with long-term use.

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

    International Nuclear Information System (INIS)

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

  14. Blood pressure management in cardiovascular risk stratification : procedure, progression, process

    OpenAIRE

    Adiyaman, A.

    2009-01-01

    In this thesis we have explored different aspects of blood pressure measurement and related it to the risk of cardiovascular disease. In the first part we showed that when the arm is positioned under heart level, for example when the arm is placed on a desk or a chair support, the blood pressure and the cardiovascular risk is overstimated. We demonstrated that crossing the legs at the level of the knee, but not at the level of the ankle, causes a rise of blood pressure. We proved that the phy...

  15. The role of traditional cardiovascular risk factors among patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Brady, Sharmayne R E; de Courten, Barbora; Reid, Christopher M; Cicuttini, Flavia M; de Courten, Maximilian; Liew, Danny

    2009-01-01

    People with rheumatoid arthritis (RA) have an increased risk of cardiovascular disease (CVD) compared with the general population. We investigated the relative contribution of traditional cardiovascular risk factors to this elevated risk.......People with rheumatoid arthritis (RA) have an increased risk of cardiovascular disease (CVD) compared with the general population. We investigated the relative contribution of traditional cardiovascular risk factors to this elevated risk....

  16. Arterial stiffness, central hemodynamics, and cardiovascular risk in hypertension

    Directory of Open Access Journals (Sweden)

    Palatini P

    2011-12-01

    reduction. Although many methodological problems still hinder the wide clinical application of parameters of arterial stiffness, these will likely contribute to cardiovascular assessment and management in future clinical practice. Each of the abovementioned parameters reflects a different characteristic of the atherosclerotic process, involving functional and/or morphological changes in the vessel wall. Therefore, acquiring simultaneous measurements of different parameters of vascular function and structure could theoretically enhance the power to improve risk stratification. Continuous technological effort is necessary to refine our methods of investigation in order to detect early arterial abnormalities. Arterial stiffness and its consequences represent the great challenge of the twenty-first century for affluent countries, and “de-stiffening” will be the goal of the next decades.Keywords: arterial elasticity, stiffness, compliance, central blood pressure, pulse wave velocity

  17. Risco cardiovascular, efetividade e mortalidade Cardiovascular risk, effectiveness and mortality Riesgo cardiovascular, efectividad y mortalidad

    Directory of Open Access Journals (Sweden)

    Juan Gérvas

    2012-02-01

    Full Text Available

    A Lei de Ferro da Epidemiologia (Ley de Hierro de La Epidemiología diz que todos que nascem, morrem. Por isso, o propósito da Medicina não é evitar a morte por si só, mas evitar as mortes, as doenças e o sofrimento que podem ser medicamente evitáveis.

    No final, todos nossos pacientes morrerão – e nós também, obviamente, morreremos. “Os corpos encontram uma forma de morrer”, e se a causa não for por fome ou desidratação, por motivo congênito e infeccioso, por lesões, câncer ou suicídio, temos que esperar que seja por ‘motivo cardiovascular’, doença pulmonar, insuficiência renal ou hepática, demência ou outras doenças degenerativas. Mas temos que morrer por alguma coisa.

    Morrer por causa cardiovascular não é desonroso, nem refere-se à atenção clínica imperfeita. O fato de a primeira causa de morte ser a cardiovascular não tem nenhuma relação com os cuidados clínicos e nem deveria assustar.

    Entretanto, muitas das mortes por motivo cardiovascular poderiam ser evitadas. Assim, poder-se-ia evitar mortalidade cardiovascular, diminuindo a desigualdade social, por exemplo, com melhor redistribuição da riqueza, melhor educação etc. Os médicos sabem que os fatores adversos psicossociais associados ao fato de pertencer à classe baixa correspondem a 35% do risco atribuído à hipertensão na incidência do infarto do miocárdio (em outra hipótese, pertencer à classe baixa duplica 2,7 tal risco1.

    Também deve-se saber que, contra as mortes cardiovasculares, não há nada como as políticas de saúde pública quanto ao tabagismo (restrições dos lugares onde fumar, aumento do preço do tabaco, campanhas de informação, entre outras.

    Na parte clínica, as mortes cardiovasculares evitáveis devem ser vistas em perspectiva, de acordo com o que seja possível conseguir2. Portanto, por 100.000 habitantes ao ano, o tratamento com inibidores da enzima conversora de angiotensina (IECA

  18. GM Risk Assessment

    Science.gov (United States)

    Sparrow, Penny A. C.

    GM risk assessments play an important role in the decision-making process surrounding the regulation, notification and permission to handle Genetically Modified Organisms (GMOs). Ultimately the role of a GM risk assessment will be to ensure the safe handling and containment of the GMO; and to assess any potential impacts on the environment and human health. A risk assessment should answer all ‘what if’ scenarios, based on scientific evidence.

  19. Cardiovascular disease risk in women with premature ovarian insufficiency : A systematic review and meta-analysis

    NARCIS (Netherlands)

    Roeters van Lennep, Jeanine E; Heida, Karst Y; Bots, Michiel L; Hoek, Annemieke

    2014-01-01

    AIMS: The purpose of this review was to assess the relationship between premature ovarian insufficiency (POI), defined as natural menopause <40 years, and risk of ischaemic heart disease (IHD), stroke and overall cardiovascular disease (CVD). METHODS AND RESULTS: We performed a systematic search in

  20. Adiponectin, type 2 diabetes and cardiovascular risk

    DEFF Research Database (Denmark)

    Lindberg, Søren; Jensen, Jan Skov; Bjerre, Mette;

    2015-01-01

    BACKGROUND: Adiponectin is viewed as an insulin-sensitizing hormone with anti-inflammatory effects. In accordance, plasma adiponectin is decreased in metabolic disorders including type 2 diabetes mellitus (T2DM). However, in spite of the apparently beneficially effects, recent data from large...... prospective studies have consistently linked high adiponectin levels with increased cardiovascular (CV) disease and mortality, thus questioning the positive view on adiponectin. Accordingly, we investigated the relationship between adiponectin, incident T2DM and subsequently CV events. METHODS: We...... prospectively followed 5349 randomly selected men and women from the community, without T2DM or CV disease. Plasma adiponectin was measured at study entry. Median follow-up time was 8.5 years (IQR 8.0-9.1 years). During follow up, 136 participants developed T2DM. Following their diagnosis, 36 of the 136...

  1. Strategic Risk Assessment

    Science.gov (United States)

    Derleth, Jason; Lobia, Marcus

    2009-01-01

    This slide presentation provides an overview of the attempt to develop and demonstrate a methodology for the comparative assessment of risks across the entire portfolio of NASA projects and assets. It includes information about strategic risk identification, normalizing strategic risks, calculation of relative risk score, and implementation options.

  2. The impact of dietary habits and metabolic risk factors on cardiovascular and diabetes mortality in countries of the Middle East and North Africa in 2010: a comparative risk assessment analysis

    OpenAIRE

    Afshin, Ashkan; Micha, Renata; Khatibzadeh, Shahab; Fahimi, Saman; Shi, Peilin; Powles, John; Singh, Gitanjali; Yakoob, Mohammad Yawar; Abdollahi, Morteza; Al-Hooti, Suad; Farzadfar, Farshad; HOUSHIAR-RAD, Anahita; Hwalla, Nahla; Koksal, Eda; Musaiger, Abdulrahman

    2015-01-01

    Objective/design We conducted a comparative risk assessment analysis to estimate the cardiometabolic disease (CMD) mortality attributable to 11 dietary and 4 metabolic risk factors in 20 countries of the Middle East by age, sex and time. The national exposure distributions were obtained from a systematic search of multiple databases. Missing exposure data were estimated using a multilevel Bayesian hierarchical model. The aetiological effect of each risk factor on disease-specific mortality wa...

  3. State of risk assessment

    International Nuclear Information System (INIS)

    In view of the growing importance assumed in recent years by scientific work on the calculation, quantification, evaluation and acceptance as well as behavior in the face of risks in general and more specifically, the risks of large industrial plants, the report attempts to provide a survey of the current situation, results and evaluation of this new branch of research, risk assessment. The emphasis of the report is on the basic discussion and criticism of the theoretical and methodological approaches used in the field of risk assessment (section 3). It is concerned above all with - methodical problems of determining and quantifying risks (3.1) - questions of the possibility of risk evaluation and comp arison (3.1, 3.2) - the premises of normative and empirical studies on decision making under risk (3.2, 3.3) - investigations into society's acceptance of risks involved in the introduction of new technologies (3.4) - attempts to combine various aspects of the field of risk assessment in a unified concept (3.5, 3.6, 3.7). Because risk assessment is embedded in the framework of decision theory and technology assessment, it can be implicitly evaluated at a more general level within this framework, as far as its possibilities and weaknesses of method and application are concerned (section 4). Sections 2 and 5 deal with the social context of origin and utilization of risk assessment. Finally, an attempt is made at a summary indicating the possible future development of risk assessment. (orig./HP)

  4. Effects of customized risk reduction program on cardiovascular risk in males with spinal cord injury

    Directory of Open Access Journals (Sweden)

    Jonathan Myers, PhD

    2012-12-01

    Full Text Available Persons with spinal cord injury (SCI have heightened risk for cardiovascular disease (CVD. Multidisciplinary risk reduction programs using case management models have been effective in reducing CVD risk in nondisabled persons, but little is known regarding the effects of such programs in SCI. Twenty-six persons with SCI underwent a pilot 2 yr risk intervention program including frequent telephone contact by a case manager and in-person visits by a dietitian, physical therapist, and exercise physiologist. At 6 mo intervals, measurements were made of dietary intake, glucose and lipids, physical activity patterns, and exercise capacity. Of the 26 participants, 10 remained in the program for the full 2 yr; medical issues unrelated to the program were the major reasons for dropping out. Significant improvements were observed in weight, plasma insulin, homeostatic model assessment insulin resistance, and total cholesterol/high-density lipoprotein ratio, although these changes were not consistent across visits. No differences in estimates of physical activity patterns were demonstrated, nor were differences in dietary macronutrient intake observed. Thus, modest changes in some CVD risk markers can be achieved by a multidisciplinary risk reduction program in SCI. Such programs present more challenges than in ambulatory persons, and more intensive risk intervention may be required to appreciably reduce CVD risk in SCI.

  5. Cardiovascular Risk Surveillance to Develop a Nationwide Health Promotion Strategy

    Science.gov (United States)

    Bansilal, Sameer; Vedanthan, Rajesh; Woodward, Mark; Iyengar, Rupa; Hunn, Marilyn; Lewis, Marcelle; Francis, Lesley; Charney, Alexander; Graves, Claire; Farkouh, Michael E.; Fuster, Valentin

    2015-01-01

    OBJECTIVE The Grenada Heart Project aims to study the clinical, biological, and psychosocial determinants of the cardiovascular health in Grenada in order to develop and implement a nationwide cardiovascular health promotion program. METHODS We recruited 2,827 adults randomly selected from the national electronic voter list. The main outcome measures were self-reported cardiovascular disease and behavioral risk factors, anthropometric measures, blood pressure, point-of-care testing for glucose and lipids, and ankle-brachial index. Risk factors were also compared with the U.S. National Health and Nutritional Survey data. RESULTS Prevalence of cardiovascular disease risk factors were: overweight and obesity—57.7% of the population, physical inactivity—23.4%, diabetes—13.3%, hypertension—29.7%, hypercholesterolemia—8.6%, and smoking—7%. Subjects who were physically active had a significantly lower 10-year Framingham risk score (p < 0.001). Compared with the U.S. National Health and Nutrition Survey data, Grenadian women had higher rates of adiposity, diabetes, hypertension, and elevated low-density lipoprotein cholesterol, whereas Grenadian men had a higher rate of diabetes, a similar rate of hypertension, and lower rates of the other risk factors. Prevalence of peripheral arterial disease was 7.6%; stroke and coronary heart disease were equally prevalent at ~2%. CONCLUSION This randomly selected adult sample in Grenada reveals prevalence rates of obesity, hypertension, and diabetes significantly exceeding those seen in the United States. The contrasting, paradoxically low levels of prevalent cardiovascular disease support the concept that Grenada is experiencing an obesity-related “risk transition.” These data form the basis for the implementation of a pilot intervention program based on the Institute of Medicine recommendations and may serve as a model for other low- and middle-income countries. PMID:25691303

  6. The effectiveness of screening for diabetes and cardiovascular disease risk factors in a community pharmacy setting.

    Directory of Open Access Journals (Sweden)

    Andrew Willis

    Full Text Available Risk factors for cardiovascular disease including diabetes have seen a large rise in prevalence in recent years. This has prompted interest in prevention through the identifying individuals at risk of both diabetes and cardiovascular disease and has seen increased investment in screening interventions taking place in primary care. Community pharmacies have become increasingly involved in the provision of such interventions and this systematic review and meta-analysis aims to gather and analyse the existing literature assessing community pharmacy based screening for risk factors for diabetes and those with a high cardiovascular disease risk.We conducted systematic searches of electronic databases using MeSH and free text terms from 1950 to March 2012. For our analysis two outcomes were assessed. They were the percentage of those screened who were referred for further assessment by primary care and the uptake of this referral.Sixteen studies fulfilled our inclusion criteria comprising 108,414 participants screened. There was significant heterogeneity for all included outcomes. Consequently we have not presented summary statistics and present forest plots with I2 and p values to describe heterogeneity. We found that all included studies suffered from high rates of attrition between pharmacy screening and follow up. We have also identified a strong trend towards higher rates for referral in more recent studies.Our results show that pharmacies are feasible sites for screening for diabetes and those at risk of cardiovascular disease. A significant number of previously unknown cases of cardiovascular disease risk factors such as hypertension, hypercholesterolemia and diabetes are identified, however a significant number of referred participants at high risk do not attend their practitioner for follow up. Research priorities should include methods of increasing uptake to follow up testing and early intervention, to maximise the efficacy of screening

  7. Family history of premature death and risk of early onset cardiovascular disease

    DEFF Research Database (Denmark)

    Ranthe, Mattis Flyvholm; Carstensen, Lisbeth; Oyen, Nina; Tfelt-Hansen, Jacob; Christiansen, Michael; McKenna, William J; Wohlfahrt, Jan; Melbye, Mads; Boyd, Heather A

    2012-01-01

    The purpose of this study was to examine the effect of a family history of premature death, cardiovascular death in particular, on the risk of early cardiovascular disease.......The purpose of this study was to examine the effect of a family history of premature death, cardiovascular death in particular, on the risk of early cardiovascular disease....

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

    Science.gov (United States)

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

    2002-01-01

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

  9. Vitamin D status and changes in cardiovascular risk factors

    DEFF Research Database (Denmark)

    Skaaby, Tea; Husemoen, Lise Lotte Nystrup; Pisinger, Charlotta;

    2012-01-01

    A low vitamin D level has been associated with increased cardiovascular disease risk but possible mechanisms remain unclear. We investigated the association between vitamin D levels and 5-year changes in blood pressure, lipid profile and incidence of the metabolic syndrome, hypertension and hyper...... hypercholesterolemia....

  10. Estimation of cardiovascular risk severity in chronic periodontitis patients

    Directory of Open Access Journals (Sweden)

    Mousumi Kundu Kundu

    2015-02-01

    CONCLUSION: Chronic periodontitis (CPD is associated with increased risk of cardiovascular disease as evidenced by increased hsCRP and radiological parameters. Successful periodontal therapy could decrease serum inflammatory parameters. [TAF Prev Med Bull 2015; 14(1.000: 49-54

  11. Hardiness and cardiovascular risk in the Czech sample

    Czech Academy of Sciences Publication Activity Database

    Šolcová, Iva; Kebza, V.

    2007-01-01

    Roč. 1, č. 1 (2007), s. 97-97. ISSN 1743-7199. [Conference of the EHPS /21./ "Health Psychology and Society". 15.08.2007-18.08.2007, Maastricht] R&D Projects: GA AV ČR(CZ) IAA700250701 Institutional research plan: CEZ:AV0Z70250504 Keywords : Hardiness * Cardiovascular Risks Subject RIV: AN - Psychology

  12. Cardiovascular risk management in diabetes in primary care.

    Science.gov (United States)

    Kalra, Sanjay; Gupta, Yashdeep

    2015-08-01

    This communication describes simple targets and interventions, aimed at cardiovascular risk reduction in diabetes mellitus, which are feasible at primary care level. It summarizes therapeutic goals and strategies for management of high blood pressure, dyslipidaemia, and anti-platelet therapy. PMID:26228345

  13. Prognostic Importance of Cardiovascular Risk Factors in Myocardial Infarction Patients

    Czech Academy of Sciences Publication Activity Database

    Monhart, Z.; Grünfeldová, H.; Zvárová, Jana; Janský, P.

    2010-01-01

    Roč. 122, č. 2 (2010), e253. ISSN 0009-7322. [World Congress of Cardiology. 16.06.2010-19.06.2010, Beijing] Institutional research plan: CEZ:AV0Z10300504 Keywords : cardiology * risk factors * myocardioal infarction Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery

  14. RISK FACTORS ASSOCIATED WITH CARDIOVASCULAR DISEASE IN PRISON POPULATION

    Directory of Open Access Journals (Sweden)

    Ricardo Soares de OliveiraI

    2014-02-01

    Full Text Available This work aimed to make a reflection about the risk factors associated with cardiovascular disease in the prison population, as well as the performance of the health care team in these spaces. It is a reflective approach, literature that included e-journal articles, published in the year 2003 to 2011, indexed at LILACS, Scielo, MEDLINE, and available in full. Textbooks were also consulted and ordinances of Ministry of health and Justice of Brazil. Used the descriptors "risk factors," "cardiovascular disease" and "Prisoners". It was noted that the current situation of overcrowding in prisons is, with unhealthy environment, which imposes risks the health of prisoners. The living habits, such as use of alcohol and drugs (cocaine, marijuana, tranquillizers and tobacco, increases the risk for cardiovascular disease. In addition, the authors emphasize, a priori, the low level of schooling of the detainees. The performance of the health care team must be based on educational practices for promoting and monitoring the health, with multidisciplinary support. Further studies need to be done in order to investigate the incidence of cardiovascular diseases, as well as evidence of the effectiveness of health care for this population.

  15. Dietary Risk Factors and Their Modification in Cardiovascular Disease.

    Science.gov (United States)

    Jeffery, Robert W.

    1988-01-01

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

  16. Physical distress is associated with cardiovascular events in a high risk population of elderly men

    Directory of Open Access Journals (Sweden)

    Klemsdal Tor O

    2009-03-01

    Full Text Available Abstract Background Self-reported health perceptions such as physical distress and quality of life are suggested independent predictors of mortality and morbidity in patients with established cardiovascular disease. This study examined the associations between these factors and three years incidence of cardiovascular events in a population of elderly men with long term hyperlipidemia. Methods We studied observational data in a cohort of 433 men aged 64–76 years from a prospective, 2 × 2 factorial designed, three-year interventional trial. Information of classical risk factors was obtained and the following questionnaires were administered at baseline: Hospital Anxiety and Depression Scale, Physical Symptom Distress Index and Life Satisfaction Index. The occurrence of cardiovascular death, myocardial infarction, cerebrovascular incidences and peripheral arterial disease were registered throughout the study period. Continuous data with skewed distribution was split into tertiles. Hazard ratios (HR were calculated from Cox regression analyses to assess the associations between physical distress, quality of life and cardiovascular events. Results After three years, 49 cardiovascular events were registered, with similar incidence among subjects with and without established cardiovascular disease. In multivariate analyses adjusted for age, smoking, systolic blood pressure, serum glucose, HADS-anxiety and treatment-intervention, physical distress was positively associated (HR 3.1, 95% CI 1.2 – 7.9 for 3rd versus 1st tertile and quality of life negatively associated (HR 2.6, 95% CI 1.1–5.8 for 3rd versus 1st tertile with cardiovascular events. The association remained statistically significant only for physical distress (hazard ratio 2.8 95% CI 1.2 – 6.8, p Conclusion Physical distress, but not quality of life, was independently associated with increased risk of cardiovascular events in an observational study of elderly men predominantly

  17. Nitric oxide and cardiovascular risk factors

    Directory of Open Access Journals (Sweden)

    Livio Dai Cas

    2007-06-01

    Full Text Available The endothelium is a dynamic organ with many properties that takes part in the regulation of the principal mechanisms of vascular physiology. Its principal functions include the control of blood-tissue exchange and permeability, the vascular tonus, and the modulation of inflammatory or coagulatory mechanisms. Many vasoactive molecules, produced by the endothelium, are involved in the control of these functions. The most important is nitric oxide (NO, a gaseous molecule electrically neutral with an odd number of electrons that gives the molecule chemically reactive radical properties. Already known in the twentieth century, NO, sometimes considered as a dangerous molecule, recently valued as an important endogenous vasodilator factor. Recently, it was discovered that it is involved in several physiological mechanisms of endothelial protection (Tab. I. In 1992, Science elected it as “molecule of the year”; 6 yrs later three American researchers (Louis Ignarro, Robert Furchgott and Fried Murad obtained a Nobel Prize for Medicine and Physiology “for their discoveries about NO as signal in the cardiovascular system”.

  18. Marine Carotenoids and Cardiovascular Risk Markers

    Directory of Open Access Journals (Sweden)

    Lorenza Speranza

    2011-06-01

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

  19. Cardiovascular Risk and Hippocampal Thickness in Alzheimer’s Disease

    OpenAIRE

    Markus Donix; Maria Scharf; Kira Marschner; Annett Werner; Cathrin Sauer; Antje Gerner; Nees, Josef A.; Shirin Meyer; Donix, Katharina L.; Rüdiger Von Kummer; Holthoff, Vjera A.

    2013-01-01

    Cardiovascular risk factors influence onset and progression of Alzheimer's disease. Among cognitively healthy people, changes in brain structure and function associated with high blood pressure, diabetes, or other vascular risks suggest differential regional susceptibility to neuronal damage. In patients with Alzheimer's disease, hippocampal and medial temporal lobe atrophy indicate early neuronal loss preferentially in key areas for learning and memory. We wanted to investigate whether this ...

  20. CARDIOVASCULAR RISK FACTORS IN CHILDREN WITH TYPE 1 DIABETES MELLITUS

    OpenAIRE

    Z ABDEYASDAN; N. Sadeghi; M HASANPOOR; M Maaroofi; A HASAN ZADEH

    2003-01-01

    Introduction: Diabetes melliuts is a chronic, metabolic disease that involves the macro and micro vascular complications and one of its maer ascular cowplications is the cardio vascular disease, as ,the risk of cardiovascular disease is 2-4 folds in diabetic patients in comparison with non diabetic individuals. The researches have demonstrated that the risk factors of the cardio vascular disease are formed at childhood. Therefore the preventive measures must begin from early childhood. S...

  1. Trans fatty acids – A risk factor for cardiovascular disease

    OpenAIRE

    Iqbal, Mohammad Perwaiz

    2014-01-01

    Trans fatty acids (TFA) are produced either by hydrogenation of unsaturated oils or by biohydrogenation in the stomach of ruminant animals. Vanaspati ghee and margarine have high contents of TFA. A number of studies have shown an association of TFA consumption and increased risk of cardiovascular disease (CVD). This increased risk is because TFA increase the ratio of LDL cholesterol to HDL cholesterol. Food and Agriculture Organization of the United Nations and World Health Organization have ...

  2. Racial/ethnic residential segregation and cardiovascular disease risk

    OpenAIRE

    Kershaw, Kiarri N.; Albrecht, Sandra S.

    2015-01-01

    A growing body of research has examined whether racial/ethnic residential segregation contributes to health disparities, but recent findings in the literature, particularly with respect to cardiovascular disease (CVD) risk, have not been summarized. This review provides an overview of findings from studies of racial/ethnic residential segregation of non-Hispanic blacks and Hispanics with CVD risk published between January 2011 and July 2014. The majority of studies of black segregation showed...

  3. Emerging Risk Biomarkers in Cardiovascular Diseases and Disorders

    OpenAIRE

    Ravi Kant Upadhyay

    2015-01-01

    Present review article highlights various cardiovascular risk prediction biomarkers by incorporating both traditional risk factors to be used as diagnostic markers and recent technologically generated diagnostic and therapeutic markers. This paper explains traditional biomarkers such as lipid profile, glucose, and hormone level and physiological biomarkers based on measurement of levels of important biomolecules such as serum ferritin, triglyceride to HDLp (high density lipoproteins) ratio, l...

  4. Breast Arterial Calcification: a New Marker of Cardiovascular Risk?

    OpenAIRE

    Iribarren, Carlos; Molloi, Sabee

    2013-01-01

    Mammographically-detected breast arterial calcifications (BAC) are considered to be an incidental finding without clinical importance since they are not associated with increased risk of breast cancer. The goal of this article is to review existing evidence that the presence of BAC on mammography correlates with several (but not all) traditional cardiovascular disease (CVD) risk factors and with prevalent and incident CVD. Thus, BAC detected during routine mammography is a noteworthy finding ...

  5. Risk factors of cardiovascular diseases in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    T V Popkova

    2009-01-01

    Full Text Available Cardiovascular complications (CVC including myocardial infarction (MI, sudden death and stroke (ST are the main cause of premature mortality in rheumatoid arthritis (RA. Chronic inflammation plays the key role in the development of CVC in RA. Objective. To analyze prevalence of cardiovascular diseases (CVD, significance of traditional risk factors (Rf, DMARDs and RA features in the development of clinical and subclinical signs of atherosclerosis (AT. To compare results with data of QUEST-RA. Material and methods. Traditional Rf and CVD frequency in RA pts were assessed with a questionnaire. Coronary heart disease, MI and ST were diagnosed according to medical documents. Subclinical signs of atherosclerosis were evaluated with carotid artery sonography. Results. Traditional CVD Rf were evaluated in 563 pts (496 female, 93 male aged 54 (44-54 years with disease duration 72 (24-144 months. Clinical signs of AT were revealed in5,6%, subclinical – in 11% of RA pts. Hyperlipidemia was present in 82%, increase of intima-media thickness – in 51%, family strain of CVD – in 44%, hypertension – in 38% of pts with RA. Traditional Rf, extra-articular features of RA, CVC and early AT signs weremore frequent in men than in women (p<0,005. Thickness of intima-media complex in 11men exceed that in women (p<0,005. RA pts were divided into two groups (I – with CVD and II – without CVD to assess relationship between traditional Rf and CVC. Frequency of traditional Rf (hypertension and increased intima-media thickness in group I was higher than in group II. Relative risk of their development was 4,78 and 2,09 respectively (p<0,05. 38% of RA pts had extra-articular features of RA (OR=2,02; p=0,04. Thickness of intima-media complex correlated with duration of treatment with hydroxichloroquine and sulfasalazine (r=0,34; p=0,0002 and r=0,28; p=0,008 respectively. CVC were not associated with administration of other DMARDs.

  6. Managing Cardiovascular Risk in the Post Solid Organ Transplant Recipient.

    Science.gov (United States)

    Munagala, Mrudula R; Phancao, Anita

    2016-05-01

    Solid organ transplantation is an effective treatment for patients with end-stage organ disease. The prevalence of cardiovascular diseases (CVD) has increased in recipients. CVD remains a leading cause of mortality among recipients with functioning grafts. The pathophysiology of CVD recipients is a complex interplay between preexisting risk factors, metabolic sequelae of immunosuppressive agents, infection, and rejection. Risk modification must be weighed against the risk of mortality owing to rejection or infection. Aggressive risk stratification and modification before and after transplantation and tailoring immunosuppressive regimens are essential to prevent complications and improve short-term and long-term mortality and graft survival. PMID:27095643

  7. Risk Assessment Overview

    Science.gov (United States)

    Prassinos, Peter G.; Lyver, John W., IV; Bui, Chinh T.

    2011-01-01

    Risk assessment is used in many industries to identify and manage risks. Initially developed for use on aeronautical and nuclear systems, risk assessment has been applied to transportation, chemical, computer, financial, and security systems among others. It is used to gain an understanding of the weaknesses or vulnerabilities in a system so modification can be made to increase operability, efficiency, and safety and to reduce failure and down-time. Risk assessment results are primary inputs to risk-informed decision making; where risk information including uncertainty is used along with other pertinent information to assist management in the decision-making process. Therefore, to be useful, a risk assessment must be directed at specific objectives. As the world embraces the globalization of trade and manufacturing, understanding the associated risk become important to decision making. Applying risk assessment techniques to a global system of development, manufacturing, and transportation can provide insight into how the system can fail, the likelihood of system failure and the consequences of system failure. The risk assessment can identify those elements that contribute most to risk and identify measures to prevent and mitigate failures, disruptions, and damaging outcomes. In addition, risk associated with public and environment impact can be identified. The risk insights gained can be applied to making decisions concerning suitable development and manufacturing locations, supply chains, and transportation strategies. While risk assessment has been mostly applied to mechanical and electrical systems, the concepts and techniques can be applied across other systems and activities. This paper provides a basic overview of the development of a risk assessment.

  8. Association of Helicobacter pylori and Chlamydia pneumoniae infections with coronary heart disease and cardiovascular risk factors.

    OpenAIRE

    Patel, P.; Mendall, M A; Carrington, D; Strachan, D. P.; Leatham, E; Molineaux, N; Levy, J.; Blakeston, C.; Seymour, C. A.; Camm, A J

    1995-01-01

    OBJECTIVE--To investigate the relation between seropositivity to chronic infections with Helicobacter pylori and Chlamydia pneumoniae and both coronary heart disease and cardiovascular risk factors. DESIGN--Cross sectional study of a population based random sample of men. Coronary heart disease was assessed by electrocardiography, Rose angina questionnaire, and a history of myocardial infarction; serum antibody levels to H pylori and C pneumoniae were measured, risk factor levels determined, ...

  9. Adverse pregnancy outcomes and subsequent risk of cardiovascular disease in women with systemic lupus erythematosus

    OpenAIRE

    Lin, Pin; Rhew, Elisa; Ness, Roberta B.; PEACEMAN, Alan; Dyer, Alan; McPherson, David; Kondos, George T.; Edmundowicz, Daniel; Sutton-Tyrrell, Kim; Thompson, Trina; Ramsey-Goldman, Rosalind

    2014-01-01

    Background/objective Patients with systemic lupus erythematosus (SLE) are at increased risk for adverse pregnancy outcomes and cardiovascular disease (CVD). The objective of this exploratory study was to investigate the association between a history of adverse pregnancy outcomes and subsequent risk of subclinical CVD assessed by imaging studies and verified clinical CVD events in 129 women with SLE. Methods The occurrence of adverse pregnancy outcomes, specifically pre-eclampsia, preterm birt...

  10. Risk prediction of cardiovascular death based on the QTc interval

    DEFF Research Database (Denmark)

    Nielsen, Jonas B.; Graff, Claus; Rasmussen, Peter V.;

    2014-01-01

    AIMS: Using a large, contemporary primary care population we aimed to provide absolute long-term risks of cardiovascular death (CVD) based on the QTc interval and to test whether the QTc interval is of value in risk prediction of CVD on an individual level. METHODS AND RESULTS: Digital electrocar......AIMS: Using a large, contemporary primary care population we aimed to provide absolute long-term risks of cardiovascular death (CVD) based on the QTc interval and to test whether the QTc interval is of value in risk prediction of CVD on an individual level. METHODS AND RESULTS: Digital...... electrocardiograms from 173 529 primary care patients aged 50-90 years were collected during 2001-11. The Framingham formula was used for heart rate-correction of the QT interval. Data on medication, comorbidity, and outcomes were retrieved from administrative registries. During a median follow-up period of 6...... interval resulted in the worst prognosis for men whereas in women, a very short QTc interval was equivalent in risk to a borderline prolonged QTc interval. The effect of the QTc interval on the absolute risk of CVD was most pronounced in the elderly and in those with cardiovascular disease whereas...

  11. Offshore risk assessment

    CERN Document Server

    Vinnem, Jan-Erik

    2014-01-01

      Offshore Risk Assessment was the first book to deal with quantified risk assessment (QRA) as applied specifically to offshore installations and operations. Risk assessment techniques have been used for more than three decades in the offshore oil and gas industry, and their use is set to expand increasingly as the industry moves into new areas and faces new challenges in older regions.   This updated and expanded third edition has been informed by a major R&D program on offshore risk assessment in Norway and summarizes research from 2006 to the present day. Rooted with a thorough discussion of risk metrics and risk analysis methodology,  subsequent chapters are devoted to analytical approaches to escalation, escape, evacuation and rescue analysis of safety and emergency systems.   Separate chapters analyze the main hazards of offshore structures: fire, explosion, collision, and falling objects as well as structural and marine hazards. Risk mitigation and control are discussed, as well as an illustrat...

  12. Cardiovascular Risk Perception among Iranian Women with type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Saeidzadeh Seyedehtanaz

    2015-07-01

    Full Text Available Objective: Cardiovascular disease (CVD is one of the fatal complications of diabetes mellitus. The mortality of CVD is higher in diabetic persons. Women are at a higher risk for CVD. The purpose of this study is to determine the perception of CVD risk among women with type 2 diabetes mellitus. Materials and Methods: This cross-sectional study was conducted among 58 diabetic women with type 2 diabetes in a Diabetes clinic in Qaen, South Khorasan province, Iran. The attitude of participants towards CVD was assessed by a modified RPS-DD questionnaire. Data were analyzed with SPSS version 20. Results: The participants aged from 31 to 66 years old. The mean duration of diabetic diagnosis was 7±4.88 years. Majority of them were literate (56.9%, married (89.7%, had low income (52% and were housekeepers (94.8%. Almost half the participants believed they had personal control over cardiovascular risk. 69% had optimistic attitude towards not getting CVD and 60.3% had a moderate level of concerns about cardiovascular risks. Also 80% had knowledge about the cardiovascular risks. Conclusion: Risk perception plays an important role in preventing CVD. A comprehensive educational program for changing the attitude toward CVD is recommended.

  13. Insulin resistance and risk of incident cardiovascular events in adults without diabetes: meta-analysis.

    Directory of Open Access Journals (Sweden)

    Karin B Gast

    Full Text Available BACKGROUND: Glucose, insulin and Homeostasis Model Assessment Insulin Resistance (HOMA-IR are markers of insulin resistance. The objective of this study is to compare fasting glucose, fasting insulin concentrations and HOMA-IR in strength of association with incident cardiovascular disease. METHODS: We searched the PubMed, MEDLINE, EMBASE, Web of Science, ScienceDirect and Cochrane Library databases from inception to March, 2011, and screened reference lists. Cohort studies or nested case-control studies that investigated the association between fasting glucose, fasting insulin or HOMA-IR and incident cardiovascular disease, were eligible. Two investigators independently performed the article selection, data extraction and risk of bias assessment. Cardiovascular endpoints were coronary heart disease (CHD, stroke or combined cardiovascular disease. We used fixed and random-effect meta-analyses to calculate the pooled relative risk for CHD, stroke and combined cardiovascular disease, comparing high to low concentrations of glucose, insulin or HOMA-IR. Study heterogeneity was calculated with the I(2 statistic. To enable a comparison between cardiovascular disease risks for glucose, insulin and HOMA-IR, we calculated pooled relative risks per increase of one standard deviation. RESULTS: We included 65 studies (involving 516,325 participants in this meta-analysis. In a random-effect meta-analysis the pooled relative risk of CHD (95% CI; I(2 comparing high to low concentrations was 1.52 (1.31, 1.76; 62.4% for glucose, 1.12 (0.92, 1.37; 41.0% for insulin and 1.64 (1.35, 2.00; 0% for HOMA-IR. The pooled relative risk of CHD per one standard deviation increase was 1.21 (1.13, 1.30; 64.9% for glucose, 1.04 (0.96, 1.12; 43.0% for insulin and 1.46 (1.26, 1.69; 0.0% for HOMA-IR. CONCLUSIONS: The relative risk of cardiovascular disease was higher for an increase of one standard deviation in HOMA-IR compared to an increase of one standard deviation in fasting

  14. [Hypertension, endothelial dysfunction and cardiovascular risk].

    Science.gov (United States)

    Nitenberg, A

    2006-10-01

    Increased blood pressure induces functional and structural changes of the vascular endothelium. Depression of endothelium-dependant vasodilatation is an early manifestation of endothelial dysfunction due to hypertension. It can be demonstrated by pharmacological or physiological tests. Decreased availability of nitric oxide (NO) is a major determinant of the depression of vasodilatation. It may be caused by a reduction in the activity of NO-endothelial synthase (NOSe) related to: 1) a deficit in substrate (L-arginine), 2) an inhibition by asymmetrical dimethylarginine, 3) a deficit in the cofactor tetrahydrobiopterin (BH4). However, the increase in oxidative stress, a producer of superoxide radicals which combine with NO to form peroxynitrates (ONOO-), is the determining factor. It is related to activation of membranous NAD(P)H oxidases initiated by the stimulation of activating mecanosensors of protein C kinase. The message is amplified by oxidation of BH4 which transforms the NOSe into a producer of superoxide radicals. A cascade of auto-amplification loops leading to atherosclerosis and its complications is then triggered. The superoxide radicals and the peroxynitrates oxidise the LDL-cholesterol. They activate the nuclear factor-kappaB which controls the genes stimulating the expression of many proteins: angiotensinogen and AT1 receptors which stimulate the sympathetic system, receptors of oxidised LDL, adhesion and migration factors (ICAM-1, VCAM-1, E-selectin and MCP-1), pro-inflammatory cytokins (interleukines and TNF-alpha), growth factors (MAP kinases), plasminogen activator inhibitor 1. The monocytes and smooth muscle cells produce metalloproteinases and pro-inflammatory cytokins which destabilise the atheromatous plaque and favourise vascular remodelling. Inshort, the endothelial dysfunction due to hypertension plays a role in a complex physiopathological process and is a marker of future cardiovascular events. PMID:17100143

  15. Diabetic foot risk assessment.

    Science.gov (United States)

    Woodbury, M Gail

    2016-05-01

    Diabetes is a serious chronic disease that results in foot complications for many people world-wide. In 2014, the World Health Organization estimated the global prevalence of diabetes in adults to be 9%. To ascertain the risk that an individual patient might develop a diabetic foot ulcer that could lead to an amputation, clinicians are strongly encouraged to perform a risk assessment. Monteiro-Soares and Dinis-Ribeiro have presented a new DIAbetic FOot Risk Assessment with the acronym DIAFORA. It is different from other risk assessments in that it predicts the risk of developing both diabetic foot ulcers and amputation specifically. The risk variables were derived by regression analysis based on a data set of 293 patients from a high-risk setting, a Hospital Diabetic Foot Clinic, who had diabetes and a diabetic foot ulcers. Clear descriptions of the risk variables are provided as well as sensitivity, specificity, positive and negative predictive values for the risk categories. As an added benefit, likelihood ratios are provided that will help clinicians determine the risk of amputation for individual patients. Having a risk assessment form is important for clinician use and examples exist. A question is raised about the effectiveness of risk assessment and how effectiveness might be determined. Copyright © 2016 John Wiley & Sons, Ltd. PMID:26825436

  16. Obesity and Cardiovascular Risk Factors among Men and Women Aged 40 Years and Older in a Rural Area of Japan

    OpenAIRE

    Aoyagi, Kiyoshi; Kusano, Yosuke; Takamura, Noboru; Abe, Yasuyo; Osaki, Makoto; Une, Hiroshi

    2006-01-01

    Obesity is one of the most common health problems, and is recognized worldwide as an "escalating epidemic." For the establishment of an obesity-prevention strategy in Japan, it is important to assess the association between obesity and cardiovascular risk factors. Therefore, we conducted anthropometric measures of obesity and investigated the association of obesity with cardiovascular risk factors such as hypertension, diabetes, and dyslipidemia among community-dwelling men (N=85) and women (...

  17. Risk of Cardiovascular Disease in an Aging HIV Population

    DEFF Research Database (Denmark)

    Martin-Iguacel, R; Llibre, J M; Friis-Moller, N

    2015-01-01

    With more effective and widespread antiretroviral treatment, the overall incidence of AIDS- or HIV-related death has decreased dramatically. Consequently, as patients are aging, cardiovascular disease (CVD) has emerged as an important cause of morbidity and mortality in the HIV population. The...... incidence of CVD overall in HIV is relatively low, but it is approximately 1.5-2-fold higher than that seen in age-matched HIV-uninfected individuals. Multiple factors are believed to explain this excess in risk such as overrepresentation of traditional cardiovascular risk factors (particularly smoking......), toxicities associated with cumulative exposure to some antiretroviral agents, together with persistent chronic inflammation, and immune activation associated with HIV infection. Tools are available to calculate an individual's predicted risk of CVD and should be incorporated in the regular follow-up of HIV...

  18. In-treatment stroke volume predicts cardiovascular risk in hypertension

    DEFF Research Database (Denmark)

    Lønnebakken, Mai T; Gerdts, Eva; Boman, Kurt; Wachtell, Kristian; Dahlöf, Björn; Devereux, Richard B

    2011-01-01

    To evaluate whether lower stroke volume during antihypertensive treatment is a predictor of cardiovascular events independent of left ventricular geometric pattern. Methods: The association between left ventricular stroke volume and combined cardiovascular death, stroke and myocardial infarction...... peripheral resistance, more concentric left ventricular geometry and impaired diastolic relaxation (all P < 0.01). Baseline stroke volume did not predict outcome. However, in time-varying multivariable Cox regression analysis, lower in-treatment left ventricular stroke volume indexed for height2.04 was...... associated with higher risk of cardiovascular events {hazard ratio 1.69 per 1 SD (6 ml/m2.04) lower stroke volume [95% confidence interval (CI) 1.35–2.11], P < 0.001} independent of in-treatment left ventricular mass and concentric geometry and in a secondary model also independent of stress...

  19. Estimation of the Cardiovascular Risk Using World Health Organization/International Society of Hypertension (WHO/ISH Risk Prediction Charts in a Rural Population of South India

    Directory of Open Access Journals (Sweden)

    Arun Gangadhar Ghorpade

    2015-08-01

    Full Text Available Background World Health Organization/International Society of Hypertension (WHO/ISH charts have been employed to predict the risk of cardiovascular outcome in heterogeneous settings. The aim of this research is to assess the prevalence of Cardiovascular Disease (CVD risk factors and to estimate the cardiovascular risk among adults aged >40 years, utilizing the risk charts alone, and by the addition of other parameters. Methods A cross-sectional study was performed in two of the villages availing health services of a medical college. Overall 570 subjects completed the assessment. The desired information was obtained using a pretested questionnaire and participants were also subjected to anthropometric measurements and laboratory investigations. The WHO/ISH risk prediction charts for the South-East Asian region was used to assess the cardiovascular risk among the study participants. Results The study covered 570 adults aged above 40 years. The mean age of the subjects was 54.2 (±11.1 years and 53.3% subjects were women. Seventeen percent of the participants had moderate to high risk for the occurrence of cardiovascular events by using WHO/ISH risk prediction charts. In addition, CVD risk factors like smoking, alcohol, low High-Density Lipoprotein (HDL cholesterol were found in 32%, 53%, 56.3%, and 61.5% study participants, respectively. Conclusion Categorizing people as low (20% risk is one of the crucial steps to mitigate the magnitude of cardiovascular fatal/non-fatal outcome. This cross-sectional study indicates that there is a high burden of CVD risk in the rural Pondicherry as assessed by WHO/ISH risk prediction charts. Use of WHO/ISH charts is easy and inexpensive screening tool in predicting the cardiovascular event.

  20. Estimation of the cardiovascular risk using World Health Organization/International Society of Hypertension (WHO/ISH) risk prediction charts in a rural population of South India

    Science.gov (United States)

    Ghorpade, Arun Gangadhar; Shrivastava, Saurabh RamBihariLal; Kar, Sitanshu Sekhar; Sarkar, Sonali; Majgi, Sumanth Mallikarjuna; Roy, Gautam

    2015-01-01

    Background: World Health Organization/International Society of Hypertension (WHO/ISH) charts have been employed to predict the risk of cardiovascular outcome in heterogeneous settings. The aim of this research is to assess the prevalence of Cardiovascular Disease (CVD) risk factors and to estimate the cardiovascular risk among adults aged >40 years, utilizing the risk charts alone, and by the addition of other parameters. Methods: A cross-sectional study was performed in two of the villages availing health services of a medical college. Overall 570 subjects completed the assessment. The desired information was obtained using a pre-tested questionnaire and participants were also subjected to anthropometric measurements and laboratory investigations. The WHO/ISH risk prediction charts for the South-East Asian region was used to assess the cardiovascular risk among the study participants. Results: The study covered 570 adults aged above 40 years. The mean age of the subjects was 54.2 (±11.1) years and 53.3% subjects were women. Seventeen percent of the participants had moderate to high risk for the occurrence of cardiovascular events by using WHO/ISH risk prediction charts. In addition, CVD risk factors like smoking, alcohol, low High-Density Lipoprotein (HDL) cholesterol were found in 32%, 53%, 56.3%, and 61.5% study participants, respectively. Conclusion: Categorizing people as low (20%) risk is one of the crucial steps to mitigate the magnitude of cardiovascular fatal/non-fatal outcome. This cross-sectional study indicates that there is a high burden of CVD risk in the rural Pondicherry as assessed by WHO/ISH risk prediction charts. Use of WHO/ISH charts is easy and inexpensive screening tool in predicting the cardiovascular event PMID:26340393

  1. Are There Genetic Paths Common to Obesity, Cardiovascular Disease Outcomes, and Cardiovascular Risk Factors?

    OpenAIRE

    Rankinen, Tuomo; Sarzynski, Mark A; Ghosh, Sujoy; Bouchard, Claude

    2015-01-01

    Clustering of obesity, coronary artery disease, and cardiovascular disease risk factors is observed in epidemiological studies and clinical settings. Twin and family studies have provided some supporting evidence for the clustering hypothesis. Loci nearest a lead single nucleotide polymorphism (SNP) showing genome-wide significant associations with coronary artery disease, body mass index, C-reactive protein, blood pressure, lipids, and type 2 diabetes mellitus were selected for pathway and n...

  2. Cardiovascular Risk in Men Aged Over 40 in Boa Vista, Brazil

    OpenAIRE

    Mário Maciel de Lima; Emanuel Araújo Bezerra; José Geraldo Ticianeli

    2016-01-01

    Background: Cardiovascular disease is the most common cause of disease in the developed world. Early detection and risk prediction are a key component in reducing cardiovascular mortality. The Framingham Risk Score uses age, sex, cholesterol, blood pressure, diabetes, and smoking to calculate the 10-year risk probability of developing cardiovascular disease for a given patient. The aim of this study was to examine cardiovascular disease risk in men aged over 40 years in Boa Vista, Brazil and ...

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

    Science.gov (United States)

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

    2016-03-01

    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

  4. Overview of risk assessment

    International Nuclear Information System (INIS)

    The paper begins by defining some terms, and then refer to a number of technical and other difficulties. Finally it attempts to set out why risk assessment is important and what its purposes are. 2) First, risk and risk assessment - what are they?. 3) Risk is a subject of universal significance. Life is very uncertain, and we can achieve no object or benefit in it except by approaching nearer to particular hazards which lie between us and our objects. That approach represents acceptance of risk. 4) Risk assessment is a way of systematising our approach to hazard with a view to determining what is more and what is less risky. It helps us in the end to diminish our exposure while obtaining whatever benefits we have in mind, or to optimise the risks and the benefits

  5. p-Cresol and Cardiovascular Risk in Kidney Transplant Recipients.

    Science.gov (United States)

    Ligabue, G; Damiano, F; Cuoghi, A; De Biasi, S; Bellei, E; Granito, M; Aldo, T; Cossarizza, A; Cappelli, G

    2015-09-01

    p-Cresol Sulphate (pCS) is a uremic toxin that originates exclusively from dietary sources and has a high plasma level related to chronic kidney disease (CKD) and cardiovascular disease (CVD). The aim of our study was to evaluate the plasma levels of pCS in kidney transplant recipients (KTRs) related to estimated glomerular filtration rate (eGFR), traditional risk factors, cardiovascular clinical events and endothelial progenitor cells (EPCs), bone marrow-derived cells for the vascular repair system. We considered 51 KTRs and 25 healthy blood donors (HBDs). pCs levels were analyzed using high-performance liquid chromatography (HPLC) coupled with mass spectrometry with an electrospray ionization (ESI) (LC/ESI-MS/MS) on a triple-quadrupole; EPCs were analyzed using flow cytometric analysis. eGFR was 52.61 ± 19.9 mL/min/1.73 m(2) in KTRs versus 94 ± 21 mL/min/1.73 m(2) in HBDs. We did not find differences in pCS levels between KTRs and HBDs. Levels of pCS were inversely related with eGFR in KTRs and pCS levels were significantly lower in KTRs with eGFR 30 mL/min/1.73 m(2). Furthermore, there was a difference in pCS levels between eGFR <30 mL/min/1.73 m(2) of KTRs compared with HBDs. Levels of pCS were almost significantly influenced by the presence of a previous vascular event and were inversely related with mature EPCs. These findings suggest that KTRs should not have higher CVD risk than HBDs and their physiological vascular repair system appears to be intact. In KTRs the reduction of eGFR also increased pCS levels and reduced EPCs numbers and angiogenesis capacity. In summary, pCS acts as an emerging marker of a uremic state, helping assess the global vascular competence in KTRs. PMID:26361658

  6. Cardiovascular risks and benefits of moderate and heavy alcohol consumption.

    Science.gov (United States)

    Fernández-Solà, Joaquim

    2015-10-01

    The heart and vascular system are susceptible to the harmful effects of alcohol. Alcohol is an active toxin that undergoes widespread diffusion throughout the body, causing multiple synchronous and synergistic effects. Alcohol consumption decreases myocardial contractility and induces arrhythmias and dilated cardiomyopathy, resulting in progressive cardiovascular dysfunction and structural damage. Alcohol, whether at binge doses or a high cumulative lifetime consumption-both of which should be discouraged-is clearly deleterious for the cardiovascular system, increasing the incidence of total and cardiovascular mortality, coronary and peripheral artery disease, heart failure, stroke, hypertension, dyslipidaemia, and diabetes mellitus. However, epidemiological, case-control studies and meta-analyses have shown a U-type bimodal relationship so that low-to-moderate alcohol consumption (particularly of wine or beer) is associated with a decrease in cardiovascular events and mortality, compared with abstention. Potential confounding influences-alcohol-dose quantification, tobacco use, diet, exercise, lifestyle, cancer risk, accidents, and dependence-can affect the results of studies of both low-dose and high-dose alcohol consumption. Mendelian methodological approaches have led to doubts regarding the beneficial cardiovascular effects of alcohol, and the overall balance of beneficial and detrimental effects should be considered when making individual and population-wide recommendations, as reductions in alcohol consumption should provide overall health benefits. PMID:26099843

  7. Risk of cardiovascular disease in inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Nynne; Nyboe; Andersen; Tine; Jess

    2014-01-01

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

  8. Current controversies in turner syndrome: Genetic testing, assisted reproduction, and cardiovascular risks

    Directory of Open Access Journals (Sweden)

    Amanda Ackermann

    2014-09-01

    Full Text Available Patients with Turner syndrome (TS require close medical follow-up and management for cardiac abnormalities, growth and reproductive issues. This review summarizes current controversies in this condition, including: 1 the optimal genetic testing for Turner syndrome patients, particularly with respect to identification of Y chromosome material that may increase the patient's risk of gonadoblastoma and dysgerminoma, 2 which patients should be referred for bilateral gonadectomy and the recommended timing of such referral, 3 options for assisted reproduction in these patients and associated risks, 4 the increased risk of mortality associated with pregnancy in this population, and 5 how best to assess and monitor cardiovascular risks.

  9. Is vitamin B12 deficiency a risk factor for cardiovascular disease in vegetarians?

    Science.gov (United States)

    Pawlak, Roman

    2015-06-01

    The goal of this paper is to describe the role of vitamin B12 deficiency in cardiovascular disease development among vegetarians. Vegetarians have a high prevalence of vitamin B12 deficiency. Deficiency of this vitamin is associated with a variety of atherogenic processes that are mainly, but not exclusively, due to vitamin B12 deficiency-induced hyperhomocysteinemia. Each 5-μmol/L increase above 10 μmol/L of serum homocysteine is associated with a 20% increased risk of circulatory health problems. Mean homocysteine concentration >10 μmol/L among vegetarians was reported in 32 of 34 reports. Macrocytosis associated with vitamin B12 deficiency is also associated with fatal and non-fatal coronary disease, myocardial infarction, stroke, and other circulatory health problems. Compared with non-vegetarians, vegetarians have an improved profile of the traditional cardiovascular disease risk factors, including serum lipids, blood pressure, serum glucose concentration, and weight status. However, not all studies that assessed cardiovascular disease incidence among vegetarians reported a protective effect. Among studies that did show a lower prevalence of circulatory health problems, the effect was not as pronounced as expected, which may be a result of poor vitamin B12 status due to a vegetarian diet. Vitamin B12 deficiency may negate the cardiovascular disease prevention benefits of vegetarian diets. In order to further reduce the risk of cardiovascular disease, vegetarians should be advised to use vitamin B12 supplements. PMID:25998928

  10. The BioImage Study: novel approaches to risk assessment in the primary prevention of atherosclerotic cardiovascular disease--study design and objectives

    DEFF Research Database (Denmark)

    Muntendam, Pieter; McCall, Carol; Sanz, Javier;

    2010-01-01

    The identification of asymptomatic individuals at risk for near-term atherothrombotic events to ensure optimal preventive treatment remains a challenging goal. In the BioImage Study, novel approaches are tested in a typical health-plan population. Based on certain demographic and risk characteris......The identification of asymptomatic individuals at risk for near-term atherothrombotic events to ensure optimal preventive treatment remains a challenging goal. In the BioImage Study, novel approaches are tested in a typical health-plan population. Based on certain demographic and risk...

  11. [Socioeconomic class as a risk factor for cardiovascular diseases].

    Science.gov (United States)

    Meier, Ch; Ackermann-Liebrich, U

    2005-09-01

    It's been known for a long time, that certain diseases are more frequent in lower socioeconomic classes. But knowledge about the nature of this association, its main risk factors and how to improve health outcomes in lower social groups is still limited. Social class has been defined by different indicators by e.g. occupation and job position or the highest school qualification achieved. For international comparisons different classifications such as "The Registrar General's Social Class Classification " or the "International Standard Classification of Education" have been used. Several European Studies show a higher prevalence of cardiovascular diseases and cardiovascular risk factors including smoking, obesity, physical inactivity, hypertension and hypercholesterolemia in lower socioeconomic classes. But this studies also show that all socioeconomic groups have access to medical services. The Data from the Swiss Health Survey show the distribution of cardiovascular risk factors and diseases by three levels of education: Behaviouralfactors such as smoking, obesity and physical inactivity are more commonly present in the lower socioeconomic groups. People with a lower educational level visit their GP more often, whereas people with a higher level of educational consult specialists more frequently. Medical services are often used to check of blood pressure, blood sugar and cholesterol. An indication of state of health may be shown by medication and treatment for cardiovascular disease which is more prevalent in lower socioeconomic groups. The present discussion of explanations of the poorer state of health in lower socioeconomic groups goes beyond the classical risk factors for cardiovascular disease. Studies have shown that after the correction for risk factors a correlation remains between social class and state of health. It is believed, that psychosocial factors such as self-esteem, control in the workplace or coping-strategies play an additional important role

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

    Directory of Open Access Journals (Sweden)

    Lau Joseph TF

    2010-06-01

    Full Text Available Abstract Background Childhood and adolescence are critical periods of habit formation with substantial tracking of lifestyle and cardiovascular risk into adulthood. There are various guidelines on recommended levels of physical activity in youth of school-age. Despite the epidemic of obesity and diabetes in China, there is a paucity of data in this regard in Chinese youth. We examined the association of self-reported level of physical activity and cardiovascular risk in Hong Kong Chinese youth of school-age. Methods This was a cross-sectional study conducted in 2007-8 in a school setting with 2119 Hong Kong Chinese youth aged 6-20 years. Physical activity level was assessed using a validated questionnaire, CUHK-PARCY (The Chinese University of Hong Kong: Physical Activity Rating for Children and Youth. A summary risk score comprising of waist circumference, blood pressure, fasting plasma glucose and lipids was constructed to quantify cardiovascular risk. Results In this cohort, 21.5% reported high level of physical activity with boys being more active than girls (32.1% versus 14.1%, p Conclusion Self-reported level of physical activity is associated with cardiovascular risk factors in Chinese youth after adjusting for sex and pubertal stage.

  13. Chronic hyperuricemia, uric acid deposit and cardiovascular risk.

    Science.gov (United States)

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

    2013-01-01

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

  14. [Screening for cardiovascular risk factors in a large workplace].

    Science.gov (United States)

    Agner, E; Jacobsen, K; Mahnfeldt, M S; Jensen, S E; Baastrup, A; Stene, G M; Bech, J; Kjaer, A

    1990-11-01

    A screening investigation was carried out in a large industry in the Copenhagen region and 1,472 of the employees were offered examination of blood cholesterol and measurement of blood pressure. At this examination the employees completed a one-page questionnaire about other cardiovascular risk factors. 45% of those invited participated in the investigation, the poorest participation was among women and the greatest among the male officials. On account of the limited number of female employees, the majority of results were only calculated for men. Over 1/3 of these had hypercholesteremia (greater than or equal to 7.0 mmol/l) and nearly 1/3 had, simultaneously, at least two cardiovascular risk factors in addition to age and male sex. Extensive occupational investigations under the auspices of WHO have demonstrated that energetic intervention at the place of work aimed at the cardiovascular risk factors can reduce the risk of development of coronary heart disease and death within a six-year follow-up period. It is therefore emphasized that similar interventions are very necessary also in Denmark. PMID:2238226

  15. Metabolic syndrome and other cardiovascular risk factors among police officers

    Directory of Open Access Journals (Sweden)

    Jayakrishnan Thayyil

    2012-01-01

    Full Text Available Background: Police force constitutes a special occupational group. They have been shown to be at high risk for the development of cardiovascular diseases. A multitude of factors may be responsible for this. There is very limited documentation of their health status and health surveillance activities are inadequate. Aim: The present study was designed to measure the prevalence of metabolic syndrome and other cardiovascular risk factors among police officers. Materials and Methods: The design was cross-sectional and spanned 900 policemen ( n = 900. A pre-tested questionnaire was used for collecting historical data. Anthropometric and biochemical measurements were carried out using standard techniques. MS was diagnosed using the National Cholesterol Education Program-Adult Treatment Panel III criteria. Statistical analysis was performed using the SPSS 16.0 software. Results: MS was observed in 16.8% of the study population. High blood pressure and hyper-triglyceridemia were the commonest abnormalities. The prevalence of other cardiovascular risk factors were high body mass index (65.6%, hypertension (37.7%, diabetes (7%, smoking (10%, and alcohol use (48%. Conclusion: Our study identified police officers as a high-risk group for developing CVDs. The findings underscore the need for regular surveillance and lifestyle interventions in this important occupational group.

  16. Usefulness of imaging techniques and novel biomarkers in the prediction of cardiovascular risk in patients with chronic kidney disease in Spain: The NEFRONA project

    OpenAIRE

    Junyent, Mireia; Martínez Alonso, Montserrat; Borràs, Mercè; Betriu i Bars, M. Àngels; Coll,Blai; Craver Hospital, Lourdes; Marco Mayayo, M. Paz; Sarró, Felipe; Valdivielso Revilla, José Manuel; Fernández i Giráldez, Elvira

    2010-01-01

    Background: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in patients with chronic kidney disease (CKD). Cardiovascular risk assessment in this population is hampered by the failure of traditional risk factors to fully account for the elevated CVD risk, mainly due to the reverse epidemiology effect, and the presence of risk factors specifically related to uraemia. Hereby, we present the protocol of a prospective study aimed to assess the ...

  17. The Impact of Dietary and Metabolic Risk Factors on Cardiovascular Diseases and Type 2 Diabetes Mortality in Brazil

    OpenAIRE

    de Oliveira Otto, Marcia C.; Afshin, Ashkan; Micha, Renata; Khatibzadeh, Shahab; Fahimi, Saman; Singh, Gitanjali; Danaei, Goodarz; Sichieri, Rosely; Carlos A. Monteiro; Maria L C Louzada; Ezzati, Majid; Mozaffarian, Dariush

    2016-01-01

    Background: Trends in food availability and metabolic risk factors in Brazil suggest a shift toward unhealthy dietary patterns and increased cardiometabolic disease risk, yet little is known about the impact of dietary and metabolic risk factors on cardiometabolic mortality in Brazil. Methods: Based on data from Global Burden of Disease (GBD) Study, we used comparative risk assessment to estimate the burden of 11 dietary and 4 metabolic risk factors on mortality due to cardiovascular diseases...

  18. The Impact of Dietary and Metabolic Risk Factors on Cardiovascular Diseases and Type 2 Diabetes Mortality in Brazil

    OpenAIRE

    de Oliveira Otto, Marcia C.; Ashkan Afshin; Renata Micha; Shahab Khatibzadeh; Saman Fahimi; Gitanjali Singh; Goodarz Danaei; Rosely Sichieri; Carlos A. Monteiro; Maria L C Louzada; Majid Ezzati; Dariush Mozaffarian

    2016-01-01

    Background Trends in food availability and metabolic risk factors in Brazil suggest a shift toward unhealthy dietary patterns and increased cardiometabolic disease risk, yet little is known about the impact of dietary and metabolic risk factors on cardiometabolic mortality in Brazil. Methods Based on data from Global Burden of Disease (GBD) Study, we used comparative risk assessment to estimate the burden of 11 dietary and 4 metabolic risk factors on mortality due to cardiovascular diseases a...

  19. Interleukin-6 Gene Promoter Polymorphisms and Cardiovascular Risk Factors. A family study

    OpenAIRE

    Iris Paola Guzmán-Guzmán; José Francisco Muñoz-Valle; Eugenia Flores-Alfaro; Lorenzo Salgado-Goytia; Aralia Berenice Salgado-Bernabé; Isela Parra-Rojas

    2010-01-01

    Interleukin-6 (IL-6) is a cytokine involved in inflammatory process, as well as in glucose and lipid metabolism. Several studies of the biological relevance of IL-6 gene polymorphisms have indicated a relationship with cardiovascular disease. The aim of this study was to assess whether the –174 G/C and –572 G/C of IL-6 gene polymorphisms are associated with cardiovascular risk factors in Mexican families. Ninety members of 30 Mexican families, in which an index case (proband) had obesity, wer...

  20. [Cardiovascular risk in polycystic kidney disease].

    Science.gov (United States)

    Di Lorenzo, Adelaide; Stallone, Giovanni; Infante, Barbara; Grandaliano, Giuseppe; Schena, Francesco Paolo

    2015-09-01

    Hypertension is common and occurs in the majority of autosomal dominant polycystic kidney disease (ADPKD) patients prior to loss of kidney function. Hypertension relates to progressive kidney enlargement, and is a significant independent risk factor for progression to end-stage renal disease. The pathogenesis of hypertension in ADPKD is complex and depends on many factors that influence each other. High expression of PKD1 and PKD2 genes is present in the cilia of tubular epithelial cells, in endothelial cells and in vascular smooth muscle cells. Decreased or absent polycystin-1 or -2 expression is associated with abnormal vascular structure and function. PKD1/PKD2 deficiency results in reduced nitric oxide levels, altered endothelial response to shear stress with attenuation in vascular relaxation. Activation of the renin-angiotensin-aldosterone system occurs in ADPKD due to decreased nitric oxide production as well as bilateral cyst expansion and intra-renal ischemia. With increasing cyst size, further activation of the renin-angiotensin-aldosterone system occurs, blood pressure increases and a vicious cycle ensues with enhanced cyst growth and hypertension ultimately leading to end-stage renal disease. Inhibition of the angiotensin-aldosterone system is possible with angiotensin-converting enzyme inhibitors and seems to be the first-line treatment for hypertension in these subjects. As suggested by the HALT-PKD study, an aggressive blood pressure control is safe and recommended and is associated with preservation of kidney function and a reduction in total kidney volume over time. A collaborative multidisciplinary approach between nephrologists and cardiologists is necessary for the monitoring of kidney and heart complications. PMID:26418387

  1. ASSESSMENT OF RISK FOR GASTROINTESTINAL AND CARDIOVASCULAR COMPLICATIONS ASSOCIATED WITH THE USE OF NONSTEROIDAL ANTI-INFLAMMATORY DRUGS IN THE CIS POPULATION: PRELIMINARY DATA OF THE CORONA-2 EPIDEMIOLOGICAL SURVEY

    Directory of Open Access Journals (Sweden)

    A. E. Karateev

    2014-01-01

    Full Text Available Nonsteroidal anti-inflammatory drugs (NSAIDs are able to effectively control the major symptoms of rheumatic diseases and widely used in real clinical practice. However, they may cause serious gastrointestinal (GI and cardiovascular (CV events. The prevention of these events is based on the estimation of whether risk factors (RFs are present.Objective: to estimate the presence of RFs in patients needing NSAIDs.Subjects and methods. A cross-sectional epidemiological survey was performed, during which 2021 physicians from 9 CIS countries questioned for 2 weeks at least 10 patients needing NSAIDs. The inclusion criterion was severe musculoskeletal pain (>40 mm on a 100-mm visual analogue scale (VAS or use of NSAIDs at the examination. Data were obtained on 21,185 patients (57.5% women and 42.5% men (mean age 50.5±14.1 years who had predominantly dorsalgia (56.6% and osteoarthritis (23.5%. The mean pain value was 62.2±25.2 mm.Results. 1.7, 11.3, and 25.3% of patients had history of gastrointestinal bleeding, ulcer, or dyspepsia, respectively; people over 65 years of age constituted 16.8%; those who took low-dose aspirin (LDA – 20.0%. The total number of patients at high risk for GI events was 29.0%. There were also common CV RFs: myocardial infarction or stroke (7.8%, coronary heart disease (17.8%, hypertension (37.7%, and diabetes mellitus (8.1%. The total number of patients at high risk for CV events (without SCOR assessment was 23.0%. Many high-risk patients who has already used NSAIDs received no effective prevention. Thus, 62.2% of the patients at high GI risk took gastroprotective drugs; 53.2% of those at high CV risk used LDA.Conclusion. A large number of patients needing active analgesic therapy have a serious risk for drug-induced complications. This limits the possibility of using NSAIDs and determines the need for effective prevention or use of alternative methods for analgesia.

  2. Family history of vascular disease and the risk of cardiovascular events

    NARCIS (Netherlands)

    Weijmans, M.

    2015-01-01

    A positive family history of cardiovascular disease is an established risk factor for the development of cardiovascular disease. In clinical practice, this evident relation between the presence of cardiovascular disease in families and first cardiovascular events has resulted in family history being

  3. Assessment of radiation dose in nuclear cardiovascular imaging using realistic computational models

    NARCIS (Netherlands)

    Xie, Tianwu; Lee, Choonsik; Bolch, Wesley E.; Zaidi, Habib

    2015-01-01

    Purpose: Nuclear cardiology plays an important role in clinical assessment and has enormous impact on the management of a variety of cardiovascular diseases. Pediatric patients at different age groups are exposed to a spectrum of radiation dose levels and associated cancer risks different from those

  4. Associations between cardiovascular risk factors and psoriasis in Iran

    Directory of Open Access Journals (Sweden)

    Farshchian M

    2015-08-01

    Full Text Available Mahmoud Farshchian, Akram Ansar, Mohammadreza Sobhan Psoriasis Research Center, Department of Dermatology, Farshchian Hospital, Hamadan University of Medical Sciences, Hamadan, Iran Background: Psoriasis is a common chronic inflammatory skin disease. There is overwhelming evidence on the higher risk of cardiovascular diseases in patients with psoriasis as a result of hyperlipidemia, which is more common in these patients. Objectives: The aim of this study was to elucidate the association between the cardiovascular risk factors and psoriasis. Methods: In a cross-sectional study, 55 patients with psoriasis and 55 matched (sex and age controls were entered the study at the Department of Dermatology between March 2011 and March 2013. Blood samples were obtained following 14 hours fasting status and serum levels of triglyceride, cholesterol, high-density lipoprotein, and low-density lipoprotein were determined using standard laboratory methods, and other variables such as sex, age, smoking, alcohol consumption, and the type of disease were recorded. Results: Our findings showed that levels of triglyceride, low-density lipoprotein, and smoking were significantly higher in psoriatic patients when compared with controls, whereas the level of high-density lipoprotein and cholesterol was not significantly different between two groups. Body mass index of psoriatic patients was not significantly higher than controls. Patients with psoriasis also had an increased prevalence of hypertension. Conclusion: Our findings further verify lipid abnormalities in psoriatic patients. Psoriasis is associated with higher rate of hypertension, which may be resulted in increasing the risk of cardiovascular diseases in these patients. Thus, serum lipid profile and blood pressure in all patients with psoriasis, regardless of disease severity, deserve consideration to be checked. Keywords: cardiovascular disease, risk factors, psoriasis, lipid profile

  5. Chronic Hyperuricemia, Uric Acid Deposit and Cardiovascular Risk

    OpenAIRE

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

    2013-01-01

    Hyperuricemia is commonly associated with traditional risk factors such as dysglicemia, dyslipidemia, central obesity and abnormal blood pressure, i.e. the metabolic syndrome. Concordantly, recent studies have revived the controversy over the role of circulating uric acid, hyperuricemia, and gout as an independent prognostic factor for cardiovascular morbidity and mortality. In this regard, different studies also evaluated the possible role of xanthine inhibitors in inducing blood pressure re...

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

    OpenAIRE

    Nicklas, Theresa A.; O’Neil, Carol E; Victor L. Fulgoni III

    2014-01-01

    Background The relationship of snacking patterns on nutrient intake and cardiovascular risk factors (CVRF) in adults is unknown. The aim of this study was to examine the associations of snacking patterns with nutrient intake, diet quality, and a selection of CVRF in adults participating in the 2001-2008 National Health and Nutrition Examination Survey. Methods 24-hour dietary recalls were used to determine intake and cluster analysis was used to identify the snacking patterns. Height and weig...

  7. Cardiovascular risk and fitness in veteran football players.

    Science.gov (United States)

    Wegmann, M; Steffen, A; Pütz, K; Würtz, N; Such, U; Faude, O; Bohm, P; Meyer, T

    2016-01-01

    Veteran football players above 40 years have rarely been subject to scientific investigations. This is worrisome because their number is considerable and their cardiovascular risk probably increased. Therefore, a cross-sectional study was conducted in 100 football players between 40 and 63 years of age. This included a medical history and physical examination, venous blood sampling, measurement of resting blood pressure, a resting electrocardiogram (ECG), an exhaustive cycle ergometry and a multistage field test. Also, measurements of heart rate and blood lactate concentration were carried out during one typical training session and one match. Participants trained 1.0 ± 0.6 sessions per week and played 27 ± 8 matches per season. Of them, 19% were smokers. Resting blood pressure was 138 ± 15/88 ± 8 mmHg. Hypertension prevalence (WHO definition) was 66%. Total cholesterol averaged 220 ± 41 mg . dl(-1), HDL 46 ± 13 mg . dl(-1) and LDL 134 ± 33 mg . dl(-1). The average 10-year risk for cardiovascular events (Framingham score) was 6%. Mean maximal power output on the cycle ergometer was 2.8 ± 0.6 W . kg(-1), mean VO2peak 40.0 ± 7.3 ml . min(-1) . kg(-1). Comparing training and competition, no significant differences in cardiovascular and metabolic load were found. In summary, their cardiovascular risk was similar to age-adjusted reference values. However, they showed slightly better ergometric performance. More frequent training stimuli might be necessary to reach more favourable risk factor profiles. Training and competition lead to similar cardiocirculatory and metabolic stress which is considerably high and might put players into danger who have pre-existing cardiac disease. PMID:26691390

  8. Affluence and the Worldwide Distribution of Cardiovascular Disease Risks

    OpenAIRE

    Ezzati, Majid; Vander Hoorn, Stephen; Lawes, Carlene M.M.; Leach, Rachel; James, W.Philip T.; Alan D Lopez; Rodgers, Anthony; Christopher J L Murray

    2005-01-01

    Background Cardiovascular diseases and their nutritional risk factors—including overweight and obesity, elevated blood pressure, and cholesterol—are among the leading causes of global mortality and morbidity, and have been predicted to rise with economic development. Methods and Findings We examined age-standardized mean population levels of body mass index (BMI), systolic blood pressure, and total cholesterol in relation to national income, food share of household expenditure, and urbanizati...

  9. Gastrointestinal and Cardiovascular Risk of Nonsteroidal Anti-inflammatory Drugs

    OpenAIRE

    Abdulwahed Al-Saeed

    2011-01-01

     Nonsteroidal anti-inflammatory drugs (NSAIDs) confer a gastrointestinal (GI) side effect profile and concerns regarding adverse cardiovascular effects have emerged associated with considerable morbidity and mortality. NSAIDs are highly effective in treating pain and inflammation, but it is well recognized that these agents are associated with substantial gastrointestinal toxicity. Cyclo-oxygenase-2 inhibitors may also reduce the risk for gastrointestinal events, although they may increase ca...

  10. Risk factors of atheromatous aorta in cardiovascular surgery

    OpenAIRE

    Fernando A. Atik; Silva, Isaac Azevedo; da Cunha, Claudio Ribeiro

    2014-01-01

    Objective To determine the prevalence and profile of ascending aorta or aortic arch atheromatous disease in cardiovascular surgery patients, its risk factors and its prognostic implication early after surgery. Methods Between January 2007 and June 2011, 2042 consecutive adult patients were analyzed, with no exclusion criteria. Atheromatous aorta diagnosis was determined intraoperatively by surgeon palpation of the aorta. Determinants of atheromatous aorta, as well as its prognostic implicatio...

  11. Socioeconomic disparities in risk factors for cardiovascular disease.

    OpenAIRE

    Wielgosz, A T; Spasoff, R. A.

    1986-01-01

    Despite a general decline in mortality rates in recent decades, these rates are substantially higher among lower socioeconomic groups. To determine target groups for preventive health promotion programs, the prevalence of risk factors for cardiovascular disease by socioeconomic group in Canadian adults aged 20 to 69 years was examined through comparison of estimates from the 1978-79 Canada Health Survey, the 1981 Canada Fitness Survey and the labour force smoking surveys of 1975 and 1983. Lev...

  12. Hypoglycemia as a driver of cardiovascular risk in diabetes

    OpenAIRE

    Moheet, Amir; Seaquist, Elizabeth R.

    2013-01-01

    Severe hypoglycemia in patients with diabetes is associated with increased risk of adverse cardiovascular events and death. Recent large randomized clinical trials in individuals with type 2 diabetes have shown that intensive glycemic control may result in increased mortality and hypoglycemia has been investigated as a possible cause. Acute hypoglycemia is a pro-arrhythmic, pro-inflammatory and pro-thrombotic state and several mechanisms have been proposed to explain how hypoglycemia might in...

  13. Alcohol intake and cardiovascular risk factors: A Mendelian randomisation study.

    Science.gov (United States)

    Cho, Yoonsu; Shin, So-Youn; Won, Sungho; Relton, Caroline L; Davey Smith, George; Shin, Min-Jeong

    2015-01-01

    Mendelian randomisation studies from Asia suggest detrimental influences of alcohol on cardiovascular risk factors, but such associations are observed mainly in men. The absence of associations of genetic variants (e.g. rs671 in ALDH2) with such risk factors in women - who drank little in these populations - provides evidence that the observations are not due to genetic pleiotropy. Here, we present a Mendelian randomisation study in a South Korean population (3,365 men and 3,787 women) that 1) provides robust evidence that alcohol consumption adversely affects several cardiovascular disease risk factors, including blood pressure, waist to hip ratio, fasting blood glucose and triglyceride levels. Alcohol also increases HDL cholesterol and lowers LDL cholesterol. Our study also 2) replicates sex differences in associations which suggests pleiotropy does not underlie the associations, 3) provides further evidence that association is not due to pleiotropy by showing null effects in male non-drinkers, and 4) illustrates a way to measure population-level association where alcohol intake is stratified by sex. In conclusion, population-level instrumental variable estimation (utilizing interaction of rs671 in ALDH2 and sex as an instrument) strengthens causal inference regarding the largely adverse influence of alcohol intake on cardiovascular health in an Asian population. PMID:26687910

  14. Prevalence of stroke/cardiovascular risk factors in Hungary

    Science.gov (United States)

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

    2010-04-01

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

  15. Obesity and cardiovascular risk in children and adolescents

    Directory of Open Access Journals (Sweden)

    Manu Raj

    2012-01-01

    Full Text Available The global prevalence of overweight and obesity in children and adolescents has increased substantially over the past several decades. These trends are also visible in developing economies like India. Childhood obesity impacts all the major organ systems of the body and is well known to result in significant morbidity and mortality. Obesity in childhood and adolescence is associated with established risk factors for cardiovascular diseases and accelerated atherosclerotic processes, including elevated blood pressure (BP, atherogenic dyslipidemia, atherosclerosis, metabolic syndrome, type II diabetes mellitus, cardiac structural and functional changes and obstructive sleep apnea. Probable mechanisms of obesity-related hypertension include insulin resistance, sodium retention, increased sympathetic nervous system activity, activation of the renin-angiotensin-aldosterone system and altered vascular function. Adiposity promotes cardiovascular risk clustering during childhood and adolescence. Insulin resistance has a strong association with childhood obesity. A variety of proinflammatory mediators that are associated with cardiometabolic dysfunction are also known to be influenced by obesity levels. Obesity in early life promotes atherosclerotic disease in vascular structures such as the aorta and the coronary arteries. Childhood and adolescent adiposity has strong influences on the structure and function of the heart, predominantly of the left ventricle. Obesity compromises pulmonary function and increases the risk of sleep-disordered breathing and obstructive sleep apnea. Neglecting childhood and adolescent obesity will compromise the cardiovascular health of the pediatric population and is likely to result in a serious public health crisis in future.

  16. Dietary patterns and changes in cardiovascular risk factors in apparently healthy Chinese women: a longitudinal study

    Science.gov (United States)

    Li, Ping; Zhang, Meilin; Zhu, Yufeng; Liu, Weiqiao; Zhang, Yuwen; Gao, Yuxia; Huang, Guowei

    2016-01-01

    Little is known of the relationships between dietary patterns and cardiovascular risk factors in China. We therefore designed a 3-year longitudinal study to evaluate the impacts of dietary patterns on changes in these factors among Chinese women. A total of 1,028 subjects who received health examination in 2011 and 2014 were recruited. Three major dietary patterns (“vegetable pattern”, “meat pattern”, and “animal offal-dessert-and-alcohol pattern”) were derived by principal component analysis based on validated food frequency questionnaires. Cardiovascular risk factors were standardized to create within-cohort z-scores and the changes in them were calculated as the differences between 2011 and 2014. Relationships between dietary patterns and changes in cardiovascular risk factors were assessed using general linear model. After adjustment for potential confounders, changes in total cholesterol and fasting blood glucose decreased across the tertiles of vegetable pattern (p for trend = 0.01 and 0.04, respectively). While, changes in diastolic blood pressure, total cholesterol and low density lipoprotein cholesterol increased across the tertiles of animal offal-dessert-and-alcohol pattern (p for trend = 0.02, 0.01, and 0.02, respectively). The findings suggest that vegetable pattern was beneficially related to cardiovascular risk factors, whereas animal offal-dessert-and-alcohol pattern was detrimental related to these factors among apparently healthy Chinese women. PMID:27257349

  17. Dietary patterns and changes in cardiovascular risk factors in apparently healthy Chinese women: a longitudinal study.

    Science.gov (United States)

    Li, Ping; Zhang, Meilin; Zhu, Yufeng; Liu, Weiqiao; Zhang, Yuwen; Gao, Yuxia; Huang, Guowei

    2016-05-01

    Little is known of the relationships between dietary patterns and cardiovascular risk factors in China. We therefore designed a 3-year longitudinal study to evaluate the impacts of dietary patterns on changes in these factors among Chinese women. A total of 1,028 subjects who received health examination in 2011 and 2014 were recruited. Three major dietary patterns ("vegetable pattern", "meat pattern", and "animal offal-dessert-and-alcohol pattern") were derived by principal component analysis based on validated food frequency questionnaires. Cardiovascular risk factors were standardized to create within-cohort z-scores and the changes in them were calculated as the differences between 2011 and 2014. Relationships between dietary patterns and changes in cardiovascular risk factors were assessed using general linear model. After adjustment for potential confounders, changes in total cholesterol and fasting blood glucose decreased across the tertiles of vegetable pattern (p for trend = 0.01 and 0.04, respectively). While, changes in diastolic blood pressure, total cholesterol and low density lipoprotein cholesterol increased across the tertiles of animal offal-dessert-and-alcohol pattern (p for trend = 0.02, 0.01, and 0.02, respectively). The findings suggest that vegetable pattern was beneficially related to cardiovascular risk factors, whereas animal offal-dessert-and-alcohol pattern was detrimental related to these factors among apparently healthy Chinese women. PMID:27257349

  18. Cytokines and clustered cardiovascular risk factors in children

    DEFF Research Database (Denmark)

    Andersen, Lars Bo; Müller, Klaus; Eiberg, Stig;

    2010-01-01

    The aim was to evaluate the possible role of tumor necrosis factor alpha (TNF-alpha), interleukin-6 (IL-6), C-reactive protein (CRP), low fitness, and fatness in the early development of clustering of cardiovascular disease (CVD) risk factors and insulin resistance. Subjects for this cross...... pronounced in fat and unfit children based on the association with CRP levels. The association between fitness and fatness variables, insulin resistance, and clustered risk could be caused by other mechanisms related to these exposures. The role of IL-6 remains unclear....... between CVD risk scores and TNF-alpha and IL-6. C-reactive protein was associated with fitness, fatness, and CVD risk score. This study does not support an association between plasma IL-6 or TNF-alpha and low insulin sensitivity or clustering of CVD risk factors in a young cohort. Inflammation was more...

  19. Cardiovascular Risks Factors and their Relationship with Disorders of Carbohydrate and Lipid Metabolism

    OpenAIRE

    Lilian Leguen Gulgar; Maricel Castellanos; María de Jesús Sánchez Bouza; Mikhail Benet Rodríguez

    2014-01-01

    Background: cardiovascular disease has been the leading cause of death in Cuba, where studies on emerging cardiovascular risk factors as predictors of cardiovascular risk are scarce. Objective: to determine the association between cardiovascular risk factors and disorders of carbohydrate and lipid metabolism. Methods: a correlational study was conducted with a sample of 105 men and women selected from a total of 346 workers of the University of Medical Sciences of Cienfuegos from June 2011 th...

  20. GAR Global Risk Assessment

    Science.gov (United States)

    Maskrey, Andrew; Safaie, Sahar

    2015-04-01

    Disaster risk management strategies, policies and actions need to be based on evidence of current disaster loss and risk patterns, past trends and future projections, and underlying risk factors. Faced with competing demands for resources, at any level it is only possible to priorities a range of disaster risk management strategies and investments with adequate understanding of realised losses, current and future risk levels and impacts on economic growth and social wellbeing as well as cost and impact of the strategy. The mapping and understanding of the global risk landscape has been greatly enhanced by the latest iteration of the GAR Global Risk Assessment and the objective of this submission is to present the GAR global risk assessment which contributed to Global Assessment Report (GAR) 2015. This initiative which has been led by UNISDR, was conducted by a consortium of technical institutions from around the world and has covered earthquake, cyclone, riverine flood, and tsunami probabilistic risk for all countries of the world. In addition, the risks associated with volcanic ash in the Asia-Pacific region, drought in various countries in sub-Saharan Africa and climate change in a number of countries have been calculated. The presentation will share thee results as well as the experience including the challenges faced in technical elements as well as the process and recommendations for the future of such endeavour.

  1. Public Risk Assessment Program

    Science.gov (United States)

    Mendeck, Gavin

    2010-01-01

    The Public Entry Risk Assessment (PERA) program addresses risk to the public from shuttle or other spacecraft re-entry trajectories. Managing public risk to acceptable levels is a major component of safe spacecraft operation. PERA is given scenario inputs of vehicle trajectory, probability of failure along that trajectory, the resulting debris characteristics, and field size and distribution, and returns risk metrics that quantify the individual and collective risk posed by that scenario. Due to the large volume of data required to perform such a risk analysis, PERA was designed to streamline the analysis process by using innovative mathematical analysis of the risk assessment equations. Real-time analysis in the event of a shuttle contingency operation, such as damage to the Orbiter, is possible because PERA allows for a change to the probability of failure models, therefore providing a much quicker estimation of public risk. PERA also provides the ability to generate movie files showing how the entry risk changes as the entry develops. PERA was designed to streamline the computation of the enormous amounts of data needed for this type of risk assessment by using an average distribution of debris on the ground, rather than pinpointing the impact point of every piece of debris. This has reduced the amount of computational time significantly without reducing the accuracy of the results. PERA was written in MATLAB; a compiled version can run from a DOS or UNIX prompt.

  2. Hypertension in Pregnancy and Future Cardiovascular Event Risk in Siblings.

    Science.gov (United States)

    Weissgerber, Tracey L; Turner, Stephen T; Mosley, Thomas H; Kardia, Sharon L R; Hanis, Craig L; Milic, Natasa M; Garovic, Vesna D

    2016-03-01

    Hypertension in pregnancy is a risk factor for future hypertension and cardiovascular disease. This may reflect an underlying familial predisposition or persistent damage caused by the hypertensive pregnancy. We sought to isolate the effect of hypertension in pregnancy by comparing the risk of hypertension and cardiovascular disease in women who had hypertension in pregnancy and their sisters who did not using the dataset from the Genetic Epidemiology Network of Arteriopathy study, which examined the genetics of hypertension in white, black, and Hispanic siblings. This analysis included all sibships with at least one parous woman and at least one other sibling. After gathering demographic and pregnancy data, BP and serum analytes were measured. Disease-free survival was examined using Kaplan-Meier curves and Cox proportional hazards regression. Compared with their sisters who did not have hypertension in pregnancy, women who had hypertension in pregnancy were more likely to develop new onset hypertension later in life, after adjusting for body mass index and diabetes (hazard ratio 1.75, 95% confidence interval 1.27-2.42). A sibling history of hypertension in pregnancy was also associated with an increased risk of hypertension in brothers and unaffected sisters, whereas an increased risk of cardiovascular events was observed in brothers only. These results suggest familial factors contribute to the increased risk of future hypertension in women who had hypertension in pregnancy. Further studies are needed to clarify the potential role of nonfamilial factors. Furthermore, a sibling history of hypertension in pregnancy may be a novel familial risk factor for future hypertension. PMID:26315531

  3. Sensitivity of cardiovascular risk factors, as part of the campaign of healthy companies and their essential contribution to the safety of a nuclear installation; Sensibilizacion sobre los factores de riesgos cardiovasculares como parte de la campana de empresas saludables y su contribucion esencial en la seguridad de una instalacion nuclear

    Energy Technology Data Exchange (ETDEWEB)

    Castillejo Puertas, F. M.

    2014-07-01

    Prevention campaigns are essential to curb the incidence of cardiovascular disease, to plan prevention programs, discovering, assessing and treating risk factors, affecting asymptomatic subjects, threaten, is the most effective and efficient measure to reduce cardiovascular disease. (Author)

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

    Energy Technology Data Exchange (ETDEWEB)

    Burgos, Miria Suzana [Universidade de Santa Cruz do Sul - UNISC, Santa Cruz do Sul, RS (Brazil); Programa de Pós-graduação - Mestrado em Promoção da Saúde - UNISC, Santa Cruz do Sul, RS (Brazil); Burgos, Leandro Tibiriçá; Camargo, Marcelo Dias [Grupo de Pesquisa em Cardiologia do Exercício HCPA/UFRGS, Porto Alegre, RS (Brazil); Franke, Silvia Isabel Rech; Prá, Daniel [Universidade de Santa Cruz do Sul - UNISC, Santa Cruz do Sul, RS (Brazil); Programa de Pós-graduação - Mestrado em Promoção da Saúde - UNISC, Santa Cruz do Sul, RS (Brazil); Silva, Antônio Marcos Vargas da [Universidade Federal de Santa Maria - UFSM, Santa Maria, RS (Brazil); Borges, Tássia Silvana; Todendi, Pâmela Ferreira [Universidade de Santa Cruz do Sul - UNISC, Santa Cruz do Sul, RS (Brazil); Programa de Pós-graduação - Mestrado em Promoção da Saúde - UNISC, Santa Cruz do Sul, RS (Brazil); Reckziegel, Miriam Beatris [Universidade de Santa Cruz do Sul - UNISC, Santa Cruz do Sul, RS (Brazil); Reuter, Cézane Priscila, E-mail: cpreuter@hotmail.com [Universidade de Santa Cruz do Sul - UNISC, Santa Cruz do Sul, RS (Brazil); Programa de Pós-graduação - Mestrado em Promoção da Saúde - UNISC, Santa Cruz do Sul, RS (Brazil)

    2013-10-15

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

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

    International Nuclear Information System (INIS)

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

  6. OBESITY-RELATED CARDIOVASCULAR RISK FACTORS AFTER LONG- TERM RESISTANCE TRAINING AND GINGER SUPPLEMENTATION

    Directory of Open Access Journals (Sweden)

    Sirvan Atashak

    2011-12-01

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

  7. The impact of dietary habits and metabolic risk factors on cardiovascular and diabetes mortality in countries of the Middle East and North Africa in 2010: a comparative risk assessment analysis

    Science.gov (United States)

    Afshin, Ashkan; Micha, Renata; Khatibzadeh, Shahab; Fahimi, Saman; Shi, Peilin; Powles, John; Singh, Gitanjali; Yakoob, Mohammad Yawar; Abdollahi, Morteza; Al-Hooti, Suad; Farzadfar, Farshad; Houshiar-rad, Anahita; Hwalla, Nahla; Koksal, Eda; Musaiger, Abdulrahman; Pekcan, Gulden; Sibai, Abla Mehio; Zaghloul, Sahar; Danaei, Goodarz; Ezzati, Majid; Mozaffarian, Dariush

    2015-01-01

    Objective/design We conducted a comparative risk assessment analysis to estimate the cardiometabolic disease (CMD) mortality attributable to 11 dietary and 4 metabolic risk factors in 20 countries of the Middle East by age, sex and time. The national exposure distributions were obtained from a systematic search of multiple databases. Missing exposure data were estimated using a multilevel Bayesian hierarchical model. The aetiological effect of each risk factor on disease-specific mortality was obtained from clinical trials and observational studies. The number of disease-specific deaths was obtained from the 2010 Global Burden of Disease mortality database. Mortality due to each risk factor was determined using the population attributable fraction and total number of disease-specific deaths. Setting/population Adult population in the Middle East by age, sex, country and time. Results Suboptimal diet was the leading risk factor for CMD mortality in 11 countries accounting for 48% (in Morocco) to 72% (in the United Arab Emirates) of CMD deaths. Non-optimal systolic blood pressure was the leading risk factor for CMD deaths in eight countries causing 45% (in Bahrain) to 68% (in Libya) of CMD deaths. Non-optimal body mass index and fasting plasma glucose were the third and fourth leading risk factors for CMD mortality in most countries. Among individual dietary factors, low intake of fruits accounted for 8% (in Jordan) to 21% (in Palestine) of CMD deaths and low intake of whole grains was responsible for 7% (in Palestine) to 22% (in the United Arab Emirates) of CMD deaths. Between 1990 and 2010, the CMD mortality attributable to most risk factors had decreased except for body mass index and trans-fatty acids. Conclusions Our findings highlight key similarities and differences in the impact of the dietary and metabolic risk factors on CMD mortality in the countries of the Middle East and inform priorities for policy measures to prevent CMD. PMID:25995236

  8. Cardiac Risk Assessment

    Science.gov (United States)

    ... to assess cardiac risk include: High-sensitivity C-reactive protein (hs-CRP) : Studies have shown that measuring ... LDL-C but does not respond to typical strategies to lower LDL-C such as diet, exercise, ...

  9. Patient caries risk assessment

    DEFF Research Database (Denmark)

    Twetman, Svante; Fontana, Margherita

    2009-01-01

    Risk assessment is an essential component in the decision-making process for the correct prevention and management of dental caries. Multiple risk factors and indicators have been proposed as targets in the assessment of risk of future disease, varying sometimes based on the age group at which they...... are targeted. Multiple reviews and systematic reviews are available in the literature on this topic. This chapter focusses primarily on results of reviews based on longitudinal studies required to establish the accuracy of caries risk assessment. These findings demonstrate that there is a strong body...... for prediction purposes, as measured until now in the literature, is at best questionable in schoolchildren, adolescents and adults. That is not to say these additional factors should not be assessed to help understand the strength of their associations with the disease experience in a particular...

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

    Directory of Open Access Journals (Sweden)

    Antonio García-Rodríguez

    2013-07-01

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

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

    Science.gov (United States)

    Simon, Kornél

    2009-05-10

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

  12. Cardiovascular magnetic resonance and computed tomography imaging for the assessment of cardiovascular complications of type 2 diabetes mellitus

    OpenAIRE

    Graça, Bruno Miguel Silva Rosa da

    2014-01-01

    Diabetes mellitus is responsible for diverse cardiovascular complications such as increased atherosclerosis in large arteries (carotids, aorta, and femoral arteries) and increased coronary atherosclerosis. A number of noninvasive tests are now available to detect coronary atherosclerotic disease, myocardial dysfunction and myocardial ischemia. The potential of cardiovascular imaging for the assessment of cardiovascular complications of type 2 diabetic patients is an active field of res...

  13. National differences in screening programmes for cardiovascular risks could obstruct understanding of cardiovascular prevention studies in Europe

    NARCIS (Netherlands)

    S.L. Thio; T.B. Twickler; M.J. Cramer; P. Giral

    2011-01-01

    Introduction In North-West Europe, cardiovascular disease is still a major cause of death and despite several efforts (e.g. European guidelines and conferences) cardiovascular risk factors are still inconsistently diagnosed and treated. Methods We evaluated the first consultations of patients in two

  14. A general practice-based study examining the absolute risk of cardiovascular disease in treated hypertensive patients.

    OpenAIRE

    Fahey, T P; Peters, T J

    1996-01-01

    BACKGROUND: When managing hypertension, the assessment of the absolute risk of a cardiovascular' event is now advocated as the most accurate way in which the risks and benefits of anti-hypertensive therapy should be judged. Most studies that have examined control of hypertension have relied solely on the blood pressure level attained after treatment, with no measurement of the likely absolute risk in individual patients. AIM: To assess control of hypertension by quantifying the 10-year absolu...

  15. A Path Analysis of a Randomized "Promotora de Salud" Cardiovascular Disease-Prevention Trial among At-Risk Hispanic Adults

    Science.gov (United States)

    de Heer, Hendrik Dirk; Balcazar, Hector G.; Castro, Felipe; Schulz, Leslie

    2012-01-01

    This study assessed effectiveness of an educational community intervention taught by "promotoras de salud" in reducing cardiovascular disease (CVD) risk among Hispanics using a structural equation modeling (SEM) approach. Model development was guided by a social ecological framework proposing CVD risk reduction through improvement of protective…

  16. Validity and reliability of a questionnaire on knowledge of cardiovascular risk factors for use in Brazil

    Directory of Open Access Journals (Sweden)

    Marco Aurelio Lumertz Saffi

    2013-10-01

    Full Text Available Using a sample of patients with coronary artery disease, this methodological study aimed to conduct a cross-cultural adaptation and validation of a questionnaire on knowledge of cardiovascular risk factors (Q-FARCS, lifestyle changes, and treatment adherence for use in Brazil. The questionnaire has three scales: general knowledge of risk factors (RFs; specific knowledge of these RFs; and lifestyle changes achieved. Cross-cultural adaptation included translation, synthesis, back-translation, expert committee review, and pretesting. Face and content validity, reliability, and construct validity were measured. Cronbach’s alpha for the total sample (n = 240 was 0.75. Assessment of psychometric properties revealed adequate face and content validity, and the construct revealed seven components. It was concluded that the Brazilian version of Q-FARCS had adequate reliability and validity for the assessment of knowledge of cardiovascular RFs.

  17. The Association between Psoriasis Area and Severity Index and Cardiovascular Risk Factor in Korean Psoriasis Patients

    Science.gov (United States)

    Ku, Sang Hyeon; Kwon, Won Joo; Cho, Eun Byul; Park, Eun Joo; Kim, Kwang Ho

    2016-01-01

    Background Psoriasis is associated with increased risk of cardiovascular morbidities, especially in severe cases. Severity of the disease has been known to be associated with higher prevalence of these risk factors. However, in the absence of robust measurements, studies to date relied mostly on treatment spectrum as a proxy for the severity. Objective To evaluate the relationship between psoriasis area and severity index (PASI) and cardiovascular risk factors in Korean patients. Methods Presence of diabetes mellitus (DM), hypertension, smoking history was surveyed through questionnaires and serum lipid profile analysis were done after fasting overnight. The severity of psoriasis was assessed using PASI scores: mild, Korean psoriasis patients, while other factors may not contribute meaningfully.

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

    Science.gov (United States)

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

    2014-06-01

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

  19. Development and pilot of an internationally standardized measure of cardiovascular risk management in European primary care

    Directory of Open Access Journals (Sweden)

    Szecsenyi Joachim

    2011-04-01

    Full Text Available Abstract Background Primary care can play an important role in providing cardiovascular risk management in patients with established Cardiovascular Diseases (CVD, patients with a known high risk of developing CVD, and potentially for individuals with a low risk of developing CVD, but who have unhealthy lifestyles. To describe and compare cardiovascular risk management, internationally valid quality indicators and standardized measures are needed. As part of a large project in 9 European countries (EPA-Cardio, we have developed and tested a set of standardized measures, linked to previously developed quality indicators. Methods A structured stepwise procedure was followed to develop measures. First, the research team allocated 106 validated quality indicators to one of the three target populations (established CVD, at high risk, at low risk and to different data-collection methods (data abstraction from the medical records, a patient survey, an interview with lead practice GP/a practice survey. Secondly, we selected a number of other validated measures to enrich the assessment. A pilot study was performed to test the feasibility. Finally, we revised the measures based on the findings. Results The EPA-Cardio measures consisted of abstraction forms from the medical-records data of established Coronary Heart Disease (CHD-patients - and high-risk groups, a patient questionnaire for each of the 3 groups, an interview questionnaire for the lead GP and a questionnaire for practice teams. The measures were feasible and accepted by general practices from different countries. Conclusions An internationally standardized measure of cardiovascular risk management, linked to validated quality indicators and tested for feasibility in general practice, is now available. Careful development and pilot testing of the measures are crucial in international studies of quality of healthcare.

  20. Are There Genetic Paths Common to Obesity, Cardiovascular Disease Outcomes, and Cardiovascular Risk Factors?

    Science.gov (United States)

    Rankinen, Tuomo; Sarzynski, Mark A.; Ghosh, Sujoy; Bouchard, Claude

    2015-01-01

    Clustering of obesity, coronary artery disease, and cardiovascular disease risk factors is observed in epidemiological studies and clinical settings. Twin and family studies have provided some supporting evidence for the clustering hypothesis. Loci nearest a lead single nucleotide polymorphism (SNP) showing genome-wide significant associations with coronary artery disease, body mass index, C-reactive protein, blood pressure, lipids, and type 2 diabetes mellitus were selected for pathway and network analyses. Eighty-seven autosomal regions (181 SNPs), mapping to 56 genes, were found to be pleiotropic. Most pleiotropic regions contained genes associated with coronary artery disease and plasma lipids, whereas some exhibited coaggregation between obesity and cardiovascular disease risk factors. We observed enrichment for liver X receptor (LXR)/retinoid X receptor (RXR) and farnesoid X receptor/RXR nuclear receptor signaling among pleiotropic genes and for signatures of coronary artery disease and hepatic steatosis. In the search for functionally interacting networks, we found that 43 pleiotropic genes were interacting in a network with an additional 24 linker genes. ENCODE (Encyclopedia of DNA Elements) data were queried for distribution of pleiotropic SNPs among regulatory elements and coding sequence variations. Of the 181 SNPs, 136 were annotated to ≥1 regulatory feature. An enrichment analysis found over-representation of enhancers and DNAse hypersensitive regions when compared against all SNPs of the 1000 Genomes pilot project. In summary, there are genomic regions exerting pleiotropic effects on cardiovascular disease risk factors, although only a few included obesity. Further studies are needed to resolve the clustering in terms of DNA variants, genes, pathways, and actionable targets. PMID:25722444

  1. Relation between Childhood Obesity and Adult Cardiovascular Risk

    Directory of Open Access Journals (Sweden)

    Darren M. Allcock

    2009-01-01

    Full Text Available The incidence of overweight and obesity is rising at an alarming pace in the pediatric population, just as in the adult population. The adult comorbidities associated with this risk factor are well-recognized and are being further elucidated continually. Additionally, we are gradually developing a better understanding of the risks of overweight and obesity among children while they are still young. However, there is now a growing body of evidence showing that childhood obesity not only leads all too frequently to adult obesity, but is in itself a risk factor for cardiometabolic syndrome and resultant cardiovascular risk in adulthood. If current trends continue, the problem of pediatric overweight and obesity will become of unmanageable proportions once these individuals reach adulthood. Future research efforts toward understanding this complex problem will need to focus on those overweight and obese children who later went on to change their metabolic course and become normal-weight adults.

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

    Directory of Open Access Journals (Sweden)

    Goh LGH

    2014-03-01

    Full Text Available Louise GH Goh,1 Satvinder S Dhaliwal,1 Timothy A Welborn,2 Peter L Thompson,2–4 Bruce R Maycock,1 Deborah A Kerr,1 Andy H Lee,1 Dean Bertolatti,1 Karin M Clark,1 Rakhshanda Naheed,1 Ranil Coorey,1 Phillip R Della5 1School of Public Health, Curtin Health Innovation Research Institute, Curtin University, Perth, WA, Australia; 2Sir Charles Gairdner Hospital, Nedlands, Perth, WA, Australia; 3School of Population Health, University of Western Australia, Perth, WA, Australia; 4Harry Perkins Institute for Medical Research, Perth, WA, Australia; 5School of Nursing and Midwifery, Curtin Health Innovation Research Institute, Curtin University, Perth, WA, Australia Purpose: Although elevated cardiovascular disease (CVD risk factors are associated with a higher risk of developing heart conditions across all ethnic groups, variations exist between groups in the distribution and association of risk factors, and also risk levels. This study assessed the 10-year predicted risk in a multiethnic cohort of women and compared the differences in risk between Asian and Caucasian women. Methods: Information on demographics, medical conditions and treatment, smoking behavior, dietary behavior, and exercise patterns were collected. Physical measurements were also taken. The 10-year risk was calculated using the Framingham model, SCORE (Systematic COronary Risk Evaluation risk chart for low risk and high risk regions, the general CVD, and simplified general CVD risk score models in 4,354 females aged 20–69 years with no heart disease, diabetes, or stroke at baseline from the third Australian Risk Factor Prevalence Study. Country of birth was used as a surrogate for ethnicity. Nonparametric statistics were used to compare risk levels between ethnic groups. Results: Asian women generally had lower risk of CVD when compared to Caucasian women. The 10-year predicted risk was, however, similar between Asian and Australian women, for some models. These findings were

  3. Inflammatory cardiovascular risk markers in obstructive sleep apnoea syndrome.

    LENUS (Irish Health Repository)

    Ryan, Silke

    2012-02-01

    Obstructive sleep apnoea syndrome (OSAS) represents a highly prevalent disease and is recognized as a major public health burden. Large-scale epidemiological studies have demonstrated an independent relationship between OSAS and various cardiovascular disorders. The pathogenesis of cardiovascular complications in OSAS is not completely understood, but given the complexity of the disorder, a multifactorial etiology is likely. Inflammatory processes have emerged as critical in the pathogenesis of atherosclerosis in general and they mediate many of the stages of atheroma formation. Circulating levels of several markers of inflammation have been associated with future cardiovascular risk. These markers include cell adhesion molecules such as intercellular adhesion molecule-1 (ICAM-1) and selectins, cytokines such as tumour necrosis factor alpha (TNF-alpha) and interleukin 6 (IL-6), chemokines such as IL-8, and C-reactive protein (CRP). There is increasing evidence that inflammatory processes also play a central role in the cardiovascular pathophysiology of OSAS. This is supported by cell culture and animal studies identifying a preferential activation of inflammatory pathways by intermittent hypoxia (IH), the hallmark of OSAS. A number of studies have selectively examined the expression of inflammatory factors in OSAS patients with different conclusions. These different findings may have been contributed to by a number of methodological factors such as small subject numbers, inadequately matched study populations, particularly in terms of body mass index (BMI), and inclusion of patients with pre-existing cardiovascular or metabolic diseases. This review will focus on the potential role of various inflammatory markers in OSAS with a critical analysis of the current literature.

  4. Helicobacter pylori infection: relation with cardiovascular risk factors, ischaemic heart disease, and social class.

    OpenAIRE

    Murray, L J; Bamford, K B; O'Reilly, D P; McCrum, E E; Evans, A. E.

    1995-01-01

    OBJECTIVE--To determine whether Helicobacter pylori infection is associated with the development of ischaemic heart disease and whether such infection can explain the social class inequality in ischaemic heart disease. DESIGN--Cardiovascular risk factor levels, prevalence of ischaemic heart disease (Rose questionnaire angina, and/or a history of myocardial infarction), and serum antibodies to H pylori (enzyme linked immunosorbent assay) were assessed in a cross sectional population based surv...

  5. Leucocyte telomere length and risk of cardiovascular disease: systematic review and meta-analysis

    OpenAIRE

    Haycock, Philip C; Heydon, Emma E.; Kaptoge, Stephen; Butterworth, Adam S.; Thompson, Alex; Willeit, Peter

    2014-01-01

    Objective To assess the association between leucocyte telomere length and risk of cardiovascular disease. Design Systematic review and meta-analysis. Data sources Studies published up to March 2014 identified through searches of Medline, Web of Science, and Embase. Eligibility criteria Prospective and retrospective studies that reported on associations between leucocyte telomere length and coronary heart disease (defined as non-fatal myocardial infarction, coronary heart disease death, or cor...

  6. Ways of coping and biomarkers of an increased atherothrombotic cardiovascular disease risk in elderly individuals

    OpenAIRE

    von Känel, Roland; Mausbach, Brent T; Dimsdale, Joel E.; Mills, Paul J.; Patterson, Thomas L.; Ancoli-Israel, Sonia; Ziegler, Michael G.; Roepke, Susan K; Allison, Matthew; Grant, Igor

    2012-01-01

    Objective. To investigate the relationship between coping and atherothrombotic biomarkers of an increased cardiovascular disease (CVD) risk in the elderly. Methods. We studied 136 elderly caregiving and noncaregiving men and women who completed the Ways of Coping Checklist to assess problem-focused coping, seeking social support (SSS), blamed self, wishful thinking, and avoidance coping. They had circulating levels of 12 biomarkers measured. We also probed for potential mediator and moderator...

  7. Ways of Coping and Biomarkers of an Increased Atherothrombotic Cardiovascular Disease Risk in Elderly Individuals

    OpenAIRE

    Roland von Känel; Mausbach, Brent T; Dimsdale, Joel E.; Mills, Paul J.; Patterson, Thomas L.; Sonia Ancoli-Israel; Ziegler, Michael G.; Roepke, Susan K; Matthew Allison; Igor Grant

    2012-01-01

    Objective. To investigate the relationship between coping and atherothrombotic biomarkers of an increased cardiovascular disease (CVD) risk in the elderly. Methods. We studied 136 elderly caregiving and noncaregiving men and women who completed the Ways of Coping Checklist to assess problem-focused coping, seeking social support (SSS), blamed self, wishful thinking, and avoidance coping. They had circulating levels of 12 biomarkers measured. We also probed for potential mediator and moderator...

  8. Effects of customized risk reduction program on cardiovascular risk in males with spinal cord injury

    OpenAIRE

    Jonathan Myers, PhD; Ramya Gopalan, MS, MPH; Troy Shahoumian, MPH; Jenny Kiratli, PhD

    2012-01-01

    Persons with spinal cord injury (SCI) have heightened risk for cardiovascular disease (CVD). Multidisciplinary risk reduction programs using case management models have been effective in reducing CVD risk in nondisabled persons, but little is known regarding the effects of such programs in SCI. Twenty-six persons with SCI underwent a pilot 2 yr risk intervention program including frequent telephone contact by a case manager and in-person visits by a dietitian, physical therapist, and exercise...

  9. SISTEMA ENDOCANABINOIDE: MODIFICANDO LOS FACTORES DE RIESGO CARDIOVASCULAR Endocannabinoid system: modifying cardiovascular risk factors

    Directory of Open Access Journals (Sweden)

    John Edwin Feliciano Alfonso

    2006-10-01

    Full Text Available La necesidad de alcanzar un tratamiento óptimo para el tabaquismo, la obesidad y sus comorbilidades, conocidos factores de riesgo cardiovascular, ha fomentado la búsqueda de objetivos terapéuticos novedosos. Es el caso del sistema endocanabinoide, involucrado en diversos fenómenos fisiológicos entre los que se encuentran el refuerzo de ciertos comportamientos y la regulación del apetito. La sobreactivación de este sistema altera la homeostasis corporal predisponiendo a dependencias o a un aumento en la ingesta alimentaria, lo que puede traducirse en tabaquismo u obesidad. La intervención farmacológica sobre el sistema endocanabinoide puede contribuir al manejo de estos factores de riesgo cardiovascular, teniendo en cuenta que a tales beneficios se suman otros independientes de la suspensión del tabaquismo o la reducción de peso, como el aumento del colesterol de alta densidad, la disminución de triglicéridos y la mejoría del control glucémico en pacientes con diabetes. Ensayos clínicos controlados aleatorizados adelantados en poblaciones con diferentes características, han evaluado la utilidad de la regulación farmacológica del sistema endocanabinoide; confirmando su eficacia en personas con factores de riesgo cardiovascular establecidos.The need for an optimal treatment for smoking, obesity and their comorbidities, well-known cardiovascular risk factors; has prompted the search for novel therapeutic targets. This is the case of the endocannabinoid system, involved in several physiological phenomena including the reinforcement of certain behaviors and the regulation of appetite.

  10. Evaluation of cardiovascular disease risk factors in patients with mycosis fungoides*

    Science.gov (United States)

    Cengiz, Fatma Pelin; Emiroglu, Nazan

    2015-01-01

    BACKGROUND Mycosis fungoides, the most common subtype of cutaneous T-cell lymphoma, is more common in patients aged 45-55. OBJECTIVE Cardiovascular risk factors have been investigated in several skin diseases. However, the relation between cardiovascular diseases and mycosis fungoides remains unclear. Therefore, the aim of this study was to assess cardiovascular risk factors in patients with mycosis fungoides. METHODS 32 patients with mycosis fungoides and 26 healthy controls were enrolled in the study. Glucose, total cholesterol, high-density lipoprotein cholesterol, triglyceride, homocystein, high sensitivity C-reactive protein, low-density lipoprotein – cholesterol, were measured in the sera of patients. RESULTS Patients had significantly higher high-sensitivity C-reactive protein, homocysteine, low-density lipoprotein - cholesterol, total cholesterol (p= 0.032) (phomocysteine and high-sensitivity C-reactive protein than healthy subjects. The present study has demonstrated an increased rate of cardiovascular risk in patients with mycosis fungoides. Even though the etiology of these associations is elusive, dermatologists should be sensitized to investigate metabolic derangements in patients with mycosis fungoides, in order to lessen mortality and comorbidity with a multidisciplinary approach. PMID:25672297

  11. Potential benefits of renal diets on cardiovascular risk factors in chronic kidney disease patients.

    Science.gov (United States)

    Cupisti, Adamasco; Aparicio, Michel; Barsotti, Giuliano

    2007-01-01

    Dietary manipulation, including protein, phosphorus, and sodium restriction, when coupled with the vegetarian nature of the renal diet and ketoacid supplementation can potentially exert a cardiovascular protective effect in chronic renal failure patients by acting on both traditional and nontraditional cardiovascular risk factors. Blood pressure control may be favored by the reduction of sodium intake and by the vegetarian nature of the diet, which is very important also for lowering serum cholesterol and improving plasma lipid profile. The low protein and phosphorus intake has a crucial role for reducing proteinuria and preventing and reversing hyperphosphatemia and secondary hyperparathyroidism, which are major causes of the vascular calcifications, cardiac damage, and mortality risk of uremic patients. The reduction of nitrogenous waste products and lowering of serum PTH levels may also help ameliorate insulin sensitivity and metabolic control in diabetic patients, as well as increase the responsiveness to erythropoietin therapy, thus allowing greater control of anemia. Protein-restricted diets may have also anti-inflammatory and anti-oxidant properties. Thus, putting aside the still debatable effects on the progression of renal disease and the more admitted effects on uremic signs and symptoms, it is possible that a proper nutritional treatment early in the course of renal disease may be useful also to reduce the cardiovascular risk in the renal patient. However, conclusive data cannot yet be drawn because quality studies are lacking in this field; future studies should be planned to assess the effect of renal diets on hard outcomes, as cardiovascular events or mortality. PMID:17654313

  12. Homocysteine status and cardiovascular risk factors in patients with psoriasis: a case-control study.

    LENUS (Irish Health Repository)

    Tobin, A-M

    2012-02-01

    BACKGROUND: Psoriasis is a hyperproliferative, cutaneous disorder with the potential to lower levels of folate. This may result in raised levels of homocysteine, an independent risk factor for the development of cardiovascular disease. OBJECTIVE: A study was conducted to compare levels of red-cell folate (RCF) and homocysteine in patients with psoriasis and in healthy controls. Levels of homocysteine were also examined in the context of other major cardiovascular risk factors. METHODS: In total, 20 patients with psoriasis and 20 controls had their RCF, homo-cysteine and other conventional cardiovascular risk factors assessed. RESULTS: Patients with psoriasis had a trend towards lower levels of RCF. Significantly raised levels of homocysteine were found in patients with psoriasis compared with controls (P = 0.007). There was no correlation between homocysteine levels, RCF levels or disease activity as measured by the Psoriasis Area and Severity Index. Patients with psoriasis had higher body mass index (P < 0.004) and higher systolic blood pressure (P < 0.001) than controls. This may contribute to the excess cardiovascular mortality observed in patients with psoriasis.

  13. Risk stratification in cardiovascular disease primary prevention - scoring systems, novel markers, and imaging techniques.

    LENUS (Irish Health Repository)

    Zannad, Faiez

    2012-04-01

    The aim of this paper is to review and discuss current methods of risk stratification for cardiovascular disease (CVD) prevention, emerging biomarkers, and imaging techniques, and their relative merits and limitations. This report is based on discussions that took place among experts in the area during a special CardioVascular Clinical Trialists workshop organized by the European Society of Cardiology Working Group on Cardiovascular Pharmacology and Drug Therapy in September 2009. Classical risk factors such as blood pressure and low-density lipoprotein cholesterol levels remain the cornerstone of risk estimation in primary prevention but their use as a guide to management is limited by several factors: (i) thresholds for drug treatment vary with the available evidence for cost-effectiveness and benefit-to-risk ratios; (ii) assessment may be imprecise; (iii) residual risk may remain, even with effective control of dyslipidemia and hypertension. Novel measures include C-reactive protein, lipoprotein-associated phospholipase A(2) , genetic markers, and markers of subclinical organ damage, for which there are varying levels of evidence. High-resolution ultrasound and magnetic resonance imaging to assess carotid atherosclerotic lesions have potential but require further validation, standardization, and proof of clinical usefulness in the general population. In conclusion, classical risk scoring systems are available and inexpensive but have a number of limitations. Novel risk markers and imaging techniques may have a place in drug development and clinical trial design. However, their additional value above and beyond classical risk factors has yet to be determined for risk-guided therapy in CVD prevention.

  14. Pediatric nonalcoholic fatty liver disease, metabolic syndrome and cardiovascular risk

    Institute of Scientific and Technical Information of China (English)

    Lucia Pacifico; Valerio Nobili; Caterina Anania; Paola Verdecchia; Claudio Chiesa

    2011-01-01

    Nonalcoholic fatty liver disease (NAFLD) encompasses a range of liver histology severity and outcomes in the absence of chronic alcohol use. The mildest form is simple steatosis in which triglycerides accumulate within hepatocytes. A more advanced form of NAFLD, nonalcoholic steatohepatitis, includes inflammation and liver cell injury, progressive to cryptogenic cirrhosis. NAFLD has become the most common cause of chronic liver disease in children and adolescents. The recent rise in the prevalence rates of overweight and obesity likely explains the NAFLD epidemic worldwide. NAFLD is strongly associated with abdominal obesity, type 2 diabetes, and dyslipidemia, and most patients have evidence of insulin resistance. Thus, NAFLD shares many features of the metabolic syndrome (MetS), a highly atherogenic condition, and this has stimulated interest in the possible role of NAFLD in the development of atherosclerosis. Accumulating evidence suggests that NAFLD is associated with a significantly greater overall mortality than in the general population, as well as with increased prevalence of cardiovascular disease (CVD), independently of classical atherosclerotic risk factors. Yet, several studies including the pediatric population have reported independent associations between NAFLD and impaired flow-mediated vasodilatation and increased carotid artery intimal medial thickness-two reliable markers of subclinical atherosclerosis-after adjusting for cardiovascular risk factors and MetS. Therefore, the rising prevalence of obesity-related MetS and NAFLD in childhood may lead to a parallel increase in adverse cardiovascular outcomes. In children, the cardiovascular system remains plastic and damage-reversible if early and appropriate interventions are established effectively. Therapeutic goals for NAFLD should address nutrition, physical activity, and avoidance of smoking to prevent not only end-stage liver disease but also CVD.

  15. Cardiovascular risk factors in hemodialysis and peritoneal dialysis patients

    Directory of Open Access Journals (Sweden)

    Helal Imed

    2010-01-01

    Full Text Available Cardiovascular diseases are a major cause of morbidity and mortality in patients with end-stage renal disease (ESRD. The aim of our investigation was the evaluation of an extensive cardiovascular profile in hemodialysis (HD and peritoneal dialysis (PD patients. We studied 74 patients with ESRD (38 males, 36 females, maintained either on chronic HD (n= 50 or chronic PD (n= 24 and age and sex matched 20 healthy subjects as controls. The lipid profile, homo-cysteine (Hcy and C reactive protein (CRP were measured. When compared to a healthy popu-lation, HD patients displayed a marked atherogenic profile, as attested by increased levels of total cholesterol (TC, triglycerides (TG, low-density lipoprotein-cholesterol (LDL-C, apolipoprotein A (Apo A, CRP, Hcy and lower concentrations of high-density lipoprotein-cholesterol (HDL-C, Apo B, albumin (ALB. A significant difference was noted concerning the rates of Apo B, HDL-C, TC, ALB and Hcy. Same biological disorders that those found at HD patients were noted in these PD patients. One also noted lower concentration in Apo A. there were a significant diffe-rence with the reference group concerning the rates of albumin, Apo A, HDL-Cl and Hcy. When compared to PD patients, HD patients had significantly decreased concentration of LDL-C. The peculiar metabolic changes observed in the present study confirm the marked tendency of patients with impaired renal function for developing cardiovascular diseases, irrespectively of the type of dialysis. We suggest including uremia-related risk factors in the panel for evaluation of cardio-vascular risk in dialysis patients.

  16. Traditional cardiovascular risk factors and coronary artery calcification in adults with polymyositis and dermatomyositis

    DEFF Research Database (Denmark)

    Diederichsen, Louise C. Pyndt Raun; Diederichsen, Axel C P; Simonsen, Jane A;

    2015-01-01

    OBJECTIVE: To determine the occurrence of traditional cardiovascular (CV) risk factors and coronary artery calcification (CAC) in adults with polymyositis (PM) or dermatomyositis (DM) compared to healthy controls and to assess the association between CV risk factors, PM/DM, and CAC score. METHODS......: Traditional CV risk factors were assessed in a cross-sectional, observational study of 76 patients with PM/DM and in 48 sex- and age-matched healthy controls. CAC was quantified by means of cardiac computed tomography scan and expressed in Agatston units. The associations between CV risk factors, PM/DM, and...... of triglycerides (P = 0.0009). High CAC score occurred more frequently in patients (20% versus 4%; P = 0.04). In multivariate analysis of patient factors associated with CAC were age (P = 0.02) and smoking (P = 0.02). CONCLUSION: In this study, traditional CV risk factors and severe CAC were commonly...

  17. Instrumentation for Non-Invasive Assessment of Cardiovascular Regulation

    Science.gov (United States)

    Cohen, Richard J.

    1999-01-01

    It is critically important to be able to assess alterations in cardiovascular regulation during and after space flight. We propose to develop an instrument for the non-invasive assessment of such alterations that can be used on the ground and potentially during space flight. This instrumentation would be used by the Cardiovascular Alterations Team at multiple sites for the study of the effects of space flight on the cardiovascular system and the evaluation of countermeasures. In particular, the Cardiovascular Alterations Team will use this instrumentation in conjunction with ground-based human bed-rest studies and during application of acute stresses e.g., tilt, lower body negative pressure, and exercise. In future studies, the Cardiovascular Alterations Team anticipates using this instrumentation to study astronauts before and after space flight and ultimately, during space flight. The instrumentation may also be used by the Bone Demineralization/Calcium Metabolism Team, the Neurovestibular Team and the Human Performance Factors, Sleep and Chronobiology Team to measure changes in autonomic nervous function. The instrumentation will be based on a powerful new technology - cardiovascular system identification (CSI) - which has been developed in our laboratory. CSI provides a non-invasive approach for the study of alterations in cardiovascular regulation. This approach involves the analysis of second-to-second fluctuations in physiologic signals such as heart rate and non-invasively measured arterial blood pressure in order to characterize quantitatively the physiologic mechanisms responsible for the couplings between these signals. Through the characterization of multiple physiologic mechanisms, CSI provides a closed-loop model of the cardiovascular regulatory state in an individual subject.

  18. Prediabetes and cardiovascular risk alert programs - useful tools for preventing diabetes mellitus and cardiovascular events in primary medicine.

    Science.gov (United States)

    Virgolici, Horia; Virgolici, Bogdana; Purcarea, Victor

    2015-01-01

    We propose alert programs, made in Excel using VBA, for general practitioners, in order not to miss the diagnosis of prediabetes and cardiovascular risk factors for their patients and to improve their management. PMID:25991138

  19. Cardiovascular risk in chronic kidney disease patients: intima-media thickness predicts the incidence and severity of histologically assessed medial calcification in radial arteries

    OpenAIRE

    Janda, Katarzyna; Krzanowski, Marcin; Gajda, Mariusz; Dumnicka, Paulina; Fedak, Danuta; Grzegorz J. Lis; Jaśkowski, Piotr; Pietrzycka, Agata; Jan A. Litwin; Sułowicz, Władysław

    2015-01-01

    Background The objective of the study was to determine the relationship between common carotid artery intima-media thickness (CCA-IMT) and histologically assessed calcification of radial artery in relation to clinical features and laboratory markers of bone and mineral metabolism, inflammation, and oxidative stress in patients with stage 5 chronic kidney disease (CKD). Methods The study comprised 59 patients (36 hemodialyzed, 23 predialysis). CCA-IMT was measured by ultrasonography; the bioch...

  20. Cardiovascular risk during early adult life. Risk markers among participants in "Live for Life" health promotion programme in Sweden

    OpenAIRE

    Persson, L. G.; Lindstrom, K.; Lingfors, H; Bengtsson, C; Lissner, L

    1998-01-01

    STUDY OBJECTIVE: To study differences in cardiovascular lifestyle risk factors and biological risk markers in early adult life, with special attention to age and sex differences. Lifestyle cardiovascular risk factors included dietary habits, physical inactivity, smoking, alcohol habits, psychosocial strain, and mental stress. Biological risk markers included anthropometric variables, arterial blood pressure, and serum cholesterol concentration. DESIGN: A combined individual and communit...

  1. Associations of job strain, isostrain, and job insecurity with cardiovascular risk factors and productivity in Mexican workers

    OpenAIRE

    Garcia Rojas, Isabel Judith

    2014-01-01

    Occupational psychosocial factors have been associated in previous research with cardiovascular diseases and low productivity. The paucity of data from developing economies including Mexico hampers the development of worksite intervention efforts in those regions. This study assessed the prevalence of psychosocial job factors (job strain, isostrain, their subdomains, and job insecurity) and their cross-sectional associations with cardiovascular risk factors and productivity in a sample of 2,3...

  2. First nationwide survey on cardiovascular risk factors in Grand-Duchy of Luxembourg (ORISCAV-LUX

    Directory of Open Access Journals (Sweden)

    Alkerwi Ala'a

    2010-08-01

    Full Text Available Abstract Background The ORISCAV-LUX study is the first baseline survey of an on-going cardiovascular health monitoring programme in Grand-Duchy of Luxembourg. The main objectives of the present manuscript were 1 to describe the study design and conduct, and 2 to present the salient outcomes of the study, in particular the prevalence of the potentially modifiable and treatable cardiovascular disease risk factors in the adult population residing in Luxembourg. Method ORISCAV-LUX is a cross-sectional study based on a random sample of 4496 subjects, stratified by gender, age categories and district, drawn from the national insurance registry of 18-69 years aged Luxembourg residents, assuming a response rate of 30% and a proportion of 5% of institutionalized subjects in each stratum. The cardiovascular health status was assessed by means of a self-administered questionnaire, clinical and anthropometric measures, as well as by blood, urine and hair examinations. The potentially modifiable and treatable risk factors studied included smoking, hypertension, dyslipidemia, diabetes mellitus, and obesity. Both univariate and multivariate statistical analyses used weighted methods to account for the stratified sampling scheme. Results A total of 1432 subjects took part in the survey, yielding a participation rate of 32.2%. This figure is higher than the minimal sample size of 1285 subjects as estimated by power calculation. The most predominant cardiovascular risk factors were dyslipidemia (69.9%, hypertension (34.5%, smoking (22.3%, and obesity (20.9%, while diabetes amounted 4.4%. All prevalence rates increased with age (except smoking with marked gender differences (except diabetes. There was a significant difference in the prevalence of hypertension and of lipid disorders by geographic region of birth. The proportion of subjects cumulating two or more cardiovascular risk factors increased remarkably with age and was more predominant in men than in women

  3. Association between coronary artery calcification score as assessed by multi-detector row computed tomography and cardiovascular risk factors%冠状动脉钙化积分与冠心病危险因素的相关性

    Institute of Scientific and Technical Information of China (English)

    张剑; 韩雅玲; 荆全民; 王效增; 李毅; 张磊; 霍勇; 张岩

    2011-01-01

    Objective The coronary artery calcification (CAC) score determined by multi-detector row computed tomography ( MDCT) predicts the onset of coronary artery disease (CAD). In addition, cardiovascular risk factors also predict the mortality of CAD. Therefore, the aim of this study was to assess whether or not the CAC score is associated with cardiovascular risk factors. Methods A total of 9847 consecutive patients with suspected coronary artery disease underwent coronary angiography between January 2001 and March 2007 at 20 centers of China were enrolled. The subjects consisted of 311 consecutive patients with suspected CAD who underwent MDCT. The body mass index, blood pressure, blood glucose, and serum total cholesterol, triglyceride and low-density lipoprotein cholesterol ( LDL-C) and high-density lipoprotein cholesterol ( HDL-C) were measured. Results When the patients were divided into three groups according to the CAC score [low (0-12 IU), intermediate ( 13 - 445 ) and high ( 5* 446) ], the classification score was significantly associated with age, prevalence of cardiovascular history and diabetes mellitus and HDL-C. In multivariate logistic regression analysis, age ( P = 0. 013) and plasma levels of high-density lipoprotein cholesterol ( P = 0.020 ) remained significant independent variables for the classification. Conclusions Age, prevalence of cardiovascular history and diabetes mellitus and HDL-C were significantly associated with the classification according to the CAC score. The detection of CACS by MSCT could provide reliable and efective evidence for diagnosis of CHD in patients with cardiovascular risk factors.%目的 经多层冠状动脉CT检查测定的冠状动脉钙化积分对冠心病的诊断具有一定预测价值.而冠心病的危险因素与冠心病的发生、发展、结局和预后密切相关.我们旨在探讨冠状动脉钙化积分与冠心病诸多危险因素之间是否具有相关性.方法 入选2001年1月至2007年3

  4. Psychosocial stress and cardiovascular risk: what is the role of daily experience?

    Science.gov (United States)

    Kamarck, Thomas W; Schwartz, Joseph E; Shiffman, Saul; Muldoon, Matthew F; Sutton-Tyrrell, Kim; Janicki, Denise L

    2005-12-01

    We describe an ecological momentary assessment (EMA) protocol designed to measure daily life experiences along several psychosocial dimensions (Social Conflict, Task Demand, Decisional Control, Negative Affect, and Arousal) hypothesized to be relevant for cardiovascular disease risk. In a large community sample, these assessments have been administered in conjunction with ambulatory blood pressure (ABP) monitoring and measures of subclinical cardiovascular disease. Several results have emerged that support the promise of this approach. First of all, each of these dimensions of experience appears to be a trigger for cardiovascular activation, with movement on each scale being associated with significant within-person changes in heart rate and blood pressure in the natural environment. Second, there appear to be individual differences in physiological responsiveness to these dimensions of daily experience, with such differences being associated in some cases with laboratory-based assessments of cardiovascular reactivity, as might be expected. Third, EMA ratings are associated in several instances with (between-person) stable individual differences in ABP readings. And finally, we have found that some of the characteristics defined by our EMA ratings are related to measures of subclinical atherosclerosis. Such effects appear to be mediated, in part, by ABP. The advantages of using EMA measures for capturing the effects of psychosocial stressors are highlighted by comparing the predictive validity of these daily life assessments to traditional global self-reports. We conclude by describing future plans for use of this type of assessment protocol for helping us to characterize psychosocial characteristics relevant to cardiovascular disease risk. Personality and social processes during daily living may have an important impact not only on psychological functioning but also on physical health and disease. In this article we review our recent work involving the assessment

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

    International Nuclear Information System (INIS)

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

  6. Subclinical carotid atherosclerosis and cardiovascular risk factors in HIV-infected patients

    Directory of Open Access Journals (Sweden)

    Wiesława Kwiatkowska

    2011-11-01

    Full Text Available Background:HIV infected patients, especially those treated with antiretroviral (ARV drugs, show an increased risk and incidence of cardiovascular disease.Objectives:The aim of this study was to evaluate the progression of subclinical atherosclerosis in the carotid arteries, expressed as the value of carotid intima-media thickness (cIMT and the amount of atherosclerotic plaques, and to analyze the correlation between cIMT and risk factors for cardiovascular diseases in a cohort of HIV infected patients.Methods:The analysis included 72 HIV infected patients, mean age 39.4 years, and 27 healthy HIV negative individuals, matched for age and sex. The data collected included evaluation of the infection, ARV treatment, past cardiovascular events, assessment of traditional and nontraditional risk factors for cardiovascular diseases, cIMT measurements and amount of atherosclerotic plaques in the carotid arteries.Results:HIV infected patients show more advanced subclinical atherosclerosis in the carotid arteries (cIMT and plaques incidence. The cardiovascular risk profile of the HIV infected patients is significantly different from HIV negative people. Among the HIV positive group lower body mass index (BMI and higher waist/hip ratio (WHR are observed. The concentration of all cholesterol fractions is lower, whereas the concentration of triglycerides is higher. Cigarette smoking is more common among HIV-infected individuals. A strong statistical correlation between cIMT and age, hypertension, non-high-density lipoprotein (non-HDL cholesterol and ARV time were found. Total and LDL cholesterol, and lifetime smoking exposure also affect the cIMT. The relationship between cIMT and current HIV RNA may indicate the impact of the current infection status on the cIMT dynamics in this subpopulation.

  7. Cardiovascular Risks in Relation to Daidzein Metabolizing Phenotypes among Chinese Postmenopausal Women

    Science.gov (United States)

    Liu, Zhao-min; Ho, Suzanne C.; Chen, Yu-ming; Liu, Jun; Woo, Jean

    2014-01-01

    Background Studies suggested that the inter-individual differences in metabolizing isoflavone daidzein to equol or O-desmethylangolensin (ODMA) might explain the inconsistency of the soy/isoflavones efficacy on cardiovascular health. Objectives The study aims to evaluate the relationship between equol and ODMA phenotypes and cardiovascular risks with habitual isoflavone consumption in Chinese postmenopausal women. Methods This is a cross-sectional study among 726 prehypertensive postmenopal women who were screened for a randomized controlled trial. 648 women returned a daidzein-challenged urine samples for determination of equol and O-DMA production. 595 attended clinic visits for assessment of cardiovascular risks including body composition, blood pressure (BP), serum lipids, uric acid, high sensitivity C-reactive protein (hs-CRP), fasting glucose and free fatty acid (FFA). Results The prevalences of equol and O-DMA producers were 53.2% and 60.9% respectively. Equol producers had higher fat free mass (p = 0.001), lower systolic (p = 0.01) and diastolic (p = 0.01) BP, serum triglyceride (p = 0.023), hs-CRP (p = 0.015) and FFA (p = 0.001) than non-producers. O-DMA producers had lower body fat% (p = 0.032), SBP (p = 0.02), total cholesterol (p = 0.002) than non-producers. The significant differences remained after further adjustment for potential confounders. The habitual soy isoflavones intake had little relation to cardiovascular risk factors in either equol/O-DMA producer phenotypes. Conclusion Equol/O-DMA producers had more favorable cardiovascular risk profiles than non-producers in prehypertensive postmenopausal women. PMID:24533060

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

    Energy Technology Data Exchange (ETDEWEB)

    Sarmento, Roberta Aguiar [Instituto de Cardiologia do Rio Grande do Sul - Fundação Universitária de Cardiologia, Porto Alegre, RS (Brazil); Serviço de Endocrinologia do Hospital de Clínicas de Porto Alegre - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Silva, Flávia Moraes [Serviço de Endocrinologia do Hospital de Clínicas de Porto Alegre - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Sbruzzi, Graciele [Instituto de Cardiologia do Rio Grande do Sul - Fundação Universitária de Cardiologia, Porto Alegre, RS (Brazil); Schaan, Beatriz D' Agord [Instituto de Cardiologia do Rio Grande do Sul - Fundação Universitária de Cardiologia, Porto Alegre, RS (Brazil); Serviço de Endocrinologia do Hospital de Clínicas de Porto Alegre - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Departamento de Medicina Interna - Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Almeida, Jussara Carnevale de, E-mail: jussara.carnevale@gmail.com [Serviço de Endocrinologia do Hospital de Clínicas de Porto Alegre - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Departamento de Medicina Interna - Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil)

    2013-09-15

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

  9. Cardiovascular risk factors in a population of Brazilian schoolchildren

    Directory of Open Access Journals (Sweden)

    A.N. Rodrigues

    2006-12-01

    Full Text Available Epidemiological and clinical evidence suggests that a judicious diet, regular physical activity and blood pressure (BP monitoring must start in early childhood to minimize the impact of modifiable cardiovascular risk factors. This study was designed to evaluate BP and metabolic parameters of schoolchildren from Vitória, Espírito Santo State, Brazil, and correlate them with cardiovascular risk factors. The study was conducted on 380 students aged 10-14 years (177 boys, 203 girls enrolled in public schools. Baseline measurements included body mass index, BP and heart rate. The students were submitted to exercise spirometry on a treadmill. VO2max was obtained from exercise testing to voluntary exhaustion. Fasting serum total cholesterol (TC, LDL-C, HDL-C, triglycerides (TG, and glucose were measured. Nine point nine percent of the boys and 11.7% of the girls were hypertensive or had pre-hypertensive levels. There was no significant correlation between VO2max and TC, LDL-C, or TG in prepubertal children, but a slight negative correlation was detected in post-pubertal boys for HDL-C and TG. In addition, children with hypertension (3.4% or pre-hypertensive levels (6.6% also had comorbidity for overweight and blood lipid abnormalities (14% for triglycerides, 44.7% for TC, 25.9% for LDL-C, 52% for low HDL-C. The present study shows for the first time high correlations between prehypertensive blood pressure levels and the cardiovascular risk factors high TC, high LDL-C, low HDL-C in schoolchildren. These are important for the formulation of public health policies and strategies.

  10. Role of echocardiography for assessment of cardiovascular haemodynamics during pregnancy

    Directory of Open Access Journals (Sweden)

    Sonali S. Somani

    2016-01-01

    Conclusions: Present study shows significant functional changes in the cardiovascular dynamics during pregnancy. Doppler echocardiography provides an excellent noninvasive method for the evaluation and serial analysis of hemodynamic changes. These results will help in distinguishing abnormal echocardiographic changes from the normal physiologic changes of pregnancy. Therefore maternal echocardiography should be introduced into the antenatal management protocol, which will help to identify women at high risk to developing cardiovascular complications and there by early intervention. [Int J Reprod Contracept Obstet Gynecol 2016; 5(1.000: 84-89

  11. Knowledge and perceptions of risk for cardiovascular disease: Findings of a qualitative investigation from a low-income peri-urban community in the Western Cape, South Africa

    Directory of Open Access Journals (Sweden)

    Sam Surka

    2015-02-01

    Full Text Available Background: South Africa currently faces an increasing burden of cardiovascular disease. Although referred to clinics after community screening initiatives, few individuals who are identified to be at high risk for developing cardiovascular disease attend. Low health literacy and risk perception have been identified as possible causes. We investigated the knowledge and perceptions about risk for cardiovascular disease in a community.Method: We conducted a series of focus group discussions with individuals from a low incomeperi-urban community in the Western Cape, South Africa. Different methods of presenting risk were explored. The data were organised into themes and analysed to find associations between themes to provide explanations for our findings.Results: Respondents’ knowledge of cardiovascular disease and its risk factors varied, but most were familiar with the terms used to describe cardiovascular disease. In contrast, understanding of the concept of risk was poor. Risk was perceived as a binary concept and evaluation of different narrative and visual methods of presenting risk was not possible.Conclusion: Understanding cardiovascular disease and its risk factors requires a different set of skills from that needed to understand uncertainty and risk. The former requires knowledge of facts, whereas understanding of risk requires numerical and computational skills. Without a better understanding of risk, risk assessments for cardiovascular disease may fail in this community.

  12. Obesity and the risk of cardiovascular disease and diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    Matthew J. Sorrentino

    2006-01-01

    @@ The increasing prevalence of obesity worldwide has many experts concerned about the worsening health of a large proportion of the population. It is well recognized that obesity is associated with a higher mortality, an increased risk of hypertension and hyperlipidemia, cardiovascular disease, diabetes mellitus, osteoarthritis, gall bladder disease and possibly some cancers. Currently it is estimated that over two thirds of adults in the United States are overweight and nearly one third are clinically obese.1 Of special concern is the rapid increase in obesity among children. Other countries both developed and developing are experiencing similar trends.

  13. Albuminuria: Prevalence, associated risk factors and relationship with cardiovascular disease

    OpenAIRE

    Chen, Fang; Yang, Wenying; Weng, Jianping; Jia, Weiping; Ji, Linong; Xiao, Jianzhong; Shan, Zhongyan; Liu, Jie; Tian, Haoming; Ji, Qiuhe; Zhu, Dalong; Ge, Jiapu; Lin, Lixiang; Chen, Li; Guo, Xiaohui

    2013-01-01

    Abstract Aims/Introduction To investigate the prevalence and associated risk factors of microalbuminuria, and to explore the relationship between albuminuria and cardiovascular disease (CVD). Materials and Methods A nationally representative sample of 38,203 Chinese participants was categorized by different levels of urinary albumin‐to‐creatinine ratio (ACR; 0 –10 mg/g, 10 –20 mg/g, 20 –30 mg/g, 30 –300 mg/g). The prevalence of albuminuria was compared by using a single urinary ACR cut‐off po...

  14. Risk Prediction of Cardiovascular Complications in Pregnant Women With Heart Disease

    Directory of Open Access Journals (Sweden)

    Luciana Carvalho Martins

    2016-04-01

    Full Text Available Abstract Background: Heart disease in pregnancy is the leading cause of non- obstetric maternal death. Few Brazilian studies have assessed the impact of heart disease during pregnancy. Objective: To determine the risk factors associated with cardiovascular and neonatal complications. Methods: We evaluated 132 pregnant women with heart disease at a High-Risk Pregnancy outpatient clinic, from January 2005 to July 2010. Variables that could influence the maternal-fetal outcome were selected: age, parity, smoking, etiology and severity of the disease, previous cardiac complications, cyanosis, New York Heart Association (NYHA functional class > II, left ventricular dysfunction/obstruction, arrhythmia, drug treatment change, time of prenatal care beginning and number of prenatal visits. The maternal-fetal risk index, Cardiac Disease in Pregnancy (CARPREG, was retrospectively calculated at the beginning of prenatal care, and patients were stratified in its three risk categories. Results: Rheumatic heart disease was the most prevalent (62.12%. The most frequent complications were heart failure (11.36% and arrhythmias (6.82%. Factors associated with cardiovascular complications on multivariate analysis were: drug treatment change (p = 0.009, previous cardiac complications (p = 0.013 and NYHA class III on the first prenatal visit (p = 0.041. The cardiovascular complication rates were 15.22% in CARPREG 0, 16.42% in CARPREG 1, and 42.11% in CARPREG > 1, differing from those estimated by the original index: 5%, 27% and 75%, respectively. This sample had 26.36% of prematurity. Conclusion: The cardiovascular complication risk factors in this population were drug treatment change, previous cardiac complications and NYHA class III at the beginning of prenatal care. The CARPREG index used in this sample composed mainly of patients with rheumatic heart disease overestimated the number of events in pregnant women classified as CARPREG 1 and > 1, and underestimated

  15. An Overview of NASA's Risk of Cardiovascular Disease from Radiation Exposure

    Science.gov (United States)

    Patel, Zarana S.; Huff, Janice L.; Simonsen, Lisa C.

    2015-01-01

    The association between high doses of radiation exposure and cardiovascular damage is well established. Patients that have undergone radiotherapy for primary cancers of the head and neck and mediastinal regions have shown increased risk of heart and vascular damage and long-term development of radiation-induced heart disease [1]. In addition, recent meta-analyses of epidemiological data from atomic bomb survivors and nuclear industry workers has also shown that acute and chronic radiation exposures is strongly correlated with an increased risk of circulatory disease at doses above 0.5 Sv [2]. However, these analyses are confounded for lower doses by lifestyle factors, such as drinking, smoking, and obesity. The types of radiation found in the space environment are significantly more damaging than those found on Earth and include galactic cosmic radiation (GCR), solar particle events (SPEs), and trapped protons and electrons. In addition to the low-LET data, only a few studies have examined the effects of heavy ion radiation on atherosclerosis, and at lower, space-relevant doses, the association between exposure and cardiovascular pathology is more varied and unclear. Understanding the qualitative differences in biological responses produced by GCR compared to Earth-based radiation is a major focus of space radiation research and is imperative for accurate risk assessment for long duration space missions. Other knowledge gaps for the risk of radiation-induced cardiovascular disease include the existence of a dose threshold, low dose rate effects, and potential synergies with other spaceflight stressors. The Space Radiation Program Element within NASA's Human Research Program (HRP) is managing the research and risk mitigation strategies for these knowledge gaps. In this presentation, we will review the evidence and present an overview of the HRP Risk of Cardiovascular Disease and Other Degenerative Tissue Effects from Radiation Exposure.

  16. Risk of cardiovascular disease from antiretroviral therapy for HIV: a systematic review.

    Directory of Open Access Journals (Sweden)

    Clay Bavinger

    Full Text Available BACKGROUND: Recent studies suggest certain antiretroviral therapy (ART drugs are associated with increases in cardiovascular disease. PURPOSE: We performed a systematic review and meta-analysis to summarize the available evidence, with the goal of elucidating whether specific ART drugs are associated with an increased risk of myocardial infarction (MI. DATA SOURCES: We searched Medline, Web of Science, the Cochrane Library, and abstract archives from the Conference on Retroviruses and Opportunistic Infections and International AIDS Society up to June 2011 to identify published articles and abstracts. STUDY SELECTION: Eligible studies were comparative and included MI, strokes, or other cardiovascular events as outcomes. DATA EXTRACTION: Eligibility screening, data extraction, and quality assessment were performed independently by two investigators. DATA SYNTHESIS: Random effects methods and Fisher's combined probability test were used to summarize evidence. FINDINGS: Twenty-seven studies met inclusion criteria, with 8 contributing to a formal meta-analysis. Findings based on two observational studies indicated an increase in risk of MI for patients recently exposed (usually defined as within last 6 months to abacavir (RR 1.92, 95% CI 1.51-2.42 and protease inhibitors (PI (RR 2.13, 95% CI 1.06-4.28. Our analysis also suggested an increased risk associated with each additional year of exposure to indinavir (RR 1.11, 95% CI 1.05-1.17 and lopinavir (RR 1.22, 95% CI 1.01-1.47. Our findings of increased cardiovascular risk from abacavir and PIs were in contrast to four published meta-analyses based on secondary analyses of randomized controlled trials, which found no increased risk from cardiovascular disease. CONCLUSION: Although observational studies implicated specific drugs, the evidence is mixed. Further, meta-analyses of randomized trials did not find increased risk from abacavir and PIs. Our findings that implicate specific ARTs in the

  17. Assessment of fracture risk

    Energy Technology Data Exchange (ETDEWEB)

    Kanis, John A. [WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield S10 2RX (United Kingdom)], E-mail: w.j.pontefract@sheffield.ac.uk; Johansson, Helena; Oden, Anders [WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield S10 2RX (United Kingdom); McCloskey, Eugene V. [WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield S10 2RX (United Kingdom); Osteoporosis Centre, Northern General Hospital, Sheffield (United Kingdom)

    2009-09-15

    Fractures are a common complication of osteoporosis. Although osteoporosis is defined by bone mineral density at the femoral neck, other sites and validated techniques can be used for fracture prediction. Several clinical risk factors contribute to fracture risk independently of BMD. These include age, prior fragility fracture, smoking, excess alcohol, family history of hip fracture, rheumatoid arthritis and the use of oral glucocorticoids. These risk factors in conjunction with BMD can be integrated to provide estimates of fracture probability using the FRAX tool. Fracture probability rather than BMD alone can be used to fashion strategies for the assessment and treatment of osteoporosis.

  18. Assessment of fracture risk

    International Nuclear Information System (INIS)

    Fractures are a common complication of osteoporosis. Although osteoporosis is defined by bone mineral density at the femoral neck, other sites and validated techniques can be used for fracture prediction. Several clinical risk factors contribute to fracture risk independently of BMD. These include age, prior fragility fracture, smoking, excess alcohol, family history of hip fracture, rheumatoid arthritis and the use of oral glucocorticoids. These risk factors in conjunction with BMD can be integrated to provide estimates of fracture probability using the FRAX tool. Fracture probability rather than BMD alone can be used to fashion strategies for the assessment and treatment of osteoporosis.

  19. Subclinical Hypothyroidism in PCOS: Impact on Presentation, Insulin Resistance, and Cardiovascular Risk

    Directory of Open Access Journals (Sweden)

    Qun Yu

    2016-01-01

    Full Text Available Aim of Study. To assess status of thyroid function and thyroid disorders particularly subclinical hypothyroidism (SCH in subjects with polycystic ovarian syndrome (PCOS and impact of SCH on various clinical and biochemical parameters and cardiovascular risk in PCOS. Methods. Hundred females diagnosed with PCOS as per Rotterdam criteria and 100 normal controls were recruited and were subjected to elaborate anthropometric, clinical, and biochemical assessment. Results. Notable findings included significantly higher frequency of subjects with subclinical hypothyroidism (p=0.0002, autoimmune thyroiditis (p<0.001, and goitre (p=0.02 in polycystic ovarian syndrome subjects compared to control subjects. Further SCH PCOS subjects were found to harbor significantly higher HOMA-IR (p<0.05 and frequency of subjects with dyslipidemia (p<0.05 compared to both euthyroid PCOS and euthyroid control subjects. Though frequency of subjects with cardiovascular risk factors was higher in SCH PCOS group than euthyroid PCOS group, it failed to reach statistical significance. Conclusion. We concluded that PCOS is associated with high incidence of SCH and AIT compared to normal population and SCH poses increased risk of cardiovascular disorder in PCOS.

  20. Education to a Healthy Lifestyle Improves Symptoms and Cardiovascular Risk Factors – AsuRiesgo Study

    Directory of Open Access Journals (Sweden)

    Graciela Chaves

    2015-05-01

    Full Text Available Background: Cardiovascular diseases are the current leading causes of death and disability globally. Objective: To assess the effects of a basic educational program for cardiovascular prevention in an unselected outpatient population. Methods: All participants received an educational program to change to a healthy lifestyle. Assessments were conducted at study enrollment and during follow-up. Symptoms, habits, ATP III parameters for metabolic syndrome, and American Heart Association’s 2020 parameters of cardiovascular health were assessed. Results: A total of 15,073 participants aged ≥ 18 years entered the study. Data analysis was conducted in 3,009 patients who completed a second assessment. An improvement in weight (from 76.6 ± 15.3 to 76.4 ± 15.3 kg, p = 0.002, dyspnea on exertion NYHA grade II (from 23.4% to 21.0% and grade III (from 15.8% to 14.0% and a decrease in the proportion of current active smokers (from 3.6% to 2.9%, p = 0.002 could be documented. The proportion of patients with levels of triglycerides > 150 mg/dL (from 46.3% to 42.4%, p 100 mg/dL (from 69.3% to 65.5%, p < 0.001 improved. A ≥ 20% improvement of AHA 2020 metrics at the level graded as poor was found for smoking (-21.1%, diet (-29.8%, and cholesterol level (-23.6%. A large dropout as a surrogate indicator for low patient adherence was documented throughout the first 5 visits, 80% between the first and second assessments, 55.6% between the second and third assessments, 43.6% between the third and fourth assessments, and 38% between the fourth and fifth assessments. Conclusion: A simple, basic educational program may improve symptoms and modifiable cardiovascular risk factors, but shows low patient adherence.

  1. Microbial Risk Assessment

    Science.gov (United States)

    Ott, C. M.; Mena, K. D.; Nickerson, C.A.; Pierson, D. L.

    2009-01-01

    Historically, microbiological spaceflight requirements have been established in a subjective manner based upon expert opinion of both environmental and clinical monitoring results and the incidence of disease. The limited amount of data, especially from long-duration missions, has created very conservative requirements based primarily on the concentration of microorganisms. Periodic reevaluations of new data from later missions have allowed some relaxation of these stringent requirements. However, the requirements remain very conservative and subjective in nature, and the risk of crew illness due to infectious microorganisms is not well defined. The use of modeling techniques for microbial risk has been applied in the food and potable water industries and has exceptional potential for spaceflight applications. From a productivity standpoint, this type of modeling can (1) decrease unnecessary costs and resource usage and (2) prevent inadequate or inappropriate data for health assessment. In addition, a quantitative model has several advantages for risk management and communication. By identifying the variable components of the model and the knowledge associated with each component, this type of modeling can: (1) Systematically identify and close knowledge gaps, (2) Systematically identify acceptable and unacceptable risks, (3) Improve communication with stakeholders as to the reasons for resource use, and (4) Facilitate external scientific approval of the NASA requirements. The modeling of microbial risk involves the evaluation of several key factors including hazard identification, crew exposure assessment, dose-response assessment, and risk characterization. Many of these factors are similar to conditions found on Earth; however, the spaceflight environment is very specialized as the inhabitants live in a small, semi-closed environment that is often dependent on regenerative life support systems. To further complicate modeling efforts, microbial dose

  2. Age-specific performance of the revised cardiac risk index for predicting cardiovascular risk in elective noncardiac surgery

    DEFF Research Database (Denmark)

    Andersson, Charlotte; Wissenberg, Mads; Jørgensen, Mads Emil;

    2015-01-01

    BACKGROUND: The revised cardiac risk index (RCRI) holds a central role in preoperative cardiac risk stratification in noncardiac surgery. Its performance in unselected populations, including different age groups, has, however, not been systematically investigated. We assessed the relationship of...... November 30, 2011) for the 30-day risk of major adverse cardiovascular events (ischemic stroke, myocardial infarction, or cardiovascular death). There were 742 of 357,396 (0.2%), 755 of 74.889 (1.0%), 521 of 11,921 (4%), and 257 of 3146 (8%) major adverse cardiovascular events occurring in RCRI classes I......, II, III, and IV. Multivariable odds ratio estimates were as follows: ischemic heart disease 3.30 (95% confidence interval, 2.96-3.69), high-risk surgery 2.70 (2.46-2.96), congestive heart failure 2.65 (2.29-3.06), cerebrovascular disease 10.02 (9.08-11.05), insulin therapy 1.62 (1.37-1.93), and...

  3. Risk of cardiovascular disease in a traditional African population with a high infectious load: a population-based study.

    Directory of Open Access Journals (Sweden)

    Jacob J E Koopman

    Full Text Available BACKGROUND: To test the inflammatory origin of cardiovascular disease, as opposed to its origin in western lifestyle. Population-based assessment of the prevalences of cardiovascular risk factors and cardiovascular disease in an inflammation-prone African population, including electrocardiography and ankle-arm index measurement. Comparison with known prevalences in American and European societies. METHODOLOGY/PRINCIPAL FINDINGS: Traditional population in rural Ghana, characterised by adverse environmental conditions and a high infectious load. Population-based sample of 924 individuals aged 50 years and older. Median values for cardiovascular risk factors, including waist circumference, BMI, blood pressure, and markers of glucose and lipid metabolism and inflammation. Prevalence of myocardial infarction detected by electrocardiography and prevalence of peripheral arterial disease detected by ankle-arm index. When compared to western societies, we found the Ghanaians to have more proinflammatory profiles and less cardiovascular risk factors, including obesity, dysglycaemia, dyslipidaemia, and hypertension. Prevalences of cardiovascular disease were also lower. Definite myocardial infarction was present in 1.2% (95%CI: 0.6 to 2.4%. Peripheral arterial disease was present in 2.8% (95%CI: 1.9 to 4.1%. CONCLUSIONS/SIGNIFICANCE: Taken together, our data indicate that for the pathogenesis of cardiovascular disease inflammatory processes alone do not suffice and additional factors, probably lifestyle-related, are mandatory.

  4. Hipotiroidismo subclínico y factores de riesgo cardiovascular Subclinical hypothyroidism and cardiovascular risk factors

    Directory of Open Access Journals (Sweden)

    M.ª C. Frías López

    2011-12-01

    center and describe the clinical characteristics and cardiovascular risk factors in patients with subclinical hypothyroidism. Methods: An observational study, retrospective, reviewing the medical histories of patients sampled from June 2005 until July 2007. We analyzed the following variables; facts: age and sex. Family history thyroid disease and other diseases. Personal history: cardiovascular pulmonary autoimmune, alterations gynecology obstetric diabetes, hypertension (HT dislipemia, obesity, psychiatric alterations and haematological. Laboratory data: novel TSH, free T4, antiperoxidase antibodies, total cholesterol and its fractions. Results: The prevalence of the sample of 100 patients collected over 8 months was 3.8% in the general population over 14 years, of which 79 were women and 21 were men. 13% were type 2 diabetics, 23% had HT and 40% had dyslipidemia. Overweight and obesity were present in 26%. The average level of TSH was 6.92 ± 2.29 μU/ml and the average level of free T4 was 1.16 ± 0.16 ng/ml. Conclusions: Prevalence subclinical hypothyroidism was 3.8%. especially in women with a mean age of 46. The incidence of cardiovascular risk factors in the subjects studied is higher in DM (13%, similar to general population in terms of dyslipidemia (40% and obesity (23% and lowest in hypertension (23%. In our study we observed a common pattern in the management of subclinical hypothyroidism, requiring the implementation and promotion of practice guidelines in primary care.

  5. Cardiovascular risk factors and risk of venous thromboembolism

    OpenAIRE

    Brækkan, Sigrid Kufaas

    2010-01-01

    Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, is a common disease, with serious short- and long-term complications and a potential fatal outcome. Despite the knowledge of several inherited and acquired risk factors for VTE, still 30-50 % of the VTE events occur in the absence of obvious predisposing factors. Traditionally, arterial and venous thrombosis has been considered as separate disease entities with different pathology, epidemiology and treatments...

  6. Circulating biomarkers for predicting cardiovascular disease risk; a systematic review and comprehensive overview of meta-analyses.

    Directory of Open Access Journals (Sweden)

    Thijs C van Holten

    Full Text Available BACKGROUND: Cardiovascular disease is one of the major causes of death worldwide. Assessing the risk for cardiovascular disease is an important aspect in clinical decision making and setting a therapeutic strategy, and the use of serological biomarkers may improve this. Despite an overwhelming number of studies and meta-analyses on biomarkers and cardiovascular disease, there are no comprehensive studies comparing the relevance of each biomarker. We performed a systematic review of meta-analyses on levels of serological biomarkers for atherothrombosis to compare the relevance of the most commonly studied biomarkers. METHODS AND FINDINGS: Medline and Embase were screened on search terms that were related to "arterial ischemic events" and "meta-analyses". The meta-analyses were sorted by patient groups without pre-existing cardiovascular disease, with cardiovascular disease and heterogeneous groups concerning general populations, groups with and without cardiovascular disease, or miscellaneous. These were subsequently sorted by end-point for cardiovascular disease or stroke and summarized in tables. We have identified 85 relevant full text articles, with 214 meta-analyses. Markers for primary cardiovascular events include, from high to low result: C-reactive protein, fibrinogen, cholesterol, apolipoprotein B, the apolipoprotein A/apolipoprotein B ratio, high density lipoprotein, and vitamin D. Markers for secondary cardiovascular events include, from high to low result: cardiac troponins I and T, C-reactive protein, serum creatinine, and cystatin C. For primary stroke, fibrinogen and serum uric acid are strong risk markers. Limitations reside in that there is no acknowledged search strategy for prognostic studies or meta-analyses. CONCLUSIONS: For primary cardiovascular events, markers with strong predictive potential are mainly associated with lipids. For secondary cardiovascular events, markers are more associated with ischemia. Fibrinogen is a

  7. Residual Cardiovascular Risk in Diabetic Patients: The Role of Fibrate Statin Combination

    Directory of Open Access Journals (Sweden)

    Angelos Liontos

    2014-10-01

    Full Text Available Patients with Type 2 diabetes mellitus (T2DM have increased cardiovascular disease (CVD risk. The use of statins significantly reduces the rate of CVD events but many T2DM patients, especially those with mixed dyslipidaemia (MD, have residual CVD risk. The use of fibrates, which improve triglyceride and high-density lipoprotein cholesterol levels, is beneficial for the treatment of patients with MD. Evidence from the Action to Control Cardiovascular Risk in Diabetes (ACCORD Lipid study showed a possible beneficial effect on CVD events of the addition of fenofibrate (FF to statin treatment in patients with T2DM and atherogenic MD. Furthermore, FF has been associated with slowing of the progression of early diabetic retinopathy. The combination of statin with a fibrate may improve the residual CVD risk and microvascular complications of patients with T2DM. However, trials specifically designed to assess the effects of fibrate-statin combination on cardiovascular outcomes in patients with T2DM are missing.

  8. Risk assessment: 'A consumer's perspective'

    International Nuclear Information System (INIS)

    The paper assesses the concept of risk, risk assessment and tolerability of risk from consumer point of view. Review of existing UK and EC directives on certain products and appliances is also covered

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

    Science.gov (United States)

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

    2009-01-01

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

  10. Cardiovascular risks in prediabetes: Preliminary data on "vasculopathy triad"

    Directory of Open Access Journals (Sweden)

    Ezekiel U Nwose

    2014-01-01

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

  11. MODERN PRINCIPLES OF QUALITY ASSESSMENT OF CARDIOVASCULAR DISEASES TREATMENT

    Directory of Open Access Journals (Sweden)

    A. Yu. Suvorov

    2015-09-01

    Full Text Available The most common ways of assessment of cardiovascular diseases treatment abroad, approaches to creation of such assessment methods are considered, as well as data on the principles of the assessment of treatment in Russia. Some foreign registers of acute myocardial infarction, the aim of which was therapy quality assessment, are given as examples. The problem of high-quality treatment based on data from evidence-based medicine, some legal aspects related to clinical guidelines in Russia are considered, as well as various ways of treatment quality assessment.

  12. Concerning ethical risk assessment

    International Nuclear Information System (INIS)

    After a fundamental consideration of the concept of responsibility and 'long-term responsibility' for late sequelae, the problems of an ehtical assessment of risks were illustrated: The concept of risk itself poses three problems - predicting the probability of occurrence, assessing the damage = subjective classification of the degree of damage, determining whether the advantages outweigh the risks. It is not possible to weigh the advantages and risks against each other without assessing the goals and the priorities which have been set. Here ethics is called for, because it concerns itself with the reasonableness of evaluative decisions. Its task is to enable us to become aware of and comprehend our system of values in all of its complexity in reference to real life. Ethics can only fulfill its task if it helps us to adopt an integral perspective, i.e. if it centers on the human being. 'One must assess all technical and economic innovations in terms of whether they are beneficial to the development of mankind on a long-term basis. They are only to be legitimized insofar as they prove themselves to be a means of liberating mankind and contributing to his sense of dignity and identity, as a means of bringing human beings together and encouraging them to care for one another, and as a means of protecting the natural basis of our existence. (orig./HSCH)

  13. ROLE OF VARIOUS RISK FACTORS ASSOCIATED WITH CARDIOVASCULAR DISEASES

    Directory of Open Access Journals (Sweden)

    Pranay Wal

    2013-06-01

    Full Text Available Coronary Artery Disease (CAD is the leading cause of cardiovascular mortality world wide. Increasing rate of CAD mortality and projected rise in CAD mortality for 2020 in the developing world necessitates immediate prevention and control measures. Cardiovascular disease (CVD is generally due to reduced blood flow to the heart, brain or body caused by atheroma or thrombosis. It is increasingly common after the age of 60, but rare below the age of 30. Plaques (plates of fatty atheroma build up in different arteries during adult life. These can eventually cause narrowing of the arteries, or trigger a local thrombosis (blood clot which completely blocks the blood flow. Despite scientific evidence that evidence based drug therapy reduce mortality in patients with established CAD, these therapies continue to be underutilized in patients receiving conventional care. It is essential to identify and manage risk factors for coronary artery diseases and to implement unique and creative approaches to stimulate better adherence to practice guidelines, to improve the quality of care given to patients with CAD. Reduction of SBP, DBP, heart rate, and body fat%, total cholesterol, triglycerides and LDL after regular yogic practices is beneficial for cardiac and hypertensive patients. Emphasis focusing on conventional risk factors, lifestyle modifications, smoking cessation, reduction of central obesity through dietary modification and exercise, can be proved to be the key interventions for preventing CAD.

  14. Cognitive development over 8 years in midlife and its association with cardiovascular risk factors

    DEFF Research Database (Denmark)

    Anstey, Kaarin J; Sargent-Cox, Kerry; Garde, Ellen;

    2014-01-01

    ) was drawn randomly from the community, followed for 8 years, and assessed on cognitive function, health, and lifestyle risk factors at 4 yearly intervals. A summary risk score (PATHrisk) was computed for presence of smoking, hypertension, depression, high body mass index, diabetes, and insufficient...... choice RT over 8 years. Education was associated with cognitive test performance and was weakly protective against slowing of RT. Individual risk factors, primarily diabetes, smoking, and depression, were associated with cognitive function, and smoking was associated with decline in simple RT. CONCLUSION......: Reliable change in cognitive function was detected in midlife, and decline occurred primarily in measures of cognitive speed. It appears that in midlife, the overall burden of cardiovascular risk factors is more important than individual risk factors. Midlife is a critical period for identifying modifiable...

  15. Prevalence of cardiovascular risks factors and 10 year predictions of coronary heart disease in seafarers of Pertamina shipping (Indonesia)

    DEFF Research Database (Denmark)

    Purnawarma, Irwin GNI; Jensen, Olaf Chresten; Canals, ML;

    2011-01-01

    Background Cardiovascular disease is (CVD) is becoming a major health problem in the world and they have to be taken into account in shipping companies. Employees and Company management should be aware of the dangers and implications, CVD can bring. Objectives To obtain the prevalence of...... cardiovascular risk factors and to evaluate the 10 year prediction of Coronary Heart Disease in both seafarers and onshore workers at Pertamina Shipping. Methods This is a cross sectional study using data of periodical Medical Fitness Examinations in 2009 among 348 active male seafarers and onshore workers......, between ages of 40 - 55 years old working at Pertamina Shipping. A 10 year coronary risk is also evaluated and comparison of the risk is made between the two groups using Fisher's exact values. Results Assessment cardiovascular risk factors of 348 male seafarers and onshore worker were done. The dominant...

  16. Riscos cardiovasculares em adolescentes com diferentes graus de obesidade Riesgos cardiovasculares en adolescentes con diferentes grados de obesidad Cardiovascular risks in adolescents with different degrees of obesity

    Directory of Open Access Journals (Sweden)

    Maria Silvia Ferrari Lavrador

    2011-03-01

    desarrollaron scores de riesgo para enfermedad cardiovascular, de acuerdo con el número de alteraciones encontradas en las siguientes variables: glucemia de ayuno, triglicéridos, HDL y PA. Se verificaron asociaciones entre estos scores y el grado de obesidad. RESULTADOS: Los dos grupos difirieron en valores de peso, circunferencia de la cintura, glucemia e insulina de ayuno, HOMA-IR, triglicéridos, HDL, PA y mediciones de composición corporal (pBACKGROUND: There have been few studies on cardiovascular risk factors in adolescents with different degrees of obesity. OBJECTIVE: To evaluate metabolic effects associated with different degrees of obesity in adolescents and their impact on cardiovascular risks. METHODS: Cross-sectional study of 80 obese adolescents, divided in two groups: 22.5, classified as obese with lower or higher degree of obesity, respectively. Physical examination was carried out, as well as biochemical and body composition assessment. The statistical analysis was performed with t-Student and Chi-square tests, aiming at comparing both groups. A multiple logistic model was used to verify the associations between the biochemical variables and the degree of obesity. Risk scores were developed for cardiovascular disease, according to the number of alterations found in the following variables: fasting glycemia, triglycerides, HDL and blood pressure. Association between these scores and degree of obesity were verified. RESULTS: The two groups differed regarding weight, waist circumference, fasting glycemia and insulin, HOMA-IR, triglycerides, HDL, blood pressure (BP and body composition measurements (p<0.05. The adolescents with the higher degree of obesity presented higher frequencies of alterations for glycemia, HOMA-IR, triglycerides, HDL and BP (p<0.05. The logistic model showed associations between the degree of obesity and the variables: HDL (OR=5.43, BP (OR=4.29, TG (OR=3.12. The risk score demonstrated that 57.7% of the adolescents with higher degrees of

  17. Physical Activity and Cardiovascular Disease Risk Factors Among Young and Middle-Aged men in Urban Mwanza, Tanzania.

    OpenAIRE

    Muhihi, Alfa; Njelekela, Marina; Mpembeni, Rose; Masesa, Zablon; KITAMORI, KAZUYA; Mori, Mari; Kato, Norihiro; Mtabaji, Jacob; Yamori, Yukio

    2012-01-01

    Background Cardiovascular diseases (CVD) risk factors are increasing at an unprecedented rate in developing countries. However, fewer studies have evaluated the role of physical activity in preventing CVD in these countries. We assessed level physical activity and its relationship with CVD risk factors among young and middle aged men in a fast growing city of Mwanza in Tanzania. Methods Physical activity was assessed among 97 healthy men aged 20–50years using Sub-Saharan Africa Activity Quest...

  18. Cigarette use and cardiovascular risk in chronic kidney disease: an unappreciated modifiable lifestyle risk factor.

    LENUS (Irish Health Repository)

    Stack, Austin G

    2012-01-31

    Tobacco use is a major modifiable cardiovascular risk factor in the general population and contributes to excess cardiovascular risk. Emerging evidence from large-scale observational studies suggests that continued tobacco use is also an independent cardiovascular risk factor among patients with chronic kidney disease (CKD). The benefits of smoking cessation programs on improving the heath status of patients and reducing mortality are unequivocal in the general population. Despite this, there has been little effort in pursuing tobacco cessation programs in dialysis cohorts or those with lesser degrees of kidney impairment. Most of our attention to date has focused on the development of "kidney-specific" interventions that reduce rates of renal disease progression and improve dialysis outcomes. The purpose of this current review is to describe the epidemiology of tobacco use among patients with CKD, draw attention to its negative impact on cardiovascular morbidity and mortality, and finally highlight potential strategies for successful intervention. We hope that this study heightens the importance of tobacco use in CKD, stimulates renewed interest in the barriers and challenges that exist in achieving smoking cessation, and endorses the efficacy of intervention strategies and the immeasurable benefits of quitting on cardiovascular and noncardiovascular outcomes.

  19. Work Stress as a Risk Factor for Cardiovascular Disease.

    Science.gov (United States)

    Kivimäki, Mika; Kawachi, Ichiro

    2015-09-01

    The role of psychosocial work stress as a risk factor for chronic disease has been the subject of considerable debate. Many researchers argue in support of a causal connection while others remain skeptical and have argued that the effect on specific health conditions is either negligible or confounded. This review of evidence from over 600,000 men and women from 27 cohort studies in Europe, the USA and Japan suggests that work stressors, such as job strain and long working hours, are associated with a moderately elevated risk of incident coronary heart disease and stroke. The excess risk for exposed individuals is 10-40 % compared with those free of such stressors. Differences between men and women, younger versus older employees and workers from different socioeconomic backgrounds appear to be small, indicating that the association is robust. Meta-analyses of a wider range of health outcomes show additionally an association between work stress and type 2 diabetes, though not with common cancers or chronic obstructive pulmonary disease, suggesting outcome specificity. Few studies have addressed whether mitigation of work stressors would reduce the risk of cardiovascular disease. In view of the limited interventional evidence on benefits, harms and cost-effectiveness, definitive recommendations have not been made (e.g. by the US Preventive Services Taskforce) for the primary prevention of cardiovascular disease via workplace stress reduction. Nevertheless, governments are already launching healthy workplace campaigns, and preventing excessive work stress is a legal obligation in several countries. Promoting awareness of the link between stress and health among both employers and workers is an important component of workplace health promotion. PMID:26238744

  20. Association between job strain (high demand-low control and cardiovascular disease risk factors among petrochemical industry workers

    Directory of Open Access Journals (Sweden)

    Siamak Poorabdian

    2013-08-01

    Full Text Available Objective: One of the practical models for assessment of stressful working conditions due to job strain is "job demand and control" or Karasek's job strain model. This model explains how adverse physical and psychological effects including cardiovascular disease risk factors can be established due to high work demand. The aim was to investigate how certain cardiovascular risk factors including body mass index (BMI, heart rate, blood pressure, serum total cholesterol levels, and cigarette smoking are associated with job demand and control in workers. Materials and Methods: In this cohort study, 500 subjects completed "job demand and control" questionnaires. Factor analysis method was used in order to specify the most important "job demand and control" questions. Health check-up records of the workers were applied to extract data about cardiovascular disease risk factors. Ultimately, hypothesis testing, based on Eta, was used to assess the relationship between separated working groups and cardiovascular risk factors (hypertension and serum total cholesterol level. Results: A significant relationship was found between the job demand-control model and cardiovascular risk factors. In terms of chisquared test results, the highest value was assessed for heart rate (Chi2 = 145.078. The corresponding results for smoking and BMI were Chi2 = 85.652 and Chi2 = 30.941, respectively. Subsequently, Eta result for total cholesterol was 0.469, followed by hypertension equaling 0.684. Moreover, there was a significant difference between cardiovascular risk factors and job demand-control profiles among different working groups including the operational group, repairing group and servicing group. Conclusion: Job control and demand are significantly related to heart disease risk factors including hypertension, hyperlipidemia, and cigarette smoking.

  1. Body Fat Distribution and Its Association with Cardiovascular Risk Factors in Adolescent Iranian Girls

    Directory of Open Access Journals (Sweden)

    Mohammad-Reza Parizadeh

    2012-03-01

    Full Text Available Objective: The relationships between body fat distribution, lipid profile and blood pressure, have not been studied extensively in young population. This study was designed to evaluate the association between measures of adiposity and established cardiovascular risk factors in adolescent girls.Methods: A total of 477 adolescent girls aged 15 to 18 years were recruited from Mashhad high schools.Socio-demographic characteristics were assessed using a self-administered questionnaire. Anthropometricassessments, blood pressure measurement and biochemical assessment were performed. Total and regionalfat mass were determined by bio-impedance analysis. Cardiovascular disease risk factors were assessed in relation to body fat measures with adjustment for confounder factors including age and family socioeconomic status.Findings: The prevalence of overweight and obesity was 14.6% and 3.4% respectively; 16% of study population had greater fat mass compared to its ideal distribution. The majority of cardiovascular riskfactors, especially systolic and diastolic blood pressure, triglyceride concentration, CRP and fasting blood sugar were significantly higher in group with a high body fat when compared to those with normal and low values. All anthropometric indices showed significant correlation with fat mass, fat free mass, total andregional body fat percent (P<0.001. After adjustment for age and family socioeconomic status, a high fat massespecially, truncal fat, was positively associated with triglyceride and blood pressure.Conclusion: Adiposity, especially truncal adiposity, which can be assessed by simple measures such as Body Mass Index (BMI and Waist Circumference (WC may predispose adolescent girls for demonstration of metabolic abnormalities and consequently cardiovascular diseases.

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

    Directory of Open Access Journals (Sweden)

    Daria Roccatagliata

    2006-12-01

    Full Text Available Daria Roccatagliata1, Fausto Avanzini1, Lara Monesi1, Vittorio Caimi2, Davide Lauri1, Paolo Longoni3, Roberto Marchioli4, Massimo Tombesi2, Gianni Tognoni1, Maria Carla Roncaglioni1, on behalf of the Collaborative Group Risk and Prevention Study*1Istituto di Ricerche Farmacologiche “Mario Negri”, Milano, Italy; 2CSeRMEG Centro Studi e Ricerca in Medicina Generale, Monza, Italy; 3CoS Consorzio Sanità, Milano, Italy; 4Consorzio Mario Negri Sud, S. Maria Imbaro, Italy *A full list of investigators is reported in the AppendixObjectives: To assess the pharmacological treatment and the control of major modifiable cardiovascular risk factors in everyday practice according to the patients’ cardiovascular risk level.Methods: In a cross-sectional study general practitioners (GPs had to identify a random sample of their patients with cardiovascular risk factors or diseases and collect essential data on the pharmacological treatment and control of hypertension, hyperlipidemia, and diabetes according to the patients’ cardiovascular risk level and history of cardiovascular disease. Participants were subjects of both sexes, aged 40–80 years, with at least one known cardiovascular risk factor or a history of cardiovascular diseases.Results: From June to December 2000, 162 Italian GPs enrolled 3120 of their patients (2470 hypertensives, 1373 hyperlipidemics, and 604 diabetics. Despite the positive association between the perceived level of global cardiovascular risk and lipid-lowering drug prescriptions in hyperlipidemic subjects (from 26% for lowest risk to 56% for highest risk p < 0.0001 or the prescription of combination therapy in hypertensives (from 41% to 70%, p < 0.0001 and diabetics (from 24% to 43%, p = 0.057, control was still inadequate in 48% of diabetics, 77% of hypertensives, and 85% of hyperlipidemics, with no increase in patients at highest risk. Trends for treatment and control were similar in patients with cardiovascular diseases

  3. p-Cresol and Cardiovascular Risk in Mild-to-Moderate Kidney Disease

    OpenAIRE

    Meijers, Björn K.I.; Claes, Kathleen; Bammens, Bert; De Loor, Henriette; Viaene, Liesbeth; Verbeke, Kristin; Kuypers, Dirk; Vanrenterghem, Yves; Evenepoel, Pieter

    2010-01-01

    Background and objectives: Cardiovascular disease is highly prevalent in chronic kidney disease. Traditional risk factors are insufficient to explain the high cardiovascular disease prevalence. Free p-cresol serum concentrations, mainly circulating as its derivative p-cresyl sulfate, are associated with cardiovascular disease in hemodialysis patients. It is not known if p-cresol is associated with cardiovascular disease in patients with chronic kidney disease not yet on dialysis.

  4. Cardiovascular risk behavior among students of a Medical College in Delhi

    Directory of Open Access Journals (Sweden)

    N Rustagi

    2011-01-01

    Full Text Available Background: Life style related behavioural risk factors are mainly implicated for increased burden of cardio- vascular diseases. Research related to these risk behaviours especially among medical students is essential, considering their role as future physicians and role models in public health intervention programmes. Objective: To evaluate the burden of cardiovascular risk behaviours among students of a medical college of Delhi, India. Materials and Methods: A cross sectional study was carried out among undergraduate medical students of a medical college in Delhi. Self administered questionnaire was used to collect information on identification data and risk behaviours in relation to cardiovascular diseases. Binary logistic regression analysis was done to calculate adjusted odds ratio to assess association between risk behaviours and covariates. Results: The minimum recommendation of taking at least five servings per day of fruits and vegetables was complied only by 12% of students. Consumption of carbonated soft drinks either once or more on daily basis was present in 23.7% students and 32.0% reported frequent consumption of fast foods in past week. Consumption of alcohol was present in 28.8% students but only small proportion of students (7% was current tobacco users. Large proportions of students (42.6% were either not carrying out or were involved in only occasional physical activity in past week. Conclusions: Unhealthy behavioural practises are present and may progress as student advance through medical college. Developing strategies targeting at these risk behaviours and determining factors is necessary to promote healthy life style among medical students.

  5. Adrenergic gene polymorphisms and cardiovascular risk in the NHLBI-sponsored Women's Ischemia Syndrome Evaluation

    Directory of Open Access Journals (Sweden)

    Sharaf Barry L

    2008-03-01

    Full Text Available Abstract Background Adrenergic gene polymorphisms are associated with cardiovascular and metabolic phenotypes. We investigated the influence of adrenergic gene polymorphisms on cardiovascular risk in women with suspected myocardial ischemia. Methods We genotyped 628 women referred for coronary angiography for eight polymorphisms in the α1A-, β1-, β2- and β3-adrenergic receptors (ADRA1A, ADRB1, ADRB2, ADRB3, respectively, and their signaling proteins, G-protein β 3 subunit (GNB3 and G-protein α subunit (GNAS. We compared the incidence of death, myocardial infarction, stroke, or heart failure between genotype groups in all women and women without obstructive coronary stenoses. Results After a median of 5.8 years of follow-up, 115 women had an event. Patients with the ADRB1 Gly389 polymorphism were at higher risk for the composite outcome due to higher rates of myocardial infarction (adjusted hazard ratio [HR] 3.63, 95% confidence interval [95%CI] 1.17–11.28; Gly/Gly vs. Arg/Arg HR 4.14, 95%CI 0.88–19.6. The risk associated with ADRB1 Gly389 was limited to those without obstructive CAD (n = 400, Pinteraction = 0.03, albeit marginally significant in this subset (HR 1.71, 95%CI 0.91–3.19. Additionally, women without obstructive CAD carrying the ADRB3 Arg64 variant were at higher risk for the composite endpoint (HR 2.10, 95%CI 1.05–4.24 due to subtle increases in risk for all of the individual endpoints. No genetic associations were present in women with obstructive CAD. Conclusion In this exploratory analysis, common coding polymorphisms in the β1- and β3-adrenergic receptors increased cardiovascular risk in women referred for diagnostic angiography, and could improve risk assessment, particularly for women without evidence of obstructive CAD. Trial Registration ClinicalTrials.gov NCT00000554.

  6. ARTERIAL STIFFNESS PARAMETERS IN PATIENTS WITH MODERATE/HIGH CARDIOVASCULAR RISK DURING LISINOPRIL AND SIMVASTATIN TREATMENT

    Directory of Open Access Journals (Sweden)

    V. N. Isakova

    2016-01-01

    Full Text Available Aim. To evaluate parameters of arterial stiffness by non-invasive arteriography in patients with moderate/high cardiovascular risk receiving lisinopril and simvastatin.Material and methods. 20 patients (aged 50-55 y.o. with arterial hypertension of the 1st degree and dislipidemia are included in the study. All patients had pulse wave velocity (PWV ≥ 10 m/s and/or the corrected index of pulse wave augmentation (AI × 80 ≥ -10% according to non-invasive arteriography data; and moderate-high cardiovascular risk (≥ 3%. Patients received therapy with lisinopril and simvastatin. Blood pressure (BP levels and lipid profiles were assessed before therapy and in 1, 2, 6 and 12 month of the observation. Non-invasive arteriography was performed before therapy and in 2, 6 and 12 months later.Results. BP target levels were reached within 1 month of treatment as well as improvement of lipid profile was reached within 2 months in majority of the patients. Reference PWV and AI were reached in 85,7% of patients within one year of treatment.Conclusion. Arterial stiffness parameters help to evaluate cardiovascular risk changes accurately as the results of treatment.

  7. Neck circumference as predictor of excess body fat and cardiovascular risk factors in adolescents

    Directory of Open Access Journals (Sweden)

    Vivian Siqueira Santos Gonçalves

    2014-04-01

    Full Text Available OBJECTIVE: To verify whether neck circumference can predict cardiovascular risk factors and excess body fat in adolescents. METHODS: This cross-sectional study included male and female adolescents aged 10 to 14 years from Viçosa, Minas Gerais. The following data were collected: anthropometric measurements, blood pressure, percentage of body fat according to dual energy X-ray absorptiometry, and levels of fasting glucose, fasting insulin, triglycerides, total cholesterol, high-density lipoprotein, and low-density lipoprotein. The anthropometric measurements were used for calculating indices and assessing nutritional status. The receiver operating characteristic curve tested whether neck circumference could predict cardiovascular risk. We also investigated how neck circumference related to the study parameters. The significance level was set at 5% (p0.5; p<0.05, varying from 0.610 for high-density lipoprotein to 0.817 for blood pressure. CONCLUSION: Neck circumference was capable of predicting excess fat and cardiovascular risk factors in adolescents.

  8. Rationale - Trial to Reduce Cardiovascular Events with Aranesp Therapy (TREAT) : Evolving the management of cardiovascular risk in patients with chronic kidney disease

    NARCIS (Netherlands)

    Mix, TCH; Brenner, RM; Cooper, ME; de Zeeuw, D; Ivanovich, P; Levey, AS; McGill, JB; McMurray, JJV; Parfrey, PS; Parving, HH; Pereira, BJG; Remuzzi, G; Singh, AK; Solomon, SD; Stehman-Breen, C; Toto, RD; Pfeffer, MA

    2005-01-01

    Background Patients with chronic kidney disease (CKD) have a high burden of mortality and cardiovascular morbidity. Additional strategies to modulate cardiovascular risk in this population are needed. Data suggest that anemia is a potent and potentially modifiable risk factor for cardiovascular dise

  9. Metabolic Syndrome and Cardiovascular Risk Factors in Obese Adolescent

    Science.gov (United States)

    Mansour, Manal; Nassef, Yasser E.; Shady, Mones Abu; Aziz, Ali Abdel; Malt, Heba A. El

    2016-01-01

    BACKGROUND: Childhood and adolescent obesity is associated with insulin resistance, abnormal glucose metabolism, hypertension, dyslipidemia, inflammation, liver disease, and compromised vascular function. The purpose of this study was to determine the prevalence of cardiovascular risk factor abnormalities and metabolic syndrome in a sample of obese adolescent as prevalence data might be helpful in improving engagement with obesity treatment in future. The high blood lipid levels and obesity are the main risk factors for cardio vascular diseases. Atherosclerotic process begins in childhood. AIM: This study aimed to investigate the relationship between obesity in adolescent and their blood lipids levels and blood glucose level. METHODS: This study was conducted with 100 adolescents of both gender age 12-17 years and body mass index (BMI) greater than 95th percentiles and 100 normal adolescents as control group. The blood samples were collected from all adolescents after overnight fasting (10 hours) to analyze blood lipids (Total cholesterol, high density lipoprotein, low density lipoprotein) and hematological profile (Hemoglobin, platelets and red blood cell, C reactive protein and fasting blood glucose. RESULTS: There were statistical difference between the two groups for red blood cells (P<0.001), Hemoglobin (P < 0.001) and platelets (P = 0.002), CRP (P = 0.02). Positive correlation was found between the two groups as regards total cholesterol (P = 0.0001), P value was positive for HDL (P = 0.005 and Atherogenic index P value was positive (P = 0.002). Positive correlation was found between the two group as regards fasting blood glucose (P = 0.001). CONCLUSION: Saturated fat was associated with elevated lipid levels in obese children. These results reinforce the importance of healthy dietary habits since child-hood in order to reduce the risks of cardiovascular diseases in adulthood.

  10. Circadian Role in Daily Pattern of Cardiovascular Risk

    Science.gov (United States)

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

    2004-03-01

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

  11. Integral risk assessment

    International Nuclear Information System (INIS)

    The series of lectures which forms the basis of this book and took place in the winter of 1989/90 at the ETH in Zuerich were held for the purpose of discussing the stage of development of our system of ethics in view of the extremely fast pace of technological progress and the risks which accompany it. Legal, psychological and political aspects of the problem were examined, but the emphasis was placed on ethical aspects. The effects which are examined in conventional risk analyses can be considered as a part of the ethical and social aspects involved, and in turn, the consideration of ethical and social aspects can be viewed as an extension of the conventional form of risk analysis. In any case, among risk experts, the significance of ethical and social factors is uncontested, especially as regards activities which can have far-reaching repurcussions. Some objective difficulties interfere with this goal, however: - No generally acknowledged set of ethical values exists. - Cultural influences and personal motives can interfere. - Normally a risk assessment is carried out in reference to individual facilities and within a small, clearly defined framework. Under certain circumstances, generalizations which are made for complete technological systems can lead to completely different conclusions. One contribution deals with integral views of the risks of atomic energy from an ethical and social perspective. (orig.)

  12. Accuracy of the ankle-brachial index using the SCVL®, an arm and ankle automated device with synchronized cuffs, in a population with increased cardiovascular risk

    OpenAIRE

    Rosenbaum, David; Rodriguez-Carranza, Sandra; Laroche, Patrick; Bruckert, Eric; Giral, Philippe; Girerd, Xavier

    2012-01-01

    Objective To evaluate the accuracy of the ankle brachial index (ABI) measured with the SCVL® (“screening cardiovascular lab”; GenNov, Paris, France), an automated device with synchronized arm and ankle cuffs with an automatic ABI calculation. Methods Patients were consecutively included in a cardiovascular prevention unit if they presented with at least two cardiovascular risk factors. ABI measurements were made using the SCVL, following a synchronized assessment of brachial and ankle systoli...

  13. Emerging Risk Biomarkers in Cardiovascular Diseases and Disorders

    Directory of Open Access Journals (Sweden)

    Ravi Kant Upadhyay

    2015-01-01

    Full Text Available Present review article highlights various cardiovascular risk prediction biomarkers by incorporating both traditional risk factors to be used as diagnostic markers and recent technologically generated diagnostic and therapeutic markers. This paper explains traditional biomarkers such as lipid profile, glucose, and hormone level and physiological biomarkers based on measurement of levels of important biomolecules such as serum ferritin, triglyceride to HDLp (high density lipoproteins ratio, lipophorin-cholesterol ratio, lipid-lipophorin ratio, LDL cholesterol level, HDLp and apolipoprotein levels, lipophorins and LTPs ratio, sphingolipids, Omega-3 Index, and ST2 level. In addition, immunohistochemical, oxidative stress, inflammatory, anatomical, imaging, genetic, and therapeutic biomarkers have been explained in detail with their investigational specifications. Many of these biomarkers, alone or in combination, can play important role in prediction of risks, its types, and status of morbidity. As emerging risks are found to be affiliated with minor and microlevel factors and its diagnosis at an earlier stage could find CVD, hence, there is an urgent need of new more authentic, appropriate, and reliable diagnostic and therapeutic markers to confirm disease well in time to start the clinical aid to the patients. Present review aims to discuss new emerging biomarkers that could facilitate more authentic and fast diagnosis of CVDs, HF (heart failures, and various lipid abnormalities and disorders in the future.

  14. Emerging risk biomarkers in cardiovascular diseases and disorders.

    Science.gov (United States)

    Upadhyay, Ravi Kant

    2015-01-01

    Present review article highlights various cardiovascular risk prediction biomarkers by incorporating both traditional risk factors to be used as diagnostic markers and recent technologically generated diagnostic and therapeutic markers. This paper explains traditional biomarkers such as lipid profile, glucose, and hormone level and physiological biomarkers based on measurement of levels of important biomolecules such as serum ferritin, triglyceride to HDLp (high density lipoproteins) ratio, lipophorin-cholesterol ratio, lipid-lipophorin ratio, LDL cholesterol level, HDLp and apolipoprotein levels, lipophorins and LTPs ratio, sphingolipids, Omega-3 Index, and ST2 level. In addition, immunohistochemical, oxidative stress, inflammatory, anatomical, imaging, genetic, and therapeutic biomarkers have been explained in detail with their investigational specifications. Many of these biomarkers, alone or in combination, can play important role in prediction of risks, its types, and status of morbidity. As emerging risks are found to be affiliated with minor and microlevel factors and its diagnosis at an earlier stage could find CVD, hence, there is an urgent need of new more authentic, appropriate, and reliable diagnostic and therapeutic markers to confirm disease well in time to start the clinical aid to the patients. Present review aims to discuss new emerging biomarkers that could facilitate more authentic and fast diagnosis of CVDs, HF (heart failures), and various lipid abnormalities and disorders in the future. PMID:25949827

  15. Management of High Blood Pressure in Those without Overt Cardiovascular Disease Utilising Absolute Risk Scores

    Directory of Open Access Journals (Sweden)

    Mark R. Nelson

    2011-01-01

    Full Text Available Increasing blood pressure has a continuum of adverse risk for cardiovascular events. Traditionally this single measure was used to determine who to treat and how vigorously. However, estimating absolute risk rather than measurement of a single risk factor such as blood pressure is a superior method to identify who is most at risk of having an adverse cardiovascular event such as stroke or myocardial infarction, and therefore who would most likely benefit from therapeutic intervention. Cardiovascular disease (CVD risk calculators must be used to estimate absolute risk in those without overt CVD as physician estimation is unreliable. Incorporation into usual practice and limitations of the strategy are discussed.

  16. The contribution of educational class in improving accuracy of cardiovascular risk prediction across European regions

    DEFF Research Database (Denmark)

    Ferrario, Marco M; Veronesi, Giovanni; Chambless, Lloyd E;

    2014-01-01

    OBJECTIVE: To assess whether educational class, an index of socioeconomic position, improves the accuracy of the SCORE cardiovascular disease (CVD) risk prediction equation. METHODS: In a pooled analysis of 68 455 40-64-year-old men and women, free from coronary heart disease at baseline, from 47...... prospective population-based cohorts from Nordic countries (Finland, Denmark, Sweden), the UK (Northern Ireland, Scotland), Central Europe (France, Germany, Italy) and Eastern Europe (Lithuania, Poland) and Russia, we assessed improvements in discrimination and in risk classification (net reclassification......) to 2.1 (Eastern Europe and Russia). After adjustment for the SCORE risk, the association remained statistically significant overall, in the UK and Eastern Europe and Russia. Education significantly improved discrimination in all European regions and classification in Nordic countries (clinical NRI=5...

  17. Risk assessment in reactors

    International Nuclear Information System (INIS)

    A survey of risk assessment methodology which is being given a lot of attention in the scientific world is presented in this paper. The maximum credible accident approach used for reactor safety assessment in the past has proved inadequate and a probabilistic approach has now caught the fancy of the scientific world. This method took to evaluating single accidents and making them the basis for decisions. This non-probabilistic approach had obvious drawbacks. Most importantly, it undermined less severe accidents which might be more important due to a high frequency of occurrence. (J.A.)

  18. Methylmercury risk assessment issues

    Energy Technology Data Exchange (ETDEWEB)

    Lipfert, F.W. [Brookhaven National Lab., Upton, NY (United States); Saroff, L. [USDOE, Washington, DC (United States)

    1996-07-01

    This paper reviews the general background of health risks associated with mercury (Hg), primarily methylmercury (MeHg), with a view towards application to advanced technologies that could reduce any contributions from coal combustion. The need for accurate assessment of such risks is discussed, since Hg is now widely dispersed in the environment and cannot easily be eliminated. The primary pathway of MeHg intake is through eating contaminated fish. The issues of concern include identification of critical health outcomes (various neurological indices) and their confounding factors, accurate assessment of MeHg intake rates, and appropriate use of dose-response functions. Ultimately, such information will be used to evaluate alternative coal combustion systems.

  19. Environmental epidemiology: risk assessment

    Energy Technology Data Exchange (ETDEWEB)

    Prentice, R.L.; Whittemore, A.S. (eds.)

    1982-01-01

    Papers presented at the symposium are in the disciplines of biometry, environmental medicine, epidemiology, mathematics, and statistics. Attention is given to assessing risk due to environmental agents, particularly those known to be carcinogenic; both the complex medical issues involved and the mathematical and statistical methodologies used in analysis are presented. Separate abstracts have been prepared for 15 papers for inclusion in the Energy Data Base. (RJC)

  20. Prevention of cardiovascular disease guided by total risk estimations - challenges and opportunities for practical implementation: highlights of a CardioVascular Clinical Trialists (CVCT) Workshop of the ESC Working Group on CardioVascular Pharmacology and Drug Therapy.

    LENUS (Irish Health Repository)

    Zannad, Faiez

    2011-11-03

    This paper presents a summary of the potential practical and economic barriers to implementation of primary prevention of cardiovascular disease guided by total cardiovascular risk estimations in the general population. It also reviews various possible solutions to overcome these barriers. The report is based on discussion among experts in the area at a special CardioVascular Clinical Trialists workshop organized by the European Society of Cardiology Working Group on Cardiovascular Pharmacology and Drug Therapy that took place in September 2009. It includes a review of the evidence in favour of the \\'treat-to-target\\' paradigm, as well as potential difficulties with this approach, including the multiple pathological processes present in high-risk patients that may not be adequately addressed by this strategy. The risk-guided therapy approach requires careful definitions of cardiovascular risk and consideration of clinical endpoints as well as the differences between trial and \\'real-world\\' populations. Cost-effectiveness presents another issue in scenarios of finite healthcare resources, as does the difficulty of documenting guideline uptake and effectiveness in the primary care setting, where early modification of risk factors may be more beneficial than later attempts to manage established disease. The key to guideline implementation is to improve the quality of risk assessment and demonstrate the association between risk factors, intervention, and reduced event rates. In the future, this may be made possible by means of automated data entry and various other measures. In conclusion, opportunities exist to increase guideline implementation in the primary care setting, with potential benefits for both the general population and healthcare resources.

  1. Cardiovascular Risk Factors and Physical Activity Behavior among Elementary School Personnel: Baseline Results from the ACTION! Worksite Wellness Program

    Science.gov (United States)

    Webber, Larry S.; Rice, Janet C.; Johnson, Carolyn C.; Rose, Donald; Srinivasan, Sathanur R.; Berenson, Gerald S.

    2012-01-01

    Background: Although the prevalence of obesity is increasing during adulthood, there have been few assessments of obesity, cardiovascular risk factors, and levels of physical activity among adult elementary school staff. Methods: Data were collected from 745 African-American and White female school personnel in a suburban school district in…

  2. Insulin Resistance and Cardiovascular Risk Factors in 3-to 5-Year-Old Overweight or Obese Children

    NARCIS (Netherlands)

    Bocca, Gianni; Ongering, Eva C.; Stolk, Ronald P.; Sauer, Pieter J. J.

    2013-01-01

    Background/Aims: The increasing rate of overweight and obesity is alarming. The complications of overweight and obesity at a young age are largely unknown. We aimed to assess the prevalence of insulin resistance (IR) and cardiovascular risk factors among overweight and obese children aged 3-5 years.

  3. Selenium Status and Cardiovascular Risk Profile in Healthy Adult Saudi Males

    Directory of Open Access Journals (Sweden)

    Eman M. Alissa

    2008-12-01

    Full Text Available The purpose of this research was to investigate the relationship between selenium levels, thyroid function and other coronary risk factors in 140 Saudi subjects without overt coronary heart disease stratified by age. Demographic data and serum fasting lipid profile, glucose, thyroid function tests, selenium status and dietary intake was assessed. The relationships between selenium status, thyroid function and cardiovascular risk factors were assessed by univariate and multivariate analysis. The results showed that thyroid hormone levels did not differ with age. Erythrocyte glutathione peroxidase (GPx levels were significantly higher in the youngest vs. oldest tertile (p<0.0001. Selenium and iodine intake did not differ significantly with age tertile, but the average intake for the population sample was below the estimated average requirements for both elements. Serum lipoprotein (a concentrations correlated with selenium (r = 0.417, p<0.0001 and TSH (r = 0.172, p<0.05. After adjustment for confounding variables; serum fT4 and erythrocytes GPx remained significant determinants of serum TSH levels, whilst serum selenium and TSH were determinants of serum fT4 levels. Serum Lp(a, a coronary risk factor, was strongly related to measures of selenium status. A significant relationship between measures of selenium status and thyroid function was found. Serum Lp(a a known risk factor for cardiovascular disease was also related to selenium status in our population.

  4. Cardiovascular morbidity and mortality risk factors in peritoneal dialysis patients

    Directory of Open Access Journals (Sweden)

    Jovanović Dijana B.

    2008-01-01

    Full Text Available Cardiovascular (CVS morbidity and mortality in the endstage renal disease (ESRD patients on peritoneal dialysis therapy is 10-30 folds higher than in general population. The prevalence of well known traditional risk factors such as age, sex, race, arterial hypertension, hyperlipidaemia, diabetes, smoking, physical inactivity is higher in the uraemic patients. Besides these, there are specific, nontraditional risk factors for dialysis patients. Mild inflammation present in peritoneal dialysis (PD patients which can be confirmed by specific inflammatory markers is the cause of CVS morbidity and mortality in these patients. Hypoalbuminaemia, hyperhomocysteinaemia and a higher level of leptin are important predictors of vascular complications as well as CVS events in the PD patients. Plasma norepinephrine, an indicator of sympathetic activity, is high in the ESRD patients and higher in the PD patients than in the patients on haemodialysis (HD. Therefore, norepinephrine may be a stronger risk factor in the PD patients. The same applies to asymmetric dimethylargine (ADMA, an endogenous inhibitor of nitric oxide synthase, which is an important risk factor of CVS morbidity and mortality 15 % higher in the PD than the HD patients. Hyperphosphataemia, secondary hyperparathyroidism and high calcium x phosphate product have been associated with the progression of the coronary artery calcification and valvular calcifications and predict all-cause CVS mortality in the PD patients. Residual renal function (RRF declines with time on dialysis but is slower in the PD than the HD patients. RRF decline is associated with the rise of proinflammatory cytokines and the onset of hypervolaemia and hypertension which increase the risk of CVS diseases, mortality in general and CVS mortality. In conclusion, it is very important to establish all CVS risk factors in the PD patients to prevent CVS diseases and CVS mortality in this population.

  5. Evidence Report: Risk of Cardiovascular Disease and Other Degenerative Tissue Effects from Radiation Exposure

    Science.gov (United States)

    Patel, Zarana; Huff, Janice; Saha, Janapriya; Wang, Minli; Blattnig, Steve; Wu, Honglu; Cucinotta, Francis

    2015-01-01

    Occupational radiation exposure from the space environment may result in non-cancer or non-CNS degenerative tissue diseases, such as cardiovascular disease, cataracts, and respiratory or digestive diseases. However, the magnitude of influence and mechanisms of action of radiation leading to these diseases are not well characterized. Radiation and synergistic effects of radiation cause DNA damage, persistent oxidative stress, chronic inflammation, and accelerated tissue aging and degeneration, which may lead to acute or chronic disease of susceptible organ tissues. In particular, cardiovascular pathologies such as atherosclerosis are of major concern following gamma-ray exposure. This provides evidence for possible degenerative tissue effects following exposures to ionizing radiation in the form of the GCR or SPEs expected during long-duration spaceflight. However, the existence of low dose thresholds and dose-rate and radiation quality effects, as well as mechanisms and major risk pathways, are not well-characterized. Degenerative disease risks are difficult to assess because multiple factors, including radiation, are believed to play a role in the etiology of the diseases. As additional evidence is pointing to lower, space-relevant thresholds for these degenerative effects, particularly for cardiovascular disease, additional research with cell and animal studies is required to quantify the magnitude of this risk, understand mechanisms, and determine if additional protection strategies are required.The NASA PEL (Permissive Exposure Limit)s for cataract and cardiovascular risks are based on existing human epidemiology data. Although animal and clinical astronaut data show a significant increase in cataracts following exposure and a reassessment of atomic bomb (A-bomb) data suggests an increase in cardiovascular disease from radiation exposure, additional research is required to fully understand and quantify these adverse outcomes at lower doses (less than 0.5 gray

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

    International Nuclear Information System (INIS)

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

  7. Gender differences in genetic risk profiles for cardiovascular disease.

    Directory of Open Access Journals (Sweden)

    Kaisa Silander

    Full Text Available BACKGROUND: Cardiovascular disease (CVD incidence, complications and burden differ markedly between women and men. Although there is variation in the distribution of lifestyle factors between the genders, they do not fully explain the differences in CVD incidence and suggest the existence of gender-specific genetic risk factors. We aimed to estimate whether the genetic risk profiles of coronary heart disease (CHD, ischemic stroke and the composite end-point of CVD differ between the genders. METHODOLOGY/PRINCIPAL FINDINGS: We studied in two Finnish population cohorts, using the case-cohort design the association between common variation in 46 candidate genes and CHD, ischemic stroke, CVD, and CVD-related quantitative risk factors. We analyzed men and women jointly and also conducted genotype-gender interaction analysis. Several allelic variants conferred disease risk for men and women jointly, including rs1801020 in coagulation factor XII (HR = 1.31 (1.08-1.60 for CVD, uncorrected p = 0.006 multiplicative model. Variant rs11673407 in the fucosyltransferase 3 gene was strongly associated with waist/hip ratio (uncorrected p = 0.00005 in joint analysis. In interaction analysis we found statistical evidence of variant-gender interaction conferring risk of CHD and CVD: rs3742264 in the carboxypeptidase B2 gene, p(interaction = 0.009 for CHD, and rs2774279 in the upstream stimulatory factor 1 gene, p(interaction = 0.007 for CHD and CVD, showed strong association in women but not in men, while rs2069840 in interleukin 6 gene, p(interaction = 0.004 for CVD, showed strong association in men but not in women (uncorrected p-values. Also, two variants in the selenoprotein S gene conferred risk for ischemic stroke in women, p(interaction = 0.003 and 0.007. Importantly, we identified a larger number of gender-specific effects for women than for men. CONCLUSIONS/SIGNIFICANCE: A false discovery rate analysis suggests that we may expect half of the reported

  8. Prevalence of cardiovascular risk factors in patients undergoing CABG: brief report

    Directory of Open Access Journals (Sweden)

    Habib Yaribeygi

    2014-11-01

    Methods: The present study is a descriptive, cross-sectional survey on 1592 patients which suffered coronary artery bypass surgery (CABG from May 2009 to May 2013 in Baqiyatallah Hospital, Tehran. Before surgery, all patients were carefully assessed and typical and atypical cardiovascular risk factors were determined and the desired data were collected. Results: More than 70.8% of subjects were men and 29.2% were women. Average age of all patients was 60.39±7.5 years and the mean weight was 73.91±6.3 kg. Typical risk factors including: smoking, plasma cholesterol level, hypertension, diabetes mellitus and family history of cardiac problems, were common in these patients. Forty seven percent of patients had diabetes mellitus, 79.4% had hypercholesterolemia, 34.3% had a smoking history, 64.5% had hypertension and 44.2% of patients had a family history of cardiovascular disease. Among atypical risk factors, various types of angina (chest pain had high prevalence (88.8% of all. Also, mean body mass index (BMI were higher than normal (27.46±2.1 which showed the incidence of obesity among these patients. But, other atypical risk factors did not have high incidence. Conclusion: We demonstrated that typical and well known risk factors have also high prevalence in CABG patients. Our results indicates that we can recognize high risk persons with continuous and accurate screening as a safe and inexpensive preventive tool. This can be done in both apparently healthy subjects and in cardiovascular patients. We can prevent the occurrence of severe degrees of atherosclerosis and also CABG. So the cost and performing surgeries will be decreased.

  9. SCORE underestimates cardiovascular risk (CVR of HIV+ patients

    Directory of Open Access Journals (Sweden)

    R Ramírez

    2012-11-01

    Full Text Available The new European Guidelines of Dislipidemia Management of the European Societies of Cardiology and Arteriosclerosis consider HIV+ as patients at high risk of developing cardiovascular events and deaths. The objective of the study was to evaluate cardiovascular events and deaths in a series of HIV+ patients. Observational, cross-sectional study, including a cohort of HIV+ and HIV− patients from 2008. CVR was calculated using the SCORE-CVR chart. Variation on lipid profile and incidence of cardiovascular events, cardiovascular death or death related to any cause were recorded. Data was analyzed using SPSS version 20.0 for MAC. 154 HIV+ and 155 HIV− patients were included. Mean age: 44.8±9.5 vs 55.2±14.3 y and 69.5% vs 49% males respectively (p<0.01. Mean time since HIV+ diagnosis was 11±6.2 y. Mean BMI and systolic blood pressure were lower in HIV+ (25.1±6.7 kg/m2 vs 28.7±5.1 kg/m2, (p<0.01 and 119.6±19.4 vs 124.7±14.7 mmHg, (p=0.044; respectively. A lower proportion of hypertense, diabetic and obese patients was observed in HIV+ (25.5% vs 6.5%; 20.6% vs 3.9% and 36.8% vs 12.3% but a larger proportion of smokers (68.8% vs 29.7% was observed (p<0.01 in all cases. Mean cholesterol and LDLc were lower in HIV+ (191.2±41.4 vs 218.5±44.6 mg/dl and 109.5±33.9 vs 134.6±37.7 mg/dl; p<0.01; respectively but with a lower mean HDLc and higher TG (50.3±19 mg/dl vs 55.2±14.9 mg/dl; p=0.013 and 156.7±85.7 vs 135.8±66.2 mg/dl; p=0.017; respectively. There was no significant difference in mean CVR-SCORE (3.5±3.6% vs 4.4±3.8%; p=0.091. With this SCORE, 5.2±5.3 and 6.7±5.8 cardiovascular events or deaths should be expected in HIV+ and HIV− respectively at 10 y. Four years later cholesterol, LDLc, HDLc, TG in HIV+ and HIV− patients did not vary compared with those obtained 4 y before. 5 events and 1 death were seen at 4 y follow-up in HIV+, and in HIV− patients. The incidence of events in HIV+ patients is similar to the expected according

  10. Prevalence of peripheral arterial disease in patients at non-high cardiovascular risk. Rationale and design of the PANDORA study

    Directory of Open Access Journals (Sweden)

    Cimminiello Claudio

    2010-08-01

    Full Text Available Abstract Background Lower extremity peripheral arterial disease (PAD is a marker of widespread atherosclerosis. Individuals with PAD, most of whom do not show typical PAD symptoms ('asymptomatic' patients, are at increased risk of cardiovascular ischaemic events. American College of Cardiology/American Heart Association guidelines recommend that individuals with asymptomatic lower extremity PAD should be identified by measurement of ankle-brachial index (ABI. However, despite its associated risk, PAD remains under-recognised by clinicians and the general population and office-based ABI detection is still poorly-known and under-used in clinical practice. The Prevalence of peripheral Arterial disease in patients with a non-high cardiovascular disease risk, with No overt vascular Diseases nOR diAbetes mellitus (PANDORA study has a primary aim of assessing the prevalence of lower extremity PAD through ABI measurement, in patients at non-high cardiovascular risk, with no overt cardiovascular diseases (including symptomatic PAD, or diabetes mellitus. Secondary objectives include documenting the prevalence and treatment of cardiovascular risk factors and the characteristics of both patients and physicians as possible determinants for PAD under-diagnosis. Methods/Design PANDORA is a non-interventional, cross-sectional, pan-European study. It includes approximately 1,000 primary care participating sites, across six European countries (Belgium, France, Greece, Italy, The Netherlands, Switzerland. Investigator and patient questionnaires will be used to collect both right and left ABI values at rest, presence of cardiovascular disease risk factors, current pharmacological treatment, and determinants for PAD under-diagnosis. Discussion The PANDORA study will provide important data to estimate the prevalence of asymptomatic PAD in a population otherwise classified at low or intermediate risk on the basis of current risk scores in a primary care setting. Trial

  11. BENEFICIAL IMPACT ON CARDIOVASCULAR RISK PROFILE OF WATER BUFFALO MEAT CONSUMPTION

    OpenAIRE

    Biondi Zoccai, Giuseppe; Giordano, Gabriele; Guarini, Pasquale; Ferrari, Patrizio; Schiavone, Beniamino; Giordano, Arturo

    2010-01-01

    Abstract BACKGROUND/OBJECTIVES : Meat is a good source of proteins and irons, yet its consumption has been associated with unfavorable cardiovascular effects. Whether this applies to all types of meat is unclear. We thus aimed to appraise the impact of water buffalo meat consumption on car?diovascular risk profile with an observational longitudinal study. METHODS: Several key cardiovascular risk features were appraised at baseline and at 12-month follow-up in 300 adult subjects ...

  12. Abdominal fat distribution and cardiovascular risk in men and women with different levels of glucose tolerance

    DEFF Research Database (Denmark)

    Scheuer, Stine H.; Færch, Kristine; Philipsen, Annelotte;

    2015-01-01

    Context: Regional fat distribution rather than overall obesity has been recognized as important tounderstanding the link between obesity and cardiovascular disease. Objective:We examined the associations of abdominal visceral adipose tissue (VAT) and abdominalsubcutaneous adipose tissue (SAT......) with cardiovascular risk factors in a Caucasian population ofmenand women with normal glucose tolerance, prediabetes, or screen-detected diabetes. Design, Setting, and Participants: The study was based on cross-sectional analysis of data from 1412adults age 45– 80 years. VAT and SAT were assessed by ultrasound....... The associations of VAT and SATwith blood pressure and lipids were examined by linear regression analysis adjusted for age, sex,smoking, alcohol, physical activity, glucose tolerance status (GTS), medication use, and body massindex. Effect modification by GTS and sex was examined, and stratified analyses performed...

  13. Saxagliptin for the treatment of type 2 diabetes mellitus: assessing cardiovascular data

    Directory of Open Access Journals (Sweden)

    Cobble Michael E

    2012-01-01

    Full Text Available Abstract Patients with type 2 diabetes mellitus (T2DM are at high risk for cardiovascular (CV disease; however, conclusive evidence that glycemic control leads to improved cardiovascular outcomes is lacking. Saxagliptin is a potent, selective dipeptidyl peptidase-4 inhibitor approved as an adjunct to diet and exercise to improve glycemic control in adults with T2DM. Saxagliptin was evaluated in a series of phase III trials as monotherapy; add-on therapy to metformin, a sulfonylurea, or a thiazolidinedione; and as initial therapy in combination with metformin. Saxagliptin consistently improved glycemic control (as reflected by significant decreases in glycated hemoglobin, fasting plasma glucose, and postprandial glucose compared with controls and was generally well tolerated. In these analyses, saxagliptin had clinically neutral effects on body weight, blood pressure, lipid levels, and other markers of CV risk compared with controls. A retrospective meta-analysis of 8 phase II and phase III trials found no evidence that saxagliptin increases CV risk in patients with T2DM (Cox proportional hazard ratio, 0.43; 95% CI, 0.23-0.80 for major adverse cardiovascular events retrospectively adjudicated. Instead, it raised the hypothesis that saxagliptin may reduce the risk of major adverse CV events. A long-term CV outcome trial, Saxagliptin Assessment of Vascular Outcomes Recorded in Patients with Diabetes Mellitus-THrombolysis in Myocardial Infarction 53 (SAVOR-TIMI 53 is currently ongoing to determine whether saxagliptin reduces CV risk in T2DM.

  14. Modifiable Cardiovascular Disease Risk Factors among Indigenous Populations

    Directory of Open Access Journals (Sweden)

    Adam A. Lucero

    2014-01-01

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

  15. Cardiovascular diseases and risk factors among Chinese immigrants.

    Science.gov (United States)

    Gong, Zhizhong; Zhao, Dong

    2016-04-01

    The aim of this study is to identify the prevalence of cardiovascular disease (CVD) and major CVD risk factors, including diabetes, hypertension, dyslipidemia, obesity and smoking among Chinese immigrants by a systematic review of studies from various countries. PubMed and the China National Knowledge Infrastructure databases were searched for studies of the prevalence of major CVDs and risk factors, and of CVD mortality among Chinese immigrants. The search identified 386 papers, 16 of which met the inclusion criteria for this review. In mainland China, there is a pattern of high stroke prevalence but low coronary heart disease (CHD) prevalence. Among Chinese immigrants, there is a much lower prevalence and mortality of stroke, but a higher prevalence and mortality of CHD, even though these are lower than the rates in immigrants of other ethnicities in the host country. The prevalence of CVD risk factors is also markedly different in immigrants. Compared with mainland Chinese, Chinese immigrants have a higher prevalence of diabetes and hypertension, higher serum cholesterol, poorer dietary patterns, and higher prevalence of obesity and smoking. Thus, the epidemiological pattern of CVD among Chinese immigrants changes compared with resident mainland Chinese. The less healthy environmental factor after immigration may be a major trigger in the adverse CVD status of Chinese immigrants. It is important for policy-makers to pay more attention to specific minority immigrant groups, and to implement more effective preventive measures to improve the health of immigrant populations. PMID:26350421

  16. Perioperative Cardiovascular Assessment of Patients Undergoing Noncardiac Surgery

    OpenAIRE

    Freeman, William K.; Gibbons, Raymond J.

    2009-01-01

    Preoperative assessment of the cardiac patient before noncardiac surgery is common in the clinical practice of the medical consultant, anesthesiologist, and surgeon. Currently, most noncardiac surgical procedures are performed for patients of advanced age, and the number of such surgeries is likely to increase with the aging of the population. These same patients have an increased prevalence of cardiovascular disease, especially ischemic heart disease, which is the primary cause of perioperat...

  17. The emerging role of cardiovascular MRI for risk stratification in hypertrophic cardiomyopathy

    International Nuclear Information System (INIS)

    Hypertrophic cardiomyopathy (HCM) is the most common inheritable cardiovascular disorder. Although many HCM patients remain asymptomatic, sudden death (SD) can occur as the initial manifestation of the disease. It has been hypothesized that myocardial architectural disorganization and scarring represent an unstable electrophysiological substrate that creates susceptibility to malignant ventricular arrhythmias. Cardiovascular magnetic resonance imaging (CMR) is widely used for the diagnosis of HCM, especially in patients with an incomplete or inconclusive echocardiography study. CMR can provide precise non-invasive assessment of biventricular function, wall thickness, and assessment of myocardial fibrosis, using inversion recovery gadolinium-enhanced sequences. CMR is also one of the most promising avenues of research in HCM, and in recent years, has provided many new insights and identified a number of potential adverse prognostic indicators for SD. Future work is still needed to integrate CMR findings into traditional risk assessment algorithms. This paper reviews the evolving role of CMR for risk stratification in HCM including assessment of myocardial hypertrophy, fibrosis and ischaemia

  18. Surgery Risk Assessment (SRA) Database

    Data.gov (United States)

    Department of Veterans Affairs — The Surgery Risk Assessment (SRA) database is part of the VA Surgical Quality Improvement Program (VASQIP). This database contains assessments of selected surgical...

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

    Science.gov (United States)

    ... A Patient’s Guide The number of people at risk of developing cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) ... lifestyle therapies because studies suggest it will reduce cardiovascular risk. Medications to lower LDL cholesterol may be added ...

  20. Sex hormone-binding globulin levels predict insulin sensitivity, disposition index, and cardiovascular risk during puberty

    DEFF Research Database (Denmark)

    Sørensen, Kaspar; Aksglaede, Lise; Munch-Andersen, Thor;

    2009-01-01

    Early puberty is associated with increased risk of subsequent cardiovascular disease. Low sex hormone-binding globulin (SHBG) levels are a feature of early puberty and of conditions associated with increased cardiovascular risk. The aim of the present study was to evaluate SHBG as a predictor of...

  1. Associations between pre-kidney-transplant risk factors and post-transplant cardiovascular events and death.

    NARCIS (Netherlands)

    Aalten, J.; Hoogeveen, E.K.; Roodnat, J.I.; Weimar, W.; Borm, G.F.; Fijter, J.W. de; Hoitsma, A.J.

    2008-01-01

    The prevalence of cardiovascular risk factors in renal transplant candidates is high. A better understanding of the relation between these risk factors and cardiovascular morbidity and mortality is mandatory to improve transplantation outcome. In this retrospective cohort study 2187 adult patients w

  2. Cardiovascular Outcomes in the Outpatient Kidney Transplant Clinic: The Framingham Risk Score Revisited

    OpenAIRE

    Kiberd, Bryce; Panek, Romuald

    2008-01-01

    Background and objectives: Cardiovascular disease is an important cause of morbidity and death in kidney transplant recipients. This study examines the Framingham risk score's ability to predict cardiac and stroke events. Because cyclosporine and tacrolimus have different cardiovascular risk profiles, these agents were also examined.

  3. Psoriasis is associated with clinically significant cardiovascular risk: a Danish nationwide cohort study

    DEFF Research Database (Denmark)

    Ahlehoff, Ole; Gislason, Gunnar Hilmar; Charlot, Mette Gitz;

    2011-01-01

    Objective. The magnitude of the cardiovascular risk from psoriasis and psoriatic arthritis is debated. We therefore investigated the psoriasis-related risk of adverse cardiovascular events and mortality. Design, setting and subjects. We conducted a cohort study of the entire Danish population aged...

  4. Cardiovascular Risk in Chronic Kidney Disease (CKD), the CKD- Mineral Bone Disorder (CKD- MBD)

    OpenAIRE

    Hruska, Keith A; Choi, Eric T.; Memon, Imran; Davis, T. Keefe; Mathew, Suresh

    2009-01-01

    Recent advances in our understanding of the excess mortality of chronic kidney disease (CKD) due to cardiovascular complications demonstrate through observational studies that vascular calcification and hyperphosphatemia are major cardiovascular risk factors. Mechanistic studies demonstrate that these two risk factors are related, and that hyperphosphatemia directly stimulates vascular calcification. The role of hyperphosphatemia in stimulating vascular calcification in CKD is associated with...

  5. Risk assessment handbook

    Energy Technology Data Exchange (ETDEWEB)

    Farmer, F.G.; Jones, J.L.; Hunt, R.N.; Roush, M.L.; Wierman, T.E.

    1990-09-01

    The Probabilistic Risk Assessment Unit at EG G Idaho has developed this handbook to provide guidance to a facility manager exploring the potential benefit to be gained by performance of a risk assessment properly scoped to meet local needs. This document is designed to help the manager control the resources expended commensurate with the risks being managed and to assure that the products can be used programmatically to support future needs in order to derive maximum beneflt from the resources expended. We present a logical and functional mapping scheme between several discrete phases of project definition to ensure that a potential customer, working with an analyst, is able to define the areas of interest and that appropriate methods are employed in the analysis. In addition the handbook is written to provide a high-level perspective for the analyst. Previously, the needed information was either scattered or existed only in the minds of experienced analysts. By compiling this information and exploring the breadth of knowledge which exists within the members of the PRA Unit, the functional relationships between the customers' needs and the product have been established.

  6. Risk assessment handbook

    Energy Technology Data Exchange (ETDEWEB)

    Farmer, F.G.; Jones, J.L.; Hunt, R.N.; Roush, M.L.; Wierman, T.E.

    1990-09-01

    The Probabilistic Risk Assessment Unit at EG&G Idaho has developed this handbook to provide guidance to a facility manager exploring the potential benefit to be gained by performance of a risk assessment properly scoped to meet local needs. This document is designed to help the manager control the resources expended commensurate with the risks being managed and to assure that the products can be used programmatically to support future needs in order to derive maximum beneflt from the resources expended. We present a logical and functional mapping scheme between several discrete phases of project definition to ensure that a potential customer, working with an analyst, is able to define the areas of interest and that appropriate methods are employed in the analysis. In addition the handbook is written to provide a high-level perspective for the analyst. Previously, the needed information was either scattered or existed only in the minds of experienced analysts. By compiling this information and exploring the breadth of knowledge which exists within the members of the PRA Unit, the functional relationships between the customers` needs and the product have been established.

  7. Risk assessment handbook

    International Nuclear Information System (INIS)

    The Probabilistic Risk Assessment Unit at EG ampersand G Idaho has developed this handbook to provide guidance to a facility manager exploring the potential benefit to be gained by performance of a risk assessment properly scoped to meet local needs. This document is designed to help the manager control the resources expended commensurate with the risks being managed and to assure that the products can be used programmatically to support future needs in order to derive maximum beneflt from the resources expended. We present a logical and functional mapping scheme between several discrete phases of project definition to ensure that a potential customer, working with an analyst, is able to define the areas of interest and that appropriate methods are employed in the analysis. In addition the handbook is written to provide a high-level perspective for the analyst. Previously, the needed information was either scattered or existed only in the minds of experienced analysts. By compiling this information and exploring the breadth of knowledge which exists within the members of the PRA Unit, the functional relationships between the customers' needs and the product have been established

  8. Prevalence of Cardiovascular disease risk among Medical Students in South India

    Directory of Open Access Journals (Sweden)

    Biswajit Paul

    2015-06-01

    Full Text Available Background: Cardiovascular diseases (CVDs are global epidemic and contribute to double burden in developing countries. Individual’s dietary habits and risk behavior influence the onset and progression of CVDs. Medical students are future role models of the society and their knowledge, habits and behavior can influence their practice in prevention of CVDs in general population. Aims & Objectives: To assess the prevalence of common cardiovascular risk factors among a sample of medical students. Methods: A cross-sectional survey was conducted among the medical students of the four professional years.  An anonymous self-administered questionnaire was used to assess the prevalent cardiovascular risk factors, dietary habits and risk behavior among the medical students. Results: Family history of CVD, obesity and hypertension were highly prevalent among the medical students. Majority of them took <5 servings of fruit or vegetables per day (97.6%, ate junk foods (91.3% and had long sedentary activity (47.6%. Taking red meat intake (OR 4.79, junk foods (Odds Ratio, OR 2.59, and snacking habit (OR 1.73 was observed more among male students; no physical activity or sports was significantly more in females. Logistic regression analysis showed that a family history of CVD was strongly associated with hypertension and obesity among medical students while exercise was protective against hypertension. Conclusion: The medical students had very poor compliance to recommended dietary intake and physical activity. Generating awareness, incorporating healthy habits and introducing structured educational programs into medical curriculum will help in changing lifestyle.

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

    Directory of Open Access Journals (Sweden)

    Itandehui Castro-Quezada

    Full Text Available 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 ex