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Sample records for cardiovascular risk prediction

  1. Cardiovascular risk prediction

    DEFF Research Database (Denmark)

    Graversen, Peter; Abildstrøm, Steen Z.; Jespersen, Lasse

    2016-01-01

    Aim European society of cardiology (ESC) guidelines recommend that cardiovascular disease (CVD) risk stratification in asymptomatic individuals is based on the Systematic Coronary Risk Evaluation (SCORE) algorithm, which estimates individual 10-year risk of death from CVD. We assessed the potential...

  2. Lipoprotein metabolism indicators improve cardiovascular risk prediction.

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    Daniël B van Schalkwijk

    Full Text Available 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 investigate whether lipoprotein metabolism indicators can improve cardiovascular risk prediction and therapy management. METHODS AND RESULTS: We calculated lipoprotein metabolism indicators for 1981 subjects (145 cases, 1836 controls from the Framingham Heart Study offspring cohort in which NMR lipoprotein profiles were measured. We applied a statistical learning algorithm using a support vector machine to select conventional risk factors and lipoprotein metabolism indicators that contributed to predicting risk for general cardiovascular disease. Risk prediction was quantified by the change in the Area-Under-the-ROC-Curve (ΔAUC and by risk reclassification (Net Reclassification Improvement (NRI and Integrated Discrimination Improvement (IDI. Two VLDL lipoprotein metabolism indicators (VLDLE and VLDLH improved cardiovascular risk prediction. We added these indicators to a multivariate model with the best performing conventional risk markers. Our method significantly improved both CVD prediction and risk reclassification. CONCLUSIONS: Two calculated VLDL metabolism indicators significantly improved cardiovascular risk prediction. These indicators may help to reduce prescription of unnecessary cholesterol-lowering medication, reducing costs and possible side-effects. For clinical application, further validation is required.

  3. Subclinical organ damage and cardiovascular risk prediction

    DEFF Research Database (Denmark)

    Sehestedt, Thomas; Olsen, Michael H

    2010-01-01

    Traditional cardiovascular risk factors have poor prognostic value for individuals and screening for subclinical organ damage has been recommended in hypertension in recent guidelines. The aim of this review was to investigate the clinical impact of the additive prognostic information provided...... by 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...

  4. 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

  5. Lipoprotein metabolism indicators improve cardiovascular risk prediction

    NARCIS (Netherlands)

    Schalkwijk, D.B. van; Graaf, A.A. de; Tsivtsivadze, E.; Parnell, L.D.; Werff-van der Vat, B.J.C. van der; Ommen, B. van; Greef, J. van der; Ordovás, J.M.

    2014-01-01

    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

  6. Cardiovascular risk prediction tools for populations in Asia.

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    Barzi, F; Patel, A; Gu, D; Sritara, P; Lam, T H; Rodgers, A; Woodward, M

    2007-02-01

    Cardiovascular risk equations are traditionally derived from the Framingham Study. The accuracy of this approach in Asian populations, where resources for risk factor measurement may be limited, is unclear. To compare "low-information" equations (derived using only age, systolic blood pressure, total cholesterol and smoking status) derived from the Framingham Study with those derived from the Asian cohorts, on the accuracy of cardiovascular risk prediction. Separate equations to predict the 8-year risk of a cardiovascular event were derived from Asian and Framingham cohorts. The performance of these equations, and a subsequently "recalibrated" Framingham equation, were evaluated among participants from independent Chinese cohorts. Six cohort studies from Japan, Korea and Singapore (Asian cohorts); six cohort studies from China; the Framingham Study from the US. 172,077 participants from the Asian cohorts; 25,682 participants from Chinese cohorts and 6053 participants from the Framingham Study. In the Chinese cohorts, 542 cardiovascular events occurred during 8 years of follow-up. Both the Asian cohorts and the Framingham equations discriminated cardiovascular risk well in the Chinese cohorts; the area under the receiver-operator characteristic curve was at least 0.75 for men and women. However, the Framingham risk equation systematically overestimated risk in the Chinese cohorts by an average of 276% among men and 102% among women. The corresponding average overestimation using the Asian cohorts equation was 11% and 10%, respectively. Recalibrating the Framingham risk equation using cardiovascular disease incidence from the non-Chinese Asian cohorts led to an overestimation of risk by an average of 4% in women and underestimation of risk by an average of 2% in men. A low-information Framingham cardiovascular risk prediction tool, which, when recalibrated with contemporary data, is likely to estimate future cardiovascular risk with similar accuracy in Asian

  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

    BACKGROUND: Treatment of cardiovascular risk factors based on disease risk depends on valid risk prediction equations. We aimed to develop, and apply in example countries, a risk prediction equation for cardiovascular disease (consisting here of coronary heart disease and stroke) that can be reca...

  8. Predictability of cardiovascular risks by psychological measures

    Czech Academy of Sciences Publication Activity Database

    Šolcová, Iva; Kebza, V.

    2008-01-01

    Roč. 23, č. 1 (2008), s. 241-241 ISSN 0887-0446 R&D Projects: GA ČR GA406/06/0747 Institutional research plan: CEZ:AV0Z70250504 Keywords : CVD risks * psychological measures * physiological risks Subject RIV: AN - Psychology

  9. Cardiovascular risk prediction in chronic kidney disease patients

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    Santiago Cedeño Mora

    2017-05-01

    Conclusion: The cardiovascular risk scores (FRS-CVD and ASCVD [AHA/ACC 2013] can estimate the probability of atherosclerotic cardiovascular events in patients with CKD regardless of renal function, albuminuria and previous cardiovascular events.

  10. Investigation on Cardiovascular Risk Prediction Using Physiological Parameters

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    Wan-Hua Lin

    2013-01-01

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

  11. 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

    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......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...

  12. Risk predictive modelling for diabetes and cardiovascular disease.

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    Kengne, Andre Pascal; Masconi, Katya; Mbanya, Vivian Nchanchou; Lekoubou, Alain; Echouffo-Tcheugui, Justin Basile; Matsha, Tandi E

    2014-02-01

    Absolute risk models or clinical prediction models have been incorporated in guidelines, and are increasingly advocated as tools to assist risk stratification and guide prevention and treatments decisions relating to common health conditions such as cardiovascular disease (CVD) and diabetes mellitus. We have reviewed the historical development and principles of prediction research, including their statistical underpinning, as well as implications for routine practice, with a focus on predictive modelling for CVD and diabetes. Predictive modelling for CVD risk, which has developed over the last five decades, has been largely influenced by the Framingham Heart Study investigators, while it is only ∼20 years ago that similar efforts were started in the field of diabetes. Identification of predictive factors is an important preliminary step which provides the knowledge base on potential predictors to be tested for inclusion during the statistical derivation of the final model. The derived models must then be tested both on the development sample (internal validation) and on other populations in different settings (external validation). Updating procedures (e.g. recalibration) should be used to improve the performance of models that fail the tests of external validation. Ultimately, the effect of introducing validated models in routine practice on the process and outcomes of care as well as its cost-effectiveness should be tested in impact studies before wide dissemination of models beyond the research context. Several predictions models have been developed for CVD or diabetes, but very few have been externally validated or tested in impact studies, and their comparative performance has yet to be fully assessed. A shift of focus from developing new CVD or diabetes prediction models to validating the existing ones will improve their adoption in routine practice.

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

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    Lønnebakken, Mai T; Gerdts, Eva; Boman, Kurt

    2011-01-01

    , the prespecified primary study endpoint, was assessed in Cox regression analysis using data from baseline and annual follow-up visits in 855 patients during 4.8 years of randomized losartan-based or atenolol-based treatment in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) echocardiography...... 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 secondary model also independent of stress-corrected midwall shortening......, hence, adds information on cardiovascular risk in treated hypertensive patients beyond assessment of left ventricular structure alone....

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

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    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

  15. Reliability of blood pressure measurement and cardiovascular risk prediction

    NARCIS (Netherlands)

    van der Hoeven, N.V.

    2016-01-01

    High blood pressure is one of the leading risk factors for cardiovascular disease, but difficult to reliably assess because there are many factors which can influence blood pressure including stress, exercise or illness. The first part of this thesis focuses on possible ways to improve the

  16. Distribution of Short-Term and Lifetime Predicted Risks of Cardiovascular Diseases in Peruvian Adults.

    Science.gov (United States)

    Quispe, Renato; Bazo-Alvarez, Juan Carlos; Burroughs Peña, Melissa S; Poterico, Julio A; Gilman, Robert H; Checkley, William; Bernabé-Ortiz, Antonio; Huffman, Mark D; Miranda, J Jaime

    2015-08-07

    Short-term risk assessment tools for prediction of cardiovascular disease events are widely recommended in clinical practice and are used largely for single time-point estimations; however, persons with low predicted short-term risk may have higher risks across longer time horizons. We estimated short-term and lifetime cardiovascular disease risk in a pooled population from 2 studies of Peruvian populations. Short-term risk was estimated using the atherosclerotic cardiovascular disease Pooled Cohort Risk Equations. Lifetime risk was evaluated using the algorithm derived from the Framingham Heart Study cohort. Using previously published thresholds, participants were classified into 3 categories: low short-term and low lifetime risk, low short-term and high lifetime risk, and high short-term predicted risk. We also compared the distribution of these risk profiles across educational level, wealth index, and place of residence. We included 2844 participants (50% men, mean age 55.9 years [SD 10.2 years]) in the analysis. Approximately 1 of every 3 participants (34% [95% CI 33 to 36]) had a high short-term estimated cardiovascular disease risk. Among those with a low short-term predicted risk, more than half (54% [95% CI 52 to 56]) had a high lifetime predicted risk. Short-term and lifetime predicted risks were higher for participants with lower versus higher wealth indexes and educational levels and for those living in urban versus rural areas (PPeruvian adults were classified as low short-term risk but high lifetime risk. Vulnerable adults, such as those from low socioeconomic status and those living in urban areas, may need greater attention regarding cardiovascular preventive strategies. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  17. Distribution of Short-Term and Lifetime Predicted Risks of Cardiovascular Diseases in Peruvian Adults

    Science.gov (United States)

    Quispe, Renato; Bazo-Alvarez, Juan Carlos; Burroughs Peña, Melissa S; Poterico, Julio A; Gilman, Robert H; Checkley, William; Bernabé-Ortiz, Antonio; Huffman, Mark D; Miranda, J Jaime

    2015-01-01

    Background Short-term risk assessment tools for prediction of cardiovascular disease events are widely recommended in clinical practice and are used largely for single time-point estimations; however, persons with low predicted short-term risk may have higher risks across longer time horizons. Methods and Results We estimated short-term and lifetime cardiovascular disease risk in a pooled population from 2 studies of Peruvian populations. Short-term risk was estimated using the atherosclerotic cardiovascular disease Pooled Cohort Risk Equations. Lifetime risk was evaluated using the algorithm derived from the Framingham Heart Study cohort. Using previously published thresholds, participants were classified into 3 categories: low short-term and low lifetime risk, low short-term and high lifetime risk, and high short-term predicted risk. We also compared the distribution of these risk profiles across educational level, wealth index, and place of residence. We included 2844 participants (50% men, mean age 55.9 years [SD 10.2 years]) in the analysis. Approximately 1 of every 3 participants (34% [95% CI 33 to 36]) had a high short-term estimated cardiovascular disease risk. Among those with a low short-term predicted risk, more than half (54% [95% CI 52 to 56]) had a high lifetime predicted risk. Short-term and lifetime predicted risks were higher for participants with lower versus higher wealth indexes and educational levels and for those living in urban versus rural areas (PPeruvian adults were classified as low short-term risk but high lifetime risk. Vulnerable adults, such as those from low socioeconomic status and those living in urban areas, may need greater attention regarding cardiovascular preventive strategies. PMID:26254303

  18. Laboratory-based and office-based risk scores and charts to predict 10-year risk of cardiovascular disease in 182 countries

    DEFF Research Database (Denmark)

    Ueda, Peter; Woodward, Mark; Lu, Yuan

    2017-01-01

    BACKGROUND: Worldwide implementation of risk-based cardiovascular disease (CVD) prevention requires risk prediction tools that are contemporarily recalibrated for the target country and can be used where laboratory measurements are unavailable. We present two cardiovascular risk scores, with and ...

  19. Use of Repeated Blood Pressure and Cholesterol Measurements to Improve Cardiovascular Disease Risk Prediction

    DEFF Research Database (Denmark)

    Paige, Ellie; Barrett, Jessica; Pennells, Lisa

    2017-01-01

    The added value of incorporating information from repeated blood pressure and cholesterol measurements to predict cardiovascular disease (CVD) risk has not been rigorously assessed. We used data on 191,445 adults from the Emerging Risk Factors Collaboration (38 cohorts from 17 countries with data...

  20. Can machine-learning improve cardiovascular risk prediction using routine clinical data?

    Science.gov (United States)

    Kai, Joe; Garibaldi, Jonathan M.; Qureshi, Nadeem

    2017-01-01

    Background Current approaches to predict cardiovascular risk fail to identify many people who would benefit from preventive treatment, while others receive unnecessary intervention. Machine-learning offers opportunity to improve accuracy by exploiting complex interactions between risk factors. We assessed whether machine-learning can improve cardiovascular risk prediction. Methods Prospective cohort study using routine clinical data of 378,256 patients from UK family practices, free from cardiovascular disease at outset. Four machine-learning algorithms (random forest, logistic regression, gradient boosting machines, neural networks) were compared to an established algorithm (American College of Cardiology guidelines) to predict first cardiovascular event over 10-years. Predictive accuracy was assessed by area under the ‘receiver operating curve’ (AUC); and sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) to predict 7.5% cardiovascular risk (threshold for initiating statins). Findings 24,970 incident cardiovascular events (6.6%) occurred. Compared to the established risk prediction algorithm (AUC 0.728, 95% CI 0.723–0.735), machine-learning algorithms improved prediction: random forest +1.7% (AUC 0.745, 95% CI 0.739–0.750), logistic regression +3.2% (AUC 0.760, 95% CI 0.755–0.766), gradient boosting +3.3% (AUC 0.761, 95% CI 0.755–0.766), neural networks +3.6% (AUC 0.764, 95% CI 0.759–0.769). The highest achieving (neural networks) algorithm predicted 4,998/7,404 cases (sensitivity 67.5%, PPV 18.4%) and 53,458/75,585 non-cases (specificity 70.7%, NPV 95.7%), correctly predicting 355 (+7.6%) more patients who developed cardiovascular disease compared to the established algorithm. Conclusions Machine-learning significantly improves accuracy of cardiovascular risk prediction, increasing the number of patients identified who could benefit from preventive treatment, while avoiding unnecessary treatment of others

  1. Predictive Accuracy of a Cardiovascular Disease Risk Prediction Model in Rural South India – A Community Based Retrospective Cohort Study

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    Farah N Fathima

    2015-03-01

    Full Text Available Background: Identification of individuals at risk of developing cardiovascular diseases by risk stratification is the first step in primary prevention. Aims & Objectives: To assess the five year risk of developing a cardiovascular event from retrospective data and to assess the predictive accuracy of the non laboratory based National Health and Nutrition Examination Survey (NHANES risk prediction model among individuals in a rural South Indian population. Materials & Methods: A community based retrospective cohort study was conducted in three villages where risk stratification was done for all eligible adults aged between 35-74 years at the time of initial assessment using the NHANES risk prediction charts. Household visits were made after a period of five years by trained doctors to determine cardiovascular outcomes. Results: 521 people fulfilled the eligibility criteria of whom 486 (93.3% could be traced after five years. 56.8% were in low risk, 36.6% were in moderate risk and 6.6% were in high risk categories. 29 persons (5.97% had had cardiovascular events over the last five years of which 24 events (82.7% were nonfatal and five (17.25% were fatal. The mean age of the people who developed cardiovascular events was 57.24 ± 9.09 years. The odds ratios for the three levels of risk showed a linear trend with the odds ratios for the moderate risk and high risk category being 1.35 and 1.94 respectively with the low risk category as baseline. Conclusion: The non laboratory based NHANES charts did not accurately predict the occurrence of cardiovascular events in any of the risk categories.

  2. Mind the gap : predicting cardiovascular risk during drug development

    NARCIS (Netherlands)

    Chain, Anne S. Y.

    2012-01-01

    Cardiovascular safety issues, specifically drug-induced QT/QTc-interval prolongation, remain a major cause of drug attrition during clinical development and is one of the main causes for post-market drug withdrawals accounting for 15-34% of all drug discontinuation. Given the potentially fatal

  3. Significant interarm blood pressure difference predicts cardiovascular risk in hypertensive patients: CoCoNet study.

    Science.gov (United States)

    Kim, Su-A; Kim, Jang Young; Park, Jeong Bae

    2016-06-01

    There has been a rising interest in interarm blood pressure difference (IAD), due to its relationship with peripheral arterial disease and its possible relationship with cardiovascular disease. This study aimed to characterize hypertensive patients with a significant IAD in relation to cardiovascular risk. A total of 3699 patients (mean age, 61 ± 11 years) were prospectively enrolled in the study. Blood pressure (BP) was measured simultaneously in both arms 3 times using an automated cuff-oscillometric device. IAD was defined as the absolute difference in averaged BPs between the left and right arm, and an IAD ≥ 10 mm Hg was considered to be significant. The Framingham risk score was used to calculate the 10-year cardiovascular risk. The mean systolic IAD (sIAD) was 4.3 ± 4.1 mm Hg, and 285 (7.7%) patients showed significant sIAD. Patients with significant sIAD showed larger body mass index (P < 0.001), greater systolic BP (P = 0.050), more coronary artery disease (relative risk = 1.356, P = 0.034), and more cerebrovascular disease (relative risk = 1.521, P = 0.072). The mean 10-year cardiovascular risk was 9.3 ± 7.7%. By multiple regression, sIAD was significantly but weakly correlated with the 10-year cardiovascular risk (β = 0.135, P = 0.008). Patients with significant sIAD showed a higher prevalence of coronary artery disease, as well as an increase in 10-year cardiovascular risk. Therefore, accurate measurements of sIAD may serve as a simple and cost-effective tool for predicting cardiovascular risk in clinical settings.

  4. Significant interarm blood pressure difference predicts cardiovascular risk in hypertensive patients

    Science.gov (United States)

    Kim, Su-A; Kim, Jang Young; Park, Jeong Bae

    2016-01-01

    Abstract There has been a rising interest in interarm blood pressure difference (IAD), due to its relationship with peripheral arterial disease and its possible relationship with cardiovascular disease. This study aimed to characterize hypertensive patients with a significant IAD in relation to cardiovascular risk. A total of 3699 patients (mean age, 61 ± 11 years) were prospectively enrolled in the study. Blood pressure (BP) was measured simultaneously in both arms 3 times using an automated cuff-oscillometric device. IAD was defined as the absolute difference in averaged BPs between the left and right arm, and an IAD ≥ 10 mm Hg was considered to be significant. The Framingham risk score was used to calculate the 10-year cardiovascular risk. The mean systolic IAD (sIAD) was 4.3 ± 4.1 mm Hg, and 285 (7.7%) patients showed significant sIAD. Patients with significant sIAD showed larger body mass index (P < 0.001), greater systolic BP (P = 0.050), more coronary artery disease (relative risk = 1.356, P = 0.034), and more cerebrovascular disease (relative risk = 1.521, P = 0.072). The mean 10-year cardiovascular risk was 9.3 ± 7.7%. By multiple regression, sIAD was significantly but weakly correlated with the 10-year cardiovascular risk (β = 0.135, P = 0.008). Patients with significant sIAD showed a higher prevalence of coronary artery disease, as well as an increase in 10-year cardiovascular risk. Therefore, accurate measurements of sIAD may serve as a simple and cost-effective tool for predicting cardiovascular risk in clinical settings. PMID:27310982

  5. 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...

  6. Twenty-Four-Hour Central Pulse Pressure for Cardiovascular Events Prediction in a Low-Cardiovascular-Risk Population: Results From the Bordeaux Cohort.

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    Cremer, Antoine; Boulestreau, Romain; Gaillard, Prune; Lainé, Marion; Papaioannou, Georgios; Gosse, Philippe

    2018-02-23

    Central blood pressure (BP) is a promising marker to identify subjects with higher cardiovascular risk than expected by traditional risk factors. Significant results have been obtained in populations with high cardiovascular risk, but little is known about low-cardiovascular-risk patients, although the differences between central and peripheral BP (amplification) are usually greater in this population. The study aim was to evaluate central BP over 24 hours for cardiovascular event prediction in hypertensive subjects with low cardiovascular risk. Peripheral and central BPs were recorded during clinical visits and over 24 hours in hypertensive patients with low cardiovascular risk (Systematic Coronary Risk Evaluation ≤5%). Our primary end point is the occurrence of a cardiovascular event during follow-up. To assess the potential interest in central pulse pressure over 24 hours, we performed Cox proportional hazard models analysis and comparison of area under the curves using the contrast test for peripheral and central BP. A cohort of 703 hypertensive subjects from Bordeaux were included. After the first 24 hours of BP measurement, the subjects were then followed up for an average of 112.5±70 months. We recorded 65 cardiovascular events during follow-up. Amplification was found to be significantly associated with cardiovascular events when added to peripheral 24-hour pulse pressure ( P =0.0259). The area under the curve of 24-hour central pulse pressure is significantly more important than area under the curve of office BP ( P =0.0296), and there is a trend of superiority with the area under the curve of peripheral 24-hour pulse pressure. Central pulse pressure over 24 hours improves the prediction of cardiovascular events for hypertensive patients with low cardiovascular risk compared to peripheral pulse pressure. © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  7. 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

  8. Improving Cardiovascular Risk Prediction--Biomarkers and Beyond; Implications for Astronaut Selection and Monitoring During Prolonged Spaceflight

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    National Aeronautics and Space Administration — Our primary objective is to identify and validate novel strategies to enhance global cardiovascular disease (CVD) risk prediction over two time windows: 1) 10-20...

  9. Body composition indices and predicted cardiovascular disease risk profile among urban dwellers in Malaysia.

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    Su, Tin Tin; Amiri, Mohammadreza; Mohd Hairi, Farizah; Thangiah, Nithiah; Dahlui, Maznah; Majid, Hazreen Abdul

    2015-01-01

    This study aims to compare various body composition indices and their association with a predicted cardiovascular disease (CVD) risk profile in an urban population in Kuala Lumpur, Malaysia. A cross-sectional survey was conducted in metropolitan Kuala Lumpur, Malaysia, in 2012. Households were selected using a simple random-sampling method, and adult members were invited for medical screening. The Framingham Risk Scoring algorithm was used to predict CVD risk, which was then analyzed in association with body composition measurements, including waist circumference, waist-hip ratio, waist-height ratio, body fat percentage, and body mass index. Altogether, 882 individuals were included in our analyses. Indices that included waist-related measurements had the strongest association with CVD risk in both genders. After adjusting for demographic and socioeconomic variables, waist-related measurements retained the strongest correlations with predicted CVD risk in males. However, body mass index, waist-height ratio, and waist circumference had the strongest correlation with CVD risk in females. The waist-related indicators of abdominal obesity are important components of CVD risk profiles. As waist-related parameters can quickly and easily be measured, they should be routinely obtained in primary care settings and population health screens in order to assess future CVD risk profiles and design appropriate interventions.

  10. Body Composition Indices and Predicted Cardiovascular Disease Risk Profile among Urban Dwellers in Malaysia

    Directory of Open Access Journals (Sweden)

    Tin Tin Su

    2015-01-01

    Full Text Available Objectives. This study aims to compare various body composition indices and their association with a predicted cardiovascular disease (CVD risk profile in an urban population in Kuala Lumpur, Malaysia. Methods. A cross-sectional survey was conducted in metropolitan Kuala Lumpur, Malaysia, in 2012. Households were selected using a simple random-sampling method, and adult members were invited for medical screening. The Framingham Risk Scoring algorithm was used to predict CVD risk, which was then analyzed in association with body composition measurements, including waist circumference, waist-hip ratio, waist-height ratio, body fat percentage, and body mass index. Results. Altogether, 882 individuals were included in our analyses. Indices that included waist-related measurements had the strongest association with CVD risk in both genders. After adjusting for demographic and socioeconomic variables, waist-related measurements retained the strongest correlations with predicted CVD risk in males. However, body mass index, waist-height ratio, and waist circumference had the strongest correlation with CVD risk in females. Conclusions. The waist-related indicators of abdominal obesity are important components of CVD risk profiles. As waist-related parameters can quickly and easily be measured, they should be routinely obtained in primary care settings and population health screens in order to assess future CVD risk profiles and design appropriate interventions.

  11. Prediction of Adulthood Obesity Using Genetic and Childhood Clinical Risk Factors in the Cardiovascular Risk in Young Finns Study.

    Science.gov (United States)

    Seyednasrollah, Fatemeh; Mäkelä, Johanna; Pitkänen, Niina; Juonala, Markus; Hutri-Kähönen, Nina; Lehtimäki, Terho; Viikari, Jorma; Kelly, Tanika; Li, Changwei; Bazzano, Lydia; Elo, Laura L; Raitakari, Olli T

    2017-06-01

    Obesity is a known risk factor for cardiovascular disease. Early prediction of obesity is essential for prevention. The aim of this study is to assess the use of childhood clinical factors and the genetic risk factors in predicting adulthood obesity using machine learning methods. A total of 2262 participants from the Cardiovascular Risk in YFS (Young Finns Study) were followed up from childhood (age 3-18 years) to adulthood for 31 years. The data were divided into training (n=1625) and validation (n=637) set. The effect of known genetic risk factors (97 single-nucleotide polymorphisms) was investigated as a weighted genetic risk score of all 97 single-nucleotide polymorphisms (WGRS97) or a subset of 19 most significant single-nucleotide polymorphisms (WGRS19) using boosting machine learning technique. WGRS97 and WGRS19 were validated using external data (n=369) from BHS (Bogalusa Heart Study). WGRS19 improved the accuracy of predicting adulthood obesity in training (area under the curve [AUC=0.787 versus AUC=0.744, P obesity. Predictive accuracy is highest among young children (3-6 years), whereas among older children (9-18 years) the risk can be identified using childhood clinical factors. The model is helpful in screening children with high risk of developing obesity. © 2017 American Heart Association, Inc.

  12. Predicting readmission risk of patients with diabetes hospitalized for cardiovascular disease: a retrospective cohort study.

    Science.gov (United States)

    Rubin, Daniel J; Golden, Sherita Hill; McDonnell, Marie E; Zhao, Huaqing

    2017-08-01

    To develop and validate a tool that predicts 30d readmission risk of patients with diabetes hospitalized for cardiovascular disease (CVD), the Diabetes Early Readmission Risk Indicator-CVD (DERRI-CVD™). A cohort of 8189 discharges was retrospectively selected from electronic records of adult patients with diabetes hospitalized for CVD. Discharges of 60% of the patients (n=4950) were randomly selected as a training sample and the remaining 40% (n=3219) were the validation sample. Statistically significant predictors of all-cause 30d readmission risk were identified by multivariable logistic regression modeling: education level, employment status, living within 5miles of the hospital, pre-admission diabetes therapy, macrovascular complications, admission serum creatinine and albumin levels, having a hospital discharge within 90days pre-admission, and a psychiatric diagnosis. Model discrimination and calibration were good (C-statistic 0.71). Performance in the validation sample was comparable. Predicted 30d readmission risk was similar in the training and validation samples (38.6% and 35.1% in the highest quintiles). The DERRI-CVD™ may be a valid tool to predict all-cause 30d readmission risk of patients with diabetes hospitalized for CVD. Identifying high-risk patients may encourage the use of interventions targeting those at greatest risk, potentially leading to better outcomes and lower healthcare costs. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. 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 glucose metabolism and metabolic risk during puberty....

  14. Prediction of cardiovascular disease risk among low-income urban dwellers in metropolitan Kuala Lumpur, Malaysia.

    Science.gov (United States)

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

    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 model (figures in parentheses are from the modified model) revealed that 20.5% (21.8%) and 38.46% (38.9%) of respondents were at high and moderate risk of CVD. The GLM models identified the importance of education, occupation, and marital status in predicting the future CVD risk. Our study indicated that one out of five low-income urban dwellers has high chance of having CVD within ten years. Health care expenditure, other illness related costs and loss of productivity due to CVD would worsen the current situation of low-income urban population. As such, the public health professionals and policy makers should establish substantial effort to formulate the public health policy and community-based intervention to minimize the upcoming possible high mortality and morbidity due to CVD among the low-income urban dwellers.

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

    Directory of Open Access Journals (Sweden)

    Tin Tin Su

    2015-01-01

    Full Text Available 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 model (figures in parentheses are from the modified model revealed that 20.5% (21.8% and 38.46% (38.9% of respondents were at high and moderate risk of CVD. The GLM models identified the importance of education, occupation, and marital status in predicting the future CVD risk. Our study indicated that one out of five low-income urban dwellers has high chance of having CVD within ten years. Health care expenditure, other illness related costs and loss of productivity due to CVD would worsen the current situation of low-income urban population. As such, the public health professionals and policy makers should establish substantial effort to formulate the public health policy and community-based intervention to minimize the upcoming possible high mortality and morbidity due to CVD among the low-income urban dwellers.

  16. Application of cardiovascular disease risk prediction models and the relevance of novel biomarkers to risk stratification in Asian Indians.

    Science.gov (United States)

    Kanjilal, S; Rao, V S; Mukherjee, M; Natesha, B K; Renuka, K S; Sibi, K; Iyengar, S S; Kakkar, Vijay V

    2008-01-01

    The increasing pressure on health resources has led to the emergence of risk assessment as an essential tool in the management of cardiovascular disease (CVD). Concern exists regarding the validity of their generalization to all populations. Existing risk scoring models do not incorporate emerging 'novel' risk factors. In this context, the aim of the study was to examine the relevance of British, European, and Framingham predictive CVD risk scores to the asymptomatic high risk Indian population. Blood samples drawn from the participants were analyzed for various 'traditional' and 'novel' biomarkers, and their CVD risk factor profiling was also done. The Framingham model defined only 5% of the study cohort to be at high risk, which appears to be an underestimation of CVD risk in this genetically predisposed population. These subjects at high risk had significantly elevated levels of lipid, pro-inflammatory, pro-thrombotic, and serological markers. It is more relevant to develop risk predictive scores for application to the Indian population. This study substantiates the argument that alternative approaches to risk stratification are required in order to make them more adaptable and applicable to different populations with varying risk factor and disease patterns.

  17. A risk score to predict type 2 diabetes mellitus in an elderly Spanish Mediterranean population at high cardiovascular risk.

    Directory of Open Access Journals (Sweden)

    Marta Guasch-Ferré

    Full Text Available INTRODUCTION: To develop and test a diabetes risk score to predict incident diabetes in an elderly Spanish Mediterranean population at high cardiovascular risk. MATERIALS AND METHODS: A diabetes risk score was derived from a subset of 1381 nondiabetic individuals from three centres of the PREDIMED study (derivation sample. Multivariate Cox regression model ß-coefficients were used to weigh each risk factor. PREDIMED-personal Score included body-mass-index, smoking status, family history of type 2 diabetes, alcohol consumption and hypertension as categorical variables; PREDIMED-clinical Score included also high blood glucose. We tested the predictive capability of these scores in the DE-PLAN-CAT cohort (validation sample. The discrimination of Finnish Diabetes Risk Score (FINDRISC, German Diabetes Risk Score (GDRS and our scores was assessed with the area under curve (AUC. RESULTS: The PREDIMED-clinical Score varied from 0 to 14 points. In the subset of the PREDIMED study, 155 individuals developed diabetes during the 4.75-years follow-up. The PREDIMED-clinical score at a cutoff of ≥6 had sensitivity of 72.2%, and specificity of 72.5%, whereas AUC was 0.78. The AUC of the PREDIMED-clinical Score was 0.66 in the validation sample (sensitivity = 85.4%; specificity = 26.6%, and was significantly higher than the FINDRISC and the GDRS in both the derivation and validation samples. DISCUSSION: We identified classical risk factors for diabetes and developed the PREDIMED-clinical Score to determine those individuals at high risk of developing diabetes in elderly individuals at high cardiovascular risk. The predictive capability of the PREDIMED-clinical Score was significantly higher than the FINDRISC and GDRS, and also used fewer items in the questionnaire.

  18. Prediction of Adult Dyslipidemia Using Genetic and Childhood Clinical Risk Factors: The Cardiovascular Risk in Young Finns Study.

    Science.gov (United States)

    Nuotio, Joel; Pitkänen, Niina; Magnussen, Costan G; Buscot, Marie-Jeanne; Venäläinen, Mikko S; Elo, Laura L; Jokinen, Eero; Laitinen, Tomi; Taittonen, Leena; Hutri-Kähönen, Nina; Lyytikäinen, Leo-Pekka; Lehtimäki, Terho; Viikari, Jorma S; Juonala, Markus; Raitakari, Olli T

    2017-06-01

    Dyslipidemia is a major modifiable risk factor for cardiovascular disease. We examined whether the addition of novel single-nucleotide polymorphisms for blood lipid levels enhances the prediction of adult dyslipidemia in comparison to childhood lipid measures. Two thousand four hundred and twenty-two participants of the Cardiovascular Risk in Young Finns Study who had participated in 2 surveys held during childhood (in 1980 when aged 3-18 years and in 1986) and at least once in a follow-up study in adulthood (2001, 2007, and 2011) were included. We examined whether inclusion of a lipid-specific weighted genetic risk score based on 58 single-nucleotide polymorphisms for low-density lipoprotein cholesterol, 71 single-nucleotide polymorphisms for high-density lipoprotein cholesterol, and 40 single-nucleotide polymorphisms for triglycerides improved the prediction of adult dyslipidemia compared with clinical childhood risk factors. Adjusting for age, sex, body mass index, physical activity, and smoking in childhood, childhood lipid levels, and weighted genetic risk scores were associated with an increased risk of adult dyslipidemia for all lipids. Risk assessment based on 2 childhood lipid measures and the lipid-specific weighted genetic risk scores improved the accuracy of predicting adult dyslipidemia compared with the approach using only childhood lipid measures for low-density lipoprotein cholesterol (area under the receiver-operating characteristic curve 0.806 versus 0.811; P =0.01) and triglycerides (area under the receiver-operating characteristic curve 0.740 versus area under the receiver-operating characteristic curve 0.758; P dyslipidemia in adulthood. © 2017 American Heart Association, Inc.

  19. The HEART score is useful to predict cardiovascular risks and reduces unnecessary cardiac imaging in low-risk patients with acute chest pain.

    Science.gov (United States)

    Dai, Siping; Huang, Bo; Zou, Yunliang; Guo, Jianbin; Liu, Ziyong; Pi, Dangyu; Qiu, Yunhong; Xiao, Chun

    2018-06-01

    The present study was to investigate whether the HEART score can be used to evaluate cardiovascular risks and reduce unnecessary cardiac imaging in China.Acute coronary syndrome patients with the thrombosis in myocardial infarction risk score risk HEART score group and 2 patients (1.5%) in the high risk HEART score group had cardiovascular events. The sensitivity of HEART score to predict cardiovascular events was 100% and the specificity was 46.7%. The potential unnecessary cardiac testing was 46.3%. Cox proportional hazards regression analysis showed that per one category increase of the HEART score was associated with nearly 1.3-fold risk of cardiovascular events.In the low-risk acute chest pain patients, the HEART score is useful to physicians in evaluating the risk of cardiovascular events within the first 30 days. In addition, the HEART score is also useful in reducing the unnecessary cardiac imaging.

  20. NT-proBNP is increased in differentiated thyroid carcinoma patients and may predict cardiovascular risk

    NARCIS (Netherlands)

    Klein Hesselink, Esther N; Horst-Schrivers, van der Anouk; van der Horst, Iwan C C; Bakker, Stephan J L; Muller Kobold, Anneke C.; Brouwers, Adrienne H; de Bock, Geertruida H; Gietema, Jourik A; Dullaart, Robin P F; Links, Thera P; Lefrandt, Joop D

    INTRODUCTION: Chronic suppression of TSH in patients treated for differentiated thyroid carcinoma (DTC) may induce cardiac damage and increase risk for cardiovascular events and premature mortality. We aimed to compare circulating concentrations of N-terminal pro Brain Natriuretic Peptide

  1. Comparison of three lifecourse models of poverty in predicting cardiovascular disease risk in youth.

    Science.gov (United States)

    Kakinami, Lisa; Séguin, Louise; Lambert, Marie; Gauvin, Lise; Nikiema, Béatrice; Paradis, Gilles

    2013-08-01

    Childhood poverty heightens the risk of adulthood cardiovascular disease (CVD), but the underlying pathways are poorly understood. Three lifecourse models have been proposed but have never been tested among youth. We assessed the longitudinal association of childhood poverty with CVD risk factors in 10-year-old youth according to the timing, accumulation, and mobility models. The Québec Longitudinal Study of Child Development birth cohort was established in 1998 (n = 2120). Poverty was defined as annual income below the low-income thresholds defined by Statistics Canada. Multiple imputation was used for missing data. Multivariable linear regression models adjusted for gender, pubertal stage, parental education, maternal age, whether the household was a single parent household, whether the child was overweight or obese, the child's physical activity in the past week, and family history. Approximately 40% experienced poverty at least once, 16% throughout childhood, and 25% intermittently. Poverty was associated with significantly elevated triglycerides and insulin according to the timing and accumulation models, although the timing model was superior for predicting insulin and the accumulation model was superior for predicting triglycerides. Early and prolonged exposure to poverty significantly increases CVD risk among 10-year-old youth. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. The metabolic syndrome: validity and utility of clinical definitions for cardiovascular disease and diabetes risk prediction.

    Science.gov (United States)

    Cameron, Adrian

    2010-02-01

    The purpose of clinical definitions of the metabolic syndrome is frequently misunderstood. While the metabolic syndrome as a physiological process describes a clustering of numerous age-related metabolic abnormalities that together increase the risk for cardiovascular disease and type 2 diabetes, clinical definitions include obesity which is thought to be a cause rather than a consequence of metabolic disturbance, and several elements that are routinely measured in clinical practice, including high blood pressure, high blood glucose and dyslipidaemia. Obesity is frequently a central player in the development of the metabolic syndrome and should be considered a key component of clinical definitions. Previous clinical definitions have differed in the priority given to obesity. Perhaps more importantly than its role in a clinical definition, however, is obesity in isolation before the hallmarks of metabolic dysfunction that typify the syndrome have developed. This should be treated seriously as an opportunity to prevent the consequences of the global diabetes epidemic now apparent. Clinical definitions were designed to identify a population at high lifetime CVD and type 2 diabetes risk, but in the absence of several major risk factors for each condition, are not optimal risk prediction devices for either. Despite this, the metabolic syndrome has several properties that make it a useful construct, in conjunction with short-term risk prediction algorithms and sound clinical judgement, for the identification of those at high lifetime risk of CVD and diabetes. A recently published consensus definition provides some much needed clarity about what a clinical definition entails. Even this, however, remains a work in progress until more evidence becomes available, particularly in the area of ethnicity-specific waist cut-points. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

  3. Improvement of cardiovascular risk prediction: time to review current knowledge, debates, and fundamentals on how to assess test characteristics.

    Science.gov (United States)

    Romanens, Michel; Ackermann, Franz; Spence, John David; Darioli, Roger; Rodondi, Nicolas; Corti, Roberto; Noll, Georg; Schwenkglenks, Matthias; Pencina, Michael

    2010-02-01

    Cardiovascular risk assessment might be improved with the addition of emerging, new tests derived from atherosclerosis imaging, laboratory tests or functional tests. This article reviews relative risk, odds ratios, receiver-operating curves, posttest risk calculations based on likelihood ratios, the net reclassification improvement and integrated discrimination. This serves to determine whether a new test has an added clinical value on top of conventional risk testing and how this can be verified statistically. Two clinically meaningful examples serve to illustrate novel approaches. This work serves as a review and basic work for the development of new guidelines on cardiovascular risk prediction, taking into account emerging tests, to be proposed by members of the 'Taskforce on Vascular Risk Prediction' under the auspices of the Working Group 'Swiss Atherosclerosis' of the Swiss Society of Cardiology in the future.

  4. 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

  5. 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

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    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.

  6. Models to Predict the Burden of Cardiovascular Disease Risk in a Rural Mountainous Region of Vietnam

    NARCIS (Netherlands)

    Nguyen, Thi Phuong Lan; Schuiling-Veninga, Nynke; Nguyen, Thi Bach Yen; Hang, Vu Thi Thu; Wright, E. Pamela; Postma, M.J.

    2014-01-01

    Objective: To compare and identify the most appropriate model to predict cardiovascular disease (CVD) in a rural area in Northern Vietnam, using data on hypertension from the communities. Methods: A cross-sectional survey was conducted including all residents in selected communities, aged 34 to 65

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

    Science.gov (United States)

    Middleton, Renee Annette

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

  8. History of preeclampsia is more predictive of cardiometabolic and cardiovascular risk factors than obesity

    NARCIS (Netherlands)

    Heidema, W.M.; Scholten, R.R.; Lotgering, F.K.; Spaanderman, M.E.A.

    2015-01-01

    OBJECTIVE: To determine to what extent a history of preeclampsia affects traditional cardiometabolic (insulin resistance and dyslipidemia) and cardiovascular (hypertension and micro-albuminuria) risk factors of the metabolic syndrome irrespective of BMI. STUDY DESIGN: In a retrospective case-control

  9. Use and Customization of Risk Scores for Predicting Cardiovascular Events Using Electronic Health Record Data.

    Science.gov (United States)

    Wolfson, Julian; Vock, David M; Bandyopadhyay, Sunayan; Kottke, Thomas; Vazquez-Benitez, Gabriela; Johnson, Paul; Adomavicius, Gediminas; O'Connor, Patrick J

    2017-04-24

    Clinicians who are using the Framingham Risk Score (FRS) or the American College of Cardiology/American Heart Association Pooled Cohort Equations (PCE) to estimate risk for their patients based on electronic health data (EHD) face 4 questions. (1) Do published risk scores applied to EHD yield accurate estimates of cardiovascular risk? (2) Are FRS risk estimates, which are based on data that are up to 45 years old, valid for a contemporary patient population seeking routine care? (3) Do the PCE make the FRS obsolete? (4) Does refitting the risk score using EHD improve the accuracy of risk estimates? Data were extracted from the EHD of 84 116 adults aged 40 to 79 years who received care at a large healthcare delivery and insurance organization between 2001 and 2011. We assessed calibration and discrimination for 4 risk scores: published versions of FRS and PCE and versions obtained by refitting models using a subset of the available EHD. The published FRS was well calibrated (calibration statistic K=9.1, miscalibration ranging from 0% to 17% across risk groups), but the PCE displayed modest evidence of miscalibration (calibration statistic K=43.7, miscalibration from 9% to 31%). Discrimination was similar in both models (C-index=0.740 for FRS, 0.747 for PCE). Refitting the published models using EHD did not substantially improve calibration or discrimination. We conclude that published cardiovascular risk models can be successfully applied to EHD to estimate cardiovascular risk; the FRS remains valid and is not obsolete; and model refitting does not meaningfully improve the accuracy of risk estimates. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  10. Predicting the 10-Year Risks of Atherosclerotic Cardiovascular Disease in Chinese Population: The China-PAR Project (Prediction for ASCVD Risk in China).

    Science.gov (United States)

    Yang, Xueli; Li, Jianxin; Hu, Dongsheng; Chen, Jichun; Li, Ying; Huang, Jianfeng; Liu, Xiaoqing; Liu, Fangchao; Cao, Jie; Shen, Chong; Yu, Ling; Lu, Fanghong; Wu, Xianping; Zhao, Liancheng; Wu, Xigui; Gu, Dongfeng

    2016-11-08

    The accurate assessment of individual risk can be of great value to guiding and facilitating the prevention of atherosclerotic cardiovascular disease (ASCVD). However, prediction models in common use were formulated primarily in white populations. The China-PAR project (Prediction for ASCVD Risk in China) is aimed at developing and validating 10-year risk prediction equations for ASCVD from 4 contemporary Chinese cohorts. Two prospective studies followed up together with a unified protocol were used as the derivation cohort to develop 10-year ASCVD risk equations in 21 320 Chinese participants. The external validation was evaluated in 2 independent Chinese cohorts with 14 123 and 70 838 participants. Furthermore, model performance was compared with the Pooled Cohort Equations reported in the American College of Cardiology/American Heart Association guideline. Over 12 years of follow-up in the derivation cohort with 21 320 Chinese participants, 1048 subjects developed a first ASCVD event. Sex-specific equations had C statistics of 0.794 (95% confidence interval, 0.775-0.814) for men and 0.811 (95% confidence interval, 0.787-0.835) for women. The predicted rates were similar to the observed rates, as indicated by a calibration χ 2 of 13.1 for men (P=0.16) and 12.8 for women (P=0.17). Good internal and external validations of our equations were achieved in subsequent analyses. Compared with the Chinese equations, the Pooled Cohort Equations had lower C statistics and much higher calibration χ 2 values in men. Our project developed effective tools with good performance for 10-year ASCVD risk prediction among a Chinese population that will help to improve the primary prevention and management of cardiovascular disease. © 2016 American Heart Association, Inc.

  11. Aldosterone dysregulation with aging predicts renal vascular function and cardiovascular risk.

    Science.gov (United States)

    Brown, Jenifer M; Underwood, Patricia C; Ferri, Claudio; Hopkins, Paul N; Williams, Gordon H; Adler, Gail K; Vaidya, Anand

    2014-06-01

    Aging and abnormal aldosterone regulation are both associated with vascular disease. We hypothesized that aldosterone dysregulation influences the age-related risk of renal vascular and cardiovascular disease. We conducted an analysis of 562 subjects who underwent detailed investigations under conditions of liberal and restricted dietary sodium intake (1124 visits) in the General Clinical Research Center. Aldosterone regulation was characterized by the ratio of maximal suppression to stimulation (supine serum aldosterone on a liberal sodium diet divided by the same measure on a restricted sodium diet). We previously demonstrated that higher levels of this Sodium-modulated Aldosterone Suppression-Stimulation Index (SASSI) indicate greater aldosterone dysregulation. Renal plasma flow (RPF) was determined via p-aminohippurate clearance to assess basal renal hemodynamics and the renal vascular responses to dietary sodium manipulation and angiotensin II infusion. Cardiovascular risk was calculated using the Framingham Risk Score. In univariate linear regression, older age (β=-4.60; Page and SASSI, where the inverse relationship between SASSI and RPF was most apparent with older age (Page may interact to mediate renal vascular disease. Our findings suggest that the combination of aldosterone dysregulation and renal vascular dysfunction could additively increase the risk of future cardiovascular outcomes; therefore, aldosterone dysregulation may represent a modifiable mechanism of age-related vascular disease.

  12. New Zealand Diabetes Cohort Study cardiovascular risk score for people with Type 2 diabetes: validation in the PREDICT cohort.

    Science.gov (United States)

    Robinson, Tom; Elley, C Raina; Wells, Sue; Robinson, Elizabeth; Kenealy, Tim; Pylypchuk, Romana; Bramley, Dale; Arroll, Bruce; Crengle, Sue; Riddell, Tania; Ameratunga, Shanthi; Metcalf, Patricia; Drury, Paul L

    2012-09-01

    New Zealand (NZ) guidelines recommend treating people for cardiovascular disease (CVD) risk on the basis of five-year absolute risk using a NZ adaptation of the Framingham risk equation. A diabetes-specific Diabetes Cohort Study (DCS) CVD predictive risk model has been developed and validated using NZ Get Checked data. To revalidate the DCS model with an independent cohort of people routinely assessed using PREDICT, a web-based CVD risk assessment and management programme. People with Type 2 diabetes without pre-existing CVD were identified amongst people who had a PREDICT risk assessment between 2002 and 2005. From this group we identified those with sufficient data to allow estimation of CVD risk with the DCS models. We compared the DCS models with the NZ Framingham risk equation in terms of discrimination, calibration, and reclassification implications. Of 3044 people in our study cohort, 1829 people had complete data and therefore had CVD risks calculated. Of this group, 12.8% (235) had a cardiovascular event during the five-year follow-up. The DCS models had better discrimination than the currently used equation, with C-statistics being 0.68 for the two DCS models and 0.65 for the NZ Framingham model. The DCS models were superior to the NZ Framingham equation at discriminating people with diabetes who will have a cardiovascular event. The adoption of a DCS model would lead to a small increase in the number of people with diabetes who are treated with medication, but potentially more CVD events would be avoided.

  13. Predictive value of ovarian stroma measurement for cardiovascular risk in polycyctic ovary syndrome: a case control study

    Directory of Open Access Journals (Sweden)

    Loverro Giuseppe

    2010-11-01

    Full Text Available Abstract Background To verify the feasibility of ovarian stromal evaluation and correlate ovarian parameteres (echogenicity and volume with hyperandrogenism, and both cardiovascular and metabolic risk factors in PCOS. Methods Twenty four young PCOS patients and twelve age-matched control women were enrolled. Diagnosis of PCOS was based on the Rotterdam criteria. Ultrasound ovarian study included ovarian volume, stromal volume, stromal area and stromal area/total ovarian area ratio (S/A. Concerning hormones, insulin, LH, FSH, estradiol, androstenedione, testosterone, DHEAS, 17-hydroxy-progesterone, and SHBG were measured during the early follicular phase (days 2-5. Cardiovascular risk factors were represented by fasting plasma levels of glucose, lipids (total and HDL-cholesterol, plasminogen activator inhibitor 1 (PAI-1, von-Willebrand factor (vWF, and adiponectin. Carotid intima-media thickness (C-IMT was measured as a parameter of cardiovascular risk. Results A positive correlation between the S/A ratio and plasma levels of testosterone (p Conclusions This study shows that the ultrasound measurement of ovarian stroma is a predicting factor of hyperandrogenism degree, prothrombotic factors and cardiovascular risk in patients with PCOS.

  14. History of preeclampsia is more predictive of cardiometabolic and cardiovascular risk factors than obesity.

    Science.gov (United States)

    Heidema, Wieteke M; Scholten, Ralph R; Lotgering, Fred K; Spaanderman, Marc E A

    2015-11-01

    To determine to what extent a history of preeclampsia affects traditional cardiometabolic (insulin resistance and dyslipidemia) and cardiovascular (hypertension and micro-albuminuria) risk factors of the metabolic syndrome irrespective of BMI. In a retrospective case-control study we compared 90 formerly preeclamptic women, divided in 3 BMI-classes (BMI 19.5-24.9, 25.0-29.9, ≥30.0kg/m(2)) to 30 controls, matched for BMI, age and parity. Cardiometabolic and cardiovascular risk factors (WHO-criteria) were tested 6-18 months post partum. Statistical analysis included unpaired t-tests, Mann-Whitney U test, or Chi square test and two-way ANOVA. Constituents of the metabolic syndrome (glucose, insulin, HOMAIR, HDL-cholesterol, triglycerides, blood pressure, micro-albuminuria) were higher in formerly preeclamptic women than in BMI-matched controls. Resultantly, traditional risk factors were more prevalent in formerly preeclamptic women than in controls (insulin resistance 80% vs 30%, dyslipidemia 52% vs 3%, hypertension 24% vs 0%, micro-albuminuria 30% vs 0%). Cardiometabolic risk factors increased with BMI, to the same extent in both groups. Formerly preeclamptic women had metabolic syndrome more often than their BMI-matched controls (38% vs 3%, p<0.001). Traditional risk factors of the metabolic syndrome are more prevalent in formerly preeclamptic women than in BMI-matched controls and increase with BMI to the same extent in both groups. A history of preeclampsia seems to be a stronger indicator of cardiovascular risk than obesity per se. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. Can dental pulp calcification predict the risk of ischemic cardiovascular disease?

    Science.gov (United States)

    Khojastepour, Leila; Bronoosh, Pegah; Khosropanah, Shahdad; Rahimi, Elham

    2013-09-01

    To report the association of pulp calcification with that of cardiovascular disease (CVD) using digital panoramic dental radiographs. Digital panoramic radiographs of patients referred from the angiography department were included if the patient was under 55 years old and had non-restored or minimally restored molars and canines. An oral and maxillofacial radiologist evaluated the images for pulpal calcifications in the selected teeth. The sensitivity, specificity, positive predictive value and negative predictive value of panoramic radiography in predicting CVD were calculated. Out of 122 patients who met the criteria, 68.2% of the patients with CVD had pulp chamber calcifications. Pulp calcification in panoramic radiography had a sensitivity of 68.9% to predict CVD. This study demonstrates that patients with CVD show an increased incidence of pulp calcification compared with healthy patients. The findings suggest that pulp calcification on panoramic radiography may have possibilities for use in CVD screening.

  16. Cardiovascular risk calculation

    African Journals Online (AJOL)

    James A. Ker

    2014-08-20

    Aug 20, 2014 ... smoking and elevated blood sugar levels (diabetes mellitus). These risk ... These are risk charts, e.g. FRS, a non-laboratory-based risk calculation, and ... for hard cardiovascular end-points, such as coronary death, myocardial ...

  17. Predictive value of quantitative dipyridamole-thallium scintigraphy in assessing cardiovascular risk after vascular surgery in diabetes mellitus

    International Nuclear Information System (INIS)

    Lane, S.E.; Lewis, S.M.; Pippin, J.J.; Kosinski, E.J.; Campbell, D.; Nesto, R.W.; Hill, T.

    1989-01-01

    Cardiac complications represent a major risk to patients undergoing vascular surgery. Diabetic patients may be particularly prone to such complications due to the high incidence of concomitant coronary artery disease, the severity of which may be clinically unrecognized. Attempts to stratify groups by clinical criteria have been useful but lack the predictive value of currently used noninvasive techniques such as dipyridamole-thallium scintigraphy. One hundred one diabetic patients were evaluated with dipyridamole-thallium scintigraphy before undergoing vascular surgery. The incidence of thallium abnormalities was high (80%) and did not correlate with clinical markers of coronary disease. Even in a subgroup of patients with no overt clinical evidence of underlying heart disease, thallium abnormalities were present in 59%. Cardiovascular complications, however, occurred in only 11% of all patients. Statistically significant prediction of risk was not achieved with simple assessment of thallium results as normal or abnormal. Quantification of total number of reversible defects, as well as assessment of ischemia in the distribution of the left anterior descending coronary artery was required for optimum predictive accuracy. The prevalence of dipyridamole-thallium abnormalities in a diabetic population is much higher than that reported in nondiabetic patients and cannot be predicted by usual clinical indicators of heart disease. In addition, cardiovascular risk of vascular surgery can be optimally assessed by quantitative analysis of dipyridamole-thallium scintigraphy and identification of high- and low-risk subgroups

  18. An updated prediction model of the global risk of cardiovascular disease in HIV-positive persons

    DEFF Research Database (Denmark)

    Friis-Møller, Nina; Ryom, Lene; Smith, Colette

    2016-01-01

    ,663 HIV-positive persons from 20 countries in Europe and Australia, who were free of CVD at entry into the Data-collection on Adverse Effects of Anti-HIV Drugs (D:A:D) study. Cox regression models (full and reduced) were developed that predict the risk of a global CVD endpoint. The predictive performance...... significantly predicted risk more accurately than the recalibrated Framingham model (Harrell's c-statistic of 0.791, 0.783 and 0.766 for the D:A:D full, D:A:D reduced, and Framingham models respectively; p models also more accurately predicted five-year CVD-risk for key prognostic subgroups...... to quantify risk and to guide preventive care....

  19. Hypertriglyceridemia and waist circumference predict cardiovascular risk among HIV patients: a cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Peter M Janiszewski

    Full Text Available Although half of HIV-infected patients develop lipodystrophy and metabolic complications, there exists no simple clinical screening tool to discern the high from the low-risk HIV-infected patient. Thus, we evaluated the associations between waist circumference (WC combined with triglyceride (TG levels and the severity of lipodystrophy and cardiovascular risk among HIV-infected men and women.1481 HIV-infected men and 841 HIV-infected women were recruited between 2005 and 2009 at the metabolic clinic of the University of Modena and Reggio Emilia in Italy. Within each gender, patients were categorized into 4 groups according to WC and TG levels. Total and regional fat and fat-free mass were assessed by duel-energy x-ray absorptiometry, and visceral adipose tissue (VAT and abdominal subcutaneous AT (SAT were quantified by computed tomography. Various cardiovascular risk factors were assessed in clinic after an overnight fast.The high TG/high WC men had the most VAT (208.0 ± 94.4 cm(2, as well as the highest prevalence of metabolic syndrome (42.2% and type-2 diabetes (16.2%, and the highest Framingham risk score (10.3 ± 6.5 in comparison to other groups (p<0.05 for all. High TG/high WC women also had elevated VAT (150.0 ± 97.9 cm(2 and a higher prevalence of metabolic syndrome (53.3%, hypertension (30.5% and type-2 diabetes (12.0%, and Framingham risk score(2.9 ± 2.8 by comparison to low TG/low WC women (p<0.05 for all.A simple tool combining WC and TG levels can discriminate high- from low-risk HIV-infected patients.

  20. Hypertriglyceridemia and Waist Circumference Predict Cardiovascular Risk among HIV Patients: A Cross-Sectional Study

    Science.gov (United States)

    Janiszewski, Peter M.; Ross, Robert; Despres, Jean-Pierre; Lemieux, Isabelle; Orlando, Gabriella; Carli, Federica; Bagni, Pietro; Menozzi, Marianna; Zona, Stefano; Guaraldi, Giovanni

    2011-01-01

    Background Although half of HIV-infected patients develop lipodystrophy and metabolic complications, there exists no simple clinical screening tool to discern the high from the low-risk HIV-infected patient. Thus, we evaluated the associations between waist circumference (WC) combined with triglyceride (TG) levels and the severity of lipodystrophy and cardiovascular risk among HIV-infected men and women. Methods 1481 HIV-infected men and 841 HIV-infected women were recruited between 2005 and 2009 at the metabolic clinic of the University of Modena and Reggio Emilia in Italy. Within each gender, patients were categorized into 4 groups according to WC and TG levels. Total and regional fat and fat-free mass were assessed by duel-energy x-ray absorptiometry, and visceral adipose tissue (VAT) and abdominal subcutaneous AT (SAT) were quantified by computed tomography. Various cardiovascular risk factors were assessed in clinic after an overnight fast. Results The high TG/high WC men had the most VAT (208.0±94.4 cm2), as well as the highest prevalence of metabolic syndrome (42.2%) and type-2 diabetes (16.2%), and the highest Framingham risk score (10.3±6.5) in comparison to other groups (p<0.05 for all). High TG/high WC women also had elevated VAT (150.0±97.9 cm2) and a higher prevalence of metabolic syndrome (53.3%), hypertension (30.5%) and type-2 diabetes (12.0%), and Framingham risk score(2.9±2.8) by comparison to low TG/low WC women (p<0.05 for all). Conclusions A simple tool combining WC and TG levels can discriminate high- from low-risk HIV-infected patients. PMID:21966404

  1. Can Dental Pulp Calcification Predict the Risk of Ischemic Cardiovascular Disease?

    Directory of Open Access Journals (Sweden)

    Leila Khojastepour

    2013-01-01

    Full Text Available Objective: To report the association of pulp calcification with that of cardiovascular disease (CVD using digital panoramic dental radiographs.Materials and Methods: Digital panoramic radiographs of patients referred from the angiography department were included if the patient was under 55 years old and had non-restored or minimally restored molars and canines. An oral and maxillofacial radiologist evaluated the images for pulpal calcifications in the selected teeth. The sensitivity, specificity, positive predictive value and negative predictive value of panoramic radiography in predicting CVD were calculated.Results: Out of 122 patients who met the criteria, 68.2% of the patients with CVD had pulp chamber calcifications. Pulp calcification in panoramic radiography had a sensitivity of 68.9% to predict CVD.Conclusion: This study demonstrates that patients with CVD show an increased incidence of pulp calcification compared with healthy patients. The findings suggest that pulp calcification on panoramic radiography may have possibilities for use in CVD screening.

  2. 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?

  3. Moving beyond regression techniques in cardiovascular risk prediction: applying machine learning to address analytic challenges.

    Science.gov (United States)

    Goldstein, Benjamin A; Navar, Ann Marie; Carter, Rickey E

    2017-06-14

    Risk prediction plays an important role in clinical cardiology research. Traditionally, most risk models have been based on regression models. While useful and robust, these statistical methods are limited to using a small number of predictors which operate in the same way on everyone, and uniformly throughout their range. The purpose of this review is to illustrate the use of machine-learning methods for development of risk prediction models. Typically presented as black box approaches, most machine-learning methods are aimed at solving particular challenges that arise in data analysis that are not well addressed by typical regression approaches. To illustrate these challenges, as well as how different methods can address them, we consider trying to predicting mortality after diagnosis of acute myocardial infarction. We use data derived from our institution's electronic health record and abstract data on 13 regularly measured laboratory markers. We walk through different challenges that arise in modelling these data and then introduce different machine-learning approaches. Finally, we discuss general issues in the application of machine-learning methods including tuning parameters, loss functions, variable importance, and missing data. Overall, this review serves as an introduction for those working on risk modelling to approach the diffuse field of machine learning. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Cardiology.

  4. A point-based prediction model for cardiovascular risk in orthotopic liver transplantation: The CAR-OLT score.

    Science.gov (United States)

    VanWagner, Lisa B; Ning, Hongyan; Whitsett, Maureen; Levitsky, Josh; Uttal, Sarah; Wilkins, John T; Abecassis, Michael M; Ladner, Daniela P; Skaro, Anton I; Lloyd-Jones, Donald M

    2017-12-01

    Cardiovascular disease (CVD) complications are important causes of morbidity and mortality after orthotopic liver transplantation (OLT). There is currently no preoperative risk-assessment tool that allows physicians to estimate the risk for CVD events following OLT. We sought to develop a point-based prediction model (risk score) for CVD complications after OLT, the Cardiovascular Risk in Orthotopic Liver Transplantation risk score, among a cohort of 1,024 consecutive patients aged 18-75 years who underwent first OLT in a tertiary-care teaching hospital (2002-2011). The main outcome measures were major 1-year CVD complications, defined as death from a CVD cause or hospitalization for a major CVD event (myocardial infarction, revascularization, heart failure, atrial fibrillation, cardiac arrest, pulmonary embolism, and/or stroke). The bootstrap method yielded bias-corrected 95% confidence intervals for the regression coefficients of the final model. Among 1,024 first OLT recipients, major CVD complications occurred in 329 (32.1%). Variables selected for inclusion in the model (using model optimization strategies) included preoperative recipient age, sex, race, employment status, education status, history of hepatocellular carcinoma, diabetes, heart failure, atrial fibrillation, pulmonary or systemic hypertension, and respiratory failure. The discriminative performance of the point-based score (C statistic = 0.78, bias-corrected C statistic = 0.77) was superior to other published risk models for postoperative CVD morbidity and mortality, and it had appropriate calibration (Hosmer-Lemeshow P = 0.33). The point-based risk score can identify patients at risk for CVD complications after OLT surgery (available at www.carolt.us); this score may be useful for identification of candidates for further risk stratification or other management strategies to improve CVD outcomes after OLT. (Hepatology 2017;66:1968-1979). © 2017 by the American Association for the Study of Liver

  5. Waist Circumference, Body Mass Index, and Other Measures of Adiposity in Predicting Cardiovascular Disease Risk Factors among Peruvian Adults.

    Science.gov (United States)

    Knowles, K M; Paiva, L L; Sanchez, S E; Revilla, L; Lopez, T; Yasuda, M B; Yanez, N D; Gelaye, B; Williams, M A

    2011-01-24

    Objectives. To examine the extent to which measures of adiposity can be used to predict selected components of metabolic syndrome (MetS) and elevated C-reactive protein (CRP). Methods. A total of 1,518 Peruvian adults were included in this study. Waist circumference (WC), body mass index (BMI), waist-hip ratio (WHR), waist-height ratio (WHtR), and visceral adiposity index (VAI) were examined. The prevalence of each MetS component was determined according to tertiles of each anthropometric measure. ROC curves were used to evaluate the extent to which measures of adiposity can predict cardiovascular risk. Results. All measures of adiposity had the strongest correlation with triglyceride concentrations (TG). For both genders, as adiposity increased, the prevalence of Mets components increased. Compared to individuals with low-BMI and low-WC, men and women with high-BMI and high- WC had higher odds of elevated fasting glucose, blood pressure, TG, and reduced HDL, while only men in this category had higher odds of elevated CRP. Overall, the ROCs showed VAI, WC, and WHtR to be the best predictors for individual MetS components. Conclusions. The results of our study showed that measures of adiposity are correlated with cardiovascular risk although no single adiposity measure was identified as the best predictor for MetS.

  6. Waist Circumference, Body Mass Index, and Other Measures of Adiposity in Predicting Cardiovascular Disease Risk Factors among Peruvian Adults

    Directory of Open Access Journals (Sweden)

    K. M. Knowles

    2011-01-01

    Full Text Available Objectives. To examine the extent to which measures of adiposity can be used to predict selected components of metabolic syndrome (MetS and elevated C-reactive protein (CRP. Methods. A total of 1,518 Peruvian adults were included in this study. Waist circumference (WC, body mass index (BMI, waist-hip ratio (WHR, waist-height ratio (WHtR, and visceral adiposity index (VAI were examined. The prevalence of each MetS component was determined according to tertiles of each anthropometric measure. ROC curves were used to evaluate the extent to which measures of adiposity can predict cardiovascular risk. Results. All measures of adiposity had the strongest correlation with triglyceride concentrations (TG. For both genders, as adiposity increased, the prevalence of Mets components increased. Compared to individuals with low-BMI and low-WC, men and women with high-BMI and high- WC had higher odds of elevated fasting glucose, blood pressure, TG, and reduced HDL, while only men in this category had higher odds of elevated CRP. Overall, the ROCs showed VAI, WC, and WHtR to be the best predictors for individual MetS components. Conclusions. The results of our study showed that measures of adiposity are correlated with cardiovascular risk although no single adiposity measure was identified as the best predictor for MetS.

  7. Prediction of First Cardiovascular Disease Event in Type 1 Diabetes Mellitus: The Steno Type 1 Risk Engine.

    Science.gov (United States)

    Vistisen, Dorte; Andersen, Gregers Stig; Hansen, Christian Stevns; Hulman, Adam; Henriksen, Jan Erik; Bech-Nielsen, Henning; Jørgensen, Marit Eika

    2016-03-15

    Patients with type 1 diabetes mellitus are at increased risk of developing cardiovascular disease (CVD), but they are currently undertreated. There are no risk scores used on a regular basis in clinical practice for assessing the risk of CVD in type 1 diabetes mellitus. From 4306 clinically diagnosed adult patients with type 1 diabetes mellitus, we developed a prediction model for estimating the risk of first fatal or nonfatal CVD event (ischemic heart disease, ischemic stroke, heart failure, and peripheral artery disease). Detailed clinical data including lifestyle factors were linked to event data from validated national registers. The risk prediction model was developed by using a 2-stage approach. First, a nonparametric, data-driven approach was used to identify potentially informative risk factors and interactions (random forest and survival tree analysis). Second, based on results from the first step, Poisson regression analysis was used to derive the final model. The final CVD prediction model was externally validated in a different population of 2119 patients with type 1 diabetes mellitus. During a median follow-up of 6.8 years (interquartile range, 2.9-10.9) a total of 793 (18.4%) patients developed CVD. The final prediction model included age, sex, diabetes duration, systolic blood pressure, low-density lipoprotein cholesterol, hemoglobin A1c, albuminuria, glomerular filtration rate, smoking, and exercise. Discrimination was excellent for a 5-year CVD event with a C-statistic of 0.826 (95% confidence interval, 0.807-0.845) in the derivation data and a C-statistic of 0.803 (95% confidence interval, 0.767-0.839) in the validation data. The Hosmer-Lemeshow test showed good calibration (P>0.05) in both cohorts. This high-performing CVD risk model allows for the implementation of decision rules in a clinical setting. © 2016 American Heart Association, Inc.

  8. Modelo predictivo de "score" de calcio alto en pacientes con factores de riesgo cardiovascular Predictive model of high calcium score in patients with cardiovascular risk factors

    Directory of Open Access Journals (Sweden)

    Gloria Franco

    2007-12-01

    prueba del score de calcio coronario a un paciente con factores de riesgo cardiovascular. Se puede observar que muchos de los factores de riesgo que se correlacionan con un valor elevado de "score" de calcio coronario pueden ser modificables: cesar el hábito de fumar o realizar ejercicio.Introduction: it has been found through multiple studies that coronary calcium score is a good predictor of coronary disease in asymptomatic individuals with one or more cardiovascular risk factors; therefore it would be ideal to perform this test in order to stratify its risk, but due to economic factors this is not possible in most cases. The model presented allows predicting the probability that a patient may have a high coronary calcium score by means of his cardiovascular risk factors. The originality of the model is that it also comprises "protector" factors that diminish such probability. Methods: study of cases and controls in asymptomatic patients with cardiovascular risk factors to whom a PCC had been performed. The cases are patients with coronary calcium score greater than percentile 75 for his age and gender; the control case relationship is 2:1. Results: ages ranged between 35 and 75 years; 14.4% were female; 44.4% had family history of CHD; 34.4% were hypertensive; 38.9% had high total cholesterol; 24.4% had HDL cholesterol under 40 mg/dl; 33.3% had LDL cholesterol greater than 160 mg/dl; 25.6% were cigarette smokers; 23.3% were sedentary; 13.3% were periodical alcohol consumers; 15.6% were obese (BMI > 30; 18.9% exercised periodically and 34.4% received statins. Cardiovascular risk factors correlated with high coronary calcium score are recorded in table 1. In the logistic regression model, factors having a p table 2 are obtained. Expression for the model would be: The values of ci values are 1, if the factor is present and 0 if it is not. Conclusions: this model does not pretend to replace stratification through Framinghan model; on the contrary, it is a complement that

  9. 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

    , 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 kidney disease 1.45 (1.33-1.59). Modeling RCRI classes as a continuous variable, C statistic was highest among age group 56 to 65 years (0.772) and lowest for those aged >85 years (0.683). Sensitivity of RCRI class >I (ie, having ≥ 1 risk factor) for capturing major adverse cardiovascular events was 59...

  10. Value of Progression of Coronary Artery Calcification for Risk Prediction of Coronary and Cardiovascular Events: Result of the HNR Study (Heinz Nixdorf Recall).

    Science.gov (United States)

    Lehmann, Nils; Erbel, Raimund; Mahabadi, Amir A; Rauwolf, Michael; Möhlenkamp, Stefan; Moebus, Susanne; Kälsch, Hagen; Budde, Thomas; Schmermund, Axel; Stang, Andreas; Führer-Sakel, Dagmar; Weimar, Christian; Roggenbuck, Ulla; Dragano, Nico; Jöckel, Karl-Heinz

    2018-02-13

    Computed tomography (CT) allows estimation of coronary artery calcium (CAC) progression. We evaluated several progression algorithms in our unselected, population-based cohort for risk prediction of coronary and cardiovascular events. In 3281 participants (45-74 years of age), free from cardiovascular disease until the second visit, risk factors, and CTs at baseline (b) and after a mean of 5.1 years (5y) were measured. Hard coronary and cardiovascular events, and total cardiovascular events including revascularization, as well, were recorded during a follow-up time of 7.8±2.2 years after the second CT. The added predictive value of 10 CAC progression algorithms on top of risk factors including baseline CAC was evaluated by using survival analysis, C-statistics, net reclassification improvement, and integrated discrimination index. A subgroup analysis of risk in CAC categories was performed. We observed 85 (2.6%) hard coronary, 161 (4.9%) hard cardiovascular, and 241 (7.3%) total cardiovascular events. Absolute CAC progression was higher with versus without subsequent coronary events (median, 115 [Q1-Q3, 23-360] versus 8 [0-83], P value of baseline CT and risk assessment in terms of C-statistic or integrated discrimination index, especially for total cardiovascular events. However, CAC progression did not improve models including CAC 5y and 5-year risk factors. An excellent prognosis was found for 921 participants with double-zero CAC b =CAC 5y =0 (10-year coronary and hard/total cardiovascular risk: 1.4%, 2.0%, and 2.8%), which was for participants with incident CAC 1.8%, 3.8%, and 6.6%, respectively. When CAC b progressed from 1 to 399 to CAC 5y ≥400, coronary and total cardiovascular risk were nearly 2-fold in comparison with subjects who remained below CAC 5y =400. Participants with CAC b ≥400 had high rates of hard coronary and hard/total cardiovascular events (10-year risk: 12.0%, 13.5%, and 30.9%, respectively). CAC progression is associated with

  11. Circulating biomarkers for predicting cardiovascular disease risk : a systematic review and comprehensive overview of meta-analyses

    NARCIS (Netherlands)

    Holten, van T.C.; Waanders, L.F.; Groot, de P.G.; Vissers, J.; Hoefer, I.E.; Pasterkamp, G.; Prins, M.W.J.; Roest, M.

    2013-01-01

    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

  12. Improved predictive value of GRACE risk score combined with platelet reactivity for 1-year cardiovascular risk in patients with acute coronary syndrome who underwent coronary stent implantation.

    Science.gov (United States)

    Li, Shan; Liu, Hongbin; Liu, Jianfeng; Wang, Haijun

    2016-11-01

    Both high platelet reactivity (HPR) and Global Registry of Acute Coronary Events (GRACE) risk score have moderate predictive value for major adverse cardiovascular disease (CVD) events in patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI), whereas the prognostic significance of GRACE risk score combined with platelet function testing remains unclear. A total of 596 patients with non-ST elevation ACS who underwent PCI were enrolled. The P2Y 12 reaction unit (PRU) value was measured by VerifyNow P2Y 12 assay and GRACE score was calculated by GRACE risk 2.0 calculator. Patients were stratified by a pre-specified cutoff value of PRU 230 and GRACE score 140 to assess 1-year risk of cardiovascular death, non-fatal myocardial infarction (MI), and stent thrombosis. Seventy-two (12.1%) patients developed CVD events during 1-year follow-up. Patients with CVD events had a higher PRU value (244.6 ± 50.9 vs. 203.7 ± 52.0, p risk independently. Compared to patients with normal platelet reactivity (NPR) and GRACE score risk (HR: 5.048; 95% CI: 2.268-11.237; p risk score yielded superior risk predictive capacity beyond GRACE score alone, which is shown by improved c-statistic value (0.871, p = 0.002) as well as net reclassification improvement (NRI 0.263, p risk of adverse CVD events. The combination of platelet function testing and GRACE score predicted 1-year CVD risk better.

  13. Risk of cardiovascular disease

    DEFF Research Database (Denmark)

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

    2014-01-01

    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...

  14. Improving risk stratification for cardiovascular disease

    NARCIS (Netherlands)

    van Wijk, Diederik F.; Boekholdt, S. Matthijs

    2010-01-01

    Evaluation of: Heslop CL, Frohlich JJ, Hill JS. Myeloperoxidase and C-reactive protein have combined utility for long-term prediction of cardiovascular mortality after coronary angiography. J. Am. Coll. Cardiol. 55(11), 1102-1109 (2010). Identifying people at high risk of cardiovascular events is

  15. Can Dental Pulp Calcification Predict the Risk of Ischemic Cardiovascular Disease?

    OpenAIRE

    Khojastepour, Leila; Bronoosh, Pegah; Khosropanah, Shahdad; Rahimi, Elham

    2013-01-01

    Objective: To report the association of pulp calcification with that of cardiovascular disease (CVD) using digital panoramic dental radiographs. Materials and Methods: Digital panoramic radiographs of patients referred from the angiography department were included if the patient was under 55 years old and had non-restored or minimally restored molars and canines. An oral and maxillofacial radiologist evaluated the images for pulpal calcifications in the selected teeth. The sensitivity, specif...

  16. Cardiovascular risk scores for coronary atherosclerosis.

    Science.gov (United States)

    Yalcin, Murat; Kardesoglu, Ejder; Aparci, Mustafa; Isilak, Zafer; Uz, Omer; Yiginer, Omer; Ozmen, Namik; Cingozbay, Bekir Yilmaz; Uzun, Mehmet; Cebeci, Bekir Sitki

    2012-10-01

    The objective of this study was to compare frequently used cardiovascular risk scores in predicting the presence of coronary artery disease (CAD) and 3-vessel disease. In 350 consecutive patients (218 men and 132 women) who underwent coronary angiography, the cardiovascular risk level was determined using the Framingham Risk Score (FRS), the Modified Framingham Risk Score (MFRS), the Prospective Cardiovascular Münster (PROCAM) score, and the Systematic Coronary Risk Evaluation (SCORE). The area under the curve for receiver operating characteristic curves showed that FRS had more predictive value than the other scores for CAD (area under curve, 0.76, P MFRS, PROCAM, and SCORE) may predict the presence and severity of coronary atherosclerosis.The FRS had better predictive value than the other scores.

  17. Electrocardiographic Changes Improve Risk Prediction in Asymptomatic Persons Age 65 Years or Above Without Cardiovascular Disease

    DEFF Research Database (Denmark)

    Jørgensen, Peter Godsk; Jensen, Jan S; Marott, Jacob L

    2014-01-01

    endpoint was fatal cardiovascular disease (CVD) event and the secondary was fatal or nonfatal CVD event. In our study, 2,236 fatal CVD and 3,849 fatal or nonfatal CVD events occurred during a median of 11.9 and 9.8 years of follow-up. RESULTS: ECG changes were frequently present (30.6%) and associated......: In all, 6,991 participants from the Copenhagen Heart Study attending an examination at age ≥65 years were included. ECG changes were defined as Q waves, ST-segment depression, T-wave changes, ventricular conduction defects, and left ventricular hypertrophy based on the Minnesota code. The primary...

  18. Cardiovascular risk prediction in the general population with use of suPAR, CRP, and Framingham Risk Score

    DEFF Research Database (Denmark)

    Lyngbæk, Stig; Marott, Jacob L; Sehestedt, Thomas

    2013-01-01

    for men (p=0.034) and borderline significant for women (p=0.054), while the integrated discrimination improvement was highly significant (P≤0.001) for both genders. CONCLUSIONS: suPAR provides prognostic information of CVD risk beyond FRS and improves risk prediction substantially when combined with CRP...... events were recorded. After adjusting for FRS, women with suPAR levels in the highest tertile had a 1.74-fold (95% confidence interval [CI]: 1.08-2.81, p=0.027) and men a 2.09-fold (95% CI: 1.37-3.18, p20%) risk categories, respectively. This was reflected in a significant improvement of C statistics...

  19. Higher glucose, insulin and insulin resistance (HOMA-IR) in childhood predict adverse cardiovascular risk in early adulthood: the Pune Children's Study.

    Science.gov (United States)

    Yajnik, Chittaranjan S; Katre, Prachi A; Joshi, Suyog M; Kumaran, Kalyanaraman; Bhat, Dattatray S; Lubree, Himangi G; Memane, Nilam; Kinare, Arun S; Pandit, Anand N; Bhave, Sheila A; Bavdekar, Ashish; Fall, Caroline H D

    2015-07-01

    The Pune Children's Study aimed to test whether glucose and insulin measurements in childhood predict cardiovascular risk factors in young adulthood. We followed up 357 participants (75% follow-up) at 21 years of age who had undergone detailed measurements at 8 years of age (glucose, insulin, HOMA-IR and other indices). Oral glucose tolerance, anthropometry, plasma lipids, BP, carotid intima-media thickness (IMT) and arterial pulse wave velocity (PWV) were measured at 21 years. Higher fasting glucose, insulin and HOMA-IR at 8 years predicted higher glucose, insulin, HOMA-IR, BP, lipids and IMT at 21 years. A 1 SD change in 8 year variables was associated with a 0.10-0.27 SD change at 21 years independently of obesity/adiposity at 8 years of age. A greater rise in glucose-insulin variables between 8 and 21 years was associated with higher cardiovascular risk factors, including PWV. Participants whose HOMA-IR measurement remained in the highest quartile (n = 31) had a more adverse cardiovascular risk profile compared with those whose HOMA-IR measurement remained in the lowest quartile (n = 28). Prepubertal glucose-insulin metabolism is associated with adult cardiovascular risk and markers of atherosclerosis. Our results support interventions to improve glucose-insulin metabolism in childhood to reduce cardiovascular risk in later life.

  20. Cardiovascular disease (CVD) and chronic kidney disease (CKD) event rates in HIV-positive persons at high predicted CVD and CKD risk

    DEFF Research Database (Denmark)

    Boyd, Mark A; Mocroft, Amanda; Ryom, Lene

    2017-01-01

    BACKGROUND: The Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study has developed predictive risk scores for cardiovascular disease (CVD) and chronic kidney disease (CKD, defined as confirmed estimated glomerular filtration rate [eGFR] ≤ 60 ml/min/1.73 m2) events in HIV...

  1. 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...

  2. Natriuretic peptides: prediction of cardiovascular disease in the general population and high risk populations

    DEFF Research Database (Denmark)

    Hildebrandt, Per

    2009-01-01

    (General Practitioner) setting as in the acute setting. Supporting this use is a very strong prognostic value of the natriuretic peptides. This has been shown in as well heart failure as acute coronary syndromes, but also in the general population and in high-risk groups as patients with diabetes......, hypertension and coronary artery disease. This has of course raised interest for the use of the natriuretic peptides as a risk marker and for screening for heart failure with reduced systolic function in these populations. In symptomatic persons and in high risk populations, the natriuretic peptides have...... demonstrated a high sensitivity for ruling out the disease, if the right decision limits are choosen. Thus the number of normal echocardiographies can be reduced. More recently, the use in screening asymptomatic persons for left ventricular systolic dysfunction has gained more interest. In the unselected...

  3. Genetic risks for cardiovascular diseases

    NARCIS (Netherlands)

    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

  4. Neck Circumference as a Predictive Indicator of CKD for High Cardiovascular Risk Patients

    Directory of Open Access Journals (Sweden)

    Ya-Fang Liu

    2015-01-01

    Full Text Available Background. Neck circumference (NC is an anthropometric measure of obesity for upper subcutaneous adipose tissue distribution which is associated with cardiometabolic risk. This study investigated whether NC is associated with indicators of chronic kidney disease (CKD for high cardiometabolic risk patients. Methods. A total of 177 consecutive patients who underwent the outpatient departments of cardiology were prospectively enrolled in the study. The patients were aged >20 years with normal renal function or with stages 1–4 CKD. A linear regression was performed using the Enter method to present an unadjusted R2, standardized coefficients, and standard error, and the Durbin-Watson test was used to assess residual independence. Results. Most anthropometric measurements from patients aged ≧65 were lower than those from patients aged <65, except for women’s waist circumference (WC and waist hip ratio. Female NC obtained the highest R2 values for 24 hr CCR, uric acid, microalbuminuria, hsCRP, triglycerides, and HDL compared to BMI, WC, and hip circumference. The significances of female NC with 24 hr CCR and uric acid were improved after adjusted age and serum creatinine. Conclusions. NC is associated with indicators of CKD for high cardiometabolic risk patients and can be routinely measured as easy as WC in the future.

  5. Prediction models for the risk of cardiovascular disease in patients with type 2 diabetes: a systematic review

    NARCIS (Netherlands)

    van Dieren, S.; Beulens, J. W. J.; Kengne, A. P.; Peelen, L. M.; Rutten, G. E. H. M.; Woodward, M.; van der Schouw, Y. T.; Moons, K. G. M.

    2012-01-01

    A recent overview of all CVD models applicable to diabetes patients is not available. To review the primary prevention studies that focused on the development, validation and impact assessment of a cardiovascular risk model, scores or rules that can be applied to patients with type 2 diabetes.

  6. 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

    independent CHD risk factors were Obesity (BMI >25%, 56%), dislipidemia (TC >200mg/dL and/or TG >150mg/dL, 72.1%), Smoking (43.7%) and Lack of Exercise (43.7%). After adjusting age and comparison to BMI and Cholesterol levels, in older age group seafarers (50-55 yrs old), the risk of a cardiovascular event...

  7. Pre-operative Carotid Plaque Echolucency Assessment has no Predictive Value for Long-Term Risk of Stroke or Cardiovascular Death in Patients Undergoing Carotid Endarterectomy.

    Science.gov (United States)

    de Waard, D; de Borst, G J; Bulbulia, R; Pan, H; Halliday, A

    2017-08-01

    In patients with carotid stenosis receiving medical treatment, carotid plaque echolucency has been thought to predict risk of future stroke and of other cardiovascular events. This study evaluated the prognostic value of pre-operative plaque echolucency for future stroke and cardiovascular death in patients undergoing carotid endarterectomy in the first Asymptomatic Carotid Surgery Trial (ACST-1). In ACST-1, 1832/3120 patients underwent carotid endarterectomy (CEA), of whom 894 had visual echolucency assessment according to the Gray-Weale classification. During follow-up patients were monitored both for peri-procedural (i.e. within 30 days) death, stroke, or MI, and for long-term risk of stroke or cardiovascular death. Unconditional maximum likelihood estimation was used to calculate odds ratios of peri-procedural risk and Kaplan-Meier statistics with log-rank test were used to compare cumulative long-term risks. Of 894 operated patients in whom echolucency was assessed, 458 plaques (51%) were rated as echolucent and peri-procedural risk of death/stroke/MI in these patients was non-significantly higher when compared with patients with non-echolucent plaques (OR 1.48 [95% CI 0.76-2.88], p = .241). No differences were found in the 10 year risk of any stroke (30/447 [11.6%] vs. 29/433 [11.0%], p = .900) or cardiovascular (non-stroke) death (85/447 [27.9%] vs. 93/433 [32.1%], p = .301). In ACST-1, carotid plaque echolucency assessment in patients undergoing CEA offered no predictive value with regard to peri-operative or long-term stroke risk or of cardiovascular (non-stroke) death. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  8. Role of γ-glutamyl transferase levels in prediction of high cardiovascular risk among patients with non-alcoholic fatty liver disease

    Directory of Open Access Journals (Sweden)

    Benan Kasapoglu

    2016-01-01

    among patients with fatty liver disease should be regarded as a sign of increased cardiovascular disease risk. Larger studies are warranted to elucidate the role of GGT in prediction of cardiovascular risk.

  9. Lipid measures and cardiovascular disease prediction

    NARCIS (Netherlands)

    van Wijk, D.F.; Stroes, E.S.G.; Kastelein, J.J.P.

    2009-01-01

    Traditional lipid measures are the cornerstone of risk assessment and treatment goals in cardiovascular prevention. Whereas the association between total, LDL-, HDL-cholesterol and cardiovascular disease risk has been generally acknowledged, the rather poor capacity to distinguish between patients

  10. HIV INFECTION, ANTIRETROVIRAL THERAPY AND CARDIOVASCULAR RISK

    Directory of Open Access Journals (Sweden)

    Katleen de Gaetano Donati

    2010-11-01

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

  11. Cardiovascular Disease Population Risk Tool (CVDPoRT): predictive algorithm for assessing CVD risk in the community setting. A study protocol.

    Science.gov (United States)

    Taljaard, Monica; Tuna, Meltem; Bennett, Carol; Perez, Richard; Rosella, Laura; Tu, Jack V; Sanmartin, Claudia; Hennessy, Deirdre; Tanuseputro, Peter; Lebenbaum, Michael; Manuel, Douglas G

    2014-10-23

    Recent publications have called for substantial improvements in the design, conduct, analysis and reporting of prediction models. Publication of study protocols, with prespecification of key aspects of the analysis plan, can help to improve transparency, increase quality and protect against increased type I error. Valid population-based risk algorithms are essential for population health planning and policy decision-making. The purpose of this study is to develop, evaluate and apply cardiovascular disease (CVD) risk algorithms for the population setting. The Ontario sample of the Canadian Community Health Survey (2001, 2003, 2005; 77,251 respondents) will be used to assess risk factors focusing on health behaviours (physical activity, diet, smoking and alcohol use). Incident CVD outcomes will be assessed through linkage to administrative healthcare databases (619,886 person-years of follow-up until 31 December 2011). Sociodemographic factors (age, sex, immigrant status, education) and mediating factors such as presence of diabetes and hypertension will be included as predictors. Algorithms will be developed using competing risks survival analysis. The analysis plan adheres to published recommendations for the development of valid prediction models to limit the risk of overfitting and improve the quality of predictions. Key considerations are fully prespecifying the predictor variables; appropriate handling of missing data; use of flexible functions for continuous predictors; and avoiding data-driven variable selection procedures. The 2007 and 2009 surveys (approximately 50,000 respondents) will be used for validation. Calibration will be assessed overall and in predefined subgroups of importance to clinicians and policymakers. This study has been approved by the Ottawa Health Science Network Research Ethics Board. The findings will be disseminated through professional and scientific conferences, and in peer-reviewed journals. The algorithm will be accessible

  12. Glycated Hemoglobin Measurement and Prediction of Cardiovascular Disease

    DEFF Research Database (Denmark)

    Di Angelantonio, Emanuele; Gao, Pei; Khan, Hassan

    2014-01-01

    IMPORTANCE: The value of measuring levels of glycated hemoglobin (HbA1c) for the prediction of first cardiovascular events is uncertain. OBJECTIVE: To determine whether adding information on HbA1c values to conventional cardiovascular risk factors is associated with improvement in prediction of c...

  13. 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-sectional de......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...

  14. Fasting and nonfasting lipid levels: influence of normal food intake on lipids, lipoproteins, apolipoproteins, and cardiovascular risk prediction

    DEFF Research Database (Denmark)

    Langsted, A.; Freiberg, J.J.; Nordestgaard, Børge

    2008-01-01

    BACKGROUND: Lipid profiles are usually measured after fasting. We tested the hypotheses that these levels change only minimally in response to normal food intake and that nonfasting levels predict cardiovascular events. METHODS AND RESULTS: We cross-sectionally studied 33 391 individuals 20 to 95...... to HDL cholesterol, and ratio of apolipoprotein B to apolipoprotein A1 did not change in response to normal food intake. The maximum changes after normal food and fluid intake from fasting levels were -0.2 mmol/L for total cholesterol, -0.2 mmol/L for low-density lipoprotein cholesterol, -0.1 mmol...... years of age from the Copenhagen General Population Study. We also studied 9319 individuals 20 to 93 years of age from the Copenhagen City Heart Study, 1166 of whom developed cardiovascular events during 14 years of follow-up. Compared with fasting levels, total cholesterol, low-density lipoprotein...

  15. Effectiveness and cost-effectiveness of a cardiovascular risk prediction algorithm for people with severe mental illness (PRIMROSE).

    Science.gov (United States)

    Zomer, Ella; Osborn, David; Nazareth, Irwin; Blackburn, Ruth; Burton, Alexandra; Hardoon, Sarah; Holt, Richard Ian Gregory; King, Michael; Marston, Louise; Morris, Stephen; Omar, Rumana; Petersen, Irene; Walters, Kate; Hunter, Rachael Maree

    2017-09-05

    To determine the cost-effectiveness of two bespoke severe mental illness (SMI)-specific risk algorithms compared with standard risk algorithms for primary cardiovascular disease (CVD) prevention in those with SMI. Primary care setting in the UK. The analysis was from the National Health Service perspective. 1000 individuals with SMI from The Health Improvement Network Database, aged 30-74 years and without existing CVD, populated the model. Four cardiovascular risk algorithms were assessed: (1) general population lipid, (2) general population body mass index (BMI), (3) SMI-specific lipid and (4) SMI-specific BMI, compared against no algorithm. At baseline, each cardiovascular risk algorithm was applied and those considered high risk ( > 10%) were assumed to be prescribed statin therapy while others received usual care. Quality-adjusted life years (QALYs) and costs were accrued for each algorithm including no algorithm, and cost-effectiveness was calculated using the net monetary benefit (NMB) approach. Deterministic and probabilistic sensitivity analyses were performed to test assumptions made and uncertainty around parameter estimates. The SMI-specific BMI algorithm had the highest NMB resulting in 15 additional QALYs and a cost saving of approximately £53 000 per 1000 patients with SMI over 10 years, followed by the general population lipid algorithm (13 additional QALYs and a cost saving of £46 000). The general population lipid and SMI-specific BMI algorithms performed equally well. The ease and acceptability of use of an SMI-specific BMI algorithm (blood tests not required) makes it an attractive algorithm to implement in clinical settings. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. The cardiovascular event reduction tool (CERT)--a simplified cardiac risk prediction model developed from the West of Scotland Coronary Prevention Study (WOSCOPS).

    Science.gov (United States)

    L'Italien, G; Ford, I; Norrie, J; LaPuerta, P; Ehreth, J; Jackson, J; Shepherd, J

    2000-03-15

    The clinical decision to treat hypercholesterolemia is premised on an awareness of patient risk, and cardiac risk prediction models offer a practical means of determining such risk. However, these models are based on observational cohorts where estimates of the treatment benefit are largely inferred. The West of Scotland Coronary Prevention Study (WOSCOPS) provides an opportunity to develop a risk-benefit prediction model from the actual observed primary event reduction seen in the trial. Five-year Cox model risk estimates were derived from all WOSCOPS subjects (n = 6,595 men, aged 45 to 64 years old at baseline) using factors previously shown to be predictive of definite fatal coronary heart disease or nonfatal myocardial infarction. Model risk factors included age, diastolic blood pressure, total cholesterol/ high-density lipoprotein ratio (TC/HDL), current smoking, diabetes, family history of fatal coronary heart disease, nitrate use or angina, and treatment (placebo/ 40-mg pravastatin). All risk factors were expressed as categorical variables to facilitate risk assessment. Risk estimates were incorporated into a simple, hand-held slide rule or risk tool. Risk estimates were identified for 5-year age bands (45 to 65 years), 4 categories of TC/HDL ratio ( or = 7.5), 2 levels of diastolic blood pressure ( or = 90 mm Hg), from 0 to 3 additional risk factors (current smoking, diabetes, family history of premature fatal coronary heart disease, nitrate use or angina), and pravastatin treatment. Five-year risk estimates ranged from 2% in very low-risk subjects to 61% in the very high-risk subjects. Risk reduction due to pravastatin treatment averaged 31%. Thus, the Cardiovascular Event Reduction Tool (CERT) is a risk prediction model derived from the WOSCOPS trial. Its use will help physicians identify patients who will benefit from cholesterol reduction.

  17. Cardiovascular risk in Turner syndrome.

    Science.gov (United States)

    Donato, Beatriz; Ferreira, Maria João

    2018-06-01

    Turner syndrome is a relatively common genetic disorder of female development, characterized by partial or complete absence of an X chromosome, with a variable clinical presentation. Congenital or acquired cardiovascular disease is highly prevalent and a major cause of early death in this syndrome. The most feared complication is aortic dissection, which can occur at a very young age and requires careful assessment of its risk factors. A systematic literature search identified sixty relevant publications. These were reviewed with regard to the increased risk of cardiovascular disease in women with Turner syndrome, especially in pregnancy. The most common congenital cardiovascular defects are presented and illustrated with appropriate iconography. The current recommendations regarding the screening and monitoring of cardiovascular disease in these patients are discussed. Copyright © 2018 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

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

    Science.gov (United States)

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

    2010-10-01

    Sporadic data present in literature report how preterm birth and low birth weight constitute the risk factors for the development of cardiovascular diseases in later life. To assess the presence of potential alterations to endothelial function in young adults born preterm at extremely low birth weight (Cesarea, Israel). Endothelial function was significantly reduced in ex-ELBW subjects compared to C (1.94 +/- 0.37 vs. 2.68 +/- 0.41, p < 0.0001). Moreover, this function correlated significantly with gestational age (r = 0.56, p < 0.0009) and birth weight (r = 0.63, p < 0.0001). The results obtained reveal a significant decrease in endothelial function of ex-ELBW subjects compared to controls, underlining a probable correlation with preterm birth and low birth weight. Taken together, these results suggest that an ELBW may underlie the onset of early circulatory dysfunction predictive of increased cardiovascular risk.

  19. 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. © 2015 The Author(s).

  20. Managers’ Practices Related to Work–Family Balance Predict Employee Cardiovascular Risk and Sleep Duration in Extended Care Settings

    Science.gov (United States)

    Berkman, Lisa F.; Buxton, Orfeu; Ertel, Karen; Okechukwu, Cassandra

    2012-01-01

    An increasing proportion of U.S. workers have family caregiving responsibilities. The purpose of this study was to determine whether employees in extended care settings whose managers are supportive, open, and creative about work–family needs, such as flexibility with work schedules, have lower cardiovascular disease (CVD) risk and longer sleep than their less supported counterparts. From semistructured interviews with managers, we constructed a work–family balance score of manager openness and creativity in dealing with employee work–family needs. Trained interviewers collected survey and physiologic outcome data from 393 employees whose managers had a work–family score. Employee outcomes are sleep duration (actigraphy) and CVD risk assessed by blood cholesterol, high glycosylated hemoglobin/diabetes, blood pressure/hypertension, body-mass index, and tobacco consumption. Employees whose managers were less supportive slept less (29 min/day) and were over twice as likely to have 2 or more CVD risk factors (ORs = 2.1 and 2.03 for low and middle manager work–family scores, respectively) than employees whose managers were most open and creative. Employees who provide direct patient care exhibited particularly elevated CVD risk associated with low manager work–family score. Managers’ attitudes and practices may affect employee health, including sleep duration and CVD risk. PMID:20604637

  1. Managers' practices related to work-family balance predict employee cardiovascular risk and sleep duration in extended care settings.

    Science.gov (United States)

    Berkman, Lisa F; Buxton, Orfeu; Ertel, Karen; Okechukwu, Cassandra

    2010-07-01

    An increasing proportion of U.S. workers have family caregiving responsibilities. The purpose of this study was to determine whether employees in extended care settings whose managers are supportive, open, and creative about work-family needs, such as flexibility with work schedules, have lower cardiovascular disease (CVD) risk and longer sleep than their less supported counterparts. From semistructured interviews with managers, we constructed a work-family balance score of manager openness and creativity in dealing with employee work-family needs. Trained interviewers collected survey and physiologic outcome data from 393 employees whose managers had a work-family score. Employee outcomes are sleep duration (actigraphy) and CVD risk assessed by blood cholesterol, high glycosylated hemoglobin/diabetes, blood pressure/hypertension, body-mass index, and tobacco consumption. Employees whose managers were less supportive slept less (29 min/day) and were over twice as likely to have 2 or more CVD risk factors (ORs = 2.1 and 2.03 for low and middle manager work-family scores, respectively) than employees whose managers were most open and creative. Employees who provide direct patient care exhibited particularly elevated CVD risk associated with low manager work-family score. Managers' attitudes and practices may affect employee health, including sleep duration and CVD risk.

  2. Cardiovascular risk prediction in HIV-infected patients: comparing the Framingham, atherosclerotic cardiovascular disease risk score (ASCVD), Systematic Coronary Risk Evaluation for the Netherlands (SCORE-NL) and Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) risk prediction models.

    Science.gov (United States)

    Krikke, M; Hoogeveen, R C; Hoepelman, A I M; Visseren, F L J; Arends, J E

    2016-04-01

    The aim of the study was to compare the predictions of five popular cardiovascular disease (CVD) risk prediction models, namely the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) model, the Framingham Heart Study (FHS) coronary heart disease (FHS-CHD) and general CVD (FHS-CVD) models, the American Heart Association (AHA) atherosclerotic cardiovascular disease risk score (ASCVD) model and the Systematic Coronary Risk Evaluation for the Netherlands (SCORE-NL) model. A cross-sectional design was used to compare the cumulative CVD risk predictions of the models. Furthermore, the predictions of the general CVD models were compared with those of the HIV-specific D:A:D model using three categories ( 20%) to categorize the risk and to determine the degree to which patients were categorized similarly or in a higher/lower category. A total of 997 HIV-infected patients were included in the study: 81% were male and they had a median age of 46 [interquartile range (IQR) 40-52] years, a known duration of HIV infection of 6.8 (IQR 3.7-10.9) years, and a median time on ART of 6.4 (IQR 3.0-11.5) years. The D:A:D, ASCVD and SCORE-NL models gave a lower cumulative CVD risk, compared with that of the FHS-CVD and FHS-CHD models. Comparing the general CVD models with the D:A:D model, the FHS-CVD and FHS-CHD models only classified 65% and 79% of patients, respectively, in the same category as did the D:A:D model. However, for the ASCVD and SCORE-NL models, this percentage was 89% and 87%, respectively. Furthermore, FHS-CVD and FHS-CHD attributed a higher CVD risk to 33% and 16% of patients, respectively, while this percentage was D:A:D, ASCVD and SCORE-NL models. This could have consequences regarding overtreatment, drug-related adverse events and drug-drug interactions. © 2015 British HIV Association.

  3. 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.

  4. Prediction of cardiovascular outcome by estimated glomerular filtration rate and estimated creatinine clearance in the high-risk hypertension population of the VALUE trial.

    Science.gov (United States)

    Ruilope, Luis M; Zanchetti, Alberto; Julius, Stevo; McInnes, Gordon T; Segura, Julian; Stolt, Pelle; Hua, Tsushung A; Weber, Michael A; Jamerson, Ken

    2007-07-01

    Reduced renal function is predictive of poor cardiovascular outcomes but the predictive value of different measures of renal function is uncertain. We compared the value of estimated creatinine clearance, using the Cockcroft-Gault formula, with that of estimated glomerular filtration rate (GFR), using the Modification of Diet in Renal Disease (MDRD) formula, as predictors of cardiovascular outcome in 15 245 high-risk hypertensive participants in the Valsartan Antihypertensive Long-term Use Evaluation (VALUE) trial. For the primary end-point, the three secondary end-points and for all-cause death, outcomes were compared for individuals with baseline estimated creatinine clearance and estimated GFR or = 60 ml/min using hazard ratios and 95% confidence intervals. Coronary heart disease, left ventricular hypertrophy, age, sex and treatment effects were included as covariates in the model. For each end-point considered, the risk in individuals with poor renal function at baseline was greater than in those with better renal function. Estimated creatinine clearance (Cockcroft-Gault) was significantly predictive only of all-cause death [hazard ratio = 1.223, 95% confidence interval (CI) = 1.076-1.390; P = 0.0021] whereas estimated GFR was predictive of all outcomes except stroke. Hazard ratios (95% CIs) for estimated GFR were: primary cardiac end-point, 1.497 (1.332-1.682), P cause death, 1.231 (1.098-1.380), P = 0.0004. These results indicate that estimated glomerular filtration rate calculated with the MDRD formula is more informative than estimated creatinine clearance (Cockcroft-Gault) in the prediction of cardiovascular outcomes.

  5. 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...

  6. Cardiovascular Risk in Primary Hyperaldosteronism.

    Science.gov (United States)

    Prejbisz, A; Warchoł-Celińska, E; Lenders, J W M; Januszewicz, A

    2015-12-01

    After the first cases of primary aldosteronism were described and characterized by Conn, a substantial body of experimental and clinical evidence about the long-term effects of excess aldosterone on the cardiovascular system was gathered over the last 5 decades. The prevalence of primary aldosteronism varies considerably between different studies among hypertensive patients, depending on patient selection, the used diagnostic methods, and the severity of hypertension. Prevalence rates vary from 4.6 to 16.6% in those studies in which confirmatory tests to diagnose primary aldosteronism were used. There is also growing evidence indicating that prolonged exposure to elevated aldosterone concentrations is associated with target organ damage in the heart, kidney, and arterial wall, and high cardiovascular risk in patients with primary aldosteronism. Therefore, the aim of treatment should not be confined to BP normalization and hypokalemia correction, but rather should focus on restoring the deleterious effects of excess aldosterone on the cardiovascular system. Current evidence convincingly demonstrates that both surgical and medical treatment strategies beneficially affect cardiovascular outcomes and mortality in the long term. Further studies can be expected to provide better insight into the relationship between cardiovascular risk and complications and the genetic background of primary aldosteronism. © Georg Thieme Verlag KG Stuttgart · New York.

  7. Risk factors for cardiovascular disease and type 2 diabetes retained from childhood to adulthood predict adult outcomes: the Princeton LRC Follow-up Study

    Directory of Open Access Journals (Sweden)

    Morrison John A

    2012-04-01

    Full Text Available Abstract Background Pediatric risk factors predict adult cardiovascular disease (CVD and type 2 diabetes (T2DM, but whether they predict events independently of adult risk factors is not fully known. Objective Assess whether risk factors for CVD and T2DM retained from childhood to adulthood predict CVD and T2DM in young adulthood. Study design 770 schoolchildren, ages 5–20 (mean age 12, 26-yr prospective follow-up. We categorized childhood and adult risk factors and 26-year changes (triglycerides [TG], LDL cholesterol, BMI, blood pressure [BP] and glucose ≥, and HDL cholesterol Results Children who had high TG and retained high TG as adults had increased CVD events as adults (p = .0005. Children who had normal BMI and retained normal BMI as adults had reduced CVD events as adults (p = .02. Children who had high BP or high TG and retained these as adults had increased T2DM as adults (p = .0006, p = .003. Conclusions Risk factors for CVD and T2DM retained from childhood to adulthood predict CVD and T2DM in young adulthood and support universal childhood screening.

  8. Prediction of atherosclerotic cardiovascular disease mortality in a nationally representative cohort using a set of risk factors from pooled cohort risk equations.

    Directory of Open Access Journals (Sweden)

    Zefeng Zhang

    Full Text Available The American College of Cardiology/American Heart Association developed Pooled Cohort equations to estimate atherosclerotic cardiovascular disease (ASCVD risk. It is unclear how well the equations predict ASCVD mortality in a nationally representative cohort. We used the National Health and Nutrition Examination Survey (NHANES 1988-1994 and Linked Mortality through 2006 (n = 6,644. Among participants aged 40-79 years without ASCVD at baseline, we used Cox proportional hazard models to estimate the 10-year probability of ASCVD death by sex and race-ethnicity (non-Hispanic white (NHW, non-Hispanic black (NHB and Mexican American (MA. We estimated the discrimination and calibration for each sex-race-ethnicity model. We documented 288 ASCVD deaths during 62,335 person years. The Pooled Cohort equations demonstrated moderate to good discrimination for ASCVD mortality, with modified C-statistics of 0.716 (95% CI 0.663-0.770, 0.794 (0.734-0.854, and 0.733 (0.654-0.811 for NHW, NHB and MA men, respectively. The corresponding C-statistics for women were 0.781 (0.718-0.844, 0.702 (0.633-0.771, and 0.789 (CI 0.721-0.857. Modified Hosmer-Lemeshow χ2 suggested adequate calibration for NHW, NHB and MA men, and MA women (p-values: 0.128, 0.295, 0.104 and 0.163 respectively. The calibration was inadequate for NHW and NHB women (p<0.05. In this nationally representative cohort, the Pooled Cohort equations performed adequately to predict 10-year ASCVD mortality for NHW and NHB men, and MA population, but not for NHW and NHB women.

  9. Is the 90th Percentile Adequate? The Optimal Waist Circumference Cutoff Points for Predicting Cardiovascular Risks in 124,643 15-Year-Old Taiwanese Adolescents.

    Directory of Open Access Journals (Sweden)

    Jason Jiunshiou Lee

    Full Text Available Adolescent obesity has increased to alarming proportions globally. However, few studies have investigated the optimal waist circumference (WC of Asian adolescents. This study sought to establish the optimal WC cutoff points that identify a cluster of cardiovascular risk factors (CVRFs among 15-year-old ethnically Chinese adolescents. This study was a regional population-based study on the CVRFs among adolescents who enrolled in all the senior high schools in Taipei City, Taiwan, between 2011 and 2014. Four cross-sectional health examinations of first-year senior high school (grade 10 students were conducted from September to December of each year. A total of 124,643 adolescents aged 15 (boys: 63,654; girls: 60,989 were recruited. Participants who had at least three of five CVRFs were classified as the high-risk group. We used receiver-operating characteristic curves and the area under the curve (AUC to determine the optimal WC cutoff points and the accuracy of WC in predicting high cardiovascular risk. WC was a good predictor for high cardiovascular risk for both boys (AUC: 0.845, 95% confidence interval [CI]: 0.833-0.857 and girls (AUC: 0.763, 95% CI: 0.731-0.795. The optimal WC cutoff points were ≥78.9 cm for boys (77th percentile and ≥70.7 cm for girls (77th percentile. Adolescents with normal weight and an abnormal WC were more likely to be in the high cardiovascular risk group (odds ratio: 3.70, 95% CI: 2.65-5.17 compared to their peers with normal weight and normal WC. The optimal WC cutoff point of 15-year-old Taiwanese adolescents for identifying CVRFs should be the 77th percentile; the 90th percentile of the WC might be inadequate. The high WC criteria can help health professionals identify higher proportion of the adolescents with cardiovascular risks and refer them for further evaluations and interventions. Adolescents' height, weight and WC should be measured as a standard practice in routine health checkups.

  10. Magnetic Resonance Volumetry: Prediction of Subjective Memory Complaints and Mild Cognitive Impairment, and Associations with Genetic and Cardiovascular Risk Factors

    Directory of Open Access Journals (Sweden)

    Sigbjørn Rogne

    2016-11-01

    Full Text Available Background/Aims: Subjective memory complaints (SMC are strong predictors of mild cognitive impairment (MCI and subsequent Alzheimer’s disease. Our aims were to see if fully automated cerebral MR volume measurements could distinguish subjects with SMC and MCI from controls, and if probable parental late-onset Alzheimer’s disease (LOAD, apolipoprotein E ε4 genotype, total plasma homocysteine, and cardiovascular risk factors were associated with MR volumetric findings. Methods: 198 stroke-free subjects comprised the control (n = 58, the SMC (n = 25 and the MCI (n = 115 groups. Analysis of covariance and receiver operating characteristic curve was used to see if MR volumetry distinguished subjects with SMC and MCI from controls. Results: Subjects with SMC and MCI had significantly larger lateral ventricles and smaller hippocampal volumes than controls. The area under the curve in subjects with SMC and MCI compared to that of controls was less than 0.68 for all volumes of intracranial structures. There was an interaction between sex and probable parental LOAD for hippocampal volume, with a significant association between probable parental LOAD and hippocampal volume in women. Conclusions: Fully automated MR volumetry can distinguish subjects with SMC and MCI from controls in a general population, but insufficiently to assume a clear clinical role. Research on sporadic LOAD might benefit from a sex-specific search for genetic risk factors.

  11. Sleep apnea and cardiovascular risk.

    Science.gov (United States)

    Floras, John S

    2014-01-01

    Sleep apnea is evident in approximately 10% of adults in the general population, but in certain cardiovascular diseases, and in particular those characterized by sodium and water retention, its prevalence can exceed 50%. Although sleep apnea is not as yet integrated into formal cardiovascular risk assessment algorithms, there is increasing awareness of its importance in the causation or promotion of hypertension, coronary artery disease, heart failure, atrial arrhythmias, and stroke, and thus, not surprisingly, as a predictor of premature cardiovascular death. Sleep apnea manifests as two principal phenotypes, both characterized by respiratory instability: obstructive (OSA), which arises when sleep-related withdrawal of respiratory drive to the upper airway dilator muscles is superimposed upon a narrow and highly compliant airway predisposed to collapse, and central (CSA), which occurs when the partial pressure of arterial carbon dioxide falls below the apnea threshold, resulting in withdrawal of central drive to respiratory muscles. The present objectives are to: (1) review the epidemiology and patho-physiology of OSA and CSA, with particular emphasis on the role of renal sodium retention in initiating and promoting these processes, and on population studies that reveal the long-term consequences of untreated OSA and CSA; (2) illustrate mechanical, autonomic, chemical, and inflammatory mechanisms by which OSA and CSA can increase cardiovascular risk and event rates by initiating or promoting hypertension, atherosclerosis, coronary artery disease, heart failure, arrhythmias, and stroke; (3) highlight insights from randomized trials in which treating sleep apnea was the specific target of therapy; (4) emphasize the present lack of evidence that treating sleep apnea reduces cardiovascular risk and the current clinical equipoise concerning treatment of asymptomatic patients with sleep apnea; and (5) consider clinical implications and future directions of clinical

  12. Association between Serum Osteopontin Levels and Cardiovascular Risk in Hypothyrodism

    OpenAIRE

    Türkan Mete; Gülhan Duman; Eda Melek Ertörer; Emre Bozkırlı; Okan Sefa Bakıner; Neslihan Başçıl Tütüncü

    2016-01-01

    Purpose: Cardiovascular effects of hypothyroidism are well known. Osteopontin (OPN) is a new inflammatory marker which was first isolated from the bone. Flow-mediated dilatation (FMD), a noninvasive technique to measure this endothelium-dependent function, has been used in several clinical studies to show cardiovascular risks. The aim of our study was to assess FMD value in hypothyroidism patients and to investigate whether plasma OPN level is a parameter which can predict cardiovascular risk...

  13. Does IQ predict total and cardiovascular disease mortality as strongly as other risk factors? Comparison of effect estimates using the Vietnam Experience Study

    DEFF Research Database (Denmark)

    Batty, G D; Shipley, M J; Gale, C R

    2008-01-01

    To compare the strength of the relation of two measurements of IQ and 11 established risk factors with total and cardiovascular disease (CVD) mortality.......To compare the strength of the relation of two measurements of IQ and 11 established risk factors with total and cardiovascular disease (CVD) mortality....

  14. Heterogeneous associations between smoking and a wide range of initial presentations of cardiovascular disease in 1937360 people in England: lifetime risks and implications for risk prediction.

    Science.gov (United States)

    Pujades-Rodriguez, Mar; George, Julie; Shah, Anoop Dinesh; Rapsomaniki, Eleni; Denaxas, Spiros; West, Robert; Smeeth, Liam; Timmis, Adam; Hemingway, Harry

    2015-02-01

    It is not known how smoking affects the initial presentation of a wide range of chronic and acute cardiovascular diseases (CVDs), nor the extent to which associations are heterogeneous. We estimated the lifetime cumulative incidence of 12 CVD presentations, and examined associations with smoking and smoking cessation. Cohort study of 1.93 million people aged ≥30years, with no history of CVD, in 1997-2010. Individuals were drawn from linked electronic health records in England, covering primary care, hospitalizations, myocardial infarction (MI) registry and cause-specific mortality (the CALIBER programme). During 11.6 million person-years of follow-up, 114859 people had an initial non-fatal or fatal CVD presentation. By age 90 years, current vs never smokers' lifetime risks varied from 0.4% vs 0.2% for subarachnoid haemorrhage (SAH), to 8.9% vs 2.6% for peripheral arterial disease (PAD). Current smoking showed no association with cardiac arrest or sudden cardiac death [hazard ratio (HR)=1.04, 95% confidence interval (CI) 0.91-1.19).The strength of association differed markedly according to disease type: stable angina (HR=1.08, 95% CI 1.01-1.15),transient ischaemic attack (HR=1.41, 95% CI 1.28-1.55), unstable angina (HR=1.54, 95% CI 1.38-1.72), intracerebral haemorrhage (HR=1.61, 95% CI 1.37-1.89), heart failure (HR=1.62, 95% CI 1.47-1.79), ischaemic stroke (HR=1.90, 95% CI 1.72-2.10), MI (HR=2.32, 95% CI 2.20-2.45), SAH (HR= 2.70, 95% CI 2.27-3.21), PAD (HR=5.16, 95% CI 4.80-5.54) and abdominal aortic aneurysm (AAA) (HR=5.18, 95% CI 4.61-5.82). Population-attributable fractions were lower for women than men for unheralded coronary death, ischaemic stroke, PAD and AAA. Ten years after quitting smoking, the risks of PAD, AAA (in men) and unheralded coronary death remained increased (HR=1.36, 1.47 and 2.74, respectively). The heterogeneous associations of smoking with different CVD presentations suggests different underlying mechanisms and have important

  15. Cardiovascular risk factors and dementia.

    Science.gov (United States)

    Fillit, Howard; Nash, David T; Rundek, Tatjana; Zuckerman, Andrea

    2008-06-01

    Dementias, such as Alzheimer's disease (AD) and vascular dementia, are disorders of aging populations and represent a significant economic burden. Evidence is accumulating to suggest that cardiovascular disease (CVD) risk factors may be instrumental in the development of dementia. The goal of this review was to discuss the relationship between specific CVD risk factors and dementia and how current treatment strategies for dementia should focus on reducing CVD risks. We conducted a review of the literature for the simultaneous presence of 2 major topics, cardiovascular risk factors and dementia (eg, AD). Special emphasis was placed on clinical outcome studies examining the effects of treatments of pharmacologically modifiable CVD risk factors on dementia and cognitive impairment. Lifestyle risk factors for CVD, such as obesity, lack of exercise, smoking, and certain psychosocial factors, have been associated with an increased risk of cognitive decline and dementia. Some evidence suggests that effectively managing these factors may prevent cognitive decline/dementia. Randomized, placebo-controlled trials of antihypertensive medications have found that such therapy may reduce the risk of cognitive decline, and limited data suggest a benefit for patients with AD. Some small open-label and randomized clinical trials of statins have observed positive effects on cognitive function; larger studies of statins in patients with AD are ongoing. Although more research is needed, current evidence indicates an association between CVD risk factors--such as hypertension, dyslipidemia, and diabetes mellitus--and cognitive decline/dementia. From a clinical perspective, these data further support the rationale for physicians to provide effective management of CVD risk factors and for patients to be compliant with such recommendations to possibly prevent cognitive decline/dementia.

  16. [Classical cardiovascular risk factors: predictive value and treatment of the elderly. The rocky road to evidence-based medicine].

    Science.gov (United States)

    Thomas, H P

    2001-04-01

    Coronary heart disease and cerebrovascular disease are still the most common causes of death in Western countries. A number of risk factors have been identified in young and middle-aged adults, such as dyslipidemia, hypertension and diabetes. Their prevalence and importance, however, are less clear in the elderly. In terms of dyslipedemia it is questionable whether hypercholesterolemia is a definite risk factor. On the other hand, mortality can be reduced by lowering LDL cholesterol, but the benefit in the oldest old is not yet known. Systolic blood pressure rises with age and is discussed controversely as a potential risk factor in the elderly. Some large trials could show a clear relationship between high blood pressure while others did not see any association. Similar to the treatment of hypercholesterolemia, antihypertensive drugs showed beneficial effects in elderly people until the age of 80. But the treatment of the oldest old cannot be recommended in general. Diabetes and impaired glucose tolerance are some of the most common diseases in elderly people. They are considered to be an important risk factor until the age of 75. Their role in the oldest old is still under debate. Until now, we do not know anything about possible treatment effects because of the lack of controlled trials. Elderly people seem to have a risk profile different from younger people; especially in extreme ages the predictive role of classical risk factors is unclear. On the other hand, drug treatment could reduce mortality and morbidity in patients with hypercholesterolemia or hypertension. There are no studies which investigated the effects of blood glucose control in the elderly. The collection of sufficient data is a geriatric challange in order to decide whether treatment is useful or not.

  17. Riesgo cardiovascular, una herramienta útil para la prevención de las enfermedades cardiovasculares Cardiovascular risk, a useful tool for prevention of cardiovascular diseases

    Directory of Open Access Journals (Sweden)

    Jorge Vega Abascal

    2011-03-01

    Full Text Available El riesgo cardiovascular se define como la probabilidad de padecer un evento cardiovascular en un determinado período. Mejorar la exactitud en la predicción del riesgo requiere la evaluación y el tratamiento de múltiples factores de riesgo cardiovascular, los que tienen un efecto sinérgico, más que aditivo, sobre el riesgo cardiovascular total. El cálculo utilizando métodos cuantitativos es más preciso que el obtenido con métodos cualitativos. La predicción del riesgo cardiovascular ha constituido, en los últimos años, la piedra angular en las guías clínicas de prevención cardiovascular, y deviene una herramienta útil del Médico de Familia para establecer prioridades en la atención primaria, mejorando la atención a los pacientes y eligiendo más eficazmente la terapéutica a seguir, con el objetivo de acercarnos más a la realidad multifactorial de las enfermedades cardiovasculares y a su prevención.The cardiovascular risk is defined like a probability of suffering a cardiovascular event in a determined period. To improve the accuracy in risk prediction requires the assessment and treatment of different cardiovascular risk factors, which have a synergistic effect more than additive on the total cardiovascular risk. The calculus using quantitative methods is more accurate than that obtained with qualitative methods. The prediction of cardiovascular risk has been in past years the cornerstone in clinical guidances of cardiovascular prevention and becomes an useful tool for Family Physician to establish priorities in the primary care, improving the patients care and selecting in a more effective way the therapy to be followed to bring closer more to multifactor reality of cardiovascular diseases and its prevention.

  18. New approaches for improving cardiovascular risk assessment.

    Science.gov (United States)

    Paredes, Simão; Rocha, Teresa; Mendes, Diana; Carvalho, Paulo; Henriques, Jorge; Morais, João; Ferreira, Jorge; Mendes, Miguel

    2016-01-01

    Clinical guidelines recommend the use of cardiovascular risk assessment tools (risk scores) to predict the risk of events such as cardiovascular death, since these scores can aid clinical decision-making and thereby reduce the social and economic costs of cardiovascular disease (CVD). However, despite their importance, risk scores present important weaknesses that can diminish their reliability in clinical contexts. This study presents a new framework, based on current risk assessment tools, that aims to minimize these limitations. Appropriate application and combination of existing knowledge is the main focus of this work. Two different methodologies are applied: (i) a combination scheme that enables data to be extracted and processed from various sources of information, including current risk assessment tools and the contributions of the physician; and (ii) a personalization scheme based on the creation of patient groups with the purpose of identifying the most suitable risk assessment tool to assess the risk of a specific patient. Validation was performed based on a real patient dataset of 460 patients at Santa Cruz Hospital, Lisbon, Portugal, diagnosed with non-ST-segment elevation acute coronary syndrome. Promising results were obtained with both approaches, which achieved sensitivity, specificity and geometric mean of 78.79%, 73.07% and 75.87%, and 75.69%, 69.79% and 72.71%, respectively. The proposed approaches present better performances than current CVD risk scores; however, additional datasets are required to back up these findings. Copyright © 2015 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  19. Renal and cardiovascular risk predictive value of two different microalbuminuria screening methods in patients with hypertension with/without diabetes in Portugal.

    Science.gov (United States)

    Polónia, J; Carvalho, D; Nazaré, J; Martins, L; da Silva, P M; Aguiar, C; Manso, M C; Carqueja, T

    2016-11-01

    MicRoAlbuminuria sCreening survEy (RACE) was a multicentre, observational, cross-sectional study conducted in primary health-care settings of Portugal. Here, we present a post-hoc analysis from the RACE study, assessing the renal and cardiovascular (CV) risk predictive value of two different microalbuminuria (MA) screening methods, nephelometry with 24-h urine (MA-24 h) and Micral test with occasional urine (MicralA) in patients with hypertension (HTN) with/without type 2 diabetes mellitus (T2DM). Out of 3065 patients, 1173 (38.3%) were in the HTN group without T2DM (HTN) and 1892 (61.7%) in the HTN group with T2DM (HTN+T2DM). The overall prevalence of MA was 50.6% determined by MicralA and 22.1% with MA-24 h. Urinary albumin excretion data obtained by both techniques correlated significantly (r s =0.586; Pvalue of 41% and negative predictive value of 97%. With both methods, the presence of MA was independently associated with a higher risk (1.5- to 2.9-fold) of CV and renal organ damage in both HTN and HTN+T2DM groups. MicralA, due to its high sensitivity and negative predictive value, can be considered as a valid and reliable method for MA screening in patients with HTN with/without T2DM.

  20. Metabolic syndrome and cardiovascular risk

    Directory of Open Access Journals (Sweden)

    Abdullah M Alshehri

    2010-01-01

    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.

  1. 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.

  2. Urine albumin/creatinine ratio, high sensitivity C-reactive protein and N-terminal pro brain natriuretic peptide--three new cardiovascular risk markers--do they improve risk prediction and influence treatment?

    DEFF Research Database (Denmark)

    Olsen, Michael H; Sehestedt, Thomas; Lyngbaek, Stig

    2010-01-01

    -proBNP), related to hemodynamic cardiovascular risk factors, high sensitivity C-reactive protein (hsCRP), related to metabolic cardiovascular risk factors and urine albumin/creatinine ratio (UACR), related to hemodynamic as well as metabolic risk factors. In healthy subjects with a 10-year risk of cardiovascular...... death lower than 5% based on HeartScore and therefore not eligible for primary prevention, the actual 10-year risk of cardiovascular death exceeded 5% in a small subgroup of subjects with UACR higher than the 95-percentile of approximately 1.6 mg/mmol. Combined use of high UACR or high hsCRP identified...... a larger subgroup of 16% with high cardiovascular risk in which primary prevention may be advised despite low-moderate cardiovascular risk based on HeartScore. Furthermore, combined use of high UACR or high Nt-proBNP in subjects with known cardiovascular disease or diabetes identified a large subgroup...

  3. Correlation between Cholesterol, Triglycerides, Calculated, and Measured Lipoproteins: Whether Calculated Small Density Lipoprotein Fraction Predicts Cardiovascular Risks

    Directory of Open Access Journals (Sweden)

    Sikandar Hayat Khan

    2017-01-01

    Full Text Available Background. Recent literature in lipidology has identified LDL-fractions to be more atherogenic. In this regard, small density LDL-cholesterol (sdLDLc has been considered to possess more atherogenicity than other LDL-fractions like large buoyant LDL-cholesterol (lbLDLc. Recently, Srisawasdi et al. have developed a method for calculating sdLDLc and lbLDLc based upon a regression equation. Using that in developing world may provide us with a valuable tool for ASCVD risk prediction. Objective. (1 To correlate directly measured and calculated lipid indices with insulin resistance, UACR, glycated hemoglobin, anthropometric indices, and blood pressure. (2 To evaluate these lipid parameters in subjects with or without metabolic syndrome, nephropathy, and hypertension and among various groups based upon glycated hemoglobin results. Design. Cross-sectional study. Place and Duration of Study. From Jan 2016 to 15 April 2017. Subjects and Methods. Finally enrolled subjects (male: 110, female: 122 were evaluated for differences in various lipid parameters, including measured LDL-cholesterol (mLDLc, HDLc and calculated LDL-cholesterol (cLDLc, non-HDLc, sdLDLC, lbLDLC, and their ratio among subjects with or without metabolic syndrome, nephropathy, glycation index, anthropometric indices, and hypertension. Results. Significant but weak correlation was mainly observed between anthropometric indices, insulin resistance, blood pressure, and nephropathy for non-HDLc, sdLDLc, and sdLDLc/lbLDLc. Generally lipid indices were higher among subjects with metabolic syndrome [{sdLDLc: 0.92 + 0.33 versus 0.70 + 0.29 (p 7.0%. Subjects having nephropathy (UACR > 2.4 mg/g had higher concentration of non-HDLc levels in comparison to sdLDLc [{non-HDLc: 3.68 + 0.59 versus 3.36 + 0.43} (p=0.007, {sdLDLc: 0.83 + 0.27 versus 0.75 + 0.35 (p=NS}]. Conclusion. Lipid markers including cLDLc and mLDLc are less associated with traditional ASCVD markers than non-HDLc, sdLDLc, and sd

  4. Cardiovascular risk and subclinical cardiovascular disease in polycystic ovary syndrome.

    Science.gov (United States)

    Bajuk Studen, Katica; Jensterle Sever, Mojca; Pfeifer, Marija

    2013-01-01

    In addition to its effects on reproductive health, it is now well recognized that polycystic ovary syndrome (PCOS) is a metabolic disorder, characterized by decreased insulin sensitivity which leads to an excess lifetime risk of type 2 diabetes and cardiovascular disease. PCOS patients are often obese, hypertensive, dyslipidemic and insulin resistant; they have obstructive sleep apnea and have been reported to have higher aldosterone levels in comparison to normal healthy controls. These are all components of an adverse cardiovascular risk profile. Many studies exploring subclinical atherosclerosis using different methods (flow-mediated dilatation, intima media thickness, arterial stiffness, coronary artery calcification) as well as assessing circulating cardiovascular risk markers, point toward an increased cardiovascular risk and early atherogenesis in PCOS. The risk and early features of subclinical atherosclerosis can be reversed by non-medical (normalization of weight, healthy lifestyle) and medical (metformin, thiazolidinediones, spironolactone, and statins) interventions. However, the long-term risk for cardiovascular morbidity and mortality as well as the clinical significance of different interventions still need to be properly addressed in a large prospective study. Copyright © 2013 S. Karger AG, Basel.

  5. Cardiovascular risk profile in women and dementia.

    Science.gov (United States)

    Dufouil, Carole; Seshadri, Sudha; Chêne, Geneviève

    2014-01-01

    There is growing evidence for the importance of cardiovascular risk factors in dementia development, including Alzheimer's disease. As cardiovascular risk profiles vary greatly by gender, with men suffering a greater burden of cardiovascular risk in midlife, this could lead to differences in dementia risk. To explore current evidence on the association between components of the cardiovascular risk profile and dementia risk in women and men, we reviewed all studies reporting the risk of dementia associated with cardiovascular risk factors stratified by gender and found 53 eligible articles out of over 4,000 published since the year 2000. Consistent results were found: 1) for exposures acting specifically in women: Overweight/obesity (harmful) and physical activity (protective), and 2) for exposures acting similarly in women and men: Moderate alcohol (protective) and hypertension, diabetes, and depression (harmful). A modified effect of tobacco or high cholesterol/statin use remained controversial. Available data do not allow us to assess whether selection of men with healthier cardiovascular profile (due to cardiovascular death in midlife) could lead in late life either to a difference in the distribution of risk factors or to a differential effect of these risk factors by gender. We recommend that results on dementia risk factors, especially cardiovascular ones, be reported systematically by gender in all future studies. More generally, as cardiovascular risk profiles evolve over time, more attention needs to be paid to the detection and correction of cardiovascular risk factors, as early as possible in the life course, and as actively in women as in men.

  6. A comparative analysis of cardiovascular disease risk profiles of five Pacific ethnic groups assessed in New Zealand primary care practice: PREDICT CVD-13.

    Science.gov (United States)

    Grey, Corina; Wells, Sue; Riddell, Tania; Pylypchuk, Romana; Marshall, Roger; Drury, Paul; Elley, Raina; Ameratunga, Shanthi; Gentles, Dudley; Erick-Peletiy, Stephanie; Bell, Fionna; Kerr, Andrew; Jackson, Rod

    2010-11-05

    Data on the cardiovascular disease risk profiles of Pacific peoples in New Zealand is usually aggregated and treated as a single entity. Little is known about the comparability or otherwise of cardiovascular disease (CVD) risk between different Pacific groups. To compare CVD risk profiles for the main Pacific ethnic groups assessed in New Zealand primary care practice to determine if it is reasonable to aggregate these data, or if significant differences exist. A web-based clinical decision support system for CVD risk assessment and management (PREDICT) has been implemented in primary care practices in nine PHOs throughout Auckland and Northland since 2002, covering approximately 65% of the population of these regions. Between 2002 and January 2009, baseline CVD risk assessments were carried out on 11,642 patients aged 35-74 years identifying with one or more Pacific ethnic groups (4933 Samoans, 1724 Tongans, 1366 Cook Island Maori, 880 Niueans, 1341 Fijians and 1398 people identified as Other Pacific or Pacific Not Further Defined). Fijians were subsequently excluded from the analyses because of a probable misclassification error that appears to combine Fijian Indians with ethnic Fijians. Prevalences of smoking, diabetes and prior history of CVD, as well as mean total cholesterol/HDL ratio, systolic and diastolic blood pressures, and Framingham 5-year CVD risk were calculated for each Pacific group. Age-adjusted risk ratios and mean differences stratified by gender were calculated using Samoans as the reference group. Cook Island women were almost 60% more likely to smoke than Samoan women. While Tongan men had the highest proportion of smoking (29%) among Pacific men, Tongan women had the lowest smoking proportion (10%) among Pacific women. Tongan women and Niuean men and women had a higher burden of diabetes than other Pacific ethnic groups, which were 20-30% higher than their Samoan counterparts. Niuean men and women had lower blood pressure levels than all

  7. Novel biomarkers with potential for cardiovascular risk reclassification.

    Science.gov (United States)

    Mallikethi-Reddy, Sagar; Briasoulis, Alexandros; Akintoye, Emmanuel; Afonso, Luis

    Precise estimation of the absolute risk for CVD events is necessary when making treatment recommendations for patients. A number of multivariate risk models have been developed for estimation of cardiovascular risk in asymptomatic individuals based upon assessment of multiple variables. Due to the inherent limitation of risk models, several novel risk markers including serum biomarkers have been studied in an attempt to improve the cardiovascular risk prediction above and beyond the established risk factors. In this review, we discuss the role of underappreciated biomarkers such as red cell distribution width (RDW), cystatin C (cysC), and homocysteine (Hcy) as well as imaging biomarkers in cardiovascular risk reclassification, and highlight their utility as additional source of information in patients with intermediate risk.

  8. Cardiovascular Risk Factors in Airline Pilots.

    Science.gov (United States)

    Lord, Dana; Conlon, Helen Acree

    2018-02-01

    The health of an airline pilot is imperative to the safe travels of millions of people worldwide. Medical providers evaluate the cardiovascular risks for airline pilots and the medical requirements to obtain and maintain licensure as an airline pilot. It is the role of the occupational health nurse practitioner to evaluate and reduce the risk of cardiovascular disease in this population.

  9. 459 Preventing Cardiovascular Disease Risk Factors through ...

    African Journals Online (AJOL)

    FIRST LADY

    2011-01-18

    Jan 18, 2011 ... injury. Risk factors may be considered as characteristic indicators ... by examining the cardiovascular risk factors that are related to various forms .... Cross country race, Handball, Jogging, Rope jumping, Running Soccer,.

  10. Cardiovascular investigations of airline pilots with excessive cardiovascular risk.

    Science.gov (United States)

    Wirawan, I Made Ady; Aldington, Sarah; Griffiths, Robin F; Ellis, Chris J; Larsen, Peter D

    2013-06-01

    This study examined the prevalence of airline pilots who have an excessive cardiovascular disease (CVD) risk score according to the New Zealand Guideline Group (NZGG) Framingham-based Risk Chart and describes their cardiovascular risk assessment and investigations. A cross-sectional study was performed among 856 pilots employed in an Oceania based airline. Pilots with elevated CVD risk that had been previously evaluated at various times over the previous 19 yr were reviewed retrospectively from the airline's medical records, and the subsequent cardiovascular investigations were then described. There were 30 (3.5%) pilots who were found to have 5-yr CVD risk score of 10-15% or higher. Of the 29 pilots who had complete cardiac investigations data, 26 pilots underwent exercise electrocardiography (ECG), 2 pilots progressed directly to coronary angiograms and 1 pilot with abnormal echocardiogram was not examined further. Of the 26 pilots, 7 had positive or borderline exercise tests, all of whom subsequently had angiograms. One patient with a negative exercise test also had a coronary angiogram. Of the 9 patients who had coronary angiograms as a consequence of screening, 5 had significant disease that required treatment and 4 had either trivial disease or normal coronary arteries. The current approach to investigate excessive cardiovascular risk in pilots relies heavily on exercise electrocardiograms as a diagnostic test, and may not be optimal either to detect disease or to protect pilots from unnecessary invasive procedures. A more comprehensive and accurate cardiac investigation algorithm to assess excessive CVD risk in pilots is required.

  11. Psychological factors, including alexithymia, in the prediction of cardiovascular risk in HIV infected patients: results of a cohort study.

    Directory of Open Access Journals (Sweden)

    Giustino Parruti

    Full Text Available Psychological factors are known predictors of cardiovascular disease in many clinical settings, but data are lacking for HIV infection. We carried out a prospective cohort study to evaluate potential psychological predictors of preclinical and clinical vascular disease in HIV patients.HIV patients were consecutively enrolled. Demographics, viral and immune parameters and traditional cardiovascular predictors were considered; Intima-Media Thickness (c-IMT, continuous measure and Carotid Plaques (CPs, focal thickening ≥1.5 mm were investigated by B-mode ultrasonography; depressive symptoms by the Beck Depression Inventory (BDI-II, Type D personality (Distressed Personality or Type D by the DS14, alexithymia by the Toronto Alexithymia Scale (TAS-20. Vascular outcomes included transient ischemic attacks or stroke, acute coronary syndrome, myocardial or other organ infarction. We enrolled 232 HIV subjects, 73.9% males, aged 44.5±9.9 y, 38.2% with AIDS diagnosis, 18.3% untreated. Mean Nadir CD4 T-cell counts were 237.5±186.2/mmc. Of them, 224 (96.5% attended IMT measurements; 201 (86.6% attended both IMT assessment and psychological profiling. Mean follow-up was 782±308 days. Fifty-nine patients (29.4% had CPs at baseline. Nineteen patients (9.5% had ≥1 vascular event; 12 (6.0% died due to such events (n = 4 or any cause. At baseline cross-sectional multivariate analysis, increasing age, total cholesterol, current smoking and Alexithymia score≥50 were significantly associated with both increased cIMT (linear regression and CPs (logistic regression. At follow-up analysis, log-rank tests and Cox's regression revealed that only older age (p = 0.001, current smoking (p = 0.019 and alexithymia score≥50 (p = 0.013 were independently associated with vascular events.In HIV-infected subjects, the Alexithymic trait emerges as a strong predictor of increased IMT, presence of CPs and vascular events. Such results are preliminary and require

  12. [Biological role of fetuin A and its potential importance for prediction of cardiovascular risk in patients with type 2 diabetes mellitus].

    Science.gov (United States)

    Horshuns'ka, M Iu; Karachentsev, Iu I; Kravchun, N O; Ĭensen, É; Leshchenko, Zh A; Hladkykh, O I; Krasova, N S; Tyzhnenko, T V; Opaleĭko, Iu A; Poltorak, V V

    2013-01-01

    The authors' data and those from literature concerning biological role of fetuin A glycoprotein have been generalized in the article. A direct correlation has been established between fetuin A and some adipokines involved in the formation of insulin resistance and atherogenesis (progranulin, omentin-1), and osteoprotegerin (the novel cardiovascular risk factor) as well as an increase of circulating levels of fetuin A in patients with type 2 diabetes mellitus with high cardiovascular risk metabolic pattern but without manifestations of macrovascular complications. This substantiates the involvement of fetuin A in the complex of biomarkers of subclinical atherosclerosis.

  13. 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.

  14. Mortality and cardiovascular morbidity within 30 days of discharge following acute coronary syndrome in a contemporary European cohort of patients: How can early risk prediction be improved? The six-month GRACE risk score.

    Science.gov (United States)

    Raposeiras-Roubín, Sergio; Abu-Assi, Emad; Cambeiro-González, Cristina; Álvarez-Álvarez, Belén; Pereira-López, Eva; Gestal-Romaní, Santiago; Pedreira-López, Milagros; Rigueiro-Veloso, Pedro; Virgós-Lamela, Alejandro; García-Acuña, José María; González-Juanatey, José Ramón

    2015-06-01

    Given the increasing focus on early mortality and readmission rates among patients with acute coronary syndrome (ACS), this study was designed to evaluate the accuracy of the GRACE risk score for identifying patients at high risk of 30-day post-discharge mortality and cardiovascular readmission. This was a retrospective study carried out in a single center with 4229 ACS patients discharged between 2004 and 2010. The study endpoint was the combination of 30-day post-discharge mortality and readmission due to reinfarction, heart failure or stroke. One hundred and fourteen patients had 30-day events: 0.7% mortality, 1% reinfarction, 1.3% heart failure, and 0.2% stroke. After multivariate analysis, the six-month GRACE risk score was associated with an increased risk of 30-day events (HR 1.03, 95% CI 1.02-1.04; p<0.001), demonstrating good discrimination (C-statistic: 0.79 ± 0.02) and optimal fit (Hosmer-Lemeshow p=0.83). The sensitivity and specificity were adequate (78.1% and 63.3%, respectively), and negative predictive value was excellent (99.1%). In separate analyses for each event of interest (all-cause mortality, reinfarction, heart failure and stroke), assessment of the six-month GRACE risk score also demonstrated good discrimination and fit, as well as adequate predictive values. The six-month GRACE risk score is a useful tool to predict 30-day post-discharge death and early cardiovascular readmission. Clinicians may find it simple to use with the online and mobile app score calculator and applicable to clinical daily practice. Copyright © 2014 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  15. Education and hypertension: impact on global cardiovascular risk.

    Science.gov (United States)

    Di Chiara, Tiziana; Scaglione, Alessandra; Corrao, Salvatore; Argano, Christiano; Pinto, Antonio; Scaglione, Rosario

    2017-10-01

    Improving cardiovascular risk prediction continues to be a major challenge and effective prevention of cardiovascular disease. Accordingly, several studies have recently reported on the role of cardiovascular risk education. This study was designed to evaluate the impact of education on global cardiovascular risk in hypertensive patients. The study population consisted of 223 consecutive hypertensive outpatients. Their educational status was categorized according to the number of years of formal education as follows: (1) low education (less than 10 years) and (2) medium-high education (10-15 years). In both groups, cardiometabolic comorbidities, global cardiovascular risk and echocardiographic measurements were analysed. Less educated hypertensive subjects were characterized by a significantly higher prevalence of patients with metabolic syndrome (MetS) (p educated hypertensive subjects. In the same subjects, a significant increase in microalbuminuria (MA) (p education (r = -0.45; p Education was independently (p education may be considered the best predictor of global cardiovascular risk in hypertensives and thus has to be evaluated in the strategies of hypertension and cardiovascular risk management.

  16. 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.

  17. Cardiovascular risk profile in burn survivors.

    Science.gov (United States)

    Leung, Becky; Younger, John F; Stockton, Kellie; Muller, Michael; Paratz, Jennifer

    2017-11-01

    Burn patients have prolonged derangements in metabolic, endocrine, cardiac and psychosocial systems, potentially impacting on their cardiovascular health. There are no studies on the risk of cardiovascular disease (CVD) after-burn. The aim of our study was to record lipid values and evaluate CVD risk in adult burn survivors. In a cross-sectional study patients ≥18 years with burn injury between 18-80% total burn surface area (TBSA) from 1998 to 2012 had total cholesterol, low density lipoprotein (LDL), high density lipoprotein (HDL) and triglycerides measured via finger prick. Means were compared to optimal ranges. Multivariate regression models were performed to assess the association of lipids with age, years after-burn and total body surface area % (TBSA). A p value Risk Score (FGCRS) was calculated. Fifty patients were included in the study. Compared to optimal values, patients had low HDL and high triglycerides. Greater %TBSA was associated with statistically significant elevation of triglycerides (p=0.007) and total cholesterol/HDL ratio (p=0.027). The median FGCRS was 3.9% (low) 10-year risk of CVD with 82% of patients in the low-risk category. Patients involved in medium/high level of physical activity had optimal values of HDL, TC/HDL and triglycerides despite the magnitude of TBSA%. Adult burn survivors had alterations in lipid profile proportional to TBSA, which could be modified by exercise, and no increase in overall formally predicted CVD risk in this cross sectional study. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  18. Renal transplantation in high cardiovascular risk patients.

    Science.gov (United States)

    Bittar, Julio; Arenas, Paula; Chiurchiu, Carlos; de la Fuente, Jorge; de Arteaga, Javier; Douthat, Walter; Massari, Pablo U

    2009-10-01

    Current transplant success allows recipients with previous contraindications to transplant to have access to this procedure with more frequency and safety. The concept of high-risk patient has changed since the first stages of transplantation. In the first studies, the high-risk concept was based on probability of early graft failure or on a patient's clinical condition to cope with high perioperatory morbimortality. Later on, this concept implied immunological factors that were crucial to ensure transplant success because hypersensitized or polytransfused patients experienced a higher risk of acute rejection and subsequent graft loss. Afterward, the presence of various comorbidities would redefine the high-risk concept for renal transplant mainly considering recipient's clinical aspects. Currently, the change in epidemiological characteristics of patients starting dialysis causes that we now deal with a greater increase of elderly patients, diabetic patients, and patients with history of cardiovascular disease. Today, high-risk patients are those with clinical features that predict an increase in the risk of perioperative morbimortality or death with functioning graft. In this review, we will attempted to analyze currents results of renal transplant outcomes in terms of patients and graft survival in elderly patients, diabetic patients, and patients with previous cardiovascular disease from the most recent experiences in the literature and from experiences in our center. In any of the groups previously analyzed, survival offered by renal transplant is significantly higher compared to dialysis. Besides, these patients are the recipient group that benefit the most with the transplant because their mortality while remaining on dialysis is extremely high. Hence, renal transplantation should be offered more frequently to older patients, diabetic patients, and patients with pretransplant cardiac and peripheral vascular disease. A positive attitude toward renal

  19. Cardiovascular risk prediction by N-terminal pro brain natriuretic peptide and high sensitivity C-reactive protein is affected by age and sex

    DEFF Research Database (Denmark)

    Olsen, M.H.; Hansen, T.W.; Christensen, M.K.

    2008-01-01

    BACKGROUND: Previous studies have shown that the urine albumin/creatinine ratio (UACR), high sensitivity C-reactive protein (hsCRP) and N-terminal pro brain natriuretic peptide (Nt-proBNP) predict cardiovascular events in a general population aged 41, 51, 61 or 71 years. This study investigated...

  20. Waist Circumference, Body Mass Index, and Other Measures of Adiposity in Predicting Cardiovascular Disease Risk Factors among Peruvian Adults

    OpenAIRE

    Knowles, K. M.; Paiva, L. L.; Sanchez, S. E.; Revilla, L.; Lopez, T.; Yasuda, M. B.; Yanez, N. D.; Gelaye, B.; Williams, M. A.

    2011-01-01

    Objectives. To examine the extent to which measures of adiposity can be used to predict selected components of metabolic syndrome (MetS) and elevated C-reactive protein (CRP). Methods. A total of 1,518 Peruvian adults were included in this study. Waist circumference (WC), body mass index (BMI), waist-hip ratio (WHR), waist-height ratio (WHtR), and visceral adiposity index (VAI) were examined. The prevalence of each MetS component was determined according to tertiles of each anthropometric mea...

  1. 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...

  2. Vitamin D, cardiovascular disease and risk factors

    DEFF Research Database (Denmark)

    Skaaby, Tea; Thuesen, Betina H.; Linneberg, Allan

    2017-01-01

    of vitamin D effects from a cardiovascular health perspective. It focuses on vitamin D in relation to cardiovascular disease, i.e. ischemic heart disease, and stroke; the traditional cardiovascular risk factors hypertension, abnormal blood lipids, obesity; and the emerging risk factors hyperparathyroidism......, microalbuminuria, chronic obstructive pulmonary diseases, and non-alcoholic fatty liver disease. Meta-analyses of observational studies have largely found vitamin D levels to be inversely associated with cardiovascular risk and disease. However, Mendelian randomization studies and randomized, controlled trials...... (RCTs) have not been able to consistently replicate the observational findings. Several RCTs are ongoing, and the results from these are needed to clarify whether vitamin D deficiency is a causal and reversible factor to prevent cardiovascular disease....

  3. Risk prediction in stable cardiovascular disease using a high-sensitivity cardiac troponin T single biomarker strategy compared to the ESC-SCORE.

    Science.gov (United States)

    Biener, Moritz; Giannitsis, Evangelos; Kuhner, Manuel; Zelniker, Thomas; Mueller-Hennessen, Matthias; Vafaie, Mehrshad; Stoyanov, Kiril M; Neumann, Franz-Josef; Katus, Hugo A; Hochholzer, Willibald; Valina, Christian Marc

    2018-01-01

    To evaluate the prognostic performance of high-sensitivity cardiac troponin T (hs-cTnT) compared with the ESC-SCORE. We included low-risk outpatients with stable cardiovascular (CV) disease categorised into need for non-secondary and secondary prevention. The prognostication of hs-cTnT at index visit was compared with the European Society of Cardiology-Systematic COronary Risk Evaluation (ESC-SCORE) with respect to all-cause mortality (ACM) and two composite endpoints (ACM, acute myocardial infarction (AMI) and stroke and ACM, AMI, stroke and rehospitalisation for acute coronary syndrome (ACS) and decompensated heart failure (DHF)). Within a median follow-up of 796 days, a total of 16 deaths, 32 composite endpoints of ACM, AMI and stroke and 83 composite endpoints of ACM, AMI, stroke, rehospitalisation for ACS and DHF were observed among 693 stable low-risk outpatients. Using C-statistics, measurement of hs-cTnT alone outperformed the ESC-SCORE for the prediction of ACM in the entire study population (Δarea under the curve (AUC) 0.221, p=0.0039) and both prevention groups (non-secondary: ΔAUC 0.164, p=0.0208; secondary: ΔAUC 0.264, p=0.0134). For the prediction of all other secondary endpoints, hs-cTnT was at least as effective as the ESC-SCORE, both in secondary and non-secondary prevention. Using continuous and categorical net reclassification improvement and integrated discrimination improvement, hs-cTnT significantly improved reclassification regarding all endpoints in the entire population and in the secondary prevention cohort. In non-secondary prevention, hs-cTnT improved reclassification only for ACM. The results were confirmed in an independent external cohort on 2046 patients. Hs-cTnT is superior to the multivariable ESC-SCORE for the prediction of ACM and a composite endpoint in stable outpatients with and without relevant CV disease. NCT01954303; Pre-results.

  4. Diabetes propels the risk for cardiovascular disease

    NARCIS (Netherlands)

    Diepen, van Janna A.; Thiem, Kathrin; Stienstra, Rinke; Riksen, Niels P.; Tack, Cees J.; Netea, Mihai G.

    2016-01-01

    Diabetes strongly predisposes to cardiovascular disease (CVD), the leading cause of mortality in these patients, as well as in the entire population. Hyperglycemia is an important cardiovascular risk factor as shown by the observation that even transient periods of hyperglycemia, despite return

  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

  6. Preeclampsia: at risk for remote cardiovascular disease

    NARCIS (Netherlands)

    Harskamp, Ralf E.; Zeeman, Gerda G.

    2007-01-01

    Epidemiological data indicate that women with preeclampsia are more likely to develop cardiovascular disease (CVD) later in life. Population-based studies relate preeclampsia to an increased risk of later chronic hypertension (RR, 2.00 to 8.00) and cardiovascular morbidity/mortality (RR, 1.3 to

  7. Preeclampsia : At risk for remote cardiovascular disease

    NARCIS (Netherlands)

    Harskamp, Ralf E.; Zeeman, Gerda G.

    2007-01-01

    Epidemiological data indicate that women with preeclampsia are more likely to develop cardiovascular disease (CVD) later in life. Population-based studies relate preeclampsia to an increased risk of later chronic hypertension (RR, 2.00 to 8.00) and cardiovascular morbidity/mortality (RR, 1.3 to

  8. Depression: risk factor for cardiovascular disease

    NARCIS (Netherlands)

    Kuehl, L.K.; Penninx, B.W.J.H.; Otte, C.

    2012-01-01

    Major depression is an independent risk factor for the development of cardiovascular disease. In patients with existing cardiovascular disease, major depression has a large impact on the quality of life and is associated with a poor course and prognosis. Potential mechanisms responsible for this

  9. Cardiovascular risk assessment in hypertensive patients

    Directory of Open Access Journals (Sweden)

    Elaine Amaral de Paula

    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.

  10. Cardiovascular risk factors in children.

    Science.gov (United States)

    Fraporti, Marisete Inês; Scherer Adami, Fernanda; Dutra Rosolen, Michele

    2017-10-01

    Systemic hypertension is one of the main risk factors for cardiovascular disease (CVD). Early diagnosis and treatment of hypertension in childhood can potentially have a significant impact on future adverse outcomes. To investigate the relationship of diastolic (DBP) and systolic blood pressure (SBP) with anthropometric data and area of residence of children in municipalities of Rio Grande do Sul state, Brazil. This is a cross-sectional study of 709 children between six and nine years of age. Blood pressure, weight, height and waist circumference (WC) were measured. Statistical tests had a maximum significance level of 5% (p≤0.05) and the software used was SPSS version 13.0. Obesity was significantly associated with pre-hypertension, and stage 1 and 2 hypertension as assessed by DBP and SBP (≤0.05); high WC was significantly associated with a classification of pre-hypertension and stage 1 hypertension based on DBP and a classification of stage 1 and 2 hypertension based on SBP (≤0.01). Children living in urban areas had significantly higher mean SBP than those living in rural areas. Those with high WC presented higher SBP and DBP compared to children with normal WC. Obese children showed higher mean SBP and DBP compared to those who were overweight or normal weight and mean SBP and DBP also increased with older age and higher mean body mass index and WC. Copyright © 2017 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Lipid-related markers and cardiovascular disease prediction

    DEFF Research Database (Denmark)

    Di Angelantonio, Emanuele; Gao, Pei; Pennells, Lisa

    2012-01-01

    The value of assessing various emerging lipid-related markers for prediction of first cardiovascular events is debated.......The value of assessing various emerging lipid-related markers for prediction of first cardiovascular events is debated....

  12. Contemporary protease inhibitors and cardiovascular risk

    DEFF Research Database (Denmark)

    Lundgren, Jens; Mocroft, Amanda; Ryom, Lene

    2018-01-01

    PURPOSE OF REVIEW: To review the evidence linking use of HIV protease inhibitors with excess risk of cardiovascular disease (CVD) in HIV+ populations. RECENT FINDINGS: For the two contemporary most frequently used protease inhibitors, darunavir and atazanavir [both pharmacologically boosted...

  13. Cardiovascular risk factors and collateral artery formation.

    Science.gov (United States)

    de Groot, D; Pasterkamp, G; Hoefer, I E

    2009-12-01

    Arterial lumen narrowing and vascular occlusion is the actual cause of morbidity and mortality in atherosclerotic disease. Collateral artery formation (arteriogenesis) refers to an active remodelling of non-functional vascular anastomoses to functional collateral arteries, capable to bypass the site of obstruction and preserve the tissue that is jeopardized by ischaemia. Hemodynamic forces such as shear stress and wall stress play a pivotal role in collateral artery formation, accompanied by the expression of various cytokines and invasion of circulating leucocytes. Arteriogenesis hence represents an important compensatory mechanism for atherosclerotic vessel occlusion. As arteriogenesis mostly occurs when lumen narrowing by atherosclerotic plaques takes place, presence of cardiovascular risk factors (e.g. hypertension, hypercholesterolaemia and diabetes) is highly likely. Risk factors for atherosclerotic disease affect collateral artery growth directly and indirectly by altering hemodynamic forces or influencing cellular function and proliferation. Adequate collateralization varies significantly among atherosclerotic patients, some profit from the presence of extensive collateral networks, whereas others do not. Cardiovascular risk factors could increase the risk of adverse cardiovascular events in certain patients because of the reduced protection through an alternative vascular network. Likewise, drugs primarily thought to control cardiovascular risk factors might contribute or counteract collateral artery growth. This review summarizes current knowledge on the influence of cardiovascular risk factors and the effects of cardiovascular medication on the development of collateral vessels in experimental and clinical studies.

  14. Cardiovascular disease risk factors and cognitive impairment.

    Science.gov (United States)

    Nash, David T; Fillit, Howard

    2006-04-15

    The role of cardiovascular disease risk factors in the occurrence and progression of cognitive impairment has been the subject of a significant number of publications but has not achieved widespread recognition among many physicians and educated laymen. It is apparent that the active treatment of certain of these cardiovascular disease risk factors is accompanied by a reduced risk for cognitive impairment. Patients with hypertension who are treated experience fewer cardiovascular disease events as well as less cognitive impairment than similar untreated patients. Patients who exercise may present with less cognitive impairment, and obesity may increase the risk for cognitive impairment. Lipid abnormalities and genetic markers are associated with an increased risk for cardiovascular disease and cognitive impairment. Autopsy studies have demonstrated a correlation between elevated levels of cholesterol and amyloid deposition in the brain. Research has demonstrated a relation between atherosclerotic obstruction lesions in the circle of Willis and dementia. Diabetes mellitus is associated with an increased risk for cardiovascular disease and cognitive impairment. A number of nonpharmacologic factors have a role in reducing the risk for cognitive impairment. Antioxidants, fatty acids, and micronutrients may have a role, and diets rich in fruits and vegetables and other dietary approaches may improve the outlook for patients considered at risk for cognitive impairment.

  15. Cardiovascular risk factors in subjects with psoriasis

    DEFF Research Database (Denmark)

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

    2013-01-01

    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...... between subjects with and without psoriasis with regard to traditional cardiovascular risk factors. Conclusions Our results contrast with the hitherto-reported increased prevalence of metabolic syndrome in subjects with psoriasis in the general US population. However, our results agree with those of other...

  16. Global Longitudinal Strain by Echocardiography Predicts Long-Term Risk of Cardiovascular Morbidity and Mortality in a Low-Risk General Population

    DEFF Research Database (Denmark)

    Biering-Sørensen, Tor; Biering-Sørensen, Sofie Reumert; Olsen, Flemming Javier

    2017-01-01

    participants in a general population study underwent a health examination, including echocardiography measurement of GLS. The primary end point was the composite of incident heart failure, acute myocardial infarction, or cardiovascular death. During a median follow-up of 11 years, 149 (12%) participants were...

  17. Clinical Prediction Models for Cardiovascular Disease: Tufts Predictive Analytics and Comparative Effectiveness Clinical Prediction Model Database.

    Science.gov (United States)

    Wessler, Benjamin S; Lai Yh, Lana; Kramer, Whitney; Cangelosi, Michael; Raman, Gowri; Lutz, Jennifer S; Kent, David M

    2015-07-01

    Clinical prediction models (CPMs) estimate the probability of clinical outcomes and hold the potential to improve decision making and individualize care. For patients with cardiovascular disease, there are numerous CPMs available although the extent of this literature is not well described. We conducted a systematic review for articles containing CPMs for cardiovascular disease published between January 1990 and May 2012. Cardiovascular disease includes coronary heart disease, heart failure, arrhythmias, stroke, venous thromboembolism, and peripheral vascular disease. We created a novel database and characterized CPMs based on the stage of development, population under study, performance, covariates, and predicted outcomes. There are 796 models included in this database. The number of CPMs published each year is increasing steadily over time. Seven hundred seventeen (90%) are de novo CPMs, 21 (3%) are CPM recalibrations, and 58 (7%) are CPM adaptations. This database contains CPMs for 31 index conditions, including 215 CPMs for patients with coronary artery disease, 168 CPMs for population samples, and 79 models for patients with heart failure. There are 77 distinct index/outcome pairings. Of the de novo models in this database, 450 (63%) report a c-statistic and 259 (36%) report some information on calibration. There is an abundance of CPMs available for a wide assortment of cardiovascular disease conditions, with substantial redundancy in the literature. The comparative performance of these models, the consistency of effects and risk estimates across models and the actual and potential clinical impact of this body of literature is poorly understood. © 2015 American Heart Association, Inc.

  18. Cardiovascular risk factors and disease in women.

    Science.gov (United States)

    Gill, Sharon K

    2015-05-01

    Coronary artery disease and stroke predominantly affect older women as opposed to younger women, but the risk factors that contribute to atherosclerotic cardiovascular disease risk often start in young women. Young women with polycystic ovary syndrome (PCOS), with migraine, and who use oral contraceptive pills (OCPs) have short-term increases in thrombotic complications that can result in coronary events or stroke. Attention should be focused on risk reduction in women of all ages. Screening for and discussing diabetes, hypertension, obesity, smoking, migraine, PCOS, and pregnancy complication history and discussing the pros and cons of hormone and statin medications are part of reducing cardiovascular risk for women. Published by Elsevier Inc.

  19. Cardiovascular Risk in Primary Hyperaldosteronism

    NARCIS (Netherlands)

    Prejbisz, A.; Warchol-Celinska, E.; Lenders, J.W.M.; Januszewicz, A.

    2015-01-01

    After the first cases of primary aldosteronism were described and characterized by Conn, a substantial body of experimental and clinical evidence about the long-term effects of excess aldosterone on the cardiovascular system was gathered over the last 5 decades. The prevalence of primary

  20. Perceptions of risk: understanding cardiovascular disease

    Directory of Open Access Journals (Sweden)

    Ruth Webster

    2010-09-01

    Full Text Available Ruth Webster1, Emma Heeley21Cardiovascular Division, 2Neurological and Mental Health Division, The George Institute for International Health, Camperdown, NSW, AustraliaAbstract: Cardiovascular disease (CVD is still the leading cause of death and disability worldwide despite the availability of well-established and effective preventive options. Accurate perception of a patient’s risk by both the patient and the doctors is important as this is one of the components that determine health-related behavior. Doctors tend to not use cardiovascular (CV risk calculators and underestimate the absolute CV risk of their patients. Patients show optimistic bias when considering their own risk and consistently underestimate it. Poor patient health literacy and numeracy must be considered when thinking about this problem. Patients must possess a reasonably high level of understanding of numerical processes when doctors discuss risk, a level that is not possessed by large numbers of the population. In order to overcome this barrier, doctors need to utilize various tools including the appropriate use of visual aids to accurately communicate risk with their patients. Any intervention has been shown to be better than nothing in improving health understanding. The simple process of repeatedly conveying risk information to a patient has been shown to improve accuracy of risk perception. Doctors need to take responsibility for the accurate assessment and effective communication of CV risk in their patients in order to improve patient uptake of cardioprotective lifestyle choices and preventive medications.Keywords: risk perception, cardiovascular disease, cardioprotective lifestyle

  1. Would male hormonal contraceptives affect cardiovascular risk?

    Directory of Open Access Journals (Sweden)

    Michael Zitzmann

    2018-01-01

    Full Text Available The aim of hormonal male contraception is to prevent unintended pregnancies by suppressing spermatogenesis. Hormonal male contraception is based on the principle that exogenous administration of androgens and other hormones such as progestins suppress circulating gonadotropin concentrations, decreasing testicular Leydig cell and Sertoli cell activity and spermatogenesis. In order to achieve more complete suppression of circulating gonadotropins and spermatogenesis, a progestin has been added testosterone to the most recent efficacy trials of hormonal male contraceptives. This review focusses on the potential effects of male hormonal contraceptives on cardiovascular risk factors, lipids and body composition, mainly in the target group of younger to middle-aged men. Present data suggest that hormonal male contraception can be reasonably regarded as safe in terms of cardiovascular risk. However, as all trials have been relatively short (< 3 years, a final statement regarding the cardiovascular safety of hormonal male contraception, especially in long-term use, cannot be made. Older men with at high risk of cardiovascular event might not be good candidates for hormonal male contraception. The potential adverse effects of hormonal contraceptives on cardiovascular risk appear to depend greatly on the choice of the progestin in regimens for hormonal male contraceptives. In the development of prospective hormonal male contraception, data on longer-term cardiovascular safety will be essential.

  2. 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.

  3. Aerobic fitness related to cardiovascular risk factors in young children

    DEFF Research Database (Denmark)

    Dencker, Magnus; Thorsson, Ola; Karlsson, Magnus K

    2012-01-01

    Low aerobic fitness (maximum oxygen uptake (VO(2PEAK))) is predictive for poor health in adults. In a cross-sectional study, we assessed if VO(2PEAK) is related to a composite risk factor score for cardiovascular disease (CVD) in 243 children (136 boys and 107 girls) aged 8 to 11 years. VO(2PEAK...

  4. Localized Scleroderma, Systemic Sclerosis and Cardiovascular Risk

    DEFF Research Database (Denmark)

    Hesselvig, Jeanette Halskou; Kofoed, Kristian; Wu, Jashin J

    2018-01-01

    Recent findings indicate that patients with systemic sclerosis have an increased risk of cardiovascular disease. To determine whether patients with systemic sclerosis or localized scleroderma are at increased risk of cardiovascular disease, a cohort study of the entire Danish population aged ≥ 18...... and ≤ 100 years was conducted, followed from 1997 to 2011 by individual-level linkage of nationwide registries. Multivariable adjusted Cox regression models were used to estimate the hazard ratios (HRs) for a composite cardiovascular disease endpoint. A total of 697 patients with localized scleroderma and 1......,962 patients with systemic sclerosis were identified and compared with 5,428,380 people in the reference population. In systemic sclerosis, the adjusted HR was 2.22 (95% confidence interval 1.99-2.48). No association was seen between patients with localized scleroderma and cardiovascular disease. In conclusion...

  5. 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

  6. Combined use of brain natriuretic peptide and C-reactive protein for predicting cardiovascular risk in outpatients with type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Toshihiro Tsuruda

    2007-09-01

    Full Text Available Toshihiro Tsuruda1, Johji Kato2, Takahiro Sumi1, Kazuya Mishima1, Hiroyuki Masuyama1, Hiroyuki Nakao3, Takuroh Imamura1, Tanenao Eto1, Kazuo Kitamura11Department of Internal Medicine, Circulatory and Body Fluid Regulation, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan; 2Frontier Research Center, University of Miyazaki, Miyazaki, Japan; 3Department of Public Health, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan Abstract: Appropriate tools are necessary for predicting cardiovascular events in patients with diabetes mellitus because of their high incidence. In this study, we assessed whether a combination of brain natriuretic peptide (BNP and C-reactive protein (CRP measurement were useful prognosticators in patients with type 2 diabetes mellitus. One hundred and nine patients with type 2 diabetes mellitus, aged 52 to 93 years, were examined at outpatient clinics for blood, urinary samples, and echocardiography. They were then followed prospectively. During the average follow-up period of 30 months (range, 3 to 37, 15 patients (14% had cardiovascular events: This was the first event in 5 patients and a recurrence in 10. Cox regression analysis showed that the past event (hazard ratio [HR] 4.819 [95% confidence interval (CI: 1.299–17.881]; p = 0.019 and plasma BNP level (HR 1.007 [95% CI: 1.002–1.012]; p = 0.010] were independently significant factors for the cardiovascular events during the follow-up period. Patients with plasma BNP ≥53 pg/mL and CRP ≥0.95 mg/dL demonstrated the highest incidence in cardiovascular event, compared to those categorized into either or both low levels of BNP and CRP. This study suggests that combination of plasma BNP and CRP measurement provides the additive prognostic information of cardiovascular events in patients with type 2 diabetes mellitus.Keywords: diabetes mellitus; natriuretic peptide; inflammation; mortality and morbidity

  7. World Health Organization cardiovascular risk stratification and target organ damage.

    Science.gov (United States)

    Piskorz, D; Bongarzoni, L; Citta, L; Citta, N; Citta, P; Keller, L; Mata, L; Tommasi, A

    2016-01-01

    Prediction charts allow treatment to be targeted according to simple markers of cardiovascular risk; many algorithms do not recommend screening asymptomatic target organ damage which could change dramatically the assessment. To demonstrate that target organ damage is present in low cardiovascular risk hypertensive patients and it is more frequent and severe as global cardiovascular risk increases. Consecutive hypertensive patients treated at a single Latin American center. Cardiovascular risk stratified according to 2013 WHO/ISH risk prediction chart America B. Left ventricular mass assessed by Devereux method, left ventricular hypertrophy considered >95g/m(2) in women and >115g/m(2) in men. Transmitral diastolic peak early flow velocity to average septal/lateral peak early diastolic relaxation velocity (E/e' ratio) measured cut off value >13. Systolic function assessed by tissue Doppler average interventricular septum/lateral wall mitral annulus rate systolic excursion (s wave). A total of 292 patients were included of whom 159 patients (54.5%) had cardiovascular risk of 20%. Left ventricular hypertrophy was detected in 17.6% low risk patients, 27.8% in medium risk and 23.3% in high risk (p<0.05), abnormal E/e' ratio was found in 13.8%, 31.1% and 27.9%, respectively (p<0.05). Mean s wave was 8.03+8, 8.1+9 and 8.7+1cm/s for low, intermediate and high risk patients, respectively (p<0.025). Target organ damage is more frequent and severe in high risk; one over four subjects was misclassified due to the presence of asymptomatic target organ damage. Copyright © 2015 SEHLELHA. Published by Elsevier España, S.L.U. All rights reserved.

  8. 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

    2014-12-02

    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.

  9. Preventing Cardiovascular Disease Risk Factors through Aerobic ...

    African Journals Online (AJOL)

    This paper focused on the reduction of cardiovascular disease risk factors, through aerobic exercises. The central argument here is that through exercise there is the tendency for increased strength of the heart muscles. When this is the case, what follows is a reduction in body weight and ultimately less risk on the ...

  10. 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

  11. The 'polypill' to reduce cardiovascular risk

    DEFF Research Database (Denmark)

    Patel, Vinod; Pedersen, Oluf; Morrissey, John

    2004-01-01

    This article considers data from the Steno-2 multifactorial intervention study in type 2 diabetes to which are applied the United Kingdom Prospective Diabetes Study (UKPDS) risk engine. Mathematical analyses support the use of a 'polypill' to reduce cardiovascular risk in type 2 diabetes. It is s...

  12. Metabolic syndrome and cardiovascular risk among adults

    Directory of Open Access Journals (Sweden)

    Reem Hunain

    2018-03-01

    Full Text Available Background: Mortality and morbidity due cardiovascular diseases in India is on the rise. Metabolic Syndrome which is a collection of risk factors of metabolic origin, can greatly contribute to its rising burden. Aims & Objectives: The present study was conducted with the objective of estimating the prevalence of metabolic syndrome and 10-year cardiovascular risk among adults. Material & Methods: This hospital-based study included 260 adults aged 20-60 years. Metabolic Syndrome was defined using National Cholesterol Education Program –Adult Treatment Panel -3 criteria. The 10 year cardiovascular risk was estimated using Framingham risk scoring. Results: The overall prevalence of metabolic syndrome among the study participants was 38.8%. Age (41-60yrs, male gender and daily consumption of high salt items were positively associated with metabolic syndrome whereas consumption of occasional high sugar items showed an inverse association with metabolic syndrome. According to Framingham Risk Scoring, 14.3% of the participants belonged to intermediate/high risk category. Conclusion: With a high prevalence of metabolic syndrome and a considerable proportion of individuals with intermediate to high 10 yr CVD risk, there is a need to design strategies to prevent future cardiovascular events.

  13. Microalbuminuria, endothelial dysfunction and cardiovascular risk

    DEFF Research Database (Denmark)

    Feldt-Rasmussen, B

    2000-01-01

    Microalbuminuria was originally considered to be an important new risk factor for diabetic nephropathy. More recently, it has been convincingly shown that microalbuminuria is also an independent risk factor for cardiovascular morbidity and mortality in Type 1 and Type 2 diabetic patients. Even...... in the non-diabetic background population, microalbuminuria is a risk factor for cardiovascular mortality. What is the link between increased loss of albumin in urine and cardiovascular disease and mortality? As microalbuminuria is apparently associated with increased universal vascular sieving of albumin...... evidence of endothelial dysfunction in patients with microalbuminuria, which may be the common link accounting for the associations mentioned above. In this context, a number of markers of endothelial cell dysfunction have been found to be increased in patients with microalbuminuria. In addition, a number...

  14. Cardiovascular disease (CVD and chronic kidney disease (CKD event rates in HIV-positive persons at high predicted CVD and CKD risk: A prospective analysis of the D:A:D observational study.

    Directory of Open Access Journals (Sweden)

    Mark A Boyd

    2017-11-01

    Full Text Available The Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D study has developed predictive risk scores for cardiovascular disease (CVD and chronic kidney disease (CKD, defined as confirmed estimated glomerular filtration rate [eGFR] ≤ 60 ml/min/1.73 m2 events in HIV-positive people. We hypothesized that participants in D:A:D at high (>5% predicted risk for both CVD and CKD would be at even greater risk for CVD and CKD events.We included all participants with complete risk factor (covariate data, baseline eGFR > 60 ml/min/1.73 m2, and a confirmed (>3 months apart eGFR 1%-5%, >5% and fitted Poisson models to assess whether CVD and CKD risk group effects were multiplicative. A total of 27,215 participants contributed 202,034 person-years of follow-up: 74% male, median (IQR age 42 (36, 49 years, median (IQR baseline year of follow-up 2005 (2004, 2008. D:A:D risk equations predicted 3,560 (13.1% participants at high CVD risk, 4,996 (18.4% participants at high CKD risk, and 1,585 (5.8% participants at both high CKD and high CVD risk. CVD and CKD event rates by predicted risk group were multiplicative. Participants at high CVD risk had a 5.63-fold (95% CI 4.47, 7.09, p < 0.001 increase in CKD events compared to those at low risk; participants at high CKD risk had a 1.31-fold (95% CI 1.09, 1.56, p = 0.005 increase in CVD events compared to those at low risk. Participants' CVD and CKD risk groups had multiplicative predictive effects, with no evidence of an interaction (p = 0.329 and p = 0.291 for CKD and CVD, respectively. The main study limitation is the difference in the ascertainment of the clinically defined CVD endpoints and the laboratory-defined CKD endpoints.We found that people at high predicted risk for both CVD and CKD have substantially greater risks for both CVD and CKD events compared with those at low predicted risk for both outcomes, and compared to those at high predicted risk for only CVD or CKD events. This suggests that CVD and

  15. Combined Value of Red Blood Cell Distribution Width and Global Registry of Acute Coronary Events Risk Score for Predicting Cardiovascular Events in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention.

    Science.gov (United States)

    Zhao, Na; Mi, Lan; Liu, Xiaojun; Pan, Shuo; Xu, Jiaojiao; Xia, Dongyu; Liu, Zhongwei; Zhang, Yong; Xiang, Yu; Yuan, Zuyi; Guan, Gongchang; Wang, Junkui

    2015-01-01

    Global Registry of Acute Coronary Events (GRACE) risk score and red blood cell distribution width (RDW) content can both independently predict major adverse cardiac events (MACEs) in patients with acute coronary syndrome (ACS). We investigated the combined predictive value of RDW and GRACE risk score for cardiovascular events in patients with ACS undergoing percutaneous coronary intervention (PCI) for the first time. We enrolled 480 ACS patients. During a median follow-up time of 37.2 months, 70 (14.58%) patients experienced MACEs. Patients were divided into tertiles according to the baseline RDW content (11.30-12.90, 13.00-13.50, 13.60-16.40). GRACE score was positively correlated with RDW content. Multivariate Cox analysis showed that both GRACE score and RDW content were independent predictors of MACEs (hazard ratio 1.039; 95% confidence interval [CI] 1.024-1.055; p risk of MACEs increased with increasing RDW content (p value of combining RDW content and GRACE risk score was significantly improved, also shown by the net reclassification improvement (NRI = 0.352, p value of RDW and GRACE risk score yielded a more accurate predictive value for long-term cardiovascular events in ACS patients who underwent PCI as compared to each measure alone.

  16. Cardiovascular risk factors in outpatients with bipolar disorder

    NARCIS (Netherlands)

    Klumpers, U.M.H.; Boom, K.; Janssen, F.M.G.; Tulen, J.H.M.; Loonen, Anton J. M.

    2004-01-01

    Background: The mortality due to cardiovascular diseases in bipolar patients is much higher than in the general population. It is unclear whether lithium treatment contributes to this cardiovascular morbidity. Methods: The cardiovascular risk factors in outpatients with bipolar disorder on

  17. Cardiovascular risk-benefit profile of sibutramine.

    Science.gov (United States)

    Scheen, A J

    2010-01-01

    Sibutramine is a combined norepinephrine and serotonin reuptake inhibitor used as an antiobesity agent to reduce appetite and promote weight loss in combination with diet and exercise. At a daily dose of 10-20 mg, it was initially considered to have a good safety profile, as it does not induce primary pulmonary hypertension or adverse effects on cardiac valves, in contrast to previous reports relating to some other antiobesity agents. However, it exerts disparate effects on cardiovascular risk factors. On the one hand, sibutramine may have antiatherogenic activities, as it improves insulin resistance, glucose metabolism, dyslipidemia, and inflammatory markers, with most of these effects resulting from weight loss rather than from an intrinsic effect of the drug. On the other hand, because of its specific mode of action, sibutramine exerts a peripheral sympathomimetic effect, which induces a moderate increase in heart rate and attenuates the reduction in BP attributable to weight loss or even slightly increases BP. It may also prolong the QT interval, an effect that could induce arrhythmias. Because of these complex effects, it is difficult to conclude what the final impact of sibutramine on cardiovascular outcomes might be. Sibutramine has been shown to exert favorable effects on some surrogate cardiovascular endpoints such as reduction of left ventricular hypertrophy and improvement of endothelial dysfunction. A good cardiovascular safety profile was demonstrated in numerous 1- to 2-year controlled trials, in both diabetic and nondiabetic well selected patients, as well as in several observational studies. However, since 2002, several cardiovascular adverse events (hypertension, tachycardia, arrhythmias, and myocardial infarction) have been reported in sibutramine-treated patients. This led to a contraindication of the use of this antiobesity agent in patients with established coronary heart disease, previous stroke, heart failure, or cardiac arrhythmias. SCOUT

  18. Thallium stress testing does not predict cardiovascular risk in diabetic patients with end-stage renal disease undergoing cadaveric renal transplantation

    International Nuclear Information System (INIS)

    Holley, J.L.; Fenton, R.A.; Arthur, R.S.

    1991-01-01

    This study assessed the usefulness of thallium stress testing as a predictor of perioperative cardiovascular risk in diabetic patients with end-stage renal disease undergoing cadaveric renal transplantation. Demographic factors influencing the exercise performance in these patients were also examined. The medical records of 189 consecutive patients with diabetic nephropathy who were evaluated for cadaveric renal transplantation were reviewed. Thallium stress testing was the initial examination of cardiovascular status in 141 patients. An adequate examination was one in which at least 70% of maximum heart rate was achieved. A thallium stress test was normal if there were no ST segment depressions on the electrocardiogram and no perfusion abnormalities on the thallium scan. Forty-four patients underwent cardiac catheterization as the initial evaluation (Group C) and four patients underwent transplantation without a formal cardiovascular evaluation (Group D). Sixty-four of the 141 patients undergoing thallium stress testing had an adequate and normal examination (Group A). The incidence of perioperative cardiac events in this group was 2%. Seventy-seven patients (Group B) had an abnormal (n = 41) or an inadequate (n = 36) thallium stress test and most (n = 61) then underwent coronary angiography. The use of beta-blockers was the only predictor of an abnormal or inadequate thallium stress test. Forty-three percent of patients with inadequate or abnormal thallium stress tests had significant coronary artery disease on cardiac catheterization. The perioperative risk of cardiac events was not different in Group A versus Groups B, C, and D combined. Survival of Group A and B patients was not different but was significantly longer than that of Group C patients

  19. Importance of Android/Gynoid Fat Ratio in Predicting Metabolic and Cardiovascular Disease Risk in Normal Weight as well as Overweight and Obese Children

    Science.gov (United States)

    Regier, Michael

    2014-01-01

    Numerous studies have shown that android or truncal obesity is associated with a risk for metabolic and cardiovascular disease, yet there is evidence that gynoid fat distribution may be protective. However, these studies have focused on adults and obese children. The purpose of our study was to determine if the android/gynoid fat ratio is positively correlated with insulin resistance, HOMA2-IR, and dislipidemia in a child sample of varying body sizes. In 7–13-year-old children with BMI percentiles ranging from 0.1 to 99.6, the android/gynoid ratio was closely associated with insulin resistance and combined LDL + VLDL-cholesterol. When separated by sex, it became clear that these relationships were stronger in boys than in girls. Subjects were stratified into BMI percentile based tertiles. For boys, the android/gynoid ratio was significantly related to insulin resistance regardless of BMI tertile with and LDL + VLDL in tertiles 1 and 3. For girls, only LDL + VLDL showed any significance with android/gynoid ratio and only in tertile 2. We conclude that the android/gynoid fat ratio is closely associated with insulin resistance and LDL + VLDL-, “bad,” cholesterol in normal weight boys and may provide a measurement of metabolic and cardiovascular disease risk in that population. PMID:25302115

  20. Importance of android/gynoid fat ratio in predicting metabolic and cardiovascular disease risk in normal weight as well as overweight and obese children.

    Science.gov (United States)

    Samsell, Lennie; Regier, Michael; Walton, Cheryl; Cottrell, Lesley

    2014-01-01

    Numerous studies have shown that android or truncal obesity is associated with a risk for metabolic and cardiovascular disease, yet there is evidence that gynoid fat distribution may be protective. However, these studies have focused on adults and obese children. The purpose of our study was to determine if the android/gynoid fat ratio is positively correlated with insulin resistance, HOMA2-IR, and dislipidemia in a child sample of varying body sizes. In 7-13-year-old children with BMI percentiles ranging from 0.1 to 99.6, the android/gynoid ratio was closely associated with insulin resistance and combined LDL + VLDL-cholesterol. When separated by sex, it became clear that these relationships were stronger in boys than in girls. Subjects were stratified into BMI percentile based tertiles. For boys, the android/gynoid ratio was significantly related to insulin resistance regardless of BMI tertile with and LDL + VLDL in tertiles 1 and 3. For girls, only LDL + VLDL showed any significance with android/gynoid ratio and only in tertile 2. We conclude that the android/gynoid fat ratio is closely associated with insulin resistance and LDL + VLDL-, "bad," cholesterol in normal weight boys and may provide a measurement of metabolic and cardiovascular disease risk in that population.

  1. Reducing cardiovascular risk : protecting the kidney

    NARCIS (Netherlands)

    Dobre, Daniela; Lambers Heerspink, Hiddo J.; de Zeeuw, Dick

    2009-01-01

    Progressive decline of renal function in chronic kidney disease (CKD), measured by a reduced glomerular filtration rate or albuminuria, is linked to an increased risk of cardiovascular (CV) disease. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs), most

  2. 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

  3. Hypoglycaemia as a new cardiovascular risk factor

    Directory of Open Access Journals (Sweden)

    Daniel Rogowicz

    2017-07-01

    Full Text Available The World Health Organization (WHO recognized diabetes as one of the four most important and priority health issues out of non-communicable diseases. According to a report by the WHO with the year 2016 the prevalence of diabetes for 3 decades and continues to grow, this problem applies to the entire world. In 2014. the number of diabetes patients brought the 422 million, by comparison, in 1980. It was 108 million. A badly aligned metabolically diabetes contributes to the development of numerous complications of micro-and macro-angiopathic, which are related to adverse prognosis and increase the risk of cardiovascular disease. Striving for the best possible alignment of the carbohydrate economy reduces both the mortality and cardiovascular. However, some patients with diabetes intensive glucose control is not effective and increases the incidence of severe hypoglycemia, which in turn some patients increases cardiovascular mortality. The aim of the work is the appearance of hypoglycemia as a factor that increases the risk of death in cardiovascular diseases. The work also emphasises the importance of cardiovascular diseases in diabetes, which are the most common complication of diabetes and the most common cause of death in this group of patients.

  4. Practicality of cardiovascular risk functions

    Directory of Open Access Journals (Sweden)

    Jaume Marrugat

    2016-12-01

    Full Text Available Resumen Las estrategias de prevención de las enfermedades cardiovasculares necesitan refinamiento porque su incidencia se reduce muy lentamente. Las funciones de riesgo incorporaron los factores de riesgo clásicos (edad, sexo, consumo de tabaco, diabetes, presión arterial, y perfil lipídico básico en cohortes seguidas generalmente más de 10 años. Son razonablemente precisas para el cribado poblacional del riesgo de enfermedad coronaria exigido en las guías de práctica clínica. Clasifican a los pacientes en niveles de riesgo para concentrar un mayor esfuerzo terapéutico y preventivo en los de mayor riesgo, y en los que el número necesario a tratar y el coste-efectividad son óptimos. Proporcionar el riesgo relativo y de la edad vascular al paciente, le motiva a cumplir seguir tratamientos y estilos de vida. Alrededor del 20% de la población de 35 a 74 años tiene riesgo intermedio y requiere reclasificación a alto o bajo riesgo porque concentra 35% de eventos poblacionales de enfermedad coronaria. Se ensayan nuevos biomarcadores (bioquímicos, genéticos o de imagen para mejorar la precisión de las predicciones. Si los equipos informáticos de los sistemas de salud incorporaran el cálculo automatizado del riesgo se facilitaría la tarea preventiva del personal asistencial.

  5. 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

    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. 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. 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). WHO/ISH charts identified 78.4% of subjects as low cardiac risk whereas the UKPDS risk engine categorized 52.3% as low cardiac risk (Pengine identified higher proportions of patients (28%) compared to WHO/ISH charts (7%). Approximately 6% of subjects were classified as low cardiac risk (20%. Agreement between the two tools was poor (κ value =0.144, Pengine. Risk assessment by both assessment tools demonstrated poor sensitivity in identifying those with treatable levels of LDL cholesterol and diastolic blood pressure.

  6. Blood pressure and control of cardiovascular risk

    OpenAIRE

    Judith A Whitworth

    2005-01-01

    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 a...

  7. Combined Value of Red Blood Cell Distribution Width and Global Registry of Acute Coronary Events Risk Score for Predicting Cardiovascular Events in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention.

    Directory of Open Access Journals (Sweden)

    Na Zhao

    Full Text Available Global Registry of Acute Coronary Events (GRACE risk score and red blood cell distribution width (RDW content can both independently predict major adverse cardiac events (MACEs in patients with acute coronary syndrome (ACS. We investigated the combined predictive value of RDW and GRACE risk score for cardiovascular events in patients with ACS undergoing percutaneous coronary intervention (PCI for the first time. We enrolled 480 ACS patients. During a median follow-up time of 37.2 months, 70 (14.58% patients experienced MACEs. Patients were divided into tertiles according to the baseline RDW content (11.30-12.90, 13.00-13.50, 13.60-16.40. GRACE score was positively correlated with RDW content. Multivariate Cox analysis showed that both GRACE score and RDW content were independent predictors of MACEs (hazard ratio 1.039; 95% confidence interval [CI] 1.024-1.055; p < 0.001; 1.699; 1.294-2.232; p < 0.001; respectively. Furthermore, Kaplan-Meier analysis demonstrated that the risk of MACEs increased with increasing RDW content (p < 0.001. For GRACE score alone, the area under the receiver operating characteristic (ROC curve for MACEs was 0.749 (95% CI: 0.707-0.787. The area under the ROC curve for MACEs increased to 0.805 (0.766-0.839, p = 0.034 after adding RDW content. The incremental predictive value of combining RDW content and GRACE risk score was significantly improved, also shown by the net reclassification improvement (NRI = 0.352, p < 0.001 and integrated discrimination improvement (IDI = 0.023, p = 0.002. Combining the predictive value of RDW and GRACE risk score yielded a more accurate predictive value for long-term cardiovascular events in ACS patients who underwent PCI as compared to each measure alone.

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

    International Nuclear Information System (INIS)

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

    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 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

  9. Predictive Value of Beat-to-Beat QT Variability Index across the Continuum of Left Ventricular Dysfunction: Competing Risks of Non-cardiac or Cardiovascular Death, and Sudden or Non-Sudden Cardiac Death

    Science.gov (United States)

    Tereshchenko, Larisa G.; Cygankiewicz, Iwona; McNitt, Scott; Vazquez, Rafael; Bayes-Genis, Antoni; Han, Lichy; Sur, Sanjoli; Couderc, Jean-Philippe; Berger, Ronald D.; de Luna, Antoni Bayes; Zareba, Wojciech

    2012-01-01

    Background The goal of this study was to determine the predictive value of beat-to-beat QT variability in heart failure (HF) patients across the continuum of left ventricular dysfunction. Methods and Results Beat-to-beat QT variability index (QTVI), heart rate variance (LogHRV), normalized QT variance (QTVN), and coherence between heart rate variability and QT variability have been measured at rest during sinus rhythm in 533 participants of the Muerte Subita en Insuficiencia Cardiaca (MUSIC) HF study (mean age 63.1±11.7; males 70.6%; LVEF >35% in 254 [48%]) and in 181 healthy participants from the Intercity Digital Electrocardiogram Alliance (IDEAL) database. During a median of 3.7 years of follow-up, 116 patients died, 52 from sudden cardiac death (SCD). In multivariate competing risk analyses, the highest QTVI quartile was associated with cardiovascular death [hazard ratio (HR) 1.67(95%CI 1.14-2.47), P=0.009] and in particular with non-sudden cardiac death [HR 2.91(1.69-5.01), P<0.001]. Elevated QTVI separated 97.5% of healthy individuals from subjects at risk for cardiovascular [HR 1.57(1.04-2.35), P=0.031], and non-sudden cardiac death in multivariate competing risk model [HR 2.58(1.13-3.78), P=0.001]. No interaction between QTVI and LVEF was found. QTVI predicted neither non-cardiac death (P=0.546) nor SCD (P=0.945). Decreased heart rate variability (HRV) rather than increased QT variability was the reason for increased QTVI in this study. Conclusions Increased QTVI due to depressed HRV predicts cardiovascular mortality and non-sudden cardiac death, but neither SCD nor excracardiac mortality in HF across the continuum of left ventricular dysfunction. Abnormally augmented QTVI separates 97.5% of healthy individuals from HF patients at risk. PMID:22730411

  10. Predicting Risk of Cognitive Decline in Very Old Adults Using Three Models: The Framingham Stroke Risk Profile; the Cardiovascular Risk Factors, Aging, and Dementia Model; and Oxi-Inflammatory Biomarkers.

    Science.gov (United States)

    Harrison, Stephanie L; de Craen, Anton J M; Kerse, Ngaire; Teh, Ruth; Granic, Antoneta; Davies, Karen; Wesnes, Keith A; den Elzen, Wendy P J; Gussekloo, Jacobijn; Kirkwood, Thomas B L; Robinson, Louise; Jagger, Carol; Siervo, Mario; Stephan, Blossom C M

    2017-02-01

    To examine the Framingham Stroke Risk Profile (FSRP); the Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) risk score, and oxi-inflammatory load (cumulative risk score of three blood biomarkers-homocysteine, interleukin-6, C-reactive protein) for associations with cognitive decline using three cohort studies of very old adults and to examine whether incorporating these biomarkers with the risk scores can affect the association with cognitive decline. Three longitudinal, population-based cohort studies. Newcastle-upon-Tyne, United Kingdom; Leiden, the Netherlands; and Lakes and Bay of Plenty District Health Board areas, New Zealand. Newcastle 85+ Study participants (n = 616), Leiden 85-plus Study participants (n = 444), and Life and Living in Advanced Age, a Cohort Study in New Zealand (LiLACS NZ Study) participants (n = 396). FSRP, CAIDE risk score, oxi-inflammatory load, FSRP incorporating oxi-inflammatory load, and CAIDE risk score incorporating oxi-inflammatory load. Oxi-inflammatory load could be calculated only in the Newcastle 85+ and the Leiden 85-plus studies. Measures of global cognitive function were available for all three data sets. Domain-specific measures were available for the Newcastle 85+ and the Leiden 85-plus studies. Meta-analysis of pooled results showed greater risk of incident global cognitive impairment with higher FSRP (hazard ratio (HR) = 1.46, 95% confidence interval (CI) = 1.08-1.98), CAIDE (HR = 1.53, 95% CI = 1.09-2.14), and oxi-inflammatory load (HR = 1.73, 95% CI = 1.04-2.88) scores. Adding oxi-inflammatory load to the risk scores increased the risk of cognitive impairment for the FSRP (HR = 1.65, 95% CI = 1.17-2.33) and the CAIDE model (HR = 1.93, 95% CI = 1.39-2.67). Adding oxi-inflammatory load to cardiovascular risk scores may be useful for determining risk of cognitive impairment in very old adults. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  11. Cardiovascular risk in individuals with depression

    Directory of Open Access Journals (Sweden)

    Danielle Bivanco-Lima

    2013-06-01

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

  12. [Air pollution, cardiovascular risk and hypertension].

    Science.gov (United States)

    Soldevila Bacardit, N; Vinyoles Bargalló, E; Agudo Ugena, J; Camps Vila, L

    2018-04-24

    Air pollution is a worrying factor and has an impact on public health. Multiple studies relate exposure to air pollutants with an increase in cardiovascular events, cardiovascular mortality and mortality for all causes. A relationship has also been demonstrated between increased pollution and high blood pressure, as well as a higher prevalence of hypertension. Pollutants that play a more relevant role in this association are particulate matters, nitrogen dioxide and sulphur dioxide. The objective of this review is to understand the mechanisms involved in this increase and to find the most recent publications that relate pollution, cardiovascular risk and hypertension. Copyright © 2018 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Risk of cardiovascular disease following radiation exposure

    International Nuclear Information System (INIS)

    Trivedi, A.; Vlahovich, S.; Cornett, R.J.

    2001-01-01

    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)

  14. 'Awareness and attitudes towards total cardiovascular disease risk ...

    African Journals Online (AJOL)

    Microsoft account

    Corresponding author: Dr S Ofori, Department of Internal Medicine, ... regarding total CVD risk assessment in clinical practice among physicians in Port ..... cardiovascular risk for prevention and control of cardiovascular disease in low and.

  15. Do Physical Activity, Body Mass Index, and Sleep Duration Predict Clustered Cardiovascular Disease Risk in Children?- A Part of the OPUS Study

    DEFF Research Database (Denmark)

    Hjorth, Mads F.; Damsgaard, Camilla T.; Dalskov, Stine-Mathilde

    Objective To investigate the single and combined associations of physical activity (PA), body mass index (BMI), and sleep duration with clustering of cardiovascular disease risk markers in healthy children. Methods We did a cross-sectional pilot-study of 74 Danish school children aged 8-11 years...... BMI was 17.1 (range 13.4-25.4) kg/m2, with 10.8% classified as overweight using isoBMI. Controlled for age and sex, P A was negatively associated with cMET-score (Standardised beta coefficients (sBeta)=-0.32); n=74; P=0.016) and BMI was positively associated with cMETscore (sBeta=0.49; n=74; P...

  16. Circulating Total Bilirubin and Risk of Incident Cardiovascular Disease in the General Population

    NARCIS (Netherlands)

    Kunutsor, Setor K.; Bakker, Stephan J. L.; Gansevoort, Ronald T.; Chowdhury, Rajiv; Dullaart, Robin P. F.

    OBJECTIVE: To assess the association of circulating total bilirubin and cardiovascular disease (CVD) risk in a new prospective study and to determine whether adding information on total bilirubin values to established cardiovascular risk factors is associated with improvement in prediction of CVD

  17. C-reactive protein, fibrinogen, and cardiovascular disease prediction

    DEFF Research Database (Denmark)

    Kaptoge, Stephen; Di Angelantonio, Emanuele; Pennells, Lisa

    2012-01-01

    There is debate about the value of assessing levels of C-reactive protein (CRP) and other biomarkers of inflammation for the prediction of first cardiovascular events.......There is debate about the value of assessing levels of C-reactive protein (CRP) and other biomarkers of inflammation for the prediction of first cardiovascular events....

  18. The paradox of diabetes, obesity and cardiovascular risk

    African Journals Online (AJOL)

    2014-06-03

    Jun 3, 2014 ... Weight loss to reduce cardiovascular risk is encouraged in both healthy overweight individuals and those at high cardiovascular risk ... cardiovascular risk factors, such as blood pressure, lipid profile and blood glucose control, but also with a reduction ..... women, normal weight obesity (body fat >3 3.3% vs.

  19. 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.

  20. Transcranial Doppler ultrasonography predicts cardiovascular events after TIA

    International Nuclear Information System (INIS)

    Holzer, Katrin; Sadikovic, Suwad; Esposito, Lorena; Bockelbrink, Angelina; Sander, Dirk; Hemmer, Bernhard; Poppert, Holger

    2009-01-01

    Transient ischemic attack (TIA) patients are at high vascular risk. We assessed the value of extracranial (ECD) and transcranial (TCD) Doppler and duplex ultrasonography to predict clinical outcome after TIA. 176 consecutive TIA patients admitted to the Stroke Unit were recruited in the study. All patients received diffusion-weighted imaging, standardized ECD and TCD. At a median follow-up of 27 months, new vascular events were recorded. 22 (13.8%) patients experienced an ischemic stroke or TIA, 5 (3.1%) a myocardial infarction or acute coronary syndrome, and 5 (3.1%) underwent arterial revascularization. ECD revealed extracranial ≥ 50% stenosis or occlusions in 34 (19.3%) patients, TCD showed intracranial stenosis in 15 (9.2%) and collateral flow patterns due to extracranial stenosis in 5 (3.1%) cases. Multivariate analysis identified these abnormal ECD and TCD findings as predictors of new cerebral ischemic events (ECD: hazard ratio (HR) 4.30, 95% confidence interval (CI) 1.75 to 10.57, P = 0.01; TCD: HR 4.73, 95% CI 1.86 to 12.04, P = 0.01). Abnormal TCD findings were also predictive of cardiovascular ischemic events (HR 18.51, 95% CI 3.49 to 98.24, P = 0.001). TIA patients with abnormal TCD findings are at high risk to develop further cerebral and cardiovascular ischemic events

  1. Cardiovascular disease prediction: do pulmonary disease-related chest CT features have added value?

    International Nuclear Information System (INIS)

    Jairam, Pushpa M.; Jong, Pim A. de; Mali, Willem P.T.M.; Isgum, Ivana; Graaf, Yolanda van der

    2015-01-01

    Certain pulmonary diseases are associated with cardiovascular disease (CVD). Therefore we investigated the incremental predictive value of pulmonary, mediastinal and pleural features over cardiovascular imaging findings. A total of 10,410 patients underwent diagnostic chest CT for non-cardiovascular indications. Using a case-cohort approach, we visually graded CTs from the cases and from an approximately 10 % random sample of the baseline cohort (n = 1,203) for cardiovascular, pulmonary, mediastinal and pleural findings. The incremental value of pulmonary disease-related CT findings above cardiovascular imaging findings in cardiovascular event risk prediction was quantified by comparing discrimination and reclassification. During a mean follow-up of 3.7 years (max. 7.0 years), 1,148 CVD events (cases) were identified. Addition of pulmonary, mediastinal and pleural features to a cardiovascular imaging findings-based prediction model led to marginal improvement of discrimination (increase in c-index from 0.72 (95 % CI 0.71-0.74) to 0.74 (95 % CI 0.72-0.75)) and reclassification measures (net reclassification index 6.5 % (p < 0.01)). Pulmonary, mediastinal and pleural features have limited predictive value in the identification of subjects at high risk of CVD events beyond cardiovascular findings on diagnostic chest CT scans. (orig.)

  2. Cardiovascular disease prediction: do pulmonary disease-related chest CT features have added value?

    Energy Technology Data Exchange (ETDEWEB)

    Jairam, Pushpa M. [University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht (Netherlands); University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Jong, Pim A. de; Mali, Willem P.T.M. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Isgum, Ivana [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands); Graaf, Yolanda van der [University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht (Netherlands); Collaboration: PROVIDI study-group

    2015-06-01

    Certain pulmonary diseases are associated with cardiovascular disease (CVD). Therefore we investigated the incremental predictive value of pulmonary, mediastinal and pleural features over cardiovascular imaging findings. A total of 10,410 patients underwent diagnostic chest CT for non-cardiovascular indications. Using a case-cohort approach, we visually graded CTs from the cases and from an approximately 10 % random sample of the baseline cohort (n = 1,203) for cardiovascular, pulmonary, mediastinal and pleural findings. The incremental value of pulmonary disease-related CT findings above cardiovascular imaging findings in cardiovascular event risk prediction was quantified by comparing discrimination and reclassification. During a mean follow-up of 3.7 years (max. 7.0 years), 1,148 CVD events (cases) were identified. Addition of pulmonary, mediastinal and pleural features to a cardiovascular imaging findings-based prediction model led to marginal improvement of discrimination (increase in c-index from 0.72 (95 % CI 0.71-0.74) to 0.74 (95 % CI 0.72-0.75)) and reclassification measures (net reclassification index 6.5 % (p < 0.01)). Pulmonary, mediastinal and pleural features have limited predictive value in the identification of subjects at high risk of CVD events beyond cardiovascular findings on diagnostic chest CT scans. (orig.)

  3. Cardiovascular Risk Factors in Cluster Headache.

    Science.gov (United States)

    Lasaosa, S Santos; Diago, E Bellosta; Calzada, J Navarro; Benito, A Velázquez

    2017-06-01

     Patients with cluster headache tend to have a dysregulation of systemic blood pressure such as increased blood pressure variability and decreased nocturnal dipping. This pattern of nocturnal nondipping is associated with end-organ damage and increased risk of cardiovascular disease.  To determine if cluster headache is associated with a higher risk of cardiovascular disease.  Cross-sectional study of 33 cluster headache patients without evidence of cardiovascular disease and 30 age- and gender-matched healthy controls. Ambulatory blood pressure monitoring was performed in all subjects. We evaluate anthropometric, hematologic, and structural parameters (carotid intima-media thickness and ankle-brachial index).  Of the 33 cluster headache patients, 16 (48.5%) were nondippers, a higher percentage than expected. Most of the cluster headache patients (69.7%) also presented a pathological ankle-brachial index. In terms of the carotid intima-media thickness values, 58.3% of the patients were in the 75th percentile, 25% were in the 90th percentile, and 20% were in the 95th percentile. In the control group, only five of the 30 subjects (16.7%) had a nondipper pattern ( P  =   0.004), with 4.54% in the 90th and 95th percentiles ( P  =   0.012 and 0.015).  Compared with healthy controls, patients with cluster headache presented a high incidence (48.5%) of nondipper pattern, pathological ankle-brachial index (69.7%), and intima-media thickness values above the 75th percentile. These findings support the hypothesis that patients with cluster headache present increased risk of cardiovascular disease. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  4. Standard cardiovascular disease risk algorithms underestimate the risk of cardiovascular disease in schizophrenia: evidence from a national primary care database.

    Science.gov (United States)

    McLean, Gary; Martin, Julie Langan; Martin, Daniel J; Guthrie, Bruce; Mercer, Stewart W; Smith, Daniel J

    2014-10-01

    Schizophrenia is associated with increased cardiovascular mortality. Although cardiovascular disease (CVD) risk prediction algorithms are widely in the general population, their utility for patients with schizophrenia is unknown. A primary care dataset was used to compare CVD risk scores (Joint British Societies (JBS) score), cardiovascular risk factors, rates of pre-existing CVD and age of first diagnosis of CVD for schizophrenia (n=1997) relative to population controls (n=215,165). Pre-existing rates of CVD and the recording of risk factors for those without CVD were higher in the schizophrenia cohort in the younger age groups, for both genders. Those with schizophrenia were more likely to have a first diagnosis of CVD at a younger age, with nearly half of men with schizophrenia plus CVD diagnosed under the age of 55 (schizophrenia men 46.1% vs. control men 34.8%, pschizophrenia women 28.9% vs. control women 23.8%, prisk factors within the schizophrenia group, only a very small percentage (3.2% of men and 7.5% of women) of those with schizophrenia under age 55 were correctly identified as high risk for CVD according to the JBS risk algorithm. The JBS2 risk score identified only a small proportion of individuals with schizophrenia under the age of 55 as being at high risk of CVD, despite high rates of risk factors and high rates of first diagnosis of CVD within this age group. The validity of CVD risk prediction algorithms for schizophrenia needs further research. Copyright © 2014 Elsevier B.V. All rights reserved.

  5. Development of a new risk model for predicting cardiovascular events among hemodialysis patients: Population-based hemodialysis patients from the Japan Dialysis Outcome and Practice Patterns Study (J-DOPPS.

    Directory of Open Access Journals (Sweden)

    Yukiko Matsubara

    Full Text Available Cardiovascular (CV events are the primary cause of death and becoming bedridden among hemodialysis (HD patients. The Framingham risk score (FRS is useful for predicting incidence of CV events in the general population, but is considerd to be unsuitable for the prediction of the incidence of CV events in HD patients, given their characteristics due to atypical relationships between conventional risk factors and outcomes. We therefore aimed to develop a new prognostic prediction model for prevention and early detection of CV events among hemodialysis patients.We enrolled 3,601 maintenance HD patients based on their data from the Japan Dialysis Outcomes and Practice Patterns Study (J-DOPPS, phases 3 and 4. We longitudinaly assessed the association between several potential candidate predictors and composite CV events in the year after study initiation. Potential candidate predictors included the component factors of FRS and other HD-specific risk factors. We used multivariable logistic regression with backward stepwise selection to develop our new prediction model and generated a calibration plot. Additinially, we performed bootstrapping to assess the internal validity.We observed 328 composite CV events during 1-year follow-up. The final prediction model contained six variables: age, diabetes status, history of CV events, dialysis time per session, and serum phosphorus and albumin levels. The new model showed significantly better discrimination than the FRS, in both men (c-statistics: 0.76 for new model, 0.64 for FRS and women (c-statistics: 0.77 for new model, 0.60 for FRS. Additionally, we confirmed the consistency between the observed results and predicted results using the calibration plot. Further, we found similar discrimination and calibration to the derivation model in the bootstrapping cohort.We developed a new risk model consisting of only six predictors. Our new model predicted CV events more accurately than the FRS.

  6. [Burnout syndrome: a "true" cardiovascular risk factor].

    Science.gov (United States)

    Cursoux, Pauline; Lehucher-Michel, Marie-Pascale; Marchetti, Hélène; Chaumet, Guillaume; Delliaux, Stéphane

    2012-11-01

    The burnout syndrome is characterized by emotional exhaustion, depersonalization and reduced personal accomplishment in individuals professionally involved with others. The burnout syndrome is poorly recognized, particularly in France, as a distinct nosology from adaptation troubles, stress, depression, or anxiety. Several tools quantifying burnout and emotional exhaustion exist, the most spread is the questionnaire called Maslach Burnout Inventory. The burnout syndrome alters cardiovascular function and its neuroregulation by autonomic nervous system and is associated with: increased sympathetic tone to heart and vessels after mental stress, lowered physiological post-stress vagal rebound to heart, and lowered arterial baroreflex sensitivity. Job strain as burnout syndrome seems to be a real independent cardiovascular risk factor. Oppositely, training to manage emotions could increase vagal tone to heart and should be cardio-protective. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  7. Determinants of cardiovascular risk in current rheumatic practice

    NARCIS (Netherlands)

    Meek, I.L.

    2014-01-01

    The aim of this thesis was to study cardiovascular risk in arthritis: Firstly, how do different rheumatic diseases compare in the patients’ traditional cardiovascular (CV) risk factor profiles, and does this justify the general focus on rheumatoid arthritis regarding cardiovascular complications in

  8. 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…

  9. Risk stratification in secondary cardiovascular prevention.

    Science.gov (United States)

    Lazzeroni, Davide; Coruzzi, Paolo

    2018-02-19

    Worldwide, more than 7 million people experience acute myocardial infarction (AMI) every year (1), and although substantial reduction in mortality has been obtained in recent decades, one-year mortality rates are still in the range of 10%. Among patients who survive AMI, 20% suffer a second cardiovascular event in the first year and approximately 50% of major coronary events occur in those with a previous hospital discharge diagnosis of AMI (2). Despite the evidence that lifestyle changes and risk factors management strongly improve long-term prognosis, preventive care post-AMI remains sub-optimal. Cross-sectional data from the serially conducted EUROASPIRE surveys in patients with established ischemic heart disease (IHD) and people at high cardiovascular risk have demonstrated a high prevalence of unhealthy lifestyle, modifiable risk factors and inadequate use of drug therapies to achieve blood pressure and lipid goals (3). Secondary prevention programmes, defined as the level of preventive care focusing on early risk stratification, are highly recommended in all IHD patients, to restore quality of life, maintain or improve functional capacity and prevent recurrence.

  10. Socioeconomic deprivation and the incidence of 12 cardiovascular diseases in 1.9 million women and men: implications for risk prediction and prevention.

    Directory of Open Access Journals (Sweden)

    Mar Pujades-Rodriguez

    Full Text Available Recent experimental evidence suggests that socioeconomic characteristics of neighbourhoods influence cardiovascular health, but observational studies which examine deprivation across a wide range of cardiovascular diseases (CVDs are lacking.Record-linkage cohort study of 1.93 million people to examine the association between small-area socioeconomic deprivation and 12 CVDs. Health records covered primary care, hospital admissions, a myocardial infarction registry and cause-specific mortality in England (CALIBER. Patients were aged ≥30 years and were initially free of CVD. Cox proportional hazard models stratified by general practice were used.During a median follow-up of 5.5 years 114,859 people had one of 12 initial CVD presentations. In women the hazards of all CVDs except abdominal aortic aneurysm increased linearly with higher small-area socioeconomic deprivation (adjusted HR for most vs. least deprived ranged from 1.05, 95%CI 0.83-1.32 for abdominal aortic aneurysm to 1.55, 95%CI 1.42-1.70 for heart failure; I2 = 81.9%, τ2 = 0.01. In men heterogeneity was higher (HR ranged from 0.89, 95%CI 0.75-1.06 for cardiac arrest to 1.85, 95%CI 1.67-2.04 for peripheral arterial disease; I2 = 96.0%, τ2 = 0.06 and no association was observed with stable angina, sudden cardiac death, subarachnoid haemorrhage, transient ischaemic attack and abdominal aortic aneurysm. Lifetime risk difference between least and most deprived quintiles was most marked for peripheral arterial disease in women (4.3% least deprived, 5.8% most deprived and men (4.6% least deprived, 7.8% in most deprived; but it was small or negligible for sudden cardiac death, transient ischaemic attack, abdominal aortic aneurysm and ischaemic and intracerebral haemorrhage, in both women and men.Associations of small-area socioeconomic deprivation with 12 types of CVDs were heterogeneous, and in men absent for several diseases. Findings suggest that policies to reduce

  11. Cardiovascular risk in women with polycystic ovary syndrome.

    Science.gov (United States)

    Cho, L W; Atkin, S L

    2007-12-01

    Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women that has received an immense amount of attention in the recent years due to the possible associated risk of cardiovascular disease. Women with PCOS demonstrate an adverse cardiovascular profile characteristic of the cardiometabolic syndrome and an established risk of progression to type 2 diabetes. Despite the presence of cardiovascular risk factors and increased surrogate markers of cardiovascular disease, it is unclear if they develop accelerated atherosclerosis. This article summarized the recent development and findings of cardiovascular risk in women with PCOS, and finally the therapeutic options will be discussed.

  12. Methodological issues in cardiovascular epidemiology: the risk of determining absolute risk through statistical models

    Directory of Open Access Journals (Sweden)

    Demosthenes B Panagiotakos

    2006-09-01

    Full Text Available Demosthenes B Panagiotakos, Vassilis StavrinosOffice of Biostatistics, Epidemiology, Department of Dietetics, Nutrition, Harokopio University, Athens, GreeceAbstract: During the past years there has been increasing interest in the development of cardiovascular disease functions that predict future events at individual level. However, this effort has not been so far very successful, since several investigators have reported large differences in the estimation of the absolute risk among different populations. For example, it seems that predictive models that have been derived from US or north European populations  overestimate the incidence of cardiovascular events in south European and Japanese populations. A potential explanation could be attributed to several factors such as geographical, cultural, social, behavioral, as well as genetic variations between the investigated populations in addition to various methodological, statistical, issues relating to the estimation of these predictive models. Based on current literature it can be concluded that, while risk prediction of future cardiovascular events is a useful tool and might be valuable in controlling the burden of the disease in a population, further work is required to improve the accuracy of the present predictive models.Keywords: cardiovascular disease, risk, models

  13. Incremental Value of Repeated Risk Factor Measurements for Cardiovascular Disease Prediction in Middle-Aged Korean Adults: Results From the NHIS-HEALS (National Health Insurance System-National Health Screening Cohort).

    Science.gov (United States)

    Cho, In-Jeong; Sung, Ji Min; Chang, Hyuk-Jae; Chung, Namsik; Kim, Hyeon Chang

    2017-11-01

    Increasing evidence suggests that repeatedly measured cardiovascular disease (CVD) risk factors may have an additive predictive value compared with single measured levels. Thus, we evaluated the incremental predictive value of incorporating periodic health screening data for CVD prediction in a large nationwide cohort with periodic health screening tests. A total of 467 708 persons aged 40 to 79 years and free from CVD were randomly divided into development (70%) and validation subcohorts (30%). We developed 3 different CVD prediction models: a single measure model using single time point screening data; a longitudinal average model using average risk factor values from periodic screening data; and a longitudinal summary model using average values and the variability of risk factors. The development subcohort included 327 396 persons who had 3.2 health screenings on average and 25 765 cases of CVD over 12 years. The C statistics (95% confidence interval [CI]) for the single measure, longitudinal average, and longitudinal summary models were 0.690 (95% CI, 0.682-0.698), 0.695 (95% CI, 0.687-0.703), and 0.752 (95% CI, 0.744-0.760) in men and 0.732 (95% CI, 0.722-0.742), 0.735 (95% CI, 0.725-0.745), and 0.790 (95% CI, 0.780-0.800) in women, respectively. The net reclassification index from the single measure model to the longitudinal average model was 1.78% in men and 1.33% in women, and the index from the longitudinal average model to the longitudinal summary model was 32.71% in men and 34.98% in women. Using averages of repeatedly measured risk factor values modestly improves CVD predictability compared with single measurement values. Incorporating the average and variability information of repeated measurements can lead to great improvements in disease prediction. URL: https://www.clinicaltrials.gov. Unique identifier: NCT02931500. © 2017 American Heart Association, Inc.

  14. Towards predictive cardiovascular safety : a systems pharmacology approach

    NARCIS (Netherlands)

    Snelder, Nelleke

    2014-01-01

    Cardiovascular safety issues related to changes in blood pressure, arise frequently in drug development. In the thesis “Towards predictive cardiovascular safety – a systems pharmacology approach”, a system-specific model is described to quantify drug effects on the interrelationship between mean

  15. 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.

  16. Cholecystokinin in plasma predicts cardiovascular mortality in elderly females

    DEFF Research Database (Denmark)

    Gøtze, Jens P.; Rehfeld, Jens F; Alehagen, Urban

    2016-01-01

    BACKGROUND: Cholecystokinin (CCK) and gastrin are related gastrointestinal hormones with documented cardiovascular effects of exogenous administration. It is unknown whether measurement of endogenous CCK or gastrin in plasma contains information regarding cardiovascular mortality. METHODS......: Mortality risk was evaluated using Cox proportional hazard regression and Kaplan-Meier analyses. Elderly patients in a primary care setting with symptoms of cardiac disease, i.e. shortness of breath, peripheral edema, and/or fatigue, were evaluated (n=470). Primary care patients were followed for 13years...... information was obtained from 4th quartile gastrin concentrations on 5-year cardiovascular mortality risk. CONCLUSIONS: CCK in plasma is an independent marker of cardiovascular mortality in elderly female patients. The study thus introduces measurement of plasma CCK in gender-specific cardiovascular risk...

  17. Cardiovascular disease risk factors: a childhood perspective.

    Science.gov (United States)

    Praveen, Pradeep A; Roy, Ambuj; Prabhakaran, Dorairaj

    2013-03-01

    Atherosclerotic cardiovascular disease (CVD) is one of the leading causes of death and disability worldwide including in developing countries like India. Indians are known to be predisposed to CVD, which occur almost a decade earlier in them. Though these diseases manifest in the middle age and beyond, it is now clear that the roots of CVD lie in childhood and adolescence. Many of the conventional risk factors of CVD such as high blood pressure, dyslipidemia, tobacco use, unhealthy diet and obesity have their beginnings in childhood and then track overtime. It is thus important to screen and identify these risk factors early and treat them to prevent onset of CVD. Similarly community based strategies to prevent onset of these risk factors is imperative to tackle this burgeoning public health crisis especially in countries like ours with limited resources.

  18. Sortilin and the risk of cardiovascular disease.

    Science.gov (United States)

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

    2013-10-01

    Plasma low-density lipoprotein cholesterol (LDL-C) levels are a key determinant of the risk of cardiovascular disease, which is why many studies have attempted to elucidate the pathways that regulate its metabolism. Novel latest-generation sequencing techniques have identified a strong association between the 1p13 locus and the risk of cardiovascular disease caused by changes in plasma LDL-C levels. As expected for a complex phenotype, the effects of variation in this locus are only moderate. Even so, knowledge of the association is of major importance, since it has unveiled a new metabolic pathway regulating plasma cholesterol levels. Crucial to this discovery was the work of three independent teams seeking to clarify the biological basis of this association, who succeeded in proving that SORT1, encoding sortilin, was the gene in the 1p13 locus involved in LDL metabolism. SORT1 was the first gene identified as determining plasma LDL levels to be mechanistically evaluated and, although the three teams used different, though appropriate, experimental methods, their results were in some ways contradictory. Here we review all the experiments that led to the identification of the new pathway connecting sortilin with plasma LDL levels and risk of myocardial infarction. The regulatory mechanism underlying this association remains unclear, but its discovery has paved the way for considering previously unsuspected therapeutic targets and approaches. Copyright © 2013 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  19. Office blood pressure or ambulatory blood pressure for the prediction of cardiovascular events.

    Science.gov (United States)

    Mortensen, Rikke Nørmark; Gerds, Thomas Alexander; Jeppesen, Jørgen Lykke; Torp-Pedersen, Christian

    2017-11-21

    To determine the added value of (i) 24-h ambulatory blood pressure relative to office blood pressure and (ii) night-time ambulatory blood pressure relative to daytime ambulatory blood pressure for 10-year person-specific absolute risks of fatal and non-fatal cardiovascular events. A total of 7927 participants were included from the International Database on Ambulatory blood pressure monitoring in relation to Cardiovascular Outcomes. We used cause-specific Cox regression to predict 10-year person-specific absolute risks of fatal and non-fatal cardiovascular events. Discrimination of 10-year outcomes was assessed by time-dependent area under the receiver operating characteristic curve (AUC). No differences in predicted risks were observed when comparing office blood pressure and ambulatory blood pressure. The median difference in 10-year risks (1st; 3rd quartile) was -0.01% (-0.3%; 0.1%) for cardiovascular mortality and -0.1% (-1.1%; 0.5%) for cardiovascular events. The difference in AUC (95% confidence interval) was 0.65% (0.22-1.08%) for cardiovascular mortality and 1.33% (0.83-1.84%) for cardiovascular events. Comparing daytime and night-time blood pressure, the median difference in 10-year risks was 0.002% (-0.1%; 0.1%) for cardiovascular mortality and -0.01% (-0.5%; 0.2%) for cardiovascular events. The difference in AUC was 0.10% (-0.08 to 0.29%) for cardiovascular mortality and 0.15% (-0.06 to 0.35%) for cardiovascular events. Ten-year predictions obtained from ambulatory blood pressure are similar to predictions from office blood pressure. Night-time blood pressure does not improve 10-year predictions obtained from daytime measurements. For an otherwise healthy population sufficient prognostic accuracy of cardiovascular risks can be achieved with office blood pressure. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

  20. Cardiovascular Risk Factors in the Antiphospholipid Syndrome

    Directory of Open Access Journals (Sweden)

    Felipe Freire da Silva

    2014-01-01

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

  1. Cardiovascular risk management in rheumatoid arthritis patients still suboptimal: the Implementation of Cardiovascular Risk Management in Rheumatoid Arthritis project

    NARCIS (Netherlands)

    van den Oever, Inge A. M.; Heslinga, Maaike; Griep, Ed N.; Griep-Wentink, Hanneke R. M.; Schotsman, Rob; Cambach, Walter; Dijkmans, Ben A. C.; Smulders, Yvo M.; Lems, Willem F.; Boers, Maarten; Voskuyl, Alexandre E.; Peters, Mike J. L.; van Schaardenburg, Dirkjan; Nurmohamed, Micheal T.

    2017-01-01

    To assess the 10-year cardiovascular (CV) risk score and to identify treatment and undertreatment of CV risk factors in patients with established RA. Demographics, CV risk factors and prevalence of cardiovascular disease (CVD) were assessed by questionnaire. To calculate the 10-year CV risk score

  2. Lifestyle Decreases Risk Factors for Cardiovascular Diseases

    Science.gov (United States)

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

    2009-01-01

    Summary 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 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 1,223 measured persons from 71.2±14.38 (SD) to 70.6±14.02 kg (pSeventh-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

  3. Awareness of Individual Cardiovascular Risk Factors and Self-Perception of Cardiovascular Risk in Women.

    Science.gov (United States)

    Monsuez, Jean-Jacques; Pham, Tai; Karam, Nicole; Amar, Laurence; Chicheportiche-Ayache, Corinne; Menasché, Philippe; Desnos, Michel; Dardel, Paul; Weill, Isabelle

    2017-09-01

    Cardiovascular risk factors (CVRFs) self-perception by women may be inaccurate. A questionnaire was completed anonymously Online by women who self-reported their personal CVRF levels including age, weight, contraceptive use, menopausal status, smoking, diet and physical activities. Self-perceived risk was matched to actual cardiovascular risk according to the Framingham score. Among 5,240 young and middle-aged women with a high educational level, knowledge of personal CVRFs increased with age, from 51-90% for blood pressure (BP), 22-45% for blood glucose and 15-47% for blood cholesterol levels, between 30 and 65 years, respectively. This knowledge was lower for smoking compared with nonsmoking women: 62.5% vs. 74.5% for BP (P self-perception of individual risk are inaccurate in women. Educational interventions should be emphasized. Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

  4. [Smoking, vaping and cardiovascular risk : an update].

    Science.gov (United States)

    Dalkou, Sofia; Clair, Carole

    2017-06-07

    It is well known that tobacco smoking increases cardiovascular (CV) mortality and morbidity, however, smoking cessation is often neglected compared to other CV risk factors. Behavioral counseling as well as smoking cessation treatments are efficient and do not increase the risk of CV events when used for a defined duration. Electronic nicotine delivery systems (ENDS) contain potentially cardiotoxic substances but in lower concentrations than in cigarettes. The CV effect of ENDS is to date difficult to assess and depends on the type of device used and its mode of consumption. For smokers with a known CV disease who have quit smoking using ENDS, it is recommended that they stop using them as soon as they have stabilized.

  5. Cardiovascular Risk Stratification in Patients with Metabolic Syndrome Without Diabetes or Cardiovascular Disease: Usefulness of Metabolic Syndrome Severity Score.

    Science.gov (United States)

    Masson, Walter; Epstein, Teo; Huerín, Melina; Lobo, Lorenzo Martín; Molinero, Graciela; Angel, Adriana; Masson, Gerardo; Millán, Diana; De Francesca, Salvador; Vitagliano, Laura; Cafferata, Alberto; Losada, Pablo

    2017-09-01

    The estimated cardiovascular risk determined by the different risk scores, could be heterogeneous in patients with metabolic syndrome without diabetes or vascular disease. This risk stratification could be improved by detecting subclinical carotid atheromatosis. To estimate the cardiovascular risk measured by different scores in patients with metabolic syndrome and analyze its association with the presence of carotid plaque. Non-diabetic patients with metabolic syndrome (Adult Treatment Panel III definition) without cardiovascular disease were enrolled. The Framingham score, the Reynolds score, the new score proposed by the 2013 ACC/AHA Guidelines and the Metabolic Syndrome Severity Calculator were calculated. Prevalence of carotid plaque was determined by ultrasound examination. A Receiver Operating Characteristic analysis was performed. A total of 238 patients were enrolled. Most patients were stratified as "low risk" by Framingham score (64%) and Reynolds score (70.1%). Using the 2013 ACC/AHA score, 45.3% of the population had a risk ≥7.5%. A significant correlation was found between classic scores but the agreement (concordance) was moderate. The correlation between classical scores and the Metabolic Syndrome Severity Calculator was poor. Overall, the prevalence of carotid plaque was 28.2%. The continuous metabolic syndrome score used in our study showed a good predictive power to detect carotid plaque (area under the curve 0.752). In this population, the calculated cardiovascular risk was heterogenic. The prevalence of carotid plaque was high. The Metabolic Syndrome Severity Calculator showed a good predictive power to detect carotid plaque.

  6. Office blood pressure or ambulatory blood pressure for the prediction of cardiovascular events

    DEFF Research Database (Denmark)

    Mortensen, Rikke Nørmark; Gerds, Thomas Alexander; Jeppesen, Jørgen Lykke

    2017-01-01

    Aims: To determine the added value of (i) 24-h ambulatory blood pressure relative to office blood pressure and (ii) night-time ambulatory blood pressure relative to daytime ambulatory blood pressure for 10-year person-specific absolute risks of fatal and non-fatal cardiovascular events. Methods...... and results: A total of 7927 participants were included from the International Database on Ambulatory blood pressure monitoring in relation to Cardiovascular Outcomes. We used cause-specific Cox regression to predict 10-year person-specific absolute risks of fatal and non-fatal cardiovascular events....... Discrimination of 10-year outcomes was assessed by time-dependent area under the receiver operating characteristic curve (AUC). No differences in predicted risks were observed when comparing office blood pressure and ambulatory blood pressure. The median difference in 10-year risks (1st; 3rd quartile) was -0...

  7. Association of Traditional Cardiovascular Risk Factors with Venous Thromboembolism

    DEFF Research Database (Denmark)

    Mahmoodi, Bakhtawar K; Cushman, Mary; Næss, Inger Anne

    2017-01-01

    Background: Much controversy surrounds the association of traditional cardiovascular disease risk factors with venous thromboembolism (VTE). Methods: We performed an individual level random-effect meta-analysis including 9 prospective studies with measured baseline cardiovascular disease risk...... factors and validated VTE events. Definitions were harmonized across studies. Traditional cardiovascular disease risk factors were modeled categorically and continuously using restricted cubic splines. Estimates were obtained for overall VTE, provoked VTE (ie, VTE occurring in the presence of 1 or more...

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

    DEFF Research Database (Denmark)

    Ahlehoff, Ole; Gislason, Gunnar; Lindhardsen, Jesper

    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....

  9. Adolescent oligomenorrhea (age 14-19) tracks into the third decade of life (age 20-28) and predicts increased cardiovascular risk factors and metabolic syndrome.

    Science.gov (United States)

    Glueck, Charles J; Woo, Jessica G; Khoury, Philip R; Morrison, John A; Daniels, Stephen R; Wang, Ping

    2015-04-01

    Assess whether adolescent oligomenorrhea (age 14-19) tracks into young adulthood (age 20-28) and predicts increased cardiometabolic risk factors, metabolic syndrome (MetS), and impaired fasting glucose-type II diabetes mellitus (IFG+T2DM). Prospective study of menstrual cyclicity and its metabolic effects in 865 black and white schoolgirls from age 9 to 19, and 605 of these 865 girls from age 20 to 28. Patterns of menstrual delays (oligomenorrhea) during ages 14-19 and ages 20-28 were closely related (ppolycystic ovary syndrome (PCOS, p=.049) predicted ages 20-28 menses delay. Menses delays during ages 14-19 and 20-28, and, their interaction product were correlated with IFG+T2DM and MetS at ages 20-28. Waist circumference (ages 20-28, prisk factor for future development of young adult IFG+T2DM, MetS, oligomenorrhea, and polycystic ovary syndrome. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Assessment of cardiovascular risk factors in obese individual in ...

    African Journals Online (AJOL)

    Background: Risk factor modification can reduce clinical events and premature death in people with established cardiovascular disease (CVD) as well as in those who are at high cardiovascular risk due to one or more risk factors. Obesity, a common nutritional disorder in industrialized countries is associated with an ...

  11. Dietary sodium intake and prediction of cardiovascular events.

    Science.gov (United States)

    Äijälä, M; Malo, E; Santaniemi, M; Bloigu, R; Silaste, M-L; Kesäniemi, Y A; Ukkola, O

    2015-09-01

    The association of dietary sodium and cardiovascular disease (CVD), as well as the reduction of sodium intake in the prevention of CVD, has been under debate. To study whether sodium consumption has a role as a risk factor for fatal and non-fatal CVD. A well-defined population-based cohort of 1045 subjects collected between 1991 and 1993 (mean age 51.4 years) was used with approximately 19 years' follow-up. At the baseline, 716 subjects filled in a 1-week food follow-up diary, which was used to calculate the daily sodium intake (mg/1000 kcal). The baseline sodium intake correlated significantly with age (rs=0.117, P=0.002), BMI (rs=0.216, P=0.000), waist circumference (rs=0.268, P=0.000), smoking (rs=0.144, P=0.000), alcohol consumption (rs=0.111, P=0.003), systolic blood pressure (rs=0.106, P=0.005) and low-density lipoprotein (LDL) cholesterol (rs=0.081, P=0.033). Those who had cardiovascular events in the follow-up consumed more sodium at the baseline (mean 2010.4 mg/1000 kcal/day, s.d. 435.2, n=101) compared with the subjects without events (mean 1849.9 mg/1000 kcal/day, s.d. 361.2, n=589; t-test; P=0.001). The incidence of cardiovascular events was greater in the highest quartile (22.1%) than in the lower quartiles (first 11.0%, second 9.9% and third 15.6%; X(2); P=0.005). Cox regression analysis showed that sodium intake as a continuous variable predicts CVD events (P=0.031) independently when age, sex, smoking, alcohol consumption, systolic blood pressure, LDL cholesterol and waist circumference were added as covariates. This predictive role is seen especially in the group of subjects on hypertensive medication (P=0.001). Dietary sodium intake is a significant independent predictor of cardiovascular events in the study population.

  12. 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.

  13. Cardiovascular Risk, Drugs and Erectile Function -A Systematic Analysis

    OpenAIRE

    Baumhäkel , Magnus; Schlimmer , Nils; Kratz , Mario; Hackett , Geoffrey; Jackson , Graham; Böhm , Michael

    2011-01-01

    Abstract Aims Erectile dysfunction is a major problem with an increasing prevalence in cardiovascular high-risk patients due to the association with cardiovascular risk factors. Drugs used for evidenced based treatment of cardiovascular diseases have been reported to decrease erectile function, but possible mechanisms are poorly characterized. Methods MEDLINE, EMBASE and Cochrane Registry search was performed including manuscripts until January 2010. Searching terms are: ...

  14. [Cardiovascular risk factors in the population at risk of poverty and social exclusión].

    Science.gov (United States)

    Álvarez-Fernández, Carlos; Vaquero-Abellán, Manuel; Ruíz-Gandara, África; Romero-Saldaña, Manuel; Álvarez-López, Carlos

    2017-03-01

    Detect if there are differences in prevalence, distribution of cardiovascular risk factors and risk according to REGICOR and SCORE's function; between people belonging to different occupational classes and population at risk of social exclusion. Cross-sectional. SITE: Occupational health unit of the City Hall of Córdoba. Sample availability of 628 people, excluding 59 by age or incomplete data. The group of municipal workers was obtained randomly while all contracted exclusion risk was taken. No preventive, diagnostic or therapeutic actions that modify the course of the previous situation of workers were applied. Smoke, glucose, lipids, blood pressure and BMI as main variables. T-student were used for comparison of means and percentages for Chi 2 . Statistical significance attached to an alpha error <5% and confidence interval with a 95% security. Receiver operator curves (ROC) were employed to find out what explanatory variables predict group membership of workers at risk of exclusion. Smoking (95% CI: -.224;-.443), hypercholesterolemia (95% CI: -.127;-.320), obesity (95% CI: -.005;-0.214), diabetes (95% CI: -.060;-.211) and cardiovascular risk were higher in men at risk of exclusion. In women there were differences in the same variables except smoking (P=.053). The existence of inequalities in prevalence of cardiovascular risk factors is checked. In a context of social crisis, health promotion and primary prevention programs directing to the most vulnerable, they are needed to mit. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  15. Dietary Fibre and Cardiovascular Risk in Diabetes Mellitus

    NARCIS (Netherlands)

    Slurink, Isabel A.L.; Soedamah-Muthu, S.S.

    2016-01-01

    Patients with type 1 and 2 diabetes have a higher risk of cardiovascular disease
    compared to non-diabetic populations. Improved dietary quality is essential to
    control risk factors and can prevent or delay cardiovascular disease in diabetic
    patients. Higher dietary fibre intake was

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

    Science.gov (United States)

    The relationship of snacking patterns on nutrient intake and cardiovascular risk factors 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 cardiovascular risk factors in adults participating in the ...

  17. Low prevalence of cardiovascular risk factors among primary school ...

    African Journals Online (AJOL)

    Background: Identification of obesity and other risk factors for cardiovascular disease in childhood is strongly recommended for prevention of the diseases in adulthood. Objectives: To determine the prevalence of the conventional cardiovascular risk factors among primary school children aged 6-15 years in Urban Dar es ...

  18. Risk Factors for Cardiovascular Diseases among Diabetic Patients ...

    African Journals Online (AJOL)

    BACKGROUND: Studies on cardiovascular risk factors among diabetic persons in Ethiopia are lacking. The objective of this study was to determine the prevalence of the cardiovascular risk factors (hypertension, obesity, physical inactivity, dyslipidemia and smoking) among diabetic patients at the diabetic clinic of Jimma ...

  19. Cardiovascular risk after preeclampsia : The effect of communicating risk factors on intended healthy behavior

    NARCIS (Netherlands)

    Bokslag, Anouk; Kroeze, Willemieke; de Groot, Christianne J.M.; Teunissen, Pim W.

    Objective: We studied the effect of communicating cardiovascular risk factors on intended healthy behavior in women with a history of preeclampsia or uncomplicated pregnancy. Methods: Intention for healthy behavior was assessed before and after cardiovascular risk assessment. Changes were calculated

  20. Research on Improved Depth Belief Network-Based Prediction of Cardiovascular Diseases

    Directory of Open Access Journals (Sweden)

    Peng Lu

    2018-01-01

    Full Text Available Quantitative analysis and prediction can help to reduce the risk of cardiovascular disease. Quantitative prediction based on traditional model has low accuracy. The variance of model prediction based on shallow neural network is larger. In this paper, cardiovascular disease prediction model based on improved deep belief network (DBN is proposed. Using the reconstruction error, the network depth is determined independently, and unsupervised training and supervised optimization are combined. It ensures the accuracy of model prediction while guaranteeing stability. Thirty experiments were performed independently on the Statlog (Heart and Heart Disease Database data sets in the UCI database. Experimental results showed that the mean of prediction accuracy was 91.26% and 89.78%, respectively. The variance of prediction accuracy was 5.78 and 4.46, respectively.

  1. Gene polymorphisms as risk factors for predicting the cardiovascular manifestations in Marfan syndrome. Role of folic acid metabolism enzyme gene polymorphisms in Marfan syndrome.

    Science.gov (United States)

    Benke, Kálmán; Ágg, Bence; Mátyás, Gábor; Szokolai, Viola; Harsányi, Gergely; Szilveszter, Bálint; Odler, Balázs; Pólos, Miklós; Maurovich-Horvat, Pál; Radovits, Tamás; Merkely, Béla; Nagy, Zsolt B; Szabolcs, Zoltán

    2015-10-01

    Folic acid metabolism enzyme polymorphisms are believed to be responsible for the elevation of homocysteine (HCY) concentration in the blood plasma, correlating with the pathogenesis of aortic aneurysms and aortic dissection. We studied 71 Marfan patients divided into groups based on the severity of cardiovascular involvement: no intervention required (n=27, Group A); mild involvement requiring intervention (n=17, Group B); severe involvement (n=27, Group C) subdivided into aortic dilatation (n=14, Group C1) and aortic dissection (n=13, Group C2), as well as 117 control subjects. We evaluated HCY, folate, vitamin B12 and the polymorphisms of methylenetetrahydrofolate reductase (MTHFR;c.665C>T and c.1286A>C), methionine synthase (MTR;c.2756A>G) and methionine synthase reductase (MTRR;c.66A>G). Multiple comparisons showed significantly higher levels of HCY in Group C2 compared to Groups A, B, C1 and control group (pMarfan patients, and especially aortic dissection, is associated with higher HCY plasma levels and prevalence of homozygous genotypes of folic acid metabolism enzymes than mild or no cardiovascular involvement. These results suggest that impaired folic acid metabolism has an important role in the development and remodelling of the extracellular matrix of the aorta.

  2. A four-year cardiovascular risk score for type 2 diabetic inpatients

    Directory of Open Access Journals (Sweden)

    Dolores Ramírez-Prado

    2015-06-01

    Full Text Available As cardiovascular risk tables currently in use were constructed using data from the general population, the cardiovascular risk of patients admitted via the hospital emergency department may be underestimated. Accordingly, we constructed a predictive model for the appearance of cardiovascular diseases in patients with type 2 diabetes admitted via the emergency department. We undertook a four-year follow-up of a cohort of 112 adult patients with type 2 diabetes admitted via the emergency department for any cause except patients admitted with acute myocardial infarction, stroke, cancer, or a palliative status. The sample was selected randomly between 2010 and 2012. The primary outcome was time to cardiovascular disease. Other variables (at baseline were gender, age, heart failure, renal failure, depression, asthma/chronic obstructive pulmonary disease, hypertension, dyslipidaemia, insulin, smoking, admission for cardiovascular causes, pills per day, walking habit, fasting blood glucose and creatinine. A cardiovascular risk table was constructed based on the score to estimate the likelihood of cardiovascular disease. Risk groups were established and the c-statistic was calculated. Over a mean follow-up of 2.31 years, 39 patients had cardiovascular disease (34.8%, 95% CI [26.0–43.6%]. Predictive factors were gender, age, hypertension, renal failure, insulin, admission due to cardiovascular reasons and walking habit. The c-statistic was 0.734 (standard error: 0.049. After validation, this study will provide a tool for the primary health care services to enable the short-term prediction of cardiovascular disease after hospital discharge in patients with type 2 diabetes admitted via the emergency department.

  3. A prediction of the renal and cardiovascular efficacy of aliskiren in ALTITUDE using short-term changes in multiple risk markers

    DEFF Research Database (Denmark)

    Smink, P A; Hoekman, J; Grobbee, D E

    2014-01-01

    in ALTITUDE would confer a relative risk change of -7.9% (95% CI -2.5 to -13.4) for the cardio-renal endpoint, a risk change of -5.1% (-1.2 to -9.0) for the CV endpoint and a non-significant risk change of -19.9% (-42.1 to +2.1) for the renal endpoint. CONCLUSIONS: PRE score estimations suggested...

  4. Natriuretic peptides and integrated risk assessment for cardiovascular disease

    DEFF Research Database (Denmark)

    Willeit, Peter; Kaptoge, S; Welsh, P.

    2016-01-01

    samples and collection of data from studies identified through a systematic search of the literature (PubMed, Scientific Citation Index Expanded, and Embase) for articles published up to Sept 4, 2014, using search terms related to natriuretic peptide family members and the primary outcomes......BACKGROUND: Guidelines for primary prevention of cardiovascular diseases focus on prediction of coronary heart disease and stroke. We assessed whether or not measurement of N-terminal-pro-B-type natriuretic peptide (NT-proBNP) concentration could enable a more integrated approach than at present...... by predicting heart failure and enhancing coronary heart disease and stroke risk assessment. METHODS: In this individual-participant-data meta-analysis, we generated and harmonised individual-participant data from relevant prospective studies via both de-novo NT-proBNP concentration measurement of stored...

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

    Directory of Open Access Journals (Sweden)

    Grace Mary George

    2014-05-01

    Conclusion: Cardiovascular risk factors are highly prevalent among school children. Importantly, school children lack adequate knowledge regarding cardiovascular risk factors. School based interventions are required for cardiovascular risk reduction in childhood.

  6. 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

  7. (n-3) Fatty acid content of red blood cells does not predict risk of future cardiovascular events following an acute coronary syndrome.

    Science.gov (United States)

    Aarsetoey, Hildegunn; Pönitz, Volker; Grundt, Heidi; Staines, Harry; Harris, William S; Nilsen, Dennis W T

    2009-03-01

    A reduced risk of fatal coronary artery disease has been associated with a high intake of (n-3) fatty acids (FA) and a direct cardioprotective effect by their incorporation into myocardial cells has been suggested. Based on these observations, the omega-3 index (eicosapentaenoic acid + docosahexaenoic acid in cell membranes of RBC expressed as percent of total FA) has been suggested as a new risk marker for cardiac death. In this study, our aim was to evaluate the omega-3 index as a prognostic risk marker following hospitalization with an acute coronary syndrome (ACS). The omega-3 index was measured at admission in 460 patients with an ACS as defined by Troponin-T (TnT) > or = 0.02 microg/L. During a 2-y follow-up, recurrent myocardial infarctions (MI) (defined as TnT > 0.05 microg/L with a typical MI presentation) and cardiac and all-cause mortality were registered. Cox regression analyses were used to relate the risk of new events to the quartiles of the omega-3 index at inclusion. After correction for age, sex, previous heart disease, hypertension, diabetes, smoking, high-sensitivity C-reactive protein, brain natriuretic peptide, creatinine, total cholesterol, HDL-cholesterol, triacylglycerol, homocysteine, BMI, and medication, there was no significant reduction in risk for all-cause mortality, cardiac death, or MI with increasing values of the index. In conclusion, we could not confirm the omega-3 index as a useful prognostic risk marker following an ACS.

  8. C-Reactive Protein, Fibrinogen, and Cardiovascular Disease Prediction

    NARCIS (Netherlands)

    Kaptoge, Stephen; Di Angelantonio, Emanuele; Pennells, Lisa; Wood, Angela M.; White, Ian R.; Gao, Pei; Walker, Matthew; Thompson, Alexander; Sarwar, Nadeem; Caslake, Muriel; Butterworth, Adam S.; Amouyel, Philippe; Assmann, Gerd; Bakker, Stephan J. L.; Barr, Elizabeth L. M.; Barrett-Connor, Elizabeth; Benjamin, Emelia J.; Bjorkelund, Cecilia; Brenner, Hermann; Brunner, Eric; Clarke, Robert; Cooper, Jackie A.; Cremer, Peter; Cushman, Mary; Dagenais, Gilles R.; D'Agostino, Ralph B.; Dankner, Rachel; Davey-Smith, George; Deeg, Dorly; Dekker, Jacqueline M.; Engstrom, Gunnar; Folsom, Aaron R.; Fowkes, F. Gerry R.; Gallacher, John; Gaziano, J. Michael; Giampaoli, Simona; Gillum, Richard F.; Hofman, Albert; Howard, Barbara V.; Ingelsson, Erik; Iso, Hiroyasu; Jorgensen, Torben; Kiechl, Stefan; Kitamura, Akihiko; Kiyohara, Yutaka; Koenig, Wolfgang; Kromhout, Daan; Kuller, Lewis H.; Lawlor, Debbie A.; Meade, Tom W.

    2012-01-01

    Background There is debate about the value of assessing levels of C-reactive protein (CRP) and other biomarkers of inflammation for the prediction of first cardiovascular events. Methods We analyzed data from 52 prospective studies that included 246,669 participants without a history of

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

    International Nuclear Information System (INIS)

    Van Poppel, Hein; Tombal, Bertrand

    2011-01-01

    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

  10. Childhood Psychosocial Cumulative Risks and Carotid Intima-Media Thickness in Adulthood: The Cardiovascular Risk in Young Finns Study

    Science.gov (United States)

    Hakulinen, Christian; Pulkki-Råback, Laura; Elovainio, Marko; Kubzansky, Laura D.; Jokela, Markus; Hintsanen, Mirka; Juonala, Markus; Kivimäki, Mika; Josefsson, Kim; Hutri-Kähönen, Nina; Kähönen, Mika; Viikari, Jorma; Keltikangas-Järvinen, Liisa; Raitakari, Olli T

    2015-01-01

    Objective Adverse experiences in childhood may influence cardiovascular risk in adulthood. We examined the prospective associations between types of psychosocial adversity as well as having multiple adversities (e.g., cumulative risk) with carotid intima-media thickness (IMT) and its progression among young adults. Higher cumulative risk score in childhood was expected to be associated with higher IMT and its progression. Methods Participants were 2265 men and women (age range: 24-39 years in 2001) from the on-going Cardiovascular Risk in Young Finns study whose carotid IMT were measured in 2001 and 2007. A cumulative psychosocial risk score, assessed at the study baseline in 1980, was derived from four separate aspects of the childhood environment that may impose risk (childhood stressful life-events, parental health behavior family, socioeconomic status, and childhood emotional environment). Results The cumulative risk score was associated with higher IMT in 2007 (b=.004; se=.001; padulthood, including adulthood health behavior, adulthood socioeconomic status and depressive symptoms. Among the individual childhood psychosocial risk categories, having more stressful life-events was associated with higher IMT in 2001 (b=.007; se=.003; p=.016) and poorer parental health behavior predicted higher IMT in 2007 (b=.004; se=.002; p=.031) after adjustment for age, sex and childhood cardiovascular risk factors. Conclusions Early life psychosocial environment influences cardiovascular risk later in life and considering cumulative childhood risk factors may be more informative than individual factors in predicting progression of preclinical atherosclerosis in adulthood. PMID:26809108

  11. 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.

  12. Subclinical hyperthyroidism and cardiovascular risk: recommendations for treatment.

    Science.gov (United States)

    Palmeiro, Christopher; Davila, Maria I; Bhat, Mallika; Frishman, William H; Weiss, Irene A

    2013-01-01

    Subclinical hyperthyroidism (SHy), the mildest form of hyperthyroidism, is diagnosed in patients having a persistently low or undetectable serum concentration of thyroid-stimulating hormone (TSH) with normal free T4 and T3 concentrations. Although overt hyperthyroidism is associated with an increased risk of adverse cardiovascular outcomes, the cardiovascular risk of SHy is controversial. Multiple studies have demonstrated an increased risk of atrial fibrillation, especially in older individuals with TSH levels effects of SHy on all-cause and cardiovascular mortality are not clear, but recent meta-analyses suggest a modest increase in mortality, with the risk increasing with age and associated with the lowest TSH levels. The long-term consequences of SHy in young- and middle-aged adults, and in those with TSH levels are mildly low, are uncertain. For these reasons, guidelines for treatment are based on patient age, the degree of TSH suppression, symptoms consistent with hyperthyroidism, and overall cardiovascular and osteoporotic fracture risks.

  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. Cardiovascular risk calculation | Ker | South African Family Practice

    African Journals Online (AJOL)

    Cardiovascular disease remains a major cause of global mortality and morbidity. Atherosclerosis is the main underlying cause in the majority of cardiovascular disease events. Traditional independent risk factors for car diovascular disease include age, abnormal lipid levels, elevated blood pressure, smoking and elevated ...

  15. Cardiovascular benefits and risks across the physical activity continuum.

    NARCIS (Netherlands)

    Eijsvogels, T.M.H.; George, K.P.; Thompson, P.D.

    2016-01-01

    PURPOSE OF REVIEW: Habitual physical activity can reduce the risk of future cardiovascular morbidity and mortality. This review evaluates recent publications that have assessed the impact of the dose of physical (in)activity on cardiovascular outcomes. RECENT FINDINGS: Sedentary behavior,

  16. Plasma levels of resistin predict cardiovascular events

    Directory of Open Access Journals (Sweden)

    Vida-Simiti Luminița

    2014-03-01

    .0616, p=0.0299 au fost independent asociate cu noi evenimente cardiovasculare. Concluzii: La pacienţi cu ateroscleroză clinic manifestă nivelele plasmatice ale resistinei pot prezice noi evenimente ischemice.

  17. Comparison of traditional cardiovascular risk models and coronary atherosclerotic plaque as detected by computed tomography for prediction of acute coronary syndrome in patients with acute chest pain.

    Science.gov (United States)

    Ferencik, Maros; Schlett, Christopher L; Bamberg, Fabian; Truong, Quynh A; Nichols, John H; Pena, Antonio J; Shapiro, Michael D; Rogers, Ian S; Seneviratne, Sujith; Parry, Blair Alden; Cury, Ricardo C; Brady, Thomas J; Brown, David F; Nagurney, John T; Hoffmann, Udo

    2012-08-01

    The objective was to determine the association of four clinical risk scores and coronary plaque burden as detected by computed tomography (CT) with the outcome of acute coronary syndrome (ACS) in patients with acute chest pain. The hypothesis was that the combination of risk scores and plaque burden improved the discriminatory capacity for the diagnosis of ACS. The study was a subanalysis of the Rule Out Myocardial Infarction Using Computer-Assisted Tomography (ROMICAT) trial-a prospective observational cohort study. The authors enrolled patients presenting to the emergency department (ED) with a chief complaint of acute chest pain, inconclusive initial evaluation (negative biomarkers, nondiagnostic electrocardiogram [ECG]), and no history of coronary artery disease (CAD). Patients underwent contrast-enhanced 64-multidetector-row cardiac CT and received standard clinical care (serial ECG, cardiac biomarkers, and subsequent diagnostic testing, such as exercise treadmill testing, nuclear stress perfusion imaging, and/or invasive coronary angiography), as deemed clinically appropriate. The clinical providers were blinded to CT results. The chest pain score was calculated and the results were dichotomized to ≥10 (high-risk) and modeling was performed to examine the association of risk scores and coronary plaque burden to the outcome of ACS. Unadjusted models were individually fitted for the coronary plaque burden and for Goldman, Sanchis, TIMI, and chest pain scores. In adjusted analyses, the authors tested whether the association between risk scores and ACS persisted after controlling for the coronary plaque burden. The prognostic discriminatory capacity of the risk scores and plaque burden for ACS was assessed using c-statistics. The differences in area under the receiver-operating characteristic curve (AUC) and c-statistics were tested by performing the -2 log likelihood ratio test of nested models. A p value capacity for the diagnosis of ACS. Plaque burden was

  18. Asymptomatic Extracranial Artery Stenosis and the Risk of Cardiovascular and Cerebrovascular Diseases

    OpenAIRE

    Wang, Dandan; Wang, Jing; Jin, Cheng; Ji, Ruijun; Wang, Anxin; Li, Xin; Gao, Xiang; Wu, Shouling; Zhou, Yong; Zhao, Xingquan

    2016-01-01

    Asymptomatic extracranial artery stenosis (ECAS) is a well-known risk factor for stroke events, but it remains unclear whether it has the same role in predicting cardiovascular and cerebrovascular diseases, especially in China. We investigated the potential associations between ECAS, carotid plaque and carotid intima-media thickness and the new occurrence of cardiovascular and cerebrovascular diseases in the study. Out of 5440 study participants, 364 showed an asymptomatic ECAS at baseline, a...

  19. Cardiovascular Risk Factors among First Year Medical Students

    Directory of Open Access Journals (Sweden)

    Raj Krishna Dangol

    2017-12-01

    Full Text Available Introduction: Detection of cardiovascular risk in young age is important to motivate them to modify life styles and seek health care early to lower the chances of acquiring cardiovascular disease in later age. This study was done to assess cardiovascular risk factors among first year medical students. Methods: A cross-sectional study was conducted throughout September and October 2017 in which all first year medical students from a medical college were assessed for the presence of cardiovascular risk factors. Participants’ demography, family history of illness, anthropometric measurements, and blood reports of lipid profile and fasting glucose were acquired. Data were analyzed with Statistical Package for Social Sciences (SPSS-21. Result: There were 99 participants; 55 males and 44 females. One or more risk factors were present in 87 (87.9% participants. Moreover, 67.7% (n = 67 participants had more than one risk factors. Low HDL-cholesterol was the most common (n = 55, 55.6% risk factor followed by elevated triacylglycerol (n = 47, 47.5% and family history of hypertension (n = 45, 45.5%. There was no significant difference in presence of various risk factors between genders. Conclusion: There was higher prevalence of cardiovascular risk factors among first year medical students. Majority of them had more than one risk factors. Low HDL-cholesterol was the most common risk factor. The risk factors were comparable in males and females.

  20. The ERICE-score: the new native cardiovascular score for the low-risk and aged Mediterranean population of Spain.

    Science.gov (United States)

    Gabriel, Rafael; Brotons, Carlos; Tormo, M José; Segura, Antonio; Rigo, Fernando; Elosua, Roberto; Carbayo, Julio A; Gavrila, Diana; Moral, Irene; Tuomilehto, Jaakko; Muñiz, Javier

    2015-03-01

    In Spain, data based on large population-based cohorts adequate to provide an accurate prediction of cardiovascular risk have been scarce. Thus, calibration of the EuroSCORE and Framingham scores has been proposed and done for our population. The aim was to develop a native risk prediction score to accurately estimate the individual cardiovascular risk in the Spanish population. Seven Spanish population-based cohorts including middle-aged and elderly participants were assembled. There were 11800 people (6387 women) representing 107915 person-years of follow-up. A total of 1214 cardiovascular events were identified, of which 633 were fatal. Cox regression analyses were conducted to examine the contributions of the different variables to the 10-year total cardiovascular risk. Age was the strongest cardiovascular risk factor. High systolic blood pressure, diabetes mellitus and smoking were strong predictive factors. The contribution of serum total cholesterol was small. Antihypertensive treatment also had a significant impact on cardiovascular risk, greater in men than in women. The model showed a good discriminative power (C-statistic=0.789 in men and C=0.816 in women). Ten-year risk estimations are displayed graphically in risk charts separately for men and women. The ERICE is a new native cardiovascular risk score for the Spanish population derived from the background and contemporaneous risk of several Spanish cohorts. The ERICE score offers the direct and reliable estimation of total cardiovascular risk, taking in consideration the effect of diabetes mellitus and cardiovascular risk factor management. The ERICE score is a practical and useful tool for clinicians to estimate the total individual cardiovascular risk in Spain. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  1. CHILDHOOD RISK FACTORS PREDICT CARDIOVASCULAR DISEASE, IMPAIRED FASTING GLUCOSE PLUS TYPE 2 DIABETES MELLITUS, AND HIGH BLOOD PRESSURE 26 YEARS LATER AT MEAN AGE 38: THE PRINCETON-LRC FOLLOW-UP STUDY

    Science.gov (United States)

    Morrison, John A; Glueck, Charles J.; Wang, Ping

    2012-01-01

    Objective Assess whether pediatric risk factors predict cardiovascular disease (CVD), impaired fasting glucose (IFG) + type 2 diabetes (T2DM), and high blood pressure (HBP) in young adulthood. Materials/Methods Prospective follow-up of 909 public-parochial suburban schoolchildren first studied at ages 6–18 and 26 years later at mean age 38. Pediatric triglycerides (TG), blood pressure, LDL cholesterol (LDLC), BMI, and glucose above and HDL cholesterol (HDLC) below established pediatric cutoffs, along with race, cigarette smoking, family history of CVD, T2DM, and HBP were assessed as determinants of young adult CVD, a composite variable including IFG + T2DM, and HBP. Results By stepwise logistic regression, adult CVD (19 yes, 862 no) was associated with pediatric high TG, odds ratio (OR) 5.85, 95% confidence intervals (CI) 2.3–14.7. High TG in pediatric probands with young adult CVD was familial, and was associated with early CVD in their high TG parents. Adult IFG + T2DM (114 yes, 535 no) was associated with parental T2DM (OR 2.2, 95% CI 1.38–3.6), high childhood glucose (OR 4.43, 95% CI 2–9.7), and childhood cigarette smoking (OR 1.64, 95% CI 1.03–2.61). Adult HBP (133 yes, 475 no) was associated with pediatric high BMI (OR 2.7, 95% CI 1.7–4.3) and HBP (OR=2.5, 95% CI 1.5–4.3). Conclusions Pediatric risk factors are significantly, independently related to young adult CVD, IFG+T2DM, and HBP. Identification of pediatric risk factors for CVD, IFG+T2DM, and HBP facilitates initiation of primary prevention programs to reduce development of adult CVD, IFG+T2DM, and HBP. PMID:22001337

  2. Obesity and Cardiovascular Disease: a Risk Factor or a Risk Marker?

    Science.gov (United States)

    Mandviwala, Taher; Khalid, Umair; Deswal, Anita

    2016-05-01

    In the USA, 69 % of adults are either overweight or obese and 35 % are obese. Obesity is associated with an increased incidence of various cardiovascular disorders. Obesity is a risk marker for cardiovascular disease, in that it is associated with a much higher prevalence of comorbidities such as diabetes, hypertension, and metabolic syndrome, which then increase the risk for cardiovascular disease. However, in addition, obesity may also be an independent risk factor for the development of cardiovascular disease. Furthermore, although obesity has been shown to be an independent risk factor for several cardiovascular diseases, it is often associated with improved survival once the diagnosis of the cardiovascular disease has been made, leading to the term "obesity paradox." Several pathways linking obesity and cardiovascular disease have been described. In this review, we attempt to summarize the complex relationship between obesity and cardiovascular disorders, in particular coronary atherosclerosis, heart failure, and atrial fibrillation.

  3. Emerging Cardiovascular Risk Research: Impact of Pets on Cardiovascular Risk Prevention.

    Science.gov (United States)

    Schreiner, Pamela J

    2016-02-01

    Animals interact with humans in multiple ways, including as therapy and service animals, commercially as livestock, as wildlife, and in zoos. But the most common interaction is as companion animals in our homes, with an estimated 180 million cats and dogs living in US households. While pet ownership has been reported to have many health benefits, the findings are inconsistent. Cardiovascular risk factors such as lipids, glucose, obesity, and heart rate variability have improved, worsened, or remained the same in the limited number of studies considering companion animals. Physical activity increases have more consistently been linked with dog ownership, although whether this reflects antecedent motivation or direct benefit from the dog is unclear. Allergies and asthma also are variably linked to pet ownership and are confounded by family history of atopy and timing of exposure to pet dander. The benefits of companion animals are most likely to be through reduction in depression, anxiety, and social isolation, but these studies have been largely cross-sectional and may depend on degree of bonding of the owner with the animal. Positive relationships show measurably higher oxytocin with lower cortisol and alpha-amylase levels. Finally, pet ownership is also a marker of better socioeconomic status and family stability, and if companion animals are to provide cardiovascular risk benefit, the route should perhaps be through improved education and opportunity for ownership.

  4. Preliminary report on hepatic and cardiovascular risk assessment of ...

    African Journals Online (AJOL)

    user

    2011-02-28

    Feb 28, 2011 ... not at greater risk of disruption of their plasma membrane ... supplementing soy protein with acetate generating amino acids. Nutr. Rep. Int. 40: ... Effects of fruits and vegetables on cardiovascular disease ris factors in non-.

  5. Cardiovascular risk markers in type II diabetes and hypertension at ...

    African Journals Online (AJOL)

    Cardiovascular risk markers in type II diabetes and hypertension at the Battor Catholic ... either precedes or is a consequence of the development of these diseases. ... The control group consisted of 62 age-matched healthy individuals.

  6. Screening of cardiovascular risk factors among workers of a ...

    African Journals Online (AJOL)

    user

    workplace and the global risk among workers of a. Construction ... Cardiovascular disease (CVD) is a public health problem with ... are rare in the workplace and there is a virtual absence of ... a reality in workplace, the more threatening due to.

  7. Lipid and Some Other Cardiovascular Risk Factors Assessment in a ...

    African Journals Online (AJOL)

    cardiovascular diseases (CVDs) by measuring such factors as blood pressure ... heart disease. Coexistence of these factors is known to have multiplier effect ... Bearing this changing trend in mind, continuous re-evaluation of these CVD risk ...

  8. 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...

  9. Lipoprotein(a) as a cardiovascular risk factor: current status

    DEFF Research Database (Denmark)

    Nordestgaard, Børge G; Chapman, M John; Ray, Kausik

    2010-01-01

    The aims of the study were, first, to critically evaluate lipoprotein(a) [Lp(a)] as a cardiovascular risk factor and, second, to advise on screening for elevated plasma Lp(a), on desirable levels, and on therapeutic strategies.......The aims of the study were, first, to critically evaluate lipoprotein(a) [Lp(a)] as a cardiovascular risk factor and, second, to advise on screening for elevated plasma Lp(a), on desirable levels, and on therapeutic strategies....

  10. Cardiovascular risk-factor knowledge and risk perception among HIV-infected adults.

    Science.gov (United States)

    Cioe, Patricia A; Crawford, Sybil L; Stein, Michael D

    2014-01-01

    Cardiovascular disease (CVD) has emerged as a major cause of morbidity and mortality in HIV-infected adults. Research in noninfected populations has suggested that knowledge of CVD risk factors significantly influences perceptions of risk. This cross-sectional study describes CVD risk factor knowledge and risk perception in HIV-infected adults. We recruited 130 HIV-infected adults (mean age = 48 years, 62% male, 56% current smokers, mean years since HIV diagnosis, 14.7). The mean CVD risk factor knowledge score was fairly high. However, controlling for age, CVD risk factor knowledge was not predictive of perceived risk [F(1, 117) = 0.13, p > .05]. Estimated risk and perceived risk were weakly but significantly correlated; r (126) = .24, p = .01. HIV-infected adults are at increased risk for CVD. Despite having adequate risk-factor knowledge, CVD risk perception was inaccurate. Improving risk perception and developing CVD risk reduction interventions for this population are imperative. Copyright © 2014 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  11. Markers of visceral obesity and cardiovascular risk in patients with polycystic ovarian syndrome.

    Science.gov (United States)

    Gateva, Antoaneta Trifonova; Kamenov, Zdravko Asenov

    2012-10-01

    Polycystic ovarian syndrome (PCOS) is one of most common endocrine disturbances in women of reproductive age. Besides its well known effects on reproductive health, it is also linked to increased cardiovascular risk in later life. The aim of this study was to investigate the link between some anthropometric indices of visceral obesity and surrogate markers of cardiovascular risk according to the Androgen Excess and Polycystic Ovary Syndrome (AE-PCOS) Society consensus. The study included 36 normal weight (BMIcardiometabolic profile and composite cardiovascular risk factors as defined by the AE-PCOS consensus. Both waist-to-stature ratio (WSR) (area under the curve 0.75, p=0.002) and waist circumference (WC) (area under the curve 0.77, p=0.001) but not waist-to-hip ratio (WHR) (area under the curve 0.62, p=0.143) were shown to be good markers of increased cardiovascular risk, insulin resistance and dislipidemia in PCOS patients. The cut-off point for WSR of 0.50 is useful and the cut-off of 80 cm for WC is more appropriate than 88 cm in detecting cardiovascular risk in PCOS patients. Androgen levels and immunoreactive insulin during an oral glucose tolerance test had lower power for predicting increased cardiovascular risk than WC and WSR. The study indicates that WSR and WC are better associated with composite cardiovascular risk factors as defined by the AE-PCOS consensus than WHR, and that the commonly used cut-off for WSR of 0.5 is useful for detecting cardiovascular risk in PCOS patients. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  12. Validation of an imaging based cardiovascular risk score in a Scottish population.

    Science.gov (United States)

    Kockelkoren, Remko; Jairam, Pushpa M; Murchison, John T; Debray, Thomas P A; Mirsadraee, Saeed; van der Graaf, Yolanda; Jong, Pim A de; van Beek, Edwin J R

    2018-01-01

    A radiological risk score that determines 5-year cardiovascular disease (CVD) risk using routine care CT and patient information readily available to radiologists was previously developed. External validation in a Scottish population was performed to assess the applicability and validity of the risk score in other populations. 2915 subjects aged ≥40 years who underwent routine clinical chest CT scanning for non-cardiovascular diagnostic indications were followed up until first diagnosis of, or death from, CVD. Using a case-cohort approach, all cases and a random sample of 20% of the participant's CT examinations were visually graded for cardiovascular calcifications and cardiac diameter was measured. The radiological risk score was determined using imaging findings, age, gender, and CT indication. Performance on 5-year CVD risk prediction was assessed. 384 events occurred in 2124 subjects during a mean follow-up of 4.25 years (0-6.4 years). The risk score demonstrated reasonable performance in the studied population. Calibration showed good agreement between actual and 5-year predicted risk of CVD. The c-statistic was 0.71 (95%CI:0.67-0.75). The radiological CVD risk score performed adequately in the Scottish population offering a potential novel strategy for identifying patients at high risk for developing cardiovascular disease using routine care CT data. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Prevalence of undiagnosed cardiovascular risk factors and 10-year CVD risk in male steel industry workers.

    Science.gov (United States)

    Gray, Benjamin J; Bracken, Richard M; Turner, Daniel; Morgan, Kerry; Mellalieu, Stephen D; Thomas, Michael; Williams, Sally P; Williams, Meurig; Rice, Sam; Stephens, Jeffrey W

    2014-05-01

    To assess the prevalence of undiagnosed cardiovascular disease (CVD) in a cohort of male steelworkers in South Wales, UK. Male steel industry workers (n = 221) with no prior diagnosis of CVD or diabetes accepted a CVD risk assessment within the work environment. Demographic, anthropometric, family, and medical histories were all recorded and capillary blood samples obtained. The 10-year CVD risk was predicted using the QRISK2-2012 algorithm. Up to 81.5% of workers were either overweight or obese. More than 20% of workers were found to have diastolic hypertension, high total cholesterol, and/or a total cholesterol/high-density lipoprotein ratio of six or more. Over one quarter of workers assessed had an increased 10-year CVD risk. Despite a physically demanding occupation, risk assessment in the workplace uncovered significant occult factors in CVD risk in a sample of male heavy industry workers.

  14. Cardiovascular risk factors burden in Saudi Arabia: The Africa Middle East Cardiovascular Epidemiological (ACE) study.

    Science.gov (United States)

    Ahmed, Amjad M; Hersi, Ahmad; Mashhoud, Walid; Arafah, Mohammed R; Abreu, Paula C; Al Rowaily, Mohammed Abdullah; Al-Mallah, Mouaz H

    2017-10-01

    Limited data exist on the epidemiology of cardiovascular risk factors in Saudi Arabia, particularly in relation to the differences between Saudi nationals and expatriates in Saudi Arabia. The aim of this analysis was to describe the current prevalence of cardiovascular risk factors among patients attending general practice clinics across Saudi Arabia. In this cross-sectional epidemiological analysis of the Africa Middle East Cardiovascular Epidemiological (ACE) study, the prevalence of cardiovascular risk factors (hypertension, diabetes, dyslipidemia, obesity, smoking, abdominal obesity) was evaluated in adults attending primary care clinics in Saudi Arabia. Group comparisons were made between patients of Saudi ethnicity (SA nationals) and patients who were not of Saudi ethnicity (expatriates). A total of 550 participants were enrolled from different clinics across Saudi Arabia [aged (mean ± standard deviation) 43 ± 11 years; 71% male]. Nearly half of the study cohort (49.8%) had more than three cardiovascular risk factors. Dyslipidemia was the most prevalent risk factor (68.6%). The prevalence of hypertension (47.5%) and dyslipidemia (75.5%) was higher among expatriates when compared with SA nationals (31.4% vs. 55.1%, p  = 0.0003 vs. p  Saudi Arabia. Improving primary care services to focus on risk factor control may ultimately decrease the incidence of coronary artery disease and improve overall quality of life. The ACE trial is registered under NCT01243138.

  15. SGLT-2 Inhibitors and Cardiovascular Risk

    DEFF Research Database (Denmark)

    Cavender, Matthew A; Norhammar, Anna; Birkeland, Kåre I

    2018-01-01

    BACKGROUND: Prior studies found patients treated with sodium-glucose co-transporter-2 inhibitors (SGLT-2i) had lower rates of death and heart failure (HF). Whether the benefits of SGLT-2i vary based upon the presence of cardiovascular disease (CVD) is unknown. OBJECTIVES: This study sought...... to determine the association between initiation of SGLT-2i therapy and HF or death in patients with and without CVD. METHODS: The CVD-REAL (Comparative Effectiveness of Cardiovascular Outcomes in New Users of SGLT-2 Inhibitors) study was a multinational, observational study in which adults with type 2 diabetes...... evidence regarding the benefit of SGLT-2i in patients without established CVD. (Comparative Effectiveness of Cardiovascular Outcomes in New Users of SGLT-2 Inhibitors [CVD-REAL]; NCT02993614)....

  16. Breast cancer risks and risk prediction models.

    Science.gov (United States)

    Engel, Christoph; Fischer, Christine

    2015-02-01

    BRCA1/2 mutation carriers have a considerably increased risk to develop breast and ovarian cancer. The personalized clinical management of carriers and other at-risk individuals depends on precise knowledge of the cancer risks. In this report, we give an overview of the present literature on empirical cancer risks, and we describe risk prediction models that are currently used for individual risk assessment in clinical practice. Cancer risks show large variability between studies. Breast cancer risks are at 40-87% for BRCA1 mutation carriers and 18-88% for BRCA2 mutation carriers. For ovarian cancer, the risk estimates are in the range of 22-65% for BRCA1 and 10-35% for BRCA2. The contralateral breast cancer risk is high (10-year risk after first cancer 27% for BRCA1 and 19% for BRCA2). Risk prediction models have been proposed to provide more individualized risk prediction, using additional knowledge on family history, mode of inheritance of major genes, and other genetic and non-genetic risk factors. User-friendly software tools have been developed that serve as basis for decision-making in family counseling units. In conclusion, further assessment of cancer risks and model validation is needed, ideally based on prospective cohort studies. To obtain such data, clinical management of carriers and other at-risk individuals should always be accompanied by standardized scientific documentation.

  17. [Air pollution and cardiovascular toxicity: known risks].

    Science.gov (United States)

    Kostrzewa, A; Filleul, L; Eilstein, D; Harrabi, I; Tessier, J F

    2004-03-01

    Review of studies about epidemiological and physiopathological knowledge of ambient air particles short-term cardio-vascular effects. CURRENTS AND STRONG POINTS: Many studies, in contrasted countries for pollution's sources, meteorological conditions or socio-demographical characteristics, have shown health effects due to ambient air particles. After having studied mainly the respiratory effects of particulate air pollution, epidemiologists are now interested in the cardio-vascular effects of ambient air particles. In fact, serious effects seem to exist in fragile people which can get to emergency department visits, hospitalisation and even death. In addition, studies have shown less serious effects, but likely to be frequent (cardiac symptoms, and stoppages for cardio-vascular causes, notably). The exact mechanism by which particles have cardio-vascular adverse health effects is unknown, but experimental and epidemiological studies have led to several hypotheses: local pulmonary effects seem to be followed by systemic effects, which would be responsible for effects on the electrical activity of the heart through cardiac autonomic dysfunction and effects on the blood supply to the heart. The objective of this work is to summarise epidemiological and physiopathological knowledge about the cardio-vascular effects of ambient air particles. To evaluate the real importance of cardio-vascular effects due to particulate air pollution and to identify their exact mechanism, a more precise knowledge of detailed causes of deaths and hospitalisations and a better knowledge of less serious effects, but likely to be frequent, is necessary. Equally, a detailed identification of fragile people is essential for developing preventive actions.

  18. [Raising women's awareness of cardiovascular risks].

    Science.gov (United States)

    Papas, Anne

    Professor Claire Mounier-Vehier, a cardiologist and vascular specialist at Lille university regional hospital, is a leading spokesperson for women in the field of the prevention of cardiovascular diseases. One of her many roles is head of the 'heart, arteries and women health care pathway' set up in 2013 at Lille university hospital. She discusses the importance of this specific and multidisciplinary care pathway at a time when epidemiological data show that the management of women's cardiovascular health has become a public health priority. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  19. DHA-enriched high–oleic acid canola oil improves lipid profile and lowers predicted cardiovascular disease risk in the canola oil multicenter randomized controlled trial123

    Science.gov (United States)

    Jones, Peter JH; Senanayake, Vijitha K; Pu, Shuaihua; Jenkins, David JA; Connelly, Philip W; Lamarche, Benoît; Couture, Patrick; Charest, Amélie; Baril-Gravel, Lisa; West, Sheila G; Liu, Xiaoran; Fleming, Jennifer A; McCrea, Cindy E; Kris-Etherton, Penny M

    2014-01-01

    Background: It is well recognized that amounts of trans and saturated fats should be minimized in Western diets; however, considerable debate remains regarding optimal amounts of dietary n−9, n−6, and n−3 fatty acids. Objective: The objective was to examine the effects of varying n−9, n−6, and longer-chain n−3 fatty acid composition on markers of coronary heart disease (CHD) risk. Design: A randomized, double-blind, 5-period, crossover design was used. Each 4-wk treatment period was separated by 4-wk washout intervals. Volunteers with abdominal obesity consumed each of 5 identical weight-maintaining, fixed-composition diets with one of the following treatment oils (60 g/3000 kcal) in beverages: 1) conventional canola oil (Canola; n−9 rich), 2) high–oleic acid canola oil with docosahexaenoic acid (CanolaDHA; n−9 and n−3 rich), 3) a blend of corn and safflower oil (25:75) (CornSaff; n−6 rich), 4) a blend of flax and safflower oils (60:40) (FlaxSaff; n−6 and short-chain n−3 rich), or 5) high–oleic acid canola oil (CanolaOleic; highest in n−9). Results: One hundred thirty individuals completed the trial. At endpoint, total cholesterol (TC) was lowest after the FlaxSaff phase (P < 0.05 compared with Canola and CanolaDHA) and highest after the CanolaDHA phase (P < 0.05 compared with CornSaff, FlaxSaff, and CanolaOleic). Low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol were highest, and triglycerides were lowest, after CanolaDHA (P < 0.05 compared with the other diets). All diets decreased TC and LDL cholesterol from baseline to treatment endpoint (P < 0.05). CanolaDHA was the only diet that increased HDL cholesterol from baseline (3.5 ± 1.8%; P < 0.05) and produced the greatest reduction in triglycerides (−20.7 ± 3.8%; P < 0.001) and in systolic blood pressure (−3.3 ± 0.8%; P < 0.001) compared with the other diets (P < 0.05). Percentage reductions in Framingham 10-y CHD risk scores (FRS) from

  20. Data on coronary artery calcium score performance and cardiovascular risk reclassification across gender and ethnicities

    Directory of Open Access Journals (Sweden)

    Marat Fudim

    2016-03-01

    Full Text Available The current guidelines recommend the new risk score, Atherosclerotic Cardiovascular Disease score (ASCVD, to assess an individual׳s risk of future cardiovascular disease (CVD events. No data exist on the predictive utility of ASCVD score with the incremental value of coronary artery calcium scoring (CACS across ethnicities and gender. Multi-Ethnic Study of Atherosclerosis (MESA is a population based study (n=6814 of White (38%, Black (28%, Chinese (22% and Hispanic (12% subjects, aged 45–84 years, free from clinical cardiovascular disease. We performed a post-hoc analysis of 6742 participants (mean age 62, 53% female from the MESA cohort. We evaluated the predictive accuracy for the ASCVD score for each participant in accord with the American College of Cardiology/American Heart Association guidelines using pooled cohort equations. Similar to the publication by Fudim et al. “The Metabolic Syndrome, Coronary Artery Calcium Score and Cardiovascular Risk Reclassification” [1] the analytic properties of models incorporating the ASCVD score with and without CACS were compared for cardiovascular disease CVD prediction. Here the analysis focused on ASCVD score (with and without CACS performance across gender and ethnicities. Keywords: Risk stratification, Coronary calcium scoring, Gender, Ethnicity, MESA, {C}{C}

  1. A new paradigm of cardiovascular risk factor modification

    Directory of Open Access Journals (Sweden)

    Muhammad Firdaus

    2005-07-01

    Full Text Available Muhammad Firdaus1, Jeffery M Asbury2, Dwight W Reynolds21Donald W Reynolds Department of Geriatric Medicine, University of Oklahoma, Oklahoma City, OK, USA; 2Department of Medicine, Cardiovascular Section, University of Oklahoma, Oklahoma City, OK, USAAbstract: Atherosclerotic cardiovascular diseases (CVDs are the leading cause of death and disability in the United States. While multiple studies have demonstrated that modification of atherosclerotic cardiovascular risk factors (CVRFs significantly reduces morbidity and mortality rates, clinical control of CVDs and CVRFs remains poor. By 2010, the American Heart Association seeks to reduce coronary heart disease, stroke, and risk by 25%. To meet this goal, clinical practitioners must establish new treatment paradigms for CVDs and CVRFs. This paper discusses one such treatment model – a comprehensive atherosclerosis program run by physician extenders (under physician supervision, which incorporates evidence-based CVD and CVRF interventions to achieve treatment goals.Keywords: atherosclerosis, cardiovascular risk factors, prevention, modification

  2. 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...... observational studies is accumulating, suggesting that NSAIDs are a major public health concern due to the widespread use of these drugs. Although it seems unlikely that we can completely avoid use of NSAIDs, even among high-risk patients, these results highlight the importance of balancing the benefit versus...

  3. Cardiovascular risk estimation by professionally active cardiovascular nurses: Results from the Basel 2005 Nurses Cohort

    NARCIS (Netherlands)

    Scholte op Reimer, W.J.M.; Moons, P.; De Geest, S.; Fridlund, B.; Heikkila, J.; Jaarsma, Trijntje (Tiny); Lenzen, M.; Martensson, J.; Norekval, T.M.; Smith, K; Stewart, S.; Stromberg, A; Thompson, D.R.

    2006-01-01

    Background: Nurses play a key role in the prevention of cardiovascular disease (CVD) and one would, therefore, expect them to have a heightened awareness of the need for systematic screening and their own CVD risk profile. The aim of this study was to examine personal awareness of CVD risk among a

  4. The Veterans Affairs Cardiac Risk Score: Recalibrating the Atherosclerotic Cardiovascular Disease Score for Applied Use.

    Science.gov (United States)

    Sussman, Jeremy B; Wiitala, Wyndy L; Zawistowski, Matthew; Hofer, Timothy P; Bentley, Douglas; Hayward, Rodney A

    2017-09-01

    Accurately estimating cardiovascular risk is fundamental to good decision-making in cardiovascular disease (CVD) prevention, but risk scores developed in one population often perform poorly in dissimilar populations. We sought to examine whether a large integrated health system can use their electronic health data to better predict individual patients' risk of developing CVD. We created a cohort using all patients ages 45-80 who used Department of Veterans Affairs (VA) ambulatory care services in 2006 with no history of CVD, heart failure, or loop diuretics. Our outcome variable was new-onset CVD in 2007-2011. We then developed a series of recalibrated scores, including a fully refit "VA Risk Score-CVD (VARS-CVD)." We tested the different scores using standard measures of prediction quality. For the 1,512,092 patients in the study, the Atherosclerotic cardiovascular disease risk score had similar discrimination as the VARS-CVD (c-statistic of 0.66 in men and 0.73 in women), but the Atherosclerotic cardiovascular disease model had poor calibration, predicting 63% more events than observed. Calibration was excellent in the fully recalibrated VARS-CVD tool, but simpler techniques tested proved less reliable. We found that local electronic health record data can be used to estimate CVD better than an established risk score based on research populations. Recalibration improved estimates dramatically, and the type of recalibration was important. Such tools can also easily be integrated into health system's electronic health record and can be more readily updated.

  5. Improving prediction of ischemic cardiovascular disease in the general population using apolipoprotein B

    DEFF Research Database (Denmark)

    Benn, Marianne; Nordestgaard, Børge G; Jensen, Gorm Boje

    2007-01-01

    Apolipoprotein B (apoB) levels predict fatal myocardial infarction. Whether apoB also predicts nonfatal ischemic cardiovascular events is unclear. We tested the following hypotheses: apoB predicts ischemic cardiovascular events, and apoB is a better predictor of ischemic cardiovascular events tha...

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

    Science.gov (United States)

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

    2011-01-01

    Background Depressed older individuals have a higher mortality than older persons without depression. Depression is associated with physical inactivity, and low levels of physical activity have been shown in some cohorts to be a partial mediator of the relationship between depression and cardiovascular events and mortality. Methods A cohort of 5888 individuals (mean 72.8±5.6 years, 58% female, 16% African-American) from four US communities was followed for an average of 10.3 years. Self-reported depressive symptoms (10-item Center for Epidemiological Studies Depression Scale) were assessed annually and self-reported physical activity was assessed at baseline and at 3 and 7 years. To estimate how much of the increased risk of cardiovascular mortality associated with depressive symptoms was due to physical inactivity, Cox regression with time-varying covariates was used to determine the percentage change in the log HR of depressive symptoms for cardiovascular mortality after adding physical activity variables. Results At baseline, 20% of participants scored above the cut-off for depressive symptoms. There were 2915 deaths (49.8%), of which 1176 (20.1%) were from cardiovascular causes. Depressive symptoms and physical inactivity each independently increased the risk of cardiovascular mortality and were strongly associated with each other (all pphysical inactivity had greater cardiovascular mortality than those with either individually (pPhysical inactivity reduced the log HR of depressive symptoms for cardiovascular mortality by 26% after adjustment. This was similar for persons with (25%) and without (23%) established coronary heart disease. Conclusions Physical inactivity accounted for a significant proportion of the risk of cardiovascular mortality due to depressive symptoms in older adults, regardless of coronary heart disease status. PMID:21339320

  7. Socioeconomic status predicts second cardiovascular event in 29,226 survivors of a first myocardial infarction.

    Science.gov (United States)

    Ohm, Joel; Skoglund, Per H; Discacciati, Andrea; Sundström, Johan; Hambraeus, Kristina; Jernberg, Tomas; Svensson, Per

    2018-01-01

    Background Risk assessment post-myocardial infarction needs improvement, and risk factors derived from general populations apply differently in secondary prevention. The prediction of subsequent cardiovascular events post-myocardial infarction by socioeconomic status has previously been poorly studied. Design Swedish nationwide cohort study. Methods A total of 29,226 men and women (27%), 40-76 years of age, registered at the standardised one year revisit after a first myocardial infarction in the secondary prevention quality registry of SWEDEHEART 2006-2014. Personal-level data on socioeconomic status measured by disposable income and educational level, marital status, and the primary endpoint, first recurrent event of atherosclerotic cardiovascular disease, defined as non-fatal myocardial infarction or coronary heart disease death or fatal or non-fatal stroke were obtained from linked national registries. Results During the mean 4.1-year follow-up, 2284 (7.8%) first recurrent manifestations of atherosclerotic cardiovascular disease occurred. Both socioeconomic status indicators and marital status were associated with the primary endpoint in multivariable Cox regression models. In a comprehensively adjusted model, including secondary preventive treatment, the hazard ratio for the highest versus lowest quintile of disposable income was 0.73 (95% confidence interval 0.62-0.83). The association between disposable income and first recurrent manifestation of atherosclerotic cardiovascular disease was stronger in men as was the risk associated with being unmarried (tests for interaction P < 0.05). Conclusions Among one year survivors of a first myocardial infarction, first recurrent manifestation of atherosclerotic cardiovascular disease was predicted by disposable income, level of education and marital status. The association between disposable income and first recurrent manifestation of atherosclerotic cardiovascular disease was independent of secondary preventive

  8. Impact of risk factors on cardiovascular risk: a perspective on risk estimation in a Swiss population.

    Science.gov (United States)

    Chrubasik, Sigrun A; Chrubasik, Cosima A; Piper, Jörg; Schulte-Moenting, Juergen; Erne, Paul

    2015-01-01

    In models and scores for estimating cardiovascular risk (CVR), the relative weightings given to blood pressure measurements (BPMs), and biometric and laboratory variables are such that even large differences in blood pressure lead to rather low differences in the resulting total risk when compared with other concurrent risk factors. We evaluated this phenomenon based on the PROCAM score, using BPMs made by volunteer subjects at home (HBPMs) and automated ambulatory BPMs (ABPMs) carried out in the same subjects. A total of 153 volunteers provided the data needed to estimate their CVR by means of the PROCAM formula. Differences (deltaCVR) between the risk estimated by entering the ABPM and that estimated with the HBPM were compared with the differences (deltaBPM) between the ABPM and the corresponding HBPM. In addition to the median values (= second quartile), the first and third quartiles of blood pressure profiles were also considered. PROCAM risk values were converted to European Society of Cardiology (ESC) risk values and all participants were assigned to the risk groups low, medium and high. Based on the PROCAM score, 132 participants had a low risk for suffering myocardial infarction, 16 a medium risk and 5 a high risk. The calculated ESC scores classified 125 participants into the low-risk group, 26 into the medium- and 2 into the high-risk group for death from a cardiovascular event. Mean ABPM tended to be higher than mean HBPM. Use of mean systolic ABPM or HBPM in the PROCAM formula had no major impact on the risk level. Our observations are in agreement with the rather low weighting of blood pressure as risk determinant in the PROCAM score. BPMs assessed with different methods had relatively little impact on estimation of cardiovascular risk in the given context of other important determinants. The risk calculations in our unselected population reflect the given classification of Switzerland as a so-called cardiovascular "low risk country".

  9. 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.

  10. Cardiovascular change during encoding predicts the nonconscious mere exposure effect.

    Science.gov (United States)

    Ladd, Sandra L; Toscano, William B; Cowings, Patricia S; Gabrieli, John D E

    2014-01-01

    These studies examined memory encoding to determine whether the mere exposure effect could be categorized as a form of conceptual or perceptual implicit priming and, if it was not conceptual or perceptual, whether cardiovascular psychophysiology could reveal its nature. Experiment 1 examined the effects of study phase level of processing on recognition, the mere exposure effect, and word identification implicit priming. Deep relative to shallow processing improved recognition but did not influence the mere exposure effect for nonwords or word identification implicit priming for words. Experiments 2 and 3 examined the effect of study-test changes in font and orientation, respectively, on the mere exposure effect and word identification implicit priming. Different study-test font and orientation reduced word identification implicit priming but had no influence on the mere exposure effect. Experiments 4 and 5 developed and used, respectively, a cardiovascular psychophysiological implicit priming paradigm to examine whether stimulus-specific cardiovascular reactivity at study predicted the mere exposure effect at test. Blood volume pulse change at study was significantly greater for nonwords that were later preferred than for nonwords that were not preferred at test. There was no difference in blood volume pulse change for words at study that were later either identified or not identified at test. Fluency effects, at encoding or retrieval, are an unlikely explanation for these behavioral and cardiovascular findings. The relation of blood volume pulse to affect suggests that an affective process that is not conceptual or perceptual contributes to the mere exposure effect.

  11. Cardiovascular disorders risk factors in different industries of Iran

    Directory of Open Access Journals (Sweden)

    Seyedeh Negar Assadi

    2013-01-01

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

  12. 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.

  13. Gestational Diabetes Mellitus and Future Cardiovascular Risk: An Update

    Directory of Open Access Journals (Sweden)

    S. Burlina

    2016-01-01

    Full Text Available The prevalence of gestational diabetes mellitus is increasing in parallel with the rising prevalence of type 2 diabetes and obesity around the world. Current evidence strongly suggests that women who have had gestational diabetes mellitus are at greater risk of cardiovascular disease later in life. Given the growing prevalence of gestational diabetes mellitus, it is important to identify appropriate reliable markers of cardiovascular disease and specific treatment strategies capable of containing obesity, diabetes, and metabolic syndrome in order to reduce the burden of cardiovascular disease in the women affected.

  14. Thematic Synthesis of Cardiovascular Risk Predictors in Children

    Directory of Open Access Journals (Sweden)

    Merlin Garí Llanes

    2012-12-01

    Full Text Available In recent decades, there has been an increased interest in the identification of cardiovascular disease and the factors that predispose its development in children and adolescents. In this sense, significant risk predictors have been cited, such as the presence of family and personal medical history, genetic predisposition, and the alteration of anthropometric and biochemical markers. The understanding of these factors is crucial to prevent the early onset of cardiovascular disease.

  15. 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...

  16. Gestational Diabetes Mellitus and Future Cardiovascular Risk: An Update

    OpenAIRE

    Burlina, S.; Dalfr?, M. G.; Chilelli, N. C.; Lapolla, A.

    2016-01-01

    The prevalence of gestational diabetes mellitus is increasing in parallel with the rising prevalence of type 2 diabetes and obesity around the world. Current evidence strongly suggests that women who have had gestational diabetes mellitus are at greater risk of cardiovascular disease later in life. Given the growing prevalence of gestational diabetes mellitus, it is important to identify appropriate reliable markers of cardiovascular disease and specific treatment strategies capable of contai...

  17. Plasma Total Cysteine and Cardiovascular Risk Burden: Action and Interaction

    OpenAIRE

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

    2012-01-01

    We hypothesized that redox analysis could provide sensitive markers of the oxidative pathway associated to the presence of an increasing number of cardiovascular risk factors (RFs), independently of type. We classified 304 subjects without cardiovascular disease into 4 groups according to the total number of RFs (smoking, hypertension, hypercholesterolaemia, hyperhomocysteinaemia, diabetes, obesity, and their combination). Oxidative stress was evaluated by measuring plasma total and reduced h...

  18. Blood pressure and cardiovascular risk: what about cocoa and chocolate?

    Science.gov (United States)

    Grassi, Davide; Desideri, Giovambattista; Ferri, Claudio

    2010-09-01

    Cocoa flavonoids are able to reduce cardiovascular risk by improving endothelial function and decreasing blood pressure (BP). Interest in the biological activities of cocoa is daily increasing. A recent meta-analysis shows flavanol-rich cocoa administration decreases mean systolic (-4.5mm Hg; pcocoa effects on cardiovascular health focusing on putative mechanisms of action and nutritional and "pharmacological" viewpoints. Cocoa consumption could play a pivotal role in human health. 2010 Elsevier Inc. All rights reserved.

  19. 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...

  20. 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...... 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 secondary CVD...

  1. Decreasing cardiovascular risk in HIV infection between 2005 and 2011.

    Science.gov (United States)

    De Socio, Giuseppe V; Parruti, Giustino; Ricci, Elena; Maggi, Paolo; Celesia, Benedetto M; Penco, Giovanni; Martinelli, Canio; Franzetti, Marco; Di Biagio, Antonio; Bonfanti, Paolo; Pucci, Giacomo; Schillaci, Giuseppe

    2014-02-20

    Cardiovascular risk profile was compared in 765 Italian HIV-infected outpatients enrolled in 2005 and in 765 individually age-matched and sex-matched patients enrolled in 2011. Median Framingham risk score was 8.6% in 2005 vs. 7.9% in 2011 (P = 0.04); metabolic syndrome was present in 40.3% vs. 33.4% (P = 0.006). Blood glucose, triglycerides, prevalence of smokers, and lipodystrophy were all significantly lower in 2011 (all P < 0.0001). Cardiovascular risk improved over a 6-year period in Italian HIV-infected patients.

  2. Incidence of cardiovascular events and associated risk factors in kidney transplant patients: a competing risks survival analysis.

    Science.gov (United States)

    Seoane-Pillado, María Teresa; Pita-Fernández, Salvador; Valdés-Cañedo, Francisco; Seijo-Bestilleiro, Rocio; Pértega-Díaz, Sonia; Fernández-Rivera, Constantino; Alonso-Hernández, Ángel; González-Martín, Cristina; Balboa-Barreiro, Vanesa

    2017-03-07

    The high prevalence of cardiovascular risk factors among the renal transplant population accounts for increased mortality. The aim of this study is to determine the incidence of cardiovascular events and factors associated with cardiovascular events in these patients. An observational ambispective follow-up study of renal transplant recipients (n = 2029) in the health district of A Coruña (Spain) during the period 1981-2011 was completed. Competing risk survival analysis methods were applied to estimate the cumulative incidence of developing cardiovascular events over time and to identify which characteristics were associated with the risk of these events. Post-transplant cardiovascular events are defined as the presence of myocardial infarction, invasive coronary artery therapy, cerebral vascular events, new-onset angina, congestive heart failure, rhythm disturbances, peripheral vascular disease and cardiovascular disease and death. The cause of death was identified through the medical history and death certificate using ICD9 (390-459, except: 427.5, 435, 446, 459.0). The mean age of patients at the time of transplantation was 47.0 ± 14.2 years; 62% were male. 16.5% had suffered some cardiovascular disease prior to transplantation and 9.7% had suffered a cardiovascular event. The mean follow-up period for the patients with cardiovascular event was 3.5 ± 4.3 years. Applying competing risk methodology, it was observed that the accumulated incidence of the event was 5.0% one year after transplantation, 8.1% after five years, and 11.9% after ten years. After applying multivariate models, the variables with an independent effect for predicting cardiovascular events are: male sex, age of recipient, previous cardiovascular disorders, pre-transplant smoking and post-transplant diabetes. This study makes it possible to determine in kidney transplant patients, taking into account competitive events, the incidence of post-transplant cardiovascular events and

  3. Physical activity and cardiovascular disease risk factors among ...

    African Journals Online (AJOL)

    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 ...

  4. 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…

  5. 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...

  6. Evaluation of cardiovascular risk factors in patients with hypertension

    African Journals Online (AJOL)

    Background: Hypertension is a major health concern in developed and developing countries. Its prevalence is high in Nigeria and accounts for a great percentage of hospital visits and admissions. Hypertension is a chief risk factor for cardiovascular events. Independent risks factors, some of which are implicated in the ...

  7. Agreement in cardiovascular risk rating based on anthropometric parameters

    International Nuclear Information System (INIS)

    Dantas, Endilly Maria da Silva; Pinto, Cristiane Jordânia; Freitas, Rodrigo Pegado de Abreu; Medeiros, Anna Cecília Queiroz de

    2015-01-01

    To investigate the agreement in evaluation of risk of developing cardiovascular diseases based on anthropometric parameters in young adults. The study included 406 students, measuring weight, height, and waist and neck circumferences. Waist-to-height ratio and the conicity index. The kappa coefficient was used to assess agreement in risk classification for cardiovascular diseases. The positive and negative specific agreement values were calculated as well. The Pearson chi-square (χ"2) test was used to assess associations between categorical variables (p<0.05). The majority of the parameters assessed (44%) showed slight (k=0.21 to 0.40) and/or poor agreement (k<0.20), with low values of negative specific agreement. The best agreement was observed between waist circumference and waist-to-height ratio both for the general population (k=0.88) and between sexes (k=0.93 to 0.86). There was a significant association (p<0.001) between the risk of cardiovascular diseases and females when using waist circumference and conicity index, and with males when using neck circumference. This resulted in a wide variation in the prevalence of cardiovascular disease risk (5.5%-36.5%), depending on the parameter and the sex that was assessed. The results indicate variability in agreement in assessing risk for cardiovascular diseases, based on anthropometric parameters, and which also seems to be influenced by sex. Further studies in the Brazilian population are required to better understand this issue

  8. Association between low education and higher global cardiovascular risk.

    Science.gov (United States)

    Di Chiara, Tiziana; Scaglione, Alessandra; Corrao, Salvatore; Argano, Christiano; Pinto, Antonio; Scaglione, Rosario

    2015-05-01

    This study was designed to evaluate the impact of educational status on global cardiovascular risk in a southern Italian urban population. The study population consisted of 488 consecutive outpatients aged 18 years and older. Educational status was categorized according to the number of years of formal education as follows: (1) low education group (education group (10-15 years). In both groups, cardiometabolic comorbidities (obesity, visceral obesity, diabetes, dyslipidemia, metabolic syndrome, microalbuminuria, left ventricular hypertrophy) and global cardiovascular risk, according to international guidelines, were analyzed. Left ventricular mass index and ejection fraction by echocardiography and E/A ratio, by pulsed-wave Doppler, were calculated. The low education group was characterized by a significantly higher prevalence of patients with visceral obesity (P=.021), hypertension (P=.010), metabolic syndrome (P=.000), and microalbuminuria (P=.000) and greater global cardiovascular risk (P=.000). Significantly increased levels of microalbuminuria (P=.000) and significantly decreased values of E/A ratio (P=.000) were also detected in the low education group. Global cardiovascular risk correlated directly with waist-to-hip ratio (P=.010), microalbuminuria (P=.015), and the metabolic syndrome (P>.012) and inversely with educational status (P=.000). Education was independently (P=.000) associated with global cardiovascular risk. These data indicate a strong association between low education and cardiometabolic comorbidities suitable to influence the evolution of chronic degenerative diseases. Preventive strategies need to be more efficient and more effective in this patient population. ©2015 Wiley Periodicals, Inc.

  9. Agreement in cardiovascular risk rating based on anthropometric parameters

    Energy Technology Data Exchange (ETDEWEB)

    Dantas, Endilly Maria da Silva; Pinto, Cristiane Jordânia; Freitas, Rodrigo Pegado de Abreu; Medeiros, Anna Cecília Queiroz de [Universidade Federal do Rio Grande do Norte, Natal, RN (Brazil)

    2015-07-01

    To investigate the agreement in evaluation of risk of developing cardiovascular diseases based on anthropometric parameters in young adults. The study included 406 students, measuring weight, height, and waist and neck circumferences. Waist-to-height ratio and the conicity index. The kappa coefficient was used to assess agreement in risk classification for cardiovascular diseases. The positive and negative specific agreement values were calculated as well. The Pearson chi-square (χ{sup 2}) test was used to assess associations between categorical variables (p<0.05). The majority of the parameters assessed (44%) showed slight (k=0.21 to 0.40) and/or poor agreement (k<0.20), with low values of negative specific agreement. The best agreement was observed between waist circumference and waist-to-height ratio both for the general population (k=0.88) and between sexes (k=0.93 to 0.86). There was a significant association (p<0.001) between the risk of cardiovascular diseases and females when using waist circumference and conicity index, and with males when using neck circumference. This resulted in a wide variation in the prevalence of cardiovascular disease risk (5.5%-36.5%), depending on the parameter and the sex that was assessed. The results indicate variability in agreement in assessing risk for cardiovascular diseases, based on anthropometric parameters, and which also seems to be influenced by sex. Further studies in the Brazilian population are required to better understand this issue.

  10. Comparison of cardiovascular risk factors in maintenance hemodialysis patients based on phase angle of bioimpedance analysis

    Science.gov (United States)

    Muzasti, R. A.; Lubis, H. R.

    2018-03-01

    Mortality and morbidity rate, especially from cardiovascular disease in hemodialysis patients in Indonesia is still quite high. One of indicator to assess the predictive value of mortality is the phase angle (PhA) of bioimpedance analysis (BIA) scan examination. Determining the comparison of BMI and laboratory data as cardiovascular risk factors in hemodialysis patients based on PhA.A cross-sectional analytical study was done on 155 outpatientsin RasyidaRenal Hospital, Medan in 2016. Patients were two groups, namely PhAcardiovascular risk factors of hemodialysis patients were determined by age, BMI, and hemoglobin.

  11. Melanoma Risk Prediction Models

    Science.gov (United States)

    Developing statistical models that estimate the probability of developing melanoma cancer over a defined period of time will help clinicians identify individuals at higher risk of specific cancers, allowing for earlier or more frequent screening and counseling of behavioral changes to decrease risk.

  12. Impact of cardiovascular risk factors on the outcome of renal transplantation

    Directory of Open Access Journals (Sweden)

    Moghimi Mehrdad

    2010-01-01

    Full Text Available Cardiovascular diseases are common in renal transplant recipients and renal insuf-ficiency has been shown to be a risk factor for cardiovascular disease. Some studies have reported that cardiovascular risk factors may contribute to the outcome of renal transplantation. This study was performed to determine the impact of cardiovascular risk factors on the outcome of renal transplantation in Iranian subjects. This is a retrospective, observational study including patients of 20-85 years of age who had undergone renal transplantation. Parameters documented and analyzed included demographics, cardiovascular risk factors, past medical history, date of last transplan-tation, the outcome of transplant, last measured serum creatinine, cause of graft failure, rejection, and death. A total of 192 patients were analyzed including 152 in the case group (with identifiable cardiovascular risk factors and 40 controls (transplant recipients without identifiable risk factors. The mean serum creatinine in the case and control groups were 1.33 ± 0.13 and 1.29 ± 0.36 mg/dL respectively (P= 0.493. Response to transplantation was categorized based on a report from the World Health Organization. Complete response to grafting occurred in the control group more than the case group (P= 0.009, while frequency of partial response to grafting was higher in the case group (0.008. A history of chronic obstructive pulmonary diseases (COPD could significantly predict the outcome of grafting (P= 0.008 as could the occurrence of renal failure (P= 0.022. Results were consistently reproduced using multivariate cumulative log it model. Our study indicates that the measured cardiovascular risk factors do not significantly influence the outcome of renal transplantation.

  13. 10-Year cardiovascular event risks for women who experienced hypertensive disorders in late pregnancy: the HyRAS study

    Directory of Open Access Journals (Sweden)

    Ponjee Gabrielle

    2010-06-01

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

  14. RELATIONSHIP BETWEEN PARENTAL AND CHILD CARDIOVASCULAR RISK FACTORS

    Directory of Open Access Journals (Sweden)

    Azita Fesharak Nia

    2010-12-01

    Full Text Available   Abstract INTRODUCTION: Adult cardiovascular disease has its root in childhood. Cardiovascular disease aggregates in families, so identification of high-risk families and early screening and control of cardiovascular risk factors in offspring will help prevent cardiovascular disease. This study was performed to determine the relationship between cardiovascular risk factors in parents having a positive history of premature myocardial infarction and their offspring. methods: This cross-sectional study was conducted in 2004 on 91 parents and their offspring (91 children. The parents were randomly selected from among patients hospitalized in the critical care unit of Vali-e-Asr hospital with premature myocardial infarction. Important indicators such as systolic blood pressure (SBP, diastolic blood pressure (DBP, body mass index (BMI, total cholesterol (TC, triglyceride (TG, low-density lipoprotein cholesterol (LDL-C and high-density lipoprotein cholesterol (HDL-C were measured in both groups. results: There was no significant relation of systolic and diastolic blood pressure between parents and their offspring. Thirty-three percent of the parents were hypertensive. No cases of hypertension were found in children. Mean systolic and diastolic blood pressure were significantly higher in the children of hypertensive parents. Significant relations were seen between BMI and obesity in parents and their children. There was no significant relation between serum lipids, high TC, high LDL-C and low HDL-C levels in parents and their children. The commonest lipid disorder in parents and their offspring was low HDL-C. CONCLUSIONS: The results of this study show a significant relation between hypertension, obesity and blood lipid disorders between parents with positive history of premature myocardial infraction and their children. Hence, screening programs in these children for detection of cardiovascular risk factors are recommended.     Keywords

  15. Prevalence of atherogenic dyslipidemia in primary care patients at moderate-very high risk of cardiovascular disease. Cardiovascular risk perception.

    Science.gov (United States)

    Plana, Nuria; Ibarretxe, Daiana; Cabré, Anna; Ruiz, Emilio; Masana, Lluis

    2014-01-01

    Atherogenic dyslipidemia is an important risk factor for cardiovascular disease. We aim to determine atherogenic dyslipidemia prevalence in primary care patients at moderate-very high cardiovascular risk and its associated cardiovascular risk perception in Spain. This cross-sectional study included 1137 primary care patients. Patients had previous cardiovascular disease, diabetes mellitus, SCORE risk ≥ 3, severe hypertension or dyslipidemia. Atherogenic dyslipidemia was defined as low HDL-C (<40 mg/dL [males], <50 mg/dL [females]) and elevated triglycerides (≥ 150 mg/dL). A visual analog scale was used to define a perceived cardiovascular disease risk score. Mean age was 63.9 ± 9.7 years (64.6% males). The mean BMI was 29.1 ± 4.3 kg/m(2), and mean waist circumference 104.2 ± 12.7 cm (males), and 97.2 ± 14.0 cm (females). 29.4% were smokers, 76.4% had hypertension, 48.0% were diabetics, 24.7% had previous myocardial infarction, and 17.8% peripheral arterial disease. European guidelines classified 83.6% at very high cardiovascular risk. Recommended HDL-C levels were achieved by 50.1% of patients and 37.3% had triglycerides in the reference range. Target LDL-C was achieved by 8.8%. The overall atherogenic dyslipidemia prevalence was 27.1% (34.1% in diabetics). This prevalence in patients achieving target LDL-C was 21.4%. Cardiovascular risk perceived by patients was 4.3/10, while primary care physicians scored 5.7/10. When LDL-C levels are controlled, atherogenic dyslipidemia is more prevalent in those patients at highest cardiovascular risk and with diabetes. This highlights the importance of intervention strategies to prevent the residual vascular risk in this population. Both patients and physicians underestimated cardiovascular risk. Copyright © 2014 Sociedad Española de Arteriosclerosis. Published by Elsevier España. All rights reserved.

  16. Calibration plots for risk prediction models in the presence of competing risks

    DEFF Research Database (Denmark)

    Gerds, Thomas A; Andersen, Per K; Kattan, Michael W

    2014-01-01

    A predicted risk of 17% can be called reliable if it can be expected that the event will occur to about 17 of 100 patients who all received a predicted risk of 17%. Statistical models can predict the absolute risk of an event such as cardiovascular death in the presence of competing risks...... prediction model is well calibrated. The first is lack of independent validation data, the second is right censoring, and the third is that when the risk scale is continuous, the estimation problem is as difficult as density estimation. To deal with these problems, we propose to estimate calibration curves...

  17. 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...

  18. Hormone therapy and cardiovascular risk markers and disease

    DEFF Research Database (Denmark)

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

    2006-01-01

    therapy (HT), although an underlying healthy-user effect may account for these observations. Progestagens are added to protect against an increased risk of endometrial cancer observed with unopposed estrogen treatment. The inclusion of progestagen in HT has been associated with possible adverse......Biological studies have demonstrated estrogen's beneficial effect on cardiovascular risk factors, including plasma lipoproteins, atherogenesis, vascular reactivity, inflammation and antioxidative activity. Additionally, observational studies have supported a cardioprotective effect of hormone...... 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...

  19. 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...... cardiovascular risk factors were independently associated with retinal vascular calibre, with stronger effect of HDL cholesterol and BMI in men than in women. Blood pressure and smoking contributed most to the explained variance....

  20. Cardiovascular Risk and the American Dream: Life Course Observations From the BHS (Bogalusa Heart Study).

    Science.gov (United States)

    Pollock, Benjamin D; Harville, Emily W; Mills, Katherine T; Tang, Wan; Chen, Wei; Bazzano, Lydia A

    2018-02-06

    Economic literature shows that a child's future earnings are predictably influenced by parental income, providing an index of "socioeconomic mobility," or the ability of a person to move towards a higher socioeconomic status from childhood to adulthood. We adapted this economic paradigm to examine cardiovascular risk mobility (CRM), or whether there is life course mobility in relative cardiovascular risk. Participants from the BHS (Bogalusa Heart Study) with 1 childhood and 1 adult visit from 1973 to 2016 (n=7624) were considered. We defined population-level CRM as the rank-rank slope (β) from the regression of adult cardiovascular disease (CVD) risk percentile ranking onto childhood CVD risk percentile ranking (β=0 represents complete mobility; β=1 represents no mobility). After defining and measuring relative CRM, we assessed its correlation with absolute cardiovascular health using the American Heart Association's Ideal Cardiovascular Health metrics. Overall, there was substantial mobility, with black participants having marginally better CRM than whites (β black =0.10 [95% confidence interval, 0.05-0.15]; β white =0.18 [95% confidence interval, 0.14-0.22]; P =0.01). Having high relative CVD risk at an earlier age significantly reduced CRM (β age×slope =-0.02; 95% confidence interval, -0.03 to -0.01; P American Heart Association, Inc., by Wiley.

  1. Coronary Artery Calcium Screening: Does it Perform Better than Other Cardiovascular Risk Stratification Tools?

    Directory of Open Access Journals (Sweden)

    Irfan Zeb

    2015-03-01

    Full Text Available Coronary artery calcium (CAC has been advocated as one of the strongest cardiovascular risk prediction markers. It performs better across a wide range of Framingham risk categories (6%–10% and 10%–20% 10-year risk categories and also helps in reclassifying the risk of these subjects into either higher or lower risk categories based on CAC scores. It also performs better among population subgroups where Framingham risk score does not perform well, especially young subjects, women, family history of premature coronary artery disease and ethnic differences in coronary risk. The absence of CAC is also associated with excellent prognosis, with 10-year event rate of 1%. Studies have also compared with other commonly used markers of cardiovascular disease risk such as Carotid intima-media thickness and highly sensitive C-reactive protein. CAC also performs better compared with carotid intima-media thickness and highly sensitive C-reactive protein in prediction of coronary heart disease and cardiovascular disease events. CAC scans are associated with relatively low radiation exposure (0.9–1.1 mSv and provide information that can be used not only for risk stratification but also can be used to track the progression of atherosclerosis and the effects of statins.

  2. Cardiovascular risk estimation by professionally active cardiovascular nurses: results from the Basel 2005 Nurses Cohort.

    Science.gov (United States)

    Scholte op Reimer, Wilma J M; Moons, Philip; De Geest, Sabina; Fridlund, Bengt; Heikkilä, Johanna; Jaarsma, Tiny; Lenzen, Mattie; Martensson, Jan; Norekvål, Tone M; Smith, Karen; Stewart, Simon; Strömberg, Anna; Thompson, David R

    2006-12-01

    Nurses play a key role in the prevention of cardiovascular disease (CVD) and one would, therefore, expect them to have a heightened awareness of the need for systematic screening and their own CVD risk profile. The aim of this study was to examine personal awareness of CVD risk among a cohort of cardiovascular nurses attending a European conference. Of the 340 delegates attending the 5th annual Spring Meeting on Cardiovascular Nursing (Basel, Switzerland, 2005), 287 (83%) completed a self-report questionnaire to assess their own risk factors for CVD. Delegates were also asked to give an estimation of their absolute total risk of experiencing a fatal CVD event in the next 10 years. Level of agreement between self-reported CVD risk estimation and their actual risk according to the SCORE risk assessment system was compared by calculating weighted Kappa (kappa(w)). Overall, 109 responders (38%) self-reported having either pre-existing CVD (only 2%), one or more markedly raised CVD risk factors, a high total risk of fatal CVD (> or =5% in 10 years) or a strong family history of CVD. About half of this cohort (53%) did not know their own total cholesterol level. Less than half (45%) reported having a 10-year risk of fatal CVD of or =5%. Based on the SCORE risk function, the estimated 10-year risk of a fatal CVD event was or =5% risk of such an event. Overall, less than half (46%) of this cohort's self-reported CVD risk corresponded with that calculated using the SCORE risk function (kappa(w)=0.27). Most cardiovascular nurses attending a European conference in 2005 poorly understood their own CVD risk profile, and the agreement between their self-reported 10-year risk of a fatal CVD and their CVD risk using SCORE was only fair. Given the specialist nature of this conference, our findings clearly demonstrate a need to improve overall nursing awareness of the role and importance of systematic CVD risk assessment.

  3. 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.

  4. 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.

  5. Does fitness improve the cardiovascular risk profile in obese subjects?

    Science.gov (United States)

    Halland, H; Lønnebakken, M T; Saeed, S; Midtbø, H; Cramariuc, D; Gerdts, E

    2017-06-01

    Good cardiorespiratory fitness has been suggested to reduce the risk of cardiovascular disease in obesity. We explored the association of fitness with the prevalences of major cardiovascular risk factor like hypertension (HT), diabetes and metabolic syndrome (MetS) in overweight and obese subjects. Clinical data from 491 participants in the FAT associated CardiOvasculaR dysfunction (FATCOR) study were analyzed. Physical fitness was assessed by ergospirometry, and subjects with at least good level of performance for age and sex were classified as fit. HT subtypes were identified from clinic and 24-h ambulatory blood pressure in combination. Diabetes was diagnosed by oral glucose tolerance test. MetS was defined by the American Heart Association and National Heart, Lung and Blood Institute criteria. The participants were on average 48 years old (60% women), and mean body mass index (BMI) was 32 kg/m 2 . 28% of study participants were classified as fit. Fitness was not associated with lower prevalences of HT or HT subtypes, diabetes, MetS or individual MetS components (all p > 0.05). In multivariable regression analysis, being fit was characterized by lower waist circumference, BMI risk factors like HT, diabetes or MetS. Given the strong association of cardiovascular risk factor burden with risk of clinical cardiovascular disease, these findings challenge the notion that fitness alone is associated with lower risk of cardiovascular disease in obesity. Copyright © 2017 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

  6. The risk of cardiovascular morbidity and cardiovascular mortality in systemic lupus erythematosus and lupus nephritis

    DEFF Research Database (Denmark)

    Hermansen, Marie-Louise; Lindhardsen, Jesper; Torp-Pedersen, Christian

    2017-01-01

    Objective: . To assess the role of LN as a risk factor for myocardial infarction (MI), stroke and cardiovascular mortality (CVM) in patients with SLE. Methods: . The study was conducted using individual-level data from multiple nationwide registers. We identified a cohort of patients diagnosed wi...

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

    International Nuclear Information System (INIS)

    Nieminen, Tuomo; Turjanmaa, Väinö; Kähönen, Mika; Lehtinen, Rami; Viik, Jari; Lehtimäki, Terho; Niemelä, Kari; Nikus, Kjell; Niemi, Mari; Kallio, Janne; Kööbi, Tiit

    2006-01-01

    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. 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. 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

  8. Quantifying prognosis with risk predictions.

    Science.gov (United States)

    Pace, Nathan L; Eberhart, Leopold H J; Kranke, Peter R

    2012-01-01

    Prognosis is a forecast, based on present observations in a patient, of their probable outcome from disease, surgery and so on. Research methods for the development of risk probabilities may not be familiar to some anaesthesiologists. We briefly describe methods for identifying risk factors and risk scores. A probability prediction rule assigns a risk probability to a patient for the occurrence of a specific event. Probability reflects the continuum between absolute certainty (Pi = 1) and certified impossibility (Pi = 0). Biomarkers and clinical covariates that modify risk are known as risk factors. The Pi as modified by risk factors can be estimated by identifying the risk factors and their weighting; these are usually obtained by stepwise logistic regression. The accuracy of probabilistic predictors can be separated into the concepts of 'overall performance', 'discrimination' and 'calibration'. Overall performance is the mathematical distance between predictions and outcomes. Discrimination is the ability of the predictor to rank order observations with different outcomes. Calibration is the correctness of prediction probabilities on an absolute scale. Statistical methods include the Brier score, coefficient of determination (Nagelkerke R2), C-statistic and regression calibration. External validation is the comparison of the actual outcomes to the predicted outcomes in a new and independent patient sample. External validation uses the statistical methods of overall performance, discrimination and calibration and is uniformly recommended before acceptance of the prediction model. Evidence from randomised controlled clinical trials should be obtained to show the effectiveness of risk scores for altering patient management and patient outcomes.

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

    Directory of Open Access Journals (Sweden)

    Kiers Henri

    2010-10-01

    Full Text Available Abstract Background Cardiovascular risk factors are associated with physical fitness and, to a lesser extent, physical activity. Lifestyle interventions directed at enhancing physical fitness in order to decrease the risk of cardiovascular diseases should be extended. To enable the development of effective lifestyle interventions for people with cardiovascular risk factors, we investigated motivational, social-cognitive determinants derived from the Theory of Planned Behavior (TPB and other relevant social psychological theories, next to physical activity and physical fitness. Methods In the cross-sectional Utrecht Police Lifestyle Intervention Fitness and Training (UP-LIFT study, 1298 employees (aged 18 to 62 were asked to complete online questionnaires regarding social-cognitive variables and physical activity. Cardiovascular risk factors and physical fitness (peak VO2 were measured. Results For people with one or more cardiovascular risk factors (78.7% of the total population, social-cognitive variables accounted for 39% (p In addition to the prediction of intention to engage in physical activity and physical active behavior, we explored the impact of the intensity of physical activity. The intentsity of physical activity was only significantly related to physical active behavior (beta = .253, p 2 = .06, p 2 = .23, p For people with one or more cardiovascular risk factors, 39.9% had positive intentions to engage in physical activity and were also physically active, and 10.5% had a low intentions but were physically active. 37.7% had low intentions and were physically inactive, and about 11.9% had high intentions but were physically inactive. Conclusions This study contributes to our ability to optimize cardiovascular risk profiles by demonstrating an important association between physical fitness and social-cognitive variables. Physical fitness can be predicted by physical active behavior as well as by self-efficacy and the intensity of

  10. Cardiovascular risk assessment between urban and rural population in Malaysia.

    Science.gov (United States)

    Noor Hassim, I; Norazman, M R; Diana, M; Khairul Hazdi, Y; Rosnah, I

    2016-12-01

    Cardiovascular disease (CVD) caused significant burden to Malaysia as it accounted for 36% of total deaths. This study aims to evaluate the burden of cardiovascular risk factors among Malaysian adult and assess the difference between urban and rural population in the selected communities. This study is part of the ongoing Prospective Urban Rural Epidemiology (PURE) database, whereby the baseline data were collected since June 2008. CVD risk was measured using INTERHEART risk score which comprised of eleven risk factors i.e. age and gender, family history of heart attack, smoking status, exposure to second hand smoke, diabetes mellitus, hypertension status, waist-hip ratio, self-reported stress, depression, dietary habits and physical activity status. Majority of the studied participants had low cardiovascular risk (57%). Participants from rural area were generally older, had lower educational status, higher prevalence of smokers, obesity, hypertension, diabetes, and more likely to be depressed. In comparison, urbanites had lower physical activities and more likely to be stressful. Mean INTERHEART score among rural participants were higher, especially for male, in comparison to urbanite (11.5±5.83 vs. 10.01±5.74, p<0.001). Contradict to common beliefs, participants in rural areas generally have higher cardiovascular risk factors compared to their urban counterparts. The rural population should be targeted for focused preventive interventions, taking account the socioeconomic and cultural context.

  11. Care for patients with an increased risk for cardiovascular diseases.

    OpenAIRE

    Boheemen, C. van; Geffen, K. van; Philbert, D.; Bos, M.; Dis, I. van; Strijbis, A.; Bouvy, M.; Dijk, L. van

    2010-01-01

    Background: In 2009, a national standard of care for vascular risk management (VRM) was developed. This standard, which was sent to all general practitioners (GPs), contains requirements for optimal care. One requirement is the formulation of a written individual-care plan which contains an extended description of the patient’s cardiovascular risk factors and a plan to reduce the risk. The aim of our study is to describe to what extent current care meets the requirement posed in the care stan...

  12. NEW MARKERS FOR CARDIOVASCULAR RISK: FROM STUDIES TO CLINICAL GUIDELINES

    Directory of Open Access Journals (Sweden)

    D. A. Anichkov

    2014-11-01

    Full Text Available New markers for cardiovascular disease (CVD risk are the subject of an intensive discussion in the scientific literature. The biomarkers (newlipid parameters, inflammatory markers and signs of subclinical atherosclerosis are candidates to be included in models to assess the cumulative risk of CVD. The paper considers the basic studies dealing with new markers of CVD risk and their place in current clinical recommendations.

  13. LEADER 7: cardiovascular risk profiles of US and European participants in the LEADER diabetes trial differ

    NARCIS (Netherlands)

    Rutten, G.E.; Tack, C.J.J.; Pieber, T.R.; Comlekci, A.; Orsted, D.D.; Baeres, F.M.; Marso, S.P.; Buse, J.B.

    2016-01-01

    AIMS: To determine whether US and European participants in the Liraglutide Effect and Action in Diabetes: Evaluation of cardiovascular outcome Results (LEADER) trial differ regarding risk factors for cardiovascular mortality and morbidity. METHODS: Baseline data, stratified for prior cardiovascular

  14. LEADER 7 : Cardiovascular risk profiles of US and European participants in the LEADER diabetes trial differ

    NARCIS (Netherlands)

    Rutten, Guy E H M; Tack, Cees J.; Pieber, Thomas R.; Comlekci, Abdurrahman; Ørsted, David Dynnes; Baeres, Florian M M; Marso, Steven P.; Buse, John B.

    2016-01-01

    Aims: To determine whether US and European participants in the Liraglutide Effect and Action in Diabetes: Evaluation of cardiovascular outcome Results (LEADER) trial differ regarding risk factors for cardiovascular mortality and morbidity. Methods: Baseline data, stratified for prior cardiovascular

  15. 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...

  16. The Cardiovascular Risk of White-Coat Hypertension

    DEFF Research Database (Denmark)

    Franklin, Stanley; Thijs, Lutgarde; Asayama, Kei

    2016-01-01

    BACKGROUND: The role of white-coat hypertension (WCH) and the white-coat-effect (WCE) in development of cardiovascular disease (CVD) risk remains poorly understood. OBJECTIVES: Using data from the population-based, 11-cohort IDACO (International Database on Ambulatory Blood Pressure Monitoring...... in Relation to Cardiovascular Outcomes), this study compared daytime ambulatory blood pressure monitoring with conventional blood pressure measurements in 653 untreated subjects with WCH and 653 normotensive control subjects. METHODS: European Society Hypertension guidelines were used as a 5-stage risk score...

  17. Aerobic exercise reduces biomarkers related to cardiovascular risk among cleaners

    DEFF Research Database (Denmark)

    Korshøj, Mette; Ravn, Marie Højbjerg; Holtermann, Andreas

    2016-01-01

    PURPOSE: Blue-collar workers have an increased risk of cardiovascular disease. Accordingly, elevated levels of biomarkers related to risk of cardiovascular disease, such as high-sensitive C-reactive protein, have been observed among blue-collar workers. The objective was to examine whether...... an aerobic exercise worksite intervention changes the level of inflammation biomarkers among cleaners. METHODS: The design was a cluster-randomized controlled trial with 4-month worksite intervention. Before the 116 cleaners aged 18-65 years were randomized, they signed an informed consent form...

  18. 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......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...

  19. Cardiovascular Risk Factors among College Students: Knowledge, Perception, and Risk Assessment

    Science.gov (United States)

    Tran, Dieu-My T.; Zimmerman, Lani M.; Kupzyk, Kevin A.; Shurmur, Scott W.; Pullen, Carol H.; Yates, Bernice C.

    2017-01-01

    Objective: To assess college students' knowledge and perception of cardiovascular risk factors and to screen for their cardiovascular risks. Participants: The final sample that responded to recruitment consisted of 158 college students from a midwestern university. Methods: A cross-sectional, descriptive study was performed using convenience…

  20. National differences in screening programmes for cardiovascular risks could obstruct understanding of cardiovascular prevention studies in Europe

    NARCIS (Netherlands)

    Thio, S. L.; Twickler, Th B.; Cramer, M. J.; Giral, P.

    2011-01-01

    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. We evaluated the first consultations of patients in two cardiovascular

  1. Cardiovascular Risks in Long Distance Runners.

    Science.gov (United States)

    Witham, Bethany Rolfe; Babbitt, Keven

    Distance running has become increasingly popular since the 1970s. Despite the health benefits, long-distance running has been associated with an increased risk for cardiac events. Healthcare professionals should be familiar with distance running cardiac risk factors and preparticipation screening recommendations from the American Heart Association, and should screen and educate patients during healthcare encounters. Nurses are particularly well suited to educate runners on risks and symptoms of cardiac dysfunction.

  2. Hematocrit levels as cardiovascular risk among taxi drivers in Bangkok, Thailand

    OpenAIRE

    ISHIMARU, Tomohiro; ARPHORN, Sara; JIRAPONGSUWAN, Ann

    2016-01-01

    In Thailand, taxi drivers employed in the informal sector often experience hazardous working conditions. Previous studies revealed that elevated Hematocrit (HCT) is a predictor of cardiovascular disease (CVD) risk. This study assessed factors associated with HCT in taxi drivers to predict their occupational CVD risk factors. A cross-sectional study was conducted on 298 male taxi drivers who joined a health check-up campaign in Bangkok, Thailand. HCT and body mass index were retrieved from par...

  3. Cardiovascular risk factors and events in women with androgen excess.

    Science.gov (United States)

    Macut, D; Antić, I B; Bjekić-Macut, J

    2015-03-01

    Androgen excess (AE) was approximated to be present in 7% of the adult population of women. Polycystic ovary syndrome (PCOS) is the most prevalent among them, followed by idiopathic hirsutism (IH), congenital adrenal hyperplasia (CAH), hyperandrogenic insulin-resistant acanthosis nigricans (HAIRAN) syndrome, and androgen-secreting neoplasms (ASNs). Increased cardiovascular risk was implicated in women with AE. Serum testosterone independently increases risk for cardiovascular disease (CVD), and correlates even with indices of subclinical atherosclerosis in various populations of postmenopausal women. Hyperandrogenism in PCOS is closely related to the aggravation of abdominal obesity, and together with insulin resistance forming the metabolic core for the development of CVD. However, phenotypic variability of PCOS generates significant influence on the cardiometabolic risks. Numerous risk factors in PCOS lead to 5-7 times higher risk for CVD and over 2-fold higher risk for coronary heart disease and stroke. However, issue on the cardiometabolic risk in postmenopausal women with hyperandrogenic history is still challenging. There is a significant overlapping in the CVD characteristics of women with PCOS and variants of CAH. Relevant clinical data on the prevalence and cardiometabolic risk and events in women with IH, HAIRAN syndrome or ASNs are scarce. The effects of various oral contraceptives (OCs) and antiandrogenic compounds on metabolic profile are varying, and could be related to the selected populations and different therapy regiments mainly conducted in women with PCOS. It is assumed relation of OCs containing antiandrogenic progestins to the increased risk of cardiovascular and thromboembolic events.

  4. Subtle gray matter changes in temporo-parietal cortex associated with cardiovascular risk factors.

    Science.gov (United States)

    de Toledo Ferraz Alves, Tânia Corrêa; Scazufca, Márcia; Squarzoni, Paula; de Souza Duran, Fábio Luiz; Tamashiro-Duran, Jaqueline Hatsuko; Vallada, Homero P; Andrei, Anna; Wajngarten, Mauricio; Menezes, Paulo R; Busatto, Geraldo F

    2011-01-01

    Vascular risk factors may play an important role in the pathophysiology of Alzheimer's disease (AD). While there is consistent evidence of gray matter (GM) abnormalities in earlier stages of AD, the presence of more subtle GM changes associated with vascular risk factors in the absence of clinically significant vascular events has been scarcely investigated. This study aimed to examine GM changes in elderly subjects with cardiovascular risk factors. We predicted that the presence of cardiovascular risk would be associated with GM abnormalities involving the temporal-parietal cortices and limbic structures. We recruited 248 dementia-free subjects, age range 66-75 years, from the population-based "São Paulo Ageing and Health Study", classified in accordance to their Framingham Coronary Heart Disease Risk (FCHDR) score to undergo an MRI scan. We performed an overall analysis of covariance, controlled to total GM and APOE4 status, to investigate the presence of regional GM abnormalities in association with FCHDR subgroups (high-risk, medium-risk, and low-risk), and followed by post hoc t-test. We also applied a co-relational design in order to investigate the presence of linear progression of the GM vulnerability in association with cardiovascular risk factor. Voxel-based morphometry showed that the presence of cardiovascular risk factors were associated with regional GM loss involving the temporal cortices bilaterally. Those results retained statistical significance after including APOE4 as a covariate of interest. We also observed that there was a negative correlation between FCHDR scores and rGM distribution in the parietal cortex. Subclinical cerebrovascular abnormalities involving GM loss may provide an important link between cardiovascular risk factors and AD.

  5. 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.

  6. Cardiovascular Risk Factors and 10-year Risk for Coronary Heart Disease in Korean Women

    Directory of Open Access Journals (Sweden)

    Sunjoo Boo, RN, PhD

    2012-03-01

    Conclusion: Modifiable cardiovascular risk factors are highly prevalent in Korean women, and the combination of risk factors is common. Development and implementation of multifaceted nursing interventions are required to confront the current epidemic rise of CHD in Korean women.

  7. Menopause management: a cardiovascular risk-based approach.

    Science.gov (United States)

    Haines, C J; Farrell, E

    2010-08-01

    Hormone replacement therapy (HRT) remains the gold standard for the management of menopausal symptoms; however, HRT use has declined due to concerns over possible adverse side-effects. Approaches to menopause management are continually being revised and these extend beyond the control of recognized menopausal symptoms to encompass wider aspects of menopausal women's health. Hypertension and associated cardiovascular risk are particularly important unmet needs in postmenopausal women, especially in the Asia-Pacific region which has a rapidly aging population and bears around half of the global burden of cardiovascular disease, two-thirds of which has been attributed to elevated blood pressure. As first point of contact for women with menopausal symptoms, gynecologists play a gatekeeper role in assessing women's health, providing appropriate lifestyle counseling, and, where appropriate, implementing treatment or referral to relevant specialists. This paper, with contributions by gynecologists and cardiologists from Asia Pacific and beyond, summarizes available evidence and provides a treatment algorithm that employs a flexible blood pressure classification strategy to assist physicians in their decision-making for the individualized management of menopausal symptoms in women with low, moderate and high cardiovascular risk, and also for women with diabetes. Individualized HRT according to cardiovascular risk may yield improvements in cardiovascular health, as well as managing menopausal symptoms.

  8. [Homocystein and cardiovascular risk: is dosage useful?].

    Science.gov (United States)

    Mathez, Ch; Trueb, L; Darioli, R; Waeber, G

    2004-12-08

    Hyperhomocysteinemia represents an independent risk factor for atherothrombotic disease. Physiopathological mechanisms of accelerated progression of atherosclerosis in presence of hyperhomocysteinemia are complex. Herein we report a clinical case which emphasis the importance of screening elevated homocystein in the absence of conventional risk factors in patients who suffer from premature atherosclerosis.

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

    International Nuclear Information System (INIS)

    Burgos, Miria Suzana; Burgos, Leandro Tibiriçá; Camargo, Marcelo Dias; Franke, Silvia Isabel Rech; Prá, Daniel; Silva, Antônio Marcos Vargas da; Borges, Tássia Silvana; Todendi, Pâmela Ferreira; Reckziegel, Miriam Beatris; Reuter, Cézane Priscila

    2013-01-01

    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

  10. 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.

  11. Cardiovascular risk in Hispanic and non-Hispanic preschoolers.

    Science.gov (United States)

    Barton, Amy J; Gilbert, Lynn; Baramee, Julaluk; Granger, Theresa

    2006-01-01

    Cardiovascular disease (CVD) is the leading cause of death in the United States for both men and women among all racial and ethnic groups. Identifying risk factors early in life can facilitate use of preventive strategies to reduce risk and improve health status across the life span. The aim of this study was to identify modifiable (tobacco smoke exposure, physical inactivity, dietary fat intake, overweight, and high blood pressure [BP]) and nonmodifiable (family history, gender, and age) cardiovascular risk factors in low-income preschool children. Low-income preschool children (N = 205) 3-5 years old were recruited to participate. Parents completed a multigenerational cardiovascular health history form and a 24-hour dietary recall for themselves and their child. The children's height, weight, and BP were obtained. Of the 205 children, 61% reported ethnicity as Latino or Hispanic, 31.7% non-Hispanic White, 1% non-Hispanic Black, 3.9% Asian, and 2.4% mixed race. The number of males (50.7%) and females (49.3%) was similar. Only 22 (10.7%) children had no identified cardiovascular risk factors. At least one modifiable risk factor was present in 179 (87.3%) children. Fifty-two (25.5%) children had a body mass index (BMI) > or = 85th percentile for gender and age; 44 (22.3%) had a systolic or diastolic BP over the 90th percentile for gender, age, and height; 128 (66.3%) had a dietary fat intake of > 30%; 77 (37.6%) watched TV or played video games more than 2 hr/day; and 48 (23.4%) were exposed to passive tobacco smoke. The identification of cardiovascular risk factors in almost 90% of presumably healthy preschoolers provides evidence to support testing of interventions that can improve health behaviors and reduce risks.

  12. 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

    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....

  13. Percent body fat is a better predictor of cardiovascular risk factors than body mass index

    Energy Technology Data Exchange (ETDEWEB)

    Zeng, Qiang; Dong, Sheng-Yong; Sun, Xiao-Nan; Xie, Jing; Cui, Yi [International Medical Center, Chinese PLA General Hospital, Beijing (China)

    2012-04-20

    The objective of the present study was to evaluate the predictive values of percent body fat (PBF) and body mass index (BMI) for cardiovascular risk factors, especially when PBF and BMI are conflicting. BMI was calculated by the standard formula and PBF was determined by bioelectrical impedance analysis. A total of 3859 ambulatory adult Han Chinese subjects (2173 males and 1686 females, age range: 18-85 years) without a history of cardiovascular diseases were recruited from February to September 2009. Based on BMI and PBF, they were classified into group 1 (normal BMI and PBF, N = 1961), group 2 (normal BMI, but abnormal PBF, N = 381), group 3 (abnormal BMI, but normal PBF, N = 681), and group 4 (abnormal BMI and PBF, N = 836). When age, gender, lifestyle, and family history of obesity were adjusted, PBF, but not BMI, was correlated with blood glucose and lipid levels. The odds ratio (OR) and 95% confidence interval (CI) for cardiovascular risk factors in groups 2 and 4 were 1.88 (1.45-2.45) and 2.06 (1.26-3.35) times those in group 1, respectively, but remained unchanged in group 3 (OR = 1.32, 95%CI = 0.92-1.89). Logistic regression models also demonstrated that PBF, rather than BMI, was independently associated with cardiovascular risk factors. In conclusion, PBF, and not BMI, is independently associated with cardiovascular risk factors, indicating that PBF is a better predictor.

  14. Percent body fat is a better predictor of cardiovascular risk factors than body mass index

    International Nuclear Information System (INIS)

    Zeng, Qiang; Dong, Sheng-Yong; Sun, Xiao-Nan; Xie, Jing; Cui, Yi

    2012-01-01

    The objective of the present study was to evaluate the predictive values of percent body fat (PBF) and body mass index (BMI) for cardiovascular risk factors, especially when PBF and BMI are conflicting. BMI was calculated by the standard formula and PBF was determined by bioelectrical impedance analysis. A total of 3859 ambulatory adult Han Chinese subjects (2173 males and 1686 females, age range: 18-85 years) without a history of cardiovascular diseases were recruited from February to September 2009. Based on BMI and PBF, they were classified into group 1 (normal BMI and PBF, N = 1961), group 2 (normal BMI, but abnormal PBF, N = 381), group 3 (abnormal BMI, but normal PBF, N = 681), and group 4 (abnormal BMI and PBF, N = 836). When age, gender, lifestyle, and family history of obesity were adjusted, PBF, but not BMI, was correlated with blood glucose and lipid levels. The odds ratio (OR) and 95% confidence interval (CI) for cardiovascular risk factors in groups 2 and 4 were 1.88 (1.45-2.45) and 2.06 (1.26-3.35) times those in group 1, respectively, but remained unchanged in group 3 (OR = 1.32, 95%CI = 0.92-1.89). Logistic regression models also demonstrated that PBF, rather than BMI, was independently associated with cardiovascular risk factors. In conclusion, PBF, and not BMI, is independently associated with cardiovascular risk factors, indicating that PBF is a better predictor

  15. Cardiovascular risk estimation in older persons

    DEFF Research Database (Denmark)

    Cooney, Marie Therese; Selmer, Randi; Lindman, Anja

    2016-01-01

    .73 to 0.75). Calibration was also reasonable, Hosmer-Lemeshow goodness of fit test: 17.16 (men), 22.70 (women). Compared with the original SCORE function extrapolated to the ≥65 years age group discrimination improved, p = 0.05 (men), p women). Simple risk charts were constructed. On simulated...... risk estimation systems, that risk factors function similarly in all age groups. We aimed to derive and validate a risk estimation function, SCORE O.P., solely from data from individuals aged 65 years and older. METHODS AND RESULTS: 20,704 men and 20,121 women, aged 65 and over and without pre...... model and were included in the SCORE O.P. model were: age, total cholesterol, high-density lipoprotein cholesterol, systolic blood pressure, smoking status and diabetes. SCORE O.P. showed good discrimination; area under receiver operator characteristic curve (AUROC) 0.74 (95% confidence interval: 0...

  16. 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.

  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. Childhood obesity, other cardiovascular risk factors, and premature death.

    Science.gov (United States)

    Franks, Paul W; Hanson, Robert L; Knowler, William C; Sievers, Maurice L; Bennett, Peter H; Looker, Helen C

    2010-02-11

    The effect of childhood risk factors for cardiovascular disease on adult mortality is poorly understood. In a cohort of 4857 American Indian children without diabetes (mean age, 11.3 years; 12,659 examinations) who were born between 1945 and 1984, we assessed whether body-mass index (BMI), glucose tolerance, and blood pressure and cholesterol levels predicted premature death. Risk factors were standardized according to sex and age. Proportional-hazards models were used to assess whether each risk factor was associated with time to death occurring before 55 years of age. Models were adjusted for baseline age, sex, birth cohort, and Pima or Tohono O'odham Indian heritage. There were 166 deaths from endogenous causes (3.4% of the cohort) during a median follow-up period of 23.9 years. Rates of death from endogenous causes among children in the highest quartile of BMI were more than double those among children in the lowest BMI quartile (incidence-rate ratio, 2.30; 95% confidence interval [CI], 1.46 to 3.62). Rates of death from endogenous causes among children in the highest quartile of glucose intolerance were 73% higher than those among children in the lowest quartile (incidence-rate ratio, 1.73; 95% CI, 1.09 to 2.74). No significant associations were seen between rates of death from endogenous or external causes and childhood cholesterol levels or systolic or diastolic blood-pressure levels on a continuous scale, although childhood hypertension was significantly associated with premature death from endogenous causes (incidence-rate ratio, 1.57; 95% CI, 1.10 to 2.24). Obesity, glucose intolerance, and hypertension in childhood were strongly associated with increased rates of premature death from endogenous causes in this population. In contrast, childhood hypercholesterolemia was not a major predictor of premature death from endogenous causes. 2010 Massachusetts Medical Society

  19. Cardiometabolic markers to identify cardiovascular disease risk in ...

    African Journals Online (AJOL)

    Background. The prevalence of HIV is the highest in sub-Saharan Africa; South Africa (SA) is one of the most affected countries with the highest number of adults living with HIV infection in the world. Besides the traditional risk factors for cardiovascular disease (CVD) in the general population, in people living with HIV there ...

  20. Reducing the risk of cardiovascular disease in older women | Davey ...

    African Journals Online (AJOL)

    Cardiovascular disease (CVD) is the leading cause of death in women older than 50 years. Risk factors for CVD differ in some aspects from those in men. The prevention of CVD in women has undergone a reappraisal with the publication of studies looking at the use of menopausal hormone therapy for both primary and ...

  1. 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

  2. Coffee consumption after myocardial infarction and risk of cardiovascular mortality

    NARCIS (Netherlands)

    Dongen, Van Laura H.; Molenberg, Famke; Soedamah-Muthu, Sabita S.; Kromhout, Daan; Geleijnse, Johanna M.

    2017-01-01

    Background: Consumption of coffee, one of the most popular beverages around the world, has been associated with a lower risk of cardiovascular and all-cause mortality in population-based studies. However, little is known about these associations in patient populations. Objective: This prospective

  3. Hashimoto thyroiditis is an independent cardiovascular risk factor in ...

    African Journals Online (AJOL)

    Hypothyroidism is a common disorder that confers an increased cardiovascular risk. The most common cause is Hashimoto thyroiditis (HT) but it can also be caused by thyroidectomy and radioiodine therapy. The aim of the study is to examine whether there is a relation between the cause of hypothyroidism and ...

  4. Cardiovascular disease risk among professionals: A survey of ...

    African Journals Online (AJOL)

    Background: Teachers are often faced with repetitive work related stress, which has been associated with chronic diseases among professionals. Those living in the urban community may be at more risk due to unhealthy lifestyle exposure, but there is little information about their cardiovascular disease profile. Such data ...

  5. Prevalence of cardiovascular risk factors in an African, Urban inner ...

    African Journals Online (AJOL)

    The object of this community based study was to determine the prevalence of selected cardiovascular risk factors in an urban inner city community which had been followed up prospectively from 1993 to 1998. Results show that the prevalence of hypertension (Blood Pressure BP > 160/95 mm Hg) was 12.4 percent with an ...

  6. 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.

  7. 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

  8. Lifestyle and cardiovascular risk factors among hypertensives and ...

    African Journals Online (AJOL)

    Background: The aim of the study was to determine the lifestyle and cardiovascular risk factors among hypertensives and the use of antihypertensive medication in Lagos, Nigeria. Methods: Two hundred and fifty consecutive patients who were attending the outpatients' clinic cardiology unit of the medical department of ...

  9. Cardiovascular risk factors and mortality in children with chronic ...

    African Journals Online (AJOL)

    Traditional and non-traditional cardiovascular risk factors. (CVRFs) play an ..... to other causes of anaemia in CKD such as declining production of erythropoietin .... Care 2008;35(2):329-. 344, vii. https:/doi.org/10.1016/j.pop.2008.01.008. 2.

  10. Blood Pressure Management in Cardiovascular Risk Stratification. Procedure, Progression, Process.

    NARCIS (Netherlands)

    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

  11. 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...

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

    DEFF Research Database (Denmark)

    Ranthe, Mattis Flyvholm; Carstensen, Lisbeth; Oyen, Nina

    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....

  13. Cardiovascular and metabolic risks associated with PCOS.

    Science.gov (United States)

    Cobin, Rhoda H

    2013-04-01

    Polycystic ovary syndrome, the most common endocrine disorder of reproductive age women, is often associated with insulin resistance and associated disorders. The frequency of type 2 diabetes, hyperlipidemia, cardiac risk markers, structural vascular disease, and clinical disease events are increased in this population of women. PCOS, however, represents a broad spectrum of clinical presentations, as defined by different criteria proposed in Europe and the United States. The role of insulin resistance and hence the risk of cardiometabolic disorders may in part be determined by the definition of PCOS used. Epidemiologic studies and clinical trials support the need to identify women with PCOS to determine their risk of cardiometabolic disorders to prevent and/or treat their serious consequences.

  14. Predictive Performance of Echocardiographic Parameters for Cardiovascular Events Among Elderly Treated Hypertensive Patients.

    Science.gov (United States)

    Chowdhury, Enayet K; Jennings, Garry L R; Dewar, Elizabeth; Wing, Lindon M H; Reid, Christopher M

    2016-07-01

    Hypertension leads to cardiac structural and functional changes, commonly assessed by echocardiography. In this study, we assessed the predictive performance of different echocardiographic parameters including left ventricular hypertrophy (LVH) on future cardiovascular outcomes in elderly hypertensive patients without heart failure. Data from LVH substudy of the Second Australian National Blood Pressure trial were used. Echocardiograms were performed at entry into the study. Cardiovascular outcomes were identified over short term (median 4.2 years) and long term (median 10.9 years). LVH was defined using threshold values of LV mass (LVM) indexed to either body surface area (BSA) or height(2.7): >115/95g/m(2) (LVH-BSA(115/95)) or ≥49/45g/m(2.7) (LVH-ht(49/45)) in males/females, respectively, and ≥125g/m(2) (LVH-BSA(125)) or ≥51g/m(2.7) (LVH-ht(51)) for both sexes. In the 666 participants aged ≥65 years in this analysis, LVH prevalence at baseline was 33%-70% depending on definition; and after adjusting for potential risk factors, only LVH-BSA(115/95) predicted both short- and long-term cardiovascular outcomes. Participants having LVH-BSA(115/95) (69%) at baseline had twice the risk of having any first cardiovascular event over the short term (hazard ratio, 95% confidence interval: 2.00, 1.12-3.57, P = 0.02) and any fatal cardiovascular events (2.11, 1.21-3.68, P = 0.01) over the longer term. Among other echocardiographic parameters, LVM and LVM indexed to either BSA or height(2.7) predicted cardiovascular events over both short and longer term. In elderly treated hypertensive patients without heart failure, determining LVH by echocardiography is highly dependent on the methodology adopted. LVH-BSA(115/95) is a reliable predictor of future cardiovascular outcomes in the elderly. © American Journal of Hypertension, Ltd 2016. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  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...... a stent dual antiplatelet therapy with a P2Y12 receptor antagonist and acetylsalicylic acid (ASA) is recommended for 12 months, preferable with prasugrel or ticagrelor unless there is an additional indication of warfarin or increased risk of bleeding. In patients with AF, warfarin is recommended...

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

    NARCIS (Netherlands)

    Waldron, C.A.; Gallacher, J.; Weijden, G.D.E.M. van der; Newcombe, R.; Elwyn, G.

    2010-01-01

    BACKGROUND: The future risk of heart disease can be predicted with increasing precision. However, more research is needed into how this risk is conveyed and presented. The aim of this study is to compare the effects of presenting cardiovascular risk in different formats on individuals' intention to

  17. 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.

  18. Cardiovascular Risks Associated with Incident and Prevalent Periodontal Disease

    Science.gov (United States)

    Yu, Yau-Hua; Chasman, Daniel I; Buring, Julie E; Rose, Lynda; Ridker, Paul M

    2014-01-01

    Aim While prevalent periodontal disease associates with cardiovascular risk, little is known about how incident periodontal disease influences future vascular risk. We compared effects of incident versus prevalent periodontal disease in developing major cardiovascular diseases (CVD), myocardial infarction (MI), ischemic stroke and total CVD. Material and Methods In a prospective cohort of 39863 predominantly white women, age ≥ 45 years and free of cardiovascular disease at baseline were followed for an average of 15.7 years. Cox proportional hazard models with time-varying periodontal status (prevalent [18%], incident [7.3%] vs. never [74.7%]) were used to assess future cardiovascular risks. Results Incidence rates of all CVD outcomes were higher in women with prevalent or incident periodontal disease. For women with incident periodontal disease, risk factor adjusted hazard ratios (HRs) were 1.42 (95% CI, 1.14–1.77) for major CVD, 1.72 (1.25–2.38) for MI, 1.41(1.02–1.95) for ischemic stroke, and 1.27(1.06–1.52) for total CVD. For women with prevalent periodontal disease, adjusted HRs were 1.14 (1.00–1.31) for major CVD, 1.27 (1.04–1.56) for MI, 1.12(0.91–1.37) for ischemic stroke, and 1.15(1.03–1.28) for total CVD. Conclusion New cases of periodontal disease, not just those that are pre-existing, place women at significantly elevated risks for future cardiovascular events. PMID:25385537

  19. Uric acid as a risk factor for cardiovascular disease and mortality in overweight/obese individuals.

    Directory of Open Access Journals (Sweden)

    Helle Skak-Nielsen

    Full Text Available The predictive value of serum uric acid (SUA for adverse cardiovascular events among obese and overweight patients is not known, but potentially important because of the relation between hyperuricaemia and obesity.The relationship between SUA and risk of cardiovascular adverse outcomes (nonfatal myocardial infarction, nonfatal stroke, resuscitated cardiac arrest or cardiovascular death and all-cause mortality, respectively, was evaluated in a post-hoc analysis of the Sibutramine Cardiovascular OUTcomes (SCOUT trial. Participants enrolled in SCOUT were obese or overweight with pre-existing diabetes and/or cardiovascular disease (CVD. Cox models were used to assess the role of SUA as an independent risk factor.9742 subjects were included in the study; 83.6% had diabetes, and 75.1% had CVD. During an average follow-up time of 4.2 years, 1043 subjects had a primary outcome (myocardial infarction, resuscitated cardiac arrest, stroke, or cardiovascular death, and 816 died. In a univariate Cox model, the highest SUA quartile was associated with an increased risk of cardiovascular adverse outcomes compared with the lowest SUA quartile in women (hazard ratio [HR]: 1.59; 95% confidence interval [CI]: 1.20-2.10. In multivariate analyses, adjusting for known cardiovascular risk factors the increased risk for the highest SUA quartile was no longer statistically significant among women (HR: 0.99; 95% CI: 0.72-1.36 nor was it among men. Analyses of all-cause mortality found an interaction between sex and SUA. In a multivariate Cox model including women only, the highest SUA quartile was associated with an increased risk in all-cause mortality compared to the lowest SUA quartile (HR: 1.51; 95% CI: 1.08-2.12. No relationship was observed in men (HR: 1.06; 95% CI: 0.82-1.36.SUA was not an independent predictor of cardiovascular disease and death in these high-risk overweight/obese people. However, our results suggested that SUA was an independent predictor of all

  20. Adiponectin, type 2 diabetes and cardiovascular risk

    DEFF Research Database (Denmark)

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

    2015-01-01

    participants experienced a CV event (myocardial infarction, ischaemic stroke, or CV death). RESULTS: Participants with increasing adiponectin had reduced risk of developing T2DM (p physical activity, alcohol......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...

  1. Added Sugars and Cardiovascular Disease Risk in Children

    Science.gov (United States)

    Vos, Miriam B.; Kaar, Jill L.; Welsh, Jean A.; Van Horn, Linda V.; Feig, Daniel I.; Anderson, Cheryl A.M.; Patel, Mahesh J.; Munos, Jessica Cruz; Krebs, Nancy F.; Xanthakos, Stavra A.; Johnson, Rachel K.

    2017-01-01

    BACKGROUND Poor lifestyle behaviors are leading causes of preventable diseases globally. Added sugars contribute to a diet that is energy dense but nutrient poor and increase risk of developing obesity, cardiovascular disease, hypertension, obesity-related cancers, and dental caries. METHODS AND RESULTS For this American Heart Association scientific statement, the writing group reviewed and graded the current scientific evidence for studies examining the cardiovascular health effects of added sugars on children. The available literature was subdivided into 5 broad subareas: effects on blood pressure, lipids, insulin resistance and diabetes mellitus, nonalcoholic fatty liver disease, and obesity. CONCLUSIONS Associations between added sugars and increased cardiovascular disease risk factors among US children are present at levels far below current consumption levels. Strong evidence supports the association of added sugars with increased cardiovascular disease risk in children through increased energy intake, increased adiposity, and dyslipidemia. The committee found that it is reasonable to recommend that children consume ≤25 g (100 cal or ≈6 teaspoons) of added sugars per day and to avoid added sugars for children added sugars most likely can be safely consumed in low amounts as part of a healthy diet, few children achieve such levels, making this an important public health target. PMID:27550974

  2. 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...... of the increased risk. METHODS: This was a meta-analysis of observational studies with continuous outcome using random-effects statistics. A systematic search of studies published before 25 October 2012 was conducted using the databases Medline, EMBASE, International Pharmaceutical Abstracts, PASCAL and BIOSIS......·65 mmol L(-1) )] and a higher HbA1c [1·09 mmol mol(-1) , 95% CI 0·87-1·31, P controls are significant, and therefore relevant to the clinical management of patients with psoriasis....

  3. [Cardiovascular risk factors in users with severe mental disorder].

    Science.gov (United States)

    Paños-Martínez, Montserrat; Patró-Moncunill, Ester; Santiago-Barragán, Ángel-María; Marti-Mestre, Marc; Torralbas-Ortega, Jordi; Escayola-Maranges, Anna; Granero-Lázaro, Alberto

    2016-01-01

    To identify the prevalence of the cardiovascular risk (RCV) in users with a Severe Mental Disorder (SMD) attended in mental health service in ParcTaulí (Sabadell - Barcelona). This is an observational, descriptive and transversal study of the factors of cardiovascular risk in 789 users with SMD. The instrument used was the scale of assessment of the Registre Gironí del Cor, which estimates the risk of cardiovascular disease. 26.6% of the sample has RCV (22.5% moderate, 3.8% high and 0.3% very high). The analysis of the modifiable risk factors shows that 16.5% of the patients are hypertensive, 55.2% are smokers, 19.77% have hyperglycaemia (8.2% of whom are diagnosed of diabetes mellitus), 40.2% have obesity, 36.2% overweight and 47.27% hypercholesterolemia. The study confirms that the prevalence of the RVC in SMD users is greater than the RCV in general population and it's associated to the presence of modifiable risk factors. Health education carried out by nurses is the best to prevent the RCV in SMD users. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Karin B Gast

    glucose or fasting insulin concentration. It may be useful to add HOMA-IR to a cardiovascular risk prediction model.

  5. 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 ... on Screening for Peripheral Artery Disease (PAD) and Cardiovascular Disease (CVD) Risk Assessment with Ankle Brachial Index (ABI) ...

  6. The plasma leptin/adiponectin ratio predicts first cardiovascular event in men : A prospective nested case-control study

    NARCIS (Netherlands)

    Kappelle, Paul J.W.H.; Dullaart, Robin P. F.; van Beek, Andre P.; Hillege, Hans L.; Wolffenbuttel, Bruce H. R.

    2012-01-01

    Objective: The plasma leptin/adiponectin (L/A) ratio has been proposed as a preferential marker of atherosclerosis susceptibility compared to leptin and adiponectin alone. We determined the extent to which the L/A ratio predicts incident cardiovascular disease (CVD) taking account of clinical risk

  7. An exploratory analysis of criteria for the metabolic syndrome and its prediction of long-term cardiovascular outcomes

    NARCIS (Netherlands)

    Girman, C.J.; Dekker, J.M.; Rhodes, T.; Nijpels, M.G.A.A.M.; Stehouwer, C.D.A.; Bouter, L.M.; Heine, R.J.

    2005-01-01

    Studies have shown an increased risk of cardiovascular outcomes with the metabolic syndrome, but information on predictive properties of the National Cholesterol Education Program Adult Treatment Panel 3 (NCEP) criteria is sparse. The authors used data from the Hoorn population-based study in the

  8. Does present use of cardiovascular medication reflect elevated cardiovascular risk scores estimated ten years ago? A population based longitudinal observational study

    Directory of Open Access Journals (Sweden)

    Straand Jørund

    2011-03-01

    Full Text Available Abstract Background It is desirable that those at highest risk of cardiovascular disease should have priority for preventive measures, eg. treatment with prescription drugs to modify their risk. We wanted to investigate to what extent present use of cardiovascular medication (CVM correlates with cardiovascular risk estimated by three different risk scores (Framingham, SCORE and NORRISK ten years ago. Methods Prospective logitudinal observational study of 20 252 participants in The Hordaland Health Study born 1950-57, not using CVM in 1997-99. Prescription data obtained from The Norwegian Prescription Database in 2008. Results 26% of men and 22% of women aged 51-58 years had started to use some CVM during the previous decade. As a group, persons using CVM scored significantly higher on the risk algorithms Framingham, SCORE and NORRISK compared to those not treated. 16-20% of men and 20-22% of women with risk scores below the high-risk thresholds for the three risk scores were treated with CVM, while 60-65% of men and 25-45% of women with scores above the high-risk thresholds received no treatment. Among women using CVM, only 2.2% (NORRISK, 4.4% (SCORE and 14.5% (Framingham had risk scores above the high-risk values. Low education, poor self-reported general health, muscular pains, mental distress (in females only and a family history of premature cardiovascular disease correlated with use of CVM. Elevated blood pressure was the single factor most strongly predictive of CVM treatment. Conclusion Prescription of CVM to middle-aged individuals by large seems to occur independently of estimated total cardiovascular risk, and this applies especially to females.

  9. Developmental dyslexia: predicting individual risk.

    Science.gov (United States)

    Thompson, Paul A; Hulme, Charles; Nash, Hannah M; Gooch, Debbie; Hayiou-Thomas, Emma; Snowling, Margaret J

    2015-09-01

    Causal theories of dyslexia suggest that it is a heritable disorder, which is the outcome of multiple risk factors. However, whether early screening for dyslexia is viable is not yet known. The study followed children at high risk of dyslexia from preschool through the early primary years assessing them from age 3 years and 6 months (T1) at approximately annual intervals on tasks tapping cognitive, language, and executive-motor skills. The children were recruited to three groups: children at family risk of dyslexia, children with concerns regarding speech, and language development at 3;06 years and controls considered to be typically developing. At 8 years, children were classified as 'dyslexic' or not. Logistic regression models were used to predict the individual risk of dyslexia and to investigate how risk factors accumulate to predict poor literacy outcomes. Family-risk status was a stronger predictor of dyslexia at 8 years than low language in preschool. Additional predictors in the preschool years include letter knowledge, phonological awareness, rapid automatized naming, and executive skills. At the time of school entry, language skills become significant predictors, and motor skills add a small but significant increase to the prediction probability. We present classification accuracy using different probability cutoffs for logistic regression models and ROC curves to highlight the accumulation of risk factors at the individual level. Dyslexia is the outcome of multiple risk factors and children with language difficulties at school entry are at high risk. Family history of dyslexia is a predictor of literacy outcome from the preschool years. However, screening does not reach an acceptable clinical level until close to school entry when letter knowledge, phonological awareness, and RAN, rather than family risk, together provide good sensitivity and specificity as a screening battery. © 2015 The Authors. Journal of Child Psychology and Psychiatry published by

  10. Relationship of Polycystic Ovarian Syndrome with Cardiovascular Risk Factors.

    Science.gov (United States)

    Bilal, Muhammad; Haseeb, Abdul; Rehman, Abdur

    2018-05-01

    Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting women of reproductive age. The two main documented pathogenic mechanisms are hyperinsulinemia and hyperandrogenemia but there is growing evidence for increased predisposition to cardiovascular disease, dyslipidemia, and type 2 diabetes mellitus. Our study aims to analyze the association of PCOS with cardiovascular risk factors. This is a prospective study which targeted 100 PCOS patients from Civil Hospital Karachi over a period of one year (July 2016 to July 2017). An equal number of age-matched healthy control participants were also included in the study. The student's t-test was used to assess the significance of differences using SPSS version (19). The statistical significance was set at a p-value of PCOS was primary infertility seen in 72% of the patients. Mean arterial pressure, fasting glucose and insulin levels and insulin resistance was found to be significantly different in PCOS patients as compared to their controls. A classic atherosclerotic lipid profile demonstrating elevated total cholesterol and low-density lipoprotein-C (LDL-C) levels and decreased serum high density lipoprotein-C(HDL-C) was observed in our study. This study established a significant yet independent association of PCOS with major cardiovascular risk factors. This association can effectively progress into CVD outcomes which necessitates early intervention programs and preventative strategies to reduce mortality from cardiovascular events. This study lays out the framework for conducting further researches on the PCOS women while exploring novel cardiovascular risk factors. Copyright © 2018 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  11. [Motivation to change unhealthy life styles and cardiovascular risk].

    Science.gov (United States)

    Pérez-Manchón, David; Alvarez-García, Gema María; González-López, Esteban

    2014-01-01

    Study the relationship between motivation to change unhealthy life styles and cardiovascular risk. Cross sectional study, random, stratified by age, carried out in the field of primary care with a sample of 369 people. It was felt that with smoking or smoking cessation active consumption less than a year, the physical habit was valued at work and leisure, food habits were assessed in adherence to mediterranean diet and the stages of motivation were categorized precontemplative phase to maintenance phase. The cardiovascular risk was stratified with the SCORE table calibrated in Spain. The 49.6% were men and 50.4% were women, with an average age of 41.2 years. The prevalence of smoking was 31.4% (95% CI 26.56-36,30), 58% in sedentary lifestyle (95% CI 52.27-62,63) and 68% for bad diet (95% CI 63.97-73,69). The 69.8% of smokers, 77.8% of sedentary and 48.4% of people without proper diet was precontemplative to change their lifestyles. Precontemplative stages in unhealthy life styles have association with risk factors and increase the global cardiovascular risk. The transtheoretical model is a useful tool for the assessment of unhealthy behaviors in lifestyles. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  12. Polycystic ovary syndrome: cardiovascular risk factors according to specific phenotypes.

    Science.gov (United States)

    Aziz, Mubeena; Sidelmann, Johannes J; Faber, Jens; Wissing, Marie-Louise M; Naver, Klara V; Mikkelsen, Anne-Lis; Nilas, Lisbeth; Skouby, Sven O

    2015-10-01

    Polycystic ovary syndrome (PCOS) is associated with obesity and insulin resistance. The objective of this cross-sectional study was to investigate the impact of insulin resistance and body mass index (BMI) on inflammatory and hemostatic variables associated with long-term risk of cardiovascular disease in women with PCOS. 149 premenopausal women with PCOS were recruited consecutively from April 2010 to February 2012 at three Danish University Hospitals. The study was conducted at the Department of Gynecology and Obstetrics, Herlev University Hospital, Denmark. PCOS was diagnosed in accordance with the Rotterdam criteria and the women were classified into four phenotypes according to BMI and insulin resistance measured by the homeostasis model assessment of insulin resistance index. Body composition was determined by dual-energy X-ray absorptiometry. Main outcome measures were the biomarkers C-reactive protein (CRP), plasminogen activator inhibitor-1 (PAI-1), and von Willebrand factor antigen. Normal weight insulin-resistant PCOS women were characterized by abdominal obesity and elevated levels of plasma PAI-1. Overweight/obese insulin-resistant PCOS women had increased levels of both PAI-1 and CRP. Of the three Rotterdam criteria, only hyperandrogenemia was significantly associated with the hemostatic risk marker of long-term cardiovascular disease risk. Surrogate risk markers for cardiovascular disease are elevated in women with PCOS, especially insulin-resistant and overweight/obese women. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

  13. Food Security and Cardiovascular Disease Risk Among Adults in the United States: Findings From the National Health and Nutrition Examination Survey, 2003?2008

    OpenAIRE

    Ford, Earl S.

    2013-01-01

    Introduction Little is known about the relationship between food security status and predicted 10-year cardiovascular disease risk. The objective of this study was to examine the associations between food security status and cardiovascular disease risk factors and predicted 10-year risk in a national sample of US adults. Methods A cross-sectional analysis using data from 10,455 adults aged 20 years or older from the National Health and Nutrition Examination Survey 2003?2008 was conducted. Fou...

  14. Quantitative characterization of myocardial infarction by cardiovascular magnetic resonance predicts future cardiovascular events in patients with ischemic cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Pauly John M

    2008-04-01

    Full Text Available Abstract Background Cardiovascular magnetic resonance (CMR can provide quantitative data of the myocardial tissue utilizing high spatial and temporal resolution along with exquisite tissue contrast. Previous studies have correlated myocardial scar tissue with the occurrence of ventricular arrhythmia. This study was conducted to evaluate whether characterization of myocardial infarction by CMR can predict cardiovascular events in patients with ischemic cardiomyopathy (ICM. Results We consecutively studied 86 patients with ICM (LVEF Conclusion Quantification of the scar volume and scar percentage by CMR is superior to LVEDV, LVESV, and LVEF in prognosticating the future likelihood of the development of cardiovascular events in patients with ICM.

  15. 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

  16. Educational differences in cardiovascular mortality: The role of shared family factors and cardiovascular risk factors.

    Science.gov (United States)

    Kjøllesdal, M K R; Ariansen, I; Mortensen, L H; Davey Smith, G; Næss, Ø

    2016-12-01

    To explore the confounding effects of early family factors shared by siblings and cardiovascular risk factors in midlife on the educational differences in mortality from cardiovascular disease (CVD). Data from national and regional health surveys in Norway (1974-2003) were linked with data from the Norwegian Family Based Life Course Study, the National Educational Registry and the Cause of Death Registry. The study population consisted of participants with at least one full sibling among the health survey participants ( n=271,310). Data were available on CVD risk factors, including weight, height, blood pressure, total cholesterol and smoking. The hazards ratio (HR) of CVD mortality was 3.44 (95% confidence interval (CI) 2.98-3.96) in the lowest educational group relative to the highest. The HRs were little altered in the within-sibship analyses. Adjusted for risk factors, the HR for CVD mortality in the cohort analyses was 2.05 (CI 1.77-2.37) in the lowest educational group relative to the highest. The respective HR in the within-sibship analyses was 2.46 (CI 1.48-2.24). Using a sibling design, we did not find that the association between education and CVD mortality was confounded by early life factors shared by siblings, but it was explained to a large extent by CVD risk factors. These results suggest that reducing levels of CVD risk factors could have the greatest effect on mortality in less well-educated people.

  17. Impact of One Year of Shift Work on Cardiovascular Disease Risk Factors

    NARCIS (Netherlands)

    Amelsvoort, van L.G.P.M.; Schouten, E.G.; Kok, F.J.

    2004-01-01

    The purpose of the study was to investigate whether the reported increased cardiovascular disease risk in shift workers could be explained by changes in cardiovascular risk factors. In a cohort of 239 shift and 157 daytime workers, 1-year changes in biological and lifestyle cardiovascular risk

  18. Cutaneous lupus erythematosus and systemic lupus erythematosus are associated with clinically significant cardiovascular risk

    DEFF Research Database (Denmark)

    Hesselvig, J Halskou; Ahlehoff, O; Dreyer, L

    2017-01-01

    Systemic lupus erythematosus (SLE) is a well-known cardiovascular risk factor. Less is known about cutaneous lupus erythematosus (CLE) and the risk of developing cardiovascular disease (CVD). Therefore, we investigated the risk of mortality and adverse cardiovascular events in patients diagnosed...

  19. 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.

    Science.gov (United States)

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

    2014-08-21

    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. 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, and HbA1c level at baseline as the usual care group. Biomedical and cardiovascular outcomes were measured at baseline and at 12-month after the enrollment. Difference-in-differences approach was employed to measure the effect of RAMP-DM on the changes in biomedical outcomes, proportion of subjects reaching treatment targets, observed and predicted cardiovascular risks. Compared to the usual care group, RAMP-DM group had lower cardiovascular events incidence (1.21% vs 2.89%, P = 0.003), and net decrease in HbA1c (-0.20%, P risks (total CVD risk, -2.06%, P risk, -1.43%, P risk, -0.71%, P risks. The RAMP-DM resulted in greater improvements in HbA1c and reduction in observed and predicted cardiovascular risks at 12 months follow-up, which indicated a risk-stratification multidisciplinary intervention was an effective strategy for managing Chinese people with diabetes in the primary care setting. ClinicalTrials.gov, NCT02034695.

  20. Cardiovascular risk assessment: audit findings from a nurse clinic--a quality improvement initiative.

    Science.gov (United States)

    Waldron, Sarah; Horsburgh, Margaret

    2009-09-01

    Evidence has shown the effectiveness of risk factor management in reducing mortality and morbidity from cardiovascular disease (CVD). An audit of a nurse CVD risk assessment programme undertaken between November 2005 and December 2008 in a Northland general practice. A retrospective audit of CVD risk assessment with data for the first entry of 621 patients collected exclusively from PREDICT-CVDTM, along with subsequent data collected from 320 of these patients who had a subsequent assessment recorded at an interval ranging from six months to three years (18 month average). Of the eligible population (71%) with an initial CVD risk assessment, 430 (69.2%) had afive-year absolute risk less than 15%, with 84 (13.5%) having a risk greater than 15% and having not had a cardiovascular event. Of the patients with a follow-up CVD risk assessment, 34 showed improvement. Medication prescribing for patients with absolute CVD risk greater than 15% increased from 71% to 86% for anti-platelet medication and for lipid lowering medication from 65% to 72% in the audit period. The recently available 'heart health' trajectory tool will help patients become more aware of risks that are modifiable, together with community support to engage more patients in the nurse CVD prevention programme. Further medication audits to monitor prescribing trends. Patients who showed an improvement in CVD risk had an improvement in one or more modifiable risk factors and became actively involved in making changes to their health.

  1. The TyG index may predict the development of cardiovascular events.

    Science.gov (United States)

    Sánchez-Íñigo, Laura; Navarro-González, David; Fernández-Montero, Alejandro; Pastrana-Delgado, Juan; Martínez, Jose Alfredo

    2016-02-01

    Cardiovascular disease (CVD) is the worldwide leading cause of morbidity and mortality. An early risk detection of apparently healthy people before CVD onset has clinical relevance in the prevention of cardiovascular events. We evaluated the association between the product of fasting plasma glucose and triglycerides (TyG index) and CVD. A total of 5014 patients of the Vascular Metabolic CUN cohort (VMCUN cohort) were followed up during a median period of 10 years. We used a Cox proportional-hazard ratio with repeated measures to estimate the risk of incidence of CVD across quintiles of the TyG index, calculated as ln[fasting triglycerides (mg/dL) × fasting plasma glucose (mg(dL)/2], and plotted a receiver-operating characteristics (ROC) curve to compare a prediction model fitted on the variables used in the Framingham risk score, a new model containing the Framingham variables with the TyG index, and the risk of coronary heart disease. A higher level of TyG index was significantly associated with an increased risk of developing CVD independent of confounding factors with a value of 2·32 (95% CI: 1·65-3·26) for those in the highest quintile and 1·52 (95% CI: 1·07-2·16) for those in the fourth quintile. The areas under the curve (AUC) of the ROC plots were 0·708 (0·68-0·73) for the Framingham model and 0·719 (0·70-0·74) for the Framingham + TyG index model (P = 0·014). The TyG index, a simple measure reflecting insulin resistance, might be useful to early identify individuals at a high risk of developing a cardiovascular event. © 2015 Stichting European Society for Clinical Investigation Journal Foundation.

  2. Vitamin d status, filaggrin genotype, and cardiovascular risk factors

    DEFF Research Database (Denmark)

    Skaaby, Tea; Husemoen, Lise Lotte Nystrup; Martinussen, Torben

    2013-01-01

    Vitamin D deficiency is associated with increased cardiovascular disease risk in observational studies. Whether these associations are causal is not clear. Loss-of-function mutations in the filaggrin gene result in up to 10% higher serum vitamin D concentrations, supposedly due to a decreased UV......-protection of the keratinocytes. We used a Mendelian randomization approach to estimate the causal effect of vitamin D status on serum lipids, blood pressure, body mass index, waist circumference, and the metabolic syndrome....

  3. Cardiovascular Risk Factors in Children and Adolescents with Subclinical Hypothyroidism.

    Science.gov (United States)

    Yadav, Yogesh; Saikia, Uma Kaimal; Sarma, Dipti; Hazarika, Manoj

    2017-01-01

    Subclinical hypothyroidism (SCH) is a commonly encountered entity in day-to-day clinical practice and has been associated with adverse cardiovascular risk profile in adults and children. Data on children and adolescents with SCH, from India, are limited. This study was a cross-sectional case-control study, conducted at a tertiary care center in Northeast India. Twenty-seven children and adolescents aged 11 ± 2.4 years with SCH and thyroid-stimulating hormone >7.5 mIU/L were included in the study along with 20 age-, gender-, and height-matched controls. Multiple clinical, biochemical, and radiological cardiovascular risk factors were assessed and compared between the two groups. Body mass index (BMI) ( P = 0.048), waist circumference ( P = 0.008), waist to height ratio ( P = 0.007), low-density lipoprotein cholesterol ( P = 0.04), triglycerides (TGs) ( P = 0.038), TGs to high-density lipoprotein (HDL) cholesterol ratio ( P = 0.005), non-HDL cholesterol ( P = 0.019), fasting insulin ( P = 0.006), and homeostasis model assessment of insulin resistance ( P = 0.007) were found to be significantly higher while free T4 ( P = 0.002) and HDL cholesterol ( P = 0.019) were found to be significantly lower in SCH subjects compared to controls. On multiple regression analysis, BMI was found to have significant association with multiple cardiovascular risk factors. Children and adolescents with SCH were found to have adverse cardiovascular risk profile. Long-term follow-up studies are required to assess the clinical significance of these findings and requirement for therapy.

  4. Cardiovascular risk factors in children and adolescents with subclinical hypothyroidism

    Directory of Open Access Journals (Sweden)

    Yogesh Yadav

    2017-01-01

    Full Text Available Background: Subclinical hypothyroidism (SCH is a commonly encountered entity in day-to-day clinical practice and has been associated with adverse cardiovascular risk profile in adults and children. Data on children and adolescents with SCH, from India, are limited. Materials and Methods: This study was a cross-sectional case–control study, conducted at a tertiary care center in Northeast India. Twenty-seven children and adolescents aged 11 ± 2.4 years with SCH and thyroid-stimulating hormone >7.5 mIU/L were included in the study along with 20 age-, gender-, and height-matched controls. Multiple clinical, biochemical, and radiological cardiovascular risk factors were assessed and compared between the two groups. Results: Body mass index (BMI (P = 0.048, waist circumference (P = 0.008, waist to height ratio (P = 0.007, low-density lipoprotein cholesterol (P = 0.04, triglycerides (TGs (P = 0.038, TGs to high-density lipoprotein (HDL cholesterol ratio (P = 0.005, non-HDL cholesterol (P = 0.019, fasting insulin (P = 0.006, and homeostasis model assessment of insulin resistance (P = 0.007 were found to be significantly higher while free T4 (P = 0.002 and HDL cholesterol (P = 0.019 were found to be significantly lower in SCH subjects compared to controls. On multiple regression analysis, BMI was found to have significant association with multiple cardiovascular risk factors. Conclusion: Children and adolescents with SCH were found to have adverse cardiovascular risk profile. Long-term follow-up studies are required to assess the clinical significance of these findings and requirement for therapy.

  5. Is cardiovascular risk in women with PCOS a real risk? Current insights.

    Science.gov (United States)

    Papadakis, Georgios; Kandaraki, Eleni; Papalou, Olga; Vryonidou, Andromachi; Diamanti-Kandarakis, Evanthia

    2017-12-01

    Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive aged women. PCOS incorporates not only symptoms related to the reproductive system but also a clustering of systemic metabolic abnormalities that are linked with increased risk for cardiovascular disease (CVD). More specifically, metabolic aberrations such as impaired glucose and lipid metabolism, accompanied by increased low-grade inflammation as well as elevated coagulation factors appear to contribute to the increased cardiovascular risk. Even though many studies have indicated a rise in surrogate biomarkers of CVD in women with PCOS, it is still doubtful to what extent and magnitude this elevation can be translated to real cardiovascular events. Furthermore, the cardiovascular risk factors appear to vary significantly in the different phenotypes of the syndrome. Women with PCOS have the potential for early atherosclerosis, myocardial and endothelial dysfunction. Whether PCOS women are at real cardiovascular risk compared to controls remains between the verge of theoretical and real threat for the PCOS women at any age but particularly in the post-menopausal state. Interestingly, although the presence of the CVD risk factors is well documented in PCOS women, their combination on different phenotypes may play a role, which eventually results in a spectrum of clinical manifestations of CVD with variable degree of severity. The present manuscript aims to review the interaction between PCOS and the combination of several cardiovascular risk factors.

  6. Basic fibroblast growth factor predicts cardiovascular disease occurrence in participants from the Veterans Affairs Diabetes Trial

    Directory of Open Access Journals (Sweden)

    Mark B Zimering

    2013-11-01

    Full Text Available Aim: Cardiovascular disease is a leading cause of morbidity and mortality in adults with type 2 diabetes mellitus. The aim of the present study was to test whether plasma basic fibroblast growth factor (bFGF levels predict future cardiovascular disease (CVD occurrence in adults from the Veterans Affairs Diabetes Trial. Methods: Nearly four- hundred veterans, 40 years of age or older, having a mean baseline diabetes duration of 11.4 years were recruited from outpatient clinics at six geographically distributed sites in the Veterans Affairs Diabetes Trial (VADT. Within the VADT, they were randomly assigned to intensive or standard glycemic treatment, with follow-up as much as seven and one-half years. Cardiovascular disease occurrence was examined at baseline in the patient population and during randomized treatment. Plasma bFGF was determined with a sensitive, specific two-site enzyme-linked immunoassay at the baseline study visit in all 399 subjects. Results: One hundred-five first cardiovascular events occurred in these 399 subjects. The best fit model of risk factors associated with the time to first cardiovascular disease occurrence (in the study over a seven and one-half year period had as significant predictors: prior cardiovascular event, (hazard ratio [HR] 3.378; 95% confidence intervals [CI] 3.079- 3.807; P < .0001, baseline plasma bFGF (HR 1.008; 95% CI 1.002-1.014; P =.01, age, (HR 1.027; 95% CI 1.004-1.051; P =.019, baseline plasma triglycerides, (HR 1.001; 95% CI 1.000-1.002; P =.02 and diabetes duration-treatment interaction (P =.03. Intensive glucose-lowering was associated with significantly decreased hazard ratios for CVD occurrence (0.38-0.63 in patients with known diabetes duration of 0-10 years, and non-significantly increased hazard ratios for CVD occurrence (0.82-1.78 in patients with longer diabetes duration. Conclusion: High level ofplasma basic fibroblast growth factor is a predictive biomarker of future cardiovascular

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

    Science.gov (United States)

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

    2014-02-01

    Cigarette smoking is the most important cause of premature death, and it is currently listed as a major independent risk factor for cardiovascular disease. Because of restrictive measures and widespread control policies, tobacco companies are now using aggressive marketing strategies in favor of smokeless tobacco, including electronic nicotine delivery systems, which are also known as electronic cigarettes or e-cigarettes. Although the regular use of these devices appears less hazardous than traditional cigarettes or other forms of smokeless tobacco, recent studies have shown that various potentially harmful substances, especially nicotine, ultraparticles, and volatile organic compounds, may be effectively inhaled or liberated in exhaled air during repeated e-cigarette puffing. This would enhance the risk of cardiac arrhythmias and hypertension, which may predispose some users to increased risk of cardiovascular events, which may be further magnified by other potential adverse effects such as arrhythmias, increased respiratory, and flow respiratory resistance. Some cases of intoxication have also been described, wherein large amounts of nicotine and other harmful compounds may be effectively absorbed. As the use of e-cigarettes is continuously rising, and it is also considered a potentially effective method for smoking cessation, more focused research is urgently needed to definitely establish the cardiovascular safeness of these devices. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  8. 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.

  9. Severity of menopausal symptoms and cardiovascular and osteoporosis risk factors.

    Science.gov (United States)

    Martínez Pérez, J A; Palacios, S; Chavida, F; Pérez, M

    2013-04-01

    To assess whether the severity of menopausal symptoms is related to increased cardiovascular and osteoporosis risk factors, and to determine whether women with more severe menopausal symptoms present a greater percentage of osteoporosis disease. This was a cross-sectional, descriptive study encompassing women aged 45-65 years in the whole Spanish territory. The study population sample was collected through random sampling. A total of 10 514 women were included. Their sociodemographic, medical history and lifestyle data were assessed by means of a survey. The Kupperman Index was used to assess the severity of menopausal symptoms. Bone mineral density was measured by the dual X-ray absorptiometry method. The prevalences of risk factors for osteoporosis and cardiovascular disease were 67.6% and 74.8%, respectively. Women with a higher intensity of symptoms also had a greater percentage of cardiovascular (p osteoporosis (p osteoporosis disease (p obesity (OR 2.23; 95% CI 1.55-2.91; p osteoporosis disease (OR 3.71; 95% CI 2.9-4.52; p osteoporosis disease risk factors and suffered more from osteoporosis disease compared to those who had milder or no menopausal symptoms.

  10. 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.

  11. The association between the activity profile and cardiovascular risk.

    Science.gov (United States)

    Maddison, Ralph; Jiang, Yannan; Foley, Louise; Scragg, Robert; Direito, Artur; Olds, Timothy

    2016-08-01

    This study sought to better understand the interrelationships between physical activity and sedentary behaviour and the relationship to risk of cardiovascular disease (CVDR) in adults aged 30-75 years. Cross-sectional. Data from two-year waves (2003-2004 and 2005-2006) of the National Health and Nutritional Examination survey were analysed in 2014. Accelerometer-derived time and proportion of time spent sedentary and on moderate-to-vigorous physical activity (MVPA) were calculated to generate four activity profiles based on cut-points to define low and high levels for the respective behaviours. Using health outcome data, CVDR was calculated for each person. Weighted multiple linear regression models were used to evaluate the predicted effects of sedentary and physical activity behaviours on the CVDR score, adjusting for participants' sex, age group, race, annual household income, and accelerometer wear time. The lowest CVDR was observed among Busy Exercisers (high MVPA and low sedentary; 8.5%), whereas Couch Potatoes (low MVPA and high sedentary) had the highest (18.6%). Compared with the reference group (Busy Exercisers), the activity profile associated with the highest CVDR was Couch Potatoes (adjusted mean difference 3.6, SE 0.38, prisk landscape" was developed to better visualise the conjoint associations of MVPA and sedentary behaviour on CVDR for each activity profile. The association between MVPA was greater than that of sedentary behaviour; however, for people with low MVPA, shifts in sedentary behaviour may have the greatest impact on CVDR. Activity profiles that consider the interrelationships between physical activity and sedentary behaviour differ in terms of CVDR. Future interventions may need to be tailored to specific profiles and be dynamic enough to reflect change in the profile over time. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  12. Fasting glucose and cardiovascular risk factors in an urban population.

    Science.gov (United States)

    Gupta, R; Sarna, M; Thanvi, Jyoti; Sharma, Vibha; Gupta, V P

    2007-10-01

    To test the hypothesis that blood glucose levels in the range of normoglycemia are associated with increased cardiovascular risk we performed an epidemiological study in an urban population. Randomly selected adults > or = 20 years were studied using stratified sampling. Target sample was 1800 (men 960, women 840) of which 1123 subjects participated. Blood samples were available in 1091 subjects (60.6%, men 532, women 559). Measurement of anthropometric variables, blood pressure, fasting blood glucose and lipids was performed. Cardiovascular risk factors were determined using US Adult Treatment Panel-3 guidelines. Pearson's correlation coefficients (r) of fasting glucose with various risk factors were determined. Fasting glucose levels were classified into various groups as 126 mg/dl or known diabetes. Prevalence of cardiovascular risk factors was determined in each group. There was a significant positive correlation of fasting glucose in men and women with body mass index (r = 0.20, 0.12), waist-hip ratio (0.17, 0.09), systolic blood pressure (0.07, 0.22), total cholesterol (0.21, 0.15) and triglycerides (0.21, 0.25). Prevalence (%) of cardiovascular risk factors in men and women was smoking/tobacco use in 37.6 and 11.6, hypertension in 37.0 and 37.6, overweight and obesity in 37.8 and 50.3, truncal obesity in 57.3 and 68.0, high cholesterol > or = 200 mg/dl in 37.4 and 45.8, high triglycerides > or = 150 mg/dl in 32.3 and 28.6 and metabolic syndrome in 22.9 and 31.6 percent. In various groups of fasting glucose there was an increasing trend in prevalence of overweight/obesity, hypertension, hypercholesterolaemia, hypertriglyceridaemia, and metabolic syndrome (Mantel-Haenzel X2 for trend, p fasting glucose continuous relationship of fasting glucose levels with many cardiovascular risk factors and level < 75 mg/dl is associated with the lowest prevalence.

  13. Usefulness of serum interleukin-18 in predicting cardiovascular mortality in patients with chronic kidney disease--systems and clinical approach.

    Science.gov (United States)

    Formanowicz, Dorota; Wanic-Kossowska, Maria; Pawliczak, Elżbieta; Radom, Marcin; Formanowicz, Piotr

    2015-12-16

    The aim of this study was to check if serum interleukin-18 (IL-18) predicts 2-year cardiovascular mortality in patients at various stages of chronic kidney disease (CKD) and history of acute myocardial infarction (AMI) within the previous year. Diabetes mellitus was one of the key factors of exclusion. It was found that an increase in serum concentration of IL-18 above the cut-off point (1584.5 pg/mL) was characterized by 20.63-fold higher risk of cardiovascular deaths among studied patients. IL-18 serum concentration was found to be superior to the well-known cardiovascular risk parameters, like high sensitivity C-reactive protein (hsCRP), carotid intima media thickness (CIMT), glomerular filtration rate, albumins, ferritin, N-terminal prohormone of brain natriuretic peptide (NT-proBNP) in prognosis of cardiovascular mortality. The best predictive for IL-18 were 4 variables, such as CIMT, NT-proBNP, albumins and hsCRP, as they predicted its concentration at 89.5%. Concluding, IL-18 seems to be important indicator and predictor of cardiovascular death in two-year follow-up among non-diabetic patients suffering from CKD, with history of AMI in the previous year. The importance of IL-18 in the process of atherosclerotic plaque formation has been confirmed by systems analysis based on a formal model expressed in the language of Petri nets theory.

  14. Blood pressure-lowering treatment based on cardiovascular risk: a meta-analysis of individual patient data.

    Science.gov (United States)

    2014-08-16

    We aimed to investigate whether the benefits of blood pressure-lowering drugs are proportional to baseline cardiovascular risk, to establish whether absolute risk could be used to inform treatment decisions for blood pressure-lowering therapy, as is recommended for lipid-lowering therapy. This meta-analysis included individual participant data from trials that randomly assigned patients to either blood pressure-lowering drugs or placebo, or to more intensive or less intensive blood pressure-lowering regimens. The primary outcome was total major cardiovascular events, consisting of stroke, heart attack, heart failure, or cardiovascular death. Participants were separated into four categories of baseline 5-year major cardiovascular risk using a risk prediction equation developed from the placebo groups of the included trials (21%). 11 trials and 26 randomised groups met the inclusion criteria, and included 67,475 individuals, of whom 51,917 had available data for the calculation of the risk equations. 4167 (8%) had a cardiovascular event during a median of 4·0 years (IQR 3·4-4·4) of follow-up. The mean estimated baseline levels of 5-year cardiovascular risk for each of the four risk groups were 6·0% (SD 2·0), 12·1% (1·5), 17·7% (1·7), and 26·8% (5·4). In each consecutive higher risk group, blood pressure-lowering treatment reduced the risk of cardiovascular events relatively by 18% (95% CI 7-27), 15% (4-25), 13% (2-22), and 15% (5-24), respectively (p=0·30 for trend). However, in absolute terms, treating 1000 patients in each group with blood pressure-lowering treatment for 5 years would prevent 14 (95% CI 8-21), 20 (8-31), 24 (8-40), and 38 (16-61) cardiovascular events, respectively (p=0·04 for trend). Lowering blood pressure provides similar relative protection at all levels of baseline cardiovascular risk, but progressively greater absolute risk reductions as baseline risk increases. These results support the use of predicted baseline cardiovascular

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

    Science.gov (United States)

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

    2015-09-01

    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 in Hong Kong. Male firefighters (n = 387) were randomly selected from serving firefighters in Hong Kong (n = 5,370) for the assessment of cardiovascular disease risk factors (obesity, hypertension, diabetes mellitus, dyslipidemia, smoking, known cardiovascular diseases). One-third (Target Group) were randomly selected for the assessment of off-duty leisure-time physical activity using the short version of the International Physical Activity Questionnaire. Maximal oxygen uptake was assessed, as well as cardiovascular workload using heart rate monitoring for each firefighter for four "normal" 24-hour working shifts and during real-situation simulated scenarios. Overall, 33.9% of the firefighters had at least two cardiovascular disease risk factors. In the Target Group, firefighters who had higher leisure-time physical activity had a lower resting heart rate and a lower average working heart rate, and spent a smaller proportion of time working at a moderate-intensity cardiovascular workload. Firefighters who had moderate aerobic fitness and high leisure-time physical activity had a lower peak working heart rate during the mountain rescue scenario compared with firefighters who had low leisure-time physical activities. Leisure-time physical activity conferred significant benefits during job tasks of moderate cardiovascular workload in firefighters in Hong Kong.

  16. Dietary fruits and vegetables and cardiovascular diseases risk.

    Science.gov (United States)

    Alissa, Eman M; Ferns, Gordon A

    2017-06-13

    Diet is likely to be an important determinant of cardiovascular disease (CVD) risk. In this article, we will review the evidence linking the consumption of fruit and vegetables and CVD risk. The initial evidence that fruit and vegetable consumption has a protective effect against CVD came from observational studies. However, uncertainty remains about the magnitude of the benefit of fruit and vegetable intake on the occurrence of CVD and whether the optimal intake is five portions or greater. Results from randomized controlled trials do not show conclusively that fruit and vegetable intake protects against CVD, in part because the dietary interventions have been of limited intensity to enable optimal analysis of their putative effects. The protective mechanisms of fruit and vegetables may not only include some of the known bioactive nutrient effects dependent on their antioxidant, anti-inflammatory, and electrolyte properties, but also include their functional properties, such as low glycemic load and energy density. Taken together, the totality of the evidence accumulated so far does appear to support the notion that increased intake of fruits and vegetables may reduce cardiovascular risk. It is clear that fruit and vegetables should be eaten as part of a balanced diet, as a source of vitamins, fiber, minerals, and phytochemicals. The evidence now suggests that a complicated set of several nutrients may interact with genetic factors to influence CVD risk. Therefore, it may be more important to focus on whole foods and dietary patterns rather than individual nutrients to successfully impact on CVD risk reduction. A clearer understanding of the relationship between fruit and vegetable intake and cardiovascular risk would provide health professionals with significant information in terms of public health and clinical practice.

  17. Physical activity in the prevention and rehabilitation of cardiovascular risk

    Directory of Open Access Journals (Sweden)

    Jovović Veselin

    2015-01-01

    Full Text Available Cardiovascular diseases (CVD are more widespread today, whereby they take dimensions of global epidemic. They are the leading cause of diseases in the world, of inability to work, of absenteeism and premature mortality up to 65 years of age. Modern lifestyle in which there is not enough physical activity is recognized as one of the major risk factors for health and emergence of CVD. Physical inactivity is responsible for poor health quality, unnecessary illnesses and premature death. The aim of this work is to point out the basic risk factors and importance and the role of physical exercise in the prevention and rehabilitation of CVD. In the analysis of the data, the methods of speculation and introspection are used. Numerous studies have shown that properly practiced physical activity is a powerful and beneficial effect in the prevention, treatment and rehabilitation of cardiovascular diseases (Scrutino et al. 2005; Secco et al. 2000; Jovović, 2008; Šuščević et al. 2011. Physical activity belongs to the concept of numerous factors, which along with the reduction of risk factors, lifestyle changes and medical therapy leads to the reduction of risk for cardiovascular diseases. To achieve the desired effect, a combination of aerobic, interval and isotonic muscle activity of moderate intensity at least four times a week for 45 minutes is recommended. During the secondary prevention and rehabilitation, physical activity adapts to health status, level of individual risk and the estimated functional abilities of patients. Transformational processes can only be achieved through regular exercise. The risk of emergence of complications during physical exercise is negligible, especially if the walking is practiced as a form of physical exercise.

  18. 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. Copyright © 2016 by the American Society of Nephrology.

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

    Science.gov (United States)

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

    2016-01-01

    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

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

    Science.gov (United States)

    2013-01-01

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

  1. Cardiovascular risk management in rheumatoid arthritis patients still suboptimal: the Implementation of Cardiovascular Risk Management in Rheumatoid Arthritis project.

    Science.gov (United States)

    van den Oever, Inge A M; Heslinga, Maaike; Griep, Ed N; Griep-Wentink, Hanneke R M; Schotsman, Rob; Cambach, Walter; Dijkmans, Ben A C; Smulders, Yvo M; Lems, Willem F; Boers, Maarten; Voskuyl, Alexandre E; Peters, Mike J L; van Schaardenburg, Dirkjan; Nurmohamed, Micheal T

    2017-09-01

    To assess the 10-year cardiovascular (CV) risk score and to identify treatment and undertreatment of CV risk factors in patients with established RA. Demographics, CV risk factors and prevalence of cardiovascular disease (CVD) were assessed by questionnaire. To calculate the 10-year CV risk score according to the Dutch CV risk management guideline, systolic blood pressure was measured and cholesterol levels were determined from fasting blood samples. Patients were categorized into four groups: indication for treatment but not treated; inadequately treated, so not meeting goals (systolic blood pressure ⩽140 mmHg and/or low-density lipoprotein ⩽2.5 mmol/l); adequately treated; or no treatment necessary. A total of 720 consecutive RA patients were included, 375 from Reade and 345 from the Antonius Hospital. The mean age of patients was 59 years (s.d. 12) and 73% were female. Seventeen per cent of the patients had a low 10-year CV risk (management remains a major challenge and better awareness and management are urgently needed to reduce the high risk of CVD in the RA population. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

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

    Science.gov (United States)

    Hopkins-Rosseel, Diana H

    2006-11-01

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

  3. Bicycling to Work and Primordial Prevention of Cardiovascular Risk

    DEFF Research Database (Denmark)

    Grøntved, Anders; Koivula, Robert W; Johansson, Ingegerd

    2016-01-01

    of incident obesity, hypertension, hypertriglyceridemia, and impaired glucose tolerance, comparing individuals who commuted to work by bicycle with those who used passive modes of transportation. We also examined the relationship of change in commuting mode with incidence of these clinical risk factors......% CI 0.74-0.91) compared with participants not cycling to work at both times points or who switched from cycling to other modes of transport during follow-up. CONCLUSIONS: These data suggest that commuting by bicycle to work is an important strategy for primordial prevention of clinical cardiovascular...... risk factors among middle-aged men and women....

  4. Electrocardiographic PR-interval duration and cardiovascular risk

    DEFF Research Database (Denmark)

    Rasmussen, Peter Vibe; Nielsen, Jonas Bille; Skov, Morten Wagner

    2017-01-01

    Background Because of ambiguous reports in the literature, we aimed to investigate the association between PR interval and the risk of all-cause and cardiovascular death, heart failure, and pacemaker implantation, allowing for a nonlinear relationship. MethodsWe included 293,111 individuals...... into 7 groups based on the population PR interval distribution. Cox models were used, with reference to a PR interval between 152 and 161 ms (40th to heart failure...... adjustment. A long PR interval conferred an increased risk of heart failure ( > 200 ms; HR, 1.31; 95% CI, 1.22-1.42; P 200 ms (HR, 3...

  5. Degree of Agreement between Cardiovascular Risk Stratification Tools.

    Science.gov (United States)

    Garcia, Guilherme Thomé; Stamm, Ana Maria Nunes de Faria; Rosa, Ariel Córdova; Marasciulo, Antônio Carlos; Marasciulo, Rodrigo Conill; Battistella, Cristian; Remor, Alexandre Augusto de Costa

    2017-05-01

    Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in Brazil, and primary prevention care may be guided by risk stratification tools. The Framingham (FRS) and QRISK-2 (QRS) risk scores estimate 10-year overall cardiovascular risk in asymptomatic individuals, but the instrument of choice may lead to different therapeutic strategies. To evaluate the degree of agreement between FRS and QRS in 10-year overall cardiovascular risk stratification in disease-free individuals. Cross-sectional, observational, descriptive and analytical study in a convenience sample of 74 individuals attending the outpatient care service of a university hospital in Brazil between January 2014 and January 2015. After application of FRS and QRS, patients were classified in low/moderate risk (Brasil, e a prevenção primária pode ser direcionada com ferramentas que estratificam o risco. Os escores de Framingham (ERF) e QRISK-2 (ERQ) estimam o risco cardiovascular (RCV) global em 10 anos em indivíduos assintomáticos, mas a escolha do instrumento pode implicar em terapêuticas distintas. Observar o grau de concordância entre o ERF e o ERQ, na estratificação do risco cardiovascular global em 10 anos, nos indivíduos livres da doença. Estudo transversal, observacional, descritivo e analítico, com uma amostra de conveniência de 74 indivíduos, atendidos em um ambulatório de ensino de um hospital universitário brasileiro, no sul do país, de janeiro de 2014 a janeiro de 2015. O ERF e o ERQ foram aplicados nos pacientes, que foram classificados em baixo/moderado (superior no ERF que no ERQ (33,7% vs 21,6%), sendo identificado efeito sinérgico do gênero masculino com hipertensão arterial sistêmica nas duas ferramentas, e com faixa etária geriátrica no ERQ (p < 0,05) nesse estrato de risco. O índice de concordância Kappa entre os dois escores foi igual a 0,519 (IC95% = 0,386-0,652; p < 0,001). Houve concordância moderada entre o ERF e o ERQ, na estimativa de

  6. National differences in screening programmes for cardiovascular risks could obstruct understanding of cardiovascular prevention studies in Europe

    NARCIS (Netherlands)

    Thio, S.L.; Twickler, T.B.; Cramer, M.J.; Giral, P.

    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

  7. Artificial neural network models for prediction of cardiovascular autonomic dysfunction in general Chinese population

    Science.gov (United States)

    2013-01-01

    Background The present study aimed to develop an artificial neural network (ANN) based prediction model for cardiovascular autonomic (CA) dysfunction in the general population. Methods We analyzed a previous dataset based on a population sample consisted of 2,092 individuals aged 30–80 years. The prediction models were derived from an exploratory set using ANN analysis. Performances of these prediction models were evaluated in the validation set. Results Univariate analysis indicated that 14 risk factors showed statistically significant association with CA dysfunction (P < 0.05). The mean area under the receiver-operating curve was 0.762 (95% CI 0.732–0.793) for prediction model developed using ANN analysis. The mean sensitivity, specificity, positive and negative predictive values were similar in the prediction models was 0.751, 0.665, 0.330 and 0.924, respectively. All HL statistics were less than 15.0. Conclusion ANN is an effective tool for developing prediction models with high value for predicting CA dysfunction among the general population. PMID:23902963

  8. Comparison of Prediction Model for Cardiovascular Autonomic Dysfunction Using Artificial Neural Network and Logistic Regression Analysis

    Science.gov (United States)

    Zeng, Fangfang; Li, Zhongtao; Yu, Xiaoling; Zhou, Linuo

    2013-01-01

    Background This study aimed to develop the artificial neural network (ANN) and multivariable logistic regression (LR) analyses for prediction modeling of cardiovascular autonomic (CA) dysfunction in the general population, and compare the prediction models using the two approaches. Methods and Materials We analyzed a previous dataset based on a Chinese population sample consisting of 2,092 individuals aged 30–80 years. The prediction models were derived from an exploratory set using ANN and LR analysis, and were tested in the validation set. Performances of these prediction models were then compared. Results Univariate analysis indicated that 14 risk factors showed statistically significant association with the prevalence of CA dysfunction (P<0.05). The mean area under the receiver-operating curve was 0.758 (95% CI 0.724–0.793) for LR and 0.762 (95% CI 0.732–0.793) for ANN analysis, but noninferiority result was found (P<0.001). The similar results were found in comparisons of sensitivity, specificity, and predictive values in the prediction models between the LR and ANN analyses. Conclusion The prediction models for CA dysfunction were developed using ANN and LR. ANN and LR are two effective tools for developing prediction models based on our dataset. PMID:23940593

  9. Cardiovascular risk in an HIV-infected population in India.

    Science.gov (United States)

    Marbaniang, Ivan P; Kadam, Dileep; Suman, Rohan; Gupte, Nikhil; Salvi, Sonali; Patil, Sandesh; Shere, Dhananjay; Deshpande, Prasad; Kulkarni, Vandana; Deluca, Andrea; Gupta, Amita; Mave, Vidya

    2017-01-01

    To characterise prevalence of traditional cardiovascular disease (CVD) risk factors, assess CVD risk and examine the effect of simulated interventions on CVD risk among HIV-infected Asian Indians. Cross-sectional data between September 2015 and July 2016 wer used to describe the prevalence of CVD risk factors. Five risk scores (Framingham, Data Collection on Adverse Effects of Anti-HIV Drugs Study (D:A:D), Atherosclerotic Cardiovascular, QRISK2 and Ramathibodi-Electricity Generating Authority of Thailand were used to estimate CVD risk. The effect of seven sensitivity analyses: smoking prevention; diabetes prevention; optimal blood pressure and dyslipidaemia control (total cholesterol, high-density lipoprotein (HDL)); CD4 augmentation and a combination of the scenarios on the median cumulative D:A:D CVD scores were assessed. Of 402 enrolled, 56% were women, median age was 40 years (IQR: 35-45 years) and median time-updated CD4 counts were 378 cells/μL (IQR: 246-622). Fifty-five and 28% had ever been screened for hypertension and diabetes, respectively prior to enrolment. The prevalence of diabetes, hypertension, hypercholesterolaemia, low HDL, previous and current smokers were 9%, 22%, 20%, 39%, 14% and 4%, respectively. Thirty-six per cent had intermediate-to-high 5-year CVD risk by D:A:D estimates. Thirty-two per cent were eligible for statin therapy by American College of Cardiology/American Heart Association guidelines; 2% were currently on statins. In sensitivity analyses, diabetes prevention was associated with the highest reduction of CVD risk. CVD at younger ages among Asian Indian people living with HIV appear to be an imminent risk for morbidity. Stepping up of preventive services including screening services and prescription of statins are important strategies that must be considered.

  10. Poor Response to Periodontal Treatment May Predict Future Cardiovascular Disease.

    Science.gov (United States)

    Holmlund, A; Lampa, E; Lind, L

    2017-07-01

    Periodontal disease has been associated with cardiovascular disease (CVD), but whether the response to the treatment of periodontal disease affects this association has not been investigated in any large prospective study. Periodontal data obtained at baseline and 1 y after treatment were available in 5,297 individuals with remaining teeth who were treated at a specialized clinic for periodontal disease. Poor response to treatment was defined as having >10% sites with probing pocket depth >4 mm deep and bleeding on probing at ≥20% of the sites 1 y after active treatment. Fatal/nonfatal incidence rate of CVD (composite end point of myocardial infarction, stroke, and heart failure) was obtained from the Swedish cause-of-death and hospital discharge registers. Poisson regression analysis was performed to analyze future risk of CVD. During a median follow-up of 16.8 y (89,719 person-years at risk), those individuals who did not respond well to treatment (13.8% of the sample) had an increased incidence of CVD ( n = 870) when compared with responders (23.6 vs. 15.3%, P 4 mm, and number of teeth, the incidence rate ratio for CVD among poor responders was 1.28 (95% CI, 1.07 to 1.53; P = 0.007) as opposed to good responders. The incidence rate ratio among poor responders increased to 1.39 (95% CI, 1.13 to 1.73; P = 0.002) for those with the most remaining teeth. Individuals who did not respond well to periodontal treatment had an increased risk for future CVD, indicating that successful periodontal treatment might influence progression of subclinical CVD.

  11. 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.

  12. Job stress and cardiovascular risk factors in male workers.

    Science.gov (United States)

    Kang, Myung Gun; Koh, Sang Baek; Cha, Bong Suk; Park, Jong Ku; Baik, Soon Koo; Chang, Sei Jin

    2005-05-01

    This study examined whether job stress (work demand and decision latitude) is associated with smoking, blood pressure, lipid level (total cholesterol, triglyceride, HDL cholesterol), and homocystein as risk factors for cardiovascular disease in Korean male workers. Study subjects of this study were recruited from a sample of 1,071 workers in 20 companies of W city and H counties, and they were grouped into four categories (high strain group, active group, passive group, and low strain group) based on the postulation of Karasek's Job Strain Model. Of them, we invited 160 male workers (40 people each subgroup) using a stratified sampling, and finally, 152 eligible participants were analyzed. In multivariate analyses, we found that decision latitude was associated with cholesterol, triglyceride, and homocystein and that work demand was related to smoking and systolic blood pressure. Job strain (the combination of high work demand with low decision latitude) was significantly related to higher levels of homocystein after controlling for age, BMI, smoking, and social support at workplace. These results indicate that job stress is associated with cardiovascular risk factors and might contribute to the development of cardiovascular disease. Some considerations for the future research were discussed.

  13. Therapeutical approach to plasma homocysteine and cardiovascular risk reduction

    Directory of Open Access Journals (Sweden)

    Marcello Ciaccio

    2008-03-01

    Full Text Available Marcello Ciaccio, Giulia Bivona, Chiara BelliaDepartment of Medical Biotechnologies and Forensic Medicine, Faculty of Medicine, University of Palermo, ItalyAbstract: Homocysteine is a sulfur-containing aminoacid produced during metabolism of methionine. Since 1969 the relationship between altered homocysteine metabolism and both coronary and peripheral atherotrombosis is known; in recent years experimental evidences have shown that elevated plasma levels of homocysteine are associated with an increased risk of atherosclerosis and cardiovascular ischemic events. Several mechanisms by which elevated homocysteine impairs vascular function have been proposed, including impairment of endothelial function, production of reactive oxygen species (ROS and consequent oxidation of low-density lipids. Endothelial function is altered in subjects with hyperhomocysteinemia, and endothelial dysfunction is correlated with plasma levels of homocysteine. Folic acid and B vitamins, required for remethylation of homocysteine to methionine, are the most important dietary determinants of homocysteine and daily supplementation typically lowers plasma homocysteine levels; it is still unclear whether the decreased plasma levels of homocysteine through diet or drugs may be paralleled by a reduction in cardiovascular risk.Keywords: homocysteine, MTHFR, cardiovascular disease, folate, B vitamin

  14. 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. © The Author(s) 2016. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  15. Spontaneous baroreflex sensitivity: toward an ideal index of cardiovascular risk in hypertension?

    Science.gov (United States)

    Lantelme, Pierre; Khettab, Fouad; Custaud, Marc-Antoine; Rial, Marie-Odile; Joanny, Christiane; Gharib, Claude; Milon, Hugues

    2002-05-01

    Estimating the risk entailed by classical risk factors like blood pressure (BP) or serum cholesterol may be difficult because of their variability and the often unknown duration of exposure. Having variables integrating the impact of those classical risk factors on the cardiovascular system would probably aid the prediction of cardiovascular events. The present study aimed at determining whether cardiac baroreflex sensitivity (BRS), correlates with several risk factors and thus is a good candidate for being such an integrative variable. As a comparison, left ventricular mass (LVM), pulse wave velocity (PWV), and creatinine were also tested for association with risk factors. A total of 302 subjects referred for hypertension, were considered. They had a 24-h BP recording and a determination of BRS by two different methods (sequence and alpha coefficient), in two different positions (lying and standing). They were also tested for the presence of left ventricular hypertrophy (LVH) (by echocardiography and electrocardiogram) and had a PWV measurement. Biological testing included serum lipids, blood glucose, creatinine, proteinuria and urinary excretion of microalbumin. There was a strong correlation between the two methods of BRS measurement in each position (P < 0.001). BRS determined by the sequence method in the lying position was correlated significantly and independently with age, 24-h systolic BP, heart rate, and serum cholesterol with P values < 0.001, < 0.001, < 0.01, and < 0.05, respectively. In an univariate analysis, BRS was also correlated with echocardiographic LVM index (r = -0.21, P < 0.05) and PWV (r = -0.27, P < 0.001), which possibly reflects its dependence on both vascular and cardiac damages. The present study supports the hypothesis that BRS could encompass the impact over time of several risk factors on the cardiovascular system. Thus, it may constitute a valuable parameter in assessing more precisely the risk of cardiovascular events.

  16. Gaps in Addressing Cardiovascular Risk in Rheumatoid Arthritis: Assessing Performance Using Cardiovascular Quality Indicators.

    Science.gov (United States)

    Barber, Claire E H; Esdaile, John M; Martin, Liam O; Faris, Peter; Barnabe, Cheryl; Guo, Selynne; Lopatina, Elena; Marshall, Deborah A

    2016-11-01

    Cardiovascular disease (CVD) is a major comorbidity for patients with rheumatoid arthritis (RA). This study sought to determine the performance of 11 recently developed CVD quality indicators (QI) for RA in clinical practice. Medical charts for patients with RA (early disease or biologic-treated) followed at 1 center were retrospectively reviewed. A systematic assessment of adherence to 11 QI over a 2-year period was completed. Performance on the QI was reported as a percentage pass rate. There were 170 charts reviewed (107 early disease and 63 biologic-treated). The most frequent CVD risk factors present at diagnosis (early disease) and biologic start (biologic-treated) included hypertension (26%), obesity (25%), smoking (21%), and dyslipidemia (15%). Performance on the CVD QI was highly variable. Areas of low performance (risk assessment, communication to the primary care physician (PCP) that patients with RA were at increased risk of CVD, body mass index documentation and counseling if overweight, communication to a PCP about an elevated blood pressure, and discussion of risks and benefits of antiinflammatories in patients at CVD risk. Rates of diabetes screening and lipid screening were 67% and 69%, respectively. The area of highest performance was observed for documentation of intent to taper corticosteroids (98%-100% for yrs 1 and 2, respectively). Gaps in CVD risk management were found and highlight the need for quality improvements. Key targets for improvement include coordination of CVD care between rheumatology and primary care, and communication of increased CVD risk in RA.

  17. Cytokines and clustered cardiovascular risk factors in children

    DEFF Research Database (Denmark)

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

    2010-01-01

    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.......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......-sectional study were obtained from 18 schools near Copenhagen, Denmark. Two hundred ten 9-year-old children were selected for cytokine analysis from 434 third-grade children with complete CVD risk profiles. The subgroup was selected according to the CVD risk factor profile (upper and lower quartile of a composite...

  18. 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.

  19. [Cardiovascular risk factors in an Arab and Hispanic working population].

    Science.gov (United States)

    Valdivielso, P; García, A; de Rus, I; Avila, J M; Andrade, R; Escolar, J L; González, P

    1991-07-01

    318 records of male workers, 169 Spanish and 149 Arab were retrospectively studied in 1987 at the "Gabinete de Seguridad e Higiene en el Trabajo" (Council for Safety and Hygiene in the Workplace) in Ceuta in order to prove the hypothesis that 2 different ethnic groups living in the same geographic area have a non-equal distribution of cardiovascular risk factors. The Spanish group showed a higher prevalence in blood hypertension, diabetes, glucose intolerance, obesity and alcohol intake, compared to the Arab group. Smoking and high levels of seric cholesterol were similar in both groups, however, medium levels of seric cholesterol were lower in the Arab group. Family histories of cardiovascular disease were very rare in the latter mentioned group. These observations suggested a major predisposition to ischemic cardiopathy in the Spanish group.

  20. Gender/Sex as a Social Determinant of Cardiovascular Risk.

    Science.gov (United States)

    O'Neil, Adrienne; Scovelle, Anna J; Milner, Allison J; Kavanagh, Anne

    2018-02-20

    The social gradient for cardiovascular disease (CVD) onset and outcomes is well established. The American Heart Association's Social Determinants of Risk and Outcomes of Cardiovascular Disease Scientific Statement advocates looking beyond breakthroughs in biological science toward a social determinants approach that focuses on socioeconomic position, race and ethnicity, social support, culture and access to medical care, and residential environments to curb the burden of CVD going forward. Indeed, the benefits of this approach are likely to be far reaching, enhancing the positive effects of advances in CVD related to prevention and treatment while reducing health inequities that contribute to CVD onset and outcomes. It is disappointing that the role of gender has been largely neglected despite being a critical determinant of cardiovascular health. It is clear that trajectories and outcomes of CVD differ by biological sex, yet the tendency for sex and gender to be conflated has contributed to the idea that both are constant or fixed with little room for intervention. Rather, as distinct from biological sex, gender is socially produced. Overlaid on biological sex, gender is a broad term that shapes and interacts with one's cognition to guide norms, roles, behaviors, and social relations. It is a fluid construct that varies across time, place, and life stage. Gender can interact with biological sex and, indeed, other social determinants, such as ethnicity and socioeconomic position, to shape cardiovascular health from conception, through early life when health behaviors and risk factors are shaped, into adolescence and adulthood. This article will illustrate how gender shapes the early adoption of health behaviors in childhood, adolescence, and young adulthood by focusing on physical activity, drinking, and smoking behaviors (including the influence of role modeling). We will also discuss the role of gender in psychosocial stress with a focus on trauma from life

  1. Potential impact of single-risk-factor versus total risk management for the prevention of cardiovascular events in Seychelles.

    Science.gov (United States)

    Ndindjock, Roger; Gedeon, Jude; Mendis, Shanthi; Paccaud, Fred; Bovet, Pascal

    2011-04-01

    To assess the prevalence of cardiovascular (CV) risk factors in Seychelles, a middle-income African country, and compare the cost-effectiveness of single-risk-factor management (treating individuals with arterial blood pressure ≥ 140/90 mmHg and/or total serum cholesterol ≥ 6.2 mmol/l) with that of management based on total CV risk (treating individuals with a total CV risk ≥ 10% or ≥ 20%). CV risk factor prevalence and a CV risk prediction chart for Africa were used to estimate the 10-year risk of suffering a fatal or non-fatal CV event among individuals aged 40-64 years. These figures were used to compare single-risk-factor management with total risk management in terms of the number of people requiring treatment to avert one CV event and the number of events potentially averted over 10 years. Treatment for patients with high total CV risk (≥ 20%) was assumed to consist of a fixed-dose combination of several drugs (polypill). Cost analyses were limited to medication. A total CV risk of ≥ 10% and ≥ 20% was found among 10.8% and 5.1% of individuals, respectively. With single-risk-factor management, 60% of adults would need to be treated and 157 cardiovascular events per 100000 population would be averted per year, as opposed to 5% of adults and 92 events with total CV risk management. Management based on high total CV risk optimizes the balance between the number requiring treatment and the number of CV events averted. Total CV risk management is much more cost-effective than single-risk-factor management. These findings are relevant for all countries, but especially for those economically and demographically similar to Seychelles.

  2. 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.

  3. Remote health monitoring: predicting outcome success based on contextual features for cardiovascular disease.

    Science.gov (United States)

    Alshurafa, Nabil; Eastwood, Jo-Ann; Pourhomayoun, Mohammad; Liu, Jason J; Sarrafzadeh, Majid

    2014-01-01

    Current studies have produced a plethora of remote health monitoring (RHM) systems designed to enhance the care of patients with chronic diseases. Many RHM systems are designed to improve patient risk factors for cardiovascular disease, including physiological parameters such as body mass index (BMI) and waist circumference, and lipid profiles such as low density lipoprotein (LDL) and high density lipoprotein (HDL). There are several patient characteristics that could be determining factors for a patient's RHM outcome success, but these characteristics have been largely unidentified. In this paper, we analyze results from an RHM system deployed in a six month Women's Heart Health study of 90 patients, and apply advanced feature selection and machine learning algorithms to identify patients' key baseline contextual features and build effective prediction models that help determine RHM outcome success. We introduce Wanda-CVD, a smartphone-based RHM system designed to help participants with cardiovascular disease risk factors by motivating participants through wireless coaching using feedback and prompts as social support. We analyze key contextual features that secure positive patient outcomes in both physiological parameters and lipid profiles. Results from the Women's Heart Health study show that health threat of heart disease, quality of life, family history, stress factors, social support, and anxiety at baseline all help predict patient RHM outcome success.

  4. Major dietary patterns and cardiovascular risk factors from childhood to adulthood. The Cardiovascular Risk in Young Finns Study.

    Science.gov (United States)

    Mikkilä, Vera; Räsänen, Leena; Raitakari, Olli T; Marniemi, Jukka; Pietinen, Pirjo; Rönnemaa, Tapani; Viikari, Jorma

    2007-07-01

    Studies on the impact of single nutrients on the risk of CVD have often given inconclusive results. Recent research on dietary patterns has offered promising information on the effects of diet as a whole on the risk of CVD. The Cardiovascular Risk in Young Finns Study is an ongoing, prospective cohort study with a 21-year follow-up to date. The subjects were children and adolescents at baseline (3-18 years, n 1768) and adults at the latest follow-up study (24-39 years, n 1037). We investigated the associations between two major dietary patterns and several risk factors for CVD. In longitudinal analyses with repeated measurements, using multivariate mixed linear regression models, the traditional dietary pattern (characterised by high consumption of rye, potatoes, butter, sausages, milk and coffee) was independently associated with total and LDL cholesterol concentrations, apolipoprotein B and C-reactive protein concentrations among both genders, and also with systolic blood pressure and insulin levels among women and concentrations of homocysteine among men (P health-conscious food choices (such as high consumption of vegetables, legumes and nuts, tea, rye, cheese and other dairy products, and alcoholic beverages) was inversely, but less strongly associated with cardiovascular risk factors. Our results support earlier findings that dietary patterns have a role in the development of CVD.

  5. Age- and sex-tailored serum phosphate thresholds do not improve cardiovascular risk estimation in CKD.

    Science.gov (United States)

    Ferraro, Pietro Manuel; Bonello, Monica; Gambaro, Alessia; Sturniolo, Antonio; Gambaro, Giovanni

    2011-01-01

    Disordered metabolism of phosphorus is one of the hallmarks of chronic kidney disease (CKD), resulting in increased cardiovascular morbidity and mortality. Age and sex may affect the metabolism of phosphorus and subsequently its serum level. We evaluated if age- and sex-specific cutoffs for hyperphosphatemia may define cardiovascular risk better than the current guideline cutoffs. We used data from 16,834 subjects participating in the 1999-2006 National Health and Nutrition Examination Survey (NHANES); the prevalence of self-reported cardiovascular disease (CVD) and mortality rates were analyzed in CKD patients for both the classic definitions (CH; i.e., NKF-KDOQI and K-DIGO) and a tailored definition (TH) of hyperphosphatemia by means of regression models adjusted for age, sex, race/ethnicity, smoking status and body mass index. The cutoffs for TH were represented by the 95th percentile of an age- and sex-matched non-CKD population. Serum phosphorus levels showed an inverse correlation with age (r = -0.12; pdefinition and CVD was marginally better compared with the CH definition (odds ratio [OR] = 1.49, 95% confidence interval [95% CI], 1.04-2.13; p=0.030 vs. OR=1.55, 95% CI, 0.98-2.44; p = 0.059), the TH model was not superior in predicting CVD or mortality. Our data suggest that a tailored, age- and sex-specific definition of hyperphosphatemia is not superior to conventional definitions in predicting cardiovascular events in patients with CKD.

  6. Case Study of Cardiovascular Risk Reduction in the Northwest Region and TRICARE Region 11

    National Research Council Canada - National Science Library

    Murphy, Rosemary

    2003-01-01

    ... and TRICARE Lead Agent Region 11. The outcomes management team developed a cardiovascular risk reduction scorecard and metrics in which to evaluate the care being given to the TRICARE prime enrollees with a cardiovascular disease diagnosis...

  7. Benzene exposure is associated with cardiovascular disease risk.

    Directory of Open Access Journals (Sweden)

    Wesley Abplanalp

    Full Text Available Benzene is a ubiquitous, volatile pollutant present at high concentrations in toxins (e.g. tobacco smoke known to increase cardiovascular disease (CVD risk. Despite its prevalence, the cardiovascular effects of benzene have rarely been studied. Hence, we examined whether exposure to benzene is associated with increased CVD risk. The effects of benzene exposure in mice were assessed by direct inhalation, while the effects of benzene exposure in humans was assessed in 210 individuals with mild to high CVD risk by measuring urinary levels of the benzene metabolite trans,trans-muconic acid (t,t-MA. Generalized linear models were used to assess the association between benzene exposure and CVD risk. Mice inhaling volatile benzene had significantly reduced levels of circulating angiogenic cells (Flk-1+/Sca-1+ as well as an increased levels of plasma low-density lipoprotein (LDL compared with control mice breathing filtered air. In the human cohort, urinary levels of t,t-MA were inversely associated several populations of circulating angiogenic cells (CD31+/34+/45+, CD31+/34+/45+/AC133-, CD34+/45+/AC133+. Although t,t-MA was not associated with plasma markers of inflammation or thrombosis, t,t-MA levels were higher in smokers and in individuals with dyslipidemia. In smokers, t,t-MA levels were positively associated with urinary metabolites of nicotine (cotinine and acrolein (3-hydroxymercapturic acid. Levels of t,t-MA were also associated with CVD risk as assessed using the Framingham Risk Score and this association was independent of smoking. Thus, benzene exposure is associated with increased CVD risk and deficits in circulating angiogenic cells in both smokers and non-smokers.

  8. Optimal dietary calcium intake in HIV treated patients: no femoral osteoporosis but higher cardiovascular risk.

    Science.gov (United States)

    Galli, Laura; Rubinacci, Alessandro; Cocorullo, Deborah; Salpietro, Stefania; Spagnuolo, Vincenzo; Gianotti, Nicola; Bigoloni, Alba; Vinci, Concetta; Mignogna, Giovanna; Sirtori, Marcella; Lazzarin, Adriano; Castagna, Antonella

    2014-04-01

    We performed a cross-sectional study on adult HIV-infected patients, on HAART, without calcium or vitamin D supplementation to evaluate if the cardiovascular risk or the presence of osteoporosis may be predictive factors of an optimal daily calcium intake (DCI>1000 mg/day). Patients underwent a dual-energy X-ray absorptiometry, measured biochemical parameters and compiled a validated questionnaire for the assessment of DCI. Osteoporosis (OP) was defined according to the WHO classification at either the vertebral spine or femoral neck. Cardiovascular risk was assessed by the 10-year Framingham cardiovascular risk score. 200 HIV-infected patients evaluated: 171 (86%) males with a median age of 48.1 (42.3-53.8) years and 10.6 (4.3-13.6) years of HAART exposure. DCI was 889 (589-1308) mg/day and 79 (40%) patients had an optimal DCI. Framingham risk>20% was found in 13 (6.7%) patients and femoral OP was diagnosed in 12 (6%) pts. By multivariate analysis, optimal DCI was more likely in patients with a Framingham risk>20% [OR = 5.547, 95% CI:1.337, p = 0.025] and less likely in patients with femoral osteoporosis [OR = 0.159, 95% CI: 0.018-0.790, p = 0.047]. We found that an optimal dietary calcium intake was more likely in patients with high cardiovascular risk and no femoral osteoporosis. Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  9. Predicting patient exposure to nickel released from cardiovascular devices using multi-scale modeling.

    Science.gov (United States)

    Saylor, David M; Craven, Brent A; Chandrasekar, Vaishnavi; Simon, David D; Brown, Ronald P; Sussman, Eric M

    2018-04-01

    Many cardiovascular device alloys contain nickel, which if released in sufficient quantities, can lead to adverse health effects. However, in-vivo nickel release from implanted devices and subsequent biodistribution of nickel ions to local tissues and systemic circulation are not well understood. To address this uncertainty, we have developed a multi-scale (material, tissue, and system) biokinetic model. The model links nickel release from an implanted cardiovascular device to concentrations in peri-implant tissue, as well as in serum and urine, which can be readily monitored. The model was parameterized for a specific cardiovascular implant, nitinol septal occluders, using in-vitro nickel release test results, studies of ex-vivo uptake into heart tissue, and in-vivo and clinical measurements from the literature. Our results show that the model accurately predicts nickel concentrations in peri-implant tissue in an animal model and in serum and urine of septal occluder patients. The congruity of the model with these data suggests it may provide useful insight to establish nickel exposure limits and interpret biomonitoring data. Finally, we use the model to predict local and systemic nickel exposure due to passive release from nitinol devices produced using a wide range of manufacturing processes, as well as general relationships between release rate and exposure. These relationships suggest that peri-implant tissue and serum levels of nickel will remain below 5 μg/g and 10 μg/l, respectively, in patients who have received implanted nitinol cardiovascular devices provided the rate of nickel release per device surface area does not exceed 0.074 μg/(cm 2  d) and is less than 32 μg/d in total. The uncertainty in whether in-vitro tests used to evaluate metal ion release from medical products are representative of clinical environments is one of the largest roadblocks to establishing the associated patient risk. We have developed and validated a multi

  10. Oximeter-based autonomic state indicator algorithm for cardiovascular risk assessment.

    Science.gov (United States)

    Grote, Ludger; Sommermeyer, Dirk; Zou, Ding; Eder, Derek N; Hedner, Jan

    2011-02-01

    Cardiovascular (CV) risk assessment is important in clinical practice. An autonomic state indicator (ASI) algorithm based on pulse oximetry was developed and validated for CV risk assessment. One hundred forty-eight sleep clinic patients (98 men, mean age 50 ± 13 years) underwent an overnight study using a novel photoplethysmographic sensor. CV risk was classified according to the European Society of Hypertension/European Society of Cardiology (ESH/ESC) risk factor matrix. Five signal components reflecting cardiac and vascular activity (pulse wave attenuation, pulse rate acceleration, pulse propagation time, respiration-related pulse oscillation, and oxygen desaturation) extracted from 99 randomly selected subjects were used to train the classification algorithm. The capacity of the algorithm for CV risk prediction was validated in 49 additional patients. Each signal component contributed independently to CV risk prediction. The sensitivity and specificity of the algorithm to distinguish high/low CV risk in the validation group were 80% and 77%, respectively. The area under the receiver operating characteristic curve for high CV risk classification was 0.84. β-Blocker treatment was identified as an important factor for classification that was not in line with the ESH/ESC reference matrix. Signals derived from overnight oximetry recording provide a novel potential tool for CV risk classification. Prospective studies are warranted to establish the value of the ASI algorithm for prediction of outcome in CV disease.

  11. How implicit motives and everyday self-regulatory abilities shape cardiovascular risk in youth.

    Science.gov (United States)

    Ewart, Craig K; Elder, Gavin J; Smyth, Joshua M

    2012-06-01

    Tested hypotheses from social action theory that (a) implicit and explicit measures of agonistic (social control) motives and transcendence (self-control) motives differentially predict cardiovascular risk; and (b) implicit motives interact with everyday self-regulation behaviors to magnify risk. Implicit/explicit agonistic/transcendence motives were assessed in a multi-ethnic sample of 64 high school students with the Social Competence Interview (SCI). Everyday self-regulation was assessed with teacher ratings of internalizing, externalizing, and self-control behaviors. Ambulatory blood pressure and daily activities were measured over 48 h. Study hypotheses were supported: implicit goals predicted blood pressure levels but explicit self-reported coping goals did not; self-regulation indices did not predict blood pressure directly but interacted with implicit agonistic/transcendence motives to identify individuals at greatest risk (all p ≤ 0.05). Assessment of implicit motives by SCI, and everyday self-regulation by teachers may improve identification of youth at risk for cardiovascular disease.

  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. Aldosterone Does Not Predict Cardiovascular Events Following Acute Coronary Syndrome in Patients Initially Without Heart Failure.

    Science.gov (United States)

    Pitts, Reynaria; Gunzburger, Elise; Ballantyne, Christie M; Barter, Philip J; Kallend, David; Leiter, Lawrence A; Leitersdorf, Eran; Nicholls, Stephen J; Shah, Prediman K; Tardif, Jean-Claude; Olsson, Anders G; McMurray, John J V; Kittelson, John; Schwartz, Gregory G

    2017-01-10

    Aldosterone may have adverse effects in the myocardium and vasculature. Treatment with an aldosterone antagonist reduces cardiovascular risk in patients with acute myocardial infarction complicated by heart failure (HF) and left ventricular systolic dysfunction. However, most patients with acute coronary syndrome do not have advanced HF. Among such patients, it is unknown whether aldosterone predicts cardiovascular risk. To address this question, we examined data from the dal-OUTCOMES trial that compared the cholesteryl ester transfer protein inhibitor dalcetrapib with placebo, beginning 4 to 12 weeks after an index acute coronary syndrome. Patients with New York Heart Association class II (with LVEF coronary heart disease death, nonfatal myocardial infarction, stroke, hospitalization for unstable angina, or resuscitated cardiac arrest. Hospitalization for HF was a secondary endpoint. Over a median follow-up of 37 months, the primary outcome occurred in 366 patients (9.0%), and hospitalization for HF occurred in 72 patients (1.8%). There was no association between aldosterone and either the time to first occurrence of a primary outcome (hazard ratio for doubling of aldosterone 0.92, 95% confidence interval 0.78-1.09, P=0.34) or hospitalization for HF (hazard ratio 1.38, 95% CI 0.96-1.99, P=0.08) in Cox regression models adjusted for covariates. In patients with recent acute coronary syndrome but without advanced HF, aldosterone does not predict major cardiovascular events. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00658515. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  14. Disseminating cardiovascular disease risk assessment with a PAHO mobile app: a public eHealth intervention

    Directory of Open Access Journals (Sweden)

    Pedro Ordúñez

    2015-07-01

    Full Text Available Cardiovasculardiseases are the leading cause of death in the Region of the Americas, making cardiovascular risk assessment a critical component of the clinical decision-making process. This process is facilitated by the use of appropriate tools. Thisarticle presents the technical characteristics of an application (app developed by the Pan American Health Organization/World Health Organization (PAHO/WHO for mobile devices and computers. Called the Cardiovascular Risk Calculator, it is based on WHO risk tables and applied to the countries of the Region. The article details the epidemiological basis of the diagram for predicting cardiovascular risk and describes the app and its four modules, its main audiences, its production process, and finally, the initial results and some of the challenges. Fourmonths after its launch, the application was being used daily by more than 12 000 users and had been downloaded in virtually all the countries of the Region. The app can be used in by physicians, nurses, and other technical personnel in their daily practice, especially at the primary care level. Since it can also be used by the general public, special attention was paid to its design and tutorial and to ensuring that the clinical estimates and recommendations were easy to understand. This type of app facilitates communication between health care providers and users, and its systematic use in the health services, especially in primary care services, should be promoted.

  15. Improvements on Cardiovascular Diseases Risk Factors in Obese Adolescents

    DEFF Research Database (Denmark)

    Gomes Silva, Humberto José; Andersen, Lars Bo; Lofrano-Prado, Mara Cristina

    2015-01-01

    BACKGROUND: It is unclear how different exercise intensities affect cardiovascular disease (CVD) risk factors in obese adolescents. The aim of this study was to compare the effects of high intensity (HIT) vs. low intensity (LIT) aerobic training on CVD risk factors in obese adolescents. METHODS......: Forty-three obese adolescents (age: 15.7±1.3y, BMI: 34.3±4.1kg/m2) participated this study either HIT (corresponding to ventilatory threshold-I, VT1; N=20) or LIT (20% below VT1; N=23) for 12 weeks (12W). All sessions were isocaloric (350 kcal). All participants received the same nutritional......, psychological and clinical counseling. Subjects were assessed in fatness, fitness, lipid profile and glucose at baseline and after 12W. The CVD risk factors assessed were waist circumference (WC), total cholesterol (TC), HDL, glucose and fitness, which were single and clustered analyzed (Z-scores sum). RESULTS...

  16. 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.

  17. Differential influence of distinct components of increased blood pressure on cardiovascular outcomes: from the atherosclerosis risk in communities study.

    Science.gov (United States)

    Cheng, Susan; Gupta, Deepak K; Claggett, Brian; Sharrett, A Richey; Shah, Amil M; Skali, Hicham; Takeuchi, Madoka; Ni, Hanyu; Solomon, Scott D

    2013-09-01

    Elevation in blood pressure (BP) increases risk for all cardiovascular events. Nevertheless, the extent to which different indices of BP elevation may be associated to varying degrees with different cardiovascular outcomes remains unclear. We studied 13340 participants (aged 54 ± 6 years, 56% women and 27% black) of the Atherosclerosis Risk in Communities Study who were free of baseline cardiovascular disease. We used Cox proportional hazards models to compare the relative contributions of systolic BP, diastolic BP, pulse pressure, and mean arterial pressure to risk for coronary heart disease, heart failure, stroke, and all-cause mortality. For each multivariable-adjusted model, the largest area under the receiver-operating curve (AUC) and smallest -2 log-likelihood values were used to identify BP measures with the greatest contribution to risk prediction for each outcome. A total of 2095 coronary heart disease events, 1669 heart failure events, 771 stroke events, and 3016 deaths occurred during 18 ± 5 years of follow-up. In multivariable analyses adjusting for traditional cardiovascular risk factors, the BP measures with the greatest risk contributions were the following: systolic BP for coronary heart disease (AUC=0.74); pulse pressure for heart failure (AUC=0.79); systolic BP for stroke (AUC=0.74); and pulse pressure for all-cause mortality (AUC=0.74). With few exceptions, results were similar in analyses stratified by age, sex, and race. Our data indicate that distinct BP components contribute variably to risk for different cardiovascular outcomes.

  18. Effects of cocoa flavanols on risk factors for cardiovascular disease.

    Science.gov (United States)

    Erdman, John W; Carson, LeaAnn; Kwik-Uribe, Catherine; Evans, Ellen M; Allen, Robin R

    2008-01-01

    Epidemiologic investigations support the hypothesis that regular consumption of flavonoid-containing foods can reduce the risk of cardiovascular diseases (CVD). While flavonoids are ubiquitous in plants, cocoa can be particularly rich in a sub-class of flavonoids known as flavanols. A number of human dietary intervention trials with flavanol-containing cocoa products have demonstrated improvements in endothelial and platelet function, as well as blood pressure. These studies provide direct evidence for the potential cardiovascular benefits of flavanol-containing foods and help to substantiate the epidemiological data. In this review, results from selective published trials with cocoa and chocolate focused on risk for CVD will be discussed along with a study we recently completed evaluating the effects of the daily consumption of flavanol-containing dark chocolate (CocoaVia?) with and without plant sterol esters on CVD markers in a normotensive population with mild hypercholesterolemia. In this study, the daily consumption of flavanol-containing dark chocolate was associated with a significant mean reduction of 5.8 mmHg in systolic blood pressure. Together the results of these human dietary intervention trials provide scientific evidence of the vascular effects of cocoa flavanols and suggest that the regular consumption of cocoa products containing flavanols may reduce risk of CVD.

  19. Cardiovascular disease risk and secondary prevention of cardiovascular disease among patients with low health literacy.

    Science.gov (United States)

    van Schaik, T M; Jørstad, H T; Twickler, T B; Peters, R J G; Tijssen, J P G; Essink-Bot, M L; Fransen, M P

    2017-07-01

    To explore the association between health literacy and the risk of cardiovascular disease (CVD), and to assess the differential effects by health literacy level of a nurse-coordinated secondary prevention program (NCPP) in patients with coronary artery disease (CAD). Data were collected in two medical centres participating in the RESPONSE trial (Randomised Evaluation of Secondary Prevention by Outpatient Nurse SpEcialists). CVD risk profiles were assessed at baseline and 12-month follow-up using the Systematic Coronary Risk Evaluation (SCORE). Health literacy was assessed by the short Rapid Estimate of Adult Literacy in Medicine (REALM-D) and the Newest Vital Sign (NVS-D); self-reported health literacy was evaluated by the Set of Brief Screening Questions (SBSQ-D). Among 201 CAD patients, 18% exhibited reading difficulties, 52% had difficulty understanding and applying written information, and 5% scored low on self-reported health literacy. Patients with low NVS-D scores had a higher CVD risk [mean SCORE 5.2 (SD 4.8) versus 3.3 (SD 4.1), p literacy levels without significant differences. Inadequate health literacy is prevalent in CAD