Pignone, Michael; Williams, Craig D.
Aspirin is effective for the prevention of cardiovascular events in patients with a history of vascular disease, as so-called secondary prevention. In general populations with no history of previous myocardial infarction or stroke, aspirin also seems useful for primary prevention of cardiovascular events, although the absolute benefits are smaller than those seen in patients with previous cardiovascular disease. Patients with diabetes mellitus are at an increased risk of cardiovascular events...
Balakumar, Pitchai; Maung-U, Khin; Jagadeesh, Gowraganahalli
Noncommunicable diseases (NCDs) have become important causes of mortality on a global scale. According to the report of World Health Organization (WHO), NCDs killed 38 million people (out of 56 million deaths that occurred worldwide) during 2012. Cardiovascular diseases accounted for most NCD deaths (17.5 million NCD deaths), followed by cancers (8.2 million NCD deaths), respiratory diseases (4.0 million NCD deaths) and diabetes mellitus (1.5 million NCD deaths). Globally, the leading cause of death is cardiovascular diseases; their prevalence is incessantly progressing in both developed and developing nations. Diabetic patients with insulin resistance are even at a greater risk of cardiovascular disease. Obesity, high cholesterol, hypertriglyceridemia and elevated blood pressure are mainly considered as major risk factors for diabetic patients afflicted with cardiovascular disease. The present review sheds light on the global incidence of cardiovascular disease and diabetes mellitus. Additionally, measures to be taken to reduce the global encumbrance of cardiovascular disease and diabetes mellitus are highlighted. Published by Elsevier Ltd.
The research presented in this thesis contributes to the understanding of the complex relationship between periodontitis and diabetes mellitus (DM), and periodontitis and atherosclerotic cardiovascular disease (ACVD). It was observed that a substantial number of suspected new DM patients could be
The research presented in this thesis contributes to the understanding of the complex relationship between periodontitis and diabetes mellitus (DM), and periodontitis and atherosclerotic cardiovascular disease (ACVD). It was observed that a substantial number of suspected new DM patients could be found in patients with periodontitis. Furthermore, periodontitis patients showed increased C-reactive protein (CRP) levels and more arterial stiffness compared to controls, reflecting an increased at...
Newman, Jonathan D; Schwartzbard, Arthur Z; Weintraub, Howard S; Goldberg, Ira J; Berger, Jeffrey S
Type 2 diabetes mellitus (T2D) is a major risk factor for cardiovascular disease (CVD), the most common cause of death in T2D. Yet, exercise, nutrition, and weight management) and CVD risk factor (blood pressure, cholesterol and blood lipids, glycemic control, and the use of aspirin) management for the prevention of CVD among patients with T2D. The authors believe appropriate lifestyle and CVD risk factor management has the potential to significantly reduce the burden of CVD among patients with T2D. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Erkens, JA; Herings, RMC; Stolk, RP; Spoelstra, JA; Grobbee, DE; Leufkens, HGM
Although patients with type 2 diabetes mellitus and cardiovascular disease share common risk factors, the link between these diseases remains largely unexplained. In this case-control study, the earlier use of cardiovascular drugs (before the diagnosis of diabetes) was investigated among cases with
Soedamah-Muthu, S.S.; Stehouwer, C.D.A.
There is an increased risk of cardiovascular disease (CVD) mortality and morbidity in patients with type 1 diabetes mellitus compared with the general population as shown by epidemiologic studies measuring cardiovascular endpoints, as well as by autopsy, angiographic, and coronary calcification
Soedamah-Muthu, S.S.; Stehouwer, C.D.A.
There is an increased risk of cardiovascular disease (CVD) mortality and morbidity in patients with type 1 diabetes mellitus compared with the general population as shown by epidemiologic studies measuring cardiovascular endpoints, as well as by autopsy, angiographic, and coronary calcification
Fetterman, Jessica L; Holbrook, Monica; Westbrook, David G; Brown, Jamelle A; Feeley, Kyle P; Bretón-Romero, Rosa; Linder, Erika A; Berk, Brittany D; Weisbrod, Robert M; Widlansky, Michael E; Gokce, Noyan; Ballinger, Scott W; Hamburg, Naomi M
Prior studies demonstrate mitochondrial dysfunction with increased reactive oxygen species generation in peripheral blood mononuclear cells in diabetes mellitus. Oxidative stress-mediated damage to mitochondrial DNA promotes atherosclerosis in animal models. Thus, we evaluated the relation of mitochondrial DNA damage in peripheral blood mononuclear cells s with vascular function in patients with diabetes mellitus and with atherosclerotic cardiovascular disease. We assessed non-invasive vascular function and mitochondrial DNA damage in 275 patients (age 57 ± 9 years, 60 % women) with atherosclerotic cardiovascular disease alone (N = 55), diabetes mellitus alone (N = 74), combined atherosclerotic cardiovascular disease and diabetes mellitus (N = 48), and controls age >45 without diabetes mellitus or atherosclerotic cardiovascular disease (N = 98). Mitochondrial DNA damage measured by quantitative PCR in peripheral blood mononuclear cells was higher with clinical atherosclerosis alone (0.55 ± 0.65), diabetes mellitus alone (0.65 ± 1.0), and combined clinical atherosclerosis and diabetes mellitus (0.89 ± 1.32) as compared to control subjects (0.23 ± 0.64, P mitochondrial DNA damage levels (β = 0.14 ± 0.13, P = 0.04 and β = 0.21 ± 0.13, P = 0.002, respectively). Higher mitochondrial DNA damage was associated with higher baseline pulse amplitude, a measure of arterial pulsatility, but not with flow-mediated dilation or hyperemic response, measures of vasodilator function. We found greater mitochondrial DNA damage in patients with diabetes mellitus and clinical atherosclerosis. The association of mitochondrial DNA damage and baseline pulse amplitude may suggest a link between mitochondrial dysfunction and excessive small artery pulsatility with potentially adverse microvascular impact.
Vistisen, Dorte; Andersen, Gregers Stig; Hansen, Christian Stevns
AND RESULTS: 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......BACKGROUND: 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. METHODS...... 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...
Oberoi, Sukhvinder Singh; Harish, Yashoda; Hiremath, Shivalingaswamy; Puranik, Manjunath
Periodontal deterioration has been reported to be associated with systemic diseases such as cardiovascular disease (CVD), diabetes mellitus, respiratory disease, liver cirrhosis, bacterial pneumonia, nutritional deficiencies, and adverse pregnancy outcomes. The present study assessed the periodontal disease among patients with systemic conditions such as diabetes, CVD, and respiratory disease. The study population consisted of 220 patients each of CVD, respiratory disease, and diabetes mellitus, making a total of 660 patients in the systemic disease group. A control group of 340 subjects were also included in the study for comparison purpose. The periodontal status of the patients with these confirmed medical conditions was assessed using the community periodontal index of treatment needs (CPITNs) index. The prevalence of CPITN code 4 was found to be greater among the patients with respiratory disease whereas the mean number of sextants with score 4 was found to be greater among the patients with diabetes mellitus and CVD. The treatment need 0 was found to be more among the controls (1.18%) whereas the treatment need 1, 2, and 3 were more among the patients with respiratory disease (100%, 97.73%, and 54.8%), diabetes mellitus (100%, 100% and 46.4%), and CVD (100%, 97.73%, and 38.1%), in comparison to the controls (6.18%). From the findings of the present study, it can be concluded that diabetes mellitus, CVD, and respiratory disease are associated with a higher severity of periodontal disease.
Snoeijs, S.P.; Boerma, W.G.W.; Baltag, V.; Schellevis, F.G.
Background: Organising effective responses to the growing problem of noncommunicable diseases (NCD) is among the biggest challenges of (primary) health care systems. In particular tackling, cardiovascular diseases (CVDs) and diabetes mellitus type 2 (DM2) requires coordinated approaches close to
Wanner, Christoph; Lachin, John M; Inzucchi, Silvio E; Fitchett, David; Mattheus, Michaela; George, Jyothis; Woerle, Hans J; Broedl, Uli C; von Eynatten, Maximilian; Zinman, Bernard
Empagliflozin, a sodium-glucose cotransporter 2 inhibitor, reduced cardiovascular morbidity and mortality in patients with type 2 diabetes mellitus and established cardiovascular disease in the EMPA-REG OUTCOME trial (Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients). Urinary glucose excretion with empagliflozin decreases with declining renal function, resulting in less potency for glucose lowering in patients with kidney disease. We investigated the effects of empagliflozin on clinical outcomes in patients with type 2 diabetes mellitus, established cardiovascular disease, and chronic kidney disease. Patients with type 2 diabetes mellitus, established cardiovascular disease, and estimated glomerular filtration rate (eGFR) ≥30 mL·min -1 ·1.73 m -2 at screening were randomized to receive empagliflozin 10 mg, empagliflozin 25 mg, or placebo once daily in addition to standard of care. We analyzed cardiovascular death, hospitalization for heart failure, all-cause hospitalization, and all-cause mortality in patients with prevalent kidney disease (defined as eGFR 300 mg/g) at baseline. Additional analyses were performed in subgroups by baseline eGFR (300, 30-≤300, 10 years, 58% were receiving insulin, and 84% were taking angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. In patients with prevalent kidney disease at baseline, empagliflozin reduced the risk of cardiovascular death by 29% compared with placebo (hazard ratio [HR], 0.71; 95% confidence interval [CI], 0.52-0.98), the risk of all-cause mortality by 24% (HR, 0.76; 95% CI, 0.59-0.99), the risk of hospitalization for heart failure by 39% (HR, 0.61; 95% CI, 0.42-0.87), and the risk of all-cause hospitalization by 19% (HR, 0.81; 95% CI, 0.72-0.92). Effects of empagliflozin on these outcomes were consistent across categories of eGFR and urine albumin-creatinine ratio at baseline and across the 2 doses studied. The adverse event profile of empagliflozin
Teeuw, W J
The relationship among periodontitis, diabetes mellitus and atherosclerotic cardiovascular disease is complex and can be thought of as a Bermuda triangle. A relationship has been demonstrated between periodontitis, a worsening in the condition of the vascular system and an increased total level of inflammatory markers. Patients with severe periodontitis also show raised levels of glycosylated haemoglobin. This means that severe periodontitis can be an early indication of diabetes mellitus. Periodontal treatment generally promotes improved blood sugar regulation in diabetes patients, an improved condition of the vascular system and a decrease in the total levels of inflammation. Factors such as genetics, lifestyle and the presence of other chronic co-morbidities contribute to the complexity of this relationship. For the treatment of severe periodontitis, interdisciplinary cooperation among dentists, general practitioners and internists is therefore recommended.
Full Text Available Type 2 diabetes mellitus patients are at significant risk of cardiovascular disease, however, the pathophysiology of these complications is complex and incompletely known in this population. The aim of this study was to compare the serum proteome of patients with type 2 diabetes mellitus presenting or not presenting cardiovascular disease with non-diabetic subjects to find essential proteins related to these cardiovascular complications. This cross-sectional study compares the serum proteome by a combination of protein depletion with 2D-DIGE (2-dimension Difference Gel Electrophoresis methodology. The proteins differentially expressed were identified by MALDI TOF/TOF (Matrix-assisted laser desorption/ionization and Time-Of-Flight ion detector or LC-MS/MS (Liquid Chromatography coupled to Mass-Mass Spectrometry. Type 2 diabetes mellitus patients with cardiovascular disease showed higher expression of plasma retinol binding protein and glutathione peroxidase-3 compared to those without cardiovascular disease and non-diabetic controls. These results show that proteins related to the inflammatory and redox state appear to play an important role in the pathogenesis of the cardiovascular disease in the type 2 diabetes mellitus patients.
Pagidipati, Neha J; Navar, Ann Marie; Pieper, Karen S; Green, Jennifer B; Bethel, M Angelyn; Armstrong, Paul W; Josse, Robert G; McGuire, Darren K; Lokhnygina, Yuliya; Cornel, Jan H; Halvorsen, Sigrun; Strandberg, Timo E; Delibasi, Tuncay; Holman, Rury R; Peterson, Eric D
Intensive risk factor modification significantly improves outcomes for patients with diabetes mellitus and cardiovascular disease. However, the degree to which secondary prevention treatment goals are achieved in international clinical practice is unknown. Attainment of 5 secondary prevention parameters-aspirin use, lipid control (low-density lipoprotein cholesterol diabetes mellitus and known cardiovascular disease at entry into TECOS (Trial Evaluating Cardiovascular Outcomes With Sitagliptin). Logistic regression was used to evaluate the association between individual and regional factors and secondary prevention achievement at baseline. Cox proportional hazards regression analysis was used to determine the association between baseline secondary prevention achievement and cardiovascular death, myocardial infarction, or stroke. Overall, 29.9% of patients with diabetes mellitus and cardiovascular disease achieved all 5 secondary prevention parameters at baseline, although 71.8% achieved at least 4 parameters. North America had the highest proportion (41.2%), whereas Western Europe, Eastern Europe, and Latin America had proportions of ≈25%. Individually, blood pressure control (57.9%) had the lowest overall attainment, whereas nonsmoking status had the highest (89%). Over a median 3.0 years of follow-up, a higher baseline secondary prevention score was associated with improved outcomes in a step-wise graded relationship (adjusted hazard ratio, 0.60; 95% confidence interval, 0.47-0.77 for those patients achieving all 5 measures versus those achieving ≤2). In an international trial population, significant opportunities exist to improve the quality of cardiovascular secondary prevention care among patients with diabetes mellitus and cardiovascular disease, which in turn could lead to reduced risk of downstream cardiovascular events. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00790205. © 2017 American Heart Association, Inc.
Bell, David S
Cardiovascular risk reduction is a key priority in patients with diabetes. The relationship between glycemic control and macrovascular outcomes, such as the benefit of intensive glucose control and the importance of postprandial or fasting blood glucose, is still under debate. A number of pharmacologic options are available to treat type 2 diabetes mellitus and these options have differing evidence for their cardiovascular safety. In this article, the novel agent bromocriptine quick release is discussed. Recently approved, this once-daily treatment provides glycemic control as monotherapy or in combination with other antihyperglycemic medications and has been shown in a prospective phase 3 safety study to not increase cardiovascular risk. Therefore, bromocriptine quick release increases the range of options available to treat patients with type 2 diabetes mellitus without increasing cardiovascular risk.
Yousefzadeh, Pegah; Wang, Xiangbing
To review the current literature investigating the effects of dipeptidyl peptidase-4 (DPP-4) inhibitors on the risk factors of cardiovascular disease (CVD). We conducted a search of PubMed and MEDLINE database, using the term DPP-4 inhibitor in combination with the following terms: metabolic syndrome, hypertension, dyslipidemia, insulin resistance, obesity, and CVD. We reviewed 100 relevant studies out of 227 articles, excluding single case reports, studies using animal models, and reports not written in English. We included 38 references in this review article. The majority of the recent clinical studies have demonstrated that DPP-4 inhibitors have beneficial effects on cardiovascular (CV) system. These agents may have the potential to lower blood pressure, improve lipid profile and endothelial dysfunction, decrease the macrophage-mediated inflammatory response, and prevent myocardial injury. DPP-4 inhibitors have some CV protective effects in type 2 diabetes mellitus (T2DM) in addition to their antidiabetic actions. Long-term outcome clinical trials are under way to investigate the effects of the DPP-4 inhibitors on the elevated CV risks in patients with T2DM. Further investigation in a large cohort is warranted to assess the exact mechanisms of CV protective effects of DPP-4 inhibitors.
Popović-Pejičić Snježana; Todorović-Đilas Ljiljana; Pantelinac Pavle
Introduction. Diabetes is strongly associated with macrovascular complications, among which ischemic heart disease is the major cause of mortality. Autonomic neuropathy increases the risk of complications, which calls for an early diagnosis. The aim of this study was to determine both presence and extent of cardiac autonomic neuropathy, in regard to the type of diabetes mellitus, as well as its correlation with coronary disease and major cardiovascular risk factors. Material and methods. We h...
Heitmar, R; Lip, G Y H; Ryder, R E; Blann, A D
Retinal vessel calibre and vascular dilation/constriction in response to flicker light provocation may provide a measure distinguishing patients suffering from diabetes mellitus and/or cardiovascular disease. One hundred and sixteen age and sex matched patients with diabetes mellitus (DM), cardiovascular disease (CVD) and both DM and CVD (DM + CVD) underwent systemic and intraocular pressure measurements. Retinal vessel calibres were assessed using a validated computer-based program to compute central retinal artery and vein equivalents (CRVE) from monochromatic retinal images. Vessel dilation and constriction responses to flicker light provocation were assessed by continuous retinal vessel diameter recordings. Plasma endothelial markers von Willebrand factor (vWf) and soluble E selectin (sEsel) were measured by ELISA. Retinal vessel calibres were comparable across groups but CRVE correlated significantly with disease duration in DM patients (r = 0.57, p < 0.001). Patients suffering DM only exhibited reduced arterial vasomotion at rest and reduced arterial constriction following flicker light induced vessel dilation compared to patients with CVD and those suffering both CVD + DM (p = 0.030). Patients suffering from CVD + DM exhibited significant differences between each flicker cycle in regards to arterial maximum constriction (p = 0.006) and time needed to reach arterial maximum dilation (p = 0.004), whereas the other two groups did not show such inconsistencies between individual flicker cycles. vWf was raised in CVD + DM compared to the other two groups (p ≤ 0.02), whilst sEsel was raised in CVD + DM compared to DM alone (p = 0.044). Dynamic retinal vascular calibres as obtained by continuous diameter measurements using flicker light provocation can reveal subtle differences between groups suffering from CVD with and without DM. This difference in reaction pattern and lack of arterial constriction in DM may provide a suitable marker to
Chang, Ting-Ting; Chen, Jaw-Wen
Chemokines are critical components in pathology. The roles of chemokine CC motif ligand 4 (CCL4) and its receptor are associated with diabetes mellitus (DM) and atherosclerosis cardiovascular diseases. However, due to the complexity of these diseases, the specific effects of CCL4 remain unclear, although recent reports have suggested that multiple pathways are related to CCL4. In this review, we provide an overview of the role and potential mechanisms of CCL4 and one of its major receptors, fifth CC chemokine receptor (CCR5), in DM and cardiovascular diseases. CCL4-related mechanisms, including CCL4 and CCR5, might provide potential therapeutic targets in DM and/or atherosclerosis cardiovascular diseases.
Pedersen, Lise; Nybo, Mads; Poulsen, Mikael Kj?r; Henriksen, Jan Erik; Dahl, Jordi; Rasmussen, Lars Melholt
Background Plasma calprotectin is a potential biomarker of cardiovascular disease (CVD), insulin resistance (IR), and obesity. We examined the relationship between plasma calprotectin concentrations, CVD manifestations and the metabolic syndrome (MetS) in patients with type 2 diabetes mellitus (T2DM) in order to evaluate plasma calprotectin as a risk assessor of CVD in diabetic patients without known CVD. Methods An automated immunoassay for determination of plasma calprotectin was developed ...
Manschot, A; van Oostrom, S H; Smit, H A; Verschuren, W M M; Picavet, H S J
To study whether being diagnosed with a cardiovascular disease (CVD) or diabetes mellitus (DM) is associated with improvements in lifestyles. We used data from the Doetinchem Cohort Study, a prospective study among 6386 Dutch men and women initially aged 20-59years who were examined four times over 15years (1987-2007). Logistic and linear regression models were used to assess the effect of a self-reported diagnosis of CVD (n=403) or DM (n=221) on smoking, alcohol consumption, weight, diet and physical activity. Self-reported diagnosis of CVD increased rates of smoking cessation (OR=2.2, 95%CI 1.6 - 3.1). Adults reporting a diagnosis of DM (relatively) decreased weight (3.2%, 95%CI 2.2 - 4.2), (relatively) decreased energy intake (4.2%, 95%CI 0.7 - 7.7), decreased energy percentage from saturated fat (0.4%, 95%CI 0.0 - 0.9) and increased fish consumption (2.8 g/day, 95%CI 0.4 - 5.1). A self-reported diagnosis of CVD or DM was not associated with changes in physical activity. A diagnosis of CVD or DM may act, along with possible effects of medical treatment, as a trigger to adopt a healthier lifestyle in terms of smoking cessation, healthier diet and weight loss. Copyright © 2013 Elsevier Inc. All rights reserved.
Chrysant, Steven G
Coffee is the most widely consumed beverage, next to water. However, there has been a long-standing controversy regarding its safety on blood pressure (BP) and cardiovascular disease (CVD) and intuitively, physicians dissuaded their patients from coffee drinking. Areas covered: This controversy was, primarily, based on older prospective studies or case reports, which showed a positive association of coffee drinking with the incidence of hypertension and CVD. In contrast to these reports, recent, well controlled, studies have demonstrated either a neutral or beneficial effect of moderate coffee consumption (3-4 cups/day), on BP, CVD, heart failure (HF), cardiac arrhythmias, or diabetes mellitus (DM). For the preparation of this special report, an English language focused search of the Medline database was conducted between 2010 and 2016 on studies with data on effect on the coffee consumption in patients with high BP, CVD, HF, cardiac arrhythmias or DM. Of the 94 abstracts reviewed, 34 pertinent papers were selected, and the findings from these papers together with collateral literature will be discussed in this special report. Expert commentary: Based on the evidence from these studies, coffee consumption in moderation, is safe and is beneficial in both healthy persons as well as patients with high BP, CVD, HF, cardiac arrhythmias or DM. Therefore, coffee restriction is not warranted for these patients, although some caution should be exercised.
Salvatore De Rosa
Full Text Available Type 2 diabetes mellitus (DM is a common metabolic disorder predisposing to diabetic cardiomyopathy and atherosclerotic cardiovascular disease (CVD, which could lead to heart failure through a variety of mechanisms, including myocardial infarction and chronic pressure overload. Pathogenetic mechanisms, mainly linked to hyperglycemia and chronic sustained hyperinsulinemia, include changes in metabolic profiles, intracellular signaling pathways, energy production, redox status, increased susceptibility to ischemia, and extracellular matrix remodeling. The close relationship between type 2 DM and CVD has led to the common soil hypothesis, postulating that both conditions share common genetic and environmental factors influencing this association. However, although the common risk factors of both CVD and type 2 DM, such as obesity, insulin resistance, dyslipidemia, inflammation, and thrombophilia, can be identified in the majority of affected patients, less is known about how these factors influence both conditions, so that efforts are still needed for a more comprehensive understanding of this relationship. The genetic, epigenetic, and environmental backgrounds of both type 2 DM and CVD have been more recently studied and updated. However, the underlying pathogenetic mechanisms have seldom been investigated within the broader shared background, but rather studied in the specific context of type 2 DM or CVD, separately. As the precise pathophysiological links between type 2 DM and CVD are not entirely understood and many aspects still require elucidation, an integrated description of the genetic, epigenetic, and environmental influences involved in the concomitant development of both diseases is of paramount importance to shed new light on the interlinks between type 2 DM and CVD. This review addresses the current knowledge of overlapping genetic and epigenetic aspects in type 2 DM and CVD, including microRNAs and long non-coding RNAs, whose
Prystupiuk, O M
The content of glycated hemoglobin, a biomarker of diabetes in patients with type 2 diabetes correlates with risk factors for cardiovascular disease: hypertension, BMI and ratio of total cholesterol to HDL cholesterol. Therefore, increase in glycosylated hemoglobin should be considered a predictor of cardiovascular disease in patients with type 2 diabetes.
Medina-Remón, Alexander; Kirwan, Richard; Lamuela-Raventós, Rosa M; Estruch, Ramón
Diet and lifestyle play a significant role in the development chronic diseases; however the full complexity of this relationship is not yet understood. Dietary pattern investigation, which reflects the complexity of dietary intake, has emerged as an alternative and complementary approach for examining the association between diet and chronic diseases. Literature on this association has largely focused on individual nutrients, with conflicting outcomes, but individuals consume a combination of foods from many groups that form dietary patterns. Our objective was to systematically review the current findings on the effects of dietary patterns on chronic diseases. In this review, we describe and discuss the relationships between dietary patterns, such as the Mediterranean, the Dietary Approach to Stop Hypertension, Prudent, Seventh-day Adventists, and Western, with risk of obesity, type-2 diabetes mellitus, cardiovascular diseases, asthma, and neurodegenearive diseases. Evidence is increasing from both observational and clinical studies that plant-based dietary patterns, which are rich in fruits, vegetables, and whole grains, are valuable in preventing various chronic diseases, whereas a diet high in red and processed meat, refined grains and added sugar seems to increase said risk. Dietary pattern analysis might be especially valuable to the development and evaluation of food-based dietary guidelines.
Muhammad Saeed Ahmad
Full Text Available Skin auto fluorescence (SAF is used as a proxy for the accumulation of advanced glycation end products (AGEs and has been proposed to stratify patients into cardiovascular disease (CVD and diabetes mellitus (DM risk groups. This study evaluates the effects of seven different ethnicities (Arab, Central-East African, Eastern Mediterranean, European, North African, South Asian and Southeast Asian and gender on SAF as well as validating SAF assessment as a risk estimation tool for CVD and DM in an Arabian cohort. SAF data from self-reported healthy 2,780 individuals, collated from three independent studies, has been linear modelled using age and gender as a covariate. A cross-study harmonized effect size (Cohens'd is provided for each ethnicity. Furthermore, new data has been collected from a clinically well-defined patient group of 235 individuals, to evaluate SAF as a clinical tool for DM and CVD-risk estimation in an Arab cohort. In an Arab population, SAF-based CVD and/or DM risk-estimation can be improved by referencing to ethnicity and gender-specific SAF values. Highest SAF values were observed for the North African population, followed by East Mediterranean, Arab, South Asian and European populations. The South Asian population had a slightly steeper slope in SAF values with age compared to other ethnic groups. All ethnic groups except Europeans showed a significant gender effect. When compared with a European group, effect size was highest for Eastern Mediterranean group and lowest for South Asian group. The Central-East African and Southeast Asian ethnicity matched closest to the Arab and Eastern Mediterranean ethnicities, respectively. Ethnic and gender-specific data improves performance in SAF-based CVD and DM risk estimation. The provided harmonized effect size allows a direct comparison of SAF in different ethnicities. For the first time, gender differences in SAF are described for North African and East Mediterranean populations.
Cho, Jaelim; Choi, Yoon Jung; Suh, Mina; Sohn, Jungwoo; Kim, Hyunsoo; Cho, Seong-Kyung; Ha, Kyoung Hwa; Kim, Changsoo; Shin, Dong Chun
There is currently insufficient evidence to confirm the effect of ambient air pollution on mental disorders, especially among susceptible populations. This study investigated the short-term effect of ambient air pollution on the risk of depressive episode and the effect modification across disease subpopulations. Subjects who visited the emergency department (ED) for depressive episode from 2005 to 2009 (n=4985) in Seoul, Republic of Korea were identified from medical claims data. We conducted a time-stratified case-crossover study using conditional logistic regression. Subgroup analyses were conducted after the subjects were stratified by underlying disease (cardiovascular disease, diabetes mellitus, chronic obstructive pulmonary disease, asthma, and depressive disorder). The risk was expressed as an odds ratio (OR) per 1 standard deviation of each air pollutant. SO2, PM10, NO2, and CO were positively associated with ED visits for depressive episode. The maximum risk was observed in the distributed lag 0-3 model for PM10 (OR, 1.120; 95% confidence interval, 1.067-1.176). PM10, NO2, and CO significantly increased the risks of ED visits for depressive episode in subjects with either underlying cardiovascular disease, diabetes mellitus, asthma, or depressive disorder. Our data may include a misclassification bias due to the validity of a diagnosis determined from medical services utilization data. SO2, PM10, NO2, and CO significantly increased the risk of ED visits for depressive episode, especially among individuals with pre-existing cardiovascular disease, diabetes mellitus, or asthma. Copyright © 2014 Elsevier B.V. All rights reserved.
H. Bueno (Hector); R. Hernáez (Rubén); A.V. Hernández (Adrián)
textabstractIntroduction. In spite of having a high prevalence of diabetes mellitus the prevalence of ischemic heart disease is low in Spain. Methods. A narrative review of the bibliography was performed to search for potential particularities in the epidemiology, pathogenecity, and care of diabetes
Ametov, A S; P'ianykh, O P; Chernikova, N A
In Russia, diabetes mellitus afflicts 8 million people, 90% of them had type 2 diabetes mellitus (T2DM) and this figure is growing steadily. At the same time there is a rise in the incidence of macrovascular events (unstable angina pectoris, myocardial infarction). Coronary heart disease and its attack are a major cause of death in the developed countries, including Russia. To prevent chronic complications of DM is likely to be the most urgent task of not only modern diabetology, but also medical science as a whole. In this connection, of great value are the results of a few large international randomized controlled studies, the main objective of which was to evaluate the impact of the rate of blood glucose control on the incidence and outcomes of cardiovascular diseases in patients with T2DM
Burlina, S.; Dalfr?, M. G.; Chilelli, N. C.; Lapolla, A.
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...
Pedersen, Lise; Nybo, M.; Poulsen, M. K.
Background: Plasma calprotectin is a potential biomarker of cardiovascular disease (CVD), insulin resistance (IR), and obesity. We examined the relationship between plasma calprotectin concentrations, CVD manifestations and the metabolic syndrome (MetS) in patients with type 2 diabetes mellitus (T2......DM) in order to evaluate plasma calprotectin as a risk assessor of CVD in diabetic patients without known CVD. Methods: An automated immunoassay for determination of plasma calprotectin was developed based on a fecal Calprotectin ELIA, and a reference range was established from 120 healthy adults...
Arteaga, Antonio; Maiz, Alberto; Rigotti, Attilio; Cortés, Víctor
Diabetes mellitus (DM) is a recognized atherosclerotic cardiovascular disease (ACVD) risk factor. This association has yet to be quantified in the Chilean population. To compare the frequency of ACVD between diabetic and non-diabetic Chilean subjects. Data was extracted from the Chile National Health Survey (ENS) performed in 2009-2010. DM diagnosis was made with fasting glucose. ACVD (coronary, cerebral and peripheral vascular disease) was established by self-report. Major cardiovascular risk factors were identified by clinical and laboratory assessment. A total of 5,416 adults (2,200 men and 3,216 women) were surveyed in ENS 2009-2010. Of these, 508 were diabetic and 375 reported ACVD. ACVD frequency was 16.1% and 6.1% in diabetic and non-diabetic subjects, respectively. In diabetic men, the frequency of ACVD steadily increased with age, from 5.1% to 22.1%. In diabetic women, the highest frequency of ACVD (17.4%) was found in ages ranging from 45 to 54 years. In people younger than 54 years, the odds ratio for ACVD in diabetic compared to non-diabetic subjects, was 3.59 in men (χ2 = 4.03 p diabetic subjects with reported ACVD. DM is associated with an increased frequency of ACVD and cardiovascular risk factors in Chilean adults. In line with international reports, our findings suggest that DM is also a cardiovascular risk factor in Chile, particularly relevant for women.
Aoyama, Norio; Suzuki, Jun-Ichi; Kobayashi, Naho; Hanatani, Tomoya; Ashigaki, Norihiko; Yoshida, Asuka; Shiheido, Yuka; Sato, Hiroki; Kumagai, Hidetoshi; Ikeda, Yuichi; Akazawa, Hiroshi; Komuro, Issei; Minabe, Masato; Izumi, Yuichi; Isobe, Mitsuaki
Objective Tooth loss is an irreversible condition that reflects the end-stage of oral diseases, including periodontitis. Although periodontitis is a major factor in the progression of diabetes mellitus (DM) and cardiovascular disease (CVD), no previous studies have compared tooth loss in CVD patients with and without DM. Methods The subjects included CVD patients with (n=94) and without (n=145) DM who attended Tokyo Medical and Dental University Hospital. Blood examinations and periodontal measurements were performed. Results The oral and periodontal examinations revealed that the numbers of missing teeth in the DM group were increased in comparison to the non-DM group. There was no significant difference between the groups with regard to the incidence of edentulism, the probing pocket depth, the clinical attachment level or the incidence of bleeding on probing. Conclusion We showed that the numbers of missing teeth among CVD patients with DM was significantly higher than that among CVD patients without DM.
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.
Full Text Available Objetivo: Conocer la prevalencia de la enfermedad cardiovascular en el momento del diagnóstico de la diabetes mellitus tipo 2. Métodos: Estudio observacional retrospectivo realizado en un centro de atención primaria urbano entre 1991 y 2000. Revisión de las características clínicas, factores de riesgo y enfermedad cardiovascular el año del diagnóstico de diabetes. Se excluyeron los pacientes sin glucemias previas al diagnóstico. Se realizó un análisis de regresión logística para identificar las variables asociadas a la presencia de eventos cardiovasculares. Resultados: De los 598 nuevos casos de diabetes diagnosticados se analizaron los 487 que tenían valores previos de glucemia (media de edad [desviación estándar]: 60,4 [10,9] años; un 53% eran mujeres. La prevalencia de factores de riesgo cardiovascular fue: obesidad 61,1%, hipertensión arterial 71,9%, hipercolesterolemia 52%, hipertrigliceridemia 35,3% y tabaquismo actual 24% o previo 16,6%. El 96,9% tenía algún factor de riesgo cardiovascular y el 53,4% tres o más. Un total de 78 pacientes presentaron enfermedad cardiovascular anterior o detectada durante el primer año de diagnóstico (16%; intervalo de confianza del 95%[IC95%]: 12,8-19,3; varones 21,4% y mujeres 11,2%. La prevalencia de enfermedad cardiovascular aumentó con el número de factores de riesgo cardiovascular. El análisis de regresión logística mostró una asociación de la enfermedad cardiovascular y la edad >55 años (odds ratio [OR]=2,91; IC95%: 1,46-5,80, el tabaquismo (OR=2,28; IC95%: 1,15-4,51 y los valores de hemoglobina glucosilada (HbA1c >7% (OR=1,85; IC95%: 1,10-3,1. Conclusiones: Se observa una elevada prevalencia de factores de riesgo y enfermedad cardiovascular en el momento del diagnóstico de la diabetes; la edad, el tabaquismo y la HbA1c son las variables relacionadas con la enfermedad cardiovascular.Objective: To determine the prevalence of cardiovascular disease at diagnosis of type 2
Full Text Available Matthias Meier,1,2 Michael Hummel3,41Clinic for Hypertension and Nephrology, Hannover, Germany; 2Department of Nephrology, Hannover Medical School, Hannover, Germany; 3Academic Hospital Schwabing, Munich, Germany; 4Diabetes Research Institute, Munich, GermanyAbstract: Type 2 diabetes mellitus (T2DM is associated with a high risk of complications, essentially macrovascular events. Surprisingly, the effect of improved glucose control on coronary and cerebrovascular complications and the target level of glycated hemoglobin (HbA1c in this population remains questionable. We here report the results of 4 recently published randomized controlled trials (ACCORD, ADVANCE, VADT, UKPDS post-trial, which did not demonstrate a significant reduction of cardiovascular events in the intensive group compared to the standard group. On the contrary, in ACCORD, the study with the most ambitious goal (HbA1c < 6%, the overall and cardiovascular mortality was greater in the intensive group, although the risk of microangiopathic complications, especially nephropathy, was significantly decreased. VADT suggests that one possibility for the lack of observed effect of intensive therapy could be that the cardiovascular benefit is delayed. This contrasts strongly with the long-term postintervention outcomes of UKPDS, which show a persistent benefit of glycemic control during 10 years of post-trial follow-up (‘legacy effect’. Therefore, the best way to protect patients with T2DM against coronary and cerebrovascular disease is to target all cardiovascular risk factors as early as possible by an individualized approach.Keywords: glycemic control, cardiovascular, ACCORD, ADVANCE, VADT, UKPDS post-trial
Calsbeek, Hiske; Morren, M.; Rijken, M.; Bensing, J.
Adequate knowledge and personal attitudes towards DNA-testing are major determinants of optimal utilization of genetic testing. This study aims to (1) assess the genetic knowledge and attitude towards genetic testing of patients with asthma, diabetes mellitus type II and cardiovascular diseases,
Chang, Yu-Hung; Chang, Dao-Ming; Lin, Kun-Cheng; Shin, Shyi-Jang; Lee, Yau-Jiunn
There are controversies regarding the association of visfatin with overweight/obesity, type 2 diabetes mellitus, insulin resistance (IR), metabolic syndrome and cardiovascular disease in published articles. A meta-analysis was performed to identify the significance of visfatin in these diseases. We searched for relevant articles in Pubmed, Scopus and SCIE. A total of 1035 articles were surveyed and 46 articles were identified, with 14 reports reporting more than one of our investigated diseases. A total of 13 (n = 644), 19 (n = 2405), 20 (n = 2249), 5 (n = 527) and 5 (n = 851) articles/(participants) were included in each meta-analysis regarding the association of visfatin and overweight/obesity, type 2 diabetes mellitus, insulin resistance, metabolic syndrome and cardiovascular diseases, respectively. Plasma visfatin concentrations were increased in participants diagnosed with overweight/obesity, type 2 diabetes mellitus, metabolic syndrome and cardiovascular diseases, with pooled log odds ratios of 1.164 [95% confidence interval (CI): 0.348 to 1.981, p = 0.005], 1.981 (95% CI: 1.377 to 2.584, p diabetes status, insulin resistance, metabolic syndrome and cardiovascular disease. Copyright © 2011 John Wiley & Sons, Ltd.
Zaharie Sorin Ioan
Full Text Available Accurate measurement of blood pressure (BP and evaluation of global cardiovascular risk is crucial for diagnosis and treatment of hypertensive patients. When hypertension and diabetes mellitus are associated, the risk for cardiovascular events is bigger than the sum of the components. Beyond systolic and diastolic BP values as targets for antihypertensive treatment, recent guidelines recognize BP variability as an independent predictor for future cardiovascular events. 24 hours ambulatory BP monitoring (ABPM and home BP monitoring (HBPM are two methods used in patient day to day life conditions for BP measurements. Increased variability of systolic and/or diastolic BP within one day (“short-term BP variability” and also over longer periods (“long-term BP variability” showed by ABPM and/or HBPM is associated with target-organ damage and cardiovascular events. This review is focused on the prognostic importance of BP variability in hypertensive patients with diabetes mellitus.
risk factors. These associations involve obesity and. 37 may be modified by improving fitness . Sedentary lifestyle with its associated risk is increasing becoming rampant in Africa due to rural to urban migration. Injury to endothelium causes endothelial dysfunction. Cardiovascular disease: A Global Epidemic extending into.
Arrieta, Francisco; Iglesias, Pedro; Pedro-Botet, Juan; Tébar, Francisco Javier; Ortega, Emilio; Nubiola, Andreu; Pardo, Jose Luis; Maldonado, Gonzálo Fernando; Obaya, Juan Carlos; Matute, Pablo; Petrecca, Romina; Alonso, Nuria; Sarabia, Elena; Sánchez-Margalet, Victor; Alemán, José Juan; Navarro, Jorge; Becerra, Antonio; Duran, Santiago; Aguilar, Manuel; Escobar-Jiménez, Fernando
The present paper updates the Clinical Practice Recommendations for the management of cardiovascular risk factors (CVRF) in diabetes mellitus. This is a medical consensus agreed by an independent panel of experts from the Spanish Society of Diabetes (SED). Several consensuses have been proposed by scientific and medical Societies to achieve clinical goals. However, the risk score for general population may lack sensitivity for individual assessment or for particular groups at risk, such as diabetics. Traditional risk factors together with non-traditional factors are reviewed throughout this paper. Intervention strategies for managing CVRF in the diabetic patient are reviewed in detail: balanced food intake, weight reduction, physical exercise, smoking cessation, reduction in HbA1c, therapy for high blood pressure, obesity, lipid disorders, and platelet anti-aggregation. It is hoped that these guidelines can help clinicians in the decisions of their clinical activity. This regular update by the SED Cardiovascular Disease Group of the most relevant concepts, and of greater practical and realistic clinical interest, is presented in order to reduce CVR of diabetics. Copyright © 2015. Publicado por Elsevier España, S.L.U.
Appiah, Duke; Winters, Stephen J; Allison, Matthew A; Baumgartner, Richard N; Groves, Frank D; Myers, John A; Hornung, Carlton A
Women with type-2 diabetes (DM2) are at high risk of cardiovascular disease (CVD) which may be partly due to increased ovarian androgen production. Since the association of bilateral oophorectomy (BSO) with CVD remains controversial, we evaluated whether BSO is inversely associated with CVD among DM2. Data were obtained from a national sample of 9599 postmenopausal women. Adjusted estimates and 95% confidence intervals (CIs) were calculated using logistic and Cox regression. At baseline 2426 women had type-2 diabetes, of whom 580 had BSO. DM2 had adverse CVD risk profiles compared to women without diabetes, as did women with BSO with or without diabetes compared to those with intact ovaries. In DM2, BSO was positively associated with prevalent CVD (odds ratio: 1.63, 95%CI: 1.16-2.30). However, the higher odds were limited to women who had BSO before age 45 years (OR: 2.11, CI: 1.45-3.08). During a mean follow-up of 12.7 years, BSO in DM2 was positively associated with CVD mortality (hazard ratio: 2.23, CI: 1.25-3.99). Among women with BSO, those with family members who had MI before age 50 had elevated odds of CVD (OR: 2.29, CI: 1.56-3.37) compared to those without such family history (OR: 0.90, CI: 0.67-1.20), Pinteraction=0.04. The risk of CVD is increased not decreased with BSO in DM2. Further, we propose that the association of BSO and CVD in young women with diabetes may partly reflect genetic susceptibility to CVD rather than an effect of ovarian hormones. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Fujii, Hiroki; Iwase, Masanori; Ohkuma, Toshiaki; Ogata-Kaizu, Shinako; Ide, Hitoshi; Kikuchi, Yohei; Idewaki, Yasuhiro; Joudai, Tamaki; Hirakawa, Yoichiro; Uchida, Kazuhiro; Sasaki, Satoshi; Nakamura, Udai; Kitazono, Takanari
Background Dietary fiber is beneficial for the treatment of type 2 diabetes mellitus, although it is consumed differently in ethnic foods around the world. We investigated the association between dietary fiber intake and obesity, glycemic control, cardiovascular risk factors and chronic kidney disease in Japanese type 2 diabetic patients. Methods A total of 4,399 patients were assessed for dietary fiber intake using a brief self-administered diet history questionnaire. The associations betwee...
Higgins, T.P; Baker, M.D; Evans, S-A; Adams, R.A; Cobbold, C
Hypertension, decreased glucose tolerance, adverse lipid profiles and low physical activity levels are associated with increased type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) risk. High intensity interval training (HIIT), a low volume, reduced time, high intensity programme, may be a useful alternative to current government guidelines which specify a minimum of 150 minutes of physical activity per week. We describe a personalised programme of high intensity exercise which p...
Jahangiri-Noudeh, Younes; Akbarpour, Samaneh; Lotfaliany, Mojtaba; Zafari, Neda; Khalili, Davood; Tohidi, Maryam; Mansournia, Mohammad Ali; Azizi, Fereidoun; Hadaegh, Farzad
To investigate secular trends in cardiovascular disease (CVD) risk factors during a decade of follow-up in a Middle Eastern cohort, and to compare observed trends between diabetic and non-diabetic populations. In a population of 6181 participants (2622 males and 3559 females), diabetes status and CVD risk factors were evaluated in 4 study phases from 1999-2011. 1045 subjects had type 2 diabetes mellitus at baseline and 5136 participants were diabetes-free. To examine the trends of CVD risk factors, generalized estimation equation models were constructed. The interaction between the diabetes status and each phase of the study was checked in a separate model. During the follow-up period diabetic females significantly gained better control of their blood pressure, serum low density lipoprotein cholesterol and general and central obesity measures compared to non-diabetic counterparts, although 60% of them had high BP and 64% had high serum LDL-C levels till the end of the study. Diabetic males however, experienced significantly better control on their serum LDL-C and general and central obesity measures compared to their non-diabetic controls; but 24% of them were still smoker, 63% had high BP and 60% had high serum LDL-C levels at the end of the follow-up (all Ps interaction risk factors have been controlled to some extent among diabetic population in Iran, still high numbers of people with diabetes have uncontrolled CVD risk factors that prompt more attention.
... Select a Language: Fact Sheet 652 HIV and Cardiovascular Disease HIV AND CARDIOVASCULAR DISEASE WHY SHOULD PEOPLE WITH HIV CARE ABOUT CVD? ... OF CVD? WHAT ABOUT CHANGING MEDICATIONS? HIV AND CARDIOVASCULAR DISEASE Cardiovascular disease (CVD) includes a group of problems ...
McMurray, John J V; Uno, Hajime; Jarolim, Petr
This study aims to examine predictors of cardiovascular mortality and morbidity in patients with chronic kidney disease (CKD). Individuals with the triad of diabetes, CKD, and anemia represent a significant proportion of patients with cardiovascular disease and are at particularly high risk for a...
Deka, Apranta; Vita, Joseph A.
There is increasing evidence for a protective effect of tea consumption against cardiovascular disease. This review summarizes the available epidemiological data providing evidence for and against such an effect. We also review observational and intervention studies that investigated an effect of tea and tea extracts on cardiovascular risk factors, including blood pressure, serum lipids, diabetes mellitus, and obesity. Finally, we review potential mechanisms of benefit, including anti-inflammatory, anti-oxidant, and anti-proliferative effects, as well as favorable effects on endothelial function. Overall, the observational data suggest a benefit, but results are mixed and likely confounded by lifestyle and background dietary factors. The weight of evidence indicates favorable effects on risk factors and a number of plausible mechanisms have been elucidated in experimental and translational human studies. Despite the growing body evidence, it remains uncertain whether tea consumption should be recommended to the general population or to patients as a strategy to reduce cardiovascular risk. PMID:21477653
McCaughey, Euan J; Li, Julie; Badrick, Tony C; Westbrook, Johanna I; Georgiou, Andrew
To evaluate how well general practitioners (GPs) manage and respond to laboratory results for patients with diabetes mellitus (DM) and cardiovascular disease (CVD). MEDLINE, CINAHL, Embase, EBM reviews, ProQuest and Scopus. Peer-reviewed journal articles published between 2000 and 2015 that assessed GPs' management of laboratory results for patients with DM or CVD. Study design and demographics, laboratory tests and key findings relating to GP management of laboratory results were extracted from studies. Thirteen articles were included, comprising seven studies which utilized surveys, four observational studies, one cohort study and one randomized controlled trial. Findings indicate that GPs often overestimate the risk of complications associated with DM and CVD based on laboratory results and have unrealistically high expectations regarding the precision of laboratory tests. Considerable variation existed in the use of repeat testing for diagnostic confirmation and in GPs' identification of the difference between two consecutive results required to indicate a change in patient condition. GPs also often failed to initiate appropriate treatment for patients with DM and CVD based on laboratory results. Feedback to GPs about their test ordering patterns and educational messages on laboratory results improved clinical outcomes. Evidence about how well GPs manage results and its impact on patient outcomes remains weak and inconclusive. This review identified a number of areas where interventions could support GPs to improve the interpretation and management of laboratory test results, including feedback to GPs and educational messages on test result reports. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: email@example.com
C.A. Baan (Caroline)
textabstractDiabetes mellitus comprises a clinically and genetically heterogeneous group of disorders that have one common feature: abnormally high levels of glucose in the blood. The most common form is non-insulin dependent diabetes mellitus (NlDDM); about 80-90% of all diabetic patients has
Orio, Francesco; Muscogiuri, Giovanna; Nese, Cinar; Palomba, Stefano; Savastano, Silvia; Tafuri, Domenico; Colarieti, Giorgio; La Sala, Giovanbattista; Colao, Annamaria; Yildiz, Bulent O
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive aged women and is characterized by two of the following three features: oligoovulation or anovulation, clinical and/or biochemical signs of hyperandrogenism, or polycystic ovaries. It has been demonstrated that PCOS includes a complex number of systemic symptoms in addition to symptoms related to the reproductive apparatus. It has been associated with obesity, metabolic syndrome, type 2 diabetes and an increased risk of cardiovascular disease. Several clinical and basic studies have investigated the link between PCOS and the cardiovascular disease risk, which seems to be due to blunted lipid/glucose metabolism, hypertension, and systemic inflammatory and coagulation disorders. Therefore, the current manuscript aims to review the main findings on PCOS and obesity/obesity-related disease (glucose derangements and cardiovascular disease risk factors). Although there are no long-term data on the morbidity and mortality for cardiovascular disease in PCOS, it is advisable to perform a careful metabolic and cardiovascular assessment in women with PCOS in order to tailor the most suitable strategy to prevent cardiovascular disease. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Singh, Kavita; Chandrasekaran, Ambalam M; Bhaumik, Soumyadeep; Chattopadhyay, Kaushik; Gamage, Anuji Upekshika; Silva, Padmal De; Roy, Ambuj; Prabhakaran, Dorairaj; Tandon, Nikhil
Objectives More than 80% of cardiovascular diseases (CVD) and diabetes mellitus (DM) burden now lies in low and middle-income countries. Hence, there is an urgent need to identify and implement the most cost-effective interventions, particularly in the resource-constraint South Asian settings. Thus, we aimed to systematically review the cost-effectiveness of individual-level, group-level and population-level interventions to control CVD and DM in South Asia. Methods We searched 14 electronic databases up to August 2016. The search strategy consisted of terms related to ‘economic evaluation’, ‘CVD’, ‘DM’ and ‘South Asia’. Per protocol two reviewers assessed the eligibility and methodological quality of studies using standard checklists, and extracted incremental cost-effectiveness ratios of interventions. Results Of the 2949 identified studies, 42 met full inclusion criteria. Critical appraisal of studies revealed 15 excellent, 18 good and 9 poor quality studies. Most studies were from India (n=37), followed by Bangladesh (n=3), Pakistan (n=2) and Bhutan (n=1). The economic evaluations were based on observational studies (n=9), randomised trials (n=12) and decision models (n=21). Together, these studies evaluated 301 policy or clinical interventions or combination of both. We found a large number of interventions were cost-effective aimed at primordial prevention (tobacco taxation, salt reduction legislation, food labelling and food advertising regulation), and primary and secondary prevention (multidrug therapy for CVD in high-risk group, lifestyle modification and metformin treatment for diabetes prevention, and screening for diabetes complications every 2–5 years). Significant heterogeneity in analytical framework and outcome measures used in these studies restricted meta-analysis and direct ranking of the interventions by their degree of cost-effectiveness. Conclusions The cost-effectiveness evidence for CVD and DM interventions in South Asia
Update on Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes Mellitus in Light of Recent Evidence: A Scientific Statement From the American Heart Association and the American Diabetes Association.
Fox, Caroline S; Golden, Sherita Hill; Anderson, Cheryl; Bray, George A; Burke, Lora E; de Boer, Ian H; Deedwania, Prakash; Eckel, Robert H; Ershow, Abby G; Fradkin, Judith; Inzucchi, Silvio E; Kosiborod, Mikhail; Nelson, Robert G; Patel, Mahesh J; Pignone, Michael; Quinn, Laurie; Schauer, Philip R; Selvin, Elizabeth; Vafiadis, Dorothea K
Cardiovascular disease risk factor control as primary prevention in patients with type 2 diabetes mellitus has changed substantially in the past few years. The purpose of this scientific statement is to review the current literature and key clinical trials pertaining to blood pressure and blood glucose control, cholesterol management, aspirin therapy, and lifestyle modification. We present a synthesis of the recent literature, new guidelines, and clinical targets, including screening for kidney and subclinical cardiovascular disease for the contemporary management of patients with type 2 diabetes mellitus. © 2015 American Heart Association, Inc.
Update on Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes Mellitus in Light of Recent Evidence: A Scientific Statement From the American Heart Association and the American Diabetes Association
Golden, Sherita Hill; Anderson, Cheryl; Bray, George A.; Burke, Lora E.; de Boer, Ian H.; Deedwania, Prakash; Eckel, Robert H.; Ershow, Abby G.; Fradkin, Judith; Inzucchi, Silvio E.; Kosiborod, Mikhail; Nelson, Robert G.; Patel, Mahesh J.; Pignone, Michael; Quinn, Laurie; Schauer, Philip R.; Selvin, Elizabeth; Vafiadis, Dorothea K.
Cardiovascular disease risk factor control as primary prevention in patients with type 2 diabetes mellitus has changed substantially in the past few years. The purpose of this scientific statement is to review the current literature and key clinical trials pertaining to blood pressure and blood glucose control, cholesterol management, aspirin therapy, and lifestyle modification. We present a synthesis of the recent literature, new guidelines, and clinical targets, including screening for kidney and subclinical cardiovascular disease for the contemporary management of patients with type 2 diabetes mellitus. PMID:26246459
Sazlina, Shariff-Ghazali; Mastura, Ismail; Ahmad, Zaiton; Cheong, Ai-Theng; Adam, Bujang-Mohamad; Jamaiyah, Haniff; Lee, Ping-Yein; Syed-Alwi, Syed-Abdul-Rahman; Chew, Boon-How; Sriwahyu, Taher
The aims of the present study were to assess the control of glycemia and other cardiovascular disease risk factors, and the association between age and these controls among older adults with type 2 diabetes in Malaysia. A cross-sectional study was carried out using cases notified to the Adult Diabetes Control and Management database between 1 January and 31 December 2009. A total of 10 363 people aged over 60 years with type 2 diabetes mellitus were included in the analyses. A standard online case report form was used to record demographic data, clinical factors (diabetes duration, comorbid condition and treatment modalities), cardiovascular disease risk factors, diabetes complications and laboratory assessments. The cardiovascular disease risk factors controls assessed included glycosylated hemoglobin (HbA(1c)) older adults who achieved target HbA(1c) (older adults aged ≥80 years significantly achieved the targets of HbA(1c) older adults with type 2 diabetes. The oldest elderly were more likely to achieve target HbA(1c) (older adults aged 60-69 years. © 2013 Japan Geriatrics Society.
... page: //medlineplus.gov/ency/patientinstructions/000759.htm Understanding cardiovascular disease To use the sharing features on this page, ... lead to heart attack or stroke. Types of Cardiovascular Disease Coronary heart disease (CHD) is the most common ...
... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More Cardiovascular Disease & Diabetes Updated:Jan 29,2018 The following statistics ... clear that there is a strong correlation between cardiovascular disease (CVD) and diabetes. At least 68 percent of ...
Pagano, Gennaro; Polychronis, Sotirios; Wilson, Heather; Giordano, Beniamino; Ferrara, Nicola; Niccolini, Flavia; Politis, Marios
To investigate whether diabetes mellitus is associated with Parkinson-like pathology in people without Parkinson disease and to evaluate the effect of diabetes mellitus on markers of Parkinson pathology and clinical progression in drug-naive patients with early-stage Parkinson disease. We compared 25 patients with Parkinson disease and diabetes mellitus to 25 without diabetes mellitus, and 14 patients with diabetes mellitus and no Parkinson disease to 14 healthy controls (people with no diabetes mellitus or Parkinson disease). The clinical diagnosis of diabetes mellitus was confirmed by 2 consecutive fasting measurements of serum glucose levels >126 mL/dL. Over a 36-month follow-up period, we then investigated in the population with Parkinson disease whether the presence of diabetes mellitus was associated with faster motor progression or cognitive decline. The presence of diabetes mellitus was associated with higher motor scores ( p Parkinson disease. In patients with diabetes but without Parkinson disease, the presence of diabetes mellitus was associated with lower striatal dopamine transporter binding ( p Parkinson disease, the presence of diabetes mellitus was associated with faster motor progression (hazard ratio = 4.521, 95% confidence interval = 1.468-13.926; p Parkinson-like pathology, and when present in patients with Parkinson disease, can induce a more aggressive phenotype. © 2018 American Academy of Neurology.
Lakerveld, J.; Bot, S.D.M.; Chin A Paw, J.M.M.; van Tulder, M.; van Oppen, P.C.; Dekker, J.M.; Nijpels, G.
Background: The number of people with cardiovascular disease (CVD) and diabetes mellitus type 2 (T2DM) is growing rapidly. To a large extend, this increase is due to lifestyle-dependent risk factors, such as overweight, reduced physical activity, and an unhealthy diet. Changing these risk factors
Everett, Brendan M; Cook, Nancy R; Magnone, Maria C; Bobadilla, Maria; Kim, Eunjung; Rifai, Nader; Ridker, Paul M; Pradhan, Aruna D
Very low levels of cardiac troponin T are associated with an increased risk of cardiovascular death in patients with stable chronic coronary disease. Whether high-sensitivity cardiac troponin T levels are associated with adverse cardiovascular outcomes in individuals without cardiovascular disease (CVD) has not been well studied. Using 2 complementary study designs, we evaluated the relationship between baseline cardiac troponin and incident CVD events among diabetic and nondiabetic participants in the Women's Health Study (median follow-up, 12.3 years). All diabetic women with blood specimens were included in a cohort study (n=512 diabetic women, n=65 events), and nondiabetic women were sampled for inclusion in a case-cohort analysis (n=564 comprising the subcohort, n=479 events). High-sensitivity cardiac troponin T was detectable (≥ 0.003 μg/L) in 45.5% of diabetic women and 30.3% of nondiabetic women (P<0.0001). In models adjusted for traditional risk factors and hemoglobin A(1c), detectable high-sensitivity cardiac troponin T was associated with subsequent CVD (myocardial infarction, stroke, cardiovascular death) in diabetic women (adjusted hazard ratio, 1.79; 95% confidence interval, 1.04 to 3.07, P=0.036) but not nondiabetic women (adjusted hazard ratio, 1.13; 95% confidence interval, 0.82 to 1.55; P=0.46). Further adjustment for amino-terminal pro-B-type natriuretic peptide and estimated renal function did not substantially alter this relationship among diabetic women (hazard ratio, 1.76; 95% confidence interval, 1.00 to 3.08; P=0.0499), which appeared to be driven by a 3-fold increase in CVD death that was not observed in nondiabetic women. Very low but detectable levels of cardiac troponin T are associated with total CVD and CVD death in women with diabetes mellitus. Among healthy nondiabetic women, detectable compared with undetectable troponin was not associated with CVD events.
A systematic review of qualitative research on the contributory factors leading to medicine-related problems from the perspectives of adult patients with cardiovascular diseases and diabetes mellitus.
Al Hamid, A; Ghaleb, M; Aljadhey, H; Aslanpour, Z
To synthesise contributing factors leading to medicine-related problems (MRPs) in adult patients with cardiovascular diseases and/or diabetes mellitus from their perspectives. A systematic literature review of qualitative studies regarding the contributory factors leading to MRPs, medication errors and non-adherence, followed by a thematic synthesis of the studies. We screened Pubmed, EMBASE, ISI Web of Knowledge, PsycInfo, International Pharmaceutical Abstract and PsycExtra for qualitative studies (interviews, focus groups and questionnaires of a qualitative nature). Thematic synthesis was achieved by coding and developing themes from the findings of qualitative studies. The synthesis yielded 21 studies that satisfied the inclusion and exclusion criteria. Three themes emerged that involved contributing factors to MRPs: patient-related factors including socioeconomic factors (beliefs, feeling victimised, history of the condition, lack of finance, lack of motivation and low self-esteem) and lifestyle factors (diet, lack of exercise/time to see the doctor, obesity, smoking and stress), medicine-related factors (belief in natural remedies, fear of medicine, lack of belief in medicines, lack of knowledge, non-adherence and polypharmacy) and condition-related factors (lack of knowledge/understanding, fear of condition and its complications, and lack of control). MRPs represent a major health threat, especially among adult patients with cardiovascular diseases and/or diabetes mellitus. The patients' perspectives uncovered hidden factors that could cause and/or contribute to MRPs in these groups of patients. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Full Text Available Abstract Background The topical role of uric acid and its relation to cardiovascular disease, renal disease, and hypertension is rapidly evolving. Its important role both historically and currently in the clinical clustering phenomenon of the metabolic syndrome (MS, type 2 diabetes mellitus (T2DM, atheroscleropathy, and non-diabetic atherosclerosis is of great importance. Results Uric acid is a marker of risk and it remains controversial as to its importance as a risk factor (causative role. In this review we will attempt to justify its important role as one of the many risk factors in the development of accelerated atherosclerosis and discuss its importance of being one of the multiple injurious stimuli to the endothelium, the arterial vessel wall, and capillaries. The role of uric acid, oxidative – redox stress, reactive oxygen species, and decreased endothelial nitric oxide and endothelial dysfunction cannot be over emphasized. In the atherosclerotic prooxidative environmental milieu the original antioxidant properties of uric acid paradoxically becomes prooxidant, thus contributing to the oxidation of lipoproteins within atherosclerotic plaques, regardless of their origins in the MS, T2DM, accelerated atherosclerosis (atheroscleropathy, or non-diabetic vulnerable atherosclerotic plaques. In this milieu there exists an antioxidant – prooxidant urate redox shuttle. Conclusion Elevations of uric acid > 4 mg/dl should be considered a "red flag" in those patients at risk for cardiovascular disease and should alert the clinician to strive to utilize a global risk reduction program in a team effort to reduce the complications of the atherogenic process resulting in the morbid – mortal outcomes of cardiovascular disease.
Fujii, Hiroki; Iwase, Masanori; Ohkuma, Toshiaki; Ogata-Kaizu, Shinako; Ide, Hitoshi; Kikuchi, Yohei; Idewaki, Yasuhiro; Joudai, Tamaki; Hirakawa, Yoichiro; Uchida, Kazuhiro; Sasaki, Satoshi; Nakamura, Udai; Kitazono, Takanari
Dietary fiber is beneficial for the treatment of type 2 diabetes mellitus, although it is consumed differently in ethnic foods around the world. We investigated the association between dietary fiber intake and obesity, glycemic control, cardiovascular risk factors and chronic kidney disease in Japanese type 2 diabetic patients. A total of 4,399 patients were assessed for dietary fiber intake using a brief self-administered diet history questionnaire. The associations between dietary fiber intake and various cardiovascular risk factors were investigated cross-sectionally. Body mass index, fasting plasma glucose, HbA1c, triglyceride and high-sensitivity C-reactive protein negatively associated with dietary fiber intake after adjusting for age, sex, duration of diabetes, current smoking, current drinking, total energy intake, fat intake, saturated fatty acid intake, leisure-time physical activity and use of oral hypoglycemic agents or insulin. The homeostasis model assessment insulin sensitivity and HDL cholesterol positively associated with dietary fiber intake. Dietary fiber intake was associated with reduced prevalence of abdominal obesity, hypertension and metabolic syndrome after multivariate adjustments including obesity. Furthermore, dietary fiber intake was associated with lower prevalence of albuminuria, low estimated glomerular filtration rate and chronic kidney disease after multivariate adjustments including protein intake. Additional adjustments for obesity, hypertension or metabolic syndrome did not change these associations. We demonstrated that increased dietary fiber intake was associated with better glycemic control and more favorable cardiovascular disease risk factors including chronic kidney disease in Japanese type 2 diabetic patients. Diabetic patients should be encouraged to consume more dietary fiber in daily life.
Full Text Available Background. In accordance with the postulates of the National Cholesterol Education Program, type 2 diabetes mellitus (DM is classified as coronary heart disease equivalent of risk. Purpose of this work is to investigate the dynamics of anthropometric indexes, parameters of carbohydrate metabolism, markers of insulin resistance (IR, indexes of hepatic complex, coagulogram, urinary acid, glomerular filtration rate (GFR, and also instrumental indexes in patients with type 2 DM during differentiated hypoglycemic and metabolic therapy by Vazonat preparation for 6 and 9 months. Materials and methods. Under supervision, there were 60 patients with type 2 DM in the state of decompensation, who received Vazonat 10 ml intravenously as metabolic therapy during 10 days from the beginning of the research and 1000 μg/day orally for prolongation of the course during 6 and 9 months. Influence of Vazonat was studied on the background the differentiated hypoglycemic therapy: by oral hypoglycemic preparations (metformin, 30 patients, combination therapy with metformin and NPH insulin (second group, 30 individuals. Study of the dynamics of carbohydrate metabolism indexes and IR markers was conducted in patients at the beginning of the research and during 6 and 9 months. Results. Vazonat strengthens the effect of hypoglycemic therapy, influences the IR indexes and anthropometric parameters, lipidogram values, hepatic complex, urinary acid level, prothrombin index, GFR and positively influences the dynamics of left ventricular ejection fraction. Conclusions. It is expedient to prescribe Vazonat as additional metabolic therapy for the improvement of clinical course and disease prognosis, and also for the improvement of quality of life in patients with type 2 DM and hepato- and nephropathy, coronary heart disease, arterial hypertension, gout, violations of blood lipid spectrum.
Oguoma, Victor M.; Nwose, Ezekiel U.; Ulasi, Ifeoma I.
.8%) was the highest followed by overweight/obese (3.1%; CI: 2.5 - 3.8%) and HBP (1.8%; CI: 1.3 - 2.4%). The predicted age of IFG or diabetes and their co-morbidity with other CVD risk factors were between 40 - 45 years. Elevated blood level of total cholesterol was the most predictive co-morbid risk factor among IFG...... and diabetes subjects. Hypertriglyceridaemia was an important risk factor among IFG-normocholesterolaemic-overweight/obese individuals. Conclusion: The higher prevalence of co-morbidity of CVD risk factors with IFG than in diabetes plus the similar age of co-morbidity between IFG and diabetes highlights......Background: Diabetes is a risk factor for cardiovascular diseases (CVDs) and there are reports of increasing prevalence of prediabetes in Nigeria. This study therefore characterised CVDs risk factors in subjects with impaired fasting glucose (IFG) and diabetes. Methods: Data from 4 population...
Higgins, Timothy P; Baker, Matthew D; Evans, Shelley-Ann; Adams, Rachel A; Cobbold, Christian
Hypertension, decreased glucose tolerance, adverse lipid profiles and low physical activity levels are associated with increased type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) risk. High intensity interval training (HIIT), a low volume, reduced time, high intensity programme, may be a useful alternative to current government guidelines which specify a minimum of 150 minutes of physical activity per week. We describe a personalised programme of high intensity exercise which provides significant improvements in CVD risk markers. Healthy volunteers undertook 6 weeks of HIIT. T2DM and CVD risk predictors including glucose tolerance, VO2max, blood pressure (BP), and lipids were measured before and after HIIT. HIIT training was associated with beneficial changes in a range of predictors of blood flow and cardiovascular risk. There was a heterogeneous response to HIIT, with some subjects responding with favourable changes and others being non-responders to HIIT. In responders, HIIT was associated with a statistically significant (p = 0.023) increase in VO2max, from 45.4 (38.4,52.5) to 56.9 (51.2,65.7) (median (interquartile range)(ml/min/kg)). In responders HIIT resulted in a decrease in systolic BP from 127 (126,129) to 116 (106,122) (mmHg) with p = 0.026 and a decrease is diastolic blood pressure from 72 (69,74) to 57 (56,66) with p = 0.026. There was also some evidence of a beneficial change in blood lipid and glucose concentrations with HIIT. In conclusion, personalised HIIT has potential as an intervention to improve blood flow and cardiovascular health.
Pedro-Botet, Juan; Chillarón, Juan J; Benaiges, David; Flores-Le Roux, Juana A
Patients with type2 diabetes mellitus have a high to very high cardiovascular risk, and often have other associated risk factors, such as hypertension, obesity and dyslipidaemia. Cardiovascular disease is the leading cause of morbidity and mortality in this population. An integrated control of all risk factors in patients with diabetes is essential for minimising the risk of macrovascular complications. Given the benefits of the multifactorial intervention strategies for cardiovascular prevention in diabetic patients, a review is presented on the therapeutic goals established for each risk factor in diabetes and the benefits of their control. Copyright © 2015 Sociedad Española de Arteriosclerosis. Published by Elsevier España. All rights reserved.
Victor M. Oguoma
Full Text Available Abstract Background Diabetes is a risk factor for cardiovascular diseases (CVDs and there are reports of increasing prevalence of prediabetes in Nigeria. This study therefore characterised CVDs risk factors in subjects with impaired fasting glucose (IFG and diabetes. Methods Data from 4 population-based cross-sectional studies on 2447 apparently healthy individuals from 18 - 89 years were analysed. Anthropometric, blood pressure and biochemical parameters were collected and classified. Individuals with IFG (prediabetes and diabetes were merged each for positive cases of dyslipidaemia, high blood pressure (HBP or obesity. Optimal Discriminant and Hierarchical Optimal Classification Tree Analysis (HO-CTA were employed. Results Overall prevalence of IFG and diabetes were 5.8% (CI: 4.9 – 6.7% and 3.1% (CI: 2.4 – 3.8%, respectively. IFG co-morbidity with dyslipidaemia (5.0%; CI: 4.1 – 5.8% was the highest followed by overweight/obese (3.1%; CI: 2.5 – 3.8% and HBP (1.8%; CI: 1.3 – 2.4%. The predicted age of IFG or diabetes and their co-morbidity with other CVD risk factors were between 40 – 45 years. Elevated blood level of total cholesterol was the most predictive co-morbid risk factor among IFG and diabetes subjects. Hypertriglyceridaemia was an important risk factor among IFG-normocholesterolaemic-overweight/obese individuals. Conclusion The higher prevalence of co-morbidity of CVD risk factors with IFG than in diabetes plus the similar age of co-morbidity between IFG and diabetes highlights the need for risk assessment models for prediabetes and education of individuals at risk about factors that mitigate development of diabetes and CVDs.
Margaix Muñoz, María; Jiménez Soriano, Yolanda; Poveda Roda, Rafael; Sarrión Pérez, María Gracia
Coronary heart disease is the principal cause of death in the industrialized world. Its most serious expression, acute myocardial infarction, causes 7.2 million deaths each year worldwide, and it is estimated that 20% of all people will suffer heart failure in the course of their lifetime. The control of risk cardiovascular factors, including arterial hypertension, obesity and diabetes mellitus is the best way to prevent such diseases. The most frequent and serious cardiovascular emergenc...
May, O.; Arildsen, H.; Damsgaard, E.M.
OBJECTIVES: The aim of the study was to estimate the prevalence of cardiovascular autonomic neuropathy (CAN) in Type 1 diabetes mellitus in the general population and to assess the relationship between CAN and risk of future coronary heart disease (CHD). METHODS: The Type 1 diabetes mellitus...... population in the municipality of Horsens, Denmark, was delineated by the prescription method and a random sample of 120 diabetics aged 40-75 years was recruited. Type 1 diabetes mellitus was registered if fasting C-peptide was below 0.30 nmol L(-1). The E/I ratio was calculated as the mean of the longest R......, was computed. Additionally, the 10-year risk of CHD was calculated using the Framingham model. RESULTS: A total of 84 people responded, of whom 71 had Type 1 diabetes mellitus. The E/I ratio was measured in 69 people. The prevalence of CAN expressed as an E/I ratio below the normal 5th percentile was 38...
Nordestgaard, Børge G; Varbo, Anette
cholesterol might not cause cardiovascular disease as originally thought has now generated renewed interest in raised concentrations of triglycerides. This renewed interest has also been driven by epidemiological and genetic evidence supporting raised triglycerides, remnant cholesterol, or triglyceride......-rich lipoproteins as an additional cause of cardiovascular disease and all-cause mortality. Triglycerides can be measured in the non-fasting or fasting states, with concentrations of 2-10 mmol/L conferring increased risk of cardiovascular disease, and concentrations greater than 10 mmol/L conferring increased risk...... of acute pancreatitis and possibly cardiovascular disease. Although randomised trials showing cardiovascular benefit of triglyceride reduction are scarce, new triglyceride-lowering drugs are being developed, and large-scale trials have been initiated that will hopefully provide conclusive evidence...
Hoogeveen, E K; Kostense, P J; Beks, P J; Mackaay, A J; Jakobs, C; Bouter, L M; Heine, R J; Stehouwer, C D
A high serum total homocysteine (tHcy) level is an independent risk factor for cardiovascular disease. Because it is not known whether the strength of the association between hyperhomocysteinemia and cardiovascular disease is similar for peripheral arterial, coronary artery, and cerebrovascular
Sliz, Monika; Olszewska-Czyz, Iwona; Kantorowicz, Malgorzata; Chomyszyn-Gajewska, Maria
Scientific studies confirm correlation between periodontitis and systemic diseases such as: arteriosclerosis, diabetes, heart diseases, stroke, diseases of the respiratory system, kidney diseases, osteoporosis, rheumatoid arthritis, premature birth and low birth weight. The interaction between periodontitis and diabetes mellitus is described, based on the literature.
J.O. Younge (John)
markdownabstract__Abstract__ Globally, the burden of cardiovascular disease (CVD) is still increasing. However, in recent decades, better treatment modalities have led to less cardiovascular related deaths. After years of research, we now generally accept that lifestyle factors are the most
Wan, Eric Yuk Fai; Fong, Daniel Yee Tak; Fung, Colman Siu Cheung; Yu, Esther Yee Tak; Chin, Weng Yee; Chan, Anca Ka Chun; Lam, Cindy Lo Kuen
Evidence-based cardiovascular diseases (CVD) risk prediction models and tools specific for Chinese patients with type 2 diabetes mellitus (T2DM) are currently unavailable. This study aimed to develop and validate a CVD risk prediction model for Chinese T2DM patients. A retrospective cohort study was conducted with 137 935 Chinese patients aged 18 to 79 years with T2DM and without prior history of CVD, who had received public primary care services between January 1, 2010 and December 31, 2010. Using the derivation cohort over a median follow-up of 5 years, the interaction effect between predictors and age were derived using Cox proportional hazards regression with a forward stepwise approach. Harrell's C statistic and calibration plot were used on the validation cohort to assess the discrimination and calibration of the models. The web calculator and chart were developed based on the developed models. For both genders, predictors for higher risk of CVD were older age, smoking, longer diabetes duration, usage of anti-hypertensive drug and insulin, higher body mass index, haemoglobin A1c (HbA1c), systolic and diastolic blood pressure, a total cholesterol to high-density lipoprotein-cholesterol (TC/HDL-C) ratio and urine albumin to creatinine ratio, and lower estimated glomerular filtration rate. Interaction factors with age demonstrated a greater weighting of TC/HDL-C ratio in both younger females and males, and smoking status and HbA1c in younger males. The developed models, translated into a web calculator and color-coded chart, served as evidence-based visual aids that facilitate clinicians to estimate quickly the 5-year CVD risk for Chinese T2DM patients and to guide intervention. © 2017 John Wiley & Sons Ltd.
Lim, R B T; Chen, C; Naidoo, N; Gay, G; Tang, W E; Seah, D; Chen, R; Tan, N C; Lee, J; Tai, E S; Chia, K S; Lim, W Y
The study investigated the relationship of general (body mass index [BMI]) and central (waist circumference [WC]; waist-hip ratio [WHipR]; waist-height ratio [WHeightR]) adiposity with all-cause and cardiovascular disease (CVD)-related mortality in an Asian population with diabetes. A total of 13,278 participants with type 2 diabetes mellitus (T2DM) recruited from public-sector primary-care and specialist outpatients clinics in Singapore were followed-up for a median duration of 2.9 years, during which time there were 524 deaths. Cox proportional-hazards regression and competing-risk models were used to obtain hazard ratios (HRs) for anthropometric variables of all-cause and CVD-related mortality. After adjusting for BMI, the highest quintiles of WC, WHipR and WHeightR were all positively associated with mortality compared with the lowest quintiles, with WHeightR exhibiting the largest effect sizes [all-cause mortality HR: 2.13, 95% confidence interval (CI): 1.33-3.42; CVD-related mortality HR: 3.42, 95% CI: 1.62-7.19]. Being overweight but not obese (BMI:≥23.0 butobesity, was associated with a reduction in risk of mortality. This was seen in T2DM patients aged≥65 years, but not in those younger than this. At the same BMI, having higher central-obesity indices such as WC, WHipR and WHeightR also increased the risk of mortality. Copyright © 2014 Elsevier Masson SAS. All rights reserved.
Prevention program including lifestyle changes was initiated with the participation of obese and overweight subjects recruited from the practices of 29 family doctors. The aim of the author was to analyse changes of non-HDL-cholesterol levels, especially when triglyceride levels were above 2.26 mmol/l, and when non-HDL cholesterol levels were high in association with low HDL-cholesterol levels in overweight or obese subjects who had no cardiovascular disease and diabetes mellitus. Data obtained from 1192 subjects (424 men and 768 women) before and 12 month after inclusion into the prevention program was analysed. The average level of non-HDL-cholesterol in the whole group of subjects decreased from 4.74 to 4.64 mmol/l, but the change was not significant. However, the average concentration of non-HDL-cholesterol was reduced significantly from 4.87 to 4.4 mmol/l in men, whereas no significant change was detected in women. In cases when triglyceride levels were higher than 2.26 mmol/l, the non-HDL-cholesterol level was reduced by 0.65 mmol/l. In cases when the non-HDL-cholesterol level was high in association with low HDL-cholesterol level, the non-HDL-cholesterol was significantly decreased from 5.22 to 4.48 mmol/l. In addition, in cases when HDL-cholesterol levels were low, the average level of the HDL-cholesterol significantly increased from 0.84 to 1.3 mmol/l. Lifestyle changes decrease the level of atherogenic lipid fractions, particularly in men with high triglyceride levels. Improvement of the atherogenic lipid profile in response to lifestyle changes is related not only to the reduction of atherogenic lipid fractions, but also to the increase of HDL-cholesterol level.
Etemad, A; Vasudevan, R; Aziz, A F A; Yusof, A K M; Khazaei, S; Fawzi, N; Jamalpour, S; Arkani, M; Mohammad, N A; Ismail, P
Type 2 diabetes mellitus (T2DM) is believed to be associated with excessive production of reactive oxygen species. Glutathione S-transferase (GST) polymorphisms result in decreased or absent enzyme activity and altered oxidative stress, and have been associated with cardiovascular disease (CVD). The present study assessed the effect of GST polymorphisms on the risk of developing T2DM in individuals of Malaysian Malay ethnicity. A total of 287 subjects, consisting of 87 T2DM and 64 CVD/T2DM patients, as well as 136 healthy gender- and age-matched controls were genotyped for selected polymorphisms to evaluate associations with T2DM susceptibility. Genomic DNA was extracted using commercially available kits, and GSTM1, GSTT1, and α-globin sequences were amplified by multiplex polymerase chain reaction. Biochemical parameters were measured with a Hitachi autoanalyzer. The Fisher exact test, the chi-square statistic, and means ± standard deviations were calculated using the SPSS software. Overall, we observed no significant differences regarding genotype and allele frequencies between each group (P = 0.224 and 0.199, respectively). However, in the combined analysis of genotypes and blood measurements, fasting plasma glucose, HbA1c, and triglyceride levels, followed by age, body mass index, waist-hip ratio, systolic blood pressure, and history of T2DM significantly differed according to GST polymorphism (P ˂ 0.05). Genetically induced absence of the GSTT1 enzyme is an independent and powerful predictor of premature vascular morbidity and death in individuals with T2DM, and might be triggered by cigarette smoking's oxidative effects. These polymorphisms could be screened in other ethnicities within Malaysia to determine further possible risk factors.
Panagiotakos, Demosthenes B; Pitsavos, Christos; Skoumas, Yannis; Lentzas, Yannis; Stefanadis, Christodoulos
Objective We evaluated the 5-year incidence of diabetes in an adult population from Greece. Research design and methods 3042 individuals (>18 years), free of cardiovascular disease, participated in the baseline examination (during 2001–2002). Of this sample, 1012 men and 1035 women were found alive at the time of follow-up, while 32 (2.1%) men and 22 (1.4%) women died during this period. The rest were lost to follow-up. Incidence of type 2 diabetes mellitus was evaluated in 1806 participants who did not have diabetes at baseline. Results The age-adjusted 5-year incidence of diabetes was 5.5% (men, 5.8%; women, 5.2%). A linear trend was observed between diabetes incidence and age (5.6% increases in incidence per 1-year difference in age, p physical activity (OR = 0.62, 95% CI 0.35–1.02) and family history of diabetes (OR = 2.65, 95% CI 1.58–4.53), as well as fasting glucose levels (OR per 1 mg/dl = 1.05, 95% CI 1.03–1.07), were the most significant baseline predictors for diabetes, after adjusting for various potential confounders. Additionally, presence of metabolic syndrome at baseline evaluation 2.95-fold the risk of diabetes (95% CI 1.89–4.61), and showed better classification ability than the model that contained the components of the syndrome (ie, correct classification rate: 94.5% vs. 92.3%). Conclusion Our findings show that a 5.5% incidence rate of diabetes within a 5-year period, which suggests that the prevalence of this disorder in Greece is rising. Aging, heredity, and metabolic syndrome were the most significant determinants of diabetes. PMID:18827919
Den Ruijter, Hester M.; Pasterkamp, Gerard
More women than men die of cardiovascular disease (CVD) each year in every major developed country and most emerging economies. Nonetheless, CVD has often been considered as men’s disease due to the higher rates of coronary artery disease (CAD) of men at younger age. This has led to the
Background: The incidence of diabetes mellitus (DM) is rapidly on the increase worldwide and is gradually becoming a major public health problem for developing nations. Diabetes in all its forms is one of the main cardiovascular risk factors. Cardiovascular complications are a leading cause of death in diabetic patients ...
Nadal, Josep Franch; Gutiérrez, Pedro Conthe
Diabetes mellitus, especially type 2, is a metabolic disease involving the coexistence of several cardiovascular risk factors. Affected patients are therefore at high cardiovascular risk (2-3 times higher than that of men in the general population and 2-6 times higher than that of women). Cardiovascular disease is the main cause of death in the diabetic population, followed by cancer. Cardiovascular risk cannot be compared between diabetic patients and persons who have already shown one or more manifestations of cardiovascular disease (such as myocardial infarction). Single risk factors should be evaluated in combination with other risk factors and a person's cardiovascular risk should be individually assessed. Cardiovascular risk assessment in patients with diabetes through current calculations methods is complex because their ability to predict risk in individuals is very low. Studies such as that by Steno have demonstrated the validity of a comprehensive strategy to control all the risk factors present in persons with type 2 diabetes mellitus, which can reduce the development of micro- and macrovascular complications and mortality by almost 50%. The present article reviews each of the classical cardiovascular risk factors (hypertension, dyslipidemia, smoking, obesity, sedentariness) in relation to diabetes, as well as their recommended targets and the benefits of their control. In view of the above, a comprehensive approach is recommended to control the multiple risk factors that can coexist in persons with type 2 diabetes mellitus. Copyright © 2013 Elsevier España, S.L. All rights reserved.
A systematic review of event rates in clinical trials in diabetes mellitus: the importance of quantifying baseline cardiovascular disease history and proteinuria and implications for clinical trial design.
Preiss, David; Sattar, Naveed; McMurray, John J
Food and Drug Administration guidance now proposes that cardiovascular safety of new diabetes medicines be demonstrated. Consequently, trials should include a sufficient number of individuals with diabetes who are at high cardiovascular risk. We aimed to examine the impact of the presence of baseline cardiovascular disease and proteinuria, as binary criteria, on cardiovascular event rates in diabetes trials and to examine whether predicted primary end-point event rates are achieved. we searched Medline and EMBASE English language records (January 1998-June 2010) for randomized controlled trials of antiplatelet, lipid-lowering, antihypertensive, and glucose-lowering agents with >1,000 diabetic subjects reporting at least one of all-cause death, cardiovascular death, myocardial infarction, and stroke. Weighted mean event rates (events/1,000 patient-years) were calculated. Data from published power calculations were also compared with achieved event rates. twenty-nine trials met inclusion criteria. Weighted mean event rates in diabetic subjects with and those without baseline cardiovascular disease were, respectively, 28.9 and 10.0 for all-cause death, 16.7 and 3.6 for cardiovascular death, 23.1 and 5.2 for myocardial infarction, and 12.1 and 5.4 for stroke. Event rates in diabetic subjects with and those without proteinuria were, respectively, 39.9 and 6.3 for all-cause death and 18.7 and 1.2 for cardiovascular death. Nine of 11 relevant trials achieved primary end-point event rates clearly lower than predicted. trials including diabetic subjects without cardiovascular disease or proteinuria generate few events and require substantial participant numbers to achieve adequate power. However, the presence of coexisting cardiovascular disease or proteinuria increases event rates multiple-fold. Such data should aid investigators designing diabetes end-point trials.
Nobles-James, Candi; James, Erskine A; Sowers, James R
Eighteen million Americans have type 2 Diabetes Mellitus (DM) while another 40 million have impaired glucose tolerance. Atherosclerotic heart disease is the leading cause of death in patients with diabetes mellitus. In addition to the increased risk for CardioVascular Disease (CVD), patients with diabetes have a worse prognosis than nondiabetics when they suffer an ischemic event. Insulin resistance is increasingly recognized as a chronic, low-level, inflammatory state. Hyperinsulinemia has been proposed as the forerunner of hypertension, low high-density lipoprotein cholesterolemia, hypertriglyceridemia, abdominal obesity, and altered glucose tolerance, linking all these abnormalities to the development of coronary vascular disease. Atherosclerosis and insulin resistance share similar pathophysiological mechanisms, due to the actions of proinflammatory cytokines. The dynamic inflammatory milieu found in diabetes explains the susceptibility of diabetics to CVD and the potential mechanism by which aspirin may prevent CVD in diabetics. Aspirin decreases the risk for CVD in diabetic patients by a variety of established and novel mechanisms. Therapeutic strategies that lesson the CVD risk in diabetic patients, including the use of aspirin for primary and secondary prevention, are potentially very important. This review article addresses the antiatherosclerotic effects of aspirin, the potential anti-diabetic effects of aspirin, and the clinical trial evidence for CVD prevention by aspirin in diabetics. We also present recommendations for the use of aspirin in the diabetic population and the current guidelines put forth by the American Heart Association and by the American Diabetes Association.
Lahoz, Carlos; Valdivielso, Pedro; González-Alegre, María Teresa; García-Iglesias, María Francisca; Estirado, Eva; Mostaza, José M
Survivors of cancer have a shorter survival in the long term partly due to the increase in cardiovascular diseases (CVD). Some chemotherapy drugs, thoracic and cranial radiotherapy and above all the transplantation of hematopoietic cells are associated with an increase in the incidence of cardiovascular events compared with general population. Some of these treatments favor the development of a metabolic syndrome that could be the intermediary between these treatments and the development of CVD. It is recommended for cancer survivors to promote healthy lifestyles and the strict control of cardiovascular risk factors. Copyright © 2015 Sociedad Española de Arteriosclerosis. Published by Elsevier España. All rights reserved.
Síndrome metabólica, resistência à ação da insulina e doença cardiovascular no diabete melito tipo 1 Síndrome metabólico, resistencia a la acción de la insulina y enfermedad cardiovascular en la diabetes mellitus tipo 1 Metabolic syndrome, insulin resistance and cardiovascular disease in type-1 diabetes mellitus
Ticiana C. Rodrigues
Full Text Available A síndrome metabólica (SM é um transtorno complexo representado por um conjunto de fatores de risco cardiovasculares relacionados à deposição central de gordura e à resistência à ação da insulina (RI, e está associada à mortalidade precoce em indivíduos não-diabéticos e em pacientes com Diabete melito (DM tipo 2. A presença da SM e dos seus componentes tem sido descrita também em pacientes com DM tipo 1 e pode contribuir para o elevado risco de doença cardiovascular observado nessa população de pacientes. O objetivo deste trabalho foi revisar as evidências disponíveis sobre o papel da SM e da RI no desenvolvimento da doença cardiovascular nos pacientes com DM tipo 1.El síndrome metabólico (SM es un trastorno complejo representado por un conjunto de factores de riesgo cardiovasculares relacionados al depósito central de grasa y a la resistencia a la acción de la insulina (RI, y se asocia a mortalidad precoz en individuos no diabéticos y en pacientes con diabetes mellitus (DM tipo 2. La presencia del SM y sus componentes viene siendo descripta también en pacientes con DM tipo 1 y puede contribuir al elevado riesgo de enfermedad cardiovascular observado en esta población de pacientes. El objetivo de este trabajo fue revisar las evidencias disponibles sobre el papel del SM y de la RI en el desarrollo de la enfermedad cardiovascular en los pacientes con DM tipo 1.Metabolic syndrome (MS is a complex disorder represented by a cluster of cardiovascular risk factors related to central fat distribution and insulin resistance (IR, and is associated with early mortality in non-diabetic individuals and in patients with type-2 diabetes mellitus (DM. The presence of MS and its components has also been described in patients with type-1 DM and may contribute to the increased risk of cardiovascular disease seen in this patient population. The objective of this study was to review the available evidences of the role of MS and IR in
Predictors of fatal and nonfatal cardiovascular events in patients with type 2 diabetes mellitus, chronic kidney disease, and anemia : An analysis of the Trial to Reduce cardiovascular Events with Aranesp (darbepoetin-alfa) Therapy (TREAT)
McMurray, John J. V.; Uno, Hajime; Jarolim, Petr; Desai, Akshay S.; de Zeeuw, Dick; Eckardt, Kai-Uwe; Ivanovich, Peter; Levey, Andrew S.; Lewis, Eldrin F.; McGill, Janet B.; Parfrey, Patrick; Parving, Hans-Henrik; Toto, Robert M.; Solomon, Scott D.; Pfeffer, Marc A.
Aims This study aims to examine predictors of cardiovascular mortality and morbidity in patients with chronic kidney disease (CKD). Individuals with the triad of diabetes, CKD, and anemia represent a significant proportion of patients with cardiovascular disease and are at particularly high risk for
Demosthenes B Panagiotakos
Full Text Available Demosthenes B Panagiotakos1, Christos Pitsavos2, Yannis Skoumas2, Yannis Lentzas2, Christodoulos Stefanadis21Department of Nutrition Science-Dietetics, Harokopio University, Athens, Greece; 2First Cardiology Clinic, School of Medicine, University of Athens, Athens, GreeceObjective: We evaluated the 5-year incidence of diabetes in an adult population from Greece.Research design and methods: 3042 individuals (>18 years, free of cardiovascular disease, participated in the baseline examination (during 2001–2002. Of this sample, 1012 men and 1035 women were found alive at the time of follow-up, while 32 (2.1% men and 22 (1.4% women died during this period. The rest were lost to follow-up. Incidence of type 2 diabetes mellitus was evaluated in 1806 participants who did not have diabetes at baseline.Results: The age-adjusted 5-year incidence of diabetes was 5.5% (men, 5.8%; women, 5.2%. A linear trend was observed between diabetes incidence and age (5.6% increases in incidence per 1-year difference in age, p < 0.001. Multiple logistic regression analysis revealed that age (OR per 1 yr = 1.04, 95% CI 1.02–1.06, waist (OR per 1 cm = 1.02, 95% CI 1.01–1.003, physical activity (OR = 0.62, 95% CI 0.35–1.02 and family history of diabetes (OR = 2.65, 95% CI 1.58–4.53, as well as fasting glucose levels (OR per 1 mg/dl = 1.05, 95% CI 1.03–1.07, were the most significant baseline predictors for diabetes, after adjusting for various potential confounders. Additionally, presence of metabolic syndrome at baseline evaluation 2.95-fold the risk of diabetes (95% CI 1.89–4.61, and showed better classification ability than the model that contained the components of the syndrome (ie, correct classification rate: 94.5% vs. 92.3%.Conclusion: Our findings show that a 5.5% incidence rate of diabetes within a 5-year period, which suggests that the prevalence of this disorder in Greece is rising. Aging, heredity, and metabolic syndrome were the most significant
Shim, Unjin; Lee, Hyejin; Oh, Jee-Young; Sung, Yeon-Ah
Background/Aims Sleep disorder (SD) is associated with an increased risk of cardiovascular disease and is more prevalent among individuals with type 2 diabetes mellitus. These health problems not only frequently coexist but also exacerbate each other. We conducted a cross-sectional study to estimate the prevalence of SD among diabetic patients and to investigate the relationship between SD and cardiovascular risk among these patients. Methods We recruited 784 patients with type 2 diabetes and...
Despite advances in the prevention and management of cardiovascular disease (CVD), this group of multifactorial disorders remains a leading cause of mortality worldwide. CVD is associated with multiple genetic and modifiable risk factors; however, known environmental and genetic influences can only...
... Venous Thromboembolism Aortic Aneurysm More Cold Weather and Cardiovascular Disease Updated:Sep 16,2015 Th is winter season ... can affect your heart, especially if you have cardiovascular disease . Some people who are outdoors in cold weather ...
Soedamah-Muthu, S.S.; Fuller, J.H.; Mulnier, H.E.; Raleigh, V.S.; Lawrenson, R.A.; Colhoun, H.M.
OBJECTIVE—To estimate the absolute and relative risk of cardiovascular disease (CVD) in patients with type 1 diabetes in the U.K. RESEARCH DESIGN AND METHODS—Subjects with type 1 diabetes (n = 7,479) and five age- and sex-matched subjects without diabetes (n = 38,116) and free of CVD at baseline
Age-related prevalence of diabetes mellitus, cardiovascular disease and anticoagulation therapy use in a urolithiasis population and their effect on outcomes: the Clinical Research Office of the Endourological Society Ureteroscopy Global Study.
Daels, F Pedro J; Gaizauskas, Andrius; Rioja, Jorge; Varshney, Anil K; Erkan, Erkan; Ozgok, Yasar; Melekos, Michael; de la Rosette, Jean J M C H
This study examined the prevalence of risk factors for urological stone surgery and their possible influence on outcome and complications following ureteroscopy (URS). The Clinical Research Office of the Endourological Society Ureteroscopy Global Study collected prospective data on consecutive patients with urinary stones treated with URS at centers around the world for 1 year. The prevalence of common comorbidities and anticoagulation therapy and their relationship with complications and age were examined. Of 11,719 patients, 2,989 patients (25.8%) had cardiovascular disease, including 22.6% with hypertension, and 1,266 patients (10.9%) had diabetes mellitus. Approximately six percent of patients were receiving oral anticoagulation therapy, including aspirin (3.7%) and clopidogrel (0.8%). The prevalence of hypertension and diabetes mellitus and the proportion of patients receiving anticoagulant medication and/or antidiabetes treatment increased with age. Elderly were more likely to develop a postoperative complication when they had diabetes, a cardiovascular disease or received anticoagulation therapy. Post-operative bleeding was higher in patients receiving anticoagulants than those not receiving them (1.1 vs. 0.4%; p < 0.01). Patients with risk factors for stone formation had more complications than those without (4.9 vs. 3.0%, p < 0.001). This is the first study confirming in a global population that URS can effectively and safely be performed in a population with high comorbidity. The risk of a complication was highest among elderly patients presenting with comorbidities.
There is an unrelenting global increase in the incidence and prevalence of diabetes mellitus (DM) with its attendant cardiovascular complications. Macrovascular complications such as peripheral arterial disease (PAD) are major consequences of DM. This review briefly summarizes the broader literature on the burden of ...
Kloner, Robert A; Carson, Culley; Dobs, Adrian; Kopecky, Stephen; Mohler, Emile R
Testosterone (T) is the principal male sex hormone. As men age, T levels typically fall. Symptoms of low T include decreased libido, vasomotor instability, and decreased bone mineral density. Other symptoms may include depression, fatigue, erectile dysfunction, and reduced muscle strength/mass. Epidemiology studies show that low levels of T are associated with more atherosclerosis, coronary artery disease, and cardiovascular events. However, treating hypogonadism in the aging male has resulted in discrepant results in regard to its effect on cardiovascular events. Emerging studies suggest that T may have a future role in treating heart failure, angina, and myocardial ischemia. A large, prospective, long-term study of T replacement, with a primary endpoint of a composite of adverse cardiovascular events including myocardial infarction, stroke, and/or cardiovascular death, is needed. The Food and Drug Administration recently put additional restrictions on T replacement therapy labeling and called for additional studies to determine its cardiac safety. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
[Cardiovascular and pupillary autonomic and somatosensory neuropathy in chronic diseases with autoimmune phenomena. A comparative study of patients with Crohn disease, ulcerative colitis, systemic lupus erythematosus, progressive systemic sclerosis and type I diabetes mellitus].
Straub, R H; Andus, T; Lock, G; Zeuner, M; Palitzsch, K D; Gross, V; Lang, B; Schölmerich, J
During the last years, examination of autonomic nervous function and of autonomic neuropathy has attracted attention not only in diabetes mellitus research but also in other areas of internal medicine. However, patients with various chronic diseases with autoimmune phenomenons have never been investigated in a comparative study with standardized examination techniques. Hence, the aim of the study was to examine the prevalence and the severity of autonomic neuropathy in patients with the following chronic diseases. We investigated 28 patients with Crohn's disease (CD: age: 32.4 +/- 2.0 y), 17 patients with ulcerative colitis (UC: 39.7 +/- 3.6 y), 39 patients with systemic lupus erythematosus (SLE: 34.9 +/- 2.0 y), 38 patients with progressive systemic sclerosis (pSS; 51.5 +/- 2.4 y) and 65 patients with insulin-dependent diabetes mellitus (IDDM: 35.5 +/- 1.6 y). Cardiovascular autonomic (cANP), pupillary autonomic (pANP), and sensorimotor (ssNP) neuropathy were assessed by standardized techniques. Prevalence rates for cANP, pANP and ssNP were found to be 0%, 19%, and 7% in CD, 6%, 25%, and 18% in UC, 5%, 29%, and 10% in SLE, 11%, 16%, and 32% in pSS, and 26%, 66%, and 29% in IDDM, respectively. The study demonstrated patients with IDDM to have the highest prevalence rates of cANP and pANP. Patients with other chronic diseases, particularly SLE, pSS and UC, had high prevalence rates of pANP. This may be due to alterations of structures of the central nervous system in these patients. cANP was rare in patients with inflammatory bowel disease and ssNP was found very often in patients with pSS, probably due to local fibrotic lesions. The various disease groups differ in the pattern and severity of autonomic and sensorimotor neuropathy, which indicates that different structures and neuropathogenic mechanisms may be involved.
Budgetary Impact Analysis of Reimbursement Varenicline for the Smoking-Cessation Treatment in Patients with Cardiovascular Diseases, Chronic Obstructive Pulmonary Disease or Type-2 Diabetes Mellitus: A National Health System Perspective.
Cedillo, Sergio; Sicras-Mainar, Antoni; Jiménez-Ruiz, Carlos A; Fernández de Bobadilla, Jaime; Rejas-Gutiérrez, Javier
The study aimed to assess the budgetary impact (BI) of reimbursing varenicline in patients with chronic obstructive pulmonary disease (COPD), type-2 diabetes mellitus (t2-DM) or cardiovascular diseases (CVD). The BI was estimated comparing the current non-reimbursed scenario versus a projected reimbursed scenario using the Spanish National Health System (SNHS) perspective. A hybrid model was developed using epidemiological data and Markov chains to estimate smoking cessation rates with varenicline during a 5-year horizon. Costs of cessation were considered in the reimbursement scenario only. Efficacy, expressed as a 1-year continuous abstinence rate, was derived from clinical trials. Cost savings due to smoking cessation were extracted from local cost-of-illness studies. Results are shown as incremental cost savings. Univariate sensitivity analysis was also applied. A total of 68,684 patients stopped smoking in the reimbursed scenario compared with 15,208 without reimbursement. In the reimbursed scenario, total savings accounted for €36.3 million, showing 14.6 million accumulated additional savings compared with the scenario without reimbursement. Sensitivity analyses showed results to be robust with monetary savings starting in the third year of modeling. Reimbursement of varenicline in smoking cessation is a cost-effective health policy in the SNHS in COPD, t2-DM or CVD, and could produce cost savings starting in the third year of implementation. © 2016 S. Karger AG, Basel.
... Fact Sheet 2016 Update Asian & Pacific Islanders and Cardiovascular Diseases Cardiovascular Disease (CVD) (ICD 10 codes I00-I99, Q20- ... of na- tive Hawaiians or oth- A indicates cardiovascular disease plus congenital cardiovascular disease (ICD-10 I00- ...
Nordestgaard, B G; Langsted, A; Freiberg, J J
, total cholesterol/HDL cholesterol, and apolipoprotein B/apolipoprotein A1 all associate with increased risk of cardiovascular disease. These new data open the possibility that nonfasting rather than fasting lipid profiles can be used for cardiovascular risk prediction. If implemented, this would...... of cardiovascular disease and early death....
Gejl, Michael; Starup-Linde, Jakob; Scheel-Thomsen, Jan
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...
Frazier, Lorraine; Johnson, Rolanda L; Sparks, Elizabeth
To describe genetic knowledge and discovery in the area of cardiovascular disease (CVD) and to discuss how these new advances will influence the clinical care of affected people. A selective review of the literature is presented on the disease mechanism of both the Mendelian and multifactorial genetic cardiovascular conditions. A case study approach is used to illustrate how the genetic paradigm affects the healthcare experience of a family affected with familial hypertrophic cardiomyopathy. The current state of CVD treatment remains complex. An understanding of genomic concepts and a genome-based approach is necessary to determine: (a) the risk of CVD susceptibility beyond traditional risk factors; (b) early detection of illness; (c) response to treatment; and (d) molecular taxonomy of the disease. The results of genetic research, education, and teaching will lead to a new understanding of genes and pathways, resulting in powerful new therapeutic approaches to CVD. The challenge is to translate genetic discoveries into clinical practice that ultimately leads to preventing CVD and reducing mortality.
Navar, Ann Marie; Gallup, Dianne S; Lokhnygina, Yuliya; Green, Jennifer B; McGuire, Darren K; Armstrong, Paul W; Buse, John B; Engel, Samuel S; Lachin, John M; Standl, Eberhard; Van de Werf, Frans; Holman, Rury R; Peterson, Eric D
Systolic blood pressure (SBP) treatment targets for adults with diabetes mellitus remain unclear. SBP levels among 12 275 adults with diabetes mellitus, prior cardiovascular disease, and treated hypertension were evaluated in the TECOS (Trial Evaluating Cardiovascular Outcomes With Sitagliptin) randomized trial of sitagliptin versus placebo. The association between baseline SBP and recurrent cardiovascular disease was evaluated using multivariable Cox proportional hazards modeling with restricted cubic splines, adjusting for clinical characteristics. Kaplan-Meier curves by baseline SBP were created to assess time to cardiovascular disease and 2 potential hypotension-related adverse events: worsening kidney function and fractures. The association between time-updated SBP and outcomes was examined using multivariable Cox proportional hazards models. Overall, 42.2% of adults with diabetes mellitus, cardiovascular disease, and hypertension had an SBP ≥140 mm Hg. The association between SBP and cardiovascular disease risk was U shaped, with a nadir ≈130 mm Hg. When the analysis was restricted to those with baseline SBP of 110 to 150 mm Hg, the adjusted association between SBP and cardiovascular disease risk was flat (hazard ratio per 10-mm Hg increase, 0.96; 95% confidence interval, 0.91-1.02). There was no association between SBP and risk of fracture. Above 150 mm Hg, higher SBP was associated with increasing risk of worsening kidney function (hazard ratio per 10-mm Hg increase, 1.10; 95% confidence interval, 1.02-1.18). Many patients with diabetes mellitus have uncontrolled hypertension. The U-shaped association between SBP and cardiovascular disease events was largely driven by those with very high or low SBP, with no difference in cardiovascular disease risk between 110 and 150 mm Hg. Lower SBP was not associated with higher risks of fractures or worsening kidney function. © 2017 American Heart Association, Inc.
Full Text Available Introduction: Diabetes melliuts is a chronic, metabolic disease that involves the macro and micro vascular complications and one of its maer ascular cowplications is the cardio vascular disease, as ,the risk of cardiovascular disease is 2-4 folds in diabetic patients in comparison with non diabetic individuals. The researches have demonstrated that the risk factors of the cardio vascular disease are formed at childhood. Therefore the preventive measures must begin from early childhood. So the present study was planned with the goals to determine and compare the cardia-vascular risk factors in the diabetic children with type 1 of diabetes mellitus. Method: This was an analytic, cross sectional study that has been done in two groups (case-control. In this research, 148 children, suffering from the typel diabetes mellitus being supported by the metabolism and endocrine research center, were chosen in the continues case manner and for the control group, 148 children, matched with the study group (according to the age and the sex, at 6-18 years old from the schools in Isfahan city randomly and at 2-6 years from the neiborhoods of the case group. The data-gathering tool was the questionnaires includes lipid profile, blood pressure, weight and height. To analyze the data we used the analytic (t student and logistic regression and descriptive (mean and standard deviation statistic methods and SPSS. Results: Findings revealed that the means of Lipid profile, systolic blood pressure and body mass index had not statistically significant differences in the two groups. But the mean of diastolic blood pressure and the mean arterial blood pressure in the control group were more than the case group and this difference was significant. The mean, 75 and 95 percentiles for cholesterol and LDL in all the age groups, mean, 75 and 95 percentile for triglyceride in all the age groups except the age group of 1-4 years in the diabetic and non diabetic groups were
Impact of metabolic syndrome and diabetes mellitus on cardiovascular events in coronary artery disease without ischemia on stress thallium-201 single photon emission computed tomography after percutaneous coronary intervention
Mori, Takao; Ohashi, Yoshitaka; Ejiri, Junya; Takatsuki, Kiyonobu; Ichikawa, Shinobu; Awano, Kojiro
The metabolic syndrome defined by the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) is a predictor of cardiovascular events. However, the significance of metabolic syndrome for cardiovascular events has been not clarified in Japan. The impact of metabolic syndrome and diabetes mellitus on cardiovascular events was investigated, especially in the high risk group after percutaneous coronary intervention. We studied 456 patients (mean age 63±10 years, range 36-88 years) without ischemia on stress thallium-201 single photon emission computed tomography after percutaneous coronary intervention. The diagnosis of metabolic syndrome was made according to the modified NCEP ATP III criteria. Cardiovascular events were examined for mean 3.7±1.8 years (range 2.0-8.7 years). There were 196 patients without diabetes mellitus or metabolic syndrome (Group D-M-), 89 patients without diabetes mellitus but with metabolic syndrome (Group D-M+), 61 patients with diabetes mellitus but without metabolic syndrome (Group D+M-), and 110 patients with both diabetes mellitus and metabolic syndrome (Group D+M+). The event-free survival curve in Group D-M+ was significantly lower than that in Group D-M- (p<0.05), but not different from that in Group D+M-. The survival curve was markedly lower in Group D+M+ than that in Group D-M+ (p<0.005). The Cox proportional hazard model revealed that diabetes mellitus and metabolic syndrome were independent significant risk factors for events. The diagnosis of metabolic syndrome was helpful for identification of patients with high cardiovascular event rate even in patients after percutaneous coronary intervention. The combination of metabolic syndrome and diabetes mellitus markedly increases the risk for cardiovascular events. (author)
When one discusses the management of chronic cardiac diseases, and in particular congestive heart failure (CHF), one cannot but think of digitalis and the important role it plays in the management of CHF. One also has to think about digitalis toxicity and the narrow margin between the therapeutic and toxic doses of digitalis and the important role that monitoring the serum level of the drug play in preventing and/or recognizing its toxic effects. Again, RIA has something to offer the clinician in this area. The purpose of this chapter is to discuss the radioassays for CPK-MB and digoxin mainly, as well as touch upon other assays of use in evaluating patients with cardiovascular disease
Yan Liu; Jie Du
Since President Obama announced the Precision Medicine Initiative in the United States, more and more attention has been paid to precision medicine. However, clinicians have already used it to treat conditions such as cancer. Many cardiovascular diseases have a familial presentation, and genetic variants are associated with the prevention, diagnosis, and treatment of cardiovascular diseases, which are the basis for providing precise care to patients with cardiovascular diseases. Large-scale c...
Lin, Kai; Lloyd-Jones, Donald M; Li, Debiao; Carr, James C
Type 2 diabetes mellitus (T2DM) is a prevalent condition in aged populations. Cardiovascular diseases are leading causes of death and disability in patients with T2DM. Traditional strategies for controlling the cardiovascular complications of diabetes primarily target a cluster of well-defined risk factors, such as hyperglycemia, lipid disorders and hypertension. However, there is controversy over some recent clinical trials aimed at evaluating efficacy of intensive treatments for T2DM. As a powerful tool for quantitative cardiovascular risk estimation, multi-disciplinary cardiovascular imaging have been applied to detect and quantify morphological and functional abnormalities in the cardiovascular system. Quantitative imaging biomarkers acquired with advanced imaging procedures are expected to provide new insights to stratify absolute cardiovascular risks and reduce the overall costs of health care for people with T2DM by facilitating the selection of optimal therapies. This review discusses principles of state-of-the-art cardiovascular imaging techniques and compares applications of those techniques in various clinical circumstances. Individuals measurements of cardiovascular disease burdens from multiple aspects, which are closely related to existing biomarkers and clinical outcomes, are recommended as promising candidates for quantitative imaging biomarkers to assess the responses of the cardiovascular system during diabetic regimens. © 2013 Elsevier Inc. All rights reserved.
Full Text Available Since President Obama announced the Precision Medicine Initiative in the United States, more and more attention has been paid to precision medicine. However, clinicians have already used it to treat conditions such as cancer. Many cardiovascular diseases have a familial presentation, and genetic variants are associated with the prevention, diagnosis, and treatment of cardiovascular diseases, which are the basis for providing precise care to patients with cardiovascular diseases. Large-scale cohorts and multiomics are critical components of precision medicine. Here we summarize the application of precision medicine to cardiovascular diseases based on cohort and omic studies, and hope to elicit discussion about future health care.
Full Text Available Cornelia Schneider,1,2 Blai Coll,3 Susan S Jick,4 Christoph R Meier1,2,4 1Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland; 2Hospital Pharmacy, University Hospital Basel, Basel, Switzerland; 3Renal Development, AbbVie, North Chicago, IL, USA; 4Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, MA, USA Background: Doubling of serum creatinine is often used as a marker for worsening kidney function in nephrology trials. Most people with chronic kidney disease die of other causes before reaching end-stage renal disease. We were interested in the association between doubling of serum creatinine and the risk of a first-time diagnosis of angina pectoris, congestive heart failure (CHF, myocardial infarction (MI, stroke, or transient ischemic attack in patients with chronic kidney disease and with diagnosed type 2 diabetes mellitus. Methods: We identified all adult patients registered in the “Clinical Practice Research Datalink” between 2002 and 2011 with incident chronic kidney disease and type 2 diabetes mellitus and did a cohort study with a Cox proportional hazard analysis. Results: We identified in total 27,811 patients, 693 developed angina pectoris, 1,069 CHF, 508 MI, 970 stroke, and 578 transient ischemic attacks. Patients whose serum creatinine doubled during follow-up had increased risks of CHF (hazard ratio [HR] 2.98, 95% confidence interval [CI] 2.27–3.89, MI (HR 2.53, 95% CI 1.62–3.96, and stroke (HR 1.93, 95% CI 1.38–2.69, as compared with patients whose serum creatinine did not double. The relative risks of angina pectoris (HR 1.18, 95% CI 0.66–2.10 or a transient ischemic attack (HR 1.32, 95% CI 0.78–2.22 were similar in both groups. Conclusion: Diabetic patients with a doubling of serum creatinine were at an increased risk of CHF, MI, or stroke, compared with diabetic
Ignateva, P A; Ballyuzek, M F; Shpakov, A O
To study the features of cardiovascular system in patients with diabetes mellitus type 2 considering the thyroid pathology and age, 264 patients were examined. They were divided into three groups: 1st - patients with diffuse-nodular changes in the thyroid gland, 2nd - patients with autoimmune thyroid disease, 3rd - a control group of patients without thyroid disease. The patients of different ages were examined in each of these groups. All patients were in euthyroid state. It was established that identified in diabetes mellitus type 2 thyroid pathology and the thyroid disease contribute special features to the clinical picture for combined diabetic and cardiovascular pathology even in a euthyroid state including the age features. The laboratory and instrumental researches showed that the patients with combined diabetes and thyroid pathology have a higher incidence of atrial fibrillation, ischemic heart disease, and ventricular arrhythmias of high grades. They also were noticed to have a more adverse form of the left ventricle remodeling, also the combination of diastolic and systolic dysfunctions were found to be more frequent. It was concluded about the necessity of early diagnosis and correction of the cardiovascular disorders and thyroid systems in type 2 diabetes mellitus patients, including euthyroid patients.
Slurink, Isabel A.L.; Soedamah-Muthu, S.S.
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
Green, A.; Sortso, C.; Jensen, Peter Bjødstrup
We present an investigation of the occurrence of cardiovascular disease in patients with diabetes in Denmark 2000 through 2011. The Diabetes Impact Study 2013 is based on all registrants in the Danish National Diabetes Register as of July 3rd 2013 (n=497,232). Record linkage with the Danish...... of diabetes has been rather constant at higher level in males (around 16-18%) than in females (around 12-14%) during 2000-2011 (incl.). In contrast, the incidence rate of CVD after having diabetes diagnosis has declined from about 4.5 to less than 3 during the same period, with higher declining level...... for males than for females. Efforts to detect diabetes at an earlier stage have not resulted in a reduced occurrence of CVD at the diagnosis of diabetes in Denmark. However, the risk of developing CVD after the diagnosis of diabetes has been declining, possibly reflecting benefits of intensified treatment...
Belkis Mercedes Vicente Sánchez; Gisela Zerquera Trujillo; Felix R. Jorrín Román; Lázaro E. de la Cruz Avilez; Elodia M. Rivas Alpízar
Background: Diabetes mellitus is considered as an independent cardiovascular risk factor. Coronary calcium scoring has proved to be a useful tool for stratifying cardiovascular risk. Objective: To quantify coronary calcium in patients with diabetes mellitus type 2 in order to estimate cardiovascular risk. Methods: A descriptive observational study was conducted. The sample included 33 patients with type 2 diabetes mellitus admitted in the Center for Diabetes Care and Education of Cienfuegos f...
Full Text Available Metabolic syndrome is characterized by a set of clinical symptoms that are related to the development of cardiovascular disease. These abdominal obesity, which is the strongest associate with the metabolic syndrome and clinically manifested increasing waist circumference and ratio of waist to hip, atherogenic dyslipidaemia, which is reflected in the routine diagnosis of increased levels of triglycerides and reduced levels of HDL-cholesterol, high blood pressure, insulin resistance and/or various forms of glucose intolerance, proinflammatory and prothrombotic state. Epidemiological, experimental and clinical investigations have shown that diets supplemented with moderate quantities of alcoholic beverages lead to biochemical changes, that are widely regarded to prevent cardiovascular diseases. Red wine contains a naturally rich sources of antioxidants which may protect the body from oxidative stress. We investigated the relationship between red wine intake and lipide profile, glucose, blood pressure and WHR index changes. Participants consumed 200 ml of red wine Frankovka modra (VÍNO-MASARYK, s.r.o., Skalica each day during supper for six weeks and were encouraged to maintain their usual diet and exercise habits. Daily intake of Frankovka modra during six weeks was associated with lower plasma levels of total cholesterol (5.66±1.12 vs 5.36±1.04, triglycerides (1.68±0.23 vs 1.47±0.66, LDL-cholesterol (3.46±0.81 vs 3.26±0.76 and glucose (5.35±0.82 vs 5.26±0.78. On the contrary we recorded higher level of „good“ HDL cholesterol (1.42±0.63 vs 1.80±0.58. Systolic and diastolic blood pressure was also decreased and diastolic blood pressure after six weeks of consumption of red wine decreased statistically significantly. Research results have shown that moderate consumption of red wine have a positive impact on changes waist and ultimately to the Waist to Hip Ratio. Our study demonstrates a positive association between moderate wine
Bone quantitative ultrasound measurements in relation to the metabolic syndrome and type 2 diabetes mellitus in a cohort of elderly subjects at high risk of cardiovascular disease from the PREDIMED study.
Bulló, M; Garcia-Aloy, M; Basora, J; Covas, M I; Salas-Salvado, J
The aim of this study is to determine whether metabolic syndrome, its individual components, or the presence of type 2 diabetes mellitus are associated with a better bone status estimated by quantitative ultrasound at the calcaneus. Cross-sectional study. Outpatient clinics. 251 elderly subjects at high cardiovascular risk from the PREDIMED study were included. MetS was defined according to the ATPIII diagnosis criteria. Calcaneus quantitative ultrasound (QUS) assessment was performed using the Sahara system. Subjects with MetS showed significantly lower 24-hour urinary deoxypyridinoline/creatinine (u-DPD/creatinine) levels and higher broadband ultrasound attenuation, and a tendency to higher bone mineral density (BMD) and quantitative ultrasound index (QUI) than their counterparts. Individuals with type 2 diabetes mellitus (T2DM) showed a significantly higher bone broadband ultrasound attenuation (BUA) and QUI than their non-diabetic counterparts, despite they shown a higher prevalence of osteoporotic fractures. Multiple linear regression analyses showed that quantitative ultrasound parameters were positively associated with the metabolic syndrome and T2DM. Of the bone biochemical markers, only u-DPD/creatinine was related to MetS, abdominal obesity, hypertriglyceridemia component of the MetS, and the number of features that define the MetS. This is the first study showing a positive association between MetS or T2DM with better bone status and lower bone resorption markers measured by quantitative ultrasound. Our results suggest that metabolic abnormalities have a positive effect on healthy bone in elderly subjects at high risk of cardiovascular disease.
Papataxiarchis, Evangelos; Panagiotakos, Demosthenes B; Notara, Venetia; Kouvari, Matina; Kogias, Yannis; Stravopodis, Petros; Papanagnou, George; Zombolos, Spyros; Mantas, Yannis; Pitsavos, Christos
The association between physical activity, diabetes mellitus (DM), and long-term acute coronary syndrome (ACS) prognosis was evaluated. The GREECS study included 2,172 consecutive ACS patients from six Greek hospitals (2003-2004). In 2013-2014, a 10-year follow up was performed with 1,918 patients. Physical activity was categorized in never, rarely (monthly basis), 1-2 and ≥ 3 times/week. Multi-adjusted analysis revealed that 1-2 and ≥ 3 times/week vs. no physical activity had a protective effect on ACS incidence (OR = 0.63 95% CI 0.38, 1.05) and (OR = 0.63 95% CI 0.40, 0.99) respectively, only in patients without prior baseline CVD event. In a subgroup analysis, with DM as strata in these patients, engagement in physical activity (i.e., 1-2 times/week) had a significant protective effect among patients with diabetes (OR = 0.51, 95% CI 0.27, 0.96, p = .037). These findings revealed the beneficial role of exercise in secondary ACS prevention, even in DM patients. Public health-oriented policies should incorporate regular physical activity as a key protective factor in disease prognosis.
Wong, Hoi Kin; Cheung, Tommy Tsang; Cheung, Bernard M Y
Summary The cardiovascular system is regulated by the autonomic nervous system, the renin–angiotensin–aldosterone system, nitric oxide (NO) and other factors including neuropeptides. Research in neurohumoral factors has led to the development of many cardiovascular drugs. Adrenomedullin (ADM), initially isolated from the adrenal gland, has diverse physiological and pathophysiological functions in the cardiovascular system. It is produced in many organs and tissues including the vasculature. A...
Martín-Timón, Iciar; Sevillano-Collantes, Cristina; Segura-Galindo, Amparo; del Cañizo-Gómez, Francisco Javier
Diabetes mellitus is a chronic condition that occurs when the body cannot produce enough or effectively use of insulin. Compared with individuals without diabetes, patients with type 2 diabetes mellitus have a considerably higher risk of cardiovascular morbidity and mortality, and are disproportionately affected by cardiovascular disease. Most of this excess risk is it associated with an augmented prevalence of well-known risk factors such as hypertension, dyslipidaemia and obesity in these patients. However the improved cardiovascular disease in type 2 diabetes mellitus patients can not be attributed solely to the higher prevalence of traditional risk factors. Therefore other non-traditional risk factors may be important in people with type 2 diabetes mellitus. Cardiovascular disease is increased in type 2 diabetes mellitus subjects due to a complex combination of various traditional and non-traditional risk factors that have an important role to play in the beginning and the evolution of atherosclerosis over its long natural history from endothelial function to clinical events. Many of these risk factors could be common history for both diabetes mellitus and cardiovascular disease, reinforcing the postulate that both disorders come independently from “common soil”. The objective of this review is to highlight the weight of traditional and non-traditional risk factors for cardiovascular disease in the setting of type 2 diabetes mellitus and discuss their position in the pathogenesis of the excess cardiovascular disease mortality and morbidity in these patients. PMID:25126392
Chamarthi, Bindu; Gaziano, J Michael; Blonde, Lawrence; Vinik, Aaron; Scranton, Richard E; Ezrokhi, Michael; Rutty, Dean; Cincotta, Anthony H
Type 2 diabetes (T2DM) patients, including those in good glycemic control, have an increased risk of cardiovascular disease (CVD). Maintaining good glycemic control may reduce long-term CVD risk. However, other risk factors such as elevated vascular sympathetic tone and/or endothelial dysfunction may be stronger potentiators of CVD. This study evaluated the impact of bromocriptine-QR, a sympatholytic dopamine D2 receptor agonist, on progression of metabolic disease and CVD in T2DM subjects in good glycemic control (HbA1c ≤ 7.0%). 1834 subjects (1219 bromocriptine-QR; 615 placebo) with baseline HbA1c ≤ 7.0% derived from the Cycloset Safety Trial (this trial is registered with ClinicalTrials.gov Identifier: NCT00377676), a 12-month, randomized, multicenter, placebo-controlled, double-blind study in T2DM, were evaluated. Treatment impact upon a prespecified composite CVD endpoint (first myocardial infarction, stroke, coronary revascularization, or hospitalization for angina/congestive heart failure) and the odds of losing glycemic control (HbA1c >7.0% after 52 weeks of therapy) were determined. Bromocriptine-QR reduced the CVD endpoint by 48% (intention-to-treat; HR: 0.52 [0.28-0.98]) and 52% (on-treatment analysis; HR: 0.48 [0.24-0.95]). Bromocriptine-QR also reduced the odds of both losing glycemic control (OR: 0.63 (0.47-0.85), p = 0.002) and requiring treatment intensification to maintain HbA1c ≤ 7.0% (OR: 0.46 (0.31-0.69), p = 0.0002). Bromocriptine-QR therapy slowed the progression of CVD and metabolic disease in T2DM subjects in good glycemic control.
Hjerpsted, Julie Bousgaard; Tholstrup, Tine
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...
Chen, Szu-chi; Tseng, Chin-Hsiao
This article reviews the relationship between dyslipidemia, chronic kidney disease, and cardiovascular diseases in patients with diabetes. Diabetes mellitus is associated with complications in the cardiovascular and renal system, and is increasing in prevalence worldwide. Modification of the multifactorial risk factors, in particular dyslipidemia, has been suggested to reduce the rates of diabetes-related complications. Dyslipidemia in diabetes is a condition that includes hypertriglyceridemia, low high-density lipoprotein levels, and increased small and dense low-density lipoprotein particles. This condition is associated with higher cardiovascular risk and mortality in diabetic patients. Current treatment guidelines focus on lowering the low-density lipoprotein cholesterol level; multiple trials have confirmed the cardiovascular benefits of treatment with statins. Chronic kidney disease also contributes to dyslipidemia, and dyslipidemia in turn is related to the occurrence and progression of diabetic nephropathy. Different patterns of dyslipidemia are associated with different stages of diabetic nephropathy. Some trials have shown that treatment with statins not only decreased the risk of cardiovascular events, but also delayed the progression of diabetic nephropathy. However, studies using statins as the sole treatment of hyperlipidemia in patients on dialysis have not shown benefits with respect to cardiovascular risk. Diabetic patients with nephropathy have a higher risk of cardiovascular events than those without nephropathy. The degree of albuminuria and the reduction in estimated glomerular filtration rate are also correlated with the risk of cardiovascular events. Treatment with angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers to reduce albuminuria in diabetic patients has been shown to decrease the risk of cardiovascular morbidity and mortality. PMID:24380085
... it ordered? As a test to evaluate lipid metabolism or cardiovascular risk, APOE genotyping is ordered when someone has: Significantly elevated cholesterol and triglyceride levels that do not respond to dietary and ...
Fox, P. L.; Mazumder, B.; Ehrenwald, E.; Mukhopadhyay, C. K.
Transition metal ion-mediated oxidation is a commonly used model system for studies of the chemical, structural, and functional modifications of low-density lipoprotein (LDL). The physiological relevance of studies using free metal ions is unclear and has led to an exploration of free metal ion-independent mechanisms of oxidation. We and others have investigated the role of human ceruloplasmin (Cp) in oxidative processes because it the principal copper-containing protein in serum. There is an abundance of epidemiological data that suggests that serum Cp may be an important risk factor predicting myocardial infarction and cardiovascular disease. Biochemical studies have shown that Cp is a potent catalyst of LDL oxidation in vitro. The pro-oxidant activity of Cp requires an intact structure, and a single copper atom at the surface of the protein, near His(426), is required for LDL oxidation. Under conditions where inhibitory protein (such as albumin) is present, LDL oxidation by Cp is optimal in the presence of superoxide, which reduces the surface copper atom of Cp. Cultured vascular endothelial and smooth muscle cells also oxidize LDL in the presence of Cp. Superoxide release by these cells is a critical factor regulating the rate of oxidation. Cultured monocytic cells, when activated by zymosan, can oxidize LDL, but these cells are unique in their secretion of Cp. Inhibitor studies using Cp-specific antibodies and antisense oligonucleotides show that Cp is a major contributor to LDL oxidation by these cells. The role of Cp in lipoprotein oxidation and atherosclerotic lesion progression in vivo has not been directly assessed and is an important area for future studies.
Cabezas-Cerrato, Jose; Hermida, Ramon Carmelo; Cabezas-Agricola, Jose Manuel; Ayala, Diana Elva
This study was designed to investigate potential factors involved in the disruption of the circadian blood pressure (BP) pattern in diabetes mellitus, as well as the relation between BP, cardiac autonomic neuropathy, and estimated cardiovascular risk. We studied 101 diabetic patients (58% with type 2 diabetes; 59% men), age 21-65 yrs, evaluated by 48 h BP monitoring. We performed three autonomic tests in a single session: deep breathing, Valsalva maneuver, and standing up from a seated position. Patients were classified according to the number of abnormal tests and their 10 yr risk of coronary heart disease or stroke. The prevalence of non-dipping 24 h patterning ranged from 47.6% in type 1 to 42.4% in type 2 diabetes. The awake/asleep ratio of systolic BP (SBP) was comparable between patients with or without abnormal autonomic tests. Pulse pressure (PP) was significantly higher in patients with > or =1 abnormal autonomic test (p risk of coronary heart disease (p Patients with higher stroke-risk had higher SBP but lower diastolic BP, and thus an elevated ambulatory PP by 9 mmHg, compared to those with lower risk (p diabetes mellitus. The most significant finding from this study is the high ambulatory PP found in patients with either cardiac autonomic dysfunction or high risk for coronary heart disease or stroke. After correcting for age, this elevated PP level emerged as the main cardiovascular risk factor in diabetes mellitus.
Negrato, Carlos Antonio; Tarzia, Olinda; Jovanovič, Lois; Chinellato, Luiz Eduardo Montenegro
Periodontal disease (PD) is one of the most commonly known human chronic disorders. The relationship between PD and several systemic diseases such as diabetes mellitus (DM) has been increasingly recognized over the past decades. The purpose of this review is to provide the reader with knowledge concerning the relationship between PD and DM. Many articles have been published in the English and Portuguese literature over the last 50 years examining the relationship between these two chronic diseases. Data interpretation is often confounded by varying definitions of DM, PD and different clinical criteria were applied to determine the prevalence, extent and severity of PD, levels of glycemic control and diabetes-related complications. This paper provides a broad overview of the predominant findings from research conducted using the BBO (Bibliografia Brasileira de Odontologia), MEDLINE, LILACS and PubMed for Controlled Trials databases, in English and Portuguese languages published from 1960 to October 2012. Primary research reports on investigations of relationships between DM/DM control, PD/periodontal treatment and PD/DM/diabetes-related complications identified relevant papers and meta-analyses published in this period. This paper describes the relationship between PD and DM and answers the following questions: 1- The effect of DM on PD, 2- The effects of glycemic control on PD and 3- The effects of PD on glycemic control and on diabetes-related complications. The scientific evidence reviewed supports diabetes having an adverse effect on periodontal health and PD having an adverse effect on glycemic control and on diabetes-related complications. Further research is needed to clarify these relationships and larger, prospective, controlled trials with ethnically diverse populations are warranted to establish that treating PD can positively influence glycemic control and possibly reduce the burden of diabetes-related complications.
NEGRATO, Carlos Antonio; TARZIA, Olinda; JOVANOVIČ, Lois; CHINELLATO, Luiz Eduardo Montenegro
Periodontal disease (PD) is one of the most commonly known human chronic disorders. The relationship between PD and several systemic diseases such as diabetes mellitus (DM) has been increasingly recognized over the past decades. Objective: The purpose of this review is to provide the reader with knowledge concerning the relationship between PD and DM. Many articles have been published in the english and Portuguese literature over the last 50 years examining the relationship between these two chronic diseases. Data interpretation is often confounded by varying definitions of DM, PD and different clinical criteria were applied to determine the prevalence, extent and severity of PD, levels of glycemic control and diabetes-related complications. Methods: This paper provides a broad overview of the predominant findings from research conducted using the BBO (Bibliografia Brasileira de Odontologia), MEDLINE, LILACS and PubMed for Controlled Trials databases, in english and Portuguese languages published from 1960 to October 2012. Primary research reports on investigations of relationships between DM/DM control, PD/periodontal treatment and PD/DM/diabetes-related complications identified relevant papers and meta-analyses published in this period. Results: This paper describes the relationship between PD and DM and answers the following questions: 1- The effect of DM on PD, 2- The effects of glycemic control on PD and 3- The effects of PD on glycemic control and on diabetes-related complications. Conclusions: The scientific evidence reviewed supports diabetes having an adverse effect on periodontal health and PD having an adverse effect on glycemic control and on diabetes-related complications. Further research is needed to clarify these relationships and larger, prospective, controlled trials with ethnically diverse populations are warranted to establish that treating PD can positively influence glycemic control and possibly reduce the burden of diabetes
I. V. Trigolosova
Full Text Available There are many endocrine diseases accompanied by development of secondary diabetes mellitus (sDM. The features of the development and course of sDM in acromegaly, Cushing’s syndrome, and growth hormone (GH deficiency are of particular interest as the prevalence of sDM associated with these pathologies is higher than that in the population. The main risk factors for sDM in acromegaly are age, female gender, arterial hypertension, family history of type 2 DM (T2DM, acromegaly activity, and duration and certain treatment methods of acromegaly. The differences of the sDM pathogenesis from pathogenesis of T2DM in the population are due to the opposite effect of GH and insulin-like growth factor 1 on glucose metabolism as well as to effect of acromegaly treatment on the mechanisms of diabetes development. The prevalence of diabetes in patients with GH deficiency, especially against the background of GH replacement therapy, is slightly higher than that in population. However, some studies have shown that GH replacement therapy may lead to normalization of the impaired glucose metabolism. High prevalence of metabolic syndrome (43% and visceral obesity in the GH deficiency are the causes of the development of lipotoxicity (free fatty acids excess and insulin resistance.In Cushing’s syndrome, the prevalence of early carbohydrate metabolism disturbances may reach 70%. In Cushing’s disease, chronic glucocorticoid excess determines insulin resistance and reduces insulin secretion, which results in hyperglycaemia. Currently, the recommendations for the treatment of sDM in acromegaly, hypercortisolism, and GH deficiency are the same as for the treatment of T2DM. However, as the pathogenesis is different in sDM and T2DM, the new algorithms for the diagnosis, prevention and treatment need to be developed. Prevention and timely treatment based on pathological principals will slow down the development of micro- and macrovascular complications leading to
Ree, M.A. van de; Maat, M.P. de; Kluft, C.; Meinders, A.E.; Princen, H.M.; Huisman, M.V.
BACKGROUND: Patients with Type 2 diabetes mellitus have increased levels of hemostatic risk variables for cardiovascular disease, such as fibrinogen, von Willebrand factor (VWF), factor (F)VIIa, d-dimer and plasminogen activator inhibitor-1 (PAI-1). OBJECTIVES: To evaluate the effect of aggressive
Risks for cardiovascular disease, stroke, ischaemic heart disease, and diabetes mellitus associated with the metabolic syndrome using the new harmonised definition: findings from nationally representative longitudinal data from an Asian population.
Khang, Young-Ho; Cho, Sung-Il; Kim, Hye-Ryun
We examined the risk of cardiovascular disease, stroke, ischaemic heart disease, and diabetes with the metabolic syndrome according to the new harmonised definition and its components using a national longitudinal data set from an Asian population. Data of 9791 men and women aged 20+ from 1998 and 2001 Korea National Health and Nutrition Examination Surveys were individually linked to national hospitalisation and mortality data using unique personal identification numbers. During a 5.8-year follow-up through 2005, 288 incident cardiovascular events (184 strokes and 122 cases of ischaemic heart disease) and 85 new diabetes cases have been detected. Men and women with the metabolic syndrome had 48%, 39%, 64%, and 127% greater risks of cardiovascular disease, stroke, ischaemic heart disease, and diabetes, respectively, than those without the metabolic syndrome. The increased risks of cardiovascular disease, ischaemic heart disease, and diabetes remained significant after adjusting for health behaviours, bio-clinical factors, family history, and socio-demographic factors. Analysis results on population attributable risks showed that about a quarter of total diabetes occurrence and more than 10% of cardiovascular disease was attributable to the metabolic syndrome. The number of metabolic syndrome components was linearly associated with risks of outcomes. High blood pressure was significantly associated with all four outcomes while hypertriglyceridemia and hyperglycemia were also important for ischaemic heart disease and diabetes, respectively. Reduction of metabolic risk factors is necessary in South Korea to lower the burden of associated diseases, especially ever-increasing ischaemic heart disease and diabetes. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Søndergaard, Grethe; Dalton, Susanne Oksbjerg; Mortensen, Laust Hvas
AIMS: Educational inequality in diseases in the circulatory system (here termed cardiovascular disease) is well documented but may be confounded by early life factors. The aim of this observational study was to examine whether the associations between education and all cardiovascular diseases...... in conventional cohort and within-sibship analyses in which the association was examined within siblings discordant on education. Assuming that attenuation of associations in the within-sibship as compared with the cohort analyses would indicate confounding from factors shared within families. RESULTS: A lower...... educational status was associated with a higher risk of cardiovascular disease, ischaemic heart disease and stroke. All associations attenuated in the within-sibship analyses, in particular in the analyses on ischaemic heart disease before age 45 years. For instance, in the cohort analyses, the hazard rate...
Pedersen, S.S.; von Kaenel, R.; Tully, P.J.; Denollet, J.
Adaptation to living with cardiovascular disease may differ from patient to patient and is influenced not only by disease severity and limitations incurred by the disease but also by socioeconomic factors (e.g. health literacy), the patients’ psychological make-up and susceptibility to distress.
Ahearn, Joseph; Shields, Kelly J; Liu, Chau-Ching; Manzi, Susan
Cardiovascular disease is increasingly recognized as a major cause of premature mortality among those with autoimmune disorders. There is an urgent need to identify those patients with autoimmune disease who are at risk for CVD so as to optimize therapeutic intervention and ultimately prevention. Accurate identification, monitoring and stratification of such patients will depend upon a panel of biomarkers of cardiovascular disease. This review will discuss some of the most recent biomarkers of cardiovascular diseases in autoimmune disease, including lipid oxidation, imaging biomarkers to characterize coronary calcium, plaque, and intima media thickness, biomarkers of inflammation and activated complement, genetic markers, endothelial biomarkers, and antiphospholipid antibodies. Clinical implementation of these biomarkers will not only enhance patient care but also likely accelerate the pharmaceutical pipeline for targeted intervention to reduce or eliminate cardiovascular disease in the setting of autoimmunity. Copyright © 2015 Elsevier Inc. All rights reserved.
Weeke, Peter; Roden, Dan M
Variability in drug responsiveness is a sine qua non of modern therapeutics, and the contribution of genomic variation is increasingly recognized. Investigating the genomic basis for variable responses to cardiovascular therapies has been a model for pharmacogenomics in general and has established...... resulted in changes to the product labels but also have led to development of initial clinical guidelines that consider how to facilitate incorporating genetic information to the bedside. This review summarizes the state of knowledge in cardiovascular pharmacogenomics and considers how variants described...
Celano, Christopher M; Daunis, Daniel J; Lokko, Hermioni N; Campbell, Kirsti A; Huffman, Jeff C
Anxiety and its associated disorders are common in patients with cardiovascular disease and may significantly influence cardiac health. Anxiety disorders are associated with the onset and progression of cardiac disease, and in many instances have been linked to adverse cardiovascular outcomes, including mortality. Both physiologic (autonomic dysfunction, inflammation, endothelial dysfunction, changes in platelet aggregation) and health behavior mechanisms may help to explain the relationships between anxiety disorders and cardiovascular disease. Given the associations between anxiety disorders and poor cardiac health, the timely and accurate identification and treatment of these conditions is of the utmost importance. Fortunately, pharmacologic and psychotherapeutic interventions for the management of anxiety disorders are generally safe and effective. Further study is needed to determine whether interventions to treat anxiety disorders ultimately impact both psychiatric and cardiovascular health.
Pedersen, Susanne S.; von Känel, Roland; Tully, Phillip J
Adaptation to living with cardiovascular disease may differ from patient to patient and is influenced not only by disease severity and limitations incurred by the disease but also by socioeconomic factors (e.g. health literacy), the patients' psychological make-up and susceptibility to distress. Co......-morbid depression and/or anxiety is prevalent in 20% of patients with cardiovascular disease, which may be either transient or chronic. Distress, such as depression, reduces adherence, serves as a barrier to behaviour change and the adoption of a healthy lifestyle, and increases the risk that patients drop out...
Allan, G Michael; Nouri, Faeze; Korownyk, Christina; Kolber, Michael R; Vandermeer, Ben; McCormack, James
Use of cardiovascular disease risk calculators is often recommended by guidelines, but research on consistency in risk assessment among calculators is limited. A search of PubMed and Google was performed. Five clinicians selected 25 calculators by independent review. Hypothetical patients were created with the use of 7 risk factors (age, sex, smoking, blood pressure, high-density lipoprotein, total cholesterol, and diabetes mellitus) dichotomized to high and low, generating 2(7) patients (128 total). These patients were assessed by each calculator by 2 clinicians. Risk estimates (and assigned risk categories) were compared among calculators. Selected calculators were from 8 countries, used 5- or 10-year predictions, and estimated either cardiovascular disease or coronary heart disease. With the use of 3 risk categories (low, medium, and high), the 25 calculators categorized each patient into a mean of 2.2 different categories, and 41% of unique patients were assigned across all 3 risk categories. Risk category agreement between pairs of calculators was 67%. This did not improve when analysis was limited to just the 10-year cardiovascular disease calculators. In nondiabetics, the highest calculated risk estimate from a calculator averaged 4.9 times higher (range, 1.9-13.3) than the lowest calculated risk estimate for the same patient. This did not change meaningfully for diabetics or when the analysis was limited to 10-year cardiovascular disease calculators. The decision as to which calculator to use for risk estimation has an important impact on both risk categorization and absolute risk estimates. This has broad implications for guidelines recommending therapies based on specific calculators.
Correia, Marcelo Lima de Gusmao; Haynes, William Geoffrey
Obesity is a risk factor for cardiovascular diseases. Leptin levels are increased in obesity and leptin exhibits cardiovascular actions that may contribute to increased cardiovascular risk. We review the sympathetic, renal and vascular actions of leptin and their relevance to cardiovascular disease. Leptin possesses cardio-renal actions potentially contributing to obesity-related hypertension including generalized sympathoactivation. However, given that leptin resistance occurs in obesity, it has been difficult to link hyperleptinemia with hypertension. One possibility is that leptin resistance is confined to the metabolic effects of leptin, with preservation of its sympathoexcitatory actions. Other mechanisms may contribute to the pressor effects of leptin. For instance, angiotensin II induces leptin generation. Leptin also potentiates the pressor effect of insulin. Therefore, interactions between angiotensin II and insulin with leptin could have deleterious cardiovascular effects in obesity. Additionally, leptin appears to stimulate vascular inflammation, oxidative stress and hypertophy. These actions may contribute to the pathogenesis of hypertension, atherosclerosis, and left ventricular hypertrophy. The potential actions of leptin in the pathophysiology of cardiovascular complications of obesity are diverse, despite evidence of leptin resistance to its metabolic actions. However, most information about cardiovascular actions of leptin derives from in-vitro and animal studies. Future research in humans is widely awaited.
Naranjo, Antonio; Sokka, Tuulikki; Descalzo, Miguel
hypertension, hyperlipidemia, diabetes mellitus, smoking, physical inactivity, and body mass index. Unadjusted and adjusted hazard ratios (HRs) (95% confidence interval [CI]) for CV morbidity were calculated using Cox proportional hazard regression models. RESULTS: Between January 2005 and October 2006......ABSTRACT: INTRODUCTION: We analyzed the prevalence of cardiovascular (CV) disease in patients with rheumatoid arthritis (RA) and its association with traditional CV risk factors, clinical features of RA, and the use of disease-modifying antirheumatic drugs (DMARDs) in a multinational cross......, the QUEST-RA project included 4,363 patients from 48 sites in 15 countries; 78% were female, more than 90% were Caucasian, and the mean age was 57 years. The prevalence for lifetime CV events in the entire sample was 3.2% for myocardial infarction, 1.9% for stroke, and 9.3% for any CV event. The prevalence...
Tang, W H Wilson; Kitai, Takeshi; Hazen, Stanley L
Significant interest in recent years has focused on gut microbiota-host interaction because accumulating evidence has revealed that intestinal microbiota play an important role in human health and disease, including cardiovascular diseases. Changes in the composition of gut microbiota associated with disease, referred to as dysbiosis, have been linked to pathologies such as atherosclerosis, hypertension, heart failure, chronic kidney disease, obesity, and type 2 diabetes mellitus. In addition to alterations in gut microbiota composition, the metabolic potential of gut microbiota has been identified as a contributing factor in the development of diseases. Recent studies revealed that gut microbiota can elicit a variety of effects on the host. Indeed, the gut microbiome functions like an endocrine organ, generating bioactive metabolites, that can impact host physiology. Microbiota interact with the host through many pathways, including the trimethylamine/trimethylamine N -oxide pathway, short-chain fatty acids pathway, and primary and secondary bile acids pathways. In addition to these metabolism-dependent pathways, metabolism-independent processes are suggested to also potentially contribute to cardiovascular disease pathogenesis. For example, heart failure-associated splanchnic circulation congestion, bowel wall edema, and impaired intestinal barrier function are thought to result in bacterial translocation, the presence of bacterial products in the systemic circulation and heightened inflammatory state. These are thought to also contribute to further progression of heart failure and atherosclerosis. The purpose of the current review is to highlight the complex interplay between microbiota, their metabolites, and the development and progression of cardiovascular diseases. We will also discuss the roles of gut microbiota in normal physiology and the potential of modulating intestinal microbial inhabitants as novel therapeutic targets. © 2017 American Heart
Sugiyama, Takehiro; Shapiro, Martin F.; Noda, Mitsuhiko; Kajio, Hiroshi
Although the use of β-blockers may help in achieving maximum effects of intensive glycemic control because of a decrease in the adverse effects after severe hypoglycemia, they pose a potential risk for the occurrence of severe hypoglycemia. This study aimed to evaluate whether the use of β-blockers is effective in patients with diabetes mellitus and whether its use is associated with the occurrence of severe hypoglycemia. Using the ACCORD trial (Action to Control Cardiovascular Risk in Diabetes) data, we performed Cox proportional hazards analyses with a propensity score adjustment. The primary outcome was the first occurrence of a cardiovascular event during the study period, which included nonfatal myocardial infarction, unstable angina, nonfatal stroke, and cardiovascular death. The mean follow-up periods (±SD) were 4.6±1.6 years in patients on β-blockers (n=2527) and 4.7±1.6 years in those not on β-blockers (n=2527). The cardiovascular event rate was significantly higher in patients on β-blockers than in those not on β-blockers (hazard ratio, 1.46; 95% confidence interval, 1.24–1.72; P<0.001). In patients with coronary heart disease or heart failure, the cumulative event rate for cardiovascular events was also significantly higher in those on β-blockers than in those not on β-blockers (hazard ratio, 1.27; 95% confidence interval, 1.02–1.60; P=0.03). The incidence of severe hypoglycemia was significantly higher in patients on β-blockers than in those not on β-blockers (hazard ratio, 1.30; 95% confidence interval, 1.03–1.64; P=0.02). In conclusion, the use of β-blockers in patients with diabetes mellitus was associated with an increased risk for cardiovascular events. PMID:28559400
Lykke, Jacob A; Langhoff-Roos, Jens; Sibai, Baha M
Minimal data exist concerning the relationship between hypertensive pregnancy disorders and various subsequent cardiovascular events and the effect of type 2 diabetes mellitus on these. In a registry-based cohort study, we identified women delivering in Denmark from 1978 to 2007 with a first...... for the development of type 2 diabetes mellitus. The end points were subsequent hypertension, ischemic heart disease, congestive heart failure, thromboembolic event, stroke, and type 2 diabetes mellitus. The risk of subsequent hypertension was increased 5.31-fold (range: 4.90 to 5.75) after gestational hypertension......, 3.61-fold (range: 3.43 to 3.80) after mild preeclampsia, and 6.07-fold (range: 5.45 to 6.77) after severe preeclampsia. The risk of subsequent type 2 diabetes mellitus was increased 3.12-fold (range: 2.63 to 3.70) after gestational hypertension and 3.68-fold (range: 3.04 to 4.46) after severe...
Full Text Available Cardiovascular disease (CVD is the leading cause of morbidity and mortality among patients with diabetes mellitus (DM. DM can lead to multiple cardiovascular complications, including coronary artery disease (CAD, cardiac hypertrophy, and heart failure (HF. HF represents one of the most common causes of death in patients with DM and results from DM-induced CAD and diabetic cardiomyopathy. Oxidative stress is closely associated with the pathogenesis of DM and results from overproduction of reactive oxygen species (ROS. ROS overproduction is associated with hyperglycemia and metabolic disorders, such as impaired antioxidant function in conjunction with impaired antioxidant activity. Long-term exposure to oxidative stress in DM induces chronic inflammation and fibrosis in a range of tissues, leading to formation and progression of disease states in these tissues. Indeed, markers for oxidative stress are overexpressed in patients with DM, suggesting that increased ROS may be primarily responsible for the development of diabetic complications. Therefore, an understanding of the pathophysiological mechanisms mediated by oxidative stress is crucial to the prevention and treatment of diabetes-induced CVD. The current review focuses on the relationship between diabetes-induced CVD and oxidative stress, while highlighting the latest insights into this relationship from findings on diabetic heart and vascular disease.
Anavekar, Nagesh S; Solomon, Scott D; McMurray, John J V
Renal dysfunction is an independent risk factor for cardiovascular (cv) disease and its associated complications. Diabetes mellitus (dm) is a common cause of renal dysfunction. Whether the presence or absence of dm modifies the relation between renal dysfunction and cv disease is unclear...... filtration rate (gfr) was estimated using the 4-component modification of diet in renal disease equation. Using multivariable cox proportional modeling, the relation of overall mortality and composite cardiovascular events with estimated gfr (egfr) between patients with and without dm was compared. Mean...
Byberg, Stine; Agyemang, Charles; Zwisler, Ann-Dorthe
Studies on cardiovascular disease (CVD) incidence and survival show varying results between different ethnic groups. Our aim was to add a new dimension by exploring the role of migrant status in combination with ethnic background on incidence of-and survival from-CVD and more specifically acute...... of some types of cardiovascular disease compared to Danish-born. Family-reunified migrants on the other hand had lower rates of CVD. All migrants had better survival than Danish-born indicating that migrants may not always be disadvantaged in health....
Martin R. Grübler
Full Text Available Vitamin D deficiency, as well as cardiovascular diseases (CVD and related risk factors are highly prevalent worldwide and frequently co-occur. Vitamin D has long been known to be an essential part of bone metabolism, although recent evidence suggests that vitamin D plays a key role in the pathophysiology of other diseases, including CVD, as well. In this review, we aim to summarize the most recent data on the involvement of vitamin D deficiency in the development of major cardiovascular risk factors: hypertension, obesity and dyslipidemia, type 2 diabetes, chronic kidney disease and endothelial dysfunction. In addition, we outline the most recent observational, as well as interventional data on the influence of vitamin D on CVD. Since it is still an unresolved issue whether vitamin D deficiency is causally involved in the pathogenesis of CVD, data from randomized controlled trials (RCTs designed to assess the impact of vitamin D supplementation on cardiovascular outcomes are awaited with anticipation. At present, we can only conclude that vitamin D deficiency is an independent cardiovascular risk factor, but whether vitamin D supplementation can significantly improve cardiovascular outcomes is still largely unknown.
Hunt, Kelly J; Kistner-Griffin, Emily; Spruill, Ida; Teklehaimanot, Abeba A; Garvey, W Timothy; Sale, Michèle; Fernandes, Jyotika
To determine the prevalence of cardiovascular disease, levels of cardiovascular risk factors, and extent of preventive care in Gullah African Americans with a high familial risk of type 2 diabetes mellitus. Between 1995 and 2003, 1321 Gullah African Americans with a high prevalence of diabetes mellitus from the South Carolina Sea Islands consented to and enrolled in the Sea Islands Genetic African American Registry (Project SuGAR). A cross-sectional analysis of cardiometabolic risk, preventive care, and self-reported cardiovascular disease was conducted. Cardiometabolic risk factor levels were high and vascular disease was prevalent. Among the subjects with diabetes mellitus, the mean disease duration was 10.5 years; approximately one-third reported reduced vision or blindness; and >80% reported numbness, pain, or burning in their feet. Preventive diabetes care was limited, with <60%, <25%, and <40% seeing an ophthalmologist, podiatrist, and dentist, respectively, within the past year. Only 54.4% of women and 39.3% of men reported daily glucose monitoring. As the largest existing study of Gullah individuals, our study offers insight into not only the level of cardiovascular risk in this population but also the pathophysiological mechanisms central to ancestral differences in cardiometabolic risk in the broader African American population.
Cobble Michael E
Full Text Available Abstract Patients with type 2 diabetes mellitus (T2DM are at high risk for cardiovascular (CV disease; however, conclusive evidence that glycemic control leads to improved cardiovascular outcomes is lacking. Saxagliptin is a potent, selective dipeptidyl peptidase-4 inhibitor approved as an adjunct to diet and exercise to improve glycemic control in adults with T2DM. Saxagliptin was evaluated in a series of phase III trials as monotherapy; add-on therapy to metformin, a sulfonylurea, or a thiazolidinedione; and as initial therapy in combination with metformin. Saxagliptin consistently improved glycemic control (as reflected by significant decreases in glycated hemoglobin, fasting plasma glucose, and postprandial glucose compared with controls and was generally well tolerated. In these analyses, saxagliptin had clinically neutral effects on body weight, blood pressure, lipid levels, and other markers of CV risk compared with controls. A retrospective meta-analysis of 8 phase II and phase III trials found no evidence that saxagliptin increases CV risk in patients with T2DM (Cox proportional hazard ratio, 0.43; 95% CI, 0.23-0.80 for major adverse cardiovascular events retrospectively adjudicated. Instead, it raised the hypothesis that saxagliptin may reduce the risk of major adverse CV events. A long-term CV outcome trial, Saxagliptin Assessment of Vascular Outcomes Recorded in Patients with Diabetes Mellitus-THrombolysis in Myocardial Infarction 53 (SAVOR-TIMI 53 is currently ongoing to determine whether saxagliptin reduces CV risk in T2DM.
New, S.E.P.; Aikawa, E.
Cardiovascular calcification is an independent risk factor for cardiovascular morbidity and mortality. This disease of dysregulated metabolism is no longer viewed as a passive degenerative disease, but instead as an active process triggered by pro-inflammatory cues. Furthermore, a positive feedback loop of calcification and inflammation is hypothesized to drive disease progression in arterial calcification. Both calcific aortic valve disease and atherosclerotic arterial calcification may possess similar underlying mechanisms. Early histopathological studies first highlighted the contribution of inflammation to cardiovascular calcification by demonstrating the accumulation of macrophages and T lymphocytes in 'early' lesions within the aortic valves and arteries. A series of in vitro work followed, which gave a mechanistic insight into the stimulation of smooth muscle cells to undergo osteogenic differentiation and mineralization. The emergence of novel technology, in the form of animal models and more recently molecular imaging, has enabled accelerated progression of this field, by providing strong evidence regarding the concept of this disorder as an inflammatory disease. Although there are still gaps in our knowledge of the mechanisms behind this disorder, this review discusses the various studies that have helped form the concept of the inflammation-dependent cardiovascular calcification paradigm. (author)
Cardiovascular disease is the number one cause of death worldwide. It is broadly defined to include anything which adversely affects the heart or blood vessels. One-third of Americans have one or more forms of it. By one estimate, average human life expectancy would increase by seven years if it were eliminated. The mainstream medical model seeks mostly to "manage" cardiovascular disease with pharmaceuticals or to surgically bypass or reopen blocked vessels via angioplasty. These methods have proven highly useful and saved countless lives. Yet drug therapy may be costly and ongoing, and it carries the risk of side effects while often doing little or nothing to improve underlying health concerns. Similarly, angioplasty or surgery are invasive methods which entail risk. Laser therapy1 regenerates tissue, stimulates biological function, reduces inflammation and alleviates pain. Its efficacy and safety have been increasingly well documented in cardiovascular disease of many kinds. In this article we will explore the effects of laser therapy in angina, atherosclerosis, coronary artery disease, hypertension, hyperlipidemia, myocardial infarction, stroke and other conditions. The clinical application of various methods of laser therapy, including laserpuncture and transcutaneous, supravascular and intravenous irradiation of blood will be discussed. Implementing laser therapy in the treatment of cardiovascular disease offers the possibility of increasing the health and wellbeing of patients while reducing the costs and enhancing safety of medical care.
Diabetes Mellitus (DM) and Osteoporosis (OP) frequently co-exist with advanced age and imply large health challenges worldwide. The last decades there has been a growing interest regarding fracture risk in DM. Currently used screening methods (Dual Energy X-ray Absorptiometry (DXA) and FRAX) underestimate fracture risk in diabetes patients. New methods for risk assessment are needed. In my thesis, we have studied the significance of neuropathy, the IGF-system and metabolic cont...
Poulsen, Mikael K; Nybo, Mads; Dahl, Jordi
Cardiovascular disease (CVD) is frequent in type 2 diabetes mellitus patients due to accelerated atherosclerosis. Plasma osteoprotegerin (OPG) has evolved as a biomarker for CVD. We examined the relationship between plasma OPG levels and different CVD manifestations in type 2 diabetes.......Cardiovascular disease (CVD) is frequent in type 2 diabetes mellitus patients due to accelerated atherosclerosis. Plasma osteoprotegerin (OPG) has evolved as a biomarker for CVD. We examined the relationship between plasma OPG levels and different CVD manifestations in type 2 diabetes....
King, Dana E; Xiang, Jun; Kulshreshtha, Ambar
The objective of this study was to assess the cardiovascular health status of baby boomers with diabetes mellitus (DM) in comparison to the same-age population with DM 10 years previously. The study was conducted in baby boomers with DM using data from the National Health and Nutrition Examination Survey (NHANES) 2009-2012 compared with NHANES 1999-2002. Cardiovascular health metrics were derived from the American Heart Association's Life's Simple 7. The primary outcome was the comparison of the proportion of individuals with each characteristic, including healthy diet, healthy weight, not smoking, exercising regularly, and maintaining an optimal level of glycated hemoglobin (HbA1C), cholesterol, and blood pressure. Current baby boomers with DM (NHANES 2009-2012) had more obesity (70.9% vs 58.8%; P = 0.009) and a lower proportion of ideal physical activity (20.9% vs 31.7%; P = 0.01) than people of the same age 10 years ago; fewer than 1% adhere to an ideal healthy diet. Current baby boomers more often had ideal cholesterol (59.4% vs 47.2; P = 0.01) and reached an ideal HbA1C (51.0% vs 43.4%; P = 0.047). Blood pressure control, adherence to ideal diet, and smoking rates were not significantly different from 10 years ago. In logistic regression analyses controlling for likely confounders, baby boomers persisted in having more obesity and exercising less often, and reaching an ideal cholesterol level more often (P < 0.01). Although improving in cholesterol and HbA1C, baby boomers demonstrated worsening in several key cardiovascular health indicators, particularly obesity and physical activity.
Kleijnen, J.; Knipschild, P.; ter Riet, G.
Randomized clinical trials of the effects of Vitamin E on complaints of intermittent claudication and angina pectoris are reviewed, and their methodological shortcomings are considered. Mechanisms by which Vitamin E might act in cardiovascular disease are discussed. The evidence about the possible
Balafa, O.; Krediet, R. T.
Cardiovascular (CV) death is the most frequent cause of dying in peritoneal dialysis (PD) patients. Risk factors include not only those that can be present in the general population, but also those related to the presence of end-stage renal disease (ESRD) and factors that are specific for PD
Puijvelde, van G.H.M.; Kuiper, J.
Despite life-style advice and the prescription of cholesterol-lowering and anti-thrombotic drugs, cardiovascular diseases are still the leading cause of death worldwide. Therefore, there is an urgent need for new therapeutic strategies focussing on atherosclerosis, the major underlying pathology of
van Puijvelde, Gijs H M; Kuiper, Johan
Despite life-style advice and the prescription of cholesterol-lowering and anti-thrombotic drugs, cardiovascular diseases are still the leading cause of death worldwide. Therefore, there is an urgent need for new therapeutic strategies focussing on atherosclerosis, the major underlying pathology of cardiovascular diseases characterized by an accumulation of lipids in an inflamed arterial/vessel wall. CD1d-restricted lipid-sensing natural killer T (NKT) cells, bridging the innate and adaptive immunity, and CD1d-expressing antigen-presenting cells are detected in atherosclerotic lesions of mice and humans. In this review we will summarize studies that point to a critical role for NKT cells in the pathogenesis of atherosclerosis and other cardiovascular diseases by the secretion of pro-atherogenic cytokines and cytotoxins. These pro-atherogenic NKT cells are potential targets for new therapeutic strategies in the prevention and treatment of cardiovascular diseases. Additionally, proteins transferring lipids during atherosclerosis, which are also important in the loading of lipids onto CD1d and possible endogenous ligands responsible for the activation of NKT cells during atherosclerosis will be discussed. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.
Tang, Jun; Lobatto, Mark E.; Read, Joanna C.; Mieszawska, Aneta J.; Fayad, Zahi A.; Mulder, Willem J. M.
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality worldwide. New diagnostic and therapeutic strategies are needed to mitigate this public health issue. Advances in nanotechnology have generated innovative strategies for diagnosis and therapy in a variety of diseases, foremost in cancer. Based on these studies, a novel concept referred to as nanomedical theranostics, or the combinatory application of nanoparticulate agents to allow diagnostic therapy, is being explor...
Roos-Hesselink, JolienW.; Cornette, Jerome; Sliwa, Karen; Pieper, Petronella G.; Veldtman, Gruschen R.; Johnson, Mark R.
Contraceptive counselling should begin early in females with heart disease, preferably directly after the start of menstruation. In coming to a decision about the method of contraception, the following issues should be considered: (i) the risk of pregnancy for the mother and the consequences of an
Aleman, Berthe M P; Moser, Elizabeth C; Nuver, Janine
Improvements in treatment and earlier diagnosis have both contributed to increased survival for many cancer patients. Unfortunately, many treatments carry a risk of late effects including cardiovascular diseases (CVDs), possibly leading to significant morbidity and mortality. In this paper we......, and the mechanisms involved, as well as the extent to which treatments may increase CVD indirectly by increasing cardiovascular risk factors is also important. Systematic collection of data relating treatment details to late effects is needed, and great care is needed to obtain valid and generalisable results...
Peter P Toth1,2 1CGH Medical Center, Sterling IL, USA, 2Johns Hopkins University School of Medicine, Baltimore, MD, USA Abstract: Most individuals with type 2 diabetes mellitus have or will develop multiple independent risk factors for cardiovascular disease, particularly coronary artery disease (CAD). CAD is the leading cause of morbidity and mortality among individuals with type 2 diabetes mellitus, and treating these patients is challenging. The risk of hypoglycemia, weight gain, or fluid...
Coronary Artery Disease Is a Predictor of Progression to Dialysis in Patients With Chronic Kidney Disease, Type 2 Diabetes Mellitus, and Anemia: An Analysis of the Trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT).
Sabe, Marwa A; Claggett, Brian; Burdmann, Emmanuel A; Desai, Akshay S; Ivanovich, Peter; Kewalramani, Reshma; Lewis, Eldrin F; McMurray, John J V; Olson, Kurt A; Parfrey, Patrick; Solomon, Scott D; Pfeffer, Marc A
Although clear evidence shows that chronic kidney disease is a predictor of cardiovascular events, death, and accelerated coronary artery disease (CAD) progression, it remains unknown whether CAD is a predictor of progression of chronic kidney disease to end-stage renal disease. We sought to assess whether CAD adds prognostic information to established predictors of progression to dialysis in patients with chronic kidney disease, diabetes, and anemia. Using the previously described Trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT) population, we compared baseline characteristics of patients with and without CAD. Cox proportional hazards models were used to assess the association between CAD and the outcomes of end-stage renal disease and the composite of death or end-stage renal disease. Of the 4038 patients, 1791 had a history of known CAD. These patients were older (mean age 70 versus 65 years, Pdisease. CAD patients were less likely to have marked proteinuria (29% versus 39%, Pdisease (adjusted hazard ratio 1.20 [95% CI 1.01-1.42], P=0.04) and to have the composite of death or end-stage renal disease (adjusted hazard ratio 1.15 [95% CI 1.01-1.30], P=0.03). In patients with chronic kidney disease, diabetes, and anemia, a history of CAD is an independent predictor of progression to dialysis. In patients with diabetic nephropathy, a history of CAD contributes important prognostic information to traditional risk factors for worsening renal disease. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.
Di Angelantonio, Emanuele; Gao, Pei; Khan, Hassan
of cardiovascular disease (CVD) risk. DESIGN, SETTING, AND PARTICIPANTS: Analysis of individual-participant data available from 73 prospective studies involving 294,998 participants without a known history of diabetes mellitus or CVD at the baseline assessment. MAIN OUTCOMES AND MEASURES: Measures of risk......,840 incident fatal and nonfatal CVD outcomes (13,237 coronary heart disease and 7603 stroke outcomes) were recorded. In analyses adjusted for several conventional cardiovascular risk factors, there was an approximately J-shaped association between HbA1c values and CVD risk. The association between HbA1c values......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...
... Thromboembolism Aortic Aneurysm More Top 10 Myths about Cardiovascular Disease Updated:Mar 16,2018 How much do you ... false assumptions can be dangerous to your heart. Cardiovascular disease kills more Americans each year than any other ...
Bu Beng Yeap
Full Text Available As men grow older, testosterone (T levels decline and the significance of this change is debated. The evidence supporting a causal role for lower circulating T, or its metabolites dihydrotestosterone (DHT and estradiol, in the genesis of atherosclerosis and cardiovascular disease (CVD in men is limited. Observational studies associate low baseline T levels with carotid atherosclerosis, aortic and peripheral vascular disease, and with the incidence of cardiovascular events and mortality. Studies using mass spectrometry suggest that when total T is assayed optimally, calculation of free T might not necessarily improve risk stratification. There is limited evidence to support an association of estradiol with CVD. Interventional studies of T therapy in men with coronary artery disease have shown beneficial effects on exercise-induced myocardial ischemia. However, placebo-controlled, randomized clinical trials (RCTs of T therapy in men with the prespecified outcomes of cardiovascular events or deaths are lacking. Meta-analyses of randomized controlled trials of T published up to 2010 found no increase in cardiovascular events, mortality, or prostate cancer with therapy. Recently, in a trial of older men with mobility limitations, men randomized to receive a substantial dose of T reported cardiovascular adverse effects. This phenomenon was not reported from a comparable trial where men received a more conservative dose of T, suggesting a prudent approach should be adopted when considering therapy in frail older men with existing CVD. Adequately powered RCTs of T in middle-aged and older men are needed to clarify whether or not hormonal intervention would reduce the incidence of CVD.
van Wier, Marieke F; Lakerveld, Jeroen; Bot, Sandra D M; Chinapaw, Mai J M; Nijpels, Giel; van Tulder, Maurits W
BACKGROUND: Cost-effectiveness studies of lifestyle interventions in people at risk for lifestyle-related diseases, addressing 'real-world' implementation, are needed. This study examines the cost-effectiveness of a primary care intervention from a societal perspective, compared with provision of
... Adult Diseases Resources Heart Disease, Stroke, or Other Cardiovascular Disease and Adult Vaccination Language: English (US) Español (Spanish) ... important step in staying healthy. If you have cardiovascular disease, talk with your doctor about getting your vaccinations ...
Cardiovascular disease is the most important cause of death in women in the Netherlands. Early identification of women at increased risk of cardiovascular disease and subsequent detection and treatment of risk factors contributes to the reduction of cardiovascular disease morbidity and mortality. A
Full Text Available Background Cardiovascular Disease (CVD is developing treacherously along industrialization and development of urbanization Objectives The aim of this study was to compare cardiovascular risk factors between subjects with and without diabetes mellitus in the Minoodar district of Qazvin. Patients and Methods This analytical study was conducted on 100 subjects with diabetes and 140 subjects without diabetes in Qazvin from September 2010 to April 2011. Standardized measurements were available for waist circumference (WC, blood pressure (BP, fasting serum cholesterol, high-density lipoprotein cholesterol (HDL, and triglycerides (TGs. Cardiovascular risk factors were defined according to the diagnostic criteria proposed by the national cholesterol education program. Data were analyzed using the t-test, Mann-Whitney U test, and Chi-square test. Results Overall, 12% of subjects with diabetes and 17.9% of subjects without diabetes were smokers (P = 0.277. The WC, TGs, systolic and diastolic BP were significantly higher in subjects with diabetes compared to subjects without diabetes. The prevalence of high WC, high BP, low HDL, and high TGs were significantly higher in subjects with diabetes compared to subjects without diabetes. Conclusions Cardiovascular risk factors were higher in subjects with diabetes compared to subjects without diabetes. Lifestyle intervention programs should be focused on community education about reduction of CVD risk factors in patients with diabetes.
Petersen, K R; Skouby, S O; Sidelmann, Johannes Jakobsen
OBJECTIVE: We evaluated established cardiovascular risk factors within lipoprotein metabolism, hemostasis, and endothelial function in women with insulin-dependent diabetes mellitus who were using oral contraceptives. STUDY DESIGN: Twenty-five women with uncomplicated insulin-dependent diabetes...... mellitus, allocated to treatment with a monophasic combination of 30 micrograms ethinyl estradiol and 75 micrograms gestodene (treatment group, n = 12) or with nonhormonal contraception (control group, n = 13), were prospectively followed up for 12 months. Nonparametric methods were used for statistical...... the cardiovascular risk profile in women with insulin-dependent diabetes mellitus, but our study indicates a risk of disturbances of the endothelial integrity, which needs further investigation....
I. Kardys (Isabella)
textabstractEstablished cardiovascular risk factors such as hypertension, hyperlipidemia, diabetes mellitus and smoking do not fully explain the occurrence of cardiovascular disease; although the majority of patients have at least one of these risk factors, a substantial proportion of cases occurs
Galleano, Monica; Oteiza, Patricia I; Fraga, Cesar G
A significant body of evidence demonstrates that diets rich in fruits and vegetables promote health and attenuate, or delay, the onset of various diseases, including cardiovascular disease, diabetes, certain cancers, and several other age-related degenerative disorders. The concept that moderate chocolate consumption could be part of a healthy diet has gained acceptance in past years based on the health benefits ascribed to selected cocoa components. Specifically, cocoa as a plant and chocolate as food contain a series of chemicals that can interact with cell and tissue components, providing protection against the development and amelioration of pathological conditions. The most relevant effects of cocoa and chocolate have been related to cardiovascular disease. The mechanisms behind these effects are still under investigation. However, the maintenance or restoration of vascular NO production and bioavailability and the antioxidant effects are the mechanisms most consistently supported by experimental data. This review will summarize the most recent research on the cardiovascular effects of cocoa flavanols and related compounds.
Arndt, Anne-Karin; MacRae, Calum A
The review is designed to outline the major developments in genetic testing in the cardiovascular arena in the past year or so. This is an exciting time in genetic testing as whole exome and whole genome approaches finally reach the clinic. These new approaches offer insight into disease causation in families in which this might previously have been inaccessible, and also bring a wide range of interpretative challenges. Among the most significant recent findings has been the extent of physiologic rare coding variation in the human genome. New disease genes have been identified through whole exome studies in neonatal arrhythmia, congenital heart disease and coronary artery disease that were simply inaccessible with other techniques. This has not only shed light on the challenges of genetic testing at this scale, but has also sharply defined the limits of prior gene-panel focused testing. As novel therapies targeting specific genetic subsets of disease become available, genetic testing will become a part of routine clinical care. The pace of change in sequencing technologies has begun to transform clinical medicine, and cardiovascular disease is no exception. The complexity of such studies emphasizes the importance of real-time communication between the genetics laboratory and genetically informed clinicians. New efforts in data and knowledge management will be central to the continued advancement of genetic testing.
Strong, Alanna; Musunuru, Kiran
Genome-editing tools, which include zinc finger nucleases (ZFNs), transcription activator-like effector nucleases (TALENs), and clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated 9 (Cas9) systems, have emerged as an invaluable technology to achieve somatic and germline genomic manipulation in cells and model organisms for multiple applications, including the creation of knockout alleles, introducing desired mutations into genomic DNA, and inserting novel transgenes. Genome editing is being rapidly adopted into all fields of biomedical research, including the cardiovascular field, where it has facilitated a greater understanding of lipid metabolism, electrophysiology, cardiomyopathies, and other cardiovascular disorders, has helped to create a wider variety of cellular and animal models, and has opened the door to a new class of therapies. In this Review, we discuss the applications of genome-editing technology throughout cardiovascular disease research and the prospect of in vivo genome-editing therapies in the future. We also describe some of the existing limitations of genome-editing tools that will need to be addressed if cardiovascular genome editing is to achieve its full scientific and therapeutic potential.
Full Text Available Recently, cell therapy has sparked a revolution in ischemic heart disease that will in the future help clinicians to cure patients. Earlier investigations in animal models and clinical trials have suggested that positive paracrine effects such as neoangiogenesis and anti-apoptotic can improve myocardial function. In this regard the Royan cell therapy center designed a few trials in collaboration with multi hospitals such as Baqiyatallah, Shahid Lavasani, Tehran Heart Center, Shahid rajaee, Masih daneshvari, Imam Reza, Razavi and Sasan from 2006. Their results were interesting. However, cardiac stem cell therapy still faces great challenges in optimizing the treatment of patients. Keyword: Cardiovascular disease, Cell therapy.
Ciaccio, Edward J; Lewis, Suzanne K; Biviano, Angelo B; Iyer, Vivek; Garan, Hasan; Green, Peter H
Celiac disease (CD) is an autoimmune response to ingestion of gluten protein, which is found in wheat, rye, and barley grains, and results in both small intestinal manifestations, including villous atrophy, as well as systemic manifestations. The main treatment for the disease is a gluten-free diet (GFD), which typically results in the restoration of the small intestinal villi, and restoration of other affected organ systems, to their normal functioning. In an increasing number of recently published studies, there has been great interest in the occurrence of alterations in the cardiovascular system in untreated CD. Herein, published studies in which CD and cardiovascular terms appear in the title of the study were reviewed. The publications were categorized into one of several types: (1) articles (including cohort and case-control studies); (2) reviews and meta-analyses; (3) case studies (one to three patient reports); (4) letters; (5) editorials; and (6) abstracts (used when no full-length work had been published). The studies were subdivided as either heart or vascular studies, and were further characterized by the particular condition that was evident in conjunction with CD. Publication information was determined using the Google Scholar search tool. For each publication, its type and year of publication were tabulated. Salient information from each article was then compiled. It was determined that there has been a sharp increase in the number of CD - cardiovascular studies since 2000. Most of the publications are either of the type "article" or "case study". The largest number of documents published concerned CD in conjunction with cardiomyopathy (33 studies), and there have also been substantial numbers of studies published on CD and thrombosis (27), cardiovascular risk (17), atherosclerosis (13), stroke (12), arterial function (11), and ischemic heart disease (11). Based on the published research, it can be concluded that many types of cardiovascular issues
Shim, Unjin; Lee, Hyejin; Oh, Jee-Young
Background/Aims Sleep disorder (SD) is associated with an increased risk of cardiovascular disease and is more prevalent among individuals with type 2 diabetes mellitus. These health problems not only frequently coexist but also exacerbate each other. We conducted a cross-sectional study to estimate the prevalence of SD among diabetic patients and to investigate the relationship between SD and cardiovascular risk among these patients. Methods We recruited 784 patients with type 2 diabetes and conducted a self-administered questionnaire. We assessed sleep quality using the Pittsburgh Sleep Quality Index and the risk of obstructive sleep apnea (OSA) using the Berlin Questionnaire. Additional information included blood pressure and metabolic profiles. Results Of the 784 diabetic patients, 301 (38.4%) patients had poor sleep quality, and 124 (15.8%) were at high risk for OSA. Patients at increased risk for OSA were more obese; they also had higher blood pressure, fasting plasma insulin levels, insulin resistance assessed by homeostasis model assessment (HOMA-IR), and serum triglycerides levels (p < 0.05). The frequency of risk for OSA was higher among obese patients compared with non-obese patients (34.8% vs. 9.4%, p < 0.05). Logistic regression analysis revealed that male sex and bone mass index were independent predictors of risk for OSA. Conclusions SD was prevalent among type 2 diabetic patients, and OSA could aggravate their risk for cardiovascular disease. Clinical treatment of these patients should include evaluation and intervention for SD. PMID:22016588
Cuende, José I; Pérez de Diego, Ignacio J; Godoy, Diego
More than a century of research has shown that atherosclerosis is an inflammatory process more than an infiltrative or thrombogenic process. It has been demonstrated epidemiologically and by imaging techniques, that systemic inflammatory diseases (in particular, but not exclusively, rheumatoid arthritis and systemic lupus erythematosus) increase the atherosclerotic process, and has a demonstrated pathophysiological basis. Furthermore, treatments to control inflammatory diseases can modify the course of the atherosclerotic process. Although there are no specific scales for assessing cardiovascular risk in patients with these diseases, cardiovascular risk is high. A number of specific risk scales are being developed, that take into account specific factors such as the degree of inflammatory activity. Copyright © 2015 Sociedad Española de Arteriosclerosis. Published by Elsevier España. All rights reserved.
Schmiegelow, Michelle D; Hedlin, Haley; Stefanick, Marcia L
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...... studies with no history of CVD, atrial fibrillation, or diabetes mellitus at baseline (1993-1998). We assessed the prognostic value of adding fasting serum insulin, HOMA-IR (homeostasis model assessment-insulin resistance), serum-triglyceride-to-serum-high-density lipoprotein-cholesterol ratio TG...... occurred in 894 (5.8%) women. Insulin resistance was associated with CVD risk after adjusting for age and race/ethnicity with hazard ratios (95% confidence interval [CI]) per doubling in insulin of 1.21 (CI, 1.12-1.31), in HOMA-IR of 1.19 (CI, 1.11-1.28), in TG/HDL-C of 1.35 (CI, 1...
Adriana Moreno Valladares
Full Text Available Apolipoprotein E is a polymorphic glycoprotein who interacts with the lipoprotein receptors (LRP-Receptor Related Protein and the receptors for low density lipoproteins of (LDL receptors. When lipoproteins bring up the receptors begins lipids captation and degradation which allows cholesterol utilization, taking place an intracellular auto regulation. The three isoforms of greater importance: Apo E2, E3 and E4 are product of three alleles e2, e3, e4 of one only gene. This factor is related with the amount of lipoproteins that contains ApoE for E/B receptors. A low concentration of lipoproteins with ApoE can increase the activity of LDL receptors and consequently downward the circulating LDL. In the other hand particles with Apo E3 or Apo E4, can cause a downward regulation of LDL and in this way produces a LDL plasma elevation. Many studies in human populations have concluded that this polymorphism of apoE and the plasma variation of lipoproteins are associated with cardiovascular risk. Cardiovascular disease is the result of different interaction between factors which are genetic factor specially ApoE polymorphism e4 allelic of ApoE can explain, in some degree, the greater frequency of cardiovascular disease in those who carries it.
Shyamal K Goswami
Full Text Available Oxidative stress caused by various oxygen containing free radicals and reactive species (collectively called "Reactive Oxygen Species" or ROS has long been attributed to cardiovascular diseases. In human body, major oxidizing species are super oxide, hydrogen peroxide, hydroxyl radical, peroxy nitrite etc. ROS are produced from distinct cellular sources, enzymatic and non-enzymatic; have specific physicochemical properties and often have specific cellular targets. Although early studies in nineteen sixties and seventies highlighted the deleterious effects of these species, later it was established that they also act as physiological modulators of cellular functions and diseases occur only when ROS production is deregulated. One of the major sources of cellular ROS is Nicotinamide adenine dinucleotide phosphate oxidases (Noxes that are expressed in almost all cell types. Superoxide and hydrogen peroxide generated from them under various conditions act as signal transducers. Due to their immense importance in cellular physiology, various Nox inhibitors are now being developed as therapeutics. Another free radical of importance in cardiovascular system is nitric oxide (a reactive nitrogen species generated from nitric oxide synthase(s. It plays a critical role in cardiac function and its dysregulated generation along with superoxide leads to the formation of peroxynitrite a highly deleterious agent. Despite overwhelming evidences of association between increased level of ROS and cardiovascular diseases, antioxidant therapies using vitamins and omega 3 fatty acids have largely been unsuccessful till date. Also, there are major discrepancies between studies with laboratory animals and human trials. It thus appears that the biology of ROS is far complex than anticipated before. A comprehensive understanding of the redox biology of diseases is thus needed for developing targeted therapeutics.
Rehman, M.M.; Salama, R.P.
Studies have supported the notion that subjects with periodontitis and patients with multiple tooth extractions as a result of chronic advanced periodontal disease (PDD) have a greater risk of developing Cardiovascular disease (CVD) than those who had little or no periodontal infection. Periodontitis may predispose affected patients to CVD by elevating systemic C-reactive protein level and pro-inflammatory activity in atherosclerotic lesions and accelerate development of cardiovascular diseases, Oral health variables including loss of teeth, positive plaque Benzoyl-D-L-Arginine- Naphthyl Amide test (BANA) scores, and compliant of xerostomia may by considered as risk indicators for CVD. Exact mechanism which links PDD and CVD has not been firmly established. The link between PDD and CVD may be attributed to bacteria entering blood stream and attaching to the fatty plaque in coronary artery and contributing to clot formation which can lead to heart attack. Inflammation caused by PDD increases the plaque build up. The association between the two disease entities is cause for concern. However, dental and medical practitioners should be aware of these findings to move intelligently to interact with inquiring patients with periodontitis. They should be urged to maintain medical surveillance of their cardiovascular status, and work on controlling or reducing all known risk factors associated with CVD, including periodontal infection. (author)
van Wijk, D.F.; Stroes, E.S.G.; Kastelein, J.J.P.
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
Goldstein, Irwin; Chambers, Richard; Tang, WingYu; Stecher, Vera; Hassan, Tarek
To evaluate the relationship of comorbidities (cardiovascular disease [CVD], diabetes mellitus [DM] and depression) with erectile dysfunction (ED) and age using real-world claims data from 48 million men in the United States. This was a cross-sectional, non-interventional study in men aged ≥18 years using data from the Truven Health MarketScan ® and Medicare Supplemental Research Databases from January 2010 to December 2015, with an observational period of January 2011 to December 2014 to allow for 12 months pre- and post-index. Comorbidity rate was compared between ED and non-ED groups by age using the χ 2 (bivariate) test. Comorbidity relationship to ED after controlling for categorical variables was assessed using logistic regression analysis. In all, 48 004 379 men were in the database. Of the 9 839 578 who met the inclusion criteria, 573 313 (6%) were ED patients and 9 266 265 (94%) were non-ED patients. ED diagnosis increased decade to decade from 18-29 years to 50-59 years but decreased from 60-69 years to ≥90 years. ED patients had a higher prevalence of CVD, DM and depression than non-ED patients in all periods (P < .0001). After controlling for potential demographic and baseline confounders, the association between ED and CVD, DM and depression remained significant for each age group beginning at 30-39 years (P < .0001). Conversations with patients concerning ED should be comprehensive regardless of patient age, in particular in those who have CVD, DM and/or depression. In the real-world setting, ED diagnosis was associated with CVD, DM and depression across age groups, suggesting a need for inquiry about the potential for comorbidities among these men as a preventative measure against potentially serious future events. © 2018 John Wiley & Sons Ltd.
Chinapaw Marijke J
Full Text Available Abstract Background The number of people with cardiovascular disease (CVD and diabetes mellitus type 2 (T2DM is growing rapidly. To a large extend, this increase is due to lifestyle-dependent risk factors, such as overweight, reduced physical activity, and an unhealthy diet. Changing these risk factors has the potential to postpone or prevent the development of T2DM and CVD. It is hypothesized that a cognitive behavioral program (CBP, focused in particular on motivation and self-management in persons who are at high risk for CVD and/or T2DM, will improve their lifestyle behavior and, as a result, will reduce their risk of developing T2DM and CVD. Methods 12,000 inhabitants, 30-50 years of age living in several municipalities in the semi-rural region of West-Friesland will receive an invitation from their general practitioner (n = 13 to measure their own waist circumference with a tape measure. People with abdominal obesity (male waist ≥ 102 cm, female waist ≥ 88 cm will be invited to participate in the second step of the screening which includes blood pressure, a blood sample and anthropometric measurements. T2DM and CVD risk scores will then be calculated according to the ARIC and the SCORE formulae, respectively. People with a score that indicates a high risk of developing T2DM and/or CVD will then be randomly assigned to the intervention group (n = 300 or the control group (n = 300. Participants in the intervention group will follow a CBP aimed at modifying their dietary behavior, physical activity, and smoking behavior. The counseling methods that will be used are motivational interviewing (MI and problem solving treatment (PST, which focus in particular on intrinsic motivation for change and self-management of problems of the participants. The CBP will be provided by trained nurse practitioners in the participant's general practice, and will consists of a maximum of six individual sessions of 30 minutes, followed by 3-monthly booster
Rafiya Begum1 , Syeda Zeba Hyder Zaidi2 , Nuha Rasheed3 and Abdul Saleem Mohammad 4
Interleukin (IL)-18 plays a key role in atherosclerosis and its complications. Cardiovascular disease (CVD) is a class of diseases that involve the heart or blood vessels. Cardiovascular disease includes coronary artery diseases (CAD) such as angina and myocardial infarction (commonly known as a heart attack). Other CVDs include stroke, heart failure, hypertensive heart disease, rheumatic heart disease, cardiomyopathy, heart arrhythmia, congenital heart disease, valvular heart disease, cardit...
Loos, B.G.; Teeuw, W.J.; Nicu, E.A.; Lynge Petersen, A.M.
The association between periodontitis and cardiovascular diseases is now well established. Cardiovascular diseases include atherosclerosis, coronary heart (artery) disease, cerebrovascular disease, and peripheral artery disease. Atherosclerosis is the underlying pathology of cardiovascular diseases.
Leila S. V. Silva
Full Text Available Cardiovascular disease is the main cause of death among patients with end-stage renal disease (ESRD. The present study was undertaken to identify the main cardiovascular diseases and their risk factors in 160 patients with ESRD on hemodialysis (HD in Brazil. Their mean age was 47 ± 39 years. The main risk factors for cardiovascular diseases were arterial hypertension (89.4%, dyslipidemia (78.3%, low high-density lipoprotein levels (84.2% and low physical activity (64.1%. Family history of coronary insufficiency and high low-density lipoprotein levels were significantly associated with coronary artery disease (P = 0.005 and P = 0.029, respectively. Sedentary life style, diabetes mellitus, secondary hyperparathyroidism and hyperglycemia also showed a significant association with the underlying vascular disease (P = 0.017, P = 0.039, P = 0.037 and P = 0.030, respectively. Hypercalcemia, hypertension and black race were factors significantly associated with left ventricular systolic dysfunction (P = 0.01, P = 0.0013 and P = 0.024, respectively. Our study shows that the most prevalent cardiovascular diseases in patients with ESRD were left ventricular hypertrophy, atherosclerotic disease, valvular disease and coronary artery disease. Hypertension and dyslipidemia were the common risk factors associated with cardiovascular diseases. The present study was undertaken to identify the main cardiovascular diseases and their risk factors in 160 patients with ESRD on HD in a single center in Brazil.
Miele, Emily M; Headley, Samuel A E
Aerobic exercise training is a component of diabetes mellitus (DM) care guidelines due to its favorable effects on glycemic control and cardiovascular disease (CVD) risk factors. The purpose of this review is to outline the recent evidence regarding the clinical effects of chronic aerobic exercise on CVD risk factors in persons with DM and to compare the effects of varying intensities and types of exercise. Among individuals with DM, all types of aerobic exercise training can impact positively on some traditional and non-traditional risk factors for CVD. Training programs with a higher volume or intensity induce greater improvements in vascular function, cardiorespiratory fitness (CRF), and lipid profiles. The beneficial outcomes of aerobic training include improvements in glycemic control, endothelial function, oxidative stress, dyslipidemia, myocardial function, adiposity, and CRF. Findings regarding markers of inflammation are discrepant and further research should focus on the role of exercise to impact upon the chronic inflammation associated with DM.
Woessner, Katharine M
The use of aspirin in coronary artery disease and address the unmet need of aspirin therapy in patients with history of hypersensitivity reactions to aspirin (acetylsalicylic acid; ASA) or other nonsteroidal inflammatory drugs (NSAIDs). Aspirin hypersensitivity is reported in 1.5% of patients with cardiovascular disease. However, many of those labeled as allergic to aspirin had experienced side-effects and could be safely treated with aspirin. Those with true hypersensitivity reactions were often not placed on appropriate antiplatelet therapy. A number of protocols of varying complexity exist in the literature for aspirin desensitization. The focus of this review is to identify the types of aspirin reactions that can occur and provide a rational approach to oral aspirin challenge and desensitization. In summary, with rare exceptions, patients with a history of 'aspirin/NSAID allergy' who need ASA for cardiovascular issues will be able to safely take aspirin either after a graded challenge or desensitization providing a central role of the allergist in the management of these patients.
Franz, Christopher A; Frishman, William H
Marijuana is currently the most used illicit substance in the world. With the current trend of decriminalization and legalization of marijuana in the US, physicians in the US will encounter more patients using marijuana recreationally over a diverse range of ages and health states. Therefore, it is relevant to review marijuana's effects on human cardiovascular physiology and disease. Compared with placebo, marijuana cigarettes cause increases in heart rate, supine systolic and diastolic blood pressures, and forearm blood flow via increased sympathetic nervous system activity. These actions increase myocardial oxygen demand to a degree that they can decrease the time to exercise-induced angina in patients with a history of stable angina. In addition, marijuana has been associated with triggering myocardial infarctions (MIs) in young male patients. Smoking marijuana has been shown to increase the risk of MI onset by a factor of 4.8 for the 60 minutes after marijuana consumption, and to increase the annual risk of MI in the daily cannabis user from 1.5% to 3% per year. Human and animal models suggest that this effect may be due to coronary arterial vasospasm. However, longitudinal studies have indicated that marijuana use may not have a significant effect on long-term mortality. While further research is required to definitively determine the impact of marijuana on cardiovascular disease, it is reasonable to recommend against recreational marijuana use, especially in individuals with a history of coronary artery disorders.
Many features of the environment have been found to exert an important influence on cardiovascular disease (CVD) risk, progression, and severity. Changes in the environment because of migration to different geographic locations, modifications in lifestyle choices, and shifts in social policies and cultural practices alter CVD risk, even in the absence of genetic changes. Nevertheless, the cumulative impact of the environment on CVD risk has been difficult to assess and the mechanisms by which some environment factors influence CVD remain obscure. Human environments are complex, and their natural, social, and personal domains are highly variable because of diversity in human ecosystems, evolutionary histories, social structures, and individual choices. Accumulating evidence supports the notion that ecological features such as the diurnal cycles of light and day, sunlight exposure, seasons, and geographic characteristics of the natural environment such as altitude, latitude, and greenspaces are important determinants of cardiovascular health and CVD risk. In highly developed societies, the influence of the natural environment is moderated by the physical characteristics of the social environments such as the built environment and pollution, as well as by socioeconomic status and social networks. These attributes of the social environment shape lifestyle choices that significantly modify CVD risk. An understanding of how different domains of the environment, individually and collectively, affect CVD risk could lead to a better appraisal of CVD and aid in the development of new preventive and therapeutic strategies to limit the increasingly high global burden of heart disease and stroke. © 2017 American Heart Association, Inc.
Full Text Available Background. The aim of present study is to observe the association between the levels of ankle-brachial index (ABI and cardiovascular risk factors among people with type 2 diabetes mellitus in north India. A cross-sectional study was carried out at a centre for heart and diabetic clinic in the state of Punjab on 1121 subjects (671 males and 450 females with type 2 diabetes mellitus. History of symptoms related to cardiovascular diseases was noted, and blood pressure and anthropometric measurements were recorded. Ankle-brachial index (ABI was measured using ultrasonic Doppler flow detector. Subjects with ABI ≤0.9 and ≥1.30 were classified as having low and high ABI, respectively. Females had a higher BMI and brachial-ankle pulse wave velocity (<0.001. Whereas, males had higher diastolic blood pressure and duration of type 2 diabetes mellitus. The differences of systolic blood pressure and ankle-brachial index were not found significant between the sexes. The prevalence of low ABI (<0.9 was 4.47% in men and 4.67% in women and high ABI (≥1.30 was prevalent in 14% of men and 10.45% of women. Age, BMI, baPWV, and blood pressures were significantly associated with ABI value in both sexes. The results suggested that the ABI might be used as a strong indicator for cardiovascular risk factors in type 2 diabetic subjects.
Skaaby, Tea; Thuesen, Betina H.; Linneberg, Allan
Observational studies have suggested a possible protective role of vitamin D on the cardiovascular system. The available evidence does not support either cardiovascular benefits or harms of vitamin D supplementation. This chapter provides an overview and discussion of the current knowledge...... 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...
Petersen, K R; Skouby, S O; Sidelmann, Johannes Jakobsen
plasminogen activator and plasminogen activator inhibitor. The concentration of von Willebrand factor increased, but no change in albumin excretion rates were found. In the control group no changes in any of the variables were observed. CONCLUSION: Intake of modern oral contraceptives does not deteriorate......OBJECTIVE: We evaluated established cardiovascular risk factors within lipoprotein metabolism, hemostasis, and endothelial function in women with insulin-dependent diabetes mellitus who were using oral contraceptives. STUDY DESIGN: Twenty-five women with uncomplicated insulin-dependent diabetes...... the cardiovascular risk profile in women with insulin-dependent diabetes mellitus, but our study indicates a risk of disturbances of the endothelial integrity, which needs further investigation....
Daniels, L.B.; Grady, D.; Mosca, L.; Collins, P.; Mitlak, B.H.; Amewou-Atisso, M.G.; Wenger, N.K.; Barrett-Connor, E.; Suryapranata, H.; et al.,
BACKGROUND: Several studies have concluded that diabetes mellitus and heart disease carry similar risk for future cardiovascular disease (CVD). Most of these studies were too small to quantify independent risks specific to women. The purpose of this study was to determine whether diabetes mellitus
Costantino, Sarah; Paneni, Francesco; Cosentino, Francesco
Age is one of the major risk factors associated with cardiovascular disease (CVD). About one-fifth of the world population will be aged 65 or older by 2030, with an exponential increase in CVD prevalence. It is well established that environmental factors (overnutrition, smoking, pollution, sedentary lifestyles) may lead to premature defects in mitochondrial functionality, insulin signalling, endothelial homeostasis and redox balance, fostering early senescent features. Over the last few years, molecular investigations have unveiled common signalling networks which may link the ageing process with deterioration of cardiovascular homeostasis and metabolic disturbances, namely insulin resistance. These different processes seem to be highly interconnected and their interplay may favour adverse vascular and cardiac phenotypes responsible for myocardial infarction, stroke and heart failure. In the present review, we carefully describe novel molecular cues underpinning ageing, metabolism and CVD. In particular, we describe a dynamic interplay between emerging pathways such as FOXOs, AMPK, SIRT1, p66(Shc) , JunD and NF-kB. This overview will provide the background for attractive molecular targets to prevent age-driven pathology in the vasculature and the heart. © 2015 The Authors. The Journal of Physiology © 2015 The Physiological Society.
Liese, Angela D; Bortsov, Andrey; Günther, Anke L B; Dabelea, Dana; Reynolds, Kristi; Standiford, Debra A; Liu, Lenna; Williams, Desmond E; Mayer-Davis, Elizabeth J; D'Agostino, Ralph B; Bell, Ronny; Marcovina, Santica
We have shown that adherence to the Dietary Approaches to Stop Hypertension (DASH) diet is related to blood pressure in youth with type 1 and type 2 diabetes mellitus. We explored the impact of the DASH diet on other cardiovascular disease risk factors. Between 2001 and 2005, data on total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, low-density lipoprotein particle density, apolipoprotein B, body mass index, waist circumference, and adipocytokines were ascertained in 2130 youth aged 10 to 22 years with physician-diagnosed diabetes mellitus. Dietary intake was assessed by food frequency questionnaire, categorized into the DASH food groups, and assigned an adherence score. Among youth with type 1 diabetes mellitus, higher adherence to the DASH diet was significantly and inversely associated with low-density lipoprotein/high-density lipoprotein ratio and A(1c) in multivariable-adjusted models. Youth in the highest adherence tertile had an estimated 0.07 lower low-density lipoprotein/high-density lipoprotein ratio and 0.2 lower A(1c) levels than those in the lowest tertile adjusted for confounders. No significant associations were observed with triglycerides, low-density lipoprotein particle density, adipocytokines, apolipoprotein B, body mass index Z score, or waist circumference. Among youth with type 2 diabetes mellitus, associations were observed with low-density lipoprotein particle density and body mass index Z score. The DASH dietary pattern may be beneficial in the prevention and management of cardiovascular disease risk in youth with diabetes mellitus.
de Visser, CL; Bilo, HJG; Groenier, KH; de Visser, W; Meyboom-de Jong, B
Background and Aims: In type 2 diabetes mellitus, disease-related complications have a considerable effect on the quality of life. We studied the influence of cardiovascular disease on quality of life in type 2 diabetic patients in a longitudinal design. We also studied whether quality of life in
Effoe, Valery S; Carnethon, Mercedes R; Echouffo-Tcheugui, Justin B; Chen, Haiying; Joseph, Joshua J; Norwood, Arnita F; Bertoni, Alain G
The concept of ideal cardiovascular health (CVH), defined by the American Heart Association primarily for coronary heart disease and stroke prevention, may apply to diabetes mellitus prevention among blacks. Our sample included 2668 adults in the Jackson Heart Study with complete baseline data on 6 of 7 American Heart Association CVH metrics (body mass index, healthy diet, smoking, total cholesterol, blood pressure, and physical activity). Incident diabetes mellitus was defined as fasting glucose ≥126 mg/dL, physician diagnosis, use of diabetes mellitus drugs, or glycosylated hemoglobin ≥6.5%. A summary CVH score from 0 to 6, based on presence/absence of ideal CVH metrics, was derived for each participant. Cox regression was used to estimate adjusted hazard ratios. Mean age was 55 years (65% women) with 492 incident diabetes mellitus events over 7.6 years (24.6 cases/1000 person-years). Three quarters of participants had only 1 or 2 ideal CVH metrics; no participant had all 6. After adjustment for demographic factors (age, sex, education, and income) and high-sensitivity C-reactive protein, each additional ideal CVH metric was associated with a 17% diabetes mellitus risk reduction (hazard ratio, 0.83; 95% CI, 0.74-0.93). The association was attenuated with further adjustment for homeostasis model assessment for insulin resistance (hazard ratio, 0.89; 95% CI, 0.79-1.00). Compared with participants with 1 or no ideal CVH metric, diabetes mellitus risk was 15% and 37% lower in those with 2 and ≥3 ideal CVH metrics, respectively. The AHA concept of ideal CVH is applicable to diabetes mellitus prevention among blacks. These associations were largely explained by insulin resistance. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
Autoimmune diseases (AD) represent a broad spectrum of chronic conditions that may afflict specific target organs or multiple systems with a significant burden on quality of life. These conditions have common mechanisms including genetic and epigenetics factors, gender disparity, environmental triggers, pathophysiological abnormalities, and certain subphenotypes. Atherosclerosis (AT) was once considered to be a degenerative disease that was an inevitable consequence of aging. However, research in the last three decades has shown that AT is not degenerative or inevitable. It is an autoimmune-inflammatory disease associated with infectious and inflammatory factors characterized by lipoprotein metabolism alteration that leads to immune system activation with the consequent proliferation of smooth muscle cells, narrowing arteries, and atheroma formation. Both humoral and cellular immune mechanisms have been proposed to participate in the onset and progression of AT. Several risk factors, known as classic risk factors, have been described. Interestingly, the excessive cardiovascular events observed in patients with ADs are not fully explained by these factors. Several novel risk factors contribute to the development of premature vascular damage. In this review, we discuss our current understanding of how traditional and nontraditional risk factors contribute to pathogenesis of CVD in AD. PMID:25177690
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.
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
Skaaby, Tea; Thuesen, Betina H.; Linneberg, Allan
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....
Although it has often been postulated that the consumption of dairy products is associated with a high risk of coronary heart disease, study results have been conflicting. This review summarizes recent observational and human intervention trial findings on dairy products and cardiovascular disease. Results from more recent observational studies on dairy products and milk disagree. This may be because of the very different methods used combined with several methodological problems. A somewhat surprising beneficial association between the intake of dairy products and the metabolic syndrome was observed in some studies, although not in a single study of elderly women. Milk may have the same cholesterol-raising properties as butter, whereas cheese does not seem to increase plasma cholesterol. Some milk products fermented by specific bacterial strains have been shown to have rather moderate cholesterol-reducing properties. There is also good evidence that certain fermented products (especially by Lactobacillus helveticus) have a mildly decreasing effect on hypertension, probably because of bioactive peptides. When guiding principles such as balance, variety and moderation are stressed, there is no strong evidence that dairy products increase the risk of coronary heart disease in healthy men of all ages or young and middle-aged healthy women. Human studies should investigate the role of dairy products with respect to sex and age by including classic and novel risk markers of coronary heart disease. Specific fermented milks may be beneficial in the future prevention of hypertension. The beneficially neutral effect of cheese on coronary heart disease risk factors should be elucidated further.
Kuehl, L.K.; Penninx, B.W.J.H.; Otte, C.
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
Jie, Zhuye; Xia, Huihua; Zhong, Shi-Long
The gut microbiota has been linked to cardiovascular diseases. However, the composition and functional capacity of the gut microbiome in relation to cardiovascular diseases have not been systematically examined. Here, we perform a metagenome-wide association study on stools from 218 individuals...... with atherosclerotic cardiovascular disease (ACVD) and 187 healthy controls. The ACVD gut microbiome deviates from the healthy status by increased abundance of Enterobacteriaceae and Streptococcus spp. and, functionally, in the potential for metabolism or transport of several molecules important for cardiovascular......), with liver cirrhosis, and rheumatoid arthritis. Our data represent a comprehensive resource for further investigations on the role of the gut microbiome in promoting or preventing ACVD as well as other related diseases.The gut microbiota may play a role in cardiovascular diseases. Here, the authors perform...
Rasines-Perea, Zuriñe; Teissedre, Pierre-Louis
The consumption of fruits and vegetables, as well as foods enriched in bioactive compounds and nutraceuticals, has increased due to consumers' interest in the relevance of food composition for human health. Considerable recent interest has focused on bioactive phenolic compounds in grape, as they possess many biological activities, such as antioxidant, cardioprotective, anticancer, anti-inflammation, anti-ageing and antimicrobial properties. Observational studies indicate that the intake of polyphenol-rich foods improves vascular health, thereby significantly reducing the risk of hypertension, and cardiovascular disease (CVD). Other researchers have described the benefits of a grape polyphenol-rich diet for other types of maladies such as diabetes mellitus. This is a comprehensive review on the consumption of polyphenolic grape compounds, concerning their potential benefits for human health in the treatment of cardiovascular diseases and diabetes.
Rådholm, Karin; Figtree, Gemma; Perkovic, Vlado; Solomon, Scott D; Mahaffey, Kenneth W; de Zeeuw, Dick; Fulcher, Greg; Barrett, Terrance D; Shaw, Wayne; Desai, Mehul; Matthews, David R; Neal, Bruce
BACKGROUND : Canagliflozin is a sodium glucose cotransporter 2 inhibitor that reduces the risk of cardiovascular events. We report the effects on heart failure and cardiovascular death overall, in those with and without a baseline history of heart failure, and in other participant subgroups. METHODS : The CANVAS Program (Canagliflozin Cardiovascular Assessment Study) enrolled 10 142 participants with type 2 diabetes mellitus and high cardiovascular risk. Participants were randomly assigned to canagliflozin or placebo and followed for a mean of 188 weeks. The primary end point for these analyses was adjudicated cardiovascular death or hospitalized heart failure. RESULTS : Participants with a history of heart failure at baseline (14.4%) were more frequently women, white, and hypertensive and had a history of prior cardiovascular disease (all P failure was reduced in those treated with canagliflozin compared with placebo (16.3 versus 20.8 per 1000 patient-years; hazard ratio [HR], 0.78; 95% confidence interval [CI], 0.67-0.91), as was fatal or hospitalized heart failure (HR, 0.70; 95% CI, 0.55-0.89) and hospitalized heart failure alone (HR, 0.67; 95% CI, 0.52-0.87). The benefit on cardiovascular death or hospitalized heart failure may be greater in patients with a prior history of heart failure (HR, 0.61; 95% CI, 0.46-0.80) compared with those without heart failure at baseline (HR, 0.87; 95% CI, 0.72-1.06; P interaction =0.021). The effects of canagliflozin compared with placebo on other cardiovascular outcomes and key safety outcomes were similar in participants with and without heart failure at baseline (all interaction P values >0.130), except for a possibly reduced absolute rate of events attributable to osmotic diuresis among those with a prior history of heart failure ( P =0.03). CONCLUSIONS : In patients with type 2 diabetes mellitus and an elevated risk of cardiovascular disease, canagliflozin reduced the risk of cardiovascular death or hospitalized heart
Kamphuis, Vivian P; Westenberg, Jos J M; van der Palen, Roel L F; Blom, Nico A; de Roos, Albert; van der Geest, Rob; Elbaz, Mohammed S M; Roest, Arno A W
Knowledge of normal and abnormal flow patterns in the human cardiovascular system increases our understanding of normal physiology and may help unravel the complex pathophysiological mechanisms leading to cardiovascular disease. Four-dimensional (4D) flow cardiovascular magnetic resonance (CMR) has emerged as a suitable technique that enables visualization of in vivo blood flow patterns and quantification of parameters that could potentially be of prognostic value in the disease process. In this review, current image processing tools that are used for comprehensive visualization and quantification of blood flow and energy distribution in the heart and great vessels will be discussed. Also, imaging biomarkers extracted from 4D flow CMR will be reviewed that have been shown to distinguish between normal and abnormal flow patterns. Furthermore, current applications of 4D flow CMR in the heart and great vessels will be discussed, showing its potential as an additional diagnostic modality which could aid in disease management and timing of surgical intervention.
Shah, Sunil M; Carey, Iain M; Harris, Tess; Dewilde, Stephen; Victor, Christina R; Cook, Derek G
Bereavement is a period of increased risk of cardiovascular death. There is limited understanding of the potential contribution of quality of cardiovascular disease management to this increased risk. In a UK primary-care database, 12 722 older individuals with preexisting cardiovascular disease (coronary heart disease, hypertension, diabetes mellitus, stroke) and a partner bereavement were matched with a non-bereaved control group (n=33 911). We examined key routine annual process measures of care in the year before and after bereavement and cardiovascular medication prescribing (lipid-lowering, antiplatelet, renin-angiotensin system drugs). Odds ratios for change after bereavement compared with the change in non-bereaved matched controls are presented. In the bereaved, uptake of all annual measures was lower in the year before bereavement, with improvement in the year after, whereas in the controls, uptake was relatively stable. The odds ratio for change was 1.30 (95% confidence interval, 1.15-1.46) for cholesterol measurement and 1.40 (95% confidence interval, 1.22-1.61) for blood pressure measurement. For all medication, there was a transient fall in prescribing in the peri-bereavement period lasting until about 3 months after bereavement. The odds ratio for at least 80% prescription coverage in the 30 days after bereavement was 0.80 (95% confidence interval, 0.73-0.88) for lipid-lowering medication and 0.82 (95% confidence interval, 0.74-0.91) for antiplatelet medication compared with the change in non-bereaved individuals. Lower uptake of key cardiovascular care measures in the year before bereavement and reduced medication coverage after bereavement may contribute to increased cardiovascular risk. Clinicians need to ensure that quality of cardiovascular care is maintained in the pre- and post-bereavement periods.
Full Text Available Recent studies demonstrated that mitochondria play an important role in the cardiovascular system and mutations of mitochondrial DNA affect coronary artery disease, resulting in hypertension, atherosclerosis, and cardiomyopathy. Traditional Chinese medicine (TCM has been used for thousands of years to treat cardiovascular disease, but it is not yet clear how TCM affects mitochondrial function. By reviewing the interactions between the cardiovascular system, mitochondrial DNA, and TCM, we show that cardiovascular disease is negatively affected by mutations in mitochondrial DNA and that TCM can be used to treat cardiovascular disease by regulating the structure and function of mitochondria via increases in mitochondrial electron transport and oxidative phosphorylation, modulation of mitochondrial-mediated apoptosis, and decreases in mitochondrial ROS. However further research is still required to identify the mechanism by which TCM affects CVD and modifies mitochondrial DNA.
El Eter, E.; Al-Masri, A.A.
The production of oxygen free radicals in type 2 diabetes mellitus contributes to the development of complications, especially the cardiovascular-related ones. Peroxiredoxins (PRDXs) are antioxidant enzymes that combat oxidative stress. The aim of this study was to investigate the associations between the levels of PRDX isoforms (1, 2, 4, and 6) and cardiovascular risk factors in type 2 diabetes mellitus. Fifty-three patients with type 2 diabetes mellitus (28F/25M) and 25 healthy control subjects (7F/18M) were enrolled. We measured the plasma levels of each PRDX isoform and analyzed their correlations with cardiovascular risk factors. The plasma PRDX1, -2, -4, and -6 levels were higher in the diabetic patients than in the healthy control subjects. PRDX2 and -6 levels were negatively correlated with diastolic blood pressure, fasting blood sugar, and hemoglobin A1c. In contrast, PRDX1 levels were positively correlated with low-density lipoprotein and C-reactive protein levels. PRDX4 levels were negatively correlated with triglycerides. In conclusion, PRDX1, -2, -4, and -6 showed differential correlations with a variety of traditional cardiovascular risk factors. These results should encourage further research into the crosstalk between PRDX isoforms and cardiovascular risk factors
El Eter, E. [Physiology Department, Faculty of Medicine, King Saud University, Riyadh (Saudi Arabia); Cardiovascular Research Group, Faculty of Medicine, King Saud University, Riyadh (Saudi Arabia); Physiology Department, Faculty of Medicine, Alexandria University, Alexandria (Egypt); Al-Masri, A.A. [Physiology Department, Faculty of Medicine, King Saud University, Riyadh (Saudi Arabia); Cardiovascular Research Group, Faculty of Medicine, King Saud University, Riyadh (Saudi Arabia)
The production of oxygen free radicals in type 2 diabetes mellitus contributes to the development of complications, especially the cardiovascular-related ones. Peroxiredoxins (PRDXs) are antioxidant enzymes that combat oxidative stress. The aim of this study was to investigate the associations between the levels of PRDX isoforms (1, 2, 4, and 6) and cardiovascular risk factors in type 2 diabetes mellitus. Fifty-three patients with type 2 diabetes mellitus (28F/25M) and 25 healthy control subjects (7F/18M) were enrolled. We measured the plasma levels of each PRDX isoform and analyzed their correlations with cardiovascular risk factors. The plasma PRDX1, -2, -4, and -6 levels were higher in the diabetic patients than in the healthy control subjects. PRDX2 and -6 levels were negatively correlated with diastolic blood pressure, fasting blood sugar, and hemoglobin A1c. In contrast, PRDX1 levels were positively correlated with low-density lipoprotein and C-reactive protein levels. PRDX4 levels were negatively correlated with triglycerides. In conclusion, PRDX1, -2, -4, and -6 showed differential correlations with a variety of traditional cardiovascular risk factors. These results should encourage further research into the crosstalk between PRDX isoforms and cardiovascular risk factors.
Yandrapalli, Srikanth; Jolly, George; Horblitt, Adam; Sanaani, Abdallah; Aronow, Wilbert S
Diabetes mellitus is a growing in exponential proportions. If the current growth trend continues, it may result in every third adult in the United States having diabetes mellitus by 2050, and every 10 th adult worldwide. Type 2 diabetes mellitus (T2DM) confers a 2- to 3-fold increased risk of cardiovascular (CV) events compared with non-diabetic patients, and CV mortality is responsible for around 80% mortality in this population. Patients with T2DM can have other features of insulin resistance-metabolic syndrome like hypertension, lipid abnormalities, and obesity which are all associated with increased CV disease and stroke risk even in the absence of T2DM. The management of a T2DM calls for employing a holistic risk factor control approach. Metformin is the first line therapy for T2DM and has been shown to have cardiovascular beneficial effects. Intense debate regarding the risk of myocardial infarction with rosiglitazone led to regulatory agencies necessitating cardiovascular outcome trials with upcoming anti-diabetic medications. Glucagon like peptide-1 agonists and sodium glucose co-transporter-2 inhibitors have shown promising CV safety and additional CV benefit in recent clinical trials. These drugs have favorable effects on traditional CV risk factors. The findings from these studies further support that fact that CV risk factor control plays an important role in reducing morbidity and mortality in T2DM patients. This review article will discuss briefly the cardiovascular safety and benefits of the oral medications which are currently being used for T2DM and will then discuss in detail about the newer medications being investigated for the treatment of T2DM.
Noman, Awsan; Balasubramaniam, Karthik; Alhous, M Hafez A; Lee, Kelvin; Jesudason, Peter; Rashid, Muhammad; Mamas, Mamas A; Zaman, Azfar G
To assess the mortality in patients with diabetes mellitus (DM) following percutaneous coronary intervention (PCI) according to their insulin requirement and PCI setting (elective, urgent, and emergency). DM is a major risk factor to develop coronary artery disease (CAD). It is unclear if meticulous glycemic control and aggressive risk factor management in patients with DM has improved outcomes following PCI. Retrospective analysis of prospectively collected data on 9,224 patients treated with PCI at a regional tertiary center between 2008 and 2011. About 7,652 patients were nondiabetics (non-DM), 1,116 had non-insulin treated diabetes mellitus (NITDM) and 456 had ITDM. Multi-vessel coronary artery disease, renal impairment and non-coronary vascular disease were more prevalent in DM patients. Overall 30-day mortality rate was 2.4%. In a logistic regression model, the adjusted odds ratios (95% confidence intervals [CI]) for 30-day mortality were 1.28 (0.81-2.03, P = 0.34) in NITDM and 2.82 (1.61-4.94, P diabetes, this study reveals higher mortality only in insulin-treated diabetic patients following PCI for stable coronary artery disease and acute coronary syndrome. Importantly, diabetic patients with good risk factor control and managed on diet or oral hypoglycemics have similar outcomes to the non-diabetic population. © 2016 The Authors Catheterization and Cardiovascular Interventions Published by Wiley Periodicals, Inc. © 2016 The Authors Catheterization and Cardiovascular Interventions Published by Wiley Periodicals, Inc.
Smyth, Andrew; O'Donnell, Martin; Mente, Andrew; Yusuf, Salim
Although an essential nutrient, higher sodium intake is associated with increasing blood pressure (BP), forming the basis for current population-wide sodium restriction guidelines. While short-term clinical trials have achieved low intake (6 months). Guidelines assume that low sodium intake will reduce BP and reduce cardiovascular disease (CVD), compared to moderate intake. However, current observational evidence suggests a J-shaped association between sodium intake and CVD; the lowest risks observed with 3-5 g/day but higher risk with 5 g/day) and increased risk of CVD. Although lower intake may reduce BP, this may be offset by marked increases in neurohormones and other adverse effects which may paradoxically be adverse. Large randomised clinical trials with sufficient follow-up are required to provide robust data on the long-term effects of sodium reduction on CVD incidence. Until such trials are completed, current evidence suggests that moderate sodium intake for the general population (3-5 g/day) is likely the optimum range for CVD prevention.
Schnall, Peter L; Dobson, Marnie; Landsbergis, Paul
Cardiovascular disease (CVD), a global epidemic, is responsible for about 30% of all deaths worldwide. While mortality rates from CVD have been mostly declining in the advanced industrialized nations, CVD risk factors, including hypertension, obesity, and diabetes, have been on the increase everywhere. Researchers investigating the social causes of CVD have produced a robust body of evidence documenting the relationships between the work environment and CVD, including through the mechanisms of psychosocial work stressors. We review the empirical evidence linking work, psychosocial stressors, and CVD. These work stressors can produce chronic biologic arousal and promote unhealthy behaviors and thus, increased CVD risk. We offer a theoretical model that illustrates how economic globalization influences the labor market and work organization in high-income countries, which, in turn, exacerbates job characteristics, such as demands, low job control, effort-reward imbalance, job insecurity, and long work hours. There is also a growing interest in "upstream" factors among work stress researchers, including precarious employment, downsizing/restructuring, privatization, and lean production. We conclude with suggestions for future epidemiologic research on the role of work in the development of CVD, as well as policy recommendations for prevention of work-related CVD. © The Author(s) 2016.
Jul 20, 2009 ... paper reports on cardiovascular disease, its associated risk factors and the potential protective role of antioxidants in the ... Key words: antioxidants, cardiovascular disease, risk factors, preventative, epidemiology. INTRODUCTION AND ..... associated with reduced risk of developing cardiovascular disease.
Stent thrombosis and adverse cardiovascular outcomes observed between six months and five years with sirolimus-eluting stents and other drug-eluting stents in patients with Type 2 diabetes mellitus complicated by coronary artery disease
Bundhun, Pravesh Kumar; Soogund, M. Zafooruddin Sani; Pursun, Manish; Chen, Meng-Hua
Abstract This study aimed to compare 6 months to 5 years stent thrombosis (ST) and adverse cardiovascular outcomes associated with sirolimus-eluting stents (SES) and other drug-eluting stents (DES) in patients with type 2 diabetes mellitus (T2DM). Electronic databases were searched for studies comparing SES with other DES in patients with T2DM. Total ST, definite ST, probable ST, and other adverse cardiovascular outcomes reported between 6 months and 5 years were considered as the clinical end points in this study. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for categorical variables and the pooled analyses were performed with RevMan 5.3 software. Twenty-nine studies involving a total number of 25,729 patients with diabetes were included in this meta-analysis. SES were not associated with significantly higher total, definite, and probable STs with OR: 0.95, 95% CI: 0.77–1.17, P = 0.62; OR: 0.94, 95% CI: 0.65–1.37, P = 0.76; and OR: 1.05, 95% CI: 0.77–1.45, P = 0.74, respectively. SES were also noninferior to the other non-sirolimus eluting drug eluting stents (non-SE DES) in terms of all-cause mortality, cardiac death, myocardial infarction, and stroke with OR: 0.92, 95% CI: 0.82–1.03, P = 0.16; OR: 1.09, 95% CI: 0.88–1.35, P = 0.44; OR: 0.92, 95% CI: 0.80–1.06, P = 0.26; and OR: 0.79, 95% CI: 0.49–1.28, P = 0.43, respectively. Target vessel revascularization, target lesion revascularization, and major adverse cardiac events were also similarly reported between SES and non-SE DES with OR: 1.04, 95% CI: 0.83–1.31, P = 0.72; OR: 1.25, 95% CI: 0.95–1.64, P = 0.11; and OR: 1.06, 95% CI: 0.90–1.25, P = 0.49, respectively. During this particular follow-up period, SES were not associated with any increase in ST among these patients with T2DM. Mortality and other adverse cardiovascular outcomes were also not significantly different between these 2 groups. Hence, SES should be considered neither superior nor inferior to other
Cazacu, A.; Ciubotaru, A.
The increasing prevalence of congenital heart disease can be attributed to major improvements in diagnosis and treatment. Cardiovascular magnetic resonance imaging plays an important role in the clinical management strategy of patients with congenital heart disease. The development of new cardiovascular magnetic resonance (CMR) techniques allows comprehensive assessment of complex cardiac anatomy and function and provides information about the long-term residual post-operative lesions and complications of surgery. It overcomes many of the limitations of echocardiography and cardiac catheterization. This review evaluates the role of cardiovascular magnetic resonance imaging modality in the management of subject with congenital heart disease (CHD). (authors)
Danzi, Sara; Klein, Irwin
Thyroid hormones, specifically triiodothyronine (T3), have significant effects on the heart and cardiovascular system. Hypothyroidism, hyperthyroidism, subclinical thyroid disease, and low T3 syndrome each cause cardiac and cardiovascular abnormalities through both genomic and nongenomic effects on cardiac myocytes and vascular smooth muscle cells. In compromised health, such as occurs in heart disease, alterations in thyroid hormone metabolism may further impair cardiac and cardiovascular function. Diagnosis and treatment of cardiac disease may benefit from including analysis of thyroid hormone status, including serum total T3 levels. Copyright © 2014 Elsevier Inc. All rights reserved.
Zhang, Hanrui; Mooney, Ciarán J.; Reilly, Muredach P.
ABO blood groups have been associated with various disease phenotypes, particularly cardiovascular diseases. Cardiovascular diseases are the most common causes of death in developed countries and their prevalence rate is rapidly growing in developing countries. There have been substantial historical associations between non-O blood group status and an increase in some cardiovascular disorders. Recent GWASs have identified ABO as a locus for thrombosis, myocardial infarction, and multiple cardiovascular risk biomarkers, refocusing attention on mechanisms and potential for clinical advances. As we highlight in this paper, more recent work is beginning to probe the molecular basis of the disease associations observed in these observational studies. Advances in our understanding of the physiologic importance of various endothelial and platelet-derived circulating glycoproteins are elucidating the mechanisms through which the ABO blood group may determine overall cardiovascular disease risk. The role of blood group antigens in the pathogenesis of various cardiovascular disorders remains a fascinating subject with potential to lead to novel therapeutics and prognostics and to reduce the global burden of cardiovascular diseases. PMID:23133757
Harskamp, Ralf E.; Zeeman, Gerda G.
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
Diepen, van Janna A.; Thiem, Kathrin; Stienstra, Rinke; Riksen, Niels P.; Tack, Cees J.; Netea, Mihai G.
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
Nordestgaard, Ask Tybjærg; Nordestgaard, Børge Grønne
Background: Coffee has been associated with modestly lower risk of cardiovascular disease and all-cause mortality in meta-analyses; however, it is unclear whether these are causal associations. We tested first whether coffee intake is associated with cardiovascular disease and all-cause mortality...... observationally; second, whether genetic variations previously associated with caffeine intake are associated with coffee intake; and third, whether the genetic variations are associated with cardiovascular disease and all-cause mortality. Methods: First, we used multivariable adjusted Cox proportional hazard......- and age adjusted Cox proportional hazard regression models to examine genetic associations with cardiovascular disease and all-cause mortality in 112 509 Danes. Finally, we used sex and age-adjusted logistic regression models to examine genetic associations with ischaemic heart disease including...
Heerspink, Hiddo J L; Perkins, Bruce A; Fitchett, David H; Husain, Mansoor; Cherney, David Z I
Sodium-glucose cotransporter-2 (SGLT2) inhibitors, including empagliflozin, dapagliflozin, and canagliflozin, are now widely approved antihyperglycemic therapies. Because of their unique glycosuric mechanism, SGLT2 inhibitors also reduce weight. Perhaps more important are the osmotic diuretic and natriuretic effects contributing to plasma volume contraction, and decreases in systolic and diastolic blood pressures by 4 to 6 and 1 to 2 mm Hg, respectively, which may underlie cardiovascular and kidney benefits. SGLT2 inhibition also is associated with an acute, dose-dependent reduction in estimated glomerular filtration rate by ≈5 mL·min(-1)·1.73 m(-2) and ≈30% to 40% reduction in albuminuria. These effects mirror preclinical observations suggesting that proximal tubular natriuresis activates renal tubuloglomerular feedback through increased macula densa sodium and chloride delivery, leading to afferent vasoconstriction. On the basis of reduced glomerular filtration, glycosuric and weight loss effects are attenuated in patients with chronic kidney disease (estimated glomerular filtration rate kidney disease. With regard to long-term clinical outcomes, the EMPA-REG OUTCOME trial (Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes) in patients with type 2 diabetes mellitus and established cardiovascular disease randomly assigned to empagliflozin versus placebo reported a 14% reduction in the primary composite outcome of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, and >30% reductions in cardiovascular mortality, overall mortality, and heart failure hospitalizations associated with empagliflozin, even though, by design, the hemoglobin A1c difference between the randomized groups was marginal. Aside from an increased risk of mycotic genital infections, empagliflozin-treated patients had fewer serious adverse events, including a lower risk of acute kidney injury. In light of the EMPA-REG OUTCOME results, some diabetes
Raza, Qaisar; Doak, Colleen M; Khan, Aroosa; Nicolaou, Mary; Seidell, Jaap C
AIM: The aim of this study was to systematically describe the gender and ethnic differences regarding the prevalence of general/central obesity and cardiovascular disease (CVD) risk factors such as diabetes mellitus type 2, hypertension, and hypercholesterolemia among the indigenous and immigrant
Shabanzadeh, Daniel Mønsted; Skaaby, Tea; Sørensen, Lars Tue
Knowledge about temporal associations for screen-detected gallstone disease and cardiovascular disease is limited. The objective of this study was to determine if screen-detected gallstones or cholecystectomy was associated with development of cardiovascular disease. A cohort study of three...... of cardiovascular disease through nationwide registers until December 2014. Multivariable Cox regression analyses were performed including traditional cardiovascular disease risk factors and apolipoprotein E genotype. Gallstone disease was identified in 10% (591/5928) of participants at baseline of whom 6.8% had...... gallstones and 3.2% had cholecystectomy. The study population was followed for a period of 32 years with only 1% lost to follow-up. Gallstone disease was associated with all cardiovascular disease (hazard ratio (HR) 1.36, 95% confidence interval (CI) [1.17;1.59]) and to the subgroups coronary artery (HR 1...
Full Text Available Exercise training is the cornerstone of rehabilitation for patients with cardiovascular disease (CVD. Although high-intensity exercise has significant cardiovascular benefits, light-to-moderate intensity aerobic exercise also offers health benefits. With lower-intensity workouts, patients may be able to exercise for longer periods of time and increase the acceptance of exercise, particularly in unfit and elderly patients. Tai Chi Chuan (Tai Chi is a traditional Chinese mind-body exercise. The exercise intensity of Tai Chi is light to moderate, depending on its training style, posture, and duration. Previous research has shown that Tai Chi enhances aerobic capacity, muscular strength, balance, and psychological well-being. Additionally, Tai Chi training has significant benefits for common cardiovascular risk factors, such as hypertension, diabetes mellitus, dyslipidemia, poor exercise capacity, endothelial dysfunction, and depression. Tai Chi is safe and effective in patients with acute myocardial infarction (AMI, coronary artery bypass grafting (CABG surgery, congestive heart failure (HF, and stroke. In conclusion, Tai Chi has significant benefits to patients with cardiovascular disease, and it may be prescribed as an alternative exercise program for selected patients with CVD.
van der Laan, Sander W.; Fall, Tove; Soumaré, Aicha; Teumer, Alexander; Sedaghat, Sanaz; Baumert, Jens; Zabaneh, Delilah; van Setten, Jessica; Isgum, Ivana; Galesloot, Tessel E.; Arpegård, Johannes; Amouyel, Philippe; Trompet, Stella; Waldenberger, Melanie; Dörr, Marcus; Magnusson, Patrik K.; Giedraitis, Vilmantas; Larsson, Anders; Morris, Andrew P.; Felix, Janine F.; Morrison, Alanna C.; Franceschini, Nora; Bis, Joshua C.; Kavousi, Maryam; O’Donnell, Christopher; Drenos, Fotios; Tragante, Vinicius; Munroe, Patricia B.; Malik, Rainer; Dichgans, Martin; Worrall, Bradford B.; Erdmann, Jeanette; Nelson, Christopher P.; Samani, Nilesh J.; Schunkert, Heribert; Marchini, Jonathan; Patel, Riyaz S.; Hingorani, Aroon D.; Lind, Lars; Pedersen, Nancy L.; de Graaf, Jacqueline; Kiemeney, Lambertus A.L.M.; Baumeister, Sebastian E.; Franco, Oscar H.; Hofman, Albert; Uitterlinden, André G.; Koenig, Wolfgang; Meisinger, Christa; Peters, Annette; Thorand, Barbara; Jukema, J. Wouter; Eriksen, Bjørn Odvar; Toft, Ingrid; Wilsgaard, Tom; Onland-Moret, N. Charlotte; van der Schouw, Yvonne T.; Debette, Stéphanie; Kumari, Meena; Svensson, Per; van der Harst, Pim; Kivimaki, Mika; Keating, Brendan J.; Sattar, Naveed; Dehghan, Abbas; Reiner, Alex P.; Ingelsson, Erik; den Ruijter, Hester M.; de Bakker, Paul I.W.; Pasterkamp, Gerard; Ärnlöv, Johan; Holmes, Michael V.; Asselbergs, Folkert W.
BACKGROUND Epidemiological studies show that high circulating cystatin C is associated with risk of cardiovascular disease (CVD), independent of creatinine-based renal function measurements. It is unclear whether this relationship is causal, arises from residual confounding, and/or is a consequence of reverse causation. OBJECTIVES The aim of this study was to use Mendelian randomization to investigate whether cystatin C is causally related to CVD in the general population. METHODS We incorporated participant data from 16 prospective cohorts (n = 76,481) with 37,126 measures of cystatin C and added genetic data from 43 studies (n = 252,216) with 63,292 CVD events. We used the common variant rs911119 in CST3 as an instrumental variable to investigate the causal role of cystatin C in CVD, including coronary heart disease, ischemic stroke, and heart failure. RESULTS Cystatin C concentrations were associated with CVD risk after adjusting for age, sex, and traditional risk factors (relative risk: 1.82 per doubling of cystatin C; 95% confidence interval [CI]: 1.56 to 2.13; p = 2.12 × 10−14). The minor allele of rs911119 was associated with decreased serum cystatin C (6.13% per allele; 95% CI: 5.75 to 6.50; p = 5.95 × 10−211), explaining 2.8% of the observed variation in cystatin C. Mendelian randomization analysis did not provide evidence for a causal role of cystatin C, with a causal relative risk for CVD of 1.00 per doubling cystatin C (95% CI: 0.82 to 1.22; p = 0.994), which was statistically different from the observational estimate (p = 1.6 × 10−5). A causal effect of cystatin C was not detected for any individual component of CVD. CONCLUSIONS Mendelian randomization analyses did not support a causal role of cystatin C in the etiology of CVD. As such, therapeutics targeted at lowering circulating cystatin C are unlikely to be effective in preventing CVD. PMID:27561768
Objectives: To determine the proportion of specific cardiovascular risk factors in ambulatory patients with type 2 diabetes and the levels of control achieved in them. Design: Prospective, cross-sectional study over a six month period. Setting: Out-patient diabetic clinic of the Kenyatta National Hospital. Subjects: Two hundred ...
Cardiovascular autonomic neuropathy (CAN) is a common form of diabetes autonomic neuropathy, causes abnormalities in heart rate control as well as central and peripheral vascular dynamics, and may carry an increased risk of mortality. The aim of this article was to review the importance of identifying CAN and ...
Full Text Available With such a high cost in money and human lives, diabetes mellitus (DM is a major challenge for health care systems and an obstacle to sustainable economic growth. The pathophysiological disorders of diabetes include, besides the defect in pancreatic insulin secretion and insulin resistance in peripheral tissues (liver, muscle and adipose tissue, increased lipolysis, increased glucagon secretion, impaired secretion and action of incretin hormones, increased glucose resorption by the kidney and defects in the central nervous system. The therapeutic intervention must be timely and personalized. Lifestyle interventions (diet, exercise, smoking cessation are the cornerstone of treatment. Treatment should begin with metformin unless there is a contraindication (eg renal failure or intolerance (eg, gastrointestinal disorders. If HbA1c remains off target a second or a third treatment may be added, orally (glitazone, DPP-4 inhibitors, SGLT-2 inhibitors, sulfonylurea or by injection (GLP-1 agonist or basal insulin. On failure to achieve glycemic target combinations of injectable treatments (combination of agonist GLP-1 with basal insulin, intensified insulin therapy or in some cases insulin mixtures are recommended. New treatments (weekly administered GLP-1 analogs, combination of a basal insulin / GLP-1 in one injection, SGLT-2 inhibitors, long acting basal insulins in combination with the old tried treatments (e.g. metformin, pioglitazone, inhibitors DPP-4 can contribute to human-centered and individualized management of patients with diabetes. The cardiovascular safety of antidiabetic treatment should be considered. There is a need for early diagnosis and treatment of glucose metabolism disorders during pregnancy (before 24 to 28 weeks of gestation in women at high risk for developing gestational diabetes.
NSGIC Local Govt | GIS Inventory — Polygon feature class based on Zip Code boundaries showing the rate of deaths due to major cardiovascular diseases per 1000 residents of Miami-Dade County in 2006.
van der Harst, Pim; de Windt, Leon J.; Chambers, John C.
A plethora of environmental and behavioral factors interact, resulting in changes in gene expression and providing a basis for the development and progression of cardiovascular diseases. Heterogeneity in gene expression responses among cells and individuals involves epigenetic mechanisms. Advancing
Riddhi Patel; Henish Patel; Rachana Sarawade
Inflammation is a part of complex biological response of vascular tissue to harmful stimuli such as pathogens, damaged cells or irritants. Recent advance in basic science have established a fundamental role for inflammation immediating all stages of cardiovascular diseases from initiation, progression and complications. Inflammation is thread linking to cardiovascular diseases. Clinical studies have shown that this emerging biology of inflammation play important role in pathogenesis of acute ...
Dunlay, Shannon M; Chamberlain, Alanna M
Multimorbidity affects more than two thirds of older individuals and the vast majority of patients with chronic cardiovascular disease. Patients with multimorbidity have high resource utilization, poor mobility, and poor health status and are at an increased risk for death. The presence of multimorbidity imposes numerous management challenges in caring for patients with chronic cardiovascular disease. It complicates decision-making, promotes fragmented care, and imposes an immense burden on the patient and their social support system. Novel models of care, such as the cardiovascular patient-centered medical home, are needed to provide high-quality, efficient, effective care to this growing population.
Faber, Jens; Selmer, Christian
Thyroid function has a profound effect on the heart, and both all-cause and cardiovascular mortality rates are increased in hyperthyroidism. New-onset atrial fibrillation carries a prolonged risk for the development of hyperthyroidism, suggesting altered availability of thyroid hormones at the ce......Thyroid function has a profound effect on the heart, and both all-cause and cardiovascular mortality rates are increased in hyperthyroidism. New-onset atrial fibrillation carries a prolonged risk for the development of hyperthyroidism, suggesting altered availability of thyroid hormones...... at the cellular level. Subclinical hyperthyroidism is associated with increased left ventricular mass of the heart, which reverts after obtaining euthyroidism. Mortality and risk of major cardiovascular events are increased. Subclinical hypothyroidism is also associated with subtle changes in the heart, e.g. its...
Within Europe large differences exist in mortality from coronary heart disease and stroke. These diseases show a clear West-East gradient with high rates in Eastern Europe. In spite the decreasing trend in age-adjusted cardiovascular disease mortality in Western European countries an increase in the
Tsujimoto, Tetsuro; Sugiyama, Takehiro; Shapiro, Martin F; Noda, Mitsuhiko; Kajio, Hiroshi
Although the use of β-blockers may help in achieving maximum effects of intensive glycemic control because of a decrease in the adverse effects after severe hypoglycemia, they pose a potential risk for the occurrence of severe hypoglycemia. This study aimed to evaluate whether the use of β-blockers is effective in patients with diabetes mellitus and whether its use is associated with the occurrence of severe hypoglycemia. Using the ACCORD trial (Action to Control Cardiovascular Risk in Diabetes) data, we performed Cox proportional hazards analyses with a propensity score adjustment. The primary outcome was the first occurrence of a cardiovascular event during the study period, which included nonfatal myocardial infarction, unstable angina, nonfatal stroke, and cardiovascular death. The mean follow-up periods (±SD) were 4.6±1.6 years in patients on β-blockers (n=2527) and 4.7±1.6 years in those not on β-blockers (n=2527). The cardiovascular event rate was significantly higher in patients on β-blockers than in those not on β-blockers (hazard ratio, 1.46; 95% confidence interval, 1.24-1.72; P diabetes mellitus was associated with an increased risk for cardiovascular events. © 2017 The Authors.
Y.K. van Pareren (Yvonne); S.M.P.F. de Muinck Keizer-Schrama (Sabine); Th. Stijnen (Theo); T.C.J. Sas (Theo); S.L.S. Drop (Stenvert)
textabstractGH treatment increases insulin levels in girls with Turner syndrome (TS), who are already predisposed to develop diabetes mellitus and other risk factors for developing cardiovascular disease. Therefore, in the present study, we investigated carbohydrate metabolism and
Trivedi, A.; Vlahovich, S.; Cornett, R.J.
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)
van Nimwegen, Frederika A.; Schaapveld, Michael; Janus, Cécile P. M.; Krol, Augustinus D. G.; Petersen, Eefke J.; Raemaekers, John M. M.; Kok, Wouter E. M.; Aleman, Berthe M. P.; van Leeuwen, Flora E.
Hodgkin lymphoma (HL) survivors are at increased risk of cardiovascular diseases. It is unclear, however, how long the increased risk persists and what the risk factors are for various cardiovascular diseases. To examine relative and absolute excess risk up to 40 years since HL treatment compared
Nimwegen, F.A. van; Schaapveld, M.; Janus, C.P.; Krol, A.D.; Petersen, E.J.; Raemaekers, J.M.M.; Kok, W.E.; Aleman, B.M.; Leeuwen, F.E. van
IMPORTANCE: Hodgkin lymphoma (HL) survivors are at increased risk of cardiovascular diseases. It is unclear, however, how long the increased risk persists and what the risk factors are for various cardiovascular diseases. OBJECTIVES: To examine relative and absolute excess risk up to 40 years since
Jackson, Jennifer; McGibbon, Elizabeth; Waldron, Ingrid
The social determinants of health (SDH) are recognized as a prominent influence on health outcomes across the lifespan. Racism is identified as a key SDH. In this article, the authors describe the concept of racism as an SDH, its impact in discriminatory actions and inactions, and the implications for cardiovascular nurses. Although research in Canada on the links among racism, stress, and cardiovascular disease is limited, there is growing evidence about the stress of racism and its long-term impact on cardiovascular health. The authors discuss how cardiovascular nursing could be enhanced through an understanding of racism-related stress, and race-based differences in cardiovascular care. The authors conclude with strategies for action to address this nursing concern.
Murray, Sara G; Yazdany, Jinoos; Kaiser, Rachel; Criswell, Lindsey A; Trupin, Laura; Yelin, Edward H; Katz, Patricia P; Julian, Laura J
Cognitive dysfunction and cardiovascular disease are common and debilitating manifestations of systemic lupus erythematosus (SLE). In this study, we evaluated the relationship between cardiovascular events, traditional cardiovascular risk factors, and SLE-specific risk factors as predictors of cognitive dysfunction in a large cohort of participants with SLE. Subjects included 694 participants from the Lupus Outcomes Study (LOS), a longitudinal study of SLE outcomes based on an annual telephone survey querying demographic and clinical variables. The Hopkins Verbal Learning Test-Revised and the Controlled Oral Word Association Test were administered to assess cognitive function. Multiple logistic regression was used to identify cardiovascular events (myocardial infarction, stroke), traditional cardiovascular risk factors (hypertension, hyperlipidemia, diabetes mellitus, obesity, smoking), and SLE-specific risk factors (antiphospholipid antibodies [aPL], disease activity, disease duration) associated with cognitive impairment in year 7 of the LOS. The prevalence of cognitive impairment as measured by verbal memory and verbal fluency metrics was 15%. In adjusted multiple logistic regression analyses, aPL (odds ratio [OR] 2.10, 95% confidence interval [95% CI] 1.3-3.41), hypertension (OR 2.06, 95% CI 1.19-3.56), and a history of stroke (OR 2.27, 95% CI 1.16-4.43) were significantly associated with cognitive dysfunction. In additional analyses evaluating the association between these predictors and severity of cognitive impairment, stroke was significantly more prevalent in participants with severe impairment when compared to those with mild or moderate impairment (P = 0.036). These results suggest that the presence of aPL, hypertension, and stroke are key variables associated with cognitive impairment, which may aid in identification of patients at greatest risk. Copyright © 2012 by the American College of Rheumatology.
Full Text Available Background. We examined the association between insufficient rest/sleep and cardiovascular disease or diabetes mellitus separately among non-Hispanic whites, non-Hispanic blacks, Hispanic Americans, and other races in a contemporary sample of US adults. Methods. Multiethnic, nationally representative, cross-sectional survey (2008 BRFSS participants who were >20 years of age (n=369, 217; 50% women. Self-reported insufficient rest/sleep in the previous month was categorized into: zero, 1–13, 14–29, and all 30 days. Outcomes were: (1 any CVD, (2 coronary artery disease (CHD, (3 stroke, and (4 diabetes mellitus. Results. Insufficient rest/sleep was found to be positively associated with (1 any CVD, (2 CHD, and (3 stroke among all race-ethnicities. In contrast, insufficient rest/sleep was positively associated with diabetes mellitus in all race-ethnicities except non-Hispanic blacks. The odds ratio of diabetes association with insufficient rest/sleep for all 30 days was 1.37 (1.26–1.48 among non-Hispanic whites, 1.11 (0.90–1.36 among non-Hispanic blacks, 1.88 (1.46–2.42 among Hispanic Americans, and 1.48 (1.10–2.00 among other race/ethnicities. Conclusion. In a multiethnic sample of US adults, perceived insufficient rest/sleep was associated with CVD, among all race-ethnicities. However, the association between insufficient rest/sleep and diabetes mellitus was present among all race-ethnicities except non-Hispanic blacks.
Danilo Rocha Santos Caracas; Daliane Barbosa Lima; Gleidson Ferreira Santos; Mariane Alves Sousa; Constança Margarida Sampaio Cruz
Chronic kidney disease is a health problem that has reached more and more individuals due to the aging and increase of diseases such as hypertension and diabetes mellitus. The presence of chronic uremic syndrome along with aggravating factors such as sedentary lifestyle is directly associated with a high risk of developing cardiovascular diseases. This study aimed to describe the prevalence of cardiovascular risk and determine the levels of regular physical activity...
Low Wang, Cecilia C.; Hess, Connie N.; Hiatt, William R.; Goldfine, Allison B.
Cardiovascular disease remains the principal cause of death and disability among patients with diabetes mellitus. Diabetes exacerbates mechanisms underlying atherosclerosis and heart failure. Unfortunately, these mechanisms are not adequately modulated by therapeutic strategies focusing solely on optimal glycemic control with currently available drugs or approaches. In the setting of multi-factorial risk reduction with statins and other lipid lowering agents, anti-hypertensive therapies, and anti-hyperglycemic treatment strategies, cardiovascular complication rates are falling, yet remain higher for patients with diabetes than for those without. This review considers the mechanisms, history, controversies, new pharmacologic agents, and recent evidence for current guidelines for cardiovascular management in the patient with diabetes mellitus to support evidence-based care in the patient with diabetes and heart disease outside of the acute care setting. PMID:27297342
Melissa S. Burroughs Peña
Full Text Available Cardiovascular disease is the leading cause of mortality in Cuba. Lifestyle risk factors for coronary heart disease (CHD in Cubans have not been compared to risk factors in Cuban Americans. Articles spanning the last 20 years were reviewed. The data on Cuban Americans are largely based on the Hispanic Health and Nutrition Examination Survey (HHANES, 1982–1984, while more recent data on epidemiological trends in Cuba are available. The prevalence of obesity and type 2 diabetes mellitus remains greater in Cuban Americans than in Cubans. However, dietary preferences, low physical activity, and tobacco use are contributing to the rising rates of obesity, type 2 diabetes mellitus, and CHD in Cuba, putting Cubans at increased cardiovascular risk. Comprehensive national strategies for cardiovascular prevention that address these modifiable lifestyle risk factors are necessary to address the increasing threat to public health in Cuba.
North, Brian J.; Sinclair, David A.
The average lifespan of humans is increasing, and with it the percentage of people entering the 65 and older age group is growing rapidly and will continue to do so in the next 20 years. Within this age group, cardiovascular disease will remain the leading cause of death, and the cost associated with treatment will continue to increase. Aging is an inevitable part of life and unfortunately poses the largest risk factor for cardiovascular disease. Although numerous studies in the cardiovascular field have considered both young and aged humans, there are still many unanswered questions as to how the genetic pathways that regulate aging in model organisms influence cardiovascular aging. Likewise, in the molecular biology of aging field, few studies fully assess the role of these aging pathways in cardiovascular health. Fortunately, this gap is beginning to close, and these two fields are merging together. We provide an overview of some of the key genes involved in regulating lifespan and health span, including sirtuins, AMP-activated protein kinase, mammalian target of rapamycin, and insulin-like growth factor 1 and their roles regulating cardiovascular health. We then discuss a series of review articles that will appear in succession and provide a more comprehensive analysis of studies carried out linking genes of aging and cardiovascular health, and perspectives of future directions of these two intimately linked fields. PMID:22499900
North, Brian J; Sinclair, David A
The average lifespan of humans is increasing, and with it the percentage of people entering the 65 and older age group is growing rapidly and will continue to do so in the next 20 years. Within this age group, cardiovascular disease will remain the leading cause of death, and the cost associated with treatment will continue to increase. Aging is an inevitable part of life and unfortunately poses the largest risk factor for cardiovascular disease. Although numerous studies in the cardiovascular field have considered both young and aged humans, there are still many unanswered questions as to how the genetic pathways that regulate aging in model organisms influence cardiovascular aging. Likewise, in the molecular biology of aging field, few studies fully assess the role of these aging pathways in cardiovascular health. Fortunately, this gap is beginning to close, and these two fields are merging together. We provide an overview of some of the key genes involved in regulating lifespan and health span, including sirtuins, AMP-activated protein kinase, mammalian target of rapamycin, and insulin-like growth factor 1 and their roles regulating cardiovascular health. We then discuss a series of review articles that will appear in succession and provide a more comprehensive analysis of studies carried out linking genes of aging and cardiovascular health, and perspectives of future directions of these two intimately linked fields.
Zinman, Bernard; Inzucchi, Silvio E; Lachin, John M; Wanner, Christoph; Fitchett, David; Kohler, Sven; Mattheus, Michaela; Woerle, Hans J; Broedl, Uli C; Johansen, Odd Erik; Albers, Gregory W; Diener, Hans Christoph
In the EMPA-REG OUTCOME trial (Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients), empagliflozin added to standard of care in patients with type 2 diabetes mellitus and high cardiovascular risk reduced the risk of 3-point major adverse cardiovascular events, driven by a reduction in cardiovascular mortality, with no significant difference between empagliflozin and placebo in risk of myocardial infarction or stroke. In a modified intent-to-treat analysis, the hazard ratio for stroke was 1.18 (95% confidence interval, 0.89-1.56; P =0.26). We further investigated cerebrovascular events. Patients were randomized to empagliflozin 10 mg, empagliflozin 25 mg, or placebo; 7020 patients were treated. Median observation time was 3.1 years. The numeric difference in stroke between empagliflozin and placebo in the modified intent-to-treat analysis was primarily because of 18 patients in the empagliflozin group with a first event >90 days after last intake of study drug (versus 3 on placebo). In a sensitivity analysis based on events during treatment or ≤90 days after last dose of drug, the hazard ratio for stroke with empagliflozin versus placebo was 1.08 (95% confidence interval, 0.81-1.45; P =0.60). There were no differences in risk of recurrent, fatal, or disabling strokes, or transient ischemic attack, with empagliflozin versus placebo. Patients with the largest increases in hematocrit or largest decreases in systolic blood pressure did not have an increased risk of stroke. In patients with type 2 diabetes mellitus and high cardiovascular risk, there was no significant difference in the risk of cerebrovascular events with empagliflozin versus placebo. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01131676. © 2017 The Authors.
Holmes, Michael V; Dale, Caroline E; Zuccolo, Luisa
OBJECTIVE: To use the rs1229984 variant in the alcohol dehydrogenase 1B gene (ADH1B) as an instrument to investigate the causal role of alcohol in cardiovascular disease. DESIGN: Mendelian randomisation meta-analysis of 56 epidemiological studies. PARTICIPANTS: 261 991 individuals of European...... descent, including 20 259 coronary heart disease cases and 10 164 stroke events. Data were available on ADH1B rs1229984 variant, alcohol phenotypes, and cardiovascular biomarkers. MAIN OUTCOME MEASURES: Odds ratio for coronary heart disease and stroke associated with the ADH1B variant in all individuals...... disease than those without the genetic variant. This suggests that reduction of alcohol consumption, even for light to moderate drinkers, is beneficial for cardiovascular health....
Truong, Uyen T; Maahs, David M; Daniels, Stephen R
The increasing prevalence of type 1 and type 2 diabetes mellitus combined with advancement in early detection of cardiovascular disease (CVD) has placed CVD as a significant concern for preventative pediatric medicine. The public health burden of type 2 diabetes is predicted to parallel increasing obesity in children with a projected increase of early CVD in adulthood. In this article, we review practice guidelines for cardiovascular health in children and adolescents with diabetes and data on which they are based. We then focus on imaging modalities that are promising tools to expand our understanding of the cardiovascular risk imposed on youths with diabetes.
Folkestad, Lars; Hald, Jannie Dahl; Gram, Jeppe
BACKGROUND: Osteogenesis imperfecta (OI) is a hereditary connective tissue disease often due to mutations in genes coding for type 1 collagen. Collagen type 1 is important in the development of the heart and vasculature. Little is known about the risk of cardiovascular disease (CVD) in OI...
Mannsåker, Bård; Vikan, Torkel; Holme, Jonas
There is some evidence linking air pollution to cardiovascular morbidity. Our aim was to examine whether there is a correlation between air pollution and cardiovascular morbidity in the city of Trondheim, Norway. We compared the mean daily number of admissions for cardiovascular disease to the St. Olav University hospital on days with relatively low and high levels of PM10 (1993-2001), PM2,5, NO, NO2, SO2, O3, toluene and paraxylene (1998-2001). A time series analysis was carried out to see how day-to-day variations in concentrations of air pollutants correlated with the number of hospitalizations for cardiovascular disease. In the bivariate analysis, the mean daily number of hospitalizations was found to be significantly higher (p < 0.05) on days with NO and NO2 levels above the 80 th percentile (57.6 microg/m3 and 43.1 microg/m3, respectively) than on days with pollutant levels below the 20th percentile (11.3 microg/m3 and 16.9 microg/m3, respectively). Time series analysis did not show any statistically significant correlation between day-to-day variations in air pollution and hospital admissions for cardiovascular disease. The findings regarding NO2 and NO indicate that exposure to gases and/or ultra-small particles from diesel exhaust may influence cardiovascular morbidity.
Full Text Available Abstract Atherosclerosis is a chronic, progressive, inflammatory disease affecting many vascular beds. Disease progression leads to acute cardiovascular events such as myocardial infarction, stroke and death. The diseased carotid alone is responsible for one third of the 700,000 new or recurrent strokes occurring yearly in the United States. Imaging plays an important role in the management of atherosclerosis, and cardiovascular magnetic resonance (CMR of the carotid vessel wall is one promising modality in the evaluation of patients with carotid atherosclerotic disease. Advances in carotid vessel wall CMR allow comprehensive assessment of morphology inside the wall, contributing substantial disease-specific information beyond luminal stenosis. Although carotid vessel wall CMR has not been widely used to screen for carotid atherosclerotic disease, many trials support its potential for this indication. This review summarizes the current state of knowledge regarding carotid vessel wall CMR and its potential clinical application for management of carotid atherosclerotic disease.
Various forms of smokeless tobacco (mainly snuff and chewing tobacco) cause an immediate increase in heart rate and blood pressure, but regular users of smokeless tobacco do not have permanent changes of heart rate or blood pressure when not exposed to tobacco. Cardiac output during workload and maximal working capacity are unaffected. Users of smokeless tobacco usually do not have the biochemical stigmata that regular smokers have. Thus, the scientific literature suggests that they are similar to non-tobacco users in terms of levels of hemoglobin/hematocrit, leukocytes, antioxidant vitamins, fibrinogen, components of the fibrinolytic system, C-reactive protein, and thromboxane A2 production. Two studies have found that snuff users, as opposed to smokers, do not have increased intima-media thickness or atherosclerotic lesions when investigated by ultrasound. Results on the risk for myocardial infarction have provided conflicting evidence, 2 case-control studies showing the same risks as in non-tobacco users and one cohort study showing an increased risk for cardiovascular death. In all, the use of smokeless tobacco (with snuff being the most studied variant) involves a much lower risk for adverse cardiovascular effects than smoking does. Whether or not the apparent risk reduction is a useful strategy to help inveterate smokers to quit is a matter of debate, as are the public health effects of a high prevalence of snuff use in some populations. Copyright 2003, Elsevier Science (USA). All rights reserved.
Gürgün, Alev; Gürgün, Cemil
Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide killing nearly 3 million people annually. Even the most optimistic estimates suggest that COPD mortality rates will increase by 50% over the next 15 years. Individuals with COPD are at increased risk of cardiovascular diseases (CVD), lung cancer, osteoporosis and muscle wasting. Smoking is a well-described risk factor for both COPD and CVD, but CVD in patients with COPD is likely to be due to other factors in addition to smoking. Systemic inflammation may be an important common etiological cause between COPD and CVD, being well described in both diseases. This paper reviews the close relationship between COPD and cardiovascular diseases, principally atherosclerosis. The common pathogenetic mechanisms, relation between cardiovascular comorbidities and pulmonary function parameters, the treatment of pulmonary and systemic inflammation, the role medications in the treatment of both disorders, the effect of cardiovascular comorbidities on the prognosis of COPD and prediction of mortality is discussed. The anti-inflammatory effects of inhaled corticosteroids and statins, their effects on cardiovascular endpoints, all-cause mortality, and survival of COPD patients are reviewed as a new perspective to the treatment.
Full Text Available A significant problem in the dental medicine is pain alleviation. Many studies in the dental anesthesiology result in the production of new agents for locoregional anesthesia. Objective: This article aim to present the results of the last studies on the effect of the local anesthetics used in the oral surgery on patients with cardiovascular diseases. Material: A general review of the existing literature on the effect of the adrenaline, included as vasoconstrictor in the local anesthetics, used in patients with cardiovascular diseases is made. The benefits of vasoconstrictors for the quality of the anesthetic effect are proven. Conclusion: A small amount of adrenaline in the anesthetic solution does not result in complications development in patients with controlled cardiovascular diseases. Articaine is recommended agent of first choice for local anesthesia in the oral surgery.
Shaya, Fadia T; Yan, Xia; Farshid, Maryam; Barakat, Samer; Jung, Miah; Low, Sara; Fedder, Donald
Cardiovascular disease remains the leading cause of death in the USA. Social networks have a positive association with obesity, smoking cessation and weight loss. This article summarizes studies evaluating the impact of social networks on the management of cardiovascular disease. The 35 studies included in the article describe the impact of social networks on a decreased incidence of cardiovascular disease, depression and mortality. In addition, having a large-sized social network is also associated with better outcomes and improved health. The role of pharmacists is beginning to play an important role in the patient-centered medical home, which needs to be incorporated into social networks. The patient-centered medical home can serve as an adaptive source for social network evolvement.
Deveza, Lorenzo; Choi, Jeffrey; Yang, Fan
Cardiovascular disease is the leading cause of death worldwide and is often associated with partial or full occlusion of the blood vessel network in the affected organs. Restoring blood supply is critical for the successful treatment of cardiovascular diseases. Therapeutic angiogenesis provides a valuable tool for treating cardiovascular diseases by stimulating the growth of new blood vessels from pre-existing vessels. In this review, we discuss strategies developed for therapeutic angiogenesis using single or combinations of biological signals, cells and polymeric biomaterials. Compared to direct delivery of growth factors or cells alone, polymeric biomaterials provide a three-dimensional drug-releasing depot that is capable of facilitating temporally and spatially controlled release. Biomimetic signals can also be incorporated into polymeric scaffolds to allow environmentally-responsive or cell-triggered release of biological signals for targeted angiogenesis. Recent progress in exploiting genetically engineered stem cells and endogenous cell homing mechanisms for therapeutic angiogenesis is also discussed. PMID:22916079
França, Carolina Nunes, E-mail: firstname.lastname@example.org [Universidade Federal de São Paulo - UNIFESP - UNISA, SP, São Paulo (Brazil); Universidade de Santo Amaro - UNISA, SP, São Paulo (Brazil); Izar, Maria Cristina de Oliveira; Amaral, Jônatas Bussador do; Tegani, Daniela Melo; Fonseca, Francisco Antonio Helfenstein [Universidade Federal de São Paulo - UNIFESP - UNISA, SP, São Paulo (Brazil)
Primary prevention of cardiovascular disease is a choice of great relevance because of its impact on health. Some biomarkers, such as microparticles derived from different cell populations, have been considered useful in the assessment of cardiovascular disease. Microparticles are released by the membrane structures of different cell types upon activation or apoptosis, and are present in the plasma of healthy individuals (in levels considered physiological) and in patients with different pathologies. Many studies have suggested an association between microparticles and different pathological conditions, mainly the relationship with the development of cardiovascular diseases. Moreover, the effects of different lipid-lowering therapies have been described in regard to measurement of microparticles. The studies are still controversial regarding the levels of microparticles that can be considered pathological. In addition, the methodologies used still vary, suggesting the need for standardization of the different protocols applied, aiming at using microparticles as biomarkers in clinical practice.
Holmes, Michael V; Dale, Caroline E; Zuccolo, Luisa
OBJECTIVE: To use the rs1229984 variant in the alcohol dehydrogenase 1B gene (ADH1B) as an instrument to investigate the causal role of alcohol in cardiovascular disease. DESIGN: Mendelian randomisation meta-analysis of 56 epidemiological studies. PARTICIPANTS: 261 991 individuals of European...... descent, including 20 259 coronary heart disease cases and 10 164 stroke events. Data were available on ADH1B rs1229984 variant, alcohol phenotypes, and cardiovascular biomarkers. MAIN OUTCOME MEASURES: Odds ratio for coronary heart disease and stroke associated with the ADH1B variant in all individuals...... subtypes of stroke, carriers of the A-allele had lower odds of ischaemic stroke (odds ratio 0.83 (0.72 to 0.95)). CONCLUSIONS: Individuals with a genetic variant associated with non-drinking and lower alcohol consumption had a more favourable cardiovascular profile and a reduced risk of coronary heart...
de Visser, C L; Bilo, H J G; Groenier, K H; de Visser, W; Jong Meyboom-de, B
In type 2 diabetes mellitus, disease-related complications have a considerable effect on the quality of life. We studied the influence of cardiovascular disease on quality of life in type 2 diabetic patients in a longitudinal design. We also studied whether quality of life in any way predicts the manifestation of cardiovascular disease. A prospective cohort study from April 1996 to October 1999. In 1996 and 1999 all known type 2 diabetics from the population of Urk, the Netherlands, were invited by their general practitioners (GPs) for extensive check-up. In both years quality of life was assessed using the generic RAND-36 and the disease-specific Diabetes Health Profile (DHP). In the intermediate period, cardiovascular morbidity and mortality were registered by the GPs. In 1996, 281 patients were examined and 248 (88.3%) persons completed the questionnaires. After 3 years 189 persons (67.3%) were re-examined and 161 (85.2%) handed in the questionnaire. When compared to diabetics without cardiovascular disease, diabetics with cardiovascular disease had a lower quality of life. Multiple regression analysis showed that contracting cardiovascular disease negatively affects the RAND-36 dimensions 'social functioning', 'vitality' and 'health change'. Cox's regression analysis showed a negative relation between the RAND-36 dimensions 'physical functioning', and time to the manifestation of cardiovascular disease. The DHP appeared not to be suitable to measure quality of life in relation to cardiovascular disease. In type 2 diabetics, cardiovascular disease has a negative effect on quality of life. A decreased quality of life is associated with a short-term manifestation of cardiovascular disease.
Wooton, Angela K; Melchior, Lynne M; Coan, Lorinda L; Reddington, Amanda R
Collaborative efforts between health team members can advance early detection of children with elevated blood glucose levels, preventing hyperglycemia and periodontal diseases. Rates of obesity are increasing in children, impacting the prevalence of type 2 diabetes mellitus and periodontal diseases. Collaborative care between nurse practitioners and dental hygienists can detect, prevent, and treat periodontal disease in children.
Goettsch, Claudia; Kjølby, Mads Fuglsang; Aikawa, Elena
of sortilin's contributions to cardiovascular and metabolic diseases but focuses particularly on atherosclerosis. We summarize recent clinical findings that suggest that sortilin may be a cardiovascular risk biomarker and also discuss sortilin as a potential drug target.......Cardiovascular disease is a leading cause of morbidity and mortality in the Western world. Studies of sortilin's influence on cardiovascular and metabolic diseases goes far beyond the genome-wide association studies that have revealed an association between cardiovascular diseases and the 1p13...
Zalesin, Kerstyn C
Obesity promotes a cascade of secondary pathologies including diabetes, insulin resistance, dyslipidemia, inflammation, thrombosis, hypertension, the metabolic syndrome, and OSA, which collectively heighten the risk for cardiovascular disease. Obesity may also be an independent moderator of cardiac risk apart from these comorbid conditions. Rates of obesity and cardiac disease continue to rise in a parallel and exponential manner. Because obesity is potentially one of the most modifiable mediators of cardiovascular morbidity and mortality, effective treatment and prevention interventions should have a profound and favorable impact on public health.
Oh, Jee-Young; Allison, Matthew A; Barrett-Connor, Elizabeth
Although the prevalence rates of hypertension (HTN) and diabetes mellitus are slowing in some high-income countries, HTN and diabetes mellitus remain as the two major risk factors for atherosclerotic cardiovascular disease (CVD), the leading cause of death in the United States and worldwide. We aimed to observe the association of HTN and diabetes mellitus with all-cause and CVD mortality in older white adults. All community-dwelling Rancho Bernardo Study participants who were at least 55 years old and had carefully measured blood pressure and plasma glucose from 75-g oral glucose tolerance test at the baseline visit (1984-1987, n = 2186) were followed up until death or the last clinic visit in 2013 (median 14.3 years, interquartile range 8.4-21.3). In unadjusted analyses, diabetes mellitus was associated with all-cause mortality [hazard ratio 1.40, 95% confidence interval (CI) 1.23-1.60] and CVD mortality (hazard ratio 1.67, 95% CI 1.39-2.00); HTN with all-cause mortality [hazard ratio 1.93 (1.73-2.15)] and CVD mortality [hazard ratio 2.45 (2.10-2.93)]. After adjustment for cardiovascular risk factors, including age, BMI, triglycerides, HDL-cholesterol, smoking, exercise, and alcohol consumption, diabetes mellitus was associated with CVD mortality only (hazard ratio 1.25, P = 0.0213). Conversely, HTN was associated with both all-cause (hazard ratio 1.34, P diabetes mellitus and HTN was associated with all-cause (hazard ratio 1.38, P = 0.0002) and CVD mortality (hazard ratio 1.70, P diabetes mellitus. Having both confers a modest increase in the hazards for these types of mortality.
Steffens, João Paulo; Glaci Reinke, Stella Maria; Angel Muñoz, Miguel; Santos, Fábio André dos; Luiz Pilatti, Gibson
There may be an interaction between periodontal disease and some systemic diseases such as diabetes mellitus. The objective of this review was to verify, by means of a review of clinical trials, if there is a positive association between periodontal disease and the glycemic control of type 2 diabetes mellitus (DM-2) patients. Eleven articles that fi t the study criteria were revised. It was concluded that periodontal disease may influence the metabolic control of DM-2. Additional studies with larger sample sizes and longer follow up are necessary for a better clarification of this issue.
R.W.J. Leunissen (Ralph)
textabstractTh is doctoral thesis describes the infl uence of diff erent growth patterns during childhood on determinants of adult disease, like cardiovascular disease, type 2 diabetes mellitus and osteoporosis, in healthy young adults. Additionally, diff erences in these determinants are described
Cardiovascular risk management is common in patients suffering from manifest cardiovascular disease, hypertension, hyperlipidaemia and diabetes mellitus. It is generally accepted that medication is the most effective treatment for reducing cardiovascular morbidity and mortality in these patients.
Elwood, P C; Hughes, C; O'Brien, J R
Aspirin was first synthesised 100 years ago and its preparation and marketing is generally reckoned to have been the foundation of the pharmaceutical industry. For most of the time since then it has been used for the relief of pain and fever. The modern phase of aspirin use commenced with the reporting in 1974 of a randomised controlled trial in the secondary prevention of death by low-dose aspirin given to patients who had suffered a myocardial infarct. Reports of other trials followed and an overview of the first six trials was presented to the inaugural meeting of the Society for Clinical Trials in Philadelphia in 1980. There have been two further major overviews and the most recent, based on 145 trials, established that low-dose aspirin reduces vascular events by around one third. It has been estimated that, used appropriately, aspirin could prevent 100,000 premature deaths each year worldwide, at a cost of about 250 Pounds ($400) per life saved, and about 80 Pounds ($130) per cardiovascular event prevented. The evidence indicates that it is seriously underused at present. The aspirin story continues and trials are in progress to test other possible uses of aspirin, in vascular dementia, colorectal cancer, and cataract.
Holmstrup, Palle; Flyvbjerg, Allan
and the presence of bacteria in the periodontal pockets, which, as the result of daily procedures, may spread after penetration of the vasculature, are possible mediators of systemic consequences. This chapter deals with the possible association between periodontitis and diabetes mellitus which is believed...
Holmes, Michael V; Dale, Caroline E; Zuccolo, Luisa
OBJECTIVE: To use the rs1229984 variant in the alcohol dehydrogenase 1B gene (ADH1B) as an instrument to investigate the causal role of alcohol in cardiovascular disease. DESIGN: Mendelian randomisation meta-analysis of 56 epidemiological studies. PARTICIPANTS: 261 991 individuals of European des...
Cooney, Marie Therese
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.
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 ...
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
R.F.M. van Schie (Rianne); T.I. Verhoef (Talitha); A-H. Maitland-van der Zee (Anke-Hilse); A.C. de Boer (Anthonius); F.J.M. van der Meer (Felix); W.K. Redekop (Ken); R. Thariani (Rahber)
textabstractIntroduction: Pharmacogenetics is the study of variations in DNA sequence as related to drug response (European Medicines Agency [EMA], 2007). Several gene-drug interactions have been discovered in the field of cardiovascular diseases (CVDs). These gene-drug interactions can help to
Felix, Renata Christian Martins; Gouvea, Clecio Maria, E-mail: email@example.com, E-mail: firstname.lastname@example.org [Instituto Nacional de Cardiologia, Rio de Janeiro, RJ (Brazil); Carneiro, Michel Pontes [Instituto Nacional de Cancer (INCA), Rio de Janeiro, RJ (Brazil); Mesquita, Claudio Tinoco [Universidade Federal Fluminense (UFF), Niteroi, RJ (Brazil)
Many articles have demonstrated the role of PET-CT in the evaluation of inflammatory and infectious diseases of the cardiovascular system. The purpose of this article is to provide a review of the literature on this topic to identify clinical situations in which there is evidence of the usefulness of PET-CT in diagnostic and therapeutic evaluation.
Background Evidence is accumulating that lifestyle factors influence the incidence of fatal and non-fatal cardiovascular diseases (CVD). A healthy diet, being physically active, moderate alcohol consumption and not smoking are associated with a lower CVD risk. In addition to
Ganz, Melanie; de Bruijne, Marleen; Nielsen, Mads
Despite general acceptance that a healthy lifestyle and the treatment of risk factors can prevent the development of cardiovascular diseases (CVD), CVD are the most common cause of death in Europe and the United States. It has been shown that abdominal aortic calcifications (AAC) correlate strong...
Wu, Ying-Ying; Xiao, E; Graves, Dana T
Diabetes mellitus and periodontal disease are chronic diseases affecting a large number of populations worldwide. Changed bone metabolism is one of the important long-term complications associated with diabetes mellitus. Alveolar bone loss is one of the main outcomes of periodontitis, and diabetes is among the primary risk factors for periodontal disease. In this review, we summarise the adverse effects of diabetes on the periodontium in periodontitis subjects, focusing on alveolar bone loss. Bone remodelling begins with osteoclasts resorbing bone, followed by new bone formation by osteoblasts in the resorption lacunae. Therefore, we discuss the potential mechanism of diabetes-enhanced bone loss in relation to osteoblasts and osteoclasts.
Wu, Ying-Ying; Xiao, E; Graves, Dana T
Diabetes mellitus and periodontal disease are chronic diseases affecting a large number of populations worldwide. Changed bone metabolism is one of the important long-term complications associated with diabetes mellitus. Alveolar bone loss is one of the main outcomes of periodontitis, and diabetes is among the primary risk factors for periodontal disease. In this review, we summarise the adverse effects of diabetes on the periodontium in periodontitis subjects, focusing on alveolar bone loss. Bone remodelling begins with osteoclasts resorbing bone, followed by new bone formation by osteoblasts in the resorption lacunae. Therefore, we discuss the potential mechanism of diabetes-enhanced bone loss in relation to osteoblasts and osteoclasts. PMID:25857702
Khan, S.B.; Rehman, H.U.; Hafeezullah, M.; Gul, A.M.
Background: Globally, obesity is now recognised as an epidemic. The degree of obesity is proportional to the rate of development of cardiovascular diseases, hence, resulting in a dramatic increase in morbidity and mortality. Apart from obesity, diabetes mellitus is another well recognised risk factor contributing to coronary artery disease. The precise prevalence of obesity-related diabetes varies with age, race and gender; and is yet unknown in our population. We therefore, carried out study with the aim to determine the prevalence of diabetes mellitus in obese and non-obese patients with diagnosed coronary artery disease. Methods: This hospital based cross-sectional comparative study was conducted in Cardiology Department of Postgraduate Medical Institute, Lady Reading Hospital, Peshawar, from March 15, 2005 to May 30, 2006. A total of 200 patients with diagnosed coronary artery disease were enrolled, 100 were classified as obese and 100 as non-obese. Results: Among these, 139 patients were male and 61 female. A total of 88 were found to be diabetic, 54 of these were obese and 34 non-obese (p =0.004). Conclusion: Diabetes mellitus was significantly more frequent among obese patients with coronary artery disease as compared to non obese patients with coronary artery disease. (author)
Agudo Villa, Teresa; Álvarez-Rodríguez, Esther; Caurel Sastre, Zaida; Martín Martínez, Alfonso; Merinero Palomares, Raúl; Alvarez Rodríguez, Virginia; Portero Sánchez, Isabel
To analyze the risk profile of patients with diabetes who seek care from hospital emergency departments and emergency department involvement in preventing cardiovascular complications in these patients. Cross-sectional analysis of case series from 2 Spanish hospital emergency departments. We included all patients with a history or final diagnosis of diabetes mellitus who were treated in the emergency department between November 1, 2010, and June 30, 2011. Each patient's cardiovascular risk profile was analyzed. The main outcome was the appropriate of prescribed treatment to prevent cardiovascular complications according to the 2012 guidelines of the American Diabetes Association on the patient's discharge from emergency care. A total of 298 patients were included; 275 (92%) had type II diabetes. Ninety percent of the series (269 patients) had at least 1 cardiovascular risk factor and 147 (49%) had prior target organ damage; target organ damage was newly diagnosed in 41 (14%). Fifty-eight percent (172 patients) were discharged home from the emergency department. Although 215 patients (72%) were not adhering to at least 1 previously prescribed preventive treatment and 30 (10%) were not adhering to any prescribed treatment, drug prescriptions were modified only in 1.1% to 3.3% of patients and no follow-up was recommended in 42 cases (24%). Although diabetic patients treated in emergency departments are at high risk for cardiovascular complications, their visit is not used to optimize preventive treatment for these complications or ensure appropriate follow-up.
Soriguer, Federico; Morcillo, Sonsoles; Hernando, Virginia; Valdés, Sergio; Ruiz de Adana, Maria Soledad; Olveira, Gabriel; Fuentes, Eduardo García; González, Inmaculada; Tapia, Maria José; Esteva, Isabel; Rojo-Martínez, Gemma
The aim of this study was to undertake a prospective study of the changes in certain risk factors for cardiovascular disease occurring during menopause. A longitudinal cohort study of 475 women was followed up for 6 years (Pizarra Study). The final menstrual period was defined after at least 6 months of amenorrhea. The women were classified into three groups: group 1, no menopause at either the first or second study; group 2, no menopause at the first study but menopause at the second study (6 y later); and group 3, menopause at the first study (and also at the second). The following are the main outcome measures used: age; body mass index; waist circumference; waist-to-hip ratio; skinfold thickness; arm circumference; intake of macronutrients (quantitative questionnaire); systolic and diastolic blood pressures; cholesterol, triglycerides; high-density lipoprotein cholesterol; uric acid; homeostasis model assessment of insulin resistance; and the prevalence of obesity, hypertension, type 2 diabetes mellitus, impaired glucose tolerance, and impaired fasting glucose. None of the cardiovascular risk factors studied changed during the passage from premenopause to postmenopause, independently of age or physical activity. Menopause is a biological condition of the human species, for which has recently received attempts at medicalization that were not always justified. If menopause is not accompanied by any other cardiovascular risk factor independently of age, the stigma of menopause being considered a risk factor should cease. Although the results have the strength of a prospective study, the sample size forced us to consider these findings as preliminary.
A major cause of morbidity and early death in the Western societies is cardiovascular disease (CVD) secondary to atherosclerotic disease. Metabolic aberrations have been linked to CVD. Particular combinations of these so-called risk markers are common and (central) obesity, Type 2 diabetes, impaired glucose tolerance, hypertension, dyslipidemia, dysfibrinolysis and hyperinsulinemia are often associated. This has been entitled the Insulin Resistance Syndrome (1RS), due to underlying insulin re...
Yusuf, Salim; Ounpuu, Stephanie; Anand, Sonia
Of the 50 million deaths that occur in the world, 40 million occur in developing countries. Already a substantial proportion of these deaths are due to cardiovascular diseases. It is projected that by the year 2025 well over 80-90% of all the cardiovascular diseases in the world will be occurring in low income and middle income countries. This increase in cardiovascular disease is due to a number of causes which include the following: (1) conquest of deaths in childhood and infancy from nutritional deficiencies and infection; (2) urbanization with increasing levels of obesity; (3) increasing longevity of the population so that a higher proportion of individuals reach the age when they are subject to chronic diseases, and (4) increasing use of tobacco worldwide. In most countries in the world other than those in the West, the burden of disease is still due to a combination of infections and nutritional disorders as well as those due to chronic diseases. This double burden of disease poses a challenge that is not only medical and epidemiological, but also social and political. Tackling this projected global epidemic of cardiovascular disease therefore needs policies that combine sound knowledge of prevention, good clinical care, but also deals with the allocation of resources for both individual level and community level preventive strategies. The former involves dealing with high-risk individuals through appropriate medical and therapeutic interventions. The latter involves societal level changes including laws that curb the use of tobacco, and strategies that promote physical activities, and appropriate nutrition. Copyright 2002 S. Karger AG, Basel
The impact of type 2 diabetes and Microalbuminuria on future cardiovascular events in patients with clinically manifest vascular disease from the Second Manifestations of ARTerial Disease (SMART) study
Soedamah-Muthu, S.S.; Visseren, F.L.J.; Algra, A.; Graaf, van der Y.
Aims Type 2 diabetes mellitus and microalbuminuria are important risk factors for cardiovascular disease (CVD). Whether these two complications are important and independent risk factors for future CVD events in a high-risk population with clinically manifest vascular disease is unknown. The
Ahmet Midhat Elmacı
Full Text Available Cardiovascular diseases are the principal cause of morbidityand mortality among child and adults with chronicrenal disease. Recent data demonstrate a high incidenceand prevalence of traditional and uremia related cardiovascularrisk factors in children. This review summarizesthe current literature on cardiovascular risk factors, mortalityand morbidity in children with chronic kidney disease.Key words: Child, chronic kidney disease, cardiovascular
Rodríguez Rodríguez, Luis Pablo
The indication of physical activity in patients with Diabetes mellitus type 2 and in the metabolic syndrome has a scientific proven evidence. There does no exist a general definite program of this activity. There is designed his methodology, modality, intensity, frequency and duration. The first results are presented in diabete type 2 patients and of them those who meet with metabolic syndrome by means of evaluation of the HbA1c, total cholesterol, triglycerides and IMC. On emphasizes that there is reached a very high and linear decrease of the HbA1c, with the individualized program of physical cardiovascular activity.
Bello, Natalie A; Pfeffer, Marc A; Skali, Hicham; McGill, Janet B; Rossert, Jerome; Olson, Kurt A; Weinrauch, Larry; Cooper, Mark E; de Zeeuw, Dick; Rossing, Peter; McMurray, John J V; Solomon, Scott D
Objective Retinopathy is an established microvascular complication of type 2 diabetes mellitus (T2DM), but its independent relationship with macrovascular and other microvascular complications is less well defined across the spectrum of kidney disease in T2DM. We examined the prognostic value of retinopathy in assessing the risk of developing end-stage renal disease (ESRD), cardiovascular morbidity or death among patients in the Trial to Reduce cardiovascular Events with Aranesp Therapy (TREAT). Design TREAT enrolled 4038 patients with T2DM, chronic kidney disease (CKD) and moderate anemia. Patients were grouped by baseline history of retinopathy. Proportional hazards regression models were utilized to assess the association between retinopathy and subsequent ESRD, cardiovascular morbidity or death over an average of 2.4 years. Results Although younger, the 1895 (47%) patients with retinopathy had longer duration of diabetes, lower estimated glomerular filtration rate, more proteinuria, and more microvascular complications. In univariate analysis, retinopathy was associated with a higher rate of ESRD, but not with cardiovascular events or mortality. After adjustment, retinopathy was no longer statistically significant for the prediction of ESRD or any clinical endpoint. Conclusions In a large cohort of patients with T2DM, CKD, and anemia, retinopathy was common but not independently associated with a higher risk of renal or cardiovascular morbidity or death. Trial registration number NCT00093015 PMID:25452859
Abildstrøm, Steen Z; Torp-Pedersen, Christian; Madsen, Mette
Introduction: The use of the unique personal identification number in the Nordic database systems enables the researchers to link the registers at the individual level. The registers can be used for both defining specific patient populations and to identify later events during follow-up. This rev...... the hospitalisation rate and treatment of cardiovascular disease. The risk of unmeasured factors affecting the results calls for cautious interpretation of the results.......-up. This review gives three examples within cardiovascular epidemiology to illustrate the use of the national administrative registers available to all researchers upon request. Research topics: The hospitalisation rate of acute myocardial infarction (AMI) was expected to be increased and case-fatality rate......-based treatment increased significantly over time and adherence to treatment was high. Finally, use of specific nonsteroidal antiinflammatory drugs by healthy subjects was associated with a dose-dependent increase in cardiovascular risk. CONCLUSION: The nationwide registers have proven very useful in monitoring...
Cruz Rodríguez, Mayerlin; Pontificia Universidad Javeriana; Cárdenas, Sebastián; Pontificia Universidad Javeriana; Moreno, Freddy; Pontificia Universidad Javeriana; Moreno, Sandra; Pontificia Universidad Javeriana
Periodontitis is a multifactorial and complex chronic inflammatory and infectious disease which has been linked to various systemic complications, including cardiovascular disease. This association has been difficult to prove because epidemiological studies are biased or classic risk factors that are difficult to control, cardiovascular disease also includes a variety of multifactorial diseases also making it even more difficult to determine the cause-effect. The studies reported in the liter...
D'Amore Patricia A
Full Text Available Abstract The identification of angiogenic growth factors, such as vascular endothelial growth factor and fibroblast growth factor, has fueled interest in using such factors to induce therapeutic angiogenesis. The results of numerous animal studies and clinical trials have offered promise for new treatment strategies for various ischemic diseases. Increased understanding of the cellular and molecular biology of vessel growth has, however, prompted investigators and clinicians alike to reconsider the complexity of therapeutic angiogenesis. The realization that formation of a stable vessel is a complex, multistep process may provide useful insights into the design of the next generation of angiogenesis therapy.
Gaceb, Abderahim; Martinez, Maria Carmen; Andriantsitohaina, Ramaroson
Extracellular vesicles, particles released by all cell types, represent a new way to convey information between cells such as proteins, second messengers, and genetic information to modify the phenotype and function of the target cells. Recent data suggest that extracellular vesicles play a crucial role in both physiology and pathology, including coagulation, angiogenesis, cell survival, modulation of the immune response, and inflammation. Thus extracellular vesicles participate in the processes of cardiovascular diseases from atherosclerosis, myocardial infarction to heart failure. Consequently, extracellular vesicles can potentially be exploited for therapy, prognosis, and biomarkers for health and disease. This review focuses on the role of extracellular vesicles in the development of cardiovascular diseases, as well as the deleterious and beneficial effects that they may provide in vascular cells and myocardium. Copyright © 2014 Elsevier Ltd. All rights reserved.
Morrison, John A; Glueck, Charles J.; Wang, Ping
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
van der Graaf, Anouk; Hutten, Barbara A.; Kastelein, John J. P.; Vissers, Maud N.
Heterozygous familial hypercholesterolemia is associated with elevated low-density lipoprotein cholesterol levels and the development of premature cardiovascular disease. Despite this general statement, data regarding the incidence of cardiovascular disease in young women with familial
Boulbou, Mary S; Gourgoulianis, Konstantinos I; Krommydas, George C; Klisiaris, Vasilios K; Arseniou, Aggelos A; Dafopoulos, Konstantinos C; Molyvdas, Paschalis A
In type II diabetes mellitus there are few data concerning pulmonary function abnormalities. In normal subjects and in patients with primary Raynaud phenomenon, cold pressor test induces a decrease in carbon monoxide single-breath diffusing capacity (DL,co) but not in secondary Raynaud phenomenon. Our objective was to assess evaluation of lung diffusion capacity postural changes in diabetes mellitus and in secondary Raynaud phenomenon, two diseases with different pulmonary capillaries functional disorders. Twenty-five patients with type II diabetes mellitus (mean age 52.24 years), 17 patients with secondary Raynaud phenomenon (mean age 47.06 years), non-smokers without pulmonary or heart disease, and 26 healthy matched subjects (mean age 47.50 years) underwent lung diffusion capacity measurements by single-breath method also corrected by alveolar volume (DL,co) in sitting and supine positions. Patients with diabetes mellitus exhibited lower values of DL,co and DL,co/VA measurements in comparison with subjects with Raynaud phenomenon and control group (p Raynaud phenomenon and in control group after cold pressor test showed a significant increase in DL,co/VA (120.93 vs. 109.78 in Raynaud and 114.36 vs. 99.47 in control group, p disease resulting from different pathophysiologic mechanisms such as diabetes mellitus and Raynaud phenomenon.
Jiang, Shengyang; Jiang, Donglin; Tao, Yijia
Cardiovascular diseases are threatening human health with rising morbidity and mortality rates. Gamma-glutamyltransferase (GGT) has been found to be involved in the pathogenesis of cardiovascular diseases, especially coronary artery disease, and the prognosis of cardiovascular disease may be predicted by increasing GGT levels. GGT levels are related to cardiovascular emergencies of chronic heart failure, and an elevated GGT level has been shown to be an independent predictive maker for cardia...
Alali, Feras Q; El-Elimat, Tamam; Khalid, Lila; Hudaib, Reema; Al-Shehabi, Tuqa Saleh; Eid, Ali H
Cardiovascular disease (CVD) is the leading cause of global mortality with a substantial economic impact. The annual deaths are expected to increase in the next decade. An array of dietary supplements is being used by people worldwide to ameliorate cardiovascular risk factors. Garlic (Allium sativum L.), a top-selling herbal dietary supplement, is renowned for its wide range beneficial effects, particularly in the treatment and prevention of CVD. This review aims to present a thorough discussion of the available evidence-based data which support the use of garlic in the treatment or prevention of cardiovascular diseases, including atherosclerosis, hypertension, and hyperlipidemia. The molecular mechanisms underlying these effects are dissected as well. This review supports the notion that garlic has the potential to treat mild hypertension, to decrease hypercholesterolemia, and to prevent atherosclerosis. More clinical studies are essential to unequivocally understand the mechanisms underlying treatment or prevention of these cardiovascular conditions. Copyright© Bentham Science Publishers; For any queries, please email at email@example.com.
Aursulesei, Viviana; Cozma, A; Krasniqi, A
Iron hypothesis has been a controversial subject for over 30 years as many studies support its role as a risk factor for cardiovascular disease, while other studies found no evidence to support it. The conflicting results are accounted for by the non-homogeneity of trial design in terms of population inclusion criteria and different endpoints, non-uniform use of parameters for assessing iron role, and incomplete understanding of the mechanisms of action. The nature of iron is dual, being of crucial importance for the human body, but also toxic as "free iron" induces oxidative stress. Under physiological conditions, there are efficient and complex mechanisms against iron-induced oxidative stress, which could be reproduced for creating new, intelligent antioxidants. Iron depletion improves the cardiovascular prognosis only if serum concentration is at the lowest limit of normal ranges. However, low iron levels and the type of dietary iron intake correlate with atherosclerotic cardiovascular disease, influence the ischemic endpoints in the elderly, and exert negative impact on heart failure prognosis. So far, the causal relation and involved mechanisms are not fully elucidated. Iron overload is a difficult and frequent condition, involving the cardiovascular system by specific pathogenic pathways, therefore determining a particular form of restrictive cardiomyopathy and vaso-occlusive arterial damage.
Ananth, Cande V.; Hansen, Anne Vinkel; Williams, Michelle A.
Background: Cardiovascular (CVD) complications stemming from vascular dysfunction have been widely explored in the setting of preeclampsia. However, the impact of abruption, a strong indicator of microvascular disturbance, on the risk of CVD mortality and morbidity remains poorly characterised...... person-years, respectively (HR 1.5, 95% CI 1.4, 1.8). The increased risks were evident for ischaemic heart disease, acute myocardial infarction, hypertensive heart disease, non-rheumatic valvular disease, and congestive heart failure. Conclusions: This study shows increased hazards of CVD morbidity...
Cardiovascular primary prevention and regeneration programs are the contemporary frontiers in functional metabolic vascular medicine. This novel science perspective harnesses our inherent ability to modulate the interface between specialized gene receptors and bioavailable nutrients in what is labeled as the nutrient-gene interaction. By mimicking a natural process through the conveyance of highly absorbable receptor specific nutrients, it is feasible to accelerate cell repair and optimize mitochondrial function, thereby achieving cardiovascular cure. We performed a comprehensive review of PubMed, EMBASE and Cochrane Review databases for articles relating to cardiovascular regenerative medicine, nutrigenomics and primary prevention, with the aim of harmonizing their roles within contemporary clinical practice. We searched in particular for large-scale randomized controlled trials on contemporary cardiovascular pharmacotherapies and their specific adverse effects on metabolic pathways which feature prominently in cardiovascular regenerative programs, such as nitric oxide and glucose metabolism. Scientific research on \\'cardiovascular-free\\' centenarians delineated that low sugar and low insulin are consistent findings. As we age, our insulin level increases. Those who can decelerate the rapidity of this process are prompting their cardiovascular rejuvenation. It is beginning to dawn on some clinicians that contemporary treatments are not only failing to impact on our most prevalent diseases, but they may be causing more damage than good. Primary prevention programs are crucial elements for a better outcome. Cardiovascular primary prevention and regeneration programs have enhanced clinical efficacy and quality of life and complement our conventional endovascular practice.
Full Text Available BackgroundThe aim of this study was to investigate the influences of visceral adiposity on cardiovascular autonomic neuropathy (CAN in patients with type 2 diabetes mellitus.MethodsTwo hundred eleven patients with type 2 diabetes participated in this study. Anthropometric and metabolic parameters were measured, and the visceral fat area was assessed using computed tomography. CAN was diagnosed using a cardiovascular reflex test. We analyzed the correlation between the visceral fat area and each parameter in this test.ResultsThe mean age, body mass index (BMI, and duration of diabetes of the study population were 60±14 years (mean±standard deviation, 25.1±4.2 kg/m2, and 12.3±8.9 years, respectively. The visceral fat area showed positive correlations with age, BMI, waist circumference, and subcutaneous fat area. There was no statistically significant difference in the cardiovascular reflex test outcome between genders. Univariate linear regression analysis showed that an increased visceral fat area diminished good heart rate response to a Valsalva maneuver (R2=4.9%, P=0.013 in an unadjusted model, but only in women. This statistical association was preserved after adjusting for age and BMI (R2=9.8%, P=0.0072.ConclusionThe results of this study suggest that visceral adiposity contributes to an autonomic imbalance to some degree, as demonstrated by the impaired cardiovascular reflex test among women with type 2 diabetes.
Almdal, Thomas; Scharling, Henrik; Jensen, Jan Skov
BACKGROUND: Epidemiological studies have reported that patients with type 2 diabetes mellitus (DM) have increased mortality and morbidity from cardiovascular diseases, independent of other risk factors. However, most of these studies have been performed in selected patient groups. The purpose...... of the present study was prospectively to assess the impact of type 2 DM on cardiovascular morbidity and mortality in an unselected population. METHODS: A total of 13,105 subjects from the Copenhagen City Heart Study were followed up prospectively for 20 years. Adjusted relative risks of first, incident......, admission for, or death from ischemic heart disease, acute myocardial infarction, or stroke, as well as total mortality in persons with type 2 DM compared with healthy controls, were estimated. RESULTS: The relative risk of first, incident, and admission for myocardial infarction was increased 1.5- to 4...
Johar, N; Dhodapkar, S V; Kumar, R; Verma, T; Jajoo, A
The present study was undertaken to determine the relationship between periodontal and cardiovascular disease. Previous studies have shown some co-relation between the two conditions. We included 186 patients divided into four groups. First two Groups (A1 & A2) were the patients with cardiac disease (100 in numbers) whilst Groups (B1 & B2) (86 in numbers) were treated as controls (without cardiac disease). Following markers of periodontal disease were assessed - plaque index, calculus index, gingival and periodontal index. Markers of cardiovascular disease included were LDL, HDL, total cholesterol and CRP. Ramfjords periodontal index was used to assess the extent of periodontal disease. In the present study there was a significant increase in CRP levels in Group A1 (CVD + PD) compared to controls and overall the two cardiac groups showed a significant increase in CRP compared to controls. There was a non-significant change in lipid profile markers (LDL, HDL and total cholesterol). Periodontal Disease Index (PDI) was also increased in Group A1 compared to other groups except Group B1 and overall in cardiac groups compared to non-cardiac (PD) groups. In this study no correlation between periodontal and cardiovascular disease was found. This may be due intake of statins by few patients in Group A with a confirmed diagnosis of cardiovascular disease.
At NASA's Jet Propulsion Laboratory (JPL), NASA-developed Video Imaging Communication and Retrieval (VICAR) software laid the groundwork for analyzing images of all kinds. A project seeking to use imaging technology for health care diagnosis began when the imaging team considered using the VICAR software to analyze X-ray images of soft tissue. With marginal success using X-rays, the team applied the same methodology to ultrasound imagery, which was already digitally formatted. The new approach proved successful for assessing amounts of plaque build-up and arterial wall thickness, direct predictors of heart disease, and the result was a noninvasive diagnostic system with the ability to accurately predict heart health. Medical Technologies International Inc. (MTI) further developed and then submitted the technology to a vigorous review process at the FDA, which cleared the software for public use. The software, patented under the name Prowin, is being used in MTI's patented ArterioVision, a carotid intima-media thickness (CIMT) test that uses ultrasound image-capturing and analysis software to noninvasively identify the risk for the major cause of heart attack and strokes: atherosclerosis. ArterioVision provides a direct measurement of atherosclerosis by safely and painlessly measuring the thickness of the first two layers of the carotid artery wall using an ultrasound procedure and advanced image-analysis software. The technology is now in use in all 50 states and in many countries throughout the world.
Nickens, Myrna Alexander; Long, Robert Craig; Geraci, Stephen A
Cardiovascular disease is the leading cause of death generally and the most common cause of death during pregnancy in industrialized countries. Improvement in early diagnosis and treatment of congenital heart disease has increased the number of women with such conditions reaching reproductive age. The growing prevalence of diabetes, hypertension, obesity, hyperlipidemia, and metabolic syndrome has concurrently added to the population of pregnant women with acquired heart disease, including coronary artery disease. Physiologic changes occurring during pregnancy can stress a compromised cardiovascular system, resulting in maternal morbidity, mortality, and compromised fetal outcomes. These risks complicate affected women's decisions to become pregnant, their ability to carry a pregnancy to term, and the complexity and risk benefit of cardiovascular treatments delivered during pregnancy. Risk assessment indices assist the obstetrician, cardiologist, and primary care provider in determining the general prognosis of the patient during pregnancy and although imperfect, can aid patients in making informed decisions. Treatments must be selected that ideally benefit the health of both mother and fetus and at a minimum limit risk to the fetus during gestation.
Ebrahimi, Mahmoud; Heidari-Bakavoli, Ali Reza; Shoeibi, Sara; Mirhafez, Seyed Reza; Moohebati, Mohsen; Esmaily, Habibollah; Ghazavi, Hamed; Saberi Karimian, Maryam; Parizadeh, Seyed Mohammad Reza; Mohammadi, Maryam; Mohaddes Ardabili, Hossein; Ferns, Gordon A; Ghayour-Mobarhan, Majid
Diabetes mellitus remains one of the major health problems of the 21st century and is associated with comorbidities including obesity and metabolic abnormalities. The study was conducted to evaluate serum high-sensitivity C-reactive protein (hs-CRP) levels, as a marker of inflammation, in a large sample of Iranian population without a history of cardiovascular or inflammatory disease and cancer, and to relate this to fasting blood glucose (FBG) and the presence of diabetes mellitus. The study consisted of 7,762 subjects divided into four groups-nonobese/nondiabetic, obese/nondiabetic, nonobese/diabetic and obese/diabetic-based on the BMI classification and their FBG. Anthropometric characteristics were measured and blood was collected for the evaluation of fasted lipid profile, FBG and serum hs-CRP levels. Several clinical and biochemical characteristics were significantly different among the four groups: FBG, P 3 mg/dl had higher TC (P < 0.001), low-density lipoprotein cholesterol (LDL-C, P < 0.001), TG (P < 0.001), fat percentage (P < 0.001), and systolic and diastolic blood pressure (P < 0.001) compared with subjects with a serum hs-CRP <3 mg/dl. Multivariate analysis showed FBG, LDL-C, and waist circumference (WC) associated with increased serum hs-CRP levels (P < 0.001). FBG, LDL-C, WC and gender are independently associated with serum hs-CRP concentrations. © 2016 Wiley Periodicals, Inc.
Full Text Available Background and aims Diabetes mellitus (DM is one of the leading causes of end-stage chronic kidney disease (CKD. Patients with DM and CKD have a 10 or even 20 times higher cardiovascular risk (CVR than the general population. Lipid metabolism disorders are more frequent in these patients, dyslipidemia being aggravated by the presence of hyperglycemia and insulin resistance. The main purpose of our study was to identify possible correlations between lipid profile parameters and altered renal function in patients with DM. We have also analyzed the correlations between lipid parameters, CKD, quality of glycemic control and CVR.
Garcia, Mariana; Mulvagh, Sharon L.; Merz, C. Noel Bairey; Buring, Julie E.; Manson, JoAnn E.
Cardiovascular disease (CVD) continues to be the leading cause of death among women in the United States, accounting for approximately one of every three female deaths. Sex-specific data focused on CVD has been increasing steadily, yet is not routinely collected nor translated into practice. This comprehensive review focuses on novel and unique aspects of cardiovascular health in women and sex-differences as they relate to clinical practice in the prevention, diagnosis, and treatment of CVD. This review also provides current approaches to the evaluation and treatment of acute coronary syndromes that are more prevalent in women, including: myocardial infarction associated with non-obstructive coronary arteries, spontaneous coronary artery dissection, and stress-induced cardiomyopathy (Takotsubo Syndrome). Other CVD entities with higher prevalence or unique considerations in women, such as heart failure with preserved ejection fraction, peripheral arterial disease and abdominal aortic aneurysms, are also briefly reviewed. Lastly, recommendations for cardiac rehabilitation are addressed. PMID:27081110
Dohadwala, Mustali M.; Vita, Joseph A.
Epidemiological studies suggest that consumption of wine, grape products, and other foods containing polyphenols is associated with decreased risk for cardiovascular disease. The benefits of wine consumption appear to be greater than other alcoholic beverages. Experimental studies indicate that grape polyphenols could reduce atherosclerosis by a number of mechanisms, including inhibition of oxidation of LDL and other favorable effects on cellular redox state, improvement of endothelial function, lowering blood pressure, inhibition of platelet aggregation, reducing inflammation, and activating novel proteins that prevent cell senescence, e.g. Sirtuin 1. Translational studies in humans support these beneficial effects. More clinical studies are needed to confirm these effects and formulate dietary guidelines. The available data, however, strongly support the recommendation that a diet rich in fruits and vegetables, including grapes, can decrease the risk for cardiovascular disease. PMID:19625699
Jindal, Ankur; Whaley-Connell, Adam; Brietzke, Stephen; Sowers, James R
Obesity has reached epidemic proportions and is a significant public health concern. Obesity is associated with increased diabetes, cardiovascular and kidney disease, and associated morbidity and mortality. Despite the increasing public health problem of obesity, there is a dearth of effective treatment options. Following the FDA mandated withdrawal of sibutramine, the treatment options for obesity were limited to orlistat as the only pharmacological treatment option for long term management ...
Eilat-Adar, Sigal; Sinai, Tali; Yosefy, Chaim; Henkin, Yaakov
Lifestyle factors, including nutrition, play an important role in the etiology of Cardiovascular Disease (CVD). This position paper, written by collaboration between the Israel Heart Association and the Israel Dietetic Association, summarizes the current, preferably latest, literature on the association of nutrition and CVD with emphasis on the level of evidence and practical recommendations. The nutritional information is divided into three main sections: dietary patterns, individual food it...
D. A. Anichkov
Full Text Available Obstructive sleep apnoea syndrome (OSAS is observed in the population with a frequency of 5–15 %. The importance of OSAS is due to its close relationship with cardiovascular diseases. OSAS increases a risk for sudden cardiac death and is an independent predictor of chronic heart failure in males. OSAS is shown to be associated with the preclinical forms of atherosclerosis and left ventricular dysfunction.
Miroshnik E.V.; Yeliseyeva N.A.
The cohort pilot study had been done. Aim: to study the effectiveness of an antistress activation therapy on the functional state of human with the purpose of formation of adaptive reactions of activation and training high levels of reactivity among the two groups of patients with cardiovascular problems, ranks first among causes of death population: arterial hypertension (AH) and coronary heart disease (CHD). Material and methods. From the sub-sample of the Moscow population (396) were alloc...
Royo-Bordonada, Miguel Ángel; Armario, Pedro; Lobos Bejarano, José María; Pedro-Botet, Juan; Villar Álvarez, Fernando; Elosua, Roberto; Brotons Cuixart, Carlos; Cortés, Olga; Serrano, Benilde; Camafort Babkowski, Miguel; Gil Núñez, Antonio; Pérez, Antonio; Maiques, Antonio; de Santiago Nocito, Ana; de Castro, Almudena; Alegría, Eduardo; Baeza, Ciro; Herranz, María; Sans, Susana; Campos, Pilar
The VI European Guidelines for Cardiovascular Prevention recommend combining population and high-risk strategies with lifestyle changes as a cornerstone of prevention, and propose the SCORE function to quantify cardiovascular risk. The guidelines highlight disease specific interventions, and conditions as women, young people and ethnic minorities. Screening for subclinical atherosclerosis with noninvasive imaging techniques is not recommended. The guidelines distinguish four risk levels (very high, high, moderate and low) with therapeutic objectives for lipid control according to risk. Diabetes mellitus confers a high risk, except for subjects with type 2 diabetes with less than alcohol abuse. Copyright © 2017. Publicado por Elsevier España, S.L.U.
Maria T. K. Zaldivia
Full Text Available Microvesicles (MVs circulating in the blood are small vesicles (100–1,000 nm in diameter derived from membrane blebs of cells such as activated platelets, endothelial cells, and leukocytes. A growing body of evidence now supports the concept that platelet-derived microvesicles (PMVs, the most abundant MVs in the circulation, are important regulators of hemostasis, inflammation, and angiogenesis. Compared with healthy individuals, a large increase of circulating PMVs has been observed, particularly in patients with cardiovascular diseases. As observed in MVs from other parent cells, PMVs exert their biological effects in multiple ways, such as triggering various intercellular signaling cascades and by participating in transcellular communication by the transfer of their “cargo” of cytoplasmic components and surface receptors to other cell types. This review describes our current understanding of the potential role of PMVs in mediating hemostasis, inflammation, and angiogenesis and their consequences on the pathogenesis of cardiovascular diseases, such as atherosclerosis, myocardial infarction, and venous thrombosis. Furthermore, new developments of the therapeutic potential of PMVs for the treatment of cardiovascular diseases will be discussed.
Vasanthi, H R; ShriShriMal, N; Das, D K
For many decades, the use of synthetic chemicals as drugs has been effective in the treatment of most diseases. Moreover, from ancient to modern history, many traditional plant based medicines are playing an important role in health care. Phytochemicals are natural bioactive compounds found in vegetables, fruits, medicinal plants, aromatic plants, leaves, flowers and roots which act as a defense system to combat against diseases. The phytochemicals from natural products cover a diverse range of chemical entities such as polyphenols, flavonoids, steroidal saponins, organosulphur compounds and vitamins. A number of bioactive compounds generally obtained from terrestrial plants such as isoflavones, diosgenin, resveratrol, quercetin, catechin, sulforaphane, tocotrienols and carotenoids are proven to reduce the risk of cardiovascular diseases and aid in cardioprotection which is the leading cause of death globally. The cardioprotective effects of the various phytochemicals are perhaps due to their antioxidative, antihypercholesteroemic, antiangiogenic, anti-ischemic, inhibition of platelet aggregation and anti inflammatory activities that reduce the risk of cardiovascular disorders. The multi-faceted role of the phytochemicals is mediated by its structure-function relationship and can be considered as leads for cardiovascular drug design in future. This review summarizes the findings of recent studies on selected phytochemicals as prophylactic and therapeutic agents in cardioprotection.
Full Text Available Michael A Grandner,1,2 Megan R Sands-Lincoln,3 Victoria M Pak,2,4 Sheila N Garland1,5 1Behavioral Sleep Medicine Program, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, PA, USA; 2Center for Sleep and Circadian Neurobiology, University of Pennsylvania, PA, USA; 3Center for Evidence Based Medicine, Elsevier Inc, Philadelphia, PA, USA; 4Division of Sleep Medicine, Perelman School of Medicine, University of Pennsylvania, PA, USA; 5Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, PA, USA Abstract: Habitual sleep duration has been associated with cardiometabolic disease, via several mechanistic pathways, but few have been thoroughly explored. One hypothesis is that short and/or long sleep duration is associated with a proinflammatory state, which could increase risk for cardiovascular and metabolic diseases. This hypothesis has been largely explored in the context of experimental sleep deprivation studies which have attempted to demonstrate changes in proinflammatory markers following acute sleep loss in the laboratory. Despite the controlled environment available in these studies, samples tend to lack generalization to the population at large and acute sleep deprivation may not be a perfect analog for short sleep. To address these limitations, population based studies have explored associations between proinflammatory markers and habitual sleep duration. This review summarizes what is known from experimental and cross-sectional studies about the association between sleep duration, cardiovascular disease, and proinflammatory biomarkers. First, the association between sleep duration with both morbidity and mortality, with a focus on cardiovascular disease, is reviewed. Then, a brief review of the potential role of proinflammatory markers in cardiovascular disease is presented. The majority of this review details specific findings related to specific
stage renal disease (ESRD) worldwide and accounts for approximately 30 - 50% of all deaths. It is a sobering fact that the risk for premature CVD in a 30-year-old patient with. ESRD is similar to that of a 70 - 80-year-old without ...
Arup Kumar Dhar
Full Text Available This review provides an outline of the association between major depressive disorder (MDD and coronary heart disease (CHD. Much is known about the two individual clinical conditions; however it is not until recently, that biological mechanisms have been uncovered that link both MDD and CHD. The activation of stress pathways have been implicated as a neurochemical mechanism that links MDD and CHD. Depression is known to be associated with poorer outcomes of CHD. Psychological factors such as major depression and stress are now known as risk factors for developing CHD which is as important and is independent of classic risk factors such as hypertension, diabetes mellitus and cigarette smoking. Both conditions have great socioeconomic importance given that depression and CHD are likely to be two of the three leading causes of global burden of disease. Better understanding of the common causal pathways will help us delineate more appropriate treatments.
Mirmiran, Parvin; Noori, Nazanin; Zavareh, Maryam Beheshti; Azizi, Fereidoun
The international guidelines issued by the World Health Organization recommend reduction in dietary saturated fat and cholesterol intakes as means to prevent hypercholesterolemia and cardiovascular disease (CVD); however, only limited data are available on the benefits of fruit and vegetable consumption on CVD risk factors in a community-based population. The aim of this study was to examine whether, and to what extent, intake of fruits and vegetables is inversely associated with CVD risk factors in adults. In this population-based cross-sectional study, a representative sample of 840 Tehranian adults (male and female) aged 18 to 74 years was randomly selected in 1998. Multivariate logistic regression adjusted for lifestyle and nutritional confounders was used in 2 models. After adjusting for confounders, dietary fruit and vegetable were found to be significantly and inversely associated with CVD risk factors. Adjusted odds ratio for high low-density lipoprotein concentrations were 1.00, 0.88, 0.81, and 0.75 (P for trend history of diabetes mellitus and coronary artery disease, a trend which was not appreciably altered by additional adjustment for education, physical activity, and saturated, polyunsaturated, and total fat intakes. This association was observed across categories of smoking status, physical activity, and tertiles of the Keys score. Exclusion of subjects with prevalent diabetes mellitus or coronary artery disease did not alter these results significantly. Consumption of fruits and vegetables is associated with lower concentrations of total and low-density lipoprotein cholesterol and with the risk of CVD per se in a dose-response manner.
Background: Gluten sensitive enteropathy (celiac disease (CD)) has a strong association with diabetes mellitus (type 1DM). Since, 2-3% of CD patients have selective IgA deficiency, the majority of the available tests may fail to show the auto-antibodies (the IgA endomysial antibody (EMA). To prevent such a false negativity, ...
Godoy-Gijón, Elena; Meseguer-Yebra, Carmen; Palacio-Aller, Lucía; Godoy-Rocati, Diego Vicente; Lahoz-Rallo, Carlos
The increased cardiovascular risk in some dermatological diseases has been demonstrated in recent decades. Diseases such as psoriasis and systemic lupus erythematosus are currently included in the guidelines for prevention of cardiovascular disease. Other diseases such as androgenic alopecia, polycystic ovary syndrome, hidradenitis suppurativa or lichen planus have numerous studies that point to an increased risk, however, they have not been included in these guidelines. In this article we review the evidence supporting this association, in order to alert the clinician to the need for greater control in cardiovascular risk factors in these patients. Copyright © 2015 Sociedad Española de Arteriosclerosis. Published by Elsevier España. All rights reserved.
Silventoinen, Karri; Hjelmborg, Jacob; Möller, Sören
Background: Familial factors play an important role in the variation of risk factors of cardiovascular diseases (CVD), but less is known about how they affect the risk of death from CVD. We estimated familial aggregation of CVD mortality for twins offering the maximum level of risk due to genetic...... and other familial factors. Methods: Altogether, 132 771 twin individuals, including 65 196 complete pairs from Denmark, Finland and Sweden born in 1958 or earlier, participated in this study. During the register-based follow-up, 11 641 deaths occurred from coronary heart disease (CHD), including 6280...
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.
Objective 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). Methods Data were
Angelantonio, Emanuele Di; Gao, Pei; Khan, Hassan; Butterworth, Adam S.; Wormser, David; Kaptoge, Stephen; Kondapally Seshasai, Sreenivasa Rao; Thompson, Alex; Sarwar, Nadeem; Willeit, Peter; Ridker, Paul M; Barr, Elizabeth L.M.; Khaw, Kay-Tee; Psaty, Bruce M.; Brenner, Hermann; Balkau, Beverley; Dekker, Jacqueline M.; Lawlor, Debbie A.; Daimon, Makoto; Willeit, Johann; Njølstad, Inger; Nissinen, Aulikki; Brunner, Eric J.; Kuller, Lewis H.; Price, Jackie F.; Sundström, Johan; Knuiman, Matthew W.; Feskens, Edith J. M.; Verschuren, W. M. M.; Wald, Nicholas; Bakker, Stephan J. L.; Whincup, Peter H.; Ford, Ian; Goldbourt, Uri; Gómez-de-la-Cámara, Agustín; Gallacher, John; Simons, Leon A.; Rosengren, Annika; Sutherland, Susan E.; Björkelund, Cecilia; Blazer, Dan G.; Wassertheil-Smoller, Sylvia; Onat, Altan; Marín Ibañez, Alejandro; Casiglia, Edoardo; Jukema, J. Wouter; Simpson, Lara M.; Giampaoli, Simona; Nordestgaard, Børge G.; Selmer, Randi; Wennberg, Patrik; Kauhanen, Jussi; Salonen, Jukka T.; Dankner, Rachel; Barrett-Connor, Elizabeth; Kavousi, Maryam; Gudnason, Vilmundur; Evans, Denis; Wallace, Robert B.; Cushman, Mary; D’Agostino, Ralph B.; Umans, Jason G.; Kiyohara, Yutaka; Nakagawa, Hidaeki; Sato, Shinichi; Gillum, Richard F.; Folsom, Aaron R.; van der Schouw, Yvonne T.; Moons, Karel G.; Griffin, Simon J.; Sattar, Naveed; Wareham, Nicholas J.; Selvin, Elizabeth; Thompson, Simon G.; Danesh, John
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 cardiovascular disease (CVD) risk. DESIGN, SETTING, AND PARTICIPANTS Analysis of individual-participant data available from 73 prospective studies involving 294 998 participants without a known history of diabetes mellitus or CVD at the baseline assessment. MAIN OUTCOMES AND MEASURES Measures of risk discrimination for CVD outcomes (eg, C-index) and reclassification (eg, net reclassification improvement) of participants across predicted 10-year risk categories of low (<5%), intermediate (5%to <7.5%), and high (≥7.5%) risk. RESULTS During a median follow-up of 9.9 (interquartile range, 7.6-13.2) years, 20 840 incident fatal and nonfatal CVD outcomes (13 237 coronary heart disease and 7603 stroke outcomes) were recorded. In analyses adjusted for several conventional cardiovascular risk factors, there was an approximately J-shaped association between HbA1c values and CVD risk. The association between HbA1c values and CVD risk changed only slightly after adjustment for total cholesterol and triglyceride concentrations or estimated glomerular filtration rate, but this association attenuated somewhat after adjustment for concentrations of high-density lipoprotein cholesterol and C-reactive protein. The C-index for a CVD risk prediction model containing conventional cardiovascular risk factors alone was 0.7434 (95% CI, 0.7350 to 0.7517). The addition of information on HbA1c was associated with a C-index change of 0.0018 (0.0003 to 0.0033) and a net reclassification improvement of 0.42 (−0.63 to 1.48) for the categories of predicted 10-year CVD risk. The improvement provided by HbA1c assessment in prediction of CVD risk was equal to or better than estimated improvements for
Eman M. Alissa
Full Text Available Cardiovascular disease (CVD is an increasing world health problem. Traditional risk factors fail to account for all deaths from CVD. It is mainly the environmental, dietary and lifestyle behavioral factors that are the control keys in the progress of this disease. The potential association between chronic heavy metal exposure, like arsenic, lead, cadmium, mercury, and CVD has been less well defined. The mechanism through which heavy metals act to increase cardiovascular risk factors may act still remains unknown, although impaired antioxidants metabolism and oxidative stress may play a role. However, the exact mechanism of CVD induced by heavy metals deserves further investigation either through animal experiments or through molecular and cellular studies. Furthermore, large-scale prospective studies with follow up on general populations using appropriate biomarkers and cardiovascular endpoints might be recommended to identify the factors that predispose to heavy metals toxicity in CVD. In this review, we will give a brief summary of heavy metals homeostasis, followed by a description of the available evidence for their link with CVD and the proposed mechanisms of action by which their toxic effects might be explained. Finally, suspected interactions between genetic, nutritional and environmental factors are discussed.
Carramolino-Cuéllar, Esther; Tomás, Inmaculada; Jiménez-Soriano, Yolanda
The components of the human body are closely interdependent; as a result, disease conditions in some organs or components can influence the development of disease in other body locations. The effect of oral health upon health in general has been investigated for decades by many epidemiological studies. In this context, there appears to be a clear relationship between deficient oral hygiene and different systemic disorders such as cardiovascular disease and metabolic syndrome. The precise relationship between them is the subject of ongoing research, and a variety of theories have been proposed, though most of them postulate the mediation of an inflammatory response. This association between the oral cavity and disease in general requires further study, and health professionals should be made aware of the importance of adopting measures destined to promote correct oral health. The present study conducts a Medline search with the purpose of offering an update on the relationship between oral diseases and cardiovascular diseases, together with an evaluation of the bidirectional relationship between metabolic syndrome and periodontal disease. Most authors effectively describe a moderate association between the oral cavity and cardiovascular diseases, though they also report a lack of scientific evidence that oral alterations constitute an independent cause of cardiovascular diseases, or that their adequate treatment can contribute to prevent such diseases. In the case of metabolic syndrome, obesity and particularly diabetes mellitus may be associated to an increased susceptibility to periodontitis. However, it is not clear whether periodontal treatment is able to improve the systemic conditions of these patients.
Wilson, Peter W F; D'Agostino, Ralph; Bhatt, Deepak L; Eagle, Kim; Pencina, Michael J; Smith, Sidney C; Alberts, Mark J; Dallongeville, Jean; Goto, Shinya; Hirsch, Alan T; Liau, Chiau-Suong; Ohman, E Magnus; Röther, Joachim; Reid, Christopher; Mas, Jean-Louis; Steg, Ph Gabriel
Prediction models for cardiovascular events and cardiovascular death in patients with established cardiovascular disease are not generally available. Participants from the prospective REduction of Atherothrombosis for Continued Health (REACH) Registry provided a global outpatient population with known cardiovascular disease at entry. Cardiovascular prediction models were estimated from the 2-year follow-up data of 49,689 participants from around the world. A developmental prediction model was estimated from 33,419 randomly selected participants (2394 cardiovascular events with 1029 cardiovascular deaths) from the pool of 49,689. The number of vascular beds with clinical disease, diabetes, smoking, low body mass index, history of atrial fibrillation, cardiac failure, and history of cardiovascular event(s) <1 year before baseline examination increased risk of a subsequent cardiovascular event. Statin (hazard ratio 0.75; 95% confidence interval, 0.69-0.82) and acetylsalicylic acid therapy (hazard ratio 0.90; 95% confidence interval, 0.83-0.99) also were significantly associated with reduced risk of cardiovascular events. The prediction model was validated in the remaining 16,270 REACH subjects (1172 cardiovascular events, 494 cardiovascular deaths). Risk of cardiovascular death was similarly estimated with the same set of risk factors. Simple algorithms were developed for prediction of overall cardiovascular events and for cardiovascular death. This study establishes and validates a risk model to predict secondary cardiovascular events and cardiovascular death in outpatients with established atherothrombotic disease. Traditional risk factors, burden of disease, lack of treatment, and geographic location all are related to an increased risk of subsequent cardiovascular morbidity and cardiovascular mortality. Copyright © 2012 Elsevier Inc. All rights reserved.
Riley, Callum James; Gavin, Matthew
Riley, Callum James, and Matthew Gavin. Physiological changes to the cardiovascular system at high altitude and its effects on cardiovascular disease. High Alt Med Biol. 18:102-113, 2017.-The physiological changes to the cardiovascular system in response to the high altitude environment are well understood. More recently, we have begun to understand how these changes may affect and cause detriment to cardiovascular disease. In addition to this, the increasing availability of altitude simulation has dramatically improved our understanding of the physiology of high altitude. This has allowed further study on the effect of altitude in those with cardiovascular disease in a safe and controlled environment as well as in healthy individuals. Using a thorough PubMed search, this review aims to integrate recent advances in cardiovascular physiology at altitude with previous understanding, as well as its potential implications on cardiovascular disease. Altogether, it was found that the changes at altitude to cardiovascular physiology are profound enough to have a noteworthy effect on many forms of cardiovascular disease. While often asymptomatic, there is some risk in high altitude exposure for individuals with certain cardiovascular diseases. Although controlled research in patients with cardiovascular disease was largely lacking, meaning firm conclusions cannot be drawn, these risks should be a consideration to both the individual and their physician.
... 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) ...
Background: Metabolomics is a promising tool of cardiovascular biomarker discovery. We systematically reviewed the literature on comprehensive metabolomic profiling in association with incident cardiovascular disease (CVD). Methods and Results: We searched MEDLINE and EMBASE from inception to Janua...
López-Jiménez, Francisco; Cortés-Bergoderi, Mery
Excess weight is the most prevalent cardiovascular risk factor and certainly the factor that improves the least over time among those with established cardiovascular disease. The association between obesity and cardiovascular disease is complex and not limited to the standard risk factors like hypertension, dyslipidemia, and type 2 diabetes mellitus. In recent years, multiple studies have shown that obesity may cause cardiovascular diseases via multiple disease mechanisms like subclinical inflammation, endothelial dysfunction, increased sympathetic tone, atherogenic lipid profiles, enhanced thrombogenic factors and also through obstructive sleep apnea. Despite the overwhelming data linking obesity to cardiovascular disease, several studies have shown a paradoxical association between obesity and prognosis among those with coronary disease and heart failure, which may be due to limitations of the way we currently define obesity. There is abundant data suggesting that measuring central obesity or total body fat content might be more appropriate than using the body mass index alone. The management of obesity is challenging and studies using lifestyle modification alone or with pharmacologic agents generally have limited success and high levels of weight regain. Bariatric surgery has proven to be an effective and safe way to induce and maintain significant weight loss but is limited to those with medically complicated obesity or people who are severely obese. Copyright © 2010 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.
Full Text Available Background: The incidence of cardiovascular disease (CVD is rapidly increasing worldwide. Occupation-related stress such as military parachuting has been considered to be a potentially important cardiovascular risk factor. The present study was performed to determine the prevalence of cardiovascular risk factors and metabolic syndrome among military parachutists which provides a guideline to prevent catastrophic cardiovascular events. Methods: This is a cross-sectional study among 96 military parachutists in southern IR Iran; who were evaluated in the military clinic in Shiraz, Southern IR Iran. Information regarding demographic and life style were obtained from each subject. Arterial blood pressure, weight, height, body mass index (BMI, waist circumference (WC and hip circumference (HC, fasting blood glucose, lipid profile consisting of total cholesterol, LDL, HDL and triglyceride were measured by standard methods. Results: The mean age of participants was 37.4±6.4 years. There were 5 (5.2% cases under treatment for cardiovascular diseases, 4 (4.2% participants were pre-diabetics and 5 (5.2% suffered from diabetes mellitus. Hypertriglyceridemia and hypercholesterolemia were seen in 23 (24% and 46 (47% military parachutists respectively. Conclusions: Although war-related stressors and high intensity physical activities are associated with both acute cardiac events and cardiac risk factors, our data is in favor of lower frequency of cardiovascular risk factors among military parachutists. However, routine monitoring of military parachutists is necessary to find the cardiovascular risk factors.
Baudet, M; Daugareil, C; Ferrieres, J
Cardiovascular diseases are mainly caused by atherosclerosis, the development of which is highly dependent on our Western lifestyle. Slowing this pathology depends on the reduction of risk factors such as hypercholesterolemia, high blood pressure, smoking, lack of physical activity, excess weight and diabetes. Drug treatment exists and is very effective, but too often they treat the immediate abnormality such as diabetes, high blood pressure and hypercholesterolemia and not the underlying causes: poor eating habits, lack of physical activity and excess weight. These have a negative impact on endothelial function, oxidative stress, and can trigger inflammation, arrythmias and thrombosis. Cardiovascular prevention must therefore target sedentary lifestyle, excess weight, and favor low-calorie, low-salt food and Mediterranean diet. The way this diet works begins to be understood and goes beyond simple cardiovascular prevention. Therapeutic education holds a growing and complementary role in the Public Health system which should call upon the strengths of all healthcare professionals. Copyright © 2011. Published by Elsevier SAS.
Rosano, G M C; Vitale, C; Marazzi, G; Volterrani, M
Menopause is a risk factor for cardiovascular disease (CVD) because estrogen withdrawal has a detrimental effect on cardiovascular function and metabolism. The menopause compounds many traditional CVD risk factors, including changes in body fat distribution from a gynoid to an android pattern, reduced glucose tolerance, abnormal plasma lipids, increased blood pressure, increased sympathetic tone, endothelial dysfunction and vascular inflammation. Many CVD risk factors have different impacts in men and women. In postmenopausal women, treatment of arterial hypertension and glucose intolerance should be priorities. Observational studies and randomized clinical trials suggest that hormone replacement therapy (HRT) started soon after the menopause may confer cardiovascular benefit. In contrast to other synthetic progestogens used in continuous combined HRTs, the unique progestogen drospirenone has antialdosterone properties. Drospirenone can therefore counteract the water- and sodium-retaining effects of the estrogen component of HRT via the renin-angiotensin-aldosterone system, which may otherwise result in weight gain and raised blood pressure. As a continuous combined HRT with 17beta-estradiol, drospirenone has been shown to significantly reduce blood pressure in postmenopausal women with elevated blood pressure, but not in normotensive women. Therefore, in addition to relieving climacteric symptoms, drospirenone/17beta-estradiol may offer further benefits in postmenopausal women, such as improved CVD risk profile.
Kolte, Dhaval; Aronow, Wilbert S; Banach, Maciej
Cardiovascular diseases (CVD) remain the leading cause of death worldwide with an estimated 17.5 million deaths per year. Since its initial conception over a decade ago, the use of cardiovascular polypills has gained increasing momentum as a strategy to lower risk factor levels and prevent CVD. Several new data have emerged including the recent publication of the first outcomes trial using polypills. Areas covered: In this review, the authors summarize the current literature on the safety, efficacy, and cost-effectiveness of polypills for primary and secondary prevention of CVD, describe the current controversies in this field, and identify important areas for future research. The authors searched PubMed, CENTRAL, and ClinicalTrials.gov from inception till 25 June 2016 using the search term 'polypill.' Expert opinion: Cardiovascular polypills containing aspirin, statin, and one or more anti-hypertensive medications, along with lifestyle interventions, represent an attractive, safe, and cost-effective strategy for primary and secondary prevention of CVD. Future research efforts should focus on identifying patients who will benefit the most from the use of polypills, marketing several polypills with different components and doses, and developing novel regulatory strategies for making polypills more readily available in all countries worldwide.
Gustafsson, Finn; Azizi, Michel; Bauersachs, Johann
Accumulated evidence has demonstrated that aldosterone is a key player in the pathogenesis of cardiovascular (CV) disease. Multiple clinical trials have documented that intervention in the aldosterone pathway can reduce blood pressure and lower albuminuria and improve outcome in patients with heart...... failure or myocardial infarction. Recent studies have unraveled details about the role of aldosterone at the cellular level in CV disease. The relative importance of glucocorticoids and aldosterone in terms of mineralocorticoid receptor activation is currently being debated. Also, studies are addressing...... which aldosterone modulator to use, which timing of treatment to aim for, and in which population to intervene. This review provides an overview of recent developments in the understanding of the role of aldosterone in CV disease, with particular reference to mechanisms and potential targets...
Hutcheson, Joshua D; Aikawa, Elena
Extracellular vesicles have emerged as one of the most important means through which cells interact with each other and the extracellular environment, but extracellular vesicle research remains challenging due to their small size, limited amount of material required for traditional molecular biology assays and inconsistency in the methods of their isolation. The advent of new technologies and standards in the field, however, have led to increased mechanistic insight into extracellular vesicle function. Herein, the latest studies on the role of extracellular vesicles in cardiovascular physiology and disease are discussed. Extracellular vesicles help control cardiovascular homeostasis and remodelling by mediating communication between cells and directing alterations in the extracellular matrix to respond to changes in the environment. The message carried from the parent cell to extracellular space can be intended for both local (within the same tissue) and distal (downstream of blood flow) targets. Pathological cargo loaded within extracellular vesicles could further result in various diseases. On the contrary, new studies indicate that injection of extracellular vesicles obtained from cultured cells into diseased tissues can promote restoration of normal tissue function. Extracellular vesicles are an integral part of cell and tissue function, and harnessing the properties inherent to extracellular vesicles may provide a therapeutic strategy to promote tissue regeneration.
Van Eyk, Jennifer; Dunn, M. J
... to cardiovascular disease. By exploring the various strategies and technical aspects of both, using examples from cardiac or vascular biology, the limitations and the potential of these methods can be clearly seen. The book is divided into three sections: the first focuses on genomics, the second on proteomics, and the third provides an overview of the importance of these two scientific disciplines in drug and diagnostic discovery. The goal of this book is the transfer of their hard-earned lessons to the growing num...
Patel, Vivek; Kantipudi, Neha; Jones, Graham; Upton, Adrian; Kamath, Markad V
Air pollution is comprised of different compounds and particulate matter (PM) of sizes 2.5 and 10 μm, with the former size posing the greatest danger to humans. Evidence suggests that the global rise in air pollution levels during the past century is correlated with the increased incidence of diseases of the cardiovascular system. On a global scale, 7 million individuals died as a result of the effects of air pollution in 2012. Air pollution leads to tremendous amounts of financial burden (in 2010, $16 trillion in the US and Europe) on the health-care system. The severity of effects experienced by varying populations due to air pollution can differ due to locale, length of exposure, weather conditions, residential proximity to major highways or factories, and soil aridity. Pollutants affect the heart, blood vessels, and blood at a molecular level through proinflammatory or oxidative stress response, autonomic nervous system imbalance, and the direct permeation of harmful compounds into the tissue. The dysfunction of cells and biological processes of the cardiovascular system due to PM leads to an increased prevalence of cardiovascular diseases (CVDs) such as atherosclerosis, hypertension, myocardial infarction, thrombosis, and restricted valve motion. Studies in countries such as China have shown an increase of 0.25% in ischemic heart disease (IHD) mortality and a 0.27% increase in IHD morbidity due to a 10 μg/m3 increase in PM. In a study conducted in the US, PM2.5 concentrations ranged from 9.2-22.6 μg/m3, and every 5-μg/m3 increase in PM2.5 caused coronary calcification to increase by 4.1 Agatston units/yr. Studies on traffic-related air pollution found that nonhypertensive participants residing within 100 m of major roadways experienced an increase in systolic (0.35 mmHg) and diastolic (0.22 mmHg) blood pressure as a result of increases in traffic. The progression of CVD due to pollution has been found to fluctuate within individuals based on age, gender
Shaw A Andrew
Full Text Available Abstract Background The high frequency of premature death from cardiovascular disease in indigenous Australians is often attributed to the high prevalence of risk factors, especially type II diabetes mellitus (DM. We evaluated the relationship of ethnicity to atherosclerotic burden, as evidenced by carotid intima-media thickness (IMT, independent of risk factor status. Methods We studied 227 subjects (147 men; 50 ± 13 y: 119 indigenous subjects with (IDM, n = 54, and without DM (InDM, n = 65, 108 Caucasian subjects with (CDM, n = 52, and without DM (CnDM, n = 56. IMT was measured according to standard methods and compared with clinical data and cardiovascular risk factors. Results In subjects both with and without DM, IMT was significantly greater in indigenous subjects. There were no significant differences in gender, body mass index (BMI, systolic blood pressure (SBP, or diastolic blood pressure (DBP between any of the groups, and subjects with DM showed no difference in plasma HbA1c. Cardiovascular risk factors were significantly more prevalent in indigenous subjects. Nonetheless, ethnicity (β = -0.34; p Conclusion Ethnicity appears to be an independent correlate of preclinical cardiovascular disease, even after correction for the high prevalence of cardiovascular risk factors in indigenous Australians. Standard approaches to control currently known risk factors are vital to reduce the burden of cardiovascular disease, but in themselves may be insufficient to fully address the high prevalence in this population.
Full Text Available Foods play an important role in preparing the health of body. Foods and nutrients are effective in increasing health and regulating the immune system as well as in prevention of different diseases such as cardiovascular diseases. In the past few years, the prevalence of cardiovascular disease is progressively increasing. Change in lifestyle and dietary pattern of the societies plays an important role in inducing cardiovascular diseases. Studies have shown that the risk of cardiovascular disease among people consuming more vegetables is lower. Recent findings suggest that foods rich in omega-3, vitamins, antioxidants and fibers are useful for the health of cardiovascular system and such nutrition, in addition to disease prevention, reduces the cost and side effects of chemical treatments. In this article, different clinical trials introducing beneficial dietary approaches in preventing cardiovascular diseases are reviewed
Olokoba, A.B.; Bojuwoye, B.J.; Olokoba, K.B.; Braimoh, K.T.; Inikori, A.K.
To determine the factors predisposing patients with type-2 diabetes mellitus to gallstone disease. One hundred type 2 diabetic patients and 100 age and gender-matched controls underwent real time ultrasonography to study factors predisposing patients with type 2 diabetes mellitus to gallstone disease. The age, gender, body mass index (BMI), duration of diabetes mellitus and serum lipids were determined in the individuals enrolled for the study. Fifteen percent of the diabetic patients had ultrasound evidence of gallstone disease as compared to 7% in non-diabetic controls. There was a steady increase in the incidence of gallstone disease in diabetic patients with age with a peak incidence in the seventh decade i.e. 60-69 years, and a decline in the eighth decade i.e. 70 - 79 years. The average age of the diabetic patients with gallstone disease - 59.1+ 9.5 years was significantly higher than in those without gallstone disease - 51.8 + 10.5 years (p 0.014). The mean duration of disease in the diabetic patients with gallstone disease was 5.0 + 4.9 years compared with 4.5 + 3.8 years in the diabetic patients without gallstone disease (p=0.772). The mean serum cholesterol and triglyceride levels - 4.3 + 1.3 mmol/L and 1.5 + 0.8 mmol/L respectively in the diabetic patients with gallstone disease was higher than in those without gallstone disease - 3.4 + 0.5 mmol/L (p=0.0941) and 1.4 + 0.7 mmol/L (p=0.712) respectively. The mean body mass index for the diabetic patients with gallstone disease was 26.2 + 5.5 kg /m 2 compared with 25.7 + 6.7 kg/m2 in those without gallstone disease (p=0.755) . Increasing age is a risk factor for gallstone disease in diabetic patients. Hyperlipidaemia, female gender, heavier weight and a longer duration of diabetes mellitus appear to be associated risk factors. (author)
Shaw, Palma M; Chandra, Venita; Escobar, Guillermo A; Robbins, Nicholas; Rowe, Vincent; Macsata, Robyn
Hispanics account for approximately 17% of the U.S. They are one of the fastest growing racial/ethnic groups, second only to Asians. This heterogeneous population has diverse socioeconomic conditions, making the prevention, diagnosis, and management of vascular disease difficult. This paper discusses the cultural, racial, and social aspects of the Hispanic community in the United States and assesses how they affect vascular disease within this population. Furthermore, it explores risk factors, medical and surgical treatments, and outcomes of vascular disease in the Hispanic population; generational evolution of these conditions; and the phenomenon called the Hispanic paradox. A systematic search of the literature was performed to identify all English-language publications from 1991 to 2014 using PubMed, which draws from the National Institutes of Health and U.S. National Library of Medicine, with the words "cardiovascular disease," "prevalence," "vascular," and "Hispanic." An additional search was performed using "cardiovascular disease and Mexico," "cardiovascular disease and Cuba," "cardiovascular disease and Puerto Rico," and "cardiovascular disease and Latin America" as well as for complications, management, outcomes, surgery, vascular disease, and Hispanic paradox. The resulting publications were queried for generational data (spanning multiple well-defined age groups) regarding cardiovascular disease, and cross-references were obtained from their bibliographies. Results are segmented by country of origin. Compared with non-Hispanic whites, Hispanics face higher risks of cardiovascular diseases because of a high prevalence of high blood pressure, obesity, diabetes mellitus, and ischemic stroke. However, the incidence of peripheral arterial disease and carotid disease appears to be significantly lower than in whites. The Hispanic paradox (lower mortality in spite of higher cardiovascular risk factors) may relate to challenges in ascribing life expectancy and
Marouane Boukhris; Salvatore Davide Tomasello; Francesco Marzà; Sonia Bregante; Francesca Romana Pluchinotta; Alfredo Ruggero Galassi
Coronary heart disease is the main cause of death in postmenopausal women (PMW); moreover its mortality exceeds those for breast cancer in women at all ages. Type II diabetes mellitus is a major cardiovascular risk factor and there is some evidence that the risk conferred by diabetes is greater in women than in men. It was established that the deficiency of endogenous estrogens promotes the atherosclerosis process. However, the impact of estrogen replacement therapy (ERT) on cardiovascular pr...
Halfon, Neal; Verhoef, Philip A; Kuo, Alice A
Through research in the prevention and treatment of adult diseases, it has become clear that many adult diseases have their origins in childhood. As illustrated in this review, these antecedents are largely a function of the nutrition, physical activity, and habits of developing children. There is also increasing evidence that chronic and toxic levels of stress can play a significant role not only in the development of mental and behavioral conditions but in the developmental pathways that lead to a number of chronic physical health conditions. Internists, family medicine physicians, and medicine-pediatrics physicians generally are comfortable managing patients with a number of cardiovascular risk factors or conditions. Although pediatric clinical guidelines have recommended universal screening for hypertension since 1977 and targeted screening for dyslipidemia since 1992 and type 2 DM since 2000, this screening is not yet common practice in general pediatrics. As the population of children and youth with risk factors for metabolic syndrome--hypertension, dyslipidemia, and type 2 DM--increases as a result of the obesity epidemic, pediatricians will have to screen routinely, and diagnose and treat these conditions in the primary care setting. Pediatric residency programs and continuing medical education programs will have to provide knowledge and clinical training in the management of these conditions before primary care pediatricians are comfortable treating children and youth with multiple cardiovascular conditions.
Doenças cardiovasculares ateroscleróticas, dislipidemias, hipertensão, obesidade e diabetes melito em população da área metropolitana da região sudeste do Brasil: I - Metodologia da pesquisa Atheroschlerotic cardiovascular disease, lipemic disorders, hypertension, obesity and diabetes mellitus in the population of a metropolitan area of Southeastern Brazil: I-Research methodology
Ignez Salas Martins
outras morbidades. O inquérito bioquímico constou da medida dos seguintes constituintes sangüíneos: colesterol total, HDL colesterol, LDL colesterol, triglicérides, magnésio, glicose, sódio, potássio, cálcio e fósforo. O inquérito alimentar envolveu informações sobre a história alimentar do indivíduo. A intervenção clínico -educativa foi feita com a participação de associações comunitárias e centros de saúde, que criaram programas locais de atendimento aos doentes e portadores de risco.An epidemiological study was carried out into the risk factors for the following atherosclerotic cardiovascular diseases: lipemics disorders, obesity, hypertension, diabetes mellitus as related to some factors which characterize life-style (sedentary, drinking, smoking and eating habits. The population studied belongs to the metropolitan area of S. Paulo. The research project had the following objectives: a the development of an epidemiological baseline for the study of the risk factors for the atherosclerotics cardiovascular diseases represented by the lipemics disorders, obesity, hypertension and diabetes mellitus and their relationship with personal, family and social characteristics; b the for clinical-educative treatment of pacients or people at risk. In view of the objectives above it was decided that the project should in an integrated way with the local health centers and community associations in the field work phase. For this purpose, the methodology adopted was that of establishing small geographical areas, denominated "study areas", in accordance with socioeconomic criterion. Clinico-biochemical and eating surveys were carried out and interviews held with a view to obtaining data on socioeconomic and demographic and life-style characteristics. The clinical survey collected data on anthropometric measurements, arterial pressure, electrocardiogram and symptoms of heart disease. The biochemical survey consisted of the measurement of the following
Carolina Castro Porto Silva Janovsky
Full Text Available Sleep apnea in type 1 diabetes mellitus (T1DM is a crescent theme of discussion. In obese patient, it is explained by the excessive central adiposity, including large neck circumference. Its presence in nonobese patients, however, brings back its possible correlation with autonomic neuropathy. The aim of this study was to compare the prevalence of OSA in young and lean T1DM, with and without cardiovascular autonomic neuropathy (CAN. We studied 20 adult, nonobese, type 1 diabetic patients, divided in two groups according to the results of the cardiovascular autonomic reflex tests (CARTs. These two groups (9 with CAN and 11 without CAN were compared to a control group of 22 healthy individuals, matched by age and BMI. A polysomnography was performed and sleep was analyzed. The CAN+ group presented significantly higher prevalence of sleep apnea compared to the other groups (67% CAN+; 23% CAN-; 4,5% controls: CAN+ vs Control; p=0.00017 and CAN+ vs CAN-; p=0.02. As it was expected, the incidence of sleep apnea was correlated with more microarousals during sleep and excessive daytime sleepiness. The CAN- group showed a better sleep efficiency compared to the CAN+ group, demonstrating impaired sleep architecture in diabetics with this chronic complication. In conclusion, sleep apnea could not only be an indication of presence of CAN, but also a contributor to diabetic neuropathy impairment, causing both worse prognosis and reduced quality of life for these patients when not treated.
Heinz, Justin; Marinello, Michael; Fredman, Gabrielle
Studies over the last couple of decades suggest that failed resolution of a chronic inflammatory response is an important driving force in the progression of atherosclerosis. Resolution of inflammation is mediated in part by lipid-derived specialized pro-resolving mediators (SPMs) such as lipoxins, resolvins, protectins and maresins. The major functions of SPMs are to quell inflammation and repair tissue damage in a manner that does not compromise host defense. An imbalance between SPMs and pro-inflammatory mediators like leukotriene B 4 (LTB 4 ) are associated with several prevalent human diseases, including atherosclerosis. Because atherosclerosis is marked by persistent, unresolved inflammation and arterial tissue injury, SPMs have garnered immense interest as a potential treatment strategy. This mini review will highlight recent advances in the application of SPMs in atherosclerosis as well as the ability of SPMs to control several of the risk factors associated with cardiovascular diseases. Copyright © 2017. Published by Elsevier Inc.
Full Text Available Epidemiological studies have shown that vegetable consumption is inversely related to the risk of cardiovascular diseases. Moreover, research has indicated that many vegetables like potatoes, soybeans, sesame, tomatoes, dioscorea, onions, celery, broccoli, lettuce and asparagus showed great potential in preventing and treating cardiovascular diseases, and vitamins, essential elements, dietary fibers, botanic proteins and phytochemicals were bioactive components. The cardioprotective effects of vegetables might involve antioxidation; anti-inflammation; anti-platelet; regulating blood pressure, blood glucose, and lipid profile; attenuating myocardial damage; and modulating relevant enzyme activities, gene expression, and signaling pathways as well as some other biomarkers associated to cardiovascular diseases. In addition, several vegetables and their bioactive components have been proven to protect against cardiovascular diseases in clinical trials. In this review, we analyze and summarize the effects of vegetables on cardiovascular diseases based on epidemiological studies, experimental research, and clinical trials, which are significant to the application of vegetables in prevention and treatment of cardiovascular diseases.
Jin Ook Chung; Dong Hyeok Cho; Dong Jin Chung; Min Young Chung
Background Diabetes mellitus is a major independent risk factor for cardiovascular disease (CVD), but high cardiovascular risk in diabetes mellitus patients is not completely explained by clustering traditional risk factors. Recently, associations between diabetic polyneuropathy (DPN) and macrovasculopathy have been suggested. We aimed to assess associations between DPN and cardiovascular complications in type 2 diabetic patients. Methods Microvascular and cardiovascular complications were ev...
Parish, James M; Somers, Virend K
Obstructive sleep apnea (OSA) is a common medical condition that occurs in approximately 5% to 15% of the population. The pathophysiology of OSA is characterized by repetitive occlusions of the posterior pharynx during sleep that obstruct the airway, followed by oxyhemoglobin desaturation, persistent inspiratory efforts against the occluded airway, and termination by arousal from sleep. Obstructive sleep apnea is associated with daytime sleepiness and fatigue, likely due to fragmented sleep from recurrent arousals. Substantial evidence shows that patients with OSA have an increased incidence of hypertension compared with individuals without OSA and that OSA is a risk factor for the development of hypertension. Recent studies show that OSA may be implicated in stroke and transient ischemic attacks. Obstructive sleep apnea appears to be associated with coronary heart disease, heart failure, and cardiac arrhythmias. Pulmonary hypertension may be associated with OSA, especially in patients with preexisting pulmonary disease. Although the exact cause that links OSA with cardiovascular disease is unknown, there is evidence that OSA is associated with a group of proinflammatory and prothrombotic factors that have been identified to be important in the development of atherosclerosis. Obstructive sleep apnea is associated with increased daytime and nocturnal sympathetic activity. Autonomic abnormalities seen in patients with OSA include increased resting heart rate, decreased R-R interval variability, and increased blood pressure variability. Both atherosclerosis and OSA are associated with endothelial dysfunction, increased C-reactive protein, interleukin 6, fibrinogen, and plasminogen activator inhibitor, and reduced fibrinolytic activity. Obstructive sleep apnea has been associated with enhanced platelet activity and aggregation. Leukocyte adhesion and accumulation on endothelial cells are common in both OSA and atherosclerosis. Clinicians should be aware that OSA may be
Catalina Liliana Andrei
Full Text Available Increasing costs of treatments have led to the apparition of the medical tourism. Patients in high-income countries seek to solve their health problems in developing countries where the cost of medical treatment is much lower. This cost difference has led to the medical tourism industry that is currently estimated with an annual growth rate of about 20%. Cardiovascular diseases are a leading cause of death worldwide. The high cost of treating these diseases cause many patients to seek treatment options abroad. This paper presents an analysis of the medical tourism industry highlighting the factors that led to its development, barriers to medical tourism, and the economic impact of this industry. Although Romania has highly appreciated doctors it hasn’t achieved yet the high level of other developing countries where medical tourism is more intense. Spa tourism is still far from Romania’s potential in this area due to the very small investments and the lack of necessary infrastructure. Using statistical and econometric techniques we examined key health indicators in Romania showing the lack of correlation between the prevalence of cardiovascular diseases, the development of the endowment of the health system in Romania, expenditures on health care and evolution of the number of foreign tourists coming to Romania to treat these diseases. We used statistical data series provided by N.S.I. that were processed using Eviews. We also tested whether there is a causal relationship in the Granger sense between the percentage of GDP allocated to the health care system and the number of nights spent by foreign tourists in resorts in Romania or the number of arrivals of foreign tourists.
Full Text Available Coronary artery disease, in the development of which inflammation mediated by innate immune cells plays a critical role, is one of the leading causes of death worldwide. The 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins are a widely used lipid-lowering drug that has lipid-independent vasculoprotective effects, such as improvement of endothelial dysfunction, antioxidant properties, and inhibitory effects on inflammation. Despite recent advances in lipid-lowering therapy, clinical trials of statins suggest that anti-inflammatory therapy beyond lipid-lowering therapy is indispensible to further reduce cardiovascular events. One possible therapeutic option to the residual risk is to directly intervene in the inflammatory process by utilizing a nanotechnology-based drug delivery system (nano-DDS. Various nano-sized materials are currently developed as DDS, including micelles, liposomes, polymeric nanoparticles, dendrimers, carbon nanotubes, and metallic nanoparticles. The application of nano-DDS to coronary artery disease is a feasible strategy since the inflammatory milieu enhances incorporation of nano-sized materials into mononuclear phagocytic system and permeability of target lesions, which confers nano-DDS on “passive-targeting” property. Recently, we have developed a polymeric nanoparticle-incorporating statin to maximize its anti-inflammatory property. This statin nanoparticle has been tested in various disease models, including plaque destabilization and rupture, myocardial ischemia-reperfusion injury, and ventricular remodeling after acute myocardial infarction, and its clinical application is in progress. In this review, we present current development of DDS and future perspective on the application of anti-inflammatory nanomedicine to treat life-threatening cardiovascular diseases.
Fernández-Gutiérrez, Benjamín; Perrotti, Pedro P.; Gisbert, Javier P.; Domènech, Eugeni; Fernández-Nebro, Antonio; Cañete, Juan D.; Ferrándiz, Carlos; Tornero, Jesús; García-Sánchez, Valle; Panés, Julián; Fonseca, Eduardo; Blanco, Francisco; Rodríguez-Moreno, Jesús; Carreira, Patricia; Julià, Antonio; Marsal, Sara; Rodriguez-Rodriguez, Luis
Abstract To analyze in several immune-mediated inflammatory diseases (IMIDs) the influence of demographic and clinical-related variables on the prevalence of cardiovascular disease (CVD), and compare their standardized prevalences. Cross-sectional study, including consecutive patients diagnosed with rheumatoid arthritis, psoriatic arthritis, psoriasis, systemic lupus erythematosus, Crohn disease, or ulcerative colitis, from rheumatology, gastroenterology, and dermatology tertiary care outpatient clinics located throughout Spain, between 2007 and 2010. Our main outcome was defined as previous diagnosis of angina, myocardial infarction, peripheral vascular disease, and/or stroke. Bivariate and multivariate logistic and mixed-effects logistic regression models were performed for each condition and the overall cohort, respectively. Standardized prevalences (in subjects per 100 patients, with 95% confidence intervals) were calculated using marginal analysis. We included 9951 patients. For each IMID, traditional cardiovascular risk factors had a different contribution to CVD. Overall, older age, longer disease duration, presence of traditional cardiovascular risk factors, and male sex were independently associated with a higher CVD prevalence. After adjusting for demographic and traditional cardiovascular risk factors, systemic lupus erythematosus exhibited the highest CVD standardized prevalence, followed by rheumatoid arthritis, psoriasis, Crohn disease, psoriatic arthritis, and ulcerative colitis (4.5 [95% confidence interval (CI): 2.2, 6.8], 1.3 [95% CI: 0.8, 1.8], 0.9 [95% CI: 0.5, 1.2], 0.8 [95% CI: 0.2, 1.3], 0.6 [95% CI: 0.2, 1.0], and 0.5 [95% CI: 0.1, 0.8], respectively). Systemic lupus erythematosus, rheumatoid arthritis, and psoriasis are associated with higher prevalence of CVD compared with other IMIDs. Specific prevention programs should be established in subjects affected with these conditions to prevent CVD. PMID:28658137
Morimoto-Yamashita, Yoko; Ito, Takashi; Kawahara, Ko-Ichi; Kikuchi, Kiyoshi; Tatsuyama-Nagayama, Shoko; Kawakami-Morizono, Yoshiko; Fijisawa, Mari; Miyashita, Keiko; Emoto, Makiko; Torii, Mitsuo; Tokuda, Masayuki
Periodontitis is a major chronic inflammatory disease associated with increased production of numerous proinflammatory cytokines, which leads to the destruction of the periodontal tissue and ultimately loss of teeth. Periodontitis has powerful and multiple influences on the occurrence and severity of systemic conditions and diseases, such as diabetes mellitus, cardiovascular disease and respiratory disease. Meanwhile, diabetes is associated with increased prevalence, severity and progression of periodontal disease. There is also abundant evidence showing that diabetes plays important etiological roles in periodontitis. High mobility group box 1 (HMGB1) was recently identified as a lethal mediator of severe sepsis and comprises a group of intracellular proteins that function as inflammatory cytokines when released into the extracellular milieu. From a clinical perspective, extracellular HMGB1 can cause multiple organ failure and contribute to the pathogenesis of sepsis, rheumatoid arthritis, cardiovascular disease and diabetes. We recently reported that HMGB1 expression in periodontal tissues was elevated in patients with severe periodontitis. In addition, the receptor for advanced glycation end-products (RAGE), a receptor for HMGB1, was strongly expressed in gingival tissues obtained from patients with type 2 diabetes and periodontitis compared with systemically healthy patients with chronic periodontitis patients. From these data, we hypothesize that HMGB1 might play a role in the development of diabetes-associated periodontitis. Copyright © 2012 Elsevier Ltd. All rights reserved.
Ahlehoff, Ole; Gislason, Gunnar; Lindhardsen, Jesper
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....
Sharifah Intan Qhadijah Syed Ikmal
Full Text Available Type 2 diabetes mellitus patients with coronary artery disease have become a major public health concern. The occurrence of insulin resistance accompanied with endothelial dysfunction worsens the state of atherosclerosis in type 2 diabetes mellitus patients. The combination of insulin resistance and endothelial dysfunction leads to coronary artery disease and ischemic heart disease complications. A recognized biological marker, high-sensitivity C-reactive protein, has been used widely to assess the progression of atherosclerosis and inflammation. Along with coronary arterial damage and inflammatory processes, high-sensitivity C-reactive protein is considered as an essential atherosclerosis marker in patients with cardiovascular disease, but not as an insulin resistance marker in type 2 diabetes mellitus patients. A new biological marker that can act as a reliable indicator of both the exact state of insulin resistance and atherosclerosis is required to facilitate optimal health management of diabetic patients. Malfunctioning of insulin mechanism and endothelial dysfunction leads to innate immune activation and released several biological markers into circulation. This review examines potential biological markers, YKL-40, alpha-hydroxybutyrate, soluble CD36, leptin, resistin, interleukin-18, retinol binding protein-4, and chemerin, as they may play significant roles in insulin resistance and atherosclerosis in type 2 diabetes mellitus patients with coronary artery disease.
Syed Ikmal, Sharifah Intan Qhadijah; Zaman Huri, Hasniza; Vethakkan, Shireene Ratna; Wan Ahmad, Wan Azman
Type 2 diabetes mellitus patients with coronary artery disease have become a major public health concern. The occurrence of insulin resistance accompanied with endothelial dysfunction worsens the state of atherosclerosis in type 2 diabetes mellitus patients. The combination of insulin resistance and endothelial dysfunction leads to coronary artery disease and ischemic heart disease complications. A recognized biological marker, high-sensitivity C-reactive protein, has been used widely to assess the progression of atherosclerosis and inflammation. Along with coronary arterial damage and inflammatory processes, high-sensitivity C-reactive protein is considered as an essential atherosclerosis marker in patients with cardiovascular disease, but not as an insulin resistance marker in type 2 diabetes mellitus patients. A new biological marker that can act as a reliable indicator of both the exact state of insulin resistance and atherosclerosis is required to facilitate optimal health management of diabetic patients. Malfunctioning of insulin mechanism and endothelial dysfunction leads to innate immune activation and released several biological markers into circulation. This review examines potential biological markers, YKL-40, alpha-hydroxybutyrate, soluble CD36, leptin, resistin, interleukin-18, retinol binding protein-4, and chemerin, as they may play significant roles in insulin resistance and atherosclerosis in type 2 diabetes mellitus patients with coronary artery disease.
Full Text Available Abstract The pericardium and pericardial diseases in particular have received, in contrast to other topics in the field of cardiology, relatively limited interest. Today, despite improved knowledge of pathophysiology of pericardial diseases and the availability of a wide spectrum of diagnostic tools, the diagnostic challenge remains. Not only the clinical presentation may be atypical, mimicking other cardiac, pulmonary or pleural diseases; in developed countries a shift for instance in the epidemiology of constrictive pericarditis has been noted. Accurate decision making is crucial taking into account the significant morbidity and mortality caused by complicated pericardial diseases, and the potential benefit of therapeutic interventions. Imaging herein has an important role, and cardiovascular magnetic resonance (CMR is definitely one of the most versatile modalities to study the pericardium. It fuses excellent anatomic detail and tissue characterization with accurate evaluation of cardiac function and assessment of the haemodynamic consequences of pericardial constraint on cardiac filling. This review focuses on the current state of knowledge how CMR can be used to study the most common pericardial diseases.
Detection of Frequency, Severity and Progression of Cardiovascular Diseases in Patients With HIV-infection.; Effect on Cardiovascular Risk and Life Quality by Age, Gender, Classic Cardiovascular Risk Factors,; HIV-specific Cardiovascular Risk Factors, Cardiovascular Medication, Antiretroviral Medication
Lyerly, G William; Sui, Xuemei; Church, Timothy S; Lavie, Carl J; Hand, Gregory A; Blair, Steven N
An abnormal ECG during maximal exercise testing has been shown to be a powerful predictor of future coronary heart disease (CHD) mortality in asymptomatic men. However, little is known about the relationship between exercise ECG responses and CHD risk in men with diabetes mellitus. We examined the association between exercise ECG responses and mortality in 2854 men with documented diabetes mellitus (mean age 49.5 years) who completed a maximal treadmill exercise test during the period from 1974 to 2001 and who were without a previous cardiovascular disease (CVD) event at baseline. Mortality due to all causes, CHD, and CVD were the main outcome measures across categories of exercise ECG responses, with stratification by cardiorespiratory fitness, quantified as treadmill test duration. During an average follow-up of 16 years, 441 deaths (210 CVD and 133 CHD) were identified. Across normal, equivocal, and abnormal exercise ECG groups, age- and examination year-adjusted CHD mortality rates per 10 000 person-years were 23.0, 48.6, and 69.0, respectively (P(trend)<0.001). After further adjustment for fasting plasma glucose level, smoking, body mass index, hypercholesterolemia, hypertension, family history of CVD or diabetes mellitus, abnormal resting ECG responses, and cardiorespiratory fitness, hazard ratios (95% confidence intervals) were 1.00 (referent), 1.68 (1.01 to 2.77), and 2.21 (1.41 to 3.46; P(trend)<0.001). Similar patterns of associations were noted between exercise ECG testing and both CVD and all-cause mortality risk. Among men with diabetes mellitus, equivocal and abnormal exercise ECG responses were associated with higher risk of all-cause, CVD, and CHD mortality.
Sep 12, 2005 ... as regards the younger woman in early menopause. Until more data is available in this regard, the main focus of prevention should be on interventions to decrease risk factors for cardiovascular disease. Introduction. Cardiovascular disease (CVD) includes hypertension, coronary heart disease. (CHD) ...
Cardiovascular disease causes 30% of deaths globally. By comparison, infectious disease accounts for 10% of global mortality. As these statistics indicate, cardiovascular disease is the most common cause of death in the world. In South Africa, through urbanisation and changes in lifestyle and dietary habits, the prevalence ...
Reddy, K.S.; Katan, M.B.
Cardiovascular diseases (CVD) are growing contributors to global disease burdens, with epidemics of CVD advancing across many regions of the world which are experiencing a rapid health transition. Diet and nutrition have been extensively investigated as risk factors for major cardiovascular diseases
Kwan, Gene F; Mayosi, Bongani M; Mocumbi, Ana O; Miranda, J Jaime; Ezzati, Majid; Jain, Yogesh; Robles, Gisela; Benjamin, Emelia J; Subramanian, S V; Bukhman, Gene
The poorest billion people are distributed throughout the world, though most are concentrated in rural sub-Saharan Africa and South Asia. Cardiovascular disease (CVD) data can be sparse in low- and middle-income countries beyond urban centers. Despite this urban bias, CVD registries from the poorest countries have long revealed a predominance of nonatherosclerotic stroke, hypertensive heart disease, nonischemic and Chagas cardiomyopathies, rheumatic heart disease, and congenital heart anomalies, among others. Ischemic heart disease has been relatively uncommon. Here, we summarize what is known about the epidemiology of CVDs among the world's poorest people and evaluate the relevance of global targets for CVD control in this population. We assessed both primary data sources, and the 2013 Global Burden of Disease Study modeled estimates in the world's 16 poorest countries where 62% of the population are among the poorest billion. We found that ischemic heart disease accounted for only 12% of the combined CVD and congenital heart anomaly disability-adjusted life years (DALYs) in the poorest countries, compared with 51% of DALYs in high-income countries. We found that as little as 53% of the combined CVD and congenital heart anomaly burden (1629/3049 DALYs per 100 000) was attributed to behavioral or metabolic risk factors in the poorest countries (eg, in Niger, 82% of the population among the poorest billion) compared with 85% of the combined CVD and congenital heart anomaly burden (4439/5199 DALYs) in high-income countries. Further, of the combined CVD and congenital heart anomaly burden, 34% was accrued in people under age 30 years in the poorest countries, while only 3% is accrued under age 30 years in high-income countries. We conclude although the current global targets for noncommunicable disease and CVD control will help diminish premature CVD death in the poorest populations, they are not sufficient. Specifically, the current framework (1) excludes deaths of
Kutyrina, I M; Rudenko, T E; Savel'eva, S A; Shvetsov, M Iu; Vasil'eva, M P
To study the prevalence of and risk factors (RF) associated with cardiovascular system damage in patients with predialysis diabetic and nondiabetic chronic kidney disease (CKD). The investigation enrolled 317 patients with CKD of various etiologies. In Group 1 (165 patients with CKD: 54% of men, 46% of women; mean age 46 +/- 15 years), the glomerular filtration rate (GFR) was 37.2 ml/min; the serum creatinine level was 2.9 mg/dl. Group 2 included 152 (41%) patients with type 2 diabetes mellitus (DM) (41% of men and 59% of women; mean age 57.3 +/- 7.1 years). The duration of DM averaged 10.4 +/- 7.1 years. All the patients underwent physical examination; the levels of glycated hemoglobin and adipose tissue hormones, urinary albumin excretion were additionally determined in the diabetic patients. Echocardiography was performed in 172 patients. The influence of populationwide and renal failure-associated RFs on the cardiovascular system was evaluated in CKD. Clinical and instrumental examinations of 165 patients with Stages II-IV nondiabetic CKD revealed atherosclerosis of the aorta and the vessels of the heart, brain, kidney, and lower extremities in 60 (37%), 35 (24%), 30 (18%), 23 (14%), and 8 (5%), respectively. As atherosclerotic vascular lesion progressed, the incidence of cardiovascular events (CVE) increased. Left ventricular hypertrophy (LVH) was diagnosed in 37.3% of the patients with nondiabetic CKD. Along with traditional cardiovascular RFs (age, smoking, gender, arterial hypertension), the renal dysfunction-related factors (anemia, diminished glomerular filtration rate, elevated creatitine levels, and abnormal phosphorus and calcium metabolism) are of importance. An association was found between LVH, atherosclerotic vascular lesion, and heart valve calcification. According to EchoCG data, 36% of the patients with type 2 DM were diagnosed as having LVH. The RFs of the latter were albuminuria, obesity, and abnormal carbohydrate and purine metabolisms. There
Methods: The researcher has carried out a systematic review of research papers published from 1970 to 2013 on DM and associated diseases in Ethiopia. Results and discussion: According to International Diabetes Federation, IDF 2012 report, the prevalence of DM in Ethiopia stands at 3.32 %. However, DM prevalence of ...
Foia, Liliana; Toma, Vasilica; Ungureanu, Didona; Aanei, Carmen; Costuleanu, M
The interrelation between diabetes mellitus and inflammatory periodontal disease has been intensively studied for more than 50 years, a real bidirectional influence existing between patient's glycemic level disorder and periodontal territories alteration. Several studies developed in this direction emerged to the evidences that reveal a general increase of prevalence, extent and severity of gingivitis and periodontitis. Inflammation plays an important role in this interrelation, orchestrating both the periodontal disease and diabetes mellitus pathogeny and complications. Conversely, periodontal disease--infectious disease characterized by a significant inflammatory component--can seriously impair metabolic control of some diabetic patient. Moreover, treatment of periodontal disease and reduction of oral signs of inflammation may have a beneficial result on the diabetic condition (1). Less clear are the mechanisms governing this interrelation (even the literature is abundant in this direction), and, very probably, periodontal diseases serve as initiators of insulin resistance (in a way similar to obesity), thereby aggravating glycemic control. Further research is so imposed in order to clarify this aspect of the relationship between diabetes and periodontal disease.
Ybarra-Muñoz, Juan; Jurado-Campos, Jeronimo; Garcia-Gil, Maria; Zabaleta-Del-Olmo, Edurne; Mir-Coll, Teresa; Zabalegui, Adelaida; Vidal, Josep; Romeo, June H
The relationship between cardiovascular disease and diabetic peripheral neuropathy is mainly sustained by data retrieved from cross-sectional studies focused on cardiovascular risk factors. We aimed to assess the presence of cardiovascular disease as a risk factor for developing diabetic peripheral neuropathy in a type 2 diabetes mellitus population. A 10-year prospective, primary care, multicentre study in a randomly selected cohort. Cardiovascular disease presence included stroke, coronary artery disease and/or peripheral ischaemia. Diabetic peripheral neuropathy diagnosis was based on clinical neurological examination as well as the neuropathy symptoms score and nerve conduction studies. Three hundred and ten (N=310) patients were initially recruited. Two-hundred and sixty seven (N=267) patients were included in the study. Diabetic peripheral neuropathy cumulative incidence was 18.3% (95% confidence intervals 14.1-23.4; N=49). Diabetic peripheral neuropathy development was significantly more frequent in participants presenting with cardiovascular disease at baseline (P=0.01). In the final logistic regression analysis, the presence of cardiovascular disease remained associated with an increased risk for diabetic peripheral neuropathy (odds ratio 2.32, 95% confidence intervals 1.03-5.22) in addition to diabetes duration and low density lipoprotein-cholesterol levels. In our series, type 2 diabetes mellitus patients with cardiovascular disease at baseline present with an increased risk of developing diabetic peripheral neuropathy at 10 years of follow-up. Our results suggest that measures aimed at the prevention, control and treatment of cardiovascular disease can also help prevent diabetic peripheral neuropathy development. © The European Society of Cardiology 2014.
Beck, Hans Christian; Overgaard, Martin; Melholt Rasmussen, Lars
There is an unmet need for new cardiovascular biomarkers. Despite this only few biomarkers for the diagnosis or screening of cardiovascular diseases have been implemented in the clinic. Thousands of proteins can be analysed in plasma by mass spectrometry-based proteomics technologies. Therefore......, this technology may therefore identify new biomarkers that previously have not been associated with cardiovascular diseases. In this review, we summarize the key challenges and considerations, including strategies, recent discoveries and clinical applications in cardiovascular proteomics that may lead...... to the discovery of novel cardiovascular biomarkers....
Asociación de la neuropatía autonómica cardiovascular y el intervalo QT prolongado con la morbimortalidad cardiovascular en pacientes con diabetes mellitus tipo 2 Association of cardiovascular autonomic neuropathy and prolonged QT interval with cardiovascular morbidity and mortality in patients with type 2 diabetes mellitus
Ray Ticse Aguirre
Full Text Available Con el objetivo de evaluar la relación entre la neuropatía autonómica cardiovascular (NACV y el intervalo QT corregido (QTc con la morbimortalidad cardiovascular en pacientes con diabetes mellitus tipo 2, se realizó el seguimiento a 5 años de 67 pacientes que acudieron a consulta externa del Servicio de Endocrinología. Se presentaron eventos cardiovasculares en 16 pacientes; el 82% completó el seguimiento y se encontró que el intervalo QTc prolongado fue la única variable que se asoció de forma significativa a morbimortalidad cardiovascular en el análisis de regresión logística múltiple (RR: 13,56; IC 95%: 2,01-91,36 (p=0,0074.In order to evaluate the relationship between cardiovascular autonomic neuropathy and corrected QT interval (QTc with cardiovascular morbidity and mortality in patients with type 2 diabetes mellitus, we followed up for 5 years 67 patients attending the outpatient Endocrinology Service. 82% completed follow-up and cardiovascular events occurred in 16 patients. We found that long QTc interval was the only variable significantly associated with cardiovascular morbidity and mortality in the multiple logistic regression analysis (RR: 13.56, 95% CI: 2.01-91.36 (p = 0.0074.
de Courten, Barbora; de Courten, Maximilian; Hanson, Robert L
Gypsies (or Roma) recently experienced a transition from a traditional to a Westernized lifestyle. Although mortality in this population is 4-fold higher compared with non-Gypsies, very limited information is available on their morbidity especially with regard to non-communicable diseases. Our aim...... was to determine the prevalence of type 2 diabetes mellitus (T2DM), metabolic syndrome and cardiovascular diseases in Gypsies and non-Gypsies living in the same region of southern Slovakia....
de Courten, Barbora; de Courten, Maximilian; Hanson, Robert L
Gypsies (or Roma) recently experienced a transition from a traditional to a Westernized lifestyle. Although mortality in this population is 4-fold higher compared with non-Gypsies, very limited information is available on their morbidity especially with regard to non-communicable diseases. Our ai...... was to determine the prevalence of type 2 diabetes mellitus (T2DM), metabolic syndrome and cardiovascular diseases in Gypsies and non-Gypsies living in the same region of southern Slovakia....
Morris, Paul D; Channer, Kevin S
Despite regional variations in the prevalence of coronary artery disease (CAD), men are consistently more at risk of developing and dying from CAD than women, and the gender-specific effects of sex hormones are implicated in this inequality. This ‘Perspectives' article reviews the current evidence regarding the cardiovascular effects of testosterone in men including an examination of the age-related decline in testosterone, the relationship between testosterone levels and coronary disease, coronary risk factors and mortality. We also review the vaso-active effects of testosterone, and discuss how these have been used in men with heart failure and angina. We discuss the ‘cause' versus ‘effect' controversy, regarding low testosterone levels in men with coronary heart disease, as well as concerns over the use of testosterone replacement therapy in middle aged and elderly men. The article concludes with a discussion regarding the future direction for work in this interesting area, including the relative merits of screening for, and treating hypogonadism with testosterone replacement therapy in men with heart disease. PMID:22522504
Badir, Aysel; Tekkas, Kader; Topcu, Serpil
Cardiovascular disease is the number one cause of death worldwide. However, there is not enough data exploring student nurses' understanding, knowledge, and awareness of cardiovascular disease. To investigate knowledge of cardiovascular disease and its risk factors among undergraduate nursing students, with an emphasis on understanding of cardiovascular disease as the primary cause of mortality and morbidity, both in Turkey and worldwide. This cross-sectional survey assessed 1138 nursing students enrolled in nursing schools in Istanbul, Turkey. Data were collected using the Cardiovascular Disease Risk Factors Knowledge Level (CARRF-KL) scale and questions from the Individual Characteristics Form about students' gender, age, level of education, and family cardiovascular health history, as well as smoking and exercise habits. Respondents demonstrated a high level of knowledge about cardiovascular disease, with years of education (p students were not aware that cardiovascular disease is the primary cause of mortality and morbidity in Turkey and worldwide. The majority of the respondents' body mass index (87%) and waist circumference values (females: 90.3%, males: 94.7%) were in the normal range and most were non-smokers (83.7%). However, more than half of the students did not exercise regularly and had inadequate dietary habits. Although students were knowledgeable about cardiovascular disease and associated risk factors, there were significant gaps in their knowledge; these should be addressed through improved nursing curricula. While students were generally healthy, they could improve their practice of health-promoting behaviors. © The European Society of Cardiology 2014.
So, Eun Sun
This study investigated the cardiovascular risk factors associated with depression among Korean adults with coronary artery disease (CAD) and cerebrovascular disease (CBVD). A total of 487 coronary artery disease and 434 cerebrovascular disease subjects from the Fourth Korean National Health and Nutrition Examination Survey were analyzed according to sex using multiple logistic regression. The prevalence of depression was 21.7% in those with CAD and 25.5% in those with CBVD. The associated risk factors for depression were female sex (odds ratio [OR] 15.77; 95% confidence interval [CI], 2.44-102.03, P = 0.004), less education (OR 7.09 and 10.36, 95% CI, 1.24-40.75, 1.86-57.70 for an elementary and middle school education, respectively), and hypertension (OR 5.35; 95% CI, 1.48-19.40) in those with CAD and were female sex (OR 4.06, 95% CI, 1.12-14.76) and diabetes mellitus (OR 3.31, 95% CI, 1.36-8.05) in CBVD. These significant associations remained in males, but not in females in those with both CAD and CBVD. This study found the associations between hypertension and depression in those with CAD and diabetes mellitus and depression in those with CBVD in males, but not in females. Further studies are needed to explore the associated psychosocial factors of depression in those with different CAD kinds in females. © 2014 Wiley Publishing Asia Pty Ltd.
Monea, Adriana; Mezei, Tibor; Popsor, Sorin; Monea, Monica
Objective. To investigate oxidative stress (OS) and histological changes that occur in the periodontium of subjects with type 2 diabetes mellitus without signs of periodontal disease and to establish if oxidative stress is a possible link between diabetes mellitus and periodontal changes. Materials and Methods. Tissue samples from ten adult patients with type 2 diabetes mellitus (T2D) and eight healthy adults were harvested. The specimens were examined by microscope using standard hematoxylin-eosin stain, at various magnifications, and investigated for tissue levels of malondialdehyde (MDA) and glutathione (GSH). Results. Our results showed that periodontal tissues in patients with T2D present significant inflammation, affecting both epithelial and connective tissues. Mean MDA tissue levels were 3.578 ± 0.60 SD in diabetics versus 0.406 ± 0.27 SD in controls (P diabetics versus 9.7875 ± 2.42 SD in controls (P Diabetic subjects had higher MDA levels in their periodontal tissues, suggesting an increased lipid peroxidation in T2D, and decreased GSH tissue levels, suggesting an alteration of the local antioxidant defense mechanism. These results are in concordance with the histological changes that we found in periodontal tissues of diabetic subjects, confirming the hypothesis of OS implication, as a correlation between periodontal disease incidence and T2D.
Full Text Available Objective. To investigate oxidative stress (OS and histological changes that occur in the periodontium of subjects with type 2 diabetes mellitus without signs of periodontal disease and to establish if oxidative stress is a possible link between diabetes mellitus and periodontal changes. Materials and Methods. Tissue samples from ten adult patients with type 2 diabetes mellitus (T2D and eight healthy adults were harvested. The specimens were examined by microscope using standard hematoxylin-eosin stain, at various magnifications, and investigated for tissue levels of malondialdehyde (MDA and glutathione (GSH. Results. Our results showed that periodontal tissues in patients with T2D present significant inflammation, affecting both epithelial and connective tissues. Mean MDA tissue levels were 3.578 ± 0.60 SD in diabetics versus 0.406 ± 0.27 SD in controls (P < 0.0001, while mean GSH tissue levels were 2.48 ± 1.02 SD in diabetics versus 9.7875 ± 2.42 SD in controls (P < 0.0001. Conclusion. Diabetic subjects had higher MDA levels in their periodontal tissues, suggesting an increased lipid peroxidation in T2D, and decreased GSH tissue levels, suggesting an alteration of the local antioxidant defense mechanism. These results are in concordance with the histological changes that we found in periodontal tissues of diabetic subjects, confirming the hypothesis of OS implication, as a correlation between periodontal disease incidence and T2D.
Full Text Available Introduction: Cardiovascular disease is the leading cause of death in type2 diabetes (DM. Microalbuminuria (MAis strongly associated with cardiovascular complications in type2 diabetes. Impaired cardiovascular autonomicfunction and increased albumin excretion are related in patients with diabetes. So this study is designed toinvestigate the relationship between cardiovascular autonomic function and microalbuminuria in type2 diabetes.Methods: The study comprised of 180 subjects of age group>50 years, classified into 3 groups of 60 subjects each.DM without MA, DM with MA and controls. The tests performed were 1 Heart rate response to deep breathing,valsalva maneuver and standing; 2 Blood pressure response to standing and to sustained handgrip. Individual testswere given score of 0, 1, or 2 and an overall autonomic test score of 0-10 was obtained.Results: Mean autonomic score in control, DM without MA and DM with MA are 1.97 ± 0.81, 5.73 ± 1.26 and 7.00± 1.80 respectively. The Coefficient of variation (% of control, DM without MA, DM with MA is 41.1, 21.9 and25.7 respectively. A significant difference in autonomic score was observed in the DM without MA (P<0.01 andDM with MA (P<0.01 when compared to controls.Conclusion: In conclusion type2 diabetic individuals should be diagnosed early to prevent disease progression tomicroalbuminuria and thus minimize complications.
Minara Shamkhalovna Shamkhalova
Full Text Available Expansion of diabetic population (predominantly due to type 2 diabetes mellitus with chronic kidney disease (CKD comorbidity constitutes one of the major challenges in modern medicine.Throughout the course of diabetes nephropathy development, from its debut to the terminal stage, survival rate and quality of life are lower than those of other categories of patients. This indicates crucial role of hyperglycemia in accelerated metabolic degradation typical of CKD.Renal disease severely narrows the spectrum of available glucose-lowering agents. Concurrent treatment for hypertension and dyslipidemia, as well as anti-platelet therapy and stimulation of erythropoiesis becomes a complex issue. A creative and patient-oriented approach with clear metabolic and cardiovascular goals should be instrumental in its solution.
Eilat-Adar, Sigal; Sinai, Tali; Yosefy, Chaim; Henkin, Yaakov
Lifestyle factors, including nutrition, play an important role in the etiology of Cardiovascular Disease (CVD). This position paper, written by collaboration between the Israel Heart Association and the Israel Dietetic Association, summarizes the current, preferably latest, literature on the association of nutrition and CVD with emphasis on the level of evidence and practical recommendations. The nutritional information is divided into three main sections: dietary patterns, individual food items, and nutritional supplements. The dietary patterns reviewed include low carbohydrate diet, low-fat diet, Mediterranean diet, and the DASH diet. Foods reviewed in the second section include: whole grains and dietary fiber, vegetables and fruits, nuts, soy, dairy products, alcoholic drinks, coffee and caffeine, tea, chocolate, garlic, and eggs. Supplements reviewed in the third section include salt and sodium, omega-3 and fish oil, phytosterols, antioxidants, vitamin D, magnesium, homocysteine-reducing agents, and coenzyme Q10.
Full Text Available Lifestyle factors, including nutrition, play an important role in the etiology of Cardiovascular Disease (CVD. This position paper, written by collaboration between the Israel Heart Association and the Israel Dietetic Association, summarizes the current, preferably latest, literature on the association of nutrition and CVD with emphasis on the level of evidence and practical recommendations. The nutritional information is divided into three main sections: dietary patterns, individual food items, and nutritional supplements. The dietary patterns reviewed include low carbohydrate diet, low-fat diet, Mediterranean diet, and the DASH diet. Foods reviewed in the second section include: whole grains and dietary fiber, vegetables and fruits, nuts, soy, dairy products, alcoholic drinks, coffee and caffeine, tea, chocolate, garlic, and eggs. Supplements reviewed in the third section include salt and sodium, omega-3 and fish oil, phytosterols, antioxidants, vitamin D, magnesium, homocysteine-reducing agents, and coenzyme Q10.
Eilat-Adar, Sigal; Sinai, Tali; Yosefy, Chaim; Henkin, Yaakov
Lifestyle factors, including nutrition, play an important role in the etiology of Cardiovascular Disease (CVD). This position paper, written by collaboration between the Israel Heart Association and the Israel Dietetic Association, summarizes the current, preferably latest, literature on the association of nutrition and CVD with emphasis on the level of evidence and practical recommendations. The nutritional information is divided into three main sections: dietary patterns, individual food items, and nutritional supplements. The dietary patterns reviewed include low carbohydrate diet, low-fat diet, Mediterranean diet, and the DASH diet. Foods reviewed in the second section include: whole grains and dietary fiber, vegetables and fruits, nuts, soy, dairy products, alcoholic drinks, coffee and caffeine, tea, chocolate, garlic, and eggs. Supplements reviewed in the third section include salt and sodium, omega-3 and fish oil, phytosterols, antioxidants, vitamin D, magnesium, homocysteine-reducing agents, and coenzyme Q10. PMID:24067391
Cordes, J; Lange-Asschenfeldt, C; Hiemke, C; Kahl, K G
Increased cardiometabolic morbidity and increased overall mortality has been observed in patients with severe mental disorders. Therefore, cardiometabolic safety is an important issue in the treatment of patients with psychiatric disorders, in particular in patients with comorbid cardiometabolic diseases. Frequent adverse side effects include disturbances of lipid and glucose metabolism, body weight changes and alterations of the QTc interval. Dependent on the particular substance used and on factors concerning individual vulnerability, these side effects vary in relative frequency. Therefore, regular monitoring is recommended including ECG. Furthermore, interactions between different medicaments may occur, either leading to enhanced or decreased drug concentrations. Prior to psychopharmacological treatment, proper cardiological treatment is recommended. The management of cardiovascular risks under psychopharmacology requires interdisciplinary cooperation between the cardiologist, general practitioner and psychiatrist.
Graves, Karen L; Vigerust, David J
Over the past decade significant advancement has occurred in the biological and pathological role that Hp has in cardiovascular disease. Hp is an acute-phase protein with a role in the neutralization and clearance of free heme. Iron has tremendous potential for initiating vascular oxidation, inflammation and exacerbating coronary atherosclerosis. Hp genotype has been linked as a prognostic biomarker of acute myocardial infarction, heart failure, restenosis and cardiac transplant rejection. The increased understanding of Hp as a biomarker has provided new insights into the mechanisms of inflammation after cardiac injury and support the concept that Hp is not only an important antioxidant in vascular inflammation and atherosclerosis, but also an enhancer of inflammation in cardiac transplant.
Full Text Available Abstract Celiac Disease (CD occurs in patients with Type 1 Diabetes (T1D ranging the prevalence of 4.4-11.1% versus 0.5% of the general population. The mechanism of association of these two diseases involves a shared genetic background: HLA genotype DR3-DQ2 and DR4-DQ8 are strongly associated with T1D, DR3-DQ2 with CD. The classical severe presentation of CD rarely occurs in T1D patients, but more often patients have few/mild symptoms of CD or are completely asymptomatic (silent CD. In fact diagnosis of CD is regularly performed by means of the screening in T1D patients. The effects of gluten-free diet (GFD on the growth and T1D metabolic control in CD/T1D patient are controversial. Regarding of the GFD composition, there is a debate on the higher glycaemic index of gluten-free foods respect to gluten-containing foods; furthermore GFD could be poorer of fibers and richer of fat. The adherence to GFD by children with CD-T1D has been reported generally below 50%, lower respect to the 73% of CD patients, a lower compliance being more frequent among asymptomatic patients. The more severe problems of GFD adherence usually occur during adolescence when in GFD non compliant subjects the lowest quality of life is reported. A psychological and educational support should be provided for these patients.
Rathcke, Camilla N; Vestergaard, Henrik
Several inflammatory cytokines are involved in vascular inflammation resulting in endothelial dysfunction which is the earliest event in the atherosclerotic process leading to manifest cardiovascular disease. YKL-40 is an inflammatory glycoprotein involved in endothelial dysfunction by promoting...... with all-cause as well as cardiovascular mortality. Finally, YKL-40 levels are elevated both in patients with type 1 and type 2 diabetes, known to be at high risk for the development of cardiovascular diseases, when compared to non-diabetic persons. A positive association between elevated circulating YKL...... dysfunction, atherosclerosis, cardiovascular disease and diabetes and look ahead on future perspectives of YKL-40 research....
Kong, L X; Peng, Z; Sugumar, D
Cardiovascular diseases are the leading cause of death and morbidity in industrialized nations and are becoming an urgent health problem for all nations due to the unstoppable trend of an ageing and obese population. Due to the rapid development of micro total analysis systems (microTAS) and nanotechnology in recent years, they will play an important role in the diagnosis, management, and therapy of cardiovascular diseases. It is envisaged that the micro and nanotechnologies developed for treating other diseases shall be explored for cardiovascular applications to reduce the research effort required for commercializing the devices and drugs to meet the increasing demand of the cardiovascular patients.
Desai, Jay R; Vazquez-Benitez, Gabriela; Xu, Zhiyuan; Schroeder, Emily B; Karter, Andrew J; Steiner, John F; Nichols, Gregory A; Reynolds, Kristi; Xu, Stanley; Newton, Katherine; Pathak, Ram D; Waitzfelder, Beth; Lafata, Jennifer Elston; Butler, Melissa G; Kirchner, H Lester; Thomas, Abraham; O'Connor, Patrick J
Examining trends in cardiovascular events and mortality in US health systems can guide the design of targeted clinical and public health strategies to reduce cardiovascular events and mortality rates. We conducted an observational cohort study from 2005 to 2011 among 1.25 million diabetic subjects and 1.25 million nondiabetic subjects from 11 health systems that participate in the Surveillance, Prevention and Management of Diabetes Mellitus (SUPREME-DM) DataLink. Annual rates (per 1000 person-years) of myocardial infarction/acute coronary syndrome (International Classification of Diseases-Ninth Revision, 410.0–410.91, 411.1–411.8), stroke (International Classification of Diseases-Ninth Revision, 430–432.9, 433–434.9), heart failure (International Classification of Diseases-Ninth Revision, 428–428.9), and all-cause mortality were monitored by diabetes mellitus (DM) status, age, sex, race/ethnicity, and a prior cardiovascular history. We observed significant declines in cardiovascular events and mortality rates in subjects with and without DM. However, there was substantial variation by age, sex, race/ethnicity, and prior cardiovascular history. Mortality declined from 44.7 to 27.1 (P<0.0001) for those with DM and cardiovascular disease (CVD), from 11.2 to 10.9 (P=0.03) for those with DM only, and from 18.9 to 13.0 (P<0.0001) for those with CVD only. Yet, in the [almost equal to]85% of subjects with neither DM nor CVD, overall mortality (7.0 to 6.8; P=0.10) and stroke rates (1.6–1.6; P=0.77) did not decline and heart failure rates increased (0.9–1.15; P=0.0005). To sustain improvements in myocardial infarction, stroke, heart failure, and mortality, health systems that have successfully focused on care improvement in high-risk adults with DM or CVD must broaden their improvement strategies to target lower risk adults who have not yet developed DM or CVD.
Vos, Miriam B; Kaar, Jill L; Welsh, Jean A; Van Horn, Linda V; Feig, Daniel I; Anderson, Cheryl A M; Patel, Mahesh J; Cruz Munos, Jessica; Krebs, Nancy F; Xanthakos, Stavra A; Johnson, Rachel K
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. 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. 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. © 2017 American Heart Association, Inc.
Apr 24, 2012 ... investigate the long term effects, animals were treated daily for four weeks with either distilled water. (controls) or 300 ... However, in the four week treated rats, glucose (mmol/L) was significantly lower (16.2±2.9; P<0.05) than in the controls ... cardiovascular disease and stroke (Gong et al., 2009;. Carmena ...
Greevenboek, van M.M.; Zhang, J.; Kallen, C.J.; Schiffers, P.M.; Feskens, E.J.M.; Bruin, T.W.
Abstract Background: Genetic dissection of complex diseases requires innovative approaches for identification of disease-predisposing genes. A well-known example of a human complex disease with a strong genetic component is Type 2 Diabetes Mellitus (T2DM). Methods: We genotyped
V. V. Syvolap
Full Text Available The prospects of using new drug of statine class – pitavastatine – in the prophylaxis and treatment of cardiovascular diseases have been considered in this review. The data of international іnvestigations on the comparative effi cacy of pitavastatine have been given; its pleiotropic effects, high profi le safety and tolerance, the decrease in the risk of drugs’ interaction have been shown.
Furuya, Fumihiko; Shimura, Hiroki; Takahashi, Kazuya; Akiyama, Daiichiro; Motosugi, Ai; Ikegishi, Yukinobu; Haraguchi, Kazutaka; Kobayashi, Tetsuro
Accelerated formation and tissue accumulation of advanced glycation end products (AGEs), reflecting cumulative glycemic and oxidative stress, occurs in age-related and chronic diseases like diabetes mellitus (DM) and renal failure, and contributes to vascular damage. Skin autofluorescence (AFR), a noninvasive measurement method, reflects tissue accumulation of AGEs. AFR has been reported to be an independent predictor of mortality in Caucasian hemodialysis patients. We assessed the relationship between levels of AFR and the prevalence of cardiovascular disease (CVD), and clarified the prognostic usefulness of skin AFR levels in Asian (non-Caucasian) hemodialysis (HD) patients. AFR was measured with an autofluorescence reader in 64 HD patients. Overall and cardiovascular mortality was monitored prospectively during the 3-year follow-up. During follow-up, CVD events occurred in 21 patients. The deaths of 10 HD patients were associated with CVD. Multivariate logistic regression analyses showed that initial AFR was an independent risk factor for de novo CVD in HD patients with or without diabetes. When patients were classified on the basis of AFR tertiles, Cochran-Armitage analysis demonstrated that the highest tertile of AFR level showed an increased odds ratio for the prevalence of CVD. These findings suggest that AFR levels can be used to detect the prevalence of CVD in HD patients with or without diabetes. © 2014 The Authors. Therapeutic Apheresis and Dialysis © 2014 International Society for Apheresis.
Background:The prevalence of cardiovascular diseases is increasing in most developing countries, especially in urban settings. Despite this increasing trend, there is limited data on the association between diet and cardiovascular disease risk factors in Tanzania. Objective: To assess the frequency of intake of various ...
Riphagen, Ineke Jowanna
Diet plays a relevant role in the development and progression of lifestyle-related diseases like hypertension and type 2 diabetes and the subsequent risk of cardiovascular and renal disease. Riphagen used several diet-sensitive biomarkers to further explore the effects of diet on cardiovascular and
The analysis, which examines the prevalence of cardiovascular diseases (ICD 9: 390-459) in Lagos State of Nigeria, was based on records obtained from the register of deaths in four Local Government Areas of the State. The result shows that there is general increase in death rates due to cardiovascular diseases over the ...
Miller, I M; Skaaby, T; Ellervik, C
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...
This study examines the effects of marital history on the burden of cardiovascular disease in midlife. With use of data from the 1992 Health and Retirement Study, a series of nested logistic regression models was used to estimate the association between marital history and the likelihood of cardiovascular disease. Results suggest that, in midlife,…
Statistical Fact Sheet 2013 Update Hispanics/Latinos & Cardiovascular Diseases Cardiovascular Disease (CVD) (ICD/10 codes I00-I99, Q20-Q28) (ICD/9 codes 390-459, 745-747) Among Mexican-American adults age 20 ...
Holmes, Michael V; Simon, Tabassome; Exeter, Holly J
This study sought to investigate the role of secretory phospholipase A2 (sPLA2)-IIA in cardiovascular disease.......This study sought to investigate the role of secretory phospholipase A2 (sPLA2)-IIA in cardiovascular disease....
Cardiovascular disease is one of the biggest contemporary health problems worldwide. To aid preventive measures, risk calculators have been developed to estimate the risk of dying of cardiovascular disease within 10 years, for use in healthy individuals. Decisions to initiate preventive measures are
Strizhakov, L A; Lebedeva, M V; Fomin, V V; Muhin, N A
The paper gives Russian and foreign authors' data on a relationship between occupational factors and cardiovascular diseases. It considers the impact of psychosocial stress on the risk of hypertension, coronary heart disease, and cardiovascular events in representatives of different professional groups.
Cardiovascular diseases are still one of the leading causes of morbidity and mortality worldwide. The major risk factors currently associated with cardiovascular diseases will continuously increase these numbers, especially in developing countries, which will lead to a steep increase in mortality
O.H. Franco (Oscar); C.E.D. de Laet (Chris); A. Peeters (Andrea); J. Jonker (Joost); J.P. Mackenbach (Johan); W.J. Nusselder (Wilma)
textabstractBackground: Physical inactivity is a modifiable risk factor for cardiovascular disease. However, little is known about the effects of physical activity on life expectancy with and without cardiovascular disease. Our objective was to calculate the consequences of different physical
Squizzato, Alessandro; Keller, Tymen; Romualdi, Erica; Middeldorp, Saskia
Aspirin is the prophylactic antiplatelet drug of choice for people with cardiovascular disease. Adding a second antiplatelet drug to aspirin may produce additional benefit for those at high risk and those with established cardiovascular disease. To quantify the benefit and harm of adding clopidogrel
Rajhans, Neelima S.; Kohad, Ramesh M.; Chaudhari, Viren G.; Mhaske, Nilkanth H.
The relationship between diabetes mellitus and periodontal disease is not clear, even though studied intensively. From the available data, it seemed reasonable to believe that diabetics were more susceptible to periodontal disease than non-diabetics. Aim: The present study was to clinically evaluate the relationship of diabetes mellitus with periodontal disease along with various parameters. Materials and Methods: Fifteen hundred patients with diabetes mellitus were examined. A thorough oral ...
Wang, Kang-Ling; Liu, Chia-Jen; Chao, Tze-Fan; Chen, Su-Jung; Wu, Cheng-Hsueh; Huang, Chi-Ming; Chang, Chun-Chin; Wang, Ko-Fan; Chen, Tzeng-Ji; Lin, Shing-Jong; Chiang, Chern-En
The Food and Drug Administration recently updated the safety warning concerning the association between statin therapy and new-onset diabetes mellitus (NODM). For prediabetes, little information is available for statins on cardiovascular outcome reduction and diabetogenic consequences. This study aimed to examine the risk of NODM and the reduction of cardiovascular events and death (MACE) after statin therapy in the prediabetic subjects. The medical and pharmacy claims of the prediabetic beneficiaries were retrieved from Taiwan National Health Insurance research database. The occurrence of NODM, MACE, and morbidity indexed by hospitalizations and emergency visits was ascertained by ambulatory and inpatient database. A propensity score-matched model was constructed for statin users and nonusers. During follow-up (4.1 ± 2.5 years), NODM and MACE occurred in 23.5% and 16.7%, respectively, of nonusers and 28.5% and 12.0%, respectively, of users. Statin therapy was associated with a greater risk of NODM (hazard ratio 1.20, 95% confidence interval 1.08 to 1.32) and less risk of MACE (hazard ratio 0.70, 95% confidence interval 0.61 to 0.80), both in dose-dependent fashions. The earlier and more persistent use correlated with the greater increase in risk of NODM offset by the proportionally larger reduction in MACE. Furthermore, the early persistent users had the lowest rate of hospitalizations and emergency visits. In conclusion, our findings suggested that the relation between NODM and therapeutic advantages of statins was parallel in the prediabetic population. Treatment benefits outweighed diabetic consequences in subjects receiving the earlier and more persistent treatment. Copyright © 2014 Elsevier Inc. All rights reserved.
Janovsky, Carolina Castro Porto Silva; Rolim, Luiz Clemente de Souza Pereira; de Sá, João Roberto; Poyares, Dalva; Tufik, Sergio; Silva, Ademir Baptista; Dib, Sergio Atala
Knowledge about association between sleep apnea and cardiovascular autonomic neuropathy (CAN) in type 1 diabetes mellitus (T1DM) might give some insight into the pathogenesis of this condition in these patients. In obese patients, excessive central adiposity, including a large neck circumference, can contribute to obstructive sleep apnea (OSA). Its presence in non-obese patients, however, indicates that it could be correlated with autonomic neuropathy. The aim of this study was to compare the prevalence of OSA in young and lean T1DM patients with and without CAN. We studied 20 adult, non-obese, T1DM patients who were divided into two groups according to the results of the cardiovascular autonomic reflex tests (CARTs). These two groups (9 with CAN and 11 without CAN) were compared to a control group of 22 healthy individuals, who were matched by age and BMI. A polysomnography was performed and sleep was analyzed. The CAN+ group had a significantly higher prevalence of sleep apnea compared to the other groups (67% CAN+; 23% CAN-; 4.5% controls: CAN+ vs. Control; p = 0.006 and CAN+ vs. CAN-; p = 0.02). The CAN- group had higher sleep efficiency compared to the CAN+ group, demonstrating impaired sleep architecture in diabetics with this chronic complication. In conclusion, OSA may be related to the presence of CAN in young and lean T1DM patients. It could contribute to worse the prognosis and reducing the quality of life of these patients without specific treatment of these conditions.
Mangge, H; Stelzer, I; Reininghaus, E Z; Weghuber, D; Postolache, T T; Fuchs, D
Atherosclerosis (AS), a major pathologic consequence of obesity, is the main etiological factor of cardiovascular disease (CVD), which is the most common cause of death in the western world. A systemic chronic low grade immune- mediated inflammation (scLGI) is substantially implicated in AS and its consequences. In particular, proinflammatory cytokines play a major role, with Th1-type cytokine interferon-γ (IFN-γ) being a key mediator. Among various other molecular and cellular effects, IFN-γ activates the enzyme indoleamine 2,3-dioxygenase (IDO) in monocyte-derived macrophages, dendritic, and other cells, which, in turn, decreases serum levels of the essential amino acid tryptophan (TRP). Thus, people with CVD often have increased serum kynurenine to tryptophan ratios (KYN/TRP), a result of an increased TRP breakdown. Importantly, increased KYN/TRP is associated with a higher likelihood of fatal cardiovascular events. A scLGI with increased production of the proinflammatory adipokine leptin, in combination with IFN-γ and interleukin-6 (IL-6), represents another central link between obesity, AS, and CVD. Leptin has also been shown to contribute to Th1-type immunity shifting, with abdominal fat being thus a direct contributor to KYN/TRP ratio. However, TRP is not only an important source for protein production but also for the generation of one of the most important neurotransmitters, 5-hydroxytryptamine (serotonin), by the tetrahydrobiopterin-dependent TRP 5-hydroxylase. In prolonged states of scLGI, availability of free serum TRP is strongly diminished, affecting serotonin synthesis, particularly in the brain. Additionally, accumulation of neurotoxic KYN metabolites such as quinolinic acid produced by microglia, can contribute to the development of depression via NMDA glutamatergic stimulation. Depression had been reported to be associated with CVD endpoints, but it most likely represents only a secondary loop connecting excess adipose tissue, scLGI and
Tuleutaeva, S; Ashirbekova, Z; Manapova, D; Almurat, S; Kharchenko, V
The aim of the article was to study the occurrence of periodontal diseases in children with type I diabetes mellitus. The examination of 78 children revealed periodontal diseases in 40 children with type I diabetes. OHI-S, CPITN, PMA indices were determined. Pathological changes in periodontal tissues were revealed in 100% of cases. The following were identified: gingival hemorrhage (100%), over - and under-gingival dental tartar (100%), inflammation of gingival papilla (87,5%) marginal (80%) and alveolar gingiva (55%). Spread of periodontal disease among children with I type diabetes is characterized as high and is equal to 100%. Degree of periodontal sickness is evaluated as average and is M=2,28; SD=0,47 according to CPITN index. Treatment and preventive measures should be carried out taking into account major somatic disease.
Full Text Available Lipoprotein(a (Lp(a is an LDL-like molecule consisting of an apolipoprotein B-100 (apo(B-100 particle attached by a disulphide bridge to apo(a. Many observations have pointed out that Lp(a levels may be a risk factor for cardiovascular diseases. Lp(a inhibits the activation of transforming growth factor (TGF and contributes to the growth of arterial atherosclerotic lesions by promoting the proliferation of vascular smooth muscle cells and the migration of smooth muscle cells to endothelial cells. Moreover Lp(a inhibits plasminogen binding to the surfaces of endothelial cells and decreases the activity of fibrin-dependent tissue-type plasminogen activator. Lp(a may act as a proinflammatory mediator that augments the lesion formation in atherosclerotic plaques. Elevated serum Lp(a is an independent predictor of coronary artery disease and myocardial infarction. Furthermore, Lp(a levels should be a marker of restenosis after percutaneous transluminal coronary angioplasty, saphenous vein bypass graft atherosclerosis, and accelerated coronary atherosclerosis of cardiac transplantation. Finally, the possibility that Lp(a may be a risk factor for ischemic stroke has been assessed in several studies. Recent findings suggest that Lp(a-lowering therapy might be beneficial in patients with high Lp(a levels. A future therapeutic approach could include apheresis in high-risk patients in order to reduce major coronary events.
Full Text Available The risk of cardiovascular (CV events and mortality is significantly higher in patients with systemic rheumatic diseases than in the general population. Although CV involvement in such patients is highly heterogeneous and may affect various structures of the heart, it can now be diagnosed earlier and promptly treated. Various types of assessments are employed for the evaluation of CV risk such as transthoracic or transesophageal echocardiography, magnetic resonance imaging (MRI, and computed tomography (CT to investigate valve abnormalities, pericardial disease, and ventricular wall motion defects. The diameter of coronary arteries can be assessed using invasive quantitative coronarography or intravascular ultrasound, and coronary flow reserve can be assessed using non-invasive transesophageal or transthoracic ultrasonography (US, MRI, CT, or positron emission tomography (PET after endothelium-dependent vasodilation. Finally, peripheral circulation can be measured invasively using strain-gauge plethysmography in an arm after the arterial infusion of an endothelium-dependent vasodilator or non-invasively by means of US or MRI measurements of flow-mediated vasodilation of the brachial artery. All of the above are reliable methods of investigating CV involvement, but more recently, introduced use of speckle tracking echocardiography and 3-dimensional US are diagnostically more accurate.
Menon, Madhav C; Ix, Joachim H
Recent epidemiologic studies have linked higher serum phosphorus concentrations to cardiovascular disease (CVD) events and mortality. This association has been identified in the general population and in those with chronic kidney disease (CKD). The risk of adverse outcomes appears to begin with phosphorus concentrations within the upper limit of the normal reference range. Multiple experimental studies have suggested pathogenetic mechanisms that involve direct and indirect effects of high phosphorus concentrations to explain these associations. Drawing from these observations, guideline-forming agencies have recommended that serum phosphorus concentrations be maintained within the normal reference range in patients with CKD and that dietary phosphorus restriction or use of intestinal phosphate binders should be considered to achieve this goal. However, outside the dialysis population, the links between dietary phosphorus intake and serum phosphorus concentrations, and dietary phosphorus intake and CVD events, are uncertain. With specific reference to the nondialysis populations, this review discusses the available data linking dietary phosphorus intake with serum phosphorus concentrations and CVD events. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.
Azad, Muhammad Chanchal; Shoesmith, Wendy Diana; Al Mamun, Mohammad; Abdullah, Ahmad Faris; Naing, Daw Khin Saw; Phanindranath, Mahadasa; Turin, Tanvir Chowdhury
The presence of comorbid physical illnesses especially, cardiovascular diseases (CVD) in schizophrenia is a growing area of concern in recent years. In order to reduce disease burden, to improve quality of life and to provide holistic care, it is important to know about the relationship between schizophrenia and CVD. The objective of this review is to explore the extent of CVD problems, relevant risk factors and potential measures for early diagnosis and prevention of CVD among patients with schizophrenia. Worldwide studies show that patients with schizophrenia have a higher mortality and lower life expectancy than the general population. CVD is the leading cause of increased mortality in schizophrenia. Common CVD risk factors in schizophrenia include metabolic syndrome, sedentary behaviour, tobacco smoking, effects of antipsychotics, long chain omega-3 fatty acid deficiency and shared genetics between CVD and schizophrenia. The potential methods for early detection and prevention of CVD in schizophrenia are also discussed. Though the patients with schizophrenia form a high risk group for CVD, consensus guidelines for early detection and prevention of CVD in schizophrenia are lacking. Comorbidity of CVD in schizophrenia needs more serious attention by clinicians and researchers. Copyright © 2015 Elsevier B.V. All rights reserved.
Kuramitsu, H K; Qi, M; Kang, I C; Chen, W
Several epidemiological studies as well as a recent animal model approach have suggested a role for periodontal diseases in the development of cardiovascular disease (CVD). This relationship could be mediated by inflammatory responses induced by periodontal pathogens as well as direct interaction of these organisms with cardiac tissue. In order to explore these possibilities, the effects of the periodontal pathogen Porphyromonas gingivalis on cellular events proposed to play a role in CVD were investigated. P. gingivalis, as well as its outer membrane vesicles (OMV), was able to induce foam cell formation (an important characteristic of CVD) in the murine macrophage cell line J774 A.1. This property appears to be mediated by the lipopolysaccharide (LPS) fraction of the cells. Several other oral bacteria were also able to induce foam cell formation. Furthermore, since the rupture of the fibrous cap of plaque appears to be an important factor in acute coronary syndrome, it was demonstrated that P. gingivalis 381 degraded fibrous caps isolated from autopsy samples. In addition, it was observed that strain 381 strongly induced matrix metalloproteinase (MMP)-9 protease activity, implicated in plaque rupture, from the J774 A.1 macrophages. Finally, strain 381 was able to enhance monocyte chemoattractant protein-1 (MCP-1) and NADH oxidase expression from endothelial cells. Therefore, P. gingivalis exhibits several properties which could play a role in CVD as mediators of LDL oxidation, foam cell formation, and rupture of atherosclerotic plaque.
Ishino, Hirokazu; Hara, Yasushi; Teshima, Takahiro; Tanaka, Shigeki; Takekoshi, Susumu; Nezu, Yoshinori; Harada, Yasuji; Yogo, Takuya; Sako, Toshinori; Koyama, Hidekazu; Teramoto, Akira; Osamura, Robert Y; Tagawa, Masahiro
An 11-year-old male mixed breed dog diagnosed with Cushing's disease and diabetes mellitus was treated by hypophysectomy. After surgery, the hypercortisolemia disappeared and the diabetes status improved. The insulin requirement to control hyperglycemia gradually decreased. At 12 weeks after surgery, there was no requirement for insulin and we suspected the diabetes was completely resolved. In the present case, diabetes mellitus seems to be secondary to Cushing's disease. In conclusion, this mixed breed dog with coexisting Cushing's disease and diabetes mellitus is the first case showing the effectiveness of hypophysectomy to treat diabetes mellitus secondary to Cushing's disease in dogs.
Friedman, Joseph I; Tang, Cheuk Y; de Haas, Hans J; Changchien, Lisa; Goliasch, Georg; Dabas, Puneet; Wang, Victoria; Fayad, Zahi A; Fuster, Valentin; Narula, Jagat
Reviews of imaging studies assessing the brain effects of vascular risk factors typically include a substantial number of studies with subjects with a history of symptomatic cardiovascular or cerebrovascular disease and/or events, limiting our ability to disentangle the primary brain effects of vascular risk factors from those of resulting brain and cardiac damage. The objective of this study was to perform a systematic review of brain changes from imaging studies in patients with vascular risk factors but without clinically manifest cardiovascular or cerebrovascular disease or events. The 77 studies included in this review demonstrate that in persons without symptomatic cardiovascular, cerebrovascular, or peripheral vascular disease, the vascular risk factors of hypertension, diabetes mellitus, obesity, hyperlipidemia, and smoking are all independently associated with brain imaging changes before the clinical manifestation of cardiovascular or cerebrovascular disease. We conclude that the identification of brain changes associated with vascular risk factors, before the manifestation of clinically significant cerebrovascular damage, presents a window of opportunity wherein adequate treatment of these modifiable vascular risk factors may prevent the development of irreversible deleterious brain changes and potentially alter patients' clinical course. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Latha, Raja; Shanthi, Palanivelu; Sachdanandam, Panchanadham
Efficacy of Kalpaamruthaa on the activities of lipid and carbohydrate metabolic enzymes, electron transport chain complexes and mitochondrial ATPases were studied in heart and liver of experimental rats. Cardiovascular damage (CVD) was developed in 8 weeks after type 2 diabetes mellitus induction with high fat diet (2 weeks) and low dose of streptozotocin (2 × 35 mg/kg b.w. i.p. in 24 hr interval). In CVD-induced rats, the activities of total lipase, cholesterol ester hydrolase and cholesterol ester synthetase were increased, while lipoprotein lipase and lecithin-cholesterol acyltransferase activities were decreased. The activities of lipid-metabolizing enzymes were altered by Kalpaamruthaa in CVD-induced rats towards normal. Kalpaamruthaa modulated the activities of glycolytic enzymes (hexokinase, phosphogluco-isomerase, aldolase and glucose-6-phosphate dehydrogenase), gluconeogenic enzymes (glucose-6-phosphatase and fructose-1, 6-bisphosphatase) and glycogenolytic enzyme (glycogen phosphorylase) along with increased glycogen content in the liver of CVD-induced rats. The activities of isocitrate dehydrogenase, succinate dehydrogenase, malate dehydrogenase, α-ketoglutarate dehydrogenase, Complexes and ATPases (Na(+)/K(+)-ATPase, Ca(2+)-ATPase and Mg(2+)-ATPase) were decreased in CVD-induced rats, which were ameliorated by the treatment with Kalpaamruthaa. This study ascertained the efficacy of Kalpaamruthaa for the treatment of CVD in diabetes through the modulation of metabolizing enzymes and mitochondrial dysfunction.
Layne, Kerry; Ferro, Albert
The aim was to perform a systematic review of the efficacy of traditional Chinese medicines (TCM) in cardiovascular disease. Electronic databases were searched up to 11 November 2015 for all randomized-controlled trials evaluating the effect of TCM in hypertension, ischaemic stroke, heart failure, coronary heart disease and type 2 diabetes mellitus. Pooled odds ratios (ORs) were calculated using a fixed-effects model. Four hypertension studies were eligible for statistical analysis and included 133 patients receiving TCM and 130 control patients. There were significant reductions in systolic blood pressure in patients receiving TCM, comparable to results achieved with pharmaceutical medicines. An OR of 3.781 (95% confidence interval 2.392, 5.977; P = 0.000) was observed for the anti-hypertensive effect of TCM. Significant heterogeneity was present (P = 0.011), with a tendency towards publication bias that did not reach significance (P = 0.05275). Outcome measures for other cardiovascular diseases were inconsistent. Certain TCM compounds appear to have significant anti-hypertensive effects, and although some are associated in some studies with improved outcomes in coronary heart disease, heart failure and type 2 diabetes mellitus, the data are inconsistent and will require large-scale randomized-controlled trials to allow full evaluation of any potential therapeutic benefit in these areas. © 2016 The British Pharmacological Society.
Full Text Available Background: Chronic Kidney Disease (CKD is one of the most severe diseases worldwide. In patients affected by CKD, a progressive destruction of the nephrons is observed not only in structuralbut also in functional level. Atherosclerosis is a progressive disease of large and medium-sized arteries. It is characterized by the deposition of lipids and fibrous elements and is a common complication of the uremic syndrome because of the coexistence of a wide range of risk factors. High blood pressure, anaemia, insulin resistance, inflammation, high oxidative stress are some of the most common factors that cause cardiovascular disease and atherogenesis in patients suffering from End Stage Kidney Disease (ESRD. At the same time, the inflammatory process constitutes a common element in the apparition and development of CKD. A wide range of possible causes can justify the development of inflammation under uremic conditions. Such causes are oxidative stress, oxidation, coexistentpathological conditions as well as factors that are due to renal clearance techniques. Patients in ESRD and coronary disease usually show increased acute phase products. Pre-inflammatory cytokines, such as IL-6 and TNF-a, and acute phase reactants, such as CRP and fibrinogen, are closely related. The treatment of chronic inflammation in CKD is of high importance for the development ofthe disease as well as for the treatment of cardiovascular morbidity.Conclusions: The treatment factors focus on the use of renin-angiotensic system inhibitors, acetylsalicylic acid, statins and anti-oxidant treatment in order to prevent the action of inflammatorycytokines that have the ability to activate the mechanisms of inflammation.
Garzón, Gerardo; Gil, Ángel; Herrero, Ana María; Jiménez, Fernando; Cerezo, María José; Domínguez, Cristina
To determine the proportion of patients with type 2 diabetes with and without cardiovascular disease achieving the main cardiovascular goals. Cross-sectional study. A regional health district in a European country, Spain. Year: 2013. Adult patients diagnosed with type 2 diabetes with and without cardiovascular disease. Study using secondary data obtained from electronic records of clinical history. Haemoglobin A1c, blood pressure, LDL cholesterol, smoking and medication were covered. n=49,658 RESULTS: The proportion of patients with diabetes achieving cardiovascular goals (among those with recent measurement) was: haemoglobin A1c 68.8% (CI95%:68.2%-69.4%), blood pressure 74.3% (CI95%:73.9%-74.7%), LDL cholesterol 59.8% (CI95%:59.0%-60.6%), tobacco 80.2% (CI95%:79.6%-80.8%). Only 40%-67% of patients has recent measurement. Only 48.0% (CI95%: 46.6%-49.4%) of patients who needed statins were receiving them. Higher proportion of patients with cardiovascular disease were achiving goals. Differences were small but significant. Cardiovascular goals were measured in around half of patients with diabetes. Proportion of patients achiving cardiovascular goals were similar to published and best in patients with cardiovascular disease but it could improve. This points to prioritising interventions in this group of patients at very high risk, improving the implementation of guidelines and patient adherence. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.
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Diabetes mellitus is a widespread disease whose frequency increases constantly and is expected to reach alarming levels by the year 2025. Introduction of insulin therapy represented a major breakthrough; however, a very strict regimen is required to maintain blood glucose levels within the normal range and to prevent or postpone chronic complications associated with this disease. Frequent hyper- and hypoglycemia seriously affect the quality of life of these patients. Reversion of this situation can only be achieved through whole organ (pancreas transplant or pancreatic islet transplant, the former being a high-risk surgical procedure, while the latter is a much simpler and may be accomplished in only 20-40 min. The advantages and perspectives of islet cell transplantation will be discussed, in the light of tissue engineering and gene therapy. Ongoing research carried out in our laboratory, aimed at developing clinical cell and molecular therapy protocols for diabetes will also be focused. Keywords: Diabetes mellitus, cell and molecular therapy, human pancreatic islets, degenerative diseases, recombinant biopharmaceuticals.
Adham, S; Miranda, S; Doucet, J; Lévesque, H; Benhamou, Y
Cardiovascular events are the second leading cause of death in France. The assessment of overall cardiovascular risk using a personalized assessment with weighting risk factors can predict the risk of cardiovascular events in ten years. The validated treatments to reduce cardiovascular mortality in primary prevention are few. The use of statins in primary prevention is discussed. We report in this review the updated conclusions from clinical trials regarding the treatment with statins in primary prevention. Copyright © 2017 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.
Hollan, I; Dessein, P H; Ronda, N; Wasko, M C; Svenungsson, E; Agewall, S; Cohen-Tervaert, J W; Maki-Petaja, K; Grundtvig, M; Karpouzas, G A; Meroni, P L
The increased risk of cardiovascular disease (CVD) in rheumatoid arthritis (RA) has been recognized for many years. However, although the characteristics of CVD and its burden resemble those in diabetes, the focus on cardiovascular (CV) prevention in RA has lagged behind, both in the clinical and research settings. Similar to diabetes, the clinical picture of CVD in RA may be atypical, even asymptomatic. Therefore, a proactive screening for subclinical CVD in RA is warranted. Because of the lack of clinical trials, the ideal CVD prevention (CVP) in RA has not yet been defined. In this article, we focus on challenges and controversies in the CVP in RA (such as thresholds for statin therapy), and propose recommendations based on the current evidence. Due to the significant contribution of non-traditional, RA-related CV risk factors, the CV risk calculators developed for the general population underestimate the true risk in RA. Thus, there is an enormous need to develop adequate CV risk stratification tools and to identify the optimal CVP strategies in RA. While awaiting results from randomized controlled trials in RA, clinicians are largely dependent on the use of common sense, and extrapolation of data from studies on other patient populations. The CVP in RA should be based on an individualized evaluation of a broad spectrum of risk factors, and include: 1) reduction of inflammation, preferably with drugs decreasing CV risk, 2) management of factors associated with increased CV risk (e.g., smoking, hypertension, hyperglycemia, dyslipidemia, kidney disease, depression, periodontitis, hypothyroidism, vitamin D deficiency and sleep apnea), and promotion of healthy life style (smoking cessation, healthy diet, adjusted physical activity, stress management, weight control), 3) aspirin and influenza and pneumococcus vaccines according to current guidelines, and 4) limiting use of drugs that increase CV risk. Rheumatologists should take responsibility for the education of
Widmer, R Jay; Flammer, Andreas J; Lerman, Lilach O; Lerman, Amir
One of the best-studied diets for cardiovascular health is the Mediterranean diet. This consists of fish, monounsaturated fats from olive oil, fruits, vegetables, whole grains, legumes/nuts, and moderate alcohol consumption. The Mediterranean diet has been shown to reduce the burden, or even prevent the development, of cardiovascular disease, breast cancer, depression, colorectal cancer, diabetes, obesity, asthma, erectile dysfunction, and cognitive decline. This diet is also known to improve surrogates of cardiovascular disease, such as waist-to-hip ratio, lipids, and markers of inflammation, as well as primary cardiovascular disease outcomes such as death and events in both observational and randomized controlled trial data. These enhancements easily rival those seen with more established tools used to fight cardiovascular disease such as aspirin, beta-blockers, angiotensin-converting enzyme inhibitors, and exercise. However, it is unclear if the Mediterranean diet offers cardiovascular disease benefit from its individual constituents or in aggregate. Furthermore, the potential benefit of the Mediterranean diet or its components is not yet validated by concrete cardiovascular disease endpoints in randomized trials or observational studies. This review will focus on the effects of the whole and parts of the Mediterranean diet with regard to both population-based and experimental data highlighting cardiovascular disease morbidity or mortality and cardiovascular disease surrogates when hard outcomes are not available. Our synthesis will highlight the potential for the Mediterranean diet to act as a key player in cardiovascular disease prevention, and attempt to identify certain aspects of the diet that are particularly beneficial for cardioprotection. Copyright © 2015 Elsevier Inc. All rights reserved.
Salzano, Andrea; Arcopinto, Michele; Marra, Alberto M; Bobbio, Emanuele; Esposito, Daniela; Accardo, Giacomo; Giallauria, Francesco; Bossone, Eduardo; Vigorito, Carlo; Lenzi, Andrea; Pasquali, Daniela; Isidori, Andrea M; Cittadini, Antonio
Klinefelter syndrome (KS) is the most frequently occurring sex chromosomal aberration in males, with an incidence of about 1 in 500-700 newborns. Data acquired from large registry-based studies revealed an increase in mortality rates among KS patients when compared with mortality rates among the general population. Among all causes of death, metabolic, cardiovascular, and hemostatic complication seem to play a pivotal role. KS is associated, as are other chromosomal pathologies and genetic diseases, with cardiac congenital anomalies that contribute to the increase in mortality. The aim of the current study was to systematically review the relationships between KS and the cardiovascular system and hemostatic balance. In summary, patients with KS display an increased cardiovascular risk profile, characterized by increased prevalence of metabolic abnormalities including Diabetes mellitus (DM), dyslipidemia, and alterations in biomarkers of cardiovascular disease. KS does not, however, appear to be associated with arterial hypertension. Moreover, KS patients are characterized by subclinical abnormalities in left ventricular (LV) systolic and diastolic function and endothelial function, which, when associated with chronotropic incompetence may led to reduced cardiopulmonary performance. KS patients appear to be at a higher risk for cardiovascular disease, attributing to an increased risk of thromboembolic events with a high prevalence of recurrent venous ulcers, venous insufficiency, recurrent venous and arterial thromboembolism with higher risk of deep venous thrombosis or pulmonary embolism. It appears that cardiovascular involvement in KS is mainly due to chromosomal abnormalities rather than solely on low serum testosterone levels. On the basis of evidence acquisition and authors' own experience, a flowchart addressing the management of cardiovascular function and prognosis of KS patients has been developed for clinical use. © 2016 European Society of Endocrinology.
Laratta, Cheryl R.; van Eeden, Stephan
Chronic obstructive pulmonary disease (COPD) is a chronic, progressive lung disease resulting from exposure to cigarette smoke, noxious gases, particulate matter, and air pollutants. COPD is exacerbated by acute inflammatory insults such as lung infections (viral and bacterial) and air pollutants which further accelerate the steady decline in lung function. The chronic inflammatory process in the lung contributes to the extrapulmonary manifestations of COPD which are predominantly cardiovascular in nature. Here we review the significant burden of cardiovascular disease in COPD and discuss the clinical and pathological links between acute exacerbations of COPD and cardiovascular disease. PMID:24724085
Sasaki, Yuichi; Ikeda, Yoshiyuki; Iwabayashi, Masaaki; Akasaki, Yuichi; Ohishi, Mitsuru
The risk of cardiovascular disease increases with age, causing chronic disability, morbidity, and mortality in the elderly. Cardiovascular aging and disease are characterized by heart failure, cardiac ischemia-reperfusion injury, cardiomyopathy, hypertension, arterial stiffness, and atherosclerosis. As a cell ages, damaged organelles and abnormal proteins accumulate. A system for removing these cytoplasmic substrates is essential for maintaining homeostasis. Autophagy assists tissue homeostasis by forming a pathway by which these substances are degraded. Growing evidence suggests that autophagy plays a role in age-related and disease states of the cardiovascular system, and it may even be effective in preventing or treating cardiovascular disease. On the other hand, overexpression of autophagy in the heart and arteries can produce detrimental effects. We summarize the current understanding of the close relationship between autophagy and cardiovascular senescence.
Aparecida Marcelino de Nazareth
Full Text Available ABSTRACT Both Alzheimer's disease (AD and type 2 diabetes mellitus (DM are two common forms of disease worldwide and many studies indicate that people with diabetes, especially DM, are at higher risk of developing AD. AD is characterized by progressive cognitive decline and accumulation of β-amyloid (Aβ forming senile plaques. DM is a metabolic disorder characterized by hyperglycemia in the context of insulin resistance and relative lack of insulin. Both diseases also share common characteristics such as loss of cognitive function and inflammation. Inflammation resulting from Aβ further induces production of Aβ1-42 peptides. Inflammation due to overnutrition induces insulin resistance and consequently DM. Memory deficit and a decrease in GLUT4 and hippocampal insulin signaling have been observed in animal models of insulin resistance. The objective of this review was to show the shared characteristics of AD and DM.
Inaba, Hiroaki; Amano, Atsuo
Periodontal diseases, some of the most common infectious diseases seen in humans, are characterized by gingival inflammation, as well as loss of connective tissue and bone from around the roots of the teeth, which leads to eventual tooth exfoliation. In the past decade, the association of periodontal diseases with the development of systemic diseases has received increasing attention. Although a number of studies have presented evidence of close relationships between periodontal and systemic diseases, the majority of findings are limited to epidemiological studies, while the etiological details remain unclear. Nevertheless, a variety of recent hypothesis driven investigations have compiled various results showing that periodontal infection and subsequent direct oral-hematogenous spread of bacteria are implicated in the development of various systemic diseases. Herein, we present current understanding in regard to the relationship between periodontal and systemic diseases, including cardiovascular diseases, preterm delivery of low birth weight, diabetes mellitus, respiratory diseases, and osteoporosis.
Full Text Available Many epidemiological studies have investigated the relationship between periodontal disease (PD and cardiovascular disease (CVD, but their results are heterogeneous. This review article is designed to update the potential association, that forms the basis of understanding for a (causal role for PD to cardiovascular events; as reported by various observational (case-control, cohort, cross-sectional studies, epidemiological and interventional studies, not considering the other number of systemic health outcomes like cerebrovascular disease, pregnancy complications, chronic obstructive pulmonary disease, diabetes mellitus complications, osteoporosis, etc. A brief overview has been included for atherosclerosis (ATH, its pathophysiology and the association of periodontal infections as a risk factor for causing ATH, which seems to be a rational one; as development of ATH involves a chronic low-grade inflammation and moreover, it has long been set up prior to development of ischemic heart disease and thus provides potential contributing mechanisms that ATH may contribute singly or in concert with other risk factors to develop ischemic heart disease. This article goes on to discuss the correlation of evidence that is gathered from many scientific studies showing either strong, modest, weak or even no links along with their critical analyses. Finally, this article summarizes the present status of the links that possibly exist between PD and its role as a risk factor in triggering cardiovascular events, in the fairly long journey for the last two decades.
van Wijk, Diederik F.; Boekholdt, S. Matthijs
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
Background Adverse cardiovascular events have been linked with PM2.5 exposure obtained primarily from air quality monitors, which rarely co-locate with participant residences. Modeled PM2.5 predictions at finer resolution may more accurately predict residential exposure; however few studies have compared results across different exposure assessment methods. Methods We utilized a cohort of 5679 patients who had undergone a cardiac catheterization between 2002–2009 and resided in NC. Exposure to PM2.5 for the year prior to catheterization was estimated using data from air quality monitors (AQS), Community Multiscale Air Quality (CMAQ) fused models at the census tract and 12 km spatial resolutions, and satellite-based models at 10 km and 1 km resolutions. Case status was either a coronary artery disease (CAD) index >23 or a recent myocardial infarction (MI). Logistic regression was used to model odds of having CAD or an MI with each 1-unit (μg/m3) increase in PM2.5, adjusting for sex, race, smoking status, socioeconomic status, and urban/rural status. Results We found that the elevated odds for CAD>23 and MI were nearly equivalent for all exposure assessment methods. One difference was that data from AQS and the census tract CMAQ showed a rural/urban difference in relative risk, which was not apparent with the satellite or 12 km-CMAQ models. Conclusions
Elaine E Steinke
Full Text Available Patients with cardiovascular disease and their partners expect health care providers to provide sexual counseling to assist them in maintaining sexual quality of life. Evidence suggests however, that there is a gap in integrating evidence into practice and that relatively few cardiac patients receive sexual counseling. This can result in negative psychological, physical, and quality of life outcomes for couples who may needlessly decide sexual activity is too risky and cease all sexual activity. Two scientific statements now exist that provide ample guidance to health care providers in discussing this important topic. Using a team approach that includes physicians, nurses, physical therapists, rehabilitation staff, and others is important to ensure that sexual counseling occurs throughout recovery. In addition, several trials using interventional approaches for sexual counseling provide insight into successful approaches for sexual counseling in practice. This article provides practical strategies and evidence-based approaches for assessment and sexual counseling for all cardiac patients and their partners, and specific counseling for those with ischemic conditions, heart failure, and implanted devices.
Chan, Faye; Adamo, Susana; Coxson, Pamela; Goldman, Lee; Gu, Dongfeng; Zhao, Dong; Chen, Chung-Shiuan; He, Jiang; Mara, Valentina; Moran, Andrew
The Coronary Heart Disease (CHD) Policy Model-China, a national scale cardiovascular disease computer simulation model, was used to project future impact of urbanization. Populations and cardiovascular disease incidence rates were stratified into four submodels: North-Urban, South-Urban, North-Rural, and South-Rural. 2010 was the base year, and high and low urbanization rate scenarios were used to project 2030 populations. Rural-to-urban migration, population growth, and aging were projected to more than double cardiovascular disease events in urban areas and increase events by 27.0-45.6% in rural areas. Urbanization is estimated to raise age-standardized coronary heart disease incidence by 73-81 per 100,000 and stroke incidence only slightly. Rural-to-urban migration will likely be a major demographic driver of the cardiovascular disease epidemic in China.
Swerdlow, Daniel I; Hingorani, Aroon D; Humphries, Steve E
Cardiovascular disease encompasses several diverse pathological states that place a heavy burden on individual and population health. The aetiological basis of many cardiovascular disorders is not fully understood. Growing knowledge of the genetic architecture underlying coronary heart disease, stroke, cardiac arrhythmias and peripheral vascular disease has confirmed some suspected causal pathways in these conditions but also uncovered many previously unknown mechanisms. Here, we consider the contribution of genetics to the understanding of cardiovascular disease risk. We evaluate the utility and relevance of findings from genome-wide association studies and explore the role that Mendelian randomisation has to play in exploiting these. Mendelian randomisation permits robust causal inference in an area of research where this has been hampered by bias and confounding in observational studies. In doing so, it provides evidence for causal processes in cardiovascular disease that could represent novel targets for much-needed new drugs for disease prevention and treatment.
Giannopoulos, Andreas A; Mitsouras, Dimitris; Yoo, Shi-Joon; Liu, Peter P; Chatzizisis, Yiannis S; Rybicki, Frank J
3D-printed models fabricated from CT, MRI, or echocardiography data provide the advantage of haptic feedback, direct manipulation, and enhanced understanding of cardiovascular anatomy and underlying pathologies. Reported applications of cardiovascular 3D printing span from diagnostic assistance and optimization of management algorithms in complex cardiovascular diseases, to planning and simulating surgical and interventional procedures. The technology has been used in practically the entire range of structural, valvular, and congenital heart diseases, and the added-value of 3D printing is established. Patient-specific implants and custom-made devices can be designed, produced, and tested, thus opening new horizons in personalized patient care and cardiovascular research. Physicians and trainees can better elucidate anatomical abnormalities with the use of 3D-printed models, and communication with patients is markedly improved. Cardiovascular 3D bioprinting and molecular 3D printing, although currently not translated into clinical practice, hold revolutionary potential. 3D printing is expected to have a broad influence in cardiovascular care, and will prove pivotal for the future generation of cardiovascular imagers and care providers. In this Review, we summarize the cardiovascular 3D printing workflow, from image acquisition to the generation of a hand-held model, and discuss the cardiovascular applications and the current status and future perspectives of cardiovascular 3D printing.
Yu, So Young; Ryu, Han Kyoung; Park, Hee Jung; Choi, Young Ju; Huh, Kap Bum; Kim, Wha Young
Single nucleotide polymorphism (SNP) in adiponectin gene has been associated with insulin resistance, diabetes, and cardiovascular disease (CVD). This study was performed to investigate the association of SNP 276G?T at adiponectin gene with CVD risk factors in Korean type 2 diabetes mellitus (DM) patients. The subjects were 351 type 2 DM patients visited a DM clinic in Seoul, and the patients with known CVD were excluded. The adiponectin SNP 276G?T was analyzed and dietary intakes were assess...
Full Text Available Many different countries suggest and justify an integrated laboratory and epidemiological research program with an aim to reject or accept the magnesium – CVD (cardiovascular disease hypothesis. The studies shown in this paper that have investigated the relationship between water hardness, especially magnesium and CVD indicate that, even though there has been an ongoing research for nearly half a century (1957-2004, it has not been completed yet. Different study designs (obductional, clinical, ecological, case-control and cohort restrict an adequate comparison of their results as well as the deduction of results applicable on each territorial level.The majority of researchers around the world, using populational and individual studies, have found an inverse (protective association between mortality and morbidity from CVD and the increase in water hardness, especially the increase in the concentration of magnesium. The most frequent benefit of the water with an optimal mineral composition is the reduction of mortality from ischemic heart disease.It was suggested that Mg from water is a supplementary source of Mg of high biological value, because magnesium from water is absorbed around 30% better than Mg in a diet. The vast majority of studies consider lower concentrations of Mg in the water, in the range of 10% of the total daily intake of Mg.Future research efforts must give better answers to low Mg concentrations in the drinking water, before any concrete recommendations are given to the public. Moreover, the researchers must also determine which chemical form of Mg is most easily absorbed and has the greatest impact.Additional research is necessary in order to further investigate the interrelation between different water and food components as well as individual risk factors in the pathogenesis of CVD.
Full Text Available The cohort pilot study had been done. Aim: to study the effectiveness of an antistress activation therapy on the functional state of human with the purpose of formation of adaptive reactions of activation and training high levels of reactivity among the two groups of patients with cardiovascular problems, ranks first among causes of death population: arterial hypertension (AH and coronary heart disease (CHD. Material and methods. From the sub-sample of the Moscow population (396 were allocated to 2 groups of patients of 30 people in each (a control group and a group for anti-stress therapy for persons with hypertension and coronary artery disease that within 1 month took adaptogens (tincture of ginseng, Eleutherococcus, etc. is minimized by a specially developed algorithm. For stress diagnosis international integrated questionnaire Perceived Stress (PSS; as well as Hospital Anxiety and Depression Scale (HADS were used. Blood pressure, heart rate, body mass index, waist circumference were measured. In addition we used new methods "Antistress activation health improvement". Results. The average age in the intervention group was 59.4 years, and in the control group was 58.3 years, p>0.05. In compliance with results of the study has been marked that persons who were treated by methods "Antistress activation health improvement" sensed general and "internal" dumping, improving of duration and quality of sleeping. Irritability, level of stress, depression, and fatigability became rather less. Dynamics of emotions locked in psychometric scales showed distinct improvement of mood, decrease of fear, sorrow, anxiety, anger, emotional instability, increase of self-reliance, activity. Conclusion. The treatment of stress, anxiety, and depression must be complexes based on biological and psychological approaches.
Full Text Available Cardiovascular disease (CVD contributes greatly to inequalities in health in Europe. The CVD death rate in Ukraine (the highest is seven fold higher than in France (the lowest. There is also a striking difference in CVD mortality between European Union (EU members before the enlargement in 2004 and Central and East European (CEE countries that joined the EU in 2004 and non-EU countries. The difference in CVD mortality between West and East Europe grew during the 1970s and 1980s when rates declined in the West and either remained the same or rose in the CEE countries. Political reforms at the beginning of the 1990s, which were followed by great socio-economic changes coincided with further diversification in CVD mortality in CEE countries. Diverse trends in CVD mortality were followed by larger gaps in life expectancy between West and East Europe and within the CEE.Rapid development of high technology treatment procedures, which followed the economic recovery of the CEE countries, would have only limited influence on the overall control of CVD. Exposure to classic risk factors might largely explain the longitudinal trend in falling CVD mortality in some countries, but it is unlikely that it could explain rapid changes in the others. Still, large potential to control the disease lies in developing effective preventive policies with targets to lower exposure to the classic CVD risk factors. The recent history of CVD in CEE countries makes the “alcohol hypothesis” less convincing as an explanation for CVD mortality trends and differences between East and West Europe. The hypothesis that dynamic changes in CVD mortality in CEE countries are triggered and explained largely by psychosocial factors is attractive. However, if confirmed, transforming such knowledge into a practical health policy would be a great challenge.
Pineda Tovar, M. A.; Ortega Ramirez, A.
Background: Coronary artery disease (CAD) remains the leading cause of death in Mexico and Western world. Symptoms in women are more subtle. Women usually feel general tiredness and lack of energy, in contrast to men having chest pain. This implies that women do not receive a timely and early diagnosis. According to the National Health Information System, 20 of 100 Mexican women die of cardiovascular disease, 68.5% of Mexicans have problems of obesity, overweight, diabetes, high blood pressure, conditions that increase the risk of CAD. SPECT myocardial perfusion scintigraphy (MPS) is currently appropriate for diagnosis, risk assessment, stratification, myocardial viability, evaluation of left ventricular function. The Objective of this investigation is to show that SPECT MPS is a noninvasive diagnostic test that identify women with increased CAD risk. Method: A 60 years old female patient with diabetes, high blood pressure and overweight was referred for a cardiac scan, for suspicion of ischemia. Her symptoms were general tiredness, lack of energy and occasionally light chest pain. A SPECT-gated myocardial perfusion test was done. The images where acquired with a gamma camera after the injection of 10 mCi (stress) and 20 mCi (Rest) of 99 mTc-Tetrofosmin. Images were reconstructed using Emory toolbox. Results: The images showed light hypoperfusion septal and inferior walls, and a small left ventricular chamber size with thickened walls. Angiography showed significant diffuse coronary stenosis in the three vessels. Conclusion: Women suffering CAD constitute a high-risk group that potentially poses a diagnostic and therapeutic challenge. Cardiac SPECT MPS is a noninvasive diagnostic and prognostic test that identify women with high CAD risk and establish timely and early the therapeutic interventions. (author)
Edmondson, Donald; von Känel, Roland
In this paper, a first in a Series of two, we look at the evidence for an association of post-traumatic stress disorder with incident cardiovascular disease risk and the mechanisms that might cause this association, as well as the prevalence of post-traumatic stress disorder due to cardiovascular disease events and its associated prognostic risk. We discuss research done after the publication of previous relevant systematic reviews, and survey currently funded research from the two most active funders in the field: the National Institutes of Health and the US Veterans Administration. We conclude that post-traumatic stress disorder is a risk factor for incident cardiovascular disease, and a common psychiatric consequence of cardiovascular disease events that might worsen the prognosis of the cardiovascular disease. There are many candidate mechanisms for the link between post-traumatic stress disorder and cardiovascular disease, and several ongoing studies could soon point to the most important behavioural and physiological mechanisms to target in early phase intervention development. Similarly, targets are emerging for individual and environmental interventions that might offset the risk of post-traumatic stress disorder after cardiovascular disease events. Copyright © 2017 Elsevier Ltd. All rights reserved.
Holzmann, Martin J; Carlsson, Axel C; Hammar, Niklas; Ivert, Torbjörn; Walldius, Göran; Jungner, Ingmar; Wändell, Per; Ärnlöv, Johan
In recent clinical guidelines, individuals with chronic kidney disease are considered to have a similar 10-year absolute risk of cardiovascular death as individuals with diabetes or established cardiovascular disease. There is limited evidence to support this claim. We investigated the 10-year risk for cardiovascular death in individuals with moderate or severe chronic kidney disease (glomerular filtration rate of 30-60 or disease. The inclusion criteria, exposure, study outcome and follow-up period adhered strictly to the definitions of the European Society of Cardiology guidelines. The absolute 10-year risk of cardiovascular death was 3.9% and 14.0% in individuals with moderate and severe chronic kidney disease, respectively, but was substantially lower in women and in younger individuals. The risk in individuals with prevalent diabetes and cardiovascular disease was approximately two and three times higher compared to the risk estimate for moderate chronic kidney disease (hazard ratio (HR) 4.1, 95% confidence interval (CI) 3.8-4.5 and HR 6.2, 95% CI 5.7-6.7 vs. HR 2.3 95% CI 2.0-2.6, respectively) while the risk for individuals with severe chronic kidney disease appeared more congruent to that of diabetes and cardiovascular disease (HR 5.5, 95% CI 3.3-8.9). Although moderate chronic kidney disease is an independent predictor for an increased 10-year risk of cardiovascular death, only those with severe chronic kidney disease had similar risk to those with diabetes or cardiovascular disease. © The European Society of Cardiology 2015.
Danilo Rocha Santos Caracas
Full Text Available Chronic kidney disease is a health problem that has reached more and more individuals due to the aging and increase of diseases such as hypertension and diabetes mellitus. The presence of chronic uremic syndrome along with aggravating factors such as sedentary lifestyle is directly associated with a high risk of developing cardiovascular diseases. This study aimed to describe the prevalence of cardiovascular risk and determine the levels of regular physical activity in patients on hemodialysis. Cross-sectional analytical study with quantitative approach. A sociodemographic and anamnestic questionnaire was applied, followed by cardiovascular risk assessment using the Framingham scale; Of weekly energy expenditure related to daily activities, using the International Physical Activity Questionnaire. The sample consisted of 113 individuals with a mean age of 54.13 years, the predominant male gender being 50.4%. 86.7% presented a moderate to high cardiovascular risk classification and 46% were classified as sedentary. From the analyzed data the present research obtained statistically significant value for the variables sedentarism x cardiovascular risk, time of hemodialysis x cardiovascular risk. It is concluded that patients are at risk of developing cardiovascular diseases, associated with sedentary lifestyle and the time the patient is exposed to dialysis.
Full Text Available Combination of ischemic heart disease and diabetes mellitus is characterized by certain features of clinical picture and insufficient effectiveness of treatment of ischemic heart disease. With the aim of investigation of pathogenic mechanisms and features of the clinical course of ischemic heart disease associated with glucose homeostasis violation we examined 116 patients (51 women, 65 men, median of age 63 years old with normal regulation of glucose metabolism (NRG, n = 24, changes in fasting glucose (n = 23, violated glucose tolerance (n = 21, combined violation (n = 24 and diabetes mellitus (n = 24. We also conducted their prospective observation for 40 months with the following endpoints — hospitalization because of cardiovascular complications, death from them and the emergence of diabetes. It was established that ischemic heart disease associated with prediabetic disorders and diabetes mellitus has the following peculiarities: earlier clinical manifestation in women; more frequent and severe heart failure; lower tolerance to physical load in patients with angina pectoris; atypical manifestation of ischemic pain: longer attacks, atypical localization or absent pain; frequent combination with arrhythmias and conduction disorders; frequent affection of multiple coronary arteries, which leads to myocardial infarction with complicated course; eccentric type of left ventricle remodeling; significant calcification of mitral and aortic valves of heart. The main principles of treatment of ischemic heart disease: weight loss; active correction of glucose metabolism violations using medications (metformin even at the stage of prediabetes, because in chronic stable forms of ischemic heart disease metformin significantly improves glucose metabolism, decreases insulin resistance and does not increase the incidence of cardiovascular complications and decompensations of heart failure; the basic drugs for treatment of ischemic heart disease should be
Sanchez, Paula; Everett, Bronwyn; Salamonson, Yenna; Ajwani, Shilpi; Bhole, Sameer; Bishop, Joshua; Lintern, Karen; Nolan, Samantha; Rajaratnam, Rohan; Redfern, Julie; Sheehan, Maria; Skarligos, Fiona; Spencer, Lissa; Srinivas, Ravi; George, Ajesh
Main objective The aim of this study was to explore the perception of patients with cardiovascular disease towards oral health and the potential for cardiac care clinicians to promote oral health. Method A needs assessment was undertaken with twelve patients with cardiovascular disease attending cardiac rehabilitation between 2015 and 2016, in three metropolitan hospitals in Sydney, Australia. These patients participated in face-to-face semi-structured interviews. Data was analysed using them...
Roeseler, Eberhard; Julius, Ulrich; Heigl, Franz
OBJECTIVE: Lipoprotein(a)-hyperlipoproteinemia (Lp(a)-HLP) along with progressive cardiovascular disease has been approved as indication for regular lipoprotein apheresis (LA) in Germany since 2008. We aimed to study the long-term preventive effect of LA and to assess hypothetical clinical...... correlations of apolipoprotein(a) (apo(a)) by analyzing genotypes and phenotypes. APPROACH AND RESULTS: This prospective observational multicenter study included 170 patients with Lp(a)-HLP and progressive cardiovascular disease (48.9 years median age at diagnosis) despite other cardiovascular risk factors......-nucleotide polymorphisms rs10455872 or rs3798220. CONCLUSIONS: Results of 5 years of prospective follow-up confirm that LA has a lasting effect on prevention of cardiovascular events in patients with Lp(a)-HLP. Patients clinically selected by progressive cardiovascular disease were characterized by a highly frequent...
Arrieta, Francisco; Iglesias, Pedro; Pedro-Botet, Juan; Tébar, Francisco Javier; Ortega, Emilio; Nubiola, Andreu; Pardo, Jose Luis; Maldonado, Gonzálo Fernando; Obaya, Juan Carlos; Matute, Pablo; Petrecca, Romina; Alonso, Nuria; Sarabia, Elena; Sánchez-Margalet, Victor; Alemán, José Juan
El presente documento actualiza las recomendaciones de práctica clínica del manejo de los factores de riesgo cardiovascular (FRCV) en la diabetes mellitus (DM). Es un consenso médico realizado por un panel de expertos independiente de la Sociedad Española de Diabetes (SED). Se han propuesto y actualizado varios consensos de diferentes sociedades científicas o médicas con el fin de mejorar los resultados terapéuticos. La valoración del RCV en la población general puede carecer de sensibilidad ...
Siscovick, David S; Barringer, Thomas A; Fretts, Amanda M; Wu, Jason H Y; Lichtenstein, Alice H; Costello, Rebecca B; Kris-Etherton, Penny M; Jacobson, Terry A; Engler, Mary B; Alger, Heather M; Appel, Lawrence J; Mozaffarian, Dariush
Multiple randomized controlled trials (RCTs) have assessed the effects of supplementation with eicosapentaenoic acid plus docosahexaenoic acid (omega-3 polyunsaturated fatty acids, commonly called fish oils) on the occurrence of clinical cardiovascular diseases. Although the effects of supplementation for the primary prevention of clinical cardiovascular events in the general population have not been examined, RCTs have assessed the role of supplementation in secondary prevention among patients with diabetes mellitus and prediabetes, patients at high risk of cardiovascular disease, and those with prevalent coronary heart disease. In this scientific advisory, we take a clinical approach and focus on common indications for omega-3 polyunsaturated fatty acid supplements related to the prevention of clinical cardiovascular events. We limited the scope of our review to large RCTs of supplementation with major clinical cardiovascular disease end points; meta-analyses were considered secondarily. We discuss the features of available RCTs and provide the rationale for our recommendations. We then use existing American Heart Association criteria to assess the strength of the recommendation and the level of evidence. On the basis of our review of the cumulative evidence from RCTs designed to assess the effect of omega-3 polyunsaturated fatty acid supplementation on clinical cardiovascular events, we update prior recommendations for patients with prevalent coronary heart disease, and we offer recommendations, when data are available, for patients with other clinical indications, including patients with diabetes mellitus and prediabetes and those with high risk of cardiovascular disease, stroke, heart failure, and atrial fibrillation. © 2017 American Heart Association, Inc.
Sinnenberg, Lauren; DiSilvestro, Christie L; Mancheno, Christina; Dailey, Karl; Tufts, Christopher; Buttenheim, Alison M; Barg, Fran; Ungar, Lyle; Schwartz, H; Brown, Dana; Asch, David A; Merchant, Raina M
As society is increasingly becoming more networked, researchers are beginning to explore how social media can be used to study person-to-person communication about health and health care use. Twitter is an online messaging platform used by more than 300 million people who have generated several billion Tweets, yet little work has focused on the potential applications of these data for studying public attitudes and behaviors associated with cardiovascular health. To describe the volume and content of Tweets associated with cardiovascular disease as well as the characteristics of Twitter users. We used Twitter to access a random sample of approximately 10 billion English-language Tweets originating from US counties from July 23, 2009, to February 5, 2015, associated with cardiovascular disease. We characterized each Tweet relative to estimated user demographics. A random subset of 2500 Tweets was hand-coded for content and modifiers. The volume of Tweets about cardiovascular disease and the content of these Tweets. Of 550 338 Tweets associated with cardiovascular disease, the terms diabetes (n = 239 989) and myocardial infarction (n = 269 907) were used more frequently than heart failure (n = 9414). Users who Tweeted about cardiovascular disease were more likely to be older than the general population of Twitter users (mean age, 28.7 vs 25.4 years; P Twitter offers promise for studying public communication about cardiovascular disease.
Holmes, Michael V.; Simon, Tabassome; Exeter, Holly J.; Folkersen, Lasse; Asselbergs, Folkert W.; Guardiola, Montse; Cooper, Jackie A.; Palmen, Jutta; Hubacek, Jaroslav A.; Carruthers, Kathryn F.; Horne, Benjamin D.; Brunisholz, Kimberly D.; Mega, Jessica L.; Van Iperen, Erik P. A.; Li, Mingyao; Leusink, Maarten; Trompet, Stella; Verschuren, Jeffrey J. W.; Hovingh, G. Kees; Dehghan, Abbas; Nelson, Christopher P.; Kotti, Salma; Danchin, Nicolas; Scholz, Markus; Haase, Christiane L.; Rothenbacher, Dietrich; Swerdlow, Daniel I.; Kuchenbaecker, Karoline B.; Staines-Urias, Eleonora; Goel, Anuj; van 't Hooft, Ferdinand; Gertow, Karl; de Faire, Ulf; Panayiotou, Andrie G.; Tremoli, Elena; Baldassarre, Damiano; Veglia, Fabrizio; Holdt, Lesca M.; Beutner, Frank; Gansevoort, Ron T.; Navis, Gerjan J.; Mateo Leach, Irene; Breitling, Lutz P.; Brenner, Hermann; Thiery, Joachim; Dallmeier, Dhayana; Franco-Cereceda, Anders; Boer, Jolanda M. A.; Stephens, Jeffrey W.; Hofker, Marten H.; Tedgui, Alain; Hofman, Albert; Uitterlinden, Andre G.; Adamkova, Vera; Pitha, Jan; Onland-Moret, N. Charlotte; Cramer, Maarten J.; Nathoe, Hendrik M.; Spiering, Wilko; Klungel, Olaf H.; Kumari, Meena; Whincup, Peter H.; Morrow, David A.; Braund, Peter S.; Hall, Alistair S.; Olsson, Anders G.; Doevendans, Pieter A.; Trip, Mieke D.; Tobin, Martin D.; Hamsten, Anders; Watkins, Hugh; Koenig, Wolfgang; Nicolaides, Andrew N.; Teupser, Daniel; Day, Ian N. M.; Carlquist, John F.; Gaunt, Tom R.; Ford, Ian; Sattar, Naveed; Tsimikas, Sotirios; Schwartz, Gregory G.; Lawlor, Debbie A.; Morris, Richard W.; Sandhu, Manjinder S.; Poledne, Rudolf; Maitland-van der Zee, Anke H.; Khaw, Kay-Tee; Keating, Brendan J.; van der Harst, Pim; Price, Jackie F.; Mehta, Shamir R.; Yusuf, Salim; Witteman, Jaqueline C. M.; Franco, Oscar H.; Jukema, J. Wouter; de Knijff, Peter; Tybjaerg-Hansen, Anne; Rader, Daniel J.; Farrall, Martin; Samani, Nilesh J.; Kivimaki, Mika; Fox, Keith A. A.; Humphries, Steve E.; Anderson, Jeffrey L.; Boekholdt, S. Matthijs; Palmer, Tom M.; Eriksson, Per; Pare, Guillaume; Hingorani, Aroon D.; Sabatine, Marc S.; Mallat, Ziad; Casas, Juan P.; Talmud, Philippa J.
Objectives This study sought to investigate the role of secretory phospholipase A(2) (sPLA(2))-IIA in cardiovascular disease. Background Higher circulating levels of sPLA(2)-IIA mass or sPLA(2) enzyme activity have been associated with increased risk of cardiovascular events. However, it is not
Introduction: cardiovascular risk factors are prevalent in HIV-positive patients which places them at increased risk for cardiovascular disease (CVD). We aimed to determine the risk factors and risk assessment for CVD in HIV-positive patients with and without antiretroviral therapy. Methods: this was a cross-sectional study of ...
Cardiovascular Medicine, Department of Medicine, University College Hospital, Ibadan, Oyo state, Nigeria.3Department of ... burden of non-communicable diseases as well as associated cardiovascular risk factors in the state using the World ...... related IEC/BCC materials, training of health care providers, provision of ...
Mathiasen, Anders Bruun; Henningsen, Kristoffer Mads Aaris; Harutyunyan, Marina Jurjevna
. But in spite of improved treatments, many patients are still plagued by a high frequency of angina symptoms, hospitalizations and a poor prognosis. There is a need for new independent or supplementary biomarkers that can help to predict cardiovascular disease and cardiovascular events earlier and more...
Pilz, S.; Kienreich, K.; Tomaschitz, A.; Lerchbaum, E.; Meinitzer, A.; Marz, W.; Zittermann, A.; Dekker, J.M.
Accumulating evidence suggests that vitamin D may play a role for cardiovascular health. Expression of the vitamin D receptor (VDR) and enzymes for vitamin D metabolism have been identified in the vasculature as well as in the heart. VDR knock-out mice suffer from cardiovascular disease (CVD) and
Wu, Ying; Mills, Douglas; Bala, Mohan
The risk factors of cardiovascular disease and other disease comorbidities appear to be more common in patients with psoriasis compared with the general population. To support this concept, the association between psoriasis and cardiovascular disease and other comorbidities was analyzed using data collected from 40 730 patients in the National Health and Wellness Survey (NHWS) during May and June 2004. A case-control study was conducted with data from 1127 patients with psoriasis and a matched cohort of nonpsoriasis patients. Psoriasis patients were significantly more likely to have cardiovascular comorbidities, including hypertension, hypercholesterolemia, and diabetes, compared with nonpsoriasis patients. Other comorbidities significantly associated with psoriasis were arthritis, depression, sleep disorder/insomnia, chronic obstructive pulmonary disease, and gastroesophageal reflux disease. Responses to this large survey confirm that patients with psoriasis have a higher rate of cardiovascular risk factors and other comorbidities compared with patients without psoriasis.
The number of type 2 diabetic patients is increasing world-wide and a prediction of prevalence of chronic kidney disease up to 2025 in European diabetic population is alarming. Albuminuria and estimated glomerular filtration rate are cardinal biochemical parameters in diagnostics of diabetic nephropathy. Following diagnostic methods are also used: renal ultrasonography, ophthalmoscopy and in not clarified cases renal biopsy. Long-term optimal glycemic control, efficient antihypertensive treatment by angiotensin converting enzyme inhibitor, or angiotensin receptor blocker and recommended protein intake is a cornerstone of therapy. The research is presently focused on new pathophysiological mechanisms, as analysis of genome, microRNA, kidney injury biomarkers and proteomes.Key words: chronic kidney disease - type 2 diabetes mellitus.
Gansevoort, Ron T.; Correa-Rotter, Ricardo; Hemmelgarn, Brenda R.; Jafar, Tazeen H.; Heerspink, Hiddo J. Lambers; Mann, Johannes F.; Matsushita, Kunihiro; Wen, Chi Pang
Since the first description of the association between chronic kidney disease and heart disease, many epidemiological studies have confirmed and extended this finding. As chronic kidney disease progresses, kidney-specific risk factors for cardiovascular events and disease come into play. As a
It is debatable whether metabolic control in patients with type 2 diabetes is followed by a commensurate reduction in cardiovascular risk. Large clinical outcome trials have shown that lowering glucose is a poor predictor of cardiovascular outcome; rather a too tight metabolic control exposes patients, particularly those at risk for hypoglycemia, and with renal failure, to severe adverse events. This article reviews the specific effects of the most commonly used glucose-lowering agents on the cardiovascular system, and specifies which drug is best suited for a given clinical condition related to cardiovascular disease.
Schoenaker, D.A.J.M.; Toeller, M.; Chaturvedi, N.; Fuller, J.H.; Soedamah-Muthu, S.S.
Aims/hypothesis - Low adherence to recommendations for dietary saturated fatty acid (SFA) and fibre intake in patients with type 1 diabetes mellitus may heighten their increased risk of cardiovascular disease (CVD) and mortality. We examined the relationship of SFA and total, soluble and insoluble
Pérez-Adan, M; Vázquez-Rodríguez, M; Álvarez-Silvares, M T; Domínguez-Vigo, P
The 8 to 10% of pregnancies are affected with hypertensive disorders of pregnancy. They are the most common obstetric complication and present significant maternal and perinatal morbidity and mortality; but also these diseases go beyond pregnancy and determine a group of women with increased cardiovascular risk in your life futura. Cardiovascular disease remains the main cause of death in the Western world and women with a history of pregnancy hypertensive disease, are at increased risk of cardiovascular complications afterwards. Therefore, pregnancy is a unique physiological situation provides an opportunity to identify a group of women who will present cardiovascular risk factors later in life. To determine the long-term cardiovascular risk factors (chronic hypertension, type 2 diabetes mellitus, metabolic syndrome) and thyroid dysfunction incidence in women who have previously been diagnosed with “hypertensive disorders of pregnancy”. Case-control study with retrospective collection of information from women whose pregnancy and childbirth occurred between 2000 and 2010. Case: Patients with a diagnosis of “hypertensive diseases of pregnancy” (N = 134). Control: random sample of pregnant women who were not diagnosed with hypertensive state of pregnancy and whose gestation was spent in 2000 (n = 145). The mean follow-up of both groups was 10,78 years. We have applied parametric test (T-Student for independent samples), and for those variables that did not meet that condition, we have applied the U of Mann-Whitney test. The Chi-square test was used to compare qualitative variables and Fisher’s exact test. For comparison between groups, model univariate logistic regression was performed. The incidence of hypertension was 41,32% in patients with a history of hypertensive pregnancy disease, with a relative risk (RR) was 9,15. The incidence of type 2 diabetes mellitus was 5,17%. Dyslipidemia was diagnosed after at 43,53% with a RR of 3,7. Metabolic syndrome
Nor Azlin Mohamed Ismail
Full Text Available This prospective observational study was done to analyse the prevalence of gestational diabetes mellitus (GDM among primigravidae and its outcome. All healthy primigravidae with singleton pregnancies were offered universal glucose tolerance testing between 16 and 28 weeks gestation. GDM and non GDM groups were managed according to hospital protocol. The antenatal features and pregnancy outcomes were analysed. Out of 616 primigravidae, 113 (18.34 % were GDM with slightly older (27.9 ± 4.2 versus 26.32 ± 3.3, p < 0.001 age. The mean fasting and two hours postprandial blood glucose in both groups were 4.99 ± 1.08 mmol/l, 8.86 ± 1.41 mmol/l(GDM and 4.36 ± 0.43 mmol/l, 5.71 ± 1.11 mmol/l (Non GDM, respectively. Maternal family history of diabetes mellitus, weight exceeding 80 Kg, polyhydramnios (2.65 % versus 0.2 %, p=0.028 and neonatal hyperbilirubinaemia (9.73 % versus 2.98 %, p=0.01 occurred significantly more frequent in the GDM group compared to normal. There was no significant difference in other pregnancy outcomes and complications between the two groups. In conclusion GDM in primigravidae was detected at a relatively young age with more frequent maternal family history of DM, weight exceeding 80 Kg, polyhydromnions and neonatal hyperbilirubinaemia. The degree of disease was mild and treatment led to no significant complication.
Dregan, Alex; Charlton, Judith; Chowienczyk, Phil; Gulliford, Martin C
This study sought to evaluate whether risks of diabetes mellitus and cardiovascular disease are elevated across a range of organ-specific and multisystem chronic inflammatory disorders. A matched cohort study was implemented in the UK Clinical Practice Research Datalink including participants with severe psoriasis (5648), mild psoriasis (85 232), bullous skin diseases (4284), ulcerative colitis (12 203), Crohn's disease (7628), inflammatory arthritis (27 358), systemic autoimmune disorders (7472), and systemic vasculitis (6283) and in 373 851 matched controls. The main outcome measures were new diagnoses of type 2 diabetes mellitus, stroke, or coronary heart disease. The outcomes were evaluated for each condition in a multiple outcomes model, with adjustment for conventional cardiovascular risk factors. Estimates for different inflammatory conditions were pooled in a random-effects meta-analysis. There were 4695 new diagnoses of type 2 diabetes mellitus, 3266 of coronary heart disease, and 1715 of stroke. The hazard ratio for pooled multiple failure estimate was 1.20 (95% confidence interval [CI], 1.15-1.26). The highest relative hazards were observed in systemic autoimmune disorders (1.32; 95% CI, 1.16-1.50) and systemic vasculitis (1.29; 95% CI, 1.16-1.44). Hazards were increased in organ-specific disorders, including severe psoriasis (1.29; 95% CI, 1.12-1.47) and ulcerative colitis (1.26; 95% CI, 1.14-1.40). Participants in the highest tertile of C-reactive protein had greater risk of multiple outcomes (1.52; 95% CI, 1.37-1.68). The risk of cardiovascular diseases and type 2 diabetes mellitus is increased across a range of organ-specific and multisystem chronic inflammatory disorders with evidence that risk is associated with severity of inflammation. Clinical management of patients with chronic inflammatory disorders should seek to reduce cardiovascular risk. © 2014 American Heart Association, Inc.
Rugbjerg, Kathrine; Mellemkjaer, Lene; Boice, John D
BACKGROUND: Cardiovascular disease has emerged as a serious late effect in survivors of adolescent and young adult cancer, but risk has not been quantified comprehensively in a population-based setting. METHODS: In the Danish Cancer Registry, we identified 43153 1-year survivors of cancer diagnosed...... at ages 15 to 39 years (1943-2009) and alive in 1977; from the Danish Civil Registration System, we randomly selected a comparison cohort of the same age and sex. Subjects were linked to the Danish Patient Register, and observed numbers of first hospitalizations for cardiovascular disease (International......-sided. RESULTS: During follow-up, 10591 survivors (24.5%) were discharged from the hospital with cardiovascular disease, whereas 8124 were expected (RR = 1.30; 95% confidence interval [CI)] = 1.28 to 1.33; P cardiovascular disease per 100000...
Vinther, Johan L; Jacobsen, Rikke K; Jørgensen, Torben
treatment and lifestyle intervention were applied to a general population using information on previous cardiovascular diseases, known diabetes, urinalbumin, smoking, total cholesterol, systolic and diabolic blood pressure, low-density lipoprotein cholesterol and a multifactor risk score (SCORE). Results...
Cardiovascular risk factors and non-communicable diseases in Abia state, Nigeria: report of a community-based survey. OS Ogah, OO Madukwe, UU Onyeonoro, II Chukwuonye, AU Ukegbu, MO Akhimien, IG Okpechi ...
... result of cardiovascular disease. Table 3 describes the advantages and disadvantages of each treatment. Talk to your ... Follow Circulation on Google Plus Follow Circulation on Instagram Follow Circulation on Pinterest Follow Circulation on YouTube ...
S.W. Van Der Laan (Sander W.); M. Fall (Magnus); A. Soumaré (Aicha); A. Teumer (Alexander); S. Sedaghat (Sanaz); J. Baumert (Jens); D. Zabaneh (Delilah); J. van Setten (Jessica); I. Isgum (Ivana); T.E. Galesloot (Tessel); J. Arpegård (Johannes); P. Amouyel (Philippe); S. Trompet (Stella); M. Waldenberger (Melanie); M. Dörr (Marcus); P.K. Magnusson (Patrik); V. Giedraitis (Vilmantas); A. Larsson (Anders); A.P. Morris (Andrew); J.F. Felix (Janine); A.C. Morrison (Alanna C.); N. Franceschini (Nora); J.C. Bis (Joshua); M. Kavousi (Maryam); C.J. O'Donnell (Christopher); F. Drenos (Fotios); V. Tragante (Vinicius); P. Munroe (Patricia); R. Malik (Rainer); C. Kubisch (Christian); B.B. Worrall (Bradford B.); J. Erdmann (Jeanette); C.P. Nelson (Christopher P.); N.J. Samani (Nilesh); H. Schunkert (Heribert); J. Marchini (Jonathan); R.S. Patel (Riyaz); A. Hingorani (Aroon); W.H.L. Kao (Wen); N.L. Pedersen (Nancy); J. de Graaf (Jacqueline); L.A.L.M. Kiemeney (Bart); S.E. Baumeister (Sebastian); O.H. Franco (Oscar); A. Hofman (Albert); A.G. Uitterlinden (André); W. Koenig (Wolfgang); C. Meisinger (Christa); A. Peters (Annette); B. Thorand (Barbara); J.W. Jukema (Jan Wouter); B.O. Eriksen (Bjørn Odvar); I. Toft (Ingrid); T. Wilsgaard (Tom); N.C. Onland-Moret (N. Charlotte); Y.T. van der Schouw (Yvonne); S. Debette (Stéphanie); M. Kumari (Meena); P. Svensson (Per); P. van der Harst (Pim); M. Kivimaki (Mika); J. Keating (John); N. Sattar (Naveed); A. Dehghan (Abbas); A. Reiner (Alexander); E. Ingelsson (Erik); H.M. den Ruijter (Hester ); P.I.W. de Bakker (Paul); G. Pasterkamp (Gerard); J. Ärnlöv (Johan); M.V. Holmes (Michael); F.W. Asselbergs (Folkert)
markdownabstract__Background__ Epidemiological studies show that high circulating cystatin C is associated with risk of cardiovascular disease (CVD), independent of creatinine-based renal function measurements. It is unclear whether this relationship is causal, arises from residual confounding,
Schenkein, Harvey A.; Loos, Bruno G.
Aims In this paper, inflammatory mechanisms that link periodontal diseases to cardiovascular diseases (CVD) are reviewed. Materials and Methods and Results This paper is a literature review. Studies in the literature implicate a number of possible mechanisms that could be responsible for increased inflammatory responses in atheromatous lesions due to periodontal infections. These include increased systemic levels of inflammatory mediators stimulated by bacteria and their products at sites distant from the oral cavity, elevated thrombotic and hemostatic markers that promote a prothrombotic state and inflammation, cross-reactive systemic antibodies that promote inflammation and interact with the atheroma, promotion of dyslipidemia with consequent increases in proinflammatory lipid classes and subclasses, and common genetic susceptibility factors present in both disease leading to increased inflammatory responses. Conclusions Such mechanisms may be thought to act in concert to increase systemic inflammation in periodontal disease and to promote or exacerbate atherogenesis. However, proof that the increase in systemic inflammation attributable to periodontitis impacts inflammatory responses during atheroma development, thrombotic events, or myocardial infarction or stroke is lacking. PMID:23627334
Nordestgaard, Børge G; Langsted, Anne
Human epidemiologic and genetic evidence using the Mendelian randomization approach in large-scale studies now strongly supports that elevated lipoprotein (a) [Lp(a)] is a causal risk factor for cardiovascular disease, that is, for myocardial infarction, atherosclerotic stenosis, and aortic valve...... with very high concentrations to reduce cardiovascular disease are awaited. Recent genetic evidence documents elevated Lp(a) as a cause of myocardial infarction, atherosclerotic stenosis, and aortic valve stenosis....
Mu?oz-Bravo, Carlos; Guti?rrez-Bedmar, Mario; G?mez-Aracena, Jorge; Garc?a-Rodr?guez, Antonio; Fern?ndez-Crehuet Navajas, Joaqu?n
Iron is the second most abundant metal in the Earth’s crust. Despite being present in trace amounts, it is an essential trace element for the human body, although it can also be toxic due to oxidative stress generation by the Fenton reaction, causing organic biomolecule oxidation. This process is the basis of numerous pathologies, including cardiovascular diseases (CVD). The relationship between iron and cardiovascular disease was proposed in 1981 by Jerome Sullivan. Since then, numerous epid...
Xing Sheng Yang, MD, PhD, FACC, FAHA
Full Text Available In clinical practice, a variety of syndromes are associated with cardiovascular disease and have characteristic findings. Most of them are an autosomal dominant genetic disorder and have different types of cardiovascular abnormalities, including electrocardiographic conduction defects, arrhythmias, cardiomyopathy, vascular and valvular diseases, cardiac septal defects, and pulmonary problems. There is a growing need for physicians to pay more attention to these syndromes.
The present paper aims to review the main pathophysiological links between red blood cell disorders and cardiovascular diseases, provides a brief description of the latest studies in this area, and considers implications for clinical practice and therapy. Anemia is associated with a special risk in proatherosclerotic conditions and heart disease and became a new therapeutic target. Guidelines must be updated for the management of patients with red blood cell disorders and cardiovascular dise...
Sierksma, A.; Grobbee, D.E.; Hendriks, H.F.J.
This chapter focuses on the vascular and biochemical effects of moderate alcohol consumption and the mechanisms of protection against cardiovascular disease. Cardiovascular disease (CVD), including coronary heart disease, cerebrovascular disease, and peripheral vascular disease, is the leading cause
Allan, G Michael; Garrison, Scott; McCormack, James
The cardiovascular benefit of many preventive interventions (like statins) is strongly dependent on the baseline cardiovascular risk of the patient. Many lipid and vascular primary prevention guidelines advocate for the use of cardiovascular risk calculators. There are over 100 cardiovascular risk prediction models, and some of these models have spawned scores of calculators. Only about 25 of these models/calculators have been externally validated. The ability to identify who will have events frequently varies little (calculators is common with one in three paired comparisons disagreeing on risk category. In part, this disagreement is because calculators vary according to the database they are derived from, choice of clinical endpoints and risk interval duration upon which the estimate is based. Additional risk factors do little to improve the basic risk predictions performance, except perhaps coronary artery calcium which still requires further study before regular use. The estimates provided by cardiovascular risk calculators are ballpark approximations and have a margin of error. Physicians should use models derived from, or calibrated for, populations similar to theirs and understand the endpoints, duration, and special features of their selected calculator.
Full Text Available Sleep plays a vital role in an individual’s mental, emotional, and physiological well-being. Not only does sleep deficiency lead to neurological and psychological disorders, but also the literature has explored the adverse effects of sleep deficiency on the cardiovascular system. Decreased quantity and quality of sleep have been linked to cardiovascular disease (CVD risk factors, such as hypertension, obesity, diabetes, and dyslipidemia. We explore the literature correlating primary sleep deficiency and deprivation as a cause for cardiovascular disease and cite endothelial dysfunction as a common underlying mechanism.
Nielsen, Jesper Bo; Leppin, Anja; Gyrd-Hansen, Dorte
BACKGROUND: Elimination of modifiable risk factors including unhealthy lifestyle has the potential for prevention of 80% of cardiovascular disease cases. The present study focuses on disclosing barriers for maintaining specific lifestyle changes by exploring associations between perceiving...... inequality even in populations with equal and cost-free access to health care. Our study suggests supplementing traditional public campaigns to counter cardiovascular disease by using individualized and targeted initiatives....... these barriers and various sociodemographic and health-related characteristics. METHODS: Data were collected through a web-based questionnaire survey and included 962 respondents who initially accepted treatment for a hypothetical cardiovascular risk, and who subsequently stated that they preferred lifestyle...
Thylstrup, Birgitte; Clausen, Thomas; Hesse, Morten
Objectives To present the prevalence and incidence of cardiovascular disease (CVD) in a national cohort of patients seeking treatment for drug use disorders (DUD). Methods This is a longitudinal record linkage study of consecutive DUD treatment admissions between 2000 and 2006 from Denmark. Results...... treatment (SHR = 1.15, p = 0.022). The use of amphetamines was negatively associated with the risk of CVD within this cohort (SHR = 0.75, p = 0.001). Conclusions Patients injecting drugs using prescribed methadone were at elevated risk for cardiovascular disease and should be monitored for CVD. Opioid...... medications should be evaluated in terms of their cardiovascular sequelae....
Stanko, Peter; Izakovicova Holla, Lydie
Diabetes mellitus is a metabolic disorder characterized by hyperglycemia. The abnormal glucose metabolism results from defects in insulin production or insulin action, or both. For decades, it was suspected that diabetes contributed to poorer oral health and the increased frequency of periodontitis. More recently it was found that periodontitis could adversely affect glycemic control in diabetics. This review focuses on the bidirectional relationship between diabetes mellitus and periodontitis. A review of the literature on periodontal disease in diabetes using the following key words: periodontitis/periodontal disease and diabetes mellitus, hyperglycemia/glycemic control. There is strong evidence for an association between diabetes mellitus and inflammatory periodontal disease. Diabetes mellitus increases the risk for and severity of periodontitis, and periodontal diseases can aggravate insulin resistance and affect glycemic control. Periodontal treatment improves glycemic control in type 2 diabetics; control of periodontal infection is not only important for oral health, it may also improve overall health.
Full Text Available Obesity represents an important health problem and its association with cardiovascular risk factors is well-known. The aim of this work was to assess the correlation between obesity and mortality (both, all-cause mortality and the combined variable of all-cause mortality plus the appearance of a non-fatal first cardiovascular event in a general population sample from the south-east of Spain.This prospective cohort study used stratified and randomized two-stage sampling. Obesity [body mass index (BMI ≥ 30 kg/m(2] as a predictive variable of mortality and cardiovascular events was assessed after controlling for age, sex, cardiovascular disease history, high blood pressure, diabetes mellitus, hypercholesterolemia, high-density lipoprotein/triglycerides ratio, total cholesterol and smoking with the Cox regression model.The mean follow-up time of the 1,248 participants was 10.6 years. The incidence of all-cause mortality during this period was 97 deaths for every 10,000 person/years (95% CI: 80-113 and the incidence of all-cause mortality+cardiovascular morbidity was 143 cases for every 10,000 person/years (95% CI: 124-163. A BMI ≥ 35 kg/m(2 yielded a hazard ratio for all-cause mortality of 1.94 (95% CI: 1.11-3.42 in comparison to non-obese subjects (BMI <30 kg/m(2. For the combination of cardiovascular morbidity plus all-cause mortality, a BMI ≥ 35 kg/m(2 had a hazard ratio of 1.84 (95% CI: 1.15-2.93 compared to non-obese subjects.A BMI ≥ 35 kg/m(2 is an important predictor of both overall mortality and of the combination of cardiovascular morbidity plus all-cause mortality.
Ponce-Garcia, Isabel; Simarro-Rueda, Marta; Carbayo-Herencia, Julio Antonio; Divisón-Garrote, Juan Antonio; Artigao-Ródenas, Luis Miguel; Botella-Romero, Francisco; Palazón-Bru, Antonio; Martínez-St. John, Damian Robert James; Gil-Guillén, Vicente Francisco
Background Obesity represents an important health problem and its association with cardiovascular risk factors is well-known. The aim of this work was to assess the correlation between obesity and mortality (both, all-cause mortality and the combined variable of all-cause mortality plus the appearance of a non-fatal first cardiovascular event) in a general population sample from the south-east of Spain. Materials and Methods This prospective cohort study used stratified and randomized two-stage sampling. Obesity [body mass index (BMI) ≥30 kg/m2] as a predictive variable of mortality and cardiovascular events was assessed after controlling for age, sex, cardiovascular disease history, high blood pressure, diabetes mellitus, hypercholesterolemia, high-density lipoprotein/triglycerides ratio, total cholesterol and smoking with the Cox regression model. Results The mean follow-up time of the 1,248 participants was 10.6 years. The incidence of all-cause mortality during this period was 97 deaths for every 10,000 person/years (95% CI: 80–113) and the incidence of all-cause mortality+cardiovascular morbidity was 143 cases for every 10,000 person/years (95% CI: 124–163). A BMI ≥35 kg/m2 yielded a hazard ratio for all-cause mortality of 1.94 (95% CI: 1.11–3.42) in comparison to non-obese subjects (BMI cardiovascular morbidity plus all-cause mortality, a BMI ≥35 kg/m2 had a hazard ratio of 1.84 (95% CI: 1.15–2.93) compared to non-obese subjects. Conclusions A BMI ≥35 kg/m2 is an important predictor of both overall mortality and of the combination of cardiovascular morbidity plus all-cause mortality. PMID:25992570
Brito Díaz, Buenaventura; Alemán Sánchez, José Juan; Cabrera de León, Antonio
Heart rate reflects autonomic nervous system activity. Numerous studies have demonstrated that an increased heart rate at rest is associated with cardiovascular morbidity and mortality as an independent risk factor. It has been shown a link between cardiac autonomic balance and inflammation. Thus, an elevated heart rate produces a micro-inflammatory response and is involved in the pathogenesis of endothelial dysfunction. In turn, decrease in heart rate produces benefits in congestive heart failure, myocardial infarction, atrial fibrillation, obesity, hyperinsulinemia, insulin resistance, and atherosclerosis. Alteration of other heart rate-related parameters, such as their variability and recovery after exercise, is associated with risk of cardiovascular events. Drugs reducing the heart rate (beta-blockers, calcium antagonists and inhibitors of If channels) have the potential to reduce cardiovascular events. Although not recommended in healthy subjects, interventions for reducing heart rate constitute a reasonable therapeutic goal in certain pathologies. Copyright © 2013 Elsevier España, S.L. All rights reserved.
Nesse, Willem; Dijkstra, P.U.; Abbas, Frank; Spijkervet, F.K.L.; Stijger, A.; Tromp, J.A.H.; van Dijk, J.L.; Vissink, A.
Background: Associations between periodontitis and cardiovascular and autoimmune diseases are most often assessed in patients with a particular cardiovascular or autoimmune disease. To prevent selection bias, this study assesses the existence of associations between periodontitis and cardiovascular
Background: Flavonoids are plant-based phytochemicals with cardiovascular protective properties. Few studies have comprehensively examined flavonoid classes in relation to cardiovascular disease mortality. We examined the association between flavonoid intake and cardiovascular disease (CVD) mortalit...
Nesse, Willem; Dijkstra, Pieter U.; Abbas, Frank; Spijkervet, Fred K. L.; Stijger, Astrid; Tromp, Jan A. H.; van Dijk, Johan L.; Vissink, Arjan
Background: Associations between periodontitis and cardiovascular and autoimmune diseases are most often assessed in patients with a particular cardiovascular or autoimmune disease. To prevent selection bias, this study assesses the existence of associations between periodontitis and cardiovascular
Rabelink, Ton J.; de Zeeuw, Dick
Albuminuria is commonly used as a marker of kidney disease progression, but some evidence suggests that albuminuria also contributes to disease progression by inducing renal injury in specific disease conditions. Studies have confirmed that in patients with cardiovascular risk factors, such as
Full Text Available Abstract Danon disease is a rare X-linked dominant lysosomal glycogen storage disease that can lead to severe ventricular hypertrophy and heart failure. We report a case of Danon disease with cardiac involvement evaluated with cardiovascular magnetic resonance, including late gadolinium enhancement and perfusion studies.
Tesauro, Manfredi; Canale, Maria Paola; Rodia, Giuseppe; Di Daniele, Nicola; Lauro, Davide; Scuteri, Angelo; Cardillo, Carmine
Obesity is a chronic disease, whose incidence is alarmingly growing. It is associated with metabolic abnormalities and cardiovascular complications. These complications are clustered in the metabolic syndrome (MetS) leading to high cardiovascular morbidity and mortality. Obesity predisposes to diabetic nephropathy, hypertensive nephrosclerosis, and focal and segmental glomerular sclerosis and represents an independent risk factor for the development and progression of chronic kidney disease (CKD). Albuminuria is a major risk factor for cardiovascular diseases (CVDs). Microalbuminuria has been described as early manifestation of MetS-associated kidney damage and diabetic nephropathy. Obesity and MetS affect renal physiology and metabolism through mechanisms which include altered levels of adipokines such as leptin and adiponectin, oxidative stress, and inflammation. Secretory products of adipose tissue also deeply and negatively influence endothelial function. A better understanding of these interactions will help in designing more effective treatments aimed to protect both renal and cardiovascular systems.
Full Text Available Obesity is a chronic disease, whose incidence is alarmingly growing. It is associated with metabolic abnormalities and cardiovascular complications. These complications are clustered in the metabolic syndrome (MetS leading to high cardiovascular morbidity and mortality. Obesity predisposes to diabetic nephropathy, hypertensive nephrosclerosis, and focal and segmental glomerular sclerosis and represents an independent risk factor for the development and progression of chronic kidney disease (CKD. Albuminuria is a major risk factor for cardiovascular diseases (CVDs. Microalbuminuria has been described as early manifestation of MetS-associated kidney damage and diabetic nephropathy. Obesity and MetS affect renal physiology and metabolism through mechanisms which include altered levels of adipokines such as leptin and adiponectin, oxidative stress, and inflammation. Secretory products of adipose tissue also deeply and negatively influence endothelial function. A better understanding of these interactions will help in designing more effective treatments aimed to protect both renal and cardiovascular systems.
Seferović-Mitrović Jelena P.
Full Text Available Introduction. Several cardiovascular manifestations in patients with diabetes may be asymptomatic. Left ventricular diastolic dysfunction (LVDD is considered to be the earliest metabolic myocardial lesion in these patients, and can be diagnosed with tissue Doppler echocardiography. Silent myocardial ischemia (SMI is a characteristic and frequently described form of ischemic heart disease in patients with diabetes. Objective. The aim of the study was to assess the prevalence of LVDD and SMI in patients with type 2 diabetes, as well as to compare demographic, clinical, and metabolic data among defined groups (patients with LVDD, patients with SMI and patients with type 2 diabetes, without LVDD and SMI. Methods. We investigated 104 type 2 diabetic patients (mean age 55.4±9.1 years, 64.4% males with normal blood pressure, prehypertension and arterial hypertension stage I. Study design included basic laboratory assessment and cardiological workup (transthoracic echocardiography and tissue Doppler, as well as the exercise stress echocardiography. Results. LVDD was diagnosed in twelve patients (11.5%, while SMI was revealed in six patients (5.8%. Less patients with LVDD were using metformin, in comparison to other two groups (χ2 =12.152; p=0.002. Values of HDL cholesterol (F=4.515; p=0.013 and apolipoprotein A1 (F=5.128; p= 0.008 were significantly higher in patients with LVDD. Conclusion. The study confirmed asymptomatic cardiovascular complications in 17.3% patients with type 2 diabetes.