Abstract 276: Obesity Even Without Co-morbidity Harbors more Cardiovascular Structural and Functional Abnormalities than what you think! Time for Early CV Screening!

2012 ◽  
Vol 5 (suppl_1) ◽  
Author(s):  
Mahfouz El Shahawy ◽  
Miglena Entcheva
Keyword(s):  
Risk Score ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Left Ventricular ◽  
Cvd Risk ◽  
Early Evaluation ◽  
Lipid Panel ◽  
Co Morbidity ◽  
Obese Subjects ◽  
Group B

Purpose: To determine the extent of structural and functional cardiovascular (CV) abnormalities in asymptomatic obese subjects with and without untreated comorbidities. Methods: We evaluated 2174 consecutive asymptomatic subjects, age 25 to 80, who presented to our Cardiovascular Disease (CVD) Assessment Center for CVD risk evaluation, utilizing Early CVD Risk Score [ECVDRS]. ECVDRS, also known as Rasmussen Risk Score (RRS), consists of 10 non-invasive tests: large (C1) and small artery (C2) stiffness, blood pressure (BP) at rest and post mild exercise (PME), carotid intima media thickness (CIMT), abdominal aorta and left ventricular ultrasound, retinal photography, microalbuminuria, ECG, and pro-BNP. Fasting lipid panel and blood sugar were measured for each subject. Obesity was assessed using waist circumference measurement (> 35 inches for female and 40 inches for male). Co morbidities were defined as BP>140/90mmHg, LDL>130mg/dl, HDL<40 mg/dl for male and <50 mg/dl for female, TrG>150mg/dl, and FBS>100mg/dl. Results: Among the subjects screened 949(44%) met criteria for obesity, 458(48%) were not receiving any CV medications and were divided in two groups: A 100 subjects (22%) with no comorbidities (CM): 68 (68%) female and 32(32%) male; and group B - 358 subjects (78%) with CM: 199(56%) female and 159(44%) male. The presence of CVD abnormalities among the subjects in the different groups is shown in Picture 1. Conclusions: 1. Obesity is very prevalent disease in Sarasota County-close to 50% in our study. 2. Co morbidity superimposed on obesity did alter significantly the incidence of abnormal C2 and BP rise PME, while there was only slight increase in the incidence of CIMT abnormalities.3. Based on our data early evaluation for structural and functional cardiovascular abnormalities in obese subjects will help risk stratification and appropriate therapeutic intervention to delay or overt future catastrophic events

scholarly journals The Relationship between Cardiovascular Risk Scores and Several Markers of Subclinical Atherosclerosis in an Asymptomatic Population

2021 ◽  
Vol 10 (5) ◽  
pp. 955
Author(s):  
Ovidiu Mitu ◽  
Adrian Crisan ◽  
Simon Redwood ◽  
Ioan-Elian Cazacu-Davidescu ◽  
Ivona Mitu ◽  
...  
Keyword(s):  
Risk Score ◽  
Subclinical Atherosclerosis ◽  
Ankle Brachial Index ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Risk Scores ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Single Center Study ◽  
Asymptomatic Individuals

Background: The current cardiovascular disease (CVD) primary prevention guidelines prioritize risk stratification by using clinical risk scores. However, subclinical atherosclerosis may rest long term undetected. This study aimed to evaluate multiple subclinical atherosclerosis parameters in relation to several CV risk scores in asymptomatic individuals. Methods: A cross-sectional, single-center study included 120 asymptomatic CVD subjects. Four CVD risk scores were computed: SCORE, Framingham, QRISK, and PROCAM. Subclinical atherosclerosis has been determined by carotid intima-media thickness (cIMT), pulse wave velocity (PWV), aortic and brachial augmentation indexes (AIXAo, respectively AIXbr), aortic systolic blood pressure (SBPao), and ankle-brachial index (ABI). Results: The mean age was 52.01 ± 10.73 years. For cIMT—SCORE was more sensitive; for PWV—Framingham score was more sensitive; for AIXbr—QRISK and PROCAM were more sensitive while for AIXao—QRISK presented better results. As for SBPao—SCORE presented more sensitive results. However, ABI did not correlate with any CVD risk score. Conclusions: All four CV risk scores are associated with markers of subclinical atherosclerosis in asymptomatic population, except for ABI, with specific particularities for each CVD risk score. Moreover, we propose specific cut-off values of CV risk scores that may indicate the need for subclinical atherosclerosis assessment.

scholarly journals Limited Utility of Cardiovascular Risk Scores for People Living with HIV in Malawi

2020 ◽  
Author(s):  
Chia Goh ◽  
Henry Mwandumba ◽  
Alicja Rapala ◽  
Willard Tingao ◽  
Irene Sheha ◽  
...  
Keyword(s):  
Risk Score ◽  
Low Income ◽  
Intima Media Thickness ◽  
Risk Groups ◽  
Carotid Intima Media Thickness ◽  
Endothelial Damage ◽  
Risk Scores ◽  
People Living With Hiv ◽  
Cvd Risk ◽  
Living With Hiv

HIV is associated with increased cardiovascular disease (CVD) risk. Despite the high prevalence of HIV in low income subSaharan Africa, there are few data on the assessment of CVD risk in the region. In this study, we aimed to compare the utility of existing CVD risk scores in a cohort of Malawian adults, and assess to what extent they correlate with established markers of endothelial damage: carotid intima media thickness (IMT) and pulse wave velocity (PWV). WHO/ISH, SCORE, FRS, ASCVD, QRISK2 and D:A:D scores were calculated for 279 Malawian adults presenting with HIV and low CD4. Correlation of the calculated 10year CVD risk score with IMT and PWV was assessed using Spearmans rho. The median (IQR) age of patients was 37 (31 to 43) years and 122 (44%) were female. Median (IQR) blood pressure was 120/73mmHg (108/68 to 128/80) and 88 (32%) study participants had a new diagnosis of hypertension. The FRS and QRISK2 scores included the largest number of participants in this cohort (96% and 100% respectively). D:A:D, a risk score specific for people living with HIV, identified more patients in moderate and high risk groups. Although all scores correlated well with physiological markers of endothelial damage, FRS and QRISK2 correlated most closely with both IMT [r2 0.51, p<0.0001 and r2 0.47, p<0.0001 respectively] and PWV [r2 0.47, p<0.0001 and r2 0.5, p<0.0001 respectively]. Larger cohort studies are required to adapt and validate risk prediction scores in this region, so that limited healthcare resources can be effectively targeted.

Abstract 85: Pre-Hypertension is a Disease Associated with Significant Structural and Functional Cardiovascular Abnormalities. It is Time to Lower the Bar.

Hypertension ◽  
2012 ◽  
Vol 60 (suppl_1) ◽  
Author(s):  
Mahfouz El Shahawy ◽  
Miglena Entcheva ◽  
Arjun Padalia
Keyword(s):  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
P Value ◽  
Cvd Risk ◽  
Structural Abnormalities ◽  
Prevalent Disease ◽  
Artery Stiffness ◽  
Group A ◽  
Group B ◽  
Asymptomatic Subjects

Purpose: To examine whether pre-HTN is a risk factor for CV structural and functional abnormalities. METHODS: We screened 2233 asymptomatic subjects, age 23-80, for CVD risk using Early CVD Risk Score (ECVDRS). ECVDRS consists of 10 tests: large (C1) and small (C2) artery stiffness, BP at rest and post mild exercise (PME), Carotid Intima Media Thickness (CIMT), abdominal aorta and left ventricle ultrasound, retinal photography, microalbuminuria, ECG, and pro-BNP. Pre-HTN and normotension (NT) was defined according to the JNC VII criteria. Results: Among the subjects screened, 38% (855 of 2233) were NT; 70% (596 of 855) were not taking CV medication. 42% (942 of 2233) of subjects were pre-HTN; 55% (521 of 942) were not taking CV medication. The untreated, NT group was split into Group A 82% (491 of 596) with norm. BP rise PME and Group B 18% (105 of 596) with abn. BP rise PME. The untreated, pre-HTN group was split into Group C 61% (318 of 521) with norm. BP rise PME and Group D 39% (203 of 521) with abn. BP rise PME. The presence of structural abnormalities in the groups is shown on Table 1. Conclusions: Based on our data, pre-HTN is a prevalent disease (42%), exceeding NT (38%) in the subjects screened. Pre-HTN is associated with greater functional and structural abnormalities than the NT group. The structural abnormalities, particularly CIMT (statistically significant p value of <0.0016), may be accounted for by the greater abn. BP rise PME in the pre-HTN group (39%). Based on our data, pre-HTN justifies ECVDRS screening for appropriate risk stratification and treatment. These findings may warrant lowering the bar for the definitions of HTN and pre-HTN in future guidelines.

scholarly journals Moderate cardiovascular risk factor among Indonesian: do carotid intima-media thickness (CIMT) predict further?

2020 ◽  
Vol 1 (2) ◽  
pp. 38
Author(s):  
Rina Mawarti ◽  
Denny Suwanto ◽  
Johanes Nugroho Eko Putranto ◽  
Djoko Soemantri
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Risk Score ◽  
Management Strategies ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Bivariate Analysis ◽  
Cvd Risk ◽  
Framingham Risk ◽  
The Impact

Determining management strategies in an individual with intermediate cardiovascular risk represent a great challenge. The impact of increased CIMT to improve estimated cardiovascular disease (CVD) risk score in individual at intermediate cardiovascular risk has not yet been fully elucidated. For this reason, we sought to determine the association between CIMT increment and incident of CVD. We conducted a longitudional retrospective cohort study involving 28 patients with intermediate cardiovascular risk (Framingham risk score 10% - 20%). Subjects with criteria fulfillment had their data collected through history taking, physical examination, and CIMT re-measurement using echocardiography. Bivariate analysis with regression logistic showed significant correlation between increased CIMT with CVD event (p=0.016). CIMT measurement is a plausible noninvasive method to predict subclinical cardiovascular disease to further promote more aggressive management.

scholarly journals Sirtuin 1, Visfatin and IL-27 Serum Levels of Type 1 Diabetic Females in Relation to Cardiovascular Parameters and Autoimmune Thyroid Disease

Biomolecules ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1110
Author(s):  
Magdalena Łukawska-Tatarczuk ◽  
Edward Franek ◽  
Leszek Czupryniak ◽  
Ilona Joniec-Maciejak ◽  
Agnieszka Pawlak ◽  
...  
Keyword(s):  
Global Longitudinal Strain ◽  
Thyroid Volume ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Left Ventricular ◽  
Sirtuin 1 ◽  
Control Group ◽  
Cardiovascular Parameters ◽  
Autoimmune Thyroid

The loss of cardioprotection observed in premenopausal, diabetic women may result from the interplay between epigenetic, metabolic, and immunological factors. The aim of this study was to evaluate the concentration of sirtuin 1, visfatin, and IL-27 in relation to cardiovascular parameters and Hashimoto’s disease (HD) in young, asymptomatic women with type 1 diabetes mellitus (T1DM). Thyroid ultrasound, carotid intima-media thickness (cIMT) measurement, electrocardiography, and echocardiography were performed in 50 euthyroid females with T1DM (28 with HD and 22 without concomitant diseases) and 30 controls. The concentrations of serum sirtuin 1, visfatin and IL-27 were assessed using ELISA. The T1DM and HD group had higher cIMT (p = 0.018) and lower left ventricular global longitudinal strain (p = 0.025) compared to females with T1DM exclusively. In women with a double diagnosis, the sirtuin 1 and IL-27 concentrations were non-significantly higher than in other groups and significantly positively correlated with each other (r = 0.445, p = 0.018) and thyroid volume (r = 0.511, p = 0.005; r = 0.482, p = 0.009, respectively) and negatively correlated with relative wall thickness (r = –0.451, p = 0.016; r = –0.387, p = 0.041, respectively). These relationships were not observed in the control group nor for the visfatin concentration. These results suggest that sirtuin 1 and IL-27 contribute to the pathogenesis of early cardiac dysfunction in women with T1DM and HD.

scholarly journals Evaluation of arterial stiffness in systolic heart failure

2021 ◽  
Vol 67 (2) ◽  
pp. 86-89
Author(s):  
Lajos Fehérvári ◽  
István Adorján Szabó ◽  
Lóránd Kocsis ◽  
Attila Frigy
Keyword(s):  
Heart Failure ◽  
Arterial Stiffness ◽  
Statistical Significance ◽  
Systolic Heart Failure ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Chi Square ◽  
Ventricular Ejection Fraction

Abstract Objective: Micro- and macrovascular changes can occur in heart failure, and could influence its prognosis and management. In a prospective study, we proposed the evaluation of arterial stiffness (macrovascular function) and its correlations in patients with systolic heart failure. Methods: 40 patients (32 men, 8 women, mean age 63±2.9 years), with hemodynamically stable systolic heart failure (left ventricular ejection fraction, EF<40%) were enrolled in the study. In every patient, beyond routine explorations (ECG, cardiac and carotid ultrasound, laboratory measurements), arterial stiffness was assessed by measuring pulse wave velocity (PWV). The correlations of PWV with clinical and echo-cardiographic characteristics were studied using t-test and chi-square test (p<0.05 being considered for statistical significance). Results: The average PWV was 8.55±2.2 m/s, and 16 patients had increased PWV (>10 m/s). We found significantly higher PWV values in patients older than 65 years (p<0.001), in patients with eGFR <60 ml/min/1.73 m2 (p<0.001), hypertension (p=0.006), and increased (>1 mm) carotid intima-media thickness (p=0.016). PWV was found to be significantly lower when EF was <30% (p=0.049). Furthermore, the presence of an increased PWV was correlated significantly with age (p<0.001), and (with borderline significance) with eGFR <60 ml/min/1.73 m2 and, inversely, with EF<30%. Conclusions: Increased arterial stiffness reflected by high PWV is frequently present in patients with systolic heart failure, and is mainly correlated with general risk factors of arterial involvement. Low EF, due to low stroke volume and decreased systolic arterial wall tension can influence the values and the interpretation of PWV.

scholarly journals Uric Acid and Potassium Serum Levels Are Independent Predictors of Blood Pressure Non-Dipping in Overweight or Obese Subjects

Nutrients ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 2970 ◽  
Author(s):  
Roberta Zupo ◽  
Fabio Castellana ◽  
Barbara Boninfante ◽  
Luisa Lampignano ◽  
Antonio Lattanzio ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Uric Acid ◽  
Antihypertensive Drugs ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Serum Levels ◽  
Primary Objective ◽  
Ultrasound Measurement ◽  
Obese Subjects ◽  
First Time

Background: Obesity and sleeping blood pressure (BP) abnormalities are well recognized as some of the main risk factors for hypertension and cardiovascular diseases (CVDs). The primary objective of this study was to evaluate the prevalence of hypertension and non-dipping profile in overweight/obese subjects. Methods: A sample of 100 consecutive healthy overweight/obese subjects, aged 20–69 years and never treated with antihypertensive drugs was examined. Ambulatory 24 h BP monitoring was performed to diagnose hypertension and a non-dipping profile. Anthropometric, metabolic and routine hematochemical parameters were assessed. All subjects underwent ultrasound measurement of common carotid intima–media thickness. Results: Hypertension was demonstrated in 69% (n = 69) and 27% of the sample (n = 27) had a non-dipping profile. Among the hematochemical variables, estimated glomerular filtration rate (eGFR) (p = 0.02) and FT4 (p = 0.01) serum levels were higher in the hypertensive group than in the normotensive group. Lower potassium and uric acid serum levels (p = 0.05) were independent predictive factors of a non-dipping BP profile. Conclusions: This study shows, for the first time, that 1) an unexpectedly high percentage (69%) of overweight/obese subjects is affected by hypertension; 2) early hypertensive subjects have an increased eGFR and higher FT4 serum levels; 3) lower potassium and uric acid levels are independent predictors of pathological nocturnal non-dipping.

P5293Effect of metabolically health obesity on carotid intima-media thickness in general population: a community-based cohort study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
H Itoh ◽  
H Kaneko ◽  
H Kiriyama ◽  
Y Yoshida ◽  
K Nakanishi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
General Population ◽  
Abdominal Obesity ◽  
Carotid Plaque ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Plaque Formation ◽  
Community Based ◽  
Obese Subjects

Abstract Introduction Obesity is a common and independent risk factor for all-cause mortality. More specifically, obesity is a major component of atherosclerosis in association with metabolic disorders including metabolic syndrome (MetS), resulting in various cardiovascular diseases (CVD). Alternatively, obese subjects without MetS are prevalent, also referred to as metabolically healthy obesity (MHO). However, most preceding studies regarding MHO have been limited by small cohorts. Therefore, the effect of MHO on atherosclerosis in the general population remains unclear. Purpose In this study, we sought to clarify the effect of MHO on carotid intima-media thickness (IMT) as a marker of early stage atherosclerosis using a community-based cohort in general population. Methods We examined subjects who underwent medical check-up at our University Hospital. We defined obesity as body mass index ≥25.0 kg/m2. Abdominal obesity, defined as waist circumstance at umbilical level ≥85 cm in men and ≥90 cm in women, was obligatory for the diagnosis of MetS. In addition to abdominal obesity, any two of the following three abnormalities should be observed for the diagnosis of MetS, [1] Dyslipidemia: triglyceride ≥150 mg/dL, HDL-C <40 mg/dL, or use of lipid lowering medication, [2] Hypertension: systolic blood pressure ≥130 mmHg, diastolic blood pressure ≥85 mmHg, or use of antihypertensive medication, and [3] Hyperglycemia: fasting plasma glucose ≥110 mg/dL or use of hypoglycemic medication. MHO was defined as obese subjects without MetS, whereas we defined metabolically unhealthy obesity (MUO) as obese subjects with MetS. We defined carotid plaque as IMT ≥1.1 mm. Results Among 1,241 subjects, 857 subjects (69%) were categorized in the normal body weight group, whereas 275 subjects (22%) were categorized as MHO, and 109 subjects (9%) were categorized as MUO. Compared to non-obese subjects, prevalence of classical cardiovascular risk factors including hypertension, diabetes mellitus, and dyslipidemia increased in subjects with MHO, and further increased in those with MUO. IMT was higher in obese subjects compared to those without obesity. Similarly, the prevalence of carotid plaque formation was also higher in obese subjects. Multivariable logistic regression analysis demonstrated that age ≥60 years, male sex, hypertension, diabetes mellitus, MHO subjects (Odds ratio [OR]; 1.6, p=0.005), and MUO subjects (OR 1.7, p=0.04) were independently associated with carotid plaque formation. There was no statistical difference in the risk of carotid plaque formation between subjects with MHO and MUO. IMT and Carotid Plaque Conclusions IMT and the prevalence of carotid plaque are higher in both subjects with MHO and MUO compared to non-obese subjects in the general population. We need to take obesity regardless of the presence of MetS into consideration as high-risk subjects for subsequent CVD.

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