Letter to the Editor on “Traditional Cardiovascular Risk Factors Strongly Underestimate the 5-Year Occurrence of Cardiovascular Morbidity and Mortality in Spinal Cord Injured Individuals”

Epidemiologic studies demonstrated that the classical cardiovascular risk factors explain only a part of the increased cardiovascular morbidity and mortality. Large scale studies have shown that novel cardiovascular risk factors, including increased plasma homocysteine, fibrinogen, C-reactive protein, uric acid levels, and increased white blood cells count as well as low adiponectin levels, might have a key role in the pathogenesis of the cardiovascular disease. This review examines recent literature data on the effect of novel risk factors on cardiovascular morbidity and mortality in healthy subjects as well as in subjects at high cardiovascular risk. In addition, the pathogenetic mechanisms linking the effects of the novel risk factors with atherosclerosis are discussed.

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Letter to the Editor in Response to the Article “Effectiveness on major cardiovascular risk factors of an educational program to promote a Mediterranean type of diet among the employees of the company FCA Italia S.p.A”

Diabetes Research and Clinical Practice ◽

10.1016/j.diabres.2021.109072 ◽

2021 ◽

pp. 109072

Author(s):

Shanpin Fanchiang ◽

Matthew F. Bouchonville

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Educational Program ◽

Letter To The Editor

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Cardiovascular morbidity and mortality in patients treated with hemodialysis: Epidemiological analysis

Vojnosanitetski pregled ◽

10.2298/vsp0812893p ◽

2008 ◽

Vol 65 (12) ◽

pp. 893-900 ◽

Cited By ~ 6

Author(s):

Dejan Petrovic ◽

Biljana Stojimirovic

Keyword(s):

Risk Factors ◽

Heart Failure ◽

Mortality Rate ◽

Cardiovascular Mortality ◽

Cardiovascular Complications ◽

Left Ventricular ◽

Cardiovascular Morbidity ◽

Morbidity And Mortality ◽

Cardiovascular Morbidity And Mortality ◽

Lv Mass

Background/Aim. Cardiovascular diseases are the leading cause of death in patients treated with hemodialysis (HD). The annual cardiovascular mortality rate in these patients is 9%. Left ventricular (LV) hypertrophy, ischemic heart disease and heart failure are the most prevalent cardiovascular causes of death. The aim of this study was to assess the prevalence of traditional and nontraditional risk factors for cardiovascular complications, to assess the prevalence of cardiovascular complications and overall and cardiovascular mortality rate in patients on HD. Methods. We investigated a total of 115 patients undergoing HD for at least 6 months. First, a cross-sectional study was performed, followed by a two-year follow-up study. Beside standard biochemical parameters, we also determined cardiac troponins and echocardiographic parameters of LV morphology and function (LV mass index, LV fractional shortening, LV ejection fraction). The results were analyzed using the Student's t test and Mann-Whitney U test. Results. The patients with adverse outcome had significantly lower serum albumin (p < 0.01) and higher serum homocystein, troponin I and T, and LV mass index (p < 0.01). Hyperhomocysteinemia, anemia, hypertriglyceridemia and uncontrolled hypertension had the highest prevalence (86.09%, 76.52%, 43.48% and 36.52%, respectively) among all investigated cardiovascular risk factors. Hypertrophy of the LV was presented in 71.31% of the patients and congestive heart failure in 8.70%. Heart valve calcification was found in 48.70% of the patients, pericardial effusion in 25.22% and disrrhythmia in 20.87% of the investigated patients. The average annual overall mortality rate was 13.74%, while average cardiovascular mortality rate was 8.51%. Conclusion. Patients on HD have high risk for cardiovascular morbidity and mortality.

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Gender peculiarities of interrelations between cardiovascular risk factors and development of prehypertension

Nauchno-prakticheskii zhurnal «Patogenez» ◽

10.25557/2310-0435.2018.03.57-63 ◽

2018 ◽

pp. 57-63

Author(s):

В.В. Шерстнёв ◽

М.А. Грудень ◽

О.В. Сенько ◽

В.П. Карлина ◽

А.В. Кузнецова ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Left Ventricular ◽

Drug Prevention ◽

Cardiovascular Morbidity And Mortality ◽

Prevention Of Hypertension ◽

The Relationship ◽

Insight Into ◽

Qualitative Changes

В настоящее время доказано, что предгипертензия, характеризующая состояние лиц с артериальным давлением (АД) от 120/80 мм рт.ст. до 139/89 мм рт.ст., имеет высокую и постоянно возрастающую распространенность среди населения во всем мире и является независимым фактором риска формирования артериальной гипертонии, развития сердечно-сосудистой заболеваемости и смертности. Это делает актуальным изучение взаимосвязи развития предгипертензии с наличием других факторов риска сердечно-сосудистых заболеваний. Целью данного исследования явилось изучение гендерных особенностей взаимосвязи факторов риска сердечно-сосудистых заболеваний и развития предгипертензии. Методы исследования. Проведен сравнительный и корреляционный анализ показателей модифицируемых и немодифицируемых факторов риска сердечно-сосудистых заболеваний у 115 обследованных лиц мужского (n = 49) и женского пола (n = 66), средний возраст которых составил 47,6 ± 0,7 года с оптимальным АД (n = 63, АД < 120/80 мм рт.ст.) и предгипертензией (n = 52, АД 120-139/80-89 мм рт.ст.). Результаты исследования. Обнаружено, что мужчины и женщины с оптимальным АД и с предгипертензией различаются спектром факторов риска и структурой взаимосвязи исследованных показателей. У мужчин предгипертензия ассоциирована с повышенным содержанием креатинина в крови и табакокурением, тогда как у женщин - с гипертрофией левого желудочка сердца, стрессом и наследственной отягощенностью по гипертонической болезни. Развитие предгипертензии у женщин по сравнению с мужчинами характеризуется более выраженными количественными и качественными изменениями структуры взаимосвязей показателей исследованных факторов риска сердечно-сосудистых заболеваний. Заключение. Полученные результаты представляют интерес для понимания механизмов патогенеза предгипертензии и разработки стратегии её персонифицированной немедикаментозной и медикаментозной профилактики, основанной на устранении или ослаблении определенных факторов риска сердечно-сосудистых заболеваний. Currently it is proved that prehypertension characterizing the condition of individuals with blood pressure (BP) from 120/80 mm Hg to 139/89 mm Hg has a high, continuously increasing prevalence worldwide and is an independent risk factor for development of arterial hypertension and cardiovascular morbidity and mortality, which justifies studying the relationship between prehypertension and the presence of other risk factors for cardiovascular diseases. The aim of this study was to investigate gender features of the relationship between risk factors for cardiovascular disease and development of prehypertension. Methods. Comparative and correlation analyses of modifiable and non-modifiable cardiovascular risk factors were performed for 115 males (n = 49) and females (n = 66) aged 47.6 ± 0.7 with optimal BP (n = 63, BP < 120/80 mm Hg) or prehypertension (n = 52, AD = 120-139/80-89 mm Hg). Results. Men and women with optimal BP and prehypertension differed in the array of risk factors and the structure of relationship between the studied indices. In men, prehypertension was associated with an elevated blood creatinine and tobacco smoking whereas in women - with left ventricular hypertrophy, stress, and hereditary burden of hypertension. The development of prehypertension in women compared to men was characterized by more pronounced quantitative and qualitative changes in the structure of interrelationships between indices of the studied cardiovascular risk factors. Conclusion. The obtained results provide insight into pathogenetic mechanisms of prehypertension. They can be used for developing a strategy for individualized non-drug and drug prevention of hypertension based on elimination or reduction of certain cardiovascular risk factors.

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Left ventricular hypertrophy in patients treated with regular hemodialyses

Medicinski pregled ◽

10.2298/mpns0808369p ◽

2008 ◽

Vol 61 (7-8) ◽

pp. 369-374 ◽

Cited By ~ 6

Author(s):

Dejan Petrovic ◽

Biljana Stojimirovic

Keyword(s):

Risk Factors ◽

Left Ventricle ◽

Left Ventricular Hypertrophy ◽

Ventricular Hypertrophy ◽

Pressure Overload ◽

Left Ventricular ◽

Cardiovascular Morbidity ◽

Morbidity And Mortality ◽

Concentric Hypertrophy ◽

Cardiovascular Morbidity And Mortality

Left ventricular hypertrophy is the main risk factor for development of cardiovascular morbidity and mortality in patients on hemodialysis. Left ventricular hypertrophy is found in 75% of the patients treated with hemodialysis. Risk factors for left ventricular hypertrophy in patients on hemodialysis include: blood flow through arterial-venous fistula, anemia, hypertension, increased extracellular fluid volume, oxidative stress, microinflammation, hyperhomocysteinemia, secondary hyperpara- thyroidism, and disturbed calcium and phosphate homeostasis. Left ventricular pressure overload leads to parallel placement of new sarcomeres and development of concentric hypertrophy of left ventricle. Left ventricular hypertrophy advances in two stages. In the stage of adaptation, left ventricular hypertrophy occurs as a response to increased tension stress of the left ventricular wall and its action is protective. When volume and pressure overload the left ventricle chronically and without control, adaptive hypertrophy becomes maladaptive hypertrophy of the left ventricle, where myocytes are lost, systolic function is deranged and heart insufficiency is developed. Left ventricular mass index-LVMi greater than 131 g/m2 in men and greater than 100 g/m2 in women, and relative wall thickness of the left ventricle above 0.45 indicate concentric hypertrophy of the left ventricle. Eccentric hypertrophy of the left ventricle is defined echocardiographically as LVMi above 131 g/m2 in men and greater than 100 g/m2 in women, with RWT ?0.45. Identification of patients with increased risk for development of left ventricular hypertrophy and application of appropriate therapy to attain target values of risk factors lead to regression of left ventricular hypertrophy, reduced cardiovascular morbidity and mortality rates and improved quality of life in patients treated with regular hemodialyses.

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From the metabolic syndrome to the concept of global cardiometabolic risk

Orvosi Hetilap ◽

10.1556/oh.2009.28606 ◽

2009 ◽

Vol 150 (18) ◽

pp. 821-829 ◽

Cited By ~ 5

Author(s):

Judit Nádas ◽

György Jermendy

Keyword(s):

Risk Factors ◽

Metabolic Syndrome ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Central Obesity ◽

Cardiometabolic Risk ◽

Adult Population ◽

Continuous Treatment ◽

The Metabolic Syndrome ◽

Cardiovascular Morbidity And Mortality

Although the clustering of cardiovascular risk factors is unquestionable, the clinical significance of the metabolic syndrome as a distinct entity has been debated in the past years. Recently, the term ‘metabolic syndrome’ has been replaced by ‘global cardiometabolic risk’ which implies cardiovascular risk factors beyond the metabolic syndrome. The metabolic syndrome can be frequently detected among people in western and developing countries affecting 25-30% of adult population, and its prevalence rate is increasing. Prospective studies show that the metabolic syndrome is a significant predictor of incident diabetes but has a weaker association with cardiovascular morbidity and mortality. At the same time the metabolic syndrome is inferior to established predicting models for either type 2 diabetes or cardiovascular disease.The underlying pathomechanism of the metabolic syndrome is still poorly understood. The role of insulin resistance – although not as a single factor – is still considered as a key component. In the last decade the importance of abdominal obesity has received increased attention but some studies, mainly in the Asian population, showed that central obesity is not an essential component of the syndrome. Regardless of the theoretical debates the practical implications are indisputable. The frequent clustering of hypertension, dyslipidaemia and glucose intolerance, that often accompanies central obesity, can not be ignored. Following the detection of one risk factor, the presence of other, traditional and non-traditional factors should be searched for, as the beneficial effect of intensive, target oriented, continuous treatment of metabolic and cardiovascular risk factors has been proven in both the short and long term.

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