Myocardial strain impairment, heterozygous familial hypercholesterolemia and systemic arterial hypertension: is there a link?

Abstract Introduction Only few studies looked for a possible association of cardiovascular disorders (CVD), in comorbid insomnia with obstructive sleep apnea (COMISA) even though this is a relevant topic in order to prevent one of the major causes of morbimortality. The present study aimed to investigate the association of insomnia symptoms in patients at risk for obstructive sleep apnea in terms of prevalence and clinical interactions and to evaluate the risk of CVD in patients with a risk for COMISA. Methods This is a cross-sectional study. All medical records with data such as age, sex, height, weight and BMI, time to sleep, time to wake up, total sleep time, the Epworth Sleepiness Scale (ESS), STOP-BANG Questionnaires were studied. Insomnia and comorbidities were also investigated, and the patientsanswered yes or no to systemic arterial hypertension, diabetes, CVD. Results 685 patients were enrolled on the present study. We observed that the mild, moderate, and high risk for COMISA presented progressively increasing levels for the frequency of hypertension, diabetes, and CVD. A binary logistic regression was performed to assess whether risk for COMISA could be a predictor for CVD, and it was found that the model containing risk for COMISA was statistically significant: [x2(1)=5.273;p<0.021, R2 Negelkerke=0.014]. Risk for COMISA presented itself as a significant predictor for CVD (OR=1.672; 95% CI=1.079–2.592). Conclusion There was an increased frequency of associated comorbidities such as CVD, systemic arterial hypertension, and diabetes, according to the mild, moderate, or high risk. These findings highlight the need for a cardiometabolic evaluation in patients with this comorbid condition which may impact prognosis and therapeutic success. Support (if any):

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Impact of Diet on Plasma Lipids in Individuals with Heterozygous Familial Hypercholesterolemia: A Systematic Review of Randomized Controlled Nutritional Studies

Nutrients ◽

10.3390/nu13010235 ◽

2021 ◽

Vol 13 (1) ◽

pp. 235

Author(s):

Gabrielle Roy ◽

Anykim Boucher ◽

Patrick Couture ◽

Jean-Philippe Drouin-Chartier

Keyword(s):

Familial Hypercholesterolemia ◽

Dietary Supplement ◽

Guar Gum ◽

Risk Of Bias ◽

Omega 3 ◽

Dietary Counseling ◽

Randomized Controlled ◽

Heterozygous Familial Hypercholesterolemia ◽

Counseling Interventions ◽

The Impact

Background: Conclusive data on the effectiveness of dietary interventions in heterozygous familial hypercholesterolemia (HeFH) management are unavailable. Whether this is due to a true lack of effects or biases in intervention designs remains unsettled. We systematically assessed the impact on LDL-C of published dietary randomized controlled trials (RCTs) conducted among individuals with HeFH in relation to their design and risk of bias. Methods: We systematically searched PubMed, Web of Science, and Embase in November 2020 to identify RCTs that assessed the impact of: (1) food-based interventions; (2) dietary counseling interventions; or (3) dietary supplements on LDL-C in individuals with HeFH. We evaluated the risk of bias of each study using the Cochrane Risk of Bias 2 method. Results: A total of 19 RCTs comprising 837 individuals with HeFH were included. Of those, five were food-based interventions, three were dietary counseling interventions and 12 were dietary supplement-based interventions (omega-3, n = 3; phytosterols, n = 7; guar gum, n = 1; policosanol, n = 1). One study qualified both as a food-based intervention and as a dietary supplement intervention due to its factorial design. A significant reduction in LDL-C levels was reported in 10 RCTs, including eight dietary supplement interventions (phytosterols, n = 6, omega-3, n = 1; guar gum, n = 1), one food-based intervention and one dietary counseling intervention. A total of 13 studies were judged to have some methodological biases in a way that substantially lowers confidence in the results. Studies at low risk of biases were more likely to report significant reductions in LDL-C concentrations, compared with studies at risk of bias (chi-square statistic: 5.49; p = 0.02). Conclusion: This systemic review shows that the apparent lack of effectiveness of diet manipulation in modulating plasma levels of LDL-C among individuals with HeFH is likely due to biases in study designs, rather than a true lack of effects. The likelihood of reporting significant reductions in LDL-C was associated with the concurrent risk of bias.

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PRESENCE AND BURDEN OF CORONARY ATHEROSCLEROSIS IN HETEROZYGOUS FAMILIAL HYPERCHOLESTEROLEMIA

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(21)02769-8 ◽

2021 ◽

Vol 77 (18) ◽

pp. 1411

Author(s):

Khurram Nasir ◽

Reed Mszar ◽

Miguel Cainzos-Achirica ◽

Gowtham Grandhi ◽

Rodrigo Alonso Karlezi ◽

...

Keyword(s):

Familial Hypercholesterolemia ◽

Coronary Atherosclerosis ◽

Heterozygous Familial Hypercholesterolemia

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Effects of weekly LDL-apheresis on metabolic parameters of apolipoprotein B in heterozygous familial hypercholesterolemia

The Journal of Lipid Research ◽

10.1016/s0022-2275(20)37487-3 ◽

1996 ◽

Vol 37 (11) ◽

pp. 2383-2393

Author(s):

K G Parhofer ◽

P H Barrett ◽

T Demant ◽

W O Richter ◽

P Schwandt

Keyword(s):

Familial Hypercholesterolemia ◽

Apolipoprotein B ◽

Metabolic Parameters ◽

Ldl Apheresis ◽

Heterozygous Familial Hypercholesterolemia

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O enfermeiro e a questão da adesão do paciente ao tratamento da hipertensão arterial sistêmica [Nurses and patient adherence to treatment for systemic arterial hypertension] [El enfermero y la cuestión de la adhesión del paciente al tratamiento de la hipertensión arterial sistémica]

Revista Enfermagem UERJ ◽

10.12957/reuerj.2019.37193 ◽

2019 ◽

Vol 27 ◽

pp. e37193

Author(s):

Anna Luisa de Oliveira Salles ◽

Carlos Eduardo Peres Sampaio ◽

Leonardo Dos Santos Pereira ◽

Nickson Scarpine Malheiros ◽

Renan Araújo Gonçalves

Keyword(s):

Arterial Hypertension ◽

Rio De Janeiro ◽

Patient Adherence ◽

Family Health ◽

Adherence To Treatment ◽

Structured Interviews ◽

Systemic Arterial Hypertension ◽

Health Strategy ◽

El Sistema ◽

Family Health Strategy

Objetivo: identificar os recursos utilizados pelo enfermeiro da estratégia saúde da família (ESF) para estimular a adesão do paciente ao tratamento da Hipertensão Arterial Sistêmica. Método: abordagem qualitativa. O projeto foi aprovado por Comitê de Ética em Pesquisa. A coleta de dados ocorreu no período de abril a agosto de 2017, por meio de entrevista semiestruturada com 10 enfermeiros atuantes em unidades de ESF localizadas no Estado do Rio de Janeiro. Os depoimentos dos sujeitos foram submetidos à análise de conteúdo de Bardin. Resultados: os enfermeiros realizam consultas de enfermagem garantindo a adesão dos participantes em atividades educativas de grupo, como palestras e orientações de enfermagem. Conclusão: o sistema utilizado na adesão ao tratamento é similar entre as unidades de ESF mantendo um padrão preconizado pela literatura.ABSTRACTObjective: to identify the resources used by Family Health Strategy (FHS) nurses to encourage patient adherence to treatment for Systemic Arterial Hypertension. Method: qualitative approach. The project was approved by the research ethics committee. Data were collected between April and August 2017, through semi-structured interviews of 10 nurses working in FHS units in Rio de Janeiro state. The transcriptions underwent Bardin content analysis. Results: the nurses held nursing appointments thus fostering participants’ adherence in group educational activities, such as talks and nursing guidance sessions. Conclusion: the treatment adherence system used is similar among FHS units, maintaining a pattern recommended by the literature.RESUMENObjetivo: identificar los recursos utilizados por el enfermero de la estrategia de salud familiar (ESF) para estimular la adhesión del paciente al tratamiento de la hipertensión. Método: enfoque cualitativo. El proyecto fue aprobado por el Comité de Ética en Investigación. La recolección de datos ocurrió en el período entre abril y agosto de 2017, por medio de entrevista semiestructurada junto a 10 enfermeros que trabajan en unidades de ESF ubicadas en el estado de Río de Janeiro. Las declaraciones fueron sometidas al análisis de contenido de Bardin. Resultados: los enfermeros realizan consultas de enfermería garantizando la adhesión de los participantes en actividades educativas de grupo, como charlas y orientaciones de enfermería. Conclusión: el sistema utilizado en la adhesión al tratamiento es similar entre las unidades de ESF manteniendo un patrón preconizado por la literatura.

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