scholarly journals Should diastolic and systolic blood pressure be considered for cardiovascular risk evaluation: a study in middle-aged men and women

2001 ◽  
Vol 37 (1) ◽  
pp. 163-168 ◽  
Author(s):  
Athanase Benetos ◽  
Frederique Thomas ◽  
Michel E Safar ◽  
Kathryn E Bean ◽  
Louis Guize
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Systolic Blood Pressure ◽  
Risk Evaluation ◽  
Middle Aged ◽  
Men And Women

Abstract 3448: Differences in the Associations between Various Ultrasound-Based Markers of Peripheral Atherosclerosis at Carotid and Femoral Levels and Risk factors in a general Middle-Aged Population

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Patrick O Yerly ◽  
Nicolas Rodondi ◽  
Fred Paccaud ◽  
Pierre Vogt ◽  
Pascal Bovet
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Systolic Blood Pressure ◽  
Ldl Cholesterol ◽  
Hdl Cholesterol ◽  
Intima Media Thickness ◽  
Plaque Morphology ◽  
Middle Aged ◽  
Plaque Area

Introduction: Ultrasound detection of sub-clinical atherosclerosis (ATS) is a useful mean to identify subjects at high risk of cardiovascular (CV) events. Most studies have evaluated intima-media thickness (IMT) at the carotid artery level, but plaque-based markers (plaque thickness, plaque area) as well as the femoral artery level have been proposed as valid alternatives. The superiority of one method upon the others has not been demonstrated. The aim of this study is to compare the relationships between five indicators of ATS (IMT, mean / maximal plaque thickness, mean / maximal plaque area) at both carotid and femoral levels and conventional cardiovascular risk factors (CVRF) in a population-based sample of middle-aged adults. Methods: High resolution B-mode ultrasound was performed in both right and left carotid and femoral arteries on 496 consecutive participants aged 45– 64 randomly selected from the general population. A plaque was defined as a focal IMT thickening ≥ 1.2 mm. CVRF included age, sex, current smoking, systolic blood pressure, LDL-cholesterol, HDL-cholesterol, and diabetes. Results : All CVRF were associated, independently of age, with each of the ATS markers at femoral level but only LDL-cholesterol and systolic blood pressure were consistently associated with ATS markers at carotid level. The table shows the adjusted R-squared values in a multivariate model with all CVRF. Variance (adjusted R 2 ) in predicting any of the ATS markers was larger at femoral than carotid levels. At both carotid and femoral levels, the CVRF accounted for more variance in predicting plaque-based markers than IMT. Conclusion: The stronger association of CVRF with ATS markers at the femoral than carotid levels and with plaque-based markers than with IMT suggest that markers assessed at femoral level and based on plaque morphology might be the most useful tools for assessing cardiovascular risk. These findings need to be confirmed in prospective studies with CV events.

Long-term effects (>24 months) of multiple lifestyle intervention on major cardiovascular risk factors among high risk subjects: a meta-analysis

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
H Bergum ◽  
I Sandven ◽  
TO Klemsdal
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Systolic Blood Pressure ◽  
Total Cholesterol ◽  
Cardiovascular Risk Factors ◽  
Lifestyle Intervention ◽  
Small Study ◽  
Long Term Effects

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The Norwegian health department Background The evidence of the long-term effects of multiple lifestyle intervention on cardiovascular risk is uncertain. We aimed to summarize the evidence from randomized clinical trials examining the efficacy of lifestyle intervention on major cardiovascular risk factors in subjects at high cardiovascular risk. Methods  Eligible trials investigated the impact of lifestyle intervention versus usual care with minimum 24 months follow-up, reporting more than one major cardiovascular risk factor. A literature search updated April 15, 2020 identified 12 eligible studies. The results from individual trials were combined using fixed and random effect models, using the standardized mean difference (SMD) to estimate effect sizes. Small-study effect was evaluated, and heterogeneity between studies examined by subgroup and meta-regression analyses considering patient- and study-level variables. Results  Small-study effect was not identified. Lifestyle intervention reduced systolic blood pressure modestly with an estimated SMD of -0.13, 95% confidence interval (CI): -0.21 to -0.04, with moderate heterogeneity (I² = 59%), corresponding to a mean difference of approximately 2 mmHg (MD = -1.86, 95% CI: -3.14 to -0.57, p = 0.0046). This effect disappeared in the subgroup of trials judged at low risk of bias (SMD = 0.02, 95% CI: -0.08 to 0.11). For the outcome total cholesterol SMD was -0.06, 95% CI: -0.13 to 0.00, with no heterogeneity (I² = 0%), indicating no effect of the intervention. Conclusion  Lifestyle intervention resulted in only a modest effect on systolic blood pressure and no effect on total cholesterol after 24 months. Further lifestyle trials should consider the challenge of maintaining larger long-term benefits to ensure impact on cardiovascular outcomes.

scholarly journals Sex-specific reference values and determinants of infra-renal abdominal aortic diameter among women and men from general population

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
F Zhu ◽  
B Arshi ◽  
M Ikram ◽  
R De Knegt ◽  
M Kavousi
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
General Population ◽  
Cardiovascular Risk Factors ◽  
Reference Values ◽  
Aortic Diameter ◽  
Funding Source ◽  
Men And Women ◽  
Abdominal Aortic

Abstract Introduction Abdominal aortic diameter has shown to be a marker of adverse cardiovascular outcomes. Among the non-aneurysmal populations, studies regarding abdominal aortic diameter normal reference values are sparse. Moreover, data regarding the associations between cardiovascular risk factors and aortic diameter among men and women are limited. Purpose To establish age- and sex-specific distribution of the infra-renal abdominal aortic diameters among non-aneurysmal older adults from the general population and to investigate the associations between cardiovascular risk factors and aortic diameters in men and women. Methods From a population-based cohort, 4032 participants (mean age, 67.2 years; 60.4% women) with infra-renal diameter assessment and without history of cardiovascular disease were included. Mean and quantile values of diameters were calculated in different age groups. Multiple linear regression analysis was used to detect the association of cardiovascular risk factors with diameters in men and women. Results The mean crude diameter was larger in men [mean (SD): 19.5 (2.6) mm] compared to women [17.0 (2.4)mm] but after adjustment for body surface area (BSA), the differences were small. There was a non-linear relationship between age and diameter (p<0.001). After 66 years of age, the increase in diameter with increasing age was attenuated. After age 74 years in women and 71 years in men, the relationship between age and infra-renal aortic diameter was no longer statistically significant (Figure). Waist [standardized β (95% CI): 0.02 (0.0–0.04) in women and 0.03 (0.01–0.06) in men] and diastolic blood pressure [0.04 (0.02–0.05) in women and 0.02 (0.0–0.04) in men] were the risk factors for diameters in both sexes. Body mass index [0.02 (0.01–0.09)], systolic blood pressure [−0.01 (−0.02 to −0.01)], smoking status [0.21 (0.02–0.39)], cholesterol [−0.19 (−0.29 to −0.09)], and lipid-lowering medication [−0.47 (−0.71 to −0.23)] were significantly associated with aortic diameter only in women. Conclusion The differences in the crude abdominal aortic diameter between women and men diminished after taking into account the BSA. The abdominal aortic diameter increased steeply with advancing age and up to 66 years of age. However, after 74 years in women and 71 years in men, the diameter values reached a plateau. We also observed sex differences in the associations of cardiovascular risk factors with abdominal aortic diameter. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Netherlands Organization for the Health Research and Development (ZonMw); the Research Institute for Diseases in the Elderly (RIDE)

Therapieziele bei der Hypertoniebehandlung

2017 ◽  
Vol 142 (19) ◽  
pp. 1420-1429 ◽  
Author(s):  
Rainer Düsing
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Systolic Blood Pressure ◽  
Measurement Procedure ◽  
Treatment Goals ◽  
High Cardiovascular Risk ◽  
Hypertensive Patients ◽  
Optimal Target ◽  
Elderly Hypertensive ◽  
Intervention Trials

AbstractThe optimal target blood pressure (BP) in the treatment of hypertensive patients remains controversial. Recently, the systolic blood pressure trial (SPRINT) has proposed that a target systolic blood pressure of < 120 mmHg provides prognostic benefit in elderly hypertensive patients at high cardiovascular risk. The results of SPRINT contrast with several other intervention trials which have investigated the effect of intense BP lowering (Secondary Prevention of Small Subcortical Strokes [SPS3], Action to Control Cardiovascular Risk in Diabetes [ACCORD], Heart Outcomes Prevention Evaluation [HOPE]-3). The differences in outcomes in SPRINT vs. other intervention trials are, to a large extend, due to an "unobserved" BP measurement procedure utilized in the SPRINT trial. Thus, a BP goal of < 120 mmHg, at least by conventional BP measurement, remains unproven. Independent of SPRINT the controversial evidence with respect to BP targets calls for further studies and, possibly, for more individualized treatment goals.

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