Treatment of high cholesterol in women should be based on all risk factors for heart disease, not just lipid levels

2004 ◽  
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Lipid Levels ◽  
High Cholesterol

Coronary Risk Factors in Adolescents Related to Their Knowledge of Familial Coronary Heart Disease and Hypercholesterolemia: The Muscatine Study

PEDIATRICS ◽  
1994 ◽  
Vol 93 (3) ◽  
pp. 444-451
Author(s):  
Linda E. Muhonen ◽  
Richard P. Nelson ◽  
Trudy L. Burns ◽  
Ronald M. Lauer
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Density Lipoprotein ◽  
Apolipoprotein A1 ◽  
Lipoprotein Cholesterol ◽  
Coronary Risk Factors ◽  
Coronary Risk ◽  
High Cholesterol ◽  
Parental History ◽  
History Of

Objective. To determine the utility of a school-based questionnaire, to identify adolescents with adverse coronary risk factor levels. Design. In Muscatine, IA, students (9th through 12th grade) completed a questionnaire providing medical history information about first- and second-degree relatives. Anthropometric measures were obtained and blood pressure, lipid, lipoprotein, and apolipoprotein levels were determined. Results. A history of parental coronary heart disease (CHD) was rare and a history of parental high cholesterol frequently was unknown; however, when known, a history of high cholesterol or early (30 to 55 years of age) or later (>55 years of age) CHD (myocardial infarction, coronary bypass, or death from a heart attack) in grandfathers enriched the identification of adolescents with adverse coronary risk factors. Parental history of CHD was associated with an increased risk for high body mass index and low apolipoprotein A1 levels in their children. Grandfather history of early or later CHD was associated with an increased risk for low apolipoprotein A1 and high density lipoprotein cholesterol levels and high body mass index in their grandchildren. Students with positive grandfather histories of high cholesterol had higher total cholesterol, low density lipoprotein cholesterol, apolipoprotein B, and low density lipoprotein cholesterol to high density lipoprotein cholesterol ratios. Grandmother histories, because most were negative, did not help identify adolescents in this population with adverse coronary risk factors. Conclusions. A parental history of CHD as well as a grandfather history of high cholesterol or CHD enriches the identification of children with adverse coronary risk factor levels. The positive predictive values associated with using a school-based history obtained from adolescents, many with the aid of their parents, are small and many adolescents do not know their family history. It is essential that pediatricians inquire about parental and especially grandparental medical histories in accordance with the National Cholesterol Education Program guidelines to help identify children at highest familial risk. The importance of determining parental and grandparental histories of CHD or hypercholesterolemia should be emphasized to families who are uncertain of their histories to identify children and adolescents who require a physician's care. It is also important for pediatricians to remind their colleagues who care for patients with premature ischemic heart disease to refer their progeny for pediatric care so that their lipids and lipoproteins may be screened and counseling provided.

Abstract P151: Primary ASCVD Risk Associated With Undiagnosed Conditions Decreased Over NHANES 1999-2014

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
David R Nelson ◽  
Jessica A Davis
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Heart Disease ◽  
High Blood Pressure ◽  
The United States ◽  
High Cholesterol ◽  
Diabetes Status ◽  
Ascvd Risk ◽  
Over Time

Introduction: Atherosclerotic cardiovascular disease (ASCVD) is a general term for a group of diseases characterized by atherosclerosis that affect the heart and blood vessels. ASCVD is the leading cause of death in the United States contributing to at least 200,000 preventable deaths from heart disease and stroke each year. Cardiovascular disease, heart disease, and stroke mortality has declined since the year 2000, due to broader use of evidence-based therapies and changes to risk factors and lifestyle modifications, but the decline began to slow after 2011. Two main risk factors contributing to ASCVD are high blood pressure and high cholesterol. Efforts have been made to increase control of these factors at the population-level, however, only those who are diagnosed can be treated. While awareness has increased over time, there is still a significant contribution to ASCVD events from those who were undiagnosed but have high blood pressure, high cholesterol, and/or diabetes. Hypothesis: To assess how much of the total U.S. population ASCVD risk is undiagnosed from 1999-2014. Methods: The Pooled Cohort Equations assessed 10-year ASCVD risk, based on age, sex, race, total cholesterol, HDL level, systolic blood pressure, use of blood pressure medication, smoking status, and diabetes status. The undiagnosed risk of the primary risk population (age 40-79 years, without missing values for necessary cholesterol, blood pressure, and glucose measures) from 1999-2014 Continuous National Health and Nutrition Examination Survey (NHANES) was calculated based on self-report questions and clinical measures, after age, sex, race, smoking, and diagnosed risks were accounted for. Linear regression for complex survey data tested whether undiagnosed risk was changing over time. Results: Applying the ASCVD risk equation to the NHANES subset (n=8,763; weighted n=104,421,757), undiagnosed conditions were associated with 10% of the projected ASCVD events. That is, per 100,000 Americans in this subset, 7,747 ASCVD events were estimated over 10-years, and 800 were based on risk from undiagnosed diabetes, hypercholesterolemia, or hypertension. However, ASCVD risk associated with undiagnosed conditions over time decreased (p<0.001), from 1,169 per 100,000 in 1999-2000, to 642 per 100,000 in 2013-2014. Conclusions: NHANES creates a unique opportunity to quantify undiagnosed ASCVD risk in a nationally representative sample. Since 1999, a sizeable portion of the US primary ASCVD risk was based on undiagnosed conditions, however, this proportion of undiagnosed risk decreased over time.

Patient Self-Medication with ASA 81 mg

2010 ◽  
Vol 143 (4) ◽  
pp. 192-198 ◽  
Author(s):  
Jeff Taylor ◽  
Charity Evans ◽  
David Blackburn ◽  
William Semchuck
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Heart Attack ◽  
Positive Family History ◽  
High Cholesterol ◽  
Chd Risk ◽  
Initiation Of Therapy ◽  
Risk Equivalent

Purpose: Low-dose acetylsalicylic acid (ASA) is an important therapy for decreasing cardiac events in patients at risk. The initiation of ASA therapy should involve physician assessment, but some people may choose to self-medicate. The purpose of this project was to determine the percentage of people taking ASA 81 mg without the recommendation of their doctor, as well as to estimate the proportion of users exhibiting an objective indication for daily use of ASA 81 mg, based on survey responses indicating the presence of established cerebrovascular disease (stroke or mini-stroke), coronary heart disease (CHD) (heart attack or prevention surgery), a CHD risk equivalent (diabetes) or at least 2 risk factors for CHD (age, smoking, high blood pressure, high cholesterol or positive family history). Methods: A 1-page survey was distributed to purchasers of ASA 81 mg at 52 community pharmacies in Saskatchewan. Respondents were asked who led them to start taking ASA for heart health and were asked for information on their age and health history. Estimates were made of the proportion of users exhibiting an objective indication for daily use of ASA 81 mg, defined as the presence of either established cerebrovascular disease (stroke or mini-stroke), coronary heart disease (CHD) (heart attack or prevention surgery), a CHD risk equivalent (diabetes) or at least 2 risk factors for CHD (age, smoking, high blood pressure, high cholesterol or positive family history). Results: Of the 481 respondents whose surveys were suitable for analysis, 417 (86.7%) were engaged in doctor-supervised care. Conversely, 13.1% did not seek a physician's advice prior to the initiation of therapy. Of the 69 respondents who were taking ASA but did not meet the indications for its use, the majority claimed to have started therapy based on the recommendation of a health care professional. Conclusion The use of ASA without physician intervention is of serious concern. In this study of Saskatchewan citizens, up to 13.1% did not involve their doctor for initiation of therapy, potentially exposing them to unnecessary risk.

Prevalence of Risk Factors for Coronary Artery Disease in Pennsylvania (USA) Firefighters

2015 ◽  
Vol 31 (1) ◽  
pp. 102-107 ◽  
Author(s):  
Brian L. Risavi ◽  
Jason Staszko
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Waist Circumference ◽  
Study Cohort ◽  
High Cholesterol ◽  
Convenience Sample ◽  
History Of ◽  
Artery Disease

AbstractIntroductionFirefighting is a physically demanding profession. Heart disease remains the number one killer of firefighters. Many firefighters have multiple risk factors, putting them at risk for sudden cardiac events. The purpose of this study was to describe the prevalence of risk factors for heart disease in a convenience sample of Pennsylvania (USA) firefighters.MethodsA convenience sample of 160 firefighters in western Pennsylvania had height, weight, waist circumference, blood pressure, and body mass index (BMI) assessed, and then were surveyed to measure their knowledge of cardiovascular risk factors. Data analysis included subgroup comparisons of age, BMI, waist circumference, and exercise for their impact on health risks in the study cohort. In particular, the researchers were interested in understanding whether the knowledge of risk was associated with lower measures of risk.ResultsEighteen firefighters (4%) reported a history of coronary artery disease (including stents/interventions). In this group, 69% to 82% correctly identified age, hypertension (HTN), high cholesterol, smoking, obesity, sedentary lifestyle, and family history as risk factors for coronary artery disease. Fourteen percent were smokers, 41% had HTN, 38% had pre-HTN with only 12% receiving treatment, and 13.5% were treated for high cholesterol. Fifty-eight percent exercised regularly.ConclusionsWhile a majority of firefighters were able to identify risk factors for coronary artery disease, many could not. Eighteen (4%) had a history of coronary artery disease, including interventions. Many had several of the risk factors indicated, which highlights the need for an organized national approach to address the medical screening/evaluation, nutrition, and exercise components of firefighter fitness.RisaviBL, StaszkoJ. Prevalence of risk factors for coronary artery disease in Pennsylvania (USA) firefighters. Prehosp Disaster Med. 2016;31(1):102–107.

The Urgent Need for Monitoring and Intervention to Reduce Metabolic Risk Factors in Patients with Schizophrenia

CNS Spectrums ◽  
2008 ◽  
Vol 13 (S10) ◽  
pp. 5-6 ◽  
Author(s):  
Henry A. Nasrallah
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Mental Illness ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
General Population ◽  
Life Expectancy ◽  
Physical Inactivity ◽  
Metabolic Risk ◽  
High Cholesterol

Serious mental illness is associated with a significant reduction in life expectancy of ≤30 years. Among patients with schizophrenia, mortality due to coronary heart disease is ∼50% higher than that of the general population.Patients with schizophrenia have substantially higher rates of cardiovascular risk factors (smoking, high cholesterol, hypertension, physical inactivity, obesity/overweight, and diabetes) than the general population. Approximately 75% of individuals with schizophrenia smoke compared to ∼25% of the general population. Patients with schizophrenia also have lipid profiles that are significantly worse than those of individuals in the general population.

scholarly journals SERUM LIPID PROFILE

2018 ◽  
Vol 21 (01) ◽  
pp. 084-093
Author(s):  
Munir Ahmed
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Control Group ◽  
Lipid Levels ◽  
Low Density Lipoprotein Cholesterol ◽  
Premature Coronary Heart Disease

… Objectives: This study was conducted to determine serum lipid profile in childrenof premature coronary heart disease patients and compare results between children havingparents with one, two or three risk factors. Study Design: A cross sectional comparative study.Patients and Methods: Ninety seven (97) subjects having parents with one risk factor, sixty three(63) subjects having parents with two risk factors and sixty five (65) subjects having parents withthree risk factors were selected from Punjab Institute of Cardiology Lahore. Fifty (50) age and sexmatched subjects of parents without a history of coronary heart disease were also selected. Theserum total cholesterol, serum triglycerides, serum low density lipoprotein cholesterol andserum high density lipoprotein cholesterol was performed and results were compared. Results:Offsprings of parents having more number of risk factors had statistically significantly high totalcholesterol and low density lipoprotein cholesterol as compared with offsprings of parentshaving one risk factor. Triglycerides and high density lipoprotein cholesterol of offsprings ofparents having one, two, three or more than three risk factors were comparable. Offsprings ofparents having premature coronary heart disease (CHD) had abnormal lipid levels as comparedwith control group. Conclusions: Coronary heart disease risk factors are significant regardingabnormal lipid levels. Offsprings of premature CHD patients are prone to develop CHD ascompared to normal control group. Genetic predisposition seems to be important indevelopment of CHD.

Sign in / Sign up

Export Citation Format

Share Document