scholarly journals Sex-specific normal values and determinants of infrarenal abdominal aortic diameter among non-aneurysmal elderly population

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Fang Zhu ◽  
Banafsheh Arshi ◽  
M. Arfan Ikram ◽  
Robert J. De Knegt ◽  
Maryam Kavousi

AbstractTo establish age- and sex-specific distribution of the infrarenal abdominal aortic diameters (IAD) among non-aneurysmal elderly population and to investigate the associations between traditional cardiovascular risk factors and IAD in men and women. We included 4032 participants (mean age 67.2 years; 60.4% women) from the population-based Rotterdam Study, free of cardiovascular disease, who underwent IAD ultrasound assessment between 2009–2014. Linear regression analysis was used to identify determinants of IAD. The medians (inter-quartile range) of absolute IAD and body surface area (BSA)-adjusted IAD were 17.0 (15.0–18.0) mm and 9.3 (8.5–10.2) mm for women and 19.0 (18.0–21.0) mm and 9.4 (8.6–10.3) mm for men, respectively. There was a non-linear relationship between age and IAD. IAD increased steeply with advancing age and up to 70 years. After around 75 years of age, the diameter values reached a plateau. Waist circumference and diastolic blood pressure were associated with larger diameters in both sexes. Body mass index [Effect estimate (95% CI): 0.04 (0.00 to 0.08)], systolic blood pressure [− 0.01(− 0.02 to 0.00)], current smoking [0.35 (0.06 to 0.65)], total cholesterol levels [− 0.21 (− 0.31 to − 0.11)], and lipid-lowering medication [− 0.43 (− 0.67 to − 0.19)] were significantly associated with IAD in women. Sex differences in IAD values diminished after taking BSA into account. The increase in diameters was attenuated after 70 years. Differences were observed in the associations of several cardiovascular risk factors with IAD among men and women.

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
F Zhu ◽  
B Arshi ◽  
M Ikram ◽  
R De Knegt ◽  
M Kavousi

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)


2006 ◽  
Vol 95 (01) ◽  
pp. 134-141 ◽  
Author(s):  
Barbara Thorand ◽  
Jens Baumert ◽  
Angela Döring ◽  
Andrea Schneider ◽  
Lloyd Chambless ◽  
...  

SummaryEndothelial dysfunction plays an important role in the pathogenesis of cardiovascular diseases and diabetes mellitus. However, the causes underlying endothelial dysfunction are not fully understood. Therefore, the aim of the present study was to investigate associations of cardiovascular risk factors with soluble adhesion molecules (sE-Selectin, sICAM-1), soluble thrombomodulin (sTM) and von Willebrand factor (vWF) as markers of endothelial dysfunction. The study population consisted of a subcohort of 2,168 men and women aged 35 to 74 years randomly drawn from three cross-sectional population-based MONICA/ KORA Augsburg surveys conducted between 1984 and 1995. In multivariable linear regression analysis, current smoking, high (versus moderate) alcohol consumption, ratio of total cholesterol/HDL-cholesterol (TC/HDL-C) and C-reactive protein (CRP) were significantly associated with elevated levels of sEselectin and sICAM-1. Increased levels of sE-selectin were also found in subjects with actual hypertension, high body mass index and prevalent diabetes mellitus. In addition, low physical activity and no (versus moderate) alcohol consumption were significantly associated with elevated concentrations of sICAM-1. Levels of sTM were higher in subjects with actual hypertension, no or high amounts of alcohol intake and a high ratio of TC/ HDL-C, but were lower in subjects witha history of myocardial infarction. VWF was significantly associated with CRP only. In conclusion, sE-selectin and sICAM-1 are more strongly associated with traditional cardiovascular risk factors than sTM and vWF.


PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249923
Author(s):  
Orsolya Kiss ◽  
Mate Babity ◽  
Attila Kovacs ◽  
Judit Skopal ◽  
Hajnalka Vago ◽  
...  

The significance of cardiology screening of referees is not well established. Cardiovascular risk factors and diseases were examined in asymptomatic Hungarian elite handball referees undergoing extended screening: personal/family history, physical examination, 12-lead ECG, laboratory tests, body-composition analysis, echocardiography, and cardiopulmonary exercise testing. Holter-ECG (n = 8), blood pressure monitorization (n = 10), cardiac magnetic resonance imaging (CMR; n = 27) and computer tomography (CCT; n = 4) were also carried out if needed. We examined 100 referees (age: 29.6±7.9years, male: 64, training: 4.3±2.0 hours/week), cardiovascular risk factors were: positive medical history: 24%, overweight: 10%, obesity: 3%, dyslipidaemia: 41%. Elevated resting blood pressure was measured in 38%. Stress-ECG was positive due to ECG-changes in 16%, due to elevated exercise blood pressure in 8%. Echocardiography and/or CMR identified abnormalities in 19%. A significant number of premature ventricular contractions was found on the Holter-ECG in two cases. The CCT showed myocardial bridge or coronary plaques in one-one case. We recommended lifestyle changes in 58%, new/modified antihypertensive or lipid-lowering therapy in 5%, iron-supplementation in 22%. By our results, a high percentage of elite Hungarian handball referees had cardiovascular risk factors or diseases, which, combined with physical and psychological stress, could increase the possibility of cardiovascular events. Our study draws attention to the importance of cardiac screening in elite handball referees.


PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252321
Author(s):  
Catharina Busch ◽  
Julius L. Katzmann ◽  
Claudia Jochmann ◽  
Jan Darius Unterlauft ◽  
Daniela Vollhardt ◽  
...  

Purpose Cardiovascular risk factors such as hypertension or dyslipidemia can influence the incidence and progression of diabetic retinopathy (DR) and diabetic macular edema (DME). The aim of this study is to describe the comorbidities in patients with DME. Methods Prospective, monocentric observational study. Patients presenting for the treatment of DME received laboratory and clinical examinations including 24-hour blood pressure measurement. Results Seventy-five consecutive patients were included in the study. The mean age was 61.0 ± 14.5 years, and 83% had type 2 diabetes. The mean body mass index (BMI) was 32.8 ± 6.0 kg/m2. Overweight (BMI ≥ 25 kg/m2) was present in 92% of all patients. HbA1c values were > 7.0% in 57%. Although 87% of the patients already received antihypertensive therapy, the blood pressure (BP) of 82% was still above the recommended target values of systolic < 140 mmHg and diastolic < 80 mmHg. An insufficient nocturnal fall of the systolic BP (< 10%, non-dipping or reverse dipping) was observed in 62%. In 83% of the patients the glomerular filtration rate was ≤ 90 ml/min/1.73m2. Despite 65% of the cohort already receiving lipid-lowering therapy, LDL cholesterol was above the target value of 1.4 mmol/l in 93%. All patients had at least one cardiovascular risk factor in addition to diabetes (overweight, hypertension, insufficient nocturnal BP fall, dyslipidemia, or renal dysfunction) and 86% had ≥ 3 risk factors. Conclusion DME patients are characterized by highly prevalent cardiovascular risk factors that are poorly controlled. These comorbidities reduce the prognosis and negatively influence existing DR and DME. The data reveal an important opportunity for improving patient care by interaction of the ophthalmologist with the general practitioner and internal specialists for the detection and treatment of these conditions.


Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Hadi Emamat ◽  
Ali Zahedmehr ◽  
Sanaz Asadian ◽  
Hadith Tangestani ◽  
Javad Nasrollahzadeh

Abstract Background Cardiovascular diseases (CVDs) remain the leading causes of morbidity and mortality in the world. Hypertension is an important and prevalent cardiovascular risk factor. The present study will be conducted to investigate the effect of barberry as a cardio-protective fruit on the blood pressure in patients with hypertension and other CVD risk factors. Furthermore, plasma concentrations of lipids and inflammatory biomarkers will be evaluated. Methods/design This is an 8-week, prospective, single-blinded, parallel assigned, randomized controlled clinical trial (RCT) in which eligible men and women with hypertension and other cardiovascular risk factors will be randomized to either placebo powder (PP; containing 9 g maltodextrin, 1 g citric acid, 1 g milled sucrose and edible red color (n = 37)) or barberry powder (BP; containing 10 g milled dried barberry and 1 g of milled sucrose (n = 37)) groups. At baseline and after 8 weeks of intervention, plasma lipids and inflammatory markers, 24-h urinary nitrite/nitrate and sodium excretion, and 24-h ambulatory blood pressure monitoring (ABPM) will be measured. Anthropometric measures and dietary assessment will be performed as well. Data analysis will be done using SPSS version-21 software. Discussion The interest in natural and functional food products has increased globally. This RCT will add to the growing literature for the potential antihypertensive, lipid-lowering, and anti-inflammatory effects of barberry in humans. Trial registration ClinicalTrials.gov (NCT number) NCT04084847. Registered on 10 December 2019.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
B Arshi ◽  
G Papageorgiou ◽  
O.L Rueda-Ochoa ◽  
M.A Ikram ◽  
D Rizopoulos ◽  
...  

Abstract Background The incidence and characteristics of heart failure (HF) differ between men and women. However, evidence regarding sex differences in determinants and changes of cardiac function in association with incidence of HF remains scarce. Purpose To study the evolution and determinants of left ventricular ejection fraction (LVEF) over time and its association with incident mortality and HF among men and women. Methods From a population-based cohort, we included 7923 participants, 3319 men and 4604 women, free of heart failure (HF) and atrial fibrillation with up to 3 repeated echocardiographic measurements. Using joint models, we analyzed the evolution of LVEF and its associated traditional cardiovascular risk factors among men and women. Second, we studied the association of LVEF changes with incident HF and mortality as a composite outcome adjusted for age (time-varying covariate) and traditional cardiovascular risk factors. We then performed the analyses with HF and mortality as competing events. Results Mean (SD) age was 65.7 (9.6) in men and 66.5 (10) in women. During a median follow-up of 9 years, 988 events in men and 840 events in women occurred. LVEF had a one-directional nonlinear declining with increasing age among men and women (Figure). Up to age of 70, LVEF showed a sharper decline per year among men compared to women. Every unit increase in systolic blood pressure (SBP) was associated with 0.03% (0.05% to 0.02%) decrease in LVEF per year in men. Among women, SBP had an inverse J-shaped association with LVEF changes (P&lt;0.001). Diastolic blood pressure (DBP) also showed a non-linear association with LVEF in both sexes. Prevalent diabetes was not associated with LVEF change. In the survival analysis, every 5% decrease in LVEF was associated with 35% and 30% increase in the risk of the composite outcome among men [HR (95% CI): 1.35 (1.26 to 1.43)] and women [HR (95% CI): 1.30 (1.22 to 1.40)]. Conclusion(s) Despite a similar risk of LVEF decline for the composite outcome, the evolution of LVEF, especially before 70 years of age, differ between men and women. Cardiovascular risk factors, especially blood pressure, play diverse roles in the evolution of left ventricular systolic function among men and women. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): The Rotterdam Study is funded by Erasmus Medical Center and Erasmus University, Rotterdam, Netherlands Organization for the Health Research and Development (ZonMw), the Research Institute for Diseases in the Elderly (RIDE), the Ministry of Education, Culture and Science, the Ministry for Health, Welfare and Sports, the European Commission (DG XII), and the Municipality of Rotterdam.


2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
Y U A Dyleva ◽  
O V Gruzdeva ◽  
E V Belik ◽  
M Y U Sinitsky ◽  
A V Sotnikov ◽  
...  

Abstract   In this study we studied the relationships between adipokines (leptin, soluble leptin receptor) in adipose tissue (AT) and cardiovascular disease (CVD) risk factors. Methods Fat tissue biopsies were obtained from 134 patients median aged 64.0 (48.0; 68.0) with stable CAD undergoing coronary artery bypass grafting. Traditional cardiovascular risk factors and patient treatment have been recorded. AH was defined as systolic blood pressure &gt;140 mm Hg Art., diastolic blood pressure &gt;90 mm Hg. Dyslipidemia was defined as a previously detected increase in total serum cholesterol (&gt;200 mg/dl), triglycerides (&gt;200 mg/dl), or low-density lipoprotein (LDL) cholesterol (&gt;150 mg/dl) for at least 1 year, or use of lipid-lowering drugs. Smoking was classified as current or former smokers; current smoking status was defined as at least one cigarette daily over the last year. Adipocytes were isolated from subcutaneous (SAT), epicardial (EAT), and perivascular AT (PVAT) samples. Isolated adipocytes were cultured for 24-h after which, Then adipocytes were immediately processed to RNA extraction and determination of adipokines gene expression. Results In this study, we showed that men with CAD LEP and LEPR expression were lower in PVAT, whereas only the latter was decreased in SAT. Thus, LEPR expression in local fat depots appeared to differ in men and women, which is consistent with previous reports. Men with CAD showed lower LEP expression than women in EAT, whereas no significant differences were observed in SAT. Patients 51–59 years old were characterized by the lowest LEP expression in SAT and the highest LEP and LEPR expression in EAT and PVAT. Those &gt;60 years presented the highest levels of LEPR in SAT. The presence of dyslipidemia in patients with CAD correlated with decreased LEPR expression in EAT, which is an unfavorable sign and may potentially lead to the development of leptin resistance. In patients with AH, LEP expression in EAT and LEPR expression in SAT and PVAT is increased. AH &gt;20 years was associated with increased LEP in ATs. Smokers with CAD exhibited higher levels of LEP expression in SAT and EAT, and LEPR expression in SAT. Conclusions The results of the study indicate a close association of traditional CVD risk factors with adipocytokine imbalance in patients with CAD. The results indicate the potential of the fat depot and leptin and its receptor data as a drug application point. The study of the molecular basis of PVAT and EAT function can provide a more complete understanding of the etiopathogenetic mechanisms of CVD and develop an effective strategy for their prevention and control. FUNDunding Acknowledgement Type of funding sources: None.


1994 ◽  
Vol 72 (01) ◽  
pp. 058-064 ◽  
Author(s):  
Goya Wannamethee ◽  
A Gerald Shaper

SummaryThe relationship between haematocrit and cardiovascular risk factors, particularly blood pressure and blood lipids, has been examined in detail in a large prospective study of 7735 middle-aged men drawn from general practices in 24 British towns. The analyses are restricted to the 5494 men free of any evidence of ischaemic heart disease at screening.Smoking, body mass index, physical activity, alcohol intake and lung function (FEV1) were factors strongly associated with haematocrit levels independent of each other. Age showed a significant but small independent association with haematocrit. Non-manual workers had slightly higher haematocrit levels than manual workers; this difference increased considerably and became significant after adjustment for the other risk factors. Diabetics showed significantly lower levels of haematocrit than non-diabetics. In the univariate analysis, haematocrit was significantly associated with total serum protein (r = 0*18), cholesterol (r = 0.16), triglyceride (r = 0.15), diastolic blood pressure (r = 0.17) and heart rate (r = 0.14); all at p <0.0001. A weaker but significant association was seen with systolic blood pressure (r = 0.09, p <0.001). These relationships remained significant even after adjustment for age, smoking, body mass index, physical activity, alcohol intake, lung function, presence of diabetes, social class and for each of the other biological variables; the relationship with systolic blood pressure was considerably weakened. No association was seen with blood glucose and HDL-cholesterol. This study has shown significant associations between several lifestyle characteristics and the haematocrit and supports the findings of a significant relationship between the haematocrit and blood lipids and blood pressure. It emphasises the role of the haematocrit in assessing the risk of ischaemic heart disease and stroke in individuals, and the need to take haematocrit levels into account in determining the importance of other cardiovascular risk factors.


2020 ◽  
Vol 16 ◽  
Author(s):  
Rahil Taheri ◽  
Shahram Molavynejad ◽  
Parvin Abedi ◽  
Elham Rajaei ◽  
Mohammad Hosein Haghighizadeh

Aim: The aim of this study was to investigate the effect of dietary education on cardiovascular risk factors in patients with rheumatoid arthritis. Method: In this randomized clinical trial, 112 patients with rheumatoid arthritis were randomly assigned into two groups, intervention and control. Dietary education was provided for the intervention group in 4 sessions; anthropometric measurements, serum levels of RF, triglycerides, cholesterol, HDL, LDL, and fasting blood sugar were measured before and three months after intervention. Data was analyzed using SPSS software and appropriate statistical tests. Results: The mean of total cholesterol (p <0.001), triglycerides (p = 0.004), LDL (p <0.001), systolic blood pressure (p = 0.001), diastolic blood pressure (p = 0.003), FBS and BMI (p <0.001) were decreased significantly in the intervention group after education compared the control group. Conclusion: Traditional care for rheumatoid arthritis patients is not enough. Patients need more education in order to improve their situation.


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