Intra- and Interindividual Variability of Hemostatic Factors and Traditional Cardiovascular Risk Factors in a Three-year Follow-up

1998 ◽  
Vol 79 (05) ◽  
pp. 969-974 ◽  
Author(s):  
Veikko Salomaa ◽  
Vesa Rasi ◽  
Jari Stengård ◽  
Elina Vahtera ◽  
Juha Pekkanen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Total Cholesterol ◽  
Diastolic Blood Pressure ◽  
Statistical Power ◽  
Rank Correlation ◽  
Small Sample ◽  
Factor Vii ◽  
Hemostatic Factors

SummaryElucidation of the key role of thrombosis in cardiovascular disease events has arisen considerable interest in hemostatic factors and in the repeatability of their determinations. Data on long-term repeatability has, however, remained scanty. We examined twice 208 men and 265 women in North Karelia, eastern Finland. The baseline examination was a part of the FINRISK 1992 Hemostasis Study and the age-range of participants was between 45-64 years. The re-examination took place three years later in 1995. Both surveys followed the same protocol and were carried out during the same season. Spearman rank correlation coefficients between 1992 and 1995 measurements of fibrinogen, factor VII coagulant activity (FVII:C), factor VII antigen (FVII:Ag), and plasminogen were among men 0.72, 0.77, 0.46 and 0.56, respectively. For total cholesterol, HDL-cholesterol, triglycerides and diastolic blood pressure the corresponding coefficients were 0.74, 0.83, 0.66, and 0.54. In women, the coefficient of fibrinogen was lower than in men, 0.62, otherwise the results were similar. Of men belonging to the highest quarter of fibrinogen, FVII:C, FVII:Ag and plasminogen in 1992, 65%, 60%, 53% and 60% belonged to the highest quarter of respective distributions also in 1995. In women, the corresponding proportions were 64%, 65%, 46% and 58%. The modest repeatability of FVII:Ag and plasminogen was mainly due to the high intraindividual variability. However, in comparisons of plasma levels between two groups, relatively small sample sizes seemed to give adequate statistical power to detect possible differences in FVII:Ag and plasminogen. In conclusion, the long-term repeatability of fibrinogen and FVII:C is similar to that of triglycerides and even better than that of diastolic blood pressure, but somewhat lower than the repeatability of total cholesterol. FVII:Ag and plasminogen did not have very good repeatability and more than one measurement of them should be considered if they are used as predictors of cardiovascular disease in prospective studies.

scholarly journals Clinical disparity of oxidative stress with blood pressure

2019 ◽  
pp. 3
Author(s):  
Elsa Mathew ◽  
J.K. Mukkadan
Keyword(s):  
Oxidative Stress ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Total Cholesterol ◽  
Diastolic Blood Pressure ◽  
Pearson Correlation ◽  
World Health ◽  
Oxidative Stress Marker ◽  
Major Public Health Problem ◽  
Hypertensive Patients

Background: Cardiovascular disease is one of the leading causes of mortality and morbidity in India and worldwide. Hypertension is a major public health problem because of its high frequency and concomitant risk of cardiovascular disease, kidney disease, and stroke. World Health Organization named it a Silent killer as hypertension is asymptomatic during its clinical course. Experimental evidence supports a role for oxidative stress in vascular injury and hypertension. This study was undertaken, to compare the serum levels of malondialdehyde (MDA) and super-oxide dismutase (SOD) among normotensive, prehypertensive and hypertensive subjects. Materials and methods: In this cross-sectional study, 34 normotensives, 44 prehypertensive and 45 hypertensive subjects were included. The participants were subjected to selection protocol consisting of physical examination and biochemical analysis. All subjects underwent blood pressure measurement, total cholesterol, and oxidative stress marker estimation, especially SOD and MDA. The comparison of parameters between the group was carried out using One Way ANOVA. The correlation between the parameter was analyzed by Karl Pearson Correlation Coefficient using SPSS 20.0. Result : The MDA (nmol/ml) in normotensive, prehypertensive and hypertensive patients was 2.55±0.072, 3.43±0.44 and 4.01±0.37 respectively. SOD (U/ml) level in normotensive, prehypertensive and hypertensive patients was 13.47±1.96, 11.57±0.81, and 8.52±1.78 respectively. Systolic and diastolic blood pressure had a negative correlation with SOD. MDA levels show a positive correlation with systolic blood pressure and diastolic blood pressure. Total cholesterol had no significant with SOD and MDA. Conclusion: The present study showed a strong association of oxidative stress with systolic and diastolic blood pressure.

scholarly journals Change in cardiovascular risk assessment tool and updated Norwegian guidelines for cardiovascular disease in primary prevention increase the population proportion at risk: the Tromsø Study 2015–2016

Open Heart ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. e001777
Author(s):  
Amalie Nilsen ◽  
Tove Aminda Hanssen ◽  
Knut Tore Lappegård ◽  
Anne Elise Eggen ◽  
Maja-Lisa Løchen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
High Risk ◽  
Systolic Blood Pressure ◽  
Total Cholesterol ◽  
Diastolic Blood Pressure ◽  
Ldl Cholesterol ◽  
National Guidelines ◽  
Population Proportion ◽  
Total Proportion

AimsTo compare the population proportion at high risk of cardiovascular disease (CVD) using the Norwegian NORRISK 1 that predicts 10-year risk of CVD mortality and the Norwegian national guidelines from 2009, with the updated NORRISK 2 that predicts 10-year risk of both fatal and non-fatal risk of CVD and the Norwegian national guidelines from 2017.MethodsWe included participants from the Norwegian population-based Tromsø Study (2015–2016) aged 40–69 years without a history of CVD (n=16 566). The total proportion eligible for intervention was identified by NORRISK 1 and the 2009 guidelines (serum total cholesterol ≥8 mmol/L, systolic blood pressure ≥160 mm Hg or diastolic blood pressure ≥100 mm Hg) and NORRISK 2 and the 2017 guidelines (serum total cholesterol ≥7 mmol/L, low density lipoprotein (LDL) cholesterol ≥5 mmol/L, systolic blood pressure ≥160 mm Hg or diastolic blood pressure ≥100 mm Hg).ResultsThe total proportion at high risk as defined by a risk score was 12.0% using NORRISK 1 and 9.8% using NORRISK 2. When including single risk factors specified by the guidelines, the total proportion eligible for intervention was 15.5% using NORRISK 1 and the 2009 guidelines and 18.9% using NORRISK 2 and the 2017 guidelines. The lowered threshold for total cholesterol and specified cut-off for LDL cholesterol stand for a large proportion of the increase in population at risk.ConclusionThe population proportion eligible for intervention increased by 3.4 percentage points from 2009 to 2017 using the revised NORRISK 2 score and guidelines.

scholarly journals Risk factors for cardiovascular disease ten years after preeclampsia

2010 ◽  
Vol 128 (1) ◽  
pp. 10-13 ◽  
Author(s):  
Ivete Cristina Teixeira Canti ◽  
Márcia Komlós ◽  
Sérgio Hofmeister Martins-Costa ◽  
José Geraldo Lopes Ramos ◽  
Edison Capp ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Diastolic Blood Pressure ◽  
Cross Sectional Study ◽  
Abdominal Circumference ◽  
Control Group ◽  
Cross Sectional ◽  
Nulliparous Women

CONTEXT AND OBJECTIVE: Preeclampsia is a gestational disease that occurs mainly among nulliparous women after the 20th week of gestation, and frequently close to delivery. The effects of preeclampsia on women's blood pressure over the long term are still controversial. Patients with recurrent preeclampsia or preeclampsia in the early stages of pregnancy appear to present higher risk of hypertension. The aim of this study was to determine the risk factors for cardiovascular disease among women with preeclampsia 10 years earlier. DESIGN AND SETTING: Cross-sectional study at Hospital de Clínicas de Porto Alegre (HCPA). METHODS: Forty women with preeclampsia and 14 normotensive pregnant women followed up 10 or more years earlier at HCPA underwent clinical and laboratory examinations. Spearman's correlation coefficient was used to correlate body mass index (BMI) and systolic and diastolic pressures. The risk of developing hypertension was measured using the chi-square test. P < 0.05 was considered significant. RESULTS: The patients with preeclampsia 10 or more years earlier had significantly higher diastolic blood pressure (P = 0.047), BMI (P = 0.019) and abdominal circumference (P = 0.026). They presented positive correlations between BMI and diastolic blood pressure (0.341; P = 0.031) and between BMI and systolic blood pressure (0.407; P = 0.009). CONCLUSION: The patients with preeclampsia 10 or more years earlier had significantly higher diastolic blood pressure, BMI and abdominal circumference than did the control group. This emphasizes the importance of long-term follow-up assessment for cardiovascular risk factors among patients with preeclampsia.

scholarly journals Effects of a 1-Year Physical Activity Intervention on Markers of Hemostasis among Breast Cancer Survivors: A Randomized Controlled Trial

TH Open ◽  
2021 ◽  
Vol 05 (01) ◽  
pp. e14-e23
Author(s):  
Siv Kjølsrud Bøhn ◽  
Inger Thune ◽  
Vidar Gordon Flote ◽  
Hanne Frydenberg ◽  
Gro Falkenér Bertheussen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Postmenopausal Women ◽  
Cancer Patients ◽  
Physical Activity Intervention ◽  
Intervention Group ◽  
Factor Vii ◽  
Breast Cancer Patients ◽  
Hemostatic Factors

Abstract Introduction Physical activity may reduce the development of breast cancer. Whereas hypercoagulability has been linked to adverse outcomes in breast cancer patients, the effects of physical activity on their hemostatic factors are unknown. The study aimed to assess whether long-term (1 year) physical activity can affect hemostatic factors in breast cancer patients. Methods Fifty-five women (35–75 years) with invasive breast cancer stage I/II were randomized to a physical activity intervention (n = 29) lasting 1 year or to a control group (n = 26), and analyzed as intention to treat. Fibrinogen, factor VII antigen, tissue factor pathway inhibitor, and von Willebrand factor (VWF) antigen as well as prothrombin fragment 1 + 2, the endogenous thrombin potential and D-dimer, were measured in plasma before intervention (baseline), and then after 6 and 12 months. Results Maximal oxygen uptake (measure of cardiorespiratory fitness) decreased the first 6 months among the controls, but remained stable in the intervention group. We found no significant differences between the two study groups regarding any of the hemostatic factors, except a significantly higher increase in factor VII antigen in the intervention group. The effect of the intervention on VWF was, however, significantly affected by menopausal stage, and a significant effect of the intervention was found on VWF among postmenopausal women, even after adjustment for dietary intake. Conclusion Long-term physical activity had no effect on the majority of the hemostatic factors measured, but led to increased plasma concentrations of factor VII antigen and prevented an increase in VWF concentration after breast cancer treatment in postmenopausal women. The clinical impact of these findings for risk of vascular thrombosis warrants further studies.

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.

Ten-year Cardiovascular Disease Risk Amongst Workers in a Tertiary Healthcare Institution in Kuala Lumpur

2020 ◽  
Vol 1 (1) ◽  
pp. 35-45
Author(s):  
Norfazilah Ahmad ◽  
Santhna Letchmi Panduragan ◽  
Chong Hong Soon ◽  
Kalaiarasan Gemini ◽  
Yee San Khor ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
High Risk ◽  
Diastolic Blood Pressure ◽  
Associated Factors ◽  
Risk Group ◽  
High Risk Group ◽  
Kuala Lumpur ◽  
Cvd Risk ◽  
Tertiary Healthcare

  Strategising, which is an effective workplace intervention to curb cardiovascular disease (CVD), requires understanding of the CVD risk related to a specific working population. The Framingham Risk Score (FRS) is widely used in predicting the ten-year CVD risk of various working populations. This study aimed to use FRS to determine the ten-year CVD risk amongst workers in a tertiary healthcare setting and its associated factors. A cross-sectional study was conducted on workers who participated in the special health check programme at the staff clinic of a tertiary healthcare institution in Kuala Lumpur, Malaysia. A set of data sheets was used to retrieve the workers’ sociodemographic and CVD risk information. The prevalence of high, moderate and low ten-year CVD risk was 12.8%, 20.0% and 67.2%, respectively. Workers in the high-risk group were older [mean age: 54.81 (standard deviation, 5.72) years], male (44%), smokers (72.7%) and having hyperglycaemia (46.7%) and hypertriglyceridemia [median triglycerides: 1.75 (interquartile range, 1.45) mmol/L]. Diastolic blood pressure (aOR 1.07, 95% CI: 1.01,1.14), hyperglycaemia (aOR 8.80, 95% CI: 1.92,40.36) and hypertriglyceridemia (aOR 4.45, 95% CI: 1.78,11.09) were significantly associated with high ten-year CVD risk. Diastolic blood pressure (aOR 1.08, 95% CI: 1.03,1.13) and hypertriglyceridemia (aOR 2.51, 95% CI: 1.12-5.61) were significantly associated with moderate ten-year CVD risk. The prevalence of high and moderate ten-year CVD risk was relatively high. Amongst the workers in the high-risk group, they were older, male, smokers and with high fasting blood sugar and triglyceride. Understanding the ten-year CVD risk and its associated factors could be used to plan periodic workplace health assessment and monitor to prevent CVD.

Abstract P355: Predicting the 20-year Risk of First Coronary or Ischemic Stroke Event in Northern Italy: The CAMUNI Absolute Risk Equation

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Giovanni Veronesi ◽  
Lloyd E Chambless ◽  
Francesco Gianfagna ◽  
Giuseppe Mancia ◽  
Giancarlo Cesana ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Family History ◽  
Diastolic Blood Pressure ◽  
Cardiovascular Events ◽  
Absolute Risk ◽  
Northern Italy ◽  
Men And Women ◽  
Basic Model ◽  
History Of

Aims. Recent US guidelines advocate the introduction of lifetime or long-term absolute risk prediction for primary prevention of cardiovascular events, especially for young people and women. Therefore, long-term prediction models might be specially beneficial in population considered at low incidence. We aim to develop a 20-year absolute risk prediction equation in a Northern Italy population. Methods. Four independent population-based cohorts were enrolled between 1986 and 1994 from the Brianza population (Northern Italy), adopting standardized MONICA procedures. The study sample comprises n=2574 men and 2673 women, aged 35 to 69 years and free of CVD at baseline. Participants were followed-up for incidence of first coronary and ischemic stroke events (fatal and non-fatal; all MONICA validated) for a median time of 15 years (IQ range: 12-20) and up to the end of 2008. We compared several gender-specific Cox Proportional Hazards models: the basic one includes age, total cholesterol, HDL-cholesterol, systolic blood pressure, anti-hypertensive treatment, cigarette smoking and diabetes. Candidates to model addition were diastolic blood pressure, triglycerides, BMI, family history of CHD, and education. Model calibration was tested using the Grønnesby-Bogan goodness-of-fit statistic. The Area Under the ROC-Curve (AUC) was a measure of discrimination, corrected for over-optimism via bootstrapping. Changes in discrimination (Δ-AUC) and reclassification (Net Reclassification Improvement, NRI) defined the improvement from the basic model due to an additional risk factor. Intermediate risk was defined as 20-year risk between 10% and 40%. Results. We observed n=286 events in men (incidence rate 7.7 per 1000 person-years) and n=108 in women (2.6 per 1000 person-years). All risk factors included in the basic model were predictive of first cardiovascular event in both genders; discrimination was 0.725 and 0.802 in men and women, respectively. Average specificity in the top risk quintile (cut-off value: 23% in men and 8.5% in women) was similar in men and women (85% vs. 83%), while sensitivity was higher in women (63% vs. 46%). All the models were well-calibrated (p-values >0.05). The addition of a positive family history of CHD in men (Hazard Ratio: 1.6; 95%CI 1.2-2.1) and of diastolic blood pressure in women (HR: 1.4 for 11 mmHg increase; 1.1-1.8) significantly improved discrimination (Δ-AUC=0.01; 95%CI 0.002-0.02 [men] and Δ-AUC=0.005; 95%CI 0.0001-0.01 [women]) and reclassification of subjects at intermediate risk (NRI=8.4%;1.7%-19.1% [men]; and NRI=11.7%; -3.2%-33.5% [women]). Conclusions. Traditional risk factors are predictive of cardiovascular events after 20 years, with good discrimination. The addition of family history of CHD may contribute to model improvement, at least among men; the role of diastolic blood pressure in women should be carefully evaluated.

scholarly journals A pilot study investigating the relationship between heart rate variability and blood pressure in young adults at risk for cardiovascular disease

2022 ◽  
Vol 28 (1) ◽  
Author(s):  
Linda P. Bolin ◽  
Amelia D. Saul ◽  
Lauren L. Bethune Scroggs ◽  
Carolyn Horne
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Pilot Study ◽  
Family History ◽  
Diastolic Blood Pressure ◽  
Biofeedback Training ◽  
Paced Breathing ◽  
History Of

Abstract Background Cardiovascular disease is one of the leading causes of death globally with hypertension being a primary cause of premature death from this disease process. Individuals with a family history of cardiovascular disease and hypertension are at a greater risk for developing the same sequela. Autonomic cardiac control is important in the level of cardiac function. One intervention that is effective in improving cardiovascular function is heart rate variability biofeedback training. The purpose of our study was to determine the effectiveness of heart rate biofeedback training on HRV and blood pressure in individuals with a family history of cardiovascular disease. Methods Thirty-four participants (76.5% female, 22.7 ± 4.3 years) completed a baseline assessment and training using an established short-term HRV protocol followed by two weeks of at-home paced breathing employing a smartphone application. The participants were then reassessed in a biofeedback clinic. Results The participants physiological measures showed a significant increase in means between pre and post intervention of SDNN (t (32) = 2.177, p =.037) and TP, (t (32) = 2.327 p = .026). Correlation noted a medium effect on diastolic blood pressure and high frequency heart rate variability, F, r = .41, n =33, p < .05. A multiple regression with all predictor variables in the model found no significance with diastolic and systolic blood pressure. Conclusions The findings from this pilot study demonstrated that a two-week paced breathing intervention may assist in reducing heart rate and diastolic blood pressure while improving heart rate variability.

scholarly journals Evaluation of the Cardiovascular Effects of Clonidine in Neonates Treated for Neonatal Abstinence Syndrome

2018 ◽  
Vol 23 (6) ◽  
pp. 473-478
Author(s):  
Raymond P. Meddock ◽  
Deirdre Bloemer
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Diastolic Blood Pressure ◽  
Neonatal Intensive Care ◽  
Dose Range ◽  
Safety Data ◽  
Cardiovascular Effects ◽  
Neonatal Abstinence Syndrome ◽  
Abstinence Syndrome

OBJECTIVES Neonatal abstinence syndrome (NAS) is characterized by withdrawal symptoms in neonates exposed to legal or illegal substances in utero, and it is often managed with medications such as opiates, phenobarbital, and clonidine. Clonidine use is increasing, but further safety data regarding its use in neonates are warranted. This study evaluated the effects of clonidine on heart rate and blood pressure in neonates treated for NAS at doses up to 24 mcg/kg/day. METHODS A retrospective review via the electronic medical record of infants at least 35 weeks' gestation treated adjunctively with clonidine for NAS in the neonatal intensive care unit at St Elizabeth was conducted. Heart rate, and systolic and diastolic blood pressure were recorded at baseline, while on different dose ranges of clonidine (small: ≤1.5 mcg/kg per dose every 3 hours; medium: &gt;1.5 to 2 mcg/kg per dose every 3 hours; and large: &gt;2 mcg/kg to 3 mcg/kg per dose every 3 hours), and upon discontinuation. RESULTS A total of 64 infants treated with clonidine for NAS between August 2015 and December 2016 were included. Heart rate decreased in all clonidine dose ranges compared with baseline (average reduction of 7 bpm [CI: −12 to −2], 9 bpm [CI: −16 to −2], and 10 bpm [CI: −18 to −1] for the small, medium, and large dose ranges, respectively; p &lt; 0.0001). Systolic and diastolic blood pressure were not significantly different from baseline when infants were receiving any dose of clonidine, except diastolic blood pressure while on medium–dose range clonidine, where diastolic blood pressure was higher than baseline (p = 0.0128). Increases in systolic and diastolic blood pressure were evident upon discontinuation of clonidine (p &lt; 0.0001 and p = 0.0156, respectively). CONCLUSIONS Clonidine doses up to 24 mcg/kg/day are well tolerated in neonates ≥35 weeks' gestation treated for NAS. Any decreases in heart rate are likely clinically insignificant, and increases in blood pressure upon discontinuing clonidine are mild and may be mitigated further with extended discontinuation protocols. Further trials should be conducted to evaluate the long-term safety of clonidine in this population.

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