Cardiovascular Risk Factors in Acromegaly: What's the Impact of Disease Control?

2018 ◽  
Vol 126 (08) ◽  
pp. 505-512 ◽  
Author(s):  
Ana Amado ◽  
Fernando Araújo ◽  
Davide Carvalho
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Disease Control ◽  
Lipid Profile ◽  
Cardiovascular Risk Factors ◽  
Antithrombin Iii ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Coagulation Status ◽  
The Impact

Abstract Objective Cardiovascular disease is one of the most important causes of death in acromegalic patients. The aim of this study is to compare the prevalence of cardiovascular risk factors among acromegalic patients and to evaluate the impact of disease control on these factors. Material and Methods 11 acromegalic patients with active disease and 12 controlled patients were evaluated for blood pressure, body mass index, glucose, coagulation status, and lipid profile. A group of 11 patients with non-functioning pituitary adenomas was used as control population. Results Significant differences were found in lipid profile, glucose and coagulation status in both active and controlled patients. Higher levels of fasting glucose (151.2±102.5 mg/dL, p=0.05 and 108.3±23.4 mg/dL, p=0.02 for active and controlled patients respectively) and fibrinogen (427.1±61.9 mg/dL, p=0.02 and 437.3±106.6 mg/dL, p=0.04 for active and controlled patients respectively) were present in both acromegalic groups. Active patients had higher levels of antithrombin III (1.1±0.1 U/mL, p=0.005) and the controlled ones had higher levels of high density lipoprotein cholesterol (56.1±12.5 mg/dL, p=0.05), compared with the non-functioning group. The differences between active and controlled acromegalic patients are that the latter have reduced total cholesterol (170.4±31.7 vs 201.7±34.6 mg/dL, p=0.02), lower density lipoprotein cholesterol (96,8±25,2 vs 130.8±31.5 mg/dL, p=0.01) and antithrombin III (1.0±0.2 vs 1.1±0.1 U/mL, p=0.05). Conclusion There is some reduction in cardiovascular risk factors with control of the disease, but possibly without the return to basal levels.

scholarly journals Age at period cessation and trajectories of cardiovascular risk factors across mid and later life

Heart ◽  
2020 ◽  
Vol 106 (7) ◽  
pp. 499-505 ◽  
Author(s):  
Linda Marie O'Keeffe ◽  
Diana Kuh ◽  
Abigail Fraser ◽  
Laura D Howe ◽  
Debbie Lawlor ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Later Life ◽  
Glycated Haemoglobin ◽  
Lipoprotein Cholesterol ◽  
The Impact

ObjectiveTo examine the association between age at period cessation and trajectories of anthropometry, blood pressure, lipids and glycated haemoglobin (HbA1c) from midlife to age 69 years.MethodsWe used data from the UK Medical Research Council National Survey of Health and Development to examine the association between age at period cessation and trajectories of systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI) and waist circumference (WC) from 36 to 69 years and trajectories of triglyceride, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and HbA1c from 53 to 69 years.ResultsWe found no evidence that age at period cessation was associated with trajectories of log triglyceride, LDL-C and HDL-C from 53 to 69 years and trajectories of SBP or DBP from 36 to 69 years, regardless of whether period cessation occurred naturally or due to hysterectomy. While we found some evidence of associations of age at period cessation with log BMI, log WC and log HbA1c, patterns were not consistent and differences were small at age 69 years, with confidence intervals that spanned the null value.ConclusionHow and when women experience period cessation is unlikely to adversely affect conventional cardiovascular risk factors across mid and later life. Women and clinicians concerned about the impact of type and timing of period cessation on conventional cardiovascular intermediates from midlife should be reassured that the impact over the long term is small.

scholarly journals The Prevalence of Cardiovascular Risk Factors among Polish Soldiers: The Results from the MIL-SCORE Program

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Grzegorz Gielerak ◽  
Paweł Krzesiński ◽  
Katarzyna Piotrowicz ◽  
Piotr Murawski ◽  
Andrzej Skrobowski ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Pressure Control ◽  
Cross Sectional Study ◽  
Lipoprotein Cholesterol ◽  
Risk Scores ◽  
Cross Sectional

The MIL-SCORE (Equalization of Accessibility to Cardiology Prophylaxis and Care for Professional Soldiers) program was designed to assess the prevalence and management of cardiovascular risk factors in a population of Polish soldiers. We aimed to describe the prevalence of cardiovascular risk factors in the MIL-SCORE population with respect to age. This observational cross-sectional study enrolled 6440 soldiers (97% male) who underwent a medical history, physical examination, and laboratory tests to assess cardiovascular risk. Almost half of the recruited soldiers were past or current smokers (46%). A sedentary lifestyle was reported in almost one-third of those over 40 years of age. The prevalence of hypertension in a subgroup over 50 years of age was almost 45%. However, the percentage of unsatisfactory blood pressure control was higher among soldiers below 40 years of age. The prevalence of overweight and obese soldiers increased with age and reached 58% and 27%, respectively, in those over 50 years of age. Total cholesterol was increased in over one-half of subjects, and the prevalence of abnormal low-density lipoprotein cholesterol was even higher (60%). Triglycerides were increased in 36% of soldiers, and low high-density lipoprotein cholesterol and hyperglycemia were reported in 13% and 16% of soldiers, respectively. In the >50 years of age subgroup, high and very high cardiovascular risk scores were observed in almost one-third of soldiers. The relative risk assessed in younger subgroups was moderate or high. The results from the MIL-SCORE program suggest that Polish soldiers have multiple cardiovascular risk factors and mirror trends seen in the general population. Preventive programs aimed at early cardiovascular risk assessment and modification are strongly needed in this population.

scholarly journals Advances in HDL: Much More than Lipid Transporters

2020 ◽  
Vol 21 (3) ◽  
pp. 732 ◽  
Author(s):  
Soumaya Ben-Aicha ◽  
Lina Badimon ◽  
Gemma Vilahur
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Molecular Mechanisms ◽  
Cardiovascular Health ◽  
Therapeutic Potential ◽  
Density Lipoprotein ◽  
Micro Rnas ◽  
Lipid Transporters ◽  
The Impact

High Density Lipoprotein (HDL) particles, beyond serving as lipid transporters and playing a key role in reverse cholesterol transport, carry a highly variable number of proteins, micro-RNAs, vitamins, and hormones, which endow them with the ability to mediate a plethora of cellular and molecular mechanisms that promote cardiovascular health. It is becoming increasingly evident, however, that the presence of cardiovascular risk factors and co-morbidities alters HDLs cargo and protective functions. This concept has led to the notion that metrics other than HDL-cholesterol levels, such as HDL functionality and composition, may better capture HDL cardiovascular protection. On the other hand, the potential of HDL as natural delivery carriers has also fostered the design of engineered HDL-mimetics aiming to improve HDL efficacy or as drug-delivery agents with therapeutic potential. In this paper, we first provide an overview of the molecules known to be transported by HDL particles and mainly discuss their functions in the cardiovascular system. Second, we describe the impact of cardiovascular risk factors and co-morbidities on HDL remodeling. Finally, we review the currently developed HDL-based approaches.

scholarly journals Distribution of C-reactive Protein and Its Association with Cardiovascular Risk Factors in a Population-Based Sample of Chinese

2010 ◽  
Vol 28 (6) ◽  
pp. 333-342 ◽  
Author(s):  
Yanfang Zhao ◽  
Rui Wang ◽  
Xiuqiang Ma ◽  
Xiaoyan Yan ◽  
Zhansai Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Population Based ◽  
Lipoprotein Cholesterol ◽  
Urban Region ◽  
C Reactive Protein ◽  
Reactive Protein

C-reactive protein (CRP) levels vary remarkably with ethnic status. Its distribution and correlates should be investigated across diverse populations, and these were limited in a representative Chinese population. We investigated 3133 participants aged 18–80 years in Shanghai, which were sampled using a randomized, stratified, multi-stage sampling method. The distribution of CRP was highly skewed toward a lower level. The median CRP was 0.55 mg/L (0.61 mg/L in males, 0.51 mg/L in females). Participants living in urban region had higher CRP levels than those in rural region (0.67 vs. 0.46 mg/L). CRP levels showed significant correlation with traditional cardiovascular risk factors, and it was most strongly correlated with body mass index. Multivariate logistic regression analyses indicated that elevated CRP (being in the top 15 percentile of CRP; CRP ≥ 2.09 mg/L) was significantly associated with obesity, hypertension, diabetes, low high-density lipoprotein cholesterol, high low-density lipoprotein cholesterol, high triglycerides and cardiovascular disease history. In conclusion, the distribution of CRP in adult Chinese was comparable with that of many other Asian populations but different from that of Western populations. Metabolic impairment was associated with elevated CRP, and CRP levels should be interpreted in conjunction with the lipid profile.

scholarly journals Endothelial-mediated coronary flow reserve in patients with mild thyroid hormone deficiency

2009 ◽  
Vol 161 (2) ◽  
pp. 323-329 ◽  
Author(s):  
Bernadette Biondi ◽  
Maurizio Galderisi ◽  
Loredana Pagano ◽  
Milena Sidiropulos ◽  
Melania Pulcrano ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Coronary Flow Reserve ◽  
Coronary Flow ◽  
Cold Pressor Test ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Flow Reserve ◽  
Endothelial Response

ContextAlthough coronary flow reserve (CFR) is reduced in patients with subclinical hypothyroidism (SHypo), the endothelial response of coronary vasomotion has never been explored in this clinical setting.ObjectiveTo investigate the endothelial response of coronary flow in young and middle-aged patients with SHypo, without associated cardiovascular risk factors compared with healthy control subjects.Patients and methodsThe study population consisted of 20 women (mean age 38.4+12.1 years) with newly diagnosed, untreated and persistent SHypo due to Hashimoto's thyroiditis. A total of 15 volunteers served as controls. Age, gender, body surface area, glucose, insulin levels, heart rate, systolic, diastolic, and mean blood pressure were similar in patients and controls. Body mass index was significantly higher in SHypo patients. Total cholesterol and low-density lipoprotein cholesterol, despite not significant, tended to be higher, and high-density lipoprotein cholesterol to be lower in SHypo. Coronary blood flow velocities were recorded in patients at rest and after the cold pressor test (CPT), a stimulus that can be considered totally endothelium-dependent. CFR was calculated as the ratio of hyperemic-to-resting diastolic peak velocities.ResultsCoronary diastolic peak velocities at rest did not differ between the two groups but were significantly lower after CPT in patients with SHypo, thereby resulting in a lower CFR. The difference remained significant after adjusting resting and CPT velocities for the respective mean blood pressures. TSH was inversely correlated with CFR in the pooled population.ConclusionPatients with SHypo without associated cardiovascular risk factors have a coronary endothelial dysfunction that appears in response to a physiological stimulus (the CPT).

scholarly journals Dietary diversity score and cardiovascular risk factors in Tehranian adults

2006 ◽  
Vol 9 (6) ◽  
pp. 728-736 ◽  
Author(s):  
Leila Azadbakht ◽  
Parvin Mirmiran ◽  
Ahmad Esmaillzadeh ◽  
Fereidoun Azizi
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Glucose Concentration ◽  
Dietary Diversity ◽  
Density Lipoprotein ◽  
Cross Sectional Study ◽  
Lipoprotein Cholesterol ◽  
Sectional Study ◽  
Cross Sectional

AbstractAimTo evaluate the relationship between dietary diversity score (DDS) and cardiovascular risk factors in Tehranian adults.MethodsIn this population-based cross-sectional study, a representative sample of 581 subjects (295 males and 286 females) aged over 18 years, residents of Tehran, participated. Hypercholesterolaemia, hypertriglyceridaemia and low high-density lipoprotein cholesterol were defined according to the Adult Treatment Panel III guidelines of the National Cholesterol Education Program. Diabetes was defined as fasting plasma glucose concentration ≥ 126 mg dl−1or 2-h post challenge glucose concentration ≥ 200 mg dl−1. Hypertension was defined on the basis of the sixth report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. Dietary diversity was defined according to the Diet Quality Index revised.ResultsMean (±standard deviation) DDS was 6.15 ± 1.02. The probability of having diabetes (odds ratio (OR) among quartiles: 1.45, 1.26, 1.11 and 1.00, respectively;Pfor trend = 0.04) and hypertriglyceridaemia (OR = 1.41, 1.23, 1.05 and 1.00, respectively;Pfor trend = 0.04) decreased with increasing quartile of the diversity score for whole grains. The probability of having obesity (OR among quartiles: 1.39, 1.06, 1.03 and 1.00, respectively;Pfor trend = 0.03), hypercholesterolaemia (OR = 1.46, 1.28, 1.11 and 1.00, respectively;Pfor trend = 0.03), hypertension (OR = 1.32, 1.17, 1.13 and 1.00, respectively;Pfor trend = 0.03) and high low-density lipoprotein cholesterol (LDL-C) (OR = 1.25, 1.12, 1.07 and 1.00, respectively;Pfor trend = 0.04) decreased with increasing quartile of the diversity score for vegetables. The probability of having hypercholesterolaemia, high LDL-C, hypertension and diabetes decreased with quartile of the DDS. But the probability of being obese increased with quartile of the DDS (Pfor trend = 0.03).ConclusionDDS was inversely associated with cardiovascular risk factors in this cross-sectional study. Increased diversity scores of diets, to increase the variety score for vegetables, may be emphasised in programmes attempting to bring about changes in lifestyle.

scholarly journals Associations of increased spatial QRS-T angle with cardiovascular risk factors: data from the regional sample of ESSE-RF study

2021 ◽  
Vol 20 (5) ◽  
pp. 3000
Author(s):  
G. A. Muromtseva ◽  
E. A.-I. Aidu ◽  
Yu. K. Makarova ◽  
V. A. Kutsenko ◽  
E. B. Yarovaya ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Rate ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Abdominal Obesity ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Coefficient Of Determination ◽  
Male Sex

Aim. To study the associations of increased spatial QRS-T angle (sQRS-Ta ≥90°) with cardiovascular risk factors (RFs).Material and methods. We analyzed 1411 electrocardiography (ECG) records of men and women aged 25-64 years from a random regional sample of the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF) study. Relationships of sQRS-Ta with the following RFs were assessed: hypertension (HTN), systolic blood pressure (SBP) ≥140 mm Hg, diastolic BP (DBP) ≥90 mm Hg, pulse pressure (PP) ≥60 mm Hg; glucose ≥7,0 mmol/l, hypercholesterolemia; hypertriglyceridemia; high-density lipoprotein cholesterol (HDL-C) ≤1,0/1,2 mmol/l in men/women, low-density lipoprotein cholesterol (LDL-C) >3,0 mmol/l; C-reactive protein (CRP) >1 mg/L; overweight, obesity and abdominal obesity; heart rate (HR) >80 bpm; age >52 years.Results. Weak but significant correlations of sQRS-Ta with age (in women), SBP, DBP, PP, body mass index, waist circumference, lipids, glucose, CRP were revealed. Univariate logistic regression demonstrated significant associations of increased sQRS-Ta with HTN, elevated SBP and PP, overweight, obesity and abdominal obesity, hypercholesterolemia, elevated LDL-C and CRP, hyperglycemia, age >52 years and heart rate >80 bpm. There were no associations of increased sQRS-Ta with male sex, elevated DBP, smoking, hypertriglyceridemia, and low HDL-C levels. The sQRS-Ta associations characteristic of women was similar with associations found among the entire sample. Men with increased sQRS-Ta had no associations with any of analyzed RFs. In multivariate models, increased sQRS-Ta was associated with the following combination of RFs: age >52 years, heart rate >80 bpm, HTN, increased PP, overwaight, and male sex. According to direct stepwise selection among all subjects and in women, the main contribution to sQRS-Ta was made by SBP, age, HDL-C and heart rate.Conclusion. Despite the significance of stepwise regression model (p=0,0001), the low coefficient of determination R2 may indicate other not yet identified determinants with relevant associations with sQRS-Ta.

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