scholarly journals Changes Over Time in Risk Factors for Cardiovascular Disease and Use of Lipid‐Lowering Drugs in HIV‐Infected Individuals and Impact on Myocardial Infarction

2008 ◽  
Vol 46 (7) ◽  
pp. 1101-1110 ◽  
Author(s):  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Lipid Lowering ◽  
Lipid Lowering Drugs ◽  
Changes Over Time ◽  
Over Time

scholarly journals Impaired endothelial glycocalyx predicts adverse outcome in subjects without overt cardiovascular disease: a 6-year follow-up study

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
I Ikonomidis ◽  
J Thymis ◽  
P Simitsis ◽  
S Katsanos ◽  
C Triantafyllou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Family History ◽  
Adverse Outcome ◽  
Endothelial Glycocalyx ◽  
Lipid Lowering ◽  
C Statistic ◽  
History Of

Abstract Aim Endothelial glycocalyx is involved in the clinical course of atherogenesis. The purpose of this study was to investigate whether disturbance of glycocalyx integrity is related with increased cardiovascular risk. Methods Perfused Boundary Region (PBR), a marker of glycocalyx integrity, was measured non-invasively in sublingual microvessels with a diameter ranging from 5–25 μm using a dedicated camera (Sideview, Darkfield Imaging). Increased PBR indicates reduced glycocalyx thickness. We measured baseline PBR in 400 apparently healthy subjects, without established cardiovascular disease. We prospectively monitored the occurrence of major cardiovascular events (MACE-death, myocardial infarction, stroke and heart failure hospitalization) during a 6-year follow-up period using electronic records and clinic visits. Results Forty-three MACE were documented during follow-up. Subjects with PBR at 5–9 μm microvessel diameter greater than 1.15 μm (mean value of the study cohort) had 2-fold higher risk for MACE than those with lower PBR in a model including sex, age, hyperlipidemia, diabetes, hypertension, current smoking, family history of coronary artery disease and treatment with ACEi/ARBs or lipid lowering agents (hazard ratio (HR): 2.49; 95% CI: 1.23–5.02, p=0.011, net reclassification improvement (NRI): 25%; C-statistic: 0.738). PBR5-9 ≥1.15 was an independent and additive predictor of outcome when added in a model including SCORE, risk factors not included in SCORE (diabetes, family history of CAD) and medication (HR: 2.48 NRI: 23.8%, C-statistic increase from 0.629 to 0.678, for all cardiac events and HR: 4.19, NRI: 33.1%, C-statistic increase from 0.654 to 0.734 for death myocardial infarction and stroke, p<0.01). Conclusion Endothelial glycocalyx integrity is an independent and additive predictor to atherosclerotic risk factors for adverse outcome at 6 years follow-up in individuals without diagnosed cardiovascular disease. FUNDunding Acknowledgement Type of funding sources: None.

IDENTIFICATION AND ASSESSMENT OF RISK FACTORS ROLE IN MYOCARDIAL INFARCTION DEVELOPMENT

2019 ◽  
Vol 72 (5) ◽  
pp. 779-783
Author(s):  
Victor A. Ognev ◽  
Anna A. Podpriadova ◽  
Anna V. Lisova
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Cardiovascular System ◽  
Control Group ◽  
Biological Factors ◽  
Prevention And Treatment ◽  
High Level ◽  
Social Importance ◽  
The Impact

Introduction:The high level of morbidity and mortality from cardiovascular disease is largely due toinsufficient influence on the main risk factors that contribute to the development of myocardial infarction.Therefore, a detailed study and assessment of risk factors is among the most important problems of medical and social importance. The aim: To study and evaluate the impact of biological, social and hygienic, social and economic, psychological, natural and climatic risk factors on the development of myocardial infarction. Materials and methods: A sociological survey was conducted in 500 people aged 34 to 85. They were divided into two groups. The main group consisted of 310 patients with myocardial infarction. The control group consisted of 190 practically healthy people, identical by age, gender and other parameters, without diseases of the cardiovascular system. Results: It was defined that 30 factors have a significant impact on the development of myocardial infarction.Data analysis revealed that the leading risk factors for myocardial infarction were biological and socio-hygienic. The main biological factors were: hypertension and hypercholesterolemia. The man socio-hygienic factor was smoking. Conclusions: Identification of risk factors provides new opportunities for the development of more effective approaches for the prevention and treatment of myocardial infarction.

scholarly journals The effect of surgery on fat mass, lipid and glucose metabolism in mild primary hyperparathyroidism

2018 ◽  
Vol 7 (8) ◽  
pp. 941-948 ◽  
Author(s):  
Kristin Godang ◽  
Karolina Lundstam ◽  
Charlotte Mollerup ◽  
Stine Lyngvi Fougner ◽  
Ylva Pernow ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Glucose Metabolism ◽  
Primary Hyperparathyroidism ◽  
Cardiovascular Risk Factors ◽  
Outcome Measures ◽  
Fat Mass ◽  
Lipid Lowering ◽  
Mild Primary Hyperparathyroidism ◽  
Over Time

Context Mild primary hyperparathyroidism has been associated with increased body fat mass and unfavorable cardiovascular risk factors. Objective To assess the effect of parathyroidectomy on fat mass, glucose and lipid metabolism. Design, patients, interventions, main outcome measures 119 patients previously randomized to observation (OBS; n = 58) or parathyroidectomy (PTX; n = 61) within the Scandinavian Investigation of Primary Hyperparathyroidism (SIPH) trial, an open randomized multicenter study, were included. Main outcome measures for this study were the differences in fat mass, markers for lipid and glucose metabolism between OBS and PTX 5 years after randomization. Results In the OBS group, total cholesterol (Total-C) decreased from mean 5.9 (±1.1) to 5.6 (±1.0) mmol/L (P = 0.037) and LDL cholesterol (LDL-C) decreased from 3.7 (±1.0) to 3.3 (±0.9) mmol/L (P = 0.010). In the PTX group, the Total-C and LDL-C remained unchanged resulting in a significant between-group difference over time (P = 0.013 and P = 0.026, respectively). This difference was driven by patients who started with lipid-lowering medication during the study period (OBS: 5; PTX: 1). There was an increase in trunk fat mass in the OBS group, but no between-group differences over time. Mean 25(OH) vitamin D increased in the PTX group (P < 0.001), but did not change in the OBS group. No difference in parameters of glucose metabolism was detected. Conclusion In mild PHPT, the measured metabolic and cardiovascular risk factors were not modified by PTX. Observation seems safe and cardiovascular risk reduction should not be regarded as a separate indication for parathyroidectomy based on the results from this study.

Four Years’ Treatment Efficacy of Patients with Severe Hyperlipidemia. Lipid Lowering Drugs versus LDL-Apheresis

1995 ◽  
Vol 18 (12) ◽  
pp. 786-793 ◽  
Author(s):  
R. Schiel ◽  
R. Bambauer ◽  
U. A. Müller
Keyword(s):  
Myocardial Infarction ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Clinical Performance ◽  
Well Being ◽  
Drug Group ◽  
Lipid Lowering ◽  
Dependent Manner ◽  
Ldl Apheresis ◽  
Lipid Lowering Drugs

A total of 47 patients suffering from heterozygous hyperlipidemia were treated with LDL-apheresis (24 patients, aged 49.5±11.5 years), diet and/or lipid-lowering drugs or with diet and lipid-lowering drugs only (23 patients, aged 48.0±11.9 years). After treatment periods of 44.4±14.3 (apheresis group) and 33.5±15.9 (drug group) months, respectively, the ensuing results revealed significant differences (p<0.0001): total cholesterol decreased from 10.4 to 5.5 vs 9.9 to 8.7 mmol/l, LDL from 7.4 to 3.9 vs 6.6 to 5.2 mmol/l, triglycerides from 5.8 to 3.7 vs 4.8 to 4.1 mmol/l and the LDL/HDL-ratio decreased from 7.1 to 3.4 vs 6.7 to 5.8. In the apheresis group one patient died from myocardial infarction vs one non-fatal myocardial infarction and the manifestation of coronary heart disease in three cases in the drug group. There were no severe side-effects in either group. All patients in the apheresis group experienced an increased clinical performance. On the other hand physological well-being of these patients was lower than that of the drug group (scores 42.3±8.9 vs 50.2±9.9, p<0.002). The present trial suggests that a continuing reduction in serum lipid concentrations may lower in a dose dependent manner the risk of development and progression of coronary heart disease. With respect to clinical and laboratory results, LDL-apheresis seems safe and appears to be the most effective therapy.

Cost offset of lipid-lowering drugs for primary and secondary prevention of cardiovascular disease

2005 ◽  
Vol 5 (2) ◽  
pp. 193-205 ◽  
Author(s):  
Luca Degli Esposti ◽  
Mirko Di Martino ◽  
Stefania Saragoni ◽  
Alessandro Capone ◽  
Pierluigi Russo ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Secondary Prevention ◽  
Lipid Lowering ◽  
Primary And Secondary Prevention ◽  
Lipid Lowering Drugs ◽  
Cost Offset ◽  
Prevention Of Cardiovascular Disease

scholarly journals Fusidic Acid: A Neglected Risk Factor for Statin-Associated Myopathy

2018 ◽  
Vol 12 ◽  
pp. 117954681881516 ◽  
Author(s):  
Josefine Rönnqvist ◽  
Pär Hallberg ◽  
Qun-Ying Yue ◽  
Mia Wadelius
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Risk Factor ◽  
Fusidic Acid ◽  
Case Reports ◽  
Statistical Significance ◽  
Lipid Lowering ◽  
Concomitant Treatment ◽  
Swedish Medical ◽  
Statin Dose

Background: Statins are widely used lipid-lowering drugs used for the prevention of cardiovascular disease. Statins are known to cause myopathy, an adverse drug reaction with various clinical features rhabdomyolysis. Objective: To describe clinical characteristics of statin-treated individuals who experienced myopathy and identify risk factors of statin-associated myopathy. Methods: A retrospective study was conducted on cases of statin-associated myopathy reported to the Swedish Medical Products Agency. Clinical factors were compared between cases and statin-treated controls not diagnosed with myopathy. Statistical methods were univariate and multivariate logistic regression and results were presented as odds ratio (OR) with 95% confidence interval (CI). To correct for multiple comparisons, the cutoff for statistical significance was set to P < .0017. Results: In total, 47 cases of statin-associated myopathy were compared with 3871 treated controls. Rhabdomyolysis was diagnosed in 51% of the cases. Markers for cardiovascular disease were more common in cases than controls. Statistical analysis revealed the following independent risk factors for myopathy: high statin dose (OR = 1.54, calculated using the standard deviation 19.82, 95% CI = 1.32-1.80, P < .0001), and concomitant treatment with fusidic acid (OR = 1002, 95% CI = 54.55-18 410, P < .0001), cyclosporine (OR = 34.10, 95% CI = 4.43-262.45, P = .0007), and gemfibrozil (OR = 12.35, 95% CI = 2.38-64.10, P = .0028). Conclusions: The risk of myopathy increases with statin dose and cotreatment with cyclosporine and gemfibrozil. Concomitant fusidic acid has previously only been noted in a few case reports. Considering that use of fusidic acid may become more frequent, it is important to remind of this risk factor for statin-associated myopathy.

scholarly journals Epidemiology of Heart Failure Stages in Middle‐Aged Black People in the Community: Prevalence and Prognosis in the Atherosclerosis Risk in Communities Study

2021 ◽  
Author(s):  
Ramachandran S. Vasan ◽  
Solomon K. Musani ◽  
Kunihiro Matsushita ◽  
Walter Beard ◽  
Olushola B. Obafemi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Heart Failure ◽  
Cardiovascular Disease ◽  
Left Ventricular ◽  
Study Cohort ◽  
Atherosclerosis Risk In Communities ◽  
Cardiovascular Morbidity And Mortality ◽  
Atherosclerosis Risk

Background Black individuals have a higher burden of risk factors for heart failure (HF) and subclinical left ventricular remodeling. Methods and Results We evaluated 1871 Black participants in the Atherosclerosis Risk in Communities Study cohort who attended a routine examination (1993–1996, median age 58 years) when they underwent echocardiography. We estimated the prevalences of 4 HF stages: (1) Stage 0 : no risk factors; (2) Stage A : presence of HF risk factors (hypertension, diabetes mellitus, obesity, smoking, dyslipidemia, coronary artery disease without clinical myocardial infarction), no cardiac structural/functional abnormality; (3) Stage B : presence of prior myocardial infarction, systolic dysfunction, left ventricular hypertrophy, regional wall motion abnormality, or left ventricular enlargement; and (4) Stage C/D : prevalent HF. We assessed the incidence of clinical HF, atherosclerotic cardiovascular disease events, and all‐cause mortality on follow‐up according to HF stage. The prevalence of HF Stages 0, A, B, and C/D were 3.8%, 20.6%, 67.0%, and 8.6%, respectively, at baseline. On follow‐up (median 19.0 years), 309 participants developed overt HF, 390 incurred new‐onset cardiovascular disease events, and 651 individuals died. Incidence rates per 1000 person‐years for overt HF, cardiovascular disease events, and death, respectively, were Stage 0, 2.4, 0.8, and 7.6; Stage A, 7.4, 9.7, and 13.5; Stage B 13.6, 15.9, and 22.0. Stage B HF was associated with a 1.5‐ to 2‐fold increased adjusted risk of HF, cardiovascular disease events and death compared with Stages 0/A. Conclusions In our large community‐based sample of Black individuals, we observed a strikingly high prevalence of Stage B HF in middle age that was a marker of high cardiovascular morbidity and mortality.

Social determinants, lifestyles and health

2012 ◽  
pp. 64-77
Author(s):  
Stefano Campostrini
Keyword(s):  
Risk Factors ◽  
Health Outcome ◽  
Health Promotion ◽  
Data Collection ◽  
Health Inequalities ◽  
Social Determinants ◽  
Collection System ◽  
Data Collection System ◽  
Changes Over Time ◽  
Over Time

The link between social determinants, risk factors and health outcome has been demonstrated globally. More research is still required, however, to deepen our understanding of the mechanisms underlying these relationships. Although further study is still needed to define better the measures of social determinants (in relation to both health outcome and risk factors), a data collection system (surveillance) already exists for risk factors that can provide information about these relationships. In particular, the observation of changes over time and trends can offer unique information on the effectiveness of health promotion programmes and policies for decreasing (or increasing) health inequalities.

Abstract MP34: Tai Chi Exercise is More Effective Than Brisk Walking in Reducing Cardiovascular Disease Risk Factors

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Aileen W Chan ◽  
Doris Y Leung ◽  
SY Chair ◽  
Janet W Sit ◽  
Ruth E Taylor-Piliae
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Perceived Stress ◽  
Tai Chi ◽  
Disease Risk ◽  
Moderate Intensity ◽  
Brisk Walking ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Over Time

Background: Physical inactivity is one of the major modifiable lifestyle risk factors associated with cardiovascular disease (CVD). Tai Chi (TC) is safe and popular among older adults; yet direct comparisons between TC and brisk walking (BW) on reducing CVD risk factors are lacking. Methods: A total of 246 adults (mean age=64.4±9.8 years, 45.5% men) with hypertension and two other CVD risk factors (i.e., smoker, diabetic, dyslipidemia, or overweight) were randomly assigned to either TC (n=82), BW (n=82), or control (C, n=82) groups. The TC and BW groups had 150 minutes/week, moderate-intensity physical activity for three months; with home-based practice encouraged for another six months. The primary outcome was blood pressure (BP). Secondary outcomes were: fasting blood sugar (FBS), HbA1c, total cholesterol, triglycerides, high and low density lipoprotein, body mass index (BMI), waist circumference and perceived stress. Data were collected at baseline, post-intervention at 3-month, 6-month and 9-month follow-up assessments. Generalized estimating equations models compared changes in the outcomes over time between groups. Results: At baseline, average BP=141/81, smokers=11%, diabetics=58%, dyslipidemia=61%, average BMI=26; with no significant differences between groups. TC significantly lowered BP (systolic -13.33 mmHg; diastolic -6.45 mmHg), FBS (-0.72 mmol/L), HbA1c (-0.39%), and perceived stress (-3.22 score) at 9-months, compared to C group. Pairwise comparisons indicated significantly greater reductions in SBP (p<0.001), DBP (p=0.049), FBS (p=0.001), HbA1c (p=0.002), and perceived stress (p=0.027) in TC group, compared to BW group. No significant changes in other CVD risk indicators over time between groups were observed. Conclusion: TC was better than BW in reducing several CVD risk factors, and can be recommended as a viable exercise to build a healthier life free of CVD.

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