Male sex and vascular risk factors affect cystatin C-derived renal function in older people without diabetes or overt vascular disease

Introduction: The AHA notes that more than 76% of strokes are the first occurrence. There are class 1 recommendations for the management of common risk factors such as atrial fibrillation (AF), hyperlipidemia (HLD), hypertension (HTN), diabetes (DM), and vascular disease. The purpose of this study is to investigate the percentage of large vessel strokes that are potentially preventable with adequate management of vascular risk factors. Methods: A retrospective chart review was conducted on all patients undergoing endovascular therapy (EVT) from 2012-2019. Data was collected on vascular risk factors present prior to admission including HTN, DM, HLD, AF, and smoking. Preventable stroke was defined as having at least one of the following: untreated AF, untreated HLD, poorly controlled HTN (presence of left ventricular hypertrophy on transthoracic echo), history of vascular disease not on an antiplatelet agent, poorly controlled DM (A1c>10), current smoking. Groups were compared based on age, sex and 90 day functional outcomes, with favorable outcome defined as mRS ≤ 2. Results: Our sample included 396 patients who underwent EVT (mean age 65, 50% female). 42% of patients with Afib were not on anticoagulation, 31% of patients with HLD were untreated, 39% of patients with HTN were poorly controlled, 27% of patients with a history of vascular disease were not on an antiplatelet, 14% of patients with DM were poorly controlled, and 46% of all patients were smokers. In total, 78% of patients had at least 1 poorly controlled risk factor and 37% had at least 2. There was no difference in rates of preventable stroke between males and females (48% vs 52%, p=0.30) and between age groups above and below 70 (40% vs 60%, p=0.68). 64% of patients with well controlled risk factors had a favorable outcome compared to 51% with at least one poorly controlled risk factor (p=0.03). Conclusions: Our data suggests that despite guidelines on management of vascular risk factors, a large number of these are poorly controlled prior to admission for large vessel stroke, leading to a potentially preventable procedure. Not only could improved primary prevention save the wide array of resources utilized in EVT, but it could also influence long term outcomes in this cohort of patients.

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Vascular Events, Vascular Disease and Vascular Risk Factors—Strongly Intertwined with COVID-19

Current Treatment Options in Neurology ◽

10.1007/s11940-020-00648-y ◽

2020 ◽

Vol 22 (11) ◽

Author(s):

Adrian Scutelnic ◽

Mirjam R. Heldner

Keyword(s):

Risk Factors ◽

Vascular Disease ◽

Vascular Risk Factors ◽

Vascular Risk ◽

Vascular Events ◽

Increased Risk ◽

Clinical Benefits ◽

Infection And Inflammation ◽

Unhealthy Diet ◽

New Perspective

Abstract Purpose of review To elucidate the intertwining of vascular events, vascular disease and vascular risk factors and COVID-19. Recent findings Strokes are a leading cause of disability and death worldwide. Vascular risk factors are important drivers of strokes. There are unmodifiable vascular risk factors such as age and ethnicity and modifiable vascular risk factors. According to the INTERSTROKE study, the 10 most frequent modifiable vascular risk factors are arterial hypertension, physical inactivity, overweight, dyslipidaemia, smoking, unhealthy diet, cardiac pathologies, diabetes mellitus, stress/depression and overconsumption of alcohol. Also, infection and inflammation have been shown to increase the risk of stroke. There is high-quality evidence for the clinical benefits of optimal primary and secondary stroke prevention. The COVID-19 pandemic brought a new perspective to this field. Vascular events, vascular disease and vascular risk factors—and COVID-19—are strongly intertwined. An increased risk of vascular events—by multifactorial mechanisms—has been observed in COVID-19 patients. Also, a higher rate of infection with COVID-19, severe COVID-19 and bad outcome has been demonstrated in patients with pre-existing vascular disease and vascular risk factors. Summary At present, we suggest that regular interactions between healthcare professionals and patients should include education on COVID-19 and on primary and secondary vascular prevention in order to reduce the burden of disease in our ageing populations.

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Vascular Risk Factors and Clinical Importance of Renal Artery Stenosis in Patients with Peripheral Vascular Disease

Clinical Science ◽

10.1042/cs085006p ◽

1993 ◽

Vol 85 (s29) ◽

pp. 6P-6P

Author(s):

CG Missouris ◽

T Buckenham ◽

FP Cappuccio ◽

GA MacGregor

Keyword(s):

Risk Factors ◽

Renal Artery ◽

Vascular Disease ◽

Renal Artery Stenosis ◽

Peripheral Vascular Disease ◽

Clinical Importance ◽

Vascular Risk Factors ◽

Artery Stenosis ◽

Vascular Risk ◽

Peripheral Vascular

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Prevalence of dementia in African–Caribbean compared with UK-born White older people: two-stage cross-sectional study

The British Journal of Psychiatry ◽

10.1192/bjp.bp.110.086405 ◽

2011 ◽

Vol 199 (2) ◽

pp. 119-125 ◽

Cited By ~ 34

Author(s):

Simon Adelman ◽

Martin Blanchard ◽

Greta Rait ◽

Gerard Leavey ◽

Gill Livingston

Keyword(s):

Risk Factors ◽

Older People ◽

Vascular Risk Factors ◽

Country Of Birth ◽

Vascular Risk ◽

Cross Sectional ◽

Caribbean Country ◽

African Caribbean ◽

The Uk ◽

Prevalence Of Dementia

BackgroundPreliminary studies in the UK, all using screening instruments of unknown cultural validity, indicate that there may be an increased prevalence of dementia in African–Caribbean people, possibly related to vascular risk factors and potentially amenable to preventative measures.AimsTo determine the prevalence of dementia in older people of African–Caribbean country of birth compared with their White UK-born counterparts.MethodA total of 218 people of African–Caribbean country of birth and 218 White UK-born people aged ⩾60 years were recruited from five general practices in North London. Those who screened positive for cognitive impairment using a culturally valid instrument were offered a standardised diagnostic interview. Two independent assessors diagnosed dementia according to standard operationalised criteria.ResultsAfrican–Caribbean participants were 2 years younger, and those with dementia nearly 8 years younger than their White counterparts. The prevalence of dementia was significantly higher in the African–Caribbean (9.6%) than the White group (6.9%) after adjustment for the confounders age and socioeconomic status (odds ratio (OR) = 3.1, 95%CI 1.3–7.3, P = 0.012).ConclusionsThere is an increased prevalence of dementia in older people of African–Caribbean country of birth in the UK and at younger ages than in the indigenous White population. These findings have implications for service provision and preventive interventions. Further research is needed to explore the role of vascular risk factors and social adversity in the excess of dementia in this population.

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Obstructive Sleep Apnoea and Vascular Disease in Patients with Type 2 Diabetes

US Endocrinology ◽

10.17925/use.2015.11.02.110 ◽

2015 ◽

Vol 11 (02) ◽

pp. 110

Author(s):

Abd A Tahrani ◽

Keyword(s):

Risk Factors ◽

Type 2 Diabetes ◽

Vascular Disease ◽

Obstructive Sleep Apnoea ◽

Sleep Apnoea ◽

Vascular Risk Factors ◽

Vascular Risk ◽

Obstructive Sleep ◽

The Impact

Obstructive sleep apnoea (OSA) is common and is associated with many vascular risk factors, such as hypertension, insulin resistance, albuminuria, dyslipidaemia, increased inflammation and endothelial dysfunction. Epidemiological studies have shown that OSA is associated with increased cardiovascular disease (CVD) and that continuous positive airway pressure (CPAP) might reduce CVD events in patients with OSA. In addition, OSA has also been shown to be associated with albuminuria, chronic kidney disease, a wide range of ocular diseases and peripheral neuropathy. Considering that CVD and microvascular complications are major contributors to the morbidity, mortality and the economic burden of diabetes and that OSA is common in patients with type 2 diabetes (T2D), it is important to understand the role of OSA in the development and/or progression of vascular disease in patients with T2D and to explore the impact of CPAP on diabetes-related vascular outcomes. The purpose of this article is to review the evidence for the relationship and impact of OSA on vascular disease and vascular risk factors particularly in patients with T2D.

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