An absolute risk-guided approach to cardiovascular risk management within a chest pain clinic: the ARCPAC randomized trial

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J.A Black ◽  
J Campbell ◽  
J Sharman ◽  
M Nelson ◽  
S Parker ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Chest Pain ◽  
Smoking Status ◽  
Absolute Risk ◽  
Pain Clinic ◽  
Risk Scores ◽  
Cardiovascular Risk Management ◽  
Risk Factor Management

Abstract Background The majority of patients attending chest pain clinics are found not to have a cardiac cause of their symptoms, but have a high burden of cardiovascular risk factors that may be opportunistically addressed. Absolute risk calculators are recommended to guide risk factor management, although it is uncertain to what extent these calculations may assist with patient engagement in risk factor modification. Purpose We sought to determine the usefulness of a proactive, absolute risk-based approach, to guide opportunistic cardiovascular risk factor management within a chest pain clinic. Methods This was a prospective, open-label, blinded-endpoint study in 192 enhanced risk (estimated 5-year risk ≥8%, based on Australian Absolute Risk Calculator) patients presenting to a tertiary hospital chest pain clinic. Patients were randomized to best practice usual care, or intervention with development of a proactive cardiovascular risk management strategy framed around a discussion of the individual's absolute risk. Patients found to have a cardiac cause of symptoms were excluded as they constitute a secondary prevention population. Primary outcome was 5-year absolute cardiovascular risk score at minimum 12 months follow up. Secondary outcomes were individual modifiable risk factors (lipid profile, blood pressure, smoking status). Results 192 people entered the study; 100 in the intervention arm and 92 in usual care. There was no statistical difference between the two groups' baseline sociodemographic and clinical variables. The intervention group showed greater reduction in 5-year absolute risk scores (difference −2.77; p<0.001), and more favourable individual risk factors, although only smoking status and LDL cholesterol reached statistical significance (table). Conclusion An absolute risk-guided proactive risk factor management strategy employed opportunistically in a chest pain clinic significantly improves 5-year cardiovascular risk scores. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): Tasmanian Community Fund

scholarly journals Absolute risk assessment for guiding cardiovascular risk management in a chest pain clinic

2021 ◽  
Author(s):  
J Andrew Black ◽  
Julie A Campbell ◽  
Serena Parker ◽  
James E Sharman ◽  
Mark R Nelson ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Risk Management ◽  
Cardiovascular Risk ◽  
Chest Pain ◽  
Absolute Risk ◽  
Pain Clinic ◽  
Cardiovascular Risk Management ◽  
Absolute Risk Assessment

scholarly journals Heart Rate – An Emerging Cardiovascular Risk Factor

2012 ◽  
Vol 8 (1) ◽  
pp. 30-35
Author(s):  
Mohammad Abu Kauser ◽  
Mohammad Safiuddin
Keyword(s):  
Heart Rate ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factor ◽  
Smoking Status ◽  
Coronary Risk ◽  
Cvd Risk ◽  
Mortality And Morbidity ◽  
Risk Factor Management ◽  
Increased Risk

The development of cardiovascular disease (CVD) is usually caused by multiple risk factors, which interact to produce an individuals total CVD risk. Therefore the guidelines on the prevention of CVD recommend the preventive measures be based on individual’s levels of total CVD risk so that the most intensive risk factor management can be directed towards those at highest risk. Elevated resting heart rate is a known independent   cardiovascular risk factor but is not included in any risk estimating system-Coronary risk chart or SCORE(Systematic Coronary Risk Evaluation).which are used for estimation of individuals 10 year risk of a CVD event based on gender, age, total cholesterol, smoking status and systolic blood pressure. The findings several epidemiological studies showed an association between elevated heart rate an increased risk of allcause mortality and morbidity in general population, hypertensives, diabetics and those with CAD. DOI: http://dx.doi.org/10.3329/uhj.v8i1.11665 University Heart Journal Vol. 8, No. 1, January 2012

Vorsorgeuntersuchungen und Check-ups in der Kardiologie

2019 ◽  
Vol 144 (17) ◽  
pp. 1192-1201
Author(s):  
Ulrike Rudolph ◽  
Ulrich Laufs
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Cardiovascular Diseases ◽  
Smoking Status ◽  
Risk Scores ◽  
Modifiable Risk Factors ◽  
Cvd Risk ◽  
Artery Disease

AbstractCardiovascular diseases (CVD), especially coronary artery disease (CAD), are the leading causes of morbidity and mortality worldwide. Elimination of modifiable risk factors has the potential to prevent up to 80 % of CVD. Therefore, disease prevention is based on the assessment of individual total CVD risk by using risk scores such as SCORE-algorithm that include the known main cardiovascular risk factors such as age, sex, smoking status, arterial hypertension und cholesterol.

Abstract 18557: Cardiovascular Risk Factor Trajectories From Childhood to Adulthood and Depression in Middle Age: The Bogalusa Heart Study

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Patrick Stuchlik ◽  
Norrina Allen ◽  
Emily Harville ◽  
Wei Chen ◽  
Lydia Bazzano
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Middle Age ◽  
Smoking Status ◽  
Hdl Cholesterol ◽  
Risk Scores ◽  
Bogalusa Heart Study ◽  
Heart Study ◽  
Cv Measurements

Introduction: It is well known that depression and heart disease are closely linked. However, it remains unclear whether changes in cardiovascular (CV) risk factors over time may be related to depression. Few studies have examined the long term patterns of CV risk factors in relation to depression in middle age. Hypothesis: The trajectories of cardiovascular risk factors are associated with depression and depressive symptoms. Methods: We examined data from the Bogalusa Heart Study, a long-term community-based observational study of a biracial cohort, with first measurements in childhood in 1976. Men and women who completed the CES-D in 2010 with at least two childhood and two adult CV measurements (n=913) were included. Age, systolic blood pressure, antihypertensive treatment status, smoking status, total and HDL cholesterol, were used to calculate standardized 10-year Framingham CV risk scores at each follow-up. CES-D scores were categorized using established cut points (<8, 8-15, >15). Discrete mixture modeling was employed to identify trajectory groupings of CV risk. The association between CV risk score trajectory and CES-D were determined using multivariable logistic regression adjusted for smoking, education, physical activity, and BMI in 2010. Results: Mean (±SD) age was 43.06±4.48 years, 57.9% were female, and 31.7% were black race. 27.7% of participants were current smokers in 2010. Mean (±SD) BMI was 30.97±7.73. We identified three CV risk patterns: stable (63.8%), slightly elevated (28.8%), and increasingly elevated (7.5%). Relative to stable CV risk, the multivariable adjusted odds ratio of higher CES-D categorization, i.e. more depressed, for slightly elevated was 1.49 (95% CI, 1.08-2.06), and for increasingly elevated, 1.53 (95% CI, 0.90-2.59). Smokers had increased odds of higher CES-D categorization over nonsmokers (OR=2.16, 95% CI 1.58-2.95). One-unit increases of BMI were associated with 1.02 times greater odds of higher CES-D categorization (95% CI, 1.01-1.04). Conclusions: Trajectories of cardiovascular risk from childhood through adulthood are associated with depression in middle age. Individuals with elevated or increasing cardiovascular risk profiles may benefit from depression screening in early middle age.

scholarly journals Rheumatoid arthritis as cardiovascular risk factor: an update

2021 ◽  
Vol 30 (4) ◽  
pp. 576-582
Author(s):  
Calin D. Popa
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Risk Management ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Cardiovascular Diseases ◽  
Cardiovascular Risk Factor ◽  
Independent Risk Factor ◽  
Daily Practice ◽  
Cardiovascular Risk Management

Rheumatoid arthritis (RA) patients have a 1.5 – 2.5 higher chance to develop cardiovascular diseases (CVD), which in turn represent the most important cause of mortality and the most frequent comorbidity in these patients. Chronic inflammation crucially contributes to that, either as an independent risk factor or as a modulator of traditional cardiovascular (CV) risk factors, such as dyslipidemia and hypertension. The cardiovascular risk management (CVRM) is therefore essential in these patients. The implementation of it in the daily practice is quite challenging and requires a good networking between different specialists (rheumatologist, cardiologist, internist) and the general practitioners (GPs), and may get various forms of organization depending on region and locations.

The prevalence of cardiovascular disease and its risk factors among prostate cancer patients treated with and without androgen deprivation.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 364-364
Author(s):  
Jehonathan H. Pinthus ◽  
Bobby Shayegan ◽  
Laurence Klotz ◽  
D. Robert Siemens ◽  
Patrick P. Luke ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Androgen Deprivation Therapy ◽  
Androgen Deprivation ◽  
Risk Scores ◽  
Cvd Risk ◽  
Framingham Risk

364 Background: Cardiovascular disease (CVD) is the second most common cause of death in prostate cancer (PC) patients, yet the prevalence of CVD and its risk factors have been incompletely described in this population. Androgen deprivation therapy (ADT) is a risk factor for CVD. The objective of this study were to describe the CVD characteristics and risk factors in PC patients and the relationship between CVD risk and how ADT is used in real-world practice. Methods: RADICAL-PC (Role of Androgen Deprivation Therapy in CArdiovascular Disease – A Longitudinal Prostate Cancer Study) is an ongoing prospective cohort study. We recruited 2395 consecutive men (mean age 68 years) with newly diagnosed PC or with a plan to prescribe ADT for the first time. Cardiovascular risk was estimated by calculating Framingham risk scores. A Framingham score >17 (corresponding with a predicted 10-year CVD risk of >30%) was considered high-risk. Multivariable logistic regression was performed with ADT use as the outcome variable and CVD risk factors as the exposures of interest. Results: The prevalence of known CVD for the entire cohort was 22% and 35% had a Framingham risk score >17. Most participants (58%) were current or former smokers; 16% had diabetes; 45% had hypertension and 23% had high blood pressure but had not received a diagnosis of hypertension; 31% were obese (BMI ≥30kg/m2); 24% had low levels of physical activity. There was a positive relationship between each major cardiovascular risk factor and the use of ADT. However, after adjustment for age, education, alcohol use, BMI and time from PC diagnosis to eligibility assessment, these associations were significantly attenuated. Participants in whom ADT was planned had higher Framingham risk scores than those not intending to receive ADT. This risk was abolished after adjustment for confounders. Conclusions: One in three men with PC is at high cardiovascular risk. Men receiving ADT are a priori at higher CVD risk than PC patients whose treatment strategy does not include ADT. These differences are explained by confounding factors. Clinical trial information: NCT03127631.

Abstract P200: Validity of self-reported hypothyroidism: Associations with cardiovascular risk factors in the CARDIA Study

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Pamela J Schreiner ◽  
Sherita Golden ◽  
Na Zhu ◽  
Martha Daviglus
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Systolic Blood Pressure ◽  
Cardiovascular Risk Factors ◽  
Smoking Status ◽  
Geometric Mean ◽  
Hdl Cholesterol ◽  
Thyroid Stimulating Hormone

BACKGROUND: Hypothyroidism (HYPOT), defined as having low levels of free thyroxine and elevated levels of thyroid-stimulating hormone (TSH), is a common condition linked to many adverse cardiovascular risk factors. Observational studies often rely on self-reported medical history that may or may not accurately reflect the presence of a condition or its adequate control. METHODS: We examined the association between self-reported HYPOT and levels of risk factors commonly altered by HYPOT using the Year 25 (2010-2011) CARDIA Study data. Systolic blood pressure, total, LDL- and HDL-cholesterol, triglycerides, body mass index (BMI), and Center for Epidemiologic Studies Depression (CES-D) score were measured using standardized methods. Crude means or geometric means were compared by HYPOT status with t-tests. Least-squared means adjusted for age, race, sex, center, smoking status, education, and BMI were estimated by HYPOT status using linear regression, and repeated with additional adjustment for levothyroxine or synthyroid use. RESULTS: After excluding 48 cases of hyperthyroidism, 4.6% (131/2851) of participants self-reported having HYPOT; mean age was 50.1 years, 55.3% were women, and 52.4% were white. Compared to those without HYPOT, those with HYPOT were more likely to be white (75.6% vs. 51.3%) and women (85.5% vs. 53.9%); crude mean systolic blood pressure was lower (114.9 vs. 120.3 mmHg, p=0.0002) and HDL-c was higher (61.7 vs. 57.9 mg/dL, p=0.03). After multivariable adjustment ( Table ), only BMI and triglycerides differed by HYPOT status. Adjustment for thyroid medication use did not materially alter mean differences. CONCLUSION: Self-reported hypothyroidism was inconsistently associated with risk factors commonly altered by thyroid abnormalities, regardless of medication status. These data suggest that TSH measurement is necessary to accurately identify individuals with low thyroid function leading to risk factor disturbances. Multivariable-adjusted mean risk factor levels by self-reported HYPOT status YES (n=131) NO (n=2720) p-difference SBP (mmHg) 118.6 120.9 0.17 Total cholesterol (mg/dL) 194.1 191.0 0.39 HDL-c (mg/dL) 57.4 57.4 0.97 LDL-c (mg/dL) 109.4 110.6 0.74 Triglycerides (mg/dL) * 114.5 100.5 0.021 BMI (kg/m 2 ) 31.5 30.0 0.05 CES-D score 10.8 9.6 0.12 * geometric mean

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