The impact of bariatric surgery on framingham risk score

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A.K.H Ho ◽  
C.J O'Boyle ◽  
H Shabana ◽  
K.J Lee
Keyword(s):  
Blood Pressure ◽  
Bariatric Surgery ◽  
Risk Reduction ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Density Lipoprotein ◽  
T Test ◽  
Cvd Risk ◽  
Framingham Risk ◽  
The Impact

Abstract Introduction Although morbid obesity is strongly associated with cardiovascular disease (CVD) risk, relatively little research has been performed to evaluate the long-term effect of bariatric surgery (BS) on CVD risk reduction. Purpose To evaluate the 2-year effects of laparoscopic gastric bypass (LGBYP) & laparoscopic sleeve gastrectomy (LSG) on blood pressure, lipid profile, diabetic profile and Framingham risk score (FRS). Methods It was a retrospective review of patients undergoing BS between January 2009–2017. Body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), lipid & diabetic profile were recorded preoperatively & 2-year postoperatively. Results Of 416 patients, 77% (320) were females, 88% (365) were non-smokers & mean (sd) age was 48 (11) years. 69% (286) underwent LGBYP. 27% (114) were diabetic, 78% (324) were hyperlipidaemic and 65% (269) were hypertensive. The mean SBP & DBP decreased progressively while mean high-density-lipoprotein (HDL) & total-cholesterol (TC) increased progressively (table 1). LGBYP has a greater reduction in DBP than LSG (p<0.001, t-test). 10-year CVD risk reduced by 37% at 2-year, with a greater effect in LGBYP than LSG (40% vs 28%, p<0.001, t-test). Conclusion The 10-year risk of CVD reduced by 37% 2-years after bariatric surgery, with a greater risk reduction in LGBYP compared to LSG. Funding Acknowledgement Type of funding source: None

Abstract P020: Triglyceride-lowering Lipoprotein Lipase Gene Variants And Improvements In Lipids And Lipoprotein Subspecies Defined By Apolipoprotein C-iii: Pounds Lost Trial

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Yoriko Heianza ◽  
Tao Zhou ◽  
Hua He ◽  
George Bray ◽  
Frank M Sacks ◽  
...  
Keyword(s):  
Weight Loss ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Dietary Intervention ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Gene Variants ◽  
Cvd Risk ◽  
Framingham Risk ◽  
Apolipoprotein C

Introduction: Triglyceride-lowering variants in the lipoprotein lipase ( LPL ) gene have been associated with a lower risk of coronary heart disease. Lipoproteins are heterogeneous, and lipoprotein subspecies containing apolipoprotein C-III (ApoCIII) have adverse effects on cardiovascular disease (CVD) risk. Hypothesis: We examined associations of triglyceride-lowering LPL gene variants with long-term improvement in lipids and lipoprotein subspecies with ApoCIII in patients with obesity. We also investigated whether the LPL gene variants were significantly related to the improvement of the 10-year CVD risk estimated using the Framingham risk score in the participants of a weight-loss dietary intervention trial. Methods: This study included 382 overweight and obese adults of white European ancestry in a 2-year weight-loss dietary intervention, the POUNDS Lost trial. We evaluated changes in lipids (triglycerides and cholesterol) and lipoproteins (such as very-low-density lipoprotein (VLDL), low-density lipoprotein (LDL), and high-density lipoprotein (HDL)) subfractions defined by the presence or absence of ApoCIII from baseline to 2 years after the intervention. A genetic risk score of LPL (LPL-GRS) was calculated by summing triglyceride-lowering alleles of five independent single nucleotide polymorphisms (SNPs). We calculated the Framingham risk score and estimated changes in the 10-year CVD risk after the intervention. Results: At baseline, higher scores of triglyceride-lowering LPL-GRS were significantly associated with higher levels of HDL cholesterol (p= 0.0065) and lower levels of triglycerides (p= 0.017). Higher LPL-GRS was also associated with more decreases in total triglycerides (p= 0.028) and triglycerides in VLDL with ApoCIII (p=0.018) at 2 years. The LPL-GRS was also predictive of 2-year improvements in other atherogenic lipoprotein subtypes, such as cholesterol in VLDL with ApoCIII (p= 0.037) and cholesterol in LDL with ApoCIII (p= 0.027) after the intervention. Further, the LPL-GRS was significantly associated with a 2-year reduction of the estimated CVD risk, regardless of the initial risk status (p=0.034). Conclusion: The triglyceride-lowering LPL-GRS was significantly predictive of improvements in unfavorable lipid profiles, including lipoprotein subtypes containing ApoCIII after consuming a weight-loss diet in patients with obesity. The reduction of the estimated CVD risk after the dietary intervention was predicted by the LPL-GRS at the pre-intervention.

scholarly journals Waist:height ratio: a superior index in estimating cardiovascular risks in Turkish adults

2013 ◽  
Vol 17 (10) ◽  
pp. 2246-2252 ◽  
Author(s):  
Reci Meseri ◽  
Reyhan Ucku ◽  
Belgin Unal
Keyword(s):  
Blood Pressure ◽  
High Risk ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Undiagnosed Diabetes ◽  
Anthropometric Measurement ◽  
Cardiovascular Risks ◽  
Framingham Risk ◽  
Chd Risk ◽  
Diabetes Status

AbstractObjectiveTo determine the best anthropometric measurement among waist: height ratio (WHtR), BMI, waist:hip ratio (WHR) and waist circumference (WC) associated with high CHD risk in adults and to define the optimal cut-off point for WHtR.DesignPopulation-based cross-sectional study.SettingBalcova, Izmir, Turkey.SubjectsIndividuals (n 10 878) who participated in the baseline survey of the Heart of Balcova Project. For each participant, 10-year coronary event risk (Framingham risk score) was calculated using data on age, sex, smoking status, blood pressure, serum lipids and diabetes status. Participants who had risk higher than 10 % were defined as ‘medium or high risk’.ResultsAmong the participants, 67·7 % were female, 38·2 % were obese, 24·5 % had high blood pressure, 9·2 % had diabetes, 1·5 % had undiagnosed diabetes (≥126 mg/dl), 22·0 % had high total cholesterol and 45·9 % had low HDL-cholesterol. According to Framingham risk score, 32·7 % of them had a risk score higher than 10 %. Those who had medium or high risk had significantly higher mean BMI, WHtR, WHR and WC compared with those at low risk. According to receiver-operating characteristic curves, WHtR was the best and BMI was the worst indicator of CHD risk for both sexes. For both men and women, 0·55 was the optimal cut-off point for WHtR for CHD risk.ConclusionsBMI should not be used alone for evaluating obesity when estimating cardiometabolic risks. WHtR was found to be a successful measurement for determining cardiovascular risks. A cut-off point of ‘0·5’ can be used for categorizing WHtR in order to target people at high CHD risk for preventive actions.

P4450Atherosclerosis in women with systemic lupus erythematosus with and without nephritis

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Panafidina ◽  
T V Popkova ◽  
D S Novikova
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Blood Pressure ◽  
Disease Activity ◽  
Risk Score ◽  
Lupus Erythematosus ◽  
Framingham Risk Score ◽  
Systemic Lupus ◽  
Framingham Risk ◽  
Coronary Events

Abstract Background Nephritis in systemic lupus erythematosus (SLE) is a factor contributing to early development of atherosclerosis (AS). Objectives The aim of the study is to determine differences in cardiovascular risk factors and AS in SLE pts with and without lupus nephritis (LN). Methods The study included 162 females, age 35 [26–43] years (median [interquartile range 25–75%])) with SLE (ACR,1997). We divided SLE pts on two groups, comparable in age: the 1st group is the pts with LN (n=84, 52%), the 2nd - without LN (n=78, 48%). We considered traditional factors of cardiovascular disease (CVD): (smoking, family history of CVD, blood pressure, cholesterol (total, HDL, LDL) and triglyceride (TG) levels, body mass index, diabetes mellitus) and SLE-related factors (age at onset, duration, clinical features, SLE Disease Activity Index (SLEDAI-2K) and the Systemic Lupus International Collaborating Clinics damage index (SLICC/DI), treatment with steroids); intima-media thickness (IMT) and the 10-year risk for coronary events. Carotid intima-media wall thickness of common carotid arteries was measured by high resolution B-mode ultrasound. The 10-year risk for coronary events was estimated by the Framingham risk equation. Results Median SLE duration was 8,0 [2,3–17,0] years, SLEDAI 2K – 8 [3–16], SLICC/DI score – 2 [0–3], duration of prednisone treatment – 72 [26–141] months. SLE pts from the 1st group had higher prevalence of hypertension (61% vs 36%, p<0,01), systolic blood pressure (130 [110–150] vs 120 [110–130]mm Hg, p<0,01), diastolic blood pressure (80 [70–95] vs 70 [70–80] mm Hg, p<0,05), TG concentration (136 [98–184] vs 100 [61–162] mg/dl, p<0,01), Framingham Risk Score (5 [1–30] vs 1 [1–27]%, p<0,05), SLEDAI-2K (12 [5–19] vs 4 [2–10], p<0,ehz745.08501), SLICC/DI score (2 [0–4] vs 0 [0–2], p<0,01), prednisone therapy duration (95 [26–192] vs 44 [14–98] months, p<0,05), prednisone cumulative dose (34,4 [13,6–82,5] vs 15,7 [6,2–35,2] g, p<0,001), mean IMT (0,73 [0,65–0,83] vs 0,67 [0,61–0,75] mm, p<0,01), than the pts from the 2nd group. There is no difference in CVD frequency in these groups (17% vs 8%, p=0,084). Conclusions SLE patients with and without LN had no difference in frequency of clinical manifestations of AS (CVD), but had a greater value of mean IMT, Framingham Risk Score and a higher incidence of both traditional (hypertension, TG concentration) and SLE-related (disease activity, prednisone therapy) risk factors for AS.

scholarly journals Correction of the Framingham Risk Score Data Reported in SPRINT

2017 ◽  
Author(s):  
Frederick Warner ◽  
Sanket S. Dhruva ◽  
Joseph S. Ross ◽  
Pranammya Dey ◽  
Karthik Murugiah ◽  
...  
Keyword(s):  
Blood Pressure ◽  
New England ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Heart Association ◽  
Pharmacologic Therapy ◽  
Total Study Population ◽  
Blood Pressure Targets ◽  
Framingham Risk ◽  
Study Participants

This report describes an error in the Framingham Risk Score data presented in the original SPRINT publication.1 The data, presented in Table 1 of the main SPRINT publication in the New England Journal of Medicine and made available to SPRINT Challenge participants, incorrectly calculated the level of baseline cardiovascular risk of the study participants using the Framingham Risk Score. The correct calculation increased the number of participants identified as having >15% 10-year risk from 5737 to 7089, a change from 61% to 76% of the total study population. This information is important for researchers attempting to validate and extend the trial’s findings and is particularly germane because the recently released American Heart Association/American College of Cardiology blood pressure guidelines changed blood pressure targets for pharmacologic therapy only for high-risk individuals.

scholarly journals Does Adding Adverse Pregnancy Outcomes Improve the Framingham Cardiovascular Risk Score in Women? Data from the Tehran Lipid and Glucose Study

2022 ◽  
Author(s):  
Marzieh Saei Ghare Naz ◽  
Ali Sheidaei ◽  
Ali Aflatounian ◽  
Fereidoun Azizi ◽  
Fahimeh Ramezani Tehrani
Keyword(s):  
Risk Factors ◽  
Risk Score ◽  
Pregnancy Outcomes ◽  
Framingham Risk Score ◽  
Adverse Pregnancy Outcomes ◽  
Proportional Hazard ◽  
Cvd Risk ◽  
C Statistic ◽  
Framingham Risk ◽  
Adverse Pregnancy

Background Limited and conflicting evidence is available regarding the predictive value of adding adverse pregnancy outcomes (APOs) to established cardiovascular disease (CVD) risk factors. Hence, the objective of this study was to determine whether adding APOs to the Framingham risk score improves the prediction of CVD events in women. Methods and Results Out of 5413 women who participated in the Tehran Lipid and Glucose Study, 4013 women met the eligibility criteria included for the present study. The exposure and the outcome variables were collected based on the standard protocol. Cox proportional hazard model was used to evaluate the association of APOs and CVDs. The variant of C‐statistic for survivals and reclassification of subjects into Framingham risk score categories after adding APOs was reported. Out of the 4013 eligible subjects, a total of 1484 (36.98%) women reported 1 APO, while 395 (9.84%) of the cases reported multiple APOs. Univariate proportional hazard Cox models showed the significant relations between CVD events and APOs. The enhanced model had a higher C‐statistic indicating more acceptable discrimination as well as a slight improvement in discrimination (C‐statistic differences: 0.0053). Moreover, we observed a greater risk of experiencing a CVD event in women with a history of multiple APOs compared with cases with only 1 APO (1 APO: hazard ratio [HR] = 1.22; 2 APOs: HR; 1.94; ≥3 APOs: HR = 2.48). Conclusions Beyond the established risk factors, re‐estimated CVDs risk by adding APOs to the Framingham risk score may improve the accurate risk estimation of CVD. Further observational studies are needed to confirm our findings.

scholarly journals 7500 steps per day is associated with lower cardiovascular risk in rural residents with a high prevalence of sedentary lifestyle

2021 ◽  
Vol 20 (Supplement_1) ◽  
Author(s):  
I Madujibeya ◽  
L Misook ◽  
T Lennie ◽  
G Mudd-Martin ◽  
M Biddle ◽  
...  
Keyword(s):  
Risk Score ◽  
Rural Areas ◽  
Framingham Risk Score ◽  
Step Count ◽  
Daily Step ◽  
Cvd Risk ◽  
Rural Residents ◽  
Physically Active ◽  
Framingham Risk ◽  
Daily Step Count

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Sedentary lifestyle is one of the modifiable risk factors that account for the high prevalence of cardiovascular diseases (CVD) in the rural areas.1,2 Daily step counting, using wearable devices, is increasingly used to monitor physical activity levels in interventions targeting CVD risk reduction in the rural areas.3,4 However, there is a lack of evidence to support a daily step count threshold that may reduce CVD risk among rural residents. The purpose of this study was to examine the relationship between daily step count cut-points and CVD risk. Methods This secondary analysis included 312 adults living in the rural areas in the southern United States. Daily step counts from pedometers were collected for 14 consecutive days. Established cut-points were used to categorize participants into groups based on mean daily step count as sedentary (≤ 5000 steps/day), less active (5000 -7499 steps/per), and physically active (≥7500 steps/day).5-7 CVD risk was measured with the Framingham risk score. Generalized additive models were used to examine differences among the 3 activity groups in Framingham risk score, controlling for educational level, perceived physical health status, depressive, marital status, and years of residence in a rural county. Results Among the participants (75% female, mean age 50.1 (±13.6) years), 40.7% were sedentary, 35.2% were less active, and 24.0% were physically active. The average Framingham risk score was 11.2% (±9.4%). Framingham risk scores were 1.7% lower in the less active compared to the sedentary group, but the effect was not significant (p &lt;  .11), and 2.6% lower in the physically active compared to the sedentary group (p &lt; .04). The model accounted for 22% of the variation in Framingham risk scores. Conclusion These findings indicate that rural residents who averaged 7500 steps or more per day had lower CVD risk, and the difference is clinically significant.

1107Reduction of cardiovascular disease risk factors in rural, medically under-served, socioeconomically distressed, high-risk individuals: a randomized controlled trial

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
D Moser ◽  
M L Chung ◽  
F Feltner ◽  
T A Lennie ◽  
M J Biddle
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Risk Reduction ◽  
Controlled Trial ◽  
Self Care ◽  
Density Lipoprotein ◽  
Control Group ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Randomized Controlled

Abstract Background People in rural, socioeconomically distressed areas of the world suffer from marked cardiovascular disease (CVD) disparities. Despite the CVD disparities seen in rural, distressed areas, efforts directed toward CVD risk reduction and prevention are limited. We conducted a randomized, controlled trial to determine the effect of an individualized, culturally appropriate, self-care CVD risk reduction intervention (HeartHealth) compared to referral of patients to a primary care provider for usual care on the following CVD risk factors: tobacco use, blood pressure, lipid profile, body mass index, depressive symptoms, and physical activity levels. Methods The study protocol and intervention were developed with a community advisory board of lay community members, business owners, local government officials, church leaders, and healthcare providers. We enrolled 355 individuals living in Appalachia with two or more CVD risk factors. The intervention was delivered in person to groups of 10 or fewer individuals over 12 weeks. In the first session, participants chose their CVD risk reduction goals. HeartHealth was designed to provide participants with self-care skills targeting CVD risk reduction while reducing barriers to risk reduction found in austere rural environments. The targeted CVD risk factors were measured at baseline and 4 and 12 months post-intervention. Repeated measures data were analyzed with mixed models. Results More individuals in the intervention group compared to the control group met their lifestyle change goal (50% vs 16%, p<0.001). The intervention produced a positive impact on systolic blood pressure (p=0.002, time X group effect), diastolic blood pressure (p=0.001, time x group), total cholesterol (p=0.026, time x group), high density lipoprotein (p=0.002, time x group), body mass index (p=0.017, time x group), smoking status (p=0.01), depressive symptoms (p=0.01, time x group), and steps per day (p=0.001, time x group). Compared to the control group, improvement was seen at 4 months in these risk factors and the positive changes were maintained through 12 months. There were no differences seen across time by group in low density lipoprotein or triglyceride levels. Conclusion Interventions like HeartHealth that focus on self-care and that are derived in collaboration with the community of interest are effective in medically underserved, socioeconomically distressed rural areas. Acknowledgement/Funding Patient Centered Outcomes Research Institute

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