TRAJECTORIES OF CARDIOVASCULAR RISK FACTORS AND HEALTHY LONGEVITY: THE CARDIOVASCULAR HEALTH STUDY

BACKGROUND Asymmetrical dimethylarginine (ADMA), an endogenous nitric oxide synthase inhibitor, has been linked to cardiovascular risk. The clinical role of its structural isomer symmetrical dimethylarginine (SDMA) remains largely unclear. METHODS We measured SDMA and ADMA in 3229 patients undergoing coronary angiography at baseline (1997–2000) and recorded total and cardiovascular mortality during a median follow-up time of 7.7 years. We investigated associations of SDMA with cardiovascular risk factors and mortality and compared its role as a cardiovascular risk factor with ADMA, which predicted mortality in previous analyses of our study. RESULTS In linear regression analyses including common cardiovascular risk factors as covariates, SDMA and ADMA were significantly associated with cystatin C, N-terminal pro-B–type natriuretic peptide, New York Heart Association classification, and homocysteine. The regression coefficients were higher for SDMA than for ADMA. In Cox proportional-hazards models adjusted for cardiovascular risk factors, the hazard ratios (HRs) (with 95% CI) in the second, third, and fourth SDMA quartile compared to the lowest quartile were 0.77 (0.60–0.99), 0.99 (0.78–1.25), and 1.51 (1.20–1.91) for total mortality and 0.92 (0.68–1.25), 0.93 (0.68–1.26), and 1.54 (1.14–2.01) for cardiovascular mortality. The same calculations for ADMA quartiles revealed HRs of 1.05 (0.83–1.32), 1.19 (0.95–1.50), and 1.61 (1.30–1.99) for total mortality and HR of 1.00 (0.74–1.34), 1.26 (0.95–1.68), and 1.54 (1.18–2.02) for cardiovascular mortality. CONCLUSIONS Serum concentrations of SDMA are independently associated with increased cardiovascular and all-cause mortality in patients undergoing coronary angiography. The pattern of risk linked to SDMA is different from that linked to ADMA, suggesting different pathophysiological roles of these 2 methylarginine metabolites.

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Cardiovascular risk factors in Norwegian women using oral contraceptives: Results from a cardiovascular health screening 1985–1988

Contraception ◽

10.1016/0010-7824(96)00082-0 ◽

1996 ◽

Vol 53 (6) ◽

pp. 337-344 ◽

Cited By ~ 3

Author(s):

Sidsel Graff-Iversen ◽

Aage Tverdal ◽

Inger Stensvold

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Oral Contraceptives ◽

Cardiovascular Health ◽

Health Screening

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Diastolic dysfunction in individuals with and without heart failure with preserved ejection fraction

Clinical Research in Cardiology ◽

10.1007/s00392-021-01907-x ◽

2021 ◽

Author(s):

Jan-Per Wenzel ◽

Ramona Bei der Kellen ◽

Christina Magnussen ◽

Stefan Blankenberg ◽

Benedikt Schrage ◽

...

Keyword(s):

Risk Factors ◽

Heart Failure ◽

Cardiovascular Risk ◽

General Population ◽

Diastolic Dysfunction ◽

Cardiovascular Risk Factors ◽

Population Based ◽

Left Ventricular ◽

Health Study ◽

Common Finding

Abstract Aim Left ventricular diastolic dysfunction (DD), a common finding in the general population, is considered to be associated with heart failure with preserved ejection faction (HFpEF). Here we evaluate the prevalence and correlates of DD in subjects with and without HFpEF in a middle-aged sample of the general population. Methods and results From the first 10,000 participants of the population-based Hamburg City Health Study (HCHS), 5913 subjects (mean age 64.4 ± 8.3 years, 51.3% females), qualified for the current analysis. Diastolic dysfunction (DD) was identified in 753 (12.7%) participants. Of those, 11.2% showed DD without HFpEF (ALVDD) while 1.3% suffered from DD with HFpEF (DDwHFpEF). In multivariable regression analysis adjusted for major cardiovascular risk factors, ALVDD was associated with arterial hypertension (OR 2.0, p < 0.001) and HbA1c (OR 1.2, p = 0.007). Associations of both ALVDD and DDwHFpEF were: age (OR 1.7, p < 0.001; OR 2.7, p < 0.001), BMI (OR 1.2, p < 0.001; OR 1.6, p = 0.001), and left ventricular mass index (LVMI). In contrast, female sex (OR 2.5, p = 0.006), atrial fibrillation (OR 2.6, p = 0.024), CAD (OR 7.2, p < 0.001) COPD (OR 3.9, p < 0.001), and QRS duration (OR 1.4, p = 0.005) were strongly associated with DDwHFpEF but not with ALVDD. Conclusion The prevalence of DD in a sample from the first 10,000 participants of the population-based HCHS was 12.7% of whom 1.3% suffered from HFpEF. DD with and without HFpEF showed significant associations with different major cardiovascular risk factors and comorbidities warranting further research for their possible role in the formation of both ALVDD and DDwHFpEF.

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Abstract 2568: Cerebral Infarcts in Blacks vs Whites: the Southall and Brent REvisited (SABRE) Multi-ethnic Cohort Study

Stroke ◽

10.1161/str.43.suppl_1.a2568 ◽

2012 ◽

Vol 43 (suppl_1) ◽

Author(s):

Dean Shibata ◽

Therese Tillin ◽

Norman Beauchamp ◽

John Heasman ◽

Wadyslaw Gedroyc ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Health ◽

African Descent ◽

Health Study ◽

Cardiovascular Health Study ◽

Stroke Mortality ◽

Black African ◽

Cerebral Mri ◽

Mri Scans

Introduction: Stroke mortality is doubled in people of Black African descent compared with Whites, but factors responsible for this excess are unclear. We wished to compare infarct like lesions (ILL) on MRI by ethnicity and the role of risk factors. Methods: SABRE is a UK community based multi-ethnic cohort of men and women aged 40-69 years at baseline (1988-1990), and 58-86 years at follow up (2008-2011). At follow up, a questionnaire was completed and investigations performed including resting and ambulatory BP, anthropometry, and bloods for glucose and lipids. Cerebral MRI scans were scored for infarcts independently by two readers according to the Cardiovascular Health Study protocol. Results: Of 2346 Whites, 684 attended follow up, and 590 completed cerebral MRI. Of 801 Blacks (first generation migrants of Black African descent to the UK), 232 attended clinic and 207 completed MRI. Mortality loss was greater in Whites (605, 25%) than Blacks (121, 15%)(p<0.0001), although stroke was more likely the underlying cause in Blacks (23, 19%), than Whites (43, 7%)(p<0.0001) . Baseline systolic/diastolic BP was similarly higher in Blacks than Whites in attendees (8/5 mmHg), non-responders (7/6 mm Hg), and those who died (8/5 mmHg). At follow up stroke risk factors were adverse in Blacks, apart from smoking ( table ). Prevalence of ILL was similar by ethnicity, not differing when those <65 years were analysed separately, or when those with stroke/TIA history were excluded. Associations between ILL and risk factors did not differ by ethnicity. But prescribed treatment in those with elevated clinic BP (≥140 mmHg systolic, or ≥90 mmHg diastolic) was 83% in Blacks, 63% in Whites (p<0.0001). Further, in those with an ILL, 95% of Blacks, and 69% (p<0.0001) of Whites were on treatment. Conclusion: Equivalence of ILL rates in Blacks and Whites was unanticipated, given the greater stroke mortality in Blacks. Mitigating against selective mortality as the explanation of our findings is the similar ethnic differential in baseline BP in survivors and non-survivors, the lower overall mortality in Blacks, and overall small numbers of stroke deaths. A more likely explanation is that better targeted more aggressive treatment is now occurring in Blacks than Whites, reducing their potential burden of ILL.

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