ECG abnormalities predict cardiovascular disease in older women

Abstract Background Combination therapy with hydroxychloroquine and darunavir/ritonavir or lopinavir/ritonavir has been suggested as an approach to improve the outcome of patients with moderate/severe COVID-19 infection. Objectives To examine the safety of combination therapy with hydroxychloroquine and darunavir/ritonavir or lopinavir/ritonavir. Methods This was an observational cohort study of patients hospitalized for COVID-19 pneumonia treated with hydroxychloroquine and darunavir/ritonavir or lopinavir/ritonavir. Clinical evaluations, electrocardiograms and the pharmacokinetics of hydroxychloroquine, darunavir and lopinavir were examined according to clinical practice and guidelines. Results Twenty-one patients received hydroxychloroquine with lopinavir/ritonavir (median age 68 years; 10 males) and 25 received hydroxychloroquine with darunavir/ritonavir (median age 71 years; 15 males). During treatment, eight patients (17.4%) developed ECG abnormalities. Ten patients discontinued treatment, including seven for ECG abnormalities a median of 5 (range 2–6) days after starting treatment. All ECG abnormalities reversed 1–2 days after interrupting treatment. Four patients died within 14 days. ECG abnormalities were significantly associated with age over 70 years, coexisting conditions (such as hypertension, chronic cardiovascular disease and kidney failure) and initial potential drug interactions, but not with the hydroxychloroquine concentration. Conclusions Of the patients with COVID-19 who received hydroxychloroquine with lopinavir or darunavir, 17% had ECG abnormalities, mainly related to age or in those with a history of cardiovascular disease.

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The StrongWomen–Healthy Hearts Program: Reducing Cardiovascular Disease Risk Factors in Rural Sedentary, Overweight, and Obese Midlife and Older Women

American Journal of Public Health ◽

10.2105/ajph.2008.145581 ◽

2009 ◽

Vol 99 (7) ◽

pp. 1271-1277 ◽

Cited By ~ 54

Author(s):

Sara C. Folta ◽

Alice H. Lichtenstein ◽

Rebecca A. Seguin ◽

Jeanne P. Goldberg ◽

Julia F. Kuder ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Older Women ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Cardiovascular Disease Risk Factors

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Cardiovascular Disease and Hypertension in Older Women

Obstetrics and Gynecology Clinics of North America ◽

10.1016/s0889-8545(21)00574-x ◽

1987 ◽

Vol 14 (1) ◽

pp. 89-105

Author(s):

Lila E. Nachtigall

Keyword(s):

Cardiovascular Disease ◽

Older Women

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Management of Risks Factors for Older Women: Osteoporosis and Cardiovascular Disease

Handbook of Gynecology ◽

10.1007/978-3-319-17002-2_47-1 ◽

2016 ◽

pp. 1-15

Author(s):

Katrina Wade ◽

Alexander M. Quaas

Keyword(s):

Cardiovascular Disease ◽

Older Women ◽

Risks Factors

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The association of six-minutes walking test (6MWT) with cardiovascular disease risk among older women with type 2 diabetes mellitus in a rural primary health care: a pilot observational study

Journal of Community Empowerment for Health ◽

10.22146/jcoemph.47599 ◽

2020 ◽

Vol 3 (1) ◽

pp. 34

Author(s):

Rakhmat Ari Wibowo ◽

Arum Tri Wahyuningsih ◽

Rio Jati Kusuma ◽

Wahyu Pamungkasih ◽

Denny Agustiningsih

Keyword(s):

Diabetes Mellitus ◽

Blood Pressure ◽

Type 2 Diabetes ◽

Cardiovascular Disease ◽

Heart Rate ◽

Older Women ◽

Walking Test ◽

Primary Health ◽

Ascvd Risk

The recent systematic review found that cardiovascular events contributed to approximately half of all deaths among patients with type 2 diabetes mellitus (T2DM). Several studies suggested that the six-minutes walking test (6MWT) could be a valuable prognostic tool for predicting cardiovascular disease (CVD) events in particular diseases. However, less is known concerning the role of 6MWT in predicting CVD events among patients with T2DM. Thus, this pilot observational study aimed to test the feasibility of conducting the 6MWT and to examine the association of measures collected during 6MWT with ASCVD risk estimator parameters for predicting CVD events among T2DM patients. Fourteen older women with T2DM in a rural primary health care were enrolled in this cross-sectional study. Blood pressure measurement, heart rate measurement, and blood sampling for HDL, LDL, and total cholesterol measurements were carried out during rest. Both heart rate and distance were measured at the end of the following 6MWT. Feasibility data were collected. Recruitment rate and measurement completion rate were 85.7% and 40% respectively. No adverse events during the 6MWT were reported. Patient’s heart rate at the end of 6MWT was correlated with diastolic blood pressure (r=0.5 p=0.48). Multivariate analyses suggested that every one-meter increase in distance of 6MWT, there is a decrease in diastolic blood pressure of -0.9 mmHg (p=0.01; 95% CI= -1.6 to -0.2). In conclusion, 6MWT is a feasible simple test which could provide a valuable prediction of ASCVD risk among older women with T2DM. Thus, this test should be considered to be conducted as a part of routine examination. Cohort study with a larger sample could be suggested to establish the usefulness of the 6MWT in predicting CVD risk.

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Electrocardiographic screening in primary care for cardiovascular disease risk and atrial fibrillation

Primary Health Care Research & Development ◽

10.1017/s1463423619000355 ◽

2019 ◽

Vol 20 ◽

Author(s):

Ralf E. Harskamp

Keyword(s):

Atrial Fibrillation ◽

Cardiovascular Disease ◽

Primary Care ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Diagnostic Testing ◽

Routine Care ◽

Pulse Palpation ◽

Primary Care Patients ◽

Ecg Abnormalities

Abstract Electrocardiograms (ECGs) are frequently recorded in primary care for screening purposes. An ECG is essential in diagnosing atrial fibrillation, and ECG abnormalities are associated with cardiovascular events. While recent studies show that ECGs adequately reclassify a proportion of patients based on the clinical risk score calculations, there are no data to support that this also results in improved health outcomes. When applied for screening for atrial fibrillation, more cases are found with routine care, but this would be undone when physicians would perform systematic pulse palpation. In most studies, the harms of routine ECG use (such as unnecessary diagnostic testing, emotional distress, increased health expenses) were poorly documented. As such, the routine performing of ECGs in asymptomatic primary care patients, whether it is for cardiovascular disease risk assessment or atrial fibrillation, cannot be recommended.

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