HIV-related cardiovascular diseases: the search for a unifying hypothesis

Although the extensive rollout of antiretroviral (ARV) therapy resulted in a longer life expectancy for people living with human immunodeficiency virus (PLHIV), such individuals display a relatively increased occurrence of cardiovascular diseases (CVD). This health challenge stimulated significant research interests in the field, leading to an improved understanding of both lifestyle-related risk factors and the underlying mechanisms of CVD onset in PLHIV. However, despite such progress, the precise role of various risk factors and mechanisms underlying the development of HIV-mediated CVD still remains relatively poorly understood. Therefore, we review CVD onset in PLHIV and focus on 1) the spectrum of cardiovascular complications that typically manifest in such persons and 2) underlying mechanisms that are implicated in this process. Here, the contributions of such factors and modulators and underlying mechanisms are considered in a holistic and integrative manner to generate a unifying hypothesis that includes identification of the core pathways mediating CVD onset. The review focuses on the sub-Saharan African context, as there are relatively high numbers of PLHIV residing within this region, indicating that the greater CVD risk will increasingly threaten the well-being and health of its citizens. It is our opinion that such an approach helps point the way for future research efforts to improve treatment strategies and/or lifestyle-related modifications for PLHIV.

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Cardiovascular Diseases in Context: Multilevel Analysis of Risk Factors in India (2004–2014)

Asian Pacific Journal of Health Sciences ◽

10.21276/apjhs.2020.7.3.14 ◽

2020 ◽

Vol 7 (3) ◽

pp. 59-69

Author(s):

Ayantika Biswas ◽

Shri Kant Singh

Keyword(s):

Risk Factors ◽

Cardiovascular Diseases ◽

Ethnic Composition ◽

Health Concern ◽

Future Research ◽

Cvd Risk ◽

Economic Variables ◽

Individual Level ◽

Socio Economic Variables ◽

Independent Effects

Cardiovascular diseases (CVDs), accounting for approximately half of all deaths owing to non-communicable diseases worldwide, have become a major public health concern. The CVD risk is high among the Indian population, as well as varies by geography. The purpose of the current study was to test the independent effects of contextual socio-economic variables, whilst adjusting for individual socio-economic variables on CVD risk factors in India. Data from the 52nd, 60th, and 71st NSSO rounds pertaining to Social Consumption related to Health have been utilized for the current study. A four-level multilevel model has been fitted to examine the measured individual, household, community, and district factors on the prevalence of CVDs.District educational attainment, household expenditure quintile, and proportion of district urbanicity have emerged as important factors with few contra-indications in terms of traditional directions of association, as opposed to extant literature. Religious and ethnic composition of the communities and districts have also been found to have an impact. In order to better manage the CVD health of the nation, there is a strong need to focus on community-level and district-level interventions, in addition to individual-level factors. Future research should investigate these factors to account for unexplained variations in CVD management.

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Preventing Cardiovascular Complications in Type 1 Diabetes: The Need for a Lifetime Approach

Frontiers in Pediatrics ◽

10.3389/fped.2021.696499 ◽

2021 ◽

Vol 9 ◽

Author(s):

Scott T. Chiesa ◽

M. Loredana Marcovecchio

Keyword(s):

Risk Factors ◽

Type 1 Diabetes ◽

Glycemic Control ◽

Treatment Strategies ◽

Critical Time ◽

Cardiovascular Complications ◽

Pharmacological Intervention ◽

Cvd Risk ◽

Increased Risk

Cardiovascular disease (CVD) remains the main cause of morbidity and mortality in individuals with type 1 diabetes (T1D). Adolescence appears to be a critical time for the development of early subclinical manifestations of CVD, with these changes likely driven by a deterioration in glycemic control during the progression through puberty, combined with the emergence of numerous other traditional cardiometabolic risk factors (e.g., hypertension, dyslipidemia, smoking, alcohol use, obesity, etc.) which emerge at this age. Although hemoglobin A1C has long been the primary focus of screening and treatment strategies, glycemic control remains poor in youth with T1D. Furthermore, screening for cardiovascular risk factors—which are often elevated in youth with T1D—is suboptimal, and use of pharmacological interventions for hypertension and dyslipidemia remains low. As such, there is a clear need not only for better screening strategies for CVD risk factors in youth, but also early interventions to reduce these, if future CVD events have to be prevented. Accumulating evidence has recently suggested that early increases in urinary albumin excretion, even within the normal range, may identify adolescents with T1D who are at an increased risk of complications, and results from pharmacological intervention with statins and ACE inhibitors in these individuals have been encouraging. These data join a growing evidence highlighting the need for a whole-life approach to prevention starting from childhood if efforts to improve CVD outcomes and related mortality in T1D are to be maintained.

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Hyperhomocysteinemia and its Relations to Conventional Risk Factors for Cardiovascular Diseases in Adult Nigerians: The REMAH Study.

10.21203/rs.3.rs-115059/v1 ◽

2020 ◽

Author(s):

Babangida Chori ◽

Benjamin Danladi ◽

Bassey Inyang ◽

Michael Okoh ◽

Maxwell Nwegbu ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Diseases ◽

Diastolic Pressure ◽

Hdl Cholesterol ◽

Black Population ◽

Cvd Risk ◽

North Central ◽

The North ◽

Sub Saharan ◽

The Individual

Abstract Background: Evidence linking homocysteine (Hcy) with cardiovascular diseases (CVD) or its risk factors are insufficient in a Sub-Saharan black population. Objective: We set out to evaluate the association between Hcy and hypertension and other CVD risk factors in a population of adult Nigerians. Methods: Data of 156 adults aged 18-70years was accessed from the North Central study site of the REmoving the MAsk on Hypertension (REMAH) study. Homocysteine, blood glucose and lipid profile in whole blood/serum were measured using standard laboratory methods. Hypertension was diagnosed if average of 5 consecutive blood pressure (BP) measurements obtained using a mercury sphygmomanometer was equal to or higher than 140 systolic and/or 90 mmHg diastolic or the individual is on antihypertensive medication. Hyperhomocysteinemia (HHcy) was defined as Hcy>10µmol/L. Results: Of the 156 participants, 72 (43.5%) were hypertensive, of whom 18 had HHcy. Subjects with HHcy were significantly (p<0.05) older (41.5 vs 40.6yrs), had lower HDL-cholesterol (0.6 vs 0.8mmol/L) and higher systolic (145.5 vs 126.0mmHg) and diastolic BP (92.9 vs 79.6mmHg), compared to those without HHcy. Intake of alcohol and a 1yr increase in age were respectively and significantly (p<0.05) associated with a 1.54 and 0.10 µmol/L increase in Hcy. In a multivariable model adjusted for age, sex and body mass index, a 1µmol/L increase in Hcy, was associated with a 1.69 mmHg and 1.34 mmHg increase in systolic and diastolic pressure (p< 0.0001) respectively; and a 0.01mmol/L decrease in HDL-cholesterol (p<0.05). Conclusion: HHcy occurs among hypertensive Nigerians and it is independently associated with age, HDL-cholesterol, systolic and diastolic BP.

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Hyperhomocysteinemia and its relations to conventional risk factors for cardiovascular diseases in adult Nigerians: the REMAH study

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-01913-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Babangida S. Chori ◽

Benjamin Danladi ◽

Bassey A. Inyang ◽

Michael P. Okoh ◽

Maxwell M. Nwegbu ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Diseases ◽

Diastolic Pressure ◽

Hdl Cholesterol ◽

Black Population ◽

Cvd Risk ◽

North Central ◽

The North ◽

Sub Saharan ◽

The Individual

Abstract Background Evidence linking homocysteine (Hcy) with cardiovascular diseases (CVD) or its risk factors are limited in a sub-Saharan black population. Objective We set out to evaluate the association between Hcy and hypertension and other CVD risk factors in a population of adult Nigerians. Methods Data of 156 adults aged 18–70 years was accessed from the North Central study site of the REmoving the MAsk on Hypertension (REMAH) study. Homocysteine, blood glucose and lipid profile in whole blood/serum were measured using standard laboratory methods. Hypertension was diagnosed if average of 5 consecutive blood pressure (BP) measurements obtained using a mercury sphygmomanometer was equal to or higher than 140 systolic and/or 90 mmHg diastolic or the individual is on antihypertensive medication. Hyperhomocysteinemia (HHcy) was defined as Hcy > 10 µmol/L. Results Of the 156 participants, 72 (43.5%) were hypertensive, of whom 18 had HHcy. Subjects with HHcy were significantly (p < 0.05) older (41.5 vs. 40.6yrs), had lower HDL-cholesterol (0.6 vs. 0.8 mmol/L) and higher systolic (145.5 vs. 126.0 mmHg) and diastolic BP (92.9 vs. 79.6 mmHg), compared to those without HHcy. Intake of alcohol and a 1 yr increase in age were respectively and significantly (p < 0.05) associated with a 1.54 and 0.10 µmol/L increase in Hcy. In a multivariable model adjusted for age, sex and body mass index, a 1 µmol/L increase in Hcy, was associated with a 1.69 mmHg and 1.34 mmHg increase in systolic and diastolic pressure (p < 0.0001) respectively; and a 0.01 mmol/L decrease in HDL-cholesterol (p < 0.05). Conclusion HHcy occurs among hypertensive Nigerians and it is independently associated with age, HDL-cholesterol, systolic and diastolic BP.

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Does HbA1cc Play a Role in the Development of Cardiovascular Diseases?

Current Pharmaceutical Design ◽

10.2174/1381612824666180903121957 ◽

2018 ◽

Vol 24 (24) ◽

pp. 2876-2882 ◽

Cited By ~ 4

Author(s):

Kailash Prasad

Keyword(s):

Risk Factors ◽

Cardiovascular Diseases ◽

Cardiovascular System ◽

Half Life ◽

Serum Levels ◽

Serum Glucose ◽

Cvd Risk ◽

Factors Affecting ◽

Diagnosis And Management ◽

Coronary Artery Atherosclerosis

Cardiovascular diseases (CVD) may be mediated through increases in the cardiovascular risk factors. Hemoglobin A1c (HbA1c) also called glycated hemoglobin is presently used for the diagnosis and management of diabetes. It has adverse effects on cardiovascular system. This review deals with its synthesis and effects on the cardiovascular system. The serum levels of HbA1c have been reported to be affected by various factors including, the lifespan of erythrocytes, factors affecting erythropoiesis, agents interfering glycation of Hb, destruction of erythrocytes, drugs that shift the formation of Hb, statins, and drugs interfering the HbA1c assay. Levels of HbA1c are positively correlated with serum glucose and advanced glycation end products ( AGE), but no correlation between AGE and serum glucose. AGE cannot replace HbA1c for the diagnosis and management of diabetes because there is no correlation of AGE with serum glucose, and because the half-life of protein with which glucose combines is only 14-20 days as compared to erythrocytes which have a half-life of 90-120 days. HbA1c is positively associated with CVD such as the carotid and coronary artery atherosclerosis, ischemic heart disease, ischemic stroke and hypertension.HbA1c induces dyslipidemia, hyperhomocysteinemia, and hypertension, and increases C-reactive protein, oxidative stress and blood viscosity that would contribute to the development of cardiovascular diseases. In conclusion, HbA1c serves as a useful marker for the diagnosis and management of diabetes. AGE cannot replace HbA1c in the diagnosis and management of diabetes. There is an association of HbA1c with CVD which be mediated through modulation of CVD risk factors.

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Comparative risk assessment for the development of cardiovascular diseases in the Hungarian general and Roma population

Scientific Reports ◽

10.1038/s41598-021-82689-0 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Peter Piko ◽

Zsigmond Kosa ◽

Janos Sandor ◽

Roza Adany

Keyword(s):

Risk Factors ◽

Risk Assessment ◽

Cardiovascular Risk ◽

Cardiovascular Diseases ◽

High Risk ◽

Risk Group ◽

High Risk Group ◽

Average Risk ◽

Cvd Risk ◽

Roma Population

AbstractCardiovascular diseases (CVDs) are the number one cause of death globally, and the early identification of high risk is crucial to prevent the disease and to reduce healthcare costs. Short life expectancy and increased mortality among the Roma are generally accepted (although not indeed proven by mortality analyses) which can be partially explained by the high prevalence of cardiovascular risk factors (CVRF) among them. This study aims to elaborate on the prevalence of the most important CVD risk factors, assess the estimation of a 10-year risk of development of fatal and nonfatal CVDs based on the most used risk assessment scoring models, and to compare the Hungarian general (HG) and Roma (HR) populations. In 2018 a complex health survey was accomplished on the HG (n = 380) and HR (n = 347) populations. The prevalence of CVRS was defined and 10-year cardiovascular risk was estimated for both study populations using the following systems: Framingham Risk Score for hard coronary heart disease (FRSCHD) and for cardiovascular disease (FRSCVD), Systematic COronary Risk Evaluation (SCORE), ACC/AHA Pooled Cohort Equations (PCE) and Revised Pooled Cohort Equations (RPCE). After the risk scores had been calculated, the populations were divided into risk categories and all subjects were classified. For all CVD risk estimation scores, the average of the estimated risk was higher among Roma compared to the HG independently of the gender. The proportion of high-risk group in the Hungarian Roma males population was on average 1.5–3 times higher than in the general one. Among Roma females, the average risk value was higher than in the HG one. The proportion of high-risk group in the Hungarian Roma females population was on average 2–3 times higher compared to the distribution of females in the general population. Our results show that both genders in the Hungarian Roma population have a significantly higher risk for a 10-year development of cardiovascular diseases and dying from them compared to the HG one. Therefore, cardiovascular interventions should be focusing not only on reducing smoking among Roma but on improving health literacy and service provision regarding prevention, early recognition, and treatment of lipid disorders and diabetes among them.

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Estimating the burden of cardiovascular risk in community dwellers over 40 years old in South Africa, Kenya, Burkina Faso and Ghana

BMJ Global Health ◽

10.1136/bmjgh-2020-003499 ◽

2021 ◽

Vol 6 (1) ◽

pp. e003499

Author(s):

Ryan G Wagner ◽

Nigel J Crowther ◽

Lisa K Micklesfield ◽

Palwende Romauld Boua ◽

Engelbert A Nonterah ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

South African ◽

Sub Saharan Africa ◽

African Countries ◽

Cvd Risk ◽

Genomic Studies ◽

Sub Saharan ◽

Context Specific ◽

The Impact

IntroductionCardiovascular disease (CVD) risk factors are increasing in sub-Saharan Africa. The impact of these risk factors on future CVD outcomes and burden is poorly understood. We examined the magnitude of modifiable risk factors, estimated future CVD risk and compared results between three commonly used 10-year CVD risk factor algorithms and their variants in four African countries.MethodsIn the Africa-Wits-INDEPTH partnership for Genomic studies (the AWI-Gen Study), 10 349 randomly sampled individuals aged 40–60 years from six sites participated in a survey, with blood pressure, blood glucose and lipid levels measured. Using these data, 10-year CVD risk estimates using Framingham, Globorisk and WHO-CVD and their office-based variants were generated. Differences in future CVD risk and results by algorithm are described using kappa and coefficients to examine agreement and correlations, respectively.ResultsThe 10-year CVD risk across all participants in all sites varied from 2.6% (95% CI: 1.6% to 4.1%) using the WHO-CVD lab algorithm to 6.5% (95% CI: 3.7% to 11.4%) using the Framingham office algorithm, with substantial differences in risk between sites. The highest risk was in South African settings (in urban Soweto: 8.9% (IQR: 5.3–15.3)). Agreement between algorithms was low to moderate (kappa from 0.03 to 0.55) and correlations ranged between 0.28 and 0.70. Depending on the algorithm used, those at high risk (defined as risk of 10-year CVD event >20%) who were under treatment for a modifiable risk factor ranged from 19.2% to 33.9%, with substantial variation by both sex and site.ConclusionThe African sites in this study are at different stages of an ongoing epidemiological transition as evidenced by both risk factor levels and estimated 10-year CVD risk. There is low correlation and disparate levels of population risk, predicted by different risk algorithms, within sites. Validating existing risk algorithms or designing context-specific 10-year CVD risk algorithms is essential for accurately defining population risk and targeting national policies and individual CVD treatment on the African continent.

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PHYSIOLOGY OF SUCCESSFUL AGING: IMPLICATIONS FOR HEALTH AND WELL-BEING

Innovation in Aging ◽

10.1093/geroni/igz038.1625 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S434-S434

Author(s):

Konstantinos Mantantzis ◽

Denis Gerstorf ◽

Thomas M Hess

Keyword(s):

Older Adults ◽

Successful Aging ◽

Well Being ◽

Empathic Accuracy ◽

Future Research ◽

Subjective Well Being ◽

Use Of Data ◽

Aging Study ◽

Underlying Mechanisms ◽

Relationship Factors

Abstract Research into peripheral physiology and its association with cognition, emotionality, and social/physical functioning has received considerable attention over the years. However, many of the underlying mechanisms are not well understood. In this symposium, we have compiled a set of four empirical projects that showcase current and future endeavors to address some of the long-standing questions about when, how, and why physiology shapes and is shaped by key psychosocial resources. Hawkley et al. make use of data from the NSHAP and HRS longitudinal studies to investigate whether social relationships such as number of friends predicts risk of diabetes among older adults. Wilson et al. use dyadic data from young and middle-aged couples to examine cardiometabolic similarity among spouses, and how such concordance is shaped by key relationship factors such as emotional closeness. Pauly et al. use data from two daily-life studies of older couples to investigate how physiological synchrony in cortisol is modulated by partner interactions, empathy, and empathic accuracy. Finally, Mantantzis et al. make use of multi-year longitudinal data from the Berlin Aging Study II to examine the role of glucose regulation capacity for trajectories of subjective well-being among older adults. Thomas Hess will discuss the importance of these papers, discuss strengths and weaknesses of the approaches chosen, and consider implications for future research.

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Sleep Deficiency and Deprivation Leading to Cardiovascular Disease

International Journal of Hypertension ◽

10.1155/2015/615681 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 22

Author(s):

Michelle Kohansieh ◽

Amgad N. Makaryus

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Well Being ◽

Underlying Mechanism ◽

Vital Role ◽

Quality Of Sleep ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Sleep Deficiency

Sleep plays a vital role in an individual’s mental, emotional, and physiological well-being. Not only does sleep deficiency lead to neurological and psychological disorders, but also the literature has explored the adverse effects of sleep deficiency on the cardiovascular system. Decreased quantity and quality of sleep have been linked to cardiovascular disease (CVD) risk factors, such as hypertension, obesity, diabetes, and dyslipidemia. We explore the literature correlating primary sleep deficiency and deprivation as a cause for cardiovascular disease and cite endothelial dysfunction as a common underlying mechanism.

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Cross-talk between renal lithogenesis and atherosclerosis: an unveiled link between kidney stone formation and cardiovascular diseases

Clinical Science ◽

10.1042/cs20171574 ◽

2018 ◽

Vol 132 (6) ◽

pp. 615-626 ◽

Cited By ~ 10

Author(s):

Asokan Devarajan

Keyword(s):

Risk Factors ◽

Uric Acid ◽

Cardiovascular Diseases ◽

Kidney Stone ◽

Arterial Wall ◽

Stone Formation ◽

Crystal Nucleation ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Kidney Stone Formation

The prevalence of kidney stones and cardiovascular diseases (CVDs) are increasing throughout the world. Both diseases are chronic and characterized by accumulation of oxidized proteins and lipids in the renal tissue and arterial wall, respectively. Emerging studies have revealed a positive association between nephrolithiasis and CVDs. Based on preclinical and clinical evidences, this review discusses: (i) stone forming risk factors, crystal nucleation, aggregation, injury-induced crystal retention, and stone formation, (ii) CVD risk factors such as dyslipidemia, perturbation of gut microbiome, obesity, free radical-induced lipoprotein oxidation, and retention in the arterial wall, subsequent foam cell formation, and atherosclerosis, (iii) mechanism by which stone forming risk factors such as oxalate, calcium, uric acid, and infection contribute toward CVDs, and (iv) how CVD risk factors, such as cholesterol, phospholipids, and uric acid, contribute to kidney stone formation are described.

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