scholarly journals Improved Landmark Dynamic Prediction Model to Assess Cardiovascular Disease Risk in On-Treatment Blood Pressure Patients: A Simulation Study and Post Hoc Analysis on SPRINT Data

2020 ◽  
Vol 2020 ◽  
pp. 1-16 ◽  
Author(s):  
Mehrab Sayadi ◽  
Najaf Zare ◽  
Armin Attar ◽  
Seyyed Mohammad Taghi Ayatollahi
Keyword(s):  
Blood Pressure ◽  
Parameter Estimation ◽  
Cardiovascular Risk ◽  
Prediction Model ◽  
Prediction Error ◽  
Dynamic Prediction ◽  
Proposed Model ◽  
Significant Difference ◽  
Over Time ◽  
Deviance Statistic

Landmark model (LM) is a dynamic prediction model that uses a longitudinal biomarker in time-to-event data to make prognosis prediction. This study was designed to improve this model and to apply it to assess the cardiovascular risk in on-treatment blood pressure patients. A frailty parameter was used in LM, landmark frailty model (LFM), to account the frailty of the patients and measure the correlation between different landmarks. The proposed model was compared with LM in different scenarios respecting data missing status, sample size (100, 200, and 400), landmarks (6, 12, 24, and 48), and failure percentage (30, 50, and 100%). Bias of parameter estimation and mean square error as well as deviance statistic between models were compared. Additionally, discrimination and calibration capability as the goodness of fit of the model were evaluated using dynamic concordance index (DCI), dynamic prediction error (DPE), and dynamic relative prediction error (DRPE). The proposed model was performed on blood pressure data, obtained from systolic blood pressure intervention trial (SPRINT), in order to calculate the cardiovascular risk. Dynpred, coxme, and coxphw packages in the R.3.4.3 software were used. It was proved that our proposed model, LFM, had a better performance than LM. Parameter estimation in LFM was closer to true values in comparison to that in LM. Deviance statistic showed that there was a statistically significant difference between the two models. In the landmark numbers 6, 12, and 24, the LFM had a higher DCI over time and the three landmarks showed better performance in discrimination. Both DPE and DRPE in LFM were lower in comparison to those in LM over time. It was indicated that LFM had better calibration in comparison to its peer. Moreover, real data showed that the structure of prognostic process was predicted better in LFM than in LM. Accordingly, it is recommended to use the LFM model for assessing cardiovascular risk due to its better performance.

scholarly journals Development of Macroscopic Cell-Based Logistic Lane Change Prediction Model

2021 ◽  
Vol 2021 ◽  
pp. 1-17
Author(s):  
Christina Ng ◽  
Susilawati Susilawati ◽  
Md Abdus Samad Kamal ◽  
Irene Mei Leng Chew
Keyword(s):  
Prediction Model ◽  
Transmission Model ◽  
Lane Change ◽  
Traffic Data ◽  
Cell Transmission Model ◽  
Traffic State ◽  
Proposed Model ◽  
Significant Difference ◽  
The Mean ◽  
Change Prediction

This paper aims at developing a macroscopic cell-based lane change prediction model in a complex urban environment and integrating it into cell transmission model (CTM) to improve the accuracy of macroscopic traffic state estimation. To achieve these objectives, first, based on the observed traffic data, the binary logistic lane change model is developed to formulate the lane change occurrence. Second, the binary logistic lane change is integrated into CTM by refining CTM formulations on how the vehicles in the cell are moving from one cell to another in a longitudinal manner and how cell occupancy is updated after lane change occurrences. The performance of the proposed model is evaluated by comparing the simulated cell occupancy of the proposed model with cell occupancy of US-101 next generation simulation (NGSIM) data. The results indicated no significant difference between the mean of the cell occupancies of the proposed model and the mean of cell occupancies of actual data with a root-mean-square-error (RMSE) of 0.04. Similar results are found when the proposed model was further tested with I80 highway data. It is suggested that the mean of cell occupancies of I80 highway data was not different from the mean of cell occupancies of the proposed model with 0.074 RMSE (0.3 on average).

scholarly journals C REACTIVE PROTEIN AND CARDIOVASCULAR RISK IN CASES WITH DIABETES MALLITUS TYPE II

2013 ◽  
Vol 3 (2) ◽  
pp. 10-15
Author(s):  
Munevera Bećarević ◽  
◽  
Duška Bećirović ◽  
Azijada Beganlić ◽  
Olivera Batić-Mujanović ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Blood Cholesterol ◽  
Cardiovascular Risks ◽  
C Reactive Protein ◽  
Score System ◽  
Reactive Protein ◽  
Significant Difference ◽  
High Level

Introduction: Factors of cardiovascular risk (CVR) are often grouped in cases with diabetes mellitus (DM) with significant increasment of risk for CV disease . The aim of this research is to determine the frequency of CVR and and total CVR in cases with DM and to investigate connection of CRP of other factors of CVR in total cardiovascular risks. Material and methods: In 92 cases with DM weist values were taken as well as body mass index (BMI), blood pressure, sugar in blood, cholesterol, triglycerides, C reactive protein (CRP) and according to SCORE system the 10 year period of CVR were determined. Results: Out of 92 tested cases with age 55,22± 8,3 years, 63,05% were males and 36,95% were women, 81,5% were with values of sugar in blood >7mmol/l, 44,6% were with values of HbA1C>7% and 63,0% >6,5%. The value of cholesterol were >4,5mmol/l in 87%, triglycerides >1,7mmol/l in 78.3% of tested cases. 81,5% of tested cases were overweight and 49% with larger weight values. Average cardiovascular factor according to SCORE system was 3, 92± 3,7% with significant difference among sexes (M-4,86; W-2,32, p<o,05). According to height value CRP (>3mg/l) 52% of tested cases were with high cardiovascular risk. There is significant positive correlation between CRP and cholesterol level (p<0, 01), triglycerides, blood in sugar, HbA1c and upper values of blood pressure (p<0, 05). Significant correlation between CRP and total cardiovascular risk (p=0, 63) was not evident. Conclusion: Cases with diabetes mellitus have high level of non regulated cardiovascular risk factors. Even though there is significant correlation between CRP and and pressure values, sugar in blood, HbA1c, cholesterol, triglycerides, significant correlation between CRP and total cardiovascular risk in cases with diabetes mellitus is not evident.

scholarly journals Risk factors for the occurrence of cardovascular system diseases in students

2009 ◽  
Vol 66 (6) ◽  
pp. 453-458 ◽  
Author(s):  
Dusica Stojanovic ◽  
Aleksandar Visnjic ◽  
Vladimir Mitrovic ◽  
Miodrag Stojanovic
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Alcohol Consumption ◽  
Cardiovascular Risk Factors ◽  
Diastolic Blood Pressure ◽  
Female Students ◽  
Female Population ◽  
Waist Size ◽  
Significant Difference

Background/Aim. Cardiovascular diseases are a leading cause of death in the majority of developed, as well as in many developing countries. The aim of this study was to determine cardiovascular risk factors in student population and to suggest possible measures for prevention. Methods. The study was carried out during 2007-2008 at the School of Medicine, University of Nis. It included 824 students in their final year (220 males, 604 females). Results. There was no significant difference in prevalence of hypertension among the male (1.81%) and female students (0%). The prevalence of obesity (Body Mass Index - BMI > 30 kg/m2) was significantly higher (p < 0.001) in the male (7.27%) than in the female population (1.32%). Abdominal obesity was also more frequently encountered (p < 0.01) in the male (9.09%) than in female population (1.32%). Every fourth student smoked cigarettes with no significant difference between the male and female students. Alcohol consumption was a significantly higher problem (p < 0.001) in the male population (18.18%) than in the female one (2.65%). Physical inactivity was more often found (p < 0.001) in the female students (65.56%), than in male ones (36.36%). By the bivariate correlation of cardiovascular risk factors, it was determined that in the male student population systolic blood pressure correlated significantly with diastolic blood pressure, BMI and waist size, whereas age correlated with sistolic blood pressure, waist size and smoking. In the female students sistolic blood pressure correlated with diastolic blood pressure, BMI and waist size; diastolic blood pressure correlated with BMI and physical inactivity; cigarette smoking correlated with alcohol consumption and age. Conclusion. Cardiovascular risk factors are present in the final-year students of the School of Medicine, University of Nis. It is necessary to insist on decreasing obesity prevalence, cigarette and alcohol consumption, and on increasing physical activity of students in order to prevent cardiovascular diseases.

scholarly journals Impact of change over time in self-reported discrimination on blood pressure: implications for inequities in cardiovascular risk for a multi-racial urban community

2018 ◽  
Vol 25 (3) ◽  
pp. 323-341 ◽  
Author(s):  
Alana M.W. LeBrón ◽  
Amy J. Schulz ◽  
Graciela Mentz ◽  
Angela G. Reyes ◽  
Cindy Gamboa ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Urban Community ◽  
Change Over Time ◽  
Over Time

scholarly journals A Pilot Study: Hypertension, Endothelial Dysfunction and Retinal Microvasculature in Rheumatic Autoimmune Diseases

2021 ◽  
Vol 10 (18) ◽  
pp. 4067
Author(s):  
Ahmed Mahdy ◽  
Martin Stradner ◽  
Andreas Roessler ◽  
Bianca Brix ◽  
Angelika Lackner ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Cardiovascular Diseases ◽  
Endothelial Dysfunction ◽  
Autoimmune Diseases ◽  
Rheumatic Diseases ◽  
Control Group ◽  
Autoimmune Rheumatic Diseases ◽  
Retinal Microvasculature ◽  
Significant Difference

Background: The etiology of autoimmune rheumatic diseases is unknown. Endothelial dysfunction and premature atherosclerosis are commonly seen in these patients. Atherosclerosis is considered one of the main causes of cardiovascular diseases. Hypertension is considered the most important traditional cardiovascular risk. This case-control study aimed to investigate the relationship between autoimmune diseases and cardiovascular risk. Methods: This study was carried out in patients with rheumatoid arthritis, RA (n = 10), primary Sjögren syndrome, PSS (n = 10), and healthy controls (n = 10). Mean blood pressure (MBP), systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse wave velocity (PWV, an indicator of arterial stiffness) were assessed via a Vicorder device. Asymmetric dimethylarginine (ADMA) was measured via ELISA. Retinal photos were taken via a CR-2 retinal camera, and retinal microvasculature analysis was carried out. T-tests were conducted to compare the disease and control groups. ANOVA and ANOVA—ANCOVA were also used for the correction of covariates. Results: A high prevalence of hypertension was seen in RA (80% of cases) and PSS (40% of cases) compared to controls (only 20% of cases). Significant changes were seen in MBP (RA 101 ± 11 mmHg; PSS 93 ± 10 mm Hg vs. controls 88 ± 7 mmHg, p = 0.010), SBP (148 ± 16 mmHg in RA vs. 135 ± 16 mmHg in PSS vs. 128 ± 11 mmHg in control group; p = 0.007), DBP (77 ± 8 mmHg in RA, 72 ± 8 mmHg in PSS vs. 67 ± 6 mmHg in control; p = 0.010 in RA compared to the controls). Patients with PSS showed no significant difference as compared to controls (MBP: p = 0.240, SBP: p = 0.340, DBP: p = 0.190). Increased plasma ADMA was seen in RA (0.45 ± 0.069 ng/mL) and PSS (0.43 ± 0.060 ng/mL) patients as compared to controls (0.38 ± 0.059 ng/mL). ADMA in RA vs. control was statistically significant (p = 0.022). However, no differences were seen in ADMA in PSS vs. controls. PWV and retinal microvasculature did not differ across the three groups. Conclusions: The prevalence of hypertension in our cohort was very high. Similarly, signs of endothelial dysfunction were seen in autoimmune rheumatic diseases. As hypertension and endothelial dysfunction are important contributing risk factors for cardiovascular diseases, the association of hypertension and endothelial dysfunction should be monitored closely in autoimmune diseases.

scholarly journals Cardiovascular Risk Factors in Adult Javanese Patients with Hemophilia A

2021 ◽  
Author(s):  
Faizal Muhammad
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Uric Acid ◽  
Cardiovascular Risk ◽  
Total Cholesterol ◽  
Cardiovascular Risk Factors ◽  
Diastolic Blood Pressure ◽  
Hemophilia A ◽  
Mean Values ◽  
Significant Difference

Hemophilia usually presents as bleeding after minor trauma or as a spontaneous bleed due its hypocoagulable state. Hemophilia A represents 80-85% of the total hemophilia population with a prevalence of 1:10,000. Cardiovascular risk factors were common in the general population compared with hemophilia patients. This study aims to identify cardiovascular risk factors in adult Javanese patients with hemophilia A and their relationship with hemophilia severity. This cross-sectional study involved registered Javanese race male patients at Dr. Moewardi General Hospital from November 2019 - April 2020. There are 76 hemophilia A patients, after excluding patients with other comorbidities, non-Javanese race and age &gt;18 years old, 33 appropriate patients were then randomized. The study group consists of 30 patients with hemophilia A and 30 non-hemophilia patients. Data were collected once during patient visits to the hospital polyclinic. The collected data were body mass index (BMI), blood pressure, fasting blood sugar (FBS), total cholesterol, and uric acid. They were analyzed using the Spearman rank test. Median values of BMI scores were 20.82 (13.67-41.52) kg/m² for hemophilia A group and 24.67 (9.38-53.32) kg/m² for the control group (p &lt; 0.05). Further, median values of diastolic blood pressure, the median of FBS, and mean values of the uric acid level also showed a significant difference (p &lt; 0.05). Otherwise, the mean values of systolic blood pressure and median values of total cholesterol showed no significant difference. The BMI score, diastolic blood pressure, fasting blood sugar, and uric acid appear to be significant cardiovascular risk factor profiles in Javanese adult patients with hemophilia A. Hence, there must be a consideration, screening, and treatment for the cardiovascular risk factors in hemophilia A patients. Although the other studies are not sufficient to show recommended therapeutic targets and the results of reducing cardiovascular risk factors in hemophilia patients.

Cardiovascular risk factor control among cancer survivors: A population-based survey

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 6535-6535
Author(s):  
K. Enright ◽  
M. Krzyzanowska
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Cancer Survivors ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Cardiac Risk ◽  
Cardiac Risk Factors ◽  
Significant Difference

6535 Background: Cardiovascular disease is a major cause of morbidity and mortality in long-term survivors of cancer. Whereas the burden of cardiovascular disease has been described in cancer survivors, the control of modifiable cardiovascular risk factors in this population is unknown. Methods: We used the National Health and Nutrition Examination Survey (NHANES 1999–2006) data to examine the rate of control of modifiable cardiac risk factors amongst US cancer survivors compared with propensity matched adult controls with no history of cancer. The modifiable cardiac risk factors (blood pressure, cholesterol, BMI, exercise, smoking) were considered to be controlled if they met the AHA/ACC guideline recommendations. Results: A total of 1,227 cancer survivors and 3,672 age, sex, and comorbidity matched controls were identified, representing 11.9 million cancer survivors and 31.2 million controls. Compared to age, sex and comorbidity matched controls cancer survivors were more likely to be current smokers (34.5% vs. 28.8%, p = 0.021), and more likely to have their BMI at target (32.8% vs. 28.6%, p = 0.034). There was no significant difference in the rate of blood pressure control (69.4% vs. 69.2%, p = 0.88), cholesterol control (47.6% vs. 48.2%, p = 0.80) or adherence to exercise recommendations (24.4% vs. 24.6%, p = 0.89). Younger cancer survivors (age 20–40 y) were 2.8 times more likely to be smokers than controls, whereas older cancer survivors (age 60–80y) were 1.2 times more likely to be smokers than controls. Compared with recent cancer survivors (10 years from diagnosis) were more likely to have optimal blood pressure control (73.3% vs. 65.5%, p = 0.02), however there was no difference in smoking rates, cholesterol, exercise or weight control with duration of cancer survival. Conclusions: Overall the control of modifiable cardiac risk factors was similar between survivors and controls, but was suboptimal in both groups. This study identified smoking cessation, particularly amongst young cancers survivors, as an important area of focus for improvement in survivorship care. No significant financial relationships to disclose.

scholarly journals Dynamic prediction of childhood high blood pressure in a population-based birth cohort: a model development study

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e023912 ◽  
Author(s):  
Marleen Hamoen ◽  
Yvonne Vergouwe ◽  
Alet H Wijga ◽  
Martijn W Heymans ◽  
Vincent W V Jaddoe ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Prediction Model ◽  
High Blood Pressure ◽  
Characteristic Curve ◽  
Model Development ◽  
Population Based ◽  
The Body ◽  
Dynamic Prediction ◽  
Internal Validation ◽  
Primordial Prevention

ObjectivesTo develop a dynamic prediction model for high blood pressure at the age of 9–10 years that could be applied at any age between birth and the age of 6 years in community-based child healthcare.Design, setting and participantsData were used from 5359 children in a population-based prospective cohort study in Rotterdam, the Netherlands.Outcome measureHigh blood pressure was defined as systolic and/or diastolic blood pressure ≥95th percentile for gender, age and height. Using multivariable pooled logistic regression, the predictive value of characteristics at birth, and of longitudinal information on the body mass index (BMI) of the child until the age of 6 years, was assessed. Internal validation was performed using bootstrapping.Results227 children (4.2%) had high blood pressure at the age of 9–10 years. Final predictors were maternal hypertensive disease during pregnancy, maternal educational level, maternal prepregnancy BMI, child ethnicity, birth weight SD score (SDS) and the most recent BMI SDS. After internal validation, the area under the receiver operating characteristic curve ranged from 0.65 (prediction at age 3 years) to 0.73 (prediction at age 5–6 years).ConclusionsThis prediction model may help to monitor the risk of developing high blood pressure in childhood which may allow for early targeted primordial prevention of cardiovascular disease.

scholarly journals Differences of Cardiovascular Risk-based on Atherogenic Index Plasma Dan Framingham Risk Score in Postpartum with Preeclampsia and Normotensive

2020 ◽  
Vol 8 (B) ◽  
pp. 389-394
Author(s):  
Cinthya Ayu Meritha Siregar ◽  
Makmur Sitepu ◽  
M. Rhiza Z Tala ◽  
Johny Marpaung ◽  
Henry Salim Siregar ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Diastolic Blood Pressure ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Atherogenic Index ◽  
Control Group ◽  
Framingham Risk ◽  
Significant Difference

BACKGROUND: Cardiovascular disease is the number one cause of death in women worldwide. Preeclampsia may be more than just risk factor for the development of cardiovascular disease later in life. Systematic reviews suggested approximately double the risk of ischemic heart disease, cerebrovascular incidents, and mortality of cardiovascular disease after preeclampsia. AIM: The aim of the study was to analyze the differences of cardiovascular risk later in life-based on atherogenic index plasma and Framingham risk score (FRS) in postpartum women with preeclampsia compared with normotensive women. METHODS: This is study a comparative analytic study with case–control design on 46 subjects, divided by 23 postpartum preeclampsia patients as a case sample subject and 23 postpartum with no history of hypertension as the control group. Subjects were examined for blood pressure, height, weight, and asked to fast for at least 8 h before blood lipid profile and glucose were examined with laboratory methods. Atherogenic index plasma and FRS were measured. Data were analyzed using SPSS version 25. p < 0.05 was considered significant. RESULTS: Based on the results, the study found significant differences between systolic and diastolic blood pressure in preeclampsia compared to the control group. Median systolic and diastolic blood pressure in the preeclampsia group compared to control group were 180 versus 110 in systolic blood pressure; 100 versus 80 in diastolic blood pressure with p < 0.000. Total cholesterol, low-density lipid, high-density lipoprotein, and triglycerides levels in preeclampsia were 218.38 ± 23.26 mg/dL, 128.60 ± 22.74 mg/dL, 38.60 ± 5.99 mg/dL, and 252.73 ± 47.16 mg/dL, respectively, with p < 0.05 and non-preeclampsia group were 143.0 ± 16.82 mg/dL, 69.17 ± 23.03 mg/dL, 51.73 ± 8.65 mg/dL, and 121.30 ± 14.65 mg/dL, respectively, with p < 0.05. Differences in plasma atherogenic index values can clearly be observed in the preeclampsia and control groups (p < 0.05). A similar interpretation was found in the FRS (p < 0.05). There was a significant positive correlation between age and body mass index with atherogenic index plasma and FRS in preeclamptic group. CONCLUSION: There was a significant difference in atherogenic index plasma and Framingham risk score of postpartum preeclampsia and normotensive women.

Effects of Ampicillin/Sulbactam and Enrofloxacin on the Blood Pressure of Isoflurane Anesthetized Dogs

2013 ◽  
Vol 49 (5) ◽  
pp. 293-300 ◽  
Author(s):  
Jeremiah D. Moorer ◽  
Heather A. Towle-Millard ◽  
Marjorie E. Gross ◽  
Mark E. Payton
Keyword(s):  
Blood Pressure ◽  
Control Group ◽  
Control Groups ◽  
Significant Difference ◽  
Anesthetized Dogs ◽  
Healthy Dogs ◽  
End Tidal ◽  
End Tidal Co2 ◽  
Randomized Crossover Study ◽  
Over Time

A blinded, prospective, randomized crossover study was performed to determine the effects of ampicillin Na/sulbactam Na and enrofloxacin on the blood pressure (BP) of healthy anesthetized dogs. Eight dogs were anesthetized three different times. They randomly received enrofloxacin, ampicillin Na/sulbactam Na, and saline. Systolic, diastolic, and mean arterial BPs (SAP, DAP, and MAP, respectively), heart rate (HR), O2 saturation of hemoglobin, end-tidal CO2 (ETCO2) concentration, inspired isoflurane concentration, end-tidal isoflurane (ETiso) concentration, respiratory rate, electrocardiogram, and body temperature were measured for 20 min prior to administration of treatment, during administration over 30 min, and for 30 min after administration. There was no significant difference in the SAP or ETiso. There was no significant change in the arterial pressure values over time in the enrofloxacin and ampicillin Na/sulbactam Na groups. The control group’s MAP increased over time and was increased compared with the enrofloxacin group at times 25, 35, 45, and 55. The statistical difference between the enrofloxacin and the control groups was due to an increase in the MAP in the control group, not a decrease in the enrofloxacin group’s BP. Neither enrofloxacin nor ampicillin Na/sulbactam Na caused hypotension in healthy dogs anesthetized with isoflurane and fentanyl.

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