Abstract 3614: Anticonceptive Drug Use And Increased Carotid and Femoral Plaque Prevalence: Population Data From Asklepios

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Ernst Rietzschel ◽  
Marc De Buyzere ◽  
Dirk De Baquer ◽  
Sofie Bekaert ◽  
Patrick Segers ◽  
...  
Keyword(s):  
Carotid Plaque ◽  
Population Sample ◽  
Population Data ◽  
Lipid Lowering ◽  
Femoral Arteries ◽  
Atherosclerotic Burden ◽  
Contraceptive Therapy ◽  
Cast Doubt ◽  
Apparently Healthy

Purpose: Combination therapy with the female hormones estrogen (E) and progestins are very frequently used with approximately 100 million women worldwide taking oral contraceptives (OC). Recent trials have cast doubt on the cardiovascular safety of hormonal replacement therapy (HRT). In contrast to the HRT-controversy, little attention has been focused on OC, a therapy using 10 –100 fold higher levels of E than HRT. We describe population correlates of long-term OC use. Methods: The Asklepios study is a representative sample (2524 M/F volunteers, 35–55 years) from the Belgian general population free from overt cardiovascular disease. Vascular echography of the carotid and femoral arteries was systematically performed and atherosclerosis was defined by presence of carotid or femoral plaque. Results: Of 1301 women (median age 45.7 y), 27.4% were taking OC and 10.0% were taking HRT. In contrast, past OC-use is far more prevalent: 81% of women having taken OC for at least 1 year, with a median exposition of 13 years. After multivariate adjustment for age, smoking, blood pressure, lipids, obesity, diabetes, physical activity, fruit, vegetable and alcohol intake, educational level and drug therapy (lipid-lowering, antihypertensive, aspirin), use of OC was associated with a significant increase in carotid or femoral unilateral plaque. Odds ratio’s (OR) per 10 years of OC exposure were: carotid plaque 1.17 (1.00 –1.33) and femoral plaque 1.28 (1.10 –1.47). We also looked at prevalence of bilateral disease (involvement of right and left carotid/femoral artery) as a more stringent phenotype of atherosclerosis. OR per 10 years OC exposure were: carotid plaque 1.42 (1.03–1.84); femoral plaque 1.34 (1.05–1.63). Interpretation : Use of contraceptive therapy is very common and associated with an unexpected increase in the prevalence of carotid and femoral atherosclerosis in otherwise young, apparently healthy women. Our data suggest a 20 –30% increased prevalence of plaque in the carotid and femoral arteries per 10 years of OC exposure. In the light of widespread (>80% of our population sample; > 100 million women globally) and usually prolonged OC use (>10 years) these results suggest OC use could be an important factor in the global atherosclerotic burden.

The effect of long-term aggressive lipid lowering on ischemic and atherosclerotic burden in patients with chronic kidney disease

2004 ◽  
Vol 43 (1) ◽  
pp. 45-52 ◽  
Author(s):  
Robert Fathi ◽  
Nicole Isbel ◽  
Leanne Short ◽  
Brian Haluska ◽  
David Johnson ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Lipid Lowering ◽  
Atherosclerotic Burden

scholarly journals Cardiovascular and musculoskeletal health disorders associate with greater decreases in physical capability in older women

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Juopperi Samuli ◽  
Sund Reijo ◽  
Rikkonen Toni ◽  
Kröger Heikki ◽  
Sirola Joonas
Keyword(s):  
Chronic Diseases ◽  
Musculoskeletal Disorders ◽  
Population Sample ◽  
The Elderly ◽  
Primary Objective ◽  
Baseline Body Mass Index ◽  
Functional Tests ◽  
Physical Capability ◽  
Study Population

Abstract Background Good physical capability is an important part of healthy biological ageing. Several factors influencing physical capability have previously been reported. Long-term reports on physical capability and the onset of clinical disorders and chronic diseases are lacking. Decrease in physical capacity has been shown to increase mortality. This study focuses on the prevalence of chronic diseases. The primary objective of the study was to reveal the association between physical capability and morbidity. Secondary objectives included the validity of self-reported physical capability and the association between baseline physical capability and mortality. Methods The OSTPRE (Kuopio Osteoporosis Risk Factor and Prevention Study) prospective cohort involved all women aged 47–56 years residing in the Kuopio Province, Finland in 1989. Follow-up questionnaires were mailed at five-year intervals. Physical capability questions were first presented in 1994. From these women, we included only completely physically capable subjects at our baseline, in 1994. Physical capability was evaluated with five scale self-reports at baseline and in 2014 as follows: completely physically capable, able to walk but not run, can walk up to 1000 m, can walk up to 100 m and temporarily severely incapable. The prevalences of selected chronic diseases, with a minimum prevalence of 10% in 2014, were compared with the change in self-reported physical capability. Additionally, associations between long-term mortality and baseline physical capability of the whole 1994 study population sample were examined with logistic regression. The correlation of self-reported physical capability with functional tests was studied cross-sectionally at the baseline for a random subsample. Results Our study population consisted of 6219 Finnish women with a mean baseline age of 57.0 years. Self-reported physical capability showed statistically significant correlation with functional tests. Cardiovascular diseases and musculoskeletal disorders show the greatest correlation with decrease of physical capability. Prevalence of hypertension increased from 48.7% in the full physical capability group to 74.5% in the “able to walk up to 100 metres” group (p < 0.001). Rheumatoid arthritis showed a similar increase from 2.1 to 7.4% between these groups. Higher baseline body mass index (BMI) decreases long-term capability (P < 0.001). Women reporting full physical capability at baseline had a mortality rate of 15.1%, in comparison to 48.5% in women within the “able to walk up to 100 m” group (p = 0.357). Mortality increased steadily with worsening baseline physical capability. Conclusions The results of this study show that chronic diseases, particularly cardiovascular and musculoskeletal disorders, correlate with faster degradation of physical capability in the elderly. Similar results are shown for increase in BMI. We also demonstrate that the risk of mortality over a 20-year period is higher in individuals with poor baseline physical capability.

scholarly journals Successful Implementation of Newborn Screening for Hemoglobin Disorders in the Philippines

2021 ◽  
Vol 7 (2) ◽  
pp. 30
Author(s):  
Carmencita D. Padilla ◽  
Bradford L. Therrell ◽  
Maria Melanie Liberty B. Alcausin ◽  
Reynaldo C. de Castro ◽  
Maria Beatriz P. Gepte ◽  
...  
Keyword(s):  
Newborn Screening ◽  
High Performance ◽  
Population Data ◽  
The Philippines ◽  
Successful Implementation ◽  
Clinical Experiences ◽  
Term Care ◽  
Confirmatory Testing ◽  
Newborn Bloodspot Screening

The Philippine newborn bloodspot screening (NBS) program began in 1996 with 24 hospitals and was formalized by legislation in 2004. The NBS panel was recently expanded to include a number of additional hereditary congenital conditions. Expertise and experiences from other NBS programs already screening for hemoglobinopathies were essential to its successful integration into the ongoing dried bloodspot NBS program in the Philippines. Building on clinical experiences and population data from Filipinos born in California, USA, hemoglobinopathies (including thalassemias) were selected for inclusion in the expanded screening panel. Hemoglobinopathy NBS, using high performance liquid chromatography, was implemented in a stepwise manner into the seven regional NBS screening laboratories. A central university laboratory provides confirmatory testing using both capillary electrophoresis and molecular methodologies. NBS results indicating carriers are followed up with educational fact sheets, while results of presumptive disease are referred for confirmatory testing and follow-up with a hematologist. Long-term care is provided through newborn screening continuity clinics across the country. Hemoglobinopathy NBS is now included in the national insurance package and screening uptake continues to increase nationally, exceeding 90% of all newborns in 7400+ hospitals and birthing centers nationwide prior to the COVID-19 pandemic.

scholarly journals Long-term effects of fine particulate matter exposure on the progression of arterial stiffness

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Dianqin Sun ◽  
Yue Liu ◽  
Jie Zhang ◽  
Jia Liu ◽  
Zhiyuan Wu ◽  
...  
Keyword(s):  
Arterial Stiffness ◽  
Health Management ◽  
Ankle Brachial Index ◽  
Population Data ◽  
Average Concentration ◽  
Air Pollutant ◽  
Stiffness Index ◽  
Long Term Effects ◽  
Annual Average

Abstract Background Prior studies have investigated the association of PM2.5 exposure with arterial stiffness measured by ankle-brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV), of which conclusions are inconsistent. Moreover, limited evidence is available on the contributory role of PM2.5 exposure on the arterial stiffness index. Methods We used the population data from the Beijing Health Management Cohort and conducted a longitudinal analysis. The annual average concentration of PM2.5 for 35 air pollutant monitoring sites in Beijing from 2014 to 2018 was used to estimate individual exposure by different interpolation methods. Multivariate logistic regression and linear regression were conducted to assess the association of annual average PM2.5 concentration with the incidence of higher baPWV, the progression of ABI, and baPWV, respectively. Results The association between PM2.5 exposure and incidence of higher baPWV was not significant (OR = 1.11, 95% CI: 0.82–1.50, P = 0.497). There was − 0.16% (95% CI: − 0.43-0.11%) decrease in ABI annually and 1.04% (95% CI: 0.72–1.37%) increase in baPWV annually with each increment of 10 μg/m3 average PM2.5 concentration. Conclusions Long-term exposure to PM2.5 was associated with the progression of arterial stiffness in Beijing. This study suggests that improvement of air quality may help to prevent arterial stiffness.

scholarly journals Modeling Linkage Disequilibrium and Identifying Recombination Hotspots Using Single-Nucleotide Polymorphism Data

Genetics ◽  
2003 ◽  
Vol 165 (4) ◽  
pp. 2213-2233 ◽  
Author(s):  
Na Li ◽  
Matthew Stephens
Keyword(s):  
Linkage Disequilibrium ◽  
Recombination Rate ◽  
Population Sample ◽  
Simulated Data ◽  
Region Of Interest ◽  
Population Data ◽  
Recombination Rates ◽  
Single Nucleotide ◽  
Recombination Hotspots ◽  
Genomic Regions

AbstractWe introduce a new statistical model for patterns of linkage disequilibrium (LD) among multiple SNPs in a population sample. The model overcomes limitations of existing approaches to understanding, summarizing, and interpreting LD by (i) relating patterns of LD directly to the underlying recombination process; (ii) considering all loci simultaneously, rather than pairwise; (iii) avoiding the assumption that LD necessarily has a “block-like” structure; and (iv) being computationally tractable for huge genomic regions (up to complete chromosomes). We examine in detail one natural application of the model: estimation of underlying recombination rates from population data. Using simulation, we show that in the case where recombination is assumed constant across the region of interest, recombination rate estimates based on our model are competitive with the very best of current available methods. More importantly, we demonstrate, on real and simulated data, the potential of the model to help identify and quantify fine-scale variation in recombination rate from population data. We also outline how the model could be useful in other contexts, such as in the development of more efficient haplotype-based methods for LD mapping.

scholarly journals Peripheral atherosclerosis and abdominal aortic aneurysm as a new risk factors of upper gastrointestinal bleeding in patients with stable CAD receiving long-term antithrombotic therapy

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
V Korobkova ◽  
AL Komarov ◽  
OO Shakhmatova ◽  
MV Andreevskaya ◽  
EB Yarovaya ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Antithrombotic Therapy ◽  
Upper Gastrointestinal Bleeding ◽  
Atherosclerotic Burden ◽  
Abdominal Aortic ◽  
Stable Cad ◽  
Upper Gastrointestinal

Abstract Funding Acknowledgements Type of funding sources: None. Background Upper gastrointestinal bleeding (UGIB) is the most common hemorrhagic complication in stable CAD patients receiving antithrombotic therapy. It seems that atherosclerotic burden may increase the overall bleeding frequency. However, this factor has never been taken into account with UGIB risk assessment. We aimed to assess the predictive value of atherosclerotic burden (peripheral atherosclerosis – PAD and abdominal aortic aneurysm - AAA) for UGIB in patients with stable CAD receiving long-term antithrombotic therapy. Patients and Methods. A single center prospective Registry of Long-term AnTithrombotic TherApy (REGATTA-1 NCT04347200) included 934 pts with stable CAD (78.6% males, median age 61 [IQR 53-68] yrs). 77,3 %  of patients received dual antiplatelet therapy due to recent PCI with a switch to aspirin monotherapy after 6 months. 17,6% of patients received aspirin only, 5,1 % of patients received oral anticoagulants because of concomitant atrial fibrillation. Risk assessment of UGIB was performed according to the 2015 European Society of Cardiology guidelines (we were not able to identify only Helicobacter pylori infection). Additional ultrasound screening for PAD (lower limbs and cerebrovascular beds) and AAA was applied. The primary outcome was any overt UGIB (BARC ≥2). Results  The frequency of PAD was 18,8%, AAA – 2,4%, PAD and/or AAA -  20,5%. In a total 2335 person-years of follow-up (median follow-up - 2,5 yrs, IQR 1,1 – 5.1), UGIB occurred in 51 patients (incidence at 1 year 1,9 per 100 patients).  The median time to first occurrence of UGIB was 72 [IQR 13-214] days. Comparing the Kaplan-Meyer curves, the UGIB developed three times more often in patients with coexisted PAD and/or AAA vs isolated CAD (19.8% vs 6.5%, Log-Rank p = 0.00006). The difference remains consisted in regression model taking in account 2015 ESC panel of UGIB risk factors (OR 3.4; CI 1.7–6.9, p = 0,0005). Conclusions Atherosclerotic burden (concomitant PAD and/or AAA) is an independent predictor of UGIB in patients with stable CAD receiving long-term antithrombotic therapy.

Sign in / Sign up

Export Citation Format

Share Document