Abstract 3649: Menstrual Cycling and Mechanisms of Cardiovascular Disease Events in Post-Menopausal Women: Results from the NIH-NHLBI-Sponsored Women’s Ischemia Syndrome Evaluation (WISE)

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
B. Delia Johnson ◽  
C. Noel Bairey Merz ◽  
Ricardo Azziz ◽  
Glenn D Braunstein ◽  
Leslee J Shaw ◽  
...  

Background: Menstrual cycling irregularity is being associated with greater frequency of diabetes and adverse cardiovascular (CV) events, suggesting a mechanistic link between ovarian dysfunction, CAD risk factors, and CAD. Confirmation of this link and potential explanatory mechanism(s) have not been established. Methods: We compared 686 postmenopausal women with and without a history of irregular cycles who were undergoing coronary angiography for suspected ischemia and enrolled in the WISE study. Coronary angiography was assessed by a core laboratory, and the women were prospectively followed for a median of 5.9 years. Chi square and rank sums analyses were used to compare the women on the presence and severity of CAD, CAD risk factors, and CV events. Multivariate Cox regression, adjusting for angiographic CAD and CAD risk factors was used to define time to death, MI, stroke, and angina hospitalization. Results: Overall mean age was 62, 18% were non-white, 130 (19%) reported a history of irregular cycles, and 42% had CAD (≥ 50% stenosis). Women with irregular cycles were younger (p=0.01) but did not exhibit more diabetes, obesity, or metabolic syndrome than those with regular cycles. They became menopausal at a younger age (42 ±10 vs 46 ±8, p=0.001) and had more frequent hysterectomy or oophorectomy (both p<0.01). Women with irregular cycles had a similar adjusted prevalence and severity of angiographic CAD compared to those without irregular cycles, yet had a doubled risk for MI (6% vs. 3%, p=0.02) and higher angina hospitalization rate (34% vs. 28%, p=0.01). No differences were found for the incidence of stroke or death. The relationship was maintained in risk-adjusted models controlling for metabolic syndrome, ethnicity and angiographic CAD severity (p=0.01 for MI and p=0.01 for angina hospitalization). Conclusion: Although less commonly applied, a history of menstrual cycling irregularity may be an important clinical marker of downstream risk, which is not immediately explained by the presence or severity of CAD risk factors or angiographic CAD. Additional, non-CAD risk factors, such as hormonal, inflammatory and thrombotic variables, may play a role mechanistically in the link between menstrual irregularity and adverse events.

2021 ◽  
Vol 8 (4) ◽  
pp. 12-17
Author(s):  
Basavaraj PG ◽  
Ashok P Yenkanchi ◽  
Chidanand Galagali

Background: Risk factors can lead to clinical conditions, like metabolic syndrome, that predisposes the development of cardiovascular diseases. Objective: The goal of this population-based, prospective and non-randomised cohort study was to study the association between patients with metabolic syndrome and other various factors defining metabolic syndrome. Methods: All the patients referred to the department of Medicine, Al-Ameen Medical college hospital and District Hospital, Vijayapur, Karnataka, India over a period of twenty-two months extending from December 2013 to September 2015 were considered in this study. Results: In the current study, out of 100 patients, 62.9% patients had metabolic syndrome with positive family history of hypertension, diabetes mellitus. 70.8% patients had metabolic syndrome with positive history of smoking. 64.3% patients had metabolic syndrome with positive history of alcohol .73.9% patients had metabolic syndrome with positive history of IHD. 87% of the patients with metabolic syndrome had SBP> 130 mmHg, and 78.85% patients had DBP>85 mmHg. And metabolic syndrome was observed in 71.8% patients on anti hypertensive drugs. The mean level of total cholesterol, LDL cholesterol, triglyceride is increased whereas the mean level of anti-atherogenic HDL cholesterol is low in subjects with MS. At least one lipid abnormality was present in > 95 % of cases. Around 81% subjects with BMI <25 (out of 38) had metabolic syndrome and 58% subjects with BMI>25(out of 62) had metabolic syndrome. Conclusion: All the components defining the metabolic syndrome correlated positively with the abdominal obesity. Systolic blood pressure values were significantly higher than diastolic blood pressure in subjects with abdominal obesity. Metabolic syndrome has multiple risk factors determined by various aspects like the race, the life style, geographical factors larger study is needed to understand the correlation between various components defining it. A healthy lifestyle, that includes avoiding tobacco exposure and proper weight control, must be encouraged in this high-risk population. Keywords: Cardiovascular diseases; Overweight; Risk factors; Smoking.


2015 ◽  
Vol 14 (3) ◽  
pp. 258-264 ◽  
Author(s):  
Vaishali R Mohite ◽  
Asha K Pratinidhi ◽  
Rajsinh Vishwasrao Mohite

Background: Breast cancer is the most common type of cancer in women and is influenced by reproductive factors perceived by women worldwide.Aims: To identify the reproductive risk factors of breast cancer in newly diagnosed cases and to find out the strength of association of the risk factors with the breast cancer. Material and Methods: A hospital based case-control study was conducted in Satara district, India during year 2009 to 2011 among newly diagnosed cases of breast cancer and matched controls. A total of 434 participants including 217 cases and 217 controls were enrolled by purposive sampling technique from selected hospitals of study area. The information was collected by employing pre-tested questionnaire by utilizing interview method. Statistical Analysis used: Descriptive statistics, Odds ratio and Chi-square test was used to find out strength of association and statistical significant difference. Results: Highest proportion [31.80%] breast cancer cases was in age group 40-49 years with lowest age of 25 years at diagnosis of the disease. A very high proportion of both cases [88.02%] and controls [67.28%] were Hindu by religion and were from rural residence. Maximum proportion of breast cancer cases were housewives [63.59%], literate [71.42%] and from upper economic class [56.68%]. The proportions of cases were higher as compared to the controls with respect to risk factors like unmarried status, nulliparity, history of abortion, post menopausal status, absence of breast feeding and the history of exposure to hormonal contraceptives. The risk of getting breast cancer as indicated by Odds ratio was 8 times higher in unmarried women, 2.8 times in nulliparous women, 2.4 times with post menopausal status, 10.4 times with absence of breast feeding, 1.5 times with exposure to hormonal contraceptives and 4.5 times with history of ovarian disease respectively. Conclusion: The reproductive risk factors such as unmarried status of women, nulliparity, menopause, absence of breast feeding, history of ovarian disease and use of contraceptives were strongly associated with breast cancer.Bangladesh Journal of Medical Science Vol.14(3) 2015 p.258-264


2020 ◽  
Vol 27 (05) ◽  
pp. 891-894
Author(s):  
Shahid Ishaq ◽  
Ejaz Mazari ◽  
Fazal ur Rehman

Objectives: Febrile seizures (FS) are the most common type of seizures and typically transpire in children with ages from 6 to 60 months. This study was planned to find out major clinical risk factors for seizures in febrile children who were aged 6 to 60 months. A total of 100 febrile children aged 6 to 60. Study Design: Analytical Study. Setting: Department of Neurology, Children’s Hospital and the Institute of Child Health, Multan. Period: From 1st April 2018 to 31st December 2018. Material & Methods: Group A had 40 children with febrile seizures while group B had 60 febrile children but without seizures. Demographic features along with family history of (H/O) epilepsy as well as family history of febrile seizure, types of seizure and infection diseases were noted and analyzed using SPSS version 20. Odds ratio was calculated for various risk factors. Chi square test was applied and P value < 0.05 was considered as significant. Results: Out of a total of 100 children, there were 54 (54.0%) male and 46 (46.0%) female. There was no statistical difference in terms of gender between the two groups (p value = 0.566). Overall, mean age of the children was 26.02 months with standard deviation of 13.4 months. There were 28 (70.0%) children who reported with simple seizures while complex seizures were found in 12 (30.0%) cases. Statistically significant difference (p value = 0.001) was seen in terms of types of infections between the two study groups. When risk of seizures for various risk factors was calculated, family H/O FS, family H/O epilepsy, and upper RTI were as 14, 7 and 3 times respectively and turned out to be the major risk factors for seizures in febrile children. Conclusions: Family H/O FS, family H/O epilepsy and upper RTIs are the major risk factors related with seizures in febrile children. Measures to prevent these risk factors can decrease the burden of FS in our population.


2020 ◽  
Vol 16 (19) ◽  
pp. 1359-1370
Author(s):  
Wei-xiang Qi ◽  
Shengguang Zhao ◽  
Jiayi Chen

Aim: To evaluate the incidence and risk of cardiac toxicities associated with panitumumab in advanced cancer of Caucasian patients. Materials & methods: The incidence of cardiac toxicity was assessed by simple incidence rates and rates per 100 person-years. Univariate and multivariate Cox regression was conducted. Results: Panitumumab-containing therapy significantly increased the risk of developing cardiac arrhythmias (p = 0.036), but not for any cardiac event (p = 0.24) or ischemic event (p = 0.087). The absolute rate of developing cardiac arrhythmia was 10.0 events versus 7.5 events per 100 person-years. Pre-existing hypertension (p = 0.033), history of cardiac disease (p = 0.055) or panitumumab usage (p = 0.046) were risk factors for cardiac arrhythmias. Conclusion: The addition of panitumumab to chemotherapy increases the risk of developing cardiac arrhythmia, but not for any cardiac toxicity or ischemic events.


2019 ◽  
Vol 34 (5) ◽  
pp. 765-765
Author(s):  
K Emami ◽  
A M Sufrinko ◽  
M W Collins ◽  
A P Kontos ◽  
E A Rossi

Abstract Purpose To determine if clinical risk factors (e.g., migraine history, motion sickness, concussion history) place an individual at risk for specific clinical profiles (e.g., posttraumatic migraine, vestibular) designated by a clinician following concussion. Methods Fifty (22M; 28F) symptomatic, concussed patients (17.02±3.14 years old) were evaluated within 21days post-injury. Demographics and medical history were obtained, including history of migraine, motion sickness, ADHD, learning disability (LD), oculomotor disorder, psychiatric diagnoses, and prior concussion. The presence of each clinical profile was determined by a clinician, based on synthesis of evaluation findings, including neurocognitive testing, symptom report, and vestibular/oculomotor screening results. Chi-square analyses were used to explore associations between risk factors and clinical profile post-injury. Results Chi-square analyses found that female sex was associated with increased odds (OR=5.25,95% CI[1.55, 17.77]) of vestibular clinical profile, X2(1, n=50)=7.55, p=.006. History of concussion was associated with increased odds (OR=7.10,95%CI[1.39,35.87]) of the PTM profile (X2[1, n=50]=6.56, p=.01) and increased odds (OR=9.85,95%CI[1.00,96.67]) of anxiety/mood profile (X2 1, n=50]=5.24, p=.022. Further, history of motion sickness was associated with increased odds OR=10.2,95%CI[1.2,86.69] of the PTM profile (X2[1, n=50]=6.11, p=.013). No other relationships were found. Conclusion Some clinical risk factors were associated with post-injury clinical profiles consistent with prior literature, while others were not. For example, females were more likely to have a vestibular profile. While motion sickness was associated with PTM, history of migraine was not. Concussion history, which has inconsistent findings for re-injury outcomes, was associated with increased likelihood of PTM and anxiety/mood profiles. Findings add to the literature supporting relationships among risk factors and clinical outcomes.


2018 ◽  
Vol 58 (4) ◽  
pp. 180-5
Author(s):  
Putu Diah Vedaswari ◽  
Ketut Dewi Kumara Wati ◽  
I Gusti Lanang Sidiartha ◽  
I Gusti Ayu Putu Eka Pratiwi ◽  
Hendra Santoso ◽  
...  

Background Highly active antiretroviral therapy (HAART) has been reported to improve growth, especially in the first 2 years of treatment. It is not clear whether catch up growth is maintained after 2 years of HAART. Objective To assess growth in stunted children with HIV after 3 years of HAART and analyze possible risk factors for non-reversal of stunting. Methods This study was done from May 2016 to April 2017 to follow children with HIV who started HAART between January 2009 and April 2014, and continued for 3 years. Inclusion criteria were children with HIV, aged < 18 years, compliance to the regimen, and stunting. Exclusion criteria were patients lost to follow up or who died prior to 3 years of HAART. Non-reversal of stunting was defined as HAZ ≤ -2SD after 3 years of HAART. Possible risk factors for non-reversal were analyzed using Chi-square test with P<0.05, as well as risk ratio (RR) and 95% confidence intervals (CI). Results Of 150 HIV-infected pediatric patients, 115 were on HAART and 55 (47.8%) were stunted at HAART initiation. Of the 55 stunted and HAART-treated children, 31 (56.4%) were male. Baseline median age was 3.6 years (interquartile range 0.37-8.48). Non-reversal occurred in 32 (58.2%) subjects. Multivariate Cox regression model analysis showed predictors of non-reversal after 3 years of HAART to be age >2 years (RR 16.05; 95%CI 2.89 to 89.02; P=0.002) and HIV stage III-IV (RR 8.93; 95%CI 1.47 to 54.37; P=0.017). Conclusion HAART initiation at age >2 years and HIV clinical stage III-IV at diagnosis are risk factors for non-reversal of stunting after 3 years of HAART.


2005 ◽  
Vol 90 (12) ◽  
pp. 6418-6423 ◽  
Author(s):  
Peter C. Y. Tong ◽  
Chung-Shun Ho ◽  
Vincent T. F. Yeung ◽  
Maggie C. Y. Ng ◽  
Wing-Yee So ◽  
...  

Context: Age-related declines in testosterone and IGF-I are associated with deposition of visceral fat, a component of the metabolic syndrome (MES). Objective: Testosterone and IGF-I may interact with familial disposition to diabetes mellitus to increase the association with MES. Design: We conducted a cross-sectional cohort study. Setting: The study was conducted in a university teaching hospital. Subjects: Study subjects included 179 middle-aged men with a family history of diabetes (FH) (aged 39.1 ± 8.1 yr) and 128 men without FH (aged 43.8 ± 8.5 yr). Main Outcome Measures: Clinical characteristics, frequency of MES using the World Health Organization criteria with Asian definitions of obesity (body mass index ≥ 25 kg/m2), and serum levels of total testosterone, IGF-I, and high-sensitive C-reactive protein (hs-CRP) were measured. Results: Men with FH had higher frequency of MES than those without FH [39.1 vs. 23.4% (P = 0.004)]. On multivariate analysis, smoking (former and current smokers), low total testosterone, and IGF-I but elevated hs-CRP levels explained 35% of the MES variance in men with FH. The frequency of MES increased with declining tertiles of total testosterone and IGF-I but increasing tertiles of hs-CRP. After adjustment for age and smoking history, subjects with all three risk factors had a 13-fold increase in risk association with MES compared with those without hormonal and inflammatory risk factors. These risk associations were not found in men without FH in whom only smoking (ex and current) and low total testosterone level were independent predictors for MES, which explained 14% of the variance. Conclusions: Clustering of FH, hormonal abnormalities, and high hs-CRP is associated with MES in Chinese middle-aged men.


2017 ◽  
Vol 56 (4) ◽  
pp. 196-202 ◽  
Author(s):  
Luka Vitez ◽  
Petra Zupet ◽  
Vesna Zadnik ◽  
Matej Drobnič

Abstract Introduction The aim of our study was to determine the self-reported incidence and prevalence of running-related injuries among participants of the 18th Ljubljana Marathon, and to identify risk factors for their occurrence. Methods A customized questionnaire was distributed over registration. Independent samples of t-test and chi-square test were used to calculate the differences in risk factors occurrence in the injured and non-injured group. Factors which appeared significantly more frequently in the injured group were included further into multiple logistic regression analysis. Results The reported lifetime running injury (absence >2 weeks) incidence was: 46% none, 47% rarely, 4% occasionally, and 2% often. Most commonly injured body regions were: knee (30%), ankle and Achilles’ tendon (24%), foot (15%), and calf (12%). Male gender, running history of 1-3 years, and history of previous injuries were risk factors for life-time running injury. In the season preceding the event, 65% of participants had not experienced any running injuries, 19% of them reported minor problems (max 2 weeks absenteeism), but 10% and 7% suffered from moderate (absence 3-4 weeks) or major (more than 4 weeks pause) injuries. BMI was identified as the solely risk factor. Conclusions This self-reported study revealed a 53% lifetime prevalence of running-related injuries, with the predominate involvement of knee, ankle and Achilles’ tendon. One out of three recreational runners experienced at least one minor running injury per season. It seems that male gender, short running experience, previous injury, and BMI do increase the probability for running-related injuries.


2004 ◽  
Vol 34 (8) ◽  
pp. 1519-1530 ◽  
Author(s):  
VALERIE S. KNOPIK ◽  
ANDREW C. HEATH ◽  
PAMELA A. F. MADDEN ◽  
KATHLEEN K. BUCHOLZ ◽  
WENDY S. SLUTSKE ◽  
...  

Background. Genetic influences have been shown to play a major role in determining the risk of alcohol dependence (AD) in both women and men; however, little attention has been directed to identifying the major sources of genetic variation in AD risk.Method. Diagnostic telephone interview data from young adult Australian twin pairs born between 1964 and 1971 were analyzed. Cox regression models were fitted to interview data from a total of 2708 complete twin pairs (690 MZ female, 485 MZ male, 500 DZ female, 384 DZ male, and 649 DZ female/male pairs). Structural equation models were fitted to determine the extent of residual genetic and environmental influences on AD risk while controlling for effects of sociodemographic and psychiatric predictors on risk.Results. Risk of AD was increased in males, in Roman Catholics, in those reporting a history of major depression, social anxiety problems, and conduct disorder, or (in females only) a history of suicide attempt and childhood sexual abuse; but was decreased in those reporting Baptist, Methodist, or Orthodox religion, in those who reported weekly church attendance, and in university-educated males. After allowing for the effects of sociodemographic and psychiatric predictors, 47% (95% CI 28–55) of the residual variance in alcoholism risk was attributable to additive genetic effects, 0% (95% CI 0–14) to shared environmental factors, and 53% (95% CI 45–63) to non-shared environmental influences.Conclusions. Controlling for other risk factors, substantial residual heritability of AD was observed, suggesting that psychiatric and other risk factors play a minor role in the inheritance of AD.


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