Abstract P006: Flow-Mediated Dilation is Inversely Associated with Cardiovascular Disease Risk: a Meta-Analysis of Prospective Studies

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Rouyanne T Ras ◽  
Martinette T Streppel ◽  
Peter L Zock ◽  
Richard Draijer
Keyword(s):  
Cardiovascular Disease ◽  
Health Status ◽  
Prospective Studies ◽  
Meta Analysis ◽  
Risk Estimate ◽  
Flow Mediated Dilation ◽  
Cvd Risk ◽  
Risk Estimates ◽  
The Relationship ◽  
Overall Risk

Background - Flow-mediated dilation (FMD) is an accepted technique to quantify endothelial (dys)function. The predictive value of FMD for future cardiovascular disease (CVD) risk has been investigated in several prospective studies. The purpose of the present study was to systematically review these studies and to quantify the relationship between FMD and CVD risk. It was hypothesized that the risk of experiencing a cardiovascular event later in life would be smaller when having a higher FMD value at baseline. Methods - Potentially relevant prospective studies were searched in several databases and by hand searching, through March 2011. Studies were selected based on predefined selection criteria. The statistical analysis was performed separately for continuous (per 1% increase in FMD) and categorical (when having a high vs. low FMD) risk estimates for CVD. The pooled overall risk estimate was calculated based on a random-effects model while weighting each study by the inverse of its variance. Potential sources of heterogeneity were investigated as well as presence of publication bias. Results - In total, 23 studies including 14,753 subjects were eligible for inclusion in the present meta-analysis. Subjects were followed for an average duration of 42.9 months (range: 12.1-94.6 months). The average age was 60.1 years (range: 46.0-78.6 years). In 8 out of 23 studies, asymptomatic subjects were included whereas in 15 studies, subjects were diagnosed as having various forms of diseases. In studies reporting continuous risk estimates, the pooled overall risk estimate for CVD expressed per 1 % increase in FMD was 0.90 (95%CI: 0.86, 0.94). One study, that was the only study including exclusively renal patients, reported results that significantly differed from this estimate. Excluding this study from the analysis did not materially affect the pooled overall risk estimate (RR = 0.92 (95%CI: 0.88; 0.95). Based on studies with categorical risk estimates, the pooled overall risk estimate for CVD when having a high FMD vs. a low FMD was 0.49 (95%CI: 0.38, 0.63). Covariate analysis revealed that health status significantly affected the association between FMD and CVD risk with a stronger association in diseased populations. Presence of publication bias could not be excluded. Conclusions - Our findings show that baseline FMD is inversely associated with CVD risk, particularly in diseased populations. Further studies should address the impact of underlying health status on the relationship between FMD and CVD.

scholarly journals The relationship of erectile dysfunction and subclinical cardiovascular disease: A systematic review and meta-analysis

2017 ◽  
Vol 23 (1) ◽  
pp. 9-20 ◽  
Author(s):  
Chukwuemeka U Osondu ◽  
Bryan Vo ◽  
Ebenezer T Oni ◽  
Michael J Blaha ◽  
Emir Veledar ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Erectile Dysfunction ◽  
Vascular Function ◽  
Meta Analysis ◽  
Ankle Brachial Index ◽  
Intima Media Thickness ◽  
Publication Date ◽  
Cvd Risk ◽  
The Relationship ◽  
Subclinical Cvd

Erectile dysfunction (ED) is associated with cardiovascular disease (CVD) and CVD mortality. However, the relationship between ED and subclinical CVD is less clear. We synthesized the available data on the association of ED and measures of subclinical CVD. We searched multiple databases for published literature on studies examining the association of ED and measures of subclinical CVD across four domains: endothelial dysfunction measured by flow-mediated dilation (FMD), carotid intima–media thickness (cIMT), coronary artery calcification (CAC), and other measures of vascular function such as the ankle–brachial index, toe–brachial index, and pulse wave velocity. We conducted random effects meta-analysis and meta-regression on studies that examined an ED relationship with FMD (15 studies; 2025 participants) and cIMT (12 studies; 1264 participants). ED was associated with a 2.64 percentage-point reduction in FMD compared to those without ED (95% CI: –3.12, −2.15). Persons with ED also had a 0.09-mm (95% CI: 0.06, 0.12) higher cIMT than those without ED. In subgroup meta-analyses, the mean age of the study population, study quality, ED assessment questionnaire (IIEF-5 or IIEF-15), or the publication date did not significantly affect the relationship between ED and cIMT or between ED and FMD. The results for the association of ED and CAC were inconclusive. In conclusion, this study confirms an association between ED and subclinical CVD and may shed additional light on the shared mechanisms between ED and CVD, underscoring the importance of aggressive CVD risk assessment and management in persons with ED.

Abstract 17412: Vital Exhaustion and Incident Cardiovascular Disease: a Meta-Analysis

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Jincy Thankachen ◽  
Chirag Bavishi ◽  
Randy Cohen ◽  
Alan Rozanski
Keyword(s):  
Cardiovascular Disease ◽  
Risk Factor ◽  
Prospective Studies ◽  
Meta Analysis ◽  
Significant Risk ◽  
Cvd Risk ◽  
Vital Exhaustion ◽  
Increased Risk ◽  
Psychosocial Conditions

Background: A number of psychosocial conditions are associated with cardiovascular disease (CVD) events. One such condition is vital exhaustion (VE), defined as a combination of fatigue, increased irritability and feelings of demoralization. To date, a number of studies have examined the association between VE, fatigue (as a stand-alone entity) and subsequent cardiovascular events with varying results. In order to evaluate the potency of VE/fatigue as a CVD risk factor, we conducted a meta-analysis of existing studies concerning these factors in the literature. Methods: A systematic search of PubMed, EMBASE and PsychINFO (1972-May, 2014) was performed to identify all prospective studies involving subjects without baseline CVD, investigating the relationship between VE/fatigue and incident CVD. Unadjusted and adjusted effect estimates were extracted from individual studies. Pooled effect estimates were calculated with DerSimonian and Laird random effects models. Results: Eleven prospective studies with a total of 60, 610 participants and a mean follow-up period of 6.5 years were included in the analysis. A significant association was observed between VE/fatigue and incident CVD, using both unadjusted estimates [Pooled Relative Risk: 1.69 (CI: 1.31-2.18), p<0.001] and adjusted estimates from individual studies [Pooled RR: 1.36 (CI: 1.14-1.63), p=0.001]. Subgroup analysis by years of follow-up and type of VE/fatigue questionnaire yielded similar increased risk of incident CVD. Conclusions: VE/fatigue is a significant risk factor for incident CVD in healthy subjects, comparable in potency to some of the other common psychosocial risk factors for cardiac disease.

scholarly journals Effects of a Paleolithic Diet on Cardiovascular Disease Risk Factors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Vol 10 (4) ◽  
pp. 634-646 ◽  
Author(s):  
Ehsan Ghaedi ◽  
Mohammad Mohammadi ◽  
Hamed Mohammadi ◽  
Nahid Ramezani-Jolfaie ◽  
Janmohamad Malekzadeh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Lipid Profile ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Cvd Risk Factors ◽  
Paleolithic Diet ◽  
Cvd Risk ◽  
Randomized Controlled

ABSTRACTThere is some evidence supporting the beneficial effects of a Paleolithic diet (PD) on cardiovascular disease (CVD) risk factors. This diet advises consuming lean meat, fish, vegetables, fruits, and nuts and avoiding intake of grains, dairy products, processed foods, and added sugar and salt. This study was performed to assess the effects of a PD on CVD risk factors including anthropometric indexes, lipid profile, blood pressure, and inflammatory markers using data from randomized controlled trials. A comprehensive search was performed in the PubMed, Scopus, ISI Web of Science, and Google Scholar databases up to August 2018. A meta-analysis was performed using a random-effects model to estimate the pooled effect size. Meta-analysis of 8 eligible studies revealed that a PD significantly reduced body weight [weighted mean difference (WMD) = −1.68 kg; 95% CI: −2.86, −0.49 kg], waist circumference (WMD = −2.72 cm; 95% CI: −4.04, −1.40 cm), BMI (in kg/m2) (WMD = −1.54; 95% CI: −2.22, −0.87), body fat percentage (WMD = −1.31%; 95% CI: −2.06%, −0.57%), systolic (WMD = −4.75 mm Hg; 95% CI: −7.54, −1.96 mm Hg) and diastolic (WMD = −3.23 mm Hg; 95% CI: −4.77, −1.69 mm Hg) blood pressure, and circulating concentrations of total cholesterol (WMD = −0.23 mmol/L; 95% CI: −0.42, −0.04 mmol/L), triglycerides (WMD = −0.30 mmol/L; 95% CI: −0.55, −0.06 mmol/L), LDL cholesterol (WMD = −0.13 mmol/L; 95% CI: −0.26, −0.01 mmol/L), and C-reactive protein (CRP) (WMD = −0.48 mg/L; 95% CI: −0.79, −0.16 mg/L) and also significantly increased HDL cholesterol (WMD = 0.06 mmol/L; 95% CI: 0.01, 0.11 mmol/L). However, sensitivity analysis revealed that the overall effects of a PD on lipid profile, systolic blood pressure, and circulating CRP concentrations were sensitive to removing some studies and to the correlation coefficients, hence the results must be interpreted with caution. Although the present meta-analysis revealed that a PD has favorable effects on CVD risk factors, the evidence is not conclusive and more well-designed trials are still needed.

scholarly journals Relationship between Depressive Symptoms and Cardiovascular Disease Risk Factors in African American Individuals

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Ali A. Weinstein ◽  
Preetha Abraham ◽  
Guoqing Diao ◽  
Stacey A. Zeno ◽  
Patricia A. Deuster
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
African American ◽  
Depressive Symptoms ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Regression Analyses ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
The Relationship

Objective. To examine the relationship between depressive symptoms and cardiovascular disease (CVD) risk factors in a group of African American individuals.Design. A nonrandom sample of 253 (age 43.7 ± 11.6 years; 37% male) African American individuals was recruited by advertisements. Data were obtained by validated questionnaires, anthropometric, blood pressure, and blood sample measurements.Results. Regression analyses were performed to assess the relationship between depressive symptoms and CVD risk factors controlling for socioeconomic status indicators. These analyses demonstrated that those with higher levels of depressive symptoms had larger waist-to-hip ratios, higher percent body fat, higher triglycerides, and were more likely to be smokers.Conclusions. It has been well documented that higher levels of depressive symptoms are associated with higher CVD risk. However, this evidence is derived primarily from samples of predominantly Caucasian individuals. The present investigation demonstrates that depressive symptoms are related to CVD risk factors in African American individuals.

scholarly journals Circulating Proangiogenic Cell Activity Is Associated with Cardiovascular Disease Risk

2012 ◽  
Vol 17 (9) ◽  
pp. 1163-1170 ◽  
Author(s):  
Kreton Mavromatis ◽  
Konstantinos Aznaouridis ◽  
Ibhar Al Mheid ◽  
Emir Veledar ◽  
Saurabh Dhawan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Bone Marrow ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Cell Activity ◽  
Atherosclerotic Cardiovascular Disease ◽  
Cvd Risk ◽  
The Relationship

Vascular injury mobilizes bone marrow–derived proangiogenic cells into the circulation, where these cells can facilitate vascular repair and new vessel formation. We sought to determine the relationship between a new biomarker of circulating bone marrow–derived proangiogenic cell activity, the presence of atherosclerotic cardiovascular disease (CVD) and its risk factors, and clinical outcomes. Circulating proangiogenic cell activity was estimated using a reproducible angiogenic colony-forming unit (CFU-A) assay in 532 clinically stable subjects aged 20 to 90 years and ranging in the CVD risk spectrum from those who are healthy without risk factors to those with active CVD. CFU-A counts increased with the burden of CVD risk factors ( p < 0.001). CFU-A counts were higher in subjects with symptomatic CVD than in those without ( p < 0.001). During follow-up of 232 subjects with CVD, CFU-A counts were higher in those with death, myocardial infarction, or stroke than in those without (110 [70–173] vs 84 [51–136], p = 0.01). Therefore, we conclude that circulating proangiogenic cell activity, as estimated by CFU-A counts, increases with CVD risk factor burden and in the presence of established CVD. Furthermore, higher circulating proangiogenic cell activity is associated with worse clinical outcome in those with CVD.

Abstract P400: The Association Between Cross-sex Hormone Therapy and Cardiovascular Disease Risk Factors Among Male-to-female Transgender Persons in Chiang Mai, Thailand

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Rebecca L Molinsky ◽  
Kanokwan Kulprachakarn ◽  
Sakaewan Ounjaijean ◽  
Ryan Demmer ◽  
Kittipan Rerkasem
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Risk Factor ◽  
Hormone Therapy ◽  
Sex Hormone ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Transgender Persons ◽  
The Relationship ◽  
Male To Female

Background: Cross-sex hormone therapy (CSHT) is prescribed to transition secondary sexual characteristics among individuals undergoing male-to-female (MtF) transitions (age range 18-41, mean age=24). Limited data exist to inform the cardiovascular disease (CVD) risk factor profile associated with CSHT. We investigated the relationship between CSHT and cardiovascular risk factors in MtF transgender persons and hypothesize that CSHT will be associated with adverse CVD risk factor profiles. Methods: A cross-sectional study was conducted from October 1 st , 2018 to November 30 th , 2018 in 100 MtF transgender people not receiving CSHT vs. 100 receiving CSHT. CSHT use was defined by self-report use of up to 23 medications. Serum testosterone and 17-beta estradiol were assessed to validate CSHT use. Systolic and diastolic blood pressure was measured. Lipid profiles, fasting plasma glucose (FPG), C-reactive protein, cardiac troponin I and pro b-type natriuretic peptide (proBNP) were assessed from fasting blood. Non-invasive arterial examinations included: carotid intima-media thickness (CIMT), ankle-brachial index (ABI), cardio-ankle vascular index (CAVI), and pulse wave velocity (PWV). Multivariable linear regression models, regressed CVD risk factors on CSHT status. Among the subgroup of CSHT users, we assessed the relationship between duration of use and CVD risk factors. Multivariable models included age, gender, education, income, drinking, smoking, exercise, and BMI. Results: Participant mean age was 24±0.38 years and did not differ by CSHT use. Mean±SE values of testosterone were in the CSHT vs. control group were 4.8±0.3 vs. 5.8±0.3 ng/ml, p=0.06 and 17-beta estradiol levels were 45.6±14.9 vs. 34.7±14.8, p=0.7). CIMT was modestly lower among CSHT vs. controls (0.35±0.01 vs. 0.38±0.01, p=0.09). The average duration of CSHT use was 6.65±0.522 years. Among CSHT users, for every 1-year increase in duration of CSHT use total cholesterol decreased by -2.360 ± 1.096, p=0.0341 mg/dL, LDL-cholesterol decreased by -3.076 ± 1.182, p=0.0109 mg/dL, ABI decreased by -0.006 ± 0.002, p=0.0087 while FPG increased by 2.558 ± 0.899 mg/dL, p=0.0055. Conclusion: Among MtF transgender persons, using CSHT was not associated with increased CVD risk factors levels.

Abstract P116: Chronic Kidney Disease And Cardiac Arrhythmias: A Systematic Review and Meta-analysis

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Esther D Kim ◽  
Ning Ding ◽  
Junichi Ishigami ◽  
Xuejuan Ning ◽  
Yijing Feng ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Prospective Studies ◽  
Cardiac Arrhythmias ◽  
Meta Analysis ◽  
Case Control ◽  
Cross Sectional ◽  
The Relationship

Background: Chronic kidney disease (CKD) strongly predicts sudden cardiac death and may elevate the risk of certain cardiac arrhythmias like atrial fibrillation; however, the relationships between CKD and various types of arrhythmia are not well-characterized. Methods: We performed a systematic review and meta-analysis by searching Embase and PubMed for prospective, cross-sectional, and case-control studies examining the associations of two key CKD measures, estimated glomerular filtration rate (eGFR) and albuminuria, with arrhythmias in adults that were published until July 2018. We performed qualitative assessment of studies using the Newcastle Ottawa Quality Assessment Scale. We pooled the results using random-effects models. Results: Among 16,245 articles, we identified 34 prospective (n=24,213,233), 21 cross-sectional (n=253,328), and 4 case-control (n=1,694) studies that included diverse study populations from 19 countries and were mostly high quality. Most prospective studies examined the relationship between eGFR and atrial fibrillation (AF), and demonstrated that lower eGFR was associated with a higher risk of AF (pooled hazard ratio [HR] 1.72 [95% CI: 1.30, 2.27] comparing reduced vs. referent eGFR groups)[ Figure ]. A few studies examined albuminuria and demonstrated its associations with AF (pooled HR 2.16 [95% CI: 1.74, 2.67] comparing high vs. low albuminuria). Results were similar for cross-sectional studies. Four prospective studies reported a higher incidence of ventricular tachycardia resulting in ICD shock according to reduced eGFR (pooled HR 2.32 [95% CI: 1.74, 3.09] comparing reduced vs. referent eGFR groups). Limited number of studies examined other types of arrhythmia. Conclusion: We identified robust data on the relationship between CKD (eGFR and albuminuria) and AF. Reduced eGFR was associated with life-threatening ventricular arrhythmias. Our review highlights the need of future studies for non-AF arrhythmias, especially in the context of albuminuria.

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