Abstract P210: Risk Factors for Intraparenchymal Hemorrhage Subtypes: The Circulatory Risk in Communities Study (CIRCS)

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Tetsuya Ohira ◽  
Eri Eguchi ◽  
Hironori Imano ◽  
Akihiko Kitamura ◽  
Masahiko Kiyama ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Total Cholesterol ◽  
Ethanol Intake ◽  
Serum Total Cholesterol ◽  
Intraparenchymal Hemorrhage ◽  
Effective Prevention ◽  
Cholesterol Levels ◽  
Increased Risk

Background: To evaluate risk factors for intraparenchymal hemorrhage (IPH) by its subtypes may contribute to more effective prevention of IPH, but few prospective studies have characterized risk factors for specific subtypes of IPH. Hypothesis: We assessed the hypothesis that the associations between traditional risk factors such as blood pressures and risk of IPH vary by IPH subtype. Methods: A prospective study of Japanese subjects aged 40-69 years was undertaken using the data collected from 9,086 participants (3,560 men and 5,526 women) in cardiovascular risk surveys of three communities between 1985 and 1994. The incidence of IPH between 1985 and 2008 was ascertained by systematic surveillance. The location of hemorrhage was assigned based on admission CT scan or MRI by trained physicians. IPH selectively involving the thalamus, basal ganglia or brainstem was defined as deep IPH, while IPH isolated to the cortex was defined as lobar. The hazard ratios (HRs) of incidence of IPH and its subtypes (deep IPH and lobar or cerebellar IPH) and 95% confidence intervals (CI) relative to the baseline variables were calculated with adjustment for age and other potential confounding factors using the Cox proportional hazards model. Results: During an average follow up of 19.2-years, 139 incident IPHs (103 deep, 31 lobar or cerebellar, and 5 mixed or unclassified IPHs) occurred. Systolic blood pressure, major ST-T abnormality on electrocardiogram, and excess ethanol intake (≥46g/day) were associated with increased risk of deep IPH, while serum total cholesterol levels was inversely associated with incidence of lobar and cerebellar IPH, even after adjustment for potential confounding variables. Serum total cholesterol levels also tended to be inversely associated with incidence of deep IPH, although it did not reach statistically significance. The multivariate-adjusted HRs (95%CI) of deep IPH were 1.14 (1.05-1.23) for systolic blood pressure (10mmHg), 2.09 (1.19- 3.66) for major ST-T abnormality, and 1.86 (1.02- 3.38) for excess ethanol intake. The adjusted HR (95%CI) of lobar and cerebellar IPH was 0.22 (0.07- 0.76) for the participants with higher total cholesterol levels (≥220 mg/dL), compared with those with lower total cholesterol levels (<160mg/dL). There were no associations of diabetes mellitus and smoking with both deep and lobar/cerebellar IPH. Conclusions: Impact of risk factors on incidence of IPH varied according to its subtype.

scholarly journals Causal associations between potentially modifiable risk factors and the Alzheimer’s disease phenome: A Mendelian randomization study

2019 ◽  
Author(s):  
Shea J Andrews ◽  
Brian Fulton-Howard ◽  
Paul O’Reilly ◽  
Lindsay A Farrer ◽  
Jonathan L Haines ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Total Cholesterol ◽  
Cortical Thickness ◽  
Mendelian Randomization ◽  
Hippocampal Volume ◽  
Cortical Surface ◽  
Cholesterol Levels ◽  
Increased Risk ◽  
Reduced Risk

AbstractObjectiveTo evaluate the causal association of 22 previously reported risk factors for Alzheimer’s disease (AD) on the “AD phenome”: AD, AD age of onset (AAOS), hippocampal volume, cortical surface area and thickness, cerebrospinal fluid (CSF) levels of Aβ42, tau, and ptau181, and the neuropathological burden of neuritic plaques, neurofibrillary tangles, and vascular brain injury (VBI).MethodsPolygenic risk scores (PRS) for the 22 risk factors were computed in 26,431 AD cases/controls and the association with AD was evaluated using logistic regression. Two-sample Mendelian randomization was used to evaluate the causal effect of risk factors on the AD phenome.ResultsPRS for increased education and diastolic blood pressure were associated with reduced risk for AD. PRS for increased total cholesterol and moderate-vigorous physical activity were associated with an increased risk of AD. MR indicated that only Education was causally associated with reduced risk of AD, delayed AAOS, and increased cortical surface area and thickness. Total-and LDL-cholesterol levels were causally associated with increased neuritic plaque burden, while diastolic blood pressure and pulse pressure are causally associated with increased risk of VBI. Furthermore, total cholesterol was associated with decreased hippocampal volume; smoking initiation and BMI with decreased cortical thickness; and sleep duration with increased cortical thickness.InterpretationOur comprehensive examination of the genetic evidence for the causal roles of previously reported risk factors in AD using PRS and MR, supports a causal role for education, blood pressure, cholesterol levels, smoking, and BMI with the AD phenome.

scholarly journals Anthropometric measures and biomarkers for cardiovascular disease risk factors: evidence from a study of Polish adults participating in the cardiovascular disease prevention program (CHUK)

2021 ◽  
Vol 84 (4) ◽  
pp. 431-441
Author(s):  
Kinga Michnik ◽  
Maciej Mularczyk ◽  
Marta Stępień-Słodkowska
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Systolic Blood Pressure ◽  
Total Cholesterol ◽  
Ldl Cholesterol ◽  
Disease Risk ◽  
Risk Of Death ◽  
Increased Risk ◽  
Score Index

Abstract The Polish national program for the prevention of cardiovascular disease (CHUK) uses the Systematic Coronary Risk Evaluation (SCORE) index which evaluates the upcoming risk of death from cardiovascular causes for a 10 year period, based on information such as age, systolic blood pressure, cholesterol levels, smoking and gender. The aim of this study was to determine health indicators in the population enrolled in the program and identify the relationships between the cardiovascular risk factors. The data was collected from 303 participating individuals; 172 women (aged 35 to 58 years) and 131 men (aged 31 to 60 years). The SCORE index showed a statistically significant positive relationship between CVD and the male gender. The higher frequency of 3–4% and 5–9% for SCORE index in men indicates that they were at a higher risk of cardiovascular incidents. The increased risk of a cardiovascular incidence in men was associated with a higher mean arm circumference, waist circumference, BMI, systolic blood pressure, diastolic blood pressure, total cholesterol, LDL cholesterol, triglyceride and fasting glucose. HDL cholesterol and heart rate were statistically significantly higher in women. Among the study subjects, the most common parameters above the normal range were elevated LDL cholesterol and total cholesterol. The highest correlation with the SCORE index was observed for the age of the subjects, total cholesterol and LDL cholesterol, regardless of gender. The results showed that biochemical parameters and blood pressure were above normal values in almost all subjects. Men had significantly less favorable parameters compared to women of similar age range. According to the SCORE index, total cholesterol and LDL cholesterol significantly increased the risk of cardiovascular incident regardless of gender. Women were characterized by a lower risk of cardiovascular incident according to the SCORE index.

Long-term effects (>24 months) of multiple lifestyle intervention on major cardiovascular risk factors among high risk subjects: a meta-analysis

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
H Bergum ◽  
I Sandven ◽  
TO Klemsdal
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Systolic Blood Pressure ◽  
Total Cholesterol ◽  
Cardiovascular Risk Factors ◽  
Lifestyle Intervention ◽  
Small Study ◽  
Long Term Effects

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The Norwegian health department Background The evidence of the long-term effects of multiple lifestyle intervention on cardiovascular risk is uncertain. We aimed to summarize the evidence from randomized clinical trials examining the efficacy of lifestyle intervention on major cardiovascular risk factors in subjects at high cardiovascular risk. Methods  Eligible trials investigated the impact of lifestyle intervention versus usual care with minimum 24 months follow-up, reporting more than one major cardiovascular risk factor. A literature search updated April 15, 2020 identified 12 eligible studies. The results from individual trials were combined using fixed and random effect models, using the standardized mean difference (SMD) to estimate effect sizes. Small-study effect was evaluated, and heterogeneity between studies examined by subgroup and meta-regression analyses considering patient- and study-level variables. Results  Small-study effect was not identified. Lifestyle intervention reduced systolic blood pressure modestly with an estimated SMD of -0.13, 95% confidence interval (CI): -0.21 to -0.04, with moderate heterogeneity (I² = 59%), corresponding to a mean difference of approximately 2 mmHg (MD = -1.86, 95% CI: -3.14 to -0.57, p = 0.0046). This effect disappeared in the subgroup of trials judged at low risk of bias (SMD = 0.02, 95% CI: -0.08 to 0.11). For the outcome total cholesterol SMD was -0.06, 95% CI: -0.13 to 0.00, with no heterogeneity (I² = 0%), indicating no effect of the intervention. Conclusion  Lifestyle intervention resulted in only a modest effect on systolic blood pressure and no effect on total cholesterol after 24 months. Further lifestyle trials should consider the challenge of maintaining larger long-term benefits to ensure impact on cardiovascular outcomes.

scholarly journals Workload-indexed blood pressure response is superior to peak systolic blood pressure in predicting all-cause mortality

2019 ◽  
Vol 27 (9) ◽  
pp. 978-987 ◽  
Author(s):  
Kristofer Hedman ◽  
Nicholas Cauwenberghs ◽  
Jeffrey W Christle ◽  
Tatiana Kuznetsova ◽  
Francois Haddad ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Exercise Testing ◽  
Lower Risk ◽  
Metabolic Equivalents ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Clinical Exercise Testing

Aims The association between peak systolic blood pressure (SBP) during exercise testing and outcome remains controversial, possibly due to the confounding effect of external workload (metabolic equivalents of task (METs)) on peak SBP as well as on survival. Indexing the increase in SBP to the increase in workload (SBP/MET-slope) could provide a more clinically relevant measure of the SBP response to exercise. We aimed to characterize the SBP/MET-slope in a large cohort referred for clinical exercise testing and to determine its relation to all-cause mortality. Methods and results Survival status for male Veterans who underwent a maximal treadmill exercise test between the years 1987 and 2007 were retrieved in 2018. We defined a subgroup of non-smoking 10-year survivors with fewer risk factors as a lower-risk reference group. Survival analyses for all-cause mortality were performed using Kaplan–Meier curves and Cox proportional hazard ratios (HRs (95% confidence interval)) adjusted for baseline age, test year, cardiovascular risk factors, medications and comorbidities. A total of 7542 subjects were followed over 18.4 (interquartile range 16.3) years. In lower-risk subjects ( n = 709), the median (95th percentile) of the SBP/MET-slope was 4.9 (10.0) mmHg/MET. Lower peak SBP (<210 mmHg) and higher SBP/MET-slope (>10 mmHg/MET) were both associated with 20% higher mortality (adjusted HRs 1.20 (1.08–1.32) and 1.20 (1.10–1.31), respectively). In subjects with high fitness, a SBP/MET-slope > 6.2 mmHg/MET was associated with a 27% higher risk of mortality (adjusted HR 1.27 (1.12–1.45)). Conclusion In contrast to peak SBP, having a higher SBP/MET-slope was associated with increased risk of mortality. This simple, novel metric can be considered in clinical exercise testing reports.

scholarly journals 1447Childhood risk factors and cardiovascular disease outcomes in adulthood. Preliminary findings from the International Childhood Cardiovascular Cohort (i3C) Consortium

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Dwyer ◽  
D R Jacobs ◽  
J G Woo ◽  
E M Urbina ◽  
L Bazzano ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Risk Factor ◽  
Total Cholesterol ◽  
Factor Model ◽  
Confidence Limits ◽  
Cvd Risk ◽  
Risk Factor Model ◽  
Increased Risk ◽  
Childhood Risk Factors

Abstract Background Atherosclerosis develops decades before clinical cardiovascular disease (cCVD) occurs. Longitudinally, childhood risk factors predict adult pre-clinical atherosclerosis. There is currently no evidence directly linking childhood risk factors to cCVD. Purpose To provide the first direct evidence of any association between known risk factors for CVD when measured in childhood and adult CVD incidence and death. Methods Using i3C Consortium data, we linked childhood risk factors to adult cCVD. cCVD events were ascertained by participant re-contact in the US and Australia, medically adjudicated hospital records; and using the Finnish national health registry. Of 16,964 adult participants (mean age 49 years) examined during ages 3–19, 201 people with any cCVD event (70% coronary artery, 25% cerebrovascular, and 5% peripheral artery disease) have been determined. The analysis included Cox proportional hazard models. Each model was adjusted for childhood age, age at followup, sex and cohort/race. Continuous childhood variables were z-scored for each participant's last repeated measure during childhood. Results Childhood body mass index (BMI), serum total cholesterol (TC) and triglycerides, and systolic blood pressure were positively associated with adult cCVD events (P<0.0001). Smoking in childhood was associated with nearly 50% increased risk of adult cCVD (P=0.08). BMI; TC remained significant in the simultaneous risk factor model. The adjudication pipeline suggests that over 500 hospitalized cCVD events will be found on completion. Regression using the full set of imputed events yielded similar findings. Analysis of deaths is in process. Childhood risk factor link to adult CVD Childhood risk variable Single risk factors models Simultaneous risk factor model n cCVD events/N at risk Hazard ratio (95% Confidence limits) p n cCVD events/N at risk Hazard ratio (95% Confidence limits) p Body Mass Index 201/16964 1.52 (1.33–1.73) <0.0001 142/11124 1.37 (1.14–1.64) 0.0008 Total cholesterol 191/13778 1.32 (1.14–1.52) 0.0001 " 1.21 (1.02–1.43) 0.03 Triglycerides 191/13654 1.17 (1.04–1.33) 0.01 " 1.04 (0.88–1.24) 0.6 Systolic blood pressure 190/14883 1.28 (1.11–1.48) 0.0007 " 1.18 (0.99–1.42) 0.07 Regular smoking ≥1/day 151/13436 1.44 (0.96–2.16) 0.08 " 1.43 (0.94–2.17) 0.10 Hazard ratios = increased risk per one standard deviation increase in continuous risk variables. E.g. every ∼0.9 mmol/L or ∼33 mg/dL increase in childhood total cholesterol is associated with a ∼32% and 21% increase in adult CVD risk in single and simultaneous risk factor models respectively. “Simultaneous risk factor model” recognizes that the risk factors are causally connected. Conclusion Childhood CVD risk factors predicts adult cCVD with implications for primordial CVD prevention. Acknowledgement/Funding National Heart, Lung, and Blood Institute (NHLBI)

Educational inequalities in midlife risk factors for non-communicable diseases in two Norwegian counties 1974–2002

2018 ◽  
Vol 47 (7) ◽  
pp. 705-712
Author(s):  
Sidsel Graff-Iversen ◽  
Inger Ariansen ◽  
Øyvind Næss ◽  
Randi M. Selmer ◽  
Bjørn Heine Strand
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Total Cholesterol ◽  
Communicable Diseases ◽  
Serum Total Cholesterol ◽  
Cross Sectional ◽  
Non Communicable Diseases ◽  
Educational Differences ◽  
Index Of Inequality ◽  
Educational Gradient

Background: The absolute educational differences in the mortality of Norwegian women and men increased during 1960–2000 and thereafter levelled off in men, but continued to widen in women. Which of the risk factors for non-communicable diseases (NCDs) might explain these trends? Aim: The aim of this study was to investigate trends in gender-specific, absolute educational differences in established risk factors during 1974–2002. Methods: We used cross-sectional data from 40–45-year-old women and men who participated in one of three health surveys in two counties, from the years 1974–1978, 1985–1988 and 2001–2002. To account for increasing educational attainment through the period we used a regression-based index of inequality (Slope Index of Inequality) to assess the educational gradients over time. Results: From 1974 to 2002, the mean levels of serum total cholesterol and blood pressure decreased and body mass index (BMI) increased in all subgroups by education in both sexes. In men, the educational gradient tended to diminish toward the null for serum total cholesterol and narrowed for systolic blood pressure, but increased for BMI. In women, the educational gradient increased to the double for smoking and increased for triglycerides. Conclusions: In two Norwegian counties, the NCD risk factors showed dynamic patterns during 1974–2002. For blood pressure and serum total cholesterol, the levels showed consistent beneficial changes in all educational subgroups, with a narrowing tendency for educational gradients in men. In women, the educational gradient for smoking increased markedly. Knowledge on midlife trends in the educational gradients of risk factors may help to explain recent and future NCD mortality.

Elevated systolic blood pressure and high cholesterol levels at midlife are risk factors for late-life dementia

2000 ◽  
Vol 21 ◽  
pp. 174 ◽  
Author(s):  
Miia Kivipelto ◽  
Eeva-Liisa Helkala ◽  
Merja Hallikainen ◽  
Kari Alhainen ◽  
Jaakko Tuomilehto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Late Life ◽  
High Cholesterol ◽  
Cholesterol Levels ◽  
Elevated Systolic Blood Pressure
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