Abstract P333: Carotid Intima Media Echolucency is Related to Age, Female Sex, Systolic Blood Pressure, BMI and Smoking in Patients with Familial Hypercholesterolemia

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Karlijn A Groenewegen ◽  
Sanne A Peters ◽  
Hester M den Ruijter ◽  
Michiel L Bots
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Systolic Blood Pressure ◽  
Cardiovascular Risk Factors ◽  
Familial Hypercholesterolemia ◽  
Controlled Trial ◽  
Multivariable Model ◽  
Female Sex ◽  
The Common

Background: Atherosclerotic vascular disease can be assessed non-invasively with B-mode ultrasound. Echolucency is an ultrasound characteristic which is measured as the Gray Scale Median (GSM). Echolucent structures appear dark on ultrasound images; echogenic structures appear light. Echolucency of the carotid intima-media is thought to be a marker of the content of the vascular wall, where low values of GSM might reflect inflammation and/or high lipid content and high values of GSM reflect increased collagen and/or calcifications. In previous studies in asymptomatic individuals, echolucency of the carotid intima-media was associated with cardiovascular risk factors. Studies in high-risk populations are lacking. Aim: To assess the relation between cardiovascular risk factors and carotid intima media echolucency in patients with familial hypercholesterolemia. Methods: Baseline data were used from the RADIANCE 1 trial, a randomized controlled trial on the effects of atorvastatin and torcetrapib (a CETP-inhibitor) compared to atorvastatin alone in familial hypercholesterolemia. Echolucency of the common carotid artery intima media was measured as the mean GSM of the first baseline visit. Linear mixed effects models were used to assess the relation between each cardiovascular risk factor and mean GSM (adjusted for age, sex and carotid intima media thickness (CIMT), and in a multivariable model containing all risk factors). We studied systolic blood pressure (SBP), body mass index (BMI), high and low density lipoprotein (HDL and LDL), triglycerides (TGs), smoking, diabetes mellitus and C - reactive protein (CRP). Results: 875 patients were included in the current analysis. Mean age was 46 years (sd 13) and 50% was female. Mean GSM was 67 (sd 18). In age, sex and CIMT adjusted analyses, higher age (ß/sd: -5.71 (95% CI-6.82;-4.61)), female sex (β:-3.53 (95% CI -5.32;-1.73)), higher SBP (β/sd:-1.86 (95% CI -2.81;-0.91)), higher BMI (β/sd:-2.37 (95% CI -2.26;-1.29)) and higher levels of TGs (β/sd:-1.34 (95% CI -2.21;-0.47 were related to a lower GSM (i.e, more echolucency) and smoking (ß 2.91 (95% CI 0.52-5.29)) was related to a higher GSM. In the multivariable model, age (β/sd: -4.92 (95% CI -6.18;-3.65)), female sex (β: -4.35 (-6.41;-2.29), systolic blood pressure (β/sd: -1.32 (-2.38;-0.25) and BMI (β/sd: -1.82 (-2.90;-0.73)) were related to a lower GSM and smoking (β: 2.78 (0.39;5.18)) was related to a higher GSM. Conclusion: Several established risk factors were related to the echolucency of the common carotid intima media in patients with familial hypercholesterolemia.

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.

Abstract P011: Cardiovascular Risk Factors and Longevity

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Michelle C Odden ◽  
Andreea Rawlings ◽  
Alice Arnold ◽  
Mary Cushman ◽  
Mary Lou Biggs ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Systolic Blood Pressure ◽  
Cardiovascular Risk Factors ◽  
Old Age ◽  
Repeated Measures ◽  
Ldl Cholesterol ◽  
Low Cardiovascular Risk

Introduction: Cardiovascular disease is the leading cause of mortality in old age, yet there is limited research on the patterns of cardiovascular risk factors that predict survival to 90 years. Hypothesis: The patterns of cardiovascular risk factors that portend longevity will differ from those that confer low cardiovascular risk. Methods: We examined repeated measures of blood pressure, LDL-cholesterol, and BMI from age 67 and survival to 90 years in the Cardiovascular Health Study (CHS). CHS is a prospective study of 5,888 black and white adults in two waves (1989-90 and 1992-93) from Medicare eligibility lists in four counties in the U.S. We restricted to participants aged 67 to 75 years at baseline to control for birth cohort effects and examined repeated measures of cardiovascular risk factors throughout the late-life course. We fit logistic regression models to predict survival to age 90 using generalized estimating equations, and modeled the risk factors as linear, a linear spline, and clinically relevant categories. Models were adjusted for demographics and medication use, and we also examined whether the association of each risk factor with longevity varied by the age of risk factor measurement. Best fit models are presented. Results: Among 3,645 participants in the birth cohort, 1,160 (31.8%) survived to 90 by June 16 th , 2015. Higher systolic blood pressure in early old age was associated with reduced odds for longevity, but there was an interaction with age such that the association crossed the null at 80 years. (Table) Among those with LDL-cholesterol <130 mg/dL, higher LDL-cholesterol was associated with greater longevity; at levels above 130 mg/dL there was no association between LDL-cholesterol and longevity. BMI had a u-shaped association with longevity. Conclusions: In summary, the patterns of risk factors that predict longevity differ from that considered to predict low cardiovascular risk. The risk of high systolic blood pressure appears to depend on the age of blood pressure measurement.

Abstract 1316: Preclinical Atherosclerosis in Primary Antiphospholipid Syndrome: The Impact of Oxidative Properties of High Density Lipopoprotein

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Marietta Charakida ◽  
Julian Halcox ◽  
Joanna Batuca ◽  
Ann Donald ◽  
Shirish Sangle ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Arterial Stiffness ◽  
Systolic Blood Pressure ◽  
Cardiovascular Risk Factors ◽  
Antiphospholipid Syndrome ◽  
High Density ◽  
Primary Antiphospholipid Syndrome ◽  
The Impact

Background: Antiphospholipid syndrome (APS) is characterised by increased thrombogenicity and/or pregnancy morbidity in the presence of raised levels of antiphospholipid antibodies (aPL). Increased oxidative properties of high density lipoprotein (HDL)(decreased activity of paraoxonase (PON)) is associated with increased risk for atherosclerosis and has been described in APS. The impact of PON on atherosclerotic disease progression in APS is unclear. We therefore examined the effect of PON on intima media thickness (IMT), and pulse wave velocity (PWV) in patients with positive aPL. Methods: We studied 77 women with positive aPL (aPL) aged 46.6±1.2 yrs (mean±SE) and a control group of 77 women aged 47.5±1.2 yrs matched for traditional cardiovascular risk factors. High resolution ultrasound was used to determine carotid IMT. Arterial stiffness was assessed non-invasively by carotid-radial PWV. PON activity was assessed by measuring p-nitrophenol formation and activity expressed as nmoles p-nitrophenol/ml serum/minute. Results: APL patients had significantly increased IMT and PWV compared to controls (0.75±0.02mm vs 0.65±0.01mm, p<0.001 and 9.14±0.18 m/s vs 8.56±0.21m/s, p<0.05 respectively). PON activity was significantly reduced in aPL compared to controls (91.5[64.3, 05.1]mmol/ml/min, median[IQR] vs 103.1[80.4, 111.5] mmol/ml/min, p<0.006). Although PON activity was not associated with vascular measures in controls, an inverse association was noted in aPL patients (r=−0.26 [cIMT] and r=−0.23 [PWV], both p<0.05). In multivariate analysis, accounting for cardiovascular risk factors, PON activity (β=−0.42, p<0.001), age (β=0.33, p<0.001) and systolic blood pressure (β=0.24, p<0.05) were independent determinants of cIMT while PON activity (β=−0.32, p<0.01) and systolic blood pressure (β=0.28, p<0.05) remained the only independent predictors of PWV in aPL positive patients. Conclusions: APS is associated with increased arterial stiffness and carotid intimal thickening. Paraoxonase activity is inversely associated with IMT and PWV in ApL positve patients. These findings indicate that oxidative stress may play an important role in the development of atherosclerosis in patients with primary antiphospholipid syndrome.

scholarly journals Hypothetical interventions and risk of myocardial infarction in a general population: application of the parametric g-formula in a longitudinal cohort study—the Tromsø Study

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e035584
Author(s):  
Tom Wilsgaard ◽  
Anne Merete Vangen-Lønne ◽  
Ellisiv Mathiesen ◽  
Maja-Lisa Løchen ◽  
Inger Njølstad ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Blood Pressure ◽  
Cohort Study ◽  
Cardiovascular Risk ◽  
Systolic Blood Pressure ◽  
Cardiovascular Risk Factors ◽  
Risk Reduction ◽  
Absolute Risk

ObjectivesThe aim of this study was to use the parametric g-formula to estimate the 19-year risk of myocardial infarction (MI) under hypothetical interventions on six cardiovascular risk factors.Design and settingA populations-based cohort study with repeated measurements, the Tromsø Study.Primary outcome measureMyocardial infarction.ParticipantsWe estimated the relative and absolute risk reduction under feasible and intensive risk reduction strategies for smoking, physical activity, alcohol drinking, body mass index, total serum cholesterol and systolic blood pressure in 14 965 men and women with 19 years of follow-up (1994–2013).ResultsThe estimated 19-year risk of MI under no intervention was 7.5% in individuals with baseline mean age 49.3 years (range 25–69). This risk was reduced by 30% (95% CI 19% to 39%) under joint feasible interventions on all risk factors, and 70% (60%, 78%) under a set of more intensive interventions. The most effective interventions were lowering of total cholesterol to 5.18 mmol/L and lowering of systolic blood pressure to 120 mm Hg (33% and 37% lower MI risk, respectively). The absolute risk reductions were significantly larger in men, in older participants, in smokers and in those with low education.ConclusionModification of population levels of cardiovascular risk factors could have prevented close to one-third of the cases of MI in the municipality of Tromsø during 19 years of follow-up.

PARAMETERS RELATING TO CARDIOVASCULAR RISK FACTORS IN PATIENTS WITH CKD TREATED BY HEMODIALYSIS

2014 ◽  
pp. 21-28
Author(s):  
Tam Vo ◽  
Phai Le ◽  
Huu Vu Quang Nguyen
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Cardiovascular Risk ◽  
Kidney Disease ◽  
Systolic Blood Pressure ◽  
Cardiovascular Risk Factors ◽  
Inverse Correlation ◽  
Positive Correlation ◽  
Residual Urine

Objectives: Study the relation of the cardiovascular disease risk factors hypertension, anemia, serum CRP, dyslipidemia, blood calcium-phospho disorders, hypoalbuminemia, hyperglycemia with the time of hemodialysis, residual urine, clearance of creatinin, index of Sokolov-Lyon on the ECG and index of EF on the echocardiography. Material and Method: 80 pateints with chronic kidney disease treated by hemodialysis at Phu Yen Hospital. Results: The inverse correlation of the time of hemodialysis with systolic blood pressure (r = - 0,7175). The inverse correlation of the residual urine time with systolic blood pressure (r = - 0.7076) and the positive correlation with hemoglobin (r =0,2213), The inverse correlation of the clearance of creatinin with systolic blood pressure (r = -0.5768). The positive correlation of the index of Sokolov-Lyon on the ECG with systolic blood pressure (r = 0.4032). The inverse correlation of the index of EF on the echocardiography with systolic blood pressure (r = -0.7379) and the positive correlation with hemoglobin (r = 0,2240). Key words: Chronic kidney disease, hemodialysis, cardiovascular risk factors, hypertension, anemia, CRP

scholarly journals The relationship between blood pressure variability and cardiovascular risk factors in patients with primary hypertension

2015 ◽  
Vol 61 (1) ◽  
pp. 31-33
Author(s):  
Annamária Magdás ◽  
I. Benedek ◽  
Boglárka Belényi ◽  
C. Carasca ◽  
Gabriella Gábos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Systolic Blood Pressure ◽  
Cardiovascular Risk Factors ◽  
Blood Pressure Variability ◽  
Ambulatory Monitoring ◽  
Pressure Profile ◽  
Primary Hypertension ◽  
Systolic Blood Pressure Variability

Abstract Objective: The aim of the study is to assess 24-hour blood pressure variability, circadian blood pressure profile and its relation to 24-hour blood pressure and cardiovascular risk factors in primary hypertension without any associated disease versus associated with a disease such as diabetes or chronic kidney disease. Methods: This observational study included 90 hypertensive patients, 49 with primary hypertension without associated disease and 41 patients with primary hypertension and diabetes or chronic kidney disease. Circadian blood pressure profile and 24-hour variability were assessed using ambulatory monitoring. Laboratory data regarding cardiovascular risk factors and demographic data were collected in a questionnaire. Results: The number of dipper patients was higher in the group without associated disease, but the difference was not statistically significant (p=0.27). In both groups a positive correlation was found between 24-hour systolic blood pressure variability and 24-hour systolic blood pressure (p=0.029) and was related to age (p=0.031). In the second group, systolic variability showed a positive correlation with serum triglycerides (p=0.006, r=0.416, CI: 0.1252 to 0.6422). Conclusion: Our findings suggest that systolic blood pressure variability is related to age, systolic blood pressure values and serum lipid levels. To prevent end organ damage in hypertension, the assessment of ambulatory monitoring derived 24-hour systolic blood pressure variability and its reduction may be at least as important as blood pressure lowering.

scholarly journals Increased risk of Roma for 10-year development of CVDs based on Framingham Risk Score calculation

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
P Piko ◽  
S Fiatal ◽  
Z Kosa ◽  
J Sandor ◽  
R Adany
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
General Population ◽  
Systolic Blood Pressure ◽  
Cardiovascular Risk Factors ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Roma Population ◽  
Framingham Risk

Abstract Background Increased mortality and short life expectancy of Roma are well known epidemiological findings which can be partially explained by the high prevalence of cardiovascular risk factors among them. This study assesses the prevalence of the cardiovascular disease (CVD) risk factors (age, sex, systolic blood pressure, smoking and diabetes status, elevated total and reduced high density lipoprotein cholesterol level (HDL-C)) and the estimation of 10-year risk of development of CVD (CVD in general, coronary heart disease (CHD), myocardial infarction (MI) and stroke) and that of death from CHD and CVD based on the Framingham Risk Score (FRS) in case of the Hungarian general (HG) and Roma (HR) populations. Methods A complex health survey incl. questionnaire based interview, physical examination and laboratory test was carried out in 2018 on the HG and HR populations. The prevalence of different cardiovascular risk factors was defined and FRS was computed and compared between the HG (n = 378) and HR (n = 386) populations. Results The prevalence of diabetes was significantly higher among Roma females compared to females of general population (17.8% vs. 7.7%; p = 0.001) while the average systolic blood pressure level was less elevated among Roma males (127.9 mmHg vs. 129.4 mmHg; p = 0.020). The prevalence of smoking (males: 63.1% vs. 33.7%; females: 67.6% vs. 31%; p &lt; 0.001) and reduced HDL-C level (males: 40% vs. 25.9%, p = 0.014; females: 55.5% vs. 35.1%, p &lt; 0.001) were significantly higher in both sexes among Roma. The 10-year estimated risk for development of CHD, MI and CVD and the death from CHD was significantly (P &lt; 0.05) higher in both sexes among Roma compared to the general population while the average risk scores for stroke and death from CVD were significantly higher only among Roma men. Conclusions Our results show that both sexes in the Roma population have a significantly higher risk for 10-year development of CVD compared to the Hungarian general population. Key messages The Roma population have a significantly higher risk for 10-year development of cardiovascular diseases and death from them based on the Framingham Risk Score. The targeted cardiovascular interventions should be focus on reduce smoking and provide information on the recognition and treatment of diabetes and lipid disorders among Roma.

scholarly journals Comparison of dietary macronutrient patterns of 14 popular named dietary programmes for weight and cardiovascular risk factor reduction in adults: systematic review and network meta-analysis of randomised trials

BMJ ◽  
2020 ◽  
pp. m696 ◽  
Author(s):  
Long Ge ◽  
Behnam Sadeghirad ◽  
Geoff D C Ball ◽  
Bruno R da Costa ◽  
Christine L Hitchcock ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Blood Pressure ◽  
Weight Loss ◽  
Cardiovascular Risk ◽  
Systolic Blood Pressure ◽  
Cardiovascular Risk Factors ◽  
Diastolic Blood Pressure ◽  
Hdl Cholesterol ◽  
Randomised Trials

Abstract Objective To determine the relative effectiveness of dietary macronutrient patterns and popular named diet programmes for weight loss and cardiovascular risk factor improvement among adults who are overweight or obese. Design Systematic review and network meta-analysis of randomised trials. Data sources Medline, Embase, CINAHL, AMED, and CENTRAL from database inception until September 2018, reference lists of eligible trials, and related reviews. Study selection Randomised trials that enrolled adults (≥18 years) who were overweight (body mass index 25-29) or obese (≥30) to a popular named diet or an alternative diet. Outcomes and measures Change in body weight, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, systolic blood pressure, diastolic blood pressure, and C reactive protein at the six and 12 month follow-up. Review methods Two reviewers independently extracted data on study participants, interventions, and outcomes and assessed risk of bias, and the certainty of evidence using the GRADE (grading of recommendations, assessment, development, and evaluation) approach. A bayesian framework informed a series of random effects network meta-analyses to estimate the relative effectiveness of the diets. Results 121 eligible trials with 21 942 patients were included and reported on 14 named diets and three control diets. Compared with usual diet, low carbohydrate and low fat diets had a similar effect at six months on weight loss (4.63 v 4.37 kg, both moderate certainty) and reduction in systolic blood pressure (5.14 mm Hg, moderate certainty v 5.05 mm Hg, low certainty) and diastolic blood pressure (3.21 v 2.85 mm Hg, both low certainty). Moderate macronutrient diets resulted in slightly less weight loss and blood pressure reductions. Low carbohydrate diets had less effect than low fat diets and moderate macronutrient diets on reduction in LDL cholesterol (1.01 mg/dL, low certainty v 7.08 mg/dL, moderate certainty v 5.22 mg/dL, moderate certainty, respectively) but an increase in HDL cholesterol (2.31 mg/dL, low certainty), whereas low fat (−1.88 mg/dL, moderate certainty) and moderate macronutrient (−0.89 mg/dL, moderate certainty) did not. Among popular named diets, those with the largest effect on weight reduction and blood pressure in comparison with usual diet were Atkins (weight 5.5 kg, systolic blood pressure 5.1 mm Hg, diastolic blood pressure 3.3 mm Hg), DASH (3.6 kg, 4.7 mm Hg, 2.9 mm Hg, respectively), and Zone (4.1 kg, 3.5 mm Hg, 2.3 mm Hg, respectively) at six months (all moderate certainty). No diets significantly improved levels of HDL cholesterol or C reactive protein at six months. Overall, weight loss diminished at 12 months among all macronutrient patterns and popular named diets, while the benefits for cardiovascular risk factors of all interventions, except the Mediterranean diet, essentially disappeared. Conclusions Moderate certainty evidence shows that most macronutrient diets, over six months, result in modest weight loss and substantial improvements in cardiovascular risk factors, particularly blood pressure. At 12 months the effects on weight reduction and improvements in cardiovascular risk factors largely disappear. Systematic review registration PROSPERO CRD42015027929.

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