Abstract P171: Hemoglobin A1c and Incident Albuminuria Among Individuals Without Diabetes: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
April P Carson ◽  
Paul Muntner ◽  
Mercedes R Carnethon ◽  
Myron D Gross ◽  
Cora E Lewis
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Cardiovascular Risk Factors ◽  
Hemoglobin A1c ◽  
The United States ◽  
Continuous Variable ◽  
Urine Albumin ◽  
Increased Risk

Background: Higher hemoglobin A1c (HbA1c) has been associated with an increased risk of reduced estimated glomerular filtration rate <60 mls/min/1.73m2 among individuals without diabetes. However, it is unclear whether higher HbA1c in the non-diabetic glycemic range also is associated with an increased risk of albuminuria. This study investigated the association of HbA1c with incident albuminuria in a biracial cohort of middle-aged men and women without a history of diabetes in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Methods: The CARDIA Study is a prospective cohort study of 5,115 African-American and white adults, age 18-30 years at baseline (1985-86), from four field centers in the United States: Birmingham, AL; Chicago, IL; Minneapolis, MN; and Oakland, CA. Participants with prevalent diabetes (defined as fasting glucose ≥126 mg/dL, 2-hour post-challenge glucose ≥ 200 mg/dL, HbA1c ≥ 6.5%, or used diabetes medications) or albuminuria (defined as a race- and sex-adjusted urine albumin-to-creatinine ratio ≥ 25 mg/g) at the year 20 examination (2005-06; baseline for this analysis) were excluded. This study included 2174 participants who had HbA1c measured at the year 20 examination and had urine albumin and creatinine measured at the year 25 examination (2010-11). Poisson regression with robust error variances was used to obtain risk ratios (RR) and 95% confidence intervals (CI) for the association of HbA1c, both as a continuous variable and dichotomous variable using its prediabetes cut-point, with albuminuria in unadjusted models and models adjusted for socio-demographics and cardiovascular risk factors. Results: During the follow-up period, 103 (4.7%) participants developed incident albuminuria. In unadjusted analyses, each 1% increase in HbA1c was associated with incident albuminuria (RR=2.55, 95% CI=1.48, 4.39). This association was attenuated and not statistically significant after adjustment for age, race, sex, and education (RR=1.68, 95% CI=0.98, 2.88) and further adjustment for cardiovascular risk factors (RR=1.42, 95% CI=0.81, 2.50). Additionally, individuals with HbA1c in the prediabetes range (5.7%-6.4%) had an increased risk of albuminuria (RR=1.59, 95% CI=1.04, 2.43) compared with those with HbA1c in the normal glycemic range (<5.7%) in the unadjusted model. However, this association was attenuated after adjustment for socio-demographics (RR=1.11, 95% CI=0.71, 1.72) and cardiovascular risk factors (RR=0.98, 95% CI=0.61, 1.55). Conclusions: After taking into account socio-demographics and traditional cardiovascular risk factors, HbA1c was not associated with incident albuminuria among individuals without diabetes.

scholarly journals Revisiting the Association Between Cardiovascular Risk Factors and Diabetes

2009 ◽  
Vol 35 (5) ◽  
pp. 770-777 ◽  
Author(s):  
Kyeongra Yang ◽  
Eileen R. Chasens ◽  
Susan M. Sereika ◽  
Lora E. Burke
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Smoking Status ◽  
Strong Predictor ◽  
Large Population ◽  
The United States ◽  
Behavioral Risk ◽  
Increased Risk

Purpose The purpose of this study was to examine the association between cardiovascular risk factors and the presence of diabetes in a large population-level dataset. Methods A secondary analysis was conducted using data from the 2007 Behavioral Risk Factor Surveillance System, a population-based survey (n = 403,137) conducted in the United States. Results The majority of the respondents were middle-aged and overweight. Approximately half of the sample reported little or no physical activity. Estimates from a logistic regression model for a weighted sample of white, black, and Hispanic adults revealed that having hypertension or elevated cholesterol was a strong predictor of diabetes even when controlling for age, gender, race, education, income, body mass index, smoking status, and physical activity. Conclusions The results confirmed the importance of diabetes educators counseling patients with hypertension or hypercholesterolemia about their increased risk for developing diabetes.

scholarly journals Asymmetrical Dimethylarginine Independently Predicts Total and Cardiovascular Mortality in Individuals with Angiographic Coronary Artery Disease (The Ludwigshafen Risk and Cardiovascular Health Study)

2007 ◽  
Vol 53 (2) ◽  
pp. 273-283 ◽  
Author(s):  
Andreas Meinitzer ◽  
Ursula Seelhorst ◽  
Britta Wellnitz ◽  
Gabriele Halwachs-Baumann ◽  
Bernhard O Boehm ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Cardiovascular Risk Factors ◽  
Cardiovascular Mortality ◽  
Asymmetrical Dimethylarginine ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Artery Disease

Abstract Background: Asymmetrical dimethylarginine (ADMA) is increased in conditions associated with increased risk of atherosclerosis. We investigated the use of ADMA to predict total and cardiovascular mortality in patients scheduled for coronary angiography. Methods: In 2543 persons with and 695 without coronary artery disease (CAD) identified by angiography we measured ADMA and recorded total and cardiovascular mortality during a median follow-up of 5.45 years. Results: ADMA was correlated positively to age, female sex, diabetes mellitus, former and current smoking, and C-reactive protein and inversely to HDL cholesterol and triglycerides. ADMA was not associated with body mass index, hypertension, LDL cholesterol, or the presence or absence of angiographic CAD. Glomerular filtration rate and homocysteine were the strongest predictors of ADMA. At the 2nd, 3rd and 4th quartile of ADMA, hazard ratios for all-cause mortality adjusted for age, sex, and cardiovascular risk factors were 1.12 [95% confidence interval (CI) 0.83–1.52], 1.35 (95% CI 1.01–1.81), and 1.87 (95% CI 1.43–2.44), respectively, compared with the 1st quartile. Hazard ratios for cardiovascular death were 1.13 (95% CI 0.78–1.63), 1.42 (95% CI 1.00–2.02), and 1.81 (95% CI 1.31–2.51). ADMA in the highest quartile remained predictive of mortality after accounting for medication at baseline. The predictive value of ADMA was similar to that in the entire cohort in persons with CAD, stable or unstable, but was not statistically significant in persons without angiographic CAD. Conclusions: ADMA concentration predicts all-cause and cardiovascular mortality in individuals with CAD independently of established and emerging cardiovascular risk factors.

scholarly journals The effects of cardiovascular risk factors on cognitive compromise

2009 ◽  
Vol 11 (2) ◽  
pp. 201-212 ◽  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Cumulative Effect ◽  
The United States ◽  
Reactive Protein ◽  
Increased Risk ◽  
Dose Dependent Fashion ◽  
Complex Relationships

As life expectancy in the United States continues to increase, the projected numbers of elderly people who will develop dementia will grow rapidly. This paper reviews four well-established cardiovascular risk factors (type 2 diabetes, hypertension, cholesterol, and inflammation), for which there is longitudinal epidemiological evidence of increased risk of dementia, Alzheimer's disease, mild cognitive impairment, and cognitive decline. These risk factors are of special interest because of their potential modifiability, which may affect the course of cognitive compromise. Diabetes is the cardiovascular risk factor (CvRF) most consistently associated with cognition. Hypertension in midlife is consistently associated with cognition, but its associations with late-life hypertension are less clear. Total cholesterol is not consistently associated with cognition. Interleukin-6 and C-reactive protein are inflammatory markers relatively consistently associated with cognition. Composites of the CvRFs increase the risk for dementia in a dose-dependent fashion, suggesting a cumulative effect of these factors on neuronal stress. In the relatively few studies that have reported interactions of risk factors, they potentiate each other. The effect of each of these risk factors varies according to apolipoprotein E genotype. It may be that the effect of these risk factors varies according to the presence of the others, and these complex relationships underlie the biological mechanisms of cognitive compromise. This may be crucial for understanding the effects on cognition of drugs and other approaches, such as lifestyle change, for treating these risk factors.

scholarly journals Prevalence of coronary artery calcification in young adults in UK

2021 ◽  
Vol 22 (Supplement_3) ◽  
Author(s):  
G Koulaouzidis
Keyword(s):  
Risk Factors ◽  
Computed Tomography ◽  
Young Adults ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Cardiovascular Risk Factors ◽  
Coronary Artery Calcification ◽  
Subclinical Atherosclerosis ◽  
Study Cohort ◽  
History Of

Abstract Funding Acknowledgements Type of funding sources: None. Background Coronary atherosclerosis is a continuous process beginning early in life, with a long and clinically asymptomatic phase, before manifestations appear in middle and/or late adulthood. Coronary artery calcification (CAC) is a well-established marker of atherosclerosis; but the clinical validity of CAC in young adults (traditionally considered as a population group of low cardiovascular risk) remains unclear. Aim We aimed to assess the prevalence of CAC in a population of young individuals without previous history of coronary artery disease (CAD) in the UK and its association with conventional cardiovascular risk factors. Methods This analysis includes 4186 asymptomatic young individuals who underwent electron beam computed tomography (EBCT). Demographic information and the presence of cardiovascular risk factors were abstracted from referral letters and/or questionnaires completed by the patients prior to their tests. Individuals with previously documented CAD or chronic kidney disease were excluded. All EBCT CAC studies were performed using the same scanner (Imatron C300 Ultrafast computed tomography scanner, GE Healthcare, London, UK) and the same scanning protocol. Results The age (mean SD) of the study cohort was 40.5 ±3.6 years (range 26–45 years, 83.8% males). Hypertension, dyslipidemia, and diabetes mellitus (DM) were present in 15.5, 7.9, and 2.8% of individuals, respectively. Family history of premature CAD was present in 17% and 17.4% were smokers.  CAC was present in 21.8% of the cohort, while individuals with CAC comparing with those with CAC score 0 were males (95.2 vs. 80%, p &lt; 0.002), older in age (41.4 3.2 vs. 40.3 3.7 years, p &lt; 0.0001), with DM (5.5 vs. 25%, p &lt; 0.0001), hypertension (22 vs. 13.7%, p &lt; 0.0001), and dyslipidemia (14.8 vs. 6%, p &lt; 0.0001). The prevalence of CAC score 0, 1–100, 101–400, 401–1000, &gt;1000 were 78.2, 19, 2.1, 0.5, and 0.2%, respectively. The prevalence and distribution of CAC among various age groups are shown in Table 1. CAC was found in 24.8% of males (CAC score 1–100, 101–400, 400–1000, &gt;1000 in 21.6, 2.5, 0.5, and 0.1%, respectively) and 6.6% of females (CAC score 1–100, 101–400, 400–1000, &gt;1000 in 5.4, 0.6, 0.15 and 0.4%, respectively) (p &lt; 0.0001). There was no statistical difference of mean CAC score between genders (males 13.8 72.7; females 11.8 142.4; p = 0.6). In multivariate analysis, the presence of CAC was associated with age (p&lt; 0.0001), male gender (p&lt; 0.0001), DM (p&lt; 0.0001), hypertension (p&lt; 0.0001), and dyslipidemia (p&lt; 0.0001).  Conclusion   In a large cohort of asymptomatic young individuals, subclinical atherosclerosis (CAC score &gt;0) was identified in approximately 20%. Assessment of CAC score is a useful clinical tool in young individuals, as it can confirm the presence of subclinical atherosclerosis.

Recreational opium use as a risk factor for coronary artery disease: results from the premature coronary artery disease Milano-Iran (MIran) study

2020 ◽  
Author(s):  
Alberto Maino ◽  
Saeed Sadeghian ◽  
Ilaria Mancini ◽  
Seyed Hesameddin Abbasi ◽  
Hamidreza Poorhosseini ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Cardiovascular Risk Factors ◽  
Premature Coronary Artery Disease ◽  
Control Analysis ◽  
Increased Risk ◽  
Artery Disease ◽  
Opium Use

Abstract The spreading of recreational opium use pose new health related concerns. In some areas of Asia its use is believed to protect from cardiovascular disorders, such as coronary artery disease (CAD). However, whether opium use has an association with CAD is unclear. We aimed to investigate the association between opium use and CAD. We set up a case-control analysis, i.e., the premature CAD Milano-Iran (MIran) study by enrolling consecutive young patients who underwent a coronary angiography at the Tehran Heart Center, between 2009 and 2012. Incident cases with CAD were contrasted with controls for recreational opium use. Relative risks were calculated in terms of odds ratios (ORs) by logistic regression models adjusted for age, sex, cigarette smoking, body mass index, hypertension, hyperlipidaemia, and diabetes. Interaction analyses were performed between opium and major cardiovascular risk factors. 1011 patients with CAD (mean age 43.6 years) and 2002 controls (mean age 54.3 years) were included in the study. Habitual opium users had a 3.8-fold increased risk of CAD (95%CI 2.4–6.2) compared with non-users. The association was strongest for men, with a fully adjusted OR of 5.5 (95%CI 3.0-9.9). No interaction was observed for the combination of opium addiction and hypertension, or diabetes, but an excess in risk was found in opium users with hyperlipidaemia (OR 16.8, 95%CI 8.9–31.7, expected OR 12.2), suggesting supra-additive interaction. In conclusion, despite common beliefs, we showed that recreational opium use is associated with an increased risk of CAD, even when other cardiovascular risk factors are taken into account.

830 Why We Should Be Looking for A Diagonal Ear Lobe Crease In ENT. A Meta-Analysis of Diagonal Ear Lobe Crease and Coronary Artery Disease

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
J Curtis ◽  
S Walford
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Cardiovascular Risk Factors ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Increased Risk ◽  
Artery Disease ◽  
The Relationship

Abstract Introduction An association between a diagonal ear lobe crease (DELC) and cardiovascular disease, was first suggested by Sanders T. Frank in 1973(1). Since then, there have been numerous further studies that have investigated the association of ‘Frank’s Sign’ with carotid disease, cerebral vascular disease, and diabetic retinopathy. This review looks to see if there is a significant association between the presence of a DELC and coronary artery disease (CAD). Method Meta-analysis of selected studies, published between 1974 and 2017, using the PRISMA checklist(2). Results We included 12 studies in the pooled analysis, which included 2415 cases and 2545 controls. Our study found that patients with DELC, have an increased likelihood of having CAD (OR 4.61). Also, despite some previous studies suggesting that DELC was simply a result of age, all ten of the included studies that looked at this found that the relationship between DELC and CAD was independent of both age and other known cardiovascular risk factors. Conclusions We found that DELC is associated with CAD independently of other known cardiovascular risk factors, including age. Patients with DELC appear to have a substantially increased risk of CAD, and this may be higher for patients with bilateral DELC.

scholarly journals Association between Hs-CRP and other Cardiovascular Risk Factors with Blood Pressure in Young Adults

2021 ◽  
Vol 20 (2) ◽  
Author(s):  
Asmak A.S. ◽  
Aszrin A. ◽  
Nor Zamzila A. ◽  
Aida N.S M. S. ◽  
Azarisman S.M.S.
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Young Adults ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Cross Sectional ◽  
Parental History ◽  
Preventable Risk Factor ◽  
Increased Risk ◽  
Hs Crp

INTRODUCTION: Hypertension remains the leading preventable risk factor for premature mortality and morbidity worldwide. The use of high-sensitivity C-reactive protein (hs-CRP) as the global risk prediction assessment for cardiovascular diseases (CVD) in asymptomatic individuals suggests the possibility that higher hs-CRP, or subclinical inflammation, maybe one of the causal factors contributing to an increased risk of CVD in young hypertensive patients. Most studies of hypertension and hs-CRP association were conducted regionally, whereby most of the participants were Caucasians with age beyond 40 years old. Studies of this association among young adults in Asian populations are lacking, therefore, a generalization of data might be limited to certain ages and populations only. MATERIALS AND METHOD: This comparative cross-sectional study analysed the association between hs-CRP and other cardiovascular risk factors with three different blood pressure statuses categorised into Normotensive (NT), Pre-hypertensive (PHT), and Hypertensive (HPT) groups among young adults in Kuantan, Pahang, Malaysia. RESULTS: Independently, the association was significant only in males and subjects with parental history of hypertension in the prehypertensive group. However, in the hypertensive group, the relationships were significant not only in males and individuals with parental histories of hypertension but also in obese subjects. Hs[1]CRP was not associated with blood pressure status in the present study. CONCLUSION: The hypothesis that hs[1]CRP has an independent association with blood pressure status was not demonstrated in the present study. However, the observed association between circulating hs-CRP and blood pressure status is likely to be driven by confounders namely age, gender, genetic factors, and BMI status.

Sign in / Sign up

Export Citation Format

Share Document