Abstract P089: Early CVD Events by Race and Sex: Does Risk for Atherothrombotic- and Hypertension-related Events Differ by Race and Sex? The Coronary Artery Risk Development in Young Adults (CARDIA) Study

African Americans (AA), both men (M) and women (W), have higher CVD mortality rates than European Americans (E), but AAM have lower prevalence of coronary calcified plaque than WM. AAs also have higher blood pressure (BP) and HDL-C than W; HDL-C is lower in M than W. We tested the hypotheses that AA race is related to higher risk of hypertension (HTN)-related events, and being male is related to higher risk of atherothrombotic (ATH)-related events, placing AAM at particularly high risk for CVD. Methods: We used baseline risk factor data, and adjudicated events through 28 years of follow-up from the CARDIA study which recruited 5,115 participants aged 18-30 years at baseline (1985-6). ATH-related events included acute coronary syndrome with or without MI, coronary revascularization, and CHD and other atherosclerosis death. HTN-related events included heart failure, end-stage renal disease (ESRD), stroke, and death due to cardiomyopathy. CVD events excluded ESRD and included peripheral artery disease procedures. We analyzed time to first event censoring at death without incident CVD and at follow-up end. We built adjusted Cox models with forward selection including race, sex, age, education, and smoking status as forced predictors and selecting among physical activity, anthropometry, glycemia, lipid, and blood pressure risk factors. Results: In unadjusted analyses, risk of HTN-related events was related to race (p<0.01) but not sex (p=0.35), ATH-related events to sex (P<0.01) but not race (p=0.44), and CVD events to race (p<0.01) and sex (P<0.01). Unadjusted, all risk factors were associated with both HTN- and ATH-related events, except physical activity was not related to ATH and CVD events. After adjustment (table), AAM had higher risk of HTN- and ATH-related events, EM had higher risk of ATH-related events, AAW had higher risk of HTN-related events, and all had higher risk of CVD events than EW. Conclusion: Race and sex are differentially associated with early HTN- vs ATH-related events, and AAM were at increased risk for both.

Download Full-text

Combined lack of blood pressure and lipid control is a major risk factor for mortality in hypertensive patients: a single-center study

European Heart Journal ◽

10.1093/ehjci/ehaa946.2743 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

N Magkas ◽

G Georgiopoulos ◽

D Konstantinidis ◽

E Manta ◽

M Kouremeti ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Baseline Risk ◽

Effective Control ◽

Hypertensive Patients ◽

Increased Risk ◽

All Cause Mortality ◽

Lipid Control ◽

The Impact

Abstract Background Hypertension and dyslipidemia are well-known risk factors for cardiovascular disease (CVD). In such patients, lowering blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) and targeting to values below pre-specified cut-offs prevents CV events and improves prognosis. However, the impact of both BP and LDL-C control as compared to control of only one and/or none of these two risk factors is not well-studied. Methods Among 2,380 treated patients with hypertension and no overt CVD at baseline, we assessed the trajectory of BP control in 1,142 subjects with 4 or more follow up visits; BP control was defined as BP<140/90 mmHg in half or more visits. In the same subgroup, data on lipid control according to LDL-C goals were available in 1,032 patients in 2 or 3 visits. The HeartScore was used to estimate the risk of all-cause death at baseline. Results Across a median follow up of 108 months, 26 deaths (2.44%) were recorded. Despite appropriate anti-hypertensive treatment, 376 patients (32.92%) did not achieve conventional BP control in half or more of follow-up visits. Respectively, 59.83% of the study population did not meet the LDL-C goals in at least one assessment. Patients with suboptimal BP control had almost 3-fold increased risk for all-cause mortality (HR=2.85, 95% CI 1.31–6.21, P=0.008) as compared to subjects with effective control. This association was not attenuated after taking into account age, gender, body mass index, smoking, and diabetes mellitus (adjusted HR=2.54, 95% CI 1.13–5.72, P=0.025). Ineffective LDL-C control was not related to death (HR=1.31, 95% CI 0.688–2.48). However, patients who did not reach treatment goals for both BP and LDL showed substantially increased risk for all-cause mortality (HR=5.42, 95% CI 1.09–26.9, P=0.039). Importantly, suboptimal BP control in our cohort of hypertensive patients was associated with death independently of the HeartScore (adjusted HR=2.65, 95% CI 1.22–5.77, P=0.014) and conferred incremental reclassification value on top of the baseline risk (continuous NRI=0.467, P=0.016). Conclusions Suboptimal BP control was related to all-cause mortality in our cohort of hypertensive patients; importantly, this association was substantially stronger in concurrent presence of LDL-C values above treatment targets, thus, highlighting the need for combined achievement of BP and LDL-C control. Moreover, association of suboptimal BP controlwith death was independent of the HeartScore, suggesting that BP control should be considered in risk stratification of hypertensive patients Funding Acknowledgement Type of funding source: None

Download Full-text

Nasal symptoms increase the risk of snoring and snoring increases the risk of nasal symptoms. A longitudinal population study

Sleep And Breathing ◽

10.1007/s11325-020-02287-8 ◽

2021 ◽

Author(s):

Maria Värendh ◽

Christer Janson ◽

Caroline Bengtsson ◽

Johan Hellgren ◽

Mathias Holm ◽

...

Keyword(s):

Risk Factors ◽

Respiratory Health ◽

Smoking Status ◽

Northern Europe ◽

Nasal Breathing ◽

Nasal Symptoms ◽

Increased Risk ◽

Study Population ◽

Independent Risk Factors

Abstract Purpose Humans have a preference for nasal breathing during sleep. This 10-year prospective study aimed to determine if nasal symptoms can predict snoring and also if snoring can predict development of nasal symptoms. The hypothesis proposed is that nasal symptoms affect the risk of snoring 10 years later, whereas snoring does not increase the risk of developing nasal symptoms. Methods In the cohort study, Respiratory Health in Northern Europe (RHINE), a random population from Denmark, Estonia, Iceland, Norway, and Sweden, born between 1945 and 1973, was investigated by postal questionnaires in 1999–2001 (RHINE II, baseline) and in 2010–2012 (RHINE III, follow-up). The study population consisted of the participants who had answered questions on nasal symptoms such as nasal obstruction, discharge, and sneezing, and also snoring both at baseline and at follow-up (n = 10,112). Results Nasal symptoms were frequent, reported by 48% of the entire population at baseline, with snoring reported by 24%. Nasal symptoms at baseline increased the risk of snoring at follow-up (adj. OR 1.38; 95% CI 1.22–1.58) after adjusting for age, sex, BMI change between baseline and follow-up, and smoking status. Snoring at baseline was associated with an increased risk of developing nasal symptoms at follow-up (adj. OR 1.22; 95% CI 1.02–1.47). Conclusion Nasal symptoms are independent risk factors for development of snoring 10 years later, and surprisingly, snoring is a risk factor for the development of nasal symptoms.

Download Full-text

Future risk of cardiovascular disease risk factors and events in women after a hypertensive disorder of pregnancy

Heart ◽

10.1136/heartjnl-2018-313453 ◽

2019 ◽

Vol 105 (16) ◽

pp. 1273-1278 ◽

Cited By ~ 19

Author(s):

Laura Benschop ◽

Johannes J Duvekot ◽

Jeanine E Roeters van Lennep

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Cardiovascular Disease ◽

Risk Assessment ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Hypertensive Disorder ◽

Cardiovascular Risk Assessment ◽

Increased Risk

Hypertensive disorders of pregnancy (HDP), such as gestational hypertension and pre-eclampsia, affect up to 10% of all pregnancies. These women have on average a twofold higher risk to develop cardiovascular disease (CVD) later in life as compared with women with normotensive pregnancies. This increased risk might result from an underlying predisposition to CVD, HDP itself or a combination of both. After pregnancy women with HDP show an increased risk of classical cardiovascular risk factors including chronic hypertension, renal dysfunction, dyslipidemia, diabetes and subclinical atherosclerosis. The prevalence and onset of cardiovascular risk factors depends on the severity of the HDP and the coexistence of other pregnancy complications. At present, guidelines addressing postpartum cardiovascular risk assessment for women with HDP show a wide variation in their recommendations. This makes cardiovascular follow-up of women with a previous HDP confusing and non-coherent. Some guidelines advise to initiate cardiovascular follow-up (blood pressure, weight and lifestyle assessment) 6–8 weeks after pregnancy, whereas others recommend to start 6–12 months after pregnancy. Concurrent blood pressure monitoring, lipid and glucose assessment is recommended to be repeated annually to every 5 years until the age of 50 years when women will qualify for cardiovascular risk assessment according to all international cardiovascular prevention guidelines.

Download Full-text

Revisiting the Association Between Cardiovascular Risk Factors and Diabetes

The Diabetes Educator ◽

10.1177/0145721709338528 ◽

2009 ◽

Vol 35 (5) ◽

pp. 770-777 ◽

Cited By ~ 2

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.

Download Full-text

The correlation between traditional risk factors and the severity of acute coronary syndrome and long-term prognosis

Cardiosomatics ◽

10.26442/cs45150 ◽

2015 ◽

Vol 6 (4) ◽

pp. 6-10

Author(s):

I. S Skopets ◽

N. N Vezikova ◽

I. M Marusenko ◽

O. Yu Barysheva

Keyword(s):

Risk Factors ◽

Acute Coronary Syndrome ◽

Family History ◽

Coronary Syndrome ◽

Increased Risk ◽

Life Threatening ◽

Traditional Risk Factors ◽

Long Term Prognosis

A number of studies demonstrate that patients with traditional risk factors (TRF) have not only increases primary risk of atherothrombotic events, but are also associated with many complicates and poor prognosis.Purpose: assessment of TRF effect on the incidence of complications and outcomes in patients with acute coronary syndrome (ACS).Materials and methods: in 255 patients hospitalized with ACS were retrospective determined the TRF prevalence, frequency of the complications and correlation between the presence of TRF and the risk of complications and long-term prognosis (follow-up 1 year).Results: patients had TRF very often, 80% patients had more than 3 TRFs. The presence of some TRFs (smoking, abdominal obesity, family history) was associated with a significantly increased risk of complications in patients with ACS, including life-threatening. Effect of TRF on long-term prognosis was not determined.Conclusion: the findings suggest the need to evaluation TRF not only in primary preventive and also to improve the effectiveness of risk stratification in patients with ACS.

Download Full-text

Effects of Physical Activity on Controlling Blood Pressure Among Hypertensive Patients at the Region of Prizren

European Journal of Multidisciplinary Studies ◽

10.26417/ejms.v6i1.p184-186 ◽

2017 ◽

Vol 6 (1) ◽

pp. 184

Author(s):

Nderim Rizanaj ◽

Agron Bytyqi

Keyword(s):

Physical Activity ◽

Blood Pressure ◽

Management Plan ◽

Hypertensive Patients ◽

Blood Pressure Targets ◽

Increased Risk ◽

Prescribing Practice ◽

Different Characteristics ◽

Structured Questionnaire

Aim: To describe the effect of physical activity on controlling blood pressure among hypertensive patients at Region of Prizren. Method: A sample of 101 patients diagnosed with hypertension in the region of Prizren, which were randomly selected from those hypertensive patients who visited the Main Family Medicine Centre and Private ambulance “Nderimed” for their regular follow up. A structured questionnaire (Life Style Questionnaire and Perceived Stress Scale) with questions on different characteristics was administered. In terms of gender composition there were 41 men and 49 women, aged between 45 and 74 years old. Result: Among our sample just 7.8% reported that they make physical activity regularly. 68% of the sample reported that they engaged less than one hour per week in some kind of activity and their motivation to do so was also weak, just half of them report that they want to lose in weight. When participants were asked how many hours they move by walk or bike, with 0 hours reported 69%. Conclusion: The increased risk of physical inactivity in controlling hypertension in this study suggests that general practitioners must be in the habit of prescribing practice of physical exercise and patients are followed up regularly to confirm that they are adhering to the management plan and the blood pressure targets are being met.

Download Full-text

Evaluating Mortality Rate and Associated Parameters in Patients with Acute Coronary Syndrome

Cardiovascular & Haematological Disorders - Drug Targets ◽

10.2174/1871529x20666200709130533 ◽

2020 ◽

Vol 20 (3) ◽

pp. 221-226

Author(s):

Alireza Gheini ◽

Ali Pooria ◽

Afsoun Pourya

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Acute Coronary Syndrome ◽

Mortality Rate ◽

Winter Season ◽

Cross Sectional Study ◽

Cross Sectional ◽

Killip Class ◽

Coronary Syndrome ◽

Increased Risk

Background: Acute coronary syndrome (ACS) is one of the leading causes of mortality worldwide and is characterized by unstable angina or acute myocardial infarction. The aim of this study is to evaluate the clinical characteristics of patients who died of ACS. Methods: In this cross-sectional study, 1000 patients presenting ACS were included. Data and records of these patients were evaluated for parameters such as; deceased status, age, gender, diagnosis, ECG, common complaints, associated risk factors, Killip class, pulse, blood pressure, geographic setup (urban or rural), complications and season in which the disease was presented. Statistical analysis was performed on the data obtained using SPSS-win software. Results: The mortality rate among ACS patients in our study was 7.1%. Of these patients, AMI was the most prevalent diagnosis and chest pain was the most common complaint. Furthermore, low blood pressure, advanced age, increased pulse rate and fall/winter season were associated with the increased risk of mortality. ST deviation was the most seen ECG finding and most of the mortalities were within the 24 hours of admission. Conclusion: Our study reports risk factors associated with mortality in ACS patients. Advanced and timely therapeutic measurements are likely to reduce the incidence of mortality in these patients.

Download Full-text

Awareness of Lifestyle and Colorectal Cancer Risk: Findings from the BeWEL Study

BioMed Research International ◽

10.1155/2015/871613 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 9

Author(s):

Annie S. Anderson ◽

Stephen Caswell ◽

Maureen Macleod ◽

Angela M. Craigie ◽

Martine Stead ◽

...

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Behavioural Change ◽

Intervention Group ◽

Knowledge Score ◽

Control Group ◽

Increased Risk ◽

Diet And Physical Activity ◽

And Control

It is estimated that 47% of colorectal cancers (CRC) could be prevented by appropriate lifestyles. This study aimed to identify awareness of the causes of CRC in patients who had been diagnosed with a colorectal adenoma through the Scottish Bowel Screening Programme and subsequently enrolled in an intervention trial (using diet and physical activity education and behavioural change techniques) (BeWEL). At baseline and 12-month follow-up, participants answered an open-ended question on factors influencing CRC development. Of the 329 participants at baseline, 40 (12%) reported that they did not know any risk factors and 36 (11%) failed to identify specific factors related to diet and activity. From a potential knowledge score of 1 to 6, the mean score was 1.5 (SD 1.1, range 0 to 5) with no difference between intervention and control groups. At follow-up, the intervention group had a significantly greater knowledge score and better weight loss, diet, and physical activity measures than the control group. Awareness of relevant lifestyle factors for CRC remains low in people at increased risk of the disease. Opportunities within routine NHS screening to aid the capability (including knowledge of risk factors) of individuals to make behavioural changes to reduce CRC risk deserve exploration.

Download Full-text

Occupational Physical Activity and New-Onset Hypertension: A Nationwide Cohort Study in China

Hypertension ◽

10.1161/hypertensionaha.121.17281 ◽

2021 ◽

Author(s):

Qinqin Li ◽

Rui Li ◽

Shaojie Zhang ◽

Yuanyuan Zhang ◽

Panpan He ◽

...

Keyword(s):

Physical Activity ◽

Blood Pressure ◽

Occupational Physical Activity ◽

Nutrition Survey ◽

Metabolic Equivalent ◽

Health And Nutrition ◽

Increased Risk ◽

Males And Females ◽

New Onset

The association between occupational physical activity (OPA) and the risk of hypertension remains uncertain. We aimed to examine the prospective relations of OPA and new-onset hypertension among Chinese males and females. A total of 9350 adults who were free of hypertension at baseline were enrolled from the CHNS study (China Health and Nutrition Survey). Data on OPA were obtained by using self-reported questionnaires and calculated as metabolic equivalent task (MET)–hours per week. MET–hours per week may account for both intensity and time spent on activities. The study outcome was new-onset hypertension, defined as systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg or diagnosed by physician or under antihypertensive treatment during the follow-up. During a median of 6.1 years (82 410 person-years) of follow-up, a total of 2949 participants developed hypertension. Overall, there was a L-shaped association between the OPA and new-onset hypertension in males and a U-shaped association in females (all P values for nonlinearity <0.001). Accordingly, when OPA was categorized as four groups (<80, 80–<160, 160–<240, and ≥240 metabolic MET–hours per week), in males, the risk of new-onset hypertension was significantly increased only among participants with OPA <80 MET–hours per week; however, in females, the lowest risk of new-onset hypertension was found among those with OPA 80 to 240 MET–hours per week. In summary, moderate OPA, in terms of both duration and intensity, is associated with a lower risk of new-onset hypertension among both males and females, whereas heavy OPA was related to increased risk of new-onset hypertension in females.

Download Full-text

Abstract P327: Risk Factors for Prehypertension in the Community

Circulation ◽

10.1161/circ.127.suppl_12.ap327 ◽

2013 ◽

Vol 127 (suppl_12) ◽

Author(s):

Lisa Rafalson ◽

Richard P Donahue ◽

Saverio Stranges

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

New York ◽

Weight Gain ◽

Waist Circumference ◽

General Population ◽

Population Based ◽

Health Study ◽

Increased Risk

Background: Prehypertension is an increasingly highly prevalent condition in the general population, and is associated with an increased risk for coronary heart disease and stroke. However, evidence from population-based studies of the risk factors for prehypertension is scant. We sought to examine the predictors of progression from normotension to prehypertension in a community-based population from Western New York. Methods: We conducted a longitudinal analysis, over six years of follow-up, among 569 men and women (51.8 years, 96% White, 70% female) who were free of prehypertension, hypertension, cardiovascular disease and type 2 diabetes at the baseline examination, in the Western New York Health Study (WNYHS). Incident prehypertension at follow-up was defined as systolic blood pressure of 120-139 mmHg and/or diastolic blood pressure of 80-89 mmHg. Results: In bivariate analyses, there were several correlates of incident prehypertension, including age, BMI and waist circumference, impaired fasting glucose (IFG), uric acid, and baseline blood pressure levels. After multivariate adjustment, IFG at baseline odds ratio (OR):1.69, 95%CI:1.06-2.67) and weight gain since age 25 (OR: 1.28, 1.11-1.58 per 10 lb. increase) were the strongest significant predictors of prehypertension at follow-up. Neither waist circumference nor current BMI were predictor variables in models when they were substituted for weight gain. Conclusions: Results from this study suggest early dysregulation of glucose metabolism and weight gain over the lifespan are likely to represent important risk factors for prehypertension in the general population.

Download Full-text