Abstract P371: Race Disparities in the Contribution of Lipid Profiles to Ankle-Brachial Index: Lifecourse Evidence from the Bogalusa Heart Study

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Camilo Fernandez ◽  
Liqiang Zheng ◽  
Yajun Guo ◽  
Rupert Barshop ◽  
Emily Harville ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ankle Brachial Index ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Lipid Lowering ◽  
Regression Analyses ◽  
Bogalusa Heart Study ◽  
Heart Study ◽  
The Impact

Background: Ankle-brachial index (ABI) is a practical non-invasive estimation of the burden of atherosclerosis on the vascular system. Although cholesterol is known to affect ABI as part of the disease process, information is limited on the contribution of longitudinal measures of cholesterol on the decline of ABI over time. Hypothesis: Race (black-white)—specific differences exist in cumulative burden effects of cholesterol, measured from childhood to adulthood, on ABI decline in young adults. Methods: We examined 497 adult participants of the Bogalusa Heart Study (72.8% white, 43.1% men, age 32-51 years), who had at least 3 measurements of cardiovascular (CV) risk factors since childhood (average follow-up 33.5 years). ABI was obtained in two separate instances: baseline (2001-2002) and follow-up (2007-2010), and its change was computed as the mean difference, divided by the time (years), between the two instances. The long-term cumulative burden of each risk factor was calculated as the total area under the curve (AUCt). Measurements of cholesterol and other CV risk factors in childhood, adulthood and AUCt were standardized to z-scores prior to regression analyses. Results: ABI significantly decreased (1.09±0.09 vs 1.03±0.09, p<0.01) after a mean follow-up of 6.8 years. There were no significant differences in annual ABI decline between male and female (p=0.56) / black and white (p=0.18) participants. In multivariable linear regression analyses, after adjustment for sex, lipid-lowering medications, smoking status, body mass index, systolic blood pressure and baseline ABI, significant predictors of annual ABI decline in white participants were: childhood total cholesterol (TC) (β= -0.11, p<0.01), low-density lipoprotein cholesterol (LDL-C; β= -0.10; p<0.01), and non-high-density lipoprotein cholesterol (non-HDL-C; β= -0.10, p<0.01), as well as the AUCt of TC (β= -0.09; p=0.02) and non-HDL-C (β= -0.08, p=0.04). The AUCt of HDL-C was the only significant predictor in black participants (β= 0.16, p=0.04). Conclusions: These findings suggest that the impact of cholesterol levels on future adult ABI decline starts in childhood, and follows a cumulative detrimental pattern throughout the lifespan in a race-dependent fashion. Further, this information may aid in the development of strategies to improve prevention, diagnosis and treatment of vascular disease by race group

Abstract 622: Inflammation and Arterial Compliance: A Paradox? The Bogalusa Heart Study

2015 ◽  
Vol 35 (suppl_1) ◽  
Author(s):  
Camilo Fernández Alonso ◽  
Patrick Stuchlik ◽  
Rupert Barshop ◽  
Patrycja Galazka ◽  
Roberto Blandon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Linear Regression ◽  
Arterial Compliance ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Regression Analyses ◽  
Bogalusa Heart Study ◽  
Non Invasive ◽  
Heart Study ◽  
Hs Crp

Introduction: Systemic inflammation -as measured by high-sensitivity C-reactive protein (hs-CRP)- is adversely associated with arterial compliance. However, information is scant on whether this association in consistent throughout the different non-invasive measurements of arterial compliance. Hypothesis: We assessed the hypothesis that divergences exist in the association between hs-CRP and measurements of arterial compliance, and that this association differs among race (white/black) groups in relatively young adults. Methods: Measurements of hsCRP and non-invasive arterial compliance --large-artery elasticity index (C1), small-artery elasticity index (C2), brachial-ankle pulse-wave velocity (ba-PWV) and augmentation index (AI@75)-- were assessed in 702 non-institutionalized participants with a mean age of 43.5 years (29.4-51.1 years); 70.8% whites and 43.7% males, as a part of the Bogalusa Heart Study. Race-specific independent associations were tested through multivariable-adjusted linear regression analyses. Results: Black vs white participants had higher hs-CRP, baPWV and AI@75 (p<0.01); whereas C1 and C2 were higher in whites (p<0.01). In multivariable-adjusted linear regression analyses, controlling for: age, sex, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), body mass index (BMI), smoking status and other traditional cardiovascular risk factors, hs-CRP was significantly and independently associated with AI@75 (β=0.11, p<0.01) and C1 (β=-0.08, p=0.04), in whites only. In contrast, black participants did not show any significant associations among these parameters. C2 and baPWV did not exhibit association with either race group. Conclusion: In conclusion, these findings help enhance the concept that the association of inflammation and arterial compliance is seemingly relative, as it is dependent on the measurement used to assess the latter; with its impact varying by race (black-white). Further, these observations may aid in revising existing methodologies used in the diagnosis of inflammation-mediated structural and functional damage, in addition to enhance race-specific approaches for screening and prevention of cardio-metabolic risk factors.

scholarly journals Technology-based methods in the improvement of therapy compliance among ambulatory cardiac patients: one-year follow-up data

2012 ◽  
Vol 11 (4) ◽  
pp. 36-41 ◽  
Author(s):  
F. T. Ageev ◽  
T. V. Fofanova ◽  
M. D. Smirnova ◽  
A. Sh. Tkhostov ◽  
A. S. Nelubina ◽  
...  
Keyword(s):  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Self Control ◽  
Lipoprotein Cholesterol ◽  
Lipid Lowering ◽  
Telephone Reminder ◽  
Therapy Compliance ◽  
One Year ◽  
The Impact

Aim. To assess the impact of automatic telephone survey with a differentiated reminder text, as well as of the survey combination with the self-control dairy, on the compliance with lipid-lowering and antihypertensive therapy and on therapy effectiveness during the longterm ambulatory follow-up. Material and methods. The study included 604 patients: 323 individuals with high or very high cardiovascular risk levels by SCORE scale and 281 participants with coronary heart disease (CHD). The patients were divided into two groups, according to their agreement to participate in the automatic telephone reminder survey (“Survey” and “Refusal”). All participants were also given a self-control diary. At baseline and one year later, the patients underwent general clinical examination, office blood pressure (BP) measurement, blood biochemistry assessment, and the measurement of therapy compliance (Morisky-Green test), anxiety, and depression levels (HADS scale). Results. The reduction in diastolic BP levels was significantly larger in the Survey group (p=0,04). This group also demonstrated a significantly larger decrease in the levels of total cholesterol (TCH) (p=0,0003) and low-density lipoprotein cholesterol (LDL-CH) (p=0,001), as well as a significantly larger increase in the levels of high-density lipoprotein cholesterol (HDL-CH) (p=0,04). The therapy compliance, assessed by the Morisky-Green test, improved in both groups; however, among CHD patients, a significant improvement was observed only in the Survey group (p<0,00001). The percentage of patients submitting their self-control diaries was higher for the Survey group (p<0,0001). Conclusion. The automatic telephone reminder method provides an opportunity to significantly increase the therapy compliance.

Triglyceride to high density lipoprotein cholesterol ratio, total cholesterol to high density lipoprotein cholesterol ratio and low ankle brachial index in an elderly population

VASA ◽  
2014 ◽  
Vol 43 (3) ◽  
pp. 189-197 ◽  
Author(s):  
Yiqiang Zhan ◽  
Jinming Yu ◽  
Rongjing Ding ◽  
Yihong Sun ◽  
Dayi Hu
Keyword(s):  
High Density Lipoprotein ◽  
Total Cholesterol ◽  
High Density Lipoprotein Cholesterol ◽  
Ankle Brachial Index ◽  
Density Lipoprotein ◽  
High Density ◽  
Lipoprotein Cholesterol ◽  
Lipid Lowering ◽  
Cholesterol Ratio ◽  
Potential Biomarker

Background: The associations of triglyceride (TG) to high-density lipoprotein cholesterol ratio (HDL‑C) and total cholesterol (TC) to HDL‑C ratio and low ankle brachial index (ABI) were seldom investigated. Patients and methods: A population based cross-sectional survey was conducted and 2982 participants 60 years and over were recruited. TG, TC, HDL‑C, and low-density lipoprotein cholesterol (LDL-C) were assessed in all participants. Low ABI was defined as ABI ≤ 0.9 in either leg. Multiple logistic regression models were applied to study the association between TG/HDL‑C ratio, TC/HDL‑C ratio and low ABI. Results: The TG/HDL‑C ratios for those with ABI > 0.9 and ABI ≤ 0.9 were 1.28 ± 1.20 and 1.48 ± 1.13 (P < 0.0001), while the TC/HDL‑C ratios were 3.96 ± 1.09 and 4.32 ± 1.15 (P < 0.0001), respectively. After adjusting for age, gender, body mass index, obesity, current drinking, physical activity, hypertension, diabetes, lipid-lowering drugs, and cardiovascular disease history, the odds ratios (ORs) with 95 % confidence intervals (CIs) of low ABI for TG/HDL‑C ratio and TC/HDL‑C ratio were 1.10 (0.96, 1.26) and 1.34 (1.14, 1.59) in non-smokers. When TC was further adjusted, the ORs (95 % CIs) were 1.40 (0.79, 2.52) and 1.53 (1.21, 1.93) for TG/HDL‑C ratio and TC/HDL‑C ratio, respectively. Non-linear relationships were detected between TG/HDL‑C ratio and TC/HDL‑C ratio and low ABI in both smokers and non-smokers. Conclusions: TC/HDL‑C ratio was significantly associated with low ABI in non-smokers and the association was independent of TC, TG, HDL‑C, and LDL-C. TC/HDL‑C might be considered as a potential biomarker for early peripheral arterial disease screening.

scholarly journals A U-Shaped Association between LDL-C/HDL-C Ratio and all-Cause Mortality in Elderly Hypertensive Patients: A Prospective Cohort Study

2020 ◽  
Author(s):  
Yu Yu ◽  
Minghui Li ◽  
Xiao Huang ◽  
Wei Zhou ◽  
Tao Wang ◽  
...  
Keyword(s):  
Reference Group ◽  
Survival Curve ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Lipid Lowering ◽  
Hypertensive Patients ◽  
All Cause Mortality ◽  
Elderly Hypertensive ◽  
Elderly Hypertensive Patients

Abstract Background: Low-density lipoprotein cholesterol/high-density lipoprotein- cholesterol (LDL-C/HDL-C) ratio is an excellent predictor of cardiovascular disease (CVD). However, previous studies linking LDL-C/HDL-C ratio to mortality have been inconsistent and limited by short follow-up. Therefore, the aim of the present study was to determine whether LDL-C/HDL-C ratio could be an effective predictor of all-cause mortality in elderly hypertensive patients.Methods: We selected 6,941 hypertensive patients aged 65 years or older and untreated with lipid-lowering drugs from the Chinese Hypertension Registry for analysis. The endpoint of the study was all-cause mortality. The relationship between LDL-C/HDL-C ratio and all-cause mortality by using multivariate cox proportional hazards regression, smoothing curve fitting (penalized spline method), subgroup analysis and Kaplan–Meier survival curve to address.Results: During a median follow-up of 1.72 years, 157 all-cause deaths occurred. A U-shaped association was found between LDL-C/HDL-C ratio and all-cause mortality. The LDL-C/HDL-C ratio was divided into five groups according to quintiles. Compared to the reference group (Q3: 1.67-2.10), both lower (Q1 and Q2) and higher (Q4 and Q5) LDL-C/HDL-C ratios were associated with higher all-cause mortality (<1.67: HR 1.81, 95% CI: 1.08-3.03; ≥2.10: HR 2.00, 95% CI: 1.18-3.39). Compare with lower and higher LDL-C/HDL-C ratio groups, patients with LDL-C/HDL-C ratio of 1.67-2.10 had a significant higher survival probability (log-rank P = 0.038).Conclusion: Our results suggested that there was a U-shaped association between LDL-C/HDL-C ratio and all-cause mortality. Both lower and higher LDL-C/HDL-C ratios were associated with increased all-cause mortality in elderly hypertensive patients.

scholarly journals The Impact of Changes in Population LDL-C Levels on LDL-C Control in Patients After PCI in China: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Huan Liu ◽  
Zhipeng Zhou ◽  
Yanqing Wu ◽  
Jingsong Xu
Keyword(s):  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Blood Lipid ◽  
Coronary Intervention ◽  
Lifestyle Changes ◽  
Treatment Goal ◽  
Lipid Lowering ◽  
Lipid Control ◽  
The Impact

Abstract BANKGROUND: Mortality from coronary artery disease continues to rise, and secondary prevention and treatment are particularly important. OBJECTIVE: The objective of this study is to evaluate low-density lipoprotein cholesterol (LDL-C) levels in patients after percutaneous coronary intervention (PCI), to describe how treatment outcomes for individual patients changed over time and to examine the potential impact of lipid control rates through population LDL-C levels changes.METHODS: This retrospective study was conducted in patients who underwent PCI between July 2017 and June 2019. The main results included LDL-C levels after PCI. To assess the outcome of prevention, three separate measures of LDL-C were considered: baseline, first follow-up, and final follow-up, and LDL-C control rates were analyzed according to different guidelines. we examine the impact of 0.1mmol/l decreases or increases in population LDL-C levels on LDL-C control.RESULTS: Data were analyzed for 423 patients (mean age, 62 ±10 years), and the baseline LDL-C level was 3.11 ± 0.99 mmol/l. 51.5% of the patients achieved the Chinese Lipids Guidelines treatment goal, 22% and 11.6% of the patients achieved the 2016 ESC Lipids Guidelines and 2019 ESC Lipids Guidelines treatment goal at the final follow-up period respectively. LDL-C levels fluctuated during the follow-up period, and the long-term maintenance results could not be guaranteed after PCI. Population LDL-C levels changes in lifestyle could have a very large impact on LDL-C control in China.CONCLUSION: LDL-C control with statins is not ideal in patients after PCI, which is far from the requirements of the latest guidelines. Although clinicians understand the lipid-lowering effect of statins, they should not give up active lifestyle changes, and should strengthen the comprehensive management of blood lipid control.

Abstract P43: Frequency and Predictors of Low-Density Lipoprotein Cholesterol Control and Appropriate Response to Elevated LDL-C Levels in Patients with Cardiovascular Disease

2011 ◽  
Vol 4 (suppl_2) ◽  
Author(s):  
Salim S Virani ◽  
Lechauncy D Woodard ◽  
Supicha Sookanan ◽  
Cassie R Landrum ◽  
Tracy H Urech ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Low Density Lipoprotein ◽  
Medication Possession Ratio ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Lipid Lowering ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
To Receive

Background: Although current cholesterol performance measures define good quality as low density lipoprotein cholesterol (LDL-C) levels < 100mg/dl in cardiovascular disease (CVD) patients, they provide a snap shot at one time point and do not inform whether an appropriate action was taken to manage elevated LDL-C levels. We assessed frequency and predictors of this appropriate response (AR). Methods: We used administrative data to assess 22,902 CVD patients receiving care in a Veterans Affairs network of 7 hospitals and affiliated clinics. We determined the proportion of CVD patients at LDL-C goal <100 mg/dl, and the proportion of patients with uncontrolled LDL-C levels (>100 mg/dl) who had an AR [defined as the initiation or dosage increase of a lipid lowering medication (LLM), addition of a new LLM, receipt of maximum dosage or >1 LLM, or LDL-C reading <100 mg/dl] at 45 days follow-up. Logistic regression was performed to evaluate facility, provider and patient characteristics associated with AR. Results: LDL-C levels were at goal in 16,350 (71.4%) patients. An additional 2,110 (9.2%) had an AR at 45 days of follow-up. Controlling for clustering between facilities and patient's illness severity, history of diabetes (OR 1.18, 95% CI 1.03-1.35), hypertension (OR 1.21, 95% CI 1.02-1.44), patients showing good medication adherence (medication possession ratio > 0.8) [OR 2.29, 95% CI 1.99-2.64] were associated with AR. Older CVD patients (age >75 years) were less likely to receive AR (OR 0.60, 95% CI 0.52-0.70). Teaching vs. non-teaching facility (p=0.40), physician vs. non-physician provider (p=0.14), specialist vs. non-specialist primary care provider (p=0.12), and patient's race (p=0.12) were not predictors of AR. Conclusion: Among patients with CVD and LDL-C above guideline recommended levels, only one-third receive AR. Diabetic and hypertensive CVD patients are more likely to receive AR, whereas older Veterans with CVD receive AR less often likely reflecting providers' belief of lack of efficacy from treatment intensification in older CVD patients. Our findings are important for quality improvement and policy making initiatives as they provide more actionable information compared with isolated LDL-C goal attainment as a quality indicator.

scholarly journals Age at period cessation and trajectories of cardiovascular risk factors across mid and later life

Heart ◽  
2020 ◽  
Vol 106 (7) ◽  
pp. 499-505 ◽  
Author(s):  
Linda Marie O'Keeffe ◽  
Diana Kuh ◽  
Abigail Fraser ◽  
Laura D Howe ◽  
Debbie Lawlor ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Later Life ◽  
Glycated Haemoglobin ◽  
Lipoprotein Cholesterol ◽  
The Impact

ObjectiveTo examine the association between age at period cessation and trajectories of anthropometry, blood pressure, lipids and glycated haemoglobin (HbA1c) from midlife to age 69 years.MethodsWe used data from the UK Medical Research Council National Survey of Health and Development to examine the association between age at period cessation and trajectories of systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI) and waist circumference (WC) from 36 to 69 years and trajectories of triglyceride, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and HbA1c from 53 to 69 years.ResultsWe found no evidence that age at period cessation was associated with trajectories of log triglyceride, LDL-C and HDL-C from 53 to 69 years and trajectories of SBP or DBP from 36 to 69 years, regardless of whether period cessation occurred naturally or due to hysterectomy. While we found some evidence of associations of age at period cessation with log BMI, log WC and log HbA1c, patterns were not consistent and differences were small at age 69 years, with confidence intervals that spanned the null value.ConclusionHow and when women experience period cessation is unlikely to adversely affect conventional cardiovascular risk factors across mid and later life. Women and clinicians concerned about the impact of type and timing of period cessation on conventional cardiovascular intermediates from midlife should be reassured that the impact over the long term is small.

scholarly journals Ten-Year Follow-Up of Clinical Governance Implementation in Primary Care: Improving Screening, Diagnosis and Control of Cardiovascular Risk Factors

2019 ◽  
Vol 16 (21) ◽  
pp. 4299
Author(s):  
Carina Aguilar Martín ◽  
Alessandra Queiroga Gonçalves ◽  
Carlos López-Pablo ◽  
José Fernández-Sáez ◽  
Emma Forcadell Drago ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
High Frequency ◽  
Cardiovascular Health ◽  
Density Lipoprotein ◽  
Health Indicators ◽  
Clinical Governance ◽  
And Control ◽  
The Impact

Current improvement strategies for the control of cardiovascular risk factors (CRFs) in Europe are based on quality management policies. With the aim of understanding the effect of interventions delivered by primary healthcare systems, we evaluated the impact of clinical governance on cardiovascular health after ten years of implementation in Catalonia. A cohort study that included 1878 patients was conducted in 19 primary care centres (PCCs). Audits that comprised 13 cardiovascular health indicators were performed and general practitioners received periodic (annual, biannual or monthly) feedback about their clinical practice. We evaluated improvement in screening, diagnosis and control of the main CRFs and the effects of the feedback on cardiovascular risk (CR), incidence of cardiovascular disease (CVD) and mortality, comparing baseline data with data at the end of the study (after a 10-year follow-up). The impact of the intervention was assessed globally and with respect to feedback frequency. General improvement was observed in screening, percentage of diagnoses and control of CRFs. At the end of the study, few clinically significant differences in CRFs were observed between groups. However, the reduction in CR was greater in the group receiving high frequency feedback, specifically in relation to smoking and control of diabetes and cholesterol (Low Density Lipoprotein (LDL) and High Density Lipoprotein (HDL)). A protective effect of having a cardiovascular event (hazard ratio (HR) = 0.64, 95% confidence interval (CI) = 0.44–0.94) or death (HR = 0.55, 95% CI = 0.35–0.88) was observed in patients from centres where general practitioners received high frequency feedback. Additionally, these PCCs presented improved cardiovascular health indicators and lower incidence and mortality by CVD, illustrating the impact of this intervention.

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