Abstract MP15: Television Watching in Mid-Life and Long-Term Diabetes Risk: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Michael Fang ◽  
Natalie R Daya ◽  
Morgan Grams ◽  
Elizabeth Selvin
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Weight Status ◽  
Incident Diabetes ◽  
Television Watching ◽  
Atherosclerosis Risk In Communities ◽  
History Of ◽  
Aric Study

Background: Prolonged television watching is associated with numerous health problems. However, its long-term impact and its joint effect with other risk factors on the development of diabetes remains unclear. Methods: We conducted a prospective cohort analysis of television watching and incident diabetes using data from the Atherosclerosis Risk in Communities (ARIC) Study. We used Cox regression models and considered television watching independently and jointly with physical activity, weight status, and family history of diabetes. At baseline (1987-1989), participants self-reported frequency of television watching, leisure-time physical activity, and parental history of diabetes. Body mass index was calculated from measured weight and height and converted into weight status categories. Incident diabetes was defined as having a fasting glucose >126 mg/dL or non-fasting glucose >200 mg/dL, or self-report of a diagnosis of diabetes or diabetes medication with follow-up to 2017. Results: There were 13,127 participants without diabetes at baseline (mean age, 54, 23% black, 56% female). During 21 years of follow-up, there were 4,280 incident cases of diabetes. Compared to those who watched low levels of television, those who watched medium and high levels were more likely to develop diabetes (HRs 1.13 and 1.51, Figure ). Other risk factors combined with television watching jointly increased the risk of incident diabetes. That is, even within categories of physical activity, weight status, and family history, television watching was an independent risk factor for diabetes. Conclusion: Currently, there is substantial debate regarding the health effects of screen-time. Our study suggests prolonged television watching confers substantial long-term risk for diabetes, even in the setting of other major risk factors. Decreasing exposure to television and other screens may be an important target for diabetes prevention.

scholarly journals Association of orthostatic hypotension with incident dementia, stroke, and cognitive decline

Neurology ◽  
2018 ◽  
Vol 91 (8) ◽  
pp. e759-e768 ◽  
Author(s):  
Andreea M. Rawlings ◽  
Stephen P. Juraschek ◽  
Gerardo Heiss ◽  
Timothy Hughes ◽  
Michelle L. Meyer ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cognitive Decline ◽  
Orthostatic Hypotension ◽  
Cox Regression ◽  
Atherosclerosis Risk In Communities ◽  
Incident Dementia ◽  
History Of ◽  
Aric Study

ObjectiveTo examine associations of orthostatic hypotension (OH) with dementia and long-term cognitive decline and to update previously published results in the same cohort for stroke with an additional 16 years of follow-up.MethodsWe analyzed data from 11,709 participants without a history of coronary heart disease or stroke who attended the baseline examination (1987–1989) of the prospective Atherosclerosis Risk in Communities (ARIC) study. OH was defined as a drop in systolic blood pressure (BP) of at least 20 mm Hg or a drop in diastolic BP of at least 10 mm Hg on standing. Dementia was ascertained via examination, contact with participants or their proxy, or medical record surveillance. Ischemic stroke was ascertained via cohort surveillance of hospitalizations, cohort follow-up, and linkage with registries. Both outcomes were adjudicated. Cognitive function was ascertained via 3 neuropsychological tests administered in 1990 to 1992 and 1996 to 1998 and a full battery of tests in 2011 to 2013. Scores were summarized and reported as SDs. We used adjusted Cox regression and linear mixed models.ResultsOver ≈25 years, 1,068 participants developed dementia and 842 had an ischemic stroke. Compared to persons without OH at baseline, those with OH had a higher risk of dementia (hazard ratio [HR] 1.54, 95% confidence interval [CI] 1.20–1.97) and ischemic stroke (HR 2.08, 95% CI 1.65–2.62). Persons with OH had greater, although nonsignificant, cognitive decline over 20 years (SD 0.09, 95% CI −0.02 to 0.21).ConclusionsOH assessed in midlife was independently associated with incident dementia and ischemic stroke. Additional studies are needed to elucidate potential mechanisms for these associations and possible applications for prevention.

Abstract P116: Trait Anger Increases Short-term and Long-term Risk for Recurrent CHD: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Janice E Williams ◽  
Sharon B Wyatt ◽  
Kathryn M Rose ◽  
David J Couper ◽  
Anna Kucharska-Newton
Keyword(s):  
Cigarette Smoking ◽  
Trait Anger ◽  
Middle Aged ◽  
Short Term ◽  
Men And Women ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk ◽  
Aric Study

Though several large epidemiologic studies have demonstrated the positive association of anger with coronary heart disease (CHD) onset, a dearth of population-based evidence exists regarding the relationship of anger to the clinical course of CHD among people with established disease. Trait anger is conceptualized as a stable personality trait and defined as the tendency to experience frequent and intense anger. Therefore, it is plausible that the effects of trait anger on CHD are long standing. We assessed the hypothesis that trait anger predicts short-term and long-term risk for recurrent CHD among middle-aged men and women. Participants were 611 black or white men and women, ages 48 - 67, who had a history of CHD at the second clinical examination (1990-1992) of the Atherosclerosis Risk in Communities (ARIC) Study. They were followed for the recurrence of CHD (myocardial infarction or fatal CHD) from 1990 through three different time intervals: 1995, 2003, and 2009 (maximum follow-up = 19.0 years). Trait anger (measured at Visit 2) was assessed using the Spielberger Trait Anger Scale, with scores categorized as high, moderate, and low. Cox proportional hazards regression analyses were adjusted for age, sex, race-center, educational level, waist-to-hip ratio, plasma LDL-and HDL-cholesterol levels, hypertension, diabetes, cigarette smoking status, and pack-years of cigarette smoking. After 3 - 5 years of follow-up, the risk for recurrent CHD among participants with high trait anger was more than twice that of their counterparts with low trait anger (2.24 [95% C.I: 1.14 to 4.40]). After 11 - 13 years, the risk was 80% greater (1.80 [95% C.I: 1.17 to 2.78]) and after 17 - 19 years, it was 70% greater (1.70 [95% C.I: 1.15 to 2.52]). The risk for recurrent CHD was strongest in the first time interval but remained strong and statistically significant through 19 years of follow-up. In conclusion, the experience of frequent and intense anger increases short-term and long-term risk for recurrent CHD in middle-aged men and women.

scholarly journals Effect of self-regulatory behaviour change techniques and predictors of physical activity maintenance in cancer survivors: a 12-month follow-up of the Phys-Can RCT

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anne-Sophie Mazzoni ◽  
Hannah L. Brooke ◽  
Sveinung Berntsen ◽  
Karin Nordin ◽  
Ingrid Demmelmaier
Keyword(s):  
Physical Activity ◽  
Cancer Survivors ◽  
Cancer Treatment ◽  
Tobacco Use ◽  
Exercise Intervention ◽  
Behaviour Change Techniques ◽  
Exercise Motivation ◽  
History Of

Abstract Background Current knowledge about the promotion of long-term physical activity (PA) maintenance in cancer survivors is limited. The aims of this study were to 1) determine the effect of self-regulatory BCTs on long-term PA maintenance, and 2) identify predictors of long-term PA maintenance in cancer survivors 12 months after participating in a six-month exercise intervention during cancer treatment. Methods In a multicentre study with a 2 × 2 factorial design, the Phys-Can RCT, 577 participants with curable breast, colorectal or prostate cancer and starting their cancer treatment, were randomized to high intensity exercise with or without self-regulatory behaviour change techniques (BCTs; e.g. goal-setting and self-monitoring) or low-to-moderate intensity exercise with or without self-regulatory BCTs. Participants’ level of PA was assessed at the end of the exercise intervention and 12 months later (i.e. 12-month follow-up), using a PA monitor and a PA diary. Participants were categorized as either maintainers (change in minutes/week of aerobic PA ≥ 0 and/or change in number of sessions/week of resistance training ≥0) or non-maintainers. Data on potential predictors were collected at baseline and at the end of the exercise intervention. Multiple logistic regression analyses were performed to answer both research questions. Results A total of 301 participants (52%) completed the data assessments. A main effect of BCTs on PA maintenance was found (OR = 1.80, 95%CI [1.05–3.08]) at 12-month follow-up. Participants reporting higher health-related quality-of-life (HRQoL) (OR = 1.03, 95%CI [1.00–1.06] and higher exercise motivation (OR = 1.02, 95%CI [1.00–1.04]) at baseline were more likely to maintain PA levels at 12-month follow-up. Participants with higher exercise expectations (OR = 0.88, 95%CI [0.78–0.99]) and a history of tobacco use at baseline (OR = 0.43, 95%CI [0.21–0.86]) were less likely to maintain PA levels at 12-month follow-up. Finally, participants with greater BMI increases over the course of the exercise intervention (OR = 0.63, 95%CI [0.44–0.90]) were less likely to maintain their PA levels at 12-month follow-up. Conclusions Self-regulatory BCTs improved PA maintenance at 12-month follow-up and can be recommended to cancer survivors for long-term PA maintenance. Such support should be considered especially for patients with low HRQoL, low exercise motivation, high exercise expectations or with a history of tobacco use at the start of their cancer treatment, as well as for those gaining weight during their treatment. However, more experimental studies are needed to investigate the efficacy of individual or combinations of BCTs in broader clinical populations. Trial registration NCT02473003 (10/10/2014).

Abstract P230: Markers of Hyperglycemia and Intracranial Atherosclerotic Stenosis by Magnetic Resonance Angiography

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Akira Fujiyoshi ◽  
M.Fareed K Suri ◽  
Alvaro Alonso ◽  
Elizabeth Selvin ◽  
Haitao Chu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Atherosclerosis Risk In Communities ◽  
Intracranial Atherosclerotic Stenosis ◽  
Atherosclerotic Stenosis ◽  
History Of ◽  
Diagnosed Diabetes ◽  
Aric Study

Introduction: Intracranial atherosclerotic stenosis (ICAS) is a common cause of stroke. Determinants of ICAS include conventional cardiovascular (CV) risk factors such as hypertension and dyslipidemia. The association of diabetes mellitus (DM) and/or hyperglycemia with ICAS, however, is less well documented. Hypothesis: In a community-based population, biomarkers of hyperglycemia will be cross-sectionally associated with prevalent ICAS independent of CV risk factors. Methods: Our analyses were conducted in a subsample of participants of the Atherosclerosis Risk in Communities (ARIC) Study who participated in the ARIC-Neurocognitive Study in 2011-13 with cerebrovascular magnetic resonance angiography and no history of stroke. For the present analyses, we grouped the participants into 3 categories based on the highest ICAS category among any of the intracranial arteries we assessed: “no stenosis”, “<50%”, or “≥50% (including occlusion)”. Diagnosed diabetes was defined as self-reported physician diagnosis or use of antidiabetic medication. Ordinal logistic regression provided odds ratios of prevalent ICAS according to quintile of glucose or glycated hemoglobin (HbA1c) adjusted for CV risk factors. Results (Table): There were 1,658 individuals included in our study (age 67-90 years, women 58%, Black 29%), 31% (514/1658) had diagnosed diabetes, 10% (165/1658) had ≥50 % stenosis at any of the intracerebral arteries. In crude analyses, those with higher glucose and HbA1c were more likely to have ICAS among the non-diabetes and the diabetes. In logistic regression, highest quintile of glucose, relative to the lowest, had odds ratio of 2.26 (95% confidence interval 1.48, 3.45) for being in each successive ICAS category after adjustment for CV risk factors. Conclusion: Higher glucose and HbA1c were associated with higher odds of ICAS independent of CV risk factors. The finding suggests that hyperglycemia plays a role in pathogenesis of ICAS.

Abstract P179: Comparison of Earlier versus Later Orthostatic Hypotension Assessment Times in Middle-Age Adults of the Atherosclerosis Risk in Communities Study (ARIC)

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Stephen P Juraschek ◽  
Natalie Daya ◽  
Andreea M Rawlings ◽  
Lawrence J Appel ◽  
Edgar R Miller ◽  
...  
Keyword(s):  
Orthostatic Hypotension ◽  
Standing Position ◽  
Adverse Outcomes ◽  
Cox Models ◽  
Atherosclerosis Risk In Communities ◽  
Adverse Health Outcomes ◽  
History Of ◽  
Risk Of Fall

Background: Guidelines recommend assessing orthostatic hypotension (OH) 3 minutes after rising from supine to standing positions. Hypothesis: Measurements performed immediately after standing will be as informative as measurements performed closer to 3 minutes after standing with regards to symptoms of dizziness or risk of adverse outcomes. Methods: OH, defined as a drop in blood pressure (systolic ≥20 mm Hg or diastolic ≥10 mm Hg) from the supine to standing position, was measured up to five times at 25 seconds intervals in middle-aged (range 44 to 66 years) ARIC participants (1987-1989). Associations between each measurement and history of dizziness upon standing were examined via logistic regression. We used Cox models to examine the association between each of five measurements with risk of fall, fracture, syncope, and all-cause mortality over a median follow-up of 23 years. Results: In 11,449 participants (mean age 54 years, 54% women, 26% black) 10% reported a history of dizziness upon standing. OH assessed at measurement 1 (performed at a mean of 28 seconds after standing) was associated with risk of fall ( P = 0.03), fracture ( P = 0.05), syncope ( P <0.001), and mortality ( P < 0.001) ( Table ). Furthermore, measurement 1 was the only measurement associated with higher odds of dizziness upon standing (OR: 1.5; P = 0.001). Measurement 2 (performed on average 53 seconds after standing) was associated with all long-term outcomes. Measurements 4 and 5 (mean 100 and 116 seconds after standing) were generally less informative with regards to prospective outcomes than earlier measurements and were not statistically associated with history of dizziness. Conclusions: OH measurements obtained, on average, within the first 30 seconds of standing were predictive of long-term adverse health outcomes and were the most strongly related to symptoms of dizziness compared to later measurements. These findings suggest that BP measurements for determining orthostatic hypotension should be performed immediately after standing.

Predictors of ICU admission and long-term outcomes in overdose presentations to Emergency Department

2020 ◽  
Vol 28 (1) ◽  
pp. 75-79
Author(s):  
Mark Savage ◽  
Ross Kung ◽  
Cameron Green ◽  
Brandon Thia ◽  
Dinushka Perera ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Emergency Department ◽  
Psychiatric Illness ◽  
Atypical Antipsychotics ◽  
Long Term Outcomes ◽  
Icu Admission ◽  
History Of

Objective: To describe the characteristics of patients presenting to an Emergency Department (ED) following overdoses; to identify risk factors for intensive care unit (ICU) admission among these patients; and to identify the rate of mortality and repeat overdose presentations over four years. Methods: Adult patients presenting to ED following drug overdose during 2014 were included. Data were collected from medical notes and hospital databases. Results: During the study period, 654 patients presented to ED 800 times following overdose. Seventy-eight (9.8%) resulted in ICU admission, and 59 (7.4%) required intubation; 57.2% had no history of overdose presentations, and 72.9% involved patients with known psychiatric illness. Overdose of atypical antipsychotics (AAP), age and history of prior overdose independently predicted ICU admission. A third of patients ( n = 196, 30%) had subsequent presentations to ED following overdose, in the four years from their index presentation, with an all-cause four-year mortality of 3.4% ( n = 22). Conclusion: A history of overdose, use of AAP and older age were risk factors for ICU admission following ED presentations. Over a third of patients had repeat overdose presentation in the four-year follow-up with a mortality of 3.4%.

scholarly journals Mitochondrial DNA copy number and diabetes: the Atherosclerosis Risk in Communities (ARIC) study

2020 ◽  
Vol 8 (1) ◽  
pp. e001204
Author(s):  
Bailey DeBarmore ◽  
Ryan J Longchamps ◽  
Yiyi Zhang ◽  
Rita R Kalyani ◽  
Eliseo Guallar ◽  
...  
Keyword(s):  
Mitochondrial Dna ◽  
Mitochondrial Dysfunction ◽  
Copy Number ◽  
Buffy Coat ◽  
Incident Diabetes ◽  
Atherosclerosis Risk In Communities ◽  
Mitochondrial Dna Copy Number ◽  
Atherosclerosis Risk ◽  
Aric Study

IntroductionMitochondrial DNA copy number (mtDNA-CN) is a measure of mitochondrial dysfunction and is associated with diabetes in experimental models. To explore the temporality of mitochondrial dysfunction and diabetes, we estimated the prevalent and incident association of mtDNA-CN and diabetes.Research design and methodsWe assessed the associations of mtDNA-CN measured from buffy coat with prevalent and incident diabetes, stratified by race, in 8954 white and 2444 black participants in the Atherosclerosis Risk in Communities (ARIC) study, an observational cohort study. Follow-up for incident analyses was complete through visit 6, 2016.ResultsMean age at mtDNA-CN measurement was 57 years and 59% were female. Prevalence of diabetes at time of mtDNA-CN measurement was higher in blacks (563/2444, 23%) than whites (855/8954, 10%). The fully adjusted odds of prevalent diabetes for the 10th vs 90th percentile of mtDNA-CN was 1.05 (95% CI 0.74 to 1.49) among black and 1.49 (95% CI 1.20 to 1.85) among white participants. Over a median follow-up time of 19 years (Q1, Q3: 11, 24 years), we observed 617 incident diabetes cases among 1744 black and 2121 cases among 7713 white participants free of diabetes at baseline. The fully adjusted hazard of incident diabetes for the 10th vs 90th percentile of mtDNA-CN was 1.07 (95% CI 0.84 to 1.38) among black and 0.97 (95% CI 0.86 to 1.10) among white participants.ConclusionsLower mtDNA-CN in buffy coat was associated with prevalent diabetes in white but not black ARIC participants. Lower mtDNA-CN was not associated with incident diabetes over 20 years of follow-up in whites or blacks.

Long Term Follow-Up of Pediatric Sickle Cell Disease Patients with Conditional Velocities on Transcranial Doppler (TCD).

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 2338-2338
Author(s):  
Lena Coïc ◽  
Suzanne Verlhac ◽  
Emmanuelle Lesprit ◽  
Emmanuelle Fleurence ◽  
Francoise Bernaudin
Keyword(s):  
Risk Factors ◽  
Color Doppler ◽  
Significant Risk ◽  
Biological Data ◽  
Treatment Intensification ◽  
Significant Difference ◽  
History Of ◽  
The Mean

Abstract Abnormal TCD defined as high mean maximum velocities &gt; 200 cm/sec are highly predictive of stroke risk and justify long term transfusion program. Outcome and risk factors of conditional TCD defined as velocities 170–200 cm/sec remains to be described. Patients and methods Since 1992, 371 pediatric SCD patients (303 SS, 44 SC, 18 Sß+, 6 Sß0) were systematically explored once a year by TCD. The newborn screened cohort (n=174) had the first TCD exploration between 12 and 18 months of age. TCD was performed with a real-time imaging unit, using a 2 MHz sector transducer with color Doppler capabilities. Biological data were assessed at baseline, after the age of 1.5 years and remotely of transfusion or VOC. We report the characteristics and the outcome in patients (n=43) with an history of conditional TCD defined by mean maximum velocities ranging between 170 and 200 cm/s in the ACM, the ACA or the ICA. Results: The mean follow-up of TCD monitoring was 5,5 years (0 – 11,8 y). All patients with an history of conditional doppler were SS/Sb0 (n=43). Mean (SD) age of patients at the time of their first conditional TCD was 4.3 years (2.2) whereas in our series the mean age at abnormal TCD (&gt; 200 cm/sec) occurrence was 6.6 years (3.2). Comparison of basal parameters showed highly significant differences between patients with conditional TCD and those with normal TCD: Hb 7g4 vs 8g5 (p&lt;0.001), MCV 82.8 vs 79 (p=0.047). We also had found such differences between patients with normal and those with abnormal TCD (Hb and MCV p&lt; 0.001). Two patients were lost of follow-up. Two patients died during a trip to Africa. Conditional TCD became abnormal in 11/43 patients and justified transfusion program. Mean (SD) conversion delay was 1.8 (2.0) years (range 0.5–7y). No stroke occurred. 16 patients required a treatment intensification for other indications (frequent VOC/ACS, splenic sequestrations): 6 were transplanted and 10 received HU or TP. Significant risk factors (Pearson) of conversion to abnormal were the age at time of conditional TCD occurrence &lt; 3 y (p&lt;0.001), baseline Hb &lt; 7g/dl (p=0.02) and MCV &gt; 80 (p=0.04). MRI/MRA was performed in 31/43 patients and showed ischemic lesions in 5 of them at the mean (SD) age of 7.1 y (1.8) (range 4.5–8.9): no significant difference was observed in the occurrence of lesions between the 2 groups. Conclusions This study confirms the importance of age as predictive factor of conditional to abnormal TCD conversion with a risk of 64% when first conditional TCD occured before the age of 3 years. TCD has to be frequently controled during the 5 first years of life.

Long-term natural history of hemorrhagic type moyamoya disease in 42 patients

2000 ◽  
Vol 93 (6) ◽  
pp. 976-980 ◽  
Author(s):  
Eiichi Kobayashi ◽  
Naokatsu Saeki ◽  
Hiromichi Oishi ◽  
Shinji Hirai ◽  
Akira Yamaura
Keyword(s):  
Risk Factors ◽  
Natural History ◽  
Moyamoya Disease ◽  
Bypass Surgery ◽  
Bleeding Episode ◽  
Content Type ◽  
History Of ◽  
Fine Print

Object. The purpose of this study was to delineate the long-term natural history of hemorrhagic moyamoya disease (MMD).Methods. A retrospective review was conducted among 42 patients suffering from hemorrhagic MMD who had been treated conservatively without bypass surgery. The group included four patients who had undergone indirect bypass surgery after an episode of rebleeding. The follow-up period averaged 80.6 months. The clinical features of the first bleeding episode and repeated bleeding episodes were analyzed to determine the risk factors of rebleeding and poor outcome.Intraventricular hemorrhage with or without intracerebral hemorrhage was a dominant finding on computerized tomography scans during the first bleeding episode in 29 cases (69%). During the follow-up period, 14 patients experienced a second episode of bleeding, which occurred 10 years or longer after the original hemorrhage in five cases (35.7%). The annual rebleeding rate was 7.09%/person/year. The second bleeding episode was characterized by a change in which hemisphere bleeding occurred in three cases (21.4%) and by the type of bleeding in seven cases (50%). After rebleeding the rate of good recovery fell from 45.5% to 21.4% and the mortality rate rose from 6.8% to 28.6%. Rebleeding and patient age were statistically significant risk factors of poor outcome. All four patients in whom there was indirect revascularization after the second bleeding episode experienced a repeated bleeding episode within 8 years.Conclusions. The occurrence of rebleeding a long time after the first hemorrhagic episode was not uncommon. Furthermore, the change in which hemisphere and the type of bleeding that occurred after the first episode suggested the difficulty encountered in the prevention of repeated hemorrhage.

Risk factors for a first thrombotic event in antiphospholipid antibody carriers. A multicentre, retrospective follow-up study

2008 ◽  
Vol 68 (3) ◽  
pp. 397-399 ◽  
Author(s):  
A Ruffatti ◽  
T Del Ross ◽  
M Ciprian ◽  
M Nuzzo ◽  
M Rampudda ◽  
...  
Keyword(s):  
Risk Factors ◽  
Thrombotic Event ◽  
Multivariate Logistic Regression Analysis ◽  
Anticardiolipin Antibody ◽  
Primary Prophylaxis ◽  
Antiphospholipid Antibody ◽  
History Of ◽  
Independent Risk Factors

Objectives:To asses risk factors for a first thrombotic event in antiphospholipid antibody (aPL) positive carriers and evaluate the efficacy of prophylactic treatments.Methods:Recruitment criteria were age 18–65 years, no history of thrombosis, positivity for lupus anticoagulant and/or IgG/IgM anticardiolipin antibody (aCL) on ⩾2 occasions at least 6 weeks apart. Demographic, laboratory and clinical parameters were collected at enrolment and at the time of the thrombotic event.Results:370 patients/subjects (mean (SD) age 34 (9.9) years) were analysed retrospectively for a mean (SD) follow-up of 59.3 (45.5) months. Thirty patients (8.1%) developed a first thrombotic event during follow-up. Hypertension and medium/high levels of IgG aCL were identified by multivariate logistic regression analysis as independent risk factors for thrombosis. Thromboprophylaxis during high-risk and long-term periods was significantly protective.Conclusions:Hypertension or medium/high titres of IgG aCL are risk factors for a first thrombotic event in asymptomatic aPL carriers and primary prophylaxis is protective.

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