Abstract P386: Pregnancy-related Risk Factors May Signal Additional Risk For Future Cardiovascular Disease

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Shivani M Reddy ◽  
Tamy H Moraes Tsujimoto ◽  
Wanda Nicholson ◽  
Jason Fine
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Health ◽  
Prediction Models ◽  
Inverse Association ◽  
Cvd Risk ◽  
Related Factors ◽  
Survival Analyses ◽  
History Of ◽  
Traditional Risk Factors

Introduction: Emerging data suggest that pregnancy may be a window on the future of women’s cardiovascular health. Cardiovascular disease (CVD) guidelines recommend using the Pooled Cohort Equation (PCE) to assess 10-year CVD risk based on traditional risk factors. Less is known about the role of pregnancy-related factors, such as a history of small for gestational age (SGA) infants or breastfeeding, and the risk of CVD events in addition to the PCE. Hypothesis: We hypothesize that pregnancy-related complications and breastfeeding can affect the risk of future CVD risk in addition to traditional risk factors currently accounted for by the PCE. Methods: Using NHANES 1999-2006, a weighted sample of 3,913 women (representing 27,102,057 women in the US population), ages 40-79, with a history of pregnancy, but no prior CVD, was identified. Variables for SGA infants and breastfeeding were abstracted along with traditional risk factors. Less than 5% of women were missing data on these variables. CVD outcomes were defined as a composite of (1) CVD death and (2) surrogates for CVD death, in which diabetes or hypertension were a secondary cause of death. CVD outcomes and survival time were obtained from the NHANES Linked Mortality File. The PCE was used to estimate 10-year CVD risk. Bivariate and survival analyses using Cox proportional hazards models adjusting for PCE risk score were performed. For survival analysis, the cause-specific hazard function was estimated considering the time of death as censoring for women dying from causes other than CVD outcomes, as well as the time of follow-up for women that did not present the death event. Results: Among the sample, 504 (11.8%) women had a SGA infant and 2133 (54.5%) reported a history of breastfeeding. 198 (5.1%) women had the composite CVD death outcome. CVD outcomes were lower in women with a history of breastfeeding (97 of 2133) compared to those who did not breastfeed (96 of 1629). (2.6% vs. 4.2%, p=0.002) The opposite relationship was observed for women with a history of SGA infant (4.2% (29 of 504) vs. 3.2% (161 of 3232), p=0.2). PCE scores were associated with breastfeeding and SGA, potentially confounding those effects. Survival analyses, adjusting for continuous PCE risk scores, showed an inverse association of breastfeeding and CVD outcomes (HR 0.7, 95% CI 0.5 to 1.0) and a positive association of history of SGA infant and CVD outcomes. (HR 1.4, 95% CI 0.8 to 2.2) Conclusion: Specific pregnancy-related complications and breastfeeding may provide additional, relevant information about the risk of CVD risk events beyond traditional risk factors. While further research is needed to incorporate pregnancy outcomes into risk prediction models, it may be helpful for clinicians to counsel women about the potential impact of pregnancy-related factors and breastfeeding on future cardiovascular health.

scholarly journals Women’s Cardiac Health in 2020: A Systematic Review

2020 ◽  
Vol 4 (02) ◽  
pp. 104-110
Author(s):  
Fabiola B. Sozzi ◽  
Marta Belmonte ◽  
Marco Schiavone ◽  
Ciro Canetta ◽  
Rakesh Gupta ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Cardiovascular Health ◽  
The Novel ◽  
Cvd Risk ◽  
Disease Manifestation ◽  
Substantial Progress ◽  
Diagnostic Approaches ◽  
Traditional Risk Factors ◽  
Gender Specific

AbstractAlthough substantial progress has been made toward improving gender- and sex-specific cardiovascular disease (CVD) management and outcomes, contemporary reports indicate a persistent knowledge gap with regard to optimal risk-stratification and management in female cardiac heart disease (CHD) patients. Prominent patient and system delays in diagnosing CHD are, in part, due to the limited awareness for the latent CVD risk in women, a lack of sex-specific thresholds within clinical guidelines, and subsequent limited performance of contemporary diagnostic approaches in women. Several traditional risk factors for CHD affect both women and men. But other factors can play a bigger role in the development of heart disease in women. In addition, little is known about the influence of socioenvironmental and contextual factors on gender-specific disease manifestation and outcomes. It is imperative that we understand the mechanisms that contribute to worsening risk factors profiles in young women to reduce future atherosclerotic CVD morbidity and mortality. This comprehensive review focuses on the novel aspects of cardiovascular health in women and sex differences as they relate to clinical practice and prevention, diagnosis, and treatment of CVD. Increased recognition of the prevalence of traditional cardiovascular risk factors and their differential impact in women, as well as emerging nontraditional risk factors unique to or more common in women, contribute to new understanding mechanisms, leading to worsening outcome for women.

Determining the Cardiovascular Disease Risk Factor Knowledge and Related Factors Among Adults With Type 2 Diabetes Mellitus

2021 ◽  
pp. 105477382110464
Author(s):  
Emine Karaman ◽  
Aslı Kalkım ◽  
Banu Pınar Şarer Yürekli
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Related Factors

In this study was to determine knowledge of cardiovascular disease (CVD) risk factors and to explore related factors among adults with type 2 diabetes mellitus (DM) who have not been diagnosed with CVD. This descriptive study was conducted with 175 adults. Data were collected individual identification form and Cardiovascular Disease Risk Factors Knowledge Level (CARRF-KL) scale. A negative correlation was found between age and CARRF-KL score. A significant difference was found between educational status and CARRF-KL score. The individuals described their health status as good, managed their condition with diet and exercise, received information from nurses, adults with DM in their family and those with no DM complications had significantly higher scores in CARRF-KL. The knowledge of an individual with DM about CVD risk factors should be assessed, CVD risks should be identified at an early stage, and individuals at risk should be subjected to screening.

Abstract P345: Prediction of Cardiovascular Disease Events and Death using Multiple Biomarkers in African Americans: the Jackson Heart Study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Solomon K Musani ◽  
Ramachandran Vasan ◽  
Aurelian Bidulescu ◽  
Jung Lee ◽  
Gregory Wilson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
African Americans ◽  
High Sensitivity ◽  
Serum Cortisol ◽  
Jackson Heart Study ◽  
Cvd Risk ◽  
Risk Reclassification ◽  
Heart Study ◽  
Traditional Risk Factors

Background: The usefulness of biomarkers from different biologic pathways for predicting cardiovascular disease (CVD) events among African Americans is not well understood. Methods: We evaluated prospectively 3,102 Jackson Heart Study participants (mean age 54 years; 64% women) with data on a panel of 9 biomarkers representing inflammation (high sensitivity C - reactive protein), adiposity (adiponectin, leptin), neurohormonal activation (B-type natriuretic peptide [BNP], aldosterone, and cortisol); insulin resistance (HOMA-IR); and endothelial function (endothelin and homocysteine). We used Cox proportional hazard regression to relate the biomarker panel to the incidence of CVD (stroke, coronary heart disease, angina, heart failure and intermittent claudication) adjusting for standard CVD risk factors. Results: On follow-up (median 8.2 years), 224 participants (141 women) experienced a first CVD event, and 238 (140 women) died. Circulating concentrations of aldosterone, BNP and HOMA-IR were associated with CVD (multivariable-adjusted hazard ratios [HR] and 95% confidence interval [CI] per standard deviation (SD) increase in log-biomarker) were, respectively 1.15, (95% CI 1.01-1.30, p=0.016), 1.97, (95% CI 1.22-2.41, p<0.0001), and 1.30, (95% CI 1.10-1.52, p=0.0064). Blood cortisol and homocysteine were associated with death (HR per SD increment log-biomarker, respectively, 1.17, (95% CI 1.01-1.35, p=0.042), and 1.24, (95% CI 1.10-1.40, pvalue=0.0005). Biomarkers improved risk reclassification by 0.135; 0.120 of which was gained in classification of participants that experienced CVD events and 0.015 from participants that did not. Also, biomarkers marginally increased the model c-statistic beyond traditional risk factors. Conclusions: In our community-based sample of African Americans, circulating aldosterone, BNP and HOMA-IR predicted CVD risk, whereas serum cortisol and homocysteine predicted death. However, the incremental yield of biomarkers over traditional risk factors for risk prediction was minimal.

scholarly journals Incidence and risk factors for recurrent cardiovascular disease in middle-eastern adults: a retrospective study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Romona D. Govender ◽  
Saif Al-Shamsi ◽  
Elpidoforos S. Soteriades ◽  
Dybesh Regmi
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Incidence Rate ◽  
United Arab Emirates ◽  
Cox Proportional Hazards ◽  
Cvd Risk ◽  
Female Sex ◽  
Increased Risk ◽  
History Of

Abstract Background Individuals with established cardiovascular disease (CVD) and risk factors such as age, smoking, hypertension, and diabetes mellitus are at an increased risk of recurrent cardiovascular events and death. The incidence rate of recurrent CVD events varies between countries and populations. The United Arab Emirates (UAE) has one of the highest age-standardized death rates for CVD worldwide. The aim of our study was to estimate the incidence rates and determine the predictors of recurrent CVD events among UAE nationals. Methods We investigated an outpatient-based cohort of patients with a history of CVD visiting Tawam Hospital between April 1, 2008 and December 31, 2008. They were followed-up until July 31, 2018. Univariable and multivariable Cox proportional hazards regression models were used to determine the association between major CVD risk factors and the risk of CVD recurrence. Results A total of 216 patients (167 males, 49 females) with a history of CVD were included. They were followed for a median (interquartile range) of 8.1 (5.5–9.3) years, with a total of 1184 patient-years of follow-up. The overall incidence rate of recurrent CVD events was 92.1 per 1000 patient-years. The 8-year cumulative incidence was 73.7%. Age, female sex, and diabetes mellitus were significant predictors of recurrent CVD events, where females had a 1.96 times higher risk of recurrent CVD events than males. Conclusion Significant predictors of recurrent CVD events are older age, female sex, and diabetes mellitus. The incidence rate of recurrent CVD events was 92.1 per 1000 patient-years. Preventive measures, based on international guidelines for CVD management, may improve CVD morbidity and mortality in the UAE population.

scholarly journals Serum sex hormone-binding globulin and testosterone in relation to cardiovascular disease risk factors in young men: a population-based study

2014 ◽  
Vol 170 (6) ◽  
pp. 863-872 ◽  
Author(s):  
D Canoy ◽  
T M Barber ◽  
A Pouta ◽  
A L Hartikainen ◽  
M I McCarthy ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Disease Risk ◽  
Young Men ◽  
Hdl Cholesterol ◽  
Sex Hormone ◽  
Sex Hormone Binding Globulin ◽  
Inverse Association ◽  
Hormone Binding ◽  
Cvd Risk

ObjectiveReduced sex hormone-binding globulin (SHBG) concentration predicts insulin resistance and type 2 diabetes, but its association with cardiovascular disease (CVD) risk is unclear. We examined the association between SHBG and cardiovascular risk factors, independently of total testosterone (TT), in young men.DesignObservational, cross-sectional study.SettingGeneral community.ParticipantsThe study included 2716 men aged 31 years in the Northern Finland Birth Cohort in 1996 with clinical examination data and fasting blood samples.Outcome variablesBlood pressure (BP), lipids and C-reactive protein (CRP) as biological CVD risk markers.ResultsSHBG concentration was significantly and inversely related to systolic and diastolic BP, triglycerides and CRP, but positively to HDL cholesterol after adjusting for insulin, BMI, waist circumference, smoking, education and physical activity (allP<0.05). These linearly graded associations persisted with additional adjustment for TT. SHBG was significantly associated with total cholesterol only with adjustment for covariates and TT (P<0.05). The direction and magnitude of associations between TT and risk factors were variable, but further adjustment for insulin, adiposity and SHBG showed positive associations between TT and BP, total and LDL-cholesterol and triglycerides and an inverse association with CRP (allP<0.05), but its relation with HDL-cholesterol was no longer significant.ConclusionsIn this cohort of young adult men, higher SHBG concentration was associated with a more favourable CVD risk profile, independently of TT. SHBG concentration modified the associations of TT with CVD risk factors.

Risk factors for cardiovascular disease

2018 ◽  
Author(s):  
Amitava Banerjee ◽  
Kaleab Asrress
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Family History ◽  
Cardiovascular Diseases ◽  
Epidemiologic Studies ◽  
Individual Factors ◽  
History Of ◽  
Novel Risk Factors ◽  
Traditional Risk Factors

The most prevalent cardiovascular diseases (CVDs) are atherosclerotic, affecting all arterial territories. Epidemiologic studies such as the Framingham and INTERHEART studies have firmly established the commonest or ‘traditional’ risk factors for CVD; namely, smoking, hypertension, diabetes mellitus, hypercholesterolaemia, and a family history of CVD. The ‘risk-factors approach’ to CVD looks at these factors, individually and in combination, in the causation of disease. The complex causation pathways involve interplay of individual factors, whether genetic or environmental. More recently, there has been increasing interest in ‘epigenetics’ or the way in which the environment interacts with genes in the process underlying CVD. This chapter presents an analysis of the traditional and novel risk factors for CVD.

scholarly journals PTC1 and PTC2: New Indices of Blood Pressure Waveforms and Cardiovascular Disease

2020 ◽  
Vol 189 (7) ◽  
pp. 726-734
Author(s):  
Lyndia C Brumback ◽  
David R Jacobs ◽  
Daniel A Duprez
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Standard Deviation ◽  
Arterial Compliance ◽  
Nonlinear Least Squares ◽  
Cvd Risk ◽  
Windkessel Model ◽  
Blood Pressures ◽  
Traditional Risk Factors

Abstract Systolic and diastolic blood pressures provide information about cardiovascular disease (CVD) but are only extremes of the pressure waveform during the cardiac cycle. We developed summaries of the pressure decay, called PTC1 and PTC2, that are related to arterial compliance and to an existing proprietary summary that has been shown to predict CVD. We derived the summaries from a Windkessel model (consisting of a decaying exponential plus a dampened cosine, with an intercept so they are independent of calibration with blood pressure, unlike the proprietary measures), and we estimated them using nonlinear least squares with standard, free software. Among 6,228 adults from the Multi-Ethnic Study of Atherosclerosis, initially free of CVD in 2000–2002, mean PTC2 was 94 (standard deviation, 46) milliseconds. During median 15-year follow-up, there were 911 CVD events (including 609 incidents of coronary heart disease and 270 strokes). One-standard-deviation higher PTC2 was associated with 17% (95% confidence interval: 10, 24) lower CVD risk, after adjustment for traditional risk factors. Results were similar for PTC1. PTC1 and PTC2 are relatively straightforward to compute and add information beyond traditional risk factors for prediction of CVD. Our work enables others to replicate and extend our results with waveforms from any suitable device.

Abstract 16935: Cardiovascular Disease in Head Neck Squamous Cell Carcinoma Patients - A Case-Control Study Using Electronic Medical Records Data

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Amrita Mukherjee ◽  
Howard Wiener ◽  
Russell Griffin ◽  
Lisle M Nabell ◽  
Carrie G Lenneman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Cancer Site ◽  
Cancer Stage ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Related Factors ◽  
Traditional Risk Factors ◽  
Head Neck

Introduction: Cancer survivors have higher rates of cardiovascular disease (CVD) compared to age-adjusted general population. However, traditional CVD risk factors alone do not fully explain increased CVD risk in cancer patients. Cancer-related factors like cancer site, stage and chemotherapy may also contribute to CVD. Despite increase in head neck squamous cell carcinoma (HNSCC) cases in recent years, little is known about CVD risk in HNSCC patients. We aim to assess association of traditional risk factors and cancer-related factors with CVD in HNSCC patients. Methods: Electronic medical records data of 2391 HNSCC patients diagnosed between 2012-2018 at the UAB O’Neal Comprehensive Cancer Center, were included. ICD-9/10 codes were used to identify HNSCC patients, CVD cases and traditional risk factors. CVD cases were defined as those with composite events of ischemic heart disease and/ or heart failure; controls were without any CVD diagnosis. Cancer site, stage and treatment were included. Logistic regression [OR(95%CI)] was used to assess association of risk factors with CVD, adjusting for age, race, and gender. Results: HNSCC patients were mostly white (82.7%), male (74.7%) and had Stage III/IV cancer (46.6%). Oral cavity was the most common cancer site (32.9%), followed by oropharynx (31.7%); 55.4% patients had hypertension, 23.0% had dyslipidemia, and 16.1% had diabetes. CVD was diagnosed in 16.1% patients, who were more likely to be older [median age 67.0 vs 60.0 years, p<0.0001]. In the multivariable model, hypertension [2.08(1.54-2.80)], diabetes [2.03(1.52-2.70)] and dyslipidemia [2.36(1.82-3.07)] were associated with CVD. Smoking status was not associated. Association of cancer stage with CVD varied by cancer site. Stage III/IV oropharynx cancer patients had lower odds of CVD than stage I/II oropharynx patients [0.38(0.30-0.92)]. No association with cancer stage was observed in oral cavity patients. Compared to chemotherapy, surgery [0.85(0.63-1.14)] and other treatments {0.61(0.41-0.89)] had lower odds of CVD. Conclusions: Traditional CVD risk factors remain associated with CVD in HNSCC patients. In addition, cancer-related factors (oropharynx cancer, advanced cancer stage and chemotherapy) are also associated with CVD.

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