scholarly journals Long-Term Incidence of Stroke and Dementia in ASCOT

Stroke ◽  
2021 ◽  
Author(s):  
William N. Whiteley ◽  
Ajay K. Gupta ◽  
Thomas Godec ◽  
Somayeh Rostamian ◽  
Andrew Whitehouse ◽  
...  
Keyword(s):  
Risk Factors ◽  
Total Cholesterol ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Measurable Effect ◽  
Stroke Risk Factors ◽  
Outcome Trial

Background and Purpose: Management of stroke risk factors might reduce later dementia. In ASCOT (Anglo-Scandinavian Outcome Trial), we determined whether dementia or stroke were associated with different blood pressure (BP)–lowering regimens; atorvastatin or placebo; and mean BP, BP variability, and mean cholesterol levels. Methods: Participants with hypertension and ≥3 cardiovascular disease risk factors were randomly allocated to amlodipine- or atenolol-based BP-lowering regimen targeting BP <140/90 mm Hg for 5.5 years. Participants with total cholesterol ≤6.5 mmol/L were also randomly allocated to atorvastatin 10 mg or placebo for 3.3 years. Mean and LDL (low-density lipoprotein) cholesterol, BP, and SD of BP were calculated from 6 months to end of trial. UK participants were linked to electronic health records to ascertain deaths and hospitalization in general and mental health hospitals. Dementia and stroke were ascertained by validated code lists and within-trial ascertainment. Results: Of 8580 UK participants, 7300 were followed up to 21 years from randomization. Atorvastatin for 3.3 years had no measurable effect on stroke (264 versus 272; adjusted hazard ratio [HR], 0.92 [95% CI, 0.78–1.09]; P =0.341) or dementia (238 versus 227; adjusted HR, 0.98 [95% CI, 0.82–1.18]; P =0.837) compared with placebo. Mean total cholesterol was not associated with later stroke or dementia. An amlodipine-based compared with an atenolol-based regimen for 5.5 years reduced stroke (443 versus 522; adjusted HR, 0.82 [95% CI, 0.72–0.93]; P =0.003) but not dementia (450 versus 465; adjusted HR, 0.94 [95% CI, 0.82–1.07]; P =0.334) over follow-up. BP variability (SD mean BP) was associated with a higher risk of dementia (per 5 mm Hg HR, 1.14 [95% CI, 1.06–1.24]; P <0.001) and stroke (HR, 1.21 [95% CI, 1.12–1.32]; P <0.001) adjusted for mean BP. Conclusions: An amlodipine-based BP regimen reduced the long-term incidence of stroke compared with an atenolol-based regimen but had no measurable effect on dementia. Atorvastatin had no effect on either stroke or dementia. Higher BP variability was associated with a higher incidence of later dementia and stroke.

scholarly journals Study of cardiovascular disease risk factors among urban schoolchildren in Sousse,Tunisia

2000 ◽  
Vol 6 (5-6) ◽  
pp. 1046-1054 ◽  
Author(s):  
H. Ghannem ◽  
K. Khlita ◽  
I. Harrabi ◽  
A. Ben Abdelaziz ◽  
R. Gaha
Keyword(s):  
Risk Factors ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Tobacco Consumption ◽  
Epidemiological Survey ◽  
Cvd Risk ◽  
Lipid Disorders ◽  
Significant Difference

To assess the risk to Tunisian children of cardiovascular diseases [CVD], we undertook an epidemiological survey of 1569 urban schoolchildren from Sousse. Prevalence rates for the following CVD risk factors were determined: hypertension, hypercholesterolaemia and other lipid disorders, obesity and tobacco consumption. Hypertension and hypertriglyceridaemia showed no statistically significant difference by sex. Hypercholesterolaemia, high levels of low-density lipoprotein cholesterol and obesity were all significantly higher for girls than boys. Smoking was significantly higher among boys. The relatively low CVD risk factor profile of Tunisian schoolchildren should be encouraged in adulthood and a school heart health programme should be established.

scholarly journals Study of cardiovascular disease risk factors among rural schoolchildren in Sousse,Tunisia

2001 ◽  
Vol 7 (4-5) ◽  
pp. 617-624
Author(s):  
H. Ghannem
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Epidemiological Survey ◽  
Cardiovascular Disease Risk Factors ◽  
Cardiovascular Disease Risk Factor ◽  
Significant Difference

We undertook an epidemiological survey based on a representative sample of 793 rural schoolchildren in Sousse, Tunisia to assess the prevalence of certain cardiovascular disease risk factors. The prevalence of hypertension [11.2%], hypercholesterolaemia [2.9%], hypertriglyceridaemia [1.0%], high levels of low-density lipoprotein cholesterol [0.6%] and obesity [4.0%] showed no statistically significant difference based on sex. However, smoking [4%] showed a significant gender difference [boys: 7.3%; girls 1.2%]. The relatively low cardiovascular disease risk factor profile of Tunisian children needs to be encouraged through to adulthood. Thus a school programme of heart health promotion should be established.

scholarly journals Association between cardiovascular disease risk factors and occurrence of venous thromboembolism

2012 ◽  
Vol 108 (09) ◽  
pp. 508-515 ◽  
Author(s):  
Pamela L. Lutsey ◽  
Elizabeth J. Bell ◽  
Heather Gornik ◽  
Mary Cushman ◽  
Susan R. Heckbert ◽  
...  
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Venous Disease ◽  
Cvd Risk Factors ◽  
Cvd Risk

SummaryApart from obesity, it remains controversial whether atherosclerosis and its cardiovascular risk disease (CVD) factors are associated with risk of venous thromboembolism (VTE). Using data from the Atherosclerosis Risk in Communities study (ARIC), we evaluated associations between CVD risk factors and incident VTE in a cohort of 15,340 participants who were free a history of VTE and/or anticoagulant use on enrolment. The CVD risk factors were updated during the follow-up period. Over a mean follow-up time of 15.5 years (237,375 person-years), 468 participants had VTE events. Adjusting for demographic variables and body mass index (BMI), current smokers were at greater risk [HR of 1.44 (95% CI: 1.12–1.86)] compared to non-smokers. There was a positive monotonic association between BMI and VTE risk. Individuals with a BMI ≥35 kg/m2 had a HR for VTE of 3.09 (95%CI: 2.26–4.23) compared to those with normal BMI (<25 kg/m2). Greater physical activity was associated with lower VTE risk in a demographic adjusted model; however, this association became non-significant following adjustment for BMI. Alcohol intake, diabetes, hypertension, high-density lipoprotein and low-density lipoprotein cholesterol, and triglycerides were not associated with VTE risk. In conclusion, among the well-established CVD risk factors, only current smoking and obesity were independently associated with VTE risk in this large cohort where risk factors were updated serially during follow-up. This finding corroborates that the pathogenesis of venous disease differs from that of atherosclerotic disease.

scholarly journals Cardiovascular Disease Risk Factors: How Relevant in African Men With Prostate Cancer Receiving Androgen-Deprivation Therapy?

2017 ◽  
Vol 3 (1) ◽  
pp. 7-14
Author(s):  
Okon Ekwere Essien ◽  
Iya Eze Bassey ◽  
Rebecca Mtaku Gali ◽  
Alphonsus Ekpe Udoh ◽  
Uwem Okon Akpan ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Waist Circumference ◽  
Total Cholesterol ◽  
Ldl Cholesterol ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Treatment Naïve

Purpose Cardiovascular disease risk factors have been associated with androgen-deprivation therapy (ADT) in white and Hispanic populations. It is therefore relevant to determine if there exists a relationship between these parameters in the African population. Patients and Methods The design of the study was cross sectional. Prostate-specific antigen concentration, waist circumference, body mass index (BMI), lipid profile, glucose level, and insulin level were determined in 153 patients with prostate cancer and 80 controls. The patients with prostate cancer were divided into subgroups of treatment-naïve patients and those receiving ADT. Results Mean total cholesterol ( P = .010), LDL cholesterol ( P = .021), BMI ( P = .001), and waist circumference ( P = .029) values were significantly higher in patients treated with ADT when compared with treatment-naïve patients. In patients treated with ADT for up to 1 year, only mean BMI was significantly higher than in treatment-naïve patients, whereas those treated with ADT for more than 1 year had significantly higher mean BMI, waist circumference, total cholesterol, and LDL cholesterol values when compared with treatment-naïve patients. There were no significant differences in insulin or glucose levels. Those undergoing hormone manipulation after orchiectomy had fewer cardiovascular risk factors compared with those undergoing hormone manipulation alone. Conclusion This study shows that ADT results in elevated total cholesterol, LDL cholesterol, BMI, and waist circumference values, all of which are risk factors of cardiovascular disease. Screening for cardiovascular risk factors should be included in treatment plans for patients with prostate cancer.

scholarly journals Time-of-day and Meal Size Effects on Clinical Lipid Markers

2020 ◽  
Author(s):  
Leilah K Grant ◽  
Charles A Czeisler ◽  
Steven W Lockley ◽  
Shadab A Rahman
Keyword(s):  
Cardiovascular Disease ◽  
Total Cholesterol ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Density Lipoprotein ◽  
Time Of Day ◽  
Lipoprotein Cholesterol ◽  
Shift Workers ◽  
Postprandial Lipid Metabolism ◽  
Lipid Panel

Abstract Context Dyslipidemia and cardiovascular disease are common in shift workers and eating at night may contribute to this pathophysiology. Objective To examine the effects of eating at different times of day on lipid profiles. Design Two 24-hour baseline days with 8 hours of sleep, 3 meals (breakfast, lunch, dinner) and a snack, followed by a 40-hour constant routine (CR) with hourly isocaloric meals. Setting Intensive Physiological Monitoring Unit, Brigham and Women’s Hospital. Participants Twenty-one healthy adults [23.4 ± 2.7 years, 5F] Intervention Forty-hour CR. Main Outcome Measures A standard clinical lipid panel, consisting of total cholesterol, triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), was assayed in blood samples collected 4-hourly across ~4 days. Results When participants ate at night, levels of TG were similar to eating during the day, however, these levels at night were reached with consuming approximately half the calories. Additionally, 24-hour levels of TG were 10% higher when meals were consumed hourly across 24 hours compared to consuming a typical 3-meal schedule while awake during the day and sleeping at night. The endogenous circadian rhythms of TG, which peaked at night, were shifted earlier by ~10 hours under baseline conditions, whereas the rhythms in total cholesterol, HDL-C, and LDL-C remained unchanged and peaked in the afternoon. Conclusions The time-of-day dependency on postprandial lipid metabolism, which leads to hypersensitivity in TG responses when eating at night, may underlie the dyslipidemia and elevated cardiovascular disease risk observed in shift workers.

scholarly journals Short-Term Effects of Healthy Eating Pattern Cycling on Cardiovascular Disease Risk Factors: Pooled Results from Two Randomized Controlled Trials

Nutrients ◽  
2018 ◽  
Vol 10 (11) ◽  
pp. 1725 ◽  
Author(s):  
Lauren O'Connor ◽  
Jia Li ◽  
R. Drew Sayer ◽  
Jane Hennessy ◽  
Wayne Campbell
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Healthy Eating ◽  
Cardiovascular Health ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Cardiovascular Disease Risk Factors ◽  
Eating Pattern

Adherence to healthy eating patterns (HEPs) is often short-lived and can lead to repetitive attempts of adopting—but not maintaining—HEPs. We assessed effects of adopting, abandoning, and readopting HEPs (HEP cycling) on cardiovascular disease risk factors (CVD-RF). We hypothesized that HEP cycling would improve, worsen, and again improve CVD-RF. Data were retrospectively pooled for secondary analyses from two randomized, crossover, controlled feeding trials (n = 60, 52 ± 2 years, 30.6 ± 0.6 kg/m2) which included two 5–6 week HEP interventions (Dietary Approaches to Stop Hypertension-style or Mediterranean-style) separated by a four-week unrestricted eating period. Ambulatory and fasting blood pressures (BP), fasting serum lipids, lipoproteins, glucose, and insulin were measured before and during the last week of HEP interventions. Fasting systolic BP and total cholesterol decreased (−6 ± 1 mm Hg and −19 ± 3 mg/dL, respectively, p < 0.05), returned to baseline, then decreased again (−5 ± 1 mm Hg and −13 ± 3 mg/dL, respectively, p < 0.05) when adopting, abandoning, and readopting a HEP; magnitude of changes did not differ. Ambulatory and fasting diastolic BP and high-density lipoprotein cholesterol concentrations followed similar patterns; glucose and insulin remained unchanged. Low-density lipoprotein cholesterol concentrations decreased with initial adoption but not readoption (−13 ± 3 and −6 ± 3, respectively, interaction p = 0.020). Healthcare professionals should encourage individuals to consistently consume a HEP for cardiovascular health but also encourage them to try again if a first attempt is unsuccessful or short-lived.

scholarly journals Identification of Endothelial Proteins in Plasma Associated With Cardiovascular Risk Factors

2021 ◽  
Author(s):  
Maria J. Iglesias ◽  
Larissa D. Kruse ◽  
Laura Sanchez-Rivera ◽  
Linnea Enge ◽  
Philip Dusart ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Body Mass Index ◽  
Risk Factor ◽  
Total Cholesterol ◽  
Body Mass ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Cardiovascular Disease Risk Factor ◽  
Venous Disease

Objective: Endothelial cell (EC) dysfunction is a well-established response to cardiovascular disease risk factors, such as smoking and obesity. Risk factor exposure can modify EC signaling and behavior, leading to arterial and venous disease development. Here, we aimed to identify biomarker panels for the assessment of EC dysfunction, which could be useful for risk stratification or to monitor treatment response. Approach and Results: We used affinity proteomics to identify EC proteins circulating in plasma that were associated with cardiovascular disease risk factor exposure. Two hundred sixteen proteins, which we previously predicted to be EC-enriched across vascular beds, were measured in plasma samples (n=1005) from the population-based SCAPIS (Swedish Cardiopulmonary Bioimage Study) pilot. Thirty-eight of these proteins were associated with body mass index, total cholesterol, low-density lipoprotein, smoking, hypertension, or diabetes. Sex-specific analysis revealed that associations predominantly observed in female- or male-only samples were most frequently with the risk factors body mass index, or total cholesterol and smoking, respectively. We show a relationship between individual cardiovascular disease risk, calculated with the Framingham risk score, and the corresponding biomarker profiles. Conclusions: EC proteins in plasma could reflect vascular health status.

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