scholarly journals Stroke and Ischemic Heart Disease With Enzyme-inducing Antiseizure Medications: Time to Change Prescribing Habits

2022 ◽  
pp. 153575972110703
Author(s):  
David G. Vossler
Keyword(s):  
Cardiovascular Disease ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Cumulative Exposure ◽  
Absolute Difference ◽  
Defined Daily Dose ◽  
Daily Dose ◽  
Incident Cases ◽  
Incident Cardiovascular Disease

Importance: Enzyme-inducing antiseizure medications (eiASMs) have been hypothesized to be associated with long-term risks of cardiovascular disease. Objective: To quantify and model the putative hazard of cardiovascular disease secondary to eiASM use. Design, Setting, and Participants: This cohort study covered January 1990 to March 2019 (median [IQR] follow-up, 9 [4–15], years). The study linked primary care and hospital electronic health records at National Health Service hospitals in England. People aged 18 years or older diagnosed as having epilepsy after January 1, 1990, were included. All eligible patients were included with a waiver of consent. No patients were approached who withdrew consent. Analysis began January 2021 and ended August 2021. Exposures: Receipt of 4 consecutive EI ASMs (carbamazepine, eslicarbazepine, oxcarbazepine, phenobarbital, phenytoin, primidone, rufinamide, or topiramate) following an adult-onset (age >/=18 years) epilepsy diagnosis or repeated exposure in a weighted cumulative exposure model. Main Outcomes and Measures: Three cohorts were isolated, 1 of which comprised all adults meeting a case definition for epilepsy diagnosed after 1990, 1 comprised incident cases diagnosed after 1998 (hospital linkage date), and 1 was limited to adults diagnosed with epilepsy at 65 years or older. Outcome was incident cardiovascular disease (ischemic heart disease or ischemic or hemorrhagic stroke). Hazard of incident cardiovascular disease was evaluated using adjusted propensity-matched survival analyses and weighted cumulative exposure models. Results: Of 10,916,166 adults, 50,888 (.6%) were identified as having period-prevalent cases (median [IQR] age, 32 [19–50] years; 16 584 [53%] female), of whom 31,479 (62%) were diagnosed on or after 1990 and were free of cardiovascular disease at baseline. In a propensity-matched Cox proportional hazards model adjusted for age, sex, baseline socioeconomic status, and cardiovascular risk factors, the hazard ratio for incident cardiovascular disease was 1.21 (95% CI, 1.06–1.39) for those receiving eiASMs. The absolute difference in cumulative hazard diverges by more than 1% and greater after 10 years. For those with persistent exposure beyond 4 prescriptions, the median hazard ratio increased from a median (IQR) of 1.54 (1.28–1.79) when taking a relative defined daily dose of an eiASM of 1 to 2.38 (1.52–3.56) with a relative defined daily dose of 2 throughout a maximum of 25 years' follow-up compared with those not receiving an eiASM. The hazard was elevated but attenuated when restricting analyses to incident cases or those diagnosed when older than 65 years. Conclusions and Relevance: The hazard of incident cardiovascular disease is higher in those receiving eiASMs. The association is dose dependent and the absolute difference in hazard seems to reach clinical significance by approximately 10 years from first exposure.

Abstract 14635: The Fib-4 Index is a Risk Factor for Incident Cardiovascular Disease in Urban Male Residents: The Suita Study

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Yoshihiro Kokubo ◽  
Masahiro Koseki ◽  
Makoto Watanabe ◽  
Aya Higashiyama ◽  
Yoko Nakao ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Platelet Count ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Disease Risk ◽  
Heart Diseases ◽  
Ischemic Heart ◽  
Index Level ◽  
Incident Cardiovascular Disease

Introduction: The fibrosis index based on four factors (FIB-4 index) is a score that predicts liver fibrosis easily, quickly, and inexpensively, but there is little evidence of its relationship with the onset of cardiovascular disease in general population in Japan. Therefore, we examined the relationship between incident cardiovascular disease (CVD) by the FIB-4 index level in urban area residents. Methods: We studied 5,333 follow-up Japanese individuals (2,478 men, 2,855 women) with no history of CVD in the Suita Study. The platelet count was measured at the time of medical examination. The FIB-4 index was calculated using age (yrs), alanine aminotransferase (ALT, IU/L), aspartate aminotransferase (AST, IU/L), and platelet count (PLT, 10^9/L) as follow: FIB-4 index = (AST x Age) / (PLT x (square root of ALT)). The primary endpoint was CVD events, including stroke or ischemic heart disease. The risk of CVD was analyzed by the FIB-4 index level using the Cox proportional hazards model adjusted by the components of the ischemic heart disease risk score in the Suita Study. Results: The percentage of the FIB-4 index ≥2.67 in the 30s to 80s at the baseline survey was 0%, 1%, 2%, 7,%, 21%, 43% for men, and 0%, 0%, 1%, 5%, 16%, 39% for women, respectively. During the mean follow-up period of 9.3 years, 195 strokes and 137 ischemic heart diseases were observed. Based on men with FIB-4 index <1.30, the adjusted hazard ratio (95% confidence interval) for incident CVD in men with FIB-4 index ≥2.67 was 1.91 (1.05-3.47), those for incident ischemic heart disease in men with FIB-4 index 1.30-2.66 and ≥2.67 were 2.49 (1.33-4.64) and 3.29 (1.32-8.16), respectively. Conclusion: The FIB-4 index was considered to be useful as a predictor of ischemic heart disease in urban men in Japan.

scholarly journals Hepatic Lipase, Genetically Elevated High-Density Lipoprotein, and Risk of Ischemic Cardiovascular Disease

2009 ◽  
Vol 94 (4) ◽  
pp. 1264-1273 ◽  
Author(s):  
Trine Holm Johannsen ◽  
Pia R. Kamstrup ◽  
Rolf V. Andersen ◽  
Gorm B. Jensen ◽  
Henrik Sillesen ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
High Density Lipoprotein ◽  
Genetic Variants ◽  
Hepatic Lipase ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Ischemic Cerebrovascular Disease

Abstract Context: Hepatic lipase influences metabolism of high-density lipoprotein (HDL), a risk factor for ischemic cardiovascular disease (ICD: ischemic heart disease and ischemic cerebrovascular disease). Objective: We tested the hypothesis that genetic variation in the hepatic lipase genetic variants V73M, N193S, S267F, L334F, T383M, and −480c&gt;t influence levels of lipids, lipoproteins, and apolipoproteins and risk of ICD. Design: For the cross-sectional study, we genotyped 9003 individuals from the Copenhagen City Heart Study; hereof were 8971 individuals included in the prospective study, 1747 of whom had incident ICD during 28 yr of follow-up. For the case-control studies, 2110 ischemic heart disease patients vs. 4899 controls and 769 ischemic cerebrovascular disease patients vs. 2836 controls, respectively, were genotyped. Follow-up was 100% complete. Results: HDL cholesterol was higher by 0.21 mmol/liter in S267F heterozygotes, by 0.06 mmol/liter in −480c&gt;t heterozygotes, and by 0.13 mmol/liter in −480c&gt;t homozygotes, as compared with noncarriers. These HDL increases theoretically predicted hazard ratios for ICD of 0.87 [95% confidence interval (CI) 0.84–0.90], 0.96 (95% CI 0.95–0.97), and 0.91 (95% CI 0.89–0.94), respectively; this calculation assumes that genetically elevated HDL levels confer decreased risk similar to common HDL elevations. In contrast, when all cases and controls were combined, the observed odds ratios for ICD for these three genetic variants vs. noncarriers were 1.19 (0.76–1.88), 1.04 (0.96–1.13), and 1.08 (0.89–1.30), respectively. Hazard/odds ratios for ICD in carriers vs. noncarriers of the four remaining hepatic lipase genetic variants did not differ consistently from 1.0. Conclusion: Hepatic lipase genetic variants with elevated levels of HDL cholesterol did not associate with risk of ICD.

Abstract P509: Olive Oil Consumption and Risk of Cardiovascular Disease

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Marta Guasch ◽  
Gang Liu ◽  
Yanping Li ◽  
Laura Sampson ◽  
Joann E Manson ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Heart Disease ◽  
Confidence Interval ◽  
Olive Oil ◽  
Lower Risk ◽  
Hazard Ratio ◽  
Mediterranean Populations ◽  
Dairy Fat ◽  
Incident Cases

Background: Olive oil intake has been associated with lower risk of cardiometabolic risk factors in Mediterranean populations, but little is known about these associations in the U.S. population, where olive oil intake is relatively low. Objectives: To examine whether olive oil intake is associated with total Cardiovascular Disease (CVD), coronary heart disease (CHD) and stroke risk. Methods: We included 63,867 women from the Nurses’ Health Study (1990 to 2014) and 35,512 men from the Health Professionals Follow-up Study (1990 to 2014) who were free of cancer, heart disease, and stroke at baseline. Diet was assessed using food frequency questionnaires at baseline and then every 4 years. Cumulative average of intake was used in the primary analysis. Cox proportional hazards regression was used to estimate hazard ratios and 95% confidence intervals. Results: During 24 years of follow-up, we documented 10,240 incident cases of CVD, including 6,270 CHD cases and 3,970 stroke cases. After adjusting for major diet and lifestyle factors, compared with non-consumers, those with higher olive oil intake (>1/2 tablespoon/d or > 7g/d) had 15% lower risk of total CVD [pooled hazard ratio (95% confidence interval): 0.85 (0.77, 0.93)] and 21% lower risk of CHD [pooled hazard ratio (95% confidence interval): 0.79 (0.70, 0.89)]. No significant associations were observed for total stroke or ischemic stroke. We estimated that replacing 5g of margarine, butter, mayonnaise, or dairy fat with the equivalent amount of olive oil was associated with 5-7% lower risk of total CVD and CHD. No significant associations were observed when olive oil was compared with other plant oils combined (corn, safflower, soybean and canola oil). Conclusions: Higher olive oil intake was associated with a lower risk of CHD and total CVD in two large prospective cohorts of U.S. men and women. The substitution of margarine, butter, mayonnaise, and dairy fat with olive oil might lead to a lower risk for CHD and CVD.

Non-alcoholic beverages intake and risk of cardiovascular disease among Japanese men and women: the JPHC study

2021 ◽  
pp. 1-20
Author(s):  
Renzhe Cui ◽  
Hiroyasu Iso ◽  
Ehab S Eshak ◽  
Koutatsu Maruyama ◽  
Junko Ishihara ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cox Regression ◽  
Alcoholic Beverages ◽  
Tea Consumption ◽  
Japanese Men ◽  
Men And Women ◽  
Incident Cardiovascular Disease

Abstract The association between the intake of non-alcoholic beverages and cardiovascular disease in Asians is uncertain. The intake of non-alcoholic beverages was estimated in 77,407 participants of the Japan public health center-based cohort study aged 45-74 years. The Cox regression calculated the HRs and 95% CIs for incident cardiovascular disease according to sex-specific quintiles of intake of non-alcoholic beverages. A total of 4578 incident cardiovascular disease (3,751 strokes and 827 coronary heart disease) were diagnosed during a 13.6-year median follow-up. The risks of stroke and total cardiovascular disease were lower for the highest versus lowest intake quintiles of non-alcoholic beverages in men and women: the multivariable HRs (95%CIs) were 0.82 (0.71-0.93, p-trend=0.005) and 0.86 (0.76-0.97, p-trend=0.02), respectively in men, and were 0.73 (0.63-0.86, p-trend=0.003) and 0.75 (0.65-0.87, p-trend=0.005) respectively in women. The reduced risk was evident for both ischemic and hemorrhagic strokes and was mainly attributable to green tea consumption. The intake of non-alcoholic beverages from coffee and other beverages was not associated with the risk of cardiovascular disease in both men and women. Also, there was no association between the intake of non-alcohol beverages and the risk of coronary heart disease in either sex. In conclusion, the risks of stroke and total cardiovascular disease were lower with a higher intake of non-alcoholic beverages in Japanese men and women.

Personality, Cardiovascular Disease, and Cancer:

2004 ◽  
Vol 12 (3) ◽  
pp. 102-115 ◽  
Author(s):  
Manfred Amelang ◽  
Petra Hasselbach ◽  
Til Stürmer
Keyword(s):  
Cardiovascular Disease ◽  
Behavioral Control ◽  
Smoking Behavior ◽  
Type A Behavior ◽  
Incremental Validity ◽  
Personality Factors ◽  
Emotional Lability ◽  
Prevalent Disease ◽  
Incident Cardiovascular Disease

Abstract. Ten years ago a sample of N = 5.133 male and female subjects (age 28-74) responded to questionnaires including scales for personality, life style, work stress as well as questions on prevalent disease. We now report on the follow-up regarding self-reported incidence of cardiovascular disease and cancer. During a mean follow-up of 10 years, 257 participants had died. Of those alive, N = 4.010 (82%) participated in the follow-up. Of these, 120 and 180 persons reported incident cardiovascular disease and cancer, respectively. The incidence of cardiovascular disease could be significantly predicted by the personality factors “Emotional Lability”, “Behavioral Control” and “Type-A-Behavior” as well as by the “Rationality/Antemotionality”-scale according to Grossarth-Maticek. After controlling for age, gender and smoking behavior only the significant effect of “Emotional Lability” remained and the predictors according to Grossarth-Maticek had no incremental validity. Cancer could not be predicted by any personality factors.

Hypertension phenotypes and incident cardiovascular disease and mortality events in a decade follow-up of a Middle East cohort

2015 ◽  
Vol 33 (6) ◽  
pp. 1153-1161 ◽  
Author(s):  
Mojtaba Lotfaliany ◽  
Samaneh Akbarpour ◽  
Amirhossein Mozafary ◽  
Reyhaneh Rajab Boloukat ◽  
Fereidoun Azizi ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Middle East ◽  
Incident Cardiovascular Disease

scholarly journals Ventricular disturbance of rhythm as a symptom of cardiovascular disease

2021 ◽  
pp. 27-33
Author(s):  
N. А. Kozhucharova
Keyword(s):  
Cardiovascular Disease ◽  
Differential Diagnosis ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Right Ventricular ◽  
Arrhythmogenic Right Ventricular Dysplasia ◽  
Ischemic Heart ◽  
Ventricular Premature Beats ◽  
Premature Beats ◽  
Diagnosis Of Diseases

The questions of the differential diagnosis of diseases accompanied by ventricular premature beats (ischemic heart disease, myocarditis, arrhythmogenic right ventricular dysplasia) are thrusted into the spotlight.

scholarly journals A CRITICAL REVIEW OF VATIKA HRIDROGA WITH SPECIAL REFERENCE TO ISCHEMIC HEART DISEASE

2022 ◽  
Vol 12 (6) ◽  
pp. 69-72
Author(s):  
Anchal Jaiswal ◽  
Sanjay Kumar Singh ◽  
Seema Joshi
Keyword(s):  
Cardiovascular Disease ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
The Other ◽  
Ischemic Heart ◽  
Detailed Knowledge ◽  
Age Group ◽  
Disease Entity ◽  
Younger Age ◽  
Day By Day

Given increasing evidence, most deaths are due to non-communicable diseases; half of them are the cardiovascular disease. Hridaya is moolasthana of pranvavaha and rasavaha strotas. According to Acharya Sushruta, any condition that produces disturbance in the heart is Hridroga. It is classified into five types. Vataja Hridroga is characterized by Ruja in Urah Pradesha (Pain in the chest region). Vatika type seems to have conceived the disease entity correlated with ischemic heart disease. None of the other Cardiac afflictions appears to have been described under Hridroga. The prevalence rate in the younger age group is increasing day by day so, we need to know the detailed knowledge of vatika hridroga

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