Cardiovascular Risk Assessment in the Older Athlete

2021 ◽  
pp. 194173812110048
Author(s):  
Alec J. Moorman ◽  
Larry S. Dean ◽  
Eugene Yang ◽  
Jonathan A. Drezner
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Cardiovascular Risk ◽  
Acute Coronary Syndromes ◽  
Cardiovascular Risk Assessment ◽  
Cardiovascular Screening ◽  
Older Athletes ◽  
Risk Patients ◽  
Coronary Syndromes ◽  
Ascvd Risk

Context: Limited data are available to guide cardiovascular screening in adult or masters athletes (≥35 years old). This review provides recommendations and the rationale for the cardiovascular risk assessment of older athletes. Evidence Acquisition: Review of available clinical guidelines, original investigations, and additional searches across PubMed for articles relevant to cardiovascular screening, risk assessment, and prevention in adult athletes (1990-2020). Study Design: Clinical review. Level of Evidence: Level 3. Results: Atherosclerotic coronary artery disease (CAD) is the leading cause of exercise-induced acute coronary syndromes, myocardial infarction, and sudden cardiac death in older athletes. Approximately 50% of adult patients who experience acute coronary syndromes and sudden cardiac arrest do not have prodromal symptoms of myocardial ischemia. The risk of atherosclerotic cardiovascular disease (ASCVD) can be estimated by using existing risk calculators. ASCVD 10-year risk is stratified into 3 categories: low-risk (≤10%), intermediate-risk (between 10% and 20%), and high-risk (≥20%). Coronary artery calcium (CAC) scoring with noncontrast computed tomography provides a noninvasive measure of subclinical CAD. Evidence supports a significant association between elevated CAC and the risk of future cardiovascular events, independent of traditional risk factors or symptoms. Statin therapy is recommended for primary prevention if 10-year ASCVD risk is ≥10% (intermediate- or high-risk patients) or if the Agatston score is >100 or >75th percentile for age and sex. Routine stress testing in asymptomatic, low-risk patients is not recommended. Conclusions: We propose a comprehensive risk assessment for older athletes that combines conventional and novel risk factors for ASCVD, a 12-lead resting electrocardiogram, and a CAC score. Available risk calculators provide a 10-year estimate of ASCVD risk allowing for risk stratification and targeted management strategies. CAC scoring can refine risk estimates to improve the selection of patients for initiation or avoidance of pharmacological therapy.

scholarly journals The CUORE project cardiovascular risk assessment in primary care: the ongoing experience in Italy

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Palmieri ◽  
S Vannucchi ◽  
C Lo Noce ◽  
A Di Lonardo ◽  
B Unim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Risk Assessment ◽  
Primary Care ◽  
Cardiovascular Risk ◽  
Risk Score ◽  
Adult Population ◽  
Cardiovascular Risk Assessment ◽  
Project Risk ◽  
Preventive Actions

Abstract Background Italian National Prevention Plan 2005-08 included 10-year cardiovascular risk assessment (10-CR) for the general population aged 35-69 years using the CUORE Project risk score. GPs were encouraged to perform 10-CR and send data to the Cardiovascular Risk Observatory (CRO). Aim To show updated data of the ongoing surveillance system of the 10-CR in the Italian adult population. Methods Data were collected using the cuore.exe software, freely downloadable by GPs from the CUORE Project website (www.cuore.iss.it). The CRO provides a web-platform to compare data on 10-CR and risk factors at regional/national level. For persons examined at least twice, variations in risk factors from baseline to follow-up and 95% confidence intervals (C.I.) were calculated using methods for matched pair samples. Results Up to February 2019, about 3,500 GPs downloaded cuore.exe; about 300,000 CR assessments on about 140,000 persons were sent to CRO. Mean CR was 3.1% in women (W), 8.5% in men (M); 28% of M, 64% of W were at low risk (CR < 3%); 9.9% of M, 0.4% of W were at high risk (CR ≥ 20%); 26% of M, 16% of W were current smokers; 13% of M, 10% of W were diabetic; 33% of hypertensive M, 35% of hypertensive W were under specific treatment. Among those with at least two risk assessments (31% of the sample), 11% shifted to a lower risk class after one year (14% of M, 7% of W). Systolic blood pressure mean levels decreased by 0.6 mmHg (95%-C.I. 0.3-0.8 mmHg), diastolic blood pressure by 0.5 mmHg (0.2-0.7 mmHg), total cholesterol by 4.1 mg/dl (3.0-5.2 mg/dl), smokers prevalence by 3.1% (2.3%-4.0%); HDL-cholesterol increased in W by 0.3 mg/dl (0.1-0.5 mg/dl). Conclusions Data demonstrate that 10-CR assessment can be an effective first step to implement preventive actions in primary care. Individual risk score is a useful tool for GPs to assess CR and promote primary prevention focusing on the adoption of healthy lifestyles. Data can be used to support health policy decision process. Key messages The cuore.exe software, freely downloadable from the CUORE Project website-www.cuore.iss.it, allows GPs to assess the CUORE Project risk score, to collect and to send data to the CVD Risk Observatory. 10 year Cardiovascular Risk assessment in the general adult population can be an effective first step to implement preventive actions in primary care.

scholarly journals Future risk of cardiovascular disease risk factors and events in women after a hypertensive disorder of pregnancy

Heart ◽  
2019 ◽  
Vol 105 (16) ◽  
pp. 1273-1278 ◽  
Author(s):  
Laura Benschop ◽  
Johannes J Duvekot ◽  
Jeanine E Roeters van Lennep
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Risk Assessment ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Hypertensive Disorder ◽  
Cardiovascular Risk Assessment ◽  
Increased Risk

Hypertensive disorders of pregnancy (HDP), such as gestational hypertension and pre-eclampsia, affect up to 10% of all pregnancies. These women have on average a twofold higher risk to develop cardiovascular disease (CVD) later in life as compared with women with normotensive pregnancies. This increased risk might result from an underlying predisposition to CVD, HDP itself or a combination of both. After pregnancy women with HDP show an increased risk of classical cardiovascular risk factors including chronic hypertension, renal dysfunction, dyslipidemia, diabetes and subclinical atherosclerosis. The prevalence and onset of cardiovascular risk factors depends on the severity of the HDP and the coexistence of other pregnancy complications. At present, guidelines addressing postpartum cardiovascular risk assessment for women with HDP show a wide variation in their recommendations. This makes cardiovascular follow-up of women with a previous HDP confusing and non-coherent. Some guidelines advise to initiate cardiovascular follow-up (blood pressure, weight and lifestyle assessment) 6–8 weeks after pregnancy, whereas others recommend to start 6–12 months after pregnancy. Concurrent blood pressure monitoring, lipid and glucose assessment is recommended to be repeated annually to every 5 years until the age of 50 years when women will qualify for cardiovascular risk assessment according to all international cardiovascular prevention guidelines.

scholarly journals Cardiovascular risk assessment in Community Pharmacies in Warri, Nigeria

2021 ◽  
Vol 17 (2) ◽  
pp. 105-111
Author(s):  
David U. Adje ◽  
Azuka C. Oparah ◽  
Timothy Megbolu
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Cardiovascular Risk ◽  
Community Pharmacy ◽  
Total Cholesterol ◽  
Community Pharmacies ◽  
Inclusion Criteria ◽  
Cardiovascular Risks ◽  
Cardiovascular Risk Assessment ◽  
High Cardiovascular Risk

Many apparently healthy persons have multiple risk factors for cardiovascular disease without being aware. Assessing cardiovascular risks and initiating appropriate interventions and referrals at the community pharmacy level could be lifesaving. The objective of this study was to explore cardiovascular risk assessment on community pharmacy clientele and to determine the proportion of patients with high cardiovascular risk factors. Subjects (140) were recruited from 5 community pharmacies in Warri Metropolis. Cardiovascular risks assessment was done among subjects that met the inclusion criteria. Blood pressure, total cholesterol levels, Diabetes status, age and gender were documented in a data collection form. Risk stratification was done using World Health Organization/ International Society of Hypertension WHO/ISH risk assessment chart. Data were analyzed using SPSS version 20. Subjects (116) who met the inclusion criteria were screened. About half (50.9%) were moderate users of alcohol. Majority (81.9%) of patients were physically active. Few subjects (2.6%) were tobacco users. Total cholesterol values and fasting blood sugar levels were abnormal for 12.9% and 4.3% of subjects respectively. The proportion of subjects with high cardiovascular risk was 6%. Cardiovascular risk assessment is feasible in community pharmacy setting. Only 6% of subjects were at high cardiovascular risk. Keywords: Cardiovascular risk assessment, Community pharmacy, WHO/ISH charts

Volunteer and career French firefighters: Cardiovascular risk factors and cardiovascular risk assessment

2019 ◽  
Vol 27 (1) ◽  
pp. 107-109 ◽  
Author(s):  
Angélique Savall ◽  
Rodolphe Charles ◽  
Anaïs Bertholon ◽  
Baptiste Gramont ◽  
Béatrice Trombert ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Cardiovascular Risk Assessment
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