scholarly journals Pharmacological management of modifiable cardiovascular risk factors (blood pressure and lipids) following diagnosis of myocardial infarction, stroke and diabetes: comparison between population-based studies in Russia and Norway

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sarah Cook ◽  
Laila A. Hopstock ◽  
Anne Elise Eggen ◽  
Katie Bates ◽  
Olena Iakunchykova ◽  
...  
BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e035584
Author(s):  
Tom Wilsgaard ◽  
Anne Merete Vangen-Lønne ◽  
Ellisiv Mathiesen ◽  
Maja-Lisa Løchen ◽  
Inger Njølstad ◽  
...  

ObjectivesThe aim of this study was to use the parametric g-formula to estimate the 19-year risk of myocardial infarction (MI) under hypothetical interventions on six cardiovascular risk factors.Design and settingA populations-based cohort study with repeated measurements, the Tromsø Study.Primary outcome measureMyocardial infarction.ParticipantsWe estimated the relative and absolute risk reduction under feasible and intensive risk reduction strategies for smoking, physical activity, alcohol drinking, body mass index, total serum cholesterol and systolic blood pressure in 14 965 men and women with 19 years of follow-up (1994–2013).ResultsThe estimated 19-year risk of MI under no intervention was 7.5% in individuals with baseline mean age 49.3 years (range 25–69). This risk was reduced by 30% (95% CI 19% to 39%) under joint feasible interventions on all risk factors, and 70% (60%, 78%) under a set of more intensive interventions. The most effective interventions were lowering of total cholesterol to 5.18 mmol/L and lowering of systolic blood pressure to 120 mm Hg (33% and 37% lower MI risk, respectively). The absolute risk reductions were significantly larger in men, in older participants, in smokers and in those with low education.ConclusionModification of population levels of cardiovascular risk factors could have prevented close to one-third of the cases of MI in the municipality of Tromsø during 19 years of follow-up.


2013 ◽  
Vol 47 (2) ◽  
pp. 301-308 ◽  
Author(s):  
Helena Gama ◽  
Albertino Damasceno ◽  
Carla Silva-Matos ◽  
Domingos Diogo ◽  
Ana Azevedo ◽  
...  

OBJECTIVE: To assess the determinants of the lack of pharmacological treatment for hypertension. METHODS: In 2005, 3,323 Mozambicans aged 25-64 years old were evaluated. Blood pressure, weight, height and smoking status were assessed following the Stepwise Approach to Chronic Disease Risk Factor Surveillance. Hypertensives (systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg and/or antihypertensive drug therapy) were evaluated for awareness of their condition, pharmacological and non-pharmacological management, as well as use of herbal or traditional remedies. Prevalence ratios (PR) were calculated, adjusted for sociodemographic characteristics, cardiovascular risk factors and non-pharmacological treatment. RESULTS: Most of the hypertensive subjects (92.3%), and nearly half of those aware of their condition were not treated pharmacologically. Among the aware, the prevalence of untreated hypertension was higher in men {PR = 1.61; 95% confidence interval (95%CI 1.10;2.36)} and was lower in subjects under non-pharmacological treatment (PR = 0.58; 95%CI 0.42;0.79); there was no significant association with traditional treatments (PR = 0.75; 95%CI 0.44;1.26). CONCLUSIONS: The lack of pharmacological treatment for hypertension was more frequent in men, and was not influenced by the presence of other cardiovascular risk factors; it could not be explained by the use of alternative treatments as herbal/traditional medicines or non-pharmacological management. It is important to understand the reasons behind the lack of management of diagnosed hypertension and to implement appropriate corrective actions to reduce the gap in the access to healthcare between developed and developing countries.


BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e028939 ◽  
Author(s):  
Susanna Ragnhild Andersdatter Siri ◽  
Bent Martin Eliassen ◽  
Bjarne K Jacobsen ◽  
Marita Melhus ◽  
Ann Ragnhild Broderstad ◽  
...  

ObjectiveTo describe changes in cardiovascular risk factors and in the estimated 10-year risk of acute myocardial infarction (AMI) or cerebral stroke (CS) between SAMINOR 1 (2003–2004) and SAMINOR 2 (2012–2014), and explore if these changes differed between Sami and non-Sami.DesignTwo cross-sectional surveys.SettingInhabitants of rural Northern Norway.ParticipantsParticipants were aged 40–79 years and participated in SAMINOR 1 (n=6417) and/or SAMINOR 2 (n=5956).Primary outcome measuresGeneralised estimating equation regressions with an interaction term were used to estimate and compare changes in cardiovascular risk factors and 10-year risk of AMI or CS between the two surveys and by ethnicity.ResultsMean cholesterol declined by 0.50, 0.43 and 0.60 mmol/L in women, Sami men and non-Sami men, respectively (all p<0.001). Sami men had a small decline in mean high-density lipoprotein (HDL) cholesterol and an increase in mean triglycerides (both p<0.001), whereas non-Sami showed no change in these variables. Non-Sami women had an increase in mean HDL cholesterol (p<0.001) whereas Sami women had no change. Triglycerides did not change in non-Sami and Sami women. Systolic and diastolic blood pressure declined by 3.6 and 1.0 mm Hg in women, and 3.1 and 0.7 in men, respectively (all p<0.01). Mean waist circumference increased by 6.7 and 5.9 cm in women and men, respectively (both p<0.001). The odds of being a smoker declined by 35% in women and 46% in men (both p<0.001). Estimated 10-year risk of AMI or CS decreased in all strata of sex and ethnicity (p<0.001), however, Sami women had a smaller decline than non-Sami did.ConclusionsIndependent of ethnicity, there was a decline in mean cholesterol, blood pressure, smoking, hypertension (women only) and 10-year risk of AMI or CS, but waist circumference increased. Relatively minor ethnic differences were found in changes of cardiovascular risk factors.


Biomolecules ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. 192 ◽  
Author(s):  
Moritz Koriath ◽  
Christian Müller ◽  
Norbert Pfeiffer ◽  
Stefan Nickels ◽  
Manfred Beutel ◽  
...  

(1) Background: Telomeres are repetitive DNA sequences located at the extremities of chromosomes that maintain genetic stability. Telomere biology is relevant to several human disorders and diseases, specifically cardiovascular disease. To better understand the link between cardiovascular disease and telomere length, we studied the effect of relative telomere length (RTL) on cardiovascular risk factors in a large population-based sample. (2) Methods: RTL was measured by a real-time quantitative polymerase chain reaction in subjects of the population-based Gutenberg Health Study (n = 4944). We then performed an association study of RTL with known cardiovascular risk factors of smoking status as well as systolic and diastolic blood pressure, body mass index (BMI), LDL cholesterol, HDL cholesterol, and triglycerides. (3) Results: A significant correlation was shown for RTL, with age as a quality control in our study (effect = −0.004, p = 3.2 × 10−47). Analysis of the relation between RTL and cardiovascular risk factors showed a significant association of RTL in patients who were current smokers (effect = −0.016, p = 0.048). No significant associations with RTL were seen for cardiovascular risk factors of LDL cholesterol (p = 0.127), HDL cholesterol (p = 0.713), triglycerides (p = 0.359), smoking (p = 0.328), diastolic blood pressure (p = 0.615), systolic blood pressure (p = 0.949), or BMI (p = 0.903). In a subsequent analysis, we calculated the tertiles of RTL. No significant difference across RTL tertiles was detectable for BMI, blood pressure, lipid levels, or smoking status. Finally, we studied the association of RTL and cardiovascular risk factors stratified by tertiles of age. We found a significant association of RTL and LDL cholesterol in the oldest tertile of age (effect = 0.0004, p = 0.006). (4) Conclusions: We determined the association of relative telomere length and cardiovascular risk factors in a population setting. An association of telomere length with age, current smoking status, as well as with LDL cholesterol in the oldest tertile of age was found, whereas no associations were observed between telomere length and triglycerides, HDL cholesterol, blood pressure, or BMI.


2014 ◽  
Vol 5 (4) ◽  
pp. 307-313 ◽  
Author(s):  
K. McCloskey ◽  
C. Sun ◽  
A. Pezic ◽  
J. Cochrane ◽  
R. Morley ◽  
...  

Childhood cardiovascular risk factors affect vascular function long before overt cardiovascular disease. Twin studies provide a unique opportunity to examine the influence of shared genetic and environmental influences on childhood cardiovascular function. We examined the relationship between birth parameters, markers of adiposity, insulin resistance, lipid profile and blood pressure and carotid–femoral pulse wave velocity (PWV), a validated non-invasive measure of arterial stiffness in a healthy cohort of school-aged twin children.PWV was performed on a population-based birth cohort of 147 twin pairs aged 7–11 years. Fasting blood samples, blood pressure and adiposity measures were collected concurrently. Mixed linear regression models were used to account for twin clustering, within- and between-twin pair associations.There were positive associations between both markers of higher adiposity, insulin resistance, elevated triglycerides and PWV, which remained significant after accounting for twin birth-set clustering. There was a positive association between both diastolic and mean arterial blood pressure and PWV in within-pair analysis in dizygotic, but not monozygotic twins, indicating genetic differences evident in dizygotic not monozygotic twins may affect these associations.Increased blood pressure, triglycerides and other metabolic markers are associated with increased PWV in school-aged twins. These results support both the genetic and environmental contribution to higher PWV, as a marker of arterial stiffness, and reiterate the importance of preventing metabolic syndrome from childhood.


1994 ◽  
Vol 72 (01) ◽  
pp. 058-064 ◽  
Author(s):  
Goya Wannamethee ◽  
A Gerald Shaper

SummaryThe relationship between haematocrit and cardiovascular risk factors, particularly blood pressure and blood lipids, has been examined in detail in a large prospective study of 7735 middle-aged men drawn from general practices in 24 British towns. The analyses are restricted to the 5494 men free of any evidence of ischaemic heart disease at screening.Smoking, body mass index, physical activity, alcohol intake and lung function (FEV1) were factors strongly associated with haematocrit levels independent of each other. Age showed a significant but small independent association with haematocrit. Non-manual workers had slightly higher haematocrit levels than manual workers; this difference increased considerably and became significant after adjustment for the other risk factors. Diabetics showed significantly lower levels of haematocrit than non-diabetics. In the univariate analysis, haematocrit was significantly associated with total serum protein (r = 0*18), cholesterol (r = 0.16), triglyceride (r = 0.15), diastolic blood pressure (r = 0.17) and heart rate (r = 0.14); all at p <0.0001. A weaker but significant association was seen with systolic blood pressure (r = 0.09, p <0.001). These relationships remained significant even after adjustment for age, smoking, body mass index, physical activity, alcohol intake, lung function, presence of diabetes, social class and for each of the other biological variables; the relationship with systolic blood pressure was considerably weakened. No association was seen with blood glucose and HDL-cholesterol. This study has shown significant associations between several lifestyle characteristics and the haematocrit and supports the findings of a significant relationship between the haematocrit and blood lipids and blood pressure. It emphasises the role of the haematocrit in assessing the risk of ischaemic heart disease and stroke in individuals, and the need to take haematocrit levels into account in determining the importance of other cardiovascular risk factors.


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