scholarly journals Combined effect of menopause and cardiovascular risk factors on death and cardiovascular disease: a cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yan Li ◽  
Dong Zhao ◽  
Miao Wang ◽  
Jia-yi Sun ◽  
Jun Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cohort Study ◽  
Ischemic Stroke ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Elevated Risk ◽  
Combined Effect ◽  
Age At Menopause ◽  
Risk Of Death

Abstract Background Observational studies suggest that early menopause is associated with increased risk of death and cardiovascular disease (CVD); however, the results of these studies have been inconsistently. We aimed to assess the association of menopause with death and CVD and whether this association was modified by cardiovascular risk factors. Methods The study population was women age 35–64 years living in two communities of Beijing who were enrolled in the Chinese Multi-provincial Cohort Study in 1992. Participants were followed until first cardiovascular event, death, or the end of follow-up (2018). Self-reported age at menopause was recorded. Multivariate Cox regression models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of death and CVD after adjusting for baseline covariates of age, family history of CVD, and white blood cell count, as well as time-varying covariates of menopause, use of oral estrogen, and conventional risk factors. Additionally, we assessed the combined effect of age at menopause and risk factors on the primary endpoint. Results Of 2104 eligible women, 124 died and 196 had a first CVD event (33 fatal CVD and 163 non-fatal CVD). Compared with women who experienced menopause at age 50–51 years, the risk of death was higher in women with menopause at age 45–49 years (HR 1.99, 95% CI 1.24–3.21; P = 0.005), and the risk of ischemic stroke was higher in women with menopause at age < 45 years (HR 2.16, 95% CI 1.04–4.51; P = 0.04) and at age 45–49 years (HR 2.05, 95% CI 1.15–3.63; P = 0.01). Women who had menopause before age 50 years and at least one elevated risk factor at baseline had a higher risk of death (HR 11.10, 95% CI 1.51–81.41; P = 0.02), CVD (HR 3.98, 95% CI 1.58–10.01; P = 0.003), ischemic CVD (HR 4.53, 95% CI 1.63–12.62; P = 0.004), coronary heart disease (HR 8.63, 95% CI 1.15–64.50; P = 0.04), and stroke (HR 2.92, 95% CI 1.03–8.29; P = 0.04) than those with menopause at age 50–51 years and optimal levels of all risk factors. Conclusions Earlier menopause may predict death and ischemic stroke. Furthermore, there is a combined effect of earlier menopause and elevated risk factors on death and CVD.

scholarly journals Gender Inequalities in Diagnostic Inertia around the Three Most Prevalent Cardiovascular Risk Studies: Protocol for a Population-Based Cohort Study

2021 ◽  
Vol 18 (8) ◽  
pp. 4054
Author(s):  
Concepción Carratala-Munuera ◽  
Adriana Lopez-Pineda ◽  
Domingo Orozco-Beltran ◽  
Jose A. Quesada ◽  
Jose L. Alfonso-Sanchez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Health Care ◽  
Cohort Study ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Disease Incidence ◽  
Population Based ◽  
Gender Inequalities ◽  
Primary Health Care Centers

Evidence shows that objectives for detecting and controlling cardiovascular risk factors are not being effectively met, and moreover, outcomes differ between men and women. This study will assess the gender-related differences in diagnostic inertia around the three most prevalent cardiovascular risk factors: dyslipidemia, arterial hypertension, and diabetes mellitus, and to evaluate the consequences on cardiovascular disease incidence. This is an epidemiological and cohort study. Eligible patients will be adults who presented to public primary health care centers in a Spanish region from 2008 to 2011, with hypertension, dyslipidemia, or/and diabetes and without cardiovascular disease. Participants’ electronic health records will be used to collect the study variables in a window of six months from inclusion. Diagnostic inertia of hypertension, dyslipidemia, and/or diabetes is defined as the registry of abnormal diagnostic parameters—but no diagnosis—on the person’s health record. The cohort will be followed from the date of inclusion until the end of 2019. Outcomes will be cardiovascular events, defined as hospital admission due to ischemic cardiopathy, stroke, and death from any cause. The results of this study could inform actions to rectify the structure, organization and training of health care teams in order to correct the inequality.

408Albuminuria as a predictor of incident ischemic stroke and myocardial infarction in patients with type 2 diabetes but without cardiovascular disease: A Danish cohort study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M V Fangel ◽  
P B Nielsen ◽  
J K Kristensen ◽  
T B Larsen ◽  
T F Overvad ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Cohort Study ◽  
Ischemic Stroke ◽  
Cardiovascular Risk ◽  
All Cause Mortality ◽  
Patients With Diabetes

Abstract Background Risk stratification in patients with type 2 diabetes continues to be an important priority in the management of diabetes-related morbidity and mortality. International guidelines generally recognize patients with diabetes and cardiovascular disease as high-risk patients. Risk stratification is, however, more uncertain in diabetes patients without cardiovascular disease. Micro- and macroalbuminuria have previously been identified as predictors of cardiovascular events and mortality in general cohorts of diabetes patients. However, less is known about the predictive value of albuminuria in patients with diabetes but without established cardiovascular disease. Purpose We aimed to examine the association between albuminuria level and the risk of ischemic stroke, myocardial infarction, and all-cause mortality in patients with type 2 diabetes and without a diagnosis of cardiovascular disease. Methods We linked Danish nationwide registries to identify patients with type 2 diabetes and without cardiovascular disease from May 2005 through June 2015. Based on two consecutive measurements of the urinary albumin excretion rate or albumin-to-creatinine ratio patients were stratified in categories of normoalbuminuria, microalbuminuria, and macroalbuminuria. Patients were followed for the outcomes ischemic stroke, myocardial infarction, and all-cause mortality until December 31, 2015. Five-year risk of outcomes were presented as cumulative incidence functions (with death as a competing event). Associations between albuminuria level and incidence of ischemic stroke, myocardial infarction, and all-cause mortality were evaluated with Cox proportional hazard regression adjusted for cardiovascular risk factors. Results The study population included 78,841 patients with type 2 diabetes (44.7% females, mean age 63.2). When comparing patients with microalbuminuria to patients with normoalbuminuria in an age- and sex-adjusted analysis, we found hazard ratios (HRs) of 1.45 (95% CI: 1.24–1.69), 1.45 (95% CI: 1.24–1.70), and 1.50 (95% CI: 1.39–1.61) for ischemic stroke, myocardial infarction, and all-cause mortality, respectively. Furthermore, macroalbuminuria was associated with HRs of 2.05 (95% CI: 1.70–2.48), 2.25 (95% CI: 1.86–2.71), and 2.03 (95% CI: 1.85–2.23) for ischemic stroke, myocardial infarction, and all-cause mortality, respectively. Similar results were found after adjusting for cardiovascular risk factors. Conclusions In this nationwide cohort study of patients with type 2 diabetes but without cardiovascular disease, patients with micro- and macroalbuminuria had a higher risk of incident ischemic stroke, myocardial infarction, and all-cause mortality. This finding supports that patients with micro- or macroalbuminuria should be screened regularly and followed closely in clinical practice. Moreover, these findings suggest that patients with type 2 diabetes and micro- or macroalbuminuria may benefit from intensive vascular risk reduction.

Low ADAMTS13 Activity Is a Strong Risk Factor for Ischemic Stroke: A Prospective Cohort Study - the Rotterdam Study

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 113-113 ◽  
Author(s):  
Michelle Alida Helena Sonneveld ◽  
Moniek de Maat ◽  
Marileen L.P. Portegies ◽  
Albert Hofman ◽  
Peter L Turecek ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Ischemic Stroke ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Population Based ◽  
Adamts13 Activity ◽  
Rotterdam Study ◽  
Advisory Committees ◽  
Cox Proportional Hazard Regression

Abstract Introduction.ADAMTS13 has antithrombotic properties because it cleaves Von Willebrand factor (VWF) in smaller, less active multimers. Low ADAMTS13 activity may therefore increase the risk of arterial thrombosis, including ischemic stroke. We prospectively studied the association between ADAMTS13 activity, VWF antigen (VWF:Ag) levels and ischemic stroke in the Rotterdam Study, a population-based cohort study among subjects ≥ 55 years. Methods.We included 5941 individuals without a history of stroke or TIA. Blood was drawn at baseline and ADAMTS13 activity (expressed as % of normal plasma) was measured using the FRETS-VWF73 assay and VWF:Ag levels by ELISA. All individuals were followed for development of stroke or TIA. The association between ADAMTS13 activity, VWF:Ag levels and ischemic stroke were assessed by Cox proportional hazard regression analysis. Results.Over an average follow-up time of 9.5 years, 461 participants suffered from a stroke, 306 of which definitely classified as ischemic. After adjustment for cardiovascular risk factors, individuals with ADAMTS13 activity in the lowest quartile had a higher risk of ischemic stroke (HR 1.65, 95% CI 1.16 – 2.32) than those in the reference highest quartile. In individuals with low ADAMTS13 activity and high VWF:Ag levels the risk of ischemic stroke risk was 3.5 fold increased (HR 3.51, 95% CI 1.60 – 7.70). Conclusions.In this large prospective population study, low ADAMTS13 activity predicts the risk of ischemic stroke, independently of age, sex, and established cardiovascular risk factors. This risk was even higher in individuals with both low ADAMTS13 activity and high VWF antigen levels. Figure 1 Figure 1. Disclosures Turecek: Baxter Innovations GmbH, Vienna, Austria: Employment. Rottensteiner:Baxter Innovations GmbH: Employment. Scheiflinger:Baxter Innovations GmbH: Employment. Leebeek:CSL Behring and Baxter: Membership on an entity's Board of Directors or advisory committees.

Abstract P166: Distribution of Cardiovascular Risk Factors in ESMaestras: A Cohort Study of 97,174 Mexican Women

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Martin Lajous ◽  
Isabelle Romieu ◽  
Andres Catzin-Kuhlmann ◽  
Walter C Willett ◽  
Ruy Lopez-Ridaura
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cohort Study ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Latin American ◽  
Lifestyle Factors ◽  
Lifestyle Factor ◽  
Mexican Women ◽  
Daily Consumption

Introduction: The ESMaestras study ( Estudio de Seguimiento la Salud de las Maestras ) is an effort to prospectively study the health effects of dietary and lifestyle factors in Mexico, a country undergoing a fast-paced nutritional and epidemiologic transition. Understanding risk factors for disease in this minimally studied population may provide insights on lifestyle-disease relations in other populations. Methods: We evaluated the cross-sectional distribution of cardiovascular risk factors in the baseline evaluation of the ESMaestras cohort study, an ongoing prospective study among 97,174 female teachers living in 12 different states in Mexico. In 2008, participants responded to a detailed questionnaire on lifestyle factors, diet and medical conditions that was sent and received by school district administration. Diet was assessed using a semi-quantitative food frequency questionnaire validated in a similar Mexican population. Results: Median age of participants was 44 years [(10 th , 90 th percentile) 33, 52] and 17.3% were postmenopausal. Median BMI was 26.7 [(10 th , 90 th percentile) 22.2, 33.6] and 66.4% were overweight or obese. Median moderate/vigorous recreational physical activity was 1 hr/week [(10 th , 90 th percentile) 0, 6.0]. Only 9.7% participants were current smokers and among them 21.5% reported smoking more than 5 cigarettes per day. Most participants reported alcohol consumption (62%) but daily consumption was very low (1.2% consumed ≥0.5 drink/day). Median (10 th , 90 th percentile) intake of fish was 0.98 servings/week (0.28, 3.3), of red meat 4.1 servings/week (1.3, 9.9), of fruits and vegetables 5.3 servings/day (1.8, 12.2) and of sugar-sweetened beverages 1.2 (0.3, 3.6). The prevalence of self-reported, treated conditions was 12.1% for hypertension, 4.3% for diabetes and 11.6% for elevated cholesterol. Conclusion: In this relatively young population of Mexican women we observed a high prevalence of some risk factors for cardiovascular disease. Adequate systematic follow-up with repeated evaluation of risk factors in this population may prove to be informative about lifestyle factor and cardiovascular disease relations in Latin-American women.

scholarly journals The impact of modern cardiovascular risk factors associated with metabolic syndrome on long-term outcome

2015 ◽  
Vol 10 (4) ◽  
pp. 380-387
Author(s):  
Gabriel Cristian BEJAN ◽  
◽  
Liviu Nicolae GHILENCEA ◽  
Mihaela Adela IANCU ◽  
Mihaela Daniela BALTĂ ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Apo B ◽  
Long Term Outcome ◽  
Factors Associated ◽  
Risk Of Death ◽  
The Impact

Metabolic syndrome is also called insulin resistance syndrome or catecholamine excess syndrome and is a cluster of cardiometabolic factors that result in increased incidence of cardiovascular disease and diabetes type 2. Due to sedentary lifestyle and hypercaloric diet with an increased content of saturated fat and carbohydrates that characterizes modern life style of the population, especially in urban areas, the prevalence of metabolic syndrome is increasing, thus becoming a very topical issue for the medical world. During the years 2013-2014 we conducted an observational study on a sample of 111 hypertensive patients without major cardiovascular events such as myocardial infarction or stroke, aged between 48 and 83 years, who have determined the prevalence of modern cardiovascular risk factors such as hs CRP, serum uric acid, 24-hour proteinuria, serum fibrinogen and the ratio of apo B/apo A1, associated with the metabolic syndrome. The study was conducted separately by gender in the sense that we followed prevalence of these modern risk factors associated with metabolic syndrome in both genders, women and men. We also watched the influence of risk factors related to lifestyle on metabolic syndrome. Finally, we determined the correlation of these factors with the risk of death from cardiovascular disease to observe their influence on the prognosis of metabolic syndrome.

scholarly journals Do Cardiovascular Risk Factors and Cardiovascular Disease Explain Sex Differences in Cognitive Functioning in Old Age?

2021 ◽  
pp. 1-13
Author(s):  
Elisabeth Maria van Zutphen ◽  
Judith Johanna Maria Rijnhart ◽  
Didericke Rhebergen ◽  
Majon Muller ◽  
Martijn Huisman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Sex Differences ◽  
Information Processing ◽  
Cardiovascular Risk ◽  
Episodic Memory ◽  
Cognitive Functioning ◽  
Cardiovascular Risk Factors ◽  
Processing Speed ◽  
Information Processing Speed

Background: Sex differences in cognitive functioning in old age are known to exist yet are still poorly understood. Objective: This study examines to what extent differences in cardiovascular risk factors and cardiovascular disease between men and women explain sex differences in cognitive functioning. Methods: Data from 2,724 older adults from the Longitudinal Aging Study Amsterdam were used. Information processing speed and episodic memory, measured three times during six years of follow-up, served as outcomes. The mediating role of cardiovascular risk factors and cardiovascular disease was examined in single and multiple mediator models. Determinant-mediator effects were estimated using linear or logistic regression, and determinant-outcome and mediator-outcome effects were estimated using linear mixed models. Indirect effects were estimated using the product-of-coefficients estimator. Results: Women scored 1.58 points higher on information processing speed and 1.53 points higher on episodic memory. Several cardiovascular risk factors had small mediating effects. The sex difference in information processing speed was mediated by smoking, depressive symptoms, obesity, and systolic blood pressure. The sex difference in episodic memory was mediated by smoking, physical activity, and depressive symptoms. Effects of smoking, LDL cholesterol, and diabetes mellitus on information processing speed differed between men and women. Conclusion: Differences in cardiovascular risk factors between women and men partially explained why women had better cognitive functioning. A healthy cardiovascular lifestyle seems beneficial for cognition and sex-specific strategies may be important to preserve cognitive functioning at older age.

scholarly journals Meta-analysis of epigenome-wide association studies of carotid intima-media thickness

2021 ◽  
Author(s):  
Eliana Portilla-Fernández ◽  
Shih-Jen Hwang ◽  
Rory Wilson ◽  
Jane Maddock ◽  
W. David Hill ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Dna Methylation ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Association Studies ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Media Thickness

AbstractCommon carotid intima-media thickness (cIMT) is an index of subclinical atherosclerosis that is associated with ischemic stroke and coronary artery disease (CAD). We undertook a cross-sectional epigenome-wide association study (EWAS) of measures of cIMT in 6400 individuals. Mendelian randomization analysis was applied to investigate the potential causal role of DNA methylation in the link between atherosclerotic cardiovascular risk factors and cIMT or clinical cardiovascular disease. The CpG site cg05575921 was associated with cIMT (beta = −0.0264, p value = 3.5 × 10–8) in the discovery panel and was replicated in replication panel (beta = −0.07, p value = 0.005). This CpG is located at chr5:81649347 in the intron 3 of the aryl hydrocarbon receptor repressor gene (AHRR). Our results indicate that DNA methylation at cg05575921 might be in the pathway between smoking, cIMT and stroke. Moreover, in a region-based analysis, 34 differentially methylated regions (DMRs) were identified of which a DMR upstream of ALOX12 showed the strongest association with cIMT (p value = 1.4 × 10–13). In conclusion, our study suggests that DNA methylation may play a role in the link between cardiovascular risk factors, cIMT and clinical cardiovascular disease.

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