Cardiovascular disease (CVD) risk factors among cisplatin-treated testicular cancer survivors (TCS): A multicenter clinical study of U.S. and Canadian patients.

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 391-391
Author(s):  
Chunkit Fung ◽  
Darren Richard Feldman ◽  
Robert James Hamilton ◽  
Somer Case-Eads ◽  
David J. Vaughn ◽  
...  

391 Background: The remarkable success of cisplatin-based chemotherapy in curing metastatic TC has been accompanied by potential life-threatening sequelae, including CVD. Most prior studies, however, have been conducted in Europe and included older chemotherapy regimens. We examined CVD risk factors in an ongoing multi-center clinical study of TCS given modern cisplatin-based chemotherapy (CHEM) at centers in North America (NCI 1R01 CA157823-02). Methods: TCS aged ≤49 years at time of first-line CHEM were eligible to undergo clinical examination and complete a questionnaire regarding co-morbidities, lifestyle behaviors, and prescription drug use. Results: We evaluated the first 443 consecutively enrolled TCS (23% seminoma; 77% nonseminoma) with most having stage II (52%) or III (28%) disease. The median age at time of TC diagnosis was 32 years (range 15-49 years) and median time since completion of chemotherapy was 59 months (range 1-24 years). Patients were largely white (90%), married (62%), and had full-time employment (82%) and health insurance (88%). 8% of TCS were current smokers. 48% of TCS had gained >10 lbs after CHEM with 29% having a ≥102 cm (40 inch) waist circumference, and 43% and 31% having a body mass index of 25 to <30 kg/m2 (overweight) and ≥ 30 kg/m2 (obese), respectively. A sizable proportion of men had abnormal systolic (21% with 130-139 mm Hg and 17% with ≥140 mm Hg) and diastolic (35% with 80-89 mm Hg and 13% with ≥90 mm Hg) blood pressure. 14%, 11%, and 5% TCS indicated that they currently used medications for hypertension, cholesterol and diabetes, respectively. Cardiac conditions were reported by 32 TCS (7%), including angina (N=2), angioplasty/stent placement (N=1), myocardial infarction (N=1), transient ischemic attack (N=1), stroke (N=2), peripheral vascular disease (N=12), deep vein thrombosis (N=23), and pulmonary embolism (N=15). Conclusions: A number ofCVD risk factors are present in a contemporary North American cohort of TCS after CHEM. Future analytic studies should focus on mechanistic investigations to facilitate the development of screening and preventive efforts for CVD in high-risk patients.

Author(s):  
Josiemer Mattei ◽  
Katherine L Tucker ◽  
Luis M Falcon ◽  
Carlos F Ríos-Bedoya ◽  
Robert M Kaplan ◽  
...  

Abstract The Puerto Rico Observational Study of Psychosocial, Environmental, and Chronic Disease Trends (PROSPECT) is a prospective cohort study in Puerto Rico (PR) aiming to identify trends and longitudinal associations in risk factors for cardiovascular disease (CVD). In 2019, PROSPECT started recruiting a sample of 2,000 adults, ages 30-75 years, in PR using a multi-stage probabilistic sampling of households and community approaches. Culturally-sensitive trained research assistants assess participants, at baseline and at 2-year follow-up, in private rooms in a network of partner clinics. The study collects comprehensive data on demographics, socioeconomic and environmental factors, medical history, health conditions, lifestyle behaviors, psychosocial status, and biomarkers of CVD and stress. PROSPECT will estimate the prevalence and incidence of psychosocial, lifestyle, and biological CVD risk factors, describe variations in risk factors by urban versus rural area and after natural disasters, and determine predictors of longitudinal changes in CVD risk factors. The study has four coordinated operational strategies: (1) research productivity (including synergy with existing epidemiological cohorts of Hispanics/Latinos for comparison); (2) research infrastructure (biorepository, ancillary studies, and clinical research network); (3) capacity-building, education, and training; and (4) community outreach, dissemination, and policy. PROSPECT will inform public health priorities to help reduce CVD in PR.


Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
JOSE L PENALVO ◽  
MERCEDES SOTOS-PRIETO ◽  
GLORIA SANTOS-BENEIT ◽  
STUART POCOCK ◽  
JULIANA REDONDO ◽  
...  

The development of CVD risk factors carries a behavioral component that may be corrected at an early age, when behaviors are first formed, by effective health promotion initiatives. School-based interventions are an effective way to promote healthy behaviors, specially when they also reach out to the children’s most proximal environment: their families, teachers and the school itself. Within this framework, the first phase of the long-term Program SI! intervention targets children from 3 to 5 years of age aiming to establish appropriate lifestyle behaviors early in life. The intervention entails a comprehensive approach including four lifestyle-related components: correct dietary habits, promotion of physical activity, understanding how the human body and heart work, and emotion’s management. To evaluate the efficacy of the Program SI! to instill healthy behaviors in children aged 3-5, a cluster-randomized controlled trial in public schools in the city of Madrid (Spain) was initiated in 2011. A total 24 schools were selected on the basis of socio-demographic characteristics. These included 2062 children (3-5 years), 1949 families, and 125 teachers at baseline. Schools were randomized (1:1) to follow their usual school curriculum or to engage in the intervention. The primary outcome of this report is the 2-years differential change from baseline in scores for knowledge, attitudes and habits (KAH) in the four components of the intervention between intervention and control. Children were interviewed by trained psychologists and scored on overall and component-specific KAH questionnaires. The Test for Emotional Comprehension (TEC) was used to assess children’s ability to recognize emotions. Mixed linear models accounting for the cluster-randomized design were used to test for intervention effects. Fixed effects in each model were the corresponding baseline score, the class year, and the treatment group. Schools were handled as random effects. After 2 years, the Program SI! intervention increased children’s overall KAH score (5.6, 95%CI, 4.1-7.1, p<0.001) corresponding to an additional 7% improvement in the intervened children. KAH assessing improved Physical activity contributed the most (3.39, 95%CI, 2.35-4.43, p<0.001) to the difference between groups, followed by KAH relating Dietary habits (1.78, 95%CI, 0.94-2.62, p<0.001). A weak, non-significant improvement in KAH score for Human body (0.37, 95%CI, -0.14-0.89) was also found. Regarding emotion’s management, this component also increased after the intervention (0.50, 95%CI, 0.02-0.97, p<0.040), with greater improvements in older children (5 years old). The Program SI! is demonstrated as an effective and feasible strategy for improving lifestyle behaviors among very young children that may eventually impact in lower rates of development of CVD risk factors.


2021 ◽  
Vol 15 (1) ◽  
pp. 23-28
Author(s):  
Nada A. AbuAlUla ◽  
Rami A. Elshatarat ◽  
Mohammed I. Yacoub ◽  
Khadega Ahmed Elhefnawy ◽  
Mohammed S. Aljohani ◽  
...  

Purpose: Identify the relationships among participants’ lifestyle and their perceptions toward physiological health status. Methods: This is a cross-sectional research study. A convenience sampling was used to recruit 480 adult clients from Jordan and Saudi Arabia. Results: The majority of the participants (48.8%) rated their physiological health status as sub-optimal health. Significant positive associations were found between participants’ perceptions about physiological health status as ‘healthy’ and their positive lifestyle and low-risk behaviors for Cardiovascular Disease (CVD). Specifically, the associations were between not being smoker (χ2 = 4.17, p = 0.04), practicing physical activity (χ2 = 60.9, p < 0.001), eating ≥ 5 cups of fruits and vegetables daily (χ2 = 8.33, p = 0.004), and being normal/under-weight (χ2 = 65.5, p < 0.001). Conclusion: Perception about poor/sub-optimal physical health status is associated with many CVD risk factors. Using a brief screening tool to assess physical health status is recommended at each clinic visit. In addition, periodic physical assessment, full check-up, and follow-up with healthcare providers are highly suggested for those who perceived their physical health status as “poor” to prevent further CVD. Health education is pressingly recommended to improve the awareness of these Arab communities toward the prevention of CVD risk factors and enhancement of positive lifestyle behaviors.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C.Q Wu ◽  
X Li ◽  
J.P Lu ◽  
B.W Chen ◽  
Y.C Li ◽  
...  

Abstract Background In China, an abundance of cardiovascular risk factors has contributed to the increasing prevalence of cardiovascular diseases (CVD), which caused almost 4 million deaths per year. However, comprehensive evidence on the geographical profiles of cardiovascular disease risk in China is lacking, as findings in prior studies have been limited to relatively small sample sizes, had incomplete regional coverage, or focused on a narrow risk factor spectrum. Purpose To compare the population CVD risk among different regions across China, and to describe the geographical distributions of CVD risk factors and their clusters throughout the nation. Methods In a nationwide population-based screening project covering 252 counties of China, standardized measurements were conducted to collect information on 12 major CVD risk factors. Individuals of high CVD risk were identified as those with previous CVD, or with a predicted 10-year risk of CVD greater than 10% according to the WHO risk prediction charts. We applied factor analysis to generate “clusters” that characterized the clustering of these risk factors, then explored their relationship with the local ambient temperature and per capital GDP. Results Among 983476 participants included, 9.2% were of high CVD risk, with a range of 1.6% to 23.6% across counties. Among the seven regions in China, the rate was relatively high in the Northeast (11.8%) and North China (10.4%), while low in the South China (7.2%) and Northwest (7.8%). We identified 6 clusters underlying CVD risk factors, including Obesity factor, Blood pressure factor, Staple food factor, Non-staple food factor, Smoking and alcohol factor, and Metabolic and physical activity factor (Figure). We found high risk regions were facing different leading challenges, like obesity and blood pressure for the North China, while unhealthy non-staple food for the Northeast. The South China, as the region with the lowest CVD risk, still had the highest prevalence of unhealthy staple food. Lower annual average ambient temperature was associated with higher risk in Blood pressure factor, Obesity factor and Non-staple food factor, but lower risk in Staple food factor and Metabolic and physical activity factor (p&lt;0.001 for all), consistently between rural and urban. Higher per capital GDP was associated with lower risk in Non-staple food factor in urban and higher risk in Metabolic and physical activity factor in rural (p&lt;0.05 for both). The correlation between per capital GDP and Smoking and alcohol factor differed significantly between in rural and urban regions (p=0.042). Conclusions The geographical profile of CVD risk in China is complex - population risk levels varied substantially across regions, which were contributed by different risk factors. China needs geographically targeted intervention strategies considering environmental and socio-economic factors to control CVD risk and reduce the burden related to CVD. Geographical disparity of risk clusters Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): The National Key Research and Development Program from the Ministry of Science and Technology of China; the CAMS Innovation Fund for Medical Science


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 808.2-808
Author(s):  
N. Hammam ◽  
G. Salem ◽  
D. Fouad ◽  
S. Rashad

Background:Osteoarthritis (OA) is the most common joint disease that results in patient’s morbidity and disabilities. There is strong evidence that OA is a significant risk factor for cardiovascular disease (CVD). Red cell distribution width (RDW) blood test is a measure of the variation in red blood cell volume and size. Elevated RDW has recently been found to correlate with CVD risk in patients with and without heart disease and autoimmune diseases. RDW may be a marker for factors driving CVS risk.Objectives:: To investigate whether RDW can serve as a potential parameter for indicating cardiovascular risk in OA patients.Methods:A subsample of 819 OA patients was extracted from 2003-2006 National Health & Nutrition Examination Survey in a cross-sectional study. 63.7% of them were females. Their mean age was 66.4 ± 14.1 yrs. Demographic, medical data, inflammatory markers & lipid panel were obtained. Only patients with Haemoglobin>12 mg/dl were included. Functional limitations were assessed using a physical function questionnaire.Results:Elevated levels of RDW were associated with CVD risk factors in OA patients. 532 (65.8%) OA patients had functional limitations, while 78 (9.5%) and 63 (7.6%) known to have heart attacks or stroke ever. Mean RDW was 12.9±1.1fL. There was a positive significant correlation between RDW & CVD risk factors including body mass index (r=0.17, p<0.001), C-reactive protein (r=0.29, p<0.001), serum uric acid (r=0.12, p<0.001), and functional limitation (0.16, p<0.001). No significant association between RDW & lipid panel was found. In multiple regression analysis controlling for age, sex as covariates, body mass index (β =0.02, 95%CI: 0.01, 0.03, p=0.002), C-reactive protein (β =0.35, 95%CI: 0.26, 0.45, p<0.001), and functional limitation (β =0.18, 95%CI: 0.13, 0.35, p=0.03).Conclusion:In addition to known CVD risk in OA patients, elevated RDW levels should prompt physicians to aggressively screen and treat their patients for modifiable CVS risk factors, in addition to OA.Disclosure of Interests:None declared


BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e045482
Author(s):  
Didier Collard ◽  
Nick S Nurmohamed ◽  
Yannick Kaiser ◽  
Laurens F Reeskamp ◽  
Tom Dormans ◽  
...  

ObjectivesRecent reports suggest a high prevalence of hypertension and diabetes in COVID-19 patients, but the role of cardiovascular disease (CVD) risk factors in the clinical course of COVID-19 is unknown. We evaluated the time-to-event relationship between hypertension, dyslipidaemia, diabetes and COVID-19 outcomes.DesignWe analysed data from the prospective Dutch CovidPredict cohort, an ongoing prospective study of patients admitted for COVID-19 infection.SettingPatients from eight participating hospitals, including two university hospitals from the CovidPredict cohort were included.ParticipantsAdmitted, adult patients with a positive COVID-19 PCR or high suspicion based on CT-imaging of the thorax. Patients were followed for major outcomes during the hospitalisation. CVD risk factors were established via home medication lists and divided in antihypertensives, lipid-lowering therapy and antidiabetics.Primary and secondary outcomes measuresThe primary outcome was mortality during the first 21 days following admission, secondary outcomes consisted of intensive care unit (ICU) admission and ICU mortality. Kaplan-Meier and Cox regression analyses were used to determine the association with CVD risk factors.ResultsWe included 1604 patients with a mean age of 66±15 of whom 60.5% were men. Antihypertensives, lipid-lowering therapy and antidiabetics were used by 45%, 34.7% and 22.1% of patients. After 21-days of follow-up; 19.2% of the patients had died or were discharged for palliative care. Cox regression analysis after adjustment for age and sex showed that the presence of ≥2 risk factors was associated with increased mortality risk (HR 1.52, 95% CI 1.15 to 2.02), but not with ICU admission. Moreover, the use of ≥2 antidiabetics and ≥2 antihypertensives was associated with mortality independent of age and sex with HRs of, respectively, 2.09 (95% CI 1.55 to 2.80) and 1.46 (95% CI 1.11 to 1.91).ConclusionsThe accumulation of hypertension, dyslipidaemia and diabetes leads to a stepwise increased risk for short-term mortality in hospitalised COVID-19 patients independent of age and sex. Further studies investigating how these risk factors disproportionately affect COVID-19 patients are warranted.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Svein Ivar Bekkelund

Abstract Background High and low levels of serum alanine aminotransferase (ALT) are both associated with cardiovascular diseases (CVD) risks especially in elderly, but the mechanisms are less known. This study investigated associations between ALT and CVD risk factors including effects of sex and age in a Caucasian population. Methods Cross-sectional data were analysed sex-stratified in 2555 men (mean age 60.4 years) and 2858 women (mean age 60.0 years) from the population study Tromsø 6. Associations were assessed by variance analysis and multivariable logistic regression of odds to have abnormal ALT. Risk factors included body mass index (BMI), waist-to-hip-ratio, blood pressure, lipids, glucose, glycated haemoglobin and high-sensitive C-reactive protein (CRP). Results Abnormal elevated ALT was detected in 113 men (4.4%) and 188 women (6.6%). Most CVD risk factors associated positively with ALT in both sexes except systolic blood pressure and CRP (women only), while ALT was positively associated with age in men when adjusted for CVD risk factors, P < 0.001. BMI predicted ALT in men (OR 0.94; 95% CI 0.88–1.00, P = 0.047) and women (OR 0.90; 95% CI 0.86–0.95, P < 0.001). A linear inversed association between age and ALT in men and a non-linear inversed U-trend in women with maximum level between 60 and 64 years were found. Conclusion This study confirms a positive relationship between ALT and CVD risk factors, particularly BMI. Age is not a major confounder in the ALT-CVD relationship, but separate sex-analyses is recommended in such studies.


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