scholarly journals Reproductive Hormones and Subclinical Cardiovascular Disease in Midlife Women

2018 ◽  
Vol 103 (8) ◽  
pp. 3070-3077 ◽  
Author(s):  
Rebecca C Thurston ◽  
Shalender Bhasin ◽  
Yuefang Chang ◽  
Emma Barinas-Mitchell ◽  
Karen A Matthews ◽  
...  
Keyword(s):  
Mass Spectrometry ◽  
Cardiovascular Disease ◽  
Endothelial Function ◽  
Postmenopausal Women ◽  
Intima Media Thickness ◽  
Reproductive Hormones ◽  
Cvd Risk ◽  
Liquid Chromatography Tandem Mass ◽  
Subclinical Cardiovascular Disease ◽  
Subclinical Cvd

Abstract Context Reproductive hormones are important to the pathophysiology of cardiovascular disease (CVD) in women. However, standard estradiol (E2) and testosterone (T) assays lack sensitivity at the levels of postmenopausal women. Objective Investigate relations of mass spectrometry–assessed estrone (E1), E2, and T and SHBG and subclinical CVD in women. Design, Setting, and Participants Three hundred and four perimenopausal and postmenopausal women aged 40 to 60 years underwent subclinical CVD measurements. E1, E2, and T were assayed using liquid chromatography–tandem mass spectrometry; free T (FT) was estimated using ensemble allostery models. Regression models were adjusted for CVD risk factors. Main Outcome Measures Carotid artery intima media thickness, interadventitial diameter (IAD), and plaque; brachial flow mediated dilation (FMD). Results Higher E1 was related to higher FMD [β(SE) = 0.77 (0.37), P = 0.04], indicating better endothelial function. Higher E2 was related to lower IAD [β(SE) = −0.07 (0.02), P = 0.004], indicating less carotid remodeling. Higher SHBG was related to higher FMD [β(SE) = 1.31 (0.40), P = 0.001], yet higher IAD [β(SE) = 0.15 (0.06), P = 0.02] and plaque [OR (95% CI) = 1.84 (1.16 to 2.91), P = 0.009]; FT showed a similar yet inverse pattern of relations as SHBG. Thus, higher SHBG and lower FT were associated with better endothelial function, yet greater carotid remodeling and plaque. Conclusions Endogenous E1 levels were related to endothelial function and E2 to vascular remodeling, suggesting distinct roles of these estrogens. SHBG and FT have complex roles depending on the vessel under study.

scholarly journals The relationship of erectile dysfunction and subclinical cardiovascular disease: A systematic review and meta-analysis

2017 ◽  
Vol 23 (1) ◽  
pp. 9-20 ◽  
Author(s):  
Chukwuemeka U Osondu ◽  
Bryan Vo ◽  
Ebenezer T Oni ◽  
Michael J Blaha ◽  
Emir Veledar ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Erectile Dysfunction ◽  
Vascular Function ◽  
Meta Analysis ◽  
Ankle Brachial Index ◽  
Intima Media Thickness ◽  
Publication Date ◽  
Cvd Risk ◽  
The Relationship ◽  
Subclinical Cvd

Erectile dysfunction (ED) is associated with cardiovascular disease (CVD) and CVD mortality. However, the relationship between ED and subclinical CVD is less clear. We synthesized the available data on the association of ED and measures of subclinical CVD. We searched multiple databases for published literature on studies examining the association of ED and measures of subclinical CVD across four domains: endothelial dysfunction measured by flow-mediated dilation (FMD), carotid intima–media thickness (cIMT), coronary artery calcification (CAC), and other measures of vascular function such as the ankle–brachial index, toe–brachial index, and pulse wave velocity. We conducted random effects meta-analysis and meta-regression on studies that examined an ED relationship with FMD (15 studies; 2025 participants) and cIMT (12 studies; 1264 participants). ED was associated with a 2.64 percentage-point reduction in FMD compared to those without ED (95% CI: –3.12, −2.15). Persons with ED also had a 0.09-mm (95% CI: 0.06, 0.12) higher cIMT than those without ED. In subgroup meta-analyses, the mean age of the study population, study quality, ED assessment questionnaire (IIEF-5 or IIEF-15), or the publication date did not significantly affect the relationship between ED and cIMT or between ED and FMD. The results for the association of ED and CAC were inconclusive. In conclusion, this study confirms an association between ED and subclinical CVD and may shed additional light on the shared mechanisms between ED and CVD, underscoring the importance of aggressive CVD risk assessment and management in persons with ED.

Abstract P180: Ten-Year and Lifetime Cardiovascular Risk and Subclinical Cardiovascular Disease in Mexican Women

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Andrea Luviano ◽  
Eduardo Ortiz-Panozo ◽  
Elsa Yunes ◽  
Carlos Cantu-Brito ◽  
Fernando Flores ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Lifetime Risk ◽  
Risk Scores ◽  
Mexican Women ◽  
Cvd Risk ◽  
Framingham Risk ◽  
Chd Risk ◽  
Subclinical Cardiovascular Disease ◽  
Risk Categories ◽  
Subclinical Cvd

Introduction: Estimates of Lifetime Cardiovascular Risk may identify individuals with different levels of cardiovascular disease (CVD) risk within the low short-term risk (10-year risk) for coronary heart disease (CHD) category defined by the Framingham Risk Score. Evidence of the applicability of this risk stratification in relatively young people is limited, especially among Hispanics. Hypothesis: We assessed the hypothesis that the risk categories from the combination of these two risk stratification scales are positively associated with subclinical CVD in Mexican women. Methods: We calculated 10-year CHD risk using the Framingham Risk Score and lifetime CVD risk based on risk factor burden in 759 women in Southern Mexico from the Mexican Teachers’ Cohort and evaluated the presence of subclinical CVD. We evaluated common carotid intima-media thickness (IMT), ankle-brachial index (ABI), and inter-arm blood pressure difference (IAD) using standard protocols and performed laboratory analyses from a fasting blood draw. We defined three risk strata: Low 10-year (<10%)/Low lifetime risk, Low 10-year (<10%)/High lifetime risk, and High 10-year risk (≥10%). We evaluated outcome measures continuously and estimated the prevalence of subclinical CVD for each risk strata. We defined subclinical CVD as IMT ≥0.8 mm or atheromatous plaque, ABI <0.90, systolic IAD ≥20 mmHg or diastolic IAD ≥10 mmHg. We calculated the sensibility and specificity of the predicted risk categories to detect subclinical CVD. Results: Women evaluated had a mean age of 48.4 years, 22.5% (n=171) were classified as High 10-year CHD Risk, 58.8% (n=446) as Low 10-year/High lifetime risk and 18.7% (n=142) as Low 10-year/Low lifetime risk. We observed significant increase in IMT measurement according to increasing risk categories: 0.656 mm (±0.062), 0.704mm (±0.085), and 0.739mm (±0.089) (p= <0.001). We found similar significant trends in ABI (p= 0.001), systolic IAD (p= <0.001), and diastolic IAD (p= <0.001). We observed a significant higher prevalence of at least one subclinical CVD as the risk category increased: 10.6%, 26.9%, and 45.6% (p= <0.001). The sensitivity and specificity of the combination of these scores to detect subclinical CVD was of 93% and 23%, whereas only considering the high vs. low 10-year risk categories these parameters were 37% and 83% respectively. Conclusion: The combination of these short-term and lifetime risk scores accurately identify differences in objective measurements of subclinical cardiovascular disease in Mexican women. Further calibration of these risk scores is needed to incorporate them in the risk assessment tools to identify individuals at risk for the implementation of preventive strategies in the Mexican population.

scholarly journals Association between Soy Food and Dietary Soy Isoflavone Intake and the Risk of Cardiovascular Disease in Women: A Prospective Cohort Study in Korea

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1407
Author(s):  
Jihyun Im ◽  
Kyong Park
Keyword(s):  
Cardiovascular Disease ◽  
Postmenopausal Women ◽  
Premenopausal Women ◽  
Soy Isoflavones ◽  
Korean Women ◽  
Cvd Risk ◽  
Soy Isoflavone ◽  
Soy Foods ◽  
Cardiovascular Disease In Women

The association between soy food and soy isoflavone intake and cardiovascular disease (CVD) risk is uncertain, especially in women. We aimed to investigate this association in Korean women. We analyzed data from the Korean Genome and Epidemiology Study, including 4713 Korean women aged 40–69 years with no CVD or cancer at baseline. Dietary information was obtained using a validated semi-quantitative food frequency questionnaire, and the incidence of CVD was assessed using biennial self-reported questionnaires on medical history. The mean follow-up time was 7.4 years, during which 82 premenopausal and 200 postmenopausal women reported CVD incidence. The highest tofu, total soy foods, and dietary soy isoflavone intake groups were significantly associated with a decreased CVD risk in premenopausal women (tofu: hazard ratio (HR) 0.39; 95% confidence interval (CI), 0.19–0.80; total soy food: HR 0.36; 95% CI, 0.18–0.70; dietary soy isoflavones: HR 0.44; 95% CI, 0.22–0.89), whereas no association was observed in postmenopausal women. Other soy foods showed no association with CVD incidence. Dietary soy isoflavones and total soy foods are associated with a decreased CVD risk in premenopausal women. Among soy foods, only tofu showed significant health benefits.

scholarly journals Endogenous Steroids Measured by High-Specificity Liquid Chromatography-Tandem Mass Spectrometry and Prevalent Cardiovascular Disease in 70-Year-Old Men and Women

2010 ◽  
Vol 95 (4) ◽  
pp. 1889-1897 ◽  
Author(s):  
Tord Naessen ◽  
Ulrika Sjogren ◽  
Jonas Bergquist ◽  
Marita Larsson ◽  
Lars Lind ◽  
...  
Keyword(s):  
Mass Spectrometry ◽  
Cardiovascular Disease ◽  
Liquid Chromatography ◽  
Tandem Mass Spectrometry ◽  
Aromatase Activity ◽  
Tandem Mass ◽  
Chromatography Tandem Mass Spectrometry ◽  
Estrogen Synthesis ◽  
Liquid Chromatography Tandem Mass ◽  
17 Hydroxyprogesterone

Abstract Context: There is a need for increased knowledge about endogenous sex hormone levels and clinical outcomes of risk/benefit. Immunoassays have poor specificity to reliably measure low steroid concentrations in elderly. Objective: The objective of the study was to evaluate plasma steroid concentrations with regard to prevalent cardiovascular disease (CVD) in elderly, using mass spectrometry. Setting: The study was conducted at a university hospital research unit. Design and Methods: Plasma samples were analyzed from 202 70-yr-olds as part of a large population-based study, Prospective Investigation of the Vasculature in Uppsala Seniors. Twenty-eight of these had prevalent CVD. Eleven steroids were quantified, using liquid chromatography-tandem mass spectrometry. Women with current/previous menopausal hormone therapy (n = 35) were excluded. Results: Men without prevalent CVD had higher plasma 17β-estradiol (E2), compared with women. Men with prevalent CVD, compared with those without, had lower 17-hydroxypregnenolone (17OHPregn), 17-hydroxyprogesterone, and higher estrone/androstenedione and E2/testosterone (T) (aromatase activity). Women with prevalent CVD had lower pregnenolone, 17OHPregn, and dehydroepiandrosterone (DHEA) but higher DHEA/17OHPregn, androstenedione/DHEA, E2/T, E2/estrone, and E2/SHBG. The aromatase index, E2/T, was higher for prevalent CVD in both sexes. Adjustment for statin use, smoking, and body mass index yielded additional significant differences in men, whereas some were lost in women. Logistic regression indicated strong associations between prevalent CVD and low 17OHPregn, adjusted odds ratio of 0.18, 95% confidence interval (0.06–0.61); P = 0.006, in women and low 17-hydroxyprogesterone, 0.45 (0.25–0.80); P = 0.007 in men, most likely caused by increased throughput (consumption) toward estrogen synthesis. Conclusions: Prevalent CVD was associated with indications of lower androgen precursors, increased aromatase activity, and higher estrogen levels in both sexes. Results might represent an endogenous response to a condition of developing atherosclerosis, rather than a causative relationship. Furthermore studies are needed.

scholarly journals Cardiovascular prevention in peri- and postmenopausal women

2011 ◽  
Vol 10 (3) ◽  
pp. 123-130
Author(s):  
N. A. Voychenko ◽  
I. V. Kuznetsova ◽  
V. B. Mychka ◽  
M. Yu. Kirillova ◽  
S. N. Tolstov
Keyword(s):  
Quality Of Life ◽  
Cardiovascular Disease ◽  
Hormone Replacement Therapy ◽  
Postmenopausal Women ◽  
Lower Risk ◽  
Ovarian Function ◽  
Hormone Replacement ◽  
Cardiovascular Prevention ◽  
Cvd Risk

The adverse consequences of estrogen deficiency in postmenopause include cardiovascular disease (CVD), which affects not only women’s quality of life, but also their life expectancy. Before premenopause, women have significantly lower risk of arterial hypertension than men of the same age. However, in people aged over 50, AH is more prevalent among women. Currently, most experts regard hormone replacement therapy (HRT) in peri- and postmenopausal women as pathogenetic, since it facilitates the adaptation of the female organism to the new metabolic state, with reduced ovarian function. Drospirenone, as a part of HRT, reduces CVD risk in postmenopausal women with climacteric disturbances.

scholarly journals Inflammatory markers, clinical and subclinical cardiovascular disease in older persons: the Health ABC study

Circulation ◽  
2001 ◽  
Vol 103 (suppl_1) ◽  
pp. 1358-1358
Author(s):  
Marco Pahor ◽  
Steve B Kritchevsky ◽  
Russell P Tracy ◽  
Anne B Newman ◽  
Kim Sutton-Tyrrell ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Smoking Status ◽  
Ankle Brachial Index ◽  
Hdl Cholesterol ◽  
Reactive Protein ◽  
Body Composition Study ◽  
History Of ◽  
Subclinical Cardiovascular Disease ◽  
Artery Disease ◽  
Subclinical Cvd

P37 Inflammation is a potentially important mechanism underlying cardiovascular disease (CVD). Several studies have assessed the asociations of inflammation with clinical CVD, but data on inflammation and sub-clinical CVD are limited. We assessed the association of C-reactive protein (CRP) and interleukin-6 (IL-6) with clinical and subclinical CVD in the Health and Body Composition study (Health ABC), a cohort study of 3075 well functioning older adults living in Memphis, TN, and Pittsburgh, PA. Mean±SDM age was 73.6±2.9 years, 51.5% were women and 41.7% were African American. History of heart attack, heart failure, stroke, peripheral artery disease or CV procedures was reported by 31.4% of participants. Subclinical disease (positive Rose questionnaire for angina or claudication, ECG abnormalities, or ankle brachial index <0.9 in persons with no clinical CVD) was found in 32.4% of participants. CRP (mean 2.31±3.01 μg/ml, range 0.16-54.03 μg/ml) was measured in 1370 participants, and IL-6 (mean±SDM 2.39±1.92 ng/ml, range 0.21-15.96 ng/ml) was measured in 2824 participants. After adjustment for age, gender, race, site, history of diabetes, smoking status, body-mass index, use of anti-inflammatory drugs and serum cholesterol, HDL cholesterol, creatinine and albumin, higher CRP levels were significantly associated with a higher risk of clincal CVD, but not with risk of subclinical CVD (p for trend with increasing IL-6 tertiles =0.0082 and =0.55)(see Table). Higher IL-6 levels were significantly associated with a higher risk of both clinical and sub-clinical CVD (p for trend with increasing IL-6 tertiles <0.0001 and =0.0003). Table 1.

scholarly journals Effects of Wine and Tyrosol on the Lipid Metabolic Profile of Subjects at Risk of Cardiovascular Disease: Potential Cardioprotective Role of Ceramides

Antioxidants ◽  
2021 ◽  
Vol 10 (11) ◽  
pp. 1679
Author(s):  
Jose Rodríguez-Morató ◽  
Anna Boronat ◽  
Gabriele Serreli ◽  
Laura Enríquez ◽  
Alex Gomez-Gomez ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Endothelial Function ◽  
Blood Lipid ◽  
White Wine ◽  
Cvd Risk ◽  
Blood Lipid Profile ◽  
Beneficial Effects ◽  
Before And After ◽  
Risk Biomarkers

Ceramides are a class of sphingolipids which have recently been shown to be better cardiovascular disease (CVD) risk predictors than traditional CVD risk biomarkers. Tyrosol (TYR) is a dietary phenolic compound known to possess cardioprotective effects per se or through its in vivo active metabolite hydroxytyrosol. The purpose of this study was to evaluate the effects of the co-administration of white wine (WW) and TYR on circulating levels of ceramides and other lipids in humans at high CVD risk. Volunteers underwent a randomized controlled crossover clinical trial (4-week duration per intervention) with three different interventions: control, WW, and WW enriched with a capsule of TYR (WW + TYR). Endothelial function cardiovascular biomarkers and plasma lipidomic profile were assessed before and after each intervention. It was found that the WW + TYR intervention resulted in lower levels of three ceramide ratios, associated with an improvement of endothelial function (Cer C16:0/Cer C24:0, Cer C18:0/Cer C24:0, and Cer C24:1/Cer C24:0), when compared to the control intervention. Moreover, WW + TYR was able to minimize the alterations in plasma diacylglycerols concentrations observed following WW. Overall, the results obtained show that the antioxidant TYR administered with WW exerts beneficial effects at the cardiovascular level, in part by modulating blood lipid profile.

scholarly journals The burden of subclinical cardiovascular disease in children and young adults with CKD and on dialysis

2021 ◽  
Author(s):  
Alexander D Lalayiannis ◽  
Charles J Ferro ◽  
David C Wheeler ◽  
Neill D Duncan ◽  
Colette Smith ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Young Adults ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Left Ventricular ◽  
Structural Abnormality ◽  
Z Score ◽  
Functional Abnormality ◽  
Cross Sectional ◽  
Subclinical Cardiovascular Disease

Abstract Introduction Cardiovascular disease (CVD) is a common cause of morbidity and mortality even in young people with chronic kidney disease (CKD). We examined structural and functional cardiovascular changes in patients with CKD stages 4-5 and on dialysis under 30 years of age. Methods 79 children and 21 young adults underwent cardiac CT for coronary artery calcification (CAC), ultrasound for carotid intima media thickness (cIMT), carotid-femoral pulse wave velocity (cfPWV), and echocardiography. Differences in structural [CAC, cIMT z-score, left ventricular mass index] and functional [carotid distensibility z-score, cfPWV z-score] measures were examined between CKD stages 4-5 and dialysis patients. Results Overall the cIMT z-score was raised (median 2.17, IQR 1.14-2.86) and 10 (10%) had CAC. 16/23(69.5%) of CKD4-5 and 68/77(88.3%) on dialysis had at least one structural or functional CV abnormality. There was no difference in the prevalence of structural abnormalities in CKD or dialysis cohorts, but functional abnormalities were more prevalent in patients on dialysis (p &lt; 0.05). The presence of &gt; 1 structural abnormality was associated with a 4.5-fold increased odds of &gt; 1 functional abnormality (95% CI 1.3 to 16.6, p &lt; 0.05). Patients with structural and functional abnormalities (cIMT z-score &gt;2SD or distensibility &lt;-2SD) had less carotid dilatation (lumen/wall cross sectional areas ratio) compared to those with normal cIMT and distensibility. Conclusion There is a high burden of subclinical cardiovascular disease in young CKD patients, with a greater prevalence of functional abnormalities in dialysis compared to CKD patients. Longitudinal studies are required to test these hypothesis generating data and define the trajectory of CV changes in CKD.

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