scholarly journals SAT-541 Difference in Aldosterone Dependency Between Cardiovascular Diseases and Renal Impairments in Patients with Primary Aldosteronism

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Masakatsu Sone ◽  
Youichi Ohno ◽  
Akiyuki Kawashima ◽  
Nobuya Inagaki ◽  
Mitsuhide Naruse ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Heart Disease ◽  
Renal Impairment ◽  
Ischemic Heart Disease ◽  
Logistic Regression Analysis ◽  
Primary Aldosteronism ◽  
Odds Ratio ◽  
Plasma Aldosterone ◽  
Ischemic Heart

Abstract BACKGROUND: There have been several clinical studies examining the factors associated with cardiovascular disease (CVD) and renal impairment in patients with primary aldosteronism (PA); however, their results have left it unclear as to whether they are affected by the plasma aldosterone concentration (PAC) itself. Method: This is a retrospective cross-sectional study. We assessed the PA database established by the multicenter JPAS (Japan Primary Aldosteronism Study) and compared the prevalences of CVD (stroke, ischemic heart disease, and heart failure) and renal impairment (proteinuria and lowered eGFR) among patients with PA and those with essential hypertension (EHT). We also performed logistic regression analysis to determine which parameters significantly increased the odds ratio for these complications. Results: The prevalence of CVD was significantly higher among 2814 patients with PA than among matched patients with EHT. The prevalence of proteinuria was also significantly higher among PA than EHT patients, whereas there was no significant difference in the prevalence of lowered eGFR. Multivariable logistic regression analysis showed that the PAC significantly increases the adjusted odds ratios for proteinuria and lowered eGFR independent of other known risk factors. By contrast, the PAC was not linearly related to the adjusted odds ratio for CVD. Conclusion: Plasma aldosterone levels are closely associated with renal impairment in patients with PA. This is contrast to our finding that the PAC was not, itself, linearly associated with CVDs, such as stroke or ischemic heart disease. The mechanism underlying the kidney damage in patients with PA may thus differ from that affecting the cardiovascular system.

A Logistic Regression Analysis of the Ischemic Heart Disease Risk

2006 ◽  
Vol 6 (4) ◽  
pp. 785-788 ◽  
Author(s):  
Irfana P. Bhatti ◽  
Heman D. Lohano . ◽  
Zafar A. Pirzado . ◽  
Imran A. Jafri .
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Logistic Regression Analysis ◽  
Disease Risk ◽  
Ischemic Heart ◽  
Ischemic Heart Disease Risk ◽  
Heart Disease Risk

scholarly journals Renal impairment is closely associated with plasma aldosterone concentration in patients with primary aldosteronism

2019 ◽  
Vol 181 (3) ◽  
pp. 339-350 ◽  
Author(s):  
Akiyuki Kawashima ◽  
Masakatsu Sone ◽  
Nobuya Inagaki ◽  
Yoshiyu Takeda ◽  
Hiroshi Itoh ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Renal Impairment ◽  
Logistic Regression Analysis ◽  
Primary Aldosteronism ◽  
Cross Sectional Study ◽  
Plasma Aldosterone ◽  
Cross Sectional ◽  
Plasma Aldosterone Concentration ◽  
Significant Difference

Objective Several clinical studies have reported that renal impairments are sometimes observed in patients with primary aldosteronism (PA). We analyzed the prevalence of renal impairments in PA patients and identified parameters that increase the risk for them. Design This is a retrospective cross-sectional study. We assessed the PA database established by the multicenter Japan PA study (JPAS). Data were also collected from patients with essential hypertension (EHT). Methods We compared the prevalences of proteinuria and lowered estimated glomerular filtration rate (eGFR) between patients with PA and age, sex, blood pressure and duration of hypertension-matched patients with EHT. We also performed logistic regression analysis to identify parameters that increase the risk for these renal impairments. Results Among 2366 PA patients, the prevalences of proteinuria and lowered eGFR were 10.3 and 11.6%, respectively. The prevalence of proteinuria was significantly higher in PA patients than matched-EHT patients (16.8 vs 4.4%), whereas there was no significant difference in the prevalence of lowered eGFR (17.2 vs 15.0%). The logistic regression analysis also showed that the plasma aldosterone concentration (PAC) significantly increases the risk of proteinuria and lowered eGFR, independent of other known risk factors. Conclusion Plasma aldosterone levels are closely associated with renal impairment in patients with PA. This is contrast to our earlier finding that the PAC was not itself linearly associated with cardiovascular events such as stroke or ischemic heart disease. The mechanism underlying the kidney damage in patients with PA may differ from that affecting the cardiovascular system.

scholarly journals SAT-564 Effectiveness of Treatment with Mineralocorticoid Receptor Antagonistsin Primary Aldosteronism

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Yuta Tezuka ◽  
Adina Turcu
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Primary Aldosteronism ◽  
Odds Ratio ◽  
Mineralocorticoid Receptor ◽  
Beta Blockers ◽  
Multiple Logistic Regression Analysis ◽  
Multiple Logistic Regression ◽  
Low Renin Hypertension

Abstract Background: Medical treatment with mineralocorticoid receptor antagonists (MRAs) is preferred for patients with primary aldosteronism (PA) who are not surgical candidates. Adequate mineralocorticoid receptor blockade, as suggested by renin elevation above suppression levels, has been associated with lower rates of cardiovascular and renal complications as compared with PA with sustained renin suppression. Objectives: To assess the timeline and rates of achieving target renin levels in patients with PA and low renin hypertension treated with MRAs. Patients and Methods: We conducted a retrospective cohort study of adult patients with hypertension who were treated with MRAs in an academic center between 2003-2019. Of these, we included patients who had suppressed renin at baseline, and repeated renin measurement(s) during MRAs therapy. Renin suppression was defined as plasma renin activity (PRA) 1.0 ng/mL/h or direct renin concentration (DRC) 8.0 pg/mL. We excluded patients with adrenal cancer, end-stage renal disease, exogenous glucocorticoids, and critically ill. Mann-Whitney test, Wilcoxon signed rank test, Chi-Square test and multiple logistic regression analysis were employed, as appropriate. Results: So far, 89 patients (45 men), median age 56 (range, 19-84), have been included. Of these, 46% had confirmed PA; 25% had positive PA screening, but no confirmatory tests; and 29% had other forms of low-renin hypertension. On average, patients were on 2.9 1.6 antihypertensive agents; 62% of patients were prescribed beta blockers, and 38% were on K+ supplements. Overall, renin (PRA in 69 cases, and DRC in 20 cases) increased after MRA treatment (from 0.40 [0.10, 0.60] ng/mL/h to 1.10 [0.60, 2.23] ng/mL/h; and from 2.1 [2.1, 3.7] pg/mL to 5.7 [2.9, 16.7] pg/mL, respectively, p<0.0001 for both). The cumulative proportions of patients in whom renin reached target levels during MRA treatment were: 25% at 2 weeks; 38.9% at 1 month; 34.2% at 3 months; 39.5% at 6 months; and 47.2% at 1 year. Age, sex, race, blood pressure, use of beta blockers, renal function, serum K+ and aldosterone concentrations were similar between patients with target vs. suppressed renin. Multiple logistic regression analysis suggested that after adjusting for age and sex, higher MRA dose and higher BMI were associated with higher likelihood of achieving target renin during MRA therapy (odds ratio (95%CI): 1.021 (1.001-1.041) and 1.097 (1.008-1.193), respectively, p<0.05 for both); conversely, beta blockers use tended to be less often associated with target renin (odds ratio, 0.37 (0.13-1.008), p=0.052). Conclusion: Although raising renin above suppression levels is important for reducing the cardiovascular risk associated with PA, this goal is achieved in less than half of patients, even after one year of treatment with MRAs, in an academic setting. Strategies for optimizing PA treatment are critically needed.

Higher Plasma Aldosterone Concentrations Are Associated With Elevated Risk of Aortic Dissection and Aneurysm: a Case-Control Study

Hypertension ◽  
2022 ◽  
Author(s):  
Qing Zhu ◽  
Mulalibieke Heizhati ◽  
Mengyue Lin ◽  
Menghui Wang ◽  
Xiaoguang Yao ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Aortic Dissection ◽  
Logistic Regression Analysis ◽  
Primary Aldosteronism ◽  
Plasma Aldosterone ◽  
Control Group ◽  
Case Group ◽  
Relationship Of ◽  
The Relationship

Background: Animal models demonstrate circulating aldosterone leads to aortic dissection and aneurysm, whereas data from humans are lacking. Therefore, we aimed to examine the associations of plasma aldosterone concentrations (PAC) with aortic dissection and aneurysm. Methods: We identified patients with aortic dissection and aneurysm with assessed PAC before disease onset from hospital-based electronic database and set as case group. Simultaneously, age and gender-matched cohort with PAC measurement whereas without aortic dissection and aneurysm were selected as control group using ratio of 1:4. Multi-variable logistic regression analysis was used to assess the relationship of PAC with aortic dissection and aneurysm. Results: Totally, 133 cases and 531 controls (all hypertensive) were enrolled between 2004 and 2021, with 77.9% men, mean age of 55.5 years and PAC of 13.9 ng/dL. Case group showed significantly higher PAC(14.51 versus 13.65 ng/dL, P =0.012) than did control group. In logistic regression analysis, higher PAC exhibited 1.68-fold higher odds (95% CI, 1.14–2.48, P =0.008) for presence of aortic dissection and aneurysm, significant in adjusted model (odds ratio, 1.69 [95% CI, 1.11–2.57], P =0.015). In stratified analysis, the association between the 2 was observed in women of all ages and in men with coronary artery disease. Sensitivity analysis by excluding those under interfering agents at PAC measurement and those with primary aldosteronism did not change the relationship of the 2. Conclusions: Higher PAC is associated with the increased odd for aortic dissection and aneurysm in patients with hypertension, even in the absence of primary aldosteronism, implying that PAC might be a target for prevention.

scholarly journals Association of metabolic syndrome and oxidative stress with ischemic heart disease in middle-aged persons

Medicina ◽  
2008 ◽  
Vol 44 (5) ◽  
pp. 392 ◽  
Author(s):  
Liucija Černiauskienė ◽  
Dalia Lukšienė ◽  
Abdonas Tamošiūnas ◽  
Regina Rėklaitienė ◽  
Lilija Margevičienė
Keyword(s):  
Oxidative Stress ◽  
Metabolic Syndrome ◽  
Heart Disease ◽  
Vitamin E ◽  
Ischemic Heart Disease ◽  
Odds Ratio ◽  
Ischemic Heart ◽  
Middle Aged ◽  
Men And Women ◽  
And Oxidative Stress

The aim of this study was to evaluate the association of metabolic syndrome and oxidative stress with ischemic heart disease in middle-aged persons (men and women aged 45–64 years). Material and methods. In this study, we have used data of 533 persons (247 men and 286 women) aged 45– 64 years from Kaunas population cohort investigated according to WHO MONICA study protocol during 2001–2002 in whom concentrations of malondialdehyde, a marker of lipid peroxidation, and antioxidant vitamin E in blood serum were determined. Metabolic syndrome was defined by the criteria of Adult Treatment Panel III. Oxidative stress was determined in the presence of increased level of malondialdehyde (≥5 mmol/L) and decreased level of lipid-standardized vitamin E (<20 mmol/L). The levels of malondialdehyde and vitamin E were measured by fluorimetric methods. Results. Ischemic heart disease was diagnosed in 19.8% of men and 21.3% of women. The frequency of ischemic heart disease among persons (men and women) with metabolic syndrome was significantly higher than among persons without metabolic syndrome (27.4% vs. 17.8%, respectively; odds ratio, 1.63; P=0.032). The frequency of ischemic heart disease among persons with oxidative stress was significantly higher than among persons without oxidative stress (29.1% vs. 17.6%, respectively; odds ratio, 1.88; P=0.029). The highest prevalence of ischemic heart disease (30.0%) was among persons with metabolic syndrome and oxidative stress, and the lowest prevalence of this disease (13.8%) was among persons without metabolic syndrome and without oxidative stress (odds ratio, 2.54; P=0.017). These data were adjusted by sex and age. Conclusion. Metabolic syndrome and oxidative stress are significantly associated with ischemic heart disease among 45–64-year-old persons.

scholarly journals Mitochondrial DNA polymorphism and myocardial ischemia: Association of haplogroup H with heart failure

2022 ◽  
Vol 36 (4) ◽  
pp. 70-77
Author(s):  
M. V. Golubenko ◽  
T. V. Shumakova ◽  
O. A. Makeeva ◽  
N. V. Tarasenko ◽  
R. R. Salakhov ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mitochondrial Dna ◽  
Heart Disease ◽  
Chronic Heart Failure ◽  
Ischemic Heart Disease ◽  
Blood Serum ◽  
Odds Ratio ◽  
Population Sample ◽  
Ischemic Heart ◽  
Mtdna Haplogroup

The pathogenesis of atherosclerosis and ischemic heart disease is associated with oxidative stress and mitochondrial dysfunction. Mitochondrial DNA encodes subunits of mitochondrial respiratory chain and is highly polymorphic in human populations. Mitochondrial DNA can be considered a candidate genetic locus for predisposition to cardiovascular diseases.Aim. To analyze the associations of the mitochondrial genome polymorphism and chronic heart failure in ischemic heart disease.Material and Methods. The study included two groups of individuals: patients with a combination of ischemic heart disease and chronic heart failure (n = 175) and a population sample of residents of Tomsk (n = 424). Percentages of patients with chronic heart failure of NYHA classes II, III, and IV were 37%, 50%, and 13%, respectively. All patients underwent echocardiographic examination; body mass index and the lipid fractions in blood serum were determined. The average was 55.4 years in patients and 47.6 years in the population sample. Polymorphism of mtDNA was studied by sequencing the hypervariable segment of D-loop of mtDNA and subsequent classification of mtDNA haplotypes into the known haplogroups. The mtDNA haplogroup frequencies were compared between the samples using the Chi-square test. The associations of genotype with quantitative trait variability were analyzed by variance analysis.Results. Male patients showed a higher frequency of haplogroup H compared to the population (45.86% in patients and 35.4% in population) and a higher total frequency of haplogroup H subgroups except the most frequent subgroup H1 (36.94% and 25.22%, respectively). The values of significance level (p-value) and odds ratio (OR) were determined as follows: p = 0.04; odds ratio OR = 1.55 (95% confidence interval (CI) 1.02–2.34) for haplogroup H as a whole; p = 0.02; OR = 1.74 (95% CI 1.12–2.70) for haplogroup H without subgroup H1. Analysis of quantitative traits revealed the associations of the same genetic marker (mtDNA haplogroup H) with the levels of high-density lipoproteins (p = 0.03) and triglycerides (p = 0.02) in blood serum of men in the population sample.Conclusion. The obtained results suggested that the most frequent European mtDNA haplogroup H may be a risk factor for the complications of ischemic heart disease in men.

scholarly journals Association between motoric cognitive risk syndrome and frailty among Chinese older adults

2019 ◽  
Author(s):  
Shanshan Shen ◽  
Xingkun Zeng ◽  
Liyu Xu ◽  
Lingyan Chen ◽  
Zixia Liu ◽  
...  
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Confidence Interval ◽  
Logistic Regression Analysis ◽  
Odds Ratio ◽  
Cognitive Complaints ◽  
Chinese Older Adults ◽  
Cognitive Risk ◽  
Subjective Cognitive Complaints

Abstract Background: Motoric cognitive risk syndrome (MCR) is a newly proposed pre-dementia syndrome incorporating subjective cognitive complaints and slow gait. Previous studies have shown that subjective cognitive complaints and slow gait are reported to be associated with frailty in cognitively unimpaired older adults, but little is known giving attention to the link between MCR and frailty in older adults. Therefore, the aim of the study was to explore the associations of MCR and its components and frailty in Chinese older adults. Methods: In an observation cross-sectional study, a total of 429 older adults aged 60 years and older were admitted to the geriatric department. According to MCR criteria, all participants were classified to 4 groups: 1) MCR group; 2) subjective cognitive complaints group; 3) slow gait group; 4) healthy control group. Physical frailty was assessed by Clinical Frailty Scale (CFS). The multivariate logistic regression analysis was used to examine the association between MCR and frailty in older adults. Results: The prevalence of subjective cognitive complaints, slow gait and MCR was 15.9%, 10.0% and 4.0%, respectively. After adjusting for confounding variables, the logistic regression analysis showed that slow gait (odds ratio [OR] 3.40, 95% confidence interval [CI] 1.40-8.23, P=0.007) and MCR (odds ratio [OR] 5.53, 95% confidence interval [CI] 1.46-20.89, P=0.012) were independently associated with frailty, but not subjective cognitive complaints. Conclusions: MCR and slow gait were significantly associated with frailty in Chinese older adults. Further study should prospectively determine the causal relationship between MCR and frailty.

scholarly journals Facemask wearing to prevent COVID-19 transmission and associated factors among taxi drivers in Dessie City and Kombolcha Town, Ethiopia

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0247954
Author(s):  
Tarikuwa Natnael ◽  
Yeshiwork Alemnew ◽  
Gete Berihun ◽  
Masresha Abebe ◽  
Atsedemariam Andualem ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Odds Ratio ◽  
Associated Factors ◽  
Multivariable Analysis ◽  
World Health ◽  
Multivariable Logistic Regression Analysis ◽  
Taxi Drivers ◽  
Targeted Interventions

Background The World Health Organization (WHO) has pointed out that urban taxi drivers and their passengers are at higher risk of transmitting coronavirus disease 19 (COVID-19) due to frequent contact among many people. Facemask wearing is one of the preventive measures recommended to control the transmission of the virus. A lack of evidence of the proportion of facemask wearing among taxi drivers and associated factors in Ethiopia, including Dessie City and Kombolcha Town, hinders the design of targeted interventions to advocate for facemask use. This study was designed to address this gap. Methods A cross-sectional study was conducted among 417 taxi drivers in Dessie City and Kombolcha Town from July to August, 2020. The study participants were selected using a simple random sampling technique after proportionally allocating the sample size from the total number of taxi drivers working in Dessie City and Kombolcha Town. The data were collected by trained data collectors using a structured questionnaire and an on-the-spot observational checklist. The collected data were checked, coded and entered to EpiData version 4.6 and exported to Statistical Package for Social Sciences (SPSS) version 25.0 for data cleaning and analysis. Bivariate (Crude Odds Ratio [COR]) and multivariable (Adjusted Odds Ratio [AOR]) logistic regression analyses were employed using 95% CI (confidence interval). From bivariate logistic regression analysis, variables with p-value < 0.250 were retained into multivariable logistic regression analysis. Then, from the multivariable analysis, variables with p-value < 0.050 were declared as factors significantly associated with facemask wearing among taxi drivers in Dessie City and Kombolcha Town. Main findings The proportion of taxi drivers who wore a facemask was 54.68% [95%CI: 50.10–59.7%]. The majority (58.3%) of drivers were using cloth facemasks, followed by N95 facemasks (24.5%) and surgical facemasks (17.3%). Out of the total 417 taxi drivers, more than two-thirds (69.8%) of them had a good knowledge about COVID-19 and 67.6% of taxi drivers had a positive attitude towards taking precautions against transmission of COVID-19. Three-fourths (74.1%) of the taxi drivers believed that wearing a facemask could prevent COVID-19. More than half (52.5%) felt discomfort when wearing a facemask. Almost three-fourths (72.2%) of taxi drivers felt that the presence of local government pressure helped them to wear a facemask. We found that marital status [AOR = 3.14, 95%CI: 1.97–5.01], fear of the disease [AOR = 2.1, 95%CI: 1.28–3.47], belief in the effectiveness of a facemask [AOR = 5.6, 95%CI: 3.1–10.16] and feeling government pressure [AOR = 3.6, 95%CI: 2.16–6.13] were factors significantly associated with wearing a facemask. Conclusion We found that the proportion of facemask wearers among taxi drivers was relatively low in Dessie City and Kombolcha Town. In order to increase that number, government bodies should work aggressively to encourage more taxi drivers to wear a facemask. We also recommend that government and non-government organizations work very closely together to implement strategies that promote facemask use, including increasing the availability of inexpensive facemasks, and monitoring and controlling facemask use.

scholarly journals Plasma levels of pentosidine in diabetic patients: an advanced glycation end product.

1998 ◽  
Vol 9 (9) ◽  
pp. 1681-1688
Author(s):  
S Sugiyama ◽  
T Miyata ◽  
Y Ueda ◽  
H Tanaka ◽  
K Maeda ◽  
...  
Keyword(s):  
Renal Function ◽  
Regression Analysis ◽  
Heart Disease ◽  
Serum Creatinine ◽  
Ischemic Heart Disease ◽  
Multiple Regression Analysis ◽  
Multiple Regression ◽  
Ischemic Heart ◽  
Diabetic Patients ◽  
Advanced Glycation

Nonenzymatic reactions between glucose and proteins yield advanced glycation end products (AGE) such as pentosidine. AGE accumulate in diabetic patients, alter the structure and function of tissue proteins, stimulate cellular response, and have thus been implicated in diabetic tissue damage. The present study was undertaken to assess the factors determining plasma total pentosidine level in diabetic patients and the possible relation between plasma pentosidine level and diabetic complications. In diabetic patients, including patients with renal failure, plasma pentosidine levels, assessed by HPLC assay, were correlated with serum creatinine (P < 0.0001). In patients with normal renal function, pentosidine levels were correlated with blood glucose control (hemoglobin Alc: P = 0.0028; fructoselysine: P = 0.0133), serum creatinine (P = 0.029), patient age (P = 0.0416), duration of diabetes (P = 0.0431), and total cholesterol (P = 0.0056) and LDL-cholesterol (P = 0.0208). Multiple regression analysis revealed an independent influence of hemoglobin Alc and serum creatinine on pentosidine levels (r2 = 0.216, P = 0.0026). Pentosidine levels were higher in patients with than in those without hypertension (P = 0.043) or ischemic heart diseases (P = 0.0061). No such differences were observed between patients with and without albuminuria or retinopathy. Multiple regression analysis revealed an independent influence of plasma pentosidine on the presence of hypertension (r2 = 0.129, P = 0.0382) and of plasma pentosidine and HDL-cholesterol on the presence of ischemic heart disease (r2 = 0.326, P = 0.0012). The present study demonstrated that plasma pentosidine level was significantly influenced by the quality of glycemic control and renal function. Pentosidine level was also correlated with hypertension and ischemic heart disease, and might be taken as a biomarker of diabetic cardiovascular risk.

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