Cardiovascular Risk Factors and MRI Markers of Cerebral Small Vessel Disease: A Mendelian Randomization Study

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000013120
Author(s):  
Victoria Taylor-Bateman ◽  
Dipender Gill ◽  
Marios Georgakis ◽  
Rainer Malik ◽  
Patricia Munroe ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Diastolic Blood Pressure ◽  
Type Ii Diabetes ◽  
Mendelian Randomization ◽  
Small Vessel Disease ◽  
Smoking Initiation ◽  
Weighted Median

Objective-Cardiovascular risk factors have been implicated in the etiology of Cerebral Small Vessel Disease (CSVD), however whether the associations are causal remains unclear in part due to the susceptibility of observational studies to reverse causation and confounding. Here we use Mendelian randomization (MR) to determine which cardiovascular risk factors are likely to be involved in the etiology of CSVD.Methods-We used data from large scale genome-wide association studies (GWAS) of European ancestry to identify genetic proxies for blood pressure, blood lipids, body mass index (BMI), type-II diabetes, smoking initiation, cigarettes per day and alcohol consumption. MR was performed to assess their association with three neuroimaging features which are altered in CSVD (white matter hyperintensities (WMH), fractional anisotropy (FA) and mean diffusivity (MD)) using genetic summary data from UK Biobank (N=31,855). Our primary analysis used inverse-weighted median (IVW) MR, with validation using weighted median, MR-Egger and a pleiotropy-minimizing approach. Finally, multivariable MR was performed to study the effects of multiple risk factors jointly.Results-MR analysis showed consistent associations across all methods for higher genetically proxied systolic and diastolic blood pressure with WMH, FA, and MD; and for higher genetically proxied BMI with WMH. There was weaker evidence for associations between total cholesterol, LDL, smoking initiation, pulse pressure and type-II diabetes liability and at least one CSVD imaging feature, but these associations were not reproducible across all validation methods used. Multivariable MR analysis for blood pressure traits found that the effect was primarily through genetically proxied diastolic blood pressure across all CSVD traits.Conclusion-Genetic predisposition to higher blood pressure, primarily diastolic blood pressure, and higher BMI is associated with a higher burden of CSVD, suggesting a causal role. Improved management and treatment of these risk factors could reduce the burden of CSVD.

Modification of Cardiovascular Risk Factors during Antihypertensive Treatment: A Multicentre Trial with Quinapril

1993 ◽  
Vol 21 (1) ◽  
pp. 15-25 ◽  
Author(s):  
E Manzato ◽  
A Capurso ◽  
G Crepaldi
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Diastolic Blood Pressure ◽  
Enzyme Inhibitor ◽  
Density Lipoprotein ◽  
Diabetic Patients ◽  
Intent To Treat

A large multicentre study involving 6003 [3044 males, 2959 females; mean (± SD) age 59 ± 11 years] mild-to-severe hypertensive patients was carried out to evaluate the effects of the angiotension converting enzyme inhibitor quinapril on blood pressure and on metabolic cardiovascular risk factors during 3 − 6 months' treatment (mean follow-up 90.4 days). The study population included 551 elderly [mean (± SD) age 71.9 ± 9.3 years] patients, 1314 subjects with diabetes mellitus and 154 non-diabetic patients with hyperlipaemia; 4% of patients were lost to follow-up. Diastolic blood pressure decreased from 102 to 87 mmHg (intent-to-treat analysis) and 62% of patients were normalized (diastolic blood pressure below 90 mmHg) at the last evaluable visit. Overall, serum lipids were favourably affected during quinapril treatment; when corrected for changes in body weight, a significant improvement in total, low- and high-density lipoprotein cholesterol, and triglycerides was detected. Quinapril treatment in elderly patients was efficacious and well tolerated, and quinapril appears to be an effective antihypertensive drug devoid of untoward effects on metabolic risk factors for cardiovascular disease.

scholarly journals THE RELATIONSHIP BETWEEN DAILY STEPS AND CARDIOVASCULAR RISK FACTORS AMONG TEACHERS IN CENTRAL REGION, MALAYSIA

2020 ◽  
Vol 9 (2) ◽  
Author(s):  
Shafiqah Mohd Radhi ◽  
Nur Zakiah Mohd Saat ◽  
Nor Farah Mohamad Fauzi ◽  
Siti Aishah Hanawi
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Waist Circumference ◽  
Cardiovascular Risk Factors ◽  
Diastolic Blood Pressure ◽  
Blood Sugar ◽  
School Teachers ◽  
Steps Per Day

Physical activity is an important component of cardiovascular health. The fact that physical activity is also associated with a substantial number of cognitive and academic benefits, therefore schools teachers can be an important role model in promoting a physically-active lifestyle in school children. The aim of this study is to examine the levels of physical activity (PA) and its association with cardiovascular risk factors in a sample of school teachers. Forty-nine (n=49) teachers from primary and secondary schools around Klang Valley urban areas were recruited. The PA level was determined using pedometer, worn for three consecutive days. Anthropometric measurements and blood samples were collected to determine cardiovascular risk factors. Findings showed that the school teachers recorded an overall mean (± SEM) of 7707 ± 490 steps/day, which is below the recommended target of 10 000 steps per day. According to pedometer-determined physical activity indices proposed by Tudor-Locke and Bassett (2004), 20.83% of the sample were classified as ‘sedentary’ (<5000 steps/day), 35.40% were ‘low active’ (5000 – 7499 steps/day) and only 18.70% achieved more than 10 000 steps/day. According to Asian BMI cut-off points, 43% of the teachers were categorized as overweight and obese (>23 kg/m2). The mean values for waist circumference, fasting blood sugar, and cholesterol level, systolic and diastolic blood pressure were 83.96 ± 1.90 cm, 5.41 ± 0.26 mmol/l, 4.64±0.26 mmol/l, 118.90 ± 1.72 mmHg and 72.40±1.58 mmHg respectively. Fisher Exact Test shown that there were significant association between daily step and age category. Daily steps weakly negative correlated with systolic blood pressure (r = -0.024, p > 0.05) as well as blood sugar levels (r = -0.061, p> 0.05), diastolic blood pressure (r = -0.079, p> 0.05), body mass index (r = -0.271, p> 0.05), waist circumference (r = -0.196, p> 0.05), as well as blood cholesterol levels (r = -0.037, p> 0.05). In conclusion, there were weak negative correlations between steps per day and cardiovascular risk factors. Generally, the level of physical activity in the sample of teachers needs to be improved. Interventions aimed at promoting PA among school teachers may be warranted in the future.

scholarly journals Risk factors for the occurrence of cardovascular system diseases in students

2009 ◽  
Vol 66 (6) ◽  
pp. 453-458 ◽  
Author(s):  
Dusica Stojanovic ◽  
Aleksandar Visnjic ◽  
Vladimir Mitrovic ◽  
Miodrag Stojanovic
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Alcohol Consumption ◽  
Cardiovascular Risk Factors ◽  
Diastolic Blood Pressure ◽  
Female Students ◽  
Female Population ◽  
Waist Size ◽  
Significant Difference

Background/Aim. Cardiovascular diseases are a leading cause of death in the majority of developed, as well as in many developing countries. The aim of this study was to determine cardiovascular risk factors in student population and to suggest possible measures for prevention. Methods. The study was carried out during 2007-2008 at the School of Medicine, University of Nis. It included 824 students in their final year (220 males, 604 females). Results. There was no significant difference in prevalence of hypertension among the male (1.81%) and female students (0%). The prevalence of obesity (Body Mass Index - BMI > 30 kg/m2) was significantly higher (p < 0.001) in the male (7.27%) than in the female population (1.32%). Abdominal obesity was also more frequently encountered (p < 0.01) in the male (9.09%) than in female population (1.32%). Every fourth student smoked cigarettes with no significant difference between the male and female students. Alcohol consumption was a significantly higher problem (p < 0.001) in the male population (18.18%) than in the female one (2.65%). Physical inactivity was more often found (p < 0.001) in the female students (65.56%), than in male ones (36.36%). By the bivariate correlation of cardiovascular risk factors, it was determined that in the male student population systolic blood pressure correlated significantly with diastolic blood pressure, BMI and waist size, whereas age correlated with sistolic blood pressure, waist size and smoking. In the female students sistolic blood pressure correlated with diastolic blood pressure, BMI and waist size; diastolic blood pressure correlated with BMI and physical inactivity; cigarette smoking correlated with alcohol consumption and age. Conclusion. Cardiovascular risk factors are present in the final-year students of the School of Medicine, University of Nis. It is necessary to insist on decreasing obesity prevalence, cigarette and alcohol consumption, and on increasing physical activity of students in order to prevent cardiovascular diseases.

scholarly journals Association of theHindIIIand S447X Polymorphisms inLPLGene with Hypertension and Type 2 Diabetes in Mexican Families

2012 ◽  
Vol 33 (6) ◽  
pp. 313-320 ◽  
Author(s):  
Salvador Muñoz-Barrios ◽  
Iris Paola Guzmán-Guzmán ◽  
José Francisco Muñoz-Valle ◽  
Aralia Berenice Salgado-Bernabé ◽  
Lorenzo Salgado-Goytia ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Diastolic Blood Pressure ◽  
Gene Polymorphisms ◽  
The Body ◽  
Mexican Families

Lipoprotein lipase (LPL) is a key enzyme in lipid metabolismand is associatedwith obesity, dyslipidemias, hypertension (HTN) and type 2 diabetes mellitus (T2DM).LPLgene polymorphisms can be related with the development of cardiovascular risk factors. The present study was conducted to analyze the relationship of theHindIIIand S447X polymorphisms inLPLgene with cardiovascular risk factors in Mexican families. The study population comprised ninety members of 30 Mexican families, in which an index case had obesity, were included in the study. We evaluated the body composition by bioelectrical impedance. Peripheral blood samples were collected to determine biochemical parameters. Screening for both polymorphisms was made by PCR-RFLPs. In the parents, both polymorphisms were in Hardy-Weinberg’s equilibrium. We found that the genotype T/T ofHindIIIwas associated with diastolic blood pressure ≧ 85 mmHg (OR = 1.1;p= 0.011), whereas the genotype C/C of S447X was associated with systolic blood pressure ≧ 130 mmHg (OR = 1.2;p< 0.001), diastolic blood pressure ≧ 85 mmHg (OR = 1.3;p< 0.001), T2DM (OR = 1.3;p< 0.001) and with increase of total cholesterol (β = 23.6 mg/mL;p= 0.03). These data suggest that theHindIIIand S447XLPLgene polymorphisms can confer susceptibility for the development of hypertension and T2DM in Mexican families.

scholarly journals Prevalence of obesity and cardiovascular risk among children and adolescents in the municipality of Santa Cruz do Sul, Rio Grande do Sul

2013 ◽  
Vol 131 (5) ◽  
pp. 323-330 ◽  
Author(s):  
Cezane Priscila Reuter ◽  
Leandro Tibirica Burgos ◽  
Marcelo Dias Camargo ◽  
Lia Goncalves Possuelo ◽  
Miriam Beatris Reckziegel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Body Mass Index ◽  
Cardiovascular Risk ◽  
Waist Circumference ◽  
Children And Adolescents ◽  
Cardiovascular Risk Factors ◽  
Diastolic Blood Pressure ◽  
Body Mass ◽  
High Prevalence

CONTEXT AND OBJECTIVE: Studies have demonstrated that metabolic complications from child obesity, although silent, increase the risk of development of cardiovascular diseases in adulthood. The present paper sought to describe the prevalence of overweight/obesity and analyze the possible relationship between obesity and other cardiovascular risk factors among children and adolescents. DESIGN AND SETTING: Cross-sectional study, conducted in a university. METHODS: The study included 564 children and adolescents, aged 8 to 17 years. Body mass index and waist circumference were used to evaluate obesity. Other cardiovascular risk factors were evaluated, like systolic and diastolic blood pressure, glycemia, triglycerides and total cholesterol. Descriptive analysis was used for sample characterization, the chi-square test for categorical variables and Pearson's linear correlation for evaluating the relationship between obesity indicators and other cardiovascular risk factors. RESULTS: High prevalence of overweight/obesity was found among the schoolchildren (25.3% among the boys and 25.6% among the girls), along with abdominal obesity (19.0%). The overweight/obese schoolchildren presented higher percentages for the pressure and biochemical indicators, compared with underweight and normal-weight schoolchildren. Body mass index and waist circumference showed a weak correlation with the variables of age and systolic and diastolic blood pressure (P < 0.001), but there was no correlation between these obesity indices and biochemical variables. CONCLUSION: The high prevalence of overweight/obesity and its relationship with other cardiovascular risk factors demonstrate that it is necessary to develop intervention and prevention strategies from childhood onwards, in order to avoid development of chronic-degenerative diseases in adulthood.

scholarly journals Cardiovascular Risk Factors in Adult Javanese Patients with Hemophilia A

2021 ◽  
Author(s):  
Faizal Muhammad
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Uric Acid ◽  
Cardiovascular Risk ◽  
Total Cholesterol ◽  
Cardiovascular Risk Factors ◽  
Diastolic Blood Pressure ◽  
Hemophilia A ◽  
Mean Values ◽  
Significant Difference

Hemophilia usually presents as bleeding after minor trauma or as a spontaneous bleed due its hypocoagulable state. Hemophilia A represents 80-85% of the total hemophilia population with a prevalence of 1:10,000. Cardiovascular risk factors were common in the general population compared with hemophilia patients. This study aims to identify cardiovascular risk factors in adult Javanese patients with hemophilia A and their relationship with hemophilia severity. This cross-sectional study involved registered Javanese race male patients at Dr. Moewardi General Hospital from November 2019 - April 2020. There are 76 hemophilia A patients, after excluding patients with other comorbidities, non-Javanese race and age &gt;18 years old, 33 appropriate patients were then randomized. The study group consists of 30 patients with hemophilia A and 30 non-hemophilia patients. Data were collected once during patient visits to the hospital polyclinic. The collected data were body mass index (BMI), blood pressure, fasting blood sugar (FBS), total cholesterol, and uric acid. They were analyzed using the Spearman rank test. Median values of BMI scores were 20.82 (13.67-41.52) kg/m² for hemophilia A group and 24.67 (9.38-53.32) kg/m² for the control group (p &lt; 0.05). Further, median values of diastolic blood pressure, the median of FBS, and mean values of the uric acid level also showed a significant difference (p &lt; 0.05). Otherwise, the mean values of systolic blood pressure and median values of total cholesterol showed no significant difference. The BMI score, diastolic blood pressure, fasting blood sugar, and uric acid appear to be significant cardiovascular risk factor profiles in Javanese adult patients with hemophilia A. Hence, there must be a consideration, screening, and treatment for the cardiovascular risk factors in hemophilia A patients. Although the other studies are not sufficient to show recommended therapeutic targets and the results of reducing cardiovascular risk factors in hemophilia patients.

scholarly journals Comparison of dietary macronutrient patterns of 14 popular named dietary programmes for weight and cardiovascular risk factor reduction in adults: systematic review and network meta-analysis of randomised trials

BMJ ◽  
2020 ◽  
pp. m696 ◽  
Author(s):  
Long Ge ◽  
Behnam Sadeghirad ◽  
Geoff D C Ball ◽  
Bruno R da Costa ◽  
Christine L Hitchcock ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Blood Pressure ◽  
Weight Loss ◽  
Cardiovascular Risk ◽  
Systolic Blood Pressure ◽  
Cardiovascular Risk Factors ◽  
Diastolic Blood Pressure ◽  
Hdl Cholesterol ◽  
Randomised Trials

Abstract Objective To determine the relative effectiveness of dietary macronutrient patterns and popular named diet programmes for weight loss and cardiovascular risk factor improvement among adults who are overweight or obese. Design Systematic review and network meta-analysis of randomised trials. Data sources Medline, Embase, CINAHL, AMED, and CENTRAL from database inception until September 2018, reference lists of eligible trials, and related reviews. Study selection Randomised trials that enrolled adults (≥18 years) who were overweight (body mass index 25-29) or obese (≥30) to a popular named diet or an alternative diet. Outcomes and measures Change in body weight, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, systolic blood pressure, diastolic blood pressure, and C reactive protein at the six and 12 month follow-up. Review methods Two reviewers independently extracted data on study participants, interventions, and outcomes and assessed risk of bias, and the certainty of evidence using the GRADE (grading of recommendations, assessment, development, and evaluation) approach. A bayesian framework informed a series of random effects network meta-analyses to estimate the relative effectiveness of the diets. Results 121 eligible trials with 21 942 patients were included and reported on 14 named diets and three control diets. Compared with usual diet, low carbohydrate and low fat diets had a similar effect at six months on weight loss (4.63 v 4.37 kg, both moderate certainty) and reduction in systolic blood pressure (5.14 mm Hg, moderate certainty v 5.05 mm Hg, low certainty) and diastolic blood pressure (3.21 v 2.85 mm Hg, both low certainty). Moderate macronutrient diets resulted in slightly less weight loss and blood pressure reductions. Low carbohydrate diets had less effect than low fat diets and moderate macronutrient diets on reduction in LDL cholesterol (1.01 mg/dL, low certainty v 7.08 mg/dL, moderate certainty v 5.22 mg/dL, moderate certainty, respectively) but an increase in HDL cholesterol (2.31 mg/dL, low certainty), whereas low fat (−1.88 mg/dL, moderate certainty) and moderate macronutrient (−0.89 mg/dL, moderate certainty) did not. Among popular named diets, those with the largest effect on weight reduction and blood pressure in comparison with usual diet were Atkins (weight 5.5 kg, systolic blood pressure 5.1 mm Hg, diastolic blood pressure 3.3 mm Hg), DASH (3.6 kg, 4.7 mm Hg, 2.9 mm Hg, respectively), and Zone (4.1 kg, 3.5 mm Hg, 2.3 mm Hg, respectively) at six months (all moderate certainty). No diets significantly improved levels of HDL cholesterol or C reactive protein at six months. Overall, weight loss diminished at 12 months among all macronutrient patterns and popular named diets, while the benefits for cardiovascular risk factors of all interventions, except the Mediterranean diet, essentially disappeared. Conclusions Moderate certainty evidence shows that most macronutrient diets, over six months, result in modest weight loss and substantial improvements in cardiovascular risk factors, particularly blood pressure. At 12 months the effects on weight reduction and improvements in cardiovascular risk factors largely disappear. Systematic review registration PROSPERO CRD42015027929.

scholarly journals Inter Arm Blood Pressure and Cardiovascular Risk in Young Adults at Ellisras

2021 ◽  
Author(s):  
Betty Sebati ◽  
Kotsedi Monyeki ◽  
Hlengani Siweya ◽  
Susan Monyeki
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Young Adults ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Diastolic Blood Pressure ◽  
Blood Analysis ◽  
The Difference ◽  
And Gender ◽  
Optimal Blood Pressure

Cardiovascular disease is a notable cause of death globally. When undetected, varying measurements of BP between arms can lead to inaccuracies in the interpretation and management of blood pressure consequently putting individuals in an avoidable risk through sub-optimal blood pressure control. The aim of the study was to determine the difference in blood pressure between the arms and its association to cardiovascular risk in young adults at Ellisras. A total of 624 young adults aged 18 to 29 years old participated in the study. Blood pressure measurements and blood analysis were done according to standard procedures. Multivariate logistic regression was used to determine the association between interarm blood pressure and cardiovascular risk factors. There was significant (p ≤ 0.05) mean difference of diastolic blood pressure of the <10 mmHg and ≥ 10 mmHg groups. There was a positive significant association between systolic inter arm blood pressure difference and hypertension (B = 5.331; 95%CI = 12.260–23.183; P = 0.026) while no significant association was found between diastolic blood pressure and interarm diastolic differences in diastolic blood pressure (B = 1.081; 95%CI = 1.032–1.131; P = 0.920). The current study showed positive associations between inter arm differences and a few cardiovascular risk factors including BMI and gender. Detection of an interarm BP difference should motivate the need for a thorough cardiovascular/health assessment.

Physical activity, sedentary behaviour and their associations with cardiovascular risk in systemic lupus erythematosus

Rheumatology ◽  
2019 ◽  
Vol 59 (5) ◽  
pp. 1128-1136 ◽  
Author(s):  
Alexandra Legge ◽  
Chris Blanchard ◽  
John G Hanly
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Diastolic Blood Pressure ◽  
Sedentary Behaviour ◽  
Assessment Tool ◽  
Cvd Risk ◽  
Cross Sectional

Abstract Objective Using a novel isotemporal substitution paradigm, this study aimed to estimate the cross-sectional associations of objectively measured sedentary behaviour and physical activity (PA) with cardiovascular risk factors among patients with SLE. Methods This was a cross-sectional study of adult SLE patients without documented cardiovascular disease (CVD). Cardiovascular risk factors were measured, including BMI, blood pressure, fasting glucose and lipid profile. Ten-year CVD risk was estimated using the American College of Cardiology/American Heart Association risk assessment tool. Time in sedentary behaviour, light PA, and moderate–vigorous PA (MVPA) was measured by accelerometry. We used three linear regression models—single-activity models, partition models, and isotemporal substitution models—to evaluate the associations of time spent at each movement intensity with each CVD risk variable. Results There were 100 SLE patients [92% female; mean (s.d.) age 52.4 (14.4) years]. Only 11 participants adhered to current PA recommendations (⩾150 MVPA min/week in ⩾10-min bouts). In isotemporal substitution, reallocating 10 min from sedentary behaviour to MVPA was associated with lower systolic (β = –2.15 mmHg; P = 0.01) and diastolic blood pressure (β = –1.56 mmHg; P = 0.01), as well as lower estimated 10-year CVD risk (RR 0.81, 95% CI 0.70, 0.93). Time reallocation from light PA to MVPA was associated with lower diastolic blood pressure (β = –1.45 mmHg; P = 0.01) and lower 10-year CVD risk estimates (RR 0.80, 95% CI 0.69, 0.94). Conclusion Given that reallocating time from other movement intensities to MVPA is associated favourably with lower cardiovascular risk, PA interventions are needed to address suboptimal MVPA levels among SLE patients.

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