Predictors for carotid and femoral artery intima-media thickness in a non-diabetic sleep clinic cohort

Introduction The impact of sleep disordered breathing (SDB) on arterial intima-media thickness (IMT), a surrogate measure for cardiovascular disease, remains uncertain, in part because of the potential for non-SDB vascular risk factor interactions. In the present study, we determined predictors for common carotid (CCA) and femoral (CFA) artery IMT in an adult, sleep clinic cohort where non-SDB vascular risk factors (particularly diabetes) were eliminated or controlled. Methods We recruited 296 participants for polysomnography (standard SDB severity metrics) and CCA/CFA ultrasound examinations, followed by a 12 month vascular risk factor minimisation (RFM) and continuous positive pressure (CPAP) intervention for participants with a range of SDB severity (RFM Sub-Group, n = 157; apnea hyponea index [AHI]: 14.7 (7.2–33.2), median [IQR]). Univariable and multivariable linear regression models determined independent predictors for IMT. Linear mixed effects modelling determined independent predictors for IMT change across the intervention study. P<0.05 was considered significant. Results Age, systolic blood pressure and waist:hip ratio were identified as non-SDB predictive factors for CCA IMT and age, weight and total cholesterol:HDL ratio for CFA IMT. No SDB severity metric emerged as an independent predictor for either CCA or CFA IMT, except in the RFM Sub-Group, where a 2-fold increase in AHI predicted a 2.4% increase in CFA IMT. Across the intervention study, CCA IMT decreased in those who lost weight, but there was no CPAP use interaction. CFA IMT, however, decreased by 12.9% (95%CI 6.8, 18.7%, p = 0.001) in those participants who both lost weight and used CPAP > = 4hours/night. Conclusion We conclude that SDB severity has little impact on CCA IMT values when non-SDB vascular risk factors are minimised or not present. This is the first study, however, to suggest a potential linkage between SDB severity and CFA IMT values. Trial registration Australian New Zealand Clinical Trials Registry, ACTRN12611000250932 and ACTRN12620000694910.

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Vascular risk at younger ages most strongly associates with current and future brain volume

Neurology ◽

10.1212/wnl.0000000000006360 ◽

2018 ◽

Vol 91 (16) ◽

pp. e1479-e1486 ◽

Cited By ~ 14

Author(s):

Matthew P. Pase ◽

Kendra Davis-Plourde ◽

Jayandra J. Himali ◽

Claudia L. Satizabal ◽

Hugo Aparicio ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Stroke Risk ◽

Brain Volume ◽

Vascular Risk Factor ◽

Vascular Risk Factors ◽

Vascular Risk ◽

Cross Sectional ◽

Strength Of Association ◽

Risk Factor Burden

ObjectiveGiven the potential therapeutic effect of vascular disease control timing to reduce dementia risk, we investigated the age-related influences of vascular risk factor burden on brain structure throughout the lifespan.MethodsWe studied participants from the community-based prospective Framingham Heart Study. Overall vascular risk factor burden was calculated according to the Framingham Stroke Risk Profile, a validated algorithm that predicts stroke risk. Brain volume was estimated by MRI. We used cross-sectional data to examine how the strength of association between vascular risk factor burden and brain volume changed across each age decade from age 45–54 years through to 85–94 years (N = 2,887). Second, we leveraged up to 40 years of longitudinal data to determine how the strength of association between vascular risk factor burden and brain volume changed when vascular risk factors were examined at progressively earlier ages (N = 7,868).ResultsIn both cross-sectional and longitudinal analyses, higher vascular risk factor burden was associated with lower brain volume across each age decade. In the cross-sectional analysis, the strength of this association decreased with each decade of advancing age (p for trend < 0.0001). In longitudinal analysis, the strength of association between vascular risk factor burden and brain volume was stronger when vascular risk factors were measured at younger ages. For example, vascular risk factor burden was most strongly associated with lower brain volume in later life when vascular risk factors were measured at age 45 years.ConclusionVascular risk factors at younger ages appear to have detrimental effects on current and future brain volume.

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The comparison of traditional vascular risk factor between hemorrhagic and non-hemorrhagic stroke

Asian Journal of Medical Sciences ◽

10.3126/ajms.v8i6.18277 ◽

2017 ◽

Vol 8 (6) ◽

pp. 5-8

Author(s):

Rizaldy Taslim Pinzon ◽

Rosa De Lima Renita Sanyasi ◽

Andre Dharmawan Wijono

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Protective Factor ◽

Hemorrhagic Stroke ◽

Sample Size Calculation ◽

Vascular Risk Factor ◽

Vascular Risk Factors ◽

Vascular Risk ◽

Significance Level ◽

Stroke Registry

Background: Understanding about risk factors of stroke based on its pathology is very important. Previous study about the vascular risk factors in patients with stroke in Indonesia is very limited.Aims and Objective: Measure the comparison between traditional vascular risk factors in patients with hemorrhagic stroke and non-hemorrhagic (ischemic) stroke.Materials and Methods: This was a nested case-control study using secondary data from electronic medical record and electronic stroke registry of Bethesda Hospital Yogyakarta Indonesia. The stroke was diagnosed with standard way by well-trained neurologist and confirmed with CT Scan. The traditional risk factors were defined systematically. We used Dupont Power and Sample Size calculation software and StatCal EpiInfo software with significance level 0,05.Result: The data of 200 subjects consisted of 100 patients with hemorrhagic stroke and 100 patients with non-hemorrhagic stroke. Hypertension was main vascular risk factor in both Group but it was more common in hemorrhagic stroke (OR: 2,528, 95% CI: 0,069 ; 0,316, p < 0,002). Dyslipidemia was a protective factor against hemorrhagic stroke (OR: 0,147, 95% CI: 1,415 ; 4,516, p < 0,001). Diabetes was more common in ischemic stroke compared with hemorrhagic stroke (68% and 32%) respectively.Conclusion: Hypertension, dyslipidemia, and diabetes were modifiable traditional vascular risk factors which significantly had effect on stroke. Asian Journal of Medical Sciences Vol.8(6) 2017 5-8

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Subclinical Arteriosclerosis is Associated with Common Vascular Risk Factors in Long-Term Survivors of Testicular Cancer

Journal of Clinical Medicine ◽

10.3390/jcm9040971 ◽

2020 ◽

Vol 9 (4) ◽

pp. 971

Author(s):

Javier Espíldora-Hernández ◽

Tania Díaz-Antonio ◽

Javier Baena-Espinar ◽

Inmaculada Alonso-Calderón ◽

José Rioja ◽

...

Keyword(s):

Risk Factors ◽

Testicular Cancer ◽

Abdominal Aorta ◽

Liver Steatosis ◽

Calcium Score ◽

Intima Media Thickness ◽

Vascular Risk Factors ◽

Metabolic Risk ◽

Vascular Risk ◽

Media Thickness

Cardiovascular disease risk is increased in survivors of testicular cancer because of exposure to treatment (chemotherapy and radiotherapy), as well as modification in lifestyle. Our aim was to assess the presence of subclinical arteriosclerosis in survivors of testicular cancer in comparison with a control group. This was a cross-sectional, observational, case–control study including 50 survivors of Germ Cell Tumor (GCT) (14 years of follow-up) and 53 age-matched controls with no cancer. We registered clinical data, cardiovascular risk factors, physical and Mediterranean questionnaires, intima-media thickness and plaque at carotid and femoral arteries by ultrasound, calcium score at the abdominal aorta, and liver steatosis by computed tomography, and applied analytical tests to quantify metabolic risk factors and inflammation markers. Patients showed a trend toward greater intima-media thickness (IMT) and plaques than controls, as well as a higher calcium score in the abdominal aorta. Remarkably, patients had higher waist circumference, insulin resistance (HOMA-IR), and liver steatosis, but lower physical activity and high-density lipoprotein (HDL) cholesterol than controls (all p < 0.05). In multivariate analyses, only common vascular risk factors were associated with subclinical arteriosclerosis. As a conclusion, in our study, a higher rate of subclinical arteriosclerosis in testicular cancer survivors was associated with classical metabolic risk factors and lifestyle, but not with exposure to chemotherapy.

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Effect of vascular risk factors on increase in carotid and femoral intima-media thickness. Identification of a risk scale

Atherosclerosis ◽

10.1016/j.atherosclerosis.2011.01.034 ◽

2011 ◽

Vol 216 (1) ◽

pp. 109-114 ◽

Cited By ~ 30

Author(s):

A. Berni ◽

A. Giuliani ◽

F. Tartaglia ◽

L. Tromba ◽

M. Sgueglia ◽

...

Keyword(s):

Risk Factors ◽

Intima Media Thickness ◽

Vascular Risk Factors ◽

Vascular Risk ◽

Media Thickness ◽

Risk Scale

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Association of Vascular Risk Factors With Carotid Intima Media Thickness After Kidney Transplant

Transplantation Journal ◽

10.1097/tp.0b013e3181f62fe4 ◽

2010 ◽

Vol 90 (9) ◽

pp. 980-985

Author(s):

Jennifer L. Larsen ◽

Gerald C. Groggel ◽

Jillian M. Witte ◽

Terica L. Hudson ◽

Elizabeth R. Lyden ◽

...

Keyword(s):

Risk Factors ◽

Kidney Transplant ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Vascular Risk Factors ◽

Vascular Risk ◽

Media Thickness

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WITHDRAWN: Neurological examination, rather than vascular risk factor assessment, serves to distinguish strokes from stroke mimics in a population with high prevalence of vascular risk factors

World Neurosurgery ◽

10.1016/j.wneu.2020.07.075 ◽

2020 ◽

Author(s):

Jessica E. Marot ◽

Tania Rebeiz ◽

Christopher Kramer ◽

Cedric McKoy ◽

James Brorson ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Neurological Examination ◽

Vascular Risk Factor ◽

Vascular Risk Factors ◽

Vascular Risk ◽

Risk Factor Assessment ◽

Stroke Mimics ◽

High Prevalence

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The effect of vascular risk factor burden on the severity of COVID-19 illness, a retrospective cohort study

Respiratory Research ◽

10.1186/s12931-020-01510-0 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Houwei Du ◽

◽

Xiaobin Pan ◽

Nan Liu ◽

Junnian Chen ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Cox Regression ◽

Vascular Risk Factor ◽

Vascular Risk Factors ◽

Hospital Treatment ◽

Vascular Risk ◽

Laboratory Findings ◽

Increasing Risk ◽

Risk Factor Burden

Abstract Background Patients with cardiovascular comorbidities are at high risk of poor outcome from COVID-19. However, how the burden (number) of vascular risk factors influences the risk of severe COVID-19 disease remains unresolved. Our aim was to investigate the association of severe COVID-19 illness with vascular risk factor burden. Methods We included 164 (61.8 ± 13.6 years) patients with COVID-19 in this retrospective study. We compared the difference in clinical characteristics, laboratory findings and chest computed tomography (CT) findings between patients with severe and non-severe COVID-19 illness. We evaluated the association between the number of vascular risk factors and the development of severe COVID-19 disease, using a Cox regression model. Results Sixteen (9.8%) patients had no vascular risk factors; 38 (23.2%) had 1; 58 (35.4%) had 2; 34 (20.7%) had 3; and 18 (10.9%) had ≥4 risk factors. Twenty-nine patients (17.7%) experienced severe COVID-19 disease with a median (14 [7–27] days) duration between onset to developing severe COVID-19 disease, an event rate of 4.47 per 1000-patient days (95%CI 3.10–6.43). Kaplan-Meier curves showed a gradual increase in the risk of severe COVID-19 illness (log-rank P < 0.001) stratified by the number of vascular risk factors. After adjustment for age, sex, and comorbidities as potential confounders, vascular risk factor burden remained associated with an increasing risk of severe COVID-19 illness. Conclusions Patients with increasing vascular risk factor burden have an increasing risk of severe COVID-19 disease, and this population might benefit from specific COVID-19 prevention (e.g., self-isolation) and early hospital treatment measures.

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Vascular risk burden is a key player in the early progression of Alzheimer's disease

10.1101/2021.12.18.21267994 ◽

2021 ◽

Author(s):

João Pedro Ferrari-Souza ◽

Wagner S. Brum ◽

Lucas A. Hauschild ◽

Lucas U. Da Ros ◽

Pâmela C. L. Ferreira ◽

...

Keyword(s):

Risk Factors ◽

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Risk Factor ◽

Cognitive Decline ◽

Vascular Risk Factor ◽

Vascular Risk Factors ◽

Vascular Risk ◽

Preclinical Alzheimer’S Disease ◽

Risk Factor Burden

Understanding whether vascular risk factors synergistically potentiate Alzheimer's disease progression is important in the context of emerging treatments for preclinical Alzheimer's disease. The existence of a synergistic relationship could suggest that the combination of therapies targeting Alzheimer's disease pathophysiology and vascular risk factors might potentiate treatment outcomes. In the present retrospective cohort study, we tested whether vascular risk factor burden interacts with Alzheimer's disease pathophysiology to accelerate neurodegeneration and cognitive decline in cognitively unimpaired subjects. We evaluated 503 cognitively unimpaired participants from the Alzheimer's Disease Neuroimaging Initiative (ADNI) study. Baseline vascular risk factor burden was calculated considering the history of cardiovascular disease, hypertension, diabetes mellitus, hyperlipidemia, stroke or transient ischemic attack, smoking, atrial fibrillation, and left ventricular hypertrophy. Alzheimer's disease pathophysiology was evaluated using cerebrospinal fluid (CSF) amyloid-β1-42 (Aβ1-42) reflecting brain amyloidosis (A) and tau phosphorylated at threonine 181 (p-tau181) reflecting brain tau pathology (T). Individuals were dichotomized as having an elevated vascular risk factor burden (V+ if having two or more vascular risk factors) and as presenting preclinical Alzheimer's disease [(AT)+ if having abnormal CSF p-tau181 and Aβ1-42 levels]. Neurodegeneration was assessed with plasma neurofilament light (NfL) and global cognition with the modified version of the Preclinical Alzheimer's Cognitive Composite. Linear mixed-effects models revealed that an elevated vascular risk factor burden synergistically interacted with Alzheimer's disease pathophysiology to drive longitudinal increases in plasma NfL levels (β = 5.08, P = 0.016) and cognitive decline (β = -0.43, P = 0.020). Additionally, we observed that vascular risk factor burden was not associated with CSF Aβ1-42 or p-tau181 changes over time. Survival analysis demonstrated that individuals with preclinical Alzheimer's disease and elevated vascular risk factor burden [(AT)+V+] had a significantly greater risk of clinical progression to cognitive impairment (adjusted Hazard Ratio = 3.5, P < 0.001). Our results support the notion that vascular risk factor burden and Alzheimer's disease pathophysiology are independent processes; however, they synergistically lead to neurodegeneration and cognitive decline. These findings can help in providing the blueprints for the combination of vascular risk factor management and Alzheimer's disease pathophysiology treatment in preclinical stages. Moreover, we observed plasma NfL as a robust marker of disease progression that may be used to track therapeutic response in future trials.

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The Age-Dependent Association Between Vascular Risk Factors and Depressed Mood

10.31219/osf.io/u2j8h ◽

2019 ◽

Author(s):

Maria Blöchl ◽

H. Lina Schaare ◽

Ute Kunzmann ◽

Steffen Nestler

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Depressed Mood ◽

Growth Models ◽

Later Life ◽

Vascular Risk Factor ◽

Vascular Risk Factors ◽

Vascular Risk ◽

Latent Growth ◽

Risk Factor Burden

Objectives: Cumulative burden from multiple vascular risk factors has been linked to depressed mood but whether this association becomes stronger or weaker from mid- to later life is still unclear. This study investigated whether vascular risk factor burden is associated with levels and longitudinal changes in depressed mood and whether these associations are dependent on age. Method: Our sample included 6,835 individuals (52–89 years) from the English Longitudinal Study of Ageing (ELSA), who were free of vascular disease at baseline and underwent up to five bi-yearly follow-up assessments of depressed mood. A composite score incorporated the presence of five vascular risk factors: hypertension, diabetes, smoking, obesity, and hypercholesterolemia. We used second-order latent growth models to test whether levels and changes of depressed mood differed as a function of baseline vascular risk factor burden, and how these associations were moderated by age. Results: Baseline vascular risk factor burden was associated with higher levels of depressed mood, and this association varied with age, such that it was stronger in midlife compared to later life. Vascular risk factor burden was not associated with changes in depressed mood. Discussion: Our findings suggest that vascular risk factor burden in midlife, but less so in later life, predicts individual differences in depressed mood. These findings are consistent with reports on the importance of midlife vascular risk and support the idea that prevention of vascular risk in this age period may be critical to maintain mental health.

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