scholarly journals Hypertension in Women: Should There be a Sex-specific Threshold?

2021 ◽  
Vol 16 ◽  
Author(s):  
Eva Gerdts ◽  
Giovanni de Simone
Keyword(s):  
Young Women ◽  
Acute Coronary Syndromes ◽  
Organ Damage ◽  
Attributable Risk ◽  
Cvd Risk ◽  
The Third ◽  
Risk Detection ◽  
Coronary Syndromes ◽  
Cvd Prevention ◽  
Definition Of

Conventionally, hypertension is defined by the same blood pressure (BP) threshold (systolic BP ≥140 and/or diastolic BP ≥90 mmHg) in both women and men. Several studies have documented that women with hypertension are more prone to develop BP-associated organ damage and that high BP is a stronger risk factor for cardiovascular disease (CVD) in women than men. While healthy young women have lower BP than men, a steeper increase in BP is found in women from the third decade of life. Studies have documented that the BP-attributable risk for acute coronary syndromes (ACS), heart failure and AF increases at a lower level of BP in women than in men. Even high normal BP (130–139/80–89 mmHg) is associated with an up to twofold higher risk of ACS during midlife in women, but not in men. Whether sex-specific thresholds for definition of hypertension would improve CVD risk detection should be considered in future guidelines for hypertension management and CVD prevention.

Abstract P104: Trends in Population Attributable Fractions of Major Risk Factors for Cardiovascular Disease in Japan, 1975 to 2014: The Circulatory Risk in Communities Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Midori Takada ◽  
Yasuhiko Kubota ◽  
Kazuhide Tezuka ◽  
Mitsumasa Umesawa ◽  
Yuji Shimizu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Risk Factor ◽  
Attributable Risk ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
The Third ◽  
The Past ◽  
Cvd Prevention ◽  
Over Time

Introduction: Over the past several decades, Asian countries including Japan have experienced westernization of their lifestyles, leading to changes in prevalence of major risk factors for cardiovascular disease (CVD). The estimation of changed in trends of population attributable fraction (PAF) of major CVD risk factors would be useful for planning of CVD prevention strategies. Hypothesis: We assessed the hypothesis that PAFs of major CVD risk factors have changed among a Japanese population over the past several decades. Methods: We conducted four 10-year cohorts from 1975 to 2014: the baseline of the first cohort as 1975-1977 (n=4,415), that of the second as 1985-1986 (n=7,155), that of the third as 1995-1997 (n=6,892), and that of the fourth as 2005-2007 (n=5,067), consisting of Japanese men and women aged 40-79 years, initially free of CVD, and with valid information on major CVD risk factors (hypertension, diabetes mellitus, hypercholesterolemia, obesity, smoking, alcohol drinking, and atrial fibrilization). Hazard ratios (HRs) and 95 % confidence intervals (95 % CIs) of CVD (incident stroke and ischemic heart disease) risk factors were calculated by Cox proportional hazard model and their PAFs (95 %CIs) were estimated. Results: During the median follow-up of 8.1 years, we documented 227 incident CVDs in the first, 251 in the second, 223 in the third, and 132 in the fourth cohort. The age-adjusted incidence rates per 1,000 person-years of CVD decreased over time; 6.4 in the first, 4.3 in the second, 3.4 in the third, 2.3 in the fourth cohort. Through the four cohorts, hypertension was the leading attributable risk factor for CVD, but its contributions decreased from the first to the fourth cohorts: PAF (95% CI)= 51 (33-64)% in the first; 42 (29-53)% in the second; 47 (32-58)% in the third; and 27 (4-45)% in the fourth cohorts. In contrast, the contributions of diabetes mellitus increased between the third and the fourth cohorts and then diabetes mellitus was promoted to the second leading risk factor: PAF (95% CI)= 1 (-4-6)% in the first; 3 (-1-8)% in the second; 3 (-1-7)% in the third; and 17 (8-25)% in the fourth cohorts. The contributions of hypercholesterolemia and other risk factors were small and did not change over time materially. Similar trends were observed for stroke and coronary heart disease. Conclusions: The contribution of hypertension for CVD risk decreased, while that of diabetes mellitus increased among Japanese over the past 40 years. Taken together with the steep decrease in stroke incidence, decrease in hypertension has contributed to reducing PAF of hypertension, and also resulted in increase in PAF of diabetes. Although hypertension is still the leading attributable risk factor for CVD, diabetes could be another target of CVD prevention strategy among Japanese.

scholarly journals Strategy of IFCC standardization and use of cardiac markers in acute coronary syndromes

2003 ◽  
Vol 22 (4) ◽  
pp. 303-309 ◽  
Author(s):  
Svetlana Ignjatovic
Keyword(s):  
Cardiac Troponin ◽  
Acute Coronary Syndromes ◽  
Clinical Chemistry ◽  
Clinical Event ◽  
Control Group ◽  
Clinical Use ◽  
Cardiac Damage ◽  
Creatine Kinase Mb ◽  
Coronary Syndromes ◽  
Definition Of

Although the use of troponin to diagnose acute myocardial infarction (AMI) has been previously proposed, the Committee on Standardization of Markers of Cardiac Damage (C-SMCD) of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) made a recommendation in 1999 to expand on the enzyme diagnostic criteria for AMI to include cardiac-specific proteins. In September 2000, a joint committee of the European Society of Cardiology and the American College of Cardiology (ESC/ACC) published a new definition of AMI that for first time officially included troponin. According to these criteria, as the best biochemical indicator for detecting myocardial necrosis is "a concentration of cardiac troponin exceeding the decision limit (defined as the 99th percentile of a reference control group) on at least one occasion during the first 24 hours after the onset of clinical event". The use of creatine kinase MB (CK-MB), measured by mass assays, is still considered as an acceptable alternative only if cardiac troponin assays are not available. It is very important to standardize the clinical use of troponin in diagnosis and management of acute coronary syndromes and to clearly define decision thresholds. Two strategies have competed as the most appropriate for the use of new markers. The first relies on the use of a combination of two markers - a rapid rising marker such as myoglobin, and a marker that takes longer to rise but is more specific, such as cardiac troponin - to enable detection of AMI in patients who present early and late after symptom onset. In the second strategy, only measurement of cardiac troponin is suggested. One of the most important problems in the practical use of the cardiac-specific troponin is the right definition of decision limits. As diagnostic cut-off for clinical use, the IFCC C-SMCD recommends for troponin assays a total imprecision, expressed as coefficient of variation (CV), of <10% at the 99th percentile of a reference control group. For troponin assays that cannot presently meet the 10% CV at the 99th percentile value, a predetermined higher concentration that meets this imprecision goal should be used as cut-off for AMI until the goal of a 10% CV can be achieved at the 99th percentile. It is very important that clinically relevant biomarker, such as cardiac troponin, on which critical decisions will rest, can be measured with highly reliable and standardized methods. There are problems in assay standardization, imprecision interference, and of pre-analytical variability. Cardiac troponin is currently the most sensitive and specific biochemical marker of myocardial damage and is the best marker for diagnosis, risk stratification, and guidance of therapy in acute coronary syndromes.

scholarly journals Regression models of individual cephalometric indicators used in the method of R. M. Ricketts

2018 ◽  
pp. 56-62
Author(s):  
A. V. Chernysh
Keyword(s):  
Young Women ◽  
Regression Models ◽  
Young Men ◽  
The Third ◽  
Normal Occlusion ◽  
Gender And Age ◽  
Definition Of ◽  
Base Of The Skull ◽  
Medical University ◽  
Cephalometric Measurements

It is proved that in the analysis of lateral teleroentgenograms according to different methods distances and angles have their normative indices which differ for persons of different ethnic, gender and age belongings. Therefore, for a full use in the orthodontics R.M. Ricketts method, similar studies are needed in Ukraine. The purpose of the work – in young men and women  with normal occlusion close to the orthognathic bite and harmonious face construct and analyze the regression models of teleroentgenographic indicators used in the method of R. M. Ricketts. Primary lateral teleroentgenograms of 38 young men (aged 17-21 years) and 55 young women (aged from 16 to 20 years) with normal occlusion close to orthognathic bite and harmonic face, obtained from the Veraviewepocs 3D device, Morita (Japan), taken from the bank data of research center of National Pirogov Memorial Medical University, Vinnytsya. Cephalometric measurements were performed according to the recommendations of R. M. Ricketts. All indicators were divided into three groups: 1 - metric characteristics of the skull, which usually do not change during surgical and orthodontic treatment; 2 – tooth-jaw indicators, the definition of which most often guided by performing orthodontic manipulations of patients in children and adolescents, as well as those with already formed bone skeleton when orthodontic surgery can change the width, length, angles and position of the bones of the upper and lower jaws; 3 - indicators that characterize the position of each individual tooth relative to each other, to the bony cranial structures and face profile. The regression models of individual teleroentgenographic indicators used in the R.M. Ricketts methodology are constructed using the “Statistica 6.0” licensing package. Constructed all 2 reliable models of the indicators included in the second group (distance Go-CF and Xi-Pm), depending on the indicators of the first group (in young men R2 = 0.884 and 0.928, and in young women - 0.735 and 0.719); as well as in young men, 7 out of 8 possible reliable models (R2 = from 0.568 to 0.887) of the indicators included in the third group (the magnitude of the distances 6u-6l, Overjet, Overbite, 6u-PTV, 1l-APog, 1u-APog and Xi-OcP ) depending on the indicators of the first and second groups; and only 5 models for young women (6u-PTV, 1l-APog, 1u-APog and Xi-OcP distances, and the magnitude of the Max1-APog angle). In the analysis of entering into the regression models of the relevant predictors, it was found that in young men, among the teleroentgenographic indicators of the first group included in the two models of the second group, is the distance P-PTV, and in young women the front length of the base of the skull N-CC and the back of the skull base Ar- Pt It was also found that among young men among the teleroentgenographic indicators of the first and second groups, which were included in the models of the third group, the most frequent is the value of the distance B-Pog (11.1%); while in young women - distance B-Pog (15.6%) and an angle DC-Xi-PM (9.4%).

Terminology of acute coronary syndromes and definition of myocardial infarction

2011 ◽  
pp. 19-24
Author(s):  
Joseph S. Alpert ◽  
Kristian Thygesen ◽  
Allan S. Jaffe ◽  
Harvey D. White
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndromes ◽  
Coronary Syndromes ◽  
Definition Of

Risk factors predisposing to acute coronary syndromes in young women ≤45 years of age

2018 ◽  
Vol 264 ◽  
pp. 165-169 ◽  
Author(s):  
Maciej Bęćkowski ◽  
Marek Gierlotka ◽  
Mariusz Gąsior ◽  
Lech Poloński ◽  
Tomasz Zdrojewski ◽  
...  
Keyword(s):  
Risk Factors ◽  
Young Women ◽  
Acute Coronary Syndromes ◽  
Coronary Syndromes
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