scholarly journals Novel Cardiovascular Biomarkers Associated with Increased Cardiovascular Risk in Women With Prior Preeclampsia/HELLP Syndrome: A Narrative Review

2021 ◽  
Vol 16 ◽  
Author(s):  
Esmee ME Bovee ◽  
Martha Gulati ◽  
Angela HEM Maas
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Hellp Syndrome ◽  
Troponin I ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Narrative Review ◽  
Elevated Liver Enzymes ◽  
Increased Risk ◽  
Cardiovascular Biomarkers

Evidence has shown that women with a history of preeclampsia or haemolysis, elevated liver enzymes and low platelets (HELLP) syndrome have an increased risk of cardiovascular disease later in life. Recommendations for screening, prevention and management after such pregnancies are not yet defined. The identification of promising non-traditional cardiovascular biomarkers might be useful to predict which women are at greatest risk. Many studies are inconsistent and an overview of the most promising biomarkers is currently lacking. This narrative review provides an update of the current literature on circulating cardiovascular biomarkers that may be associated with an increased cardiovascular disease risk in women after previous preeclampsia/HELLP syndrome. Fifty-six studies on 53 biomarkers were included. From the summary of evidence, soluble fms-like tyrosine kinase-1, placental growth factor, interleukin (IL)-6, IL-6/IL-10 ratio, high-sensitivity cardiac troponin I, activin A, soluble human leukocyte antigen G, pregnancy-associated plasma protein A and norepinephrine show potential and are interesting candidate biomarkers to further explore. These biomarkers might be potentially eligible for cardiovascular risk stratification after preeclampsia/HELLP syndrome and may contribute to the development of adequate strategies for prevention of hypertension and adverse events in this population.

scholarly journals Factor VIII, Protein C and Cardiovascular Disease Risk: The REasons for Geographic and Racial Differences in Stroke Study (REGARDS)

2018 ◽  
Vol 118 (07) ◽  
pp. 1305-1315 ◽  
Author(s):  
Neil Zakai ◽  
Suzanne Judd ◽  
Brett Kissela ◽  
George Howard ◽  
Monika Safford ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Factor Viii ◽  
Racial Differences ◽  
Protein C ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Cox Models ◽  
Chd Risk ◽  
Increased Risk

Background Haemostatic balance represented by low protein C (PC) and elevated factor VIII (FVIII) has been inconsistently associated with stroke and coronary heart disease (CHD) risk. Objective This article assesses whether an elevated FVIII and a low PC would increase cardiovascular risk more than either individually. Patients and Methods REGARDS recruited 30,239 black and white U.S. participants aged ≥ 45 years between 2003 and 2007. FVIII and PC were measured in a case–cohort sample of 646 stroke, 654 CHD, and a 1,104-person random sample with follow-up for approximately 4.5 years. Hazard ratios (HRs) were estimated using Cox models adjusted for demographic and cardiovascular risk factors. Results Elevated FVIII (per standard deviation [SD] increase) was associated with increased risk of both stroke (HR, 1.26; 95% confidence interval [CI], 1.08, 1.46) and CHD (HR, 1.52; 95% CI, 1.29, 1.79), while there was no association of PC per SD decrease. For PC, there was a trend towards increased cardiovascular disease risk in the lowest values (bottom 5%). For stroke, there was no interaction between FVIII and low PC (p interaction = 0.55). For CHD, the adjusted HR of FVIII per SD increase was significantly greater with PC in the bottom 5% (HR, 3.59; 95% CI, 1.39, 8.29) than PC in the upper 95% (HR, 1.45; 95% CI, 1.23, 1.71; p interaction = 0.07). Conclusion Higher FVIII was associated with both CHD and stroke risk and the risk potentiated by low PC for CHD. Findings demonstrate that risks for cardiovascular diseases conferred by adverse levels of haemostasis biomarkers may be augmented by levels of other biomarkers.

Hypertensive disorders of pregnancy and later cardiovascular disease risk in mothers and children

2020 ◽  
pp. 1-6
Author(s):  
Michelle D. Plummer ◽  
Prabha H. Andraweera ◽  
Amy Garrett ◽  
Shalem Leemaqz ◽  
Melanie Wittwer ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Microvascular Function ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Nulliparous Women ◽  
Increased Risk ◽  
Female Children

Abstract Preeclampsia (PE) and gestational hypertension (GH) are pregnancy-specific diseases that occur in around 10% of pregnancies worldwide. Increasing evidence suggests that women whose pregnancies were complicated by PE or GH, and their offspring, are at increased risk of cardiovascular disease (CVD) later in life. We hypothesised that PE and GH would associate with CVD risk factors 8–10 years after the first pregnancy in the mother and child and that differences in cardiovascular risk profile would be seen between 8- and 10-year-old male and female children. This is a follow-up study of the Adelaide SCOPE pregnancy cohort where 1164 nulliparous women and their babies were recruited between 2005 and 2008. Haemodynamic function was assessed using non-invasive USCOMBP+ and USCOM1A devices. Microvascular function was assessed by post-occlusive reactive hyperaemia. Of the 273 mother–child pairs followed up, 38 women had PE and 20 had GH during pregnancy. Augmentation index (Aix) and suprasystolic pulse pressure (ssPP) were increased, whereas measures of microvascular function were decreased in children who were born to PE compared to uncomplicated pregnancies. Female children had decreased Aix and ssPP compared to male children after in utero exposure to PE. Women who developed GH during their first pregnancy had increased systolic, diastolic and mean arterial pressures compared to women who had uncomplicated pregnancy. Our data suggest that GH is associated with increased cardiovascular risk in women 8–10 years after first pregnancy and PE is associated with increased offspring risk at 8–10 years of age, highlighting differences between these two hypertensive disorders of pregnancy.

scholarly journals Rationales and uncertainties for aspirin use in COVID-19: a narrative review

2021 ◽  
Vol 9 (2) ◽  
pp. e000741
Author(s):  
Hazem A Sayed Ahmed ◽  
Eric Merrell ◽  
Mansoura Ismail ◽  
Anwar I Joudeh ◽  
Jeffrey B Riley ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Low Dose ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Narrative Review ◽  
Cochrane Library ◽  
Atherosclerotic Cardiovascular Disease ◽  
Dose Aspirin ◽  
Hospitalised Patients ◽  
Low Dose Aspirin

ObjectivesTo review the pathophysiology of COVID-19 disease, potential aspirin targets on this pathogenesis and the potential role of aspirin in patients with COVID-19.DesignNarrative review.SettingThe online databases PubMed, OVID Medline and Cochrane Library were searched using relevant headlines from 1 January 2016 to 1 January 2021. International guidelines from relevant societies, journals and forums were also assessed for relevance.ParticipantsNot applicable.ResultsA review of the selected literature revealed that clinical deterioration in COVID-19 is attributed to the interplay between endothelial dysfunction, coagulopathy and dysregulated inflammation. Aspirin has anti-inflammatory effects, antiplatelet aggregation, anticoagulant properties as well as pleiotropic effects on endothelial function. During the COVID-19 pandemic, low-dose aspirin is used effectively in secondary prevention of atherosclerotic cardiovascular disease, prevention of venous thromboembolism after total hip or knee replacement, prevention of pre-eclampsia and postdischarge treatment for multisystem inflammatory syndrome in children. Prehospital low-dose aspirin therapy may reduce the risk of intensive care unit admission and mechanical ventilation in hospitalised patients with COVID-19, whereas aspirin association with mortality is still debatable.ConclusionThe authors recommend a low-dose aspirin regimen for primary prevention of arterial thromboembolism in patients aged 40–70 years who are at high atherosclerotic cardiovascular disease risk, or an intermediate risk with a risk-enhancer and have a low risk of bleeding. Aspirin’s protective roles in COVID-19 associated with acute lung injury, vascular thrombosis without previous cardiovascular disease and mortality need further randomised controlled trials to establish causal conclusions.

scholarly journals Cardiovascular Disease Risk Factors: How Relevant in African Men With Prostate Cancer Receiving Androgen-Deprivation Therapy?

2017 ◽  
Vol 3 (1) ◽  
pp. 7-14
Author(s):  
Okon Ekwere Essien ◽  
Iya Eze Bassey ◽  
Rebecca Mtaku Gali ◽  
Alphonsus Ekpe Udoh ◽  
Uwem Okon Akpan ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Waist Circumference ◽  
Total Cholesterol ◽  
Ldl Cholesterol ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Treatment Naïve

Purpose Cardiovascular disease risk factors have been associated with androgen-deprivation therapy (ADT) in white and Hispanic populations. It is therefore relevant to determine if there exists a relationship between these parameters in the African population. Patients and Methods The design of the study was cross sectional. Prostate-specific antigen concentration, waist circumference, body mass index (BMI), lipid profile, glucose level, and insulin level were determined in 153 patients with prostate cancer and 80 controls. The patients with prostate cancer were divided into subgroups of treatment-naïve patients and those receiving ADT. Results Mean total cholesterol ( P = .010), LDL cholesterol ( P = .021), BMI ( P = .001), and waist circumference ( P = .029) values were significantly higher in patients treated with ADT when compared with treatment-naïve patients. In patients treated with ADT for up to 1 year, only mean BMI was significantly higher than in treatment-naïve patients, whereas those treated with ADT for more than 1 year had significantly higher mean BMI, waist circumference, total cholesterol, and LDL cholesterol values when compared with treatment-naïve patients. There were no significant differences in insulin or glucose levels. Those undergoing hormone manipulation after orchiectomy had fewer cardiovascular risk factors compared with those undergoing hormone manipulation alone. Conclusion This study shows that ADT results in elevated total cholesterol, LDL cholesterol, BMI, and waist circumference values, all of which are risk factors of cardiovascular disease. Screening for cardiovascular risk factors should be included in treatment plans for patients with prostate cancer.

Abstract P375: Vascular Age Versus Calendar Age as Surrogate for Atherosclerotic Burden and Cardiovascular Disease Risk

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Sanne A Peters ◽  
Karlijn A Groenewegen ◽  
Hester M den Ruijter ◽  
Michiel L Bots
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Disease Risk ◽  
Meta Analysis ◽  
Cardiovascular Disease Risk ◽  
Intima Media Thickness ◽  
Chronological Age ◽  
Specific Reference ◽  
Communication Tool ◽  
Vascular Age

Background Vascular age is the chronological age of an individual adjusted by their level of atherosclerosis. Vascular age can be used as understandable communication tool towards patients. It has been proposed that carotid intima-media thickness (CIMT) could be used to estimate the vascular age in individuals. The issue on how to best estimate vascular age remains an unanswered question and was evaluated in this study. Methods Data were used from the USE-IMT study collaboration, a global individual patient data meta-analysis including 14 population-based cohorts contributing data for 45 828 individuals. We used two methods to define vascular age. First, vascular age was the age at which a participant’s CIMT value would be at the 50th percentile of the age-and sex specific reference values of the healthy USE-IMT subpopulation (VA50). Second, vascular age was the age at which the estimated cardiovascular risk equals the risk of the observed CIMT value (VArisk). Results Mean (+/- standard deviation [SD]) chronological age, VA50, and VArisk were 58 (9), 63 (19), and 59 (7) years, respectively. VArisk was 0.24 yrs higher in women and 1.5 yrs higher in men than chronological age whereas VA50 was 4.4 yrs higher in women and 5.8 yrs higher in men than chronological age. After adjustment for traditional cardiovascular risk factors, a SD increase in VA50 and VArisk was associated with a 15% (95% confidence interval [CI]: 1.12; 1.19) and 22% (95% CI: 1.17; 1.28) higher risk of cardiovascular disease. For comparison, a SD increase in mean common CIMT increased the risk of cardiovascular disease with 15% (95% CI: 1.12; 1.19). Conclusion We presented two distinct measures a vascular age: VA50, and VArisk. VA50 is a straightforward translation of CIMT and is a measure of the age at which the average person would be expected to have a certain CIMT. In contrast, VArisk incorporates information about expected cardiovascular risk and is the chronological age of a person that conveys the same risk as the CIMT. VA50 and VArisk might provide a convenient transformation of CIMT to a scale that is more easily understood by patients and clinicians.

Thirty-year cardiovascular risk score in patients with newly diagnosed bipolar disorder and their unaffected first-degree relatives

2018 ◽  
Vol 53 (7) ◽  
pp. 651-662 ◽  
Author(s):  
Klara Coello ◽  
Hanne L Kjærstad ◽  
Sharleny Stanislaus ◽  
Sigurd Melbye ◽  
Maria Faurholt-Jepsen ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Bipolar Disorder ◽  
Cardiovascular Risk ◽  
Risk Score ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Newly Diagnosed ◽  
Healthy Individuals ◽  
First Degree Relatives ◽  
Age And Sex

Objectives: Bipolar disorder is associated with a decreased life expectancy of 8–12 years. Cardiovascular disease is the leading cause of excess mortality. For the first time, we investigated the Framingham 30-year risk score of cardiovascular disease in patients with newly diagnosed/first-episode bipolar disorder, their unaffected first-degree relatives and healthy individuals. Methods: In a cross-sectional study, we compared the Framingham 30-year risk score of cardiovascular disease in 221 patients with newly diagnosed/first-episode bipolar disorder, 50 of their unaffected first-degree relatives and 119 healthy age- and sex-matched individuals with no personal or first-degree family history of affective disorder. Among patients with bipolar disorder, we further investigated medication- and illness-related variables associated with cardiovascular risk. Results: The 30-year risk of cardiovascular disease was 98.5% higher in patients with bipolar disorder ( p = 0.017) and 85.4% higher in unaffected first-degree relatives ( p = 0.042) compared with healthy individuals in models adjusted for age and sex. When categorizing participants in low cardiovascular risk without considering age and sex distribution among participants, 81% of patients were at low risk, versus 92% of unaffected relatives and 89% of healthy individuals. Of the patients 209 (94.6%) were diagnosed within the preceding 2 years. Smoking was more prevalent among patients with bipolar disorder (45.2%) and their unaffected first-degree relatives (20.4%) compared with healthy individuals (12.8%). Similarly, dyslipidemia was more common among patients with bipolar disorder compared with healthy individuals. Treatment with psychotropic medication with metabolic adverse effects was associated with higher 30-year cardiovascular disease risk score, whereas we did not find illness-related variables associated with cardiovascular risk among patients with bipolar disorder. Conclusion: We found an enhanced cardiovascular disease risk score in patients with newly diagnosed bipolar disorder and their unaffected first-degree relatives, which points to a need for specific primary preventive interventions against smoking and dyslipidemia in these populations.

scholarly journals Habitual physical activity is not associated with lower cardiovascular risk profile or higher aerobic fitness

2020 ◽  
pp. 1-6
Author(s):  
Denis Fabrício Valério ◽  
Arthur Fernandes Gáspari ◽  
Giovana Vergínea de Souza ◽  
Cleiton Augusto Libardi ◽  
Claudia Regina Cavaglieri ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Aerobic Fitness ◽  
Physical Inactivity ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Risk Profile ◽  
Cardiovascular Risk Profile ◽  
Vo2 Max

Introduction: Physical inactivity is considered as one of the factors to increase the risk of developing cardiovascular diseases (CVDs) and decrease aerobic fitness mainly in middle-age. Increased habitual physical activity (HPA) is one of the strategies recommended to reduce physical inactivity. However, it is not known whether middle-age individuals who exclusively perform greater amount of HPA have greater aerobic fitness and / or a lower risk of CVDs. Objective: Verify the association between HPA with the risk of CVDs and aerobic fitness in individuals who only perform HPA. Method: We selected 89 male volunteers, age: 47.4 ± 5.06 years, who did not practice systemized physical training. Our measurements were: HPA by the International Physical Activity Questionnaire and Baecke questionnaires, the aerobic fitness by direct assessment of maximal oxygen consumption (VO2 máx) and the risk of developing cardiovascular disease by the score calculation of General Cardiovascular Risk Profile from Framingham Study. Results: There was no correlation of the HPA level with cardiovascular risk factors, general cardiovascular disease risk and VO2 máx. Moreover, no difference was found between the categorical groups of the IPAQ questionnaire and between the groups, “clusters”, calculated from the Baecke questionnaire scores for the variables of cardiovascular risk, general cardiovascular disease risk and VO2 máx. Conclusion: This study have found that the HPA level of middle-aged men is not associated with lower cardiovascular risk profile or higher aerobic fitness, suggesting that only increase HPA may not be enough to promote beneficial adaptations in aerobic fitness and improve risk profile for CVDs. These results may be related to low volume and intensity of HPA, which reinforces the importance of performing physical training with control of these variables for health promotion.

scholarly journals Plasma Dehydroepiandrosterone Sulfate and Cardiovascular Disease Risk in Older Men and Women

2020 ◽  
Vol 105 (12) ◽  
pp. e4304-e4327 ◽  
Author(s):  
Xiaoming Jia ◽  
Caroline Sun ◽  
Olive Tang ◽  
Ivan Gorlov ◽  
Vijay Nambi ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Dehydroepiandrosterone Sulfate ◽  
Mortality Data ◽  
Atherosclerosis Risk In Communities ◽  
Percentage Decrease ◽  
Increased Risk ◽  
Study Population

Abstract Context Lower dehydroepiandrosterone-sulfate (DHEA-S) levels have been inconsistently associated with coronary heart disease (CHD) and mortality. Data are limited for heart failure (HF) and association between DHEA-S change and events. Objective Assess associations between low DHEA-S/DHEA-S change and incident HF hospitalization, CHD, and mortality in older adults. Design DHEA-S was measured in stored plasma from visits 4 (1996-1998) and 5 (2011-2013) of the Atherosclerosis Risk in Communities study. Follow-up for incident events: 18 years for DHEA-S level; 5.5 years for DHEA-S change. Setting General community. Participants Individuals without prevalent cardiovascular disease (n = 8143, mean age 63 years). Main Outcome Measure Associations between DHEA-S and incident HF hospitalization, CHD, or mortality; associations between 15-year change in DHEA-S (n = 3706) and cardiovascular events. Results DHEA-S below the 15th sex-specific percentile of the study population (men: 55.4 µg/dL; women: 27.4 µg/dL) was associated with increased HF hospitalization (men: hazard ratio [HR] 1.30, 95% confidence interval [CI], 1.07-1.58; women: HR 1.42, 95% CI, 1.13-1.79); DHEA-S below the 25th sex-specific percentile (men: 70.0 µg/dL; women: 37.1 µg/dL) was associated with increased death (men: HR 1.12, 95% CI, 1.01-1.25; women: HR 1.19, 95% CI, 1.03-1.37). In men, but not women, greater percentage decrease in DHEA-S was associated with increased HF hospitalization (HR 1.94, 95% CI, 1.11-3.39). Low DHEA-S and change in DHEA-S were not associated with incident CHD. Conclusions Low DHEA-S is associated with increased risk for HF and mortality but not CHD. Further investigation is warranted to evaluate mechanisms underlying these associations.

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