scholarly journals Association of hemodynamic parameters and cardiovascular risk factors with cardiac remodeling in young patients with prehypertension and hypertension

2020 ◽  
Vol 25 (6) ◽  
pp. 3797
Author(s):  
O. N. Antropova ◽  
S. B. Silkina ◽  
I. G. Polyakova ◽  
T. V. Perevozchikova
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Uric Acid ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Wall Thickness ◽  
Young Patients ◽  
Left Ventricular ◽  
Hemodynamic Parameters ◽  
Group 1

Aim. To assess the prevalence of left ventricular (LV) remodeling and identify its association with hemodynamic parameters and cardiovascular risk factors in young patients with prehypertension (preHTN) and hypertension (HTN).Material and methods. Group 1 (n=47) included patients with preHTN, group 2 (n=65) — patients with untreated HTN (age — 25-44 years). We performed 24-hour ambulatory blood pressure (BP) monitoring using a BpLAB monitor (OOO Petr Telegin). Echocardiography was carried out using a EnVisorC ultrasound system (Philips, Netherlands). Statistical analysis was performed using the software package Microsoft Excel 2010.Results. We revealed that 2,4% and 17,0% (p=0,002) of patients with preHTN and HTN had LV concentric remodeling, respectively; LV hypertrophy was recorded in 9,5% and 12,0% of patients, respectively. In group 1, a moderate positive relationship was found between the ratio of early to late peak velocities (E/A) and the average 24-hour aortic BP (r=0,66, p<0,05) was revealed. We also identified correlation of the augmentation index with the LV mass index (LVMI) (r=0,57, p<0,05) and LV relative wall thickness (RWT) (r=-0,7, p<0,05). In hypertensive patients, a correlation of LVMI and left atrial dimensions with a decrease in peripheral systolic blood pressure (SBP) and diastolic blood pressure (DBP) at night was found. A correlation of average 24-hour aortic BP and E/A (r=0,58, p<0,05), LV posterior wall thickness (r=0,53, p<0,05) and LV end-diastolic volume (r=0,45, p<0,05) was also revealed. A direct effect of BMI, waist circumference, uric acid values on echocardiographic data in patients with preHTN and HTN was detected.Conclusion. Despite the age, young patients with preHTN and HTN can have LV concentric remodeling and hypertrophy. LV geometry is correlated with obesity and uric acid values; in preHTN patients — with vascular stiffness and 24-hour aortic BP, in HTN patients — with 24-hour central and peripheral BP.

Investigation of the prevalence of cardiovascular risk factors in obese patients diagnosed with metabolic syndrome in childhood and examination of left ventricular function by echocardiography

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Güzin Özden ◽  
Ayşe Esin Kibar Gül ◽  
Eda Mengen ◽  
Ahmet Ucaktürk ◽  
Hazım Alper Gürsu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Left Ventricular ◽  
Atherogenic Index ◽  
Volume Index ◽  
Common Component

Abstract Objectives The objective of this study is to investigate the cardiovascular risk factors associated with metabolic syndrome (MetS), which is increasingly becoming prevalent in childhood obesity. Methods A total of 113 patients, 76 of whom were between the ages of 10 and 17 (mean age: 14.5 ± 1.8 years) and diagnosed with obesity (30 non-MetS and 46 MetS using IDF) and 37 of whom constituted the control group, participated in the study. Echocardiographic examination and atherogenicity parameters (Atherogenic index of plasma [AIP: logTG/HDL], total cholesterol/HDL, and TG/HDL ratio and non-HDL) were evaluated. Results The most common component accompanying obese MetS was found to be hypertension and low HDL. While obesity duration, body mass index (BMI), blood pressure, fasting insulin, insulin resistance, atherogenicity parameters were determined to be significantly higher in the obese-MetS group. Echocardiography showed that while the thickness, volume, and diameter of LV end-diastolic wall, left ventricular mass (LVM), LVM index (LVMI g/m2) and relative wall thickness (RWT) were significantly high in the MetS group, however, mitral E/A ratio was significantly lower (p<0.05). Change in LV geometry consistent with concentric remodeling (increased RWT, normal LVMI) was visible in obese groups. LVM were positively significantly related to BMI, waist circumference, insulin resistance, blood pressure, LDL level, and negative to mitral E/A ratio. In the obese-MetS group, LVMI was positively correlated to office systolic BP, left atrium end-diastolic volume/index. Conclusions LVMI and atherogenicity parameters that were found to be significantly higher in obese MetS exhibit increased cardiovascular risk in childhood.

scholarly journals Impact of successful transsphenoidal surgery on cardiovascular risk factors in acromegaly

2003 ◽  
pp. 193-201 ◽  
Author(s):  
ML Jaffrain-Rea ◽  
G Minniti ◽  
C Moroni ◽  
V Esposito ◽  
E Ferretti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Insulin Sensitivity ◽  
Glucose Tolerance ◽  
Cardiovascular Risk Factors ◽  
Transsphenoidal Surgery ◽  
Left Ventricular ◽  
Diastolic Filling ◽  
Igf I

BACKGROUND: Cardiac abnormalities develop in patients with acromegaly as a consequence of effects of GH/IGF-I on the heart and related cardiovascular risk factors. OBJECTIVE: To evaluate the possible contribution of postoperative variations in blood pressure (BP), glucose tolerance and insulin sensitivity to the cardiac improvement reported in patients who have been cured of acromegaly. DESIGN: Thirty-one patients with acromegaly were studied before and 6 Months after successful transsphenoidal surgery, defined by normal age-related IGF-I concentrations and glucose-suppressed GH concentrations <1 microg/l. METHODS: Cardiovascular parameters were assessed by Doppler echocardiography and 24-h ambulatory blood pressure monitoring. Insulin sensitivity indexes were calculated on the basis of fasting and post-load glycaemia and insulinaemia and referred to as HOMA(ISI) and OGTT(ISI), respectively. RESULTS: Successful surgery was confirmed to improve left ventricular mass index (LVMI) and diastolic filling significantly. Mean 24-h systolic BP values decreased (P=0.009) and BP rhythm was restored in 12 of 15 patients with a blunted preoperative profile. Glucose tolerance normalized in patients with preoperative glucose intolerance (n=7) or diabetes mellitus (n=3). HOMA(ISI) and OGTT(ISI) increased (P=0.0001 for each parameter), indicating a marked improvement in insulin sensitivity. The postoperative reduction in LVMI correlated with increased insulin sensitivity (P<0.001 for both indexes), but not with other parameters. Improved diastolic filling correlated with the reduction in LVMI. CONCLUSIONS: Successful surgery in patients with acromegaly induces a significant improvement in haemodynamic and metabolic risk factors. This study suggests a direct link between insulin resistance and acromegalic cardiomyopathy.

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 Association of serum uric acid, morning home blood pressure and cardiovascular risk factors in a population with previous prehypertension: a cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e038046 ◽  
Author(s):  
Lucky Aziza Bawazier ◽  
Mochammad Sja'bani ◽  
Fredie Irijanto ◽  
Zulaela Zulaela ◽  
Agus Widiatmoko ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Uric Acid ◽  
Cardiovascular Risk ◽  
Blood Glucose ◽  
Cardiovascular Risk Factors ◽  
Fasting Blood Glucose ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

ObjectiveTo observe the changes in blood pressure (BP) over 10 years and to investigate current BP association to serum uric acid (SUA) levels and cardiovascular risk factors in the epidemiological data of a target group of patients with prehypertension in 2007.DesignCross-sectional study.SettingMlati Subdistrict, Sleman District, Yogyakarta Province, Indonesia.ParticipantsA total of 733 patients from ‘Mlati Study Database’ in 2007 were selected by simple random sampling using statistical software. Subjects had both physical and laboratory examinations.Outcome measuresMorning home BP and laboratory examination of urine (uric acid excretion and creatinine) and blood samples (SUA, blood urea nitrogen, creatinine, a lipid profile and fasting blood glucose levels).ResultsAbout 31.1% of 733 subjects with prehypertension became hypertensive after 10 years, 24.6% returned to normal tension and the rest of it remained in prehypertensive state. Mean (SD) of SUA levels in 2017 was significantly higher in men than in women (5.78 (1.25) mg/dL vs 4.52 (1.10) mg/dL, p<0.001). Furthermore, men tended to have high-normal (5–7 mg/dL) or high SUA levels (≥7 mg/dL) compared with women (p<0.001, Relative Risk (RR)=2.60). High-normal and high SUA levels in population with a history of prehypertension were significantly associated with current prehypertension and hypertension only in women (p=0.001, RR=1.21). Age and body mass index was found to be significantly associated with both systolic and diastolic BP in men, but only with systolic BP in women. Fasting blood glucose and SUA levels were significantly associated with systolic and diastolic BP only in women.ConclusionWe concluded that after 10 years, of 733 subjects with prehypertension, 31.1% became hypertensive. The SUA levels in men are significantly higher than those in women. Moreover, high-normal and high SUA levels were significantly associated with prehypertension and hypertension in women but not in men.

Longitudinal changes of left ventricular systolic function and risk of heart failure and mortality among men and women from a general population

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
B Arshi ◽  
G Papageorgiou ◽  
O.L Rueda-Ochoa ◽  
M.A Ikram ◽  
D Rizopoulos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Systolic Function ◽  
Left Ventricular Systolic Function ◽  
Left Ventricular ◽  
Composite Outcome ◽  
Men And Women

Abstract Background The incidence and characteristics of heart failure (HF) differ between men and women. However, evidence regarding sex differences in determinants and changes of cardiac function in association with incidence of HF remains scarce. Purpose To study the evolution and determinants of left ventricular ejection fraction (LVEF) over time and its association with incident mortality and HF among men and women. Methods From a population-based cohort, we included 7923 participants, 3319 men and 4604 women, free of heart failure (HF) and atrial fibrillation with up to 3 repeated echocardiographic measurements. Using joint models, we analyzed the evolution of LVEF and its associated traditional cardiovascular risk factors among men and women. Second, we studied the association of LVEF changes with incident HF and mortality as a composite outcome adjusted for age (time-varying covariate) and traditional cardiovascular risk factors. We then performed the analyses with HF and mortality as competing events. Results Mean (SD) age was 65.7 (9.6) in men and 66.5 (10) in women. During a median follow-up of 9 years, 988 events in men and 840 events in women occurred. LVEF had a one-directional nonlinear declining with increasing age among men and women (Figure). Up to age of 70, LVEF showed a sharper decline per year among men compared to women. Every unit increase in systolic blood pressure (SBP) was associated with 0.03% (0.05% to 0.02%) decrease in LVEF per year in men. Among women, SBP had an inverse J-shaped association with LVEF changes (P&lt;0.001). Diastolic blood pressure (DBP) also showed a non-linear association with LVEF in both sexes. Prevalent diabetes was not associated with LVEF change. In the survival analysis, every 5% decrease in LVEF was associated with 35% and 30% increase in the risk of the composite outcome among men [HR (95% CI): 1.35 (1.26 to 1.43)] and women [HR (95% CI): 1.30 (1.22 to 1.40)]. Conclusion(s) Despite a similar risk of LVEF decline for the composite outcome, the evolution of LVEF, especially before 70 years of age, differ between men and women. Cardiovascular risk factors, especially blood pressure, play diverse roles in the evolution of left ventricular systolic function among men and women. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): The Rotterdam Study is funded by Erasmus Medical Center and Erasmus University, Rotterdam, Netherlands Organization for the Health Research and Development (ZonMw), the Research Institute for Diseases in the Elderly (RIDE), the Ministry of Education, Culture and Science, the Ministry for Health, Welfare and Sports, the European Commission (DG XII), and the Municipality of Rotterdam.

Abstract 3488: Hyperuricemia and the Risk of Isolated Hypertension among Young People without Cardiovascular and Metabolic Risk Factors: The CARDIA Study

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Eswar Krishnan ◽  
Hyon K Choi ◽  
Lewis H Kuller ◽  
Kiang Liu
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Uric Acid ◽  
Cardiovascular Risk ◽  
Young People ◽  
Cardiovascular Risk Factors ◽  
Serum Uric Acid ◽  
The Metabolic Syndrome

PURPOSE: The association between higher serum uric acid (SUA) levels and hypertension in the context of the metabolic syndrome is well known. If such an association was causal, one would expect to demonstrate a link between hyperuricemia and incidence of isolated hypertension - a hypothesis that has not been tested so far. METHODS: We used the 15-year limited-access data from the prospective cohort study of Coronary Artery Risk Development in young adults (CARDIA), sponsored by the National Institutes of Health, to identify a group of non-smoking young people with normal blood pressure and free of insulin resistance, hyperlipidemia, obesity, and a family history of cardiovascular diseases. These young people aged between 18 and 30 years at baseline were followed-up for a period of 15 years by 6 study visits where all cardiovascular risk factors were reassessed. Incidence of JNC-7 hypertension was the outcome of interest in Cox proportional hazards models where age, gender, race, lipid levels, blood pressure, alcohol, body mass index, smoking and serum insulin levels (time-varying where appropriate) were the covariates. Baseline serum uric acid (continuous) was the independent variable of interest. A second set of Cox regression analyses was performed among the subgroup of these individuals who remained free of all cardiovascular risk factors (except for hypertension) over the 15-year follow up. RESULTS: Out of the 5113 CARDIA participants at baseline, 2057 subjects were free of cardiovascular risk factors at baseline and were available for evaluation at year 15. Over the follow-up period, 828 subjects developed hypertension. In multivariate Cox models, each mg/dl increase in serum uric acid was associated with a hazard ratio of 1.45 (1.09–1.91). In the second set of analyses, 753 were free of all cardiovascular risk factors at baseline and remained free of any of the components of the metabolic syndrome except hypertension (n = 122 incident cases of hypertension) were studied. In these analyses each mg/dl increasse in SUA was associated with a risk adjusted hazard ratio of 1.60 (95% CI 1.02–2.49). CONCLUSIONS: Unrelated to the other features of the metabolic syndrome, higher levels of SUA among young people predicts isolated hypertension.

scholarly journals Pericardial adipose tissue, cardiac structures, and cardiovascular risk factors in school-age children

2020 ◽  
Author(s):  
Liza Toemen ◽  
Susana Santos ◽  
Arno A W Roest ◽  
Meike W Vernooij ◽  
Willem A Helbing ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Adipose Tissue ◽  
Cardiovascular Risk ◽  
Standard Deviation ◽  
Cardiovascular Risk Factors ◽  
Left Ventricular ◽  
Normal Weight ◽  
Overweight Children ◽  
Pericardial Adipose Tissue

Abstract Aims  We examined the associations of pericardial adipose tissue with cardiac structures and cardiovascular risk factors in children. Methods and results  We performed a cross-sectional analysis in a population-based cohort study among 2892 children aged 10 years (2404 normal weight and 488 overweight/obese). Pericardial adipose tissue mass was estimated by magnetic resonance imaging (MRI) and indexed on height3. Left ventricular mass (LVM) and left ventricular mass-to-volume ratio (LMVR) were estimated by cardiac MRI. Cardiovascular risk factors included android adipose tissue percentage obtained by Dual-energy X-ray absorptiometry, blood pressure and glucose, insulin, cholesterol, and triglycerides concentrations. Adverse outcomes were defined as values above the 75 percentile. Median pericardial adipose tissue index was 3.6 (95% range 1.6–7.1) among normal weight and 4.7 (95% range 2.0–8.9) among overweight children. A one standard deviation (1 SD) higher pericardial adipose tissue index was associated with higher LMVR [0.06 standard deviation scores, 95% confidence interval (CI) 0.02–0.09], increased odds of high android adipose tissue [odd ratio (OR) 2.08, 95% CI 1.89–2.29], high insulin concentrations (OR 1.17, 95% CI 1.06–1.30), an atherogenic lipid profile (OR 1.22, 95% CI 1.11–1.33), and clustering of cardiovascular risk factors (OR 1.56, 95% CI 1.36–1.79). Pericardial adipose tissue index was not associated with LVM, blood pressure, and glucose concentrations. The associations showed largely the same directions but tended to be weaker among normal weight than among overweight children. Conclusion  Pericardial adipose tissue is associated with cardiac adaptations and cardiovascular risk factors already in childhood in both normal weight and overweight children.

scholarly journals Influence of modifiable cardiovascular risk factors on antihypertensive therapy efficiency escape

2017 ◽  
Vol 89 (9) ◽  
pp. 10-14 ◽  
Author(s):  
O O Mikhailova ◽  
A Yu Litvin ◽  
A N Rogoza
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Family History ◽  
Cardiovascular Risk Factors ◽  
Antihypertensive Therapy ◽  
Fasting Blood Glucose ◽  
Number Of Patients ◽  
Group 2 ◽  
Group 1

Aim. To evaluate the influence of cardiovascular risk factors on antihypertensive therapy (AHT) efficiency escape (EE). Subjects and methods. Data on 59 patients with grades 1—3 hypertension (Stages I—II) were analyzed. During chosen AHT, 24-hour blood pressure monitoring was done at baseline, 1 and 3 months after beginning the observation to identify/rule out the AHT EE phenomenon. Results. The AHT EE group (Group 1) as compared with the group that needed no therapy correction within 3 months (Group 2) was observed to have the following: elevated fasting blood glucose levels (FBGL) (5.8±0.8 vs 5.3±0.7 mmol/l; p=0.008) and higher impaired glucose tolerance (IGT) rates (8 (27.6%) vs 4 (13.3%) cases (p=0.03)); a more number of smoking patients (8 (27.6%) vs 3 (10%) cases; p=0.02); a larger number of patients with a compromised family history of cardiovascular diseases (17 (58.6%) vs 11 (36%); p=0.02). Furthermore, in Group 1 baseline average systolic blood pressure during 24 hours (SBP-24) proved to be higher than that in Group 2 (127.4±4.2 vs 122.4±6.8 mm Hg; p=0.002). Odds ratio (OR) for developing the EE phenomenon increased by 60% with a rise of 0.5 mmol in FBGL (OR, 1.60; 95% confidence interval (CI), 1.06 to 2.4; p=0.02) and by 18% with an increase of 1 mm Hg in baseline SBP-24 (OR, 1.18; 95% CI, 1.05 to 1.33; p=0.004). Multivariate analysis indicated that the independent predictors of AHT EE were a compromised family history (OR, 3.7; 95% CI, 1.1 to 12.1; p=0.03) and IGT (OR, 4.1; 95% CI, 1.02 to 16.4; p=0.04). Conclusion. AHT EE was influenced by FBGL, IGT, smoking, a compromised family history, and baseline SBP-24 level.

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