scholarly journals Gender characteristics of retinal parameters in patients with uncomplicated hypertension

2020 ◽  
Vol 19 (4) ◽  
pp. 2500
Author(s):  
A. V. Barsukov ◽  
K. A. Shcherbakova ◽  
M. A. Burnasheva ◽  
D. S. Maltsev ◽  
A. N. Kulikov ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Relative Increase ◽  
Left Ventricular ◽  
Urinary Albumin ◽  
Foveal Avascular Zone ◽  
Inverse Association ◽  
Uncomplicated Hypertension ◽  
Ophthalmic Pathology ◽  
Gender Characteristics ◽  
Procollagen Iii Peptide

Aim. To establish gender specificities of retinal arteriolar and venular diameters, foveal avascular zone (FAZ) area, subfoveal choroid thickness (SCT), and to determine their association with cardiovascular risk and prognosis in patients with uncomplicated hypertension (HTN).Material and methods. The study included 70 patients (56 males and 14 females) aged 45-59 years with stage I or II HTN. There were following  exclusion  criteria:  diabetes,  liver  failure,  clinically  relevant  ophthalmic pathology. We assessed routine hemodynamic parameters, biochemical profile, serum N-terminal procollagen-III peptide, urinary albumin-creatinine ratio, 24-hour urinary albumin excretion, retinal parameters. All patients underwent electrocardiography and echocardiography. Ten-year risk of fatal cardiovascular disease (SCORE) was estimated. Based on scanning laser ophthalmoscopy, central   retinal   arterial   (CRAE)   and   venous   (CRVE)   equivalents, arteriovenous ratio (AVR) were calculated. Using optical coherence tomography angiography, we determined FAZ area and SCT. Data processing was performed using StatSoft Statistica 10.Results. Hypertensive women were characterized by significantly larger FAZ area (p<0,001), CRVE  (p=0,005), CRAE (p=0,012)  compared with men. SCT values (p>0,05) were comparable. CRVE was associated with Cornell voltage product (r=0,3) in the male group. In women, age was negatively correlated with SCT (r=-0,54); SCORE value was inversely associated with SCT (r=-0,56), AVR (r=-0,53), CRAE (r=-0,3).Conclusion. In patients with uncomplicated HTN, the gender specificities of retina are manifested by a relative decrease of arteriolar diameters in males and a relative increase of venular diameters and FAZ in females. SCT decreases most clearly with age among hypertensive women. Men are characterized by a direct association of retinal venular diameters with a quantitative electrocardiographic marker of left ventricular hypertrophy. In women, there are an inverse association of SCT and arteriolar diameters with a ten-year risk of fatal cardiovascular  disease.

scholarly journals Retinal vascular changes and right ventricular structure and function: the MESA-Right Ventricle and MESA-Eye studies

2018 ◽  
Vol 9 (1) ◽  
pp. 204589401881978 ◽  
Author(s):  
Anthony C. Chyou ◽  
Barbara E.K. Klein ◽  
Ronald Klein ◽  
R. Graham Barr ◽  
Mary Frances Cotch ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Right Ventricle ◽  
Retinal Vessel ◽  
Left Ventricular ◽  
Inverse Association ◽  
Systolic Volume ◽  
End Diastolic Volume ◽  
Retinal Arterioles ◽  
Mri Scans ◽  
And Function

Retinal vessel diameters have been associated with left ventricular morphology and function but their relationship with the right ventricle (RV) has not been studied. We hypothesized that wider retinal venules and narrower retinal arterioles are associated with RV morphology and function. RV end-diastolic mass (RVEDM), end-diastolic volume (RVEDV), end-systolic volume (RVESV), stroke volume (RVSV), and ejection fraction (RVEF) were assessed using cardiac magnetic resonance imaging (MRI) scans of 4204 participants without clinical cardiovascular disease at the baseline examination; retinal photography was obtained at the second examination. Mean diameters of retinal arterioles and venules were measured and summarized as central retinal vein and artery equivalents (“veins” and “arteries,” respectively). After adjusting for covariates, wider veins were associated with greater RVEDM and RVEDV in women ( P = 0.04 and P = 0.02, respectively), whereas there was an inverse association with RVEDV in men ( P = 0.02). In both sexes, narrower arteries were associated with lower RVEDM ( P < 0.001 in women and P = 0.002 in men) and smaller RVEDV ( P < 0.001 in women and P = 0.04 in men) in adjusted models. Narrower arteries were also associated with lower RVEF in men but this was of borderline significance after adjusting for the LVEF ( P = 0.08). Wider retinal venular diameter was associated with sex-specific changes in RVEDM and RVEDV in adults without clinical cardiovascular disease. Narrower retinal arteriolar diameter was associated with significantly lower RVEDM and smaller RVEDV in both sexes.

Urine Albumin to Creatinine Ratio and Echocardiographic Left Ventricular Structure and Function in Patients with Essential Hypertension

2011 ◽  
Vol 9 (2) ◽  
pp. 90 ◽  
Author(s):  
Rohola Hemmati ◽  
Mojgan Gharipour ◽  
Hasan Shemirani ◽  
Alireza Khosravi ◽  
Elham Khosravi ◽  
...  
Keyword(s):  
Essential Hypertension ◽  
Peak Velocity ◽  
Left Ventricular ◽  
Lv Function ◽  
Creatinine Ratio ◽  
Uncomplicated Hypertension ◽  
Urine Albumin ◽  
Lv Dysfunction ◽  
Mitral Annulus Velocity ◽  
Lv Mass

Background:Appearance of microalbuminuria, particularly in patients with hypertension, might be associated with a higher prevalence of left ventricular (LV) dysfunction and geometric abnormalities. This study was undertaken to determine whether high urine albumin to creatinine ratio (UACR) as a sensitive marker for microalbuminuria can be associated with LV hypertrophy (LVH) and systolic and diastolic LV dysfunction.Methods:The study population consisted of 125 consecutive patients with essential uncomplicated hypertension. Urine albumin and creatinine concentration was determined by standard methods. LVH was defined as a LV mass index >100 g/m2 of body surface area in women and >130 g/m2 in men. Echocardiographic LV systolic and diastolic parameters were measured.Results:The prevalence of microalbuminuria in patients with essential hypertension was 5.6 %. UACR was significantly no different in patients with LVH than in patients with normal LV geometry (21.26 ± 31.55 versus 17.80 ± 24.52 mg/mmol). No significant correlation was found between UACR measurement and systolic and diastolic function parameters, including early to late diastolic peak velocity (E/A) ratio (R=-0.192, p=0.038), early diastolic peak velocity to early mitral annulus velocity (E/E') ratio (R=-0.025, p=0.794), LV ejection fraction (R=0.008, p=0.929), and LV mass (R=-0.132, p=0.154). According to the receiver operator characteristic (ROC) curve analysis, UACR measurement was not an acceptable indicator of LVH with areas under the ROC curves 0.514 (95 % confidence interval 0.394–0.634). The optimal cut-off value for UACR for predicting LVH was identified at 9.4, yielding a sensitivity of 51.6 % and a specificity of 48.3 %.Conclusion:In patients with uncomplicated essential hypertension, abnormal systolic and diastolic LV function and geometry cannot be effectively predicted by the appearance of microalbuminuria.

Risk factors for cardiovascular diseases and development of prehypertension

2018 ◽  
pp. 37-43
Author(s):  
В.В. Шерстнев ◽  
М.А. Грудень ◽  
В.П. Карлина ◽  
В.М. Рыжов ◽  
А.В. Кузнецова ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Ldl Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Serum Levels ◽  
Left Ventricular ◽  
Optimal Blood Pressure

Цель - исследование взаимосвязи факторов риска сердечно-сосудистых заболеваний и развития предгипертонии. Методика. Проведен сравнительный и корреляционный анализы показателей модифицируемых и немодифицируемых факторов риска сердечно-сосудистых заболеваний у обследованных лиц в возрасте 30-60 лет с «оптимальным» артериальным давлением, (n = 63, АД <120/80 мм рт.ст.) и лиц с предгипертонией (n = 52, АД = 120-139/80-89 мм рт.ст.). Результаты. Показано, что лица с предгипертонией по сравнению с группой лиц, имеющих «оптимальное» артериальное давление характеризуются статистически значимо повышенным содержанием холестерина и холестерина липопротеидов низкой плотности, интеллектуальным характером трудовой деятельности, а также значимыми сочетаниями факторов риска: повышенный уровень холестерина липопротеидов низкой плотности с интеллектуальным характером трудовой деятельности; повышенное содержание креатинина с уровнем триглициридов; наследственная отягощенность по заболеваниям почек и интеллектуальным характером трудовой деятельности; наследственная отягощенность по сахарному диабету и гипертрофия левого желудочка сердца. У лиц с предгипертонией документированы перестройки структуры взаимосвязи (количество, направленность и сила корреляций) между показателями факторов риска в сравнении с лицами, имеющими «оптимальное» артериальное давление. Заключение. Выявленные особенности взаимосвязей факторов риска сердечно-сосудистых заболеваний при предгипертонии рассматриваются как проявление начальной стадии дизрегуляционной патологии и нарушения регуляции физиологических систем поддержания оптимального уровня артериального давления. The aim of the study was to investigate the relationship between risk factors for cardiovascular disease and development of prehypertension. Methods. Comparative and correlation analyses of modifiable and non-modifiable risk factors for cardiovascular disease were performed in subjects aged 30-60 with «optimal» blood pressure (n = 63, BP <120/80 mm Hg) and prehypertension (n = 52, BP = 120-139 / 80-89 mm Hg). Results. The group with prehypertension compared with the «optimal» blood pressure group had significantly increased serum levels of low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol, sedentary/intellectual type of occupation, and significant combinations of risk factors. The risk factor combinations included an increased level of LDL cholesterol and a sedentary/intellectual occupation; increased serum levels of creatinine and triglycerides; hereditary burden of kidney disease and a sedentary/intellectual occupation; hereditary burden of diabetes mellitus and cardiac left ventricular hypotrophy. In subjects with prehypertension compared to subjects with «optimal» blood pressure, changes in correlations (correlation number, direction, and strength) between parameters of risk factors were documented. Conclusion. The features of interrelationships between risk factors for cardiovascular disease observed in prehypertension are considered a manifestation of early dysregulation pathology and disordered regulation of physiological systems, which maintain optimal blood pressure.

Prevalence, Biochemical and Clinical Characteristics of Resistant Hypertension

2018 ◽  
Vol 69 (10) ◽  
pp. 2845-2849
Author(s):  
Daniela Gurgus ◽  
Elena Ardeleanu ◽  
Carmen Gadau ◽  
Roxana Folescu ◽  
Ioan Tilea ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Resistant Hypertension ◽  
Clinical Characteristics ◽  
Salt Intake ◽  
Target Organ Damage ◽  
Multivariate Logistic Regression Analysis ◽  
Organ Damage ◽  
Left Ventricular ◽  
High Salt Intake

The objectives of the present study were to evaluate the prevalence of resistant hypertension (RH) in primary care setting and to analyse its biochemical and clinical characteristics. After 3 months of treatment and evaluation, 721 (14.01%) of 5,146 patients with hypertension did not reach target office blood pressure of [ 140/90 mmHg. After exclusion of �white-coat effect� with ambulatory blood pressure, of secondary and pseudo- resistant hypertension, prevalence of RH was 6.74%. Lifestyle factors associated with RH were physical inactivity, obesity, high salt intake, smoking and excessive alcohol ingestion. Compared to controlled hypertension, RH patients presented higher incidence of family history of cardiovascular disease (38.90% vs 25.94%), diabetes mellitus (34.87% vs 19.01%), impaired fasting glucose (21.91% vs 19.07%), target organ damage (29.1% vs 15.95%), and cardiovascular disease (27.09% vs 17.06%). Dyslipidaemia (52.90% vs 42.03%), fasting plasma glucose (116.10�38.9 vs 107.80�37.2), HbA1c (6.41�1.42 vs 5.96�0.94), serum creatinine (1.09�0.27 vs 1.03�0.24) and microalbuminuria (21.90% vs 10.95%) were significantly higher in RH. Predictors of RH, determined by a multivariate logistic regression analysis were left ventricular hypertrophy (OD 2.14, 95% CI 1.32-3.69), renal impairment expressed as eGFR [ 60 ml/min/1.73m2 (OD 1.62, 95% CI 1.21-2.21) and the presence of cardiovascular disease (OD 1.48, 95% CI 1.02-2.16).

scholarly journals Association of Lipoprotein (a) variants with risk of cardiovascular disease: a Mendelian randomization study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Juan Xia ◽  
Chunyue Guo ◽  
Kuo Liu ◽  
Yunyi Xie ◽  
Han Cao ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Cardiovascular Disease ◽  
Chinese Population ◽  
Left Ventricular Mass Index ◽  
Mendelian Randomization ◽  
Left Ventricular ◽  
Han Chinese ◽  
Han Chinese Population ◽  
Internal Dimension

Abstract Background There is a well-documented empirical relationship between lipoprotein (a) [Lp(a)] and cardiovascular disease (CVD); however, causal evidence, especially from the Chinese population, is lacking. Therefore, this study aims to estimate the causal association between variants in genes affecting Lp(a) concentrations and CVD in people of Han Chinese ethnicity. Methods Two-sample Mendelian randomization analysis was used to assess the causal effect of Lp(a) concentrations on the risk of CVD. Summary statistics for Lp(a) variants were obtained from 1256 individuals in the Cohort Study on Chronic Disease of Communities Natural Population in Beijing, Tianjin and Hebei. Data on associations between single-nucleotide polymorphisms (SNPs) and CVD were obtained from recently published genome-wide association studies. Results Thirteen SNPs associated with Lp(a) levels in the Han Chinese population were used as instrumental variables. Genetically elevated Lp(a) was inversely associated with the risk of atrial fibrillation [odds ratio (OR), 0.94; 95% confidence interval (95%CI), 0.901–0.987; P = 0.012)], the risk of arrhythmia (OR, 0.96; 95%CI, 0.941–0.990; P = 0.005), the left ventricular mass index (OR, 0.97; 95%CI, 0.949–1.000; P = 0.048), and the left ventricular internal dimension in diastole (OR, 0.97; 95%CI, 0.950–0.997; P = 0.028) according to the inverse-variance weighted method. No significant association was observed for congestive heart failure (OR, 0.99; 95% CI, 0.950–1.038; P = 0.766), ischemic stroke (OR, 1.01; 95%CI, 0.981–1.046; P = 0.422), and left ventricular internal dimension in systole (OR, 0.98; 95%CI, 0.960–1.009; P = 0.214). Conclusions This study provided evidence that genetically elevated Lp(a) was inversely associated with atrial fibrillation, arrhythmia, the left ventricular mass index and the left ventricular internal dimension in diastole, but not with congestive heart failure, ischemic stroke, and the left ventricular internal dimension in systole in the Han Chinese population. Further research is needed to identify the mechanism underlying these results and determine whether genetically elevated Lp(a) increases the risk of coronary heart disease or other CVD subtypes.

OP139 Attaining Universal Electrocardiographic Diagnosis Coverage Through Telemedicine

2020 ◽  
Vol 36 (S1) ◽  
pp. 1-1
Author(s):  
Pedro Galvan ◽  
José Ortellado ◽  
Ronald Rivas ◽  
Juan Portillo ◽  
Julio Mazzoleni ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Disease Prevention ◽  
Prevention Program ◽  
Sinus Bradycardia ◽  
Universal Coverage ◽  
Left Ventricular ◽  
Cardiovascular Disease Prevention ◽  
Public Hospitals ◽  
Cross Sectional Survey ◽  
Health Technologies

IntroductionInnovative health technologies, like telemedicine, offer advantageous telediagnostic apps that can improve the health care of populations in remote regions. However, evidence on how these developments can enhance universal coverage for electrocardiographic (ECG) diagnosis to support a cardiovascular disease prevention program is limited. The utility of telemedicine for attaining universal coverage for ECG diagnosis according to the national cardiovascular disease prevention program in Paraguay was investigated.MethodsThis cross-sectional survey included adults (aged 19 to 80 years) and children (aged 1 to 18 years) with a medical prescription. The study was carried out by the Telemedicine Unit to evaluate the utility of a telemedicine net for a countrywide detection and prevention program for cardiovascular disease. The results obtained by the tele-ECG net, which was implemented in sixty public hospitals countrywide, were analyzed and used to verify adherence to the cardiovascular prevention program.ResultsBetween 2014 and 2019, 331,418 remote ECG diagnoses were performed. Of these, eighty-two percent (n = 270,539) were in adults and eighteen percent (n = 60,879) were in children. Among the adult diagnoses, the majority (52%) were pathological and included sinus bradycardia (13%), right bundle branch block (6%), left ventricular hypertrophy (5%), and ventricle repolarization disorder (5%). Among the children, only twenty percent of diagnoses pathological and included sinus bradycardia (11%) and sinus tachycardia (4%). The mean rate of adherence to the prevention program was 38.2 per 1,000 diagnoses performed.ConclusionsThe results showed that telemedicine can significantly enhance coverage for universal ECG diagnosis to support cardiovascular disease prevention and health programs. However, before carrying out the systematic implementation of such a program contextualization using the regional epidemiological profile must be performed.

scholarly journals Myocardial infarctions, subtypes and coronary atherosclerosis in SLE: a case–control study

2021 ◽  
Vol 8 (1) ◽  
pp. e000515
Author(s):  
Isak Samuelsson ◽  
Ioannis Parodis ◽  
Iva Gunnarsson ◽  
Agneta Zickert ◽  
Claes Hofman-Bang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Coronary Atherosclerosis ◽  
Great Majority ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Medical File ◽  
Similar Frequency ◽  
Ventricular Ejection Fraction ◽  
Increased Risk

ObjectivePatients with SLE have increased risk of myocardial infarction (MI). Few studies have investigated the characteristics of SLE-related MIs. We compared characteristics of and risk factors for MI between SLE patients with MI (MI-SLE), MI patients without SLE (MI-non-SLE) and SLE patients without MI (non-MI-SLE) to understand underlying mechanisms.MethodsWe identified patients with a first-time MI in the Karolinska SLE cohort. These patients were individually matched for age and gender with MI-non-SLE and non-MI-SLE controls in a ratio of 1:1:1. Retrospective medical file review was performed. Paired statistics were used as appropriate.ResultsThirty-four MI-SLE patients (88% females) with a median age of 61 years were included. These patients had increased number of coronary arteries involved (p=0.04), and ≥50% coronary atherosclerosis/occlusion was numerically more common compared with MI-non-SLE controls (88% vs 66%; p=0.07). The left anterior descending artery was most commonly involved (73% vs 59%; p=0.11) and decreased (<50%) left ventricular ejection fraction occurred with similar frequency in MI-SLE and MI-non-SLE patients (45% vs 36%; p=0.79). Cardiovascular disease (44%, 5.9%, 12%; p<0.001) and coronary artery disease (32%, 2.9%, 0%; p<0.001), excluding MI, preceded MI/inclusion more commonly in MI-SLE than in MI-non-SLE and non-MI-SLE patients, respectively. MI-SLE patients had lower plasma albumin levels than non-MI-SLE patients (35 (29–37) vs 40 (37–42) g/L; p=0.002).ConclusionIn the great majority of cases, MIs in SLE are associated with coronary atherosclerosis. Furthermore, MIs in SLE are commonly preceded by symptomatic vascular disease, calling for attentive surveillance of cardiovascular disease and its risk factors and early atheroprotective treatment.

Antithrombotic Therapy for Stroke Patients with Cardiovascular Disease

2021 ◽  
Author(s):  
Aaron M. Gusdon ◽  
Salia Farrokh ◽  
James C. Grotta
Keyword(s):  
Atrial Fibrillation ◽  
Cardiovascular Disease ◽  
Antithrombotic Therapy ◽  
Antiplatelet Agents ◽  
Left Ventricular ◽  
Optimal Treatment ◽  
Ventricular Assist Devices ◽  
Left Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Nonbacterial Thrombotic Endocarditis

AbstractPrevention of ischemic stroke relies on the use of antithrombotic medications comprising antiplatelet agents and anticoagulation. Stroke risk is particularly high in patients with cardiovascular disease. This review will focus on the role of antithrombotic therapies in the context of different types of cardiovascular disease. We will discuss oral antiplatelet medications and both IV and parental anticoagulants. Different kinds of cardiovascular disease contribute to stroke via distinct pathophysiological mechanisms, and the optimal treatment for each varies accordingly. We will explore the mechanism of stroke and evidence for antithrombotic therapy in the following conditions: atrial fibrillation, prosthetic heart values (mechanical and bioprosthetic), aortic arch atherosclerosis, congestive heart failure (CHF), endocarditis (infective and nonbacterial thrombotic endocarditis), patent foramen ovale (PFO), left ventricular assist devices (LVAD), and extracorporeal membrane oxygenation (ECMO). While robust data exist for antithrombotic use in conditions such as atrial fibrillation, optimal treatment in many situations remains under active investigation.

scholarly journals Influence of height on endothelial maintenance activity: a narrative review

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Yuji Shimizu ◽  
Takahiro Maeda
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Stem Cells ◽  
Bone Marrow ◽  
Hematopoietic Stem Cells ◽  
Inverse Association ◽  
Hematopoietic Stem ◽  
Genetic Characteristics ◽  
Maintenance Activity ◽  
Marrow Activity

AbstractRecent studies have revealed an inverse association between height and cardiovascular disease. However, the background mechanism of this association has not yet been clarified. Height has also been reported to be positively associated with cancer. Therefore, well-known cardiovascular risk factors, such as increased oxidative stress and chronic inflammation, are not the best explanations for this inverse association because these risk factors are also related to cancer. However, impaired blood flow is the main pathological problem in cardiovascular disease, while glowing feeding vessels (angiogenesis) are the main characteristic of cancer pathologies. Therefore, endothelial maintenance activity, especially for the productivity of hematopoietic stem cells such as CD34-positive cells, could be associated with the height of an individual because this cell contributes not only to the progression of atherosclerosis but also to the development of angiogenesis. In addition, recent studies have also revealed a close connection between bone marrow activity and endothelial maintenance; bone marrow-derived hematopoietic stem cells contribute towards endothelial maintenance. Since the absolute volume of bone marrow is positively associated with height, height could influence endothelial maintenance activity. Based on these hypotheses, we performed several studies. The aim of this review is not only to discuss the association between height and bone marrow activity, but also to describe the potential mechanism underlying endothelial maintenance. In addition, this review also aims to explain some of the reasons that implicate hypertension as a major risk factor for stroke among the Japanese population. The review also aims to clarify the anthropological reasons behind the high risk of atherosclerosis progression in Japanese individuals with acquired genetic characteristics.

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