Lifetime prevention of cardiovascular disease. Part III: young, middle, elderly and senile age

Intensive investigation of cardiovascular disease (CVD) risk factors (RFs), both traditional (smoking, dyslipidemia, diabetes, etc.) and non-traditional, which are a component of the so-called exposome, as well as their non-drug and drug correction provide wide prospects for effective cardiovascular prevention. Prevention becomes the dominant trend in cardiology and in medicine in general. The aim of the article was to describe cardiovascular prevention in young, middle, elderly and senile age. Due to the multifaceted nature of cardiovascular RFs, an integrated biopsychosocial approach, individual and population-based prevention, cumulative risk assessment of all CVDs, intersectoral collaboration and the involvement of decision-makers, are key to the success and effectiveness of prevention measures. It is important to note that, on the one hand, preventive measures should be started as early as possible due to cumulative effect of RFs, on the other hand, most of the preventive interventions for CVD are extremely relevant at all life stages.

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Abstract P156: Assessing the Effect of the Heart of New Ulm Project: a Population-Based Program to Reduce Cardiovascular Disease

Circulation ◽

10.1161/circ.135.suppl_1.p156 ◽

2017 ◽

Vol 135 (suppl_1) ◽

Author(s):

Abbey C Sidebottom ◽

Arthur Sillah ◽

David M Vock ◽

Michael M Miedema ◽

Raquel Pereira ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Cardiovascular Disease ◽

Health System ◽

Matched Control ◽

Population Based ◽

Control Population ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Matched Control Population

Background: Despite a highly recognized priority for public health and healthcare to implement population-level strategies to reduce the burden of cardiovascular disease (CVD), limited evidence exists on the most effective strategies. Data collection and evaluation of large scale, community based-prevention programs can be challenging and costly to achieve. The Heart of New Ulm (HONU) Project, begun in 2009, is a population-based initiative with healthcare, community, and workplace interventions addressing multiple levels of the social-ecological model designed to reduce modifiable CVD risk factors in rural New Ulm, MN. The community is served by one health system, enabling the use of electronic health record (EHR) data for surveillance. Objective: To assess trends for CVD risk factors, events, and healthcare utilization for New Ulm residents compared to a matched control population. Methods: We matched New Ulm residents (n = 4,077) with controls (n = 4,077) from a regional community served by the same health system using refined covariate balance techniques to match on baseline demographics, CVD risk factors, and health care utilization. Mixed effects longitudinal models with adjustment for age and gender, and an interaction for time by community, were run. Model based estimates were constructed for the entire cohort at each time period. Results: Over the first 6 years of the HONU Project,blood pressure, LDL, total cholesterol, and triglycerides were managed better in New Ulm than the matched comparison community. The proportion of New Ulm residents with controlled blood pressure increased by 6.2 percentage points while the control group increased by 2 points. 10-year ASCVD risk scores showed less decline for New Ulm residents than controls (16 vs. 18.4). The intervention and control groups did not differ with regard to inpatient stays, CVD events, smoking, or glucose. Conclusions: Compared to a matched control population, we found improved control of CVD risk factors in the New Ulm Population exposed to the HONU Project.

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Differences in estimates for ten-year risk of cardiovascular disease in Black versus white persons with identical risk factor profiles using pooled cohort equations

10.1101/2021.04.18.21255704 ◽

2021 ◽

Author(s):

Ramachandran S. Vasan ◽

Edwin van den Heuvel

Keyword(s):

Cardiovascular Disease ◽

Black Women ◽

White Women ◽

Absolute Risk ◽

Density Lipoprotein ◽

Clinical Decision ◽

Population Based ◽

Decision Threshold ◽

Cvd Risk ◽

Risk Profiles

AbstractBackgroundSex- and race-specific pooled cohort equations (PCE) are recommended for estimating the 10-year risk of cardiovascular disease (CVD), with an absolute risk >7.5% indicating a clinical decision threshold.MethodsWe generated in silico 30,565 risk profiles in men and 29,515 in women by combining numerical (age, total and high-density lipoprotein cholesterol, systolic blood pressure) and binary risk factors (smoking, diabetes, antihypertensive treatment). We compared PCE-estimated 10-year CVD risk in Black versus white individuals with identical risk profiles. We performed similar comparisons in participants in the Framingham Third Generation cohort and the National Health and Nutrition Examination Survey 2017-2018.ResultsThere were 6357 risk profiles associated with 10-year CVD risk >7.5% for Black but not for white men (median risk difference [RD] 6.25%, range 0.15-22.8%; median relative risk [RR] 2.40, range 1.02-12.6). There were 391 profiles with 10-year CVD risk >7.5% for white but not for Black men (median RD 2.68%, range 0.07-16.9%; median RR 1.42, range 1.01-3.57). There were 6543 risk profiles associated with 10-year estimated CVD risk >7.5% for Black but not for white women (median RD 6.14%, range 0.35-26.8%; median RR 2.29, range 1.05-12.6). There were 318 profiles with 10-year CVD risk >7.5% for white but not for Black women (median RD 3.71%, range 0.22-20.1%; median RR 1.66, range 1.03-5.46). The population-based samples demonstrated similar risk differences.ConclusionsThe PCE may generate substantially divergent CVD risk estimates for Black versus white individuals with identical risk profiles, which could introduce race-related variations in clinical recommendations for CVD prevention.

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Cardiovascular Disease Prediction from Electrocardiogram by using Machine Learning Method: A Snapshot from the Subjects of the Malaysian Cohort

10.21203/rs.2.22561/v1 ◽

2020 ◽

Author(s):

Nazrul Anuar Nayan ◽

Hafifah Ab Hamid ◽

Mohd Zubir Suboh ◽

Noraidatulakma Abdullah ◽

Rosmina Jaafar ◽

...

Keyword(s):

Machine Learning ◽

Cardiovascular Disease ◽

Nearest Neighbor ◽

Total Cholesterol Level ◽

Population Based ◽

Support Vector ◽

K Nearest Neighbor ◽

Cvd Risk ◽

Linear Discriminant ◽

Artificial Neural Network Ann

Abstract Background: Cardiovascular disease (CVD) is the leading cause of deaths worldwide. In 2017, CVD contributed to 13,503 deaths in Malaysia. The current approaches for CVD prediction are usually invasive and costly. Machine learning (ML) techniques allow an accurate prediction by utilizing the complex interactions among relevant risk factors. Results: This study presents a case–control study involving 60 participants from The Malaysian Cohort, which is a prospective population-based project. Five parameters, namely, the R–R interval and root mean square of successive differences extracted from electrocardiogram (ECG), systolic and diastolic blood pressures, and total cholesterol level, were statistically significant in predicting CVD. Six ML algorithms, namely, linear discriminant analysis, linear and quadratic support vector machines, decision tree, k-nearest neighbor, and artificial neural network (ANN), were evaluated to determine the most accurate classifier in predicting CVD risk. ANN, which achieved 90% specificity, 90% sensitivity, and 90% accuracy, demonstrated the highest prediction performance among the six algorithms. Conclusions: In summary, by utilizing ML techniques, ECG data can serve as a good parameter for CVD prediction among the Malaysian multiethnic population.

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Skeletal muscle mass in relation to 10 year cardiovascular disease incidence among middle aged and older adults: the ATTICA study

Journal of Epidemiology & Community Health ◽

10.1136/jech-2019-212268 ◽

2019 ◽

Vol 74 (1) ◽

pp. 26-31 ◽

Cited By ~ 9

Author(s):

Stefanos Tyrovolas ◽

Demosthenes Panagiotakos ◽

Ekavi Georgousopoulou ◽

Christina Chrysohoou ◽

Dimitrios Tousoulis ◽

...

Keyword(s):

Cardiovascular Disease ◽

Skeletal Muscle ◽

Muscle Mass ◽

Skeletal Muscle Mass ◽

Disease Incidence ◽

Population Based ◽

Cardiometabolic Health ◽

Inverse Association ◽

Cvd Risk ◽

Appendicular Skeletal Muscle

BackgroundSkeletal muscle mass (SMM) is inversely associated with cardiometabolic health and the ageing process. The aim of the present work was to evaluate the relation between SMM and 10 year cardiovascular disease (CVD) incidence, among CVD-free adults 45+ years old.MethodsATTICA is a prospective, population-based study that recruited 3042 adults without pre-existing CVD from the Greek general population (Caucasians; age ≥18 years; 1514 men). The 10 year study follow-up (2011–2012) captured the fatal/non-fatal CVD incidence in 2020 participants (50% men). The working sample consisted of 1019 participants, 45+ years old (men: n=534; women: n=485). A skeletal muscle mass index (SMI) was created to reflect SMM, using appendicular skeletal muscle mass (ASM) standardised by body mass index (BMI). ASM and SMI were calculated with specific indirect population formulas.ResultsThe 10 year CVD incidence increased significantly across the baseline SMI tertiles (p<0.001). Baseline SMM showed a significant inverse association with the 10 year CVD incidence (HR 0.06, 95% CI 0.005 to 0.78), even after adjusting for various confounders. Additionally, participants in the highest SMM tertile had 81% (95% CI 0.04 to 0.85) lower risk for a CVD event as compared with those in the lowest SMM tertile.ConclusionsThe presented findings support the importance of SMM evaluation in the prediction of long-term CVD risk among adults 45+ years old without pre-existing CVD. Preservation of SMM may contribute to CVD health.

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Cardiovascular Disease Prediction from Electrocardiogram by Using Machine Learning

International Journal of Online and Biomedical Engineering (iJOE) ◽

10.3991/ijoe.v16i07.13569 ◽

2020 ◽

Vol 16 (07) ◽

pp. 34

Author(s):

Nayan Nazrul Anuar ◽

Ab Hamid Hafifah ◽

Suboh Mohd Zubir ◽

Abdullah Noraidatulakma ◽

Jaafar Rosmina ◽

...

Keyword(s):

Machine Learning ◽

Cardiovascular Disease ◽

Nearest Neighbor ◽

Total Cholesterol Level ◽

Population Based ◽

Support Vector ◽

K Nearest Neighbor ◽

Cvd Risk ◽

Linear Discriminant ◽

Artificial Neural Network Ann

<p>Cardiovascular disease (CVD) is the leading cause of deaths worldwide. In 2017, CVD contributed to 13,503 deaths in Malaysia. The current approaches for CVD prediction are usually invasive and costly. Machine learning (ML) techniques allow an accurate prediction by utilizing the complex interactions among relevant risk factors. This study presents a case–control study involving 60 participants from The Malaysian Cohort, which is a prospective population-based project. Five parameters, namely, the R–R interval and root mean square of successive differences extracted from electrocardiogram (ECG), systolic and diastolic blood pressures, and total cholesterol level, were statistically significant in predicting CVD. Six ML algorithms, namely, linear discriminant analysis, linear and quadratic support vector machines, decision tree, k-nearest neighbor, and artificial neural network (ANN), were evaluated to determine the most accurate classifier in predicting CVD risk. ANN, which achieved 90% specificity, 90% sensitivity, and 90% accuracy, demonstrated the highest prediction performance among the six algorithms. In summary, by utilizing ML techniques, ECG data can serve as a good parameter for CVD prediction among the Malaysian multiethnic population.</p>

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Absolute and Relative Risk of Cardiovascular Disease in Men With Prostate Cancer: Results From the Population-Based PCBaSe Sweden

Journal of Clinical Oncology ◽

10.1200/jco.2010.29.1567 ◽

2010 ◽

Vol 28 (21) ◽

pp. 3448-3456 ◽

Cited By ~ 116

Author(s):

Mieke Van Hemelrijck ◽

Hans Garmo ◽

Lars Holmberg ◽

Erik Ingelsson ◽

Ola Bratt ◽

...

Keyword(s):

Prostate Cancer ◽

Cardiovascular Disease ◽

Absolute Risk ◽

Population Based ◽

Curative Treatment ◽

Endocrine Treatment ◽

Circulatory Disease ◽

Cvd Risk ◽

Calendar Time ◽

Swedish Population

Purpose Cardiovascular disease (CVD) is a potential adverse effect of endocrine treatment (ET) for prostate cancer (PC). We investigated absolute and relative CVD risk in 76,600 patients with PC undergoing ET, curative treatment, or surveillance. Methods PCBaSe Sweden is based on the National Prostate Cancer Register, which covers more than 96% of PC cases. Standardized incidence ratios (SIRs) and standardized mortality ratios (SMRs) of ischemic heart disease (IHD), acute myocardial infarction (MI), arrhythmia, heart failure, and stroke were calculated to compare observed and expected (using total Swedish population) numbers of CVD, taking into account age, calendar time, and previous CVD. Results Between 1997 and 2007, 30,642 patients with PC received primary ET, 26,432 curative treatment, and 19,527 surveillance. SIRs for CVD were elevated in all men with the highest for those undergoing ET, independent of circulatory disease history (SIR MI for men without circulatory disease history: 1.40 [95% CI, 1.31 to 1.49], 1.15 [95% CI, 1.01 to 1.31], and 1.20 [95% CI, 1.11 to 1.30] for men undergoing ET, curative treatment, and surveillance, respectively). Absolute risk differences (ARD) showed that two (arrhythmia) to eight (IHD) extra cases of CVD would occur per 1,000 person-years. SMRs showed similar patterns, with ARD of zero (arrhythmia) to three (IHD) per 1,000 person-years. Conclusion Increased relative risks of nonfatal and fatal CVD were found among all men with PC, especially those treated with ET. Because ET is currently the only effective treatment for metastatic disease and the ARDs were rather small, our findings indicate that CVD risk should be considered when prescribing ET but should not constitute a contraindication when the expected gain is tangible.

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Cardiovascular prevention in peri- and postmenopausal women

CARDIOVASCULAR THERAPY AND PREVENTION ◽

10.15829/1728-8800-2011-3-123-130 ◽

2011 ◽

Vol 10 (3) ◽

pp. 123-130

Author(s):

N. A. Voychenko ◽

I. V. Kuznetsova ◽

V. B. Mychka ◽

M. Yu. Kirillova ◽

S. N. Tolstov

Keyword(s):

Quality Of Life ◽

Cardiovascular Disease ◽

Hormone Replacement Therapy ◽

Postmenopausal Women ◽

Lower Risk ◽

Ovarian Function ◽

Hormone Replacement ◽

Cardiovascular Prevention ◽

Cvd Risk

The adverse consequences of estrogen deficiency in postmenopause include cardiovascular disease (CVD), which affects not only women’s quality of life, but also their life expectancy. Before premenopause, women have significantly lower risk of arterial hypertension than men of the same age. However, in people aged over 50, AH is more prevalent among women. Currently, most experts regard hormone replacement therapy (HRT) in peri- and postmenopausal women as pathogenetic, since it facilitates the adaptation of the female organism to the new metabolic state, with reduced ovarian function. Drospirenone, as a part of HRT, reduces CVD risk in postmenopausal women with climacteric disturbances.

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Number of parity/live birth(s) and cardiovascular disease among Iranian women and men: Results of over 15 years of follow-up.

10.21203/rs.3.rs-24011/v2 ◽

2020 ◽

Author(s):

Seyyed Saeed Moazzeni ◽

Hossein Toreyhi ◽

Samaneh Asgari ◽

Fereidoun Azizi ◽

Fahimeh Ramezani Tehrani ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Live Birth ◽

Middle Eastern ◽

Population Based ◽

P Value ◽

Cvd Risk ◽

Live Births ◽

Potential Risk Factors

Abstract Background: Most previous studies, conducted in non-Middle Eastern populations, have suggested that increase in the number of parity/live birth(s) leads to cardiovascular disease (CVD) development, although their findings were inconclusive on this issue for both sexes. Biologic and socioeconomic pathways were suggested to explain this association. We studied this issue among urban Iranian men and women. Methods: In this population-based cohort study, included 3929 women and 2571 men aged ≥ 30 years, Data for number of parity/live birth(s) were obtained by standard questionnaire. Participants were then annually followed for CVD events. Multivariate Cox proportional hazard models were used to estimate hazard ratios (HRs), and 95% confidence intervals (CIs) for the number of parity/live birth(s) and other traditional CVD risk factors. Results: During more than 15 years of follow-up, 456 and 524 CVD events have occurred among women and men, respectively. Among women, a J-shaped association was found between the number of live births and incident CVD with the lowest risk for women with 2 live births. Among women in multivariate analyses, each unit increase in parity had a HR of 1.05 (CI: 1.01-1.10) and having ≥4 parity was associated with a HR of 1.86 (0.97-3.56, p-value=0.061). Among men, in comparison with participants who had 1 child, multivariate HRs of having 2, 3 and ≥4 children were 1.97 (1.24-3.12), 2.08 (1.31-3.31) and 2.08 (1.30-3.34), respectively. Conclusion: To the best of our knowledge, the current study is the first report of this issue in the Middle East and North Africa region, a region with high burden of CVD. It can now be suggested that the number of parity/live birth(s) is linked to CVD among the Iranian population, with this issue being more prominent among men. Further research is needed to support our results and clarify the pathways between the number of parity/live birth(s) and CVD development among Iranian populations by considering potential risk factors, especially psycho-socio-economic risk factors.

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Number of parity/live birth(s) and cardiovascular disease among Iranian women and men: Results of over 15 years of follow-up.

10.21203/rs.3.rs-24011/v3 ◽

2020 ◽

Author(s):

Seyyed Saeed Moazzeni ◽

Hossein Toreyhi ◽

Samaneh Asgari ◽

Fereidoun Azizi ◽

Fahimeh Ramezani Tehrani ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Live Birth ◽

Middle Eastern ◽

Population Based ◽

P Value ◽

Cvd Risk ◽

Live Births ◽

Potential Risk Factors

Abstract Background: Most previous studies conducted in non-Middle Eastern populations have suggested that an increase in the number of parity/live birth(s) leads to cardiovascular disease (CVD) development, although their findings were inconclusive on this issue for both sexes. Biologic and socioeconomic pathways were suggested to explain this association. We studied this issue among urban Iranian men and women.Methods: In this population-based cohort study, which included 3929 women and 2571 men aged ≥ 30 years, data for the number of parity/live birth(s) were obtained by a standard questionnaire. Participants were then annually followed for CVD events. Multivariate Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the number of parity/live birth(s) and other traditional CVD risk factors.Results: During more than 15 years of follow-up, 456 and 524 CVD events have occurred among women and men, respectively. Among women, a J-shaped association was found between the number of live births and incident CVD with the lowest risk for women with two live births. Among women in multivariate analyses, each unit increase in parity had a HR of 1.05 (CI: 1.01-1.10), and having ≥4 parity was associated with a HR of 1.86 (0.97-3.56, p-value=0.061). Among men, in comparison with participants who had 1 child, multivariate HRs of having 2, 3, and ≥4 children were 1.97 (1.24-3.12), 2.08 (1.31-3.31), and 2.08 (1.30-3.34), respectively.Conclusion: To the best of our knowledge, the current study is the first report on this issue in the Middle East and North Africa region, a region with a high burden of CVD. It can now be suggested that the number of parity/live birth(s) is linked to CVD among the Iranian population, with this issue being more prominent among men. Further research is needed to support our results and clarify the pathways between the number of parity/live birth(s) and CVD development among Iranian populations by considering potential risk factors, especially psycho-socio-economic risk factors.

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Cohort study on the effects of depression on atherosclerotic cardiovascular disease risk in Korea

BMJ Open ◽

10.1136/bmjopen-2018-026913 ◽

2019 ◽

Vol 9 (6) ◽

pp. e026913 ◽

Cited By ~ 2

Author(s):

Yon Ho Jee ◽

Hyoungyoon Chang ◽

Keum Ji Jung ◽

Sun Ha Jee

Keyword(s):

Cardiovascular Disease ◽

Cohort Study ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Population Based ◽

Western World ◽

Atherosclerotic Cardiovascular Disease ◽

Cvd Risk ◽

National Health Insurance System ◽

Increased Risk

ObjectivesDepression has been reported to be a risk factor of cardiovascular disease in the western world, but the association has not yet been studied among Asian populations. The aim of this study was to investigate whether depression increases the risk of developing atherosclerotic cardiovascular disease (ASCVD) in a large Korean cohort study.DesignPopulation based cohort study.SettingDatabase of National Health Insurance System, Republic of Korea.Participants481 355 Koreans (260 695 men and 220 660 women) aged 40–80 years who had a biennial health check-up between 2002 and 2005.Main outcome measureThe main outcome in this study was the first ASCVD event (hospital admission or death).ResultsDepression increased the risk of developing ASCVD by 41% for men and 48% for women. In men, 3–4 outpatient visits for depression increased the risk of angina pectoris by 2.12 times (95% CI 1.55 to 2.90) and acute myocardial infarction by 2.29 times (95% CI 1.33 to 3.95). Depression was also associated with stroke in men (HR 1.29, 95% CI 1.19 to 1.39) and in women (HR 1.37, 95% CI 1.29 to 1.46). However, no increased risk of ASCVD was found for men who received 10 or more depressive treatments, compared with those without any outpatient visit for depression.ConclusionsIn this cohort, depressed people were at increased risk of ASCVD incidence. Therefore, individuals with depression may need routine monitoring of heart health that may prevent their future CVD risk.

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