scholarly journals Cardiovascular risk in obese patients with chronic periodontitis: a clinical controlled study

2013 ◽  
Vol 42 (3) ◽  
pp. 188-195 ◽  
Author(s):  
Juliana Rico Pires ◽  
Thaís Uenoyama Dezem ◽  
Eliane Marçon Barroso ◽  
Benedicto Egbert Corrêa de Toledo ◽  
Sally Cristina Moutinho Monteiro ◽  
...  

INTRODUCTION: Studies have shown that obesity is considered a risk factor for the development of periodontal disease and cardiovascular events. OBJECTIVE: The objective was to evaluate the risk for cardiovascular diseases (CVDs) in obese patients with and without periodontal. MATERIAL AND METHOD: One hundred patients were divided into four groups: Group O - obese without chronic periodontitis (n=25); Group OP - obese with chronic periodontitis (n=25); Group NO - non-obese without chronic periodontitis (n=25); and Group NOP - non-obese with chronic periodontitis (n=25). Demographic and laboratorial data (total cholesterol, high-density lipoprotein - HDL and low-density lipoprotein - LDL, triglycerides, and glucose); anthropometric measurements (body mass index - BMI; waist circumference - WC; body fat - BF); blood pressure; and periodontal parameters (bleeding on probing - BOP, periodontal probing depth - PPD, and the clinical attachment level - CAL) were evaluated. Cardiovascular risk was obtained according to the PROCAM's score. The correlation between obesity, periodontal disease and risk for CVD was verified by Spearman's test (α = 0.05). RESULT: The group OP showed a statistically higher rate of PPD > 7 mm (11.2 ± 2.03) when compared with other groups, as well as higher levels of triglycerides, total cholesterol, and LDL (p<0.05). The risk for CVD was statistically higher in the group OP (28.1 ± 3.3) when compared with group O (16.5 ± 3.5), group NOP (12.8 ± 3.9), and group NO (7.7 ± 0.9). Obesity and periodontal disease are directly related to a moderate increase in CVD risk (r = 0.53, p <0.0001 and r = 0.62, p <0.0001, respectively). CONCLUSION: It was concluded that obesity and periodontal disease increases the risk to cardiovascular events.

2012 ◽  
Vol 8 (4) ◽  
pp. 398-404
Author(s):  
M Aryal ◽  
A Poudel ◽  
B Satyal ◽  
P Gyawali ◽  
B R Pokheral ◽  
...  

Background Cardiovascular disease (CVD), is the primary cause of morbidity and mortality in patients with diabetes and have approximately - two to four times higher CVD rate than adult without diabetes. Low density lipoprotein cholesterol (LDL-C) is primarily used as the marker of cardiovascular risk in diabetes despite its several limitations. Although several newer markers of CVD are emerging, no marker has been established in Nepal. Objectives The study was designed to evaluate the non-high-density-lipoprotein- cholesterol(Non-HDL-C) and Total Cholesterol to High density lipoprotein cholesterol (TC:HDL-C ratio) as CVD risk marker in diabetes mellitus. Methods The study was conducted in the Department of Bbiochemistry, Kathmandu University School of Medical Sciences. The study comprised of 76 diabetic subjects and 60 non-diabetic subjects. The anthropometric and biochemical parameters were measured. The Non-HDL-C and TC:HDL-C ratio were also calculated employing their respective formula. Results Body mass index (BMI), waist circumference (WC), blood pressure and lipid parameters were significantly different between diabetic subjects and non-diabetic subjects. There was increased non-HDL-C and TC:HDL-C ratio in subjects with diabetes mellitus. Furthermore, statistically significant correlations of non-HDL-C and TC:HDL-C ratio were obtained with BMI, WC, total cholesterol, HDL-C and LDL-C in diabetic subjects. Conclusions The present study observation revealed that the Non-HDL-C and TC: HDL-C strongly correlate with established independent risk factors such as obesity(WC), elevated blood pressure, HDL-C and LDL-C in diabetes. Thus, the evaluation of Non-HDL-C and TC: HDL-C ratio can be used as the simple, cost-effective and cumulative marker of cardiovascular risk in diabetes mellitus.http://dx.doi.org/10.3126/kumj.v8i4.6239 Kathmandu Univ Med J 2010;8(4):398-404 


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Kristensen ◽  
V Rosberg ◽  
J Vishram-Nielsen ◽  
M Pareek ◽  
A Linneberg ◽  
...  

Abstract Background Body composition predicts cardiovascular outcomes, but it is uncertain whether anthropometric measures can replace the more expensive serum total cholesterol for cardiovascular risk stratification in low resource settings. Purpose The purpose of the study was to compare the additive prognostic ability of serum total cholesterol with that of body mass index (BMI), waist/hip ratio (WHR), and estimated fat mass (EFM, calculated using a validated prediction equation), individually and combined. Methods We used data from the MORGAM (MONICA, Risk, Genetics, Archiving, and Monograph) Prospective Cohort Project, an international pooling of cardiovascular cohorts, to determine the relationship between anthropometric measures, serum cholesterol, and cardiovascular events, using multivariable Cox proportional-hazards regression analysis. We further investigated the ability of these measures to enhance prognostication beyond a simpler prediction model, consisting of age, sex, smoking status, systolic blood pressures, and country, using comparison of area under the receiver operating characteristics curve (AUCROC) derived from binary logistic regression models. The primary endpoint was major adverse cardiovascular events (MACE), defined as a composite of death from coronary heart disease, myocardial infarction, or stroke. Results The study population consisted of 52,188 apparently healthy subjects (56.3% men) aged 47±12 years ranging from 20 to 84, derived from 37 European cohorts, with baseline between 1982–2002 all followed for 10 years during which MACE occurred in 2465 (4.7%) subjects. All anthropometric measures (BMI: hazard ratio (HR) 1.04 [95% confidence interval (CI): 1.03–1.05] per kg/m2; WHR: HR 7.5 [4.0–14.0] per unit; EFM: HR 1.02 [1.01–1.02] per kg) as well as serum total cholesterol (HR 1.20 [1.16–1.24] per mmol/l) were significantly associated with MACE (P&lt;0.001 for all), independently of age, sex, smoking status, systolic blood pressures, and country. The addition of serum cholesterol significantly improved the predictive ability of the simple model (AUCROC 0.818 vs. 0.814, P&lt;0.001), as did the combination of WHR, BMI, and EFM (AUCROC 0.817 vs. 0.814, P=0.004). When assessed individually, BMI (AUCROC 0.816 vs. 0.814, P=0.004) and WHR (AUCROC 0.815 vs. 0.814, P=0.02) improved model performance, while EFM narrowly missed significance (AUCROC 0.815 vs. 0.814, P=0.06). There was no significant difference in the predictive ability of a model including serum cholesterol versus that including all three anthropometric measures (AUCROC 0.818 vs. 0.817, P=0.13). The figure shows the pertinent areas under the ROC curve in predicting MACE. Conclusion In this large population-based cohort study, the addition of a combination of anthropometric measures, i.e. BMI, WHR, and EFM, raised the predictive ability of a simple prognostic model comparable to that obtained by the addition of serum total cholesterol. Figure 1 Funding Acknowledgement Type of funding source: None


2021 ◽  
Vol 10 (15) ◽  
pp. 3400
Author(s):  
Cathy Degroote ◽  
Roland von Känel ◽  
Livia Thomas ◽  
Claudia Zuccarella-Hackl ◽  
Jens C. Pruessner ◽  
...  

Hyperreactivity to stress may be one explanation for the increased risk of cardiovascular disease (CVD) in individuals with essential hypertension. We investigated blood lipid reactivity to the Montreal Imaging Stress Task (MIST), a psychosocial stressor, in hypertensive and normotensive men and tested for prospective associations with biological risk factors. Fifty-six otherwise healthy and medication-free hypertensive and normotensive men underwent the MIST. We repeatedly measured cortisol and blood lipid profiles (total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG)) immediately before and up to 1 h after stress. Lipid levels were corrected for stress hemoconcentration. Thirty-five participants completed follow-up assessment 2.9 ± 0.12 (SEM) years later. CVD risk was assessed by prospective changes in TC/HDL-C ratio, IL-6, D-dimer, and HbA1c from baseline to follow-up. The MIST induced significant changes in all parameters except TC (p-values ≤ 0.043). Compared with normotensives, hypertensives had higher TC/HDL-C-ratio and TG (p-values ≤ 0.049) stress responses. Blood lipid stress reactivity predicted future cardiovascular risk (p = 0.036) with increases in HbA1c (ß = 0.34, p = 0.046), IL-6 (ß = 0.31, p = 0.075), and D-dimer (ß = 0.33, p = 0.050). Our results suggest that the greater blood lipid reactivity to psychosocial stress in hypertensives, the greater their future biological CVD risk. This points to lipid stress reactivity as a potential mechanism through which stress might increase CVD risk in essential hypertension.


2020 ◽  
pp. bmjmilitary-2020-001608
Author(s):  
Stefan Sammito ◽  
N Güttler

IntroductionCardiovascular disease (CVD) is the leading cause of death in western industrial countries and one of the most frequent causes of sudden incapacitation in flight for pilots. There are limited data available on cardiovascular risk profiles of pilots, and especially military pilots. The aim of this study was to assess the prevalence of cardiovascular risk factors (CVRF) in German military pilots.MethodsThe changing prevalence of CVRF in active military pilots was studied using a cross-sectional survey during two distinct periods, 2007–2009 and 2016–2018. Data collected included sex, body mass index (BMI), smoking status, resting blood pressure, total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), triglycerides and glucose. The use of antihypertensive drugs, diagnosis of diabetes mellitus and positive family history of myocardial infarction were also captured. Based on these data, the PROCAM (Prospective Cardiovascular Münster) score was calculated.ResultsData from 5353 flight medical examinations were analysed, 3397 from 2007 to 2009, and 1959 from 2016 to 2018. Between the cohorts, age, BMI, total cholesterol, HDL, LDL, glucose and triglycerides increased significantly. The number of pilots on antihypertensive medication decreased significantly. The PROCAM score increased between cohorts from 18 to 23 points predicting a 10-year risk of an acute coronary event of <1% and 1.3%, respectively.ConclusionThe German military pilot population has become older with increased CVRF. CVD will be a future challenge for the German Armed Forces and probably other military forces. However, there was only a mild increase of the PROCAM score over time.


JAMA ◽  
2016 ◽  
Vol 315 (10) ◽  
pp. 990 ◽  
Author(s):  
Steven E. Nissen ◽  
Kathy E. Wolski ◽  
Lisa Prcela ◽  
Thomas Wadden ◽  
John B. Buse ◽  
...  

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Susana Coimbra ◽  
Flávio Reis ◽  
Sara Nunes ◽  
Sofia Viana ◽  
Maria João Valente ◽  
...  

Cardiovascular disease (CVD) events are the main causes of death in end-stage renal disease (ESRD) patients on dialysis. The number and severity of CVD events remain inappropriate and difficult to explain by considering only the classic CVD risk factors. Our aim was to clarify the changes and the relationship of lipoprotein subfractions with other CVD risk factors, namely, body mass index (BMI) and adipokines, inflammation and low-density lipoprotein (LDL) oxidation, and the burden of the most prevalent comorbidities, diabetes mellitus (DM) and hypertension (HT). We studied 194 ESRD patients on dialysis and 22 controls; lipid profile, including lipoprotein subpopulations and oxidized LDL (oxLDL), C-reactive protein (CRP), adiponectin, leptin, and paraoxonase 1 activity were evaluated. Compared to controls, patients presented significantly lower levels of cholesterol, high-density lipoprotein cholesterol (HDLc), LDLc, oxLDL, and intermediate and small HDL and higher triglycerides, CRP, adiponectin, large HDL, very-low-density lipoprotein (VLDL), and intermediate-density lipoprotein- (IDL) B. Adiponectin levels correlated positively with large HDL and negatively with intermediate and small HDL, oxLDL/LDLc, and BMI; patients with DM (n=17) and with DM+HT (n=70), as compared to patients without DM or HT (n=69) or only with HT (n=38), presented significantly higher oxLDL, oxLDL/LDLc, and leptin and lower adiponectin. Obese patients (n=45), as compared to normoponderal patients (n=81), showed lower HDLc, adiponectin, and large HDL and significantly higher leptin, VLDL, and intermediate and small HDL. In ESRD, the higher adiponectin seems to favor atheroprotective HDL modifications and protect LDL particles from oxidative atherogenic changes. However, in diabetic and obese patients, adiponectin presents the lowest values, oxLDL/LDLc present the highest ones, and the HDL profile is the more atherogenic. Our data suggest that the coexistence of DM and adiposity in ESRD patients on dialysis contributes to a higher CVD risk, as showed by their lipid and adipokine profiles.


2018 ◽  
Vol 3 (1) ◽  
pp. 291-303 ◽  
Author(s):  
Monik C Jiménez ◽  
Katherine L Tucker ◽  
Fátima Rodriguez ◽  
Bianca C Porneala ◽  
James B Meigs ◽  
...  

Abstract Low blood dehydroepiandrosterone sulfate (DHEAS) levels have strong positive associations with stroke and coronary heart disease. However, it is unclear whether DHEAS is independently associated with cardiovascular risk factors. Therefore, we examined the association between cardiovascular risk factors and DHEAS concentration among a high-risk population of Latinos (Puerto Ricans aged 45 to 75 years at baseline) in a cross-sectional analysis of the Boston Puerto Rican Health Study. Of eligible participants, 72% completed baseline interviews and provided blood samples. Complete data were available for 1355 participants. Associations between cardiovascular risk factors (age, sex, total cholesterol, high-density lipid cholesterol, triglycerides, and glucose) and log-transformed DHEAS (μg/dL) were assessed. In robust multivariable regression analyses, DHEAS was significantly inversely associated with age (β = −12.4; 95% CI: −15.2, −9.7; per 5 years), being female (vs. male) (β = −46; 95% CI: −55.3, −36.6), and plasma triglyceride concentration (β = −0.2; 95% CI: −0.3, −0.1; per 10 mg/dL) and was positively associated with total cholesterol and plasma glucose levels (β = 1.8; 95% CI: 0.6, 3 and β = 0.2; 95% CI: 0.04, 0.3, respectively, per 10 mg/dL) after adjustment for smoking, alcohol, and physical activity and for postmenopausal hormone use in women. Estimates were unchanged after adjustment for measures of chronic disease and inflammation. Women exhibited a stronger age-related decline in DHEAS and a positive association with glucose in contrast to findings among men (Pinteraction &lt; 0.05). In conclusion, in this large study of Latinos with a heavy cardiovascular risk factor burden, we observed significant associations between cardiovascular disease (CVD) risk factors and DHEAS, with variations by sex. These findings improve our understanding of the role DHEAS may play in CVD etiology.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
C Magnussen

Abstract Background Knowledge about the impact of modifiable risk factors for cardiovascular disease (CVD) onset is essential to improve CVD prevention. Purpose We estimated population-attributable fractions (PAFs) of body-mass-index (BMI), systolic blood pressure (SBP), diabetes, blood lipids (non-high-density lipoprotein cholesterol; non-HDL-C) and daily smoking for CVD. Methods Harmonized data from MOnica Risk, Genetics, Archiving and Monograph (MORGAM) and Biomarkers for Cardiovascular Risk Assessment in Europe (BiomaCaRE) consortia were used to calculate hazard ratios (HRs; 95% CI) and PAFs for incident CVD (myocardial infarction or coronary death, unstable angina, cardiac revascularization, ischemic stroke). PAFs for single risk factors or any combination of them were estimated using methods by Laaksonen 2011. Results We included 150,190 participants (77,801 men and 72,389 women) without CVD at baseline. Strongest associations were seen for SBP ≥160 mmHg (HR 1.79, 1.67–1.92 men; HR 1.93, 1.75–2.14 women), diabetes (HR 2.02, 1.86–2.20 men; HR 2.29, 2.06–2.55 women), non-HDL-C ≥220 mg/dL (HR 3.11, 2.49–3.88 men; HR 2.27, 1.68–3.05 women), daily smoking (HR 1.82, 1.73–1,90 men; HR 2.16, 2.0–2.33 women). Table 1 provides PAFs for incident CVD. Overall PAFs for men and women were 73.7% (67.7–79.1) and 73.3% (64.9–80.9). Table 1. PAFs (%) for 5-year incident CVD Risk factor/category PAFs (95% CI), men PAFs (95% CI), women Underweight 0.1 (−0.1, 0.3) 0.2 (−0.1, 0.6) Pre-obesity 6.6 (4.3, 8.9) 4.3 (1.5, 6.9) Obesity 3.9 (2.7, 5.3) 8.0 (5.3, 10.5) SBP 130 to <140 mmHg 2.8 (1.7, 4.0) 2.7 (1.3, 4.0) SBP 140 to <160 mmHg 9.7 (8.1, 11.3) 9.3 (6.7, 11.6) SBP ≥160 mmHg 11.3 (9.7, 12.8) 18.9 (16.2, 21.8) Diabetes 5.2 (4.5, 6.2) 7.8 (6.5, 9.4) non-HDL-C 100 to <145 mg/dL 4.3 (1.8, 6.4) 3.3 (0.5, 6.5) non-HDL-C 145 to <185 mg/dL 13.9 (9.8, 17.5) 11.3 (6.0, 16.2) non-HDL-C 185 to <220 mg/dL 15.8 (12.8, 18.4) 12.8 (8.8, 17.0) non-HDL-C ≥220 mg/dL 16.7 (14.6, 18.5) 17.0 (12.5, 21.1) Daily smoking 16.5 (15.0, 18.3) 12.3 (10.7, 13.7) The N CVD events/N used was 8,302/77,801 for men and 4,071/72,389 for women. Conclusion Uncontrolled risk factors, especially non-HDL-C and SBP in the highest category, daily smoking and diabetes had the highest impact for incident CVD. All risk factors combined accounted for a PAF of 73%. Targeting risk factors would lead to a substantial reduction of CVD onset. Acknowledgement/Funding BiomarCaRE: EU Seventh Framework Programme (FP7/2007-2013), No. HEALTH-F2-2011-278913. MORGAM: EU FP 7 CHANCES (HEALTH-F3-2010-242244).


1991 ◽  
Vol 66 (2) ◽  
pp. 161-169 ◽  
Author(s):  
Geert Van Poppel ◽  
Petra Schneijder ◽  
Michiel R. H. Löwik ◽  
Jaap Schrijver ◽  
Frans J. Kok

As part of the Dutch Nutrition Surveillance System, cardiovascular risk factors and food consumption (24 h recall) as well as haematological, Fe and vitamin status (A, B6, C) were assessed in 126 Dutch boys aged 10–11 years (response 71 %). Body mass index (BMI) and the sum of four skinfolds were strongly associated (r0.85,P< 0.01) and 8% of the boys were overweight (BMI > 20.1 kg/m2). Elevated serum total cholesterol levels (> 4.4 mmol/l) were observed in 38 %; total cholesterol and low-density-lipoprotein-cholesterol levels were strongly associated (r0.88,P< 0.001). Intake of fat was high (38 % of energy) and too much fat was saturated (polyunsaturated: saturated 0.44, guideline: 0.5–1.0), whereas intake of carbohydrate (49% of energy) and dietary fibre was low. About 12% of the boys had insufficient Fe stores (plasma ferritin < 12.0 μg/l) and the mean Fe intake (9.0 mg/d) was below recommended daily allowance (10.0 mg/d). Plasma ferritin was, however, not associated with haematological indices and no frank anaemias were observed. No marginal values were observed for vitamins A, B6and C status. In conclusion, the main nutritional risks in boys aged 10–11 years are cardiovascular risk factors and Fe nutrition.


2005 ◽  
Vol 153 (5) ◽  
pp. 679-686 ◽  
Author(s):  
Cheng-Chieh Lin ◽  
Tsai-Chung Li ◽  
Ming-May Lai

Objective: The purpose of this study was to assess the lipid-lowering effect of Monascus purpureus Went rice on serum lipids in patients with hyperlipidemia, and to assess its safety by reporting adverse events and clinical laboratory measurements. Design and methods: This was a randomized, double-blind, placebo-controlled study. In all, 79 patients (aged 23–65 years) with a mean baseline low-density lipoprotein cholesterol (LDL-C) level of 5.28 mmol/l (203.9 mg/dl) received a twice daily dose of placebo or Monascus purpureus Went rice (600 mg) for 8 weeks. Results: At week 8, Monascus purpureus Went rice therapy reduced LDL-C by 27.7%, total cholesterol by 21.5%, triglycerides by 15.8% and apolipoprotein B by 26.0%. High-density lipoprotein cholesterol and apolipoprotein A-I levels were increased by 0.9 and 3.4% respectively (not significant). No patient in the Monascus purpureus Went rice treatment group had an alanine aminotransferase (ALT), aspartate aminotransferase (AST) or creatine phosphokinase (CPK) measurement that was ≥ 3 times the upper limit of normal at week 4 and week 8. Conclusion: Monascus purpureus Went rice significantly reduced LDL-C, total cholesterol, triglycerides and apolipoprotein B levels, and was well tolerated in patients with hyperlipidemia. However, this study only provides data from an 8-week trial and long-term safety and efficacy data are needed.


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