scholarly journals Factors Determining the Three-Year Dynamics of Lipid Metabolism Indicators in Residents of a Large Industrial Region of Siberia

2022 ◽  
Vol 17 (6) ◽  
pp. 837-844
Author(s):  
D. P. Tsygankova ◽  
E. D. Bazdyrev ◽  
E. V. Indukaeva ◽  
A. S. Agienko ◽  
O. V. Nakhratova ◽  
...  
Keyword(s):  
Risk Factors ◽  
Economic Status ◽  
Hdl Cholesterol ◽  
Lipid Lowering ◽  
Behavioral Risk ◽  
Lipid Lowering Therapy ◽  
Socioeconomic Groups ◽  
Increased Risk ◽  
Low Hdl ◽  
Obesity Hypertension

Aim. To assess the contribution of traditional and socio-economic factors to the development and dynamics of dyslipidemia based on the results of an epidemiological study in a large region of Siberia.Material and methods. Clinical and epidemiological prospective study of the population 35-70 years old was carried out. At the basic stage, 1600 participants were examined, including 1124 women and 476 men, the prospective stage included 807 respondents (the response was 84.1%). A survey was carried out to find out the state of health (presence of diseases, taking medications), socio-economic status (level of education and income, marital status) and the presence of behavioral risk factors (tobacco and alcohol use).Results. The proportion of people with hypercholesterolemia increased 1.2 times, low LDL – 1.1 times, and hypertriglyceridemia and low HDL – 1.7 times. In persons with hypertriglyceridemia, the frequency of detected obesity and hypertension decreased by 7.9% and 4.6%, respectively (p = 0.046). Obesity was associated with an increased risk of developing hypercholesterolemia (OR = 1.49, CI: 1.0-2.2), hypertriglyceridemia (OR = 2.14, CI: 1.5-3.0), high LDL cholesterol (OR = 2.16, CI: 1.3-3.6) and low HDL cholesterol (OR = 2.07, CI: 1.5-2.9). The presence of hypertension - with an increased risk of developing hypertriglyceridemia (OR = 2.19, CI: 1.5-3.1) and low HDL (OR = 2.49, CI: 1.8-3.5). Among people with low HDL levels, the number of smokers and drinkers decreased (by 7.0% and 5.7%, respectively), as well as those with obesity by 8.6%. The prevalence of dyslipidemia increased in all socioeconomic groups.Conclusion. Over 3 years of follow-up, there was a statistically significant increase in the proportion of persons with dyslipidemia in all socio-economic groups. There was a significant decrease in such risk factors as obesity, hypertension, smoking, alcohol consumption and an increase in the number of respondents taking lipid-lowering therapy.

scholarly journals Multimorbidity of Four Cardiometabolic and Chronic Pulmonary Disease Groups: Prevalence and Attributable Fraction in US Adults, 2007–2012

2017 ◽  
Vol 7 (1) ◽  
pp. 22-32 ◽  
Author(s):  
Lisa R. Staimez ◽  
Melissa Y. Wei ◽  
Min Kim ◽  
K. M. Venkat Narayan ◽  
Sharon H. Saydah
Keyword(s):  
Risk Factors ◽  
Pulmonary Disease ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Modifiable Risk Factors ◽  
Chronic Pulmonary Disease ◽  
Chronic Pulmonary Diseases ◽  
The Usa ◽  
Low Hdl ◽  
Obesity Hypertension

Background Cardiometabolic and chronic pulmonary diseases may be associated with modifiable risk factors that can be targeted to prevent multimorbidity. Objectives (i) Estimate the prevalence of multimorbidity across four cardiometabolic and chronic pulmonary disease groups; (ii) compare the prevalence of multimorbidity to that of one disease and no disease; and (iii) quantify population attributable fractions (PAFs) for modifiable risk factors of multimorbidity. Design Data from adults aged 18–79 years who participated in the US National Health and Nutrition Examination Survey 2007–2012 were examined. Multimorbidity was defined as ≥2 co-occurring diseases across four common cardiometabolic and chronic pulmonary disease groups. Multivariate-adjusted PAFs for poverty, obesity, smoking, hypertension, and low high-density lipoprotein (HDL) cholesterol were estimated. Results Among 16,676 adults, the age-standardized prevalence of multimorbidity was 9.3%. The occurrence of multimorbidity was greater with age, from 1.5% to 5.9%, 15.0% and 34.8% for adults aged 18–39, 40–54, 55–64 and 65–79 years, respectively. Multimorbidity was greatest among the poorest versus non-poorest adults and among blacks versus other races/ethnicities. Multimorbidity was also greater in adults with obesity, hypertension, and low HDL cholesterol. Risk factors with greatest PAFs were hypertension (38.8%; 95% confidence interval [CI] 29.4–47.4) and obesity (19.3%; 95% CI 10.2–28.2). Conclusions In the USA, 9.3% of adults have multimorbidity across four chronic disease groups, with a disproportionate burden among older, black, and poor adults. Our results suggest that targeting two intermediate modifiable risk factors, hypertension and obesity, might help to reduce the prevalence of multimorbidity in US adults.

scholarly journals SAT0586 PREVALENCE AND RISK FACTORS FOR CARDIO-METABOLIC ABNORMALITIES IN PATIENTS WITH INFLAMMATORY ARTHRITIS ATTENDING CARDIO-RHEUMATOLOGY PRIMARY PREVENTION CLINICS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1252.1-1252
Author(s):  
L. Eder ◽  
S. Akhtari ◽  
P. Harvey ◽  
K. Bindee
Keyword(s):  
Risk Factors ◽  
Primary Prevention ◽  
Inflammatory Arthritis ◽  
Clinical Laboratory ◽  
Hdl Cholesterol ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Metabolic Abnormalities ◽  
Research Support ◽  
Obesity And Diabetes

Background:Cardio-metabolic abnormalities are common in patients with inflammatory arthritis (IA) but tend to be under-recognized and under-treated.Objectives:We aimed to compare the prevalence and risk factors for cardio-metabolic abnormalities between patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS).Methods:Consecutive patients enrolled in the University of Toronto Cardio-Rheumatology Network from July 2017 to August 2019 were analyzed. This is a primary prevention program that uses structured clinical, laboratory and multimodal imaging to diagnose and treat cardiovascular disease (CVD). Patients with a rheumatologist-confirmed diagnosis of RA, PsA or AS with no known CVD were evaluated. Information about IA diagnosis, medications and comorbidities was recorded. Each patient was evaluated by a cardiologist focusing on CVD risk assessment. We evaluated the prevalence of previously recorded and newly recognized cardio-metabolic risk factors including hypertension, dyslipidemia, obesity and diabetes. The prevalence of these abnormalities was compared between IA diagnoses. Regression models were used to assess the association between diagnosis and cardio-metabolic abnormalities after adjusting for demographics, smoking, BMI, measures of disease activity and medications.Results:A total of 358 patients (201 RA, 124 PsA, 33 AS) were assessed (mean age 59±10.5 years, 68.7% female). Hypertension was reported in 33%, dyslipidemia in 26.8%, diabetes mellitus in 8.9% and overweight/obesity in 69.7% (Figure 1). Newly detected elevations in lipids were frequent for triglycerides (9.3%,), non-HDL-cholesterol (6%,) and LDL-cholesterol (2.7%). Elevated HbA1c occurred in 1.4% and newly diagnosed hypertension occurred in 9.8%. A total of 32.8% patients required a change or initiation of medications for their cardio-metabolic abnormalities (21.7% lipid-lowering therapy, 14.6% aspirin, 11.1% anti-hypertension therapy). Patients with PsA had the highest prevalence of cardio-metabolic abnormalities including dyslipidemia, obesity and hypertension. Having hypertension (prior or new diagnosis), elevated levels of triglycerides, non-HDL cholesterol, total cholesterol and BMI were associated with PsA vs. RA after adjusting for potential confounders (all p<0.05) (Figure 2). No significant association was found between cardio-metabolic abnormalities and AS vs. PsA or RA.Conclusion:Dedicated cardio-rheumatology clinics have improved CVD screening and management in an IA population. The burden of cardio-metabolic abnormalities is elevated in PsA and suggests that tailored strategies to reduce adverse CVD events are particularly needed in this subgroup.Disclosure of Interests:Lihi Eder Grant/research support from: Abbvie, Lily, Janssen, Amgen, Novartis, Consultant of: Janssen, Speakers bureau: Abbvie, Lily, Janssen, Amgen, Novartis, Shadi Akhtari: None declared, Paula Harvey: None declared, Kuriya Bindee Grant/research support from: Abbvie, Pfizer, Sanofi, BMS, Consultant of: Abbvie, Eli Lily, Pfizer

Abundance of undiagnosed cardiometabolic risk within the population of a long-stay prison in the UK

2020 ◽  
Author(s):  
Benjamin J Gray ◽  
Christie Craddock ◽  
Zoe Couzens ◽  
Evie Bain ◽  
Gareth J Dunseath ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiometabolic Risk ◽  
Hdl Cholesterol ◽  
Cardiometabolic Risk Factors ◽  
Risk Assessments ◽  
Public Health Issue ◽  
Clinical Markers ◽  
Screening Guidelines ◽  
Increased Risk ◽  
Low Hdl

Abstract Background The health of people in prisons is a public health issue. It is well known that those in prison experience poorer health outcomes than those in the general community. One such example is the burden of non-communicable diseases, more specifically cardiovascular disease (CVD), stroke and type 2 diabetes (T2DM). However, there is limited evidence research on the extent of cardiometabolic risk factors in the prison environment in Wales, the wider UK or globally. Methods Risk assessments were performed on a representative sample of 299 men at HMP Parc, Bridgend. The risk assessments were 30 min in duration and men aged 25–84 years old and free from pre-existing CVD and T2DM were eligible. During the risk assessment, a number of demographic, anthropometric and clinical markers were obtained. The 10-year risk of CVD and T2DM was predicted using the QRISK2 algorithm and Diabetes UK Risk Score, respectively. Results The majority of the men was found to be either overweight (43.5%) or obese (37.5%) and/or demonstrated evidence of central obesity (40.1%). Cardiometabolic risk factors including systolic hypertension (25.1%), high cholesterol (29.8%), low HDL cholesterol (56.2%) and elevated total cholesterol: HDL ratios (23.1%) were observed in a considerable number of men. Ultimately, 15.4% were calculated at increased risk of CVD, and 31.8% predicted at moderate or high risk of T2DM. Conclusions Overall, a substantial prevalence of previously undiagnosed cardiometabolic risk factors was observed and men in prison are at elevated risk of cardiometabolic disease at a younger age than current screening guidelines.

Lipid-lowering drugs

ESC CardioMed ◽  
2018 ◽  
pp. 204-209
Author(s):  
Cesare R. Sirtori ◽  
Massimiliano Ruscica
Keyword(s):  
Ldl Cholesterol ◽  
Hdl Cholesterol ◽  
Lipid Lowering ◽  
High Density Lipoproteins ◽  
Omega 3 ◽  
Transfer Protein ◽  
Increased Risk ◽  
Low Hdl ◽  
Coronary Events ◽  
Systemic Agents

Hyperlipidaemias, multifactorial conditions partly genetically and partly life habit induced, are the most important underlying risk factors for cardiovascular disease. They can lead to arterial lipid deposition with a consequent increased risk of coronary events. The primary effort in hypolipidaemic drug therapy is focused on the lowering of the primary carriers of cholesterol, the low-density lipoproteins (LDLs), but more recent efforts have been placed on the lowering of triglycerides. Reduced levels of the protective high-density lipoproteins (HDLs) are generally considered a primary risk factor, ‘dysfunctional’ HDL may probably be a more important factor. Among drugs primarily reducing LDL cholesterol the most important systemic agents are statins. Non-systemic agents, such as resins, have a lesser use, whereas ezetimibe is frequently given in combination with statins. A new series of systemic compounds, the inhibitors of proprotein convertase subtilisin/kexin type 9 (PCSK9), recently available, have a higher activity on LDL cholesterol. Drugs indicated for the treatment of the homozygous forms of hypercholesterolaemia are lomitapide, an inhibitor of the microsomal transfer protein, and the antisense nucleotide mipomersen, designed to inhibit synthesis of apolipoprotein B. Treatment of hypertriglyceridaemias mainly relies on fibrates, activating the peroxisomal proliferator-activated receptor-α‎. They treat particularly the atherogenic dyslipidaemias (elevated triglycerides with low HDL cholesterol). Nicotinic acid is less frequently used and the omega-3 fatty acids have an as yet unclear cardiovascular protective activity.

Lipid-lowering drugs

ESC CardioMed ◽  
2018 ◽  
pp. 204-209
Author(s):  
Cesare R. Sirtori ◽  
Massimiliano Ruscica
Keyword(s):  
Ldl Cholesterol ◽  
Hdl Cholesterol ◽  
Lipid Lowering ◽  
High Density Lipoproteins ◽  
Omega 3 ◽  
Transfer Protein ◽  
Increased Risk ◽  
Low Hdl ◽  
Coronary Events ◽  
Systemic Agents

Hyperlipidaemias, multifactorial conditions partly genetically and partly life habit induced, are the most important underlying risk factors for cardiovascular disease. They can lead to arterial lipid deposition with a consequent increased risk of coronary events. The primary effort in hypolipidaemic drug therapy is focused on the lowering of the primary carriers of cholesterol, the low-density lipoproteins (LDLs), but more recent efforts have been placed on the lowering of triglycerides. Reduced levels of the protective high-density lipoproteins (HDLs) are generally considered a primary risk factor, ‘dysfunctional’ HDL may probably be a more important factor. Among drugs primarily reducing LDL cholesterol the most important systemic agents are statins. Non-systemic agents, such as resins, have a lesser use, whereas ezetimibe is frequently given in combination with statins. A new series of systemic compounds, the inhibitors of proprotein convertase subtilisin/kexin type 9 (PCSK9), recently available, have a higher activity on LDL cholesterol. Drugs indicated for the treatment of the homozygous forms of hypercholesterolaemia are lomitapide, an inhibitor of the microsomal transfer protein, and the antisense nucleotide mipomersen, designed to inhibit synthesis of apolipoprotein B. Treatment of hypertriglyceridaemias mainly relies on fibrates, activating the peroxisomal proliferator-activated receptor-α‎. They treat particularly the atherogenic dyslipidaemias (elevated triglycerides with low HDL cholesterol). Nicotinic acid is less frequently used and the omega-3 fatty acids have an as yet unclear cardiovascular protective activity.

Stroke in chronic renal failure

2008 ◽  
Vol 149 (15) ◽  
pp. 691-696
Author(s):  
Dániel Bereczki
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
Chronic Renal Disease ◽  
Kidney Diseases ◽  
Cerebrovascular Diseases ◽  
Lipid Lowering ◽  
Increased Risk ◽  
Intracerebral Hemorrhages

Chronic kidney diseases and cardiovascular diseases have several common risk factors like hypertension and diabetes. In chronic renal disease stroke risk is several times higher than in the average population. The combination of classical risk factors and those characteristic of chronic kidney disease might explain this increased risk. Among acute cerebrovascular diseases intracerebral hemorrhages are more frequent than in those with normal kidney function. The outcome of stroke is worse in chronic kidney disease. The treatment of stroke (thrombolysis, antiplatelet and anticoagulant treatment, statins, etc.) is an area of clinical research in this patient group. There are no reliable data on the application of thrombolysis in acute stroke in patients with chronic renal disease. Aspirin might be administered. Carefulness, individual considerations and lower doses might be appropriate when using other treatments. The condition of the kidney as well as other associated diseases should be considered during administration of antihypertensive and lipid lowering medications.

Cardiovascular Risk in Rheumatoid Arthritis and Mechanistic Links: From Pathophysiology to Treatment

2020 ◽  
Vol 18 (5) ◽  
pp. 431-446 ◽  
Author(s):  
George E. Fragoulis ◽  
Ismini Panayotidis ◽  
Elena Nikiphorou
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Current Evidence ◽  
Pharmacological Intervention ◽  
Cvd Risk ◽  
The Past ◽  
Increased Risk ◽  
Cv Disease ◽  
Obesity Hypertension ◽  
Inflammatory Burden

Rheumatoid arthritis (RA) is an autoimmune inflammatory arthritis. Inflammation, however, can spread beyond the joints to involve other organs. During the past few years, it has been well recognized that RA associates with increased risk for cardiovascular (CV) disease (CVD) compared with the general population. This seems to be due not only to the increased occurrence in RA of classical CVD risk factors and comorbidities like smoking, obesity, hypertension, diabetes, metabolic syndrome, and others but also to the inflammatory burden that RA itself carries. This is not unexpected given the strong links between inflammation and atherosclerosis and CVD. It has been shown that inflammatory cytokines which are present in abundance in RA play a significant role in every step of plaque formation and rupture. Most of the therapeutic regimes used in RA treatment seem to offer significant benefits to that end. However, more studies are needed to clarify the effect of these drugs on various parameters, including the lipid profile. Of note, although pharmacological intervention significantly helps reduce the inflammatory burden and therefore the CVD risk, control of the so-called classical risk factors is equally important. Herein, we review the current evidence for the underlying pathogenic mechanisms linking inflammation with CVD in the context of RA and reflect on the possible impact of treatments used in RA.

scholarly journals Cardiovascular risk factors and COVID-19 outcomes in hospitalised patients: a prospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e045482
Author(s):  
Didier Collard ◽  
Nick S Nurmohamed ◽  
Yannick Kaiser ◽  
Laurens F Reeskamp ◽  
Tom Dormans ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cox Regression ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Icu Admission ◽  
Lowering Therapy ◽  
Secondary Outcomes ◽  
Age And Sex

ObjectivesRecent reports suggest a high prevalence of hypertension and diabetes in COVID-19 patients, but the role of cardiovascular disease (CVD) risk factors in the clinical course of COVID-19 is unknown. We evaluated the time-to-event relationship between hypertension, dyslipidaemia, diabetes and COVID-19 outcomes.DesignWe analysed data from the prospective Dutch CovidPredict cohort, an ongoing prospective study of patients admitted for COVID-19 infection.SettingPatients from eight participating hospitals, including two university hospitals from the CovidPredict cohort were included.ParticipantsAdmitted, adult patients with a positive COVID-19 PCR or high suspicion based on CT-imaging of the thorax. Patients were followed for major outcomes during the hospitalisation. CVD risk factors were established via home medication lists and divided in antihypertensives, lipid-lowering therapy and antidiabetics.Primary and secondary outcomes measuresThe primary outcome was mortality during the first 21 days following admission, secondary outcomes consisted of intensive care unit (ICU) admission and ICU mortality. Kaplan-Meier and Cox regression analyses were used to determine the association with CVD risk factors.ResultsWe included 1604 patients with a mean age of 66±15 of whom 60.5% were men. Antihypertensives, lipid-lowering therapy and antidiabetics were used by 45%, 34.7% and 22.1% of patients. After 21-days of follow-up; 19.2% of the patients had died or were discharged for palliative care. Cox regression analysis after adjustment for age and sex showed that the presence of ≥2 risk factors was associated with increased mortality risk (HR 1.52, 95% CI 1.15 to 2.02), but not with ICU admission. Moreover, the use of ≥2 antidiabetics and ≥2 antihypertensives was associated with mortality independent of age and sex with HRs of, respectively, 2.09 (95% CI 1.55 to 2.80) and 1.46 (95% CI 1.11 to 1.91).ConclusionsThe accumulation of hypertension, dyslipidaemia and diabetes leads to a stepwise increased risk for short-term mortality in hospitalised COVID-19 patients independent of age and sex. Further studies investigating how these risk factors disproportionately affect COVID-19 patients are warranted.

Abstract 3441: Paraoxonase-192 Polymorphism Interaction with Low HDL Cholesterol in Coronary Artery Risk

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Andreia M Pereira ◽  
Isabel M Mendonca ◽  
Ana I Freitas ◽  
Ana C Sousa ◽  
Susana Gomes ◽  
...  
Keyword(s):  
Lipid Peroxidation ◽  
Coronary Artery ◽  
Hdl Cholesterol ◽  
High Density Lipoproteins ◽  
Synergy Index ◽  
Attributable Proportion ◽  
Increased Risk ◽  
Low Hdl ◽  
Lower Ability ◽  
Male Sex

Background: Increased lipid peroxidation is associated with accelerated progression of atherosclerosis. Paraoxonase (PON1) is an antioxidative enzyme in high density lipoproteins (HDL), which protects against lipid per oxidation and Coronary Artery Disease (CAD). PON 1 activity is under genetic control and its molecular basis is a polymorphism in the PON 1 gene that shows two common isoforms: Q (192 Gln) with high ability to protect LDL from lipid peroxidation in vitro, and R (Arg) with lower ability. Aim: To explore the interaction of the R allele paraoxonase gene and low HDL cholesterol concentrations, in CAD risk emergence. Methods: 818 individuals participated in the study, 298 coronary patients, 55.0±10.3 years, 78.9% male sex, and 520 healthy controls, 47.3±12.6 years, 57.5% male sex, age and sex matched. Low HDL-C was defined as <0.90 mmol/L in men and < 1.11 mmol/L in the women. Comparisons of genotypes between cases and control subjects were performed by a chi-square test. Statistical significance was accepted at p<0.05. Odds ratio as well as their 95% confidence intervals for the RR genotypes and HDL deficient subjects were computed using univariate analysis (2x2 tables). To determine the interaction between the RR paraoxonase genotype and HDL-deficient subjects, we used the epidemiologic tables 4x2 and the synergy measures: the additive model (Rothman’s synergy index) and the multiplicative model (Khoury’s synergy index). We calculated the relative excess risk (RERI) and the attributable proportion (AP) due to interaction (Rothman). Results: The PON 1 RR192 is associated with coronary heart disease [OR=1.61; p=0.043] in whole population. The HDL-deficient subjects 192 RR homozygotes showed an increased risk of CAD (OR=17.38; p< 0.0001) compared to normal HDL 192 RR (OR=1.39; p=0.348) and HDL-deficient subjects not carrying RR genotype (OR=7.79; p<0.0001). The genotype PON 192 RR increases the risk of CAD in the HDL-deficient populations (SI=2.3, SIM=1.6). The attributable proportion due to this interaction (AP) was 0.53, meaning that 53% of CAD was explained by this interaction. Conclusion: These data suggest the existence of a synergistic effect of the RR 192 PON 1 genotype (with lower ability) and HDL-deficient subjects in CAD emergence.

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