scholarly journals The Role of Postprandial Very-low-density Lipoprotein in the Development of Atrial Remodeling in Metabolic Syndrome

2020 ◽  
Author(s):  
Hsiang-Chun Lee ◽  
Shyi-Jang Shin ◽  
Jih-Kai Huang ◽  
Yu-Hsun Lin ◽  
Liang-Yin Ke ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Left Atrial ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Atrial Remodeling ◽  
Very Low Density Lipoprotein ◽  
Low Density ◽  
Hip Circumference

Abstract Background:Negatively charged very-low-density lipoprotein (VLDL-χ) in metabolic syndrome (MetS) patients exerts cytotoxic effects on endothelial cells and atrial myocytes. Atrial cardiomyopathy, manifested by atrial remodeling with a dilated diameter, contributes to atrial fibrillation pathogenesis and predicts atrial fibrillation development. The correlation of VLDL-χ with atrial remodeling is unknown. This study investigated the association between VLDL-χ and left atrial dilatation. Methods: We evaluated 87 MetS and 80 non-MetS individuals between 23 and 74 years old (50.6% men) without overt cardiovascular diseases. Blood samples were collected while fasting and postprandially (at 0.5, 1, 2, and 4 hours after a unified meal). VLDL was isolated by ultracentrifugation; the percentile concentration of VLDL-χ (%) was determined by ultra-performance liquid chromatography. The correlations of left atrial diameter (LAD) with variables including VLDL-χ, LDL-C, HDL-C, triglycerides, glucose, and blood pressure, were analyzed by multiple linear regression models. A hierarchical linear model was conducted to test the independencies of each variable’s correlation with LAD. Results: The mean LAD was 3.4 ± 0.5 cm in non-MetS subjects and 3.9 ± 0.5 cm in MetS patients (P< 0.01). None of the fasting lipid profiles were associated with LAD. VLDL-χ, BMI, waist circumference, hip circumference, and blood pressure were positively correlated with LAD (all P<0.05) after adjustment for age and sex. We observedsignificant interactions between VLDL-χ and blood pressure, waist circumference, and hip circumference. When adjusted for obesity- and blood pressure-related variables, 2-hour postprandial VLDL-χ (mean 1.30 ± 0.61%) showed a positive correlation with LAD in MetS patients. Each 1% VLDL-χ increase was estimated to increase LAD by 0.62 cm. Conclusions: Postprandial VLDL-χ is associated with atrial remodeling. VLDL-χ is a novel biomarker for atrial cardiomyopathy in MetS patients and may be a therapeutic target. Trial registration: ISRCTN 69295295. Retrospectively registered 9 June 2020.

scholarly journals Postprandial Negatively Charged Very-Low-Density Lipoprotein ­Is a Novel Biomarker for Atrial Remodeling in Metabolic Syndrome

2020 ◽  
Author(s):  
Hsiang-Chun Lee ◽  
Shyi-Jang Shin ◽  
Jih-Kai Huang ◽  
Yu-Hsun Lin ◽  
Liang-Yin Ke ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Left Atrial ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Atrial Remodeling ◽  
Very Low Density Lipoprotein ◽  
Low Density ◽  
Hip Circumference

Abstract Background: Negatively charged very-low-density lipoprotein (VLDL-χ) in metabolic syndrome (MetS) patients exerts cytotoxic effects on endothelial cells and atrial myocytes. Atrial cardiomyopathy, manifested by atrial remodeling with a dilated diameter, contributes to atrial fibrillation pathogenesis and predicts atrial fibrillation development. The correlation of VLDL-χ with atrial remodeling is unknown. This study investigated the association between VLDL-χ and left atrial dilatation. Methods: We evaluated 87 MetS and 80 non-MetS individuals between 23 and 74 years old (50.6% men) without overt cardiovascular diseases. Blood samples were collected while fasting and postprandially (at 0.5, 1, 2, and 4 hours after a unified meal). VLDL was isolated by ultracentrifugation; the percentile concentration of VLDL-χ (%) was determined by ultra-performance liquid chromatography. The correlations of left atrial diameter (LAD) with variables including VLDL-χ, LDL-C, HDL-C, triglycerides, glucose, and blood pressure, were analyzed by multiple linear regression models. A hierarchical linear model was conducted to test the independencies of each variable’s correlation with LAD. Results: The mean LAD was 3.4 ± 0.5 cm in non-MetS subjects and 3.9 ± 0.5 cm in MetS patients (P< 0.01). None of the fasting lipid profiles were associated with LAD. VLDL-χ, BMI, waist circumference, hip circumference, and blood pressure were positively correlated with LAD (all P<0.05) after adjustment for age and sex. We observed significant interactions between VLDL-χ and blood pressure, waist circumference, and hip circumference. When adjusted for obesity- and blood pressure-related variables, 2-hour postprandial VLDL-χ (mean 1.30 ± 0.61%) showed a positive correlation with LAD in MetS patients. Each 1% VLDL-χ increase was estimated to increase LAD by 0.62 cm. Conclusion: Postprandial VLDL-χ is associated with atrial remodeling. VLDL-χ is a novel biomarker for atrial cardiomyopathy in MetS patients and may be a therapeutic target. Trial registration: ISRCTN 69295295. Registered 9 June 2020.

scholarly journals The Role of Postprandial Very-Low-Density Lipoprotein ­in the Development of Atrial Remodeling in Metabolic Syndrome 

2020 ◽  
Author(s):  
Hsiang-Chun Lee ◽  
Shyi-Jang Shin ◽  
Jih-Kai Huang ◽  
Ming-Yen Lin ◽  
Yu-Hsun Lin ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Left Atrial ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Atrial Remodeling ◽  
Very Low Density Lipoprotein ◽  
Low Density ◽  
Hip Circumference

Abstract Background: Negatively charged very-low-density lipoprotein (VLDL-χ) in metabolic syndrome (MetS) patients exerts cytotoxic effects on endothelial cells and atrial myocytes. Atrial cardiomyopathy, manifested by atrial remodeling with a dilated diameter, contributes to atrial fibrillation pathogenesis and predicts atrial fibrillation development. The correlation of VLDL-χ with atrial remodeling is unknown. This study investigated the association between VLDL-χ and left atrial dilatation. Methods: Consecutively, 87 MetS and 80 non-MetS individuals between 23 and 74 years old (50.6% men) without overt cardiovascular diseases were included in the prospective cohort study. Blood samples were collected while fasting and postprandially (at 0.5, 1, 2, and 4 hours after a unified meal). VLDL was isolated by ultracentrifugation; the percentile concentration of VLDL-χ (%) was determined by ultra-performance liquid chromatography. The correlations of left atrial diameter (LAD) with variables including VLDL-χ, LDL-C, HDL-C, triglycerides, glucose, and blood pressure, were analyzed by multiple linear regression models. A hierarchical linear model was conducted to test the independencies of each variable’s correlation with LAD. Results: The mean LAD was 3.4 ± 0.5 cm in non-MetS subjects and 3.9 ± 0.5 cm in MetS patients (P< 0.01). None of the fasting lipid profiles were associated with LAD. VLDL-χ, BMI, waist circumference, hip circumference, and blood pressure were positively correlated with LAD (all P<0.05) after adjustment for age and sex. Significant interactions between VLDL-χ and blood pressure, waist circumference, and hip circumference were observed. When adjusted for obesity- and blood pressure-related variables, 2-hour postprandial VLDL-χ (mean 1.30 ± 0.61%) showed a positive correlation with LAD in MetS patients. Each 1% VLDL-χ increase was estimated to increase LAD by 0.23 cm. Conclusions: Postprandial VLDL-χ is associated with atrial remodeling. VLDL-χ is a novel biomarker and may be a therapeutic target for atrial cardiomyopathy in MetS patients. Trial registration: ISRCTN 69295295. Retrospectively registered 9 June 2020.

scholarly journals The role of postprandial very-low-density lipoprotein in the development of atrial remodeling in metabolic syndrome

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Hsiang-Chun Lee ◽  
Shyi-Jang Shin ◽  
Jih-Kai Huang ◽  
Ming-Yen Lin ◽  
Yu-Hsun Lin ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Waist Circumference ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Atrial Remodeling ◽  
Very Low Density Lipoprotein ◽  
Low Density ◽  
Hip Circumference

Abstract Background Negatively charged very-low-density lipoprotein (VLDL-χ) in metabolic syndrome (MetS) patients exerts cytotoxic effects on endothelial cells and atrial myocytes. Atrial cardiomyopathy, manifested by atrial remodeling with a dilated diameter, contributes to atrial fibrillation pathogenesis and predicts atrial fibrillation development. The correlation of VLDL-χ with atrial remodeling is unknown. This study investigated the association between VLDL-χ and remodeling of left atrium. Methods Consecutively, 87 MetS and 80 non-MetS individuals between 23 and 74 years old (50.6% men) without overt cardiovascular diseases were included in the prospective cohort study. Blood samples were collected while fasting and postprandially (at 0.5, 1, 2, and 4 h after a unified meal). VLDL was isolated by ultracentrifugation; the percentile concentration of VLDL-χ (%) was determined by ultra-performance liquid chromatography. The correlations of left atrium diameter (LAD) with variables including VLDL-χ, LDL-C, HDL-C, triglycerides, glucose, and blood pressure, were analyzed by multiple linear regression models. A hierarchical linear model was conducted to test the independencies of each variable’s correlation with LAD. Results The mean LAD was 3.4 ± 0.5 cm in non-MetS subjects and 3.9 ± 0.5 cm in MetS patients (P < 0.01). None of the fasting lipid profiles were associated with LAD. VLDL-χ, BMI, waist circumference, hip circumference, and blood pressure were positively correlated with LAD (all P < 0.05) after adjustment for age and sex. Significant interactions between VLDL-χ and blood pressure, waist circumference, and hip circumference were observed. When adjusted for obesity- and blood pressure-related variables, 2-h postprandial VLDL-χ (mean 1.30 ± 0.61%) showed a positive correlation with LAD in MetS patients. Each 1% VLDL-χ increase was estimated to increase LAD by 0.23 cm. Conclusions Postprandial VLDL-χ is associated with atrial remodeling particularly in the MetS group. VLDL-χ is a novel biomarker and may be a therapeutic target for atrial cardiomyopathy in MetS patients. Trial registration ISRCTN 69295295. Retrospectively registered 9 June 2020.

scholarly journals The Role of Postprandial Very-Low-Density Lipoprotein ­in the Development of Atrial Remodeling in Metabolic Syndrome

2020 ◽  
Author(s):  
Hsiang-Chun Lee ◽  
Shyi-Jang Shin ◽  
Jih-Kai Huang ◽  
Ming-Yen Lin ◽  
Yu-Hsun Lin ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Waist Circumference ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Atrial Remodeling ◽  
Very Low Density Lipoprotein ◽  
Low Density ◽  
Linear Regression Models

Abstract Background: Negatively charged very-low-density lipoprotein (VLDL-χ) in metabolic syndrome (MetS) patients exerts cytotoxic effects on endothelial cells and atrial myocytes. Atrial cardiomyopathy, manifested by atrial remodeling with a dilated diameter, contributes to atrial fibrillation pathogenesis and predicts atrial fibrillation development. The correlation of VLDL-χ with atrial remodeling is unknown. This study investigated the association between VLDL-χ and the remodeling of left atrium.Methods: Consecutively, 87 MetS and 80 non-MetS individuals between 23 and 74 years old (50.6% men) without overt cardiovascular diseases were included in the prospective cohort study. Blood samples were collected while fasting and postprandially (at 0.5, 1, 2, and 4 hours after a unified meal). VLDL was isolated by ultracentrifugation; the percentile concentration of VLDL-χ (%) was determined by ultra-performance liquid chromatography. The correlations of left atrial diameter (LAD) with variables including VLDL-χ, LDL-C, HDL-C, triglycerides, glucose, and blood pressure, were analyzed by multiple linear regression models. A hierarchicallinear model was conducted to test the independencies of each variable’s correlation with LAD.Results: The mean LAD was 3.4 ± 0.5 cm in non-MetS subjects and 3.9 ± 0.5 cm in MetS patients (P< 0.01). None of the fasting lipid profiles were associated with LAD. VLDL-χ, BMI, waist circumference, hip circumference, and blood pressure were positively correlated with LAD (all P<0.05) after adjustment for age and sex. Significant interactions between VLDL-χ and blood pressure, waist circumference, and hipcircumference were observed. When adjusted for obesity- and blood pressure-related variables, 2-hour postprandial VLDL-χ (mean 1.30 ± 0.61%) showed a positive correlation with LAD in MetS patients. Each 1% VLDL-χ increase was estimated to increase LAD by 0.23 cm.Conclusions: Postprandial VLDL-χ is associated with atrial remodeling particularly in the MetS group. VLDL-χ is a novel biomarker and may be a therapeutic target for atrial cardiomyopathy in MetS patients.Trial registration: ISRCTN 69295295. Retrospectively registered 9 June 2020.

scholarly journals Tinospora cordifolia stem supplementation in diabetic dyslipidemia: an open labelled randomized controlled trial

2015 ◽  
Vol 5 (8) ◽  
pp. 265
Author(s):  
Kuhu Roy
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Significant Decline ◽  
Tinospora Cordifolia ◽  
Low Density ◽  
Hip Circumference ◽  
Hs Crp ◽  
The Impact

Background: Medicinal plants are powerful health promoting nutritional agents. Among the vast library of medicinal plants Tinospora cordifolia (Willd.) has been meagrely explored. It belongs to the family Menispermaceae and is a rich source of alkaloid and terpenes. It has hepatoprotective, antioxidant, immunostimulatory, hyperlipidemic, anticancer and antidiabetic properties. The stem contains berberine, palmatine, tembetarine, magnoflorine, tinosporin, tinocordifolin. The stem starch is highly nutritive and digestive. In modern medicine it is called the magical rejuvenating herb owing to its properties to cure many diseases. The stem contains higher alkaloid content than the leaves because of which it is approved for medicinal usage. With a host of phytochemical properties present in the stem, it may hold potential to manage dyslipidemia and dysglycemia, which otherwise has been proven only in pre-clinical studies.Objective: To study the impact of tinospora cordifolia stem supplementation on the glycemic and lipemic profile of subjects with diabetic dyslipidemia.Methods: Type 2 diabetics with dyslipidemia on oral hypoglycemic agents were enrolled. Baseline data on medical history, family history of lifestyle diseases, duration of diabetes diagnosis, drug profile, anthropometric data, dietary data and physical activity data was obtained along with a fasting blood sample for estimating high sensitivity C reactive protein (hs-CRP), hepatic, renal, lipid profile and glycated hemoglobin. The participants were randomized into either of the two groups; intervention group (n=29) received 250mg of encapsulated mature stem of tinospora cordifolia pre meal twice a day along with prescribed dyslipidemic agent and control group (n=30) only on dyslipidemic agents for a period of 60 days. After 60 days all the parameters were re-assessed to analyse the impact of the intervention.Results: Majority of the subjects in both the arms were in the 50-60 years age bracket with a similar duration of diabetes, disease and drug profile. Tinospora cordifolia supplementation led to a significant decline in waist circumference (94.7 to 94.2cm, P 0.004), hip circumference (99.9 to 9.5cm, P 0.004), waist stature ratio (0.594 to 0.591, P 0.004) and systolic blood pressure (132.6 to 127.1mmHg, P 0.0017) vs. significant decline in hip circumference (100.02 to 99.7cm, P 0.01) and systolic blood pressure (134.5 to 130.1mmHg, P 0.0013) in controls. The intervention brought about a significant decline in hs-CRP (4.6 to 2.8mg/l, P 0.0007) and the prevalence of hs-CRP>3mg/l declined from 65.5% to 37.9% (P 0.037). Renal and hepatic parameters remained in the normal range. Decline in HbA1c, although non-significant, was more evident in the intervention arm (7.7 to 7.5%, P 0.09) than the controls (7.9 to 7.81%, P 0.52). Intervention led to significant reductions in total cholesterol, low density lipoprotein, triglycerides and very low density lipoprotein and among controls too, but of lesser intensity. The number of dyslipidemic features declined by 28.6% (P 0.0036) in the intervention arm and by 19.4% in controls (P 0.020). The prevalence of metabolic syndrome decreased by 13.73% from 68.9% to 55.17% in the intervention arm and reduced by 6.7% from 56.7% to 50% among controls.Conclusion: Tinospora cordifolia stem supplementation brought about more evident changes in the lipoprotein fractions, inflammatory markers and metabolic syndrome than the controls.Keywords: Diabetic dyslipidemia, tinospora cordifolia, lipid profile, metabolic syndrome

scholarly journals Phospholipase D Activity Underlies Very-Low-Density Lipoprotein (VLDL)-induced Aldosterone Production in Adrenal Glomerulosa Cells

Endocrinology ◽  
2014 ◽  
Vol 155 (9) ◽  
pp. 3550-3560 ◽  
Author(s):  
Ying-Ying Tsai ◽  
William E. Rainey ◽  
Zhi-qiang Pan ◽  
Michael A. Frohman ◽  
Vivek Choudhary ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Phospholipase D ◽  
Low Density Lipoprotein ◽  
Primary Cultures ◽  
Density Lipoprotein ◽  
Very Low Density Lipoprotein ◽  
Low Density ◽  
Peripheral Tissues ◽  
Aldosterone Production ◽  
Glomerulosa Cells

Abstract Aldosterone is the mineralocorticoid responsible for sodium retention, thus increased blood volume and pressure. Excessive production of aldosterone results in high blood pressure as well as renal disease, stroke, and visual loss via both direct effects and effects on blood pressure. Weight gain is often associated with increased blood pressure, but it remains unclear how obesity increases blood pressure. Obese patients typically have higher lipoprotein levels; moreover, some studies have suggested that aldosterone levels are also elevated and represent a link between obesity and hypertension. Very-low-density lipoprotein (VLDL) functions to transport triglycerides from the liver to peripheral tissues. Although previous studies have demonstrated that VLDL can stimulate aldosterone production, the mechanisms underlying this effect are largely unclear. Here we show for the first time that phospholipase D (PLD) is involved in VLDL-induced aldosterone production in both a human adrenocortical cell line (HAC15) and primary cultures of bovine zona glomerulosa cells. Our data also reveal that PLD mediates steroidogenic acute regulatory (StAR) protein and aldosterone synthase (CYP11B2) expression via increasing the phosphorylation (activation) of their regulatory transcription factors. Finally, by using selective PLD inhibitors, our studies suggest that both PLD1 and PLD2 isoforms play an important role in VLDL-induced aldosterone production.

scholarly journals Metabolic evaluation in overweight and obese cats and association with blood pressure

2017 ◽  
Vol 48 (1) ◽  
Author(s):  
Vanessa Danielle de Freitas ◽  
Alessandra Ramos Castilho ◽  
Luciana Auxiliadora Viebrantz da Conceição ◽  
Valéria Régia Franco Sousa ◽  
Adriane Jorge Mendonça ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Serum Levels ◽  
Very Low Density Lipoprotein ◽  
Low Density ◽  
Metabolic Evaluation ◽  
Morphometric Measurements ◽  
Metabolic Alterations ◽  
Significant Difference

ABSTRACT: Obesity has been increasing in cats andis associated with metabolic and cardiovascular diseases. The association of these alterations can trigger the onset of metabolic syndrome (MS). Therefore, this study aimed to analyze the serum levels of glucose, fructosamine, cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein, very low-density lipoprotein (VLDL), andalanine aminotransferase of cats and to identify the possibility of MS,as well as to evaluate changes in arterial pressure. Thirty-seven cats were classified by ECC and morphometric measurements, namely, 15 obese, 12 overweight, and 10 controls. Nocat manifested MS. Only VLDL had a statistically significant difference (P<0.05) between groups. Therefore, obesity may not be associated with arterial hypertension, and more studies are needed to evaluate the metabolic alterations in overweight and obese cats.

scholarly journals Duration of Type 2 Diabetes and Very Low Density Lipoprotein Levels Are Associated with Cognitive Dysfunction in Metabolic Syndrome

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Divya Yogi-Morren ◽  
Rachel Galioto ◽  
Sarah Elizabeth Strandjord ◽  
L. Kennedy ◽  
Pooja Manroa ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Cognitive Impairment ◽  
Executive Function ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipid Lowering ◽  
Very Low Density Lipoprotein ◽  
Low Density

Type 2 diabetes (T2D) is now recognized as an independent risk factor for accelerated cognitive decline and neurological conditions like Alzheimer’s disease. Less is known about the neurocognitive function of T2D patients with comorbid metabolic syndrome, despite their elevated risk for impairment. Computerized testing in 47 adults with T2D that met criteria for NCEP metabolic syndrome revealed that cognitive impairment was prevalent, including 13% in tests of memory, 50% in attention, and 35% in executive function. Partial correlations showed that longer duration of diabetes was associated with poorer performance on tests of basic attention (r=-0.43), working memory (r=0.43), and executive function (r=0.42). Strong associations between very low density lipoprotein and poor cognitive function also emerged, including tests of set shifting (r=0.47) and cognitive inhibition (r=-0.51). Findings suggest that patients with T2D that meet criteria for metabolic syndrome are at high risk for cognitive impairment. Prospective studies should look to replicate these findings and examine the possible neuroprotective effects of lipid-lowering medication in this population.

scholarly journals Risk Factors for Polyvascular Involvement in Patients With Peripheral Artery Disease: A Mendelian Randomization Study

2020 ◽  
Vol 9 (24) ◽  
Author(s):  
Ozan Dikilitas ◽  
Benjamin A. Satterfield ◽  
Iftikhar J. Kullo
Keyword(s):  
Blood Pressure ◽  
Lipid Content ◽  
Mendelian Randomization ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Very Low Density Lipoprotein ◽  
Low Density ◽  
Peripheral Artery ◽  
Artery Disease ◽  
Intermediate Density

Background Atherosclerosis in >1 vascular bed (ie, polyvascular disease), often a feature of peripheral artery disease (PAD), is associated with high morbidity and mortality. We sought to identify risk factors for polyvascular involvement in patients with PAD. Methods and Results We performed 2‐sample Mendelian randomization using an inverse‐variance‐weighted approach, to assess 60 exposures including size and lipid content of atherogenic lipoproteins, blood pressure, glycated hemoglobin, and smoking as causal mediators for polyvascular disease in patients with PAD. Genetic instruments for these exposures were obtained from prior genome‐wide association studies. Patients with PAD were from the Mayo Vascular Disease Biorepository, and polyvascular disease (ie, concomitant coronary heart disease, cerebrovascular disease, and/or abdominal aortic aneurysm) was ascertained by validated phenotyping algorithms. Of 3279 patients with PAD, 61% had polyvascular disease. Genetically predicted levels of the lipid content and/or particle measures of very small and small size very low‐density lipoprotein, intermediate‐density lipoprotein, and large low‐density lipoprotein were associated with polyvascular disease: odds ratios (OR) of 1.80 (95% CI, 1.23–2.61), 1.70 (95% CI, 1.17–2.61), and 1.40 (95% CI, 1.09–1.80) per 1 SD increase in genetically determined levels, respectively. Both genetically predicted diastolic and systolic blood pressure were associated with polyvascular disease; OR per 10 mm Hg genetic increase in diastolic and systolic blood pressure were 1.66 (95% CI, 1.19–2.33) and 1.31 (95% CI, 1.07–1.60), respectively. Conclusions Lifetime exposure to increased lipid content and levels of very small and small very low‐density lipoprotein, intermediate‐density lipoprotein, and large low‐density lipoprotein particles as well as elevated blood pressure are associated with polyvascular involvement in patients with PAD. Reduction in levels of such exposures may limit progression of atherosclerosis in patients with PAD.

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