Hyperuricemia, gout and high cardiovascular risk - how to manage them in clinical practice

In recent years, the relationship of hyperuricemia and gout with a high risk of cardiovascular disease has been widely discussed. Therefore, it is important to systematically examine patients in order to diagnose comorbidities, among which cardiovascular disease and its complications occupy a leading place and consider mandatory treatment of patients with hyperuricemia and gout with high cardiovascular risk with lowering drugs, which fully reflects the provisions of the latest European recommendations for the management and treatment of patients with gout.

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The Relationship of the Atlantic Diet with Cardiovascular Risk Factors and Markers of Arterial Stiffness in Adults without Cardiovascular Disease

Nutrients ◽

10.3390/nu11040742 ◽

2019 ◽

Vol 11 (4) ◽

pp. 742 ◽

Cited By ~ 7

Author(s):

Carmela Rodríguez-Martín ◽

Luis Garcia-Ortiz ◽

Emiliano Rodriguez-Sanchez ◽

Carlos Maderuelo-Fernandez ◽

Alba Lugones-Sanchez ◽

...

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Cardiovascular Disease ◽

Cardiovascular Risk ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Pulse Wave ◽

Diet And Physical Activity ◽

Relationship Of ◽

The Relationship

Background: Studying the adherence of the population to the Atlantic Diet (AD) could be simplified by an easy and quickly applied dietary index. The aim of this study is to analyse the relationship of an index measuring compliance with recommendations regarding the Atlantic diet and physical activity with cardiovascular disease risk factors, cardiovascular risk factors, obesity indexes and arterial stiffness markers. Methods: We included 791 individuals from the EVIDENT study (lifestyles and arterial ageing), (52.3 ± 12 years, 61.7% women) without cardiovascular disease. Compliance with recommendations on AD was collected through the responses to a food frequency questionnaire, while physical activity was measured by accelerometer. The number of recommendations being met was estimated using a global scale between 0 and 14 points (a higher score representing greater adherence). Blood pressure, plasma lipid and glucose values and obesity rates were measured. Cardiovascular risk was estimated with the Framingham equation. Results: In the overall sample, 184 individuals (23.3%) scored between 0–3 on the 14-point index we created, 308 (38.9%) between 4 and 5 points, and 299 (37.8%) 6 or more points. The results of multivariate analysis yield a common tendency in which the group with an adherence score of at least 6 points shows lower figures for total cholesterol (p = 0.007) and triglycerides (p = 0.002). Similarly, overall cardiovascular risk in this group is the lowest (p < 0.001), as is pulse wave velocity (p = 0.050) and the mean values of the obesity indexes studied (p < 0.05 in all cases). Conclusion: The rate of compliance with the Atlantic diet and physical activity shows that greater adherence to these recommendations is linked to lower cardiovascular risk, lower total cholesterol and triglycerides, lower rates of obesity and lower pulse wave velocity values.

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Cardiovascular risk and history of gestational hypertension in women of reproductive age

Kazan medical journal ◽

10.17750/kmj2017-85 ◽

2017 ◽

Vol 98 (1) ◽

pp. 85-91

Author(s):

A R Shamkina ◽

A R Sadykova

Keyword(s):

Cardiovascular Disease ◽

Cardiovascular Risk ◽

Gestational Hypertension ◽

Target Organ Damage ◽

Age Determination ◽

Reproductive Age ◽

History Of ◽

The Individual ◽

Relationship Of ◽

The Relationship

In recent years, gestational hypertension, defined in accordance with the classification of the European Society of Cardiology (2011) as hypertension induced by pregnancy, occurring with or without proteinuria, developing after 20 weeks of pregnancy and resolving up to 42 days after delivery, is considered as a adverse prognostic factor in respect of development of cardiovascular diseases in the future and cardiovascular mortality. This review presents the results of various studies on the relationship of history of gestational hypertension with risk factors for cardiovascular disease, target organ damage, associated clinical conditions and cardiovascular risk in women, including those of reproductive age. Determination of the individual cardiovascular risk in women, especially in young women, is difficult due to the low sensitivity and specificity of the tests in this category of patients. In spite of the conducted studies and obtained experience regarding issues on the relationship of history of hypertension during pregnancy with cardiovascular risk, until now the origin and the contribution of the various forms of hypertensive disorders during pregnancy, including gestational hypertension, to the development of future cardiovascular disease is still unclear. Detection of the history of gestational hypertension will allow to more accurately assess the individual cardiovascular risk and administer an adequate range of therapeutic and preventive measures for women, including those of reproductive age, at an earlier stage.

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BODY COMPOSITION, BONE MASS AND ADIPOKINES IN POSTMENOPAUSAL WOMEN WITH DIFFERENT CARDIOVASCULAR RISK (SCORE)

Osteoporosis and Bone Diseases ◽

10.14341/osteo201213-6 ◽

2012 ◽

Vol 15 (1) ◽

pp. 3-6

Author(s):

P. A. Ptichkina ◽

I. A. Skripnikova ◽

V. E. Novikov ◽

V. A. Metelsky ◽

V. A. Vygodina ◽

...

Keyword(s):

Cardiovascular Disease ◽

Regression Analysis ◽

Cardiovascular Risk ◽

High Risk ◽

Bone Mass ◽

Fat Mass ◽

Lean Mass ◽

Proximal Femur ◽

Increased Risk ◽

The Relationship

Women after menopause have an increased risk of cardiovascular disease associated with atherosclerosis (CVD-AS), and osteoporosis. Low body weight is an independent risk factor for osteoporosis and related fractures. At the same time, osteoporosis occurs in people with overweight and is associated with a high risk of death from cardiovascular disease. As the link of overweight with CVD-AS was proved long ago, the impact of obesity on bone status is not sufficiently investigated. Purpose: To study the relationship between bone, fat, lean mass and adipokines in postmenopausal women with low and high risk of cardiovascular disease. Materials and Methods: The cross-sectional study included 100 women aged 45-65 years. Assessment of cardiovascular risk was carried out using an electronic version of the scale of SCORE. Measurement of bone mineral density (BMD), the amount of bone, fat and lean mass was performed using dual energy x-ray absorptiometry. We investigated the concentration of leptin and adiponectin in serum. Results: The increased cardiovascular risk, and low BMD was associated with duration of menopause. Women with an increased risk of CVD-AS more common had obesity and osteoporosis. Osteopenia and osteoporosis were found in 63% of patients, among whom 49% were overweight and 27% obese. To assess the distribution of fat and lean body mass in the ratio have been introduced «fat mass in the trunk (kg)/fat mass in the limbs (kg)» (TF/LF) and «lean mass in the trunk (kg) / lean mass in the limbs (kg) «(TL/LL). The ratio TF/LF, was associated with the presence or absence of abdominal obesity, directly correlated with an increased cardiovascular risk, and BMD at the proximal femur, and TL/LL directly correlated with BMD of the proximal femur and spine. In a linear regression analysis confirmed the connection of the BMD only with the lean mass. Leptin was directly correlated with % fat in the body, spine and BMD of the proximal femur, in the regression analysis the relationship of leptin and BMD remained highly significant. The inverse correlation of BMD in the proximal femoral neck and adiponectin after regression analysis was not confirmed. Conclusions: Low bone mass is associated with increased cardiovascular risk. Fat mass does not have neither protective, nor deleterious effect on BMD. Lean body mass and leptin may claim to be independent prognostic factors for bone mass.

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Estimation of the 10-Year Risk of Fatal Cardiovascular Disease in the Portuguese Population: Results from the First Portuguese Health Examination Survey (INSEF 2015)

Acta Médica Portuguesa ◽

10.20344/amp.13009 ◽

2020 ◽

Vol 33 (11) ◽

pp. 726

Author(s):

Vânia Gaio ◽

Ana Paula Rodrigues ◽

Irina Kislaya ◽

Marta Barreto ◽

Sónia Namorado ◽

...

Keyword(s):

Cardiovascular Disease ◽

Cardiovascular Risk ◽

High Risk ◽

European Countries ◽

Occupational Activity ◽

Health Examination ◽

High Cardiovascular Risk ◽

Portuguese Population ◽

Health Examination Survey ◽

Very High

Introduction: Cardiovascular disease is the leading cause of morbidity and mortality in Portugal and globally. Cardiovascular risk algorithms, namely the SCORE (Systematic Coronary Risk Evaluation), are recommended in the context of cardiovascular disease prevention. Our aim is to estimate and characterize the cardiovascular risk of the Portuguese population aged between 40 and 65 years old, in 2015, using the SCORE algorithm.Material and Methods: This study was performed on a subsample of the first Portuguese National Health Examination Survey - INSEF, including all participants between 40 and 65 years old with available data on sex, age, smoking status, total cholesterol and systolic blood pressure (n = 2945). The prevalence of the cardiovascular risk categories were stratified by sex, age group, marital status, educational level, occupational activity, urbanization of living area, region and income.Results: In 2015, about 5.1% and 11.9% of the Portuguese resident population aged between 40 and 65 years old were, respectively, at high and very high risk of having a fatal CV event in the following 10 years. The highest prevalence of very high cardiovascular risk was found in males, individuals aged 60-65 years old, married or living with someone, without any formal education or just with the 1st cycle of basic education and belonging to the less skilled category of the occupational activity (C category) in comparison with the othercorresponding groups.Discussion: A previous national study found a similar proportion of the population at high/very high cardiovascular risk (19.5% versus 17.1%). Our study is representative of the adult Portuguese population and adopted the European Health Examination Survey procedures, which are essential for future comparisons with other European countries. Some of the limitations of this study include the possible participation bias and the non-calibration of the SCORE algorithm for the Portuguese population.Conclusion: In 2015, a considerable proportion of the Portuguese population aged between 40 and 65 years old had a high or very high risk of developing a fatal cardiovascular event in the next 10 years. Due to the possible overestimation of the cardiovascular risk already reported in other European countries, it will be important to carry out a follow-up study to validate the adequacy of using the SCORE algorithm in the Portuguese population.

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Characteristics of the Relationship of Kidney Dysfunction with Cardiovascular Disease in High Risk Patients with Diabetes

International Journal of Nephrology ◽

10.1155/2016/7180784 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Attilio Losito ◽

Loretta Pittavini ◽

Ivano Zampi ◽

Elena Zampi

Keyword(s):

Cardiovascular Disease ◽

High Risk ◽

General Population ◽

High Risk Population ◽

Kidney Dysfunction ◽

Cross Sectional ◽

High Risk Patients ◽

Risk Patients ◽

Relationship Of ◽

The Relationship

We aimed at comparing the relationship of reduced estimated glomerular filtration rate (eGFR) with cardiovascular disease (CVD) and mortality between high risk patients with and without type 2 diabetes mellitus (T2DM). The cross-sectional study evaluated 16,298 participants (1,627 T2DM) acutely admitted to hospital. The longitudinal study comprised 7,508 patients (673 with diabetes and 6,835 without). eGFR was categorized into 6 stages from >90 to <15 mL/min/1.73 m2. Kidney dysfunction was defined by an eGFR < 60 mL/min/1.73 m2. Patients with T2D showed a higher prevalence of CVD (37.9% versus 23.6%;P<0.001) and kidney dysfunction (25% versus 13.2%;P<0.001) than in the general population. An association with CVD was found with eGFR stages from 30 to 90 mL/min/1.73 m2in T2D and from <15 to 90 mL/min/1.73 m2in general population, in whom the association of eGFR with coronary heart disease was in an inverse relationship (P<0.01for trend). Survival, in diabetes, was lower (P=0.037) but not associated with kidney dysfunction.Conclusions. In a high risk population, patients admitted to hospital, the relationship of kidney function with CVD is different between T2D and the general population. Competing mortality and the presence of other major risk factors in diabetes may be responsible for this difference.

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Hyperuricemia as risk factor for cardiovascular disease – what’s new?

Medical alphabet ◽

10.33667/2078-5631-2020-13-5-11 ◽

2020 ◽

pp. 5-11

Author(s):

Yu. V. Zhernakova

Keyword(s):

Cardiovascular Disease ◽

Chronic Kidney Disease ◽

Uric Acid ◽

Cardiovascular Risk ◽

Epidemiological Studies ◽

Point Of View ◽

Medical Society ◽

High Cardiovascular Risk ◽

Management Algorithm ◽

Russian Medical

A significant number of epidemiological studies have shown that hyperuricemia is highly associated with the risk of developing cardiovascular disease, chronic kidney disease, and diabetes. In this connection, increased attention is required to monitor serum uric acid levels in patients, not only from a rheumatological point of view, but also with regard to reducing cardiovascular and renal risks. This article is a review of studies on the association of hyperuricemia with cardiovascular risk and a new consensus for the management of patients with hyperuricemia and high cardiovascular risk, published in december 2019 by a group of experts of the Russian Medical Society for Arterial Hypertension, which, among other things, includes a management algorithm of this category of patients.

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Telmisartan in High Cardiovascular Risk Patients

European Cardiology Review ◽

10.15420/ecr.2012.8.1.10 ◽

2012 ◽

Vol 8 (1) ◽

pp. 10 ◽

Cited By ~ 1

Author(s):

Roland Asmar ◽

Keyword(s):

Cardiovascular Disease ◽

Cardiovascular Risk ◽

Ace Inhibitors ◽

Angiotensin Receptor Blockers ◽

High Cardiovascular Risk ◽

Raas Blockade ◽

Risk Patients ◽

Receptor Blockers ◽

Current Guidelines

The worldwide morbidity and mortality burden of cardiovascular disease (CVD) is overwhelming and caused by increasing life expectancy and an epidemic of risk factors, including hypertension. Therapeutic options targeting different areas of the renin–angiotensin–aldosterone system (RAAS) to disrupt pathophysiological processes along the cardiovascular continuum are available. Angiotensin-converting enzyme (ACE) inhibitors are first-line treatments for CVD and angiotensin receptor blockers (ARBs) are suitable alternatives. Both ACE inhibitors and ARBs prevent CVD by lowering blood pressure (BP). Additionally, several studies have demonstrated that RAAS blockade can reduce cardiovascular risk beyond what might be expected from BP lowering alone. However, the ARBs are not all equally effective. Telmisartan is a long-lasting ARB that effectively controls BP over the full 24-hour period. Recently, the Ongoing telmisartan alone and in combination with ramipril global endpoint trial (ONTARGET) study showed that telmisartan reduces cardiovascular events in high cardiovascular risk patients similarly to the gold standard ACE inhibitor ramipril beyond BP lowering alone, but with a better tolerability. Based on the results of the ONTARGET and Telmisartan randomized assessment study in ACE intolerant subjects with cardiovascular disease (TRANSCEND) studies, telmisartan is indicated for the reduction of cardiovascular morbidity. This article aims to review current guidelines for the management of CVD and consider key data from clinical trials and clinical practice evaluating the role of telmisartan in CVD.

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Usia Resiko Tinggi dan Perdarahan Post Partum

Jurnal Informasi Kesehatan Indonesia (JIKI) ◽

10.31290/jiki.v(3)i(2)y(2017).page:91-95 ◽

2018 ◽

Vol 3 (2) ◽

pp. 91

Author(s):

Ani Media Harumi ◽

Kasiati Kasiati

Keyword(s):

High Risk ◽

Post Partum ◽

Chi Square ◽

Sample Number ◽

Chi Square Test ◽

Study Population ◽

Relationship Of ◽

The Relationship

Abstract: The purpose of this study is to analyze the relationship of age high risk with the incidence ofbleeding post partum in dr. M. Soewandhie Surabaya hospital. This research is analytic with an approachof a sectional cross. The study population was all post partum mothers in the Dr. M. Soewandhie Surabayahospital in January 2016 to March 2017, which amounts to an average of 1840respondents while theresearch sample number 182. Measuring collection sheet data obtained by systematic random sampling.The Study was conducted Chi-Square test obtained mean count X2 (0,00) is less than á (0.05) thenH0 is rejected and H1 accepted it means that there is a relationship between the age of high risk withbleeding post partum. Conclusion, there is a relationship between the age of high risk with the incidenceof bleeding post partum in the Spaceof the Maternity room Dr. Moch. Soewandhie Surabayahospital.

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