Superiority of waist circumference and body mass index in cardiovascular risk assessment in hypertensive patients with coronary heart disease

2015 ◽  
Vol 24 (2) ◽  
pp. 90-95 ◽  
Author(s):  
Wojciech Sobiczewski ◽  
Marcin Wirtwein ◽  
Daniel Jarosz ◽  
Marcin Gruchala
2016 ◽  
Vol 5 (2) ◽  
pp. 98-103
Author(s):  
Tabassum Samad ◽  
Wasim Md Mohosin ul Haque

Microalbuminuria is an early sign of vascular damage. Now-a-days it is considered as a predictor of worse outcome for both renal and cardiac patients. In this review we investigate the magnitude of relationship between microalbuminuria and incident coronary heart disease and mortality. Microalbuminuria is an independent predictor of coronary heart disease and all cause mortality. It is demonstrated that cardiovascular and renal risk is elevated even in the high normal range of microalbuminuria. Early detection of microalbuminuria, or therapies that prevent or delay the development of microalbuminuria, and all measures that prevent it, may help to prevent or delay cardiovascular eventsBirdem Med J 2015; 5(2): 98-103


Circulation ◽  
2018 ◽  
Vol 138 (Suppl_1) ◽  
Author(s):  
Parinya Chamnan ◽  
Weera Mahawanakul ◽  
Wichai Aekplakorn ◽  
Wannee Nitiyanant ◽  
Prasert Boongird ◽  
...  

Introduction: Body mass index (BMI) and waist circumference has been reported to have a positive association with risk of coronary heart disease (CHD) and their optimal levels have been proposed. However, the association was less well described in Asian population. Hypothesis: This study aimed to examine the risk of developing CHD across different levels of BMI and waist circumference in a large retrospective cohort of Thai general population. Methods: This retrospective cohort was derived from the linkage of 2006 health checks data with diagnostic information from electronic health records of 708,544 men and women aged 20 years and above residing in Ubon Ratchathani. We examined the incidence of CHD over 6 years of follow-up in individuals with different levels of BMI defined by the WHO Asia-Pacific cut-offs and central obesity defined as waist circumference higher than half of each individual’s height. Corresponding hazard ratios were computed using Cox proportional hazards regression. Results: Over 3,514,681 person-years, 2,562 CHD cases developed, an overall incidence of 0.73 (95%CI 0.70-0.76) per 1,000 person-years. BMI had a J-shape association with CHD risk, with those with a BMI of 20-22.4 kg/m2 showing the lowest CHD incidence. Waist circumference had a curvilinear relationship with CHD risk, with CHD risk starting to increase after waist circumference of 80 and 85 cm in women and men respectively. CHD risk increased with higher levels of BMI and waist circumference (Table 1). Compared to those with BMI of 20.0-22.9 kg/m 2 and without central obesity, those with BMI higher than 30 kg/m 2 and with and without central obesity had a 1.8 and 2.4 fold increased risk of CHD (Adjusted hazards ratio 1.80 (1.46-2.24) and 2.39 (1.38-4.13) respectively). Conclusions: Different levels of BMI and waist circumference conferred different CHD risk. Change in optimal cut-off of BMI and waist circumference for the Thai population should be considered.


2013 ◽  
Vol 20 (5) ◽  
pp. 759-762 ◽  
Author(s):  
Dexter Canoy ◽  
Benjamin J Cairns ◽  
Angela Balkwill ◽  
F Lucy Wright ◽  
Jane Green ◽  
...  

2015 ◽  
Vol 16 (06) ◽  
pp. 607-617
Author(s):  
Nadeem Qureshi ◽  
Joe Kai ◽  
Jo Middlemass ◽  
Paula Dhiman ◽  
Laura Cross-Bardell ◽  
...  

AimThis study assesses the feasibility of collecting genetic samples and self-reported outcome measures after cardiovascular risk assessment, and presenting the genetic test results to participants.BackgroundCoronary heart disease (CHD) genetic tests are increasingly available through direct-to-consumer marketing, but their potential clinical impact on cardiovascular risk assessment is unclear.MethodsObservational study in 10 British general practices in Central England. A total of 320 individuals, who had completed conventional cardiovascular risk assessment, were offered CHD genetic test, with follow-up outcome questionnaire at eight months for lifestyle change and State-Trait Anxiety.FindingsA total of 119 (37%) participants returned genetic test specimens, with over a third reporting family history of CHD in a specified relative; 79 (66.4%) were categorized above-average risk on conventional cardiovascular risk assessment, 65 of whom (82.3%) were only average risk on genetic assessment. The dietary fat questionnaire was poorly completed while study participation was not associated with increased anxiety (mean increase in anxiety score=2.1; 95% CI −0.1–4.3;P=0.06).ConclusionAs a feasibility study, over a third of individuals offered genetic testing in primary care, as part of CVD risk assessment, took up the offer. Although intervention did not appear to increase anxiety, this needs further evaluation. To improve generalizability and effect size, future studies should actively engage individuals from wider socio-economic backgrounds who may not have already contemplated lifestyle change. The current research suggests general practitioners will face the clinical challenge of patients presenting with direct-to-consumer genetic results that are inconsistent with conventional cardiovascular risk assessment.


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