Cardiovascular Disorders in Autoimmune Disease

2019 ◽  
Vol 2 (2) ◽  
pp. 01-04
Author(s):  
Delcio G Silva Junior

The presence of Cardio Vascular Disease (CVD) impacts negatively on expectation and quality of life of the population, being one of the main causes of disability. Many of those who become cardiovascular patients throughout their life could have had different evolution if preventive attitudes were taken. Since 50’s decade, Framingham studies have shown the importance of predetermining factors for CVD occurrence. The classical CVD risk factors such as diabetes, metabolic syndrome, dyslipidemia, hypertension, smoking and family history are well established as predictors of cardiovascular events. The presence of Cardio Vascular Disease (CVD) impacts negatively on expectation and quality of life of the population, being one of the main causes of disability. Many of those who become cardiovascular patients throughout their life could have had different evolution if preventive attitudes were taken. Since 50’s decade, Framingham studies have shown the importance of predetermining factors for CVD occurrence. The classical CVD risk factors such as diabetes, metabolic syndrome, dyslipidemia, hypertension, smoking and family history are well established as predictors of cardiovascular events. However, in certain clinical conditions, traditional risk factors seem not to fully explain the incidence of CVD. Coronary artery disease and early atherosclerosis in young women with Systemic Lupus Erythematosus (SLE) are one of the best examples of how chronic inflammatory diseases can affect individuals who are normally poorly exposed to traditional risk factors. Even with the plurality of extra-articular manifestations of rheumatologic diseases, such as pulmonary hypertension and SLE encephalopathy, uveitis in spondyloarthritis, or as Achalasia in scleroderma, attention is being paid to the frequent cardiovascular system involvement in these patients, especially in the vascular territory

2020 ◽  
Author(s):  
Ana Stefancic ◽  
Nathaniel Lu ◽  
Xiaoyan Wang ◽  
Lauren Bochicchio ◽  
Christopher Weatherly ◽  
...  

Abstract Background: Given indications of widening disparities in mortality for people with serious mental illness, understanding and reducing their risk of cardiovascular disease (CVD) and improving health-related quality of life is an urgent public health priority. This study examined CVD risk factor clustering, health-related quality of life (HRQoL), and their correlates among people with SMI who were overweight/obese (i.e., BMI ≥ 25) and living in supportive housing. Methods: Baseline data were used from participants enrolled in a clinical trial examining the effectiveness of a peer-led healthy lifestyle program. univariate analyses were used to describe the distribution of individual risk factors and the cumulative number of CVD risk factors. Bivariate and regression analyses were used to explore correlates of individual CVD risk factors, the cumulative number of risk factors, and HRQoL Physical and Mental Health Composite Scores. Results: Participants were 48.7 years old, on average (sd = 11.6) and the majority identified as male (57.3%) and as racial/ethnic minorities (82%; primarily non-Hispanic black). Most participants (75.4%) had at least two co-occurring CVD risk factors and almost half (46.7%) had three or more, most commonly obesity, smoking, and hypertension. Prevalence of individual risk factors, particularly smoking and diabetes, varied by demographic and clinical characteristics. Identifying as female, older age, and taking second generation antipsychotic medication were associated with having more co-occurring CVD risk factors, while having completed high school was associated with fewer risks. Number of co-occurring CVD risk factors, identifying as female, and greater psychiatric symptoms were negatively associated with physical HRQoL. Older age, lower psychiatric symptoms, and greater internal locus of control were positively associated with mental HRQoL.Conclusion: Even when compared to other studies examining CVD risk among individuals diagnosed with schizophrenia, our study sample generally had higher rates of clustering of multiple risk factors, highlighting the need for urgent intervention among those living in supportive housing. Demographic and clinical factors further identify those who may have the highest risk as well as factors that may adversely affect perceived health status and functioning. Reducing CVD risk and improving HRQoL will likely require expanding access to quality care, adapting intervention approaches to subpopulations, and providing increased support to facilitate health behavior change and perceived control for modifiable risk factors.Trial Registration: This trial was registered through ClinicalTrials.gov on June 26, 2014. The registration number is NCT02175641.


2012 ◽  
Vol 17 (1) ◽  
pp. 17-28 ◽  
Author(s):  
Roberta K Oka ◽  
Michael S Conte ◽  
Christopher D Owens ◽  
Joseph Rapp ◽  
Gordon Fung ◽  
...  

Peripheral artery disease (PAD) is an understudied chronic illness most prevalent in elderly individuals. PAD patients experience substantial walking impairment due to symptoms of limb ischemia that significantly diminishes quality of life (QOL). Cardiovascular disease (CVD) morbidity and mortality is increased in this population because of aggressive atherosclerosis resulting from untreated CVD risk factors. Despite current national guidelines recommending intensive CVD risk factor management for PAD patients, untreated CVD risk factors are common. Interventions that bridge this gap are imperative. The Vascular Insufficiency – Goals for Optimal Risk Reduction (VIGOR2) study is a randomized controlled trial (RCT) that examines the effectiveness of a long-term multifactor CVD risk reduction program on walking and quality of life in patients with PAD. The purpose of this article is to provide a detailed description of the design and methods of VIGOR2. Clinical Trial Registration – URL: http://clinicaltrials.gov/ct2/show/NCT00537225


Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Catherine Aquino-Russell ◽  
Amy Ruff ◽  
Robert H Schneider

Introduction: Epidemiological research has documented that psychosocial stress is a major risk factor for atherosclerotic cardiovascular disease (CVD). In providing effective health education to patients with CVD, nurses and other health professionals require evidence-based information on behavioral methods to reduce stress for primary and secondary prevention of CVD. Previously published trials suggest that selected stress reduction methods, including meditation may modify CVD risk factors, quality of life, morbidity and mortality. Hypothesis: Stress reduction with meditation may contribute to the management of psychosocial stress, hypertension, metabolic syndrome, chronic CVD, nonfatal/fatal CVD clinical events and associated health care costs. Methods: We performed a meta-synthesis (qualitative review) of published biomedical literature for randomized controlled trials, meta-analyses and professional guidelines on the effects of meditation on CVD and its risk factors. Results: The two most widely studied stress reduction - meditation approaches in CVD were the Transcendental Meditation (TM) technique and mindfulness meditation There were 11 RCTs, two meta-analyses and one American Heart Association scientific statement on TM and blood pressure that suggest TM is clinically useful in lowering high BP, short and long-term, in diverse populations. Other risk factors showing beneficial responses to TM were anxiety, insulin resistance, smoking and surrogate markers for CVD. RCTs and meta-analyses report significant risk reductions for myocardial infarction, stroke and mortality over 5-8 years. In patients with CVD, mindfulness meditation was associated with beneficial psychological effects; however, in meta-analyses of physical parameters of CVD, effects were not yet well-established. Conclusion: Available evidence suggests that meditation may be useful in the behavioral interventions for cardiovascular health and quality of life. Both Transcendental Meditation and mindfulness meditation practices show beneficial effects on psychosocial stress factors. Substantial evidence indicates that TM practice is associated with reductions in hypertension, other CVD risk factors, and rates of CVD morbidity and mortality.


2020 ◽  
Author(s):  
Najmeh Shakibaei ◽  
Razieh Hassannejad ◽  
Noushin Mohammadifard ◽  
Hamid Reza Marateb ◽  
Marjan Mansourian ◽  
...  

Abstract Background: A comprehensive study on the interaction of cardiovascular disease (CVD) risk factors is critical to prevent cardiovascular events. The main focus of this study is thus to understand direct and indirect relationships between different CVD risk factors. Methods: A longitudinal data on adults aged ≥35 years, who were free of CVD at baseline, were used in this study. The endpoints were CVD events, whereas their measurements were demographic, lifestyle components, socio-economics, anthropometric measures, laboratory findings, quality of life status, and psychological factors. A Bayesian structural equation modelling was used to determine the relationships among 21 relevant factors associated with total CVD, stroke, acute coronary syndrome (ACS), and fatal CVDs. Results: In this study, a total of 3161 individuals with complete information were involved in the study. A total of 407 CVD events, with an average age of 54.77(10.66) years, occurred during follow-up. The causal associations between six latent variables were identified in the causal network for fatal and non-fatal CVDs. Lipid profile, with the coefficient of 0.26 (0.01), influenced the occurrence of CVD events as the most critical factor, while it was indirectly mediated through risky behaviours and comorbidities. Lipid profile at baseline was influenced by a wide range of other protective factors, such as quality of life and healthy lifestyle components. Conclusions: Analysing a causal network of risk factors revealed the flow of information in direct and indirect paths. It also determined predictors and demonstrated the utility of integrating multi-factor data in a complex framework to identify novel preventable pathways to reduce the risk of CVDs.


2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Michelle Kohansieh ◽  
Amgad N. Makaryus

Sleep plays a vital role in an individual’s mental, emotional, and physiological well-being. Not only does sleep deficiency lead to neurological and psychological disorders, but also the literature has explored the adverse effects of sleep deficiency on the cardiovascular system. Decreased quantity and quality of sleep have been linked to cardiovascular disease (CVD) risk factors, such as hypertension, obesity, diabetes, and dyslipidemia. We explore the literature correlating primary sleep deficiency and deprivation as a cause for cardiovascular disease and cite endothelial dysfunction as a common underlying mechanism.


2020 ◽  
Vol 9 (2) ◽  
pp. 47-53
Author(s):  
Kashyap Dahal ◽  
A. Baral ◽  
K.K. Sah ◽  
J.R. Shrestha ◽  
A. Niraula ◽  
...  

Background and Aims: Cardiovascular disease (CVD) is the commonest cause of morbidity and mortality in patients with chronic kidney disease (CKD) due to increased prevalence of traditional and nontraditional CVD risk factors. Our study aimed to evaluate these risk factors in pre-dialysis Nepalese CKD patients. Methods: This was a cross-sectional study conducted in Department of Nephrology, Bir hospital. Total 100 consecutive pre-dialysis CKD patients were enrolled. Ten traditional and six nontraditional CVD risk factors were analyzed and compared between CKD stages. Descriptive statistics was used to illustrate the socio-demographic and clinical characteristics, chi square test for categorical variables and multiple logistic regression analysis was done to determine the risk factors of CVD in CKD patients. p-value<0.05 was considered to be statistically significant. Results: Mean patient age was 52.03}13.64 years with majority (60%) of the patients being male. Comparison of traditional risk factors in different stages depicted similar trend except for old age in Stage 3 CKD (p=0.002). Anemia (p<0.001), hyperphosphatemia (p=0.01), hyperparathyroidism (p<0.01) and cumulative nontraditional risk factors were significantly higher (p=0.01) in stage 5 CKD. The predicted CVD events by Framingham risk score showed high risk in 37% with no significant difference among the stages. Multiple logistic regression analysis showed increased body mass index, low serum albumin and increased serum phosphate as the three significant predictors for left ventricular hypertrophy. Conclusion: Our study shows that the CVD risk factors were prevailing along the various stages of CKD. The occurrence of non-traditional risk factors increased with increasing stage of CKD.


2018 ◽  
pp. 109-112
Author(s):  
Z. Dubossarskya ◽  

Problems and prospects of extension of life of woman are discussed in the given article, taking into account that МHТ gives an opportunity of improvement of quality of life with realized of minimum risks at the observance of international and Ukrainian recommendations. Creation of conceptual model of overcoming of climacteric disorders and cardiovascular events on the basis of totality of risk factors will allow to the hormonotherapy to improve indexes and life-span of woman. Key words: quality of life, stopping HRT, menopause.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Amrita Mukherjee ◽  
Howard Wiener ◽  
Russell Griffin ◽  
Lisle M Nabell ◽  
Carrie G Lenneman ◽  
...  

Introduction: Cancer survivors have higher rates of cardiovascular disease (CVD) compared to age-adjusted general population. However, traditional CVD risk factors alone do not fully explain increased CVD risk in cancer patients. Cancer-related factors like cancer site, stage and chemotherapy may also contribute to CVD. Despite increase in head neck squamous cell carcinoma (HNSCC) cases in recent years, little is known about CVD risk in HNSCC patients. We aim to assess association of traditional risk factors and cancer-related factors with CVD in HNSCC patients. Methods: Electronic medical records data of 2391 HNSCC patients diagnosed between 2012-2018 at the UAB O’Neal Comprehensive Cancer Center, were included. ICD-9/10 codes were used to identify HNSCC patients, CVD cases and traditional risk factors. CVD cases were defined as those with composite events of ischemic heart disease and/ or heart failure; controls were without any CVD diagnosis. Cancer site, stage and treatment were included. Logistic regression [OR(95%CI)] was used to assess association of risk factors with CVD, adjusting for age, race, and gender. Results: HNSCC patients were mostly white (82.7%), male (74.7%) and had Stage III/IV cancer (46.6%). Oral cavity was the most common cancer site (32.9%), followed by oropharynx (31.7%); 55.4% patients had hypertension, 23.0% had dyslipidemia, and 16.1% had diabetes. CVD was diagnosed in 16.1% patients, who were more likely to be older [median age 67.0 vs 60.0 years, p<0.0001]. In the multivariable model, hypertension [2.08(1.54-2.80)], diabetes [2.03(1.52-2.70)] and dyslipidemia [2.36(1.82-3.07)] were associated with CVD. Smoking status was not associated. Association of cancer stage with CVD varied by cancer site. Stage III/IV oropharynx cancer patients had lower odds of CVD than stage I/II oropharynx patients [0.38(0.30-0.92)]. No association with cancer stage was observed in oral cavity patients. Compared to chemotherapy, surgery [0.85(0.63-1.14)] and other treatments {0.61(0.41-0.89)] had lower odds of CVD. Conclusions: Traditional CVD risk factors remain associated with CVD in HNSCC patients. In addition, cancer-related factors (oropharynx cancer, advanced cancer stage and chemotherapy) are also associated with CVD.


Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Miguel Cainzos-Achirica ◽  
Sanjay Rampal ◽  
Yoosoo Chang ◽  
Seungho Ryu ◽  
Yiyi Zhang ◽  
...  

Introduction: The role of pulse wave velocity (PWV) in assessing cardiovascular disease (CVD) risk in asymptomatic non-elderly adults is unclear. PWV assessment, however, is readily available, non-invasive, cheap, and does not involve radiation exposure. Hypothesis: The aim of our study was to evaluate the hypothesis that brachial-ankle PWV was associated with coronary artery calcium (CAC) in a large sample of young and middle-aged asymptomatic adults, and that PWV increases the predictive value of traditional CVD risk factors for predicting the presence of CAC. Methods: Cross-sectional study of 15,009 asymptomatic men and women without a history of cardiovascular disease who underwent a health screening program that included both PWV and CAC measurements. Brachial-ankle PWV was obtained from bilateral brachial and posterior tibial artery pressure waveforms using the oscillometric method. Robust tobit regression was used to assess the association between PWV and natural log(CAC+1) and logistic regression was used to model the presence of detectable CAC (CAC>0) and CAC>100 adjusting for multiple CVD risk factors. Measures of calibration and discrimination were calculated to test the incremental value of adding PWV to traditional risk factors in predicting prevalent CAC. Results: The mean age of the study participants was 41.6 years (SD 7.2) and 83% (12,452) were men. Subjects with higher PWV had generally less favorable CVD risk profiles. The multivariable-adjusted CAC score ratios (95% confidence interval) comparing quintiles 2 - 5 of PWV to the first quintile were 1.21 (0.78, 1.86), 1.54 (1.01, 2.33), 1.98 (1.30, 3.01), and 2.83 (1.84, 4.37), respectively (P trend 100 were consistent with the results for CAC ratios. The addition of PWV to traditional risk factors significantly improved the discrimination and calibration of models for predicting the prevalence of detectable CAC (net reclassification index [NRI] for predicting detectable CAC and CAC score > 100 of 0.167 and 0.252, respectively; both p<0.001). Conclusions: In this large sample of young and middle-aged asymptomatic adults, brachial-ankle PWV was independently associated with the presence and the extent of CAC. PWV measurements improve the prediction of detectable CAC compared to traditional CVD risk factors and may help identify young and middle-age subjects with increased risk of subclinical disease.


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