Endothelial Dysfunction Is Associated with Cerebrovascular Events in Pre-Dialysis CKD Patients: A Prospective Study

Background: Patients with chronic kidney disease (CKD) have markedly increased rates of end stage renal disease, major adverse cardiovascular/cerebrovascular events (MACCEs), and mortality. Endothelial dysfunction (ED) is an early marker of atherosclerosis that is emerging as an increasingly important non-traditional cardiovascular risk factor in CKD. There is a lack of clinical studies examining the association between ED and both cardiovascular and renal endpoints in patients with CKD. Aims: We examined the association between reactive hyperemia index (RHI), a validated measure of endothelial function measured by peripheral arterial tonometry (PAT), with traditional cardiovascular risk factors in pre-dialysis CKD patients and prospectively evaluated the role of RHI as predictor of renal and cardiovascular outcomes in this population. Methods: One hundred and twenty pre-dialysis patients with CKD stages 1 to 5 (CKD group) and 18 healthy kidney donor candidates (control group) were recruited and had a successful RHI measurement by PAT. General demographic and clinical information including traditional cardiovascular risk factors were registered from all participants. Thereafter, patients were prospectively followed-up for a median time of 47 (IQR 19–66) months to determine associations of RHI with renal outcomes, MACCEs, hospitalizations or mortality. Results: In the CKD patient population, the mean age was 57.7 ± 15.5 years, the mean eGFR was 54.9 ± 36.7 mL/min/1.73 m2 (CKD-EPI) and 57 were males (47.5%). At baseline, in univariate analysis, RHI in the CKD group correlated positively with eGFR (r = 0.332, p < 0.0001) and correlated negatively with age (r = −0.469, p < 0.0001), Charlson index (r = −0.399, p < 0.0001), systolic blood pressure (r = −0.256, p = 0.005), and proteinuria (r = 0.211, p = 0.027). Reactive hyperemia index in the control group did not significantly differ from RHI observed in patients with CKD stages 1 to 5 (2.09 ± 0.40 vs. 2.01 ± 0.06, p = 0.493). In adjusted analysis, only age (β = −0.014, p = 0.003) remained independently associated with RHI at baseline. During follow-up, 8 patients suffered a MACCEs, 33 patients experienced renal function deterioration, 17 patients were hospitalized for medical reasons and 6 patients died. RHI at baseline was not significantly associated with CKD progression (1.94 vs. 2.02, p = 0.584), hospitalizations (1.90 vs. 2.04, p = 0.334), and all-cause mortality (1.65 vs. 2.01, p = 0.208) or MACCEs (1.77 vs. 2.01, p = 0.356), but was significantly associated with cerebrovascular events (1.27 vs. 2.02, p = 0.004) and with a composite cardiovascular outcome (MACCEs, hospital admissions and death; 1.73 vs. 2.07, p = 0.035). Conclusion: Our results suggest that RHI may be a predictor for the development of cerebrovascular events in pre-dialysis CKD patients who may benefit from more aggressive preventive measures.

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Long-term effects of radiotherapy on cardiovascular risk factors in acromegaly

Acta Endocrinologica ◽

10.1530/eje-10-1105 ◽

2011 ◽

Vol 164 (5) ◽

pp. 675-684 ◽

Cited By ~ 4

Author(s):

Cristina L Ronchi ◽

Elisa Verrua ◽

Emanuele Ferrante ◽

Gwendolyn Bender ◽

Elisa Sala ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Control Group ◽

Oral Glucose ◽

Long Term Effects ◽

End Point ◽

Cerebrovascular Events

ObjectiveRadiation therapy (RT) is a useful adjuvant tool for acromegalic patients not cured by surgery and/or not responding to pharmacotherapy. However, its specific effects on cardio- and cerebrovascular morbidity are still on debate.DesignRetrospective analysis of 42 acromegalic patients cured after conventional radiotherapy (CRT, n=31) or radiosurgery by gamma-knife (GKRS, n=11) followed for a median period of 16.5 years (range: 2–40). Totally, 56 patients cured by surgery alone, with similar GH/IGF1 levels and duration of disease remission, served as control group.MethodsChanges in cardiovascular risk factors, such as body mass index, glucose metabolism, insulin resistance, blood pressure, and lipid profile (pre-defined primary end point) and occurrence of new major cardio- and cerebrovascular events (secondary end point) during follow-up.ResultsThe number of obese, hypertensive, and dyslipidemic subjects increased over time only in patients cured with RT. In contrast, the glucose response to the oral glucose tolerance test and the percentage of subjects with glucose alterations improved only in controls. As expected, the percentage of patients with pituitary failure was deeply higher among RT patients than among controls (86 vs 30%, P<0.0005). Despite these findings, a similar number of RT patients and controls developed major cardio- or cerebrovascular events (4/42 vs 3/56, P: NS). No differences were found between CRT and GKRS subgroups.ConclusionsPrevious RT seems to be associated with a worse metabolic profile in acromegalic patients studied after a long-term follow-up. Nevertheless, a direct link between RT and cardiovascular events remains to be proven.

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Effect of Dietary Education on Cardiovascular risk Factors in Rheumatoid Arthritis Patients

Current Rheumatology Reviews ◽

10.2174/1573397116666200907112338 ◽

2020 ◽

Vol 16 ◽

Author(s):

Rahil Taheri ◽

Shahram Molavynejad ◽

Parvin Abedi ◽

Elham Rajaei ◽

Mohammad Hosein Haghighizadeh

Keyword(s):

Rheumatoid Arthritis ◽

Risk Factors ◽

Blood Pressure ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Statistical Tests ◽

Intervention Group ◽

Serum Levels ◽

Control Group ◽

Dietary Education

Aim: The aim of this study was to investigate the effect of dietary education on cardiovascular risk factors in patients with rheumatoid arthritis. Method: In this randomized clinical trial, 112 patients with rheumatoid arthritis were randomly assigned into two groups, intervention and control. Dietary education was provided for the intervention group in 4 sessions; anthropometric measurements, serum levels of RF, triglycerides, cholesterol, HDL, LDL, and fasting blood sugar were measured before and three months after intervention. Data was analyzed using SPSS software and appropriate statistical tests. Results: The mean of total cholesterol (p <0.001), triglycerides (p = 0.004), LDL (p <0.001), systolic blood pressure (p = 0.001), diastolic blood pressure (p = 0.003), FBS and BMI (p <0.001) were decreased significantly in the intervention group after education compared the control group. Conclusion: Traditional care for rheumatoid arthritis patients is not enough. Patients need more education in order to improve their situation.

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Association of cardiovascular risk factors with markers of endothelial dysfunction in middle-aged men and women

Thrombosis and Haemostasis ◽

10.1160/th05-08-0552 ◽

2006 ◽

Vol 95 (01) ◽

pp. 134-141 ◽

Cited By ~ 24

Author(s):

Barbara Thorand ◽

Jens Baumert ◽

Angela Döring ◽

Andrea Schneider ◽

Lloyd Chambless ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Cardiovascular Risk ◽

Endothelial Dysfunction ◽

Alcohol Consumption ◽

Cardiovascular Risk Factors ◽

Linear Regression Analysis ◽

High Body Mass Index ◽

Moderate Alcohol Consumption ◽

Men And Women

SummaryEndothelial dysfunction plays an important role in the pathogenesis of cardiovascular diseases and diabetes mellitus. However, the causes underlying endothelial dysfunction are not fully understood. Therefore, the aim of the present study was to investigate associations of cardiovascular risk factors with soluble adhesion molecules (sE-Selectin, sICAM-1), soluble thrombomodulin (sTM) and von Willebrand factor (vWF) as markers of endothelial dysfunction. The study population consisted of a subcohort of 2,168 men and women aged 35 to 74 years randomly drawn from three cross-sectional population-based MONICA/ KORA Augsburg surveys conducted between 1984 and 1995. In multivariable linear regression analysis, current smoking, high (versus moderate) alcohol consumption, ratio of total cholesterol/HDL-cholesterol (TC/HDL-C) and C-reactive protein (CRP) were significantly associated with elevated levels of sEselectin and sICAM-1. Increased levels of sE-selectin were also found in subjects with actual hypertension, high body mass index and prevalent diabetes mellitus. In addition, low physical activity and no (versus moderate) alcohol consumption were significantly associated with elevated concentrations of sICAM-1. Levels of sTM were higher in subjects with actual hypertension, no or high amounts of alcohol intake and a high ratio of TC/ HDL-C, but were lower in subjects witha history of myocardial infarction. VWF was significantly associated with CRP only. In conclusion, sE-selectin and sICAM-1 are more strongly associated with traditional cardiovascular risk factors than sTM and vWF.

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Factor XIII Val34Leu polymorphism and the risk of myocardial infarction under the age of 36 years

Thrombosis and Haemostasis ◽

10.1160/th07-12-0755 ◽

2008 ◽

Vol 99 (06) ◽

pp. 1085-1089 ◽

Cited By ~ 15

Author(s):

Marianna Politou ◽

Christoforos Komporozos ◽

Demosthenes Panagiotakos ◽

Chrisoula Belessi ◽

Anthi Travlou ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Factor Xiii ◽

Control Group ◽

Lower Prevalence ◽

Premature Coronary Heart Disease ◽

Acute Mi ◽

The Impact

SummaryThere are limited and controversial data regarding the impact of factor XIII (FXIII) Val34Leu polymorphism in the pathogenesis of premature myocardial infarction (MI). We examined whether FXIII Val34Leu polymorphism is associated with the development of early MI.We recruited 159 consecutive patients who had survived their first acute MI under the age of 36 years (mean age=32.1 ± 3.6 years, 138 were men). The control group consisted of 121 healthy individuals matched with cases for age and sex, without a family history of premature coronary heart disease (CHD). FXIII Val34Leu polymorphism was tested with polymerase chain reaction and reverse hybridization. There was a lower prevalence of carriers of the Leu34 allele in patients than in controls (30.2 vs. 47.1%, p=0.006). FXIII Val34Leu polymorphism was associated with lower risk for acute MI after adjusting for major cardiovascular risk factors (odds ratio [OR] = 0.51, 95% confidence interval [CI] 0.27–0.95, p=0.03). Subgroup analysis according to angiographic findings (“normal” coronary arteries [n=29] or significant CHD [n=130]) showed that only patients with MI and significant CHD had lower prevalence of carriers of the Leu34 allele compared to controls after adjusting for major cardiovascular risk factors (OR = 0.42, 95% CI 0.22–0.83, p=0.01). Our data indicate that FXIII Val34Leu polymorphism has a protective effect against the development of MI under the age of 36 years, particularly in the setting of significant CHD.

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Serum Vitamin D Binding Protein Level Associated with Metabolic Cardiovascular Risk Factors in Women with the Polycystic Ovary Syndrome

Hormone and Metabolic Research ◽

10.1055/a-0759-7533 ◽

2018 ◽

Vol 51 (01) ◽

pp. 54-61 ◽

Cited By ~ 4

Author(s):

Justyna Kuliczkowska-Plaksej ◽

Renato Pasquali ◽

Andrzej Milewicz ◽

Felicja Lwow ◽

Diana Jedrzejuk ◽

...

Keyword(s):

Risk Factors ◽

Vitamin D ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Polycystic Ovary ◽

Serum Insulin ◽

Normal Weight ◽

Control Group ◽

Vitamin D Binding Protein ◽

Ovary Syndrome

AbstractThe objective of the study was to measure the levels of 25-hydroxyvitamin D [25(OH)D] and vitamin D binding protein (VDBP) and assess their relationships with cardiovascular risk factors in women with the polycystic ovary syndrome (PCOS). A group of 267 women, aged 20–35 years (24.7 ± 4.9): 167 with PCOS and 100 healthy women were divided according to body mass index. Biochemical and hormonal parameters were measured. Free and bioavailable 25(OH)D were calculated using the mathematical equations. The percentage of body fat and visceral fat deposit were assessed by DXA. In the normal weight control group total, free, bioavailable 25(OH)D (p<0.001 for all) were significantly higher than in its overweight/obese counterpart, while VDBP levels were comparable. In PCOS women total 25(OH)D (p<0.001), and VDBP (p –0.006) were lower in the overweight/obese subgroups than in the normal weight ones. In both groups serum VDBP levels correlated negatively with serum insulin and positively with sex hormone binding globulin. In PCOS group, in contrast to control group, VDPB was negatively correlated with abdominal fat deposit, BMI, fasting glucose and positively with HDL. Despite lower total 25(OH)D in obese PCOS women, all women with PCOS (lean and obese) had comparable free and bioavailable 25(OH)D, which might be a result of concomitantly lowered serum VDBP levels in obese PCOS women. VDBP might play important role in the regulation of availability of active fractions of 25(OH)D in PCOS women. VDBP seems to be associated with cardiovascular risk factors such as BMI, waist circumference, visceral fat, and fasting serum insulin in women with PCOS.

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Abstract 13062: Epicardial Fat Associates With Endothelial Dysfunction, but Not With Coronary Calcium Score: From the Elsa-brasil Cohort Study

Circulation ◽

10.1161/circ.142.suppl_3.13062 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Karina P Martins ◽

Sandhi Barreto ◽

Daniel Bos ◽

JESIANA PEDROSA ◽

Douglas Mesquita ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Coronary Artery ◽

Endothelial Dysfunction ◽

Endothelial Function ◽

Cardiovascular Risk Factors ◽

Subcutaneous Fat ◽

Epicardial Fat ◽

Fat Deposits ◽

Multivariable Analyses

Introduction: Epicardial fat has been related to coronary artery disease (CAD) independent of visceral or subcutaneous fat. The mechanism responsible for this association has not yet been elucidated. Our objective was to evaluate the association between automatically measured epicardial fat volume (EFV), cardiovascular risk factors, coronary artery calcium (CAC) and endothelial function in participants of ELSA-Brasil. Methods and Results: The sample comprised 470 (mean age 55± 8y, 52.3% men) participants from ELSA-MG, one of the Investigation Centers of the cohort, who had valid computed tomography scans and endothelial function evaluated by peripheral arterial tonometry (PAT). The mean EFV was 111 (IQ 86-144) mL. CAC=0 was detected in 55% of participants. In the multivariable analyses between cardiovascular risk factors and EFV, the following associations were observed with higher EFV: female sex; and increased age, waist circumference and triglycerides (p <0.001 for all). In multivariable analyses, higher EFV remained associated with worse endothelial function - basal pulse amplitude (q2=1.22, CI95% 1.07-1.40, p=0.004; q3=1.50, CI95% 1.30-1.74, p<0.001; q4=1.50, CI95% 1.28-1.79, p<0.001) and PAT ratio (q2=0.87, CI95% 0.81-0.95, p<0.001; q3=0.86, CI95% 0.79-0.94, p<0.001; q4=0.80, CI95% 0.73-0.89, p<0.001), but not with CAC. Conclusions: Higher EFV was associated with impaired endothelial function, but not with higher CAC. Our results suggest that the mechanism by which epicardial fat deposits relates to CAD may be different from the pathway of CAC, which relates to calcified plaques. A possible mechanism may be through the enhancement of endothelial dysfunction, microvascular disease and predominantly lipidic non-calcified plaques.

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Cardiovascular Risk Factors and their Relationship with Endothelial Dysfunction in Rural and Urban South African Children

10.21203/rs.3.rs-54162/v1 ◽

2020 ◽

Author(s):

Edna N. Matjuda ◽

Godwill Azeh Engwa ◽

Samuel Nkeh Chungag Anye ◽

Benedicta N. Nkeh Chungag ◽

Nandu Goswami

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Cardiovascular Risk ◽

Endothelial Dysfunction ◽

Cardiovascular Risk Factors ◽

High Blood Pressure ◽

Urban Children ◽

Urban Settings ◽

Arterial Blood ◽

Rural And Urban

Abstract Background: Endothelial dysfunction is known to be an initiator to the development and progression of atherosclerotic cardiovascular disease (CVD). However, there is paucity o knowledge on its relationship with cardiovascular risk factors in children. More so, some of these cardiovascular risk factors are known to be influenced by feeding habits and life style changes which often vary between rural and urban settings. This study was aimed to investigate the relationship between cardiovascular risk factors and endothelial function in rural and urban children. Methods: A cross-sectional study on 6-9 years old children in randomly selected rural and urban schools of the Eastern Cape Province of South Arica was conducted. General anthropometric indices were measured followed by blood pressure (BP) measurements. The pulse wave velocity (PWV) was measured using a Vicorder. Urine sample was collected for the determination of albumin, creatinine, asymmetric dimethylarginine (ADMA), 8-hydroxy-2deoxyguanosine (8-OHdG) and thiobarbituric acid reactive substance (TBARS). Albumin to creatinine ratio (ACR) was calculated.Results: Children from urban settings (10.8%) had a higher prevalence of overweight/obesity than their rural counterparts (8.5%) while the prevalence of elevated/high blood pressure was higher in rural children (23.2%) than in urban children (19.0%). Diastolic blood pressure (DBP) and mean arterial blood pressure (MAP) significantly (p<0.005) increased with increasing quartiles of PWV. ADMA positively associated with HR in rural girls and showed a weak risk for elevated SBP and MAP. Body mass index (BMI) increased with increasing PWV and predicted endothelial dysfunction. 8-OHdG significantly (p<0.005) increased with increasing quartiles of ADMA and positively correlated with ADMA. Creatinine, albumin and ACR significantly (p<0.005) increased with increasing ADMA and ADMA associated positively with creatinine. Conclusion: Endothelial dysfunction was associated with obesity, high blood pressure, oxidative stress and microalbuminuria in children, and this relationship varied between rural and urban children.

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The significant gap between international standards and stroke management practices at Queen Elizabeth Central Hospital (Malawi): An audit report

Malawi Medical Journal ◽

10.4314/mmj.v31i4.6 ◽

2019 ◽

Vol 31 (4) ◽

pp. 249-255 ◽

Cited By ~ 1

Author(s):

Yohane Gadama

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Acute Stroke ◽

Cardiovascular Risk Factors ◽

Management Practices ◽

Vital Signs ◽

Central Hospital ◽

Stroke Management ◽

The Mean ◽

Queen Elizabeth Central Hospital

BackgroundThe Queen Elizabeth Central Hospital (QECH) is preparing to set up the first stroke unit in Blantyre, Malawi. We conducted this audit to assess current stroke management practices and outcomes at QECH and identify priority areas for intervention.MethodsFrom April to June 2018, we prospectively enrolled patients with acute stroke and collected data on clinical presentation, cardiovascular risk factors, investigations and interventions, in-hospital outcomes, and follow-up plans after discharge. The American Heart Association/American Stroke Association (AHA/ASA) guidelines were used as the standard of care for comparison.ResultsFifty patients with acute stroke were enrolled (46% women, 54% men). The mean age was 63.1 years (95% CI: 59.7–66.6). The diagnosis of stroke was based on the World Health Organization criteria. The diagnosis was made within 24 hours of admission in 19 patients (38%). Acute revascularisation therapy was not available. Forty-eight patients (96%) had their vital signs checked at baseline and <10% had their vital signs checked more than three times within the first 24 hours. Essential blood tests including random blood sugar (RBS), full blood count (FBC), urea/creatinine, and lipid profiles were performed in 72%, 68%, 48%, and 4%, respectively. An electrocardiogram was performed on 34 patients (68%). Blood pressure on admission was >140/90 mmHg in 34 patients (68%), including 4 with values >220/120 mmHg. Nine patients had an RBS >10 mmol/L and four received insulin. Prophylaxis for deep venous thrombosis was offered to 12 patients (24%). Aspiration pneumonia was reported in 16 patients (32%) and was the most common hospital complication. The mean duration of hospitalisation was 10.4 days (95% CI: 5.6–15.2), and case fatality was 18%. The modified Rankin scale at discharge was ≤2 in 32% of patients. Only four patients (8%) were transferred to a rehabilitation centre. At the time of discharge, only 32% of patients received education on stroke.ConclusionAcute stroke care is less than optimal in this setting. Simple interventions such as reducing the delay in making a stroke diagnosis, early swallow assessments, and closer monitoring of vital signs could make a significant difference in stroke outcome. Furthermore, treating cardiovascular risk factors and setting up health education programmes to improve secondary prevention represent key priorities.

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1108Effectiveness of nursing counseling for patients with cardiovascular risk factors: controlled clinical trial with a 24 months post-intervention follow-up

European Heart Journal ◽

10.1093/eurheartj/ehz748.0002 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

A Salazar ◽

V Vilchez-Barboza ◽

K Saez ◽

T Paravic

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Intervention Group ◽

Health Centers ◽

Control Group ◽

Controlled Clinical Trial ◽

Post Intervention ◽

Face To Face

Abstract Objective To establish the effect after 24 months of a face-to-face and telephone nursing counseling intervention, aimed at controlling cardiovascular risk factors (hypertension, dyslipidemia and overweight) and improving health-related quality of life (HRQoL) in patients of the cardiovascular health program of family health centers of Concepciόn, Chile. Methods Randomized controlled clinical trial with a 24 months post-intervention follow-up. 120 patients with cardiovascular risk factors under the cardiovascular health program were recruited from 6 family health centers and randomized into a control group (60) and an intervention group (60). The intervention group received the regular care in addition to face-to-face and telephone nursing counseling. Baseline measurements were taken and also at the end of the intervention (7 months). Participants returned then after 12 and 24 months for follow-up evaluations. A total of 109 subjects completed the intervention at 7 months and 45 returned at 24 months. During follow-up evaluations both groups continued to receive regular care given in the health centers. The measurements consisted of HRQoL (physical and mental health), systolic blood pressure (SBP) and diastolic blood pressure (DBP), body mass index (BMI), abdominal circumference (AC), total cholesterol (TC), low density lipoproteins (LDL-Chol), high density lipoprotein (HDL-Chol), atherogenicity index (LDL/HDL), cardiovascular risk factor (TC/HDL), 10-year coronary risk. Ethical requirements were considered and statistical analysis was carried out using MANCOVA and d-Cohen repeated measurements. Results The analysis of the effects of the intervention in the 24-month follow-up showed that subjects in the intervention group only maintained significant improvement of AC over time (F=3.18; p=0.03), compared to the control group. Conclusion Although participants in the intervention group only maintained the AC improvement over time, this can be regarded as an indirect indicator of the presence of intra-abdominal fat that makes it possible to predict and classify the risk of cardiovascular disease. Long-term follow-up studies are required to investigate behaviors and mechanisms that contribute to maintaining improvements in this indicator. Additionally, future research should include reinforcement activities, either face-to-face or by telephone, to help maintain the positive results of interventions. Acknowledgement/Funding Universidad de Concepciόn 214.082.049-1.0

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High prevalence of obesity in rheumatoid arthritis patients: association with disease activity, hypertension, dyslipidemia and diabetes, a multi-center study

Advances in Rheumatology ◽

10.1186/s42358-019-0089-1 ◽

2019 ◽

Vol 59 (1) ◽

Cited By ~ 4

Author(s):

Maria Fernanda Brandão de Resende Guimarães ◽

Carlos Ewerton Maia Rodrigues ◽

Kirla Wagner Poti Gomes ◽

Carla Jorge Machado ◽

Claiton Viegas Brenol ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Risk Factors ◽

Cardiovascular Disease ◽

Cardiovascular Risk ◽

Disease Activity ◽

Cardiovascular Risk Factors ◽

Laboratory Data ◽

Premature Cardiovascular Disease ◽

Prevalence Of Obesity ◽

The Mean

Abstract Introduction Rheumatoid arthritis (RA) is a well-documented independent risk factor for cardiovascular disease. Obesity may provide an additional link between inflammation and accelerated atherosclerosis in RA. Objective To evaluate the association between obesity and disease parameters and cardiovascular risk factors in RA patients. Method Cross-sectional study of a cohort of RA patients from three Brazilian teaching hospitals. Information on demographics, clinical parameters and the presence of cardiovascular risk factors was collected. Blood pressure, weight, height and waist circumference (WC) were measured during the first consultation. Laboratory data were retrieved from medical records. Obesity was defined according to the NCEP/ATPIII and IDF guidelines. The prevalence of obesity was determined cross-sectionally. Disease activity was evaluated using the DAS28 system (remission < 2.6; low 2.6–3.1; moderate 3.2–5.0; high > 5.1). Results The sample consisted of 791 RA patients aged 54.7 ± 12.0 years, of whom 86.9% were women and 59.9% were Caucasian. The mean disease duration was 12.8 ± 8.9 years. Three quarters were rheumatoid factor-positive, the mean body mass index (BMI) was 27.1 ± 4.9, and the mean WC was 93.5 ± 12.5 cm. The observed risk factors included dyslipidemia (34.3%), type-2 diabetes (15%), hypertension (49.2%) and family history of premature cardiovascular disease (16.5%). BMI-defined obesity was highly prevalent (26.9%) and associated with age, hypertension and dyslipidemia. Increased WC was associated with diabetes, hypertension, dyslipidemia and disease activity. Conclusion: Obesity was highly prevalent in RA patients and associated with disease activity.

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