scholarly journals Cardiovascular comorbidity of osteoarthritis: clinical significance and therapy strategies

2021 ◽  
pp. 241-246
Author(s):  
A. V. Naumov
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Older Patients ◽  
Significant Decline ◽  
Cardiovascular Comorbidity ◽  
Low Intensity ◽  
Pharmaceutical Substances ◽  
Loss Of Autonomy ◽  
Comprehensive Programs ◽  
Therapy Strategies

The comorbidity of osteoarthritis and cardiovascular disease is the most frequent and typical polymorbidity in older patients. The identity of risk factors, low intensity pathogenetic effect of systemic inflammation, dyslipidemia define a greater degree and progression of both osteoarthritis and cardiovascular diseases in patients with a combination thereof. There is a significant decline in physical functioning and loss of autonomy. There is a higher risk of cardiovascular mortality in osteoarthritis patients. Only comprehensive programs involving physical rehabilitation, nutraceutical support, and pharmaceutical substances of chondroitin sulfate and glucosamine sulfate can supply effective and safe treatment in patients with osteoarthritis and cardiovascular disease.

scholarly journals Metabolic Profile and Body Composition in Adult Women with Congenital Adrenal Hyperplasia due to 21-Hydroxylase Deficiency

2007 ◽  
Vol 92 (1) ◽  
pp. 110-116 ◽  
Author(s):  
Henrik Falhammar ◽  
Helena Filipsson ◽  
Gundela Holmdahl ◽  
Per-Olof Janson ◽  
Agneta Nordenskjöld ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Body Composition ◽  
Fat Mass ◽  
Older Patients ◽  
Adrenal Hyperplasia ◽  
Hydroxylase Deficiency ◽  
Younger Patients ◽  
Waist To Hip Ratio ◽  
21 Hydroxylase Deficiency

Abstract Context: The chronic, often supraphysiological glucocorticoid doses used in congenital adrenal hyperplasia (CAH) might increase morbidity in cardiovascular disease and diabetes. Objective: Our aim was to assess risk factors for cardiovascular disease and diabetes in CAH women. Subjects, Methods, and Design: We compared 61 women, 18–63 yr, with CAH due to 21-hydroxylase deficiency with 61 age- and sex- matched controls. Twenty-seven were younger than 30 yr, and 34 were 30 yr or older. Anthropometry, fat and lean mass measured by dual-energy x-ray absorptiometry, serum lipids, insulin, and adrenocortical steroids were studied. Main Outcome Measure: Body composition and cardiovascular risk factors were the main outcome measures. Results: Younger patients and controls had similar waist to hip ratio, lean and fat mass, and insulin. Older patients had higher waist to hip ratio, lean mass, and insulin than controls. Fat mass was similar to controls but higher than in younger patients. Lipid profiles were slightly more favorable in older patients than controls. Gestational diabetes was more common in patients (21% of pregnancies vs. 0, P < 0.026). Few older patients had hypertension, cardiovascular disease, or diabetes. Despite moderate glucocorticoid doses, most patients had suppressed androgens. Conclusions: No clear evidence of unfavorable cardiovascular risk factors were found. Increased fat mass and higher insulin levels were, however, found in patients older than 30 yr. High frequency of gestational diabetes is a risk marker for future diabetes. Lifelong follow-up, lifestyle modifications, and attempts to adjust and reduce the glucocorticoid doses seem important.

scholarly journals Managing older patients with hemophilia

Hematology ◽  
2015 ◽  
Vol 2015 (1) ◽  
pp. 41-47 ◽  
Author(s):  
Dana Angelini ◽  
Suman L. Sood
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Liver Disease ◽  
Older Patients ◽  
Joint Disease ◽  
Evidence Based ◽  
The Past ◽  
Age Related ◽  
Obesity And Diabetes ◽  
Evidence Based Guidelines

AbstractWith access to safe factor products, the life expectancy of persons with hemophilia (PWHs) has increased almost 10-fold over the past 7 decades. Unfortunately, hand in hand with this success comes the burden of aging. As PWHs age, they are subject to develop many of the same risk factors as the general population, including increasing rates of hypertension, obesity, and diabetes. Such comorbidities predispose them to chronic diseases, such as cardiovascular disease and chronic kidney disease, although how their coagulopathy affects the expression of these conditions remains unclear. The older hemophilia population faces additional challenges, such as chronic joint arthropathy, which provokes falls and fractures, and complications related to HIV and hepatitis C infections, which greatly affect the incidence of cancer and liver disease. In light of the paucity of evidence-based guidelines to direct therapy, a new challenge has arisen for hematologists to optimally manage these complex age-related issues. In general, elderly PWHs should be treated similarly to their peers without hemophilia, with the addition of factor replacement therapy as appropriate. Primary prevention of risk factors should be emphasized, and close coordination between specialties is essential. This review will focus on common complications affecting the older hemophilia population, including cardiovascular disease, malignancy, liver disease, renal insufficiency, and joint disease.

Serum Retinol and β-carotene Levels and Risk Factors for Cardiovascular Disease in Morbid Obesity

2010 ◽  
Vol 80 (3) ◽  
pp. 159-167 ◽  
Author(s):  
Gabriela Villaça Chaves ◽  
Gisele Gonçalves de Souza ◽  
Andréa Cardoso de Matos ◽  
Dra. Wilza Abrantes Peres ◽  
Silvia Elaine Pereira ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Morbid Obesity ◽  
Serum Levels ◽  
World Health ◽  
Morbidly Obese ◽  
Serum Retinol ◽  
Significant Difference ◽  
Β Carotene

Objective: To evaluate retinol and β-carotene serum levels and their relationship with risk factors for cardiovascular disease in individuals with morbid obesity, resident in Rio de Janeiro. Methodology: Blood serum concentrations of retinol and β-carotene of 189 morbidly obese individuals were assessed. The metabolic syndrome was identified according to the criteria of the National Cholesterol Education Program (NCEP) and World Health Organization (WHO). Lipid profile, insulin resistance, basal insulin, glycemia, blood pressure, and anthropometry and their correlation with retinol and β-carotene serum levels were evaluated. Results: Metabolic syndrome diagnosis was observed in 49.0% of the sample. Within this percentage the levels of β-carotene were significantly lower when body mass index increased. Serum retinol didn't show this behavior. Serum retinol inadequacy in patients with metabolic syndrome (61.3%), according to WHO criterion, was higher (15.8%) than when the whole sample was considered (12.7%). When metabolic syndrome was diagnosed by NCEP criterion, β-carotene inadequacy was higher (42.8%) when compared to the total sample (37.5%). There was a significant difference between average β-carotene values of patients with and without metabolic syndrome (p=0.048) according to the classification of the NCEP. Lower values were found in patients with metabolic syndrome. Conclusion: Considering the vitamin A contribution in antioxidant protection, especially when risk factors for cardiovascular disease are present, it is suggested that great attention be given to morbidly obese. This could aid in prevention and treatment of cardiovascular disease, which affects a significant part of the population.

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