scholarly journals Possibilities of telemedical monitoring risk factors in patients with cardiovascular diseases: experience of using a patient-oriented model of remote rehabilitation care

2021 ◽  
Vol 65 (6) ◽  
pp. 549-556
Author(s):  
Elena V. Kotelnikova ◽  
Valery N. Senchikhin ◽  
Tatyana P. Lipchanskaya
Keyword(s):  
Risk Factors ◽  
Cardiovascular Diseases ◽  
Cardiac Rehabilitation ◽  
Healthy Lifestyle ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Rehabilitation Care ◽  
Rehabilitation Model ◽  
High Level ◽  
Remote Assistance

Introduction. The modern system for the prevention of cardiovascular diseases and the creation of conditions for the formation and maintenance of a healthy lifestyle (coolant) includes activities in the development of monitoring systems for information on risk factors. Purpose: to assess the capabilities of telemedicine monitoring of cardiovascular risk factors in the structure of a patient-oriented model of distance rehabilitation care. Material and methods. The study included patients with coronary heart disease and/or arterial hypertension of the I-III degree, without cognitive dysfunction and contraindications to physical rehabilitation, with a mobile device with Internet access. The following groups were distinguished: remote cardiac rehabilitation, with the participation of patients in a 12-month program (28 patients, 86% of men, average age 55.2 ± 10.7 years), and traditional follow-up (30 patients, 80% of men, average age 64.7 ± 6.9 years). Remote cardiac rehabilitation model provided for office consulting using a decision support system, monitoring indicators based on digital recording devices, mobile applications and the electronic «Patient Diary» deferred telemedicine counselling. The effectiveness of the observation was evaluated by the trend of the modified risk factors; patient satisfaction with remote assistance - according to the «Client Satisfaction Questionnaire - CSQ-8» questionnaire. Results. After completion of the remote cardiac rehabilitation (RCR) program, a significant decrease in systolic and diastolic blood pressure, total cholesterol, low-density lipoprotein cholesterol and triglycerides were observed, and a tendency to increase physical activity. Upon completion of the RCR-program, a high level of satisfaction with telemedicine assistance was noted. Conclusion. The results of the pilot phase of the study, dedicated to the study of the possibilities of remote rehabilitation in the context of maximizing the benefits for cardiovascular prophylaxis, indicate the possibility of using a patient-oriented model of remote cardiac rehabilitation to monitor and modify risk factors in patients with cardiovascular diseases.

Identifying the prevalence of undiagnosed cardiovascular disease risk factors in healthy Indians

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
S Thanvi ◽  
P Thakkar
Keyword(s):  
Risk Factors ◽  
Heart Attack ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Healthy Individuals ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Health Checkup ◽  
Study Population ◽  
High Level

Abstract Funding Acknowledgements Type of funding sources: None. Introduction   Cardiovascular disease (CVD) including heart disease and stroke, is the leading cause of death globally and in India.  The importance of primary prevention, defined as interventions designed to modify adverse risk factors with the goal of preventing an initial CVD event has been established beyond doubt by several population based studies in healthy individuals. While there have been many studies defining the high prevalence in CVD risk factors in Indian population, this study sought to determine the prevalence of undiagnosed modifiable CVD risk factors in healthy individuals.  Methods The  cross sectional, analytical study was carried out at the hospitals, from 1st April 2015 to 31st dec 2017. Subjects between 18 - 70 years of age who were healthy and were undergoing health checkup were included in the study. A total of 5000 patients were screened, those having existing CVD risk factors were excluded from the study.  This study was approved by the institutional ethics committee of the hospital. Written informed consent was obtained from all subjects. The data collection record sheet was prepared based on validated and standardized questionnaires which was used to enter all data.  Physical examination for vitals and BMI was done by qualified physicians. Blood investigations were done for diabetes and dyslipidemia and thyroid dysfunction. ACC/AHA criteria was used for diagnosis of  hypertension, ADA criteria for diabetes. Joint British society 3 risk score and ASCVD risk score was calculated using standard calculators. Results At screening, 4998 participants aged ≥18 years were approached to participate in study. The study population included 2705 men (68.1%) and 1265 women (31.9%) with a mean age of 68± 18.8 years. The most prevalent risk factor was overweight and obesity (71.2%). The prevalence of undiagnosed HTN was 73.3%, undiagnosed pre-diabetes was 24.9% and undiagnosed diabetes was 28.3%. Out of total, 44.3% subjects had high level of low-density lipoprotein and 36.6% subjects had low level of high-density lipoprotein, 20.1% subjects had high level of very-low density lipoprotein (VLDL) and 17.3% subjects had high level of triglyceride. Tobacco smoking was present in 7.7% of the population. The risk estimation predicted 29.1% of the study participants to have more than 10% risk of heart attack/stroke risk at 10 years. Conclusion Our study reveals a fairly good snapshot of CVDs risk factors in healthy general population. Increased prevalence of high BMI, undiagnosed HTN, diabetes, dyslipidemia was present in our study population.  The population had significantly high predicted risk of heart attack/stroke. These findings warrant the need of community based life style modifications, regular health checkup for healthy population for early detection and modification of CVD risk factors.

scholarly journals Association between Rosacea and Cardiovascular Diseases and Related Risk Factors: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Yanmei Li ◽  
Linghong Guo ◽  
Dan Hao ◽  
Xiaoxue Li ◽  
Yujia Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Diseases ◽  
Meta Analysis ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Pooled Analysis ◽  
Lipoprotein Cholesterol ◽  
Cvd Risk ◽  
Related Risk ◽  
Mean Differences

Background. Rosacea is a common inflammatory skin disorder. Several studies, but not all, have suggested a high prevalence of cardiovascular diseases (CVDs) in rosacea patients. This study is aimed at investigating the association between rosacea and CVDs and related risk factors. Methods. We performed a literature search through PubMed, Embase, and Web of Science databases, from their respective inception to December 21, 2019. Two reviewers independently screened the articles, extracted data, and performed analysis, following the PRISMA guidelines. Odds ratios (OR) or standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated for outcomes. The included studies’ quality was evaluated using the Newcastle Ottawa Scale (NOS). Results. The final meta-analysis included ten studies. The pooled analysis found no association between rosacea prevalence and the incidence of CVDs (OR 0.97; 95% CI 0.86-1.10). Rosacea was found to be significantly associated with several risk factors for CVDs (OR 1.17; 95% CI 1.05-1.31), including hypertension (OR 1.17; 95% CI 1.02-1.35), dyslipidemia (OR 1.34; 95% CI 1.00-1.79), and metabolic syndrome (OR 1.72; 95% CI 1.09-2.72). However, no association was found between rosacea and diabetes mellitus (OR 0.98; 95% CI 0.82-1.16). Among the biological parameters, a significant association was found between rosacea and total cholesterol (SMD=0.40; 95% CI=−0.00, 0.81; p<0.05), low-density lipoprotein cholesterol (SMD=0.28; 95% CI=0.01, 0.56; p<0.05), and C-reactive protein (CRP) (SMD=0.25; 95% CI=0.10, 0.41; p<0.05). We found no association between rosacea and high-density lipoprotein cholesterol (SMD=0.00; 95% CI=−0.18, 0.18; p=0.968) or triglycerides (SMD=0.10; 95% CI=−0.04, 0.24; p=0.171). Conclusions. Although no significant association was found between rosacea and CVDs, rosacea was found to be associated with several of related risk factors. Patients with rosacea should pay more attention to identifiable CVD risk factors, especially those related to inflammatory and metabolic disorders.

scholarly journals Determinants of coronary artery disease risk factor management across three world regions

Heart Asia ◽  
2019 ◽  
Vol 11 (1) ◽  
pp. e011112
Author(s):  
Min Zhao ◽  
Ian Graham ◽  
Marie Therese Cooney ◽  
Diederick E Grobbee ◽  
Ilonca Vaartjes ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Middle East ◽  
Cardiac Rehabilitation ◽  
Cardiovascular Health ◽  
Disease Risk ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Risk Factor Management ◽  
Logistic Regression Models

BackgroundThe SUrvey of Risk Factors (SURF) indicated poor control of risk factors in subjects with established coronary heart disease (CHD). The present study aimed to investigate determinants of risk factor management in patients with CHD.Methods and resultsSURF recruited 9987 consecutive patients with CHD from Europe, Asia and the Middle East between 2012 and 2013. Risk factor management was summarised as a Cardiovascular Health Index Score (CHIS) based on six risk factor targets (non-smoker/ex-smoker, body mass index <30, adequate exercise, controlled blood pressure, controlled low-density lipoprotein and controlled glucose). Logistic regression models assessed the associations between determinants (age, sex, family history, cardiac rehabilitation, previous hospital admission and diabetes) and achievement of moderate CHIS (≥3 risk factors controlled). The results are presented as OR with corresponding 95% CI. A moderate CHIS was less likely to be reached by women (OR 0.90, 95% CI 0.69 to 1.00), those aged <55 years old (OR 0.62, 95% CI 0.53 to 0.76) and those with diabetes (OR 0.41, 95% CI 0.37 to 0.46). Attendance in cardiac rehabilitation was associated with better CHIS achievements (OR 1.62, 95% CI 1.42 to 1.87). Younger Asian and European patients had poorer risk factor management, whereas for patients from the Middle East age was not significantly associated with risk factor management. The availability and applicability of cardiac rehabilitation varied by region.ConclusionsOverall, risk factor management was poorer in women, those younger than 55 years old, those with diabetes and those who did not participate in a cardiac rehabilitation. Determinants of cardiovascular risk factor management differed by region.

scholarly journals Association of AGT, ACE, NOS3 polymorphism with subclinical arterial wall changes and cardiovascular diseases risk factors.

2020 ◽  
Author(s):  
Anna Akopyan ◽  
Karina Kirillova ◽  
Irina Strazhesko ◽  
Larisa Samokhodskaya ◽  
Sergey Leonov ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Diseases ◽  
Endothelial Dysfunction ◽  
Arterial Wall ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Intima Media Thickness ◽  
Lipoprotein Cholesterol ◽  
Atherosclerotic Plaques ◽  
System Activation

Aim:Renin-Angiotensin-Aldosterone System activation (RAAS) and nitric oxide (NO) decline are leading to changes in arterial wall, which, in turn, is increasing risk of cardiovascular diseases (CVD). There is limited evidence on influence of AGT, ACE, NOS3polymorphism on pulse wave velocity (PWV) carotid artery intima-media thickness (cIMT), endothelium-dependent vasodilation (EDVD), presence of atherosclerotic plaques and risk factors of CVD. Aim of this study was to find association between AGT, ACE, NOS3polymorphism and PWV, cIMT, EDV, presence of atherosclerotic plaques and risk factors of CVD in a healthy population.Methods:We examined association of AGTс.521СТpolymorphism, AСEInsDel polymorphism, NOS3 с.894GT polymorphismwith arterial wall changes and risk factors of CVD in 160 healthy people of different ages. Results:CT genotype ofAGTс.521СТpolymorphism was associated with lower levels of systolic blood pressure (BP) (p=0,013)and central systolic BP (p=0,029), higher level of Insulin-Like Growth Factor (IGF) (p=0,027). DD genotype ofACEInsDel polymorphism was associated with higher waist/hip ratio (p=0,044), lower level of high density lipoprotein cholesterol (p=0,01), lower index of EDVD (p=0,042),most commonly found endothelial dysfunction (ED) (p=0,026).GG genotype ofNOS3с.894GT polymorphism was associated with higher levels of central systolic BP (p=0,022) and central mean BP (p=0,033),total cholesterol (p=0,025), low density lipoprotein cholesterol(p=0,014) and IGF (p=0,042),most commonly found ED (p=0,007), albuminuria (p =0,032) and insulin resistance (p=0,03).Conclusion:We found association of AСE andNOS3polymorphism with endothelial dysfunction and metabolic parameters.

scholarly journals Relationship of obesity, low-density lipoprotein cholesterol and myocardial perfusion in patients with risk factors and without atherosclerotic cardiovascular diseases

2021 ◽  
Vol 20 (2) ◽  
Author(s):  
V. B. Sergienko ◽  
A. A. Ansheles ◽  
I. V. Sergienko ◽  
S. A. Boytsov
Keyword(s):  
Risk Factors ◽  
Cardiovascular Diseases ◽  
Myocardial Perfusion ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Atherosclerotic Cardiovascular Diseases ◽  
The Relationship ◽  
Rest Myocardial Perfusion

Aim. In the retrospective study, to identify the relationship between body mass index (BMI), low-density lipoprotein cholesterol (LDL-C) levels and myocardial perfusion in patients without established atherosclerotic cardiovascular diseases.Material and methods. The study included 534 patients with cardiovascular risk factors but without established coronary artery disease, diabetes, myocardial infarction or coronary revascularization. In 76 of them, stress/rest myocardial perfusion single-photon emission computed tomography (SPECT) was performed.Results. The relationship between BMI and LDL-C levels is described by a quadratic (r2=0,21, p<0,001) function or a linear spline kinked in BMI of 27 kg/m2 (r=0,51, -0,46 — before and after this value, respectively; p<0,001). According to SPECT, focal stable and transient left ventricular myocardial perfusion abnormalities were not detected. However, there was a direct linear correlation between the heterogeneity of rest myocardial perfusion (ohet) and BMI (r=0,43, p<0,001), ohet and waist circumference (r=0,40, p<0,001), as well as between ohet and LDL-C (r=0,44, p<0,001).Conclusion. The relationship between BMI and LDL-C levels can be explained by endocrine dysfunction of adipose tissue, which disturbs the synthesis and metabolism of atherogenic lipoproteins. Obesity and increased LDL-C levels affect myocardial perfusion both by aggravating coronary atherogenesis and by microcirculatory disorders. Rest myocardial perfusion SPECT can be a method of screening for myocardial disorders caused by both diffuse atherosclerosis and metabolic syndrome.

Risk predictors of arterial hypertension development in population of Mountain Shoriya of various ethnical origins

2019 ◽  
Vol 1 (3) ◽  
pp. 39-42
Author(s):  
T. A. Mulerova ◽  
M. Yu. Ogarkov ◽  
O. L. Barbarash
Keyword(s):  
Cardiovascular Diseases ◽  
Total Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Low Density Lipoprotein Cholesterol ◽  
Type Settlement ◽  
The Family ◽  
Genotype C ◽  
Hypertension Development ◽  
Risk Predictors

1409 people (901 Shors, 508 non-indigenous people) from remote villages of Mountain Shoriya (Orton and Ust-Kabyrsa) and urban-type settlement Sheregesh took part in the survey. In Shors, the risk of developing hypertension was determined by elevated levels of total cholesterol and low density lipoprotein cholesterol, violation of carbohydrate metabolism, obesity, including its abdominal type, the family anamnesis of early cardiovascular diseases, and a carriage of prognostically unfavorable genotypes D/D and C/C of the corresponding genes ACE and AGTR 1 candidates; in the cohort of non-indigenous ethnos-elevated levels of total cholesterol and triglycerides, obesity, abdominal obesity, the family anamnesis of early cardiovascular diseases, a carrier of the minor genotype C/C of the AGTR 1 gene

Risk factors for cardiovascular diseases and development of prehypertension

2018 ◽  
pp. 37-43
Author(s):  
В.В. Шерстнев ◽  
М.А. Грудень ◽  
В.П. Карлина ◽  
В.М. Рыжов ◽  
А.В. Кузнецова ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Ldl Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Serum Levels ◽  
Left Ventricular ◽  
Optimal Blood Pressure

Цель - исследование взаимосвязи факторов риска сердечно-сосудистых заболеваний и развития предгипертонии. Методика. Проведен сравнительный и корреляционный анализы показателей модифицируемых и немодифицируемых факторов риска сердечно-сосудистых заболеваний у обследованных лиц в возрасте 30-60 лет с «оптимальным» артериальным давлением, (n = 63, АД <120/80 мм рт.ст.) и лиц с предгипертонией (n = 52, АД = 120-139/80-89 мм рт.ст.). Результаты. Показано, что лица с предгипертонией по сравнению с группой лиц, имеющих «оптимальное» артериальное давление характеризуются статистически значимо повышенным содержанием холестерина и холестерина липопротеидов низкой плотности, интеллектуальным характером трудовой деятельности, а также значимыми сочетаниями факторов риска: повышенный уровень холестерина липопротеидов низкой плотности с интеллектуальным характером трудовой деятельности; повышенное содержание креатинина с уровнем триглициридов; наследственная отягощенность по заболеваниям почек и интеллектуальным характером трудовой деятельности; наследственная отягощенность по сахарному диабету и гипертрофия левого желудочка сердца. У лиц с предгипертонией документированы перестройки структуры взаимосвязи (количество, направленность и сила корреляций) между показателями факторов риска в сравнении с лицами, имеющими «оптимальное» артериальное давление. Заключение. Выявленные особенности взаимосвязей факторов риска сердечно-сосудистых заболеваний при предгипертонии рассматриваются как проявление начальной стадии дизрегуляционной патологии и нарушения регуляции физиологических систем поддержания оптимального уровня артериального давления. The aim of the study was to investigate the relationship between risk factors for cardiovascular disease and development of prehypertension. Methods. Comparative and correlation analyses of modifiable and non-modifiable risk factors for cardiovascular disease were performed in subjects aged 30-60 with «optimal» blood pressure (n = 63, BP <120/80 mm Hg) and prehypertension (n = 52, BP = 120-139 / 80-89 mm Hg). Results. The group with prehypertension compared with the «optimal» blood pressure group had significantly increased serum levels of low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol, sedentary/intellectual type of occupation, and significant combinations of risk factors. The risk factor combinations included an increased level of LDL cholesterol and a sedentary/intellectual occupation; increased serum levels of creatinine and triglycerides; hereditary burden of kidney disease and a sedentary/intellectual occupation; hereditary burden of diabetes mellitus and cardiac left ventricular hypotrophy. In subjects with prehypertension compared to subjects with «optimal» blood pressure, changes in correlations (correlation number, direction, and strength) between parameters of risk factors were documented. Conclusion. The features of interrelationships between risk factors for cardiovascular disease observed in prehypertension are considered a manifestation of early dysregulation pathology and disordered regulation of physiological systems, which maintain optimal blood pressure.

Non-Traditional Cardiovascular Risk Markers in the Era of Established Major Risk Factors and Multiple Guidelines

2019 ◽  
Vol 17 (3) ◽  
pp. 270-277 ◽  
Author(s):  
Thomas F. Whayne
Keyword(s):  
Risk Factors ◽  
Interleukin 1 ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
High Sensitivity ◽  
Arterial Disease ◽  
Good Evidence ◽  
Ldl Particles ◽  
Cv Disease ◽  
Peripheral Arterial

The non-traditional cardiovascular (CV) risk factors that appear to be of most clinical interest include: apolipoprotein A (ApoA), apolipoprotein B (ApoB), high-sensitivity C-Reactive protein (hsCRP), homocysteine, interleukin 1 (IL1), lipoprotein (a) [Lp(a)], the density of low-density lipoprotein (LDL) particles, the LDL particle number, tissue/tumor necrosis factor-α (TNF-α) and uric acid. These non-traditional risk factors may be of value in adding further confirmation and attention to suspected significant CV risk. They can also provide a better understanding of current concepts of atherogenesis (e.g. various potential mechanisms associated with inflammation) as an etiology and in guiding current plus future therapies. In the mid-20th century, atherosclerosis and CV disease were considered mechanistic occurrences with essentially no attention to possible metabolic and molecular etiologies. Therefore, the only treatments then centered around mainly surgical procedures to try to improve blood flow, first with peripheral arterial disease (PAD) and later coronary artery disease (CAD). Now, failure to treat CV risk factors, especially where there is good evidence-based medicine, as in the case of statins for high CV risk patients, is considered medical negligence. Nevertheless, many problems remain to be solved regarding atherosclerosis prevention and treatment.

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