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At least 19 recordsLinked to original sources

Vascular compliance versus flow-mediated vasodilation: correlation with cardiovascular risk factors.

Cardiovascular risk factors are associated with impaired endothelium dependent vasodilation and reduced vascular compliance. In this study, the correlation with cardiovascular risk factor score of two common techniques for assessing vascular function was compared. Risk factors and vascular function were evaluated in a study population of 122 people with peripheral arterial disease (PAD) or with risk factors for PAD (73 men and 49 women; mean age 69 years). A risk factor score was determined using Framingham criteria. Vascular compliance was assessed by pulse waveform analysis and simultaneous blood pressure measurement. Flow-mediated vasodilation of the brachial artery was measured using duplex ultrasonography. Participants with a high risk factor score had significantly reduced vascular compliance of large and small vessels. By contrast, the difference in flow-mediated vasodilation between those with a high or low risk factor score did not reach statistical significance. There was a significant negative correlation between vascular compliance and risk factor score. There was a similar trend between flow-mediated vasodilation and risk factor score, but this did not reach statistical significance. A measure of vascular compliance was more significantly correlated with cardiovascular risk factor score than was a measure of flow-mediated vasodilation in the study population. Neither technique provided values that were highly correlated with risk factor burden. Although flow-mediated vasodilation is a preferred research tool for assessing vascular function, technical limitations and biological variability may reduce its clinical application in assessing individual cardiovascular risk.

Aged↗

[Association between clustering of cardiovascular risk factors and the risk of cardiovascular disease].

BACKGROUND: Cardiovascular diseases are the main cause of mortality in Spain. The aim of this work was to study the association between clustering of cardiovascular risk factors and the risk of suffering major cardiovascular events: ischemic cardiopathy, cerebrovascular disease and peripheral arteriopathy of the lower limbs. METHOD: A descriptive transversal study was carried out in a city health centre, with a total of 2248 patients selected by simple random sampling of the clinical records with a mean age of 15 years. The data were obtained by examining the clinical records and estimating Odds Ratios (OR) for any cardiovascular event (n = 224), ischemic cardiopathy (n = 123), cerebrovascular disease (n = 84) and peripheral arteriopathy (n = 55) in relation to the number of cardiovascular risk factors. The cardiovascular risk factors included in the study were smoking, arterial hypertension, hypercholesterolemia, hypertriglyceridemia, diabetes and obesity. The OR was adjusted for age and sex. RESULTS: The percentage of patients with 0, 1, 2, 3 and 4-6 cardiovascular risk factors was 39.1, 32.8, 17.5, 6.9 and 3.7 respectively. The OR for experiencing a cardiovascular event associated to 1, 2, 3 and 4-6 cardiovascular risk factors was 1.6 (CI95%: 0.9-2.7), 2.8 (CI95%: 1.7-4.7), 3.6 (CI95%: 1.9-6.5) and 5.6 (CI95%: 2.9-10.8), respectively. The OR for ischemic cardiopathy associated to the same risk levels were 2.3 (CI95%: 1.1-4.6), 2.5 (CI95%: 1.2-5.2), 5.3 (CI95%: 2.4-11.5) and 6.2 (CI95%: 2.7-14.3), respectively. For cardiovascular disease, the OR were 1.1 (CI95%: 0.5-2.5), 2.3 (CI95%: 1.2-5.3), 2.4 (CI95%: 1.0-5.9) and 5.6 (CI95%: 2.2-14.1), respectively. The OR for peripheral arteriopathy were 2.1 (CI95%: 0.8-5.9), 3.7 (CI95%: 1.3-10.5), 3.3 (CI95%: 1.0-11.1) and 6.1 (CI95%: 1.8-20.3), respectively. CONCLUSIONS: The addition of cardiovascular risk factors is associated with an increased risk of cardiovascular events. This finding emphasises the need for prevention of cardiovascular risk factors in primary care.

Adolescent↗

Impact of sex-specific body composition on cardiovascular risk factors: the Hong Kong Cardiovascular Risk Factor Study.

The aim of the study was to analyze the effects of sex-specific distribution of adiposity, particularly emphasizing the independent contribution of waist and hip circumferences relative to body mass index (BMI), on cardiovascular risk factors in a Chinese population. Blood pressure and anthropometric and biochemical parameters were measured in 2510 population-based Chinese subjects. The relative contributions of waist and hip circumferences to the presence of cardiovascular risk factors were determined. The Chinese men were significantly larger than women, with greater BMI and central adiposity. Waist and hip circumferences were both positively associated with the presence of hypertension, dyslipidemia, and diabetes. However, after adjustment for BMI and age, hip circumference exhibited a significant dose-dependent inverse relationship with dyslipidemia and diabetes in women, but not men. Sex-specific differences exist. After adjustment for age and BMI, hip circumferences independently and inversely contribute to cardiovascular risk in women, but not in men. Increasing adjusted waist circumference was associated with increased risk of hypertension and diabetes in Chinese and dyslipidemia in women only.

Abdominal Fat↗

Swiss Hypertension and Risk Factor Program (SHARP): cardiovascular risk factors management in patients with type 2 diabetes in Switzerland.

The prevalence of hypertension in type 2 diabetics is high, though there is no published data for Switzerland. This prospective cohort survey determined the frequency of type 2 diabetes mellitus associated with hypertension from medical practitioners in Switzerland, and collected data on the diagnostic and therapeutic work-up for cardiovascular risk patients. The Swiss Hypertension And Risk Factor Program (SHARP) is a two-part survey: The first part, I-SHARP, was a survey among 1040 Swiss physicians to assess what are the target blood pressure (BP) values and preferred treatment for their patients. The second part, SHARP, collected data from 20,956 patients treated on any of 5 consecutive days from 188 participating physicians. In I-SHARP, target BP?135/85 mmHg, as recommended by the Swiss Society of Hypertension, was the goal for 25% of physicians for hypertensives, and for 60% for hypertensive diabetics; values >140/90 mmHg were targeted by 19% for hypertensives, respectively 9% for hypertensive diabetics. In SHARP, 30% of the 20,956 patients enrolled were hypertensive (as defined by the doctors) and 10% were diabetic (67% of whom were also hypertensive). Six per cent of known hypertensive patients and 4% of known hypertensive diabetics did not receive any antihypertensive treatment. Diabetes was not treated pharmacologically in 20% of diabetics. Proteinuria was not screened for in 45% of known hypertensives and in 29% of known hypertensive diabetics. In Switzerland, most physicians set target BP levels higher than recommended in published guidelines. In this country with easy access to medical care, high medical density and few financial constraints, appropriate detection and treatment for cardiovascular risk factors remain highly problematic.

Adult↗

Update in prevention of atherosclerotic heart disease: management of major cardiovascular risk factors.

Cardiovascular disease (CVD) remains as the first cause of death worldwide. Scientific community works everyday trying to ameliorate this burden. Only in the year 2004 around 2,790 publications about the therapeutic use of antihypertensive agents can be found in MEDLINE. Despite this overwhelming effort and information, only a relatively short number of manuscripts have a real impact in clinical practice. For the busy clinician, it becomes almost impossible to screen and be updated with the landmark publications. The purpose of this article is to provide concise information related to prevention of CVD. We reviewed publications in the past 5 years regarding cardiovascular risk factors with special attention to dyslipidemia, hypertension, diabetes, smoking cessation and obesity, discussing some new findings and treatments. We also discuss obstructive sleep apnea (OSA) as a recently identified cardiovascular risk factor, and provide a general overview about its pathophysiology and treatment.

Antihypertensive Agents↗

Microalbuminuria, cardiovascular risk factors and cardiovascular morbidity in a British population: the EPIC-Norfolk population-based study.

BACKGROUND: Microalbuminuria is independently associated with increased cardiovascular risk and renal function deterioration in diabetes and hypertension, but the clinical relevance of raised albuminuria in the general population is less certain. We examined the prevalence of microalbuminuria and its relationship to cardiovascular risk factors and cardiovascular morbidity in the UK general population. METHODS: Cross-sectional population-based study of 23,964 individuals, aged 40-79 years recruited in 1993-1997 for the EPIC-Norfolk Study. Smoking status, prevalent physician diagnosed diabetes, hypertension, cardiovascular disease and cancer were derived from a health and lifestyle questionnaire. Albumin-to-creatinine ratios were estimated from random spot urine specimens collected at the survey visit, and using these ratios participants were categorized into normoalbuminuria, microalbuminuria (2.5-25 mg/mmol), and macroalbuminuria. RESULTS: The prevalence of microalbuminuria and macroalbuminuria was 11.8% and 0.9% respectively in the total population and significantly higher in women (14.4%) compared with men (8.9%) (P<0.001). Independent determinants of microalbuminuria were age, sex, systolic blood pressure and current smoking. Microalbuminuria was independently associated with cardiovascular morbidity, after adjusting for known cardiovascular risk factors, with odds ratio (95% confidence interval) for prevalent cardiovascular disease of 1.30 (1.12-1.51) in all men and women. CONCLUSION: Microalbuminuria was present in approximately 12% of this population. It was independently associated with cardiovascular risk factors and prevalent cardiovascular disease. Microalbuminuria may be a useful indicator of high absolute cardiovascular risk in the community but prospective data are needed to establish its independent predictive value for future events.

Adult↗

Microalbuminuria is common, also in a nondiabetic, nonhypertensive population, and an independent indicator of cardiovascular risk factors and cardiovascular morbidity.

OBJECTIVES: To assess the prevalence of microalbuminuria in the general population, especially in nondiabetic and nonhypertensive subjects, and its association with known cardiovascular risk factors and cardiovascular morbidity. DESIGN: Cross-sectional cohort study. SETTING: Inhabitants of the city of Groningen, the Netherlands. SUBJECTS: All inhabitants, aged between 28 and 75 years, were send a postal questionnaire and a vial to collect an early morning urine sample (n = 85 421). Of these 40 856 subjects (47.8%) responded. Cardiovascular risk factors and morbidity were validated in a well defined nondiabetic and nonhypertensive group of 5241 subjects. MAIN OUTCOME MEASURES: Microalbuminuria, self-reported cardiovascular risk and cardiovascular morbidity in the total study cohort, and additionally more detailed measurements in a subset of the total population. RESULTS: Microalbuminuria (20-200 mg L-1) was present in 7.2% of the subjects and independently associated with age, gender, hypertension, diabetes, smoking, previous myocardial infarction and stroke. Some of these associations were already observed at albuminuria levels of 10-20 mg L-1. After exclusion of the diabetic and hypertensive subjects, microalbuminuria was still prevalent in 6.6% of the subjects. CONCLUSIONS: Microalbuminuria appears to be common not only in the general population but also in a nondiabetic, nonhypertensive population and is independently associated with increased cardiovascular risk factors and cardio-vascular morbidity. Importantly, some of these associations are present at urinary albumin levels currently considered to be normal. These findings suggest that urinary albumin measurements may be useful in early risk profiling and prevention of cardiovascular disease in the population at large.

Adult↗

Homocysteine: an emergent cardiovascular risk factor?

Cardiovascular disease is the leading cause of mortality and disability in the western world. In the last years, the accumulation of evidence coming from both retrospective and prospective clinical studies has led to an increased interest in the potential role of mild hyperhomocysteinemia as a major, independent risk factor for cardiovascular disease. The present paper reviews the position of homocysteine in metabolism to understand the pathogenesis of hyperhomocysteinemia, as well as the clinical data pointing to its proposed role as an independent cardiovascular disease risk factor.

Cardiovascular Diseases↗

Aortic valve calcification: association with bone mineral density and cardiovascular risk factors.

BACKGROUND: Cardiovascular risk factors are reported to increase the incidence of aortic valve calcification. Among older women, low bone mineral density appears to be associated with increased prevalence of aortic calcification. We aimed to assess and compare cardiovascular risk factors and bone mineral density of patients with and without aortic valve calcification. MATERIALS AND METHODS: Cardiovascular risk factors and bone mineral density measurements have been assessed in 49 patients with aortic valve calcification and in 65 patients without aortic valve calcification. All patients were subsequently referred to the nuclear medicine department to measure bone mineral density after echocardiographic evaluation. RESULTS: No statistically significant differences were observed between the two groups with respect to sex, body mass index, history of coronary artery disease, diabetes mellitus, hypercholesterolemia, and smoking status. Although height and weight of the patients with aortic valve calcification were significantly lower than those of patients without aortic valve calcification, they were not independent risk factors. Age and hypertension were found to be independent positive risk factors for aortic valve calcification, whereas T score was found to be negatively associated with aortic valve calcification. CONCLUSION: We have shown that aortic valve calcification is positively associated with age and hypertension, whereas bone mineral density is negatively associated with aortic valve calcification. The mechanism underlying the association between decreased bone mineral density and aortic valve calcification remains to be clarified in further studies.

Aged↗

Coronary electron beam computed tomography in 13 patients with systemic lupus erythematosus and two or more cardiovascular risk factors.

Cardiovascular and cerebrovascular events, the third leading cause of death in patients with systemic lupus erythematosus (SLE), are disproportionately common by age and gender. Risk factors for atherosclerotic cardiovascular disease (ASCVD) cannot reliably predict subsets of patients at risk for events. Coronary electron beam computed tomography (EBCT), a noninvasive imaging technique that quantifies ASCVD by measuring calcium deposition in the walls of coronary arteries, has been demonstrated to be a marker of ASCVD in traditional populations. A pilot group of 13 SLE patients (ages, 33-48 years) with two or more traditional risk factors for cardiovascular disease were studied by EBCT. Five of these SLE patients had calcification scores in the 70th percentile or higher, as compared with age-matched women without known coronary artery disease, and three had scores in the 90th percentile. Four of these five patients had antiphospholipid antibodies currently or in the past. These data suggest that EBCT may be able to detect premature ASCVD in SLE patients and may be a useful noninvasive tool as more attention is directed to ASCVD as a major complication of SLE.

Journal Article↗

Blood pressure and pulse responses to three stressors: associations with sociodemographic characteristics and cardiovascular risk factors.

Cardiovascular reactivity is hypothesized to increase the risk of hypertension and other CVD-related conditions. However, studies to date are inconclusive. We compared the association of blood pressure and pulse responses to three stressors (postural challenge, handgrip test, mental arithmetic) with sociodemographic characteristics and CVD risk factors. We included 782 participants from the Hypertension Genetic Epidemiology Study. Blood pressure and pulse responses to stressors were defined as the difference between post- and pre-stress measurements. Stepwise regression analyses examined change in SBP and pulse in response to stressors as a function of sociodemographic and CVD risk factors. Age, race, and gender were forced into models and other variables (education, BMI, waist circumference, resting SBP and DBP, cigarette smoking, LDL and HDL cholesterol, glucose, and antihypertensive medications (beta-blockers, calcium channel blockers, diuretics, ace inhibitors)) were retained if P<0.10. Age was a significant predictor of SBP response to all stressors. The SBP response to a change in posture was not related to other variables. The SBP response to mental arithmetic was significantly higher among men, those with larger waists, higher SBP, beta-blocker users, and lower among smokers. SBP response to the handgrip was significantly higher among those with higher SBP and beta-blocker users. Similarly, the association of the pulse response to the risk factors varied considerably across the stressors. Overall, the socio-demographic and CVD risk factors accounted for between 9 and 14% of the variance in the SBP response to the stressors and from between 4 and 12% of the variance in the pulse response to the three stressors. The associations between sociodemographic and CVD risk factors and the SBP and pulse response to stress were modest and inconsistent across stressors. The findings suggest that cardiovascular reactivity is a concept that needs to be defined in reference to specific stressors so that mechanisms leading to responses can be better understood.

Adult↗

Prevalence of type 2 diabetes mellitus, other cardiovascular risk factors, and cardiovascular disease in Turkish and Moroccan immigrants in North West Europe: a systematic review.

BACKGROUND: The prevalence of diabetes, other cardiovascular risk factors, and cardiovascular morbidity and mortality varies between immigrant groups in Western societies, but epidemiological data on these topics are scarce for Turks and Moroccan immigrant living in North West Europe. METHODS: Medline and Embase were systematically searched for studies containing data on the prevalence of diabetes, cardiovascular risk factors, and cardiovascular morbidity and mortality in Turkish or Moroccan immigrants living in Northwestern European countries. RESULTS: Eighteen studies were identified. Corresponding findings were a high prevalence of type 2 diabetes in Turkish and Moroccan immigrants, a high prevalence of smoking among Turkish men, and a very low prevalence of smoking in Moroccan women compared to the indigenous population. Because of lack of valid studies, no definite conclusions could be drawn for in particular blood pressure and lipids. One German study showed exceptionally lower cardiovascular mortality rates in Turkish immigrants. CONCLUSION: The reviewed studies yielded insufficient evidence for a good quality comparison of the cardiovascular risk profile between Turkish and Moroccan immigrants and indigenous populations. Diabetes mellitus was more prevalent in Turkish and Moroccan immigrants, smoking more prevalent in Turkish males, and very rare in Moroccan females.

Adult↗

Association of fibrinogen with cardiovascular risk factors and cardiovascular disease in the Framingham Offspring Population.

BACKGROUND: Fibrinogen has been identified as an independent risk factor for cardiovascular disease and associated with traditional cardiovascular risk factors. Also, the role of elevated fibrinogen in thrombosis suggests that it may be on the causal pathway for certain risk factors to exert their effect. These associations remain incompletely characterized. Moreover, the optimal fibrinogen assay for risk stratification is uncertain. METHODS AND RESULTS: In 2632 subjects from cycle 5 of the Framingham Offspring Population, fibrinogen levels were determined with a newly developed immunoprecipitation test (American Biogenetic Sciences) and the functional Clauss method. With the immunoprecipitation method, there were significant linear trends across fibrinogen tertiles (P:<0.001) for age, body mass index, smoking, diabetes mellitus, total cholesterol, HDL cholesterol, and triglycerides in men and women. The Clauss method had significant results (P:<0.030), except for triglycerides in men. Fibrinogen levels were higher for those with compared with those without cardiovascular disease. After covariate adjustment, fibrinogen remained significantly higher in those with cardiovascular disease with the use of the immunoprecipitation test (P:=0.035 and P:=0.018 for men and women, respectively) but not with the Clauss method. CONCLUSIONS: Fibrinogen was associated with traditional cardiovascular risk factors. Elevation of fibrinogen may provide a mechanism for risk factors to exert their effect. Also, fibrinogen levels were higher among subjects with cardiovascular disease compared with those without disease. The immunoprecipitation test showed a stronger association with cardiovascular disease than the Clauss method, suggesting that it may be a useful screening tool to identify individuals at increased thrombotic risk.

Biomarkers↗

Risk factors for cardiovascular disease in obese and normal school children: association of insulin with other cardiovascular risk factors.

OBJECTIVE: To investigate the level of insulin and other known cardiovascular risk factors in school children and their association with obesity. DESIGN: Cross-sectional study. SUBJECTS: 123 normal and 116 obese school children categorized by weight-for-height, mean age: 10.2 and 10.5 years old respectively. MEASUREMENTS: Family histories of diseases by questionnaires; blood pressure (BP) and waist and hip circumferences by measurements; fasting blood for glucose, insulin, total cholesterol, HDL-cholesterol and triglycerides. RESULTS: The numbers of boys in the normal and obese group were 65 and 58, those of the girls, 53 and 63 respectively. The obese group was more likely to have family histories of obesity, high blood pressure and diabetes; had significantly greater waist-hip-ratio (WHR), higher systolic and diastolic BP, lower HDL-cholesterol, higher triglyceride and fasting insulin levels (with fasting blood sugar in the normal range) than the normal weight group. In a crude analysis, insulin levels were positively correlated with obesity, systolic BP, WHR, age and triglycerides and negatively associated with male gender and HDL-cholesterol. After adjustment using multiple regression, only obesity status, age, gender and triglycerides still remained significantly associated with insulin level. Limitation of utilizing family disease history report for identification of children at risk was discussed. CONCLUSION: These findings suggest that risk to coronary heart disease and hypertension through insulin resistance already operates in school-aged children.

Analysis of Variance↗

Effect of age on the relationship of occupational social class with prevalence of modifiable cardiovascular risk factors and cardiovascular diseases. A population-based cross-sectional study from European Prospective Investigation into Cancer - Norfolk (EPIC-Norfolk).

BACKGROUND: Previous studies on cardiovascular risk profile in different socioeconomic status were focused on younger populations and many of them have not been able to take into account age and sex differences. OBJECTIVES: To investigate the relationship of occupational social class with the prevalence of cardiovascular disease risk factors and cardiovascular diseases in younger (<65 years) and older (>or=65 years) men and women. METHODS: A population-based-cross sectional study was conducted in a general community in Norfolk, United Kingdom. Participants were 23,085 men and women aged 40-79 years, recruited from general practice age-sex registers as part of European Prospective Investigation into Cancer-Norfolk (EPIC-Norfolk). The prevalence of cardiovascular risk factors and cardiovascular diseases were examined. RESULTS: The prevalence of smoking was significantly higher in those in manual social classes particularly in the younger (<65) age group. Younger women in manual social classes were more likely to be smokers compared to older women in the same social class. Being in manual social classes was associated with higher cholesterol levels in women but lower cholesterol levels in men. Manual social class was associated with higher physical activity in those younger than 65 years but this association was reversed in those 65 years or older. CONCLUSION: Occupational social class is differently related to cardiovascular risk factors in individuals depending on their age and sex. This may reflect differences in behavior at work and leisure, which vary by sex and pre- and postretirement. Interventions to promote health and reduce social inequalities need to take age and gender into account.

Age Factors↗

[Lipids/hemostasis interactions. A new approach to cardiovascular risk factors].

NEW CARDIOVASCULAR RISK FACTORS: A causal link would appear to exist between hemostasis and cardiovascular disease. This is particularly true for fibrinogen which is an independent risk factor. MULTIPLE INTERACTIONS: There is an association between elevated triglyceride and FVIIc (pro-coagulant) levels and hypofibrinolytic PAI-1. In addition, an association exists between elevated cholesterol and FVIIc and platelet activation. LIPID LOWERING DRUGS AFFECT HEMOSTASIS: The hemostasis equilibrium is modulated by diet. In addition, fibrinogen levels are lowered by fibrates and platelet activation and thrombin generation are decreased by statins. These modifications have a potential clinical interest. Such observations remain to be confirmed by cardiovascular prevention studies with the specific objective of evaluating the effect of lipid lowering drugs on hemostasis parameters.

Blood Coagulation Factors↗

Diabetes-associated cardiovascular risk factors.

Cardiovascular disease is the biggest killer in the UK and diabetes puts people at increased risk of this disease. The role of nurses in reducing cardiovascular risk in diabetes is explored.

Adult↗

[Lipid disturbances in type 1 diabetes mellitus--cardiovascular risk factor].

Cardiovascular diseases are the cause of the highest mortality in Poland. In children and adolescents with type 1 diabetes mellitus there is a significant increase of risk of hypertension, cardiovascular diseases and atherosclerosis later in life. It is important to identify risk factors early in this group. There is a need to undertake appropriate preventive and therapeutic measures already in early childhood in order to avoid these disorders.

Cardiovascular Diseases↗