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Musung JM, Kakoma PK, Kaut Mukeng C, Tshimanga SL, Munkemena Banze JP, Kaj NK, Kamuna MK, Mwamba JK, Nkulu DN, Katchunga PB, Mukuku O, Muyumba EK. Prevalence of Hypertension and Associated Factors in Lubumbashi City, Democratic Republic of Congo: A Community-Based Cross-Sectional Study. Int J Hypertens 2021; 2021:6674336. [PMID: 33880188 PMCID: PMC8046564 DOI: 10.1155/2021/6674336] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 03/30/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Hypertension is the leading cause of cardiovascular disease morbidity and mortality worldwide. Its struggle involves knowing its prevalence. Insufficient data on hypertension in adults in Lubumbashi, Democratic Republic of Congo (DRC), prompted the conduct of this study. The objectives were to determine the prevalence of hypertension and to identify the associated factors in adults in Lubumbashi. Methodology. A cross-sectional study was carried out among 6,708 adults from October 15th to November 24th, 2018, in Lubumbashi. Anthropometric data, lifestyle, and medical history were collected. Hypertension was defined when the mean of the last two blood pressure (BP) measurements was greater than or equal for systolic (SBP) at 140 mmHg and for diastolic (DBP) at 90 mmHg or a history of taking antihypertensive medication whatever the value of the BP. Logistic regression was used to identify the relative effects of hypertension risk factors and all statistical tests were declared significant at a p value <0.05. RESULTS The female participants numbered 4479 (66.8%). The mean age of all participants was 47.9 ± 16.5 years. The mean SBP and DBP were 128.4 ± 25.9 mmHg and 79.1 ± 15.3 mmHg, respectively. The overall prevalence of hypertension was 33.6%. This prevalence was statistically higher in women than in men (34.5% vs. 31.7%; p=0.024). After logistic regression, the risk of hypertension increased with age >50 years (aOR = 5.85 [5.19-6.60]), overweight (aOR = 1.25 [1.11-1.41]), obesity (aOR = 1.25 [1.11-1.41]), central obesity (aOR = 1.37 [1.16-1.61]), diabetes mellitus (aOR = 2.19 [1.63-2.95]), alcohol consumption (aOR = 1.21 [1.05-1.39]), nonconsumption of vegetables (aOR = 1.35 [1.02-1.80]), and history of stroke (aOR = 2.57 [1.88-3.51]). Hypertension was inversely associated with being underweight (aOR = 0.68 [0.53-0.87]). CONCLUSION The prevalence of hypertension in the city of Lubumbashi is high as in other cities of the DRC and Africa. This situation requires the implementation of prevention, detection, and treatment programs for hypertension.
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Affiliation(s)
- Jacques Mbaz Musung
- Department of Internal Medicine, University of Lubumbashi, Lubumbashi, Congo
| | | | | | | | | | | | | | | | - Dophra Ngoy Nkulu
- Department of Internal Medicine, University of Lubumbashi, Lubumbashi, Congo
| | | | - Olivier Mukuku
- Department of Research, Institu Supérieur des Techniques Médicales de Lubumbashi, Lubumbashi, Congo
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Prevalence of Hypertension and Associated Factors in Dire Dawa City, Eastern Ethiopia: A Community-Based Cross-Sectional Study. Int J Hypertens 2019; 2019:9878437. [PMID: 31223500 PMCID: PMC6541960 DOI: 10.1155/2019/9878437] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 02/15/2019] [Accepted: 04/01/2019] [Indexed: 12/20/2022] Open
Abstract
Background Hypertension is a major cardiovascular risk factor that is linked with fatal complications and is an overwhelming global challenge. Primary prevention is a key to control hypertension with identification of major risk factors. This study was aimed at assessing the prevalence and factors associated with hypertension. Methods Community-based cross-sectional study was conducted among 903 adults aged 25 to 64 years in Dire Dawa City, East Ethiopia. Data were collected using World Health Organization (WHO) STEPwise approach to Surveillance (STEPS) for non-communicable disease (NCD) standard survey tool. Multivariate logistic regression models were used to identify relative effects of distal, proximal, and immediate risk factors of hypertension, and all statistical tests were declared significantly at P-value<0.05. Results The average SBP and DBP were 124.98±17.18 mmHg and 78.92±10.13 mmHg, respectively. The prevalence of hypertension was 24.43% (95% CI: 21.57, 27.28). Majority (51.64%) of adults were not aware of their elevated blood pressure status. hypertension was significantly associated with the age group 30-44 (aOR 3.61, 95% CI: 2.0, 6.55), 45-54 (aOR 5.36, 95% CI: 2.62, 10.91), and 55-64 (aOR 9.38, 95% CI: 4.73, 18.59), being unemployed (aOR 1.68, 95%CI: 1.03, 2.77), ever smoking (aOR 1.89, 95% CI: 1.04, 2.23), having abdominal obesity (aOR 1.72, 95% CI: 1.13, 2.64), and BMI≥25 kg/m2 (aOR 1.48, 95%CI: 1.01, 2.15). Conclusion Moderately high prevalence of hypertension was observed among adults in study setting demonstrating a major public health problem. Majority of adults with hypertension in study setting were not aware of their elevated BP status highlighting the burden of the hidden morbidity and subsequent complications. Community level intervention and routine assessment of sociodemographic, behavioral, and biophysiological risk factors, screening, and diagnosis of NCDs should be institutionalized to address the occult burden.
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Stamatelopoulos K, Papavagelis C, Augoulea A, Armeni E, Karagkouni I, Avgeraki E, Georgiopoulos G, Yannakoulia M, Lambrinoudaki I. Dietary patterns and cardiovascular risk in postmenopausal women: Protocol of a cross-sectional and prospective study. Maturitas 2018; 116:59-65. [DOI: 10.1016/j.maturitas.2018.07.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 07/16/2018] [Accepted: 07/18/2018] [Indexed: 11/25/2022]
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Georgiopoulos G, Karatzi K, Yannakoulia M, Georgousopoulou E, Efthimiou E, Mareti A, Bakogianni I, Mitrakou A, Papamichael C, Stamatelopoulos K. Eating frequency predicts changes in regional body fat distribution in healthy adults. QJM 2017; 110:729-734. [PMID: 29017004 DOI: 10.1093/qjmed/hcx120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Eating frequency (EF) has been associated with generalized obesity. AIM We aimed to prospectively investigate potential associations of frequency of eating episodes with regional fat layers. DESIGN EF was evaluated at baseline in 115 subjects free of clinically overt cardiovascular disease (54 ± 9.1 years, 70 women) in a prospective, observational study. METHODS Metabolic parameters known to be associated with dietary factors and anthropometric markers including ultrasound assessment of subcutaneous (Smin) and pre-peritoneal (Pmax) fat and their ratio Smin/Pmax (AFI) were evaluated at baseline and at follow-up, 5 years later. RESULTS EF at baseline positively correlated with Pmax, even after adjustment for potential confounders. EF above median was also an independent predictor for Pmax (beta coefficient = -0.192, P = 0.037) and AFI (beta coefficient = 0.199, P = 0.049) at follow up. Multivariable linear mixed models analysis demonstrated that subjects with increased EF presented a lower progression rate of Pmax (beta = -0.452, P = 0.006) and a higher progression rate of AFI (beta = 0.563, P = 0.003) over time, independently of age, sex, progression of BMI, energy intake, smoking and changes in parameters of glucose metabolism. CONCLUSIONS High EF is associated with lower progression rate of pre-peritoneal fat accumulation. Future interventional studies should further investigate the clinical utility of these findings.
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Affiliation(s)
- G Georgiopoulos
- Vascular Laboratory, Department of Clinical Therapeutics, Alexandra University Hospital, 80 V. Sofias str, 11528 Athens, Greece
| | - K Karatzi
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El Venizelou str, 17671 Athens, Greece
| | - M Yannakoulia
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El Venizelou str, 17671 Athens, Greece
| | - E Georgousopoulou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El Venizelou str, 17671 Athens, Greece
| | - E Efthimiou
- Vascular Laboratory, Department of Clinical Therapeutics, Alexandra University Hospital, 80 V. Sofias str, 11528 Athens, Greece
| | - A Mareti
- Vascular Laboratory, Department of Clinical Therapeutics, Alexandra University Hospital, 80 V. Sofias str, 11528 Athens, Greece
| | - I Bakogianni
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Athens, Greece
| | - A Mitrakou
- Vascular Laboratory, Department of Clinical Therapeutics, Alexandra University Hospital, 80 V. Sofias str, 11528 Athens, Greece
| | - C Papamichael
- Vascular Laboratory, Department of Clinical Therapeutics, Alexandra University Hospital, 80 V. Sofias str, 11528 Athens, Greece
| | - K Stamatelopoulos
- Vascular Laboratory, Department of Clinical Therapeutics, Alexandra University Hospital, 80 V. Sofias str, 11528 Athens, Greece
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Lambrinoudaki I, Armeni E, Rizos D, Georgiopoulos G, Athanasouli F, Triantafyllou N, Panoulis K, Augoulea A, Creatsa M, Alexandrou A, Alevizaki M, Stamatelopoulos K. Indices of adiposity and thyroid hormones in euthyroid postmenopausal women. Eur J Endocrinol 2015; 173:237-45. [PMID: 26142102 DOI: 10.1530/eje-15-0141] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE We aimed to evaluate the association between thyroid hormones and indices of obesity in a sample of euthyroid postmenopausal women. DESIGN Cross-sectional study. METHODS Serum levels of TSH, free triiodothyronine (FT3), and free thyroxine (FT4) as well as BMI and waist:hip ratio (WHR) were evaluated in 194 healthy euthyroid postmenopausal women. Ultrasonography was used to assess abdominal fat layers (subcutaneous fat (SF), preperitoneal fat (PF), and SF:PF ratio). Indices of adiposity were defined as high vs low depending on the median value of the assessed parameters. RESULTS After multivariate adjustment for traditional risk factors, lower FT4 levels and a higher FT3:FT4 ratio predicted higher SF mass (FT4, Exp(β)=0.035, P=0.020 and FT3:FT4, Exp(β)=2.374, P=0.018), whereas higher FT3 predicted higher PF mass (Exp(β)=2.815, P=0.032). Women with FT3:FT4 above the highest quartile had a significantly higher SF mass as compared to women in the lowest quartile (1.81 ± 0.62 cm vs 1.54 ± 0.46 cm, P=0.027). BMI had a positive independent association with TSH (Exp(β)=1.829, P=0.018). Finally, FT3 was significantly associated with SF mass among women with higher BMI (FT3, β=0.259, P=0.040) and women with higher WHR (β=0.309, P=0.020) but not among women with lower BMI or WHR values. CONCLUSION Thyroid hormone levels, and in particular FT3, were independently associated with SF and PF in euthyroid postmenopausal women, and this association was mainly evident in women with higher BMIs. On the other hand, among traditional indices of adiposity, only TSH was positively associated with BMI. Larger prospective studies are needed to evaluate the significance of the present findings.
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Affiliation(s)
- Irene Lambrinoudaki
- Second Department of Obstetrics and GynecologyHormonal LaboratoryAretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of TherapeuticsAlexandra Hospital, University of Athens, 80 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of NeurologyAiginiteion Hospital, University of Athens, 72-74 Vas. Sofias Avenue, GR-11528 Athens, Greece
| | - Eleni Armeni
- Second Department of Obstetrics and GynecologyHormonal LaboratoryAretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of TherapeuticsAlexandra Hospital, University of Athens, 80 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of NeurologyAiginiteion Hospital, University of Athens, 72-74 Vas. Sofias Avenue, GR-11528 Athens, Greece
| | - Demetrios Rizos
- Second Department of Obstetrics and GynecologyHormonal LaboratoryAretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of TherapeuticsAlexandra Hospital, University of Athens, 80 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of NeurologyAiginiteion Hospital, University of Athens, 72-74 Vas. Sofias Avenue, GR-11528 Athens, Greece
| | - Georgios Georgiopoulos
- Second Department of Obstetrics and GynecologyHormonal LaboratoryAretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of TherapeuticsAlexandra Hospital, University of Athens, 80 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of NeurologyAiginiteion Hospital, University of Athens, 72-74 Vas. Sofias Avenue, GR-11528 Athens, Greece
| | - Foteini Athanasouli
- Second Department of Obstetrics and GynecologyHormonal LaboratoryAretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of TherapeuticsAlexandra Hospital, University of Athens, 80 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of NeurologyAiginiteion Hospital, University of Athens, 72-74 Vas. Sofias Avenue, GR-11528 Athens, Greece
| | - Nikolaos Triantafyllou
- Second Department of Obstetrics and GynecologyHormonal LaboratoryAretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of TherapeuticsAlexandra Hospital, University of Athens, 80 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of NeurologyAiginiteion Hospital, University of Athens, 72-74 Vas. Sofias Avenue, GR-11528 Athens, Greece
| | - Konstantinos Panoulis
- Second Department of Obstetrics and GynecologyHormonal LaboratoryAretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of TherapeuticsAlexandra Hospital, University of Athens, 80 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of NeurologyAiginiteion Hospital, University of Athens, 72-74 Vas. Sofias Avenue, GR-11528 Athens, Greece
| | - Areti Augoulea
- Second Department of Obstetrics and GynecologyHormonal LaboratoryAretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of TherapeuticsAlexandra Hospital, University of Athens, 80 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of NeurologyAiginiteion Hospital, University of Athens, 72-74 Vas. Sofias Avenue, GR-11528 Athens, Greece
| | - Maria Creatsa
- Second Department of Obstetrics and GynecologyHormonal LaboratoryAretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of TherapeuticsAlexandra Hospital, University of Athens, 80 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of NeurologyAiginiteion Hospital, University of Athens, 72-74 Vas. Sofias Avenue, GR-11528 Athens, Greece
| | - Andreas Alexandrou
- Second Department of Obstetrics and GynecologyHormonal LaboratoryAretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of TherapeuticsAlexandra Hospital, University of Athens, 80 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of NeurologyAiginiteion Hospital, University of Athens, 72-74 Vas. Sofias Avenue, GR-11528 Athens, Greece
| | - Maria Alevizaki
- Second Department of Obstetrics and GynecologyHormonal LaboratoryAretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of TherapeuticsAlexandra Hospital, University of Athens, 80 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of NeurologyAiginiteion Hospital, University of Athens, 72-74 Vas. Sofias Avenue, GR-11528 Athens, Greece
| | - Kimon Stamatelopoulos
- Second Department of Obstetrics and GynecologyHormonal LaboratoryAretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of TherapeuticsAlexandra Hospital, University of Athens, 80 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of NeurologyAiginiteion Hospital, University of Athens, 72-74 Vas. Sofias Avenue, GR-11528 Athens, Greece
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Karatzi K, Yannakoulia M, Psaltopoulou T, Voidonikola P, Kollias G, Sergentanis TN, Retsas T, Alevizaki M, Papamichael C, Stamatelopoulos K. Meal patterns in healthy adults: Inverse association of eating frequency with subclinical atherosclerosis indexes. Clin Nutr 2015; 34:302-8. [DOI: 10.1016/j.clnu.2014.04.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 04/29/2014] [Accepted: 04/29/2014] [Indexed: 12/26/2022]
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Terzis ID, Papamichail C, Psaltopoulou T, Georgiopoulos GA, Lipsou N, Chatzidou S, Kontoyiannis D, Kollias G, Iacovidou N, Zakopoulos N, Alevizaki M, Stamatelopoulos KS. Long-Term BMI changes since adolescence and markers of early and advanced subclinical atherosclerosis. Obesity (Silver Spring) 2012; 20:414-20. [PMID: 21617635 DOI: 10.1038/oby.2011.137] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Although long-term weight gain has been associated with cardiovascular risk and intima-media thickening (IMT), no sufficient data exist on possible associations of such weight changes with more advanced stages of subclinical atherosclerosis. Moreover, the value of self-reported weight changes, a more practical approach to assess long-term history in adiposity status, is still a matter of debate. In this longitudinal study, long-term changes in BMI and overweight status were assessed in 106 healthy young adults (age 40.5 ± 1.1 years, 60 males). These were a subgroup of adolescent school students who had originally been examined in 1983 initially aiming to assess cardiovascular risk factor prevalence. Markers of early (carotid IMT) and advanced (presence of plaques in the carotid and femoral arteries and ankle-brachial index, ABI) subclinical atherosclerosis were measured in all individuals. By multivariate analysis, among other risk factors, IMT and the presence of plaques were independently determined by BMI change, while a low ABI was also determined by changes in overweight status. An adverse long term adiposity profile change (≥ +4 kg/m(2) and/or change into overweight/obese status from normal weight since adolescence) incrementally determined a low ABI over current risk factors. Self-reported and actual BMI changes were correlated (r = 0.587) but their means significantly differed, while the former significantly correlated with IMT only (P = 0.032). In conclusion, an adverse long term adiposity status change was more prominently associated with advanced subclinical atherosclerosis and particularly low ABI. These results also suggest that the utility of self-reported weight changes may be limited in primary prevention practice.
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Affiliation(s)
- Ioannis D Terzis
- Vascular Laboratory, Department of Therapeutics, Alexandra Hospital, School of Medicine, University of Athens, Athens, Greece
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Saltiki K, Papageorgiou G, Voidonikola P, Mantzou E, Xiromeritis K, Papamichael C, Alevizaki M, Stamatelopoulos K. Endogenous estrogen levels are associated with endothelial function in males independently of lipid levels. Endocrine 2010; 37:329-35. [PMID: 20960271 DOI: 10.1007/s12020-010-9307-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2009] [Accepted: 12/23/2009] [Indexed: 10/20/2022]
Abstract
Estrogens and androgens may play an important role in vascular health in both sexes. The aim of this study was to examine the relation of endogenous sex hormone levels with early markers of atherosclerosis in a cohort of apparently healthy males. 124 males (age 46.25 ± 9.56) attending a preventive medicine program were examined for unrecognised features of the metabolic syndrome. Flow-mediated dilatation (FMD) and intima-media thickness (IMT) of the common carotid artery were evaluated. Obesity parameters were recorded; estradiol, testosterone, SHBG, free testosterone, insulin, as well as glucose and lipid levels were measured. FMD was positively correlated with estradiol (r = 0.201, P = 0.041) and negatively with total cholesterol (r = -0.205, P = 0.022), low density lipoproteins (r = -0.232, P = 0.009), and triglyceride levels (r = -0.179, P = 0.046). In multivariate analysis, the association of FMD with estrogen was independent of BMI and lipid levels. No significant association between FMD and testosterone levels was found. Subjects with an increased mean IMT (> 0.73 mm, i.e., > 3rd tertile) had lower levels of free (P = 0.021) and bioavailable (P = 0.016) testosterone. In multivariate logistic regression analysis, this association was no longer significant when age or cholesterol levels were considered. Endogenous estrogen levels are associated with FMD, independently of age and lipid levels, showing a protective effect in middle-age male subjects. Circulating androgens are associated, although not independently, with structural changes such as the IMT of carotid artery; this effect is possibly influenced by lipid levels and age.
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Affiliation(s)
- Katerina Saltiki
- Endocrine Unit, Evgenidion Hospital, Athens University School of Medicine, Athens, Greece.
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The Effects of Endurance and Recreational Exercise on Subclinical Evidence of Atherosclerosis in Young Adults. Am J Med Sci 2010; 339:332-6. [DOI: 10.1097/maj.0b013e3181cefbb9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Stamatelopoulos K, Karatzi K, Sidossis LS. Noninvasive methods for assessing early markers of atherosclerosis: the role of body composition and nutrition. Curr Opin Clin Nutr Metab Care 2009; 12:467-73. [PMID: 19571744 DOI: 10.1097/mco.0b013e32832f0d99] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE OF REVIEW To present the methodology used to assess early atherosclerosis and its application in assessing the impact of body composition and nutrition on the cardiovascular system. RECENT FINDINGS Accumulating evidence supports the use of noninvasive markers of subclinical atherosclerosis, namely carotid intima-media thickness, flow-mediated dilatation of the brachial artery and augmentation index or pulse wave velocity, in the prediction of cardiovascular risk, especially in primary prevention settings. These markers reflect early initiation of the atherogenetic process, as well as the impact of the treatment currently used. Factors like smoking cessation, exercise and a balanced nutrition have a remarkable effect on these markers and consequently on vascular function. It is interesting to note that individual nutrients such as lipids, vitamins, antioxidants, ethanol, caffeine and isoflavones are capable of manipulating vascular function, which is depicted in these markers of atherosclerosis. SUMMARY A number of noninvasive markers of early atherosclerosis are currently used in order to detect possible initiation of atherosclerotic procedure. Vascular function is greatly affected by nutrition, which might prove to be an alternative to drug therapy for reversing dysfunction of the vessels.
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Alevizaki M, Saltiki K, Voidonikola P, Mantzou E, Papamichael C, Stamatelopoulos K. Free thyroxine is an independent predictor of subcutaneous fat in euthyroid individuals. Eur J Endocrinol 2009; 161:459-65. [PMID: 19700640 DOI: 10.1530/eje-09-0441] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Thyroid function parameters have been associated with obesity, but associations with the type of adiposity have not been examined. We used ultrasound (US) to assess regional adiposity and investigated associations of thyroid function with parameters of central obesity. DESIGN Cross-sectional study. METHODS A total of 303 apparently healthy individuals (age 42.9+/-8.8, body mass index (BMI) 19.0-43.3, median 26.2 kg/m(2), 181 women) were examined for indices of the metabolic syndrome. BMI, waist and hip circumference, abdominal subcutaneous fat (SF), and preperitoneal fat (PF) layer was estimated. TSH, free thyroxine (fT(4)), triiodothyronine (T(3)), thyroid autoantibodies, insulin, glucose, and lipid levels were measured. Subjects receiving T(4) (9.2%) were excluded. RESULTS SF and SF/PF ratio were inversely correlated with fT(4) levels (r=-0.169, P=0.023, r=-0.193, P=0.009 respectively). In multivariate analysis, fT(4) was a predictor of SF and SF/PF, independently of age, sex, and smoking. SF correlated with TSH levels (r=0.149, P=0.037). PF and SF were positively associated with T(3) levels (r=0.245, P=0.004 and r=0.189, P=0.019 respectively). T(3) levels were positively associated with BMI (r=0.257, P=0.0004), waist perimeter (r=0.324, P<0.0001), and waist-to-hip ratio (WHR; r=0.363, P<0.0001). The T(3)/fT(4) ratio was positively correlated with SF (r=0.182, P=0.028), WHR (r=0.267, P=0.0003), and BMI (r=0.146, P=0.043). CONCLUSIONS Increasing SF accumulation as assessed by US is associated with lower fT(4) and higher TSH levels among euthyroid slightly overweight individuals. These associations indicate that subtle variation in thyroid function may participate in regional adiposity.
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Affiliation(s)
- Maria Alevizaki
- Endocrine Unit, Department of Endocrinology and Metabolism, Evgenidion Hospital, Athens, Greece.
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12
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Stamatelopoulos KS, Kitas GD, Papamichael CM, Chryssohoou E, Kyrkou K, Georgiopoulos G, Protogerou A, Panoulas VF, Sandoo A, Tentolouris N, Mavrikakis M, Sfikakis PP. Atherosclerosis in rheumatoid arthritis versus diabetes: a comparative study. Arterioscler Thromb Vasc Biol 2009; 29:1702-8. [PMID: 19608975 DOI: 10.1161/atvbaha.109.190108] [Citation(s) in RCA: 142] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The extent to which atherosclerosis is accelerated in chronic inflammatory diseases is not established. We compared preclinical atherosclerosis in rheumatoid arthritis with diabetes mellitus, a known coronary heart disease equivalent. METHODS AND RESULTS Endothelial function, arterial stiffness, carotid intima-media thickness, and analysis of atheromatous plaques were examined in 84 rheumatoid arthritis patients without cardiovascular disease versus healthy controls matched for age, sex, and traditional cardiovascular disease risk factors, as well as in 48 diabetes patients matched for age, sex, and disease duration with 48 rheumatoid arthritis patients. Rheumatoid arthritis duration associated with arterial stiffening, whereas disease activity associated with carotid plaque vulnerability. All markers of preclinical atherosclerosis were significantly worse in rheumatoid arthritis compared to controls, whereas they did not differ in comparison to diabetes despite a worse cardiovascular risk factor profile in diabetics. Both diseases were associated independently with increased intima-media thickness; rheumatoid arthritis, but not diabetes, was independently associated with endothelial dysfunction. CONCLUSIONS Preclinical atherosclerosis appears to be of equal frequency and severity in rheumatoid arthritis and diabetes of similar duration with differential impact of traditional risk factors and systemic inflammation. Cardiovascular disease risk factors in rheumatoid arthritis may need to be targeted as aggressively as in diabetes.
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Affiliation(s)
- Kimon S Stamatelopoulos
- Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, 80, Vassilissis Sofias Ave, Athens, Greece.
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Stamatelopoulos KS, Lekakis JP, Alevizaki M, Vamvakou G, Katsichti P, Protogerou A, Revela I, Karatzi K, Zakopoulos N, Papamichael CM. Markers of adiposity and early atherosclerosis. Int J Cardiol 2009. [DOI: 10.1016/j.ijcard.2007.08.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Amin R, Anthony L, Somers V, Fenchel M, McConnell K, Jefferies J, Willging P, Kalra M, Daniels S. Growth velocity predicts recurrence of sleep-disordered breathing 1 year after adenotonsillectomy. Am J Respir Crit Care Med 2008; 177:654-9. [PMID: 18174542 DOI: 10.1164/rccm.200710-1610oc] [Citation(s) in RCA: 138] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Adenotonsillectomy, the first line of treatment of sleep-disordered breathing (SDB), is the most commonly performed pediatric surgery. Predictors of the recurrence of SDB after adenotonsillectomy and its impact on cardiovascular risk factors have not been identified. OBJECTIVES Demonstrate that gain velocity in body mass index (BMI) defined as unit increase in BMI/year confers an independent risk for the recurrence of SDB 1 year after adenotonsillectomy. METHODS Children with SDB and hypertrophy of the tonsils and a comparison group of healthy children were followed prospectively for 1 year. MEASUREMENTS AND MAIN RESULTS Serial polysomnographies, BMI, and blood pressure were obtained before adenotonsillectomy and 6 weeks, 6 months, and 1 year postoperatively. Gain velocity in BMI, BMI and being African American (odds ratios, 4-6/unit change/yr; 1.4/unit and 15, respectively) provided equal amounts of predictive power to the risk of recurrence of SDB. In the group that experienced recurrence, systolic blood pressure at 1 year was higher than at baseline and higher than in children who did not experience recurrence. CONCLUSIONS Three clinical parameters confer independent increased risk for high recurrence of SDB after adenotonsillectomy: gain velocity in BMI, obesity, and being African American. A long-term follow-up of children with SDB and monitoring of gain velocity in BMI are essential to identifying children at risk for recurrence of SDB and in turn at risk for hypertension.
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Affiliation(s)
- Raouf Amin
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
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Hirani V, Zaninotto P, Primatesta P. Generalised and abdominal obesity and risk of diabetes, hypertension and hypertension–diabetes co-morbidity in England. Public Health Nutr 2007; 11:521-7. [PMID: 17767799 DOI: 10.1017/s1368980007000845] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectivesTo look at trends in generalised (body mass index (BMI) ≥30 kg m–2) and abdominal (waist circumference (WC) >102 cm in men, >88 cm in women) obesity among adults between 1993 and 2003, and to evaluate their association with diabetes, hypertension and hypertension–diabetes co-morbidity (HDC) in England.DesignAnalyses of nationally representative cross-sectional population surveys, the Health Survey for England (HSE).SubjectsNon-institutionalised men and women aged ≥35 years.MeasurementsInterviewer-administered questionnaire (sociodemographic information, risk factors, doctor-diagnosed diabetes), measurements of height and weight to calculate BMI. WC and blood pressure measurements were taken by trained nurses.ResultsGeneralised obesity increased among men from 15.8% in 1993 to 26.3% in 2003, and among women from 19.3% to 25.8%. Abdominal obesity also increased in both sexes (men: 26.2% in 1993 to 39.0% in 2003; women: 32.4% to 47.0%). In 1994, 1998 and 2003, generalised and abdominal obesity were independently associated with risk of hypertension, diabetes and HDC. The odds of diabetes associated with generalised obesity in 1994, 1998 and 2003 were 1.62, 2.26 and 2.62, respectively, in women and 1.24, 1.82 and 2.10, respectively, in men. Similar differences were observed for hypertension and HDC. Men and women with abdominal obesity also showed a higher risk for diabetes, hypertension and HDC than those with a normal WC.ConclusionsIf current trends in obesity continue then the risk of related morbidities may also increase. This will impact on cardiovascular disease morbidity and mortality, with cost implications for the health service. Therefore there is an urgent need to control the epidemic of obesity.
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Affiliation(s)
- Vasant Hirani
- Department of Epidemiology and Public Health, Royal Free and University College London Medical School, University College London, London, UK.
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Celik T, Iyisoy A, Yuksel UC, Isik E. The role of abdominal obesity and weight gain since adolescence in early atherosclerosis. Int J Cardiol 2007; 132:263-4; author reply 264-5. [PMID: 17651829 DOI: 10.1016/j.ijcard.2007.05.094] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2007] [Accepted: 05/26/2007] [Indexed: 10/23/2022]
Abstract
The distribution of body fat appears to be an important determinant as patients with abdominal obesity are at greatest cardiovascular risk. Also abdominal obesity is more predictive of coronary risk than simple body mass. On the other hand, weight gain after age 18 increases cardiovascular risk even in patients with normal body mass index. We believe that providing a healthy lifestyle, including dietary and physical activity modification, especially in early adolescence may play an essential part in the battle against atherosclerosis.
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Barness LA, Opitz JM, Gilbert-Barness E. Obesity: Genetic, molecular, and environmental aspects. Am J Med Genet A 2007; 143A:3016-34. [DOI: 10.1002/ajmg.a.32035] [Citation(s) in RCA: 223] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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