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Miao R, Dong Q, Liu X, Chen Y, Wang J, Chen J. A cost-effective, machine learning-driven approach for screening arterial functional aging in a large-scale Chinese population. Front Public Health 2024; 12:1365479. [PMID: 38572001 PMCID: PMC10987946 DOI: 10.3389/fpubh.2024.1365479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 02/23/2024] [Indexed: 04/05/2024] Open
Abstract
Introduction An easily accessible and cost-free machine learning model based on prior probabilities of vascular aging enables an application to pinpoint high-risk populations before physical checks and optimize healthcare investment. Methods A dataset containing questionnaire responses and physical measurement parameters from 77,134 adults was extracted from the electronic records of the Health Management Center at the Third Xiangya Hospital. The least absolute shrinkage and selection operator and recursive feature elimination-Lightweight Gradient Elevator were employed to select features from a pool of potential covariates. The participants were randomly divided into training (70%) and test cohorts (30%). Four machine learning algorithms were applied to build the screening models for elevated arterial stiffness (EAS), and the performance of models was evaluated by calculating the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and accuracy. Results Fourteen easily accessible features were selected to construct the model, including "systolic blood pressure" (SBP), "age," "waist circumference," "history of hypertension," "sex," "exercise," "awareness of normal blood pressure," "eat fruit," "work intensity," "drink milk," "eat bean products," "smoking," "alcohol consumption," and "Irritableness." The extreme gradient boosting (XGBoost) model outperformed the other three models, achieving AUC values of 0.8722 and 0.8710 in the training and test sets, respectively. The most important five features are SBP, age, waist, history of hypertension, and sex. Conclusion The XGBoost model ideally assesses the prior probability of the current EAS in the general population. The integration of the model into primary care facilities has the potential to lower medical expenses and enhance the management of arterial aging.
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Affiliation(s)
- Rujia Miao
- Health Management Medicine Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Qian Dong
- School of Science, Hunan University of Technology and Business, Changsha, China
| | - Xuelian Liu
- Health Management Medicine Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Yingying Chen
- Health Management Medicine Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Jiangang Wang
- Health Management Medicine Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Jianwen Chen
- School of Science, Hunan University of Technology and Business, Changsha, China
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Jae SY, Lee KH, Kim HJ, Kunutsor SK, Heffernan KS, Climie RE, Bunsawat K, Kang M. Separate and Joint Associations of Cardiorespiratory Fitness and Healthy Vascular Aging With Subclinical Atherosclerosis in Men. Hypertension 2022; 79:1445-1454. [PMID: 35535602 DOI: 10.1161/hypertensionaha.122.19016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Achieving healthy vascular aging (HVA) is important for decelerating age-related cardiovascular disease risk. We evaluated the interplay between HVA, cardiorespiratory fitness (CRF), and subclinical atherosclerosis. METHODS We analyzed data on 3722 men who underwent cardiopulmonary exercise testing in a health examination program. HVA was defined as blood pressure <140/90 mm Hg without hypertension and brachial-ankle pulse wave velocity <1266 cm/s. CRF was directly measured by peak oxygen uptake. Subclinical atherosclerosis was defined as coronary artery calcification scores of >0 and ≥100 and a mean carotid artery intima-media thickness (CIMT) >75th percentile for each age group as well as >0.8 mm of CIMT. Separate and joint associations of HVA and CRF with subclinical atherosclerosis were evaluated. RESULTS Each 1 metabolic equivalent increment in CRF was associated with 23% higher odds for having HVA. HVA was associated with lower odds of coronary artery calcification but not CIMT. CRF modified the association between HVA and CIMT>0.8 mm (interaction: P=0.01); HVA was associated with lower odds of CIMT>0.8 mm in fit men with no significant association between HVA and CIMT>0.8 mm in unfit men. Compared with no HVA and being unfit, HVA and being fit was associated with lower odds of subclinical atherosclerosis, but there was no significant association between HVA and being unfit with subclinical atherosclerosis. CONCLUSIONS HVA and higher CRF are each associated with a lower risk of subclinical atherosclerosis in men. Higher CRF is associated with a higher prevalence of HVA and may modify the association between HVA and subclinical atherosclerosis.
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Affiliation(s)
- Sae Young Jae
- Department of Sport Science (S.Y.J., H.J.K.), University of Seoul, Republic of Korea.,Division of Urban Social Health, Graduate School of Urban Public Health (S.Y.J.), University of Seoul, Republic of Korea
| | - Kyung Hyun Lee
- Department of Digital Health, SAIHST, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (K.H.L., M.K.)
| | - Hyun Jeong Kim
- Department of Sport Science (S.Y.J., H.J.K.), University of Seoul, Republic of Korea
| | - Setor K Kunutsor
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, United Kingdom (S.K.K.).,Translational Health Sciences, Bristol Medical School, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, United Kingdom (S.K.K.)
| | | | - Rachel E Climie
- Menzies Institute for Medical Research, University of Tasmania, Hobart TAS, Australia (R.E.C.)
| | - Kanokwan Bunsawat
- Department of Internal Medicine, Division of Geriatrics, University of Utah, Salt Lake City (K.B.).,Geriatric Research, Education, and Clinical Center, George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah (K.B.)
| | - Mira Kang
- Department of Digital Health, SAIHST, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (K.H.L., M.K.).,Health Promotion Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (M.K.).,Digital Innovation Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. Seoul, Republic of Korea (M.K.)
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Adam CA, Anghel R, Marcu DTM, Mitu O, Roca M, Mitu F. Impact of Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitors on Arterial Stiffness and Vascular Aging-What Do We Know So Far? (A Narrative Review). Life (Basel) 2022; 12:803. [PMID: 35743834 PMCID: PMC9224553 DOI: 10.3390/life12060803] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 05/23/2022] [Accepted: 05/25/2022] [Indexed: 11/23/2022] Open
Abstract
Vascular aging, early vascular aging or supernormal vascular aging are concepts used for estimating the cardiovascular risk at a certain age. From the famous line of Thomas Sydenham that "a man is as old as his arteries" to the present day, clinical studies in the field of molecular biology of the vasculature have demonstrated the active role of vascular endothelium in the onset of cardiovascular diseases. Arterial stiffness is an important cardiovascular risk factor associated with the occurrence of cardiovascular events and a high risk of morbidity and mortality, especially in the presence of diabetes. Sodium-glucose cotransporter 2 inhibitors decrease arterial stiffness and vascular resistance by decreasing endothelial cell activation, stimulating direct vasorelaxation and ameliorating endothelial dysfunction or expression of pro-atherogenic cells and molecules.
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Affiliation(s)
- Cristina Andreea Adam
- Clinical Rehabilitation Hospital, Cardiovascular Rehabilitation Clinic, Pantelimon Halipa Street nr. 14, 700661 Iaşi, Romania; (C.A.A.); (R.A.); (M.R.); (F.M.)
| | - Razvan Anghel
- Clinical Rehabilitation Hospital, Cardiovascular Rehabilitation Clinic, Pantelimon Halipa Street nr. 14, 700661 Iaşi, Romania; (C.A.A.); (R.A.); (M.R.); (F.M.)
- Department of Internal Medicine, University of Medicine and Pharmacy, Grigore T. Popa, University Street nr. 16, 700115 Iaşi, Romania
| | - Dragos Traian Marius Marcu
- Department of Internal Medicine, University of Medicine and Pharmacy, Grigore T. Popa, University Street nr. 16, 700115 Iaşi, Romania
| | - Ovidiu Mitu
- Department of Internal Medicine, University of Medicine and Pharmacy, Grigore T. Popa, University Street nr. 16, 700115 Iaşi, Romania
- Sf. Spiridon Clinical Emergency Hospital, Independence Boulevard nr. 1, 700111 Iasi, Romania
| | - Mihai Roca
- Clinical Rehabilitation Hospital, Cardiovascular Rehabilitation Clinic, Pantelimon Halipa Street nr. 14, 700661 Iaşi, Romania; (C.A.A.); (R.A.); (M.R.); (F.M.)
- Department of Internal Medicine, University of Medicine and Pharmacy, Grigore T. Popa, University Street nr. 16, 700115 Iaşi, Romania
| | - Florin Mitu
- Clinical Rehabilitation Hospital, Cardiovascular Rehabilitation Clinic, Pantelimon Halipa Street nr. 14, 700661 Iaşi, Romania; (C.A.A.); (R.A.); (M.R.); (F.M.)
- Department of Internal Medicine, University of Medicine and Pharmacy, Grigore T. Popa, University Street nr. 16, 700115 Iaşi, Romania
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Tao B, Li Y, Wang C, Luo X, Chen S, Wang G, Yang P, Hou L, Cui L, Wu S. Influencing factors of supernormal vascular aging in Chinese population. J Hypertens 2022; 40:381-388. [PMID: 34879388 DOI: 10.1097/hjh.0000000000003023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Previous studies have analysed the epidemic characteristics of supernormal vascular aging (SUPERNOVA), and found that SUPERNOVA were significantly associated with lower risk of cardiovascular disease. However, the influencing factors of SUPERNOVA are still unclear. The aim of this study was to investigate the characteristics and influencing factors of SUPERNOVA. METHODS A total of 42 196 participants of the Kailuan Study were enrolled in the study. SUPERNOVA was defined as the lowest 2.5% of the age-quintile brachial-ankle pulse wave velocity (baPWV), early vascular aging was defined as the highest 2.5% of the age-quintile baPWV. Multivariable logistic regression analysis was applied to investigate the influencing factors of SUPERNOVA. RESULTS The population with SUPERNOVA was mostly women, nonsmokers, nondrinkers, and those with higher education. They had lower levels of cardiovascular disease risk factors and healthier lifestyles. The results of logistics regression showed that the influencing factors of SUPERNOVA include age, sex, hypertension, diabetes, resting heart rate, hypersensitive C-reactive protein, and uric acid. However, the effects of these factors were different across age groups. We also observed that in addition to the unalterable factors (age and sex), only resting heart rate above 80 bpm (OR = 0.396, 95% CI: 0.231-0.681) and SBP (OR = 0.945, 95% CI: 0.932-0.958) were significantly associated with odds of SUPERNOVA in participants without cardiovascular risk factors. CONCLUSION This study investigated the characteristics of the population with SUPERNOVA and the factors influencing it, which provided a basis for different populations to take preventive measures to slow down the process of vascular aging.
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Affiliation(s)
- Boni Tao
- School of Public Health, North China University of Science and Technology
| | - Yun Li
- School of Public Health, North China University of Science and Technology
| | - Cun Wang
- School of Public Health, North China University of Science and Technology
| | | | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital
| | - Guodong Wang
- Department of Cardiology, Kailuan General Hospital
| | - Peng Yang
- Department of Neurosurgery, Affiliated Hospital of North China University of Science and Technology
| | - Liying Hou
- School of Public Health, North China University of Science and Technology
| | - Liufu Cui
- Department of Rheumatology and Immunology, Kailuan General Hospital, Tangshan, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital
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Lawson JS, Glenn WK. Infection and food combine to cause atherosclerotic coronary heart disease - Review and hypothesis. IJC HEART & VASCULATURE 2021; 35:100807. [PMID: 34286061 PMCID: PMC8273202 DOI: 10.1016/j.ijcha.2021.100807] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 05/23/2021] [Accepted: 05/24/2021] [Indexed: 02/07/2023]
Abstract
HYPOTHESIS It is hypothesised that a combination of childhood and later life infections and excess food consumption, particularly of Western style food, initiates and contributes to atherosclerotic coronary heart disease. To consider this hypothesis we have conducted a brief review of the role of childhood infections, food, and their combined influence on atherosclerosis. EVIDENCE (i) Studies of populations with high prevalence of infections and low "hunter gather" like food consumption, have extremely low prevalence of atherosclerosis, (ii) there are consistent associations between infections in childhood and adult atherosclerotic coronary heart disease, (iii) there is an association between increased body weight, (an indication of excess eating), and atherosclerotic heart disease, and (iv) there is evidence that a combination of increased body weight and infections influences the development of atherosclerotic coronary heart disease.Infections do not appear to act independently to cause atherosclerosis. A combination of both food and infection appears to be required to cause atheroma. CONCLUSION The hypothesis that infections when combined with excess eating initiates atherosclerosis, is plausible. ACTION Action aimed at prevention of atherosclerotic heart disease is possible. There are three safe approaches to prevention (i) encouragement of Mediterranean like diets, (ii) avoidance of overeating and (iii) vigorous control of infections among all age groups. There is a need to monitor patients with a history of serious childhood infections and poor nutrition. In addition, for high risk subjects, cholesterol lowering statins are of proven and safe value.
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Affiliation(s)
- James S. Lawson
- School of Biotechnology and Biomolecular Science, University of New South Wales, Sydney, NSW 2052, Australia
| | - Wendy K. Glenn
- School of Biotechnology and Biomolecular Science, University of New South Wales, Sydney, NSW 2052, Australia
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Vascular aging and its relationship with lifestyles and other risk factors in the general Spanish population: Early Vascular Ageing Study. J Hypertens 2021; 38:1110-1122. [PMID: 32371801 DOI: 10.1097/hjh.0000000000002373] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To describe the prevalence of healthy vascular aging (HVA), normal vascular aging and early vascular aging (EVA) in a sample of Spanish population without cardiovascular disease. The relationship of vascular aging with lifestyle, cardiovascular risk factors, psychological and inflammatory risk factors is also analyzed. METHODS A total of 501 participants were recruited (49.70% men, aged 55.90 ± 14.24 years) by random sampling. Vascular aging was defined in three steps: Step 1: participants with vascular damage in carotid arteries or peripheral artery disease were classified as EVA. Step 2: with the percentiles of carotid-to-femoral pulse wave velocity (cfPWV) we used three criteria, first, the 10th and 90th cfPWV percentiles of the population studied by age and sex; second, the 10th and 90th percentiles of the European population reference values and third, the 25th and 75th cfPWV percentiles of the population studied by age and sex. Step 3: participants with hypertension or type 2 diabetes mellitus included in HVA were reclassified as normal vascular aging. Arterial stiffness was assessed with cfPWV using a Sphygmocor device. Physical activity was measured with an accelerometer. Psychological factors, lifestyle and other clinical information were obtained by standard questionnaire. RESULTS The global prevalence of HVA was 8 and 14% (men 8 and 10%, women 9 and 18%), and 22 and 18% (men 26 and 23%, women 17 and 12%) for EVA, using criteria a and b, respectively. In the logistic regression analysis, vascular aging maintains positive associations with more sedentary time [odds ratio (OR) = 2.37 and 4.51], having triglycerides above 150 mg/dl (OR = 6.55 and 4.06), abdominal obesity (OR = 2.73 and 2.90), increased uric acid (OR = 4.63 and 2.98) and insulin resistance index homeostatic model assessment (OR = 4.05 and 6.78), and a negative association with less physical activity (OR = 0.29 and 0.28) using criteria a and b, respectively. CONCLUSION One in 10 has HVA and one in five EVA. The prevalence of EVA is higher in men. Study results suggest that preventive strategies aimed at increasing physical activity, reducing sedentary time and decreasing obesity and insulin resistance improve vascular aging.
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Abstract
Arterial stiffness, a leading marker of risk in hypertension, can be measured at material or structural levels, with the latter combining effects of the geometry and composition of the wall, including intramural organization. Numerous studies have shown that structural stiffness predicts outcomes in models that adjust for conventional risk factors. Elastic arteries, nearer to the heart, are most sensitive to effects of blood pressure and age, major determinants of stiffness. Stiffness is usually considered as an index of vascular aging, wherein individuals excessively affected by risk factor exposure represent early vascular aging, whereas those resistant to risk factors represent supernormal vascular aging. Stiffness affects the function of the brain and kidneys by increasing pulsatile loads within their microvascular beds, and the heart by increasing left ventricular systolic load; excessive pressure pulsatility also decreases diastolic pressure, necessary for coronary perfusion. Stiffness promotes inward remodeling of small arteries, which increases resistance, blood pressure, and in turn, central artery stiffness, thus creating an insidious feedback loop. Chronic antihypertensive treatments can reduce stiffness beyond passive reductions due to decreased blood pressure. Preventive drugs, such as lipid-lowering drugs and antidiabetic drugs, have additional effects on stiffness, independent of pressure. Newer anti-inflammatory drugs also have blood pressure independent effects. Reduction of stiffness is expected to confer benefit beyond the lowering of pressure, although this hypothesis is not yet proven. We summarize different steps for making arterial stiffness measurement a keystone in hypertension management and cardiovascular prevention as a whole.
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Affiliation(s)
- Pierre Boutouyrie
- Faculté de Médecine, Université de Paris, INSERM U970, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, France (P.B.)
| | - Phil Chowienczyk
- King's College London British Heart Foundation Centre, Department of Clinical Pharmacology, St Thomas' Hospital, London, United Kingdom (P.C.)
| | - Jay D Humphrey
- Department of Biomedical Engineering and Vascular Biology and Therapeutics Program, Yale University, New Haven, CT (J.D.H.)
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de Andrade Barboza C, Moura EG, Ministro G, Castaño JB, Silva Santos GC, Dias Junior G, Moreno Junior H, Rodrigues B. Central blood pressure and aortic pulse wave reflection in water-exercised postmenopausal hypertensive women: A cross-sectional study. Exp Gerontol 2020; 143:111146. [PMID: 33166610 DOI: 10.1016/j.exger.2020.111146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 11/03/2020] [Accepted: 11/04/2020] [Indexed: 11/27/2022]
Abstract
Exercise training has been associated with the attenuation of cardiovascular impairment after menopause. This study aimed to compare central and peripheral blood pressure and aortic pulse wave reflection in sedentary and trained (aerobic exercise in the water) hypertensive postmenopausal women. Hypertensive postmenopausal women were divided into sedentary (SED, n = 53) and trained groups (TR, n = 31). Self-reporting from the trained group presented a mean of 1.7 ± 0.3 years of exercise practice in the water. Central blood pressure and amplification indexes (AIx) were obtained by the applanation tonometry of radial and aortic arteries. No changes were observed in systolic blood pressure (SBP) in the TR group than the SED group; however, office diastolic blood pressure (DBP) was reduced compared to the SED group. Central blood pressure and augmentation index (AIx@75%) values were similar in the SED and TR groups. These data suggest that self-reported long-term exercise training in the water could not improve central hemodynamic variables in postmenopausal hypertensive women compared to sedentary ones. However, it should be emphasized that DBP levels were reduced in trained subjects, which might reduce cardiovascular outcomes.
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Affiliation(s)
| | - Eliezer Guimarães Moura
- School of Physical Education, University of Campinas - FEF/UNICAMP, Campinas, SP, Brazil; University Center Adventist of São Paulo/UNASP-HT, Laboratory for Studies on Physical Activity, Metabolism and Health, Hortolândia, SP, Brazil
| | - Gabriela Ministro
- School of Physical Education, University of Campinas - FEF/UNICAMP, Campinas, SP, Brazil
| | - Javier Bedoya Castaño
- School of Physical Education, University of Campinas - FEF/UNICAMP, Campinas, SP, Brazil
| | | | - Gilmar Dias Junior
- School of Physical Education, University of Campinas - FEF/UNICAMP, Campinas, SP, Brazil
| | - Heitor Moreno Junior
- School of Medical Sciences, University of Campinas, FCM/UNICAMP, Campinas, SP, Brazil
| | - Bruno Rodrigues
- School of Physical Education, University of Campinas - FEF/UNICAMP, Campinas, SP, Brazil.
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Bruno RM, Nilsson PM, Engström G, Wadström BN, Empana JP, Boutouyrie P, Laurent S. Early and Supernormal Vascular Aging: Clinical Characteristics and Association With Incident Cardiovascular Events. Hypertension 2020; 76:1616-1624. [PMID: 32895017 DOI: 10.1161/hypertensionaha.120.14971] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Pulse wave velocity is an established marker of early vascular aging but may also help identifying individuals with supernormal vascular aging. We tested the hypothesis that individuals with the largest difference (Δ-age) between chronological and vascular age show the lowest rate of cardiovascular events and may thus be defined as supernormal vascular aging. Vascular age was defined as the predicted age in the best fitting multivariable regression model including classical risk factors and treatment and pulse wave velocity, in a subset of the Reference Values for Arterial Stiffness Collaboration Database (n=3347). Δ-age was then calculated as chronological age minus vascular age, and the 10th and 90th percentiles were used to define early (Δ-age<-5.7 years), normal (Δ-age -5.7 to 6.8 years) and supernormal vascular aging (Δ-age>6.8 years). The risk for fatal and nonfatal cardiovascular events associated with vascular aging categories was investigated in the Malmö Diet and Cancer Study cohort (n=2642). In the Malmö Diet and Cancer Study Cohort (6.6-year follow-up, 286 events), Δ-age was significantly (P<0.01) and inversely associated with cardiovascular events. Compared with normal vascular aging, supernormal vascular aging had lower risk (hazard ratio, 0.59 [95% CI, 0.41-0.85]), whereas early vascular aging had higher risk (hazard ratio, 2.70 [95% CI, 1.55-4.70]) of cardiovascular events, in particular coronary events. There was no significant association with all-cause mortality. This study represents the first validation of the clinical significance of the supernormal vascular aging concept, based on prospective data. Its further characterization may help discovering novel protective molecular pathways and providing preventive strategies for successful vascular aging.
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Affiliation(s)
- Rosa Maria Bruno
- From the INSERM, U970, Paris Cardiovascular Research Center-PARCC, France (R.M.B., J.-P.E., P.B., S.L.)
| | - Peter M Nilsson
- Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden (P.M.N., G.E., B.N.W.)
| | - Gunnar Engström
- Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden (P.M.N., G.E., B.N.W.)
| | - Benjamin Nilsson Wadström
- Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden (P.M.N., G.E., B.N.W.)
| | - Jean-Philippe Empana
- From the INSERM, U970, Paris Cardiovascular Research Center-PARCC, France (R.M.B., J.-P.E., P.B., S.L.).,Université de Paris, France (RM.B., J.-P.E., P.B., S.L.)
| | - Pierre Boutouyrie
- From the INSERM, U970, Paris Cardiovascular Research Center-PARCC, France (R.M.B., J.-P.E., P.B., S.L.).,Université de Paris, France (RM.B., J.-P.E., P.B., S.L.).,Assistance Publique-Hopitaux de Paris, France (P.B., S.L.)
| | - Stephane Laurent
- From the INSERM, U970, Paris Cardiovascular Research Center-PARCC, France (R.M.B., J.-P.E., P.B., S.L.).,Université de Paris, France (RM.B., J.-P.E., P.B., S.L.).,Assistance Publique-Hopitaux de Paris, France (P.B., S.L.)
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Prevalence and determinants of blood pressure variability in pygmies of Southern region Cameroon. J Hypertens 2020; 38:2198-2204. [PMID: 32694331 DOI: 10.1097/hjh.0000000000002529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The impact of urbanization and living conditions on the prevalence of hypertension in the Cameroonian population is poorly known. AIM To evaluate the prevalence and determinants of blood pressure (BP) in adult Pygmies and Bantus living in urban and rural areas of Southern Cameroon. PARTICIPANTS AND METHODS This was a cross-sectional comparative study of 406 adults (96 urban Bantus, 100 urban Pygmies, 111 rural Bantus and 99 tropical rainforest Pygmies with a traditional Pygmies way of life), recruited in Southern Cameroon (mean age 42 ± 17 years; 56.7% women). Sociodemographic, anthropometric and BP parameters were collected. Hypertension was defined as BP at least 140/90 mmHg and/or use of BP-lowering drug(s). RESULTS The age-standardized prevalence of hypertension in urban Bantus, rural Bantus, urban Pygmies and traditional Pygmies was 18.0, 13.5, 9.3 and 4.1%, respectively. Mean SBP and DBP differed significantly according to Bantu vs. Pygmy ethnicity, and urban vs. rural residency. After multiple adjustments, mean arterial pressure was significantly associated with age, BMI, Bantu ancestry and urban residency. CONCLUSION Bantu ethnicity and urban residency are significantly associated with high-BP among people from Southern Cameroon.
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Nilsson Wadström B, Engström G, Nilsson PM. Exploring and comparing definitions of healthy vascular ageing in the population: characteristics and prospective cardiovascular risk. J Hum Hypertens 2020; 35:428-436. [PMID: 32415282 DOI: 10.1038/s41371-020-0353-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 04/25/2020] [Accepted: 05/04/2020] [Indexed: 11/09/2022]
Abstract
Different methods can be used to define healthy vascular ageing (HVA). In this prospective cohort study, we explored three different definitions in order to provide guidance for which to use. 2718 subjects were included from the Cardiovascular (CV) arm of the Malmö Diet Cancer Study (MDCS; median age 71.9 years, 62.2% females). Three different definitions of HVA were used: HVA-1 (<15th percentile of aortic pulse wave velocity (aPWV) distribution from age-quintiles); HVA-2 (<35th percentile of aPWV+ <35th percentile of carotid Intima-Media Thickness. cIMT); and HVA-3 (aPWV < 7.6 m/s + no hypertension). The HVA-1 and HVA-2 groups were compared with the HVA-3, and to the corresponding groups without HVA (non-HVA), in cross-sectional analyses for baseline characteristics and using Cox regressions for prospective risk, yielding hazard ratios (HRs) adjusted for conventional risk factors. A composite CVD endpoint was used, consisting of myocardial infarctions, ischemic heart disease mortality, and coronary artery procedures. The baseline characteristics were, with minor exceptions, similar across HVA groups. In the fully adjusted model, the HRs (95%CI) were 0.62 (0.41-0.93), 0.45 (0.26-0.76), and 0.56 (0.34-0.91) for HVA-1, HVA-2, and HVA-3, respectively. In summary, this observational study of elderly subjects provides examples of integrating hypertension and cIMT in the definition of HVA, as compared with only using aPWV. As aPWV itself is such a robust marker of HVA, it is demanding to find additional markers which improve the definition. There is a need to create a generally accepted definition of HVA.
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Affiliation(s)
| | - Gunnar Engström
- Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Peter M Nilsson
- Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden. .,Clinical Research Unit, Department of Internal medicine, Skåne University Hospital, Malmö, Sweden.
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Khaltourina D, Matveyev Y, Alekseev A, Cortese F, Ioviţă A. Aging Fits the Disease Criteria of the International Classification of Diseases. Mech Ageing Dev 2020; 189:111230. [PMID: 32251691 DOI: 10.1016/j.mad.2020.111230] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 03/04/2020] [Accepted: 03/09/2020] [Indexed: 12/24/2022]
Abstract
The disease criteria used by the World Health Organization (WHO) were applied to human biological aging in order to assess whether aging can be classified as a disease. These criteria were developed for the 11th revision of the International Classification of Diseases (ICD) and included disease diagnostics, mechanisms, course and outcomes, known interventions, and linkage to genetic and environmental factors. RESULTS: Biological aging can be diagnosed with frailty indices, functional, blood-based biomarkers. A number of major causal mechanisms of human aging involved in various organs have been described, such as inflammation, replicative cellular senescence, immune senescence, proteostasis failures, mitochondrial dysfunctions, fibrotic propensity, hormonal aging, body composition changes, etc. We identified a number of clinically proven interventions, as well as genetic and environmental factors of aging. Therefore, aging fits the ICD-11 criteria and can be considered a disease. Our proposal was submitted to the ICD-11 Joint Task force, and this led to the inclusion of the extension code for "Ageing-related" (XT9T) into the "Causality" section of the ICD-11. This might lead to greater focus on biological aging in global health policy and might provide for more opportunities for the new therapy developers.
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Affiliation(s)
- Daria Khaltourina
- Department of Risk Factor Prevention, Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Dobrolyubova St. 11, Moscow, 127254, Russia; International Longevity Alliance, 19 avenue Jean Jaurès, Sceaux, 92330, France.
| | - Yuri Matveyev
- Research Lab, Moscow Regional Research and Clinical Institute, Schepkina St. 61/2 k.1, Moscow, 129110, Russia
| | - Aleksey Alekseev
- Faculty of Physics, Lomonosov Moscow State University, Leninskie Gory, GSP-1, Moscow, 119991, Russia
| | - Franco Cortese
- Biogerontology Research Foundation, Apt 2354 Chynoweth House, Trevissome Park, Truro, London, TR4 8UN, UK
| | - Anca Ioviţă
- International Longevity Alliance, 19 avenue Jean Jaurès, Sceaux, 92330, France
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13
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Yu S, McEniery CM. Central Versus Peripheral Artery Stiffening and Cardiovascular Risk. Arterioscler Thromb Vasc Biol 2020; 40:1028-1033. [PMID: 32188277 DOI: 10.1161/atvbaha.120.313128] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The large elastic arteries fulfill an important role in buffering the cyclical changes in blood pressure, which result from intermittent ventricular ejection. With aging and accrual of cardiovascular risk factors, the elastic arteries stiffen, and this process holds a number of deleterious consequences for the cardiovascular system and major organs. Indeed, arterial stiffness is now recognized as an important, independent determinant of cardiovascular disease risk. Additional, important information concerning the mechanisms underlying arterial stiffening has come from longitudinal studies of arterial stiffness. More recently, attention has focused on the role of peripheral, muscular arteries in cardiovascular disease risk prediction and, in particular, the clinical consequences of reversal of the normal gradient of arterial stiffness between central and peripheral arteries, with aging and disease.
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Affiliation(s)
- Shikai Yu
- From the Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, China (S.Y.).,Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, United Kingdom (S.Y., C.M.M.)
| | - Carmel M McEniery
- Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, United Kingdom (S.Y., C.M.M.)
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14
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Orkaby AR, Lunetta KL, Sun FJ, Driver JA, Benjamin EJ, Hamburg NM, Mitchell GF, Vasan RS, Murabito JM. Cross-Sectional Association of Frailty and Arterial Stiffness in Community-Dwelling Older Adults: The Framingham Heart Study. J Gerontol A Biol Sci Med Sci 2019; 74:373-379. [PMID: 29917058 DOI: 10.1093/gerona/gly134] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Frailty is a risk factor for cardiovascular disease (CVD). Underlying mechanisms to explain the connection between frailty and CVD are unclear. We sought to examine the association between frailty and arterial stiffness, a precursor of hypertension and CVD. METHODS We conducted a cross-sectional analysis of community-dwelling Framingham Heart Study Offspring and Omni participants ≥60 years of age examined in 2005-2008. Frailty was defined primarily according to the Fried physical phenotype definition, which identifies nonfrail, prefrail, and frail individuals. Arterial stiffness was assessed using carotid-femoral pulse wave velocity (CFPWV). Generalized linear regression was used to examine the association between frailty level and CFPWV (modeled as -1000/CFPWV in msec/m, then transformed back to the original scale, m/s), adjusted for age, sex, cohort, mean arterial pressure, heart rate, height, and smoking. RESULTS Of 2,171 participants (55% women, 91% white), 45% were prefrail and 7% were frail. Mean ages were 67, 70, and 73 years, and adjusted CFPWV least squares means were 10.0 (95% CI, 9.9-10.1), 10.3 (10.2-10.5), and 10.5 m/s (10.1-11.0); p = .0002 for nonfrail, prefrail, and frail groups, respectively. Results were similar using the Rockwood cumulative deficit model of frailty, and in a sensitivity analysis adjusting for prevalent coronary heart disease and diabetes. CONCLUSIONS Prefrailty and frailty were associated with higher arterial stiffness in a cohort of community-dwelling older adults. Arterial stiffness may help explain the relationship between frailty and CVD.
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Affiliation(s)
- Ariela R Orkaby
- Geriatric Research, Education, and Clinical Center (GRECC), VA Boston Healthcare System, Massachusetts.,Division of Aging, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Kathryn L Lunetta
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
| | - Fangui J Sun
- Framingham Heart Study, National Heart, Lung, and Blood Institute, Boston University, Framingham, Massachusetts
| | - Jane A Driver
- Geriatric Research, Education, and Clinical Center (GRECC), VA Boston Healthcare System, Massachusetts.,Division of Aging, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Emelia J Benjamin
- Framingham Heart Study, National Heart, Lung, and Blood Institute, Boston University, Framingham, Massachusetts.,Section of Cardiovascular Medicine and Preventive Medicine, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts.,Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Naomi M Hamburg
- Division of Cardiology, Department of Medicine, Boston University, Boston, Massachusetts.,Vascular Biology Section, Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts
| | | | - Ramachandran S Vasan
- Framingham Heart Study, National Heart, Lung, and Blood Institute, Boston University, Framingham, Massachusetts.,Division of Cardiology, Department of Medicine, Boston University, Boston, Massachusetts.,Division of Preventive Medicine, Department of Medicine, Boston University, Boston, Massachusetts
| | - Joanne M Murabito
- Framingham Heart Study, National Heart, Lung, and Blood Institute, Boston University, Framingham, Massachusetts.,Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Massachusetts
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15
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Yang Y, Wang A, Yuan X, Zhao Q, Liu X, Chen S, Wang X, Wang Y, Wu S, Wang Y. Association between healthy vascular aging and the risk of the first stroke in a community-based Chinese cohort. Aging (Albany NY) 2019; 11:5807-5816. [PMID: 31422381 PMCID: PMC6710043 DOI: 10.18632/aging.102170] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 08/05/2019] [Indexed: 12/25/2022]
Abstract
In this study we tested whether vascular aging is associated with the risk of first stroke in the Kailuan cohort, a community-based Chinese cohort. For participants aged ≥ 50 years, healthy vascular aging (HVA) was defined as an absence of hypertension and a brachial-ankle pulse wave velocity < the mean + 2 standard deviations, which was determined from a reference sample of healthy participants aged < 30 years. The primary outcome was first stroke (ischemic or hemorrhagic). In total, 11,474 participants were enrolled. The prevalence of HVA decreased from 36.0% in participants aged 50-59 years to 4.7% in those aged ≥ 70 years. During a median follow-up of 3.3 years, the incidence of first stroke was 0.5% in the HVA group but was 2.6% in the Non-HVA group. After adjusting for confounding variables, HVA was associated with a 0.32-fold lower risk of first stroke compared to the Non-HVA group (95% confidence interval, 0.18-0.56; p < 0.001). It thus appears that HVA reduced the risk of first stroke in a community-based Chinese population. This suggests that evaluation of vascular aging as part of public health screening may be useful for stroke risk assessment.
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Affiliation(s)
- Yingying Yang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xiaodong Yuan
- Department of Neurology, Kailuan General Hospital, North China University of Science and Technology, Tangshan, China
| | - Quanhui Zhao
- Graduate School, North China University of Science and Technology, Tangshan, China.,Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, Tangshan, China
| | - Xiaoxue Liu
- Department of Cardiology, Tangshan People's Hospital, North China University of Science and Technology, Tangshan, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, Tangshan, China
| | - Xiuyan Wang
- Department of Geriatric disease, Kailuan General Hospital, North China University of Science and Technology, Tangshan, China
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, Tangshan, China
| | - Yilong Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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16
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Laurent S, Boutouyrie P, Cunha PG, Lacolley P, Nilsson PM. Concept of Extremes in Vascular Aging. Hypertension 2019; 74:218-228. [DOI: 10.1161/hypertensionaha.119.12655] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Stephane Laurent
- From the Department of Pharmacology, INSERM U970, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, France (S.L., P.B.)
| | - Pierre Boutouyrie
- From the Department of Pharmacology, INSERM U970, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, France (S.L., P.B.)
| | - Pedro Guimarães Cunha
- Center for the Research and Treatment of Arterial Hypertension and Cardiovascular Risk, Serviço de Medicina Interna do Hospital da Senhora da Oliveira, Guimarães, Portugal (P.G.C.)
- Life and Health Science Research Institute, School of Medicine, University of Minho, Guimarães, Portugal (P.G.C.)
| | | | - Peter M. Nilsson
- Department of Clinical Sciences, Lund University, Skane University Hospital, Malmo, Sweden (P.M.N.)
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17
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Polygenic adaptation and convergent evolution on growth and cardiac genetic pathways in African and Asian rainforest hunter-gatherers. Proc Natl Acad Sci U S A 2018; 115:E11256-E11263. [PMID: 30413626 DOI: 10.1073/pnas.1812135115] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Different human populations facing similar environmental challenges have sometimes evolved convergent biological adaptations, for example, hypoxia resistance at high altitudes and depigmented skin in northern latitudes on separate continents. The "pygmy" phenotype (small adult body size), characteristic of hunter-gatherer populations inhabiting both African and Asian tropical rainforests, is often highlighted as another case of convergent adaptation in humans. However, the degree to which phenotypic convergence in this polygenic trait is due to convergent versus population-specific genetic changes is unknown. To address this question, we analyzed high-coverage sequence data from the protein-coding portion of the genomes of two pairs of populations: Batwa rainforest hunter-gatherers and neighboring Bakiga agriculturalists from Uganda and Andamanese rainforest hunter-gatherers and Brahmin agriculturalists from India. We observed signatures of convergent positive selection between the rainforest hunter-gatherers across the set of genes with "growth factor binding" functions ([Formula: see text]). Unexpectedly, for the rainforest groups, we also observed convergent and population-specific signatures of positive selection in pathways related to cardiac development (e.g., "cardiac muscle tissue development"; [Formula: see text]). We hypothesize that the growth hormone subresponsiveness likely underlying the adult small body-size phenotype may have led to compensatory changes in cardiac pathways, in which this hormone also plays an essential role. Importantly, in the agriculturalist populations, we did not observe similar patterns of positive selection on sets of genes associated with growth or cardiac development, indicating our results most likely reflect a history of convergent adaptation to the similar ecology of rainforests rather than a more general evolutionary pattern.
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18
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Corlin L, Lane KJ, Sunderarajan J, Chui KKH, Vijayakumar H, Krakoff L, Chandrasekaran A, Thanikachalam S, Brugge D, Thanikachalam M. Urbanization as a risk factor for aortic stiffness in a cohort in India. PLoS One 2018; 13:e0201036. [PMID: 30067798 PMCID: PMC6070252 DOI: 10.1371/journal.pone.0201036] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 06/05/2018] [Indexed: 01/20/2023] Open
Abstract
Urbanization is associated with higher prevalence of cardiovascular disease worldwide. Aortic stiffness, as measured by carotid-femoral pulse wave velocity is a validated predictor of cardiovascular disease. Our objective was to determine the association between urbanization and carotid-femoral pulse wave velocity. The analysis included 6166 participants enrolled in an ongoing population-based study (mean age 42 years; 58% female) who live in an 80 × 80 km region of southern India. Multiple measures of urbanization were used and compared: 1) census designations, 2) satellite derived land cover (crops, grass, shrubs or trees as rural; built-up areas as urban), and 3) distance categories based on proximity to an urban center. The association between urbanization and carotid-femoral pulse wave velocity was tested in sex-stratified linear regression models. People residing in urban areas had significantly (p < 0.05) elevated mean carotid-femoral pulse wave velocity compared to non-urban populations after adjustment for other risk factors. There was also an inverse association between distance from the urban center and mean carotid-femoral pulse wave velocity: each 10 km increase in distance was associated with a decrease in mean carotid-femoral pulse wave velocity of 0.07 m/s (95% CI: -0.09, -0.06 m/s). The association was stronger among older participants, among smokers, and among those with other cardiovascular risk factors. Further research is needed to determine which components in the urban environment are associated with higher carotid-femoral pulse wave velocity.
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Affiliation(s)
- Laura Corlin
- Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, Massachusetts, United States of America
| | - Kevin J. Lane
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | | | - Kenneth K. H. Chui
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts, United States of America
| | | | - Lawrence Krakoff
- Mount Sinai Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | | | | | - Doug Brugge
- Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, Massachusetts, United States of America
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts, United States of America
- Tisch College of Civic Life, Tufts University, Medford, Massachusetts, United States of America
| | - Mohan Thanikachalam
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts, United States of America
- * E-mail:
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19
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Pemberton TJ, Verdu P, Becker NS, Willer CJ, Hewlett BS, Le Bomin S, Froment A, Rosenberg NA, Heyer E. A genome scan for genes underlying adult body size differences between Central African hunter-gatherers and farmers. Hum Genet 2018; 137:487-509. [PMID: 30008065 DOI: 10.1007/s00439-018-1902-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Accepted: 07/03/2018] [Indexed: 12/16/2022]
Abstract
The evolutionary and biological bases of the Central African "pygmy" phenotype, a characteristic of rainforest hunter-gatherers defined by reduced body size compared with neighboring farmers, remain largely unknown. Here, we perform a joint investigation in Central African hunter-gatherers and farmers of adult standing height, sitting height, leg length, and body mass index (BMI), considering 358 hunter-gatherers and 169 farmers with genotypes for 153,798 SNPs. In addition to reduced standing heights, hunter-gatherers have shorter sitting heights and leg lengths and higher sitting/standing height ratios than farmers and lower BMI for males. Standing height, sitting height, and leg length are strongly correlated with inferred levels of farmer genetic ancestry, whereas BMI is only weakly correlated, perhaps reflecting greater contributions of non-genetic factors to body weight than to height. Single- and multi-marker association tests identify one region and eight genes associated with hunter-gatherer/farmer status, and 24 genes associated with the height-related traits. Many of these genes have putative functions consistent with roles in determining their associated traits and the pygmy phenotype, and they include three associated with standing height in non-Africans (PRKG1, DSCAM, MAGI2). We find evidence that European height-associated SNPs or variants in linkage disequilibrium with them contribute to standing- and sitting-height determination in Central Africans, but not to the differential status of hunter-gatherers and farmers. These findings provide new insights into the biological basis of the pygmy phenotype, and they highlight the potential of cross-population studies for exploring the genetic basis of phenotypes that vary naturally across populations.
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Affiliation(s)
- Trevor J Pemberton
- Department of Biochemistry and Medical Genetics, University of Manitoba, Winnipeg, MB, Canada.
| | - Paul Verdu
- CNRS-MNHN-Université Paris Diderot, UMR 7206 Eco-Anthropologie et Ethnobiologie, Paris, France.
| | - Noémie S Becker
- Division of Evolutionary Biology, Faculty of Biology, Ludwig-Maximilians-Universität München, Planegg-Martinsried, Germany
| | - Cristen J Willer
- Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Barry S Hewlett
- Department of Anthropology, Washington State University, Vancouver, WA, USA
| | - Sylvie Le Bomin
- CNRS-MNHN-Université Paris Diderot, UMR 7206 Eco-Anthropologie et Ethnobiologie, Paris, France
| | | | | | - Evelyne Heyer
- CNRS-MNHN-Université Paris Diderot, UMR 7206 Eco-Anthropologie et Ethnobiologie, Paris, France.
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20
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Lemogoum D, Ngatchou W, Bika Lele C, Okalla C, Leeman M, Degaute JP, van de Borne P. Association of urinary sodium excretion with blood pressure and risk factors associated with hypertension among Cameroonian pygmies and bantus: a cross-sectional study. BMC Cardiovasc Disord 2018. [PMID: 29514623 PMCID: PMC5842583 DOI: 10.1186/s12872-018-0787-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background High salt intake increases blood pressure (BP) and hypertension risk. This study aimed to examine association of urinary sodium excretion with BP and hypertension correlates among Cameroonian pygmies under hunter-gatherer subsistence mode and Bantus, living in urban area under unhealthy behavioral habits. Methods In this cross-sectional cluster sampling study, we randomly enrolled rural pygmies living in Lolodorf and urban Bantus living in Douala. The World Health Organization steps questionnaire was used to collect socio-demographic and lifestyle data. Height, weight, BP and single overnight spot urine samples were obtained in all participants. BP was measured in triplicate. Urinary sodium and potassium excretion was determined by flame photometry. Data were recorded and analyzed using SPSS 16.0. Results We included 150 Pygmies and 150 Bantus aged 38 ± 12 years and 33 ± 11 years, respectively (p < 0.0001). Compare to Bantus, pygmy’s height and weight were respectively: 1.54 ± 0.09 m vs 1.72 ± 0.12 m; and 54.4 ± 9.2 kg vs 77.2 ± 14.8 kg, all p < 0.0001. Age-standardized prevalence of hypertension was 3.3% among Pygmies and 28% among Bantus (p < 0.0001). Age-adjusted systolic and diastolic BP were lower in Pygmies than in Bantus (107 ± 12 vs 119 ± 17 mmHg and 71 ± 11 vs 78 ± 13 mmHg respectively, all P < 0.0001). BP increased with age but to a lesser extent in Pygmies (all p < 0.01). Urinary sodium excretion was lower in Pygmies than in Bantus (46.9 ± 32.4 vs 121.5 ± 61.0 mmol/l, p < 0.0001). Systolic and diastolic BP were positively associated with urinary sodium excretion in Bantus (all p < 0.05). In the two groups, urinary potassium excretion was similar, and was not related to blood pressure. In the total study group and in Bantus taken separately, urinary sodium excretion was higher in hypertensive than in normotensive subjects. Multivariable logistic regression showed that urinary sodium excretion, Bantu status and age emerged as independent determinants of hypertension in the whole study group (OR (95%CI): 1.012 (1.005–1.018); 11.408 (3.599–36.165); 1.095 (1.057–1.135) respectively, p < 0.0001). Conclusion Hunter-gatherer pygmies exhibit low level of urinary sodium excretion related to low rate of hypertension and slower BP increase with age. Salt intake was a major driver of hypertension in our study population. Our findings highlight the need of efforts to implement nationwide prevention programs promoting risk factor screening and healthier lifestyles including reduction of dietary salt intake in Cameroonian.
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Affiliation(s)
- Daniel Lemogoum
- Douala School of Medicine and Pharmaceutical Sciences, Douala University, Douala, Cameroon. .,ULB-Erasme Hospital, Free Brussels University, University, 808, Lennik Road, 1070, Brussels, Belgium. .,Douala Heart Institute, Douala, Cameroon.
| | - William Ngatchou
- Douala School of Medicine and Pharmaceutical Sciences, Douala University, Douala, Cameroon
| | | | - Cecile Okalla
- Douala School of Medicine and Pharmaceutical Sciences, Douala University, Douala, Cameroon
| | - Marc Leeman
- ULB-Erasme Hospital, Free Brussels University, University, 808, Lennik Road, 1070, Brussels, Belgium
| | - Jean-Paul Degaute
- ULB-Erasme Hospital, Free Brussels University, University, 808, Lennik Road, 1070, Brussels, Belgium
| | - Philippe van de Borne
- ULB-Erasme Hospital, Free Brussels University, University, 808, Lennik Road, 1070, Brussels, Belgium
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22
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Prevalence, awareness, treatment, and control of hypertension among rural and urban dwellers of the Far North Region of Cameroon. J Hypertens 2018; 36:159-168. [DOI: 10.1097/hjh.0000000000001513] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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23
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Campo D, Khettab H, Yu R, Genain N, Edouard P, Buard N, Boutouyrie P. Measurement of Aortic Pulse Wave Velocity With a Connected Bathroom Scale. Am J Hypertens 2017; 30:876-883. [PMID: 28520843 PMCID: PMC5861589 DOI: 10.1093/ajh/hpx059] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 03/24/2017] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Measurement of arterial stiffness should be more available. Our aim was to show that aortic pulse wave velocity can be reliably measured with a bathroom scale combining the principles of ballistocardiography (BCG) and impedance plethysmography on a single foot. METHOD The calibration of the bathroom scale was conducted on a group of 106 individuals. The aortic pulse wave velocity was measured with the SphygmoCor in the supine position. Three consecutive measurements were then performed on the Withings scale in the standing position. This aorta-leg pulse transit time (alPTT) was then converted into a velocity with the additional input of the height of the person. Agreement between the SphygmoCor and the bathroom scale so calibrated is assessed on a separate group of 86 individuals, following the same protocol. RESULTS The bias is 0.25 m·s−1 and the SE 1.39 m·s−1. This agreement with Sphygmocor is “acceptable” according to the ARTERY classification. The alPTT correlated well with cfPTT with (Spearman) R = 0.73 in pooled population (cal 0.79, val 0.66). The aorta-leg pulse wave velocity correlated with carotid-femoral pulse wave velocity with R = 0.76 (cal 0.80, val 0.70). CONCLUSION Estimation of the aortic pulse wave velocity is feasible with a bathroom scale. Further investigations are needed to improve the repeatability of measurements and to test their accuracy in different populations and conditions.
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Affiliation(s)
- David Campo
- Withings, 2 rue Maurice Hartman, Issy le Moulineaux, France
| | - Hakim Khettab
- AP-HP, Pharmacology Unit, Hôpital Européen Georges Pompidou, INSERM, U970, Paris Cardiovascular Research Center PARCC, University Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Roger Yu
- Withings, 2 rue Maurice Hartman, Issy le Moulineaux, France
| | - Nicolas Genain
- Withings, 2 rue Maurice Hartman, Issy le Moulineaux, France
| | - Paul Edouard
- Withings, 2 rue Maurice Hartman, Issy le Moulineaux, France
| | - Nadine Buard
- Withings, 2 rue Maurice Hartman, Issy le Moulineaux, France
| | - Pierre Boutouyrie
- AP-HP, Pharmacology Unit, Hôpital Européen Georges Pompidou, INSERM, U970, Paris Cardiovascular Research Center PARCC, University Paris Descartes, Sorbonne Paris Cité, Paris, France
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Niiranen TJ, Lyass A, Larson MG, Hamburg NM, Benjamin EJ, Mitchell GF, Vasan RS. Prevalence, Correlates, and Prognosis of Healthy Vascular Aging in a Western Community-Dwelling Cohort: The Framingham Heart Study. Hypertension 2017; 70:267-274. [PMID: 28559398 DOI: 10.1161/hypertensionaha.117.09026] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 01/17/2017] [Accepted: 04/02/2017] [Indexed: 12/24/2022]
Abstract
Hypertension and increased vascular stiffness are viewed as inevitable parts of aging. To elucidate whether the age-related decrease in vascular function is avoidable, we assessed the prevalence, correlates, and prognosis of healthy vascular aging (HVA) in 3196 Framingham Study participants aged ≥50 years. We defined HVA as absence of hypertension and pulse wave velocity <7.6 m/s (mean+2 SD of a reference sample aged <30 years). Overall, 566 (17.7%) individuals had HVA, with prevalence decreasing from 30.3% in people aged 50 to 59 to 1% in those aged ≥70 years. In regression models adjusted for physical activity, caloric intake, and traditional cardiovascular disease (CVD) risk factors, we observed that lower age, female sex, lower body mass index, use of lipid-lowering drugs, and absence of diabetes mellitus were cross-sectionally associated with HVA (P<0.001 for all). A unit increase in a cardiovascular health score (Life's Simple 7) was associated with 1.55-fold (95% confidence interval, 1.38-1.74) age- and sex-adjusted odds of HVA. During a follow-up of 9.6 years, 391 CVD events occurred. In Cox regression models adjusted for traditional CVD risk factors, including blood pressure, HVA was associated with a hazard ratio of 0.45 (95% confidence interval, 0.26-0.77) for CVD relative to absence of HVA. Although HVA is achievable in individuals acculturated to a Western lifestyle, maintaining normal vascular function beyond 70 years of age is challenging. Although our data are observational, our findings support prevention strategies targeting modifiable factors and behaviors and obesity, in particular, to prevent or delay vascular aging and the associated risk of CVD.
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Affiliation(s)
- Teemu J Niiranen
- From the National Heart, Lung, and Blood Institute's and Boston University's Framingham Heart Study, MA (T.J.N., A.L., M.G.L., E.J.B., R.S.V.); Department of Mathematics and Statistics, Boston University, MA (A.L., M.G.L.); Department of Biostatistics (M.G.L.), Evans Department of Medicine, Whitaker Cardiovascular Institute (N.M.H., E.J.B., R.S.V.), Section of Cardiology, Department of Medicine (N.M.H., E.J.B., R.S.V.), Section of Vascular Biology, Department of Medicine (N.M.H.), Section of Preventive Medicine, Department of Medicine (E.J.B., R.S.V.), and Department of Epidemiology (E.J.B., R.S.V.), Boston University School of Public Health, MA; and Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.).
| | - Asya Lyass
- From the National Heart, Lung, and Blood Institute's and Boston University's Framingham Heart Study, MA (T.J.N., A.L., M.G.L., E.J.B., R.S.V.); Department of Mathematics and Statistics, Boston University, MA (A.L., M.G.L.); Department of Biostatistics (M.G.L.), Evans Department of Medicine, Whitaker Cardiovascular Institute (N.M.H., E.J.B., R.S.V.), Section of Cardiology, Department of Medicine (N.M.H., E.J.B., R.S.V.), Section of Vascular Biology, Department of Medicine (N.M.H.), Section of Preventive Medicine, Department of Medicine (E.J.B., R.S.V.), and Department of Epidemiology (E.J.B., R.S.V.), Boston University School of Public Health, MA; and Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.)
| | - Martin G Larson
- From the National Heart, Lung, and Blood Institute's and Boston University's Framingham Heart Study, MA (T.J.N., A.L., M.G.L., E.J.B., R.S.V.); Department of Mathematics and Statistics, Boston University, MA (A.L., M.G.L.); Department of Biostatistics (M.G.L.), Evans Department of Medicine, Whitaker Cardiovascular Institute (N.M.H., E.J.B., R.S.V.), Section of Cardiology, Department of Medicine (N.M.H., E.J.B., R.S.V.), Section of Vascular Biology, Department of Medicine (N.M.H.), Section of Preventive Medicine, Department of Medicine (E.J.B., R.S.V.), and Department of Epidemiology (E.J.B., R.S.V.), Boston University School of Public Health, MA; and Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.)
| | - Naomi M Hamburg
- From the National Heart, Lung, and Blood Institute's and Boston University's Framingham Heart Study, MA (T.J.N., A.L., M.G.L., E.J.B., R.S.V.); Department of Mathematics and Statistics, Boston University, MA (A.L., M.G.L.); Department of Biostatistics (M.G.L.), Evans Department of Medicine, Whitaker Cardiovascular Institute (N.M.H., E.J.B., R.S.V.), Section of Cardiology, Department of Medicine (N.M.H., E.J.B., R.S.V.), Section of Vascular Biology, Department of Medicine (N.M.H.), Section of Preventive Medicine, Department of Medicine (E.J.B., R.S.V.), and Department of Epidemiology (E.J.B., R.S.V.), Boston University School of Public Health, MA; and Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.)
| | - Emelia J Benjamin
- From the National Heart, Lung, and Blood Institute's and Boston University's Framingham Heart Study, MA (T.J.N., A.L., M.G.L., E.J.B., R.S.V.); Department of Mathematics and Statistics, Boston University, MA (A.L., M.G.L.); Department of Biostatistics (M.G.L.), Evans Department of Medicine, Whitaker Cardiovascular Institute (N.M.H., E.J.B., R.S.V.), Section of Cardiology, Department of Medicine (N.M.H., E.J.B., R.S.V.), Section of Vascular Biology, Department of Medicine (N.M.H.), Section of Preventive Medicine, Department of Medicine (E.J.B., R.S.V.), and Department of Epidemiology (E.J.B., R.S.V.), Boston University School of Public Health, MA; and Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.)
| | - Gary F Mitchell
- From the National Heart, Lung, and Blood Institute's and Boston University's Framingham Heart Study, MA (T.J.N., A.L., M.G.L., E.J.B., R.S.V.); Department of Mathematics and Statistics, Boston University, MA (A.L., M.G.L.); Department of Biostatistics (M.G.L.), Evans Department of Medicine, Whitaker Cardiovascular Institute (N.M.H., E.J.B., R.S.V.), Section of Cardiology, Department of Medicine (N.M.H., E.J.B., R.S.V.), Section of Vascular Biology, Department of Medicine (N.M.H.), Section of Preventive Medicine, Department of Medicine (E.J.B., R.S.V.), and Department of Epidemiology (E.J.B., R.S.V.), Boston University School of Public Health, MA; and Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.)
| | - Ramachandran S Vasan
- From the National Heart, Lung, and Blood Institute's and Boston University's Framingham Heart Study, MA (T.J.N., A.L., M.G.L., E.J.B., R.S.V.); Department of Mathematics and Statistics, Boston University, MA (A.L., M.G.L.); Department of Biostatistics (M.G.L.), Evans Department of Medicine, Whitaker Cardiovascular Institute (N.M.H., E.J.B., R.S.V.), Section of Cardiology, Department of Medicine (N.M.H., E.J.B., R.S.V.), Section of Vascular Biology, Department of Medicine (N.M.H.), Section of Preventive Medicine, Department of Medicine (E.J.B., R.S.V.), and Department of Epidemiology (E.J.B., R.S.V.), Boston University School of Public Health, MA; and Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.)
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Chiadak JD, Perret J, Womeni HM, Kuiaté JR, Cullus P, Senterre C, Delporte C. Pilot study of risk factors associated with cardiovascular disease in northern and southern Cameroonians. Cardiovasc J Afr 2017; 28:235-241. [PMID: 28556848 PMCID: PMC5642027 DOI: 10.5830/cvja-2016-094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 10/16/2016] [Indexed: 12/14/2022] Open
Abstract
Aim: The aim of the study was to evaluate whether the risk factors for cardiovascular disease (CVD) are similar in the northern and southern regions of Cameroon. Methods: The participants answered a questionnaire concerning their lifestyle. Anthropometric and blood pressure measurements were evaluated in 192 individuals and biochemical parameters in 50 randomly selected volunteers. Results: Northerners displayed low alcohol and tobacco consumption, little practice of sport but physically demanding professions, and consumption of soybean, refined palm and other polyunsaturated oils. Southerners consumed alcohol, practiced sport, had intellectually based professions, and consumed crude and refined palm oils. Waist circumference and body mass index were higher in the southerners compared to the northerners. Blood glucose levels, and systolic and diastolic blood pressures were higher among the northerners than the southerners. Among the southerners, there were positive correlations between total cholesterol levels and systolic or diastolic blood pressure, low-density lipoprotein cholesterol and blood glucose levels or diastolic blood pressure, triglyceride levels and systolic blood pressure. Conclusion: Providing region-adapted, health-related advice for northern and southern Cameroonians would contribute to reducing risk factors for CVD.
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Affiliation(s)
- Jeanne Durendale Chiadak
- Laboratory of Pathophysiological and Nutritional Biochemistry, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium; Department of Biochemistry, Faculty of Sciences, University of Dschang, Cameroon
| | - Jason Perret
- Laboratory of Pathophysiological and Nutritional Biochemistry, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Jules Roger Kuiaté
- Department of Biochemistry, Faculty of Sciences, University of Dschang, Cameroon
| | - Pierre Cullus
- Biostatistics and Medical Informatics Service, Faculty of Medicine, Université Libre de Bruxelles, Belgium
| | - Christelle Senterre
- Research Centre of Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université Libre de Bruxelles, Belgium
| | - Christine Delporte
- Laboratory of Pathophysiological and Nutritional Biochemistry, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium.
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Kuller LH, Lopez OL. Cardiovascular disease and dementia risk: an ever growing problem in an aging population. Expert Rev Cardiovasc Ther 2016; 14:771-3. [DOI: 10.1080/14779072.2016.1185366] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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PCSK9 inhibition as an emerging lipid lowering therapy: Unanswered questions. Hellenic J Cardiol 2016; 57:86-91. [PMID: 27445021 DOI: 10.1016/j.hjc.2016.03.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 01/04/2016] [Indexed: 11/23/2022] Open
Abstract
Although statins have been used for the treatment of hypercholesterolemia for more than two decades, cardiovascular disease (CVD), which is related at least in part to high levels of low-density lipoprotein cholesterol (LDL-C), is the number one cause of death in Europe and the USA. Several studies have shown that the reduction in cardiovascular (CV) events is proportional to the absolute LDL-C lowering achieved with statins. In the quest for further reduction in LDL-C and CV events, new drugs that mainly support statin action have emerged. Since 2003, with the discovery of proprotein convertase subtilisin/kexin type 9 (PCSK9), which is a key factor in the LDL clearance pathway, new modalities, mainly in the form of monoclonal antibodies that block this protein (PCSK9 inhibitors), have reached phase III of clinical development with very promising efficacy and safety data. With a mean further reduction of LDL-C levels of ∼60% beyond that achieved with statins, the PCSK9 inhibitors set the bar even lower in terms of LDL-C levels. This review manuscript addresses important questions about the efficacy, safety and clinical use of PCSK9 inhibitors to evaluate the role of these agents in reducing CV risk.
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Tölle M, Reshetnik A, Schuchardt M, Höhne M, van der Giet M. Arteriosclerosis and vascular calcification: causes, clinical assessment and therapy. Eur J Clin Invest 2015; 45:976-85. [PMID: 26153098 DOI: 10.1111/eci.12493] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 07/01/2015] [Indexed: 01/07/2023]
Abstract
BACKGROUND Arteriosclerosis is a pathological, structural (media vascular calcification) and physiological (modified vascular smooth vessel cells; increased arterial stiffness) alteration of the vessel wall. Through improved assessment methods (functional and imaging), it has become a well-known phenomenon in recent decades. However, its clinical importance was underestimated until recently. MATERIALS AND METHODS Currently available English-speaking data about conditions/diseases associated with arteriosclerosis, its clinical sequels, available diagnostic procedures and therapeutic modalities were reviewed and summarized. RESULTS In recent decades, emerging data have brought about a better understanding of causes and consequences of arteriosclerosis and highlight its growing clinical impact. CONCLUSION Although arteriosclerosis showed an independent clinical impact on cardiovascular morbidity and mortality, especially in patients with chronic kidney disease/end-stage renal disease (CKD/ESRD) and diabetes mellitus, convincing clinical therapy concepts are not available until now. The establishment of novel therapeutic strategies derived from basic research is strongly needed.
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Affiliation(s)
- Markus Tölle
- Charité Centrum 13, Department of Nephrology and Transplantation, Charité - Universitaetsmedizin Berlin, Berlin, Germany
| | - Alexander Reshetnik
- Charité Centrum 13, Department of Nephrology and Transplantation, Charité - Universitaetsmedizin Berlin, Berlin, Germany
| | - Mirjam Schuchardt
- Charité Centrum 13, Department of Nephrology and Transplantation, Charité - Universitaetsmedizin Berlin, Berlin, Germany
| | | | - Markus van der Giet
- Charité Centrum 13, Department of Nephrology and Transplantation, Charité - Universitaetsmedizin Berlin, Berlin, Germany
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Doumas M, Faselis C, Kokkinos P. Exaggerated Blood Pressure Response to Exercise: Will It Ever Be Ready for Prime Time? J Clin Hypertens (Greenwich) 2015; 17:845-7. [PMID: 26234157 DOI: 10.1111/jch.12630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Michael Doumas
- Department of Veterans Affairs and George Washington University, Washington, DC
| | - Charles Faselis
- Department of Veterans Affairs and George Washington University, Washington, DC
| | - Peter Kokkinos
- Department of Veterans Affairs and George Washington University, Washington, DC
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30
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Brun JF, Guiraudou M, Romain AJ, Pollatz M, Fédou C, Mercier J. Le niveau d’oxydation maximale des lipides (LIPOXmax), un niveau d’exercice adapté par ses propriétés énergétiques et comportementales au « génotype économe » du syndrome métabolique : l’hypothèse du « healthy primitive lifestyle ». Sci Sports 2015. [DOI: 10.1016/j.scispo.2015.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Affiliation(s)
- Peter Kokkinos
- From the Cardiology Department, Veterans Affairs Medical Center, Washington, DC; Department of Cardiology, Georgetown University School of Medicine, Washington, DC; George Washington University School of Medicine and Health Sciences, Washington, DC; and Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia.
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Lemogoum D. Challenge for hypertension prevention and control worldwide: the time for action. J Clin Hypertens (Greenwich) 2014; 16:554-6. [PMID: 25056672 DOI: 10.1111/jch.12373] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Daniel Lemogoum
- School of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
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Ohanian J, Liao A, Forman SP, Ohanian V. Age-related remodeling of small arteries is accompanied by increased sphingomyelinase activity and accumulation of long-chain ceramides. Physiol Rep 2014; 2:2/5/e12015. [PMID: 24872355 PMCID: PMC4098743 DOI: 10.14814/phy2.12015] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The structure and function of large arteries alters with age leading to increased risk of cardiovascular disease. Age‐related large artery remodeling and arteriosclerosis is associated with increased collagen deposition, inflammation, and endothelial dysfunction. Bioactive sphingolipids are known to regulate these processes, and are also involved in aging and cellular senescence. However, less is known about age‐associated alterations in small artery morphology and function or whether changes in arterial sphingolipids occur in aging. We show that mesenteric small arteries from old sheep have increased lumen diameter and media thickness without a change in media to lumen ratio, indicative of outward hypertrophic remodeling. This remodeling occurred without overt changes in blood pressure or pulse pressure indicating it was a consequence of aging per se. There was no age‐associated change in mechanical properties of the arteries despite an increase in total collagen content and deposition of collagen in a thickened intima layer in arteries from old animals. Analysis of the sphingolipid profile showed an increase in long‐chain ceramide (C14–C20), but no change in the levels of sphingosine or sphingosine‐1‐phosphate in arteries from old compared to young animals. This was accompanied by a parallel increase in acid and neutral sphingomyelinase activity in old arteries compared to young. This study demonstrates remodeling of small arteries during aging that is accompanied by accumulation of long‐chain ceramides. This suggests that sphingolipids may be important mediators of vascular aging. In this study, we have investigated remodeling of small arteries in a large animal model of aging, the sheep. We show that there is age‐related formation of neointima and increased collagen deposition that is accompanied by changes in sphingolipid metabolism resulting in ceramide accumulation in the tissues. These are the first data implicating sphingolipids as important mediators of vascular aging in small arteries. Given that aging is a major risk factor for cardiovascular disease, our study opens a new area for further research into the mechanisms that underlie vascular remodeling in aging.
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Affiliation(s)
- Jacqueline Ohanian
- Institute of Cardiovascular Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Aiyin Liao
- Institute of Cardiovascular Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Simon P Forman
- Institute of Cardiovascular Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Vasken Ohanian
- Institute of Cardiovascular Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
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Mathew G, Thambi M, Unnikrishnan MK. A multimodal Darwinian strategy for alleviating the atherosclerosis pandemic. Med Hypotheses 2013; 82:159-62. [PMID: 24355423 DOI: 10.1016/j.mehy.2013.11.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Accepted: 11/24/2013] [Indexed: 01/15/2023]
Abstract
The conflict between our 'primitive' genes and 'modern' lifestyle probably lies at the root of several disorders that afflict modern man. Atherosclerosis, which is relatively unknown among contemporary hunter-gatherer populations, has reached pandemic proportions in recent times. Being an evolutionary problem with several inter-related pathologies, current therapeutic strategy for treating atherosclerosis has inherent limitations. Reviewing evolution-linked risk factors suggests that there are four aspects to the etiology of atherosclerosis namely, decreased intestinal parasitism, oversensitivity of evolutionarily redundant mast cells, chronic underactivation of AMPK (cellular energy sensor) and a deficiency of vitamin D. A combination of these four causes appear to have precipitated the atherosclerosis pandemic in modern times. Man and worms co-existed symbiotically in the past. Massive de-worming campaigns could have disrupted this symbiosis, increasing nutritional availability to man (pro-obesity) at the cost of decreased immunotolerance (pro-atherogenicity). A reduction in helminth-induced chronic TH2 activation could also have enhanced TH1 polarization, eventually disrupting the reciprocal regulation of TH1/TH2 balance and resulting in atherosclerosis. The riddance of helminth infestations may have rendered mast cells immunologically redundant, making them oversensitive to inflammatory stimuli, thereby playing a pro-atherogenic role. AMPK activation exerts pleiotropic anti-atherogenic effects, such as suppression of fatty acid, cholesterol, protein synthesis, reduction of vascular smooth muscle proliferation, etc. As energy deficit is the chief stimulus for AMPK activation, the over-nourished modern man appears to be suffering from chronic underactivation of AMPK, legitimising the unrivalled supremacy of metformin, the oldest prescribed antidiabetic drug. The fact that humans evolved in the sunny tropics suggests that humans are selected for high vitamin D levels. Vitamin D deficiency is now linked to several conditions including increased risk of CV disorders, diabetes, etc. The manifold decrease in vitamin D levels in modern man justifies a need for supplementation. We therefore hypothesize that a judicious combination of mast cell stabilization, AMPK activation, vitamin D supplementation, and moderation in hygiene practices could be an evolution-based multimodal strategy for both preventing and mitigating the pandemic of atherosclerosis.
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Affiliation(s)
- Geetha Mathew
- Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal University, Manipal 576104, India
| | - Magith Thambi
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal University, Manipal 576104, India
| | - M K Unnikrishnan
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal University, Manipal 576104, India.
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Abstract
Atherosclerosis, the major cause of cardiovascular disease (CVD), is a chronic inflammatory condition with immune competent cells in lesions producing mainly pro-inflammatory cytokines. Dead cells and oxidized forms of low density lipoproteins (oxLDL) are abundant. The major direct cause of CVD appears to be rupture of atherosclerotic plaques. oxLDL has proinflammatory and immune-stimulatory properties, causes cell death at higher concentrations and contains inflammatory phospholipids with phosphorylcholine (PC) as an interesting epitope. Antibodies against PC (anti-PC) may be atheroprotective, one mechanism being anti-inflammatory. Bacteria and virus have been discussed, but it has been difficult to find direct evidence, and antibiotic trials have not been successful. Heat shock proteins could be one major target for atherogenic immune reactions. More direct causes of plaque rupture include pro-inflammatory cytokines, chemokines, and lipid mediators. To prove that inflammation is a cause of atherosclerosis and CVD, clinical studies with anti-inflammatory and/or immune-modulatory treatment are needed. The potential causes of immune reactions and inflammation in atherosclerosis and how inflammation can be targeted therapeutically to provide novel treatments for CVD are reviewed.
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Affiliation(s)
- Johan Frostegård
- Institute of Environmental Medicine, Unit of Immunology and Chronic Disease, Nobels väg 13, Stockholm, Sweden.
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Affiliation(s)
- Ian B. Wilkinson
- From the Clinical Pharmacology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Carmel M. McEniery
- From the Clinical Pharmacology Unit, University of Cambridge, Cambridge, United Kingdom
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