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He C, Li R, Yang J, Shen H, Wang Y, Chen X, Luo W, Zeng Q, Ma L, Song Y, Cheng Q, Wang Z, Wu FF, Li Q, Yang S, Hu J. Optimizing the aldosterone-to-renin ratio cut-off for screening primary aldosteronism based on cardiovascular risk: a collaborative study. Clin Exp Hypertens 2024; 46:2301571. [PMID: 38270079 DOI: 10.1080/10641963.2023.2301571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 12/28/2023] [Indexed: 01/26/2024]
Abstract
OBJECTIVES Aldosterone-to-renin ratio (ARR) based screening is the first step in the diagnosis of primary aldosteronism (PA). However, the guideline-recommended ARR cutoff covers a wide range, from the equivalent of 1.3 to 4.9 ng·dl-1/mIU∙l-1. We aimed to optimize the ARR cutoff for PA screening based on the risk of cardiovascular diseases (CVD). METHODS Longitudinally, we included hypertensive participants from the Framingham Offspring Study (FOS) who attended the sixth examination cycle and followed up until 2014. At baseline (1995-1998), we used circulating concentrations of aldosterone and renin to calculate ARR (unit: ng·dl-1/mIU∙l-1) among 1,433 subjects who were free of CVD. We used spline regression to calculate the ARR threshold based on the incident CVD. We used cross-sectional data from the Chongqing Primary Aldosteronism Study (CONPASS) to explore whether the ARR cutoff selected from FOS is applicable to PA screening. RESULTS In FOS, CVD risk increased with an increasing ARR until a peak of ARR 1.0, followed by a plateau in CVD risk (hazard ratio 1.49, 95%CI 1.19-1.86). In CONPASS, when compared to essential hypertension with ARR < 1.0, PA with ARR ≥ 1.0 carried a higher CVD risk (odds ratio 2.24, 95%CI 1.41-3.55), while essential hypertension with ARR ≥ 1.0 had an unchanged CVD risk (1.02, 0.62-1.68). Setting ARR cutoff at 2.4 ~ 4.9, 10% ~30% of PA subjects would be unrecognized although they carried a 2.45 ~ 2.58-fold higher CVD risk than essential hypertension. CONCLUSIONS The CVD risk-based optimal ARR cutoff is 1.0 ng·dl-1/mIU∙l-1 for PA screening. The current guideline-recommended ARR cutoff may miss patients with PA and high CVD risk. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov (NCT03224312).
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Affiliation(s)
- Chunxue He
- Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ruolin Li
- Department of Dermatology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jun Yang
- Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Clayton, Victoria, Australia
- Department of Medicine, Monash University, Clayton, Victoria, Australia
| | - Hang Shen
- Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yue Wang
- Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiangjun Chen
- Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wenjin Luo
- Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qinglian Zeng
- Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Linqiang Ma
- Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ying Song
- Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qingfeng Cheng
- Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhihong Wang
- Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Fei-Fei Wu
- Department of Endocrinology, Affiliated Heping Hospital, Changzhi Medical College, Changzhi, China
| | - Qifu Li
- Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Shumin Yang
- Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jinbo Hu
- Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Kähönen E, Kähönen E, Pälve K, Hulkkonen J, Kähönen M, Raitakari OT, Hutri N, Lehtimäki T, Aatola H. Association of childhood socioeconomic status with adulthood maximal exercise blood pressure: the Cardiovascular Risk in Young Finns Study. Blood Press 2024; 33:2323987. [PMID: 38465629 DOI: 10.1080/08037051.2024.2323987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 02/20/2024] [Indexed: 03/12/2024]
Abstract
PURPOSE Socioeconomic status has been related to resting blood pressure (BP) levels at different stages of life. However, the association of childhood socioeconomic status (SES) and adulthood exercise BP is largely unknown. Therefore, we studied the association of childhood SES with adulthood maximal exercise BP. MATERIALS AND METHODS This investigation consisted of 373 individuals (53% women) participating in the Cardiovascular Risk in Young Finns Study who had data concerning family SES in childhood (baseline in 1980, at age of 6-18 years) and exercise BP response data in adulthood (follow-up in adulthood in 27-29 years since baseline). A maximal cardiopulmonary exercise test with BP measurements was performed by participants, and peak exercise BP was measured. RESULTS In stepwise multivariable analysis including childhood risk factors and lifestyle factors (body mass index, systolic BP, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, insulin, fruit consumption, vegetable consumption, and physical activity), lower family SES in childhood was associated with higher maximal exercise BP in adulthood (β value ± SE, 1.63 ± 0.77, p = 0.035). The association remained significant after further adjustment with participants SES in adulthood (β value ± SE, 1.68 ± 0.65, p = 0.011) and after further adjustment with adulthood body-mass index, systolic BP, maximal exercise capacity, and peak heart rate in exercise (β value ± SE, 1.25 ± 0.56, p = 0.027). CONCLUSIONS These findings suggest that lower childhood family SES is associated with higher maximal exercise BP in adulthood.
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Affiliation(s)
- Erika Kähönen
- Department of Clinical Physiology and Nuclear Medicine, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
| | - Emilia Kähönen
- Department of Clinical Physiology and Nuclear Medicine, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
| | - Kristiina Pälve
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Heart Center, Turku University Hospital, Turku, Finland
| | | | - Mika Kähönen
- Department of Clinical Physiology and Nuclear Medicine, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
- Finnish Cardiovascular Research Center-Tampere, Tampere, Finland
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Nina Hutri
- Tampere Centre for Skills Training and Simulation, Tampere University, Tampere, Finland
| | - Terho Lehtimäki
- Finnish Cardiovascular Research Center-Tampere, Tampere, Finland
- Fimlab Laboratories, Tampere, Finland
- Department of Clinical Chemistry, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
| | - Heikki Aatola
- Department of Clinical Physiology and Nuclear Medicine, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
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Herrera D, Sanz M, Shapira L, Brotons C, Chapple I, Frese T, Graziani F, Hobbs FDR, Huck O, Hummers E, Jepsen S, Kravtchenko O, Madianos P, Molina A, Ungan M, Vilaseca J, Windak A, Vinker S. Periodontal diseases and cardiovascular diseases, diabetes, and respiratory diseases: Summary of the consensus report by the European Federation of Periodontology and WONCA Europe. Eur J Gen Pract 2024; 30:2320120. [PMID: 38511739 PMCID: PMC10962307 DOI: 10.1080/13814788.2024.2320120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 02/05/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Periodontitis is a chronic inflammatory non-communicable disease (NCD) characterised by the destruction of the tooth-supporting apparatus (periodontium), including alveolar bone, the presence of periodontal pockets, and bleeding on probing. OBJECTIVES To outline, for family doctors, the implications of the association between periodontal and systemic diseases; to explore the role of family doctors in managing periodontitis as an ubiquitous non-communicable disease (NCD). METHODS The consensus reports of previous focused collaborative workshops between WONCA Europe and the European Federation of Periodontology (using previously undertaken systematic reviews), and a specifically commissioned systematic review formed the technical papers to underpin discussions. Working groups prepared proposals independently, and the proposals were subsequently discussed and approved at plenary meetings. RESULTS Periodontitis is independently associated with cardiovascular diseases, diabetes, chronic obstructive pulmonary disease, obstructive sleep apnoea, and COVID-19 complications. Treatment of periodontitis has been associated with improvements in systemic health outcomes. The article also presents evidence gaps. Oral health care professionals (OHPs) and family doctors should collaborate in managing these conditions, including implementing strategies for early case detection of periodontitis in primary medical care centres and of systemic NCDs in oral/dental care settings. There is a need to raise awareness of periodontal diseases, their consequences, and the associated risk factors amongst family doctors. CONCLUSION Closer collaboration between OHPs and family doctors is important in the early case detection and management of NCDs like cardiovascular diseases, diabetes mellitus, and respiratory diseases. Strategies for early case detection/prevention of NCDs, including periodontitis, should be developed for family doctors, other health professionals (OHPs), and healthcare funders. Evidence-based information on the reported associations between periodontitis and other NCDs should be made available to family doctors, OHPs, healthcare funders, patients, and the general population.
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Affiliation(s)
- David Herrera
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Lior Shapira
- Department of Periodontology, Faculty of Dental Medicine, Hadassah and the Hebrew University Medical Center, Jerusalem, Israel
| | - Carlos Brotons
- Biomedical Research Institute Sant Pau (IIB Sant Pau), Sardenya Primary Health Care Center, Barcelona, Spain
| | - Iain Chapple
- Periodontal Research Group, and Birmingham NIHR Biomedical Research Centre in Inflammation, Institute of Clinical Sciences, College of Medical & Dental Sciences, The University of Birmingham, Birmingham, UK
- Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK
| | - Thomas Frese
- Institut für Allgemeinmedizin, Medizinische Fakultät der Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Germany
| | - Filippo Graziani
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, School of Dentistry, University of Pisa, Pisa, Italy
| | - F. D. Richard Hobbs
- Oxford Primary Care, Radcliffe Primary Care Building, ROQ, University of Oxford, Oxford, UK
| | - Olivier Huck
- Dental Faculty, University of Strasbourg, Strasbourg, France
| | - Eva Hummers
- Department of General Practice and Family Medicine, University Medical Center Göttingen, Göttingen, Germany
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Bonn, Germany
| | | | - Phoebus Madianos
- Department of Periodontology, Faculty of Dentistry, National & Kapodistrian University of Athens, Athens, Greece
| | - Ana Molina
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Mehmet Ungan
- Department of Family Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Josep Vilaseca
- Department of Medicine, University of Vic–Central Catalonia University, Vic, Spain
- Primary Health Care Service, Althaia Foundation–Healthcare and University Network, Manresa, Spain
| | - Adam Windak
- Department of Family Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Shlomo Vinker
- Department of Family Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Cho H, Kim YJ, Moon IJ, Lee WJ, Won CH, Lee MW, Chang SE, Jung JM. Risk of major adverse cardiovascular events and all-cause mortality among patients with psoriatic disease treated with tumor necrosis factor-α and interleukin-12/23 inhibitors: a nationwide population-based cohort study in Korea. J DERMATOL TREAT 2024; 35:2321194. [PMID: 38403279 DOI: 10.1080/09546634.2024.2321194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 02/13/2024] [Indexed: 02/27/2024]
Abstract
PURPOSE Few studies have investigated the impact of biologics on the risk of major adverse cardiovascular events (MACEs) among Korean patients with psoriatic diseases. We compared the risk of MACEs and all-cause mortality among patients with psoriatic disease treated with tumor necrosis factor (TNF)-α and interleukin (IL)-12/23 inhibitors in Korea. METHODS Patients with psoriatic disease prescribed with TNF-α and IL-12/23 inhibitors since 2016 were selected from the Korean National Health Insurance Service (NHIS) Database. Follow-up data for MACEs and all-cause mortality between 2016 and 2020 were collected. A total of 2886 individuals were included, including 1987 IL-12/23 inhibitor users and 899 TNF-α inhibitor users. RESULTS Compared with IL-12/23 inhibitor users, TNF-α inhibitor users had a higher prevalence of dyslipidemia and a significantly higher risk of all-cause mortality but not MACE. After controlling for age, female TNF-α inhibitor users had a significantly increased risk of all-cause mortality. Meanwhile, after controlling for sex, TNF-α inhibitor users aged 60 years or older demonstrated a significantly elevated risk of all-cause mortality. In conclusion, No statistically significant difference in MACE risk was observed between patients who used TNF-α and IL-12/23 inhibitors. Nevertheless, the use of IL-12/23 inhibitors, especially among older and female patients, resulted in a lower overall mortality.
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Affiliation(s)
- Hyesoo Cho
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ye-Jee Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ik Jun Moon
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Woo Jin Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chong Hyun Won
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Mi Woo Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung Eun Chang
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joon Min Jung
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Jutterström L, Stenlund AL, Otten J, Lilja M, Hellström Ängerud K. Awareness of cardiovascular risk among persons with type 2 diabetes: a qualitative study. Int J Qual Stud Health Well-being 2024; 19:2294512. [PMID: 38112175 DOI: 10.1080/17482631.2023.2294512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 12/10/2023] [Indexed: 12/21/2023] Open
Abstract
PURPOSE To describe the process of becoming aware of and acting on personal cardiovascular (CVD) risk in type 2 diabetes (T2D). METHOD A purposive sample of 14 persons living with T2D participated in semi-structured, open-ended, in-dept interviews. The interviews were analysed with grounded theory. RESULT The analysis identified the core category "Balancing emotions, integrating knowledge and understanding to achieve risk awareness and act on it." Five categories describe the movement from not being aware of the risk of cardiovascular disease (CVD) to becoming aware of this risk and taking action to reduce it. Persons with T2D need to transform their knowledge and experience of CVD risk and incorporate it in their individual situations. Emotional and existential experiences of CVD risk can lead to awareness about the severity of the condition and contribute to increased motivation for self-management. However, an overly high emotional response can be overwhelming and may result in insufficient self-management. CONCLUSION Persons with T2D seemed not to fully grasp their increased risk of CVD or recognize that self-management activities were aimed at reducing this risk. However, their awareness of CVD risk gradually increased as they came to understand the severity of T2D and became more emotionally and existentially engaged.
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Affiliation(s)
- Lena Jutterström
- Department of Nursing, Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden
| | | | - Julia Otten
- Department of Public Health and Clinical Medicine, Medicine, Umeå University, Umeå, Sweden
| | - Mikael Lilja
- Unit of Research, Education and Development Department of Public Health and Clinical Medicine - Östersund Hospital, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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6
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Lu C, Cheng S, Fan W, Zhang Z, Wang J. The relationship of platelet distribution width with all-cause and cardiovascular mortality in peritoneal dialysis patients. Ren Fail 2024; 46:2300730. [PMID: 38343320 PMCID: PMC10863511 DOI: 10.1080/0886022x.2023.2300730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 12/26/2023] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is a major complication in peritoneal dialysis (PD) patients. Previous studies have demonstrated that platelet distribution width (PDW) is associated with cardiovascular events in hemodialysis (HD) patients. In this study, we hypothesized that elevated PDW can predict all-cause and cardiovascular mortality in PD patients. METHODS We recruited PD patients for a single-center retrospective cohort study from 1 January 2007, to 30 June 2020. Receiver-operating characteristic (ROC) curves were made to determine the PDW cutoff value for predicting all-cause mortality. The propensity score matching (PSM) method was used to improve the equilibrium between groups. The relation of PDW with all-cause and cardiovascular mortality was analyzed by Cox proportional hazards models. Restricted cubic spline (RCS) models were used to determine whether there was a linear relationship between PDW and all-cause and cardiovascular mortality. RESULTS A total of 720 PD patients were screened, and 426 PD patients were enrolled after PSM. After adjusting for confounders, Cox proportional hazards models showed that the PDW value was positively correlated with the risk of all-cause and cardiovascular mortality (HR = 1.162, 95% CI 1.057-1.278, p = 0.002 and HR = 1.200, 95% CI 1.041-1.382, p = 0.012). The adjusted RCS analysis further showed that the relationship of PDW with all-cause and cardiovascular mortality was linear (p for nonlinearly = 0.143 and 0.062). CONCLUSION Elevated PDW is independently associated with all-cause and cardiovascular mortality in PD patients.
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Affiliation(s)
- Chunyu Lu
- Jinling Hospital Department of Nephrology, Nanjing Medical University, Nanjing, PR China
| | - Shuiqin Cheng
- National Clinical Research Center of Kidney Disease, Jinling Hospital, Nanjing University School of Medicine, Nanjing, PR China
| | - Wenjing Fan
- National Clinical Research Center of Kidney Disease, Jinling Hospital, Nanjing University School of Medicine, Nanjing, PR China
| | - Zhihong Zhang
- National Clinical Research Center of Kidney Disease, Jinling Hospital, Nanjing University School of Medicine, Nanjing, PR China
| | - Jinquan Wang
- Jinling Hospital Department of Nephrology, Nanjing Medical University, Nanjing, PR China
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Holm H, Kennbäck C, Laucyte-Cibulskiene A, Nilsson PM, Jujic A. The impact of prediabetes and diabetes on endothelial function in a large population-based cohort. Blood Press 2024; 33:2298309. [PMID: 38185988 DOI: 10.1080/08037051.2023.2298309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 12/17/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND Diabetes and prediabetes are well-recognized risk factors for cardiovascular disease (CVD) and are marked by vascular endothelial dysfunction (ED). However, there is a scarcity of thorough population-based studies examining ED in individuals with diabetes/prediabetes free from manifest CVD. Here, we examined the association between ED assessed by reactive hyperaemia index (RHI) in the finger and diabetes/prediabetes in a large middle-aged population cohort. METHODS Within the Malmö Offspring Study, following the exclusion of participants <30 years and participants with prevalent CVD, 1384 participants had complete data on all covariates. The RHI was calculated using pulse amplitude tonometry. ED was defined as RHI < 1.67. Multivariable logistic and linear regression models were conducted to investigate associations between ED and RHI with diabetes and prediabetes. RESULTS The study population had a mean age of 53.6 ± 7.6 years (53% women). In study participants with manifest diabetes (n = 121) and prediabetes (n = 514), ED was present in 42% and 25% respectively, compared to 23% in those with normal glucometabolic status. In multivariable logistic regression analyses, prevalent diabetes was significantly associated with ED (OR 1.95; 95%CI 1.57-3.39; p = 0.002), as well as with lower RHI (β-coeff. -0.087; p = 0.002). However, prediabetes showed no association with neither ED nor RHI. CONCLUSION In a population free from CVD, vascular endothelial dysfunction was primarily associated with manifest diabetes, but not with prediabetes, implying that finger ED may develop when diabetes is established, rather than being an early sign of glucose intolerance. Further research is needed to explore whether addressing glucose intolerance could potentially delay or prevent vascular ED onset.
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Affiliation(s)
- H Holm
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Cardiology, Skåne University Hospital, Malmö, Sweden
| | - C Kennbäck
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | | | - P M Nilsson
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - A Jujic
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Cardiology, Skåne University Hospital, Malmö, Sweden
- Lund University Diabetes Centre, Lund University, Malmö, Sweden
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Glądys K, Siudak Z, Trzeciak P, Siłka W, Skrzypek M, Chyrchel M, Gąsior M, Januszek R. Mortality of patients presented with acute ST-segment elevation myocardial infarction according to the status of standard modifiable cardiovascular risk factors. Am J Med Sci 2024; 367:328-336. [PMID: 38320673 DOI: 10.1016/j.amjms.2024.01.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 01/25/2024] [Accepted: 01/30/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND Standard modifiable cardiovascular risk factors (SMuRFs) remain well-established elements of assessing cardiovascular risk scores. However, there is growing evidence that patients presented without known SMuRFs at admission demonstrate worse post-myocardial outcomes. The aim of the study was to assess the influence of the SMuRF status on short- and long-term mortality rates in patients with first-time ST-segment elevation myocardial infarction (STEMI). METHODS This observational, cross-sectional study covered 182,726 patients admitted between 2003-2020 to the CathLabs, according to data from the Polish Registry of Acute Coronary Syndrome. Both baseline characteristics and mortality (in-hospital, 30-day, and 12-month) were examined and stratified by SMuRF status. The predictors of mortality were assessed at selected time points by multivariable analysis. RESULTS The majority of STEMI patients had at least one SMuRF (88.7%), however, mortality rates of SMuRF-less individuals were greater at selected time points of the follow-up (p < 0.001), and persisted at a higher level during each year of the follow-up period compared to the SMuRF group and general population. Furthermore, the SMuRFs status constituted an independent predictor of mortality at the 30-day (OR: 1.345; 95% CI: 1.142-1.585, p < 0.001) and 12-month (OR: 1.174; 95% CI: 1.054-1.308, p < 0.001) follow-ups. CONCLUSIONS SMuRF-less individuals presented with STEMI are at an increased risk of all-cause mortality compared to those with at least one SMuRF. Consequently, further investigations regarding the recognition and treatment of risk factors, irrespective of SMuRF status, are indicated.
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Affiliation(s)
- Kinga Glądys
- Jagiellonian University Medical College, Kraków, Poland
| | - Zbigniew Siudak
- Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Przemysław Trzeciak
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | | | - Michał Skrzypek
- Department of Biostatistics, School of Public Health in Bytom, Medical University of Silesia in Katowice, Poland
| | - Michał Chyrchel
- 2nd Department of Cardiology and Cardiovascular Interventions, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Mariusz Gąsior
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Rafał Januszek
- Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Cracow University, Kraków, Poland.
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Bonnet F, Balkau B, Lambert O, Diawara Y, Combe C, Frimat L, Laville M, Liabeuf S, Massy ZA, Metzger M, Stengel B, Alencar de Pinho N, Fouque D. The number of nephroprotection targets attained is associated with cardiorenal outcomes and mortality in patients with diabetic kidney disease. The CKD-REIN cohort study. Diabetes Obes Metab 2024; 26:1908-1918. [PMID: 38418407 DOI: 10.1111/dom.15507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 02/01/2024] [Accepted: 02/02/2024] [Indexed: 03/01/2024]
Abstract
AIM The risk of cardiorenal events remains high among patients with diabetes and chronic kidney disease (CKD), despite the prescription of recommended treatments. We aimed to determine whether the attainment of a combination of nephroprotection targets at baseline (glycated haemoglobin <7.0%, urinary albumin-creatinine ratio <300 mg/g, blood pressure <130/80 mmHg, renin-angiotensin system inhibition) was associated with better cardiorenal outcomes and lower mortality. MATERIALS AND METHODS From the prospective French CKD-REIN cohort, we studied 1260 patients with diabetes and CKD stages 3-4 (estimated glomerular filtration rate: 15-60 ml/min/1.73 m2); 69% were men, and at inclusion, mean ± SD age: 70 ± 10 years; estimated glomerular filtration rate: 33 ± 11 ml/min/1.73 m2. The median follow-up was 4.9 years. RESULTS In adjusted Cox regression models, the attainment of two nephroprotection targets was consistently associated with a lower risk of cardiorenal events [hazard ratio 0.70 (95% confidence interval 0.57-0.85)], incident kidney failure with replacement therapy [0.58 (0.43-0.77)], four major adverse cardiovascular events (cardiovascular death, myocardial infarction, stroke, hospitalization for heart failure) [0.75 (0.57-0.99)] and all-cause mortality [0.59 (0.42-0.82)] when compared with the attainment of zero or one target. For patients with a urinary albumin-creatinine ratio ≥300 mg/g, those who attained at least two targets had lower hazard ratios for cardiorenal events [0.61 (0.39-0.96)], four major adverse cardiovascular events [0.53 (0.28-0.98)] and all-cause mortality [0.35 (0.17-0.70)] compared with those who failed to attain any targets. CONCLUSIONS These findings suggest that the attainment of a combination of nephroprotection targets is associated with better cardiorenal outcomes and a lower mortality rate in people with diabetic kidney disease.
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Affiliation(s)
- Fabrice Bonnet
- Department of Diabetology, CHU de Rennes, Université de Rennes 1, Rennes, France
- Centre for Research in Epidemiology and Population Health (CESP), Paris-Saclay University, Inserm U1018, Versailles Saint-Quentin University, Clinical Epidemiology Team, Villejuif, France
| | - Beverley Balkau
- Centre for Research in Epidemiology and Population Health (CESP), Paris-Saclay University, Inserm U1018, Versailles Saint-Quentin University, Clinical Epidemiology Team, Villejuif, France
| | - Oriane Lambert
- Centre for Research in Epidemiology and Population Health (CESP), Paris-Saclay University, Inserm U1018, Versailles Saint-Quentin University, Clinical Epidemiology Team, Villejuif, France
| | - Yakhara Diawara
- Centre for Research in Epidemiology and Population Health (CESP), Paris-Saclay University, Inserm U1018, Versailles Saint-Quentin University, Clinical Epidemiology Team, Villejuif, France
| | - Christian Combe
- Department of Nephrology, transplantation, dialysis, CHU de Bordeaux, Université de Bordeaux, Bordeaux, France
- Inserm U1026, Biotis, Bordeaux University, France
| | - Luc Frimat
- Department of Nephrology, CHRU de Nancy, Vandoeuvre-lès-Nancy, France
- Inserm CIC 1433, Clinical Epidemiology Unit, Vandoeuvre-lès-Nancy, France
| | | | - Sophie Liabeuf
- Department of Pharmacology, CHU Amiens-Picardie, MP3CV Unit, Université Picardie Jules Verne, Amiens, France
| | - Ziad A Massy
- Centre for Research in Epidemiology and Population Health (CESP), Paris-Saclay University, Inserm U1018, Versailles Saint-Quentin University, Clinical Epidemiology Team, Villejuif, France
- Department of Nephrology, AP-HP, CHU Ambroise Paré, Boulogne-Billancourt, France
| | - Marie Metzger
- Centre for Research in Epidemiology and Population Health (CESP), Paris-Saclay University, Inserm U1018, Versailles Saint-Quentin University, Clinical Epidemiology Team, Villejuif, France
| | - Bénédicte Stengel
- Centre for Research in Epidemiology and Population Health (CESP), Paris-Saclay University, Inserm U1018, Versailles Saint-Quentin University, Clinical Epidemiology Team, Villejuif, France
| | - Natalia Alencar de Pinho
- Centre for Research in Epidemiology and Population Health (CESP), Paris-Saclay University, Inserm U1018, Versailles Saint-Quentin University, Clinical Epidemiology Team, Villejuif, France
| | - Denis Fouque
- Université de Lyon, Lyon, France
- Inserm U1060, CARMEN, Lyon, France
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10
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Krecak I, Verstovsek S, Lucijanic M. Optimization of cardiovascular risk factor management in patients with BCR::ABL1 negative chronic myeloproliferative neoplasms, current knowledge, and perspectives. Ann Hematol 2024; 103:1513-1523. [PMID: 37665349 DOI: 10.1007/s00277-023-05426-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 08/24/2023] [Indexed: 09/05/2023]
Abstract
The exact prognostic role of cardiovascular (CV) risk factors in patients with BCR::ABL1 negative chronic myeloproliferative neoplasms (MPNs) remains unknown as it is often masked by other MPN-related features that bear strong prognostic impact on thrombotic risk. Therefore, current MPN treatment is not primarily guided by presence of CV risk factors. Treatment of CV risk factors in MPN patients usually mirrors that from the general population, despite the fact that CV risk factors in MPNs have their own specificities. Moreover, the optimal target levels for different metabolic deflections in MPNs (i.e., low-density lipoprotein, serum uric acid, or glycated hemoglobin levels) have not been defined. In the current review, we separately discuss the most important aspects of every individual CV risk factor (arterial hypertension, hyperlipidemia, chronic kidney disease, smoking, diabetes mellitus, hyperuricemia, and obesity and cachexia) in MPNs, summarize recent advances in the field, and propose future directions and research areas which may be needed to appropriately manage CV risk factors in MPNs.
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Affiliation(s)
- Ivan Krecak
- Department of Internal Medicine, General Hospital of Sibenik-Knin County, Stjepana Radića 83, 22000, Sibenik, Croatia.
- Faculty of Medicine, University of Rijeka, Rijeka, Croatia.
- University of Applied Sciences, Sibenik, Croatia.
| | | | - Marko Lucijanic
- Department of Hematology, University Hospital Dubrava, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
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11
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Carrasquilla GD, Ängquist L, Sørensen TIA, Kilpeläinen TO, Loos RJF. Child-to-adult body size change and risk of type 2 diabetes and cardiovascular disease. Diabetologia 2024; 67:864-873. [PMID: 38085289 PMCID: PMC10954919 DOI: 10.1007/s00125-023-06058-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 10/20/2023] [Indexed: 03/21/2024]
Abstract
AIMS/HYPOTHESIS Childhood overweight increases the risk of type 2 diabetes and cardiovascular disease in adulthood. However, the impact of childhood leanness on adult obesity and disease risk has been overlooked. We examined the independent and combined influences of child and adult body size on the risk of type 2 diabetes and cardiovascular disease. METHODS Data from the UK Biobank on 364,695 individuals of European ancestry and free of type 2 diabetes and cardiovascular disease were divided into nine categories based on their self-reported body size at age 10 and measured BMI in adulthood. After a median follow-up of 12.8 years, 33,460 individuals had developed type 2 diabetes and/or cardiovascular disease. We used Cox regression models to assess the associations of body size categories with disease incidence. RESULTS Individuals with low body size in childhood and high body size in adulthood had the highest risk of type 2 diabetes (HR 4.73; 95% CI 4.50, 4.99), compared to those with average body size in both childhood and adulthood. This was significantly higher than the risk in those with high body size in both childhood and adulthood (HR 4.05; 95% CI 3.84, 4.26). By contrast, cardiovascular disease risk was determined by adult body size, irrespective of childhood body size. CONCLUSIONS/INTERPRETATION Low body size in childhood exacerbates the risk of type 2 diabetes associated with adult obesity but not the risk of cardiovascular disease. Thus, promoting healthy weight management from childhood to adulthood, among lean children, is crucial.
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Affiliation(s)
- Germán D Carrasquilla
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Lars Ängquist
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Thorkild I A Sørensen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Public Health, Section of Epidemiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Tuomas O Kilpeläinen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Genomic Mechanisms of Disease, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Ruth J F Loos
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Genomic Mechanisms of Disease, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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12
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Park E, Bathon J. Cardiovascular complications of rheumatoid arthritis. Curr Opin Rheumatol 2024; 36:209-216. [PMID: 38334476 DOI: 10.1097/bor.0000000000001004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
PURPOSE OF REVIEW Rheumatoid arthritis (RA) patients remain at higher cardiovascular (CV) risk compared to non-RA patients, driven by accelerated atherosclerosis, leading to plaque rupture and acute CV events (CVE), including heart failure (HF). It has been hypothesized that chronic inflammation is the main driving force behind such outcomes. We summarize the current evidence supporting this hypothesis, focusing on arterial disease and myocardial disease. RECENT FINDINGS RA patients demonstrate higher prevalence of subclinical atherosclerosis (high risk plaque and arterial inflammation) compared to non-RA patients, with RA disease activity correlating independently with CVE and death. Nonischemic HF with preserved ejection fraction (HFpEF) is more common in RA compared to non-RA, with subclinical myocardial structural and functional alterations also more prevalent in RA. HFpEF and myocardial remodeling and dysfunction bear a strong and independent association with inflammatory correlates. SUMMARY All of this suggests that inflammation contributes to enhanced risk of CVE in RA. A more accurate and specific CV risk stratification tool for RA, incorporating biomarkers or imaging, is needed. Likewise, more prospective studies outlining the trajectory from preclinical to clinical HF, incorporating biomarkers and imaging, are also needed.
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Affiliation(s)
- Elizabeth Park
- Columbia University Irving Medical Center. Vagelos College of Physicians & Surgeons, New York, New York, USA
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13
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Corrao S, Calvo L, Amico S, Argano C. The critical role of abdominal obesity as a crucial cardiovascular risk factor. Diabetes Obes Metab 2024; 26:1967-1970. [PMID: 38268344 DOI: 10.1111/dom.15467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 01/26/2024]
Affiliation(s)
- Salvatore Corrao
- Department of Clinical Medicine, Internal Medicine Unit, National Relevance and High Specialization Hospital Trust ARNAS Civico, Palermo, Italy
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties, [PROMISE], University of Palermo, Palermo, Italy
| | - Luigi Calvo
- Department of Clinical Medicine, Internal Medicine Unit, National Relevance and High Specialization Hospital Trust ARNAS Civico, Palermo, Italy
| | - Salvatore Amico
- Medicina e Chirurgia d'Accettazione e d'Urgenza, Azienda Sanitaria Provinciale di Caltanisetta, Caltanissetta, Italy
| | - Christiano Argano
- Department of Clinical Medicine, Internal Medicine Unit, National Relevance and High Specialization Hospital Trust ARNAS Civico, Palermo, Italy
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Zhang Y, Jiong OX, Tang S, Tang YC, Wong CT, Ng CS, Quan J. Comparison of prediction models for cardiovascular and mortality risk in people with type 2 diabetes: An external validation in 23 685 adults included in the UK Biobank. Diabetes Obes Metab 2024; 26:1697-1705. [PMID: 38297974 DOI: 10.1111/dom.15474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 01/11/2024] [Accepted: 01/15/2024] [Indexed: 02/02/2024]
Abstract
AIMS To validate cardiovascular risk prediction models for individuals with diabetes using the UK Biobank in order to assess their applicability. METHODS We externally validated 19 cardiovascular risk scores from seven risk prediction models (Chang et al., Framingham, University of Hong Kong-Singapore [HKU-SG], Li et al, RECODe [risk equations for complications of type 2 diabetes], SCORE [Systematic Coronary Risk Evaluation] and the UK Prospective Diabetes Study Outcomes Model 2 [UKPDS OM2]), identified from systematic reviews, using UK Biobank data from 2006 to 2021 (n = 23 685; participant age 40-71 years, 63.5% male). We evaluated performance by assessing the discrimination and calibration of the models for the endpoints of mortality, cardiovascular mortality, congestive heart failure, myocardial infarction, stroke, and ischaemic heart disease. RESULTS Over a total of 269 430 person-years of follow-up (median 11.89 years), the models showed low-to-moderate discrimination performance on external validation (concordance indices [c-indices] 0.50-0.71). Most models had low calibration with overprediction of the observed risk. RECODe outperformed other models across four comparable endpoints for discrimination: all-cause mortality (c-index 0.67, 95% confidence interval [CI] 0.65-0.69), congestive heart failure (c-index 0.71, 95% CI 0.69-0.72), myocardial infarction (c-index 0.67, 95% CI 0.65-0.68); and stroke (c-index 0.65, 95% CI 0.62-0.68), and for calibration (except for all-cause mortality). The UKPDS OM2 had comparable performance to RECODe for all-cause mortality (c-index 0.67, 95% CI 0.66-0.69) and cardiovascular mortality (c-index 0.71, 95% CI 0.70-0.73), but worse performance for other outcomes. The models performed better for younger participants and somewhat better for non-White ethnicities. Models developed from non-Western datasets showed worse performance in our UK-based validation set. CONCLUSIONS The RECODe model led to better risk estimations in this predominantly White European population. Further validation is needed in non-Western populations to assess generalizability to other populations.
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Affiliation(s)
- Yikun Zhang
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Ong Xin Jiong
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Shiqi Tang
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Yui Chit Tang
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Cheuk Tung Wong
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Carmen S Ng
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Jianchao Quan
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- HKU Business School, The University of Hong Kong, Hong Kong SAR, China
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15
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Souama C, Milaneschi Y, Lamers F, Vinkers CH, Giltay EJ, Liemburg EJ, Penninx BWJH. Metabolic syndrome after childhood trauma: a 9-year longitudinal analysis. Psychol Med 2024; 54:1373-1381. [PMID: 37981868 DOI: 10.1017/s0033291723003264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
BACKGROUND Childhood trauma (CT) has been cross-sectionally associated with metabolic syndrome (MetS), a group of biological risk factors for cardiometabolic disease. Longitudinal studies, while rare, would clarify the development of cardiometabolic dysregulations over time. Therefore, we longitudinally investigated the association of CT with the 9-year course of MetS components. METHODS Participants (N = 2958) from the Netherlands Study of Depression and Anxiety were assessed four times across 9 years. The CT interview retrospectively assessed childhood emotional neglect and physical, emotional, and sexual abuse. Metabolic outcomes encompassed continuous MetS components (waist circumference, triglycerides, high-density lipoprotein [HDL] cholesterol, blood pressure [BP], and glucose) and count of clinically elevated MetS components. Mixed-effects models estimated sociodemographic- and lifestyle-adjusted longitudinal associations of CT with metabolic outcomes over time. Time interactions evaluated change in these associations. RESULTS CT was reported by 49% of participants. CT was consistently associated with increased waist (b = 0.32, s.e. = 0.10, p = 0.001), glucose (b = 0.02, s.e. = 0.01, p < 0.001), and count of MetS components (b = 0.04, s.e. = 0.01, p < 0.001); and decreased HDL cholesterol (b = -0.01, s.e.<0.01, p = .020) and systolic BP (b = -0.33, s.e. = 0.13, p = 0.010). These associations were mainly driven by severe CT and unaffected by lifestyle. Only systolic BP showed a CT-by-time interaction, where CT was associated with lower systolic BP initially and with higher systolic BP at the last follow-up. CONCLUSIONS Over time, adults with CT have overall persistent poorer metabolic outcomes than their non-maltreated peers. Individuals with CT have an increased risk for cardiometabolic disease and may benefit from monitoring and early interventions targeting metabolism.
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Affiliation(s)
- Camille Souama
- Department of Psychiatry, Amsterdam UMC, location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, The Netherlands
| | - Yuri Milaneschi
- Department of Psychiatry, Amsterdam UMC, location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Stress, and Sleep Program, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Complex Trait Genetics, Amsterdam, The Netherlands
| | - Femke Lamers
- Department of Psychiatry, Amsterdam UMC, location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, The Netherlands
| | - Christiaan H Vinkers
- Department of Psychiatry, Amsterdam UMC, location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Stress, and Sleep Program, Amsterdam, The Netherlands
- Department of Anatomy & Neurosciences, Amsterdam University Medical Center location Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
- GGZ inGeest Mental Health Care, 1081 HJ Amsterdam, The Netherlands
| | - Erik J Giltay
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Edith J Liemburg
- Rob Giel Research Center, Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam UMC, location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Stress, and Sleep Program, Amsterdam, The Netherlands
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Riaz A, Kalsoom S, Hamza M, Asif S. Letter to editor: The relationship between vitamin D status and cardiovascular diseases. Curr Probl Cardiol 2024; 49:102511. [PMID: 38431147 DOI: 10.1016/j.cpcardiol.2024.102511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 02/28/2024] [Indexed: 03/05/2024]
Affiliation(s)
- Asma Riaz
- Department of Medicine, Fazaia Medical College Islamabad, Fazaia Medical College Islamabad, Pakistan.
| | - Sidra Kalsoom
- Department of Medicine, Fazaia Medical College Islamabad, Fazaia Medical College Islamabad, Pakistan
| | - Muhammad Hamza
- Department of Medicine, Fazaia Medical College Islamabad, Fazaia Medical College Islamabad, Pakistan
| | - Sara Asif
- Department of Medicine, Fazaia Medical College Islamabad, Fazaia Medical College Islamabad, Pakistan
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17
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Guo Q, Wang Y, Liu Y, Wang Y, Deng L, Liao L, Lin X, Wu M, Sun M, Liao Y. Association between the cardiometabolic index and chronic kidney disease: a cross-sectional study. Int Urol Nephrol 2024; 56:1733-1741. [PMID: 38063958 PMCID: PMC11001751 DOI: 10.1007/s11255-023-03888-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/12/2023] [Indexed: 03/27/2024]
Abstract
BACKGROUND Central obesity is a risk factor for chronic kidney disease (CKD). However, the exact correlation between the cardiometabolic index (CMI), an indicator of central obesity, and CKD remains unclear. Here, we aimed to investigate the correlation between the CMI and CKD in the general American population. METHODS This cross-sectional study involved 64,313 members of the general population (≥ 20 years of age) with data in the National Health and Nutrition Examination Survey (NHANES) 1999-2020. The individuals were grouped into three categories by CMI tertile: T1 group (n = 7,029), T2 group (n = 7,356), and T3 group (n = 7,380). Logistic regression analysis was performed, with NHANES recommended weights, to assess the association between the CMI and CKD. RESULTS A total of 21,765 participants were included; the overall prevalence of CKD was 12.2%. From the low to the high CMI tertile, the prevalence of CKD increased from 8.9% to 16.0% (P < 0.001). After full adjustment for confounders, the higher tertile of CMI (OR: 1.08, 95% CI: 1.03 - 1.13, P = 0.002) had the higher risk of CKD. Compared with the T1 group, the groups with higher CMI levels had a higher CKD risk (T2: OR: 1.01, 95%CI: 0.87-1.18, P = 0.812; T3: OR: 1.22, 95%CI: 1.05-1.43, P = 0.013). CONCLUSIONS Higher CMI was independently associated with higher CKD risk in the general population.
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Affiliation(s)
- Qian Guo
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China
| | - Yani Wang
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China
| | - Yuchen Liu
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China
| | - Yun Wang
- Department of Electrocardiography, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China
| | - Lin Deng
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China
| | - Lihua Liao
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China
| | - Xueqin Lin
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China
| | - Mingxin Wu
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China
| | - Meirui Sun
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China
| | - Ying Liao
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China.
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Sebastian SA. Cardiovascular disease risk communication: Strategies, impact, and future directions. Curr Probl Cardiol 2024; 49:102490. [PMID: 38417473 DOI: 10.1016/j.cpcardiol.2024.102490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 02/24/2024] [Indexed: 03/01/2024]
Abstract
Cardiovascular disease (CVD) prevails as the leading cause of global mortality, claiming the lives of an estimated 17.9 million individuals in 2019, representing a substantial portion of worldwide mortality. Research indicates that individuals with a deeper understanding of their cardiovascular health are more inclined to adhere to preventive measures, potentially leading to improved outcomes. Moreover, inadequate communication may undermine confidence in healthcare professionals, fostering anxiety and other adverse consequences. CVD risk communication serves as a powerful tool in enhancing comprehension and supporting informed decisions regarding the clinical management of CVD. This review examines the impact of CVD risk communication on cardiovascular outcomes, exploring diverse strategies for conveying information about cardiovascular risks and preventive measures. The effectiveness of these strategies in influencing patient behavior and health outcomes is thoroughly assessed. Furthermore, gaps in current approaches are discussed, and future directions are proposed for enhancing CVD risk communication and improving patient education, engagement, and overall cardiovascular health.
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Affiliation(s)
- Sneha Annie Sebastian
- Department of Internal Medicine, Azeezia Medical College, Kollam, Kerala, India; Research Nexus, Philadelphia, United States.
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Naiyarakseree N, Phannajit J, Naiyarakseree W, Thongsricome T, Mahatanan N, Asavapujanamanee P, Lekhyananda S, Vanichakarn S, Avihingsanon Y, Praditpornsilpa K, Eiam-Ong S, Susantitaphong P. Prevalence of arterial stiffness and associated factors in Thai hemodialysis patients: A multicenter cross-sectional study. Clin Nephrol 2024; 101:222-231. [PMID: 38358375 DOI: 10.5414/cn111187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Hemodialysis (HD) patients have higher risks of cardiovascular morbidity and mortality compared to the general population. Cardio-femoral pulse wave velocity (cfPWV) is associated with cardiovascular morbidity and mortality in HD patients. This study aimed to evaluate the prevalence and associated factors of arterial stiffness in Thai HD patients. MATERIALS AND METHODS This cross-sectional multicenter study was conducted at 4 HD centers in Bangkok, Thailand. cfPWV and peripheral blood pressure were assessed using SphygmoCor XCEL Model EM4C (AtCor medical Inc., Sydney, Australia). Significant arterial stiffness was defined by cfPWV > 10 m/s. Univariate and multivariable regression models were used to identify factors associated with arterial stiffness. RESULTS 144 HD patients were assessed for arterial stiffness by cfPWV measurement. The mean age of the patients was 57.8 ± 12.8 years, with 50% male and a mean dialysis vintage of 7.6 years. The mean cfPWV was 11.7 ± 3.0 m/s. The prevalence of increased arterial stiffness was 73.6%. Multivariable analysis showed that older age, hypertension, lower HD adequacy, and higher fasting plasma glucose were independently associated with arterial stiffness. CONCLUSION There was a high prevalence of arterial stiffness among HD patients. Some modifiable factors found to be independently associated, including dialysis adequacy and glycemic control, should be further investigated to identify approaches to retard vascular stiffness.
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Gilbert MP, Skelly J, Hernandez AF, Green JB, Krychtiuk KA, Granger CB, Leiter LA, McMurray JJV, Del Prato S, Pratley RE. Effect of albiglutide on cardiovascular outcomes in older adults: A post hoc analysis of a randomized controlled trial. Diabetes Obes Metab 2024; 26:1714-1722. [PMID: 38317618 DOI: 10.1111/dom.15479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 01/12/2024] [Accepted: 01/18/2024] [Indexed: 02/07/2024]
Abstract
AIM To analyse the effects of albiglutide, a glucagon-like peptide 1 receptor agonist, on cardiovascular outcomes in older adults aged ≥65 years with type 2 diabetes and cardiovascular disease who participated in the Harmony Outcomes trial (NCT02465515). MATERIALS AND METHODS We conducted a post hoc analysis of the primary endpoint of the Harmony Outcomes trial-time to first occurrence of a major adverse cardiovascular event-in subgroups of participants aged <65 and ≥65 years and <75 and ≥75 years at baseline. Hazard ratios and 95% confidence intervals (CIs) were generated using Cox proportional hazards regression. RESULTS The analysis population included 9462 Harmony Outcomes participants, including 4748 patients ≥65 and 1140 patients ≥75 years at baseline. Hazard ratios for the prevention of major adverse cardiovascular events were 0.66 (95% CI, 0.53-0.82) in persons <65 and 0.86 (95% CI, 0.71-1.04) in those ≥65 years (age interaction p = .07), and 0.78 (95% CI, 0.67-0.91) in <75 and 0.70 (95% CI, 0.48-1.01) in ≥75 year age groups (interaction p = .6). When analysed as a continuous variable, age did not modify the effect of albiglutide on the primary endpoint. CONCLUSIONS This post hoc analysis adds to the body of literature showing that glucagon-like peptide 1 receptor agonists added to standard type 2 diabetes therapy safely reduce the incidence of cardiovascular events in older adults with established cardiovascular disease. In this analysis, the risk-benefit profile was similar between younger and older age groups treated with albiglutide.
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Affiliation(s)
- Matthew P Gilbert
- Department of Medicine, Division of Endocrinology, Diabetes, and Osteoporosis, Larner College of Medicine at The University of Vermont, Burlington, Vermont, USA
| | - Joan Skelly
- Department of Biomedical Statistics, The University of Vermont, Burlington, Vermont, USA
| | - Adrian F Hernandez
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA
| | - Jennifer B Green
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA
| | - Konstantin A Krychtiuk
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA
| | - Christopher B Granger
- Department of Medicine, Division of Endocrinology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Lawrence A Leiter
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - John J V McMurray
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, Scotland
| | - Stefano Del Prato
- Interdisciplinary Research Centre "Health Science," Sant'Anna School of Advanced Studies, Pisa, Italy
| | - Richard E Pratley
- Advent Health Translational Research Institute, Orlando, Florida, USA
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21
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Chang WL, Chen YF, Lee YH, Shiu MN, Chang PY, Guo CY, Huang CJ, Chiang CE, Chen CH, Chuang SY, Cheng HM. Cardiovascular Risk in Patients With Treated Isolated Diastolic Hypertension and Isolated Low Diastolic Blood Pressure. J Am Heart Assoc 2024; 13:e032771. [PMID: 38606761 DOI: 10.1161/jaha.123.032771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 03/08/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND The prognosis of high or markedly low diastolic blood pressure (DBP) with normalized on-treatment systolic blood pressure on major adverse cardiovascular events (MACEs) is uncertain. This study examined whether treated isolated diastolic hypertension (IDH) and treated isolated low DBP (ILDBP) were associated with MACEs in patients with hypertension. METHODS AND RESULTS A total of 7582 patients with on-treatment systolic blood pressure <130 mm Hg from SPRINT (Systolic Blood Pressure Intervention Trial) were categorized on the basis of average DBP: <60 mm Hg (n=1031; treated ILDBP), 60 to 79 mm Hg (n=5432), ≥80 mm Hg (n=1119; treated IDH). MACE risk was estimated using Cox proportional-hazards models. Among the SPRINT participants, median age was 67.0 years and 64.9% were men. Over a median follow-up of 3.4 years, 512 patients developed a MACE. The incidence of MACEs was 3.9 cases per 100 person-years for treated ILDBP, 1.9 cases for DBP 60 to 79 mm Hg, and 1.8 cases for treated IDH. Comparing with DBP 60 to 79 mm Hg, treated ILDBP was associated with an 1.32-fold MACE risk (hazard ratio [HR], 1.32, 95% CI, 1.05-1.66), whereas treated IDH was not (HR, 1.18 [95% CI, 0.87-1.59]). There was no effect modification by age, sex, atherosclerotic cardiovascular disease risk, or cardiovascular disease history (all P values for interaction >0.05). CONCLUSIONS In this secondary analysis of SPRINT, among treated patients with normalized systolic blood pressure, excessively low DBP was associated with an increased MACE risk, while treated IDH was not. Further research is required for treated ILDBP management.
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Affiliation(s)
- Wei-Lun Chang
- Division of Faculty Development Taipei Veterans General Hospital Taipei Taiwan
| | - Ying-Fan Chen
- Department of Internal Medicine Taipei Veterans General Hospital Taipei Taiwan
| | - Yu-Hsuan Lee
- Division of Faculty Development Taipei Veterans General Hospital Taipei Taiwan
| | - Ming-Neng Shiu
- Department of Pharmacy, College of Pharmaceutical Sciences National Yang Ming Chiao Tung University Taipei Taiwan
| | - Po-Yin Chang
- Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, US Food and Drug Administration Silver Spring MD USA
| | - Chao-Yu Guo
- Division of Biostatistics and Data science Institute of Public Health, College of Medicine, National Yang Ming Chiao Tung University Taipei Taiwan
| | - Chi-Jung Huang
- Center for Evidence-based Medicine Taipei Veterans General Hospital Taipei Taiwan
| | - Chern-En Chiang
- School of Medicine, College of Medicine National Yang Ming Chiao Tung University Taipei Taiwan
- Division of Cardiology, Department of Medicine Taipei Veterans General Hospital Taipei Taiwan
| | - Chen-Huan Chen
- School of Medicine, College of Medicine National Yang Ming Chiao Tung University Taipei Taiwan
- Division of Cardiology, Department of Medicine Taipei Veterans General Hospital Taipei Taiwan
- ReShining Clinic Taipei Taiwan
| | - Shao-Yuan Chuang
- Institute of Population Health Science, National Health Research Institutes Miaoli County Taiwan
| | - Hao-Min Cheng
- Division of Faculty Development Taipei Veterans General Hospital Taipei Taiwan
- Center for Evidence-based Medicine Taipei Veterans General Hospital Taipei Taiwan
- Ph.D. Program of Interdisciplinary Medicine (PIM) National Yang Ming Chiao Tung University College of Medicine Taipei Taiwan
- Institute of Public Health National Yang Ming Chiao Tung University College of Medicine Taipei Taiwan
- Institute of Health and Welfare Policy National Yang Ming Chiao Tung University College of Medicine Taipei Taiwan
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Graul EL, Nordon C, Rhodes K, Marshall J, Menon S, Kallis C, Ioannides AE, Whittaker HR, Peters NS, Quint JK. Temporal Risk of Nonfatal Cardiovascular Events After Chronic Obstructive Pulmonary Disease Exacerbation: A Population-based Study. Am J Respir Crit Care Med 2024; 209:960-972. [PMID: 38127850 DOI: 10.1164/rccm.202307-1122oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 12/20/2023] [Indexed: 12/23/2023] Open
Abstract
Rationale: Cardiovascular events after chronic obstructive pulmonary disease (COPD) exacerbations are recognized. Studies to date have been post hoc analyses of trials, did not differentiate exacerbation severity, included death in the cardiovascular outcome, or had insufficient power to explore individual outcomes temporally.Objectives: We explore temporal relationships between moderate and severe exacerbations and incident, nonfatal hospitalized cardiovascular events in a primary care-derived COPD cohort.Methods: We included people with COPD in England from 2014 to 2020, from the Clinical Practice Research Datalink Aurum primary care database. The index date was the date of first COPD exacerbation or, for those without exacerbations, date upon eligibility. We determined composite and individual cardiovascular events (acute coronary syndrome, arrhythmia, heart failure, ischemic stroke, and pulmonary hypertension) from linked hospital data. Adjusted Cox regression models were used to estimate average and time-stratified adjusted hazard ratios (aHRs).Measurements and Main Results: Among 213,466 patients, 146,448 (68.6%) had any exacerbation; 119,124 (55.8%) had moderate exacerbations, and 27,324 (12.8%) had severe exacerbations. A total of 40,773 cardiovascular events were recorded. There was an immediate period of cardiovascular relative rate after any exacerbation (1-14 d; aHR, 3.19 [95% confidence interval (CI), 2.71-3.76]), followed by progressively declining yet maintained effects, elevated after one year (aHR, 1.84 [95% CI, 1.78-1.91]). Hazard ratios were highest 1-14 days after severe exacerbations (aHR, 14.5 [95% CI, 12.2-17.3]) but highest 14-30 days after moderate exacerbations (aHR, 1.94 [95% CI, 1.63-2.31]). Cardiovascular outcomes with the greatest two-week effects after a severe exacerbation were arrhythmia (aHR, 12.7 [95% CI, 10.3-15.7]) and heart failure (aHR, 8.31 [95% CI, 6.79-10.2]).Conclusions: Cardiovascular events after moderate COPD exacerbations occur slightly later than after severe exacerbations; heightened relative rates remain beyond one year irrespective of severity. The period immediately after an exacerbation presents a critical opportunity for clinical intervention and treatment optimization to prevent future cardiovascular events.
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Affiliation(s)
| | | | | | | | - Shruti Menon
- Medical and Scientific Affairs, AstraZeneca, London, United Kingdom
| | - Constantinos Kallis
- School of Public Health and
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Anne E Ioannides
- School of Public Health and
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Hannah R Whittaker
- School of Public Health and
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Nicholas S Peters
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Jennifer K Quint
- School of Public Health and
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
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23
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Li L, Dai F. Comparison of the associations between Life's Essential 8 and Life's Simple 7 with depression, as well as the mediating role of oxidative stress factors and inflammation: NHANES 2005-2018. J Affect Disord 2024; 351:31-39. [PMID: 38280569 DOI: 10.1016/j.jad.2024.01.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 01/17/2024] [Accepted: 01/21/2024] [Indexed: 01/29/2024]
Abstract
BACKGROUND Cardiovascular health (CVH) is closely associated with depression. However, Life's Essential 8 (LE8), a novel CVH measure, has not yet been clearly linked to depression. This study aims to explore the association between LE8 and depression, compare its advantages over Life's Simple 7 (LS7), and investigate the mediating effects of oxidative stress and inflammation. METHODS This study investigated cross-sectional data of adults aged 20 and above from National Health and Nutrition Examination Survey (NHANES) 2005 to 2018. The LE8 score (ranging from 0 to 100) was derived from the American Heart Association's definition, based on the unweighted average of 8 metrics, classified as low cardiovascular health (CVH) (0-49), moderate CVH (50-79), and high CVH (80-100). Similar to LE8, LS7 scores were categorized into inadequate (0-7), average (8-10), or optimal (11-14) after calculating the unweighted mean of each component. Depression was diagnosed using the Patient Health Questionnaire (PHQ-9), with a score of ≥10 defining depression. Adjusted for sociodemographic factors and other risk factors for depression, weighted logistic regression and restricted cubic spline analysis were used to explore the correlation. Receiver operating characteristic (ROC) curves were used to study the associations between CVH scores and depression. Subsequently, subgroup analysis and sensitivity analysis were conducted, followed by an exploration of the mechanisms involved. RESULTS A total of 7 cycles from 2005 to 2018 contained complete data. Weighted logistic regression showed that both LS7 and LE8 were significantly associated with depression. Specifically, for LE8, after adjustment, the risk of depression decreased by 52 % for moderate CVH compared to low CVH (OR: 0.48, 95 % CI: 0.41-0.57, P < 0.0001), while the risk decreased by 80 % for high CVH (OR: 0.20, 95 % CI: 0.15-0.26, P < 0.0001, Ptrend < 0.0001). For LS7, after adjustment, compared with inadequate CVH, the risk of depression decreased by 49 % for average CVH (OR: 0.51, 95 % CI: 0.34-0.78, P = 0.002), and by 55 % for optimal CVH (OR: 0.45, 95 % CI: 0.27-0.74, P = 0.002, Ptrend < 0.0001). Area under ROC curves for predicting depression were 0.672 (95 % CI, 0.66-0.684; P < 0.001) and 0.605 (95 % CI, 0.59-0.619; P < 0.001) for LE8 and LS7 (PDeLong < 0.001), respectively. Sensitivity analysis demonstrated the robustness of the association. GGT and WBC jointly mediated 9.62 % of this association (all P < 0.001). LIMITATIONS The cross-sectional study cannot infer causality. CONCLUSIONS The association between Life's Essential 8 and depression was stronger and more practical. Oxidative stress and inflammation mediate this association. Individuals with extremely poor cardiovascular health have a 7-fold increased risk of depression, highlighting the necessity of maintaining at least moderate cardiovascular health.
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Affiliation(s)
- Laifu Li
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China; Shaanxi Province Key Laboratory of Gastrointestinal Motility Disorders, Xi'an, China
| | - Fei Dai
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China; Shaanxi Province Key Laboratory of Gastrointestinal Motility Disorders, Xi'an, China.
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Won MH, Yun KH, Kim H, Son YJ. Prognostic role of sarcopenia on major adverse cardiac events among patients who underwent successful percutaneous coronary intervention: a retrospective cohort study. Eur J Cardiovasc Nurs 2024; 23:287-295. [PMID: 37579073 DOI: 10.1093/eurjcn/zvad080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 08/09/2023] [Accepted: 08/09/2023] [Indexed: 08/16/2023]
Abstract
AIMS We investigated the prevalence of sarcopenia and its influence on 1-year major adverse cardiac events (MACEs) in patients after successful percutaneous coronary intervention (PCI). METHODS AND RESULTS This retrospective medical record review using purposive sampling was conducted at a tertiary care university hospital in Korea. Medical records of a total of 303 patients (≥40 years) who underwent successful PCI between January 2014 and December 2020 were analysed. We retrospectively assessed sarcopenia at initial admission. Sarcopenia was assessed by a sarcopenia index based on a ratio of serum creatinine to serum cystatin C. MACE rates were evaluated within l year after PCI. A Kaplan-Meier analysis with a log-rank test was performed to compare the time with 1-year MACE event-free survival between groups with and without sarcopenia. Cox proportional hazards regression was conducted to assess sarcopenia's influence on MACE. The prevalence of sarcopenia and 1-year MACE after PCI were 24.8 and 8.6%, respectively. We found that sarcopenia at admission (hazard ratio, 3.01; 95% confidence interval, 1.22-7.38, P = 0.017) was significantly associated with 1-year MACE among patients after PCI. CONCLUSION Expanding knowledge of sarcopenia among cardiovascular nurses may aid in early recognition of patients at risk of sarcopenia. Our finding implies that the sarcopenia index based on serum creatinine and cystatin C may be available as a prognostic factor for MACE in patients undergoing PCI. Future studies should be conducted to prospectively validate the sarcopenia index with a multi-centre, large sample.
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Affiliation(s)
- Mi Hwa Won
- Department of Nursing, Wonkwang University, Iksan, South Korea
| | - Kyeong Ho Yun
- Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, South Korea
| | - Heeseon Kim
- Department of Nursing, Wonkwang University, Iksan, South Korea
| | - Youn-Jung Son
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, South Korea
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Contardo Ayala AM, Ridgers ND, Timperio A, Arundell L, Dunstan DW, Hesketh KD, Daly RM, Salmon J. The association between device-measured sitting time and cardiometabolic health risk factors in children. BMC Public Health 2024; 24:1015. [PMID: 38609909 PMCID: PMC11010425 DOI: 10.1186/s12889-024-18495-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 04/01/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND There is limited evidence of the associations between postural-derived sitting time, waist-worn derived sedentary time and children's health and the moderation effect of physical activity (PA). This study examined associations of children's device-measured sitting time with cardiometabolic health risk factors, including moderation by physical activity. METHODS Cross-sectional baseline data from children (mean-age 8.2 ± 0.5 years) in Melbourne, Australia (2010) participating in the TransformUs program were used. Children simultaneously wore an activPAL to assess sitting time and an ActiGraph GT3X to assess sedentary time and physical activity intensity. Cardiometabolic health risk factors included: adiposity (body mass index [BMI], waist circumference [WC]), systolic and diastolic blood pressure (SBP, DBP), high-density lipoprotein (HDL), low-density lipoprotein (LDL), cholesterol, triglycerides, fasting plasma glucose (FPG), serum insulin, and 25-hydroxyvitaminD (25[OH]D). Linear regression models (n = 71-113) assessed associations between sitting time with each health risk factor, adjusted for different PA intensities (i.e. light [LIPA], moderate-vigorous intensities [MVPA], separately on each model), age, sex, adiposity, and clustering by school. Interaction terms examined moderation. The analyses were repeated using device-measured sedentary time (i.e. ActiGraph GT3X) for comparison. RESULTS Sitting time was positively associated with SBP (b = 0.015; 95%CI: 0.004, 0.026), DBP (b = 0.012; 95%CI:0.004, 0.020), and FPG (b = 0.001; 95%CI: 0.000, 0.000), after adjusting for higher PA intensities. The association between sitting time and insulin (b = 0.003; 95%CI: 0.000, 0.006) was attenuated after adjusting for higher PA intensities. When the models were adjusted for LIPA and MVPA, there was a negative association with LDL (b=-0.001; 95%CI: -0.002, -0.000 and b=-0.001; 95%CI: -0.003, -0.000, respectively). There was a negative association of sedentary time with WCz (b=-0.003; 95%CI: -0.005, 0.000) and BMIz (b=-0.003; 95%CI: -0.006, -0.000) when the models were adjusted by MVPA. Sedentary time was positively associated with triglycerides (b = 0.001; 95%CI: 0.000, 0.001) but attenuated after adjusting for MVPA. No evidence of moderation effects was found. CONCLUSIONS Higher volumes of sitting and sedentary time were associated with some adverse associations on some cardiometabolic health risk factors in children. These associations were more evident when sitting time was the predictor. This suggests that reducing time spent sitting may benefit some cardiometabolic health outcomes, but future experimental research is needed to confirm causal relationships and identify the biological mechanisms that might be involved. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry: ACTRN12609000715279.
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Affiliation(s)
- Ana María Contardo Ayala
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Geelong, Victoria, Australia.
| | - Nicola D Ridgers
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Geelong, Victoria, Australia
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Anna Timperio
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Geelong, Victoria, Australia
| | - Lauren Arundell
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Geelong, Victoria, Australia
| | - David W Dunstan
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Geelong, Victoria, Australia
| | - Kylie D Hesketh
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Geelong, Victoria, Australia
| | - Robin M Daly
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Geelong, Victoria, Australia
| | - Jo Salmon
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Geelong, Victoria, Australia
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McCann ZH, Chang HH, D'Souza R, Scovronick N, Ebelt S. Assessment of census-tract level socioeconomic position as a modifier of the relationship between short-term PM 2.5 exposure and cardiovascular emergency department visits in Missouri. J Epidemiol Community Health 2024; 78:296-302. [PMID: 38302278 PMCID: PMC11006568 DOI: 10.1136/jech-2023-221438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 01/16/2024] [Indexed: 02/03/2024]
Abstract
INTRODUCTION Ambient particulate matter ≤ 2.5 µm in aerodynamic diameter (PM2.5) exposure elevates the risk for cardiovascular disease morbidity (CVDM). The aim of this study is to characterise which area-level measures of socioeconomic position (SEP) modify the relationship between PM2.5 exposure and CVDM in Missouri at the census-tract (CT) level. METHODS We use individual level Missouri emergency department (ED) admissions data (n=3 284 956), modelled PM2.5 data, and yearly CT data from 2012 to 2016 to conduct a two-stage analysis. Stage one uses a case-crossover approach with conditional logistic regression to establish the baseline risk of ED visits associated with IQR changes in PM2.5. In the second stage, we use multivariate metaregression to examine how CT-level SEP modifies the relationship between ambient PM2.5 exposure and CVDM. RESULTS We find that overall, ambient PM2.5 exposure is associated with increased risk for CVDM. We test effect modification in statewide and urban CTs, and in the warm season only. Effect modification results suggest that among SEP measures, poverty is most consistently associated with increased risk for CVDM. For example, across Missouri, the highest poverty CTs are at an elevated risk for CVDM (OR=1.010 (95% CI 1.007 to 1.014)) compared with the lowest poverty CTs (OR=1.004 (95% CI 1.000 to 1.008)). Other SEP modifiers generally display an inconsistent or null effect. CONCLUSION Overall, we find some evidence that area-level SEP modifies the relationship between ambient PM2.5 exposure and CVDM, and suggest that the relationship between air-pollution, area-level SEP and CVDM may be sensitive to spatial scale.
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Affiliation(s)
- Zachary H McCann
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Howard H Chang
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory Univeristy, Atlanta, Georgia, USA
| | - Rohan D'Souza
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory Univeristy, Atlanta, Georgia, USA
| | - Noah Scovronick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Stefanie Ebelt
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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Abstract
Cardiovascular disease (CVD) remains the most prevalent cause of premature death worldwide. It had been suspected for decades that increased activity of the sympathetic nervous system (SNS) might play a pathogenetic role in the development and progression of hypertension, heart failure (HF) and CVD. The use of microneurographic techniques to directly assess the SNS has allowed this field to advance considerably in recent years. We now have compelling evidence for a key role of sympathetic overactivity in the pathogenesis and progression of hypertension and associated hypertension-mediated organ damage (such as endothelial dysfunction, arterial stiffness and left ventricular hypertrophy), HF (with or without reduced left ventricular ejection fraction). Sympathetic overactivity also drives increased cardiovascular risk in the settings of obesity, metabolic syndrome, chronic kidney disease and obstructive sleep apnoea, among other conditions. Thus, sympathetic overactivity is an important factor that drives patients through the CVD continuum, from the early appearance of cardiovascular risk factors, to impairments of the structure and function of components of the heart and arteries, to established CVD, and ultimately to a life-threatening cardiovascular event. A deeper understanding of the role of sympathetic overactivity in the pathogenesis of CVD and HF will support the optimization of therapeutic interventions for these conditions.
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Affiliation(s)
- Guido Grassi
- Department of Medicine and Surgery, Clinica Medica, University of Milano-Bicocca, Milan, Italy
| | - Luciano F Drager
- Hypertension Unit, Renal Division, University of São Paulo Medical School, Sao Paulo, Brazil
- Hypertension Unit, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil
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Zhang A, Kalil R, Marzec A, Coulter SA, Virani S, Patel KV, Segar MW. Cardiovascular Disease Management With Sodium-Glucose Cotransporter-2 Inhibitors in Patients With Type 2 Diabetes: A Cardiology Primer. Tex Heart Inst J 2024; 51:e238375. [PMID: 38590152 DOI: 10.14503/thij-23-8375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
Patients with type 2 diabetes face an elevated risk of cardiovascular disease. This review centers on sodium-glucose cotransporter-2 (SGLT2) inhibitors, a class of drugs that, according to a growing body of evidence, may have major potential for managing cardiovascular disease in patients with type 2 diabetes. This review presents findings from multiple clinical trials suggesting that SGLT2 inhibitors can not only serve as preventive therapeutic agents but also play a role in the active management of heart failure. The discussion includes the mechanism of action of SGLT2 inhibitors, emphasizing that they enhance urinary glucose excretion, which could lead to improved glycemic control and contribute to metabolic shifts beneficial to cardiac function. Alongside these cardiometabolic effects, safety concerns and practical considerations for prescribing these agents are addressed, taking into account potential adverse effects such as genitourinary infections and diabetic ketoacidosis as well as the financial implications for patients. Despite these drawbacks, therapeutic indications for SGLT2 inhibitors continue to expand, including for kidney protection, although further research is necessary to fully understand the mechanisms driving the cardioprotective and kidney-protective effects of SGLT2 inhibitors. By synthesizing current knowledge, this review intends to inform and guide clinical decision-making, thereby enhancing cardiovascular disease outcomes in patients with type 2 diabetes.
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Affiliation(s)
- Allan Zhang
- Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Ramsey Kalil
- Department of Cardiology, The Texas Heart Institute, Houston, Texas
| | - Alexander Marzec
- Department of Medicine, Baylor College of Medicine, Houston, Texas
| | | | - Salim Virani
- Department of Cardiology, The Texas Heart Institute, Houston, Texas
- Aga Khan University, Karachi, Pakistan
| | - Kershaw V Patel
- Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas
| | - Matthew W Segar
- Department of Cardiology, The Texas Heart Institute, Houston, Texas
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de Farias VF, Soares LA, Aranha LN, Luiz RR, de Oliveira GMM, Rosa G. Social vulnerability and cardiovascular risk factors in adolescents. BMC Public Health 2024; 24:982. [PMID: 38589841 PMCID: PMC11000392 DOI: 10.1186/s12889-023-16959-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 10/11/2023] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Social vulnerability can influence in the development of cardiovascular risk factors in adolescents (CRF). For this reason, the objective of our study was to evaluate the presence of CRF in adolescents, according to social vulnerability. METHODS This is a cross-sectional study with 517 adolescents of both sexes, from 10 to 19 years of age, classified into 2 groups by social vulnerability, according to socioeconomic characteristics collected by means of questionnaires, where adolescents who did not have access to drinking water, sewage network, and adequate per capita income were classified as vulnerable. Anthropometric, biochemical, and blood pressure data were evaluated. Level of physical activity was assessed by an adapted questionnaire, and food intake was assessed by a 3-day food record. Independent T, Mann-Whitney, and χ2 tests were used, according to the scale of measurement of the variables, on the statistical program SPSS, version 25, at a significance level of 5%. RESULTS Adolescents had median age of 14 (11 to 15) years; 58.4% were female; 32.4% were overweight, and 52.4% were physically inactive in leisure. Mean consumption of ultra-processed food was observed to account for 45.0% of calorie intake. Adolescents classified as vulnerable had lower weight, body mass index, waist circumference, hip circumference, and neck circumference when compared to non-vulnerable adolescents. Both groups had cholesterol concentrations above the normal level. Non-vulnerable adolescents had higher triglyceride concentrations, higher alcohol consumption, and lower fiber intake compared to vulnerable adolescents. CONCLUSIONS Adolescents with social vulnerability are less likely to have cardiovascular risk factors.
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Affiliation(s)
- Viviane Freire de Farias
- Postgraduate Program in Medicine (Cardiology), Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Larissa Almenara Soares
- Department of Nutrition and Dietetics, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Luciana Nicolau Aranha
- Postgraduate Program in Medicine (Cardiology), Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Ronir Raggio Luiz
- Institute for Studies in Collective Health, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Gláucia Maria Moraes de Oliveira
- Postgraduate Program in Medicine (Cardiology), Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
- Universidade Federal do Rio de Janeiro, UFRJ, Cidade Universitária, R. Prof. Rodolpho P. Rocco, 255 - 8, Andar Sala 6, Rio de Janeiro, RJ, Brazil.
| | - Glorimar Rosa
- Postgraduate Program in Medicine (Cardiology), Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Department of Nutrition and Dietetics, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Egger F, Schilling T, Baumann S, Meyer T, Scharhag J. Cardiovascular risk of veterans' football: An observational cohort study with follow-up. PLoS One 2024; 19:e0297951. [PMID: 38578731 PMCID: PMC10997130 DOI: 10.1371/journal.pone.0297951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 01/11/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND The cardiac stress for veteran football players during match is considerable. In this specific elderly population, the kinetics of exercise-induced cardiac troponin I (cTnI) and B-Type natriuretic peptide (BNP) could potentially be related to cardiovascular risk factors (CVRF) and cardiovascular disease and are therefore be investigated for their usefulness as an complement to established screening measures. METHODS cTnI and BNP was measured in 112 veteran football players (age: 51 ± 10 years) within 30 minutes pre- and post-match. Players with elevated cTnI (cTnI-positive) and a control group (out of the 112 veteran players) with normal cTnI (cTnI-negative) underwent cardiac follow-up 4.2 ± 3.5 months post-match, comprising history, resting and stress ECG (including 30 minutes pre- and post cTnI and BNP), and echocardiography. RESULTS In 33 players (29%) cTnI and in 6 players BNP (5%) exceeded the upper range limit for increased risk of myocardial damage (cTnI ≥ 5 ng/l) and myocardial wall stress (BNP ≥ 100 pg/ml) post-match, respectively. No correlation was observed between Δ cTnI (pre- vs. post-match) and the number of CVRF (r = -0.06, p = 0.50). Follow-up was conducted in 62 players (31 cTnI-positive and 31 cTnI-negative players) of which 6 (10%, 3 cTnI positive and 3 cTnI negative players) had cardiac abnormalities (hypertrophic cardiomyopathy n = 2, coronary artery disease n = 2, coronary artery anomaly n = 1, hypertensive heart disease n = 1). CONCLUSION Veterans' football matches elicit increases in BNP and particularly cTnI in a considerable number of players. However, these biochemical alterations do not indicate acute cardiac damage as evidenced by follow-up. Routine determination of cardiac biomarkers is unlikely to improve cardiovascular screening in veteran football players.
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Affiliation(s)
- Florian Egger
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Tilman Schilling
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Sybille Baumann
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Tim Meyer
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Jürgen Scharhag
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
- Department of Sport and Human Movement Science, Centre for Sport Science and University Sports, Sports Medicine, Exercise Physiology and Prevention, University of Vienna, Wien, Austria
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Austin G, Ferguson JJA, Eslick S, Oldmeadow C, Wood LG, Garg ML. Cardiovascular Disease Risk in Individuals Following Plant-Based Dietary Patterns Compared to Regular Meat-Eaters. Nutrients 2024; 16:1063. [PMID: 38613096 PMCID: PMC11013900 DOI: 10.3390/nu16071063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 03/22/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024] Open
Abstract
Plant-based diets (PBDs) have been associated with a lower risk of cardiovascular disease (CVD). The aim was to investigate the predicted 5-year and 10-year risk of developing CVD in individuals following PBDs compared to regular meat-eating diets. This cross-sectional study included n = 240 middle-aged adults habitually consuming dietary patterns for ≥6 months: vegan, lacto-ovo vegetarian (LOV), pesco-vegetarian (PV), semi-vegetarian (SV) or regular meat-eater (RME) (n = 48 per group). Predicted 5-year and 10-year CVD risks were quantified using the Framingham Risk Equation and the Australian Absolute CVD risk calculator, respectively. Multivariable regression analysis was used to adjust for age, sex, smoking status, physical activity, alcohol use and BMI. Over three-quarters of the participants were women, mean age of 53.8 yrs. After adjustments for potential confounders, there was no difference in the predicted risk of CVD between regular-meat diets and PBDs, although crude analyses revealed that vegans had a lower 5-year and 10-year predicted risk of CVD compared to RMEs. SVs, PVs and LOVs had lower CVD risk scores, however, not significantly. Vegans had a favourable cardiometabolic risk profile including significantly lower serum lipid levels, fasting blood glucose and dietary fats and higher dietary fibre intake compared to RMEs. This was the first study to purposefully sample Australians habitually following PBDs. We found that PBDs do not independently influence the predicted risk of CVD, although PBDs tended to have lower risk and vegans had significantly lower cardiometabolic risk factors for CVD.
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Affiliation(s)
- Grace Austin
- School of Biomedical Sciences & Pharmacy, University of Newcastle, Newcastle, NSW 2308, Australia (S.E.); (L.G.W.)
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Jessica J. A. Ferguson
- School of Biomedical Sciences & Pharmacy, University of Newcastle, Newcastle, NSW 2308, Australia (S.E.); (L.G.W.)
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- School of Health Sciences, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Shaun Eslick
- School of Biomedical Sciences & Pharmacy, University of Newcastle, Newcastle, NSW 2308, Australia (S.E.); (L.G.W.)
- Macquarie Medical School, Macquarie University, Macquarie Park, NSW 2109, Australia
| | - Christopher Oldmeadow
- Clinical Research Design, Information Technology and Statistical Support Unit, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Lisa G. Wood
- School of Biomedical Sciences & Pharmacy, University of Newcastle, Newcastle, NSW 2308, Australia (S.E.); (L.G.W.)
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Manohar L. Garg
- School of Biomedical Sciences & Pharmacy, University of Newcastle, Newcastle, NSW 2308, Australia (S.E.); (L.G.W.)
- Macquarie Medical School, Macquarie University, Macquarie Park, NSW 2109, Australia
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Marcadenti A, Machado RHV, Santos RHN, Kasai CCDS, Kovacs C, Bello A, de Matos CH, Bertacco RTA, Souza GC, Schirmann GDS, Nagano FEZ, Poloni S, Kik RME, Feres NH, Rodrigues IG, Sousa ACS, Pinheiro JMF, Vasconcelos SML, Carlos DMDO, Souza VS, Gomes AB, Figueiredo Neto JAD, Moriguchi EH, Izar MC, Pinto SL, Bressan J, de Souza SR, Kumbier MC, de Araújo CBP, Torreglosa CR, Weber B, Bersch-Ferreira ÂC. Adequacy of Fatty Acids Consumption Among Individuals in Secondary Cardiovascular Prevention. Arq Bras Cardiol 2024; 121:e20230487. [PMID: 38597553 DOI: 10.36660/abc.20230487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 12/13/2023] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Adhering to a diet adequate in macronutrients is crucial for the secondary prevention of cardiovascular diseases. OBJECTIVE To assess the prevalence of adherence to recommendations for the consumption of dietary fatty acids for the prevention and treatment of cardiovascular diseases and to estimate whether the presence of certain cardiovascular risk factors would be associated with adherence. METHODS Cross-sectional study using baseline data from 2,358 participants included in the "Brazilian Cardioprotective Nutritional Program Trial". Dietary intake and cardiovascular risk factors were assessed. Adequate intake of polyunsaturated fatty acids (PUFA) was considered as ≥10% of total daily energy intake; for monounsaturated fatty acids (MUFA), 20%; and for saturated fatty acids (SFA), <7% according to the Brazilian Society of Cardiology. A significance level of 5% was considered in the statistical analysis. RESULTS No participant adhered to all recommendations simultaneously, and more than half (1,482 [62.9%]) did not adhere to any recommendation. Adherence exclusively to the SFA recommendation was the most prevalent, fulfilled by 659 (28%) participants, followed by adherence exclusively to the PUFA (178 [7.6%]) and MUFA (5 [0.2%]) recommendations. There was no association between the number of comorbidities and adherence to nutritional recommendations (p = 0.269). Participants from the Brazilian Northeast region showed a higher proportion of adherence to SFA consumption recommendations (38.42%) and lower adherence to PUFA intake (3.52%) (p <0.001) compared to other regions. CONCLUSIONS Among the evaluated sample, there was low adherence to nutritional recommendations for dietary fatty acid consumption.
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Affiliation(s)
| | | | | | | | - Cristiane Kovacs
- Instituto Dante Pazzanese de Cardiologia, São Paulo, SP - Brasil
| | - Annie Bello
- Instituto Nacional de Cardiologia, Rio de Janeiro, RJ - Brasil
| | | | | | - Gabriela C Souza
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS - Brasil
| | | | | | - Soraia Poloni
- Hospital de Clínicas de Porto Alegre, Porto Alegre, RS - Brasil
| | - Raquel Milani El Kik
- Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS - Brasil
| | | | - Isa G Rodrigues
- Pronto Socorro Cardiológico Universitário de Pernambuco, Recife, PE - Brasil
| | | | | | | | | | | | | | | | | | | | | | | | | | - Magali C Kumbier
- Consultoria Terapia Nutricional - COTENUT, Porto Alegre, RS - Brasil
| | | | | | - Bernardete Weber
- Real e Benemérita Associação Portuguesa de Beneficência, São Paulo, SP - Brasil
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Fraga LL, Nascimento BR, Haiashi BC, Ferreira AM, Silva MHA, Ribeiro IKDS, Silva GA, Vinhal WC, Coimbra MM, Silva CA, Machado CRL, Pires MC, Diniz MG, Santos LPA, Amaral AM, Diamante LC, Fava HL, Sable C, Nunes MCP, Ribeiro ALP, Cardoso CS. Combination of Tele-Cardiology Tools for Cardiovascular Risk Stratification in Primary Care: Data from the PROVAR+ Study. Arq Bras Cardiol 2024; 121:e20230653. [PMID: 38597537 DOI: 10.36660/abc.20230653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/13/2023] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Tele-cardiology tools are valuable strategies to improve risk stratification. OBJECTIVE We aimed to evaluate the accuracy of tele-electrocardiography (ECG) to predict abnormalities in screening echocardiography (echo) in primary care (PC). METHODS In 17 months, 6 health providers at 16 PC units were trained on simplified handheld echo protocols. Tele-ECGs were recorded for final diagnosis by a cardiologist. Consented patients with major ECG abnormalities by the Minnesota code, and a 1:5 sample of normal individuals underwent clinical questionnaire and screening echo interpreted remotely. Major heart disease was defined as moderate/severe valve disease, ventricular dysfunction/hypertrophy, pericardial effusion, or wall-motion abnormalities. Association between major ECG and echo abnormalities was assessed by logistic regression as follows: 1) unadjusted model; 2) model 1 adjusted for age/sex; 3) model 2 plus risk factors (hypertension/diabetes); 4) model 3 plus history of cardiovascular disease (Chagas/rheumatic heart disease/ischemic heart disease/stroke/heart failure). P-values < 0.05 were considered significant. RESULTS A total 1,411 patients underwent echo; 1,149 (81%) had major ECG abnormalities. Median age was 67 (IQR 60 to 74) years, and 51.4% were male. Major ECG abnormalities were associated with a 2.4-fold chance of major heart disease on echo in bivariate analysis (OR = 2.42 [95% CI 1.76 to 3.39]), and remained significant after adjustments in models (p < 0.001) 2 (OR = 2.57 [95% CI 1.84 to 3.65]), model 3 (OR = 2.52 [95% CI 1.80 to3.58]), and model 4 (OR = 2.23 [95%CI 1.59 to 3.19]). Age, male sex, heart failure, and ischemic heart disease were also independent predictors of major heart disease on echo. CONCLUSIONS Tele-ECG abnormalities increased the likelihood of major heart disease on screening echo, even after adjustments for demographic and clinical variables.
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Affiliation(s)
- Lucas Leal Fraga
- Hospital das Clínicas da Universidade Federal de Minas Gerais - Serviço de Cardiologia e Cirurgia Carvdiovascular, Belo Horizonte, MG - Brasil
| | - Bruno Ramos Nascimento
- Hospital das Clínicas da Universidade Federal de Minas Gerais - Serviço de Cardiologia e Cirurgia Carvdiovascular, Belo Horizonte, MG - Brasil
- Hospital Madre Teresa - Serviço de Hemodinâmica, Belo Horizonte, MG - Brasil
- Universidade Federal de Minas Gerais - Departamento de Clínica Médica - Faculdade de Medicina, Belo Horizonte, MG - Brasil
| | - Beatriz Costa Haiashi
- Hospital das Clínicas da Universidade Federal de Minas Gerais - Centro de Telessaúde, Belo Horizonte, MG - Brasil
| | - Alexandre Melo Ferreira
- Hospital das Clínicas da Universidade Federal de Minas Gerais - Centro de Telessaúde, Belo Horizonte, MG - Brasil
| | - Mauro Henrique Agapito Silva
- Hospital das Clínicas da Universidade Federal de Minas Gerais - Centro de Telessaúde, Belo Horizonte, MG - Brasil
| | | | - Gabriela Aparecida Silva
- Universidade Federal de São João del Rei - Campus Centro-Oeste Dona Lindu - Campus Divinópolis, Divinópolis, MG - Brasil
| | - Wanessa Campos Vinhal
- Universidade Federal de São João del Rei - Campus Centro-Oeste Dona Lindu - Campus Divinópolis, Divinópolis, MG - Brasil
| | - Mariela Mata Coimbra
- Universidade Federal de São João del Rei - Campus Centro-Oeste Dona Lindu - Campus Divinópolis, Divinópolis, MG - Brasil
| | - Cássia Aparecida Silva
- Hospital das Clínicas da Universidade Federal de Minas Gerais - Serviço de Cardiologia e Cirurgia Carvdiovascular, Belo Horizonte, MG - Brasil
| | - Cristiana Rosa Lima Machado
- Universidade Federal de São João del Rei - Campus Centro-Oeste Dona Lindu - Campus Divinópolis, Divinópolis, MG - Brasil
| | - Magda C Pires
- Universidade Federal de Minas Gerais - Instituto de Ciências Exatas - Departamento de Estatística, Belo Horizonte, MG - Brasil
| | - Marina Gomes Diniz
- Hospital das Clínicas da Universidade Federal de Minas Gerais - Centro de Telessaúde, Belo Horizonte, MG - Brasil
| | | | - Arthur Maia Amaral
- Universidade Federal de Ouro Preto - Departamento de Medicina, Ouro Preto, MG - Brasil
| | - Lucas Chaves Diamante
- Hospital das Clínicas da Universidade Federal de Minas Gerais - Centro de Telessaúde, Belo Horizonte, MG - Brasil
| | - Henrique Leão Fava
- Hospital das Clínicas da Universidade Federal de Minas Gerais - Centro de Telessaúde, Belo Horizonte, MG - Brasil
| | - Craig Sable
- Children's National Health System - Cardiology, Washington, District of Columbia - EUA
| | - Maria Carmo Pereira Nunes
- Universidade Federal de Minas Gerais - Departamento de Clínica Médica - Faculdade de Medicina, Belo Horizonte, MG - Brasil
- Hospital das Clínicas da Universidade Federal de Minas Gerais - Centro de Telessaúde, Belo Horizonte, MG - Brasil
| | - Antonio Luiz P Ribeiro
- Hospital das Clínicas da Universidade Federal de Minas Gerais - Centro de Telessaúde, Belo Horizonte, MG - Brasil
| | - Clareci Silva Cardoso
- Universidade Federal de São João del Rei - Campus Centro-Oeste Dona Lindu - Campus Divinópolis, Divinópolis, MG - Brasil
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Cao Y, Feng Y, Xia N, Zhang J. Causal associations of particulate matter 2.5 and cardiovascular disease: A two-sample mendelian randomization study. PLoS One 2024; 19:e0301823. [PMID: 38578766 PMCID: PMC10997086 DOI: 10.1371/journal.pone.0301823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 03/20/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND According to epidemiological studies, particulate matter 2.5 (PM2.5) is a significant contributor to cardiovascular disease (CVD). However, making causal inferences is difficult due to the methodological constraints of observational studies. In this study, we used two-sample Mendelian randomization (MR) to examine the causal relationship between PM 2.5 and the risk of CVD. METHODS Genome-wide association study (GWAS) statistics for PM2.5 and CVD were collected from the FinnGen and UK Biobanks. Mendelian randomization analyses were applied to explore the causal effects of PM2.5 on CVD by selecting single-nucleotide polymorphisms(SNP) as instrumental variables. RESULTS The results revealed that a causal effect was observed between PM2.5 and coronary artery disease(IVW: OR 2.06, 95% CI 1.35, 3.14), and hypertension(IVW: OR 1.07, 95% CI 1.03, 1.12). On the contrary, no causal effect was observed between PM2.5 and myocardial infarction(IVW: OR 0.73, 95% CI 0.44, 1.22), heart failure(IVW: OR 1.54, 95% CI 0.96, 2.47), atrial fibrillation(IVW: OR 1.03, 95% CI 0.71, 1.48), and ischemic stroke (IS)(IVW: OR 0.98, 95% CI 0.54, 1.77). CONCLUSION We discovered that there is a causal link between PM2.5 and coronary artery disease and hypertension in the European population, using MR methods. Our discovery may have the significance of public hygiene to improve the understanding of air quality and CVD risk.
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Affiliation(s)
- Ye Cao
- Department of Cardiology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, P. R. China
- Department of Cardiology, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, P. R. China
| | - Yi Feng
- Department of Cardiology, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, P. R. China
| | - Nan Xia
- Department of Cardiology, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, P. R. China
| | - Jiancheng Zhang
- Department of Cardiology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, P. R. China
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Manrique-Acevedo C, Hirsch IB, Eckel RH. Prevention of Cardiovascular Disease in Type 1 Diabetes. N Engl J Med 2024; 390:1207-1217. [PMID: 38598575 DOI: 10.1056/nejmra2311526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Affiliation(s)
- Camila Manrique-Acevedo
- From the Division of Endocrinology and Metabolism, Department of Medicine, and NextGen Precision Health, University of Missouri, and the Harry S. Truman Memorial Veterans' Hospital - both in Columbia (C.M.-A.); the Department of Medicine, University of Washington School of Medicine, Seattle (I.B.H.); and the Divisions of Endocrinology, Metabolism and Diabetes, and Cardiology, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora (R.H.E.)
| | - Irl B Hirsch
- From the Division of Endocrinology and Metabolism, Department of Medicine, and NextGen Precision Health, University of Missouri, and the Harry S. Truman Memorial Veterans' Hospital - both in Columbia (C.M.-A.); the Department of Medicine, University of Washington School of Medicine, Seattle (I.B.H.); and the Divisions of Endocrinology, Metabolism and Diabetes, and Cardiology, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora (R.H.E.)
| | - Robert H Eckel
- From the Division of Endocrinology and Metabolism, Department of Medicine, and NextGen Precision Health, University of Missouri, and the Harry S. Truman Memorial Veterans' Hospital - both in Columbia (C.M.-A.); the Department of Medicine, University of Washington School of Medicine, Seattle (I.B.H.); and the Divisions of Endocrinology, Metabolism and Diabetes, and Cardiology, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora (R.H.E.)
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Lee JK, Tran TMC, Choi E, Baek J, Kim HR, Kim H, Yun BH, Seo SK. Association between Daily Dietary Calcium Intake and the Risk of Cardiovascular Disease (CVD) in Postmenopausal Korean Women. Nutrients 2024; 16:1043. [PMID: 38613076 PMCID: PMC11013752 DOI: 10.3390/nu16071043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 03/31/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024] Open
Abstract
We aimed to evaluate the association between daily dietary calcium intake and the risk of cardiovascular disease (CVD) in postmenopausal women using data from the Korean National Health and Nutrition Examination Survey (KNHANES). This cross-sectional study included 12,348 women aged 45-70 years who had reached natural menopause. They were classified into three groups according to daily dietary calcium intake: <400 mg, 400-800 mg, and >800 mg. The risks of CVD, stroke, angina, and myocardial infarction were assessed in each group. Further, we performed subgroup analysis according to the post-menopause duration (≤10 vs. >10 postmenopausal years). We performed logistic regression analysis with adjustment for age, menopausal age, income, urban area, education, insulin use, body mass index, hypertension, diabetes mellitus, dyslipidemia, high alcohol intake, smoking, exercise, oral contraceptive use, and hormonal therapy use. Calcium intake level was not significantly associated with the risk of CVD in the total population and the ≤10 postmenopausal years subgroup. However, in the >10 postmenopausal years subgroup, daily calcium intake >800 mg was associated with significantly decreased risks of all CVD (odds ratio [OR], 0.27; 95% confidence interval [CI], 0.11-0.64), stroke (OR, 0.06; 95% CI, 0.01-0.42), and myocardial infarction (OR, 0.27; 95% CI, 0.11-0.64). Our findings suggest that a dietary calcium intake of >800 mg/day decreases the risk of CVD events in women who have been menopausal for >10 years.
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Affiliation(s)
- Jae Kyung Lee
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea; (J.K.L.); (E.C.); (J.B.); (H.K.)
| | - Thi Minh Chau Tran
- Department of Obstetrics and Gynecology, Tu Du Hospital, University of Medicine and Pharmacy, Ho Chi Minh City 700000, Vietnam;
| | - Euna Choi
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea; (J.K.L.); (E.C.); (J.B.); (H.K.)
| | - Jinkyung Baek
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea; (J.K.L.); (E.C.); (J.B.); (H.K.)
| | - Hae-Rim Kim
- College of Natural Science, School of Statistics, University of Seoul, 163 Seoulsiripdae-ro, Dongdaemun-gu, Seoul 02504, Republic of Korea;
| | - Heeyon Kim
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea; (J.K.L.); (E.C.); (J.B.); (H.K.)
| | - Bo Hyon Yun
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea; (J.K.L.); (E.C.); (J.B.); (H.K.)
| | - Seok Kyo Seo
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea; (J.K.L.); (E.C.); (J.B.); (H.K.)
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Alam AB, Toledo-Atucha E, Romaguera D, Alonso-Gómez AM, Martínez-Gonzalez MA, Tojal-Sierra L, Mora MN, Mas-Llado C, Li L, Gonzalez-Casanova I, Salas-Salvadó J, Fitó M, Alonso A. Associations of Alcohol Consumption With Left Atrial Morphology and Function in a Population at High Cardiovascular Risk. J Am Heart Assoc 2024; 13:e031915. [PMID: 38533958 DOI: 10.1161/jaha.123.031915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 12/28/2023] [Indexed: 03/28/2024]
Abstract
BACKGROUND Excessive alcohol consumption has been associated with increased risk of atrial fibrillation, although the underlying mechanisms remain unclear. An enlarged left atrium and impaired left atrial function may lead to atrial fibrillation. The association of alcohol consumption with structural and functional left atrial measures, however, has received limited attention. METHODS AND RESULTS We studied 503 participants from the PREDIMED-Plus (Prevención con Dieta Mediterránea) trial, a randomized trial testing intensive weight loss intervention with an energy-reduced Mediterranean diet and physical activity promotion in preventing cardiovascular disease in adults with metabolic syndrome. Participants underwent transthoracic echocardiography at baseline, year 3, and year 5 of the study. Outcomes of interest included volume index and reservoir, conduit, and contractile strains of the left atrium. Alcohol consumption was calculated through food frequency questionnaires and presented as drinks consumed per day. Multiple linear regression and mixed models estimated the association of alcohol consumption with left atrial measurements at baseline and through follow-up. Cross-sectionally, higher alcohol consumption (per 1 drink/day increases) was associated with larger left atrial volume (0.65 mL/m2 [95% CI, 0.18-1.11]) and lower left atrial reservoir and contractile strain (-0.44% [95% CI, -0.87 to -0.01]; and -0.44% [95% CI, -0.75 to -0.14]). Baseline alcohol consumption was not associated with changes in left atrial measurements, but increases in alcohol consumption (per 1 drink/day increase) during follow-up were associated with left atrial enlargement (0.71 mL/m2 [95% CI, 0.17-1.26]). CONCLUSIONS In a population at high cardiovascular risk, increased alcohol consumption was associated with left atrial enlargement and worsening atrial function. REGISTRATION URL: http://www.controlled-trials.com; Unique identifier: ISRCTN89898870.
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Affiliation(s)
- Aniqa B Alam
- Department of Epidemiology, Rollins School of Public Health Emory University Atlanta GA USA
| | - Estefania Toledo-Atucha
- CIBER Consortium, M.P. Physiopathology of Obesity and Nutrition (CIBERObn) Carlos III Health Institute (ISCIII) Madrid Spain
- Navarra's Health Research Institute (IdiSNA), Navarra Institute for Health Research Pamplona Spain
- Department of Preventive Medicine and Public Health University of Navarra Pamplona Spain
| | - Dora Romaguera
- CIBER Consortium, M.P. Physiopathology of Obesity and Nutrition (CIBERObn) Carlos III Health Institute (ISCIII) Madrid Spain
- Health Research Institute of the Balearic Islands (IdISBa) Palma de Mallorca Spain
| | - Angel M Alonso-Gómez
- CIBER Consortium, M.P. Physiopathology of Obesity and Nutrition (CIBERObn) Carlos III Health Institute (ISCIII) Madrid Spain
- Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU Vitoria-Gasteiz Spain
| | - Miguel A Martínez-Gonzalez
- CIBER Consortium, M.P. Physiopathology of Obesity and Nutrition (CIBERObn) Carlos III Health Institute (ISCIII) Madrid Spain
- Navarra's Health Research Institute (IdiSNA), Navarra Institute for Health Research Pamplona Spain
- Department of Preventive Medicine and Public Health University of Navarra Pamplona Spain
| | - Lucas Tojal-Sierra
- Navarra's Health Research Institute (IdiSNA), Navarra Institute for Health Research Pamplona Spain
- Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU Vitoria-Gasteiz Spain
| | - Marta Noris Mora
- Health Research Institute of the Balearic Islands (IdISBa) Palma de Mallorca Spain
- Department of Cardiology Hospital Universitari Son Espases Palma Spain
| | - Caterina Mas-Llado
- Health Research Institute of the Balearic Islands (IdISBa) Palma de Mallorca Spain
- Cardiology Department, Hospital de Manacor Manacor Spain
- Facultad de Medicina Universitat de les Illes Balears (UIB) Palma Spain
| | - Linzi Li
- Department of Epidemiology, Rollins School of Public Health Emory University Atlanta GA USA
| | - Ines Gonzalez-Casanova
- Department of Applied Health Science Indiana University-Bloomington, School of Public Health Bloomington Indiana USA
| | - Jordi Salas-Salvadó
- CIBER Consortium, M.P. Physiopathology of Obesity and Nutrition (CIBERObn) Carlos III Health Institute (ISCIII) Madrid Spain
- Human Nutrition Unit, Department of Biochemistry and Biotechnology Rovira i Virigili University Reus Spain
- Human Nutrition Unit, Pere Virgili Health Research Institute (IISPV) Reus Spain
| | - Montserrat Fitó
- CIBER Consortium, M.P. Physiopathology of Obesity and Nutrition (CIBERObn) Carlos III Health Institute (ISCIII) Madrid Spain
- Cardiovascular Risk and Nutrition Group, Hospital del Mar Medical Research Institute (IMIM) Barcelona Spain
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health Emory University Atlanta GA USA
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Evangelatos G, Konstantonis G, Tentolouris N, Sfikakis PP, Tektonidou MG. Arterial stiffness tested by pulse wave velocity and augmentation index for cardiovascular risk stratification in antiphospholipid syndrome. Rheumatology (Oxford) 2024; 63:1030-1038. [PMID: 37294733 PMCID: PMC10986810 DOI: 10.1093/rheumatology/kead267] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 05/06/2023] [Accepted: 05/26/2023] [Indexed: 06/11/2023] Open
Abstract
OBJECTIVES Cardiovascular disease is a major cause of morbidity and mortality in Antiphospholipid syndrome (APS). Arterial stiffness (ArS) has emerged as a predictor of future cardiovascular events in the general population. We aimed to assess ArS in patients with thrombotic APS versus diabetes mellitus (DM) and healthy controls (HC) and identify predictors of increased ArS in APS. METHODS ArS was evaluated by carotid-femoral pulse wave velocity (cfPWV) and augmentation index normalized to 75 beats/min (AIx@75) using the SphygmoCor device. Participants also underwent carotid/femoral ultrasound for atherosclerotic plaque detection. We used linear regression to compare ArS measures among groups and assess ArS determinants in the APS group. RESULTS We included 110 patients with APS (70.9% female, mean age 45.4 years), 110 DM patients and 110 HC, all age/sex matched. After adjustment for age, sex, cardiovascular risk factors and plaque presence, APS patients exhibited similar cfPWV [β = -0.142 (95% CI -0.514, 0.230), p = 0.454] but increased AIx@75 [β = 4.525 (95% CI 1.372, 7.677), p = 0.005] compared with HC and lower cfPWV (p < 0.001) but similar AIx@75 (p = 0.193) versus DM patients. In the APS group, cfPWV was independently associated with age [β = 0.056 (95% CI 0.034, 0.078), p < 0.001], mean arterial pressure (MAP) [β = 0.070 (95% CI 0.043, 0.097), p < 0.001], atherosclerotic femoral plaques [β = 0.732 (95% CI 0.053, 1.411), p = 0.035] and anti-β2-glycoprotein I IgM positivity [β = 0.696 (95% CI 0.201, 1.191), p = 0.006]. AIx@75 was associated with age [β = 0.334 (95% CI 0.117, 0.551), p = 0.003], female sex [β = 7.447 (95% CI 2.312, 12.581), p = 0.005] and MAP [β = 0.425 (95% CI 0.187, 0.663), p = 0.001]. CONCLUSION APS patients exhibit elevated AIx@75 vs HC and similar to DM patients, indicating enhanced arterial stiffening in APS. Given its prognostic value, ArS evaluation may help to improve cardiovascular risk stratification in APS.
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Affiliation(s)
- Gerasimos Evangelatos
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Joint Academic Rheumatology Program, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - George Konstantonis
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Tentolouris
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Petros P Sfikakis
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Joint Academic Rheumatology Program, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria G Tektonidou
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Joint Academic Rheumatology Program, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Shimizu Y, Arima K, Yamanashi H, Kawashiri SY, Noguchi Y, Honda Y, Nakamichi S, Nagata Y, Maeda T. Association between atherosclerosis and height loss among older individuals. Sci Rep 2024; 14:7776. [PMID: 38565613 PMCID: PMC10987634 DOI: 10.1038/s41598-024-57620-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 03/20/2024] [Indexed: 04/04/2024] Open
Abstract
Atherosclerosis and height loss are each reportedly associated with cardiovascular disease. However, no studies have found an association between atherosclerosis and height loss. A retrospective study of 2435 individuals aged 60-89 years who underwent annual health check-ups was conducted. Atherosclerosis was defined as carotid intima-media thickness (CIMT) ≥ 1.1 mm. Height loss was defined as being in the highest quintile of height decrease per year, as in our previous studies. Among study participants, 555 were diagnosed as having atherosclerosis. Independent of known cardiovascular risk factors, atherosclerosis was positively associated with height loss. The adjusted odds ratio (OR) was 1.46 (95% confidence interval, 1.15, 1.83). Essentially the same associations were observed for men and women. The adjusted OR (95% CI) was 1.43 (1.01, 2.04) for men and 1.46 (1.07, 1.99) for women. Among older individuals, atherosclerosis is associated with height loss. This result can help clarify the mechanism underlying the association between height loss and cardiovascular disease.
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Affiliation(s)
- Yuji Shimizu
- Department of General Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8501, Japan.
- Epidemiology Section, Division of Public Health, Osaka Institute of Public Health, Osaka, 537-0025, Japan.
| | - Kazuhiko Arima
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8523, Japan
| | - Hirotomo Yamanashi
- Department of General Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8501, Japan
- Leading Medical Research Core Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8523, Japan
| | - Shin-Ya Kawashiri
- Leading Medical Research Core Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8523, Japan
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8523, Japan
| | - Yuko Noguchi
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8523, Japan
| | - Yukiko Honda
- Department of General Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8501, Japan
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, 606-8315, Japan
| | - Seiko Nakamichi
- Department of General Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8501, Japan
- Nagasaki University Health Center, Nagasaki, 852-8521, Japan
| | - Yasuhiro Nagata
- Leading Medical Research Core Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8523, Japan
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8523, Japan
| | - Takahiro Maeda
- Department of General Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8501, Japan
- Leading Medical Research Core Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8523, Japan
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Gresele P, Migliacci R, Paciullo F. Measurement of arterial stiffness in antiphospholipid syndrome: a step forward in cardiovascular risk stratification? Rheumatology (Oxford) 2024; 63:912-913. [PMID: 38197575 DOI: 10.1093/rheumatology/keae008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 12/28/2023] [Accepted: 12/30/2023] [Indexed: 01/11/2024] Open
Affiliation(s)
- Paolo Gresele
- Department of Medicine and Surgery, Section of Internal and Cardiovascular Medicine, University of Perugia, Perugia, Italy
| | - Rino Migliacci
- Department of Internal and Specialized Medicine USL South-East Tuscany, Division of Internal Medicine, Ospedale della Valdichiana 'S Margherita', Cortona, Italy
| | - Francesco Paciullo
- Department of Medicine and Surgery, Section of Internal and Cardiovascular Medicine, University of Perugia, Perugia, Italy
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41
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Ko D, Pascual-Leone A, Shah SJ. Use of Lecanemab for Patients With Cardiovascular Disease: The Challenge of Uncertainty. JAMA 2024; 331:1089-1090. [PMID: 38488809 DOI: 10.1001/jama.2024.2991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
This Viewpoint discusses lecanemab use and the risk of cerebral macrohemorrhage for patients with mild cognitive impairment or early dementia.
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Affiliation(s)
- Darae Ko
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, Massachusetts
- Section of Cardiovascular Medicine, Boston Medical Center, Boston, Massachusetts
| | - Alvaro Pascual-Leone
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, Massachusetts
| | - Sachin J Shah
- Center for Aging and Serious Illness and Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston
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Brar R, Whitlock RH, Katz A, Di Nella M, Komenda P, Bohm C, Rigatto C, Tangri N, Solmundson C, Collister D. Impact of a Medical Fitness Model on Incident Major Adverse Cardiovascular Events: A Prospective Cohort Study of 11 000 Members. J Am Heart Assoc 2024; 13:e030028. [PMID: 38533967 DOI: 10.1161/jaha.123.030028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 02/27/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Cardiovascular disease remains the leading cause of disease burden and death in the world. The medical fitness model may be an alternative public health strategy to address cardiovascular risk factors with medical integrated programming. METHODS AND RESULTS We performed a retrospective cohort study between January 1, 2005, and December 31, 2015. Adults (aged ≥18 years) who did not have a prior major adverse cardiovascular event were included. Controls were assigned a pseudo-index date at random on the basis of the frequency distribution of start dates in the medical fitness facility group. Multivariate Cox proportional hazards regression models were adjusted for age, sex, socioeconomic status, comorbidities, and year of index date. We stratified the medical fitness facility group into low-frequency attenders (≤1 weekly visit) and regular-frequency attenders (>1 weekly visit). Our primary outcome was a hospitalization for nonfatal myocardial infarction and stroke, heart failure, or cardiovascular death. We included 11 319 medical fitness facility members and 507 400 controls in our study. Compared with controls, members had a lower hazard risk of a major adverse cardiovascular event-plus (hazard ratio [HR], 0.88 [95% CI, 0.81-0.96]). Higher weekly attendance was associated with a lower hazard risk of a major adverse cardiovascular event-plus compared with controls, but the effect was not significant for lower weekly attendance (low-frequency attenders: HR, 0.94 [95% CI, 0.85-1.04]; regular-frequency attenders: HR, 0.77 [95% CI, 0.67-0.89]). CONCLUSIONS Medical fitness facility membership and attendance at least once per week may lower the risk of a major adverse cardiovascular event-plus. The medical fitness model should be considered as a public health intervention, especially for individuals at risk for cardiovascular disease.
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Affiliation(s)
- Ranveer Brar
- Department of Community Health Sciences, Max Rady Faculty of Health Sciences University of Manitoba Winnipeg Manitoba Canada
- Chronic Disease Innovation Centre Seven Oaks General Hospital Winnipeg Manitoba Canada
| | - Reid H Whitlock
- Chronic Disease Innovation Centre Seven Oaks General Hospital Winnipeg Manitoba Canada
| | - Alan Katz
- Department of Community Health Sciences, Max Rady Faculty of Health Sciences University of Manitoba Winnipeg Manitoba Canada
- Manitoba Centre for Health Policy, Department of Community Health Sciences, Max Rady Faculty of Health Sciences University of Manitoba Winnipeg Manitoba Canada
- Department of Family Medicine, Rady Faculty of Health Sciences University of Manitoba Winnipeg Manitoba Canada
| | - Michelle Di Nella
- Chronic Disease Innovation Centre Seven Oaks General Hospital Winnipeg Manitoba Canada
| | - Paul Komenda
- Department of Community Health Sciences, Max Rady Faculty of Health Sciences University of Manitoba Winnipeg Manitoba Canada
- Chronic Disease Innovation Centre Seven Oaks General Hospital Winnipeg Manitoba Canada
- Department of Internal Medicine, Section of Nephrology, Max Rady Faculty of Health Sciences University of Manitoba Winnipeg Manitoba Canada
| | - Clara Bohm
- Department of Community Health Sciences, Max Rady Faculty of Health Sciences University of Manitoba Winnipeg Manitoba Canada
- Chronic Disease Innovation Centre Seven Oaks General Hospital Winnipeg Manitoba Canada
- Department of Internal Medicine, Section of Nephrology, Max Rady Faculty of Health Sciences University of Manitoba Winnipeg Manitoba Canada
| | - Claudio Rigatto
- Department of Community Health Sciences, Max Rady Faculty of Health Sciences University of Manitoba Winnipeg Manitoba Canada
- Chronic Disease Innovation Centre Seven Oaks General Hospital Winnipeg Manitoba Canada
- Department of Internal Medicine, Section of Nephrology, Max Rady Faculty of Health Sciences University of Manitoba Winnipeg Manitoba Canada
| | - Navdeep Tangri
- Department of Community Health Sciences, Max Rady Faculty of Health Sciences University of Manitoba Winnipeg Manitoba Canada
- Chronic Disease Innovation Centre Seven Oaks General Hospital Winnipeg Manitoba Canada
- Department of Internal Medicine, Section of Nephrology, Max Rady Faculty of Health Sciences University of Manitoba Winnipeg Manitoba Canada
| | - Carrie Solmundson
- Chronic Disease Innovation Centre Seven Oaks General Hospital Winnipeg Manitoba Canada
- Wellness Institute Winnipeg Manitoba Canada
| | - David Collister
- Chronic Disease Innovation Centre Seven Oaks General Hospital Winnipeg Manitoba Canada
- Department of Internal Medicine, Section of Nephrology, Max Rady Faculty of Health Sciences University of Manitoba Winnipeg Manitoba Canada
- Department of Medicine, Faculty of Medicine & Dentistry University of Alberta Edmonton Alberta Canada
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Khater J, Malakouti S, Khoury AE, Cortese B. Performance of sodium-glucose cotransporter 2 inhibitors in cardiovascular disease. J Cardiovasc Med (Hagerstown) 2024; 25:247-258. [PMID: 38305141 DOI: 10.2459/jcm.0000000000001598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
AIMS The use of sodium-glucose cotransporter 2 inhibitors (SGLT2i) as a new class of drug in treating type 2 diabetes has expanded beyond its original framework. Positive results have been achieved in reducing symptoms in patients with cardiovascular disease (CVD). The aim of this article is to present an in-depth review of the basic principles of this class of medications and how it has brought benefits to patients affected particularly by heart failure. METHODS Following a thorough PubMed search, this review includes 62 studies published between 2015 and 2023. Keywords searched included 'sodium-glucose cotransporter 2 inhibitors', 'cardiovascular disease', 'heart failure', 'chronic kidney disease', and 'type 2 diabetes'. The most recent and comprehensive data were used. RESULTS Positive results have been achieved in reducing symptoms in patients with CVD. SGLT2 inhibitors have also been shown to be useful in other contexts such as nonalcoholic fatty liver disease (NAFLD) by reducing liver fat accumulation, kidney benefits by improving body weight and vascular endothelium, improving eGFR, and reducing progression to end stage kidney disease (ESKD). SGLT2 inhibitors are also effective in reducing the need for heart failure hospitalizations and the risk of serious cardiac adverse events, including cardiovascular and all-cause mortality, in patients with reduced or preserved left ventricular (LV) ejection fraction and in acute or decompensated settings. CONCLUSION SGLT2 inhibitors have evolved into metabolic drugs because of their multisystem action and are indicated for the treatment of all spectrums of heart failure, type 2 diabetes, and chronic kidney disease.
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Affiliation(s)
- Jacinthe Khater
- DCB Academy, Milan, Italy
- Faculty of Medical Sciences, Lebanese University Rafic Hariri University Campus Hadath
| | | | - Antoine El Khoury
- DCB Academy, Milan, Italy
- Department of Cardiology, Faculty of Medicine and Medical Sciences, University of Balamand, Beirut, Lebanon
| | - Bernardo Cortese
- DCB Academy, Milan, Italy
- Fondazione Ricerca e Innovazione Cardiovascolare, Milan, Italy
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Kibret KT, Strugnell C, Backholer K, Peeters A, Tegegne TK, Nichols M. Life-course trajectories of body mass index and cardiovascular disease risks and health outcomes in adulthood: Systematic review and meta-analysis. Obes Rev 2024; 25:e13695. [PMID: 38226403 DOI: 10.1111/obr.13695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 10/17/2023] [Accepted: 12/02/2023] [Indexed: 01/17/2024]
Abstract
OBJECTIVE This systematic review aimed to assess the effect of life course body mass index (BMI) trajectories (childhood to adulthood) on cardiovascular disease (CVD) risk factors and outcomes. METHODS Prospective or retrospective cohort studies were identified that assessed the association of BMI trajectories with CVD risks and outcomes from databases published in English. The pooled effect sizes were estimated using a random-effects model. FINDINGS Seventeen eligible studies were included in this systematic review. The results revealed that a persistently overweight trajectory from childhood to adulthood was associated with a higher risk of hypertension (RR: 2.49; 95% CI: 1.9, 3.28) and type 2 diabetes (RR: 4.62; 95% CI: 2.36, 9.04) compared with a trajectory characterized by a normal BMI throughout both childhood and adulthood. Similarly, the risk of hypertension (RR: 2.38; 95% CI: 1.70, 3.33) and type 2 diabetes (RR: 3.66; 95% CI: 2.57, 5.19) was higher in those with normal-to-overweight trajectory compared with participants with a stable normal weight trajectory. CONCLUSION The findings suggest that lifetime BMI trajectories may be influential on health outcomes, and preventive strategies should be designed accordingly. Implementing appropriate preventive strategies at all life stages may reduce CVD risks and adverse outcomes later in life.
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Affiliation(s)
- Kelemu Tilahun Kibret
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Claudia Strugnell
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Kathryn Backholer
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Anna Peeters
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Teketo Kassaw Tegegne
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Melanie Nichols
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC, Australia
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Henry A, Mangos G, Roberts LM, Brown MA, Pettit F, O’Sullivan AJ, Crowley R, Youssef G, Davis GK. Preeclampsia-Associated Cardiovascular Risk Factors 6 Months and 2 Years After Pregnancy: The P4 Study. Hypertension 2024; 81:851-860. [PMID: 38288610 PMCID: PMC10956664 DOI: 10.1161/hypertensionaha.123.21890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 01/11/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Increased cardiovascular risk following preeclampsia is well established and there are signs of early cardiovascular aging 6 months postpartum. This study assessed whether blood pressure (BP) and other cardiovascular measures are abnormal 2 years postpartum in the same cohort to determine ongoing risk markers. METHODS Six months and 2 years postpartum, BP was measured using sphygmomanometry, 24-hour ambulatory BP monitoring, and noninvasive central BP. Anthropometric measures, blood, and urine biochemistry were performed. Cross-sectional comparisons between preeclampsia and normotensive pregnancy (NP) groups and longitudinal comparisons within each group were made at 6 months and 2 years. RESULTS Two years postpartum, 129 NP, and 52 preeclampsia women were studied who also had 6 months measures. At both time points, preeclampsia group had significantly higher BP (office BP 2 years, 112±12/72±8 versus 104±9/67±7 mm Hg NP; [P<0.001]; mean ambulatory BP monitoring 116±9/73±8 versus 106±8/67±6 mm Hg NP; [P<0.001]). No significant BP changes noted 6 months to 2 years within either group. Office BP thresholds of 140 mm Hg systolic and 90 mm Hg diastolic classified 2% preeclampsia and 0% NP at 2 years. American Heart Association 2017 criteria (above normal, >120/80 mm Hg) classified 25% versus 8% (P<0.002), as did our reference range threshold of 122/79 mm Hg. American Heart Association criteria classified 60% post-preeclampsia versus 16% after NP with above-normal ambulatory BP monitoring (P<0.001). Other cardiovascular risk markers more common 2 years post-preeclampsia included higher body mass index (median 26.6 versus 23.1, P=0.003) and insulin resistance. CONCLUSIONS After preeclampsia, women have significantly higher BP 6 months and 2 years postpartum, and have higher body mass index and insulin-resistance scores, increasing their future cardiovascular risk. Regular cardiovascular risk screening should be implemented for all who have experienced preeclampsia.
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Affiliation(s)
- Amanda Henry
- School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, Australia (A.H., G.M., L.M.R., M.A.B., F.P., A.J.O., G.K.D.)
- Departments of Women’s and Children’s Health (A.H., L.M.R., G.K.D.)
| | - George Mangos
- School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, Australia (A.H., G.M., L.M.R., M.A.B., F.P., A.J.O., G.K.D.)
- Departments of Renal Medicine (G.M., M.A.B., F.P.)
| | - Lynne M. Roberts
- School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, Australia (A.H., G.M., L.M.R., M.A.B., F.P., A.J.O., G.K.D.)
- Departments of Women’s and Children’s Health (A.H., L.M.R., G.K.D.)
| | - Mark A. Brown
- School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, Australia (A.H., G.M., L.M.R., M.A.B., F.P., A.J.O., G.K.D.)
- Departments of Renal Medicine (G.M., M.A.B., F.P.)
| | - Franziska Pettit
- School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, Australia (A.H., G.M., L.M.R., M.A.B., F.P., A.J.O., G.K.D.)
- Departments of Renal Medicine (G.M., M.A.B., F.P.)
| | - Anthony J. O’Sullivan
- School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, Australia (A.H., G.M., L.M.R., M.A.B., F.P., A.J.O., G.K.D.)
- Endocrinology (A.J.O.), St George Hospital, Kogarah, Australia
| | - Rose Crowley
- Cardiology (R.C., G.Y.) St George Hospital, Sydney, Australia
| | - George Youssef
- Cardiology (R.C., G.Y.) St George Hospital, Sydney, Australia
| | - Gregory K. Davis
- School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, Australia (A.H., G.M., L.M.R., M.A.B., F.P., A.J.O., G.K.D.)
- Departments of Women’s and Children’s Health (A.H., L.M.R., G.K.D.)
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Saito Y, Ito H, Fukagawa M, Akizawa T, Kagimura T, Yamamoto M, Kato M, Ogata H. Effect of renin-angiotensin system inhibitors on cardiovascular events in hemodialysis patients with hyperphosphatemia: A post hoc analysis of the LANDMARK trial. Ther Apher Dial 2024; 28:192-205. [PMID: 37921027 DOI: 10.1111/1744-9987.14080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/27/2023] [Accepted: 10/14/2023] [Indexed: 11/04/2023]
Abstract
INTRODUCTION The clinical benefits of renin-angiotensin system inhibitors (RASi) in patients undergoing hemodialysis remain obscure. METHODS This is a post hoc cohort analysis of the LANDMARK trial investigate whether RASi use was associated with cardiovascular events (CVEs) and all-cause mortality. A total of 2135 patients at risk for vascular calcification were analyzed using a Cox proportional hazards model with propensity-score matching. RESULTS The risk of CVEs was similar between participants with RASi use at baseline and those without RASi use at baseline and between participants with RASi use during the study period and those without RASi use during the study period. No clinical benefits of RASi use on all-cause mortality were observed. Serum phosphate levels were significantly associated with the effect of RASi on CVEs. CONCLUSIONS RASi use was not significantly associated with a lower risk of CVEs or all-cause mortality in hemodialysis patients at risk of vascular calcification.
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Affiliation(s)
- Yoshinori Saito
- Division of Nephrology, Department of Internal Medicine, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - Hidetoshi Ito
- Division of Nephrology, Department of Internal Medicine, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - Masafumi Fukagawa
- Division of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Tadao Akizawa
- Division of Nephrology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Tatsuo Kagimura
- The Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe, Kobe, Hyogo, Japan
| | - Masahiro Yamamoto
- Division of Nephrology, Department of Internal Medicine, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - Masanori Kato
- Division of Nephrology, Department of Internal Medicine, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - Hiroaki Ogata
- Division of Nephrology, Department of Internal Medicine, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
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Shen R, Zou T. Association Between Cancer and Cardiovascular Toxicity: A Nationwide Cross-Sectional Study on NHANES 1999-2018. Cardiovasc Toxicol 2024; 24:351-364. [PMID: 38466544 DOI: 10.1007/s12012-024-09845-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 02/28/2024] [Indexed: 03/13/2024]
Abstract
There is a dearth of evidence pertaining to the relationship of cardiovascular disease (CVD) and its subtype with adjudicated cancer, thereby limiting our understanding of the heightened risk of CVD resulting from long-term complications of cancer and its therapies. The aim of this study was to quantify the risks of CVD and its subtypes in adult cancer survivors compared with cancer-free controls in a nationwide cross-sectional study on Continuous National Health and Nutrition Examination Survey (NHANES). We included 44,442 participants ranging in age from 20 to 85 years. Cancer and CVD diagnoses were ascertained via the household questionnaires. The association of cancer status with the risk of CVD and CVD subtype was examined using weighted logistic regression. Stratification analyses were also performed by age, sex, race, marital status, income status, educational level, and hyperlipidemia. The Wald test was used to calculate P-value for interaction. A total of 4178 participants have cancer, while 4829 participants had CVD, respectively. In the multivariable-adjusted model, the cancer was consistently linked to an elevated risk of CVD. Stratification analyses showed that stronger association between cancer status and CVD risk was found in younger adults, non-white, and participants living without a spouse or partner, and without hyperlipidemia. Our study confirmed that cancer participants were strongly linked to living with CVD, independent of traditional cardiovascular risk factors, especially in younger adults, non-white, and participants living without a spouse or partner, and without hyperlipidemia. There exists a pressing requirement to establish effective strategies for the prevention of CVD within this population characterized by a heightened risk.
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Affiliation(s)
- Ruihuan Shen
- Department of Cardiology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
- Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Tong Zou
- Department of Cardiology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.
- Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People's Republic of China.
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Alunno A, Carubbi F, Rodríguez-Carrio J, Gossec L, Donohoe S, Ferri C. The management of cardiovascular risk in psoriatic disease: A bridge over troubled water. Semin Arthritis Rheum 2024; 65:152389. [PMID: 38325054 DOI: 10.1016/j.semarthrit.2024.152389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 01/09/2024] [Accepted: 01/18/2024] [Indexed: 02/09/2024]
Abstract
Evidence that psoriatic disease is burdened by an excess cardiovascular (CV) risk has accrued, however many questions remain unanswered. Although an interplay between traditional risk factors inflammation, disease activity and pharmacological therapies, as observed in rheumatoid arthritis (RA), may account for this increased risk, metabolic comorbidities rather than inflammation seem to have a leading role in psoriatic disease. Therefore, specific approaches, risk factors targeting and the importance of traditional risk factors and inflammation management need to be considered. The purpose of this review article is to discuss current data on CV risk in psoriatic disease, and to outline similarities and differences with RA in the light of international recommendations. Arguments in favour of developing specific guidance for CV prevention in psoriatic disease are discussed.
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Affiliation(s)
- Alessia Alunno
- University of L'Aquila, Department of Life, Health & Environmental Sciences, Internal Medicine and Nephrology Division, ASL1 Avezzano-Sulmona-L'Aquila, San Salvatore Hospital, L'Aquila, Italy.
| | - Francesco Carubbi
- University of L'Aquila, Department of Life, Health & Environmental Sciences, Internal Medicine and Nephrology Division, ASL1 Avezzano-Sulmona-L'Aquila, San Salvatore Hospital, L'Aquila, Italy
| | - Javier Rodríguez-Carrio
- Area of Immunology, Department of Functional Biology, Faculty of Medicine, University of Oviedo, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Laure Gossec
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris France; AP-HP, Pitié-Salpêtrière hospital, Rheumatology department, Paris, France
| | | | - Claudio Ferri
- University of L'Aquila, Department of Life, Health & Environmental Sciences, Internal Medicine and Nephrology Division, ASL1 Avezzano-Sulmona-L'Aquila, San Salvatore Hospital, L'Aquila, Italy
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Ben Dhaou C, Scott ML, Orr AW. Advances in Understanding Cardiovascular Disease Pathogenesis through Next-Generation Technologies. Am J Pathol 2024; 194:476-481. [PMID: 38519246 PMCID: PMC10988757 DOI: 10.1016/j.ajpath.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 01/19/2024] [Accepted: 01/23/2024] [Indexed: 03/24/2024]
Affiliation(s)
- Cyrine Ben Dhaou
- Department of Pathology and Translational Pathobiology, LSU Health Shreveport, Shreveport, Louisiana
| | - Matthew L Scott
- Department of Pathology and Translational Pathobiology, LSU Health Shreveport, Shreveport, Louisiana
| | - A Wayne Orr
- Department of Pathology and Translational Pathobiology, LSU Health Shreveport, Shreveport, Louisiana; Department of Molecular and Cellular Physiology, LSU Health Shreveport, Shreveport, Louisiana; Department of Cell Biology and Anatomy, LSU Health Shreveport, Shreveport, Louisiana.
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50
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Hjort A, Iggman D, Rosqvist F. Glycemic variability assessed using continuous glucose monitoring in individuals without diabetes and associations with cardiometabolic risk markers: A systematic review and meta-analysis. Clin Nutr 2024; 43:915-925. [PMID: 38401227 DOI: 10.1016/j.clnu.2024.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 02/06/2024] [Accepted: 02/13/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND & AIMS Continuous glucose monitoring (CGM) provides data on short-term glycemic variability (GV). GV is associated with adverse outcomes in individuals with diabetes. Whether GV is associated with cardiometabolic risk in individuals without diabetes is unclear. We systematically reviewed the literature to assess whether GV is associated with cardiometabolic risk markers or outcomes in individuals without diabetes. METHODS Searches were performed in PubMed/Medline, Embase and Cochrane from inception through April 2022. Two researchers were involved in study selection, data extraction and quality assessment. Studies evaluating GV using CGM for ≥24 h were included. Studies in populations with acute and/or critical illness were excluded. Both narrative synthesis and meta-analyzes were performed, depending on outcome. RESULTS Seventy-one studies were included; the majority were cross-sectional. Multiple measures of GV are higher in individuals with compared to without prediabetes and GV appears to be inversely associated with beta cell function. In contrast, GV is not clearly associated with insulin sensitivity, fatty liver disease, adiposity, blood lipids, blood pressure or oxidative stress. However, GV may be positively associated with the degree of atherosclerosis and cardiovascular events in individuals with coronary disease. CONCLUSION GV is elevated in prediabetes, potentially related to beta cell dysfunction, but less clearly associated with obesity or traditional risk factors. GV is associated with coronary atherosclerosis development and may predict cardiovascular events and type 2 diabetes. Prospective studies are warranted, investigating the predictive power of GV in relation to incident disease. GV may be an important risk measure also in individuals without diabetes.
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Affiliation(s)
- Anna Hjort
- Department of Biology and Biological Engineering, Division of Food and Nutrition Science, Chalmers University of Technology, Kemivägen 10, 41296 Gothenburg, Sweden.
| | - David Iggman
- Center for Clinical Research Dalarna, Uppsala University, Nissers väg 3, 79182 Falun, Sweden; Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Husargatan 3, BMC, Box 564, 75122 Uppsala, Sweden.
| | - Fredrik Rosqvist
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Husargatan 3, BMC, Box 564, 75122 Uppsala, Sweden.
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