Cardiovascular Risk

Source: www.ncbi.nlm.nih.gov --- 21 days ago
Cardiovascular Risk Factors and Incident Alzheimer Disease: A Systematic Review of the Literature. Alzheimer Dis Assoc Disord. 2008 Aug 13; Authors: Purnell C, Gao S, Callahan CM, Hendrie HC OBJECTIVE: The purpose of this study was to conduct a systematic review of the literature of Cardiovascular factors pertaining to incident Alzheimer disease (AD). METHODS: A systematic literature review was conducted of all studies of Cardiovascular Risk factors for incident AD listed in PubMed in English from 2000 to 2007. Risk factors included hypertension, diabetes, exercise, alcohol intake, smoking, B complex vitamins, homocysteine, stroke, atrial fibrillation, apolipoprotein E (APOE), lipids, and diet. Inclusion criteria consisted of diagnoses of incident AD and longitudinal studies with cohorts of 500 or more. RESULTS: Individual clinically defined Risk factors such as hypertension and diabetes were not significantly associated with increased Risk for AD. The strength of the association for hypertension could be considerably strengthened by changing criteria such as midlife measurements or using higher cutoffs for systolic blood pressure. APOE ϵ4 was the most consistent Risk factor. Interactions between Risk factors modify Risk particularly for hypertension and diabetes. Interactions modifying Risk were also found for exercise and physical function, APOE ϵ4, diabetes, and cholesterol. CONCLUSIONS: In this review, the evidence that ...

Source: www.ncbi.nlm.nih.gov --- 23 days ago
Related Articles Different Calculations of Ankle-Brachial Index and Their Impact on Cardiovascular Risk Prediction. Circulation. 2008 Aug 12; Authors: Espinola-Klein C, Rupprecht HJ, Bickel C, Lackner K, Savvidis S, Messow CM, Munzel T, Blankenberg S, BACKGROUND: -An ankle-brachial index (ABI; ratio of ankle and brachial systolic blood pressure) <0.9 indicates peripheral arterial disease (PAD) and is a strong predictor of Cardiovascular events. The aim of the present study was to address the prognostic value of different methods of ABI calculation. Methods and Results-In 831 patients admitted with chest pain for diagnostic heart catheterization, blood pressure of both anterior and posterior tibial arteries was measured. ABI was calculated for each leg with the higher of the 2 ankle pressures (current definition of the American Heart Association) or with the lower of the 2 ankle pressures (modified definition) in relation to the higher of the left or right brachial systolic blood pressure. For each patient, the lower ABI from both legs was used for further evaluation. Fifteen patients (1.8%) with ABI >1.5 were excluded. We compared patients with ABI <0.9 according to the current definition (with PAD, n=204 [25.0%]), those with ABI >/=0.9 according to the modified definition (without PAD, n=524 [64.2%]), and those with ABI <0.9 according to the modified definition and >/=0.9 according to the current definition (suspected PAD, n=88 [10.8 ...

Source: www.ncbi.nlm.nih.gov --- 23 days ago
Related Articles Cardiovascular Risk factors and the metabolic syndrome in pediatric nonalcoholic fatty liver disease. Circulation. 2008 Jul 15;118(3):277-83 Authors: Schwimmer JB, Pardee PE, Lavine JE, Blumkin AK, Cook S BACKGROUND: Nonalcoholic fatty liver disease (NAFLD), the most common cause of liver disease in children, is associated with obesity and insulin resistance. However, the relationship between NAFLD and Cardiovascular Risk factors in children is not fully understood. The objective of this study was to determine the association between NAFLD and the presence of metabolic syndrome in overweight and obese children. METHODS AND RESULTS: This case-control study of 150 overweight children with biopsy-proven NAFLD and 150 overweight children without NAFLD compared rates of metabolic syndrome using Adult Treatment Panel III criteria. Cases and controls were well matched in age, sex, and severity of obesity. Children with NAFLD had significantly higher fasting glucose, insulin, total cholesterol, low-density lipoprotein cholesterol, triglycerides, systolic blood pressure, and diastolic blood pressure than overweight and obese children without NAFLD. Subjects with NAFLD also had significantly lower high-density lipoprotein cholesterol than controls. After adjustment for age, sex, race, ethnicity, body mass index, and hyperinsulinemia, children with metabolic syndrome had 5.0 (95% confidence interval, 2.6 to 9.7) times the odds o ...

Source: www.ncbi.nlm.nih.gov --- 23 days ago
Related Articles Improved survival of diabetic foot ulcer patients 1995-2008, possible impact of aggressive Cardiovascular Risk management. Diabetes Care. 2008 Aug 12; Authors: Young MJ, McCardle JE, Randall LE, Barclay JI Objectives: To determine if a strategy of aggressive Cardiovascular Risk management reduced the mortality associated with diabetic foot ulceration. Research design and methods: Following an initial audit of outcomes demonstrating a high mortality rate in 404 diabetic foot ulceration patients with first ulceration developing between 1995 and 1999, a new aggressive Cardiovascular Risk policy was introduced as standard practice at the Diabetic Foot Clinic, Royal Infirmary of Edinburgh in 2001. 251 patients were screened and identified in the first three years of this policy. The audit cycle was then closed by re-auditing the five year mortality for a second group of foot ulcer patients in 2008. Results: Overall five-year mortality reduced from 48.0% in cohort 1 to 26.8% in cohort 2 (p<0.001). Improvement in survival was seen for both neuroischaemic patients (five year mortality 58% to 36% relative reduction 38%) and neuropathic patients (36% to 19%, relative reduction 47%), both p<0.001. Patients were more likely to die if they were older at time of ulceration or had type 2 diabetes, renal impairment, pre-existing Cardiovascular disease or were already on aspirin. Prior statin use, current or ex smoking, blood pressure ...

Source: www.ncbi.nlm.nih.gov --- 16 days ago
Aortic pressure augmentation as a marker of Cardiovascular Risk in obstructive sleep apnea syndrome. Hypertens Res. 2008 Jun;31(6):1109-14 Authors: Noda A, Nakata S, Fukatsu H, Yasuda Y, Miyao E, Miyata S, Yasuma F, Murohara T, Yokota M, Koike Y Obstructive sleep apnea syndrome (OSAS) is associated with increases in Cardiovascular morbidity and mortality. Vascular changes in individuals with OSAS have not been fully elucidated, however. The possible impact of OSAS on the extent of aortic pressure augmentation (AG), an indicator of Cardiovascular Risk, was investigated. Forty-five consecutive male patients aged 35 to 78 years (56.0+/-9.6 years) who were referred to the sleep clinic of Nagoya University Hospital for screening and treatment of OSAS and 71 age-matched healthy men were enrolled in the study. AG was derived from the pressure waveform measured at the radial artery by applanation tonometry. The number of apnea and hypopnea episodes per hour (apnea-hypopnea index [AHI]) was determined by standard polysomnography. AG was significantly greater in OSAS patients than in controls (9.0+/-4.1 vs. 6.4+/-3.4 mmHg, p<0.001), and it was significantly reduced in 19 OSAS patients treated with continuous positive airway pressure. AG was also significantly correlated with the AHI (r=0.562, p<0.001) and age (r=0.356, p=0.016) but not with the serum concentrations of low and high density lipoprotein-cholesterol, triglyceride, or glycosylated he ...

Source: www.ncbi.nlm.nih.gov --- 31 days ago
Related Articles Left ventricular volumes and mass in marathon runners and their association with Cardiovascular Risk factors. Int J Cardiovasc Imaging. 2008 Aug 3; Authors: Nassenstein K, Breuckmann F, Lehmann N, Schmermund A, Hunold P, Broecker-Preuss M, Sandner TA, Halle M, Mann K, Jöckel KH, Heusch G, Budde T, Erbel R, Barkhausen J, Möhlenkamp S Background To assess left ventricular volumes and mass by cardiac magnetic resonance imaging in relation to conventional Cardiovascular Risk factors and coronary atherosclerotic plaque burden in master marathon runners aged >/=50 years. Methods Cardiac MRI was performed in 105 clinically healthy male marathon runners (mean age 57.3 +/- 5.7 years, range 50-71 years) on a 1.5 T MR system (Avanto, Siemens, Germany). Cine steady state free precession images in standard long and short axes views were acquired to assess left ventricular volumes and mass. Cardiovascular Risk factors (blood pressure, HDL/LDL cholesterol, smoking, body mass index) were assessed and coronary artery calcification (CAC) was quantified by electron beam computed tomography. Results Left ventricular muscle mass (mean LVMM = 140 +/- 27 g; 73 +/- 13 g/m(2)) increased with increasing left ventricular end-diastolic volume (mean LVEDV = 137 +/- 32 ml; 72 +/- 15ml/m(2)) (r = 0.41, P < 0.0001) and with systolic (r = 0.33, P = 0.005) and diastolic (r = 0.28, P = 0.005) blood pressures. Left ventricular EDV increased up to the age ...

Source: www.ncbi.nlm.nih.gov --- 32 days ago
Related Articles Body Mass Index, Waist Circumference, and Cardiovascular Risk Factors in Adolescents. J Pediatr. 2008 Jul 31; Authors: Messiah SE, Arheart KL, Lipshultz SE, Miller TL OBJECTIVE: To determine optimal threshold values for body mass index (BMI) and waist circumference (WC) for detecting Cardiovascular disease (CVD) Risk (as defined with >/=3 CVD Risk factors [RFs]) in adolescents. STUDY DESIGN: The 1999-2004 National Health and Nutrition Examination Surveys (NHANES) cross-sectional data for 12- to 19-year-old adolescents (n = 2581) was analyzed. Main outcome measures were >/=3 age-adjusted CVD RFs (high- and low-density lipoprotein cholesterol level, triglyceride level, glucose level, insulin level, and systolic and diastolic blood pressure). The presence of >/=3 RFs was predicted from age- and sex-adjusted BMI and WC values with receiver operating characteristics analyses. RESULTS: The proportion of adolescents at Risk for >/=3 RFs ranged from 17% to 19%. Both BMI and WC had good diagnostic accuracy, ranging from 0.73 to 0.83, and good sensitivity and specificity, ranging from 0.68 to 0.77. The BMI cutoff points ranged from 19.5 to 25.0 kg/m(2) for boys and from 19.4 to 27.0 kg/m(2) for girls, and WC cutoff points ranged from 66.8 to 87.5 cm for boys and from 71.5 to 87.2 cm for girls. CONCLUSIONS: Age-, sex-, and ethnicity/race-specific threshold values for BMI and WC may have significant clinical usefulness in identifyi ...

Source: www.ncbi.nlm.nih.gov --- 6 days ago
Related Articles Body mass index and Cardiovascular Risk factors and biomarkers in hemodialysis patients. J Nephrol. 2008 Mar-Apr;21(2):197-204 Authors: Bossola M, Giungi S, Panocchia N, Vulpio C, Luciani G, Tazza L BACKGROUND: Being overweight and obesity are associated with improved survival in hemodialysis (HD) patients, based on mechanisms that are presently uncertain. We compared traditional and uremia-related Cardiovascular Risk factors in HD patients stratified according to their body mass index (BMI). METHODS: One hundred sixteen HD patients were stratified into 4 groups according to the BMI: underweight (<18.5), normal weight (18.5-24.9), overweight (25.0-29.9) and obese (> or =30). Blood samples were obtained before the HD session to measure serum albumin, high-sensitivity C-reactive protein, fibrinogen, ferritin, total cholesterol, LDL cholesterol, HDL cholesterol, apolipoprotein A-I and apolipoprotein B-100, apolipoprotein B (apoB) to apolipoprotein A (apoA) ratio and Lp(a) lipoprotein. RESULTS: There were 3 underweight (excluded from the analysis), 58 normal weight, 35 overweight and 20 obese patients. Their mean age was 62.1 +/- 14.1 years. There were 68 men and 45 women. Mean dialytic age was 5.32 +/- 3.2 years. The mean BMI of the study population was 25.2 +/- 4.1. The prevalence of smoking habit was similar in the 3 groups (17.2%, 8.5% and 25%, respectively; p=0.28). The prevalence of hypertension was higher in overwei ...

Source: www.ncbi.nlm.nih.gov --- 4 days ago
Related Articles Anemia and Cardiovascular Risk in the Patient with Kidney Disease. Heart Fail Clin. 2008 Oct;4(4):401-410 Authors: Fishbane S Patients with chronic kidney disease (CKD) often experience anemia, which causes fatigue and diminished quality of life. In addition, anemia in CKD has been associated with increased Risk for Cardiovascular events and left ventricular hypertrophy. To the extent that anemia plays a causal role in these relationships, treatment with erythropoiesis-stimulating agents (ESAs) could potentially help improve outcomes. To date, however, results from interventional studies have been disappointing in this regard. This article reviews the relationship between anemia in CKD and Cardiovascular Risk and explores current knowledge on ESA treatment. PMID: 18760752 [PubMed - as supplied by publisher] ...

Source: www.ncbi.nlm.nih.gov --- 6 days ago
Related Articles Will screening individuals at high Risk of Cardiovascular events deliver large benefits? No. BMJ. 2008;337:a1395 Authors: Capewell S PMID: 18755771 [PubMed - in process] ...

Source: www.moreover.com --- 5 days ago
NEW YORK--(BUSINESS WIRE)-- Pfizer announced that in patients with established heart disease, Lipitor(R) (atorvastatin calcium) 80 mg not only significantly reduced the relative Risk of suffering a first Cardiovascular event by 19 percent compared to ...

Source: www.ncbi.nlm.nih.gov --- 6 days ago
Related Articles Will screening individuals at high Risk of Cardiovascular events deliver large benefits? Yes. BMJ. 2008;337:a1371 Authors: Jackson R, Wells S, Rodgers A PMID: 18755770 [PubMed - in process] ...

Source: www.ncbi.nlm.nih.gov --- 20 days ago
Multiple biomarkers and Cardiovascular Risk. N Engl J Med. 2008 Aug 14;359(7):760-1 Authors: Pfister R, Hellmich M, Austin MJ, Heneghan MA, Zethelius B, Venge P, Arnlöv J PMID: 18703482 [PubMed - in process] ...

Source: www.ncbi.nlm.nih.gov --- 24 days ago
Related Articles Why traumatic leg amputees are at increased Risk for Cardiovascular diseases. QJM. 2008 Apr;101(4):251-9 Authors: Naschitz JE, Lenger R BACKGROUND: Post-traumatic lower limb amputees have an increased morbidity and mortality from Cardiovascular disease. Risk factors for this amplified morbidity and the involved pathophysiologic mechanisms have not been comprehensively studied. METHODS: The MEDLINE database was reviewed, with case-controlled studies and nested in cohort studies eligible for inclusion in this analysis. RESULTS: Insulin resistance, psychological stress and patients' deviant behaviors are prevalent in traumatic lower limb amputees. Each of these factors may have systemic consequences on the arterial system and may contribute to the increased Cardiovascular morbidity in traumatic amputees. Abnormalities of arterial flow proximal to the amputation site may hold the explanation for the linkage between the extent of leg amputation and the magnitude of the Cardiovascular Risk: proximal leg amputation is associated with greater Risk than distal amputation and bilateral amputation with greater Risk than unilateral amputation. This review focuses on hemodynamic culprits (shear stress, circumferential strain, reflected waves), hemodynamic consequences in proximity to the occluded femoral artery and hemodynamic consequences at a distance. CONCLUSION: Coronary Risk in lower limb amputees may be substantially greater ...

Source: www.ncbi.nlm.nih.gov --- 24 days ago
Related Articles PLASMA ADIPONECTIN FOR PREDICTION OF Cardiovascular EVENTS AND MORTALITY IN HIGH-Risk PATIENTS. J Clin Endocrinol Metab. 2008 Aug 12; Authors: Maiolino G, Cesari M, Sticchi D, Zanchetta M, Pedon L, Antezza K, Pessina AC, Rossi GP Context: the prognostic value of plasma levels of adiponectin, an adipocytokine with anti-atherogenic, anti-inflammatory and insulin-sensitizing effects, is contentious. Objective: to investigate if plasma adiponectin levels predict Cardiovascular (CV) events and mortality in high-Risk CAD patients. Design, Setting, Participants and Main Outcome Measure: we measured plasma adiponectin and examined its impact on the incidence of CV deaths and events at follow-up in the context of all potentially relevant background covariates in 712 high-Risk patients of the GENICA study who underwent coronary angiography for suspected CAD. Based on the population plasma adiponectin median (6.38 microg/mL, IQR 4.2-10.2) we split the patients in a high- and a low-plasma adiponectin subgroup. After a median follow-up of 3,8 years (IQR 3,3-4,3 years) outcome data were obtained in 100% of the patients and 45 (6.3%) CV deaths were recorded. Kaplan-Meier analysis unexpectedly showed a higher CV death rate in high-plasma adiponectin than in low-plasma adiponectin patients. By contrast, multivariate Cox regression analysis, where potential confounders, including ongoing medical treatment, were considered, showed no imp ...

Source: www.ncbi.nlm.nih.gov --- 20 days ago
Related Articles Metabolic syndrome, endothelial dysfunction, and Risk of Cardiovascular events: the Northern Manhattan Study (NOMAS). Am Heart J. 2008 Aug;156(2):405-10 Authors: Suzuki T, Hirata K, Elkind MS, Jin Z, Rundek T, Miyake Y, Boden-Albala B, Di Tullio MR, Sacco R, Homma S BACKGROUND: Metabolic syndrome (MetS) predisposes to Cardiovascular disease. Endothelial dysfunction is thought to be an important factor in the pathogenesis of atherosclerosis. We tested the hypothesis that both MetS and endothelial dysfunction are vascular Risk factors and provide additive prognostic values in predicting Cardiovascular events in a multiethnic community sample. METHODS: The study population consisted of 819 subjects (467 female, mean age 66.5 +/- 8.8 years, 66% Hispanic) enrolled in the NOMAS. Metabolic syndrome was defined using the revised Adult Treatment Panel III criteria. Brachial artery flow-mediated dilation (FMD) was measured using high-resolution ultrasound. Endothelial dysfunction was defined as FMD <8.44% (lower 3 quartiles). Cox proportional hazards models were used to assess the effect of MetS and endothelial dysfunction on Risk of Cardiovascular events. RESULTS: During 81 +/- 21 months of follow-up, events occurred in 84 subjects. Metabolic syndrome was independently associated with Cardiovascular events in a multivariate model, including Cardiovascular Risk factors (adjusted hazard ratio 2.08, 95% CI 1.27-3.40). Subjects wit ...

Source: www.medscape.com --- 23 days ago
Young women with gestational diabetes mellitus (GDM) are at significantly increased Risk of developing Cardiovascular disease, compared to women without GDM, according to a Canadian study published in the August issue of Diabetes Care. Reuters Health Information ...

Source: www.medscape.com --- 19 days ago
A meta-analysis shows that sulfonylureas and metformin increase the Risk for Cardiovascular hospitalization or mortality but not the Risk for Cardiovascular death or all-cause mortality alone. Medscape Medical News ...