Cardiovascular Disease In People Research Articles

Risk of cardiovascular disease in people taking psychotropic medication: a literature review

In people with serious mental illness, mortality and morbidity are significantly increased compared to the general population. This is often as a result of physical health problems; about two-thirds of premature death in people with serious mental illness has been attributed to natural causes including cardiovascular disease and diabetes. Cardiovascular disease risk in people with serious mental illness is higher than the general population, this risk is further increased in those with serious mental illness taking psychotropic medication. In this article, cardiovascular disease risk in serious mental illness, particularly the association with psychotropic interventions and monitoring required, is examined.

Global burden of atherosclerotic cardiovascular disease in people with hepatitis C virus infection: a systematic review, meta-analysis, and modelling study

SummaryBackgroundMore than 70 million people worldwide are estimated to have hepatitis C virus (HCV) infection. Emerging evidence indicates an association between HCV and atherosclerotic cardiovascular disease. We aimed to determine the association between HCV and cardiovascular disease, and estimate the national, regional, and global burden of cardiovascular disease attributable to HCV.MethodsFor this systematic review and meta-analysis, we searched MEDLINE, Embase, Ovid Global Health, and Web of Science databases from inception to May 9, 2018, without language restrictions, for longitudinal studies that evaluated the risk ratio (RR) of cardiovascular disease in people with HCV compared with those without HCV. Two investigators independently reviewed and extracted data from published reports. The main outcome was cardiovascular disease, defined as hospital admission with, or mortality from, acute myocardial infarction or stroke. We calculated the pooled RR of cardiovascular disease associated with HCV using a random-effects model. Additionally, we calculated the population attributable fraction and disability-adjusted life-years (DALYs) from HCV-associated cardiovascular disease at the national, regional, and global level. We also used age-stratified and sex-stratified HCV prevalence estimates and cardiovascular DALYs for 100 countries to estimate country-level burden associated with HCV. This study is registered with PROSPERO, number CRD42018091857.FindingsOur search identified 16 639 records, of which 36 studies were included for analysis, including 341 739 people with HCV. The pooled RR for cardiovascular disease was 1·28 (95% CI 1·18–1·39). Globally, 1·5 million (95% CI 0·9–2·1) DALYs per year were lost due to HCV-associated cardiovascular disease. Low-income and middle-income countries had the highest disease burden with south Asian, eastern European, north African, and Middle Eastern regions accounting for two-thirds of all HCV-associated cardiovascular DALYs.InterpretationHCV infection is associated with an increased risk of cardiovascular disease. The global burden of cardiovascular disease associated with HCV infection was responsible for 1·5 million DALYs, with the highest burden in low-income and middle-income countries.FundingBritish Heart Foundation and Wellcome Trust.

Do nurse interventions cut cardiovascular disease in people with severe mental illness?

Research into how to prevent heart attacks or strokes in people with severe mental illnesses (SMI) in 76 primary care practices in England found that practice nurses adhered to the intervention and behaviour change components more than healthcare assistants (HCAs).

Cardiovascular Disease Risk in Older Adults and Elderly Patients with Rheumatoid Arthritis: What Role Can Disease-Modifying Antirheumatic Drugs Play in Cardiovascular Risk Reduction?

The prevalence of rheumatoid arthritis (RA), the most common autoimmune inflammatory arthritis, is increasing, partly due to the aging of the general population. RA is an independent risk factor for the development of cardiovascular disease (CVD). Older adults and elderly patients with RA develop CVD at a younger age compared with their general population peers. Both the traditional cardiovascular risk factors (age, sex, smoking, diabetes mellitus, hypertension), and systemic inflammation (i.e. high disease activity) are contributors to accelerated CVD in people with RA. Of the disease-modifying antirheumatic drugs (DMARDs) used for RA treatment, methotrexate, triple combination oral therapy (methotrexate, sulfasalazine, and hydroxychloroquine), tumor necrosis factor inhibitor biologicals, and abatacept have the strongest data in favor of the reduction of cardiovascular events in patients with RA. A treat-to-target strategy should be employed in older adults and elderly patients with RA to ensure appropriate reduction in cardiovascular risk, which can also prevent short- and long-term musculoskeletal disability. Our review findings are in line with the 2016 European League Against Rheumatism guideline recommendations, specifically: (1) RA disease activity should be controlled with an optimal DMARD regimen using a treat-to-target approach; (2) the lipid profile should be assessed and monitored in every older adult and elderly RA patient; (3) CVD risk factors, including smoking cessation, blood pressure, and blood glucose control, should be optimized; (4) RA treatment should be initiated as soon as possible; and (5) shared decision making regarding the treatment of patients with RA should include a discussion on the potential amelioration of increased cardiovascular risk.

The importance of dyslipidaemia in the pathogenesis of cardiovascular disease in people with diabetes.

Atherosclerotic cardiovascular events are the leading cause of mortality and morbidity in those with diabetes. A key contributor to the development of atherosclerosis in this population is the presence of a particularly atherogenic lipid profile often referred to as 'Diabetic Dyslipidemia'. This profile is characterized by elevated triglycerides, triglyceride-rich lipoproteins, small dense LDL particles, and reduced HDL levels. This article reviews the underlying aetiology and pathophysiology of this dyslipidaemia and atherosclerosis in those with diabetes, provides insights from epidemiological and genetic studies, and current cardiovascular risk reducing interventions including novel therapies such as PCSK-9 inhibitors.

Aspirin for primary prevention of cardiovascular disease in diabetes.

Aspirin for primary prevention of cardiovascular disease in diabetes.

Correlation between coagulation and inflammation state in patients with diabetes mellitus type 2 in relation to gender differences: Is there any impact of eight-week exercise training?

Background/Aim. The hypercoagulable state and inflammation state in diabetics has been widely studied by previous researchers, but there is a lack of research about a possible impact of exercise training on this relationship. The aim of this study was to assess and compare correlation between the coagulation and inflammation status in patients with type 2 diabetes mellitus taking into account the gender differences as well as an impact of the 8-week exercise training on the correlation coefficient and parameters of the inflammation and coagulation state. Methods. A total of 60 patients in stable clinical condition and well-regulated diabetic status passed through all phases of the study. The exercise training included the exercise program as interval training with estimated intensity uphill to 75% of a maximal heart rate in particular individual, 5 times a week for 8 weeks, and walking for 30 minutes with a speed of 5 km/h, 5 times a week for 8 weeks. Further fibrinolytic, coagulation and inflammatory parameters were analyzed before and after the study: D-dimer, von Willebrand factor (vWF), fibrinogen, high sensitivity CRP (hs-CRP), leukocytes, thrombin time (TT), prothrombin time (PT), activated partial thromboplastin time (APTT) and coagulation factors: FII, FV, FVII and FX. Results. Our research showed a statistically significant reduction in the mean vWF levels after intervention both at the males (p < 0.001) and females (p < 0.001). According to a correlation analysis between hs-CRP and fibrinogen, there was a positive correlation as baseline both at the males (p < 0.05, r = 0.492) and females (p < 0.01, r = 0.516) which became weaker in the males (p < 0.01, r = 0.449) and disappeared in the females (p < 0.05, r = 0.059) after intervention. The correlation which existed as baseline in the males between D-dimer and either hs-CRP (p < 0.01, r = 0.633) or fibrinogen (p < 0.01, r = 0.673) as well as the correlation between hs-CRP and FII (p < 0.01, r = 0.728), FV (p < 0.05, r = 0.366), FVII (p < 0.05, r = 0.373) coagulation as well as between D-dimer and FII (p < 0.01, r = 0.851), FVII (p < 0.05, r = 0.367)was absent in the females. Our research demonstrated a weakening correlations in the males after intervention between D-dimer and hs-CRP (p < 0.05, r = 0.378), between hs-CRP and FII (p < 0.01, r = 0.501), FV (p < 0.05, r = 0.298), FVII (p < 0.05, r = 0.351) as well as between D-dimer and FII (p < 0.01, r = 0.759), and FVII (p < 0.05, r = 0.296). The increase of the FX values (p < 0.05) in the females after intervention suggested the possible antiinflammatory effect of exercise training. Conclusion. According to previous research, the higher levels of vWF was associated with a risk of cardiovascular disease in people with type 2 diabetes mellitus and vWF may be a risk factor unique to these populations. We demonstrated that the 8-week exercise training can significantly reduce the value of vWF in the males and females, suggesting a potential beneficial effect on the endothelial function parameters. Our research demonstrated a stronger correlation between the coagulation and inflammation parameters as baseline in the males than in the females with type 2 diabetes mellitus. According to our results, the 8-week exercise training lead to a weakening of the strength of correlation between the coagulation and inflammation parameters in the males and complete disappearance of this correlation in the females, suggesting a unique effect of exercise training that should be explored in future research.

Net benefit of statins for primary prevention of cardiovascular disease in people 75 years or older: a benefit-harm balance modeling study.

Background:We determined the risk thresholds above which statin use would be more likely to provide a net benefit for people over the age of 75 years without history of cardiovascular disease (CVD).Methods:An exponential model was used to estimate the differences in expected benefit and harms in people treated with statins over a 10-year horizon versus not treated. The analysis was repeated 100,000 times to consider the statistical uncertainty and produce a distribution of the benefit–harm balance index from which we determined the 10-year CVD risk threshold where benefits outweighed the harms. We considered treatment estimates from trials and observational studies, baseline risks, patient preferences, and competing risks of non-CVD death, and statistical uncertainty.Results:Based on average preferences, statins were more likely to provide a net benefit at a 10-year CVD risk of 24% and 25% for men aged 75–79 years and 80–84 years, respectively, and 21% for women in both age groups. However, these thresholds varied significantly depending on differences in individual patient preferences for the statin-related outcomes, with interquartile ranges of 21–33% and 23–36% for men aged 75–79 years and 80–84 years, respectively, as well as 20–32% and 21–32% for women aged 75–79 years and 80–84 years, respectively.Conclusions:Statins would more likely provide a net benefit for primary prevention in older people taking the average preferences if their CVD risk is well above 20%. However, the thresholds could be much higher or lower depending on preferences of individual patients, which suggests more emphasis should be placed on individual-based decision-making, instead of recommending statins for everyone based on a single or a small number of thresholds.

Results of the ASCEND study: time to abandon aspirin for the primary prevention of cardiovascular disease in people with diabetes

Results of the ASCEND study: time to abandon aspirin for the primary prevention of cardiovascular disease in people with diabetes

Motivators and Deterrents to Diet Change in Low Socio-Economic Pakistani Patients With Cardiovascular Disease

This study explores factors that affect the people of low socioeconomic status regarding food choices after diagnosis with cardiovascular disease. Qualitative approach was used to identify the important factors associated with dietary changes as a result of their disease. Twenty-four participants were interviewed from two cardiac facilities in Karachi, the largest metropolitan city of Pakistan. Data were analyzed to identify the themes using the interpretative description approach. While most participants understood the need for dietary changes, few were able to follow recommended diets. Their food choices were primarily influenced by financial constraints as well as cultural, familial, and religious values and practices. The challenge for health care providers lies in understanding the economical, sociocultural, and religious factors that influence behavioral changes which, in turn, affect dietary choices. It is apparent that cardiovascular risk and disease outcomes for the people of low socioeconomic status are likely to escalate. Thus, it is necessary to address the sociocultural, religious, and behavioral factors affecting dietary choices. Achieving this imperative requires an intersectorial, multilevel intervention for the prevention of cardiovascular diseases in people of low socioeconomic status.

The Utility of Visceral Adiposity Index in Prediction of Metabolic Syndrome and Hypercholesterolemia

Metabolic syndrome (MS) is defined as a complex entity that involves the accumulation of cardiovascular and metabolic risk factors represented by: abdominal obesity, insulin resistance, hypertension, dyslipidemia [1]. The presence of MS correlates with the risk of cardiovascular disease in people without diabetes mellitus (DM), as well as those with type 2 DM [2-8].Visceral adipose tissue is an active metabolic organ and abdominal obesity is an independent risk factor for metabolic disorder present in MS [9,10,11], associated with the development of cardiovascular disease and type 2 diabetes in children, adolescents and adults [12-15]. Our findings have shown an association of visceral adiposity index (VAI) with MS in both men and women with prediabetes and diabetes, these findings allow us to conclude that VAI is a simple but effective indicator for estimating the presence of MS among adults.

Implications of the Intestinal Microbiota in Diagnosing the Progression of Diabetes and the Presence of Cardiovascular Complications.

The prevalence of diabetes is steadily rising, and once it occurs, it can cause multiple complications with a negative impact on the whole organism. Complications of diabetes may be macrovascular: such as stroke and ischemic heart disease as well as peripheral vascular and microvascular diseases—retinopathy, nephropathy, and neuropathy. Key factors that cause cardiovascular disease in people with diabetes include hyperglycemia, dyslipidemia, obesity, insulin resistance, inflammation, hypertension, autonomic dysfunction, and decreased vascular response capacity. Microbes can be considered a complex endocrine system capable of ensuring the proper functioning of the body but are also responsible for the development of numerous pathologies (diabetes, coronary syndromes, peripheral arterial disease, neoplasia, Alzheimer's disease, and hepatic steatosis). Changes in the intestinal microbiota may influence the host's sensitivity to insulin, body weight, and lipid and carbohydrate metabolism. Dysbiosis causes activation of proinflammatory mechanisms, metabolic toxicity, and insulin resistance. Trimethylamine N-oxide (TMAO) is a microbial organic compound generated by the large intestine, and its concentration increases in the blood after ingestion of foods rich in L-carnitine and choline, such as red meat, eggs, and fish. The interest for TMAO in cardiometabolic research has recently emerged, given the preclinical evidence that reveals a link between TMAO, diabetes, and cardiovascular complications. Intestinal microbiota can be modulated by changing one's lifestyle but also by antibiotic, probiotic, prebiotic, and fecal transplantation. The purpose of this article is to highlight issues related to the involvement of microbiota and trimethylamine N-oxide in the pathogenesis of diabetes mellitus and cardiovascular disease. Better appreciation of the interactions between food intake and intestinal floral-mediated metabolism can provide clinical insights into the definition of individuals with diabetic risk and cardiometabolic disease as well as potential therapeutic targets for reducing the risk of progression of the disease.

ASSOCIAÇÃO ENTRE HÁBITOS DE VIDA E RISCO CARDIOVASCULAR EM PESSOAS VIVENDO COM HIV/AIDS

Objetivo: analisar os hábitos de vida e o risco cardiovascular de pessoas vivendo com o vírus da imunodeficiênciahumana, por meio de fatores sociodemográficos, clínicos e comportamentais. Método: trata-se de estudo transversal,quantitativo, realizado em serviços especializados no atendimento de pessoas vivendo com o vírus da imunodeficiênciahumana, no período de 2014 a 2016, num município no interior do estado de São Paulo – Brasil. Utilizou-se Escorede Risco de Framingham para estratificação do risco cardiovascular. Resultados: participaram 340 pessoas. Houveassociação entre o risco cardiovascular e as variáveis sexo (p=0,003), idade (p<0,001), escolaridade (p=0,006), antecedentesfamiliares para Hipertensão (p=0,026), Diabetes (p=0,003), Infarto do Miocárdio (p=0,004) e Acidente VascularEncefálico (p=0,003), o tempo de diagnóstico pelo HIV (p<0,001) e uso de antirretrovirais (p=0,003). Conclusão: osresultados apontaram associações entre o risco cardiovascular e os fatores de risco modificáveis e não modificáveis paraocorrência de doenças cardiovasculares em pessoas vivendo com HIV.

Global Burden of Atherosclerotic Cardiovascular Disease in People Living With HIV: Systematic Review and Meta-Analysis.

With advances in antiretroviral therapy, most deaths in people with HIV are now attributable to noncommunicable illnesses, especially cardiovascular disease. We determine the association between HIV and cardiovascular disease, and estimate the national, regional, and global burden of cardiovascular disease attributable to HIV. We conducted a systematic review across 5 databases from inception to August 2016 for longitudinal studies of cardiovascular disease in HIV infection. A random-effects meta-analysis across 80 studies was used to derive the pooled rate and risk of cardiovascular disease in people living with HIV. We then estimated the temporal changes in the population-attributable fraction and disability-adjusted life-years (DALYs) from HIV-associated cardiovascular disease from 1990 to 2015 at a regional and global level. National cardiovascular DALYs associated with HIV for 2015 were derived for 154 of the 193 United Nations member states. The main outcome measure was the pooled estimate of the rate and risk of cardiovascular disease in people living with HIV and the national, regional, and global estimates of DALYs from cardiovascular disease associated with HIV. In 793 635 people living with HIV and a total follow-up of 3.5 million person-years, the crude rate of cardiovascular disease was 61.8 (95% CI, 45.8-83.4) per 10 000 person-years. In comparison with individuals without HIV, the risk ratio for cardiovascular disease was 2.16 (95% CI, 1.68-2.77). Over the past 26 years, the global population-attributable fraction from cardiovascular disease attributable to HIV increased from 0.36% (95% CI, 0.21%-0.56%) to 0.92% (95% CI, 0.55%-1.41%), and DALYs increased from 0.74 (95% CI, 0.44-1.16) to 2.57 (95% CI, 1.53-3.92) million. There was marked regional variation with most DALYs lost in sub-Saharan Africa (0.87 million, 95% CI, 0.43-1.70) and the Asia Pacific (0.39 million, 95% CI, 0.23-0.62) regions. The highest population-attributable fraction and burden were observed in Swaziland, Botswana, and Lesotho. People living with HIV are twice as likely to develop cardiovascular disease. The global burden of HIV-associated cardiovascular disease has tripled over the past 2 decades and is now responsible for 2.6 million DALYs per annum with the greatest impact in sub-Saharan Africa and the Asia Pacific regions. URL: https://www.crd.york.ac.uk/prospero . Unique identifier: CRD42016048257.

Prevalent cerebrovascular and cardiovascular disease in people with Parkinson's disease: a meta-analysis.

BackgroundPeople with Parkinson’s disease (PwP) are speculated to be at a low risk of cerebrovascular and cardiovascular disease (CVD) because they have fewer vascular risk factors and lower smoking rate. However, emerging evidence suggests that PwP are at higher risk of CVD, which introduces controversy to the notion that there is no association between Parkinson’s disease (PD) and CVD. Hence, we conducted a meta-analysis to analyze the risk of CVD in PwP.MethodsElectronic databases were searched using terms related to PD and CVD. Articles were included in the meta-analysis only if they employed clear diagnostic criteria for PD and CVD. The reference lists of the relevant articles were reviewed to identify eligible studies not found during the keyword search.ResultsThe enrolled studies were categorized into case–control and cohort studies, and the former was further divided into postmortem (three) and clinical (four) studies. In the clinical case–control studies group, PD was more associated with CVD (OR: 2.89, 95% CI: 1.36–6.13). Three studies were enrolled in the cohort studies group, and the merged results demonstrated that PwP were at higher risk of CVD during the follow-up period (HR: 1.84, 95% CI: 1.34–2.54).ConclusionPD is associated with CVD, which may be due to the shared pathogeneses between the two diseases or PD-related effects. PwP should be more aware of the risk of CVD despite having fewer traditional vascular risk factors.

Hemoglobin glycation index predicts cardiovascular disease in people with type 2 diabetes mellitus: A 10-year longitudinal cohort study

Background and aimsPrevious studies have suggested that the hemoglobin glycation index (HGI) can be used as a predictor of diabetes-related complications. We examined the prognostic significance of a high HGI for cardiovascular disease (CVD) in an ongoing hospital-based cohort. MethodsFrom March 2003 to December 2004, 1302 consecutive patients with type 2 diabetes and without a prior history of CVD were enrolled. CVD was defined as the occurrence of coronary artery disease or ischemic stroke. The HGI was calculated as the measured glycated hemoglobin (HbA1c) minus predicted HbA1c. Predicted HbA1c were calculated for 1302 participants by inserting fasting blood glucose (FBG) into the equation, Predicted HbA1c level = 0.02106 × FBG [mg/dL] + 4.973. Cox proportional hazards models were used to identify the associations between the HGI and CVD after adjusting for confounding variables. ResultsDuring 11.1 years of follow-up, 225 participants (17.2%) were newly diagnosed with CVD. The baseline HGI was significantly higher in subjects with incident CVD than in those without CVD, although the baseline FBG levels did not differ according to the occurrence of CVD. Compared with patients without CVD, those with CVD were older, had a longer duration of diabetes and hypertension, and used more insulin at baseline. A Cox hazard regression analysis revealed that the development of CVD was significantly associated with baseline HGI (hazard ratio [HR], 1.94; 95% confidence interval [CI], 1.31–2.87; p < 0.001, comparing the highest and lowest quartiles of HGI). This relationship was unchanged after additional adjustment for baseline HbA1c level (HR, 1.74; 95% CI, 1.08–2.81). The HRs of HbA1c in relation to outcomes were similar to or lower than those seen for HGI. After adjustment for HGI, the effect of the highest HbA1c on incident CVD disappeared. ConclusionsHigh HGI was independently associated with incident CVD in patients with type 2 diabetes. Patients with high HGI at baseline had a higher inherent risk for CVD.

Rapid eGFR change as a determinant of cardiovascular and renal disease outcomes and of mortality in hypertensive adults with and without type 2 diabetes

A rapid decline in estimated glomerular filtration rate over 2 years in a large hypertensive cohort was associated with similar risks for overall cardiovascular disease in people with or without diabetes mellitus, but with higher all-cause mortality, heart failure, and end stage renal disease risk in people with diabetes.

The HIV protease inhibitor, ritonavir, dysregulates human platelet function in vitro

There are 37 million people globally infected with the Human Immunodeficiency Virus (HIV). People living with HIV can achieve nearly normal lifespans due to the use of antiretroviral drugs (ARVs). However, people living with HIV experience chronic inflammation and increased risk for cardiovascular diseases (CVD) relative to uninfected people. While the cause for this risk is unclear, some ARVs have been associated with CVD, and it is speculated that some ARVs potentiate inflammation in infected individuals. Platelets are a critical link between inflammation and the development and progression of CVD, but the effects of ARVs on platelets are largely understudied. In this study, we examined the effects of ARVs on human platelet function in vitro. Our data show that the ARV ritonavir, a protease inhibitor, severely altered human platelet lipid mediator production (prostaglandin E2 and thromboxane) in both resting and activated platelets. Further characterization revealed that ritonavir altered measures of platelet hemostatic and thrombotic function that included significantly decreased platelet spreading, increased platelet aggregation, and trended toward increased clot strength. These data provide proof-of-principle that ARVs can directly dysregulate human platelets, possibly contributing to inflammation-related comorbidities. These data may provide mechanistic insight into the factors contributing to increased risk of CVD in people living with HIV, and may help guide future development of new HIV agents and ARV regimens that mitigate platelet dysregulation by ARVs.

Serum Apolipoprotein C-III and Cardiovascular Events in Type 1 Diabetes

Background: Apolipoproteins Apo-B, Apo-C-III, and Apo-E are atherogenic and are associated with diabetic dyslipidemia and cardiovascular disease (CVD). Apolipoprotein-defined lipoprotein subclasses (ADLS) also show associations with CVD, but prospective associations of these detailed metrics with CVD in people with type 1 diabetes (T1DM) have not been explored. Objective: Prospective associations of serum apolipoproteins and ADLS with CVD and major atherosclerotic cardiovascular events (MACE: composite of CVD death, nonfatal myocardial infraction or nonfatal stroke) in T1DM. Methods: Serum apolipoproteins and ADLS (14 biomarkers in total) measured in sera (1997-2000) in a subset (n=465) of the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications cohort. Prospective associations of CVD and MACE over 5942 and 6180 patient-years follow-up, respectively, were investigated using Cox proportional hazards models unadjusted and adjusted for risk factors. Results: During 15 years follow-up, 50 CVD and 24 MACE events occurred. Significant positive univariate associations for CVD were: Lp-B, Apo-B, Apo-C-III (total, heparin precipitate (HP), i.e., Apo-C-III in VLDL, and heparin soluble (HS), i.e., Apo-C-III in HDL) and Lp-B:C; for MACE: Apo-C-III sub fractions (total, Apo-C-III-HP, and Apo-C-III-HS). Adjusting for sex, age, HbA1c, systolic blood pressure, pulse rate, LDL-cholesterol, and triglycerides: for CVD, Apo-C-III-HS remained significant (HR (95% CI): 1.18 (1.03, 1.35); P=0.01). For MACE, total Apo-C-III and Apo-C-III-HS persisted when adjusted for age, HbA1c and LDL [1.11 (1.01, 1.22); P=0.02, and 1.22 (1.02, 1.45); P=0.02, respectively], but not for age, HbA1c and (log) triglycerides. No significant associations of other ADLS, Apo-A-I, A-II and Apo-E with CVD/MACE were observed. Conclusions: Total serum Apo-C-III and Apo-C-III in HDL and Apo-B-containing lipoproteins may serve as predictive biomarkers for CVD events in T1DM adults. Disclosure A. Basu: None. I. Bebu: None. A. Jenkins: Research Support; Self; Medtronic, Mylan, Sanofi-Aventis. J. Stoner: None. Y. Zhang: None. R.L. Klein: None. M.F. Lopes-Virella: None. W. Garvey: Advisory Panel; Self; Novo Nordisk Inc., Merck &amp; Co., Inc.. Research Support; Self; Sanofi, Pfizer Inc., Novo Nordisk Inc., AstraZeneca, Merck &amp; Co., Inc., Elcelyx Therapeutics, Inc., Lexicon Pharmaceuticals, Inc., Eisai Inc. M. Budoff: Speaker's Bureau; Self; Janssen Pharmaceuticals, Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Amarin Corporation. T. Lyons: None.

Cardiovascular disease risk marker responses to breaking up prolonged sedentary time in individuals with paraplegia: the Spinal Cord Injury Move More (SCIMM) randomised crossover laboratory trial protocol

IntroductionSedentary behaviour is a distinct risk factor for cardiovascular disease (CVD) and could partly explain the increased prevalence of CVD in people with spinal cord injury (SCI). Interrupting prolonged sitting...