Cardiovascular Disease In Men Research Articles

Факторы и уровень суммарного сердечно-сосудистого риска у населения северо-востока России

In northern regions, cardiovascular pathology tends to be more aggressive, is likely to occur at a young age already and often results in disability and even mortality among people who have not yet reached the retirement age. The aim of this study was to assess the structure and age-specific dynamics of basic factors able to cause cardiovascular diseases in men living in northern regions and the total cardiovascular risk. We conducted a one-center experimental cross-sectional comparative one-sample study of 116 men living in the north of the Magadan region. The complex study program included questioning, anthropometric examination, laboratory biochemical tests and molecular-genetic screening of candidate genes of essential hypertension (AGT (rs 4762), AGTR1 (rs5186), ADD1 (rs4961), NOS3 (rs2070744), and АСЕ (rs4340)). Genotyping was performed using real-time polymerase chain reaction. The total cardiovascular risk was calculated using the SCORE scale. The structure of basic risk factors that can cause cardiovascular diseases in men in the Magadan region includes both modifiable (smoking, obesity, essential hypertension, and dyslipidemia) and non-modifiable ones (climatic-geographic and genetic risk factors) in various age groups. With age, risk factors exert stronger influence on each other thus aggravating the clinical course of cardiovascular diseases and increasing risks of fatal cardiac events. This is especially important for northern regions where people are exposed to such non-modifiable risk factors as extreme climate. Moderate risk of cardiovascular diseases (according to the SCORE scale) was established for all men living in the North already at a young age. Therefore, a key task is to develop a strategy for active prevention of cardiovascular pathology that covers public at large starting from younger age groups.

Factors and level of the total cardiovascular risk for people in the north-eastern Russia

In northern regions, cardiovascular pathology tends to be more aggressive, is likely to occur at a young age already and often results in disability and even mortality among people who have not yet reached the retirement age. The aim of this study was to assess the structure and age-specific dynamics of basic factors able to cause cardiovascular diseases in men living in northern regions and the total cardiovascular risk. We conducted a one-center experimental cross-sectional comparative one-sample study of 116 men living in the north of the Magadan region. The complex study program included questioning, anthropometric examination, laboratory biochemical tests and molecular-genetic screening of candidate genes of essential hypertension (AGT (rs 4762), AGTR1 (rs5186), ADD1 (rs4961), NOS3 (rs2070744), and АСЕ (rs4340)). Genotyping was performed using real-time polymerase chain reaction. The total cardiovascular risk was calculated using the SCORE scale. The structure of basic risk factors that can cause cardiovascular diseases in men in the Magadan region includes both modifiable (smoking, obesity, essential hypertension, and dyslipidemia) and non-modifiable ones (climatic-geographic and genetic risk factors) in various age groups. With age, risk factors exert stronger influence on each other thus aggravating the clinical course of cardiovascular diseases and increasing risks of fatal cardiac events. This is especially important for northern regions where people are exposed to such non-modifiable risk factors as extreme climate. Moderate risk of cardiovascular diseases (according to the SCORE scale) was established for all men living in the North already at a young age. Therefore, a key task is to develop a strategy for active prevention of cardiovascular pathology that covers public at large starting from younger age groups.

Associations of lipoprotein(a) concentrations with cardiovascular disease in men and women with primary hypercholesterolemia

Associations of lipoprotein(a) concentrations with cardiovascular disease in men and women with primary hypercholesterolemia

Endothelium-mediated vasodilation: associations with cardiometabolic diseases and their risk factors in aging

Aim. To evaluate the association of flow-mediated vasodilation (FMD) with cardiometabolic diseases (CMDs) and their risk factors (RF) in old age.Material and methods. The study was conducted in the Russian population cohort of the HAPIEE project (Novosibirsk, 2015-2018). Endothelial function was assessed in a random subsample (788 men and women aged 55-84 years) using ultrasound measurements of the brachial artery FMD. Endothelial dysfunction (ED) was recorded with FMD <10%. Cardiovascular diseases (CVD) and risk factors were assessed using standard epidemiological methods.Results. The incidence of hypertension (HTN) was 78,8% (the same in men and women), major CVDs — 21,7% and 17,1%, type 2 diabetes (T2D) — 18,7% and 19,1% in men and women, respectively. The mean FMD values were 2,7% (SD 7,32) and 3,2% (7,19), while the prevalence of ED was 88,2% and 85,8% in men and women, respectively, and did not differ significantly by sex. Men with ED had higher levels of blood triglycerides (125,1 (71,23) vs 102,7 (45,79) mg/dl; p=0,033), waist/hip circumference indices (0,94 (0,050) vs 0,92 (0,076); p=0,009) and body weight (27,7 (45,79) vs 26,5 (4,36) kg/m2; p=0,077). In women, a tendency towards an association of ED with smoking was revealed (p=0,067). There were no associations of ED with HTN, T2D and CVD in men and women.Conclusion. The PMD test demonstrated a high incidence of ED in a population sample of 55-84 years old. ED is associated with metabolic risk factors in men and smoking in women. No associations of PMD with CMDs were found, presumably due to the high incidence of ED and cumulative disease in the elderly. Modification of metabolic risk factors and smoking cessation are relevant at any age to prevent the progression of ED.

Ambient Air Pollution and Incident Cardiovascular Disease in People with Type 2 Diabetes Mellitus: A cohort study.

We aimed to assess the effect of air pollution on incident cardiovascular disease (CVD) in people with type 2 diabetes mellitus (T2DM). We tracked 486 T2DM patients from 2012 to 2021. Cox regression models were applied to assess the hazard of exposure to particulate matter, carbon monoxide (CO), ozone, nitrogen dioxide, and sulfur dioxide (SO2) on incident CVD, revealing hazard ratios (HRs). CVD incidents occurred in 73 individuals. Among men, each 1-ppm increase in CO levels raised the risk of CVD (HR: 2.66 (95% CI: 1.30-5.44). For women, a 5-ppb rise in SO2 increased CVD risk (HR: 1.60 (95% CI: 1.11-2.30). No notable impact of particulate pollutants was found. Persistent exposure to gaseous air pollutants, specifically CO and SO2, is linked to the development of CVD in men and women with T2DM.

Social Determinants of Health Mediate Racial Disparities in Cardiovascular Disease in Men With Prostate Cancer

BackgroundCardiovascular disease (CVD) is a significant cause of morbidity and mortality in men with prostate cancer; however, data on racial disparities in CVD outcomes are limited. ObjectivesWe quantified the disparities in CVD according to self-identified race and the role of the structural social determinants of health in mediating disparities in prostate cancer patients. MethodsA retrospective cohort study of 3,543 prostate cancer patients treated with systemic androgen deprivation therapy (ADT) between 2008 and 2021 at a quaternary, multisite health care system was performed. The multivariable adjusted association between self-reported race (Black vs White) and incident major adverse cardiovascular events (MACE) after ADT initiation was evaluated using cause-specific proportional hazards. Mediation analysis determined the role of theme-specific and overall social vulnerability index (SVI) in explaining the racial disparities in CVD outcomes. ResultsBlack race was associated with an increased hazard of MACE (HR: 1.38; 95% CI: 1.16-1.65; P < 0.001). The association with Black race was strongest for incident heart failure (HR: 1.79; 95% CI: 1.32-2.43), cerebrovascular disease (HR: 1.98; 95% CI: 1.37-2.87), and peripheral artery disease (HR: 1.76; 95% CI: 1.26-2.45) (P < 0.001). SVI, specifically the socioeconomic status theme, mediated 98% of the disparity in MACE risk between Black and White patients. ConclusionsBlack patients are significantly more likely to experience adverse CVD outcomes after systemic ADT compared with their White counterparts. These disparities are mediated by socioeconomic status and other structural determinants of health as captured by census tract SVI. Our findings motivate multilevel interventions focused on addressing socioeconomic vulnerability.

Annals Video Summary - Associations of Testosterone and Related Hormones With All-Cause and Cardiovascular Mortality and Incident Cardiovascular Disease in Men.

Annals Video Summary - Associations of Testosterone and Related Hormones With All-Cause and Cardiovascular Mortality and Incident Cardiovascular Disease in Men.

Associations of Testosterone and Related Hormones With All-Cause and Cardiovascular Mortality and Incident Cardiovascular Disease in Men : Individual Participant Data Meta-analyses.

Whether circulating sex hormones modulate mortality and cardiovascular disease (CVD) risk in aging men is controversial. To clarify associations of sex hormones with these outcomes. Systematic literature review to July 2019, with bridge searches to March 2024. Prospective cohort studies of community-dwelling men with sex steroids measured using mass spectrometry and at least 5 years of follow-up. Independent variables were testosterone, sex hormone-binding globulin (SHBG), luteinizing hormone (LH), dihydrotestosterone (DHT), and estradiol concentrations. Primary outcomes were all-cause mortality, CVD death, and incident CVD events. Covariates included age, body mass index, marital status, alcohol consumption, smoking, physical activity, hypertension, diabetes, creatinine concentration, ratio of total to high-density lipoprotein cholesterol, and lipid medication use. Nine studies provided individual participant data (IPD) (255 830 participant-years). Eleven studies provided summary estimates (n = 24 109). Two-stage random-effects IPD meta-analyses found that men with baseline testosterone concentrations below 7.4 nmol/L (<213 ng/dL), LH concentrations above 10 IU/L, or estradiol concentrations below 5.1 pmol/L had higher all-cause mortality, and those with testosterone concentrations below 5.3 nmol/L (<153 ng/dL) had higher CVD mortality risk. Lower SHBG concentration was associated with lower all-cause mortality (median for quintile 1 [Q1] vs. Q5, 20.6 vs. 68.3 nmol/L; adjusted hazard ratio [HR], 0.85 [95% CI, 0.77 to 0.95]) and lower CVD mortality (adjusted HR, 0.81 [CI, 0.65 to 1.00]). Men with lower baseline DHT concentrations had higher risk for all-cause mortality (median for Q1 vs. Q5, 0.69 vs. 2.45 nmol/L; adjusted HR, 1.19 [CI, 1.08 to 1.30]) and CVD mortality (adjusted HR, 1.29 [CI, 1.03 to 1.61]), and risk also increased with DHT concentrations above 2.45 nmol/L. Men with DHT concentrations below 0.59 nmol/L had increased risk for incident CVD events. Observational study design, heterogeneity among studies, and imputation of missing data. Men with low testosterone, high LH, or very low estradiol concentrations had increased all-cause mortality. SHBG concentration was positively associated and DHT concentration was nonlinearly associated with all-cause and CVD mortality. Medical Research Future Fund, Government of Western Australia, and Lawley Pharmaceuticals. (PROSPERO: CRD42019139668).

EFFECTS OF DIFFERENT SEX HORMONES ON CARDIOVASCULAR DISEASE: A META-ANALYSIS AND SYSTEMATIC REVIEW

Objective: Sex hormones play different roles in cardiovascular risk of male and female patients. Especially for postmenopausal women, sex hormone disorder is the main reason for their increased risk of cardiovascular disease. This study mainly explores the effects of different sex hormone levels on cardiovascular diseases in men and postmenopausal women. Design and method: This study included 16 studies with 404,474 patients, including 387,361 male patients and 17,113 female patients. Hazard ratio (HR) and 95%CI results of studies on sex hormones and cardiovascular disease risk in the included literature were extracted as research data. The main outcome events are: cardiovascular disease (CVD), heart failure (HF), cardiovascular death, major cardiovascular adverse events (MACE) and all-cause death. This paper mainly researches the effects of sex hormones on cardiovascular risk and the differences of cardiovascular events between men and women. Results: 1. DHT is a protective factor of cardiovascular risk in male patients, HR = 0.83, 95% CI (0.72, 0.96). 2. For postmenopausal women, SHBG and cFT are the risk factors of CVD in postmenopausal women, with HR 95%CI of 1.06(1.01,1.11) and 1.11 (1.04, 1.19) respectively. 3. DHEA and TT is a risk factor for heart failure in postmenopausal women, which can increase the risk by 17% (HR = 1.17, 95% CI (1.09, 1.24)) and HR = 1.07, 95% CI (1.03, 1.12), while the SHBG and DHEA had no significant effect on the occurrence of chronic heart failure. Conclusions: DHT is a protective factor of cardiovascular disease risk in men, and the increase of androgen level is an important risk factor of cardiovascular disease risk in postmenopausal women.

The relationship of arterial hypertension, elevated low-density lipoprotein cholesterol and their combination with the occurrence of new cases of cardiovascular diseases in men and women of working age

The relationship of arterial hypertension, elevated low-density lipoprotein cholesterol and their combination with the occurrence of new cases of cardiovascular diseases in men and women of working age

Association of cardiovascular disease prevalence with BMD and fracture in men with T2DM.

Patients with type 2 diabetes mellitus (T2DM) are predisposed to cardiovascular disease (CVD). Bone mineral density (BMD) is linked to CVD, but most studies focused on women. Our analysis aims to explore the association of BMD and fracture with the prevalence of CVD in men with T2DM. In this retrospective cross-sectional study, 856 men with T2DM were enrolled. BMDs at the lumbar spine (L2-4), femoral neck (FN), and total hip (TH) were measured by dual-energy X-ray absorptiometry (DXA). The CVD outcome was determined as the sum of the following conditions: congestive heart failure, coronary heart disease, angina pectoris, myocardial infarction, the requirement for coronary artery revascularization, and stroke. The relationship between BMDs and CVD was investigated by restricted cubic spline curves and logistic regression models. A total of 163 (19.0%) patients developed CVD. The restricted cubic spline curve revealed a linear and negative association between FN-BMD, TH-BMD, and CVD. After full adjustments for confounding covariates, the odds ratios were 1.34 (95% confidence interval [CI] [1.11-1.61], p < .05), 1.3 (95% CI [1.05-1.60], p < .05), and 1.26 (95% CI [1.02-1.55], p < .05) for each 1-SD decrease in BMDs of L2-4, FN and TH, respectively. T-scores of < -1 for BMD of L2-4 and FN were independently associated with CVD (p < .05). Subgroup analyses further supported our findings. The prevalence of CVD was inversely correlated with BMD levels in men with T2DM, particularly at the FN. We hypothesized that monitoring FN-BMD and early intervention would help reduce CVD risk in men with T2DM, especially those with hypertension.

Prediction of cardiovascular disease risk by serum zinc and copper concentrations and anthropometric measurements

IntroductionWe aimed to investigate the association between cardiovascular disease (CVD) and various anthropometric indices, as well as the serum levels of copper (Cu) and zinc (Zn), copper-zinc ratio (Cu/Zn ratio) and zinc-copper ratio (Zn/Cu ratio), in a large population sample from northeastern Iranian. Method9704 individuals aged 35 to 65 were enrolled in the first phase of the study. After a 10-year follow-up, 7560 participants were enrolled into the second phase. The variables used in this study included demographic characteristics, such as gender and age; biochemical parameters including: serum Zn, Cu, Cu/Zn ratio, and Zn/Cu ratio; anthropometric parameters including: waist circumference (WC), body mass index (BMI), and waist-to-hip ratio (WHR). The relationship between the aforementioned indices and CVD was examined using decision tree (DT) and logistic regression (LR) models. ResultsA total of 837 individuals were diagnosed with CVD among the 7560 participants. LR analysis showed that BMI, age, WH zinc-copper ratio (Zn/Cu ratio), and serum Zn/Cu ratio were significantly associated the development of CVD in men, and WHR, age, BMI, serum Cu, and Cu/Zn ratio in women. DT analysis showed that, age was the most important predictor of CVD in both genders. 71% of women, older than 49 years, with a WHR≥ 0.89, serum Cu< 75 (µg/dl), BMI≥ 22.93 (kg/m2), and serum Cu≥ 14 (µg/dl), had the highest risk of CVD. In men, among those who were ≥ 53 years, with a WHR≥ 0.98, serum Zn/Cu ratio< 1.69, and BMI≥ 22.30, had the highest risk of CVD. ConclusionAmong Iranian adult population, BMI, age, and WHR were one of the predictors of CVD for both genders. The Zn/Cu ratio was CVD predictor for men while Cu/Zn ratio was CVD predictor for women.

Association Between Nonalcoholic Fatty Liver Disease and the Risk of Cardiovascular Disease in the Middle-Age and Elderly Population of Northern China: A Cross-Sectional Study.

Nonalcoholic fatty liver disease (NAFLD) has become a major global health burden, which increases the risk of extra-hepatic complications such as type 2 diabetes mellitus (T2DM), dyslipidemia, metabolic syndrome (MetS), and cardiovascular disease (CVD). However, NAFLD remains underappreciated and underdiagnosed. Our study aimed to explore the prevalence of NAFLD and the association between NAFLD and CVD events among adults aged 40 and older in Northern China. This study was conducted in the Shijingshan district of Beijing, China from November 2011 to August 2012. A total of 18891 subjects were recruited in the study. The information including demographical information, lifestyle, previous history of diabetes, hypertension, dyslipidemia, CVD, and liver disease were gathered. Data on physical examination, blood lipid profile, fasting blood glucose, and 2-hour blood glucose were recorded. Determination of MetS was according to T2DM guideline of Chinese Diabetes Society (2020 edition). The association between CVD and NAFLD was evaluated by multivariate logistic regression. The prevalence of NAFLD was 15.2%. After adjustment for age, smoking status, alcohol intake, WC, hypertension, dyslipidemia and hyperglycemia, the odds ratios (ORs) of CVD in men were 1.622 (95%CI: 1.345-1.957) and 1.990 (95%CI: 1.709-2.316) in women with NAFLD, compared with the subjects without NAFLD. NAFLD is independently associated with increased risk of CVD development.

EGG CONSUMPTION AND INCIDENT CARDIOVASCULAR DISEASE: VARIATION BY DIETARY PATTERN

Abstract Some studies link egg consumption with cardiovascular disease, but none considers modification by dietary pattern. This study examines effects of egg consumption on incident cardiovascular disease (CVD), and variations of associations within the context of dietary pattern. Participants were 4,930 men and women from the Rancho Bernardo Study without prevalent CVD in 1972-74, who were followed through 2021 via mailed surveys, follow-up visits, and death certificates. Dietary data from 1988-91 enabled calculation of the alternate Mediterranean diet (aMed) score for 1632 individuals. Comparisons showed those with incident CVD (N=2066, 49.1%)were older (p&amp;lt; 0.001), had higher BMI (p=0.004), cholesterol, triglycerides, systolic and diastolic blood pressures (p’s&amp;lt; 0.001) than those without incident CVD, but did not differ in egg consumption. Those consuming more eggs/week were older (p&amp;lt; 0.001) and had higher BMI (p=0.002). Men consumed more eggs/week than women (means=4.2 vs. 3.2, p&amp;lt; 0.001). Adjusted Cox proportional hazards models showed there were no significant associations of egg consumption with incident CVD in men or women (HR=1.00, 95%CI=0.98-1.02; HR=1.01, 95%CI=0.99-1.03, respectively). However,analyses by dietary patterns showed that in men, but not women, increased egg consumption was associated with a 7% reduced risk of incident CVD (HR=0.93; 95%CI=0.88-0.98) among those with high aMed scores, but a 6% increased risk (HR=1.06; 95%CI=1.01-1.11) among those with low aMed scores. In conclusion, for men, dietary pattern modified associations such that among those with a healthier dietary pattern, egg intake was associated with lower incident CVD. For women, egg intake was unassociated with incident CVD regardless of dietary pattern.

Mendelian randomization identifies sex differences in pain manifestation of coronary artery disease

Abstract Background and aim Clinical manifestation of atherogenic cardiovascular disease differs between men and women. Men often present with classical symptoms i.e., chest pain radiating to left arm and jaw. Women may show a wide range of symptoms considered atypical, including but not limited to back pain and nausea. Anatomical pathways feeding cardiac pain have not been properly characterized with respect to sex-related differences in human at population level. Methods We performed sex-stratified GWAS analysis on CAD as well as chest, neck and shoulder, back and facial pain using the UK Biobank cohort (men N = 203,823; women N = 239,631). To unravel given differences in pain manifestation of atherogenic cardiovascular disease in men and women, we performed Mendelian Randomization to approximate the causal associations between coronary artery disease (CAD) and a variety of pain locations. Results We identified 32 and 19 independent instrumental variables (R2&amp;lt; 0.001, p-value 5x10-6) associated with CAD for men and women, respectively. MR analysis revealed potential causality between CAD and self-reported chest pain for men (OR: 1.33, CI: 1.25 – 1.41) and women (OR: 1.44, CI: 1.20 – 1.73) as well as a link between CAD and clinical chest pain for both sexes (men OR: 1.22, CI: 1.17 — 1.26; women OR: 1.31, CI: 1.18 — 1.46). MR displayed a relationship between CAD and back pain in women (OR: 1.35, CI: 1.03 — 1.66) but not in men (OR: 0.99, CI: 0.90 — 1.11, p-value difference: 0.036). Manifestation of neck and shoulder pain revealed a suggestive difference in causality between men and women (p-value difference: 0.051). Discussion Our study provided evidence supporting a causal association between CAD with manifestation of chest pain in both men and women. Additionally, no stronger effect in men was found contrary to clinical observations suggesting pain perception of the chest at population level could be similar between the sexes. Manifestation of back pain with CAD, however, showed a more causal effect in women compared to men. Here we show that pain perception of the heart is not limited to the chest in women at population level. Future research is required to identify what drives these differences at multiple levels.

Impaired artery elasticity predicts cardiovascular morbidity and mortality- A longitudinal study in the Vara-Skövde Cohort

It is still debated whether arterial elasticity provides prognostic information for cardiovascular risk beyond blood pressure measurements in a healthy population. To investigate the association between arterial elasticity obtained by radial artery pulse wave analysis and risk for cardiovascular diseases (CVD) in men and women. In 2002–2005, 2362 individuals (men=1186, 50.2%) not taking antihypertensive medication were included. C2 (small artery elasticity) was measured using the HDI/Pulse Wave CR2000. Data on acute myocardial infarction or stroke, fatal or non-fatal, was obtained between 2002–2019. Cox- regression was used to investigate associations between C2 and future CVD, adjusting for confounding factors such as age, sex, systolic blood pressure, heart rate, HOMA-IR (Homeostatic Model Assessment for Insulin Resistance), LDL- cholesterol, CRP (C-Reactive Protein), alcohol consumption, smoking and physical activity. At baseline, the mean age of 46 ± 10.6 years and over the follow-up period, we observed 108 events 70 events in men [event rate: 5.9%], 38 in women [event rate: 3.2%]. In the fully adjusted model, and for each quartile decrease in C2, there was a significant increase in the risk for incident CVD by 36%. (HR = 1.36, 95% CI: 1.01–1.82, p = 0.041). The results were accentuated for all men (HR = 1.74, 95% CI: 1.21–2.50, p = 0.003) and women over the age of 50 years (HR = 1.70, 95% CI: 0.69–4.20). We showed a strong and independent association between C2 and CVD in men. In women after menopause, similar tendencies and effect sizes were observed.

Serum Uric Acid and Clinical Cardiovascular Diseases in Men and Women: A Perspective for the Drug Target and the Effect of Sex.

Serum Uric Acid and Clinical Cardiovascular Diseases in Men and Women: A Perspective for the Drug Target and the Effect of Sex.

Sex-specific associations of γ-glutamyltransferase to HDL-cholesterol ratio and the incident risk of cardiovascular disease: three Korean longitudinal cohorts from different regions.

The combination of gamma-glutamyl transferase (GGT) and high-density lipoprotein cholesterol (HDL-C) (GGT/HDL-C) is a novel noninsulin-based marker for assessing the risk of nonalcoholic fatty liver disease and type 2 diabetes mellitus. However, whether the GGT/HDL-C ratio is related to the risk of incident cardiovascular disease (CVD) risk is not well known. Therefore, we aimed to investigate the longitudinal effect of GGT/HDL-C ratio on incident CVD risk in three large cohorts of Korean men and women. Data were assessed from 27,643 participants without CVD from the Korean Genome and Epidemiology Study (KoGES), Health Risk Assessment Study (HERAS), and Korea Health Insurance Review and Assessment (HIRA) (HERAS-HIRA) datasets. The participants were divided into four groups according to the GGT/HDL-C quartiles. We prospectively assessed hazard ratios (HRs) with 95% confidence intervals (CIs) for CVD using multivariate Cox proportional-hazard regression models over a 50-month period following the baseline survey. During the follow-up period, 949 patients (3.4%; 529 men and 420 women) developed CVD. The HRs of CVD for GGT/HDL-C quartiles 2-4 were 1.36 (95% CI, 0.91-2.02), 1.54 (95% CI, 1.05-2.26), and 1.66 (95% CI, 1.12-2.47) after adjusting for metabolic parameters in women, but GGT/HDL-C did not show a trend toward increases in incident CVD in men. Regional discrepancies were evident in the results; the increase in HR in the metropolitan hospital cohort was more pronounced than that in the urban cohort, and the risk was not increased in the rural cohort. GGT/HDL-C ratio may be a useful predictive marker for CVD in women. Furthermore, the prevalence of CVD was strongly correlated with the GGT/HDL-C ratio in metropolitan areas, and this correlation was more significant than that observed with GGT or HDL-C in isolation.

A study on knowledge, awareness, and practice of familial hypercholesterolemia among doctors at two tertiary care hospitals in Sri Lanka

Introduction: Familial Hypercholesterolemia (FH) is an inherited disorder affecting low-density lipoprotein cholesterol (LDL-C) metabolism. Individuals with FH have a substantially increased risk of cardiovascular disease (CVD). South Asia is burdened by premature CVD. Early detection and management of FH can reduce the burden of CVD. Despite growing awareness, FH remains underdiagnosed and therefore untreated, and assessing the present level of knowledge among doctors would help to implement educational activities.Methods: Doctors from two large teaching hospitals in Sri Lanka were requested to complete a survey questionnaire comprising questions on awareness, clinical features, prevalence, inheritance, and treatment of FH.Results: Of the 269 doctors surveyed, 168 (66.42%) of them correctly described FH and only 44 (16.66.%) knew about its global prevalence. 12 (4.55%) were aware of the risk of CVD associated with FH. Only 01 (0.75%) and 02 (1.5%) correctly identified the age threshold for premature CVD in men and women, respectively. 228 (87.36%) and 136 (54.84%) identified statins as monotherapy and statin and ezetimibe as combination therapy for FH, respectively. Furthermore, in practice 117 (44.66%) routinely screened family members for FH, and only half the doctors correctly identified the transmission rate to first-degree relatives (38.78%).Conclusion: Substantial defects in the knowledge of FH were seen among doctors. Immediate steps have to be taken to increase awareness and knowledge about FH in doctors practicing in Sri Lanka.

Adherence to healthy diet and risk of cardiovascular disease in adult survivors of childhood cancer in the St. Jude Lifetime Cohort: a cross-sectional study

BackgroundWhether diet has beneficial effects on cardiovascular disease (CVD) in childhood cancer survivors as in the general population is unknown. Therefore, we examined associations between dietary patterns and risk of CVD in adult survivors of childhood cancer.MethodsChildhood cancer survivors, 18–65 years old in the St Jude Lifetime Cohort (1882 men and 1634 women) were included in the analysis. Dietary patterns were defined by the adherence to the Healthy Eating Index (HEI)–2015, Dietary Approaches to Stop Hypertension (DASH), and alternate Mediterranean diet (aMED) based on a food frequency questionnaire at study entry. CVD cases (323 in men and 213 in women) were defined as participants with at least one grade 2 or higher CVD-related diagnosis at baseline. Multivariable logistic regression adjusted for confounders was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of CVD.ResultsGreater adherence to HEI-2015 (OR=0.88, 95% CI: 0.75–1.03, per 10 score increment), DASH (OR=0.85, 95% CI: 0.71–1.01, per 10 score increment), and aMED (OR=0.92, 95% CI: 0.84–1.00, each score increment) were, albeit trending towards significance, associated with a lower risk of CVD in women. HEI-2015 was associated with a non-significantly lower risk of CVD in men (ORQ5 vs. Q1=0.80, 95% CI: 0.50–1.28). These dietary patterns were also associated with a lower risk of CVD in survivors with high underlying CVD risk.ConclusionsAs recommended to the general population, a diet rich in plant foods and moderate in animal foods needs to be a part of CVD management and prevention in childhood cancer survivors.