Family History Of Cardiovascular Disease Research Articles

Place de l’électrocardiogramme dans la visite de non-contre-indication à la pratique sportive de compétition entre 12 et 35 ans : enquête auprès des médecins membres de l'Association Guinéenne des Médecins Sportifs

IntroductionAn electrocardiogram (ECG), combined with a well-conducted clinical examination, is more effective than the clinical examination alone in detecting underlying cardiac pathologies in athletes. The aim of this study was to evaluate the use of ECGs by physicians who are members of the Guinean Association of Sports Physicians, during the non-contraindication visit for competitive sports between the ages of 12 and 35. MethodologyWe conducted a web-survey from July 15 to August 15, 2023. A survey form was created on “Google Docs” and pre-tested. It was then broadcast on all the communication networks used by these doctors. The data were secured using “Google Drive” software. Analyses were performed using SPSS version 20 software. ResultsOf the 51 included, 74.51% said they had received at least one training session on ECG interpretation for athletes. All of them either requested or performed an ECG at least once in a while, as part of the check-up for non-contraindication to competitive sport. The ECG was systematic, according to 72.55% of doctors. Three quarters referred to a sports cardiologist in the event of an abnormal ECG, 66.67% to a cardiology resident and 58.82% to a cardiologist. In the absence of an ECG, the presence of functional signs on exertion, the notion of a family history of cardiovascular disease and the presence of at least two cardiovascular risk factors were the main reasons for seeking an opinion. ConclusionA resting ECG is carried out almost systematically by doctors who are members of the Guinean Association of Sports Doctors, as part of the check-up for non-contraindication to practising sport.

CORONARY ARTERY ANEURYSM IN IGG4–RELATED DISEASE

Abstract Introduction Coronary artery ectasia is a rare disease defined as a local or diffuse dilatation of the coronary artery more than 1.5 times the diameter of the adiacent normal segment. The etiology is diverse and can be rarely associated with immunoglobulin G4 (IgG4)–related disease. The high levels of serum IgG4 may promote the development of low–density plaques, intimal thickening due to pericoronitis and subsequent coronary ectasia. Case Report We present the case of a 72–year–old male patient with arterial hypertension, dyslipidemia, chronic renal insufficiency, and a family history of cardiovascular diseases. In the previous year, he suffered a cerebral hemorrhage attributed to an unspecified cerebral vascular malformation, which was managed with an endovascular approach. The patient was admitted for Non–ST–segment Elevation Myocardial Infarction (NSTEMI). Coronary angiography revealed widespread ectasia of the coronary vessels, a chronically occluded marginal branch, and an aneurysmatic proximal right coronary artery with the presence of a thrombus on the aneurysmal segment, dissolved following administration of intracoronaric heparin. Furthermore a critical stenosis at the crux involving the posterior interventricular branch was detected and angioplasty with drug–eluting stent implantation was performed on the affected vessel. Given the coronary artery ectasia, aortic ectasia revealed by echocardiography, renal insufficiency and persistently elevated amylase and lipase levels, further diagnostic investigation was conducted suspecting IgG4–related disease. Hematological tests revealed elevated IgG and IgG4 subclass levels (882 mg/dL and 1438 mg/L, respectively), C3 117 mg/dL, C4 30 mg/dL, and total IgE 130 KU/L. The diagnosis of IgG4–related disease was confirmed and the patient was advised to continue cardiological and rheumatological follow–up. Conclusion When the coronary arteries are involved in the IgG4–related disease, risk of acute events such as heart attack may increase and the prognosis is poor. Coronary thickening and ectasia, typical imaging features, other aortic involvement and inflammation indicators, like elevated serum IgG4, should be considered as red flags for an early investigation and subsequent early intervention.

CARDIOVASCULAR CONSIDERATIONS IN ANTIDEPRESSANT THERAPY: SINUS ARREST DUE TO SERTRALINE

Abstract A 39–year–old Caucasian woman with a silent cardiac anamnesis and no family history of cardiovascular diseases, and a history of mood disorder treated with Sertraline for about 1 month, went to the Emergency Department reporting several syncopal episode, all with rapid and complete recovery of consciousness. In the Emergency Department, another syncopal episode occurred in the supine position, characterized by sinus bradycardia evolving into a brief asystole, with spontaneous restoration of normal sinus rhythm. Admitted to the Cardiovascular Intensive Care Unit, the patient showed no abnormalities in laboratory testsas well as in echocardiography results. The patient received appropriate hydration, and home medication was discontinued. A non–contrast head CT scan showed no acute lesions. Cardiac MR revealed normal morpho–functional findings, with no evidence of myocardial edema or pericardial effusion and no pathological late gadolinium enhancement areas. Brain MRI demonstrated normal anatomical and functional findings, with no signal abnormalities. Considering the patient‘s young age and the suspicion of an iatrogenic origin of the rhythm disorder, the decision to postpone pacemaker implantation was made, and cardiac electrical activity was monitored using a loop recorder. At the one–month follow–up, the patient, who had been off Sertraline since admission, was in good health, reporting no further syncopal or pre–syncopal episodes. Loop recorder monitoring revealed no significant arrhythmias. The only relevant anamnestic data was the use of Sertraline, and the application of the Adverse Drug Reaction Probability Scale suggests that the iatrogenic origin of this event as a pharmacological adverse effect is at least probable (score: 7). Limited literature connects Sertraline directly to documented cases of asystole, but reports indicate that drugs in the same pharmacological class may induce cardiac rhythm disturbances, including tachyarrhythmias and bradyarrhythmias. This case draws attention to sinus arrest during sertraline therapy and how an appropriate pharmacological washout led to the resolution of the pathology.

Clinical epidemiology of cardiovascular disease in advanced chronic kidney disease prior to dialysis to a tertiary care centre in Bangladesh

Background: Patients with advanced CKD stages exhibit a markedly elevated risk of cardiovascular disease. Patients with chronic kidney disease (CKD) exhibit an elevated cardiovascular risk manifesting as coronary artery disease, heart failure, arrhythmias, and sudden cardiac death .The main objective of this study was to observe the clinical epidemiology of cardiovascular disease in advanced stages of CKD prior to dialysis to a tertiary care centre in Bangladesh. Methods: This was a cross-sectional observational study on 150 cases of diagnosed advanced stages (4&5) of CKD patients in the indoor Department of Medicine of Sir Salimullah Medical College Mitford Hospital, Dhaka, Bangladesh from July 2022to January2023 for 6 months. Data was analyzed SPSS 25. Results: Out of the total group, 62.0% are male, 38.0% are female, and the average (mean) age of the entire group was 55.2 ±10.3. Patients are compared in terms of their relative percentages and the associated cardiovascular disease (CVD) risk, with the hypothesis that lower hemoglobin levels (<9 mg/dL), common in advanced CKD, may be associated with higher CVD risk. A statistically significant P-value (0.036) indicates a significant association between lower hemoglobin levels and increased risk of CVD. Hypertension is the most common risk factor in both stages showing (80%) in stage 4 and 86.6% in Stage -5 of CKD respectively that increasing prevalence as stages of CKD increases . Other factors like diabetes 50.6%) and 53.3% , dyslipidemia 61.3% and 66.7% , and family history of cardiovascular disease (CVD) 40% and 46.6% also in prevalence from Stage 4 to Stage 5. However, the differences in the prevalence of these risk factors between the two stages are not statistically significant, as indicated by the P-values. The prevalence of Congestive Heart Failure rises from 44% in Stage 4 to 52% in Stage 5, and a similar trend is observed in Coronary Artery Disease from 40% in Stage 4 to 48% in Stage 5 and for other diseases, albeit with lesser increments. The provided pvalues, which assess statistical significance, indicate that the differences in disease prevalence between the two stages are not statistically significant, suggesting that the progression from Stage 4 to Stage 5. Conclusion: This study stated that increased prevalence and progression of cardiovascular risks in advanced CKD stages. Bangladesh J Medicine 2024; 35: 96-100

REMNANT CHOLESTEROL TRAJECTORY AND INCIDENT ISCHEMIC STROKE IN THE GENERAL POPULATION: A PROSPECTIVE COHORT STUDY

Objective: Studies have demonstrated that single measure of remnant cholesterol (RC) is correlated with the risk of ischemic stroke. However, it is unknown whether long-term patterns such as RC trajectory affects the risk of ischemic stroke. We sought to examine the role of RC trajectory in the subsequent development of ischemic stroke in the general population. Design and method: We performed analysis using data of eligible participants from the Kailuan Study cohort who underwent 3 health examinations and were free of atrial fibrillation, myocardial infarction, stroke, cancer, or known lipid-medication use from 2006 to 2010. Distinct RC trajectories were fitted using group-based trajectory modeling. Participants were followed up for stroke events until 31 December 2021. Multivariate analysis was performed using Cox proportional hazards regression models to estimate hazard ratio (HR) with 95% CI. Results: The final study cohort comprised 42 979 participants (mean [SD] age, 49.3 [11.8] years, and 76.6% of them were men). After a median follow-up of 11.0 years, 2277 individuals were newly diagnosed with ischemic stroke. We identified three RC trajectories, which included the low-decreasing group (n=38 413, 89.4%), the moderate-increasing group (n=1282, 3%), and the high-decreasing group (n=3284, 7.6%). Compared with the low-decreasing trajectory group, both individuals in the moderate-increasing group (HR, 1.26; 95% CI, 1.01 to 1.56) and high-decreasing group (HR, 1.24; 95% CI, 1.07 to 1.43) had higher risk of ischemic stroke after adjusting for age, sex, education, income, marriage, smoking, drinking, physical activity, family history of cardiovascular disease, estimated glomerular filtration rate, C-reactive protein, heart rate, body mass index, fasting blood glucose, antidiabetic drugs, systolic blood pressure, diastolic blood pressure, antihypertensive drugs, triglycerides, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol. Results remained robust after additionally adjusting for baseline RC or cumulative RC exposure during 2006-2010, excluding events within the first year of follow-up, or considering death as competing risk. Conclusions: Both moderate and high RC trajectories were associated with a higher risk of ischemic stroke in the general population.

Endodontic inflammatory disease and future cardiovascular events and mortality. A report from the PAROKRANK study

IntroductionProspective studies assessing the relation between endodontic inflammatory disease and subsequent cardiovascular events are few. The present aim was to explore associations between endodontic variables and future cardiovascular events in patients with myocardial infarction and matched controls participating in the PAROKRANK study. MethodsEight-hundred and five patients hospitalized for a first myocardial infarction and 805 controls were recruited between 2010 to 2014. Signs of endodontic inflammatory disease were assessed in panoramic radiographs taken at baseline. Mortality and morbidity data during the approximately eight years of follow up were obtained from national registries. The risk for future cardiovascular events (first of mortality and non-fatal myocardial infarction, stroke, or hospitalization for heart failure) was analyzed with the Log-rank test and Cox proportional hazards regression, adjusted for the following confounders: sex, age, smoking, myocardial infarction, diabetes, education, marital status, family history of cardiovascular disease, and marginal periodontitis. ResultsIn total, 285 future events were observed during the follow-up period. Unadjusted analyses revealed that ≥1 root filled tooth increased the risk of a future event. Following adjustment, the number of remaining teeth and non-root filled teeth decreased the risk of future events while higher DMFT-score increased the risk and ≥1 primary apical periodontitis decreased the risk of suffering cardiovascular events. Higher DMFT-score and decayed teeth increased the risk of all-cause mortality. ConclusionsTooth loss is a strong indicator of an increased risk for future cardiovascular events. Root filled teeth seem of limited value as a risk indicator when accounting for other risk factors. The potential effect of dental interventions on future events should be assessed in future research.

Association between pre-treatment with statin and its inhibitory effect on the onset of coronary artery disease at the time of coronary computed tomography angiography: a new look at an old medication.

Coronary artery stenosis is often advanced by the time coronary computed tomography angiography (CCTA). Statins are the most important anti-lipidemic medication for improving the prognosis of coronary artery disease (CAD) patients. Although lipid-lowering therapy using statins appears to have been established as a method for preventing CAD, there remains the problem that CAD cannot be completely suppressed. In this study, we investigated whether pre-treatment with statin could significantly inhibit the onset of CAD when patients received CCTA for screening of CAD. The subjects were 1164 patients who underwent CCTA as screening for CAD. CAD was diagnosed when 50% or more coronary stenosis was present in the coronary arteries. Patient backgrounds were investigated by age, gender, body mass index, coronary risk factors [family history of cardiovascular diseases, smoking history, hypertension (HTN), diabetes mellitus (DM), dyslipidemia, chronic kidney disease (CKD) or metabolic sydrome] and medications. Patients were classified into two groups according to the presence or absence of statin pre-administration during CCTA [statin (-) group (n = 804) and (+) group (n = 360)]. Compared with the statin (-) group, the statin (+) group was significantly older and had higher rates of family history, HTN, and DM. The statin (+) group had a significantly higher % CAD than the statin (-) group. Serum levels of low-density lipoprotein cholesterol (LDL-C) were significantly lower in the statin (+) group than in the statin (-) group. There was no significant difference in either high-density lipoprotein cholesterol levels or triglyceride levels between the two groups. Age, male gender, HTN, DM and pre-treatment with statin were all associated with CAD (+) in all patients. In addition, factors that contributed to CAD (+) in the statin (-) group were age, male gender, and DM, and factors that contributed to CAD (+) in the statin (+) group were age, smoking, HTN and % maximum dose of statin. At the time of CCTA, the statin (+) group had a high rate of CAD and coronary artery stenosis progressed despite a reduction of LDL-C levels. To prevent the onset of CAD, in addition to strict control of other coronary risk factors (HTN etc.), further LDL cholesterol-lowering therapy may be necessary.

Cardiovascular risk profile in two cohorts of young apparently healthy South Asian descendants in the Netherlands: still a long way to go!

Cardiovascular disease (CVD) imposes a major healthcare burden on young descendants of South Asian migrants living in the western world. In comparison to the native population, the prevalence is significantly higher and the prevalence of CVD risk factors is increasing rapidly. The cardiovascular risk profile and 10-year risk scores of South Asian descendants were evaluated in two cohorts with a 10-year time difference. Two cross-sectional studies, conducted in 2004 and 2014, focused on asymptomatic South Asian descendants aged 18-59 years were performed. A short questionnaire, BMI, waist circumference, blood pressure, and nonfasting blood tests were obtained. The cohort of 2014 was matched with the cohort of 2004, based on age, gender, and family history of CVD. In 2014, 674 South Asians (44% men, age 38.2 ± 12.0 years) were matched with 674 South Asians (44% men, age 38.3 ± 12.1 years) included in 2004. Notably, hypertension prevalence decreased significantly in 2014 (10.6% vs 23.1% in 2004, P < 0.001), while mean BMI increased (26.1 vs 24.9, P < 0.001). The mean Framingham risk score was lower in 2014 (5.31 ± 6.19%) than in 2004 (6.45 ± 8.02%, P < 0.05). This study demonstrates that South Asian descendants in 2014 have a lower but still high absolute risk for coronary events compared to 2004. Important differences in cardiovascular risk profile exist. Despite improvements, South Asian descendants in 2014 still face a high absolute risk for coronary events compared to 2004, indicating the necessity for continued primary prevention and lifestyle interventions.

The effect of obesity phenotype changes on cardiovascular outcomes in adults older than 40 years in the prospective cohort of the Tehran lipids and glucose study (TLGS): joint model of longitudinal and time-to-event data

BackgroundObesity is a worldwide health concern with serious clinical effects, including myocardial infarction (MI), stroke, cardiovascular diseases (CVDs), and all-cause mortality. The present study aimed to assess the association of obesity phenotypes and different CVDs and mortality in males and females by simultaneously considering the longitudinal and survival time data.MethodsIn the Tehran Lipid and Glucose Study (TLGS), participants older than three years were selected by a multi-stage random cluster sampling method and followed for about 19 years. In the current study, individuals aged over 40 years without a medical history of CVD, stroke, MI, and coronary heart disease were included. Exclusions comprised those undergoing treatment for CVD and those with more than 30% missing information or incomplete data. Joint modeling of longitudinal binary outcome and survival time data was applied to assess the dependency and the association between the changes in obesity phenotypes and time to occurrence of CVD, MI, stroke, and CVD mortality. To account for any potential sex-related confounding effect on the association between the obesity phenotypes and CVD outcomes, sex-specific analysis was carried out. The analysis was performed using packages (JMbayes2) of R software (version 4.2.1).ResultsOverall, 6350 adults above 40 years were included. In the joint modeling of CVD outcome among males, literates and participants with a family history of diabetes were at lower risk of CVD compared to illiterates and those with no family history of diabetes in the Bayesian Cox model. Current smokers were at higher risk of CVD compared to non-smokers. In a logistic mixed effects model, odds of obesity phenotype was higher among participants with low physical activity, family history of diabetes and older age compared to males with high physical activity, no family history of diabetes and younger age. In females, based on the results of the Bayesian Cox model, participants with family history of diabetes, family history of CVD, abnormal obesity phenotype and past smokers had a higher risk of CVD compared to those with no history of diabetes, CVD and nonsmokers. In the obesity varying model, odds of obesity phenotype was higher among females with history of diabetes and older age compared to those with no history of diabetes and who were younger. There was no significant variable associated with MI among males in the Bayesian Cox model. Odds of obesity phenotype was higher in males with low physical activity compared to those with high physical activity in the obesity varying model, whereas current smokers were at lower odds of obesity phenotype than nonsmokers. In females, risk of MI was higher among those with family history of diabetes compared to those with no history of diabetes in the Bayesian Cox model. In the logistic mixed effects model, a direct and significant association was found between age and obesity phenotype. In males, participants with history of diabetes, abnormal obesity phenotype and older age were at higher risk of stroke in the Bayesian Cox model compared to males with no history of diabetes, normal obesity phenotype and younger persons. In the obesity varying model, odds of obesity phenotype was higher in males with low physical activity, family history of diabetes and older age compared to those with high physical activity, no family history of diabetes and who were younger. Smokers had a lower odds of obesity phenotype than nonsmokers. In females, past smokers and those with family history of diabetes were at higher risk of stroke compared to nonsmokers and females with no history of diabetes in the Bayesian Cox model. In the obesity varying model, females with family history of diabetes and older ages had a higher odds of obesity phenotype compared to those with no family history of diabetes and who were younger. Among males, risk of CVD mortality was lower in past smokers compared to nonsmokers in the survival model. A direct and significant association was found between age and CVD mortality. Odds of obesity phenotype was higher in males with a history of diabetes than in those with no family history of diabetes in the logistic mixed effects model.ConclusionsIt seems that modifications to metabolic disorders may have an impact on the heightened incidence of CVDs. Based on this, males with obesity and any type of metabolic disorder had a higher risk of CVD, stroke and CVD mortality (excluding MI) compared to those with a normal body mass index (BMI) and no metabolic disorders. Females with obesity and any type of metabolic disorder were at higher risk of CVD(, MI and stroke compared to those with a normal BMI and no metabolic disorders suggesting that obesity and metabolic disorders are related. Due to its synergistic effect on high blood pressure, metabolic disorders raise the risk of CVD.

Cardiovascular risk factors among nurses: A global systematic review and meta-analysis.

Nurses as the largest group of health workers have a very stressful job which can cause number of diseases specially increase cardiovascular risk factors. This study aims to investigate the overall epidemiology of cardiovascular disease (CVD) risk factors among nurses. We searched all four main databases such as Scopus, PubMed, Embase and Web of Sciences from the beginning of 2000 to March 2022 with appropriate Mesh Terms. We also searched Google scholar. Then we applied inclusion and exclusion criteria and after selection the studies the Newcastle-Ottawa Scale (NOS) was used to assess the methodological quality of included studies. Comprehensive Meta-analysis and R software was used for analysis. Finally, 22 articles with a total number of 117922 nurses were included. Among all risk factors, sedentary lifestyle and lack of regular physical activity with a prevalence of 46.3% (CI 95%, 26.6-67.2) was regarded as the main prevalent risk factor among nurses. The mean systolic blood pressure (SBP) measured in the study population was 121.31 (CI 95%, 114.73-127.90) and the mean diastolic blood pressure (DBP) was 78.08 (CI 95%, 74.90-81.25). Also family history of cardiovascular disease (41.9%; 95% IC: 29.8-55.1%), being overweight (33.3%; 95% IC: 24.7-43.2%), and alcohol consumption (24.6%; 95% IC: 16.4-35.2%) was found among the participants. Study results revealed that sedentary lifestyle was the main prevalent CVD risk factor among nurses followed by family history of cardiovascular disease, being overweight and alcohol consumption. Furthermore, among nurses with shift works almost all risk factors got higher score representing the worse condition in comparison with day workers' nurses. This study enables learning the associated risk factors of CVD among nurses to facilitate interventional programs with a view to reduce the exposure of nursing staff particularly those who work in shifts to cardiovascular risk factors. In general, many studies have emphasized the impact of the nursing profession on the incidence of some cardiovascular patients. Also, different shifts of nurses can have a double effect. In this study, the mean for sedentary lifestyle was reported to be 46.3% which represented the most prevalent risk factor for cardiovascular risk factors among study population. This study enables learning the associated risk factors of CVD among nurses to facilitate interventional programs with a view to reduce the exposure of nursing staff particularly those who work in shifts to cardiovascular risk factors. This information can comprise essential tools for health human resource management contributing to advance nursing.

Abstract 27: Chronotype, Life’s Essential 8, and Risk of Cardiovascular Disease: A Prospective Cohort Study in UK Biobank

Introduction: Individuals with evening chronotype often experience circadian misalignment, which may disrupt health behaviors and circadian regulation of cardiometabolic functions such as blood pressure and heart rate. However, the association of chronotype with cardiovascular disease (CVD) and the interplay with other CVD risk factors are not fully understood. Hypothesis: We assessed the hypothesis that individuals with an evening chronotype, compared to those with a morning chronotype, have a poorer cardiovascular health as measured by the Life’s Essential 8 (LE8), and consequently an increased CVD risk. We further explored if the associations differed by sex. Methods: We conducted a prospective study in the UK Biobank among 477,878 adults aged 39-74 years and free of CVD at baseline in 2006-2010. Chronotype was self-reported using a single representative question from the Morningness-Eveningness Questionnaire. The LE8 score was calculated based on 8 modifiable CVD risk factors, and ranged from 0 to 100 with higher scores indicating better cardiovascular health. Incident CVD was defined as first myocardial infarction (MI) or stroke leading to hospitalization or death, identified via validated algorithms that mapped national medical records and death certificates to ICD-10 codes until May 2022. We used Cox proportional hazards models to estimate the association between chronotype and CVD risk. Models were adjusted for demographics, shift work, and family history of CVD. We applied causal mediation framework to decompose the total chronotype-CVD effect into estimated natural direct effect (i.e., independent of LE8) and natural indirect effect (i.e., mediated by LE8; NIE). Results: Participants with a “definite evening” chronotype were 75% more likely to have a low LE8 score (&lt;50) compared to “intermediate” type (prevalence ratio 95% CI: 1.67, 1.84). This association was notably stronger among women ( P -interaction: 0.0001). Over 12.7 years of follow-up, there were 27,346 documented incident CVD events (17,180 MI; 11,329 stroke). The hazard ratio (HR) for total CVD was 1.03 (95% CI: 1.00, 1.06) for the “definite morning” and 1.15 (95% CI: 1.10, 1.20) for “definite evening” compared with “intermediate” chronotype ( P -trend: 0.06). This association was stronger in women ( P -interaction: 0.05), and similar for MI and stroke. The NIE of the chronotype-CVD association comparing “definite evening” to “intermediate” was 1.11 (95% CI: 1.09, 1.13), equivalent to 95% of the association being mediated by LE8. Conclusions: Evening chronotype was associated with a modest increase in CVD risk, compared to intermediate chronotype, which appeared to be mainly explained by overall poor cardiovascular health. Our results suggest potential benefits of targeted interventions in evening chronotype for CVD prevention. Ongoing work is exploring potential effect modification by night shift work.

Abstract P350: Increased Trunk Fat and Decreased Limb Fat Linked to Elevated Cardiovascular Risk in Hong Kong Chinese Women

Introduction: Despite known links between overall body fat and cardiovascular disease (CVD) risk, the relationship involving regional body fat (arm, trunk, and leg) remains underexplored in Chinese populations. This study examined the associations between overall and regional body fat percentage (BFP) and CVD risk in Hong Kong Chinese women. Hypothesis: We hypothesized that higher overall and trunk BFP were associated with increased CVD risk, whereas higher arm and leg BFP predicted decreased risk. Methods: This study used baseline data of 3616 women (mean age 56.12±8.51) from an ongoing cohort named ‘MECH-HK’ (Migraine Exposures and Cardiovascular Health in Hong Kong Chinese Women). The recruitment was conducted between October 2019 and October 2021. BFP was measured using the bioelectrical impedance analysis device of Inbody 270 model. Framingham 10-Year Risk Score (FRS) was calculated to present the CVD risks. Multivariate linear models were used to estimate the BFP-FRS associations. Potential non-linear relationships were assessed with restricted cubic spline models. Results: Mean overall BFP was 32.55%, and regional BFP for arm, trunk and leg were 4.59%, 15.38% and 10.76%, respectively. Non-linear associations between overall BFP and FRS were observed (P for non-linear = 0.03). After adjustment for age, education level, monthly family income, smoking and drinking status, physical activity level, family history of CVD and BMI, the overall BFP was associated with increased FRS (β: 0.04, 95% CI: 0.00 to 0.08, P = 0.03) when overall BFP &lt; 35%. However, no significant association was observed when overall BFP &gt;= 35% (β:-0.07, 95% CI: -0.16 to 0.02, P = 0.13). Higher trunk BFP was associated with increased FRS (β: 0.30, 95% CI: 0.21 to 0.38, P &lt; 0.001), while higher arm (β: -0.69, 95% CI: -0.98 to -0.40, P &lt; 0.001) and leg (β: -0.38, 95% CI-0.50 to -0.25, P &lt; 0.001) BFP were associated with decreased FRS. Conclusions: Increased overall (when &lt; 35%) and trunk BFP and decreased arm and leg BFP are associated with elevated CVD risk.

Abstract P500: Proton Pump Inhibitor Use and Incident Cardiovascular Disease in Postmenopausal Women, Results From the Women’s Health Initiative

Introduction: Evidence from in-vitro and animal studies suggests that proton pump inhibitor (PPI) use is associated with incident cardiovascular disease (CVD). Observational studies in humans have shown conflicting results and didn’t account for relevant confounders such as diet and physical activity or confounding by indication. Methods: This study included 148,452 postmenopausal women without history of CVD at enrollment into the Women’s Health Initiative (WHI) observational study and clinical trials in 1993-1998. The primary exposure was PPI use (no, yes) determined by medication inventory conducted at baseline. The main outcome was incident primary CVD defined as a composite endpoint of physician-adjudicated myocardial infarction, coronary revascularization, stroke, and CVD mortality. Follow-up time was to September 2010. Cox proportional hazards regression was used to estimate hazards ratios (HR) and 95% confidence intervals (CI) for the association of PPI use and CVD. All models were adjusted for baseline age and stratified according to WHI study component. Additional models were further adjusted for demographics (education, income), lifestyle (smoking, alcohol, diet quality, physical activity, sleep duration), and major CVD risk factors (body mass index, family history of CVD, treated hypercholesterolemia, treated diabetes, treated hypertension). Results: Baseline prevalence of PPI use was 1.91%. After a mean follow-up of 11.3 years, there were 10,944 CVD events. PPI use was associated with a 28% higher risk of CVD compared to non-use in the age adjusted model (HR: 1.28, 95%CI: 1.13-1.45). The association was attenuated but remained significant after adjusting for potential confounders and was materially unchanged when using propensity score adjustment to better address confounding by indication (Table). Conclusions: PPI use was associated with higher risk of incident CVD in postmenopausal women. Further investigations are warranted to confirm this finding and identify potential mechanisms.

Women and Cardiovascular Health: Unraveling Gender-Specific Factors, Risks, and Therapeutic Approaches in Contemporary Medicine.

Background and objective Cardiovascular diseases (CVDs) constitute a significant global health challenge,causing millions of deaths annually and straining healthcare systems worldwide. This study aimed to investigate and elucidate gender-specific factors, risks, and therapeutic approaches related to cardiovascular health in women within the context of contemporary medicine. Methodology We conducted a prospective observational study spanning one year (November 2022 to October 2023)at the Peshawar Medical Complex Hospital, to meticulously explore the field of women's cardiovascular health. With a diverse cohort of 435 women (age range: 18-55 years), representing various socioeconomic backgrounds and geographic locations, our study aimed to elicit comprehensive insights. Through structured interviews covering reproductive history, lifestyle, and psychosocial aspects, coupled with clinical assessments, we gathered multifaceted data. Statistical analysis was done using SPSS Statisticsversion 23.0 (IBM Corp., Armonk, NY). By employing descriptive and t-tests for quantitative analysisand by thematically analyzing qualitative insights, our approach ultimately sought to provide a nuanced understanding of gender-specific factors impacting women's cardiovascular health. Results The study, involving 435 women, revealed various prevalent cardiovascular risk factors. Notable findings include a high incidence of a family history of CVD (n=213, 48.96%, p=0.013), hypertension (n=207, 47.58%), hypercholesterolemia (n=114, 26.21%), elevated triglycerides (n=162, 37.24%), and diabetes (n=64, 14.71%). Physical inactivity was also significantly more common (53.56%, p=0.004) compared to those engaging in regular activity. Women-specific risk factors comprised miscarriage (n=191, 43.91%). Therapeutic preferences varied, with a majority opting for lifestyle modifications (n=263, 60.39%) and pharmacological interventions (n=331, 76.33%). Conclusions This study provides a comprehensive understanding of prevalent cardiovascular risk factors, distinctive women-specific contributors, and diverse therapeutic preferences, highlighting the importance of personalized and targeted interventions to optimize women's cardiovascular health outcomes in contemporary medicine.

AN EDUCATIONAL ASSESSMENT OF PREVENTIVE BEHAVIORS OF CARDIOVASCULAR DISEASE AMONG ADULT WORKERS WITH HYPERTENSION

Introduction: In Thailand, approximately 13 million adult workers have hypertension, with approximately 4.7% of those living in acculturated societies at a higher risk of developing cardiovascular disease (CVD). Aims: This study aims to examine the factors that predicted CVD prevention behaviors in individuals with hypertension. Methods: A cross-sectional analytical study was conducted on 1,151 adult workers with hypertension from Sukhothai Province, Thailand, using a multistage sampling technique. The measurement tools included a standardized questionnaire approved by three experts and tested for reliability using the Cronbach’s alpha. A multiple regression analysis was used to identify factors that predicted CVD prevention behaviors. Results: This study involved a total of 1,151 participants, 61.90% of whom were females, with an average age of 52 years. In addition, 71.80% of the participants had a family history of CVD. The majority of the participants (73.4%) exhibited moderate levels of CVD preventive behaviors. Factors that predicted CVD preventive behaviors included self-efficacy (β = 0.423), family and social support (β = 0.162), perceived information (β = 0.119), attitude (β = 0.117), knowledge (β = 0.089), living with nuisance (β = -0.049), and family history of hypertension (β = 0.049). These predictors accounted for 39.2% of the variance (R2 = 0.392, p = 0.05). Conclusion: The intervention mapping to promote CVD preventive behaviors in adult workers with hypertension should focus on increasing self-efficacy by providing information to improve individual knowledge and attitude, as well as addressing environmental factors that may affect people's well-being, such as nuisances.

Impaired perception of cardiovascular risk and health literacy in individuals with high cardiovascular diseases risk from different socioeconomic levels in Antalya, Turkey.

This study aimed to determine how the frequency of impaired perception of cardiovascular disease (CVD) risk is correlated with health literacy in individuals with high CVD risk in two regions with different socioeconomic levels. A descriptive study was conducted. The Systematic Coronary Risk Estimation, recommended by the European and Turkish Cardiology Societies, provides recommendations based on individuals' actual CVD risk levels. According to the Systematic Coronary Risk Estimation, participants suffering from diseases were identified as high and very high risk. The perception of risk was determined by subjectively assessing the risk level of the individuals. The European Health Literacy Survey Questionnaire was used. The Mann-Whitney U test, Chi-squared test and Spearman's correlation analysis were used to analyse the data. We also conducted a logistic regression analysis to identify factors contributing to impaired perception of CVD risk. A total of 384 individuals, aged between 40 and 70years (with a mean age of 58.35±8.33years), were included in the study. These individuals had a high risk of CVD and were registered to family health centres from two different socioeconomic levels. Out of the 384 participants, 201 individuals belonged to the lower socioeconomic level region and 183 individuals belonged to the higher socioeconomic level region. A total of 61.7% of the participants with high CVD risk had an impaired perception of CVD risk. The health literacy level of 59.9% of individuals was either inadequate or problematic. The health literacy score of participants with impaired risk perception (29.59±9.07) was lower than those with correct risk perception (35.83±10.94; P <0.001). Factors that affected the perception of CVD risk included age, education level, working status, occupation, a family history of CVD, the CVD risk assessment by health professionals and the recommendation of health professionals to individuals for CVD screening. It is necessary for health care professionals to make risk assessments and perform interventions to improve health literacy to raise the awareness of individuals with high CVD risk on their actual risk.

Predictive machine learning models for ascending aortic dilatation in patients with bicuspid and tricuspid aortic valves undergoing cardiothoracic surgery: a prospective, single-centre and observational study

ObjectivesThe objective of this study was to develop clinical classifiers aiming to identify prevalent ascending aortic dilatation in patients with bicuspid aortic valve (BAV) and tricuspid aortic valve (TAV).Design and...

Dyslipidemia and its associated factors among community adults located in Shangcheng district, Zhejiang province

Dyslipidemia and its associated factors among community adults located in Shangcheng district, Zhejiang province

Age-specific differences in the association between prediabetes and cardiovascular diseases in China: A national cross-sectional study.

Cardiovascular disease (CVD) is a leading cause of morbidity and mortality worldwide, the global burden of which is rising. It is still unclear the extent to which prediabetes contributes to the risk of CVD in various age brackets among adults. To develop a focused screening plan and treatment for Chinese adults with prediabetes, it is crucial to identify variations in the connection between prediabetes and the risk of CVD based on age. To examine the clinical features of prediabetes and identify risk factors for CVD in different age groups in China. The cross-sectional study involved a total of 46239 participants from June 2007 through May 2008. A thorough evaluation was conducted. Individuals with prediabetes were categorized into two groups based on age. Chinese atherosclerotic CVD risk prediction model was employed to evaluate the risk of developing CVD over 10 years. Random forest was established in both age groups. SHapley Additive exPlanation method prioritized the importance of features from the perspective of assessment contribution. In total, 6948 people were diagnosed with prediabetes in this study. In pre-diabetes, prevalences of CVD were 5 (0.29%) in the younger group and 148 (2.85%) in the older group. Overall, 11.11% of the younger group and 29.59% of the older group were intermediate/high-risk of CVD for prediabetes without CVD based on the Prediction for ASCVD Risk in China equation in ten years. In the younger age group, the 10-year risk of CVD was found to be more closely linked to family history of CVD rather than lifestyle, whereas in the older age group, resident status was more closely linked. The susceptibility to CVD is age-specific in newly diagnosed prediabetes. It is necessary to develop targeted approaches for the prevention and management of CVD in adults across various age brackets.

Gender characteristics of the prevalence of noncommunicable diseases in the adult population of the Vladimir region

Aim. To assess the prevalence of major noncommunicable diseases (NCDs) taking into account gender characteristics in a random sample of adults in 5 cities of the Vladimir region.Material and methods. This cross-sectional population-based study (May 2018 — March 2020) included 1350 people (men and women aged 30-69 years) from 5 cities of the Vladimir region. The response rate was 87%. A total of 1174 people completed the study. Of these, 424 (36,1%) were men and 750 (63,9%) women. Respondents were surveyed using a standard questionnaire prepared by the National Medical Research Center for Therapy and Preventive Medicine, which included socio-demographic characteristics, behavioral risk factors, data on somatic diseases and medications taken.Results. The prevalence of coronary artery disease among men was 14,1%, among women — 9,5% (p=0,016). In men, the second most common disease is chronic obstructive pulmonary disease (COPD), which was 2,5 times more common than in women — 10,6 and 4,5%, respectively (p=0,001). Among women, the second most common disease was type 2 diabetes (T2D), accounting for 7,6%. Cerebrovascular diseases occupy fourth place in the NCD structure. Their prevalence was 6,1% among men and 4,4% among women. Cancer diseases were less common than other chronic diseases without sex differences — 2,8 and 3,1%, respectively. In certain cities, the prevalence of NCDs varied. Every third man and fourth women had a positive family history for cardiovascular diseases (CVDs) (p=0,005). About 20% of men reported a positive family history for COPD, while among women this figure was 2 times lower (p=0,001). Men and women were comparable in terms a family history for T2D — 10,4 and 12,5%, respectively. A positive family history for tumors of various locations was recorded in ~5%.Conclusion. In the adult working-age population of the Vladimir region, atherosclerosis-related CVDs was identified in 17% of cases. The incidence of T2D and COPD in the adult population was approximately the same and amounted to &gt;7%. The prevalence of cancer was 3%. Sex differences were identified in the prevalence of coronary artery disease and COPD.