Frequency Of Cardiovascular Risk Factors Research Articles

Obstetric Anesthesia Management of the Patient With Cardiac Disease

(Int J Obstet Anesth. 2019;37:73–85) Cardiovascular disease is now the leading cause of maternal mortality in much of the developed world. This has occurred for a variety of reasons, including the increasing frequency of cardiovascular risk factors among women of childbearing age and the improved treatment for congenital heart disease that allows most of these patients to reach adulthood. The level of care required to address the needs of parturients with cardiovascular conditions requires a coordinated effort among experts in cardiology, obstetrics, perinatology, neonatology, and anesthesiology.

Cardiovascular and psychopathological factors among non-sexually compulsive, sexually compulsive, and hypersexual individuals in Sao Paulo, Brazil

ABSTRACTWe decided to explore the frequency of cardiovascular risk factors, according to three levels of severity of compulsive sexual behavior (CSB), namely, non-sexually compulsive (1), sexually compulsive (2), and sexually compulsive, and hypersexual (3). We also investigated the impact of a psychiatric co-morbidity on the Framingham heart risk score (FRS). 94 non-sexually compulsive, 57 sexually compulsive, and 60 hypersexual individuals underwent psychiatric interview, blood collection, self-responsiveness, and anthropometric measurement. The analyses were repeated with individuals aged up to 44 and aged more than 44 years old. Regarding the total sample, we observed significant association among those sexually compulsive, and hypersexual participants with presenting the HIV serologic status, and a greater proportion of psychiatric conditions as much as the severity of CSB increases. Individuals with substance-related disorder predicted higher Framingham scores. The analyses with people aged more than 44 years old presented some different results, such as association among presenting low FRS and the sexually compulsive participants, and sexual compulsivity predicted lower scores of the Framingham. The study points out to the relevance of comprehensive psychiatric examination of whom presenting CSB and opens an avenue forward investigation of the effect of high rates of sexual activity on cardiovascular risk.

Impact Of Cardiovascular Risk Factors In Type 2 Diabetics Living In Tlemcen And Saida,Western Algeria

The aim of the current study was to assess cardiovascular risk (modifiable and non-modifiable factors) in type 2 diabetics, living in Tlemcen and Saida (West Algeria) on a group of 315 diabetics type 2 of which; 160 patients in the Tlemcen region (64% man and 96 % woman) and 155 patients in the Saida region (90 % man and 65% woman) (western Algeria) during the period of December 2018 - May 2019. Filling of a questionnaire for patients on dietary habits, socio-economic factors, with anthropometric parameters such as weight, height and Body Mass Index were measured as well as lifestyle, a biochemical assessment was carried out and an assessment of the nutritional contributions during 24 hours were made. The results of our study showed that the frequencies of cardiovascular risk factors in the patients studied are probably related to lifestyle (smoking) more than 80% were females with family history including diabetes and hypertensia. 30% were overweight, Glycated hemoglobin level was above the recommended value in both sexes which represents one of the cardiovascular risk factors, energy imbalance and high calorie foods are also recorded in our population. Our study showed a positive relationship between cardiovascular risk factors and type 2 diabetes. The Type 2 Diabetic Population living in Tlemcen and Saida Area was Highly Exposed to Cardiovascular Risk Factors. For better management of our diabetics, we recommend: Launch a national prevention program with well-structured objectives based on information on nutrition, dietetics and healthy living among patients at risk through associations in public health.

In patients with diabetic foot, improved left ventricular functions are detected by strain echocardiography after the diabetic foot treatment: A cross-sectional study.

Diabetic foot is a macrovascular complication of diabetes mellitus (DM). In the literature, the relationship between diabetic foot and another macrovascular complication of DM is not clear. The aim of this study was to determine the current left ventricular (LV) systolic function in patients with diabetic foot and to investigate the effect of diabetic foot treatment on LV systolic functions.In this study, 54 patients with diabetic foot and 22 patients without diabetic foot were included. Routine anamnesis, physical examination, echocardiography, and laboratory examinations were performed. In addition, LV global longitudinal strain (LV-GLS) was measured by strain echocardiography technique. LV ejection fraction (LV-EF) and LV-GLS measurements were repeated with echocardiography at the 3rd month of diabetic foot treatment.The incidence of cardiovascular risk factors such as smoking, hypertension, and coronary artery disease was found to be higher in patients with diabetic foot. (P < .05 for each one). Similarly, in patients with diabetic foot, glucose, Hemoglobin A1c, neutrophil, sedimentation, urea, creatinine, potassium, uric acid, alanine aminotransferase, aspartate aminotransferase, C-reactive protein, and brain natriuretic protein were higher; high-density lipoprotein cholesterol level was found to be significantly lower. LV wall thicknesses and diameters were higher and LV-EF was lower in patients with diabetic foot (P < .05 each one). LV-GLS values were significantly lower in patients with diabetic foot (P < .05). Although no significant change was found in the LV-EF value at the 3rd-month follow-up echocardiography (48.6% ± 7.0% vs 48.5% ± 5.9% and P = .747), it was detected that LV-GLS values (17.3 ± 2.1 vs 18.4 ± 2.3) were significantly increased (P < .001).LV systolic function was significantly affected in patients with diabetic foot. This may be related to the increased frequency of cardiovascular risk factors in these patients. However, the significant improvement in LV-GLS values after the diabetic foot treatment showed that diabetic foot itself was an important cause of LV systolic dysfunction.

Prevention of chronic diseases in middle-age women: a cross-sectional study on an Italian large sample.

The age around 50 years represents a crucial point for women: menopause leads to biological changes and it begins breast and colon-rectal cancer screening. This study aimed at assessing frequencies of cardiovascular risk factors and analyzing participation in screening and vaccination. In 2017, a cross-sectional study was performed in Northern Italy. Totally, 12 249 women, aged between 50 and 54 years, were enrolled by General Practitioners (GPs). It was used a 21-item form, with information about: socio-demographic, anamnestic and clinical data, execution of a booster shot of tetanus-diphtheria-acellular pertussis (Tdap) vaccine in the last decade and of PAP-test, mammography and faecal occult blood test in the last 2 years. Descriptive and crosstab χ2 analyses were performed with STATA MP13. The significance level was P ≤ 0.05. Our findings showed the presence of cardiovascular risk factors, such as obesity (10.95%), hypertension (13.76%), hyperlipidaemia (11.57%), glycaemia ≥ 100 mg dl-1 (16.97%), poor physical activity (73.49%), smoking (18.28%), cardiovascular family history (FH) (51.70%). There were a lower participation in colo-rectal cancer screening (45.09%) compared with breast (85.06%) and cervical (77.16%) cancer screening and an insufficient Tdap booster dose compliance (17.56%). Chi-square analyses showed correlations between cardiovascular FH and body mass index, hypertension, hyperlipidaemia, glycaemia and smoking, and between cancer FH and participation in breast and colo-rectal cancer screening (P < 0.05). Women with cardiovascular disease FH represent a priority target of educational interventions considering the prevalence of concomitant risk factors. Programmes aimed at increasing screening and vaccination participation should be implemented.

Factors Affecting Cardiovascular Risk in Children, Adolescents, and Young Adults with Type 1 Diabetes.

Cardiovascular risk and obesity are becoming major health issues among individuals with type 1 diabetes (T1D). The aim of this study was to evaluate cardiovascular risk factors and obesity in youth with T1D in Lithuania. Methods. 883 patients under 25 years of age with T1D for at least 6 months were investigated. Anthropometric parameters, blood pressure, and microvascular complications were evaluated, and the lipid profile and HbA1c were determined for all patients. Results. Study subjects' mean HbA1c was 8.5 ± 2%; 19.5% were overweight and 3.6% obese. Hypertension and dyslipidemia were diagnosed in 29.8% and 62.6% of participants, respectively. HbA1c concentration was directly related to levels of total cholesterol (r = 0.274, p < 0.001), LDL (r = 0.271, p < 0.001), and triglycerides (r = 0.407, p < 0.001) and inversely associated with levels of HDL (r = 0.117, p = 0.001). Prevalence of dyslipidemia increased with duration of diabetes (p < 0.05). Hypertension was more prevalent in overweight and obese compared to normal-weight patients (40.6 and 65.6 vs. 25.6%, respectively, p < 0.001). Frequency of microvascular complications was higher among patients with dyslipidemia (27.2 vs. 18.8%, p = 0.005) and among those with hypertension (25.9 vs. 23.2%, p < 0.001). Conclusion. The frequency of cardiovascular risk factors is high in youth with T1D and associated with diabetes duration, obesity, and metabolic control.

Factores de riesgo cardiovascular en mujeres obesas menopáusicas y premenopáusicas de Lima Metropolitana

Objetivos. Establecer la frecuencia de factores de riesgo cardiovascular (FRCV) en mujeres obesas menopáusicas y premenopáusicas de 30 a 70 años de Lima Metropolitana. Métodos. Estudio analítico, observacional, transversal en 95 pacientes obesas de 30 a 75 años de edad, de Lima Metropolitana, cuyo grado de obesidad se catalogó de acuerdo a los criterios del Organización Mundial de la Salud; 48 fueron menopáusicas (MENO) y un grupo control de 47 premenopáusicas (PREMENO). Se determinó las medidas antropométricas, presión arterial (PA) y, en una muestra de sangre en ayunas, glucosa (G), colesterol total (CT), triglicéridos (Tg), colesterol HDL, insulina (I), y transaminasas; se calculó las fracciones VLDL, LDL, No-HDL (cNoHDL) e índice HOMA, los cálculos estadísticos mediante el programa SPSS v.23. Se consideró FRCV a la obesidad, dislipoproteinemia, hipertensión arterial (HTA), resistencia a la insulina (RI), transaminasas elevadas. Resultados. De las 95 mujeres, 45,3% tenía obesidad grado I, 28,4% grado II y 26,3% grado III. Las MENO tuvieron mayor edad, talla, PA, cNoHDL, I y HOMA que las PREMENO. Conclusiones. Las mujeres obesas menopáusicas tienen mayor riesgo cardiovascular que las mujeres premenopáusicas obesas.

Prevalence of lifestyle and cardiovascular risk factors in a group of medical students.

The aim of the cross-sectional study was to evaluate cardiovascular risk factors in the group of medical students with gender, overweight and obesity categorisation. Cross-sectional study included 364 medical students, 207 females and 157 males. We investigated anthropometric parameters, BMI, body fat percentage, WHR (waist-hip ratio), TCH (total cholesterol) and LDL-CH (LDL-cholesterol), SBP and DBP (systolic and diastolic blood pressure). The participants also completed questionnaires with socio-demographic characteristic, including smoking, unhealthy eating, self-perceived health, and physical activity status. Statistical analysis used t-test differences in arithmetic means and OR calculation with 95% CI. Prevalence of increased blood pressure (> SBP/DBP 120/80 mmHg) among participants was 10.99% (SBP) and 9.07% (DBP). The results confirmed risk of "overweight + obesity" in 15.38% (using BMI evaluation) versus 18.54% cases (using body fat percentage evaluation). The results of the study confirmed statistically higher risk for males compared to females in the following parameters: SBP, DBP, BMI, body fat percentage, self-perceived health, unhealthy eating and body weight watching. "Overweight and obesity" group (BMI evaluation) confirmed all factors on statistically significant level a risky group: SBP, DBP, body fat percentage, TCH, self-perceived health, smoking, stress at university, and body weight watching. The outputs confirmed, on the other hand, low amount of clinical obesity (0.8%), clinical hypertension (BP > 140/90) 1.1%, and clinically higher cholesterol level (TCH > 5.2 mmol/l) in 8.7% participants. We confirmed higher prevalence or cardiovascular risk factors among males. Also, group of "overweight and obese" students had higher frequency of cardiovascular risk factors. Border limits for risk evaluation were strong, so on clinical level we can evaluate the group of medical students as healthy. In the group of young medical students, we confirmed lower frequency of risk factors compared to the Slovak population average.

78. Cardiovascular risk factors in young women after hypertensive disorders during pregnancy

Introduction Hypertensive disorders during pregnancy (HDP) are associated with later maternal cardiovascular disease risk. It is important to understand the pathophysiological mechanisms before the development of the cardiovascular complications. Objectives The study aimed to scrutinize cardiovascular risk factors and biomarkers among young women with and without prior hypertensive disorders during pregnancy. Methods Retrospective cohort study. The study included 77 women: gr. 1 – with prior HDP (n = 33) aged 41 (40–43) years, gr. 2 – without prior HDP (n = 44) aged 39 (33–43) years. Inclusion criteria: age 18–44 years, prior delivery. Exclusion criteria: diabetes mellitus, secondary hypertension. We measured serum glucose, insulin, HOMA-IR, leptin, lipids, PAI-1 and blood pressure (BP). Left ventricular mass index (LVMI) was estimated by transthoracic echocardiography. Data are presented as M ± SD and Me (Q25–Q75). Results The average postpartum period was 15 (12–19) years in gr. 1 and 12 (5–19) years in gr. 2, NS. Women in gr. 1 more often had hypertension (n = 27; 82% vs n = 9; 20.5%; RR 4.0 95%CI [2.2–7.3], p Discussion Taking into account the high frequency of cardiovascular risk factors and biomarkers in young women, we noticed that women who had prior HDP should be informed about the increased risk for hypertension later in life. The present study indicates that women with prior HDP should also receive lifestyle counseling aimed at optimizing body weight and to control lipid and glucose levels for long-term follow-up.

Cardiovascular Complications of Multiple Myeloma Treatment: Evaluation, Management, and Prevention

Multiple myeloma treatment regimens consist of proteasome inhibitors (bortezomib, carfilzomib, and ixazomib), immunomodulatory drugs (thalidomide, lenalidomide, and pomalidomide), and steroids. In this paper, we will review the pathophysiology and associated cardiotoxicities of the different multiple myeloma therapeutic modalities and present methods to mitigate the development of cardiovascular complications. Although proteasome inhibitors and immunomodulatory drugs have led to significant improvements in oncologic outcomes, there is increasing evidence of serious cardiovascular side effects which may be exacerbated in the setting of underlying cardiovascular risk factors or disease. Cardiotoxicities include cardiomyopathy and heart failure, accelerated hypertension, arrhythmias, and both arterial and venous thromboembolism. Given the frequency of cardiovascular risk factors in multiple myeloma patients as well as the cardiotoxicities associated with the different treatment regimens, it is essential to closely monitor these patients. Collaboration between cardiologists and oncologists is necessary to ensure patients receive optimal cancer treatment while minimizing cardiovascular risk.

Frequency of Cardiovascular risk factors among the athletes and non-athletes

ABSTRACT: Background: Proper screening of the Cardiovascular risk factors is not a common practice in Pakistan, until the development of signs and symptoms, which is a concerning factor regarding the cardiovascular implications on athletes and other individuals. Objective of study: To determine the frequency of cardiovascular risk factors among athletes and non-athletes. Materials and Methods: A cross sectional study was conducted on 417 individuals (n=189 athletes and n=228 non-athletes), aged 15-30 years, recruited from fitness centres of twin cities (Rawalpindi-Islamabad), over a duration of 6 months (January 2016 to June 2016). Sample was selected on the basis of inclusion criteria and non.-probability convenient sampling was employed. A self-structured questionnaire was filled by all the participants to assess the presence of cardiovascular risk factors. Result: Out of a sample of 417 individuals, 189 were athletes and 228 were non-athletes with a mean age of 23.7 ± 3.22. Frequency of the risk factor hypertension was found to be higher in non-athletes (5.8%) as compared to athletes (0.7%). Smoking was equally present in both athletes 32 (7.7%) and non-athletes 40 (9.6%). Hypertension and cholesterol which showed significant difference with p value < 0.001. Obesity and psychological risk factors depicted low significant difference with the p value

Data on prevalence of dyslipidemia and lipid values in Turkey: Systematic review and meta-analysis of epidemiological studies on cardiovascular risk factors

Dyslipidemias, primarily hypercholesterolemia, are independent and strong predictors of cardiovascular (CV) events. The frequency of dyslipidemia is very important in terms of determining CV prevention policies. In order to determine the up-to-date frequency of CV risk factors in Turkey, a meta-analysis of the epidemiologic studies carried out in the last 15 years was performed. This article presents the results on the dyslipidemia data including hypercholesterolemia principally. Epidemiological studies conducted during the last 15 years and having the potential to represent the general population in Turkey were searched in databases (Ovid Medline, Web of Science Core Collection, and Turkish Academic Network and Information Center [ULAKBIM]) and web pages (Ministry of Health, Turkey Statistical Institute, Turkish Society of Cardiology, Nephrology and Endocrinology Associations). A total of 7 studies including lipid data were found. Systematic review and meta-analysis of the studies with low bias score were performed. Crude values of the prevalence of hypercholeterolemia, hypertriglyceridemia and low HDL and mean lipid levels were calculated. Random effects model was used in meta-analysis. The prevalence of hypercholesterolemia defined as a LDLcholesterol >130 and/or ≥130 mg/dL, was 29.1% (95% CI 23.6-35.0) in the general population, 30.2% in females (%95 CI 24.7-36.1), and 27.8% in males (95% CI 22.3-33.6). The prevalence of low HDLcholesterol (≤50 mg/dL for females and ≤40 mg/dL for males) was calculated as 46.1% (95% CI 42.4-49.9) in the whole group, 50.7% (95% CI 47.7-53.6) in females and 41.1% (95% CI 36.1-46.3) in males. The prevalence of hypertriglyceridemia (>150 mg/dL) was 36.5% (95% CI 30.6-42.5) in general, 32.0% (95% GA 26.6-37.8) in females and 41.3% (95% CI 34.9-47.8) in males. Dyslipidemia constitutes a major public health problem in Turkey. In the adult population, almost 3 of 10 have hypercholesterolemia, one of 2 has a low HDL-cholesterol, and 1 of 3 has high triglycerides levels.

Cardiovascular risk factors among geriatric Nigerians in a primary care clinic of a tertiary hospital in Southeastern Nigeria

Background: Cardiovascular (CV) risk factors tend to aggregate in geriatric population with variable distribution. These risk factors may act as alert signals for proactive geriatric CV health programs. This study was aimed at determining the frequencies of CV risk factors among geriatric Nigerians in a primary care clinic of a tertiary hospital in Southeastern Nigeria. Patients and Methods: This was a cross-sectional study carried out on 280 geriatric Nigerians at the primary care clinic of Federal Medical Centre, Umuahia, Nigeria. Geriatric Nigerians aged 60 years and above were screened for risk factors of CV disease. The data collected included sociodemographic variables and metabolic, dietary, and behavioral risk factors using a structured, pretested, and researcher-administered questionnaire. Results: The top five most common CV risk factors were physical inactivity (67.1%), inadequate fruit consumption (65.7%), hypertension (48.2%), abdominal obesity (47.9%), and dyslipidemia (36.8%). Others were general obesity (31.1%), inadequate vegetable consumption (22.5%), diabetes mellitus (15.7%), habitual use of alcoholic beverages (9.0%), habitual use of snuff (3.9%), and nonhabitual smoking of cigarettes (2.8%). Conclusion: This study has demonstrated that the risk factors of CV disease exist among geriatric Nigerians in primary care, with five most frequent being physical inactivity, inadequate fruit consumption, hypertension, abdominal obesity, and dyslipidemia. Screening geriatric Nigerians for modifiable CV risk factors should be integrated into geriatric primary care in the study area.

Incidence and impact of atrial arrhythmias on thrombotic events in MPNs.

Atrial arrhythmias (AA) induce a high rate of thromboses and require vitamin K antagonists (VKA) or direct anticoagulants (DOAC) prescriptions. Essential thrombocythemia (ET) and polycythemia vera (PV) are also pro-thrombotic diseases. The prevention of thromboses is based on the association of cytoreductive drug and low-dose aspirin (LDA). We studied the incidence and complications of AA among patients with ET or PV. We identified 96/713 patients (13.5%) carrying AA. These patients were older (median 72.1 vs. 61.3years old, p<0.0001). In a case-control analysis, we observed that patients with AA had a higher frequency of cardiovascular risk factors (77/96, 80% vs. 61/96, 61%; p=0.01). A higher incidence of thromboses before and after myeloproliferative neoplasm (MPN) diagnosis was seen in this group: 26/96, 27.1% vs. 14/96, 14.6% (p=0.03) and 34/96, 35% vs. 18/96, 18.8% (p=0.009). Most of the events were arterial (82 vs. 61%, p=0.09). This translates into a shorter thrombosis-free survival (11.0 vs. 21.6years, p=0.01). Continuation of LDA in this situation exposed patients to more thrombotic events (p=0.04) but VKA did not seem to be good anticoagulant drugs either. The association of AA and MPN is more frequent than expected. AA clearly increased the thrombotic risk of these patients. Anticoagulant drugs should be carefully managed between cardiologists and hematologists. Association of LDA and VKA or the role of DOAC in such population should be rapidly discussed to reduce the thrombotic rate.

Assessment of the frequency of cardiovascular risk factors in patients with Takayasu's arteritis.

The prevalence of atherosclerotic risk factors and disease in Takayasu's arteritis (TAK) has not been well defined. We aimed to assess the frequency of cardiovascular (CV) risk factors and the incidence of CV events (CVEs) in patients with TAK from two ethnically different populations. Patients with TAK followed at Mayo Clinic, Rochester, MN, USA and Marmara University, Istanbul, Turkey were included in this retrospective study. Patients with TAK were compared with age-, sex- and calendar year-matched controls from the same geographical region without TAK. The 2008 Framingham 10-year general CV risk score (FRS) was used for the evaluation of CV risk at the time of TAK incidence/index date. In total, 191 patients with TAK and 191 non-TAK controls were included. Hypertension and the prevalence of lipid-lowering treatments were significantly more frequent in TAK. Prior to the incidence/index date, occurrence of CVE was significantly higher in TAK. The FRS was significantly higher in TAK compared with non-TAK at incidence/index date. The cumulative incidence of CVE was 15.4% at 10 years in TAK vs 5.8% in non-TAK; the risk of CVE was increased among patients with TAK (hazard ratio = 4.36; 95% CI: 1.25, 15.13). CV risk factors are more common in patients with TAK, particularly hypertension. The FRS is higher in patients with TAK at the time of diagnosis. The cumulative incidence of CVE was also significantly higher during follow-up in TAK. Our results suggest that patients with TAK should undergo careful assessment of CV risk factors, and an aggressive risk modification approach is warranted.

Prevalence of diabetes and frequency of cardiovascular risk factors in paramedical and administrative staff of Charles Nicolle hospital

Prevalence of diabetes and frequency of cardiovascular risk factors in paramedical and administrative staff of Charles Nicolle hospital

Cardiovascular risk and stress in employees of a higher education institution

Objective: to analyze the association between high levels of stress and the frequency of cardiovascular risk factors in employees of a higher education institution. Methods: this is a cross-sectional study with 201 employees of a university. A form containing socioeconomic data, the International Physical Activity Questionnaire (short version), the Alcohol Use Disorders Identification Test and the Work Stress Scale were used for data collection. Data analysis was performed using the probability ratio and One-way analysis of variance tests. Results: worrisome frequencies of cardiovascular risk factors were identified, in which sedentary lifestyle, excess weight, and increased abdominal circumference presented the most expressive indexes. Regarding the stressors evaluated, some of the employees had increased stress indexes, distributed between the medium and high levels. Conclusion: sedentary lifestyle, excess weight, and increased abdominal circumference presented expressive high indexes, without statistically significant associations with the level of stress.

Prevalence of metabolic syndrome in rheumatoid arthritis patients from Northeastern Brazil: Association with disease activity

Objectives: To determine the prevalence of metabolic syndrome (MetS) in patients with rheumatoid arthritis (RA) and controls from Northeastern Brazil and to verify its association with specific RA parameters and cardiovascular risk factors.Methods: The prevalence of MetS was assessed cross-sectionally in 338 RA patients from a single center and 84 age and gender-matched controls from the local community. MetS was defined according to NCEP/ATPIII guidelines. Disease activity was assessed with CDAI, SDAI and DAS28 scores. Independent risk factors for MetS in RA patients were identified by multivariate logistic regression.Results: The prevalence of MetS was higher in RA patients than in controls (51.3% vs. 21.8%; p < .001). RA patients had a higher frequency of hypertension and type-2 diabetes mellitus, greater waist circumference (WC), higher blood glucose levels and lower HDL levels. DAS28, CDAI and SDAI scores were higher and high disease activity was more frequent in MetS patients. The multivariate logistic regression identified BMI (OR = 1.12, 95% CI = 1.05–1.20; p < .001) and disease activity (OR = 1.23, 95% CI = 1.04–1.47; p = .016) as independent risk factors for MetS in patients with RA.Conclusion: RA in patients from Northeastern Brazil was found to be associated with increased WC, high prevalence of MetS (one of the highest in the world) and disease activity. Patients with MetS displayed a higher frequency of cardiovascular risk factors, indicating the need for better control of disease activity and modifiable risk factors for cardiovascular disease (CVD).

Stroke characterization in Sun Saharan Africa: Congolese population

BackgroundStroke is the second cause of death worldwide and over than 80% of deaths occurs in developing countries. However, its characteristics in the Democratic Republic of Congo (DRC) are poorly defined. This study aimed to describe the key features of stroke in a hospital population of Kinshasa in DRC and to assess the frequency of cardiovascular risk factors and their impact on target organs. MethodsA descriptive study was carried out from three hospitals in Kinshasa between January and April 2013. Cardiovascular risk factors, clinical and biological data were collected during the study period. The study involved 166 patients aged 18years and over. ResultsThe mean age of patients was 59.6±12.3years, the sex ratio for male of 1.9. Stroke was ischemic in 66% of cases. Hypertension was the most frequent cardiovascular risk factor (84.3%), followed by high blood cholesterol (45.2%).The etiologies of ischemic stroke (TOAST classification) were dominated by lacunas (38.5%) and embolic heart diseases (12.8%). The origin was unknown in 45.9% of cases. Coma was observed in 37% of patients on admission and was the main independent prognostic factor of mortality, which was 19.3%. Left ventricular hypertrophy and renal failure were found respectively in 64.7% and 34% of patients. ConclusionThis study found a growing increase of ischemic stroke in a society where hemorrhagic type used to be the most common, a high rate of hypertension, hypercholesterolemia and diabetes, indicative of a fast epidemiological transition.

Evaluation of left ventricular functions in patients with primary hyperparathyroidism: is there any effect of parathyroidectomy?

Our aim was to evaluate left ventricular (LV) systolic and diastolic functions of primary hyperparathyroidism (pHPT) patients with detailed echocardiographic analysis and investigate the effect of parathyroidectomy on echocardiographic parameters. A total of 22 eligible consecutive patients with pHPT who underwent parathyroidectomy operation were recruited to the study. Another 22 subjects with similar age, gender and frequency of cardiovascular risk factors compared to patients were used as acontrol group. Echocardiographic parameters of patients scheduled for parathyroidectomy were compared to healthy matched controls. Echocardiographic parameters measured 6months after the operation were also compared with preoperative values for each patient. Patients had higher LV mass index compared with controls. There were no significant differences between groups regarding 2D echocardiographic parameters reflecting LV systolic function and tissue Doppler velocities; however, 2D echocardiographic parameters demonstrated impairment in LV diastolic functions compared with controls. Speckle tracking echocardiography (STE) demonstrated similar LV global longitudinal systolic strain; however, left atrial conduit and reservoir functions were significantly reduced in patients with pHPT. In general, there were no significant differences between baseline and postoperative state regarding parameters reflecting LV systolic and diastolic functions; however, STE demonstrated significantly increased LV global longitudinal strain after surgery (22.3± 3.3% vs 20.3± 2.9%, p=0.026). Patients with pHPT displayed higher LV mass and impairment in LV diastolic function compared with controls. Parathyroidectomy did not lead to significant improvements in LV mass or LV diastolic function; however, subtle but not apparent increases in LV systolic function were observed 6months after surgery.