Indicator Of Cardiovascular Disease Risk Research Articles

Abstract MP34: Tai Chi Exercise is More Effective Than Brisk Walking in Reducing Cardiovascular Disease Risk Factors

Background: Physical inactivity is one of the major modifiable lifestyle risk factors associated with cardiovascular disease (CVD). Tai Chi (TC) is safe and popular among older adults; yet direct comparisons between TC and brisk walking (BW) on reducing CVD risk factors are lacking. Methods: A total of 246 adults (mean age=64.4±9.8 years, 45.5% men) with hypertension and two other CVD risk factors (i.e., smoker, diabetic, dyslipidemia, or overweight) were randomly assigned to either TC (n=82), BW (n=82), or control (C, n=82) groups. The TC and BW groups had 150 minutes/week, moderate-intensity physical activity for three months; with home-based practice encouraged for another six months. The primary outcome was blood pressure (BP). Secondary outcomes were: fasting blood sugar (FBS), HbA1c, total cholesterol, triglycerides, high and low density lipoprotein, body mass index (BMI), waist circumference and perceived stress. Data were collected at baseline, post-intervention at 3-month, 6-month and 9-month follow-up assessments. Generalized estimating equations models compared changes in the outcomes over time between groups. Results: At baseline, average BP=141/81, smokers=11%, diabetics=58%, dyslipidemia=61%, average BMI=26; with no significant differences between groups. TC significantly lowered BP (systolic -13.33 mmHg; diastolic -6.45 mmHg), FBS (-0.72 mmol/L), HbA1c (-0.39%), and perceived stress (-3.22 score) at 9-months, compared to C group. Pairwise comparisons indicated significantly greater reductions in SBP (p<0.001), DBP (p=0.049), FBS (p=0.001), HbA1c (p=0.002), and perceived stress (p=0.027) in TC group, compared to BW group. No significant changes in other CVD risk indicators over time between groups were observed. Conclusion: TC was better than BW in reducing several CVD risk factors, and can be recommended as a viable exercise to build a healthier life free of CVD.

Cardiovascular Risk Assessment and Follow-Up of Women After Hypertensive Disorders of Pregnancy

Hypertensive disorders of pregnancy (HDP) are associated with increased risk of cardiovascular disease (CVD) in women and serve as some of the earliest clinical indicators of CVD risk. This study examines the utility of CVD risk models proposed in the 2016 Canadian Cardiovascular Society (CCS) Dyslipidemia Guidelines in identifying women eligible for assessment and treatment following HDP.

Oxidative DNA Damage and Carotid Intima Media Thickness as Predictors of Cardiovascular Disease in Prediabetic Subjects.

Prediabetes is considered as a risk factor for the development of diabetes mellitus and cardiovascular disease. The present study was conducted with the aim of finding out the relationship between oxidative DNA damage and carotid intima media thickness for the prediction of cardiovascular disease in prediabetic subjects. The study included 100 prediabetic subjects and 100 normal individuals as controls. In both cases and controls, 8-OHdG was measured by ELISA, and CIMT was measured by B mode ultrasonography. Both 8-OHdG and CIMT were significantly higher in subjects with prediabetes as compared to controls (185.80 ± 10.72 pg/mL vs. 126.13 ± 16.01 pg/mL, p < 0.001 and 0.70 ± 0.04 mm vs. 0.57 ± 0.03 mm, p < 0.001, respectively). There was significant and positive correlation of IGT with 8-OHdG (r = 0.783; p < 0.001) and CIMT (r = 0.787; p < 0.001) in prediabetic subjects. Moreover, 8-OHdG showed significant positive correlation with CIMT (r = 0.704; p < 0.001) in prediabetic subjects. In conclusion, increased 8-OHdG and CIMT in prediabetic subjects indicate that biochemical changes of atherosclerosis start even before the onset of diabetes mellitus. Hence, 8-OHdG and CIMT could be used as indicators of cardiovascular disease risk in these subjects.

Changes in the Blood Components Caused by Water Intake

Although water is an essential component of the human body and is involved in many physiological processes, the effect of a steady and sufficient water intake on blood components has not well elucidated. Therefore, we investigated the changes in hematological parameters, high-sensitivity C-reactive protein (hs-CRP), and immunoglobulin G (IgG) after water intake in 13 healthy adults. They were divided into two groups: The control group (N=4), which consumed water ad libitum, and the experimental group (N=9), which consumed 2 L of water per day. Two weeks later, blood cell counts, hematocrit, and hemoglobin content had increased in the experimental group, although not significantly (p>0.05); however, there was a significant increase in the mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC) (p<0.05; and p<0.01, respectively), and a significant decrease in the mean platelet volume (MPV) (p<0.05). Of the immunologic parameters, a non-significant decrease in the concentration of hs-CRP, an indicator of cardiovascular disease risk, was observed (p>0.05). However, there was a dramatic and significant increase in the concentration of IgG (p<0.05). In conclusion, a steady and sufficient water intake may contribute to alleviate anemia by increasing hemoglobin. Additionally, it may decrease the risk of cardiovascular disease by decreasing platelet activation and concentration of hs-CRP. Furthermore, a steady intake of water may improve immune function by increasing the concentration of the components of humoral immunity.

Visceral adiposity index and 10-year cardiovascular disease incidence: The ATTICA study

Background and aimsVisceral adiposity index (VAI) has been proposed as a marker of visceral adipose tissue accumulation/dysfunction. Our aim was to evaluate potential associations between the VAI and the 10-year cardiovascular disease (CVD) incidence. Methods and resultsDuring 2001–2002, 3042 Greek adults (1514 men; age: ≥18 years) without previous CVD were recruited into the ATTICA study, whilst the 10-year study follow-up was performed in 2011–2012, recording the fatal/non-fatal CVD incidence in 2020 (1010 men) participants. The baseline VAI scores for these participants were calculated based on anthropometric and lipid variables, while VAI tertiles were extracted for further analyses. During the study follow-up a total of 317 CVD events (15.7%) were observed. At baseline, the participants' age and the prevalence of hypertension, diabetes, hypercholesterolemia and metabolic syndrome increased significantly across the VAI tertiles. After adjusting for multiple confounders, VAI exhibited a significantly independent positive association with the 10-year CVD incidence (OR = 1.05, 95%CI: 1.01, 1.10), whereas the association of the body mass index (HR = 1.03, 95%CI: 0.99, 1.08), or the waist circumference (HR = 1.01, 95%CI: 0.99, 1.02) was less prominent. Sex-specific analysis further showed that VAI remained significantly predictive of CVD in men alone (HR = 1.06, 95%CI: 1.00, 1.11) but not in women (HR = 1.06, 95%CI: 0.96, 1.10). ConclusionsOur findings show for the first time in a large-sample, long-term, prospective study in Europe that the VAI is independently associated with elevated 10-year CVD risk, particularly in men. This suggests that the VAI may be utilized as an additional indicator of long-term CVD risk for Caucasian/Mediterranean men without previous CVD.

Zinc and Selenium Co-supplementation Reduces Some Lipid Peroxidation and Angiogenesis Markers in a Rat Model of NAFLD-Fed High Fat Diet

Studies have shown that non-alcoholic fatty liver disease (NAFLD) patients are more prone to cardiovascular disease (CVD). Zinc and selenium deficiency are common in NAFLD. But the effects of zinc and selenium co-supplementation before and/or after disease progression on CVD markers are not clear in NAFLD patients. This study aimed to compare the effects of zinc and selenium co-supplementation before and/or after disease progression on some of the CVD markers in an experimental model of NAFLD. Forty male Sprague Dawley rats (197±4g) were randomly assigned into four dietary groups: control group (C; received 9% of calorie as fat), model group (M; received 82% of calorie as fat), and supplementation before (BS) or after (AS) disease progression. Animals were fed diets for 20weeks in all groups. Fasting plasma glucose (FPG), insulin, HOMA-IR, ALT, AST, lipid profile, malondialdehyde (MDA) and vascular endothelial growth factor (VEGF) levels were measured as CVD indices. Serum ALT, AST, FPG, insulin, MDA, VEGF and HOMA-IR were significantly higher in the M than C group. Co-supplementation reduced serum ALT and AST levels in the BS and AS groups compared with the M group. FPG, insulin, HOMA-IR, VEGF, MDA, LDL/HDL-c and TC/HDL-c ratio were significantly reduced in the AS compared with the M group. TG/HDL-c ratio was significantly reduced in the BS and AS compared with the M group. Serum MDA, VEGF, Insulin and HOMA-IR were significantly lowered in the AS than BS group (p<0.05). Zinc and selenium co-supplementation after NAFLD progression reduced CVD risk indices in an experimental model.

Abstract P019: Family History of Cardiovascular Disease is Associated With Cognitive Function: The Emory Healthy Aging Study

Background: Family history of cardiovascular disease (CVD) is a readily available risk indicator of future CVD, combining the influence of shared genetic, environmental and behavioral risk factors. Though CVD risk factors have been associated with an increased risk of cognitive impairment and decline, less is known about the association between family history of CVD and cognitive function. Evaluating this association may further elucidate the role of cardiovascular health in cognitive health. Methods: The Emory Healthy Aging Study isan ongoing prospective cohort study aimed at identifying predictors of healthy aging and age-related diseases. Participants are primarily residents of the Atlanta area, at least 18 years old, who completed an online baseline health survey. Multiple recruitment forums were used, including clinic waiting rooms, informational letters and emails, community events and online recruitment. Baseline information about demographic (age, race, gender), socioeconomic (education, household income), and health behavior factors (physical activity, smoking) as well as personal health (diabetes, hyperlipidemia, and hypertension) and family health history were collected by online survey. Family history of CVD was defined as self-reported history for any parent or sibling of coronary artery disease, myocardial infarction, or stroke. Cognitive function was measured using the validated Cognitive Function Instrument (CFI) with scores ranging between 0-14 (lower is better). The association between family history of CVD and CFI score was assessed using multivariable linear regression, adjusting for demographic, socioeconomic, lifestyle and CVD risk factors, as well as family history of mild cognitive impairment (MCI) or Alzheimer’s disease (AD). Results: We studied 3801 participants (75% female, 85% white, 10% black, and 5% other), recruited between October 2015 and October 2016. Mean age was 59±13 years and 61% reported a family history of CVD. Adjusting for age, gender, race, education, household income, exercise habits, smoking status and family history of MCI or AD, family history of CVD was associated with poorer cognitive performance (β=0.26; 95% CI (0.12, 0.41)). Additional adjustment for hypertension, hyperlipidemia, diabetes and BMI only slightly attenuated estimates (β=0.22; 95% CI (0.08, 0.41)). In the same model, the estimated β for family history of cognitive impairment was similar: 0.22 (0.07, 0.37). Conclusion: In this cross-sectional study of people from the community, family history of CVD was associated with poorer cognitive function, and this association was of the same magnitude as having a first-degree family member with a history of cognitive impairment. Although longitudinal data are needed, these results underscore the link between cardiovascular and neurocognitive health and potential role of shared genetic and behavioral factors.

Extracellular Fluid/Intracellular Fluid Volume Ratio as a Novel Risk Indicator for All-Cause Mortality and Cardiovascular Disease in Hemodialysis Patients.

BackgroundIn hemodialysis patients, fluid overload and malnutrition are accompanied by extracellular fluid (ECF) expansion and intracellular fluid (ICF) depletion, respectively. We investigated the relationship between ECF/ICF ratio (as an integrated marker reflecting both fluid overload and malnutrition) and survival and cardiovascular disease (CVD) in the context of malnutrition-inflammation-arteriosclerosis (MIA) complex.MethodsSeventy-seven patients from a single hemodialysis unit were prospectively enrolled. The ECF/ICF volume was measured by segmental multi-frequency bioimpedance analysis. MIA and volume status were measured by serum albumin, C-reactive protein (CRP), pulse wave velocity (PWV) and plasma B-type natriuretic peptide (BNP), respectively.ResultsThe mean ECF/ICF ratio was 0.56±0.06 and the cut-off value for maximum discrimination of survival was 0.57. Compared with the low ECF/ICF group, the high ECF/ICF group (ratio≥0.57, 42%) had higher all-cause mortality, CVD, CRP, PWV, and BNP, but lower serum albumin. During the 5-year follow-up, 24 all-cause mortality and 38 CVD occurred (18 and 24, respectively, in the high ECF/ICF group versus 6 and 14 respectively in the low ECF/ICF group, P<0.001). In the adjusted Cox analysis, the ECF/ICF ratio nullifies the effects of the MIA and volume status on survival and CVD and was an independent predictor of all-cause mortality and CVD: hazard ratio (95% confidence interval); 1.12 (1.01–1.25) and 1.09 (1.01–1.18) for a 0.01 increase in the ECF/ICF ratio. The degree of malnutrition (albumin), inflammation (CRP), arteriosclerosis (PWV), and fluid overload (BNP) were correlated well with the ECF/ICF ratio.ConclusionsHemodialysis patients with high ECF/ICF ratio are not only fluid overloaded, but malnourished and have stiff artery with more inflammation. The ECF/ICF ratio is highly related to the MIA complex, and is a major risk indicator for all-cause mortality and CVD.

Correlation of metabolic syndrome severity with cardiovascular health markers in adolescents

Background and ObjectivesThe presence of metabolic syndrome (MetS) in childhood is a significant risk factor for later cardiovascular disease (CVD). Recent data showed temporal decreases in a sex- and race/ethnicity-specific MetS severity z-score among U.S. adolescents. Our goal was to characterize the relationship of this MetS z-score with other CVD risk indicators and assess their temporal trends and lifestyle influences. MethodsWe analyzed 4837 participants aged 12–20years from the National Health and Nutrition Examination Survey by 2-year waves from 1999 to 2012. We used linear regression to compare MetS z-score and dietary factors with serum levels of low-density lipoprotein (LDL), apolipoprotein-B (ApoB), high-sensitivity C-reactive protein (hsCRP) and uric acid. ResultsMetS severity z-score was positively correlated with LDL, ApoB, hsCRP, and uric acid measurements (p<0.0001 for all). These correlations held true among individual racial/ethnic groups. LDL, ApoB, and hsCRP measurements decreased over time among U.S. adolescents (p=0.002, p<0.0001, and p=0.024, respectively). Saturated fat consumption was positively correlated with LDL (p=0.005) and ApoB (p=0.012) and inversely related to serum uric acid (p=0.001). Total caloric intake was inversely related to LDL (p=0.003) and serum uric acid (p=0.003). Unsaturated fat, carbohydrate, and protein consumption were not related to LDL, ApoB, hsCRP, or serum uric acid. ConclusionsThere is a positive correlation between MetS severity and all four CVD risk indicators studied. LDL, ApoB, and hsCRP showed favorable temporal trends, which could be related to similar trends in MetS z-score. These data support the importance of considering multiple inter-related factors in clinical CVD risk assessment.

Smoking cessation reduces ratio of total cholesterol/high density lipoprotein (HDL) cholesterol levels on adult people in Yogyakarta Special Region

Cigarette smoking is a major cause of cardiovascular disease due to elevation of free radical substances as well impairment in lipid metabolism. Smoking cesation has been linked with reduced risk of mortality. However, data regarding cardiovascular disease (CVD) risk factor in former smoker is limited. The aim of the study was to evaluate the CVD risk factor among smoker, non-smoker and former smoker in Yogyakarta Special Region, Indonesia. A cross-sectional design from 86 apparently healthy male, aged between 25-50 years old was performed for this study. From total subjects, 45 subjects are smokers, 26 are non-smokers and 15 are former smokers. Body weight, height, and blood pressure were also measured from the subjects. Blood was drawn for assessment of total cholesterol (TC), triglyceride, low density lipoprotein (LDL), high density lipoprotein (HDL) and C-reactive protein (CRP) concentrations. We found significant difference in the level of HDL, cardiovascular risk index (LDL/HDL ratio), atherogenic index (TC/HDL ratio) and also in systolic blood pressure among groups (p<0.05). Smoking person had significantly low HDL level with high CVD risk index and atherogenic index (p<0.05). The CVD risk index was not different between former smoker and smoker groups. Serum CRP level was not different among the groups. In conclusion, smoking is associated with increased risk of CVD. Smoking cessation slightly decrease the CVD risk.

Menopausal Hot Flashes and Carotid Intima Media Thickness Among Midlife Women.

There has been a longstanding interest in the role of menopause and its correlates in the development of cardiovascular disease (CVD) in women. Menopausal hot flashes are experienced by most midlife women; emerging data link hot flashes to CVD risk indicators. We tested whether hot flashes, measured via state-of-the-art physiologic methods, were associated with greater subclinical atherosclerosis as assessed by carotid ultrasound. We considered the role of CVD risk factors and estradiol concentrations in these associations. A total of 295 nonsmoking women free of clinical CVD underwent ambulatory physiologic hot flash assessments; a blood draw; and carotid ultrasound measurement of intima media thickness and plaque. Associations between hot flashes and subclinical atherosclerosis were tested in regression models controlling for CVD risk factors and estradiol. More frequent physiologic hot flashes were associated with higher carotid intima media thickness (for each additional hot flash: β [SE]=0.004 [0.001]; P=0.0001; reported hot flash: β [SE]=0.008 [0.002]; P=0.002, multivariable) and plaque (eg, for each additional hot flash, odds ratio [95% confidence interval] plaque index ≥2=1.07 [1.003-1.14]; P=0.04, relative to no plaque, multivariable] among women reporting daily hot flashes; associations were not accounted for by CVD risk factors or by estradiol. Among women reporting hot flashes, hot flashes accounted for more variance in intima media thickness than most CVD risk factors. Among women reporting daily hot flashes, frequent hot flashes may provide information about a woman's vascular status beyond standard CVD risk factors and estradiol. Frequent hot flashes may mark a vulnerable vascular phenotype among midlife women.

Cardiovascular risk profiles of world masters games participants.

Increasing evidence indicates adherence to exercise throughout life is concurrent with improved health. World masters games (WMG) have more participants than any other international sporting competition and is under investigated, particularly with regard to indices of cardiovascular disease risk. Therefore, we chose to investigate selected cardiovascular risk factors in WMG participants. This was a cross-sectional, observational study which utilized a web-based questionnaire to survey cardiovascular risk factors of WMG participants. The survey consisted of three sections: basic demographics, medical history and physiological parameters which included Body Mass Index (BMI), waist circumference (WC), resting blood pressure (BP) and lipids (total cholesterol [TC], high density lipoprotein [HDL] and low density lipoprotein [LDL]). A total of 1435 participants, 872 male, aged 27-91 years (mean age 54.99 years) participated in the study. Key findings included significant differences (P<0.05) between genders in BMI (17.7%, P<0.001), WC (10.6%, P<0.001), resting SBP (5.8%, P<0.001) and resting DBP (4.8%, P<0.001). Significant differences were also found between genders in HDLs (15.2%, P<0.001), TC:HDL ratio (17.2%, P<0.001) and LDL:HDL ratio (19.0%, P<0.001). Significant differences (P<0.001) were also identified when comparing WMG lipid results to the Australian general population (TC P<0.001; HDLs P<0.001; LDLs P<0.001). A high percentage of WMG participants demonstrated optimal values in a number of cardiovascular disease (CVD) risk factors when compared to the general population, female WMG participants had better values as compared to males. This reflected a decreased CVD in WMG participants and supports our hypothesis of enhanced health characteristics in an active, but aged cohort.

Assessment of Subclinical Atherosclerosis by Carotid Intima-Media Thickness and Epicardial Adipose Tissue Thickness in Prediabetes.

Impaired fasting glucose (IFG) and impaired glucose intolerance (IGT) are predictors of cardiovascular disease (CVD). We tested the hypothesis that epicardial fat thickness (EFT) and carotid intima-media thickness (cIMT), as markers of early atherosclerosis, are increased in patients with prediabetes. We prospectively enrolled 246 patients (162 with prediabetes and 84 controls). Prediabetes was defined according to American Diabetes Association criteria, and patients were divided into 3 groups: group 1-IFG, group 2-IGT, and group 3-IFG + IGT. Both cIMT and EFT were significantly greater in patients with prediabetes compared with controls (0.81 ± 0.20 mm vs 0.68 ± 0.16 mm, P < .001 and 7.0 ± 2.0 mm vs 5.6 ± 1.6 mm, P < .001, respectively). This difference was mainly attributed to patients with IGT. Age, waist circumference, and 2-hour glucose independently predicted cIMT, while 2-hour glucose was the only independent predictor of EFT in multivariate analysis among other relevant parameters for cIMT and EFT. The cIMT and EFT (measured noninvasively) could be useful indicators of CVD risk in these patients. In order to prove this hypothesis, long-term prospective studies with greater patient numbers are required.

Assessing perinatal depression as an indicator of risk for pregnancy-associated cardiovascular disease.

Cardiovascular conditions associated with pregnancy are serious complications. In general, depression is a well-known risk indicator for cardiovascular disease (CVD). Mental distress and depression are associated with physiological responses such as inflammation and oxidative stress. Both inflammation and oxidative stress have been implicated in the pathophysiology of CVDs associated with pregnancy. This article discusses whether depression could represent a risk indicator for CVDs in pregnancy, in particular in pre-eclampsia and peripartum cardiomyopathy (PPCM).

Triglyceride-rich lipoproteins as a causal factor for cardiovascular disease.

Approximately 25% of US adults are estimated to have hypertriglyceridemia (triglyceride [TG] level ≥150 mg/dL [≥1.7 mmol/L]). Elevated TG levels are associated with increased cardiovascular disease (CVD) risk, and severe hypertriglyceridemia (TG levels ≥500 mg/dL [≥5.6 mmol/L]) is a well-established risk factor for acute pancreatitis. Plasma TG levels correspond to the sum of the TG content in TG-rich lipoproteins (TRLs; ie, very low-density lipoproteins plus chylomicrons) and their remnants. There remains some uncertainty regarding the direct causal role of TRLs in the progression of atherosclerosis and CVD, with cardiovascular outcome studies of TG-lowering agents, to date, having produced inconsistent results. Although low-density lipoprotein cholesterol (LDL-C) remains the primary treatment target to reduce CVD risk, a number of large-scale epidemiological studies have shown that elevated TG levels are independently associated with increased incidence of cardiovascular events, even in patients treated effectively with statins. Genetic studies have further clarified the causal association between TRLs and CVD. Variants in several key genes involved in TRL metabolism are strongly associated with CVD risk, with the strength of a variant’s effect on TG levels correlating with the magnitude of the variant’s effect on CVD. TRLs are thought to contribute to the progression of atherosclerosis and CVD via a number of direct and indirect mechanisms. They directly contribute to intimal cholesterol deposition and are also involved in the activation and enhancement of several proinflammatory, proapoptotic, and procoagulant pathways. Evidence suggests that non-high-density lipoprotein cholesterol, the sum of the total cholesterol carried by atherogenic lipoproteins (including LDL, TRL, and TRL remnants), provides a better indication of CVD risk than LDL-C, particularly in patients with hypertriglyceridemia. This article aims to provide an overview of the available epidemiological, clinical, and genetic evidence relating to the atherogenicity of TRLs and their role in the progression of CVD.

Evaluation of the serum cholesterol ester fatty acid composition in the elderly with subclinical atherosclerosis

Objective To investigate serum levels of cholesterol ester fatty acids in elderly patients with subclinical atherosclerosis (AS), in order to provide supportive laboratory data for early prevention of AS. Methods A retrospective study was undertaken on 180 elderly volunteers (age ≥60 years) who had received regular health checkups at Beijing Hospital in 2013, including 92 subclinical AS patients (the subclinical AS group) with carotid intima-media thickness (cIMT) greater than 1 mm and 88 healthy subjects (the control group). Venous blood samples were taken. Liquid chromatography tandem mass spectrometry was used to determine eleven serum cholesterol ester fatty acids, and enzyme activities of desaturases and elongases were estimated from product-to-precursor ratios. Serum total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein AI (ApoAI), ApoB, high sensitivity C-reactive protein (hsCRP) and other biochemical indicators were analyzed with automatic biochemistry analyzers and the results were analyzed with independent sample t-test, nonparametric test and logistic regression. Results Compared with the control group, age, TC, LDL-C, ApoB, serum CE16: 1 and Δ9-desaturase were higher, and serum CE22: 6 was lower in the subclinical AS group (P<0.05). After adjustment for confounding factors such as age, gender, body mass index, TC, TG, HDL-C, and LDL-C, the odds ratio of serum CE22: 6 was 0.29 (95%CI: 0.11-0.78, Wald χ2: 6.009, P<0.05), compared with the highest quartile and the lowest quartile. However, no significant difference was found in serum CE16: 1 and Δ9-desaturase. Spearman partial correlation analysis was used to analyze the relationship between CE22: 6 and the cardiovascular disease risk index and revealed that CE22: 6 was negatively correlated with Apo A, TC and HDL-C (r=-0.166, -0.149 and -0.194, respectively, each P<0.05), while no significant correlation with other indicators was found. Conclusions Serum CE22: 6 may play a protective role in subclinical AS patients. A balanced intake of fatty acids is helpful for prevention of AS in elderly people. Key words: Fatty acids; Docosahexaenoic acid ester; Atherosclerosis

Abstract P229: Small Visceral Adipose Volumes and Quality Associated with Aortic and Coronary Artery Calcification in Women with SLE

Introduction: Women with systemic lupus erythematosus (SLE) have an increased risk of cardiovascular disease (CVD) not explained by CVD or SLE risk factors. Small visceral fat volumes of the heart and aorta quantified by computed tomography (CT) have been associated with subclinical CVD. Additionally, fat quality, assessed by CT attenuation (Hounsfield Units, HU), may confer CVD risk. Hypothesis: Low density (more negative HU) fat is associated with aorta and coronary artery calcification (AC/CAC) in women with SLE independent of fat volume and BMI or waist-to-hip ratio (whratio). Methods: CT scans from clinically CVD-free SLE women (n=143) were used to quantify AC/CAC (Agatston score) and aortic perivascular and total heart fat tissue (aPVAT, TAT) volumes. Fat quality was assessed using average HU (aorta:avgHUa; heart:avgHUh). Logistic regression models (any AC/CAC) were used and final models were adjusted for BMI or whratio. Results: In this study, AC/CAC was detected in 118/143 women (AC score (median (IQR)): 70(10-381) CAC score 1.4(0-30)). SLE women with any AC/CAC were more likely to be hypertensive and postmenopausal with a greater BMI (all p&lt;0.05). Those with any AC had elevated circulating levels of CRP, fibrinogen and total cholesterol, while those with any CAC also had higher triglyceride, homocysteine, C3 and C4 (all p&lt;0.05). SLE with any AC/CAC had greater volumes (cm 3 ) of TAT (111 (84-137)) and aPVAT (34 (27-45)) when compared to those with no AC/CAC (TAT 71 (52-102); aPVAT 27 (23-30), both&lt;0.01). SLE women with any AC/CAC had a more positive avgHUa (mean(std): -83.4(1.9)) when compared to those with no AC/CAC (-84.5(1.6)), p&lt;0.03). In logistic regression analysis, TAT (OR[95%]: 2.8[1.4-5.6]), aPVAT (4.9[1.7-14]) and avgHUa (1.9[1.1-3.1]) were associated with any AC/CAC (all p&lt;0.03). After adjusting for BMI or whratio, TAT remained associated with any AC (2.1[1.0-4.2] and 2.8[1.4-5.5], p&lt;0.05) and any CAC (1.7[1.0-2.7] and 2.4[1.5-3.7], all p&lt;0.05). Both aPVAT and avgHUa were attenuated when adjusting for BMI with any AC; however, avgHUa remained significant with any CAC (1.9[1.2-3.0), p&lt;0.01). The association with any AC and CAC remained significant when adjusting for whratio for both aPVAT (5.4[1.8-16], 1.9[1.2-3.1], both p&lt;0.01) and avgHUa (1.7[1.0-2.9], 1.9[1.2-3.1]) both p&lt;0.04).When evaluating fat volume and quality with any CAC, avgHUa (2.1[1.3-3.5],p&lt;0.01) attenuated aPVAT(1.3[0.86-1.8],p=0.2). Conclusions: Fat volumes surrounding the heart and aorta are greater and, contrary to our hypothesis, the avgHU was more positive in clinically CVD-free SLE women with calcification. This higher density may reflect unhealthy fibrotic fat. AC generally precedes CAC development and the independent association of both aPVAT and avgHUa suggest that the relationship between fat volume and quality may be an indicator of more advanced vascular calcification and CVD risk.

The stressors of being young and Black: Cardiovascular health and Black young adults

Objective: To examine the impact of stressors relevant to the lives of Black young adults including racial, financial, occupational, and general stress and psychological distress on cardiovascular disease (CVD) risk. Specifically, this study examined the relationship between multiple psychosocial stressors and two CVD risk indicators (i.e. obesity and blood pressure).Design: This study used a quantitative design which included surveys, the collection of anthropometric and blood pressure (BP) measures. Participants were 124 Black college students aged 18 to 27 years old. Main Outcome Measures: Participants completed measures to assess psychological distress, general, occupational, financial and racial stress. Measures of body mass index (BMI), waist-to-hip ratio (WHR) and BP were collected to assess CVD risk.Results: Findings indicated a significant effect of internalised racism on BMI and a significant effect of individual racial stress on diastolic BP. Also, depression was significantly associated with systolic BP. There were no significant results for WHR.Conclusion: Findings suggested that the relationship among racial stress, psychological distress and CVD be further explored.

Influence of weight status on physical and mental health in Moroccan perimenopausal women.

IntroductionThere is a lack of information about fitness and other health indicators in women from countries such as Morocco. This study aims to explore the association of weight status with physical and mental health in Moroccan perimenopausal women.Methods151 women (45-65 years) from the North of Morocco were analyzed by standardized field-based fitness tests to assess cardiorespiratory fitness, muscular strength, flexibility, agility and balance. Quality of life was assessed by means of the Short-Form-36 Health Survey. Resting heart rate, blood pressure and plasma fasting glucose, total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides were also measured.ResultsBlood pressure (P=0.001), plasma triglycerides (P=0.041) and the prevalence of metabolic syndrome (P<0.001) increased as weight status increased. Levels of cardiorespiratory fitness, upper-body flexibility (both, P<0.001), static balance (P<0.05) and dynamic balance (P<0.01) decreased as weight status increased. Pairwise comparisons showed differences mainly between normal-weight and overweight vs. obese groups. No differences between groups were observed on quality of life.ConclusionCardiovascular and lipid profile and fitness, important indicators of cardiovascular disease risk, worsened as weight status increased, whereas quality of life appears to be independent of weight status. Exercise and nutritional programs focus on weight management may be advisable in this under studied population.

Anthropometric variables and cardiovascular risk factors in adolescents

Background: Childhood Obesity is increasing worldwide including the developing countries. Obesity defined by body mass index (BMI) is likely to be associated with increased risk of cardiovascular disease. However, waist circumference (WC), a marker of central adiposity, may be better indicator of cardiovascular disease risk. In children, the relationship between body-fat distribution and disease risk factors is not yet clear. Hence this study was undertaken to explore the relationship between anthropometric variables, lipid concentrations, and blood pressure (BP) and to assess the clinical relevance of waist circumference in identifying children with higher cardiovascular risk. Methods: A total of 610 children (355 boys and 255 girls) were studied. Height, weight, waist circumference, BP and plasma lipid profile (total cholesterol, LDL cholesterol, Apo-lipoprotein A1 (Apo-A1), and Apo-lipoprotein B (Apo-B) were determined. Results: The plasma lipid profile and blood pressure was significantly higher in children with high waist circumference than in children with normal waist circumference. Waist circumference showed strong association with plasma lipid profile and blood pressure (p< 0.001). Conclusions: Since WC is a good predictor of cardiovascular risk factors, we suggest that all children with high WC should undergo routine screening for hypertension and abnormal lipid profile.