Main Cardiovascular Risk Factors Research Articles

Prevalence of Diabetes and Associated Risk Factors among a Group of Prisoners in the Yaoundé Central Prison.

Background Diabetes is a public health problem worldwide, associated with increased morbidity and mortality. According to the International Diabetes Federation (IDF) 2017 data, around 425 million people worldwide suffer from diabetes. This number is expected to increase to 629 million in 2045. Various occidental studies reported the increased prevalence and lower control of diabetes among prisoners. However, there is no data on the characteristics of inmates with diabetes in sub-Saharan Africa. Methods A cross-sectional study among incarcerated detainees from the Yaoundé Central Prison was conducted from January to July 2017. Diabetes was defined according to the American Diabetes Association (ADA) criteria. Analyzed variables included phenotypic characteristics, lifestyle, the reason for detention, the sentence severity, and the length of detention. Results We recruited 437 inmates (344 men) with an average age of 37.0 (95% CI: 35.9-38.3) years. The most frequent age group was 20 to 39 years with 281 (64.7%) inmates, and the mean prison stay was 29.1 (95% CI: 25.7-32.8) months. The prevalence of diabetes in the Yaoundé Central Prison was 9.4%. The main cardiovascular risk factors were a sedentary lifestyle (91.1%), hypertension (39.6%), smoking (31.6%), and alcohol consumption (28.1%). Hypertension (p = 0.005), obesity (p = 0.005), obesity (p = 0.005), obesity (p = 0.005), obesity (p = 0.005), obesity (p = 0.005), obesity (Conclusion Diabetes prevalence in the Yaoundé Central Prison was high, at 9.4%, compared to that in the general population. It was associated with other classical cardiovascular risk factors and factors linked to the sentence (minor and major crimes). This trial is registered with CE00617/CRERSHC/2016.

STEREOTYPES OF EATING BEHAVIOR AND RISK FACTORS FOR CARDIOVASCULAR DISEASE IN RESIDENTS OF A LARGE INDUSTRIAL REGION OF SIBERIA

Purpose of the study was to identify the main stereotypes of eating behavior among residents of a large industrial region of Siberia and to assess their relationship with the main factors of cardiovascular risk. Material and methods . It included 1600 people aged 35–70, permanently residing in the Kemerovo region. The sample is mainly represented by females (1124 people, men – 476 people), the average age was 54.9 ± 9.75 years and 52.6 ± 10.0 years, respectively, p < 0.001. Taking into account the differences in age between men and women, to identify gender and age characteristics, the entire sample was divided into age groups: 35-49 years old, 50-59 years old, 60-70 years old. To identify latent factors (stereotypes of eating behavior), factor analysis (principal component analysis) was used. Three stereotypes of eating behavior were identified: «fruit and vegetable», «proteincarbohydrate » and «mixed». Results. Most of the examined persons aged 35–49 adhered to the protein-carbohydrate stereotype of nutrition (40.3 % versus 25.3 % and 34.4 % of persons who adhered to the fruit-vegetable and mixed, respectively, p < 0.001). In other age groups, no statistically significant differences were found. Thus, among respondents aged 50–59, 34.0 % preferred fruit and vegetable, 33.8 % – protein-carbohydrate, 32.0 % – mixed. Among people 60–70 years old – 36.6 %, 30.4 %, 33.0 %, respectively. Adherence to a fruit and vegetable diet was associated with an increased risk of diabetes (OR = 1.27, CI: 1.2–2.2, p = 0.046) and obesity (OR = 1.57, CI: 1.27– 1.96, p < 0.001), and adherence to protein-carbohydrate – with a decrease in the risk of detecting obesity (OR = 0.75, CI: 0.6–0.95, p = 0.015), DM (OR = 0.66, CI: 0.47–0.93, p = 0.018), hypercholesterolemia (OR = 0.78, CI: 0.62–0.98, p = 0.032) and hypertriglyceridemia (OR = 0.66, CI: 0, 52–0.83, p < 0.001). Conclusion. Among the inhabitants of a large industrial region of Siberia, it was possible to distinguish three stereotypes of nutrition: fruit-vegetable, protein-carbohydrate and mixed. Among the supporters of the mixed and protein-carbohydrate stereotype aged 35–49, hypercholesterolemia, hypertriglyceridemia and high LDL levels were more often diagnosed in men than in women of the corresponding group. Also, hypertriglyceridemia and diabetes were more often detected in young men adhering to a fruit and vegetable stereotype of nutrition, in contrast to women in a similar group. Adherence to a fruit-vegetable dietary stereotype was associated with an increased risk of diabetes and obesity, and adherence to protein-carbohydrate – with a decrease in the risk of obesity, diabetes, hypercholesterolemia and hypertriglyceridemia.

P674 Epicardial fat volume is associated with the risk of atrial fibrillation recurrence following pulmonary vein isolation

Abstract Funding Acknowledgements Plaqueimage Background Atrial fibrillation (AF) is the most common supraventricular rhythm disturbance and pulmonary vein (PV) isolation has an important role in rhythm control treatment strategies of this disease. Various anatomical and clinical characteristics have been well established as predictors of the risk of recurrence following ablation procedures, but the role of epicardial fat tissue (EFT) in the recurrence of AF has not been elucidated so far. Purpose To investigate the influence of left atrial size and EFT volume in the recurrence of AF after pulmonary vein ablation, during a 6-month follow-up. Methods A total of 40 patients, 52.5% with paroxysmal and 47.5% with chronic AF underwent PV isolation using radiofrequency and cryoablation techniques. EFT was determined using cardiac computed tomography angiography (CCTA) associated with advanced image post-processing techniques. Results In patients who developed AF recurrence at 6 months after AF ablation, the volume of EFT and of left atrium were significantly larger than in the group who maintained sinus rhythm (202.5 ± 64.56 ml vs. 138 ± 55.74 ml, p = 0.01 for EFT, and 149.3 ± 4.66 ml vs. 90.63 ± 5.19 ml, p &amp;lt;0.0001 for left atrial volume, respectively). The left ventricular ejection fraction was significantly lower in patients with AF recurrence (50.25 ± 6.54% vs. 54.22 ± 3.95%, p = 0,04). The analysis of AF recurrence between the two different ablation techniques did not show any difference in recurrence rates between radiofrequency and cryoablation methods (29% vs. 23%, respectively p = 0.73). At the same time, recurrence rates after AF ablation were not influenced by the main cardiovascular risk factors (age, hypertension, dyslipidemia and smoking) and was not associated with different risk scores (CHA2DS2-VASc and HAS-BLED). Conclusion Patients with AF recurrence after pulmonary vein ablation present significantly higher EFT or left atrial volumes compared to patients who maintained sinus rhythm. This indicates the inflammatory mediated response, usually accompanied by an increased amount of EFT, could be associated with the risk of AF recurrence following catheter ablation of the pulmonary veins.

Интенсификация липидснижающей терапии у пациентов с тяжелыми нарушениями липидного обмена в условиях специализированных липидных центров. Возможности применения эволокумаба

The article presents current data on the prevalence of dyslipidemia worldwide and in the Russian Federation as the main cardiovascular risk factor of developing diseases associated with atherosclerosis. The article identifies the problems of low-level detection of dyslipidemia in the population and insufficient efficacy of lipid-lowering therapy to achieve the lipid profile target values depending on the established risk. It also presents the possibilities of modern lipid-lowering therapy with the use of innovative drugs — PCSK9 inhibitors and the use of evolocumab in accordance with evidence-based medicine. Adding that, the article shows the experience of two lipid control centers (in Kemerovo and Surgut) with the postulation of the need to expand the lipid control center chain to improve methods for providing medical care to patients with severe forms of dyslipidemia. The possibilities of intensifying lipid-lowering therapy in real clinical practice are outlined on the example of patients undergoing treatment in the lipid control center of Kemerovo. Evolocumab has been shown to be highly effective: reduction of atherogenic cholesterol fractions by 67% from the baseline and high safety of such therapy.KEYWORDS: lipid metabolism disorders, statins, lipid-lowering therapy, familial hypercholesterolemia, PCSK9 inhibitors, evolocumab.FOR CITATION: Barbarash O.L., Kashtalap V.V., Fedorova N.V. et al. Intensification of lipid-lowering therapy in patients with severe lipid metabolism disorders in specialized lipid control centers. Possibilities of using evolocumab. Russian Medical Inquiry. 2020;4(7):437–444. DOI: 10.32364/2587-6821-2020-4-7-437-444.

Contribution of Ambulatory Pulsed Pressure in the Modification of the Left Ventricular Geometry of the African Black People

Introduction-Purpose: Pulsed pressure is recognized as an important predictor of cardiovascular risk. The purpose of this study was to identify a possible association between high ambulatory pulsed pressure and left ventricular geometry change in African black people. Material and methods: We conducted a bicentric, retrospective descriptive and analytical study that took place from 2010 to 2015 at the Abidjan Heart Institute and the Polyclinic Sainte Anne Marie in Abidjan. The people were selected from MAPA’s archive files. Those aged 18 years and over were included, all of whom had valid echocardiography and MAPA. The analyzed parameters concerned epidemiological data with age, gender and body surface area. The clinical data analyzed included systolic, diastolic, mean and 24-hours pulsed pressures. On the echocardiographic parameters, it was the evaluation of the ventricular mass indexed to the body surface. Results: A total of 177 patients records were selected. The mean age of the patients was 56.32 ± 10.51 years. There was a male predominance with a sex ratio of 1.15. The main cardiovascular risk factors found outside high blood pressure were dyslipidemia (06.87%) and obesity (13.7%). In clinical terms, hypertension was found in 75% of cases (n = 133) versus 25% (n = 44) of normotensive patients. These blood pressure profiles allowed us to classify our study population into two groups: hypertensives people and normotensives people. The hypertensives people had significantly higher mean pulsed pressure levels than the normotensives people. All normotensive patients had normal pulsed pressure. In the hypertensive population, the prevalence of high pulsed pressure was 31% (n = 41) versus 69% (n = 92) normal pulsed pressure. Concerning the relationship between 24 hour ambulatory pulsed pressure and left ventricular mass, hypertensives patients with a high ambulatory pulsed pressure had a significantly higher average indexed ventricular mass than the opposite groups (p = 0.039). Their ejection fraction was significantly lower than those of the opposite populations (p = 0.000). On the analysis of the correlation between the left ventricular mass and the tension profile, we noted in our series, a strong and significant correlation (r = 0.6342; p = 0.0000) between pulsed pressure and the ventricular geometry change. Conclusion: High ambulatory pulsed pressure remains an independent factor of change in left ventricular geometry in black people.

Temporal changes in the secondary prevention of coronary artery disease in patients following myocardial revascularization.

IntroductionWell-organized, effective secondary prevention of coronary artery disease (CAD) has a potential to improve the patients’ prognosis following myocardial revascularization procedures.AimTo evaluate overtime changes in the implementation of the ESC guidelines for secondary prevention by assessing control of the main risk factors and the rate of cardioprotective drug use in patients following myocardial revascularization procedures.Material and methodsPatients aged < 81 years who had been hospitalized for a myocardial revascularization procedure in five hospitals serving Krakow and surrounding districts were recruited and interviewed 6–18 months following discharge. Their personal medical history, medication use and control of the main cardiovascular risk factors were evaluated using a standard questionnaire in 2006–2007, 2011–2013, and 2016–2017. The same five hospitals took part in surveys on each occasion.ResultsWe examined 260 patients in 2006–2007, 200 in 2011–2013 and 190 in 2016–2017. We noted a significant difference in the management of surveys participants: 62% underwent percutaneous coronary intervention (PCI) and 38% coronary artery coronary artery bypass grafting (CABG) in 2006–2007 whereas the corresponding proportions in 2016–2017 were 90% and 10%. The proportion of patients who did not achieve target blood pressure (according to ESC guidelines valid at the time of each survey) in 2006–2007, 2011–2013 and 2016–2017 was 53.5%, 52.3%, and 38.9%, respectively, the proportion of those who did not achieve the LDL cholesterol target (according to ESC guidelines valid at the time of each survey) was 36.3%, 64.0%, and 61.7%, respectively, and the proportion of those with high fasting glucose was 12.6%, 14.6%, and 19.7%, respectively. The proportion of smokers was 16.2%, 19.5%, and 16.8%, whereas 30.5%, 28.6% and 40.5% of patients were obese in 2006–2007, 2011–2013 and 2016–2017, respectively. The proportion of patients taking antiplatelets (91.8% vs. 92.0% vs. 96.3%), β-blockers (90.3% vs. 87.5% vs. 92.6%), and lipid-lowering drugs (88.7% vs. 91.0% vs. 93.7%) did not change significantly.Conclusions: The analysis of three multicenter surveys provides evidence of the considerable potential for a further reduction in cardiovascular risk in patients following elective myocardial revascularization in Poland.

Symptomatic Hypercalcemia in Patients with Primary Hyperparathyroidism Is Associated with Severity of Disease, Polypharmacy, and Comorbidity.

Current primary hyperparathyroidism (PHPT) clinical presentation is asymptomatic in more than 90% of patients, while symptoms concern osteoporosis and rarely kidney stones. Here, we retrospectively investigated the prevalence of PHPT patients presenting with hypercalcemic-related symptoms (HS-PHPT) as cognitive impairment, changes in sensorium, proximal muscle weakness, nausea and vomiting, constipation, and severe dehydration, in a single center equipped with an emergency department and described their clinical features and outcome in comparison with a series of asymptomatic PHPT out-patients (A-PHPT). From 2006 to 2016, 112 PHPT patients were consecutively diagnosed: 16% (n = 18, 3M/15F) presented with hypercalcemic-related symptoms. Gastrointestinal symptoms occurred in 66% of HS-PHPT patients and cognitive impairment in 44%; one woman experienced hypertensive heart failure. Two-thirds of HS-PHPT patients were hospitalized due to the severity of symptoms. Comparing the clinical features of HS-PHPT patients with A-PHPT patients, no gender differences were detected in the two groups, while HS-PHPT patients were older at diagnosis (71 (61–81) vs. 64 (56–74) years, P=0.04; median (IQR)). HS-PHPT patients presented higher albumin-corrected calcium levels (12.3 (11.3–13.7) vs. 10.6 (10.3–11.3) mg/dl, P < 0.001); 4 HS-PHPT presented corrected calcium levels >14 mg/dl. Serum PTH levels and total alkaline phosphatase activity were higher in HS-PHPT. Reduced kidney function (eGFR < 45 ml/min) was prevalent in HS-PHPT patients (42% vs. 5%, P=0.05). No differences in kidney stones and osteoporosis were detected, as well as in the rates of cardiovascular comorbidities and main cardiovascular risk factors. HS-PHPT patients had an age-adjusted Charlson Comorbidity Index higher than that of the A-PHPT patients and were on chronic therapy with a greater number of medications than A-PHPT patients. In conclusion, hypercalcemic-related symptoms occurred in 16% of PHPT patients. Risk factors were severity of the parathyroid tumor function, multimorbidity, and polypharmacy.

Hipertansiyon Hastası Yaşlı Bireylerde DASH Diyetine Uyumun Kan Basıncı, Antropometrik Ölçümler ve Diyet Alımı Üzerine Etkisi

Amaç: Bu araştırmada, Kuzey Kıbrıs Türk Cumhuriyeti’nde bir sağlık merkezine kayıtlı yaşlı hipertansiyon hastalarında, ‘Hipertansiyonu Önlemek için Diyet Yaklaşımları’na (Dietary Approaches to Stop Hypertension DASH) uyumun kan basıncı, antropometrik ölçümler ve diyetle alım üzerine etkilerinin değerlendirilmesi amaçlanmıştır.&#x0D; Bireyler ve Yöntem: Araştırmaya 60 yaş üzeri 133 hipertansiyon hastası (%18 erkek) dahil edilmiştir. Hastaların boy uzunluğu, vücut ağırlığı, bel çevresi, sistolik (SKB) ve diyastolik kan basıncı (DKB) ölçülmüştür. Hastaların diyetle alımını değerlendirmek için 24 saatlik geriye dönük besin tüketim kaydı alınmıştır. Bireylerin DASH diyetine uyumu ‘düşük uyum: &lt;4 puan’ ve ‘yüksek uyum: ≥4 puan’ şeklinde değerlendirilmiştir.&#x0D; Bulgular: DASH skoru 3.1±0.8 ve DASH diyetine yüksek uyum gösteren bireylerin oranı %19.5’tir. DASH diyetine düşük ve yüksek uyum gösteren bireylerin SKB ve DKB değerleri arasında anlamlı bir farklılık bulunmamıştır (p&gt;0.05). Hem beden kütle indeksi, hem de kardiyovasküler risk faktörlerinden biri olan bel/boy oranının her iki grup arasında benzer olduğu görülmüştür (p&gt;0.05). DASH diyetine yüksek uyum gösteren bireylerde, düşük uyum gösteren bireylere göre sebze ve süt ürünleri gruplarının tüketim miktarları tüm bireylerde daha yüksek, meyve tüketimi yalnızca kadın bireylerde yüksek ve şeker tüketimi tüm bireylerde daha düşük bulunmuştur (p&lt;0.05). Erkeklerde, DASH diyetine yüksek uyum gösteren bireylerin posa, B2 vitamini, folik asit, potasyum, magnezyum ve çinko alımının; kadınlarda ise B2 vitamini, folik asit, C vitamini, potasyum, magnezyum, kalsiyum ve fosfor alımının düşük uyum gösteren gruptan anlamlı olarak yüksek olduğu saptanmıştır (p&lt;0.05). Hem erkek hem de kadınlarda sodyum alımı yüksek uyum gösteren grupta anlamlı olarak daha düşük bulunmuştur (p&lt;0.05). &#x0D; Sonuç: Hipertansiyon hastası yaşlı bireylerde DASH diyetine yüksek uyumun kan basıncına olumlu etkisinin olmadığı ancak vücut ağırlığında artışın DKB düzeyinde artışla ilişkili olduğu görülmüştür. Bu hasta grubunda diyete uyumun genel olarak düşük olmasının, DASH diyetinin olumlu etki gösterememiş olmasında rolü olabileceği düşünülmektedir.

Type 2 diabetes therapy’s quality based on gender. Monographs of AMD Annals 2018

OBJECTIVE OF THE STUDY Evaluate the evolution of the therapy’s quality by gender in type 2 diabetes (DM2) in Italy, from 2011 to 2016, considering the new AMD Indicators in a gender perspective and the possible disparity in the drug treatment. DESIGN AND METHODS For the purpose of this analysis, data from the AMD Annals 2018 were used. They refer to patients with DM2, treated in 2016 in 222 diabetology services. This report is based on the analysis of the new 2015 AMD indicators (Audit 2, January 23rd, 2018). The characteristics of the study population and the analysis of the indicators are reported separately for men and women affected by DM2. RESULTS The data of 242,422 men and 184,696 women with DM2 were evaluated. The patients were treated by 222 diabetology services in 2016. The distribution by gender shows the prevalence of males and the one by age shows a general aging of the population and an increased survival, mainly in women (3.6% of men and 6.6% of women with DM2 have an age &gt;85 years). The average number of visits per treatment group was comparable between sexes. Compared to the 2011 evaluation, an improvement was achieved in all the process indicators in both genders, although still slightly better in males. In particular, the evaluation of metabolic control through the monitoring of glycated hemoglobin affects almost all male and female patients (96.9% vs 97%). The percentage of patients monitored for lipid profile, renal function, retinopathy and foot screening is lower. Some parameters were considered intermediate outcome indicators as they predict cardiovascular (CV) risk: the achievement of targets for the main CV risk factors is systematically unfavorable for women with DM2. In particular, women are more obese, have a worse diabetes compensation (especially a worse lipid profile) and a greater frequency of glomerularfiltrate reduction. The average levels of glycosylated hemoglobin were slightly higher in women than in men (7,3% ± 1,3 vs 7,2% ± 1,2), also the average levels of LDL cholesterol (100,2 mg/dl ± 33,4 vs 92,5 mg/dl ± 32,3) and average BMI levels (30,1 kg/m2 ± 6.1 vs 29,2 kg / m2 ± 4,9). In comparison with 2011 data, is noticeable a slight reduction in smokers among males and a slight increase among women (20,5% vs 21,5% in men, 12,2% vs 11,8% in women). Overall, the quality of the therapy (assessed with Q score) has improved over the years, in a similar way for both sexes. About half of the patients, in both sexes, have a Q score &gt;25, therefore adequate levels of therapy. The use of drugs for the control of glycaemia in both genders is similar also for innovative drugs. The use of statins is high in both sexes, slightly in favor of women. The intensity of the therapy for hypertension has improved in both sexes. Hence, the available data does not highlight a problem of under-treatment of women, despite their worst results. Gender data related to micro and macroangiopathic complications show differences in the two sexes, but the quality of the data recording on final outcomes, especially cardiovascular, is still modest. CONCLUSIONS Data analysis shows a significant improvement in the quality of specialistic health care, with greater attention in monitoring CV risk factors and complications, an increase in the percentage of subjects in target and a more intensive use of drugs in both sexes. However, some gaps are still present. The examined data confirm that the cardiovascular risk profile is decidedly unfavorable for women and that the main cardiovascular risk factors control, although improved over the years, remains sub-optimal in women and men. Greater efforts are needed to optimize CV risk factors management in both sexes and to reduce, or better eliminate, differences between genders. These data offer important insights for research, clinical practice and review of guidelines in a gender perspective, taking into account that various factors related to gender, such as genetic/biological aspects, lifestyle, adherence to therapies, psycho-social aspects, in addition to prescriptive differences, can affect the achievement of the various outcomes. KEYWORDS gender; DM2; AMD indicators.

Ten-Year Follow-Up of Clinical Governance Implementation in Primary Care: Improving Screening, Diagnosis and Control of Cardiovascular Risk Factors.

Current improvement strategies for the control of cardiovascular risk factors (CRFs) in Europe are based on quality management policies. With the aim of understanding the effect of interventions delivered by primary healthcare systems, we evaluated the impact of clinical governance on cardiovascular health after ten years of implementation in Catalonia. A cohort study that included 1878 patients was conducted in 19 primary care centres (PCCs). Audits that comprised 13 cardiovascular health indicators were performed and general practitioners received periodic (annual, biannual or monthly) feedback about their clinical practice. We evaluated improvement in screening, diagnosis and control of the main CRFs and the effects of the feedback on cardiovascular risk (CR), incidence of cardiovascular disease (CVD) and mortality, comparing baseline data with data at the end of the study (after a 10-year follow-up). The impact of the intervention was assessed globally and with respect to feedback frequency. General improvement was observed in screening, percentage of diagnoses and control of CRFs. At the end of the study, few clinically significant differences in CRFs were observed between groups. However, the reduction in CR was greater in the group receiving high frequency feedback, specifically in relation to smoking and control of diabetes and cholesterol (Low Density Lipoprotein (LDL) and High Density Lipoprotein (HDL)). A protective effect of having a cardiovascular event (hazard ratio (HR) = 0.64, 95% confidence interval (CI) = 0.44–0.94) or death (HR = 0.55, 95% CI = 0.35–0.88) was observed in patients from centres where general practitioners received high frequency feedback. Additionally, these PCCs presented improved cardiovascular health indicators and lower incidence and mortality by CVD, illustrating the impact of this intervention.

Medical awareness of risk factors of cardiovascular diseases in different types of hospitalized patients (part 2)

To study medical awareness of cardiovascular risk factors (RFs) in different types of hospitalized patients (pts). A total of 150 pts from neurological, endocrinological and cardiac units one of Moscow city hospital were enrolled into the survey (50pts in each unit). The pts were interviewed during the I-II days of the hospitalization. A special questionnaire was developed in‑ cluding socio-demographic and clinical indicators, open questions on the awareness of traditional cardiovascular RFs and their target values. Pts of three units did not differ in gender and age. The range of diagnoses corresponded to the profile of the unit. The survey revealed an extremely low awareness of major cardiovascular RFs of pts in all 3 units: almost none of them pointed to elevatedcholesterol (0%, 4% and 0%, respectively) and blood pressure (2%, 2% and 0%) respectively) as RF of cardiovascular diseases. The pts of the three units most often referred to stress (64%, 56% and 66%, respectively) and unhealthy diet (50%, 56% and 64%, respectively) as the main cardiovascular RFs. On average, pts in three units correctly indicated only 2 RFs. The survey revealed a low awareness of cardiovascular RFs in different types of medical pts, including cardiac pts, at time of hospital admission.

Intravenous thrombolysis by tenecteplase: Experience of the neurology department of Chu Hassan II Fez, Morocco

Intravenous infusion of alteplase was the thrombolytic agent used for thrombolysis of ischemic stroke since 2010 in our neurology department.Tenecteplase was used as a thrombolytic agent for 127 patients in 2 years.The objective of our study is to determine the prevalence of Thrombolysis patients by Tenecteplase, to evaluate the length of care, the NIHSS scale before and after thrombolysis, the modified Rankin scale at 3 months, in order to assess the autonomy and the mortality rate. It’s a retrospective study involving a group of 127 patients over 2 years old, who have undergone intravenous Thrombolysis by tenecteplase in our department. The mean age was 67 years with a slight male predominance (69%). High blood pressure was the main cardiovascular risk factor. 38% of patients had a NIHSS between 8 and 14, 47% greater than 14. The average time to admit patients (from onset of symptoms to arrival in the emergency room) was 130 minutes. The average imaging time (from admission to the imaging room) was 22 minutes. The mean time to Thrombolysis (from admission to emergency at the start of treatment with rt-PA) was 69 minutes. The average time from onset of symptoms to treatment was 200 minutes.The main etiology for our patients was the cardio-embolic origin.The mean of the Rankin scale is not yet defined (our study is in progress). This study shows that tenecteplase before thrombectomy was associated with a high incidence of reperfusion and appears to be effective in thrombolysis among patients with ischemic stroke.

Cardiologic Check-ups

Cardiovascular diseases (CVD), especially coronary artery disease (CAD), are the leading causes of morbidity and mortality worldwide. Elimination of modifiable risk factors has the potential to prevent up to 80 % of CVD. Therefore, disease prevention is based on the assessment of individual total CVD risk by using risk scores such as SCORE-algorithm that include the known main cardiovascular risk factors such as age, sex, smoking status, arterial hypertension und cholesterol.

Tendencies Of Body Mass Index And Waist Circumference Along With Aging In Middle-Aged Lithuanian Men Without Overt Cardiovascular Disease

Background and Aims: Obesity is one of the main cardiovascular risk factors and total risk modifiers. Our aim was to evaluate tendencies of body mass index (BMI) and waist circumference tendencies along with aging among middle-aged men in Lithuanian High Cardiovascular Risk primary prevention program.

Prevalence of cardiovascular complications in hemodialysis patients; a multicenter study

Heart disease is particularly common in chronic hemodialysis patients, worsening the prognosis for this population. Left ventricular hypertrophy and coronary artery disease are the most common cardiac abnormalities. The purpose of our work was to determine the prevalence of cardiovascular complications in patients with extra-renal purification and to identify the main cardiovascular risk factors in this population. For this retrospective multicenter study of descriptive type we recruited chronic hemodialysis patients treated in the Sidi Bel Abbes University Hospital Center and in three private centers in the same city. Cardiovascular explorations with face chest X-ray, electrocardiogram and cardiac ultrasound echocardiography. Biological parameters and regular monitoring of the progressive aspects of cardiac complications were collected for each patient. Five hundred and twenty-seven patients were included from January 2014 to December 2017. The mean age was 57 years ± 13.85 and the sex ratio men/women = 1.4. All patients had arteriovenous fistula. The prevalence of cardiovascular complications in our series was 66%, mainly left ventricular hypertrophy: 63%, arterial hypertension (HT): 54%, acute coronary syndrome: 15%, hemorrhagic stroke: 4%, arterial occlusive disease of the lower limbs: 12%, vascular calcification 5% of cases. The prevalence of cardiovascular diseases in chronic hemodialysis patients is very high. Their prevention requires a good control of the main risk factors, namely hypertension and anemia. Regularly performing echocardiograms would allow early detection so that optimal treatment can be provided.

Influence of cardiovascular risk factors on arterial rigidity in young people

Purpose of the study – to determine the relationship between the main factors of cardiovascular risk and arterial rigidity in young people.Material and methods. The evaluation of factors of cardiovascular risk and arterial rigidity in 100 people aged 22±8.3 years, followed by correlation analysis of dependence.Results. The study revealed a correlation with the body mass index, with the pulse wave velocity (r=0.36; p=0.013) and the presence of complaints of a cardiac and cerebral nature (r=0.386; p=0.011).Conclusion. Young people have a prerequisite for the development of cardiovascular diseases, based on an assessment of the combination of arterial stiffness and cardiovascular risk factors.

Validez y limitaciones de los métodos para medir la ingesta y la eliminación de sal

High blood pressure (HBP) is the main modifiable cardiovascular risk factor. HBP can be related to high salt intake. To measure intake, not all feeding surveys are comparable and valid. The reference procedure for assessing salt intake consists of measuring the urinary excretion of sodium in urine collected during 24hours, although alternative methods have been proposed, such as the collection of punctual and timed urine samples. In this review, we analyze which instruments allow the assessment of salt intake and which of them have provided greater validity and reliability through studies of concordance with the elimination of sodium in urine. Current food consumption surveys are inadequate because of their wide variability and relatively low correlation with the elimination of sodium in 24-hour urine. Its main limitation is the need for validation in different population groups. In primary care, salt intake should be assessed by using frequency-of-consumption questionnaires that collect foods with a high salt content, the consumption of preprepared dishes and questions that quantify the addition of salt in the preparation of food or at the table. For the validation of these questionnaires, the standard gold elimination of 24-hour urine sodium adjusted according to creatinine clearance should be used.

PHYSICAL ACTIVITY IS ASSOCIATED WITH LOWER AMYLOID LOAD IN MIDDLE-AGED COGNITIVELY UNIMPAIRED INDIVIDUALS

Alzheimer's disease (AD) is becoming increasingly prevalent worldwide and it is hence crucial to identify modifiable risk factors that can lead to prevention of the disease. The effect of several cardiovascular and psychiatric risk factors on cognition and dementia risk is well known, but their impact on the pathophysiology of AD defined by core biomarkers is not yet well established. The aim of this study was to perform an exploratory analysis to assess whether the main cardiovascular and psychiatric AD risk factors are associated with core AD biomarkers in middle-aged cognitively unimpaired individuals. This is a cross-sectional study performed in the ALFA+ (for ALzheimer and FAmilies) cohort comprising middle-aged cognitively unimpaired individuals at risk for AD. We studied the following factors: hypertension, dyslipidaemia, body mass index (BMI), diabetes mellitus, physical activity, depression and anxiety. Core AD biomarkers (Aβ42, t-tau and p-tau) were measured in cerebrospinal fluid (CSF) using Elecsys and subjects were categorized according to whether or not they were amyloid (A) positive (CSF Aβ42 < 1098 pg/mL), tau (T) positive (p-tau > 19.2 pg/mL) and neurodegeneration (N) positive (t-tau > 242 pg/mL). We used logistic regression analyses to test whether the risk factors predict CSF biomarker positivity, adjusted by the effect of age, gender, years of education and APOE-ε4 status. We studied 257 participants, with a mean age of 60.7 years, 64.5% were female, 40.1% APOE-ε4carriers and 29.6% were A+, 26.1% T+ and 23.3% N+. Physical activity was associated with reduced risk of amyloidosis; 46.7% of physically inactive individuals were A+ vs 25.9% of physically active subjects (P = 0.014). No significant associations were found regarding the other risk factors.

DESCRIPTIVE ANALYSIS OF A POPULATION WITH KIDNEY DISEASE AND HYPERTENSION. DIAGNOSTIC-THERAPEUTIC IMPORTANCE OF AMBULATORY BLOOD PRESSURE MONITORING

Objective:Hypertension (HBP) is one of the main cardiovascular risk factors of the general population and even more so in patients with kidney disease, who present more severe hypertension, difficult to control and with a circadian profile of higher risk. That is why the use of ambulatory blood pres

Prevalence, awareness, treatment and control of high blood pressure in the elderly according to the ethnic group. Colombian survey.

Introduction:High blood pressure (HBP) is the main cardiovascular risk factor, it is more prevalent in the older adult population, and the prevalence can vary between ethnic groups.Objective: To estimate the prevalence of HBP, knowledge, treatment and control in population aged ≥60 years, resident in Colombia, according to their ethnic condition.Methods: Population sample selected by multistage sampling. Ethnicity was defined based on skin color. HBP was defined as systolic blood pressure ≥140, and/or diastolic blood pressure ≥90 mm Hg, and/or the participants’ self-report. Controlled HBP at a blood pressure value <140/90, knowledge and treatment were identified by self-report.Results: 23,694 adults aged ≥ 60 years were included, of which 54.5%, 34.5% and 10.9% were respectively identified as having light, medium or dark skin color; 54.5% were women, and 78.1% resided in urban areas. The standardized prevalence of HBP, by age, was 57.7% (95% CI: 55.2 - 60.2); 51.4% (95% CI: 47.3-55. 5), in men; and 62.9% (60.9-64.9), in women. The standardized prevalence for light, medium and dark skin in men was 53.2% (95% CI: 48.7-57.7), 49.6% (44.5-54.7), and 49.4% (95% CI: 41.0-57.8) respectively; and in women was 62.5% (95% CI: 60.5-64 , 5), 61.7% (95% CI: 57.8-65.6), and 69.9% (95% CI: 63.6-76.2) respectively. 98% of the population received treatment, and 93.9% were aware of HBP diagnosis. 42.5% of men and 55.5% of women with HBP were under control. Only 21.8% performed regular physical activity.Conclusion: Half of the adult population aged over 60 years suffers from HBP; the prevalence is higher in women particularly in dark-skinned women. It is necessary to develop policies to increase physical activity in the elderly.