Major Risk Factor For Cardiovascular Disease Research Articles

Jackson Heart Study: Aggregate cardiovascular disease risk and auditory profiles.

Evaluate the relationship between cardiovascular disease (CVD) risk factors and cochlear function in African Americans. Relationships between hearing loss, cochlear function, and CVD risk factors were assessed in a cross-sectional analysis of 1106 Jackson Heart Study participants. Hearing loss was defined as puretone average (PTA0.5,1,2,4) > 15 dB HL. Distortion product otoacoustic emissions (DPOAEs) were collected for f 2=1.0-8.0kHz. Two amplitude averages were computed: DPOAElow (f 2 ≤ 4kHz) and DPOAEhigh (f 2 ≥ 6kHz). Based on major CVD risk factors (diabetes, current smoking, total cholesterol ≥240 mg/dL or treatment, and systolic blood pressure [BP]/diastolic BP ≥ 140/≥90 mmHg or treatment), four risk groups were created: 0, 1, 2, and ≥3 risk factors. Logistic regression estimated the odds of hearing loss and absent/reduced DPOAElow and DPOAEhigh by CVD risk status adjusting for age, sex, education, BMI, vertigo, and noise exposure. With multivariable adjustment, diabetes was associated with hearing loss (OR=1.48 [95% CI: 1.04-2.10]). However, there was not a statistically significant relationship between CVD risk factors (individually or for overall risk) and DPOAEs. Diabetes was associated with hearing loss. Neither individual CVD risk factors nor overall risk showed a relationship to cochlear dysfunction. 2b.

SERUM URIC ACID IN TYPE 2 DIABETES MELLITUS AND ITS ASSOCIATION WITH CARDIOVASCULAR RISK FACTORS

BACKGROUND: Prevalence of Type 2 Diabetes mellitus is rapidly increasing and is already as epidemic in India. Diabetes mellitus is an important risk factor associated with increased incidence of cardiovascular disease (CVD) Prevalence of CVD has rapidly increased in past few years. The four major risk factors for CVD are hypertension, dyslipidemia, diabetes mellitus and cigarette smoking.The Morbidity and mortality due to noncommunicable diseases specially attributed to diabetes mellitus and coronary heart disease is rising rapidly in India, causing nearly 5.8 million deaths per year annually. Insulin resistance state is associated with diabetes mellitus and metabolic syndrome. AIM To study the effect of serum uric acid levels in type 2 diabetes mellitus and its association with cardiovascular risk factors. OBJECTIVES :To compare serum uric acid levels with other CVD risk factors (hypertension, dyslipidemia, obesity, smoking) among type 2 diabetic subjects.To compare duration of diabetes and serum uric acid levels STUDY DESIGN: Cross sectional , observational study. PLACE OF STUDY: Department of General Medicine, Kamineni institute of medical sciences, Narketpally. DURATION OF STUDY : October 2020 to September 2022

Adenine base editing as a promising therapy for cardiovascular diseases

Cardiovascular diseases (CVDs) are the leading causes of human death worldwide. Genetic variants serve as the major risk factor for CVDs, with limited therapeutic interventions in clinical practice. The recent surge of genome editing technologies offers the hope to correct genetic variants and to cure genetic diseases. Among the diverse genome editing tools, adenine base editors (ABEs) exhibit high efficiency, high specificity, and low off-target effects, successfully entering a clinical trial and demonstrating the tremendous potential to transform modern cardiovascular therapy. In this review, we summarize the basic knowledge about ABE, showcase three hallmark studies using ABE to ameliorate or treat CVDs in experimental animals, and lastly discuss about the key technical concerns that should be addressed to achieve the full potential of ABEs in the future.

Relationship of cardiovascular disease risk and hearing loss in a clinical population

Hearing loss has been associated with individual cardiovascular disease (CVD) risk factors and, to a lesser extent, CVD risk metrics. However, these relationships are understudied in clinical populations. We conducted a retrospective study of electronic health records to evaluate the relationship between hearing loss and CVD risk burden. Hearing loss was defined as puretone average (PTA0.5,1,2,4) > 20 dB hearing level (HL). Optimal CVD risk was defined as nondiabetic, nonsmoking, systolic blood pressure (SBP) < 120 and diastolic (D)BP < 80 mm Hg, and total cholesterol < 180 mg/dL. Major CVD risk factors were diabetes, smoking, hypertension, and total cholesterol ≥ 240 mg/dL or statin use. We identified 6332 patients (mean age = 62.96 years; 45.5% male); 64.0% had hearing loss. Sex-stratified logistic regression adjusted for age, noise exposure, hearing aid use, and body mass index examined associations between hearing loss and CVD risk. For males, diabetes, hypertension, smoking, and ≥ 2 major CVD risk factors were associated with hearing loss. For females, diabetes, smoking, and ≥ 2 major CVD risk factors were significant risk factors. Compared to those with no CVD risk factors, there is a higher likelihood of hearing loss in patients with ≥ 2 major CVD risk factors. Future research to better understand sex dependence in the hearing loss-hypertension relationship is indicated.

The Global Cardiovascular Nursing Leadership Forum: Promoting Optimal Cardiovascular Health Worldwide.

The Global Cardiovascular Nursing Leadership Forum: Promoting Optimal Cardiovascular Health Worldwide.

Insights into Causal Cardiovascular Risk Factors from Mendelian Randomization.

This review summarizes major insights into causal risk factors for cardiovascular disease (CVD) by using Mendelian randomization (MR) to obtain unconfounded estimates, contextualized within its strengths and weaknesses. MR studieshave confirmed the role of major CVD risk factors, including alcohol, smoking, adiposity, blood pressure, type 2 diabetes, lipids, and possibly inflammation, but added that the relation with alcohol is likely linear, confirmed the role of diastolic blood pressure, identified apolipoprotein B as the major target lipid, and foreshadowed results of some trials concerning anti-inflammatories. Identifying a healthy diet and the role of early life influences, such as birth weight, has proved more difficult. Use of MR has winnowed empirically driven hypotheses about CVD into a set of genetically validated targets of intervention. Greater inclusion of global diversity in genetic studies and the use of an overarching framework would enable even more informative MR studies.

Advanced glycation end products are associated with cardiovascular risk in the Mexican population

Background and aimsChronic exposure to hyperglycemia is a significant risk factor for cardiovascular disease (CVD). Advanced glycation end products (AGES) result from multiple sugar-dependent reactions interacting with proteins and their receptors, generating endothelial dysfunction and CVD. However, there is little epidemiological data about its impact on CVD risk. We aimed to assess the association between circulating AGES and CVD risk in the Mexican population. Methods and resultsWe used longitudinal data from waves 2004–2006 and 2010–2012 of 1195 participants from the Health Workers Cohort Study. Circulating AGES were assessed by radioimmunoassay, and cardiovascular risk (CVR) was computed with the Framingham risk score. Linear and logistic fixed-effects regression models were used to assess the interest association, adjusting for confounding factors. An increase in 200 μU/ml of AGES was associated with a 0.18% increased risk of CVD (95% CI 0.05–0.31%). After adjusting for physical activity and smoking status, individuals who increased their AGES category had higher odds of middle–high CVR (low to medium AGES: OR 1.83, 95% CI 1.11–3.20; low to high AGES: OR 2.61, 95% CI 1.51–4.50). The associations remained statistically significant when we further adjusted for insulin resistance, dietary intake of AGES, and total daily calorie intake. ConclusionOur data show that circulating AGES are associated with the Framingham CVD risk score, independently of other major risk factors for CVD in the Mexican population.

Improving Fitness Through Exercise Will Improve Our Heart and Mind

In the interview, Prof. Carl “Chip” J. Lavie gave suggestions on daily exercise, shared impressive cases of cardiovascular disease (CVD) patients, gave professional explanations of weight management and CVD outcomes, etc. His major viewpoints are: (a) psychological stress is a major risk factor for CVDs, (b) a low-level physical activity contributes to a high prevalence of most CVD risk factors, and regular exercise training can improve cardiac function and aerobic performance, and (c) the prognosis and survival among CVD patients with low physical activity are better in the obese than the lean.

Impact of yoga on lipid parameters in different age groups

Background: Cardiovascular diseases (CVDs) rise first among the causes of death occurring due to non-communicable diseases in the world. The majority of cardiovascular deaths are due to ischemic heart disease and cerebrovascular disease. Among the major risk factors, dyslipidemia is an important risk factor. Hence, the prevention of dyslipidemia results in the prevention of ischemic heart disease. Dyslipidemia can be corrected by drugs but more importantly, it can be prevented by lifestyle modification. Aim and Objectives: Our aim is to observe the impact of yoga on lipid parameters in different age groups. Materials and Methods: We included 54 subjects between the age group of 30 and 60 years for this study. They were categorized into two groups: Group I having ages between 30 and 45 years (n = 23) and Group II having ages between more than 45 years and &lt;60 years (n = 31). The lipid parameters were measured afore of yoga training, at the end of 2 months and after 6 months of yogic practices. Statistical analysis was done using the SPSS version of 20.0. A P value of less than 0.05 is considered as statistically significant. Results: Our study revealed that yoga induces a decrease in total cholesterol, triglycerides, low-density lipoprotein cholesterol, and very LDL cholesterol and an increase in high-density lipoprotein cholesterol in both Group I and Group II subjects which were statistically significant. Conclusion: Yoga tends to improve dyslipidemia, a major risk factor for CVDs. A yoga lifestyle can be considered a preventive measure for CVDs.

PS-BPP05-8: THE ACCESSIBILITY OF SUBSIDIZED ANTIHYPERTENSION DRUGS AMONG THE HYPERTENSIVE POPULATION IN MONGOLIA, 2019–2021.

Objective: Cardiovascular diseases (CVD) are the leading cause of mortality in Mongolia, and hypertension is the major risk factor for CVD in the country. In this study, we aim to assess the accessibility of subsidized antihypertensive drugs among the hypertensive population in Mongolia to draw a picture of hypertension control and monitoring at Primary Healthcare Centers (PHC). Design and method: For this study, we processed the full national data on subsidized medicine to obtain the number of unique people who had a subsidized antihypertensive medicine prescription at least once every 3 months. This number was compared to the number of hypertensive people in Mongolia, which was estimated using the hypertension prevalence from the 2019 National STEPS survey and the census data. Results: In 2019, the number of people who consulted their primary physician and had the antihypertensive drugs prescribed at least every 3 months was 60468 which comprised 11.3% of all hypertensive people 15 years of age or older in Mongolia. This percentage increased to 12.7% (68339) in 2020 and 16% (87621). Across the 3 years, the rate of access to the subsidized antihypertensive medicine remains significantly higher among the female hypertensive compared to their male counterparts (2019: 15.5% vs 7.5%, OR = 1.55, P &lt; 0.001; 2020: 17.3% vs 8.3%, OR = 1.55, P &lt; 0.001; 2021: 21.9% vs 10.5%, OR = 1.62, P &lt; 0.001). In addition, across the 3 years, older age groups, especially the oldest group of 55 and older, were significantly more active when accessing the subsidized care, although the gap between the youngest (15–24 years) and older age groups narrowed in 2021 (OR of older age groups decreased in 2021, compared to previous years) (Table 1). Around 30 international non-proprietary names (INN) of antihypertensive drugs were subsidized in the years 2019–2020. Amlodipine, losartan, lisinopril, amlodipine + lisinopril, and bisoprolol were the five most prescribed subsidized drugs. Across the three years, the ratio between fixed-dose combination drugs and single active ingredient drugs subsidized by the Health Insurance Fund was 3:7. The most prescribed classes of subsidized single active ingredient drugs were angiotensin receptor blockers (ARB), followed by calcium channel blockers and ACE inhibitors. Fixed-dose combination drugs, beta-adrenergic blocking agents, and ARBs were significantly more prescribed in Ulaanbaatar (OR = 1.15, P &lt; 0.001; OR = 1.93, P &lt; 0.001; OR = 1.53, P &lt; 0.001), while diuretics, calcium channel blockers, and ACE inhibitors were significantly more prescribed in rural areas (OR = 1.15, P = 0.008; OR = 1.75, P &lt; 0.001; OR = 1.22, P &lt; 0.001). Conclusion: The percentage of the hypertensive population accessing subsidized medicine is insufficient. Subsidization not only increases the affordability of the medicine but also can serve as a tool for monitoring as the subsidy can only be accessed through PHC visits, so it can be inferred that the rate of accessing the subsidized medicine is also the rate of hypertension control at PCCs. We can observe a slight surge in the access rate in 2021, especially among the younger population. In 2021, the National Health Insurance Fund modified their policy, allowing citizens to obtain the subsidized medicine prescription any day of the month, as opposed to the 1st of every month like in previous years. Additional measures need to be taken specifically toward decreasing the gap between sexes, as males are accessing the subsidized care at lower rates, while CVD mortality remains higher among them.

STUDY TO ASSESS RELATION OF LIPID PROFILE AND HYPERTENSION IN PATIENTS ATTENDING NIMS HOSPITAL, JAIPUR, RAJASTHAN

Dyslipidaemia and hypertension are major cardiovascular disease risk factors, and the Indian population experiences the highest rates of morbidity and mortality. The objective of this study was to determine the relation between lipid profiles in hypertensive patients with normotensive control subjects in patients attending NIMS Hospital, Jaipur Rajasthan. A single-Center, case-control hospital based study was carried out among 140 participants (eighty (80) patients were included in the study) from January 2021 to June 2022 in National Institute of Medical Sciences and Research, Jaipur, Rajasthan, India. Data were collected on sociodemographic factors, anthropometric measurements, blood pressure, and lipid profile including total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), and high density lipoprotein (HDL). On analysis of the lipid profile of 80 hypertensive patients and 80 Normotensive control subjects the mean TC values in cases and controls are 199 mg/dl and 167 mg/dl respectively. The mean TG values are 199 mg/dl and 123 mg/dl, the mean LDL c values are 121.5 mg/dl and 97.5 mg/dl. The serum levels of TC, TG, and LDL were higher while HDL levels were lower in hypertensive subjects compared to normotensives, which was statistically significant (P&lt;0.001). Age, waist circumference, and body mass index showed significant association with hypertensive patients (P&lt;0.0001) but not with normotensives. The logistic regression analysis showed that hypertensive patients had higher TC and TG, LDL and lower HDL than normotensives, which was statistically significant (P&lt;0.05). Hypertensive patients in NIMS hospital, Jaipur, Rajasthan have a close association with dyslipidaemia and need measurement of blood pressure and lipid profile at regular intervals to prevent cardiovascular disease, stroke, and other comorbidities.

STUDY TO ASSESS RELATION OF LIPID PROFILE AND HYPERTENSION IN PATIENTS ATTENDING NIMS HOSPITAL, JAIPUR, RAJASTHAN

Dyslipidaemia and hypertension are major cardiovascular disease risk factors, and the Indian population experiences the highest rates of morbidity and mortality. The objective of this study was to determine the relation between lipid profiles in hypertensive patients with normotensive control subjects in patients attending NIMS Hospital, Jaipur Rajasthan. A single-Center, case-control hospital based study was carried out among 140 participants (eighty (80) patients were included in the study) from January 2021 to June 2022 in National Institute of Medical Sciences and Research, Jaipur, Rajasthan, India. Data were collected on sociodemographic factors, anthropometric measurements, blood pressure, and lipid profile including total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), and high density lipoprotein (HDL). On analysis of the lipid profile of 80 hypertensive patients and 80 Normotensive control subjects the mean TC values in cases and controls are 199 mg/dl and 167 mg/dl respectively. The mean TG values are 199 mg/dl and 123 mg/dl, the mean LDL c values are 121.5 mg/dl and 97.5 mg/dl. The serum levels of TC, TG, and LDL were higher while HDL levels were lower in hypertensive subjects compared to normotensives, which was statistically significant (P&lt;0.001). Age, waist circumference, and body mass index showed significant association with hypertensive patients (P&lt;0.0001) but not with normotensives. The logistic regression analysis showed that hypertensive patients had higher TC and TG, LDL and lower HDL than normotensives, which was statistically significant (P&lt;0.05). Hypertensive patients in NIMS hospital, Jaipur, Rajasthan have a close association with dyslipidaemia and need measurement of blood pressure and lipid profile at regular intervals to prevent cardiovascular disease, stroke, and other comorbidities.

STUDY TO ASSESS RELATION OF LIPID PROFILE AND HYPERTENSION IN PATIENTS ATTENDING NIMS HOSPITAL, JAIPUR, RAJASTHAN

Dyslipidaemia and hypertension are major cardiovascular disease risk factors, and the Indian population experiences the highest rates of morbidity and mortality. The objective of this study was to determine the relation between lipid profiles in hypertensive patients with normotensive control subjects in patients attending NIMS Hospital, Jaipur Rajasthan. A single-Center, case-control hospital based study was carried out among 140 participants (eighty (80) patients were included in the study) from January 2021 to June 2022 in National Institute of Medical Sciences and Research, Jaipur, Rajasthan, India. Data were collected on sociodemographic factors, anthropometric measurements, blood pressure, and lipid profile including total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), and high density lipoprotein (HDL). On analysis of the lipid profile of 80 hypertensive patients and 80 Normotensive control subjects the mean TC values in cases and controls are 199 mg/dl and 167 mg/dl respectively. The mean TG values are 199 mg/dl and 123 mg/dl, the mean LDL c values are 121.5 mg/dl and 97.5 mg/dl. The serum levels of TC, TG, and LDL were higher while HDL levels were lower in hypertensive subjects compared to normotensives, which was statistically significant (P&lt;0.001). Age, waist circumference, and body mass index showed significant association with hypertensive patients (P&lt;0.0001) but not with normotensives. The logistic regression analysis showed that hypertensive patients had higher TC and TG, LDL and lower HDL than normotensives, which was statistically significant (P&lt;0.05). Hypertensive patients in NIMS hospital, Jaipur, Rajasthan have a close association with dyslipidaemia and need measurement of blood pressure and lipid profile at regular intervals to prevent cardiovascular disease, stroke, and other comorbidities.

PS-P13-7: O.N.E. (ONWARD NONCOMMUNICABLE DISEASE EDUCATION) CAVITE INITIATIVE: A COLLABORATIVE PROJECT TO IMPLEMENT PHILPEN AMONG PRIVATE PRACTITIONERS

Objective: Cardiovascular diseases account for most noncommunicable disease (NCD) deaths about 17.9 million people annually. The Philippine Department of Health (DOH) began implementing the PhilPEN (Philippine Package of Essential Noncommunicable Disease interventions) nationwide in 2014. The protocol screens adult Filipinos seen in the public health facilities for major cardiovascular disease risk factors and includes interventions such as lifestyle advice and medications to achieve target goals. ONE Cavite Project is a collaboration between DOH, the Philippine Society of Hypertension (PSH), and private practitioners in Cavite- a densely populated semi-urbanized province in the Philippines. The primary objective of the One Cavite Project is to engage private medical practitioners in Cavite in screening, diagnosing, and managing adult patients (20 years old and above) for the following significant cardiovascular risk (CV) factors: hypertension, type 2 diabetes mellitus, dyslipidemia, smoking and to complement the PhilPEN implementation by the DOH in all its public health facilities in Cavite by private general physicians. Design and Methods: The first phase of the project is to organize a series of seminars to gather, enroll, and engage private doctors to ensure proper screening, monitoring, and follow up of patients with hypertension, diabetes, dyslipidemia, and other CV risk factors. The second phase is to enroll the patients of these private doctors, where patient data was collected, collated, and submitted to PSH for descriptive analysis by a third party. Results: A total of 680 doctors were engaged with a total of 41,477 patients screened. Preliminary data showed that out of the 41,477 patients, 61% have hypertension, 17% have diabetes, 22% have dyslipidemia, and 16% are smokers. Moreover, 21% have both hypertension and diabetes, 19% have hypertension and dyslipidemia, while 7% have hypertension, diabetes, and dyslipidemia. On follow-up after six months, out of 18,348 patients with hypertension, 88% of patients with hypertension had their blood pressure under control. For the 5,024 patients with diabetes, 15% had a fasting blood sugar &lt; 110 mg/dL, and 32% had an HBA1c&lt; 6.5 mg/dl. Out of 7,146 patients with dyslipidemia, 14% had an LDL &lt; 130 mg/dl, while for the 3,510 smokers, 56% quit smoking on follow-up. Conclusion: The One Cavite Project has shown that engagement of private medical practitioners in screening, diagnosing, and managing adult patients for significant cardiovascular risk (CV) factors have complemented the implementation of PhilPEN by the DOH and this led to active prevention and control of these risk factors.

Association of Area Deprivation Index and hypertension, diabetes, dyslipidemia, and Obesity: A Cross-Sectional Study of the HABS-HD Cohort.

Objective: This study aims to investigate the association between neighborhood deprivation and the prevalence of major cardiovascular disease (CVD) risk factors (hypertension, diabetes, dyslipidemia, and obesity) in a Mexican American (MA) population compared to NonHispanic Whites (NHW). Method: A cross-sectional analysis was conducted to include 1,867 subjects (971 MA and 896 NHW). Participants underwent a clinical interview, neuropsychological exam battery, functional examination, MRI of the head, amyloid PET scan, and blood draw for clinical and biomarker analysis. We use the Area Deprivation Index (ADI) Model to assign an ADI score to participants based on their neighborhoods. Descriptive, Cochran-Armitage test for trend, and odds ratio statistical analysis were applied. Results: Our results suggest that NHW had higher odds of having HTN, DM, and obesity in the most deprived neighborhoods, while MA showed no increased odds. The study also found that neighborhood deprivation contributed to diabetes in both MA and NHW and was associated with obesity in NHW. Conclusions: These findings highlighted the importance of addressing both individual and societal factors in efforts to reduce cardiovascular risk. Future research should explore the relationship between socio-economic status and cardiovascular risk in more detail to inform the development of targeted interventions.

Clinician perceptions of a clinical decision support system to reduce cardiovascular risk among prediabetes patients in a predominantly rural healthcare system

BackgroundThe early detection and management of uncontrolled cardiovascular risk factors among prediabetes patients can prevent cardiovascular disease (CVD). Prediabetes increases the risk of CVD, which is a leading cause of death in the United States. CVD clinical decision support (CDS) in primary care settings has the potential to reduce cardiovascular risk in patients with prediabetes while potentially saving clinicians time. The objective of this study is to understand primary care clinician (PCC) perceptions of a CDS system designed to reduce CVD risk in adults with prediabetes.MethodsWe administered pre-CDS implementation (6/30/2016 to 8/25/2016) (n = 183, 61% response rate) and post-CDS implementation (6/12/2019 to 8/7/2019) (n = 131, 44.5% response rate) independent cross-sectional electronic surveys to PCCs at 36 randomized primary care clinics participating in a federally funded study of a CVD risk reduction CDS tool. Surveys assessed PCC demographics, experiences in delivering prediabetes care, perceptions of CDS impact on shared decision making, perception of CDS impact on control of major CVD risk factors, and overall perceptions of the CDS tool when managing cardiovascular risk.ResultsWe found few significant differences when comparing pre- and post-implementation responses across CDS intervention and usual care (UC) clinics. A majority of PCCs felt well-prepared to discuss CVD risk factor control with patients both pre- and post-implementation. About 73% of PCCs at CDS intervention clinics agreed that the CDS helped improve risk control, 68% reported the CDS added value to patient clinic visits, and 72% reported they would recommend use of this CDS system to colleagues. However, most PCCs disagreed that the CDS saves time talking about preventing diabetes or CVD, and most PCCs also did not find the clinical domains useful, nor did PCCs believe that the clinical domains were useful in getting patients to take action. Finally, only about 38% reported they were satisfied with the CDS.ConclusionsThese results improve our understanding of CDS user experience and can be used to guide iterative improvement of the CDS. While most PCCs agreed the CDS improves CVD and diabetes risk factor control, they were generally not satisfied with the CDS. Moreover, only 40–50% agreed that specific suggestions on clinical domains helped patients to take action. In spite of this, an overwhelming majority reported they would recommend the CDS to colleagues, pointing for the need to improve upon the current CDS.Trial registration: NCT02759055 03/05/2016.

Cardiorespiratory Fitness in the Prevention and Management of Cardiovascular Disease.

Cardiovascular disease (CVD) is the leading cause of death among adults in the U.S. and elsewhere. Variation in the presence, severity, and control of major modifiable risk factors accounts for much of the variation in CVD rates worldwide. Cardiorespiratory fitness (CRF) reflects the integration of ventilation, circulation, and metabolism for the delivery and utilization of oxygen in support of dynamic aerobic physical activity. The gold standard measure of CRF is maximal oxygen uptake. Because the primary factor underlying differences in this measure between individuals is maximal cardiac output, it can serve as a clinical indicator of cardiac function. Higher CRF is associated with favorable levels of major CVD risk factors, lower prevalence and severity of subclinical atherosclerosis, and lower risks of developing both primary and secondary clinical CVD events. The beneficial associations between CRF and CVD are seen in women and men, older and younger adults, in those with multiple coexisting risk factors or prior diagnosis of CVD. Exercise training and regular physical activity of at least moderate intensities and volumes improves CRF in adults, and improvements in CRF are associated with lower risks of subsequent CVD and mortality. Routine assessment of CRF in primary care settings could enhance individual-level CVD risk assessment and thereby guide implementation of appropriate measures to prevent future clinical events.

Abstract 11767: Alarmingly Rising Trends in Cardiovascular Disease Risk Factors and Atrial Fibrillation in Young [18-44 Years] Asian Patients: A Nationwide Analysis Between 2016 and 2019

Background: Traditional cardiovascular disease (CVD) risk factors can increase the risk of Atrial Fibrillation (AF) even in young adults. With rising trends in CVD in the Asian population, we aimed to assess the prevalence and disparities of major modifiable risk factors for CVD and AF in the young Asians hospitalized in the US. Methods: The National Inpatient Sample (2016-2019) was used to estimate the temporal trends in modifiable CVD risk factors among young (18-44 years) Asian hospitalizations and evaluated disparities by sex. Also, we assessed the prevalence of AF in young Asians hospitalized with vs. without atleast one CVD risk factor. Results: From 2016 through 2019, a total of 1,324,259 young Asian admissions (Male 85%, age 18-44 years) were analyzed, the highest increase was noted for Obesity (1.8%) followed by Diabetes (1.3%). Males demonstrated the most prominent prevalence of Obesity (2.1%) and Hypertension (1.7%) as compared to the female population (1.7% and 0.4%), respectively. The incidence of AF in patients with at least one CVD risk factor increased by 0.4% (males 0.9% vs females 0.15%), (OR 2.80, 95%CI 2.44-3.21, p&lt;0.001). Conclusion: The prevalence of modifiable risk factors for CVD are increasing at a steady pace in the young Asian population. There is a need for urgent preventive and curative strategies to decrease the overall burden of CVD in this population.

Hearing Loss and Cardiovascular Disease Risk Profiles: Data from the Hispanic Community Health Study/Study of Latinos.

Individual cardiovascular disease (CVD) risk factors (RFs) have been associated with hearing loss (HL). The relationship to aggregate risk is poorly understood and has not been explored in the Hispanic/Latino population. The aim of this study was to characterize the association between aggregate CVD RF burden and hearing among Hispanics/Latinos. Cross-sectional examination. Participants (18-74 years; n = 12,766) in the Hispanic Community Health Study/Study of Latinos. Thresholds (0.5-8 kHz) were obtained, and HL was defined dichotomously as pure-tone average (PTA0.5,1, 2,4) > 25 dB HL. Optimal CVD risk burden was defined as follows: systolic blood pressure (SBP) < 120 mm Hg and diastolic blood pressure (DBP) < 80 mm Hg; total cholesterol < 180 mg/dL; nonsmoking; and no diabetes. Major CVD RFs were diabetes, currently smoking, SBP >160 or DBP > 100 mm Hg (or antihypertensives), and total cholesterol > 240 mg/dL (or statins). Thresholds were estimated by age (18-44 and ≥45 years) and sex using linear regression. The association between CVD risk burden and HL was assessed using multivariable logistic regression. Models were adjusted for age, sex, Hispanic/Latino background, center, education, income, alcohol use, body mass index, and noise exposure. In the target population, 53.03% were female and 18.81% and 8.52% had all RFs optimal and ≥2 major RFs, respectively. Elevated BP (SBP 120-139 mm Hg or DBP 80-89 mm Hg) was associated with HL in females < 45 years (odds ratio [OR], 2.18; 95% confidence interval [CI], 1.14-4.16). Diabetes (OR, 1.37; 95% CI, 1.01-1.84) and tobacco smoking (OR, 1.44; 95% CI, 1.03-2.01) were associated with HL in females ≥ 45 years. The odds of HL were higher for females ≥ 45 years with ≥2 RFs versus those with all RFs optimal (OR, 1.99; 95% CI, 1.12-3.53). Elevated BP (SBP 140-159 mm Hg or DBP 90-99 mm Hg), but not aggregate risk burden, was associated with HL in males ≥ 45 years (OR, 1.49; 95% CI, 1.02-2.19). No relationships with major CVD RFs were significant in males < 45 years. HL is associated with elevated BP in females < 45 years, with diabetes and hypertension in males ≥ 45 years, and with diabetes, smoking, and having ≥2 major CVD RFs in females ≥ 45 years. Future studies are needed to examine if these factors are associated with incident HL.

Measured Blood Pressure, Genetically Predicted Blood Pressure, and Cardiovascular Disease Risk in the UK Biobank

Hypertension remains the major cardiovascular disease risk factor globally, but variability in measured blood pressure may result in suboptimal management. Whether genetic contributors to elevated blood pressure may complementarily inform cardiovascular disease risk assessment is unknown. To examine incident cardiovascular disease by blood pressure polygenic risk score independent of measured blood pressures and antihypertensive medication prescriptions. The cohort study (UK Biobank) recruited UK residents aged 40 to 69 years between March 2006 and August 2010. Participants without a prior physician diagnosis of cardiovascular disease, including myocardial infarction, stroke, or heart failure, were included. Excluded were individuals with mismatch between self-reported and genotypically inferred sex, sex aneuploidy, missing genotype rates of 1% or greater, and excess genotypic heterozygosity. Data analyses were performed from September 25, 2021, to July 21, 2022. Measured blood pressure and externally derived blood pressure polygenic risk score stratified by hypertension diagnosis and management, which included normal blood pressure (<130/80 mm Hg without antihypertensives), untreated hypertension (systolic blood pressure ≥130 mm Hg or diastolic blood pressure ≥80 mm Hg without antihypertensives), and treated hypertension (current antihypertensives prescriptions). Composite of first incident myocardial infarction, stroke, heart failure, or cardiovascular-related death. Of the 331 078 study participants included (mean [SD] age at enrollment, 56.9 [8.1] years; 178 824 female [54.0%]), 83 094 (25.1%) had normal blood pressure, 197 597 (59.7%) had untreated hypertension, and 50 387 (15.2%) had treated hypertension. Over a median (IQR) follow-up of 11.1 (10.4-11.8) years, the primary outcome occurred in 15 293 participants. Among those with normal blood pressure, untreated hypertension, and treated hypertension, each SD increase in measured systolic blood pressure was associated with hazard ratios of 1.08 (95% CI, 0.93-1.25), 1.20 (95% CI, 1.16-1.23), and 1.16 (95% CI, 1.11-1.20), respectively, for the primary outcome. Among these same categories, each SD increase in genetically predicted systolic blood pressure was associated with increased hazard ratios of 1.13 (95% CI, 1.05-1.20), 1.04 (95% CI, 1.01-1.07), and 1.06 (95% CI, 1.02-1.10), respectively, for the primary outcome independent of measured blood pressures and other covariates. Findings were similar for measured and genetically predicted diastolic blood pressure. Blood pressure polygenic risk score may augment identification of individuals at heightened cardiovascular risk, including those with both normal blood pressure and hypertension. Whether it may also guide antihypertensive initiation or intensification requires further study.