Cardiovascular Premature Death Research Articles

Clinical exome sequencing unravels the diverse spectrum of genetic heterogeneity and genotype-phenotype correlations in hypertrophic cardiomyopathy.

BackgroundCatalogues of pathogenic genetic mutations in hypertrophic cardiomyopathy (HCM) are disproportionately small when compared to that of the size of the population with South Asian ancestry and their collective increased risk of heart disease. MethodsWe conducted clinical exome sequencing of 200 HCM patients to identified cardiomyopathy-associated genetic mutations. The clinical and echocardiographic characteristics of genotype-positive and genotype-negative patients were compared, and the likelihood of detecting a positive genetic test result was evaluated. Allelic burden analysis was done to compare the minor allele frequencies (MAF) of the pathogenic or likely pathogenic (P/LP) variants and variants of uncertain significance (VUSs) identified in the cohort against various population genomics databases. ResultsThe genetic yield was 40% for P/LP variants, with MYBPC3 and MYH7 as the predominant sarcomere genes. Younger age-at-diagnosis, family history of HCM, asymmetric hypertrophic (ASH) pattern, the ratio of the interventricular septum to posterior wall thickness (IVS/PW ratio), left atrial (LA) dimensions, severe mitral regurgitation grade (MR grade), late gadolinium enhancement (LGE) detected fibrosis and absence of hypertension were associated with an increased likelihood of HCM-associated variants. Patients who experienced ventricular tachycardia and premature cardiovascular death were significantly likely to carry MYBPC3 or loss-of-function variants. LA and interventricular septal (IVS) dimensions were associated with MYH7 variants. The rare variant burden for P/LP variants and VUSs was significantly enriched in HCM cases compared to population controls. ConclusionOur study provides a comprehensive evaluation of HCM-associated genetic mutations from an Indian population. The identified genotype-phenotype associations could improve the yield of targeted genetic testing in HCM.

Air pollution associates with poor mental health and amplifies the premature cardiovascular death in the United States: longitudinal nationwideanalysis

Air pollution associates with poor mental health and amplifies the premature cardiovascular death in the United States: longitudinal nationwideanalysis

Area deprivation and premature cardiovascular mortality: a nationwide population-based study in South Korea

BackgroundRegional disparities in cardiovascular disease (CVD) burden exist. The effect of area deprivation, one of the possible explanations, still needs to be fully understood. This population-based study investigated the association...

Abstract P377: Association Between Area Deprivation and Premature Cardiovascular Mortality in South Korea

Background: The underlying factors for regional disparities in cardiovascular disease (CVD) have yet to be fully understood. There is limited research on the effect of regional-level socioeconomic conditions on CVD mortality. This ecological study aims to investigate the association between area deprivation and premature death from CVD. Methods: The deprivation index was formulated with 10 socioeconomic indicators across all the 250 municipalities in Korea. Mortality rates from total CVD, ischemic heart disease, and cerebrovascular disease in adults <65 years were directly standardized for sex and age using the total population structure. Municipalities are stratified by urbanicity, and the number of hospitals and the size of an area were adjusted in log-linear regression models. Results: The most deprived municipalities showed 41.6% excess mortality for total CVD, 30.3% for ischemic heart disease, and 36.9% for cerebrovascular disease, compared to the least deprived ones. Even after adjusting for the number of hospitals per unit area, the association of area deprivation was more significant in metropolitan areas than in other provinces. As one increment of the deprivation index increased, the adjusted rate ratios for total CVD were 1.031 (1.020-1.043) in metropolitans and 1.009 (1.000-1.019) in other provinces. Additional multilevel analyses showed consistent findings of higher risks in deprived areas. Conclusions: This study highlights a higher risk of premature cardiovascular death in socioeconomically disadvantaged areas. The CVD prevention strategies should reflect regional characteristics, with a particular focus on reducing the burden in deprived metropolitan areas.

Regional prevalence of hypertension among people diagnosed with diabetes in Africa, a systematic review and meta-analysis.

Hypertension and diabetes comorbidity can increase healthcare expenditure and the risk of coronary heart disease. We conducted a systematic review and meta-analysis to estimate the prevalence of hypertension among people with diabetes in African countries. We searched EMBASE, PubMed and HINARI databases from inception to March 2023. Cross-sectional studies reporting the prevalence of hypertension among people with diabetes and published in English in Africa were eligible for inclusion. The cross-sectional study design component of the mixed method appraisal tool was used to assess the quality of the included studies. We quantified the overall and regional prevalence of hypertension among people with diabetes using random-effects meta-analysis. We assessed heterogeneity and publication bias using I2 statistics and funnel plots. Out of 3815 articles retrieved from the various databases, 41 met the inclusion criteria with sample sizes ranging from 80 to 116726. The mean age was 58 years (± 11) and 56% were women. The pooled prevalence of hypertension in people diagnosed with diabetes was 58.1% [95% CI: 52.0% - 63.2%]. By region, Central Africa had the highest hypertension prevalence; 77.6% [95% CI: 53.0% - 91.4%], Southern Africa 69.1% [95% CI: 59.8% - 77.1%;], North Africa 63.4% [95% CI: 37.1% - 69.1%;], West Africa 51.5% [95% CI: 41.8% - 61.1%] and East Africa 53.0% [95% CI: 45.8% - 59.1%]. Increasing age, being overweight/obese, being employed, longer duration of diabetes, urban residence, and male sex were reported to be associated with a higher likelihood of developing hypertension. The high prevalence of hypertension among people with diabetes in Africa highlights the critical need for an integrated differentiated service delivery to improve and strengthen primary care and prevent cardiovascular disease. Findings from this meta-analysis may inform the delivery of interventions to prevent premature cardiovascular disease deaths among persons in the region.

Correlation of heart healthy lifestyle parameters to blood pressure and obesity: A cross sectional study in medical students

Abstract Background Incidence of premature cardiovascular (CV) deaths in medical practitioners is increasing. Stress and emotional status have the potential to initiate premature CV disease. Rigors of medical course can worsen the stress and emotional wellbeing of medical students(MS), particularly as they move from preclinical to clinical years. Purpose To evaluate the heart healthy lifestyle (HHL) of MS and identify their correlation with two CV risk factors- obesity and high blood pressure (BP). To compare the differences between pre/para clinical students (PCS) and clinical students (CS) in HHL. Methods All undergraduate MS of a medical college from low-and middle-income country in south Asia during 2017-2018 were eligible for inclusion. The study had Institutional ethics committee approval and participation was voluntary. Height, weight, waist and hip circumference and blood pressure were measured using standard methods. Lifestyle habits, psychological status, stress levels and attitude towards CV health were collected using a specially designed questionnaire. Each participant was assigned pre-defined scores on five areas- physical activity, dietary habits, emotional status, psychological status and attitude towards lifestyle counselling all of whom sum up to give a total heart healthy lifestyle score(HHLS). Results 824 MS (394[47.8%] CS and 430[52.2%] PCS) participated in the study. The HHLS had significant negative correlation with body mass index (BMI) and systolic blood pressure (BP). (Figure-1 and 2a). Physical activity, emotional status, social media screen time and sleep had significant negative correlation with BMI (Figure 2a). The proportion of CS and PCS with abnormal BMI, waist hip ratio (WHR) and BP were similar. The attitude towards HHL counselling and willingness to implement when needed (57.3% vs 47.7%; P<0.001) was better in CS compared to PCS. However higher proportion of CS had low self-esteem (78.5% vs 68.9%; P=0.002) and suicidal thoughts (18.7% vs 12.4%; P=0.03) compared to PCS. Further the scores for emotional and psychological health were lower in CS (Figure-2b) 29.4% of MS recorded high levels of stress in daily life, which however was similar between CS and PCS. Academic performance (41.2%) was the most common reason cited for stress followed by health(19.2%), relationships (17.4%) and finances (14.8%). Teachers (4.5%) and parents (5.9%) were less likely to be causes of stress. Conclusion The unhealthy lifestyle habits in MS, significantly correlated with BMI and SBP. Higher proportion of CS experience lack of self-worth and suicidal thoughts. One third of MS experience high levels of stress in daily life. Cardiovascular health education and training and emotional support to MS have to be started early in medical students, in order to have healthy medical practitioners serving the society.

External validation of survival predicting score in repaired tetralogy of Fallot: an opportunity to improve

Abstract Introduction In recent years, integrating both better diagnosis and treatment allowed most adults with repaired tetralogy of Fallot (rTOF) to expect a longer life expectancy. However, a minority is at higher risk for premature cardiovascular death. Recently, 2 scores identified the subgroup of rTOF patients (pts) who are at high annual risk of death and ventricular arrhytmias (VA). We aimed to implement both in our population. Methods Retrospective single center review was done on rTOF pts who undergone cardiovascular magnetic resonance with gadolinium, blood sampling for B-type natriuretic peptide (BNP), echocardiography and cardiopulmonary exercise testing. The risk scores were calculated with weighted independent predictors, namely presence of late gadolinium enhancement in left ventricle (LV) and right ventricle (RV), akinetic RV outflow length, LV and RV ejection fraction (EF), RV systolic pressure, peak oxygen uptake (pVO2), BNP, atrial arrythmias and age. Low mortality risk was defined as 0-20 points, intermediate as 21-50 and high ≥51. In terms of VA prediction, low risk was defined as 0-20 points, intermediate as 21-39 and high as ≥51. Results From a total of 240 rTOF pts, 61 (56% male, mean age 34±9 years) had all the necessary data. RV dysfunction was present in 52.5%, RV systolic pressure was high in 12 and LVEF≤35% in 18% pts. BNP level was elevated in 27 and pVO2≤17mL/kg/m2 in 14.8% pts. The mean mortality risk score was 15.1±11.2, being that 68.9% had a lower and 31.1% an intermediate risk. Regarding VA score, the mean was 14.7±10.8, where the majority (80.3%) were in lower risk. 29.5% had a sustain atrial arrhythmia (mainly atrial fibrillation) and 14.8% a VA. There were 3 cardiac related deaths (4.9%). Analysis of time to event data showed that mortality and VA scores were not predictors of overall mortality (M) or VA events, respectively. However, considering 1-year M, LVEF≤35% (p= 0.002), RVEF≤35% (p=0.002), pVO2≤17mL/kg/m2 (p<0.001), and both scores: M (p=0.013) and VA (p<0.001) were predictors of that endpoint. In multivariate analysis, VA risk score (p=0.035) and low pVO2 (p= 0.006) were independent 1-year M predictors. Conclusion In our population, ventricular arrhythmia score and low peak oxygen uptake were independent predictors of 1-year mortality. However, there is probably a selection bias. Since the scores were recently proposed, patients were not recruited prospectively, many ended up not having all the needed or recent data, thus were not included. There is the need to validate and improve available scores to truly assess the risk of mortality and arrhythmias, as well as defined protocols and longer follow-up for this purpose.

Gender differences in lifestyle and psycho-social aspects of medical students. A cross sectional study

Abstract Background Incidence of premature cardiovascular deaths in medical practitioners is on the increase. Lifestyle habits, psychosocial and emotional status of medical students has the potential to initiate the premature onset of cardiovascular disease. Gender differences in diagnosis and management of cardiovascular diseases is well known. However, data on gender differences in heart healthy status of medical students are sparce. Purpose To investigate the gender differences heart healthy lifestyle habits among undergraduate medical students of a medical college from low-and-middle income country in south Asia. Methods All students pursing MBBS between 2017 and 2018 were included in the cross-sectional study. The study had Institutional ethics committee approval and the participation was voluntary. Anthropometric measurements (weight using digital weighting scale, height, waist and hip circumference using measuring tape), vital signs (pulse and blood pressure using digital manometer) and self-reported lifestyle/psychosocial cum behavioural pattern (using a specially designed proforma) were collected for all the participants. (525) Results 824 medical students were enrolled in the study of whom 377 (45.8%) were women. Overall 37.1% had abnormal body mass index (BMI) and 27.8% had abnormal waist hip ratio (WHR). Overall 14% and 10.3% students had abnormal systolic (≤ 85 mm of Hg) or diastolic blood pressure(BP) (≤ 135 mm of Hg) readings respectively. 19.4% of students had either systolic or diastolic abnormal BP values. Gender differences: Abnormal BMI and abnormal WHR (Figure 1A) were found in similar proportion among women and men. However less women has abnormal BP readings compared to men. More men has abnormal diastolic BP and abnormal systolic BP compared to women. Either systolic or diastolic BP values were abnormal in lower proportion of women (7.8% vs 29.4%; P<0.001). Women had less physically active minutes per day compared to men (71.15 ± 68.2 vs 109. 38± 81.7; P < 0.001). A feeling of lack of self-worth (73.5%) was common among medical students, however no significant gender differences were observed (Figure 1B). Significantly more women students have harbored suicidal thoughts than men. Women students were more likely to feel life style counseling is necessary for medical students and were more likely to implement lifestyle changes if advised. Conclusion High blood pressure and feeling of lack of self-worth is commonly observed in medical students. Women were more likely to harbor suicidal thoughts, bitterness and anger more likely to implement lifestyle modifications if advised. Interventions warranted at improving heart healthy lifestyle patterns is warranted, and must be optimized by observed gender differences.Figure 1Gender and life style habits

Abstract 13051: Profiling CD8+ T Cell Activation in Experimental Models With LDL-R Deficiency and in Patients With Familial Hypercholesteroleamia

Introduction and Hypothesis: Familial Hypercholesterolaemia (FH) is a rare genetic disease characterized by elevated plasma cholesterol levels, xanthomas, overt atherosclerosis and premature cardiovascular death. HoFH and severe HeFH present an elevated inflammatory burden and poorly responsive to therapeutics such as anti-PCSK9 monoclonal antibodies. Therefore, innovative approaches to diagnose the severity of the disease and control the over-activation of the immune-inflammatory response in the arterial wall of FH patients should be studied to improve the management of this genetic disease. Here we profiled the activation of CD8+ T lymphocytes from experimental models and with patients with clinical diagnosis of FH. Methods: Immunophenotypic characterization of T cells from WT and LDLR KO mice was performed in vitro and in vivo coupled to proteomics and WB analysis on isolated T cells. CD8 T cell response in FH patients, carrying mutations in the LDLR gene, was profiled. Results: LDLR mRNA expression increased after in vitro activation of CD8, but not CD4 T cells, suggesting a different regulation of cholesterol homeostasis between T cell subsets. LDLR deficiency mainly affected CD8 T cell activation as demonstrated by reduced in vitro and in vivo proliferation and cytokine production after ovalbumin vaccination of LDL-R KO T cells compared to their wild type counterpart. The addition of LDL to serum free media increased CD8 proliferation in WT but not in KO CD8 T cells. Proteomic and WB analysis showed that this phenotype is the consequence of reduced mTORC1 activation and impaired lysosomal organization. The proliferation of CD8 T cells from FH patients was less pronounced compared to sex- and age-matched controls. In addition, CD8 T cells from FH vaccinated for seasonal influenza were tested in vitro with virus-derived peptides, showing a decreased granzyme production compared to CD8 from vaccinated controls. Conclusions: LDLR plays a critical role in regulating the immunometabolic reprogramming of activated CD8 T cells by fuelling the cholesterol-lysosome-mTORC1 axis. Acknowledgments: This study is supported by a Grant from the Italian Ministry of Health: RF-2019-12370896

Circulating microRNA Profiles for Premature Cardiovascular Death in Patients with Kidney Failure with Replacement Therapy.

Patients with kidney failure with replacement therapy (KFRT) suffer from a disproportionately high cardiovascular disease burden. Circulating small non-coding RNAs (c-sncRNAs) have emerged as novel epigenetic regulators and are suggested as novel biomarkers and therapeutic targets for cardiovascular disease; however, little is known about the associations of c-sncRNAs with premature cardiovascular death in KFRT. In a pilot case-control study of 50 hemodialysis patients who died of cardiovascular events as cases, and 50 matched hemodialysis controls who remained alive during a median follow-up of 2.0 years, we performed c-sncRNAs profiles using next-generation sequencing to identify differentially expressed circulating microRNAs (c-miRNAs) between the plasma of cases and that of controls. mRNA target prediction and pathway enrichment analysis were performed to examine the functional relevance of differentially expressed c-miRNAs to cardiovascular pathophysiology. The association of differentially expressed c-miRNAs with cardiovascular mortality was examined using multivariable conditional logistic regression. The patient characteristics were similar between cases and controls, with a mean age of 63 years, 48% male, and 54% African American in both groups. We detected a total of 613 miRNAs in the plasma, among which five miRNAs (i.e., miR-129-1-5p, miR-500b-3p, miR-125b-1-3p, miR-3648-2-5p, and miR-3150b-3p) were identified to be differentially expressed between cases and controls with cut-offs of p < 0.05 and log2 fold-change (log2FC) > 1. When using more stringent cut-offs of p-adjusted < 0.05 and log2FC > 1, only miR-129-1-5p remained significantly differentially expressed, with higher levels of miR-129-1-5p in the cases than in the controls. The pathway enrichment analysis using predicted miR-129-1-5p mRNA targets demonstrated enrichment in adrenergic signaling in cardiomyocytes, arrhythmogenic right ventricular cardiomyopathy, and oxytocin signaling pathways. In parallel, the circulating miR-129-1-5p levels were significantly associated with the risk of cardiovascular death (adjusted OR [95% CI], 1.68 [1.01-2.81] for one increase in log-transformed miR-129-1-5p counts), independent of potential confounders. Circulating miR-129-1-5p may serve as a novel biomarker for premature cardiovascular death in KFRT.

Early echocardiographic signs of cardiovascular affection in pediatric familial hypercholesterolemia

Familial hypercholesterolemia (FH) is a rare autosomal dominant genetic disorder caused by defective low-density lipoprotein (LDL) receptors or abnormal apolipoprotein B. FH raises the risk of premature atherosclerotic disease and cardiovascular death in young adults. However, cardiovascular affection in children needs to be more adequately studied. Our study aimed to evaluate the effect of hypercholesterolemia on the cardiovascular system of pediatric patients with homozygous FH using conventional and advanced echocardiographic parameters such as tissue Doppler imaging (TDI) and 2-dimensional speckle-tracking echocardiography (2D-STE). This case-control study matched 25 healthy children with 21 patients with homozygous FH. Both groups had conventional echocardiography, TDI, and 2D-STE. Myocardial velocities of the left and right ventricles, left ventricular strain, and aortic stiffness parameters were measured. The FH group had greater systolic blood pressure, dilated coronary arteries, and hypertrophied left ventricle (LV) compared to the control (P = 0.0001, P = 0.001, P = 0.01, respectively). The mitral E/E′ ratio was higher in the patient group than in the control group (P = 0.007), indicating LV diastolic dysfunction in patients. At the same time, LV systolic function evaluated by 2D-STE was comparable to that in the control group. The abdominal aorta circumferential strain and ascending aorta M-mode-derived strain were significantly lower in patients compared to those in the control (P = 0.024, P = 0.0001, respectively), indicating increased aortic stiffness in the patients’ group; moreover, 85.7% of patients had mild aortic insufficiency. Conclusion: Mild aortic insufficiency, coronary artery dilatation, left ventricular (LV) diastolic dysfunction, and increased aortic stiffness are among early cardiovascular markers in pediatric patients with homozygous FH before impaired LV systolic function.What is Known:• Familial hypercholesterolemia (FH) in adults is associated with accelerated atherosclerosis, aortic valvopathy, dilated coronary arteries, ischemic heart disease, and premature cardiovascular death.• The cardiovascular effects of FH in children require additional research.What is New:• Pediatric patients with familial hypercholesterolemia tend to have an early affection for left ventricular diastolic function before the affection for the systolic function.• The diastolic dysfunction associated with pediatric FH is correlated to the aortic stiffness and low-density lipoprotein levels.

Protein structural insights into a rare PCSK9 gain-of-function variant (R496W) causing familial hypercholesterolemia in a Saudi family: whole exome sequencing and computational analysis.

Familial hypercholesterolemia (FH) is a globally underdiagnosed genetic condition associated with premature cardiovascular death. The genetic etiology data on Arab FH patients is scarce. Therefore, this study aimed to identify the genetic basis of FH in a Saudi family using whole exome sequencing (WES) and multidimensional bioinformatic analysis. Our WES findings revealed a rare heterozygous gain-of-function variant (R496W) in the exon 9 of the PCSK9 gene as a causal factor for FH in this family. This variant was absent in healthy relatives of the proband and 200 healthy normolipidemic controls from Saudi Arabia. Furthermore, this variant has not been previously reported in various regional and global population genomic variant databases. Interestingly, this variant is classified as "likely pathogenic" (PP5) based on the variant interpretation guidelines of the American College of Medical Genetics (ACMG). Computational functional characterization suggested that this variant could destabilize the native PCSK9 protein and alter its secondary and tertiary structural features. In addition, this variant was predicted to negatively influence its ligand-binding ability with LDLR and Alirocumab antibody molecules. This rare PCSK9 (R496W) variant is likely to expand our understanding of the genetic basis of FH in Saudi Arabia. This study also provides computational structural insights into the genotype-protein phenotype relationship of PCSK9 pathogenic variants and contributes to the development of personalized medicine for FH patients in the future.

Modelling the potential long-term survival benefit of evinacumab treatment vs. standard of care in patients with homozygous familial hypercholesterolaemia.

Despite intensive lipid-lowering therapies (LLTs), most patients with homozygous familial hypercholesterolaemia (HoFH) do not achieve guideline recommended low-density lipoprotein cholesterol (LDL-C) targets and are at increased risk of premature cardiovascular death. This analysis aimed to predict the impact of evinacumab and standard-of-care LLTs on life expectancy in an HoFH population using mathematical modelling. Mathematical models were developed using efficacy data for evinacumab from the phase 3 ELIPSE HoFH trial plus efficacy data for standard-of-care LLTs from peer-reviewed publications. Treatment strategies evaluated included (i) untreated, (ii) high-intensity statin (HIS) only, (iii) HIS plus ezetimibe, (iv) HIS plus ezetimibe plus proprotein convertase subtilisin/kexin type 9 inhibitor (PCSK9i), and (v) HIS plus ezetimibe plus PCSK9i plus evinacumab. Markov analyses were used to assess differences in survival probability for different LLT strategies. The median survival for untreated HoFH patients was only 33-43 years, depending on different assumptions on baseline untreated LDL-C levels. In the most robust model, we estimated that HIS increased median survival by 9 years and ezetimibe further increased median survival by an additional 9 years. When PCSK9i was added on top of HIS plus ezetimibe, median survival was further improved by 14 years. Finally, the addition of evinacumab to standard-of-care LLTs was estimated to increase median survival by ∼12 years. In this mathematical modelling analysis, evinacumab treatment could potentially increase long-term survival vs. standard-of-care LLTs for patients with HoFH.

Association of DNA methylation signatures with premature ageing and cardiovascular death in patients with end-stage kidney disease: a pilot epigenome-wide association study

ABSTRACT Patients with end-stage kidney disease (ESKD) display features of premature aging. There is strong evidence that changes in DNA methylation (DNAm) contribute to age-related pathologies; however, little is known about their association with premature aging and cardiovascular mortality in patients with ESKD. We assayed genome-wide DNAm in a pilot case-control study of 60 hemodialysis patients with (n=30, cases) and without (n=30, controls) a fatal cardiovascular event. DNAm was profiled on the Illumina EPIC BeadChip. Four established DNAm clocks (i.e., Horvath-, Hannum-, Pheno-, and GrimAge) were used to estimate epigenetic age (DNAmAge). Epigenetic age acceleration (EAA) was derived as the residuals of regressing DNAmAge on chronological age (chroAge), and its association with cardiovascular death was examined using multivariable conditional logistic regression. An epigenome-wide association study (EWAS) was performed to identify differentially methylated CpGs associated with cardiovascular death. All clocks performed well at predicting chroAge (correlation between DNAmAges and chroAge of r=0.76-0.89), with GrimAge showing the largest deviation from chroAge (a mean of +21.3 years). There was no significant association of EAAs with cardiovascular death. In the EWAS, a CpG (cg22305782) in the FBXL19 gene had the strongest association with cardiovascular death with significantly lower DNAm in cases vs. controls (P FDR=2.0x10−6). FBXL19 is involved in cell apoptosis, inflammation, and adipogenesis. Overall, we observed more accelerated aging in patients with ESKD, although there was no significant association of EAAs with cardiovascular death. EWAS suggests a potential novel DNAm biomarker for premature cardiovascular mortality in ESKD.

Cardiovascular risk factors and impending 10-year risk of fatal or non-fatal cardiovascular disease events among an urban population in Tamil Nadu state in South India - A community based cross-sectional study

Background: Coronary heart disease, peripheral arterial disease, cerebrovascular disease, congenital and rheumatic heart illnesses are among the heart and blood vessel disorders classified as cardiovascular diseases (CVDs). Sudden premature cardiovascular deaths among apparently healthy population can be well prevented by the early recognition of cardiovascular risk factors using validated cardiovascular risk prediction tools. Aims and Objectives: The World Health Organization/international society of hypertension (WHO/ISH) Risk Prediction Charts was utilized to estimate the upcoming 10-year risk of CVD events, and the study’s objectives were to identify the risk factors for high CVD risk among urban residents aged ≥40–79 years in Tamil Nadu State, South India. Materials and Methods: A total of 350 participants were selected for a community-based cross-sectional study using a two-stage selection technique. A pretested questionnaire, anthropometry and laboratory research were used to acquire the required data. Finding the relationship between the risk factors and high CVD risk among the subjects was done using both univariate and multivariate regression analysis. Results: Mean age of subjects was 55.6 years. Hypertensives and diabetics were 35.4% and 27.4%, respectively. An alarming 75.1% subjects were either overweight or obese. The WHO/ISH chart categorized 20.9% subjects with &gt;10% risk of impending CVDs. Risk factors which independently influenced high cardiovascular risk were “being unmarried” (adjusted odds ratio [aOR] 31.76; 95% CI; P=0.009), “positive family history” (aOR 4.13; P=0.017), “Sedentary Occupation” (aOR 3.18; P=0.036), and “alcohol usage” (aOR 3.03; 95% CI [1.06–10.27]; P=0.039). Conclusion: The study has identified that more than one-fifth of the subjects were under the &gt;10% CVD risk category thereby underscoring the immediate need for inclusion of CVD risk scoring tools in routine screening programs in all levels of health care settings as an effective health promotion strategy in curtailing the escalating incidence of CVDs events worldwide.

Hematocrit value at early middle age predicts hypertension at late middle age; the Tampere adult population cardiovascular risk study, a 30-year follow-up

A 50-year-old cohort from the Tampere adult population cardiovascular risk study having hypertension and their controls were examined retrospectively at the age of 35 years, and followed up prospectively up to the age of 65 years to determine whether an early hematocrit (HCR) measurement predicts later hypertension or cardiovascular complications. A total of 307 subjects having hypertension and 579 non-hypertensive controls were chosen from the 50-year-old cohort and regrouped according to HCR values obtained when they were 35 years old, one with HCT < 45 % (n = 581), and the other, with HCT ≥ 45 % (n = 305). Hypertension and coronary artery disease (CAD) by the age of 60 years were determined by self-report and the National Hospital Discharge Registry. Outcomes for death up to the age of 65 years were collected from the National Statistics Centre. HCT ≥ 45 % at the age of 35 years associated with hypertension (p = 0.041) and CAD (P = 0.047) by the age of 60 years. When the subjects were followed up to the age of 65 years, HCT ≥ 45 % associated with premature cardiovascular death (P = 0.029), and death by any cause (P = 0.004). These results were obtained after adjusting for BMI-class recorded at 50 years of age. However, when outcome was also adjusted by gender, current smoking, vocational education, and state of one's health, association of the ≥ 45 % group with CAD and death was abolished. The association with hypertension remained (P = 0.007). In conclusion, there was a significant association of HCT ≥ 45 % at early middle age with subsequent hypertension.

Association of DNA Methylation Signatures With Premature Aging and Cardiovascular Death in Patients With ESKD: A Pilot Study

Association of DNA Methylation Signatures With Premature Aging and Cardiovascular Death in Patients With ESKD: A Pilot Study

Circulating Small Non-Coding RNA Profiles for Premature Cardiovascular Death in Hemodialysis Patients

Circulating Small Non-Coding RNA Profiles for Premature Cardiovascular Death in Hemodialysis Patients

SEX DISPARITIES IN TREATMENT AND CLINICAL OUTCOMES OF FAMILIAL HYPERCHOLESTEROLEMIA

SEX DISPARITIES IN TREATMENT AND CLINICAL OUTCOMES OF FAMILIAL HYPERCHOLESTEROLEMIA

Registry data indicate higher risk of eating disorders in individuals with familial hypercholesterolemia compared with age and sex matched controls

Background and Aims : Events of illness, loss of family members and maintaining a restrictive diet are some of many risk factors for developing an eating disorder. Familial hypercholesterolemia (FH) is a hereditary condition that predisposes for premature atherosclerotic cardiovascular disease and death. Consequently, medical and dietary treatment are initiated from childhood. The aim of this study was to examine whether having FH is associated with a risk of developing an eating disorder.