Heart Attack Risk Factors Research Articles

Linking cohort data with administrative health data to develop a new hypertension prediction model to aid precision health approach

IntroductionHypertension is a common medical condition, affecting 1 in 5 Canadians, and is a major risk factor for heart attack, stroke, and kidney disease. Predicting the risk of developing incident hypertension may help to inform targeted preventive strategies.
 Objectives and ApproachIdentification of major risk factors and incorporation into a multivariable model for risk stratification may help to identify individuals who are at highest risk for developing incident hypertension and would potentially benefit most from intervention. The goal of the proposed research is to develop a robust hypertension prediction model for the general population using the Alberta Tomorrow Project (ATP) cohort data linked with Alberta’s administrative health data. ATP is Alberta's largest population health cohort, contains baseline data on socio-demographic characteristic, personal and family history of disease, medication use, lifestyle and health behavior, environmental exposures, physical measures and bio samples.
 ResultsAlberta’s administrative health data additionally provides information on health care utilization, enrollment, drugs, physician services, and hospital services. A prediction model for hypertension will be developed using logistic regression where information on candidate variables for the model will be gathered from ATP data and outcome (incident hypertension) will be ascertained from administrative health data (physicians/practitioner claim data and hospital discharge abstract data). Lacking follow-up information in current ATP data has laid the foundation of linking the two data sources through an anonymous unique person identifier (e.g. PHN) that will eventually provide follow-up information on ATP participants who are free of hypertension at baseline developed the disease as well as information on other potential variables.
 Conclusion/ImplicationsThe proposed prediction model will help to identify individuals at highest risk for developing hypertension and those who may benefit most from targeted healthy behavioral interventions and/or treatment. Such identification of high risk people may help prevent hypertension as well as the continuing costly cycle of managing hypertension and its complications.

Strengthening quit smoking services in Malaysia through Malaysia Quit (mQuit) Program

1. Awareness of the Risk Factors for Heart Attack Among the General Public in Pahang, Malaysia: A Cross-Sectional Study Abdullah Ahmed, Abdulkareem AL-Shami, Shazia Jamshed, Mohammed Zawiah, Mohamed Elnaem, Ibrahim Mohamed Risk Management and Healthcare Policy CrossRef

Hyperuricemia and metabolic syndrome in type 2 diabetes mellitus patients at Hawassa university comprehensive specialized hospital, South West Ethiopia

BackgroundMetabolic syndrome is a cluster of the most dangerous heart attack risk factors such as diabetes and prediabetes, abdominal obesity, high cholesterol and high blood pressure. Hyperuricemia is a condition in which the serum uric acid concentration is greater than 5.5 mg per deciliter for child and greater than 7.2 and 6.0 mg per deciliters for male and female adults respectively.MethodsA cross-sectional study was conducted to determine the magnitude of hyperuricemia and associated factors among type 2 diabetes mellitus patients at Hawassa Comprehensive Specialized Hospital (HCSH) from February 28 to May 30 /2017. A random sampling technique was used to include 319 study subjects and a signed consent had been provided by each study subject before running any data collection. An interviewer administered structured questionnaire was used to collect socio-demographic and some clinically useful data. In addition to this, we reviewed the records of the study subjects to obtain other useful clinical data. Five milliliter blood specimen was collected from each study subjects after overnight fasting. A25TM Bio-System Random Access chemistry analyzer was used for blood sample analysis. All data were checked visually, coded and entered into epi-data version 3.4 and statistical analysis was performed using SPSS version 20.0 software. Bi-variate and multivariate logistic regressions were used to determine the association between explanatory and the outcome variables.ResultsThe prevalence of hyperuricemia and metabolic syndrome among type 2 diabetic patients in the study area were 33.8%(n = 106) and 70.1% (n = 220) respectively. Having age greater or equal to 45 years (AOR: 1.9, CI: 1.-3.2, P value =0.015) and having metabolic syndrome (AOR: 2.6, CI: 1.5–4.7, P value = 0.001) were the determinant variables for hyperuricemia among type 2 diabetic patients.ConclusionThere was high prevalence of hyperuricemia among type 2 diabetic patients with high prevalence of metabolic syndrome. Therefore, regular health information about life style modification, early diagnosis and treatment for hyperuricemia and metabolic syndrome are essential to reduce hyperuricemia and metabolic syndrome in type 2 diabetic patients.

The V279F polymorphism might change protein character and immunogenicity in Lp-PLA2 protein

BackgroundLipoprotein-associated phospholipase A2 (Lp-PLA2) plays a strong role in the occurrence of certain cardiovascular disease processes. Polymorphisms at the protein level are also estimated to correlate with increased risk factors for heart attacks. One such polymorphism is the V279F polymorphism in Lp-PLA2 which results in a change in enzyme performance capability. This in turn implies a reduced risk of acute myocardial infarct (AMI) in Korean and Indonesian subpopulations. AimThis study aimed to analyze changes in protein properties, structure, energy stability, epitope, and immunogenicity that are due to the substitution of the Valine (V) amino acid at position 279 to Phenylalanine (F) in the Lp-PLA2 protein. MethodologyThe role of Lp-PLA2 in the cardiovascular process and in AMI was analyzed based on the protein-protein network according to the BioGRID, MENTHA, and STRING databases. Protein properties and energy stability were examined by FoldX; this was followed by identification of epitope using ElliPro. The immunogenicity was evaluated in vivo by injecting the protein into mice and subsequently measuring their antibody production using the ELISA technique. ResultsThe substitution of Valine for Phenylalanine was predicted to increase protein stability and epitope shifts. Further studies on animal experiments exhibit that the 279V variant is able to induce IgG production better than the 279F variant. ConclusionBased on these data, it can be concluded that the V279F polymorphism influences the surface structure, energy stability, epitope and immunogenicity of the Lp-PLA2 protein. The changes in the immunogenicity and epitope shift indicated that the protein is valuable as a biomarker for use in acute myocardial infarct. The results of this study provide an opportunity to develop monoclonal antibodies that are specifically able to identify V279F polymorphisms as a predictor of the risk of acute myocardial infarct.

Mutations in tropomyosin 4 underlie a rare form of human macrothrombocytopenia

Platelets are anuclear cells that are essential for blood clotting. They are produced by large polyploid precursor cells called megakaryocytes. Previous genome-wide association studies in nearly 70,000 individuals indicated that single nucleotide variants (SNVs) in the gene encoding the actin cytoskeletal regulator tropomyosin 4 (TPM4) exert an effect on the count and volume of platelets. Platelet number and volume are independent risk factors for heart attack and stroke. Here, we have identified 2 unrelated families in the BRIDGE Bleeding and Platelet Disorders (BPD) collection who carry a TPM4 variant that causes truncation of the TPM4 protein and segregates with macrothrombocytopenia, a disorder characterized by low platelet count. N-Ethyl-N-nitrosourea–induced (ENU-induced) missense mutations in Tpm4 or targeted inactivation of the Tpm4 locus led to gene dosage–dependent macrothrombocytopenia in mice. All other blood cell counts in Tpm4-deficient mice were normal. Insufficient TPM4 expression in human and mouse megakaryocytes resulted in a defect in the terminal stages of platelet production and had a mild effect on platelet function. Together, our findings demonstrate a nonredundant role for TPM4 in platelet biogenesis in humans and mice and reveal that truncating variants in TPM4 cause a previously undescribed dominant Mendelian platelet disorder.

Low-protein diet for the prevention of renal failure.

The prevalence of chronic kidney disease (CKD) is estimated to be 8–16% worldwide, and it is increasing. CKD is a risk factor for heart attack and stroke, and it can progress to kidney failure requiring dialysis or transplantation. Recently, diabetic nephropathy has become the most common cause of CKD. In Japan, the cumulative probability of requiring hemodialysis by the age 80 years is 1/50 in males and 1/100 in females. The number of patients under hemodialysis in Japan exceeded 320,000 in 2014, among which 38,000 were newcomers and 27,000 died.The annual medical costs of hemodialysis are 1.25 trillion yen in Japan, representing 4% of the total national medical expenditures in 2014. A low-protein diet (less than 0.5 g/kg b.wt.) is a very effective intervention. Low-protein rice (1/10 to 1/25 of the normal protein contents) is helpful to control the consumption of proteins, decreasing at the same time the intake of potassium and phosphate.Protein restriction is indicated as soon as the eGFR becomes lower than 60 ml/min/1.73 m2 body surface, in order, to slow disease progression. The newly developed low-protein Indica rice is expected to help many CKD patients in China and Southeast Asia.

Prevalence of hypertension in an area of urban Varanasi, India and its association with selected demographic factors

Background: Non communicable diseases (NCDs) are the leading cause of death in WHO South East Asian Region and the rising trend is attributed to a variety of factors viz smoking, sedentary life style etc. Hypertension is considered as the principle risk factor for heart attack and stroke. The main objective was to assess the prevalence and spectrum of hypertension and its association with selected demographic factors in an area of urban Varanasi. Methods: This cross- sectional community based study was undertaken in a selected area of urban Varanasi. The study sample comprised of subjects 25 years and above. After obtaining ethical clearance and taking consent from study subjects, they were specifically interviewed for selected demographic characteristics using pre designed and pre tested proforma. Their blood pressure was measured using electronic BP machine following standard technique. The data was entered in personal computer and analyzed with SPSS. Results: Out of 611 subjects, 314 (51.4%) subjects were male and 297 (48.6%) were female. 51.7% and 20.0% subjects were categorized as normal and pre hypertensive respectively. As much as 19.6% and 8.7% subjects were in stage 1 and stage 2 hypertension. Presence of hypertension increased significantly (p<0.001) with advancing age. Conclusions: Hypertension is a significant problem in study subjects. Nearly one fifth of the subjects were in pre hypertensive stage. Preventive strategies should be directed to them for positive impact.

Sympathovagal imbalance is enhanced by smoking in Saudi male young adults with prehypertension

Background and Aim: Hypertension and smoking are among the most common universal risk factors for heart attack and stroke, involving the impairment of the autonomic nervous system. Therefore, in this study, we aim to investigate the contribution of smoking to sympathovagal imbalance (SVI) in prehypertension. Methods: Hundred and twenty-two male subjects aged 19-30 years were classified into nonsmoker normotensive ( n = 38), nonsmoker prehypertensive ( n = 38), smoker normotensive ( n = 30), and smoker prehypertensive ( n = 16). SVI was assessed from low-frequency power to high-frequency power (LF-HF ratio) and correlated with number of cigarette smoked/day in all the groups by Pearson's correlation. Results: LF-HF ratio, LF and LF in normalized units were significantly ( P P P P Conclusion: In prehypertensive smokers, SVI was linked to number of cigarette smoking. Stopping smoking would enable to achieve the sympathovagal balance and BP homeostasis in prehypertensives.

Metabolic Syndrome May be a Sign of Rapid Aging

The metabolic syndrome [MS] is a combination of the most dangerous heart attack risk factors. Several definitions have been suggested with the most acceptable being the IDF definition while the most recent is the Joint Interim statement. Irrespective of the definition used, the MS Several studies point to the metabolic syndrome as a potential target to avert aging. Some predisposing conditions that increase in prevalence during aging are actually the indicators or determinants of the metabolic syndrome (MS). Besides, very relevant to promoting normal aging is the prevention and treatment of MS and cardiovascular disease [CVD]. From the Biochemical, pathophysiological and hormonal stand points, the metabolic syndrome can be considered as a sign of rapid aging. It can thus be stated that the metabolic syndrome is a sign that the individual is aging faster. Preventing and treating this global time bomb should rekindle normal aging by decelerating rapid or premature aging.

Perception of selected risk factors for cancer and heart attack among visitors of a public hospital

Background: To assess perception of selected risk factors for cancer and heart attack among visitors of a public hospital. Materials and Methods: Randomly 1651 ambulatory adults were contacted using predesigned, pretested, semi-structure interview schedule comprising selective 12 risk factors for cancer (increasing age, tobacco, obesity, alcohol, diet-rich in fat/oil, diet-poor in fruits and vegetables (F and V), physical in-activity, environmental pollution, multiple sexual partners, insecticides/pesticides/chemicals, micro-organism, family history) and 11 for heart attack (increasing age, tobacco, obesity, alcohol, diet-rich in fat/oil, diet-poor in F and V, physical in-activity, hypertension, diabetes mellitus, mental stress, family history). Correct response was awarded one mark and incorrect/do not know response as zero. Results: The study participants comprised of 56.2% attendants and 43.8% patients with mean age of 36.78 (±13.05) years; 71.2% were male, 65% resided in rural area and 32.3% subjects were smoker. A statistically ( P = 0.001) higher odds for smoking was found among less educated (odds ratio [OR]: 1.30), rural (OR: 1.60), male (OR: 2.85), patients (OR: 1.41) of more than 30 years of age (OR: 1.67). Nearly, 64.5% and 82.0% subject responded that tobacco causes the heart attack and cancer while obesity was considered as a risk factor by 68.4% (heart attack) and 28.1% (cancer). Nearly, 70.7% and 32.0% reported diet rich in fat/oil and poor in F and V could lead to heart attack but only 23.5% and 25.8% mentioned respectively for cancer. Mean risk factors identified for heart attack were 6.64 ± 2.29 (range: 0-11) while for cancer it was 5.01 ± 2.33 (range: 0-12). Nearly, 670 (40.58%) and 620 (37.55%) subjects mentioned spontaneously at least one type/anatomical site-specific cancer of male and female respectively; 73.4% believed that cancer does not spread by social activity and 54.2% opined that cancer is treatable if detected early. Conclusion: Overall low to moderate level of awareness was noticed for selected risk factors of heart attack but still better than cancer with ample scope for capacity building of stakeholders.

Metabolic Syndrome - A Bomb with Delayed Reaction

Premise: According to the International Diabetes Federation (IDF) consensus worldwide 2013 the metabolic syndrome is a cluster of the most dangerous heart attack risk factors: diabetes and raised fasting plasma glucose, abdominal obesity, high cholesterol and high blood pressure. It is known that about 20-25% of the world population has metabolic syndrome. The risk of dying through complications such as heart attack or stroke is two to three times higher than the general population. Platinum standard definition (IDF) proposed for including metabolic syndrome in addition to other measurements determination of pro-inflammatory status. Objectives: Identifying inflamation and its severity using inflamatory markers: C-reactive protein fibrinogen and leukocytes. Assesment of these markers considering the diversity of metabolic syndrome elements. Material and method: We performed a study that enrolled 152 patients registered to a family physician and diagnosed with metabolic syndrome. The subjects included in study were divided in two groups: group A-78 subjects diagnosed with metabolic syndrome that was defined by 3 elements: abdominal obesity+arterial hypertension+diabetes mellitus; group B-74 patients diagnosed with metabolic syndrome based on 5 elements: abdominal obesity+arterial hypertension+diabetes mellitus+decreased high density lipoprotein+increased triglycerides. We also established a control group-30 healthy people to compare inflammatory markers values. Results: We observed increased values of CRP fibrinogen and leukocytes for group B in comparison to group A: 0.9±0.8 mg/dl vs 0.79 ± 0.8 mg/dl (p=0.02, significantly statistic)Fibrinogen increased in group B significantly in comparison to group A (442,35 versus 365,8 p=0,0006. Leukocytes level was less responsive in patients with metabolic syndrome; leukocytes value was higher for group B, but not significantly statistic. Conclusions: Inflammation in patients with metabolic syndrome depends on the number and association of elements that define this entity, being more accentuated for subjects who associate more elements.

Quantitative proteomics reveals novel therapeutic and diagnostic markers in hypertension

Hypertension is a prevalent disorder in the world representing one of the major risk factors for heart attack and stroke. These risks are increased in salt sensitive individuals. Hypertension and salt sensitivity are complex phenotypes whose pathophysiology remains poorly understood and, remarkably, salt sensitivity is still laborious to diagnose.Here we present a urinary proteomic study specifically designed to identify urinary proteins relevant for the pathogenesis of hypertension and salt sensitivity. Despite previous studies that underlined the association of UMOD gene variants with hypertension, this work provides novel evidence showing different uromodulin protein level in the urine of hypertensive patients compared to healthy individuals. Notably, we also show that patients with higher level of uromodulin are homozygous for UMOD risk variant and display a decreased level of salt excretion, highlighting the essential role of UMOD in the regulation of salt reabsorption in hypertension. Additionally, we found that urinary nephrin 1, a marker of glomerular slit diaphragm, may predict a salt sensitive phenotype and positively correlate with increased albuminuria associated with this type of hypertension.

Watermelon extract for hypertension

One out of every three American adults has hypertension, and by 2030, the prevalence is expected to increase by 7%.1 Uncontrolled hypertension is a major risk factor for heart attack, stroke, chronic heart failure, and kidney disease. Although prescription drugs are effective in treating hypertension, patients may also take supplements such as garlic, calcium, and magnesium.

Exploring metabolic syndrome serum profiling based on gas chromatography mass spectrometry and random forest models

Metabolic syndrome (MetS) is a constellation of the most dangerous heart attack risk factors: diabetes and raised fasting plasma glucose, abdominal obesity, high cholesterol and high blood pressure. Analysis and representation of the variances of metabolic profiles is urgently needed for early diagnosis and treatment of MetS. In current study, we proposed a metabolomics approach for analyzing MetS based on GC–MS profiling and random forest models. The serum samples from healthy controls and MetS patients were characterized by GC–MS. Then, random forest (RF) models were used to visually discriminate the serum changes in MetS based on these GC–MS profiles. Simultaneously, some informative metabolites or potential biomarkers were successfully discovered by means of variable importance ranking in random forest models. The metabolites such as 2-hydroxybutyric acid, inositol and d-glucose, were defined as potential biomarkers to diagnose the MetS. These results obtained by proposed method showed that the combining GC–MS profiling with random forest models was a useful approach to analyze metabolites variances and further screen the potential biomarkers for MetS diagnosis.

Health risk factors and the incidence of hypertension: 4-year prospective findings from a national cohort of 60 569 Thai Open University students

ObjectiveThis study evaluates the impact of a number of demographic, biological, behavioural and lifestyle health risk factors on the incidence of hypertension in Thailand over a 4-year period.DesignA 4-year prospective...

Mining the risk of heart attack: a comprehensive study

This paper attempts to mine important predisposing risk factors of heart attack from a sample of 300 real-world cases, each having 12 predisposing factors. Initially ranking of the factors are made according to the medical doctors. According to the risk level (i.e. mild, moderate, and severe) the sample has been clustered using Divisive Hierarchical Clustering (DHC) techniques with ‘single’, ‘average’, and ‘complete’ linkages. It also observes that High Blood Cholesterol (HBC), Intake of Alcohol (IA), and Passive Smoking (PS) play the most crucial role on ‘severe’, ‘moderate’ and ‘mild’ cardiac risks, respectively, which matches the result of Andrews plot. The study also observes that ‘males’ with age group of 48–60 years (mean age 53.45 years) are more prone to suffer ‘severe’ and ‘moderate’ heart attack risk, while females over 50 years (mean 53.23 years) are affected mostly with ‘mild’ risk.

The influence of selected factors on the risk of myocardial infarction

The most important risk factors for heart attack are considered to be: lifestyle, smoking, high-calorie diet rich in animal fats, physiological and biochemical factors, elevated levels of cholesterol - especially LDL cholesterol, elevated concentration of triglycerides, hyperglycemia or diabetes, increased levels of homocysteine, elevated thrombotic factors. The aim of the study was to analyze the influence of selected factors on the risk of myocardial infarction. The study was conducted among patients with diagnosed coronary artery disease who reported to the family doctor for a check. The effect of selected variables: age, sex, duration of coronary artery disease, smoking, and LDL cholesterol on the risk of myocardial infarction was studied. The results were statistically analyzed. It was found that the incidence of myocardial infarction is higher in men than in women, especially of premenopausal age. In the age group 35-44 years, the risk of the disease in men is almost nine times higher than in women. The risk of heart attack increases with age in both men and women. Among smokers heart attacks are observed significantly more frequently, and the risk of heart attack in this group is more than 2-fold higher than in non-smokers. The longer the duration of coronary artery disease, the risk of myocardial infarction increases. In patients with elevated LDL cholesterol the risk of heart attack is more than 3-fold higher than in those with normal levels.

5-Adenosine Monophosphate-Activated Protein Kinase and the Metabolic Syndrome

Lifestyle changes such as physical inactivity combined with calorie-rich, low-fibre diets have triggered an explosive surge in metabolic syndrome, outlined as a cluster of heart attack risk factors such as insulin resistance, raised fasting plasma glucose, abdominal obesity, high cholesterol and high blood pressure. By acting as a master-switch of energy homeostasis and associated pathophysiological phenomena, 5'-adenosine monophosphate-activated protein kinase (AMPK) appears to orchestrate the adaptive physiology of energy deficit, suggesting that the sedentary modern human could be suffering from chronic suboptimal AMPK activation. Addressing individual targets with potent ligands with high specificity may be inappropriate (it has not yielded any molecule superior to the sixty year old metformin) because this strategy cannot address a cluster of interrelated pathologies. However, spices, dietary supplements and nutraceuticals attenuate the multiple symptoms of metabolic syndrome in a collective and perhaps more holistic fashion with fewer adverse events. Natural selection could have favoured races that developed a taste for spices and dietary supplements, most of which are not only antioxidants but also activators of AMPK. The review will outline the various biochemical mechanisms and pathophysiological consequences of AMPK activation involving the cluster of symptoms that embrace metabolic syndrome and beyond. Recent advances that integrate energy homeostasis with a number of overarching metabolic pathways and physiological phenomena, including inflammatory conditions, cell growth and development, malignancy, life span, and even extending into environmental millieu, as in obesity mediated by gut microflora and others will also be outlined.

Index Event Bias as an Explanation for the Paradoxes of Recurrence Risk Research

Index Event Bias as an Explanation for the Paradoxes of Recurrence Risk Research

Knowledge of heart attack symptoms and risk factors among native Thais: A street‐intercept survey method

This study aimed to determine Thais' knowledge of heart attack symptoms and risk factors and whether that knowledge was related to age, gender or education. Via a street-intercept survey method, a convenience sample of people aged ≥ 35 years (n = 192) was recruited. Mean age was 47 ± 9.6 years (range 35-81), and 55.2% were female. Participants identified on average 5.6 of 9 heart attack symptoms (SD 1.8) and 5.3 of 8 heart attack risk factors (SD 2.1). However, 66.7% mistakenly thought the chest discomfort would be severe, sharp and stabbing, and many subjects erroneously selected symptoms that are actually stroke symptoms. There were no gender or educational differences in knowledge of heart attack symptoms and risk factors. Older adults recognized fewer total symptoms than did younger adults. These findings could direct health-care providers to help the Thai population differentiate symptoms of heart attack from stroke.