Risk Factor For Cardiovascular Events Research Articles

Increased Tryptophan Catabolism Provides Predictive Value to Chronic Heart Failure Patients with Low-Grade Inflammation.

Kynurenine to tryptophan ratio (KTR), which serves as an indicator for evaluating indoleamine-2,3-dioxygenase activity and inflammation, has been reported to be linked with cardiovascular incidences. However, its correlation with cardiovascular outcomes in patients suffering from heart failure (HF) remains to be explored. The objective of this study was to investigate the prognostic value of KTR in HF. The concentration of tryptophan and kynurenine were quantified by liquid chromatography-tandem mass spectrometry, and the KTR value was calculated in a population of 3150 HF patients. The correlation between plasma KTR levels and the occurrence of adverse cardiovascular events was evaluated for its prognostic value. We also assessed the role of KTR in addition to the classic inflammatory biomarker hypersensitive C-reactive protein (hs-CRP) in different subtypes of HF. We found that increased KTR levels were associated with an elevated risk and severity of the primary endpoints in different subtypes of HF. The simultaneous evaluation of KTR and hs-CRP levels enhanced risk categorization among HF patients. Furthermore, the KTR index presented complementary prognostic value for those HF patients with low-grade inflammation (hs-CRP ≤ 6mg/L). Our results indicated plasma KTR is an independent risk factor for cardiovascular events. Plasma KTR levels in patients with HF can provide both concurrent and complementary prognostic value to hs-CRP.

Visit-to-Visit Systolic Blood Pressure Variability Independently Predicts Cardiovascular Events in a Kidney Transplant Recipients' Cohort.

The predictive role of blood pressure variability for all-cause mortality and fatal and nonfatal cardiovascular events has been described in the general population and in patients with diabetes, independently of mean BP. Although systolic blood pressure variability has been proposed as an informative measure for predicting clinical outcomes in patients with chronic kidney disease, its role in kidney transplant recipients is still debatable. We performed a retrospective, observational, monocentric analysis of all kidney transplant recipients in follow-up at the outpatient Nephrology Clinic of San Martino Hospital from January 1, 2016 to December 31, 2016, who underwent kidney transplantation >12 months. The primary outcome was a fatal or nonfatal cardiovascular event (myocardial infarction, unstable angina, stroke, and hospitalization for heart failure). Visit-to-visit systolic blood pressure variability was expressed as the SD of systolic blood pressure values recorded at baseline and 3 months up to 18 months. Among the 272 patients (mean age, 64±13; 63% men) included in the present analyses, for each increase of 2.7 mm Hg in systolic blood pressure SD, the risk for events increased 3-fold (hazard ratio [HR], 3.1 [95% CI, 1.19-7.88]; P=0.02), and patients in the highest tertile of systolic blood pressure SD showed a 4-fold increased risk (HR, 4.1 [95% CI, 1.34-12.43]; P=0.01). This relationship was maintained even after incremental adjustment for time-averaged pulse pressure, age, diabetes, and prior cardiovascular event (HR, 3.2 [95% CI, 1.1-10.0]; P=0.04). Long-term blood pressure variability represents a risk factor for cardiovascular events in kidney transplant recipients, even independently by several confounding factors including blood pressure load.

Depressive symptoms as risk factors for the onset of home hypertension: a prospective cohort study

Depression is comorbid with somatic diseases; however, the relationship between depressive symptoms and hypertension (HT), a risk factor for cardiovascular events, remains unclear. Home blood pressure (BP) is more reproducible and accurately predictive of cardiovascular diseases than office BP. Therefore, we focused on home BP and investigated whether depressive symptoms contributed to the future onset of home HT. This prospective cohort study used data from the Tohoku Medical Megabank Community-Cohort Study (conducted in the Miyagi Prefecture, Japan) and included participants with home normotension (systolic blood pressure (SBP) < 135 mmHg and diastolic blood pressure (DBP) < 85 mmHg). Depressive symptoms were evaluated using the Center for Epidemiologic Studies Depression Scale-Japanese version at the baseline survey. In the secondary survey, approximately 4 years later, the onset of home HT was evaluated (SBP ≥ 135 mmHg or DBP ≥ 85 mmHg) and was compared in participants with and without depressive symptoms. Of the 3 082 (mean age: 54.2 years; females: 80.9%) participants, 729 (23.7%) had depressive symptoms at the baseline survey. During the 3.5-year follow-up, 124 (17.0%) and 388 (16.5%) participants with and without depressive symptoms, respectively, developed home HT. Multivariable adjusted odds ratios were 1.37 (95% confidence interval (CI): 1.02–1.84), 1.18 (95% CI: 0.86–1.61), and 1.66 (95% CI: 1.17–2.36) for home, morning, and evening HT, respectively. This relationship was consistent in the subgroup analyses according to age, sex, BP pattern, and drinking habit. Depressive symptoms increased the risk of new-onset home HT, particularly evening HT, among individuals with home normotension.This prospective cohort study revealed that depressive symptoms are risk factors for new-onset home hypertension, particularly evening hypertension among individuals with home normotension. Assessing home blood pressure in individuals with depressive symptoms is important for the prevention of hypertension and concomitant cardiovascular diseases.

Assessment of Coronary Involvement with MDCT and Long-term Outcomes in Patients with Takayasu’s Arteritis

Takayasu's arteritis (TA) mainly affects the aorta and its branches involving the coronary arteries. Coronary CT angiography can be used to detect coronary artery lesions. Outcome of TA patients with coronary involvement has not been well established. Our study aimed to systematically analyze coronary lesions in patients with TA and to access long-term outcome in TA patients with coronary involvement. A retrospective cohort study of TA patients with coronary CT angiography was conducted between January 2009 and October 2021. Baseline clinical characteristics, laboratory parameters, imaging features and therapeutic features were collected and analyzed. Follow-up was scheduled since the onset of TA. Overall survival and major adverse cardiovascular events (MACE) were analyzed in patients with coronary lesions. 48(59.3%) TA patients had coronary involvement. Coronary ostial stenosis was detected in 31 (64.6%) patients by MDCT. Prevalence of disease activity (p=0.007) was higher in patients with ostial stenosis. The median follow-up was 10.0 years. Death was observed in ninepatients including seven died from myocardial infarction. TA patients with ostial stenosis had higher rate of MACE (p=0.013). Baseline activity(HR: 5.250, 95%CI 2.004-8.639), ostial involvement(HR:8.954, 95%CI 3.875-56.038), stenosis≥70% (HR: 10.822, 95%CI 2.764-61.230) and activity recurrence (HR:11.913, 95%CI 2.321-85.747) were independently associated with increased major cardiovascular events. MDCT should be performed in patients suspected with coronary involvement to make early diagnosis. Myocardial ischemia is the major cause of longterm death in TA patients with coronary lesions. Baseline disease activity, coronary ostial stenosis, stenosis ≥70% and activity recurrence were independent risk factors of cardiovascular events in TA patients.

Does Dolutegravir-Based Treatment in HIV-Infected Diabetic Individuals Require More Intensive Cardiovascular Health Monitoring: A Point of Concern for Developing Nations

We are all aware that obesity is a growing health problem globally. An estimated 600 million adults are affected with some form of obesity-related metabolic complications worldwide. It increases cardiovascular disease, diabetes mellitus, chronic kidney disease, nonalcoholic fatty liver disease, and cancer in the long run. Human immunodeficiency virus (HIV) infection is a common occurrence throughout the World. Developed countries can access early diagnosis, standardized treatment protocols, and close monitoring. It not only prevents incidences of opportunistic infections but also takes care of non-infective complications. On the contrary, lack of education, awareness, and access to good healthcare facilities are often responsible for delayed diagnosis and advanced disease at presentation. Even those who are initiated on therapy also have persistent modifiable risk factors for cardiovascular events. The Importance of regular exercise, a healthy diet, and tight control of blood sugar, hypertension, and dyslipidemia are often under-practiced and must be stressed.

Effects of a Dietary Supplement Composed of Baicalin, Bromelain and Escin for Venous Chronic Insufficiency Treatment: Insights from a Retrospective Observational Study.

Chronic venous insufficiency (CVI) represents a risk factor for cardiovascular events. The first-line treatment includes the use of compression stockings and lifestyle changes. Natural products, such as flavonoids, could be used to improve the effects of compression therapy due to their anti-inflammatory and anti-oxidant properties. This study aims to evaluate the effects of a dietary supplement containing baicalin, bromeline and escin in CVI patients. A retrospective cohort study was performed by using the medical records of CVI affected outpatients. Patients treated with the dietary supplement were defined as "users". A modified Venous Clinical Severity Score (VCSS) was calculated, including pain, inflammation, vessels induration and skin pigmentation. All clinical variables were evaluated at baseline (T0), after 30 (T1) and 90(T2) days in "users" and "non-users". Out of 62 patients, 30 (48.4%) were "users". No difference was observed between groups at baseline. A lower VCSS value was recorded in "users" than that observed in "non-users" at T2 (7.0 (4.0-9.0) vs. 9.0 (5.0-10.0); p = 0.025). Vessels' induration and pain significantly reduced in 53.3% and 43.3% of "users" and in 18.8% and 9.4% of "non-users". Only "users" (33.3%) showed a reduction of the inflammatory signs as well as a decrease in malleolar circumference, from 29.0 (26.5-30.0) to 27.5 (26.0-28.5) (p < 000.1). A reduction of C-reactive Protein levels was found in "users" compared to "non-users" at T2 (1.0 (0.9-1.2) vs. 1.3 (1.0-1.5); p = 0.006). These findings suggest that implementation of a dietary supplement could improve the clinical outcomes of CVI patients.

Gut microbiota metabolites and risk of major adverse cardiovascular events and death: A systematic review and meta-analysis.

Gut microbial metabolites such as trimethylamine N-oxide (TMAO) and its precursors, namely betaine, L-carnitine, and choline, have been implicated as risk factors for cardiovascular events and mortality development. Therefore, we aim to perform a systematic review and meta-analysis to assess the validity of these associations. MEDLINE and Scopus were queried from their inception to August 2023 to identify studies that quantified estimates of the associations of TMAO with the development of major adverse cardiovascular events (MACE) or death. A random-effects meta-analysis was conducted to pool unadjusted or multivariable-adjusted hazard ratios (HR) and their 95% confidence intervals. The primary endpoint was the risk of MACE and all-cause death. 30 prospective observational studies (n = 48 968) were included in the analysis. Elevated TMAO levels were associated with a significantly greater risk of MACE and all-cause death compared to low TMAO levels (HR: 1.41, 95% CI 1.2-1.54, P < .00001, I2 = 43%) and (HR: 1.55, 95% CI 1.37-1.75, P < .00001, I2 = 46%), respectively. Furthermore, high levels of either L-carnitine or choline were found to significantly increase the risk of MACE. However, no significant difference was seen in MACE in either high or low levels of betaine. Elevated concentrations of TMAO were associated with increased risks of MACE and all-cause mortality. High levels of L-carnitine/choline were also significantly associated with an increased risk of MACE. However, no significant difference was found between high or low levels of betaine for the outcome of MACE.

Lipoprotein Oxidation, Genetic Expression and Polymorphism of Apo A and B Gene in Patients with Coronary Artery Disease in A Pakistani Punjabi Population

Oxidative alterations of lipoproteins and numerous polymorphism locations in the apolipoprotein A1 (APOA1) and B (APOB) genes have been identified as risk factors for cardiovascular events. The aim of the study was to investigate the gene expression and the role of APOA and B gene polymorphisms in coronary artery disease (CAD) and their relationship with lipid profiles, oxidized High Density Lipoprotein (oxHDL), and oxidized Low Density Lipoprotein (oxLDL) in the Punjabi Pakistani population. A total of 200 subjects were included, of which 135 were diagnosed as having CAD and 65 were not. The lipid profile, oxHDL, and oxLDL were measured through the calorimetric method and ELISA, respectively. Quantitative variables represented by mean ± SD for normally distributed data. Gene expression was done on cDNA through Real-time PCR. Genotyping of APOA1 (rs670, rs5069) and APOB (rs693, rs11279109) were performed by PCR-RFLP (Polymerase Chain Reaction-Restriction Fragment Length Polymorphism), and gel electrophoresis was used for band visualization. Our findings showed that the oxHDL, oxLDL, APOA, B gene expression and Del genotype of APOB rs11279109 was significantly increased in CAD cases. In addition, significant high levels of oxHDL, oxLDL, serum cholesterol, VLDL, TG, and cholesterol/HDL ratio has been shown to be associated with CAD. APOB (rs11279109) has a significant impact on dyslipidemia and exhibit a higher risk of CAD (OR=3.97) while, APOB (rs693), APOA1 (rs670), (rs5069) possesses a lower risk of CAD in the population. Hence, levels of oxHDL and oxLDL as well as ApoA1 and APOB genotyping could be useful in identifying individuals who are at risk of CAD.

Correlation of hematocrit and cardiovascular events in peritoneal dialysis patients

Objective: To investigate the correlation between hematocrit (HCT) and cardiovascular events in peritoneal dialysis (PD) patients. Methods: Patients undergoing maintenance PD in the PD center of Guizhou Provincial People's Hospital from March 19, 2012 to July 9, 2020 were included. Demographic, baseline clinical and laboratory data of the patients were collected and patients were followed up until April 8, 2022. The primary endpoint was the first occurrence of a cardiovascular event. According to the tertiles of baseline HCT, the patients were divided into group Q1 (HCT≤26.6%), group Q2 (HCT>26.6%-32.4%), and group Q3 (HCT>32.4%). Laboratory indexes and cardiovascular events were compared among the three groups. Kaplan-Meier survival curve, Cox regression analysis and sensitivity analysis were used to analyze the effect of HCT on cardiovascular outcomes. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of HCT for cardiovascular events in PD patients. Results: A total of 860 PD patients were included, including 494 males (57.4%) and 366 females (42.6%), with a mean age of (41.5±15.0) years. There were 287 cases in group Q1, 289 cases in group Q2, and 284 cases in group Q3, respectively. A total of 265 (30.8%) patients experienced first cardiovascular events during the follow-up period. The incidence of cardiovascular events in groups Q1, Q2 and Q3 was 36.2% (104/287), 34.3% (99/289), and 21.8% (62/284), respectively, with a statistically significant difference (P<0.001). The incidence of cardiovascular events decreased with the increase of HCT. Multivariate Cox proportional hazards regression model analysis showed that decreased HCT was a risk factor for cardiovascular events. Compared with group Q3, the risk of cardiovascular events in group Q1 increased by 50.7% (group Q2: HR=1.444, 95%CI: 1.029-2.028, P=0.034; group Q1: HR=1.570, 95%CI: 1.096-2.250, P=0.014). In the sensitivity analysis, using kidney transplantation as the competition event, the risk of cardiovascular events was lower in group Q3 than that in group Q1 (subdistributional HR=1.413, 95%CI: 1.006-1.990, P=0.046). Kaplan-Meier survival curve showed that compared with the other two groups, the cardiovascular events-free survival rate of patients in group Q1 was significantly lower (log-rank χ2=9.722, P=0.008). ROC analysis showed that the area under the curve (AUC) of HCT for predicting cardiovascular events in PD patients was 0.583 (95%CI: 0.542-0.623, P<0.001), with the sensitivity of 40.6% and the specificity of 75.1%. Conclusion: Low-level HCT is associated with an increased risk of the first cardiovascular event in PD patients.

Healthcare professionals' perspectives on the use of PCSK9 inhibitors in cardiovascular disease: an in-depth qualitative study.

Injectable medicines such as PCSK9 inhibitors are increasingly used to manage risk factors for cardiovascular events with little information around the perceptions of healthcare professionals (HCPs) on the administrative and clinical practicalities. The aim was to identify the facilitators and barriers on the use of injectable therapies with cardiovascular benefits through interviews with HCPs. Qualitative interviews were conducted in the UK (London and Leeds) and Italy (Rome and Milan) in 2021. Coding was undertaken using NVivo and thematic analysis performed. A total of 38 HCPs were interviewed, 19 in each country composing of physicians (n = 18), pharmacists (n = 10), nurses (n = 9), and pharmacy technician (n = 1). Four themes emerged: (i) clinicians' previous experiences with injectable therapies, (ii) challenges with patients' behaviours and beliefs, (iii) clinicians' knowledge of injectable therapies and therapeutic inertia, and (iv) organizational and governance issues. The behaviour and beliefs from HCPs focused on facilitating behaviour change as well as the poor interdisciplinary working and collaboration. Therapeutic inertia was raised where physicians either lacked awareness of injectable therapies or were unwilling to prescribe them. The importance of facilitating patient education on injection techniques was highlighted, while organizational and governance issues identified the lack of guidance to inform practice. Clear pathways are required to identify those who were eligible for injectable therapies as well as on how injectables should be prescribed. If medicine optimization is to be achieved, there need to be structured processes in place to identify eligible patients and the development of educational material.

#2251 Long-term systolic blood pressure variability as an independent risk factor for cardiovascular events in kidney transplant recipients

Abstract Background and Aims Cardiovascular (CV) events represent the main cause of death in patients undergoing renal transplantation. Several studies have described the role of blood pressure variability (BPV) in predicting all-cause mortality and fatal and non-fatal CV events in the general population and in diabetic patients. Systolic blood pressure variability (SBPV) has recently been proposed as a predictor of clinical outcomes in patients with chronic kidney disease. However, evidence is still scarce about the prognostic role of BPV in the setting of renal transplantation. The aim of the study was to evaluate the role of long-term SBPV in the development of fatal and non-fatal CV events (myocardial infarction, unstable angina or revascularization, stroke and hospitalization for heart failure) in subjects undergoing kidney transplantation. Method We performed a single-center retrospective observational analysis in a cohort of 272 kidney transplant patients (mean age 64 ± 13 years, 66% men), with a transplant duration ≥12 months and with at least 6 blood pressure measurements at defined intervals (3 months ±15 days) over an assessment period of 18 months. BPV was expressed as standard deviation of ambulatory systolic blood pressure (SBP) and patients were accordingly classified in tertiles (low &amp;lt;9.3 mmHg, medium 9.3-13 mmHg, high &amp;gt;13 mmHg). The role of SBPV was analyzed by Kaplan-Meier (logrank) and its independent effect by Cox Regression. Results Over a mean follow-up of 58.7 ± 17.2 months, 27 subjects (9.9%) developed CV events. For each increase of 2.7 mmHg in SBP standard deviation, the risk for fatal or non-fatal CV events increased almost 3-folds (P = 0.02) and patients in the highest tertile of SBP standard deviation showed a 4-fold increased risk (P = 0.01) (Fig. 1). This relationship was maintained even after incremental adjustment for time-averaged pulse pressure, age, diabetes, prior CV event, and dialysis vintage (HR 3.2, 95% CI 1.1–10.0, p 0.04) (Table 1). Conclusion Long-term BPV represents an independent risk factor for CV events in kidney transplant patients. It is therefore essential to seek for stable long-term blood pressure levels in this population in order to minimize the residual CV risk.

Osteocalcin: A Potential Marker of Peripheral Arterial Stiffness in Hypertensive Patients.

Background and Objectives: Brachial-ankle pulse wave velocity (baPWV) is an established independent risk factor for cardiovascular events, cardiovascular mortality, and all-cause mortality. Osteocalcin (OC) is recognized to be associated with vascular function. The present study assessed the correlation between serum OC levels and peripheral arterial stiffness (PAS) measured through baPWV in hypertensive patients. Materials and Methods: Fasting blood samples were collected from 120 hypertensive participants. The serum total OC levels were measured using a commercial enzyme-linked immunosorbent assay kit, whereas the baPWV device was used to detect PAS. The PAS group had left or right baPWV > 18.0 m/s. Results: Among the hypertensive patients, 24 (20.0%) were classified into the PAS group. The PAS group exhibited a significantly older age (p = 0.011), higher prevalence of diabetes (p = 0.010), systolic blood pressure (p = 0.019), levels of serum fasting glucose (p = 0.003), blood urea nitrogen (p = 0.024), creatinine (p = 0.004), C-reactive protein (p = 0.007), OC (p = 0.002), and lower estimated glomerular filtration rate (p = 0.004) than the non-PAS group. Age (odds ratio [OR]: 1.076, 95% CI: 1.004-1.153, p = 0.037) and serum OC level (OR: 1.797, 95% confidence interval (CI): 1.077-3.000, p = 0.025) were independent factors linked to PAS in hypertensive patients in the multivariate logistic regression analysis. Conclusions: Serum OC levels and older age are positively associated with PAS in hypertensive patients.

Additive association of blood pressure and short stature with stroke incidence in 450,000 Japanese adults: the Shizuoka study.

Short stature was suggested to be a risk factor for cardiovascular events. Because short stature increases central blood pressure, this study aimed to investigate a longitudinal association between short stature, blood pressure, and incidence of cardiovascular disease by the analysis of insurance-based real-world dataset. We analyzed data from 463,844 adults aged 40 or older with a mean age of 66.7 enrolled in National Health Insurance, excluding individuals who experienced a stroke or myocardial infarction, or required long-term care. Data from annual health checkups were used to obtain baseline clinical information. Comorbidities and incidences of stroke and myocardial infarction were obtained from the insurance data. During a 5.5-year follow-up period, we observed 11,027 cases of stroke. Adults of a short stature exhibited a higher incidence rate in both men (≤155 cm: 99.7, >175 cm: 24.4) and women (≤140 cm: 85.9, >160 cm: 13.7). Although those in the short stature group had higher blood pressure, and often took antihypertensive drugs, the inverse association between height and stroke incidence was independent of these factors (hazard ratio for 5 cm shorter in height; men: 1.06 [1.03-1.09], women: 1.11 [1.06-1.13]). Short stature and blood pressure showed additive association with stoke incidence (log-rank p < 0.001). No significant association was observed with myocardial infarction (men: 1.01 [0.95-1.06], women: 1.06 [0.98-1.14]). In a longitudinal analysis of a large general Japanese population, short stature was linked to an increased risk of stroke in both genders in any blood pressure range.

(198) MID-TERM DETERIORATION OF ENDOTHELIAL FUNCTION AND METABOLIC PARAMETERS FOLLOWING ONE-YEAR ANDROGEN DEPRIVATION THERAPY IN MEN WITH PROSTATE CANCER

Abstract Introduction Androgen deprivation therapy (ADT) is a standard treatment for advanced prostate cancer. Although ADT delays cancer progression and alleviates cancer-related symptoms, this treatment is related to metabolic derangement and increase of cardiovascular risk. Despite the well-established association between the levels of circulating testosterone and endothelial integrity, the short to mid-term effects of ADT on vascular endothelial function are not completely understood. Objective Our aim was to evaluate the impact on endothelial function after one year of ADT, through the analysis of vascular parameters of the brachial artery, and the measurement of serum inflammatory markers. We also investigated the effects of this treatment on body composition and metabolic parameters. Methods We prospectively evaluated men with moderate to high-risk prostate cancer treated with ADT from January 2022 to January 2024 at our institution. Smokers and those who stopped smoking less than five years ago, decompensated diabetics (glycated hemoglobin &amp;gt;9%) and those who had already had a cardiovascular event were excluded. Ultrasound was used to assess vascular diameter and flow-mediated (FMD) endothelium-dependent brachial artery vasodilation. Metabolic and inflammatory profile included serum measurement of total cholesterol and fractions, triglycerides, fasting glucose, glycated hemoglobin, basal insulin, C-reactive protein, and bioelectrical impedance assessment of body fat distribution. Individuals were evaluated prior to ADT with goserelin acetate 10.80 mg and after 3 and 12 months of therapy, for those who remained on ADT for this entire timeframe. Difference between groups was analyzed using anova test. Results 32 men were evaluated in two visits (baseline and 3 months). From the initial group of patients, 18 men were also evaluated in a third visit (12 months). The mean age was 69 years and prevalence of diabetes was 31,25%. There was no significant change in FMD after 12 months of ADT (p = 0.25). The baseline diameter of the brachial artery demonstrated significant worsening after one year of ADT (p = 0.004) (Fig. 1). With regard to the metabolic profile, ADT significantly increased insulin resistance: fasting insulin levels (p = 0.03) and homeostatic model assessment insulin resistance (p = 0.04) increased significantly after 12 months. Total cholesterol and triglyceride concentrations were higher after 12 months of ADT (p = 0.04 and p = 0.03, respectively) (Fig. 2). There was a significant decrease in HDL after 12 months of treatment (p &amp;lt; 0.0001). Abdominal circumference, weight and body fat percentage increased significantly after ADT (p = 0.01; p &amp;lt; 0.0001; p = 0.006; respectively). After one year, there was a significant increase in blood pressure, both systolic (p = 0.02) and diastolic (p = 0.003). Conclusions Although the present study did not demonstrate a significant change in brachial artery FMD, we found a significant worsening of blood pressure, arterial diameter and metabolic profile with ADT, especially an increase in insulin resistance, dyslipidemia and abdominal circumference, which represent well-established risk factors for cardiovascular events. Disclosure No.

A Prospective Cross‐Sectional Study: Fatty Liver Is A Risk Factor For Cardiovascular Events

A Prospective Cross‐Sectional Study: Fatty Liver Is A Risk Factor For Cardiovascular Events

Salt Sensitivity of Blood Pressure.

The year 2024 marks the centennial of the initiation of the American Heart Association. Over the past 100 years, the American Heart Association has led groundbreaking discoveries in cardiovascular disease including salt sensitivity of blood pressure, which has been studied since the mid-1900s. Salt sensitivity of blood pressure is an important risk factor for cardiovascular events, but the phenotype remains unclear because of insufficient understanding of the underlying mechanisms and lack of feasible diagnostic tools. In honor of this centennial, we commemorate the initial discovery of salt sensitivity of blood pressure and chronicle the subsequent scientific discoveries and efforts to mitigate salt-induced cardiovascular disease with American Heart Association leading the way. We also highlight determinants of the pathophysiology of salt sensitivity of blood pressure in humans and recent developments in diagnostic methods and future prospects.

The association of siMS and siMS risk scores with risk factors for cardiovascular events in university students with metabolic syndrome

The association of siMS and siMS risk scores with risk factors for cardiovascular events in university students with metabolic syndrome

Effects of At-Risk Drinking on Ambulatory Blood Pressure in Young Adults

Introduction: At-risk drinking is associated with an increased risk of cardiovascular diseases (CVD) even in young adults. However, this association is mainly based on offce blood pressure (BP) measurement. Ambulatory BP monitoring captures diurnal variation in BP and is a more sensitive CVD predictor than offce BP. Therefore, the purpose of this study is to investigate the effects of at-risk drinking on ambulatory BP in young healthy adults with normal offce BP. Method: A total of 20 healthy men and women (21-35 years), non-smokers, were included in this cross-sectional study. All participants had an offce BP lower than 130/80 mmHg. Using the US Alcohol Use Disorders Identification Test (USAUDIT), at-risk drinkers were defined as those having a total USAUDIT score higher than 7 for men (6 for women). All participants underwent 24-hour ambulatory BP monitoring (Oscar 2™, SunTech Medical®). To investigate the vascular mechanisms underlying the effects of at-risk drinking on ambulatory blood pressure, aortic arterial stiffness and wave reflection were measured as pulse wave velocity (PWV) and augmentation index (AIx) by using SphygmoCor XCEL system (AtCor Medical). Results: No differences were found in age and BMI between at-risk drinkers (n=10) vs. low-risk drinkers (n=10; mean ± SD for age: 26.7 ± 3.7 vs. 26.6 ± 4.3 years, P&gt;0.99 and BMI: 24.5 ± 2.4 vs. 23.8 ± 2.9 kg/m2, P=0.6). At-risk drinkers had a higher total USAUDIT score (10.6 ± 2.7 vs. 1.4 ± 1.2, p&lt;0.001). While there was no difference between at-risk drinkers and low-risk drinkers in 24-hour, daytime, and nighttime systolic and diastolic BP (P≥0.5), at-risk drinkers had a higher blood pressure morning surge compared to low-risk drinkers (systolic: 34 ± 10 vs. 22 ± 6 mmHg, P=0.014 and diastolic: 29 ± 9 vs. 15 ± 4 mmHg, P=0.002). No significant difference was found in PWV (5.7 ± 0.6 Vs. 5.5 ± 0.7 m/sec, P=0.4) and AIx (8 ± 8 Vs. 15 ± 11, P=0.1). Conclusion: Our results indicate that despite similar offce BP, young adult at-risk drinkers had higher BP morning surge, an independent risk factor for cardiovascular events, than low-risk drinkers. These findings provide implications in using USAUDIT and out-of-offce BP measurements for cardiovascular disease risk assessment. This work was supported by NIAAA AA028537 to CLH. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

COMPARISON OF CENTRAL SYSTOLIC BLOOD PRESSURE (CSBP) ESTIMATED BY DIRECT CENTRAL BLOOD PRESSURE (DCBP) FORMULA AND RADIAL TONOMETRY BY SPIGMOCOR: AN INVASIVE VALIDATION STUDY

Objective: Background: Arterial hypertension (AH) is the main risk factor for cardiovascular events for western populations. Blood pressure (BP) is usually measured at brachial artery level, but current evidence suggest that central blood pressure (cBP) could have a greater prognostic role. Recent studies showed that central Systolic BP (cSBP) can be reliably estimated by Direct Central Blood Pressure formula (DCBP = MBP2/DBP) using mean (MBP) and diastolic (DBP) blood pressure measured at brachial level. Aim: this study seeks to compare cSBP calculated using DCBP with cSBP estimated by radial tonometry (cSBPpwa) in comparison to SBP invasively measured (invSBP). Design and method: Methods: Consecutive patients who underwent invasive catheterization of the aorta and coronary arteries for clinical reasons were included. Using applanation tonometry with SphygmoCor device, cSBP was estimated by a generalized transfer function derived from radial pressure waveform calibrated to brachial SBP and DBP evaluated by oscillometric approach. Results: Results: We included 50 patients (66 ± 9.1 years, 74% men). The mean invSBP, cSBPpwa and DCBP were 140 ± 19.6, 134 ± 17.8 and 131 ± 16.7 mmHg respectively. The (DCBP-cSBPpwa) and (DCBP-invSBP) errors were -3.0 ± 11.9 and -9.6 ± 14.3 mmHg respectively. There was a linear relationship between invSBP and cSBPpwa, and invSBP and DCBP (R2 = 0. 783 and 0.490 respectively, p &lt; 0.001). 35 patients (70%) had invSBP values &gt; 130 mmHg: a cSBPpwa value of 129 and a DCBP value of 125.6 mmHg exhibited a sensitivity and a specificity of 13.3 and 22.9%, and 26.7 and 25.6% respectively in discriminating this threshold (Youden index = -0.638 and – 0.47; AUC 0.048 and 0.170 respectively). Conclusions: Conclusions: The DCBP formula allows for the estimation of invSBP worse than radial tonometry generalized transfer function, but better describing the risk of high central blood pressure values.

ARTERIAL HYPERTENSION PROFILE IN PATIENTS WITH KIDNEY DISEASES

Objective: Arterial hypertension is a global public health worldwide. It is a risk factor for cardiovascular events which represent major cause of morbidity and mortality as it contributes to the development and progression of kidney diseases. The aim of the study was to investigate the profile of arterial hypertension in patients with kidney diseases. Design and method: It is a prospective study that entails young hypertensive patients aged between 18 and 65 years old in the course of six months from 1st January 2022 to June 30th 2022 within the nephrology department in which we assessed an array of parameters. Results: Hypertension prevalence represented 75% (81 patients) among 107 hospitalized patients with a male predominance of 59%, a sex ratio of 1.45 and was widespread among patients aged from 55-65 years old. The mean age of our patients was 48.98±14.066 years. History of hypertension was observed in 85,2% followed by diabetes in 40,7%. 14,8% among hypertensives were newly detected. The main cardiovascular risk factors were diabetes (65%), obesity (15%) and sedentary lifestyle (11%). Systolo-diastolic hypertension was present in 57% whereas grade 2 hypertension affected 30% of patients aged from 18 to 34 years old. Our patients presented left ventricular hypertrophy in 19,61% of the cases while 80% manifested renal failure which was chronic in 50% of the patients. 58% of the patients were on monotherapy, followed by dual (35%) and triple therapy (7%). The most prescribed treatment was either calcium channel blockers in monotherapy or combined with angiotensin receptor blockers/angiotensin-converting enzyme inhibitors inhibitor in dual therapy or with angiotensin-converting enzyme inhibitors + diuretic/beta-blocker in triple therapy. Control rate was 54.3%, majorly, observed among women and patients who belong to the 55- 65 years old age category. Conclusions: In order to reduce the hypertension prevalence and prevent the occurrence of its renal complications. The application of an intensive management of hypertension as well as the cardiovascular risk factors should be integrated into primary care systems. Beside treatment, lifestyle modifications should be implemented in the first line as they exert blood pressure lowering effects additionally to therapeutic treatment.