Risk Of Cardiovascular Disease Onset Research Articles

Beneficial effects of carvedilol modulating potassium channels on the control of glucose.

The increased prevalence of hypertensive patients with type 2 diabetes mellitus (T2DM) is evident worldwide, leading to a higher risk of cardiovascular disease onset, which is substantially associated with disabilities and mortality in the clinic. In order to achieve the satisfyingly clinical outcomes and prognosis, the comprehensive therapies have been conducted with a beneficial effect on both blood pressure and glucose homeostasis, and clinical trials reveal that some kind of antihypertensive drugs such as angiotensin converting enzyme inhibitors (ACE-I) may, at least in part, meet the dual requirement during the disease management. As a nonselective β-blocker, carvedilol is employed for treating many cardiovascular diseases in clinical practice, including hypertension, angina pectoris and heart failure, and also exhibit the effectiveness for glycemic control and insulin resistance. Apart from alleviating sympathetic nervous system activity, several causes, such as lowering oxygen reactive species, may contribute to the effects of carvedilol on controlling plasma glucose levels, suggesting a feature of this drug having multiple targets. Interestingly, numerous distinct K+ channels expressed in pancreatic β-cells and peripheral insulin-sensitive tissues, which play a sentential role in glucose metabolism, are subjected to extensive modulation of carvdilol, establishing a linkage between K+ channels and drug's effects on the control of glucose. A variety of evidence shows that the impact of carvedilol on different K+ channels, including Kv, KAch, KATP and K2P, can lead to positive influences for glucose homeostasis, contributing to its clinical beneficial effectiveness in treatment of hypertensive patients with T2DM. This review focus on the control of plasma glucose conferred by carvedilol modulation on K+ channels, providing the novel mechanistic explanation for drug's actions.

Relationship of leisure-time and household physical activity level and type with cardiovascular disease: secondary analysis of the Takashima Study data

BackgroundHigh levels of participation in leisure-time and household physical activity lower the risk of cardiovascular disease (CVD), although it is unclear whether the number of activity types is related to new-onset CVD. We aimed to evaluate the effect of the amount of leisure-time physical activity and the number of types of leisure-time physical activities on the risk of CVD incidence.MethodsFrom 2002 to 2003, 3,741 participants without any history of CVD participated in the Takashima Study. Data on the amount of leisure-time and household physical activity and the types of leisure-time and household physical activity were obtained from a self-administered questionnaire. Hazard ratios for CVD (acute myocardial infarction and stroke) incidence (follow-up data from 2002 to 2013), according to the participation level and number of activity types, were calculated using Cox proportional hazards models.ResultsThe mean age of the subjects was 58.7 ± 13.1 years. During the mean follow-up period of 8.0 ± 1.1 years, 92 participants developed CVD. An inverse dose–response relationship was noted between the amount of leisure-time and household physical activity and CVD events. After adjusting for baseline characteristics, lifestyle-related diseases, and the amount of physical activity other than leisure-time and household, the risk of CVD onset was compared by dividing the participants into two groups by the level of participation; the highest activity group had an adjusted hazard ratio (95% confidence interval) of 0.40 (0.20–0.82) compared to the lowest activity group. Compared to participants who engaged in 0–1 type of activity, participants who engaged in two or more types of activities had a multivariable-adjusted hazard ratio (95% confidence interval) of 0.31 (0.12–0.79).ConclusionIncreasing the amount of leisure-time and household physical activity and promoting engagement in two or more types of such activities may reduce the rate of CVD incidence in the Japanese general population.

The Prevalence of Smoking in 41-43-Year-Old Males and its Relation to Some Risk Factors

Aim. To evaluate the prevalence of smoking in 41-43-year-old men living in Moscow and its association with other chronic non-communicable diseases risk factors.Material and methods. People of male sex were prospectively followed up during 32 years since childhood (11-12 years). Only 301 (30%) representatives of 1005 initially enrolled people were examined after 32 years. The examination included: survey by a standard questionnaire (the passport data, the level of physical activity, bad habits – smoking, alcohol consumption); three-time blood pressure measurement; assessment of heart rate; measurement of weight and height, thickness of skin folds (over the triceps, under the scapula and on the abdomen); waist circumference.Results. Almost 50% of 41-44-year-old males smoked every day; less than a third of the study participants had never smoked. Every fifth of the smokers smoked less than 10 cigarettes per day while more than a half of them – a pack and more. The vast majority of the past smokers (85.2%) had stopped smoking at their own will and only very few (1.2%) by doctor’s advice. The intensity of smoking according to the pack/year index was >10 in almost 81.9% of the current smokers. The past smokers had abdominal obesity significantly more often than the non-smokers and the current smokers (57.5% vs 37% and 50.7%, respectively). The current smokers revealed the significantly higher risk of hypertension. The past smokers had 2.5 times higher risk of general obesity and 2.3 times higher one – of abdominal obesity as compared to the non-smokers. The intensity of smoking at the present time correlated with heart rate (HR). The past smokers (who smoked ≥20 cigarettes/day) as compared to the non-smokers had significantly higher HR, the Quetelet index, thickness of skin fold over the triceps and on the abdomen. The currents smokers revealed correlation of the status of smoking with HR, while the past smokers – with such parameters as the Quetelet index, waist circumference, thickness of skin fold under the scapula and over the triceps and no correlation with HR. The current smokers had significantly higher the 10-year risk of death as compared to thepast smokers and the non-smokers. Conclusion. Smoking is one of the most important risk factors of development of chronic non-communicable diseases. The struggle against smoking must be promoted, while close attention should be paid to people who had stopped smoking as a group of risk of cardiovascular disease onset.

AER Is a More Sensitive Predictive Factor than eGFR for CVD in Patients with Type 2 Diabetes—Results from a Perspective Study in Beijing Communities

Objective: The predictive values of AER and eGFR for CVD outcomes in T2DM patients have not been well documented. In this study, the effects of AER and eGFR on outcomes of CVD were analyzed in a population of T2DM patients. Methods: 1914 T2DM patients were enrolled in this 8 -year prospective study in Beijing Communities. The patients’ serum creatinine levels were lower than 176.8μmol/l. The risk of CVD onset was assessed according to CKD staging, which was categorized by urine albumin excretion (AER; mg/d) and estimated GFR (eGFR; ml min −11.73 m−2). The effects of AER and eGFR on risk of cardiovascular disease onset in type 2 diabetes after eight years’ prevention were also analyzed. Results: The mean age and BMI of patients were 66.4 ± 10.1 years and 25.5 ± 3.5 kg/m2, respectively; the duration of diabetes was 5.7 to 17.8 years. The proportion of patients with hypertension and smokers were 71.11% and 16.84%. During the follow-up period (median 6.8 years), 71 CVD events occurred. At baseline, those with AER≥300 mg/d and co-existing eGFR 60-89 ml min −11.73 m−2 or <60 ml min −1/1.73 m−2 showed increased risk for CVD onset when compared with ’no CKD’. No increased risk was observed for patients with AER <30 mg/d and eGFR <60 ml min −11.73 m−2. The increased CVD risk was observed in patients progressed to AER ≥30mg/d during follow-up period, whereas patients who progressed to eGFR <90 ml min −11.73 m−2 alone showed no increased CVD risk. During the follow-up period, 8.7% patients with microalbuminuria (n=166) and 1.8% patients with overt nephropathy (n=34) reversed to normoalbuminuria or microalbuminuria. Conclusions: AER is a more sensitive predictor than eGFR for CVD onset in T2DM patients. DKD, even patients with overt nephropathy can be reversed after multi-factorial intervention in a part of patients. Disclosure X. Zhang: None. S. Yuan: None.

Interleukin-6 Level among Shift and Night Workers in Japan: Cross-Sectional Analysis of the J-HOPE Study.

Aim: Shift workers have a high risk of cardiovascular disease (CVD). Systemic inflammation measured has been associated with the risk of CVD onset, in addition to classical risk factors. However, the association between work schedule and inflammatory cytokine levels remains unclear. The purpose of this study was to examine the association between work schedule and interleukin-6 (IL-6)/high-sensitivity C-reactive protein (hs-CRP) levels among Japanese workers.Methods: The present cross-sectional study was a part of the Japanese Study of Health, Occupation and Psychosocial Factors Related Equity (J-HOPE). A total of 5259 persons who measured inflammatory cytokine were analyzed in this study. One-way analysis of variance was used to test log-transformed IL-6/hs-CRP differences by work schedule. Multiple regression analysis was used to examine the difference adjusted for other possible CVD risk factors.Results: There were 3660 participants who had a regular work schedule; the remaining schedules were shift work without night work for 181 participants, shift work with night work for 1276 participants, and only night work for 142 participants. The unadjusted model showed that only night workers were significantly related to high levels of IL-6 compared with regular workers. Even in the multiple regression analysis, the higher level of IL-6 among only night workers remained significant (β = 0.058, P = 0.01). On the contrary, hs-CRP was not.Conclusion: The present study revealed that only night shift work is significantly associated with high levels of IL-6 in Japanese workers. These observations help us understand the mechanism for the association between work schedule and CVD onset.

Approach to Lipid Screening as a Risk Marker for Cardiovascular Disease in Pediatric Patients with Diabetes

Cardiovascular disease (CVD) is a well-known complication of diabetes mellitus (DM), and patients with DM are at an increased risk for early onset of CVD. Hyperglycemia is believed to be the primary mediator in premature development of atherosclerosis in patients with DM, but there are also derangements in cholesterol levels and inflammatory markers beyond the explanation of hyperglycemia. Although clinicians often screen for dyslipidemia as part of routine care for children and adolescents with DM, many do not feel comfortable treating this condition. Multiple guidelines exist to help clinicians with the prevention, screening, and treatment of CVD risk factors in pediatric patients with DM, but the guidelines do not always agree on screening intervals or medical treatment. Furthermore, the cost-effectiveness of medication use in this population has not been established. Research has advanced our understanding of the role of other biomarkers and radiologic studies of CVD risk, but these studies do not currently have a place in routine clinical practice. It is evident that the increased CVD risk in pediatric patients with DM is complex in origin and the optimal approach to managing dyslipidemia remains unclear. Therefore, an algorithm designed at the University of North Carolina (UNC), Division of Pediatric Endocrinology, is presented to help guide clinicians through screening and treatment of dyslipidemia in youth with DM.