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INTRODUCTION: The association of APOL1 risk variants with cardiovascular risk and cardiovascular disease (CVD) in observational and clinical trials has had inconsistent results. We aim to assess the relationship between the presence of APOL1 risk variants and the CVD risk in Afro-descendant patients with end-stage renal disease (ESRD). METHODS: We performed an observational, cross-sectional study of Afro-descendant adult patients with ESRD who were on the waitlist for a kidney transplant. Associations of APOL1 genotypes (high-risk [HR] = 2 alleles; low-risk [LR] = 0 or 1 allele) with cardiovascular risk were the primary clinical endpoint. The relation was evaluated using univariate and multivariate analysis. RESULTS: We enrolled a total of 102 patients with ESRD; 37% (38 patients) had APOL1 HR status with two alleles in homozygous (G1/G1 = 21 and G2/G2 = 3) or compound heterozygote (G1/G2 = 14) form and 63% (64 patients) had APOL1 LR status. No significant association was found between HR APOL1 genotypes and high cardiovascular risk (in adjusted Colombia Framingham Risk Score). APOL1 HR versus LR variants were not independently associated with left ventricular hypertrophy or systolic dysfunction. No cardiovascular deaths occurred during the follow-up. CONCLUSION: In Afro-descendent patients with ESRD, APOL1 HR status is not associated with the increase in cardiovascular risk profile and metabolic disturbances.
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Apolipoproteína L1 , Doenças Cardiovasculares , Falência Renal Crônica , Adulto , Humanos , Apolipoproteína L1/genética , Doenças Cardiovasculares/genética , Estudos Transversais , Predisposição Genética para Doença , Genótipo , Falência Renal Crônica/genética , Fatores de Risco , População NegraRESUMO
BACKGROUND: Patients with diabetes mellitus (DM) have cardiovascular diseases (CVD) as a major cause of mortality and morbidity. The primary purpose of this study was to assess the echocardiographic parameters that showed alterations in patients with type 2 diabetes mellitus(T2DM) with suggestive coronary artery disease (CAD) determined by electrocardiography and the secondary was to assess the relationship of these alterations with established cardiovascular risk factors. METHODS: This cross-sectional, observational pilot study included 152 consecutive patients with T2DM who attended a tertiary DM outpatient care center. All patients underwent clinical examination and history, anthropometric measurements, demographic survey, determination of the Framingham global risk score, laboratory evaluation, basal electrocardiogram, echocardiogram, and measurement of carotid intima-media thickness (CIMT). RESULTS: From the overall sample, 134 (88.1%) patients underwent an electrocardiogram. They were divided into two groups: patients with electrocardiograms suggestive of CAD (n = 11 [8.2%]) and those with normal or non-ischemic alterations on electrocardiogram (n = 123 [91.79%]). In the hierarchical multivariable logistic model examining all selected independent factors that entered into the model, sex, high triglycerides levels, and presence of diabetic retinopathy were associated with CAD in the final model. No echocardiographic parameters were significant in multivariate analysis. The level of serum triglycerides (threshold) related to an increased risk of CAD was ≥ 184.5 mg/dl (AUC = 0.70, 95% IC [0.51-0.890]; p = 0.026. CONCLUSION: Our pilot study demonstrated that no echocardiogram parameters could predict or determine CAD. The combination of CIMT and Framingham risk score is ideal to determine risk factors in asymptomatic patients with T2DM. Patients with diabetic retinopathy and hypertriglyceridemia need further investigation for CAD. Further prospective studies with larger sample sizes are needed to confirm our results.
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Introdução: A síndrome metabólica é um conjunto de desordens metabólicas, consideradas fatores de risco cardiovascular. Estima-se que indivíduos com síndrome metabólica apresentam probabilidade três vezes maior de desenvolver doenças cardiovasculares. O status inadequado de vitamina D tem apresentado múltiplos mecanismos fisiopatológicos que sugerem um envolvimento no desenvolvimento de doenças cardiovasculares. Objetivo: avaliar a associação entre o status de vitamina D e o risco de doenças cardiovasculares em indivíduos com síndrome metabólica. Métodos: Estudo do tipo transversal realizado com 161 indivíduos adultos, diagnosticados com síndrome metabólica. Foram realizadas as medidas antropométricas, pressão arterial, e as análises bioquímicas, incluindo a dosagem de 25(OH)D no soro. O critério estabelecido para classificação do status de 25(OH)D foi deficiente < 20 ng/mL; insuficiente≤ 29 ng/mL e suficiente ≥ 30 ng/mL. Ademais, avaliou-se o risco absoluto de desenvolver doenças cardiovasculares usando o Escore de Risco de Framingham. Resultados: A mediana da concentração de 25(OH)D foi 29,7 (21-34) ng/mL, indicando status de 25(OH)D insuficiente na população. Não houve associação entre status de vitamina D e o risco cardiovascular em indivíduos com síndrome metabólica (p > 0,05). Conclusão: Não se observou associação entre status 25(OH)D inadequado e maior risco cardiovascular nos indivíduos com síndrome metabólica. Entretanto,esses resultados reforçam a importância do monitoramento clínico para prevenir os impactos da hipovitaminose D nos indivíduos com síndrome metabólica e o desenvolvimento de novos estudos para avaliar a relação entre status de 25(OH)D e risco cardiovascular.
Introduction: Metabolic syndrome is a set of metabolic disorders that are considered cardiovascular risk factors. It is estimated that individuals with metabolic syndrome are three times more likely to develop cardiovascular disease. Inadequate vitamin D status has shown multiple pathophysiological mechanisms that suggest an involvement in the development of cardiovascular disease. Objective: To evaluate the association between vitamin D status and the risk of cardiovascular disease in individuals with metabolic syndrome. Methods: This is a cross-sectional study carried out with 161 adult individuals diagnosed with metabolic syndrome. Anthropometric measurements, blood pressure, and biochemical analyzes were performed, including serum 25(OH)D status. The established criterion for classifying 25(OH)D status was deficient < 20 ng/mL; insufficient ≤ 29 ng/mL and sufficient ≥ 30 ng/mL. Furthermore, the absolute risk of developing cardiovascular disease was assessed using the Framingham Risk Score. Results: The mean 25(OH)D concentration was 29.7 (21-34) ng/mL, indicating insufficient 25(OH)D status in the population. There was no association between vitamin D status and cardiovascular risk in subjects with metabolic syndrome (p > 0.05). Conclusion: There was no association between inadequate 25(OH)D status and increased cardiovascular risk in individuals with metabolic syndrome. However, these results reinforce the importance of clinical monitoring to prevent the impacts of hypovitaminosis D in individuals with metabolic syndrome and the development of new studies to assess the relationship between 25(OH)D status and cardiovascular risk.
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Deficiência de Vitamina D , Síndrome Metabólica , Fatores de Risco de Doenças Cardíacas , Estudos TransversaisRESUMO
A maioria dos indivíduos com diabetes mellitus também apresenta obesidade, hipertensão arterial sistêmica (HAS) e dislipidemia. Por esse motivo, preconiza-se a Estratificação de Risco de Framingham (ERF), de modo a identificar o risco de desenvolvimento de doenças cardiovasculares (DCV) em dez anos. Este estudo analisa a prevalência de diabetes mellitus para determinar o risco cardiovascular pelo ERF na Estratégia de Saúde da Família (ESF), visando um cuidado integral para a prevenção de DCV. Trata-se de uma pesquisa de corte transversal com população (n = 746) dividida em 150 indivíduos diabéticos (apenas quatro do tipo 1) e 596 não diabéticos a partir de 3.325 prontuários. Foi identificado 57,9% (n = 432) de indivíduos com baixo risco (ERF < 10%); 24,7% (n = 185) em médio risco (ERF 10-20%), e 17,2% (n = 129) em alto risco (ERF > 20%). Os diabéticos de baixo risco representam 23,3% (n = 35/150); 36,6% (n = 55/150) com médio risco e 40% (n = 60/150) com alto risco. Os grupos são significativamente distintos entre si quanto ao ERF (P < 0, 0001) ao comparar os subgrupos de risco (baixo, médio, alto), assim como as taxas de glicemia (P < 0,0001). A prevalência de médio e alto risco aumenta a partir dos 48 anos de idade; o sexo feminino prevalece em todos os níveis de risco e faixas etárias. O risco cardiovascular para diabéticos é 2,5 vezes maior; há impacto aumentado se concomitante com hipertensão, tabagismo, obesidade, sedentarismo e etilismo. O panorama do risco cardiovascular, determinado pelo ERF, é relevante para o uso clínico pela equipe de saúde básica ao lidar com pacientes diabéticos.
Most individuals with diabetes mellitus also present obesity, hypertension and dyslipidemia. Hence, the Framingham Risk Stratification (ERF) is recommended to identify the risk of developing cardiovascular diseases (CVD) in 10 years. This study analyzes the prevalence of diabetes mellitus to determine cardiovascular risk using the ERF in the Family Health Strategy, aiming at comprehensive care for CVD prevention. Cross-sectional research was conducted with 746 patients divided into 150 diabetic individuals (only four with type 1) and 596 non-diabetic individuals, identified from 3,325 medical records. Of the total, 57.9% (n = 432) were low-risk individuals (ERF < 10%), 24.7% (n = 185) medium risk (ERF 10-20%), and 17.2% (n = 129) high risk (ERF > 20%). Among diabetics, 23.3% (n = 35/150) were at low risk, 36.6% (n = 55/150) at medium risk, and 40% (n = 60/150) at high risk. The groups are significantly different regarding ERF (P < 0.0001), and when comparing risk subgroups (low, medium, high) and blood glucose rates (P < 0.0001). The prevalence of medium and high risk increases from 48 years of age. Women prevails at all risk levels and age groups. Diabetics have a 2.5 times higher cardiovascular risk, presenting an increased impact if concomitant with hypertension, smoking, obesity, sedentary lifestyle, and alcoholism. The panorama of cardiovascular risk determined by the ERF is relevant for clinical use by primary care staff when treating diabetic patients.
La mayoría de las personas que padecen diabetes mellitus también tiene obesidad, hipertensión arterial sistémica (HAS) y dislipidemia. Por este motivo, se recomienda la Estratificación de Riesgo de Framingham (ERF) para identificar el riesgo de desarrollar enfermedades cardiovasculares (ECV) en 10 años. Este estudio busca analizar la prevalencia de la diabetes mellitus para determinar el riesgo cardiovascular utilizando la ERF en la Estrategia de Salud Familiar, con el objetivo de proporcionar una atención integral para la prevención de las ECV. Este es un estudio de corte transversal con una población (n = 746) dividida en 150 individuos diabéticos (solo 4 de tipo 1) y 596 individuos no diabéticos desde 3.325 historias clínicas. Se identificaron un 57,9% (n = 432) de individuos de bajo riesgo (ERF <10%); el 24,7% (n = 185) de riesgo medio (ERF 10-20%) y el 17,2% (n = 129) de alto riesgo (ERF > 20%). Los diabéticos de bajo riesgo constituyen el 23,3% (n = 35/150); con riesgo medio el 36,6% (n = 55/150) y con riesgo alto el 40% (n = 60/150). Los grupos son significativamente diferentes entre sí con respecto a la ERF (P < 0,0001) al comparar subgrupos de riesgo (bajo, medio, alto) y las tasas de glucosa en sangre (P < 0,0001). La prevalencia de riesgo medio y alto aumenta a partir de los 48 años; el género femenino predomina en todos los niveles de riesgo y grupos de edad. El riesgo cardiovascular para los diabéticos es 2,5 veces mayor; hay un mayor impacto si es concomitante con hipertensión, tabaquismo, obesidad, inactividad física y alcoholismo. El panorama de riesgo cardiovascular, determinado por la ERF, es relevante para el uso clínico por parte del equipo básico de salud cuando se trata de pacientes diabéticos.
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Atenção Primária à Saúde , Doenças Cardiovasculares , Fatores de Risco , Diabetes Mellitus , Prevenção de Doenças , ObesidadeRESUMO
Background and Aims: Cardiovascular diseases (CVDs) are the leading cause of death globally and in Brazil. Evidence suggests that the risk of CVDs differs by race/ethnicity. Scarce information exists about the association between CVD risk, obesity indicators and sociodemographic characteristics in the Brazilian population. Objectives: We aimed to assess the CVD risk following the Framingham risk score in relation to the population's sociodemographic profile. Further, we examined the association between anthropometric markers and risk of CVDs. Methods: A total of 701 subjects aged ≥20 years from North-eastern Brazil were recruited randomly to participate in a population-based, cross-sectional survey. Age-adjusted data for CVD risk, sociodemographic characteristics, and anthropometric indices were assessed, and their relationships examined. Results: High CVD risk (Framingham risk score ≥10%) was observed in 18.9% of the population. Males (31.9 vs. 12.5%) and older subjects (age ≥45 years: 68.9% vs. age <45 years: 4.2%) had significantly higher risk of CVDs, whereas those employed in manual labor showed lower risk (7.6 vs. 21.7%). Central obesity measures like waist-to-hip ratio and waist-to-height ratio were more strongly associated with predicted CVD risk than body mass index. Conclusions: Our population had a high risk of CVDs using the Framingham risk score. Cost-effective strategies for screening, prevention and treatment of CVDs may likely reduce disease burden and health expenditure in Brazil. Central obesity measures were strongly associated with predicted CVD risk and might be useful in the clinical assessment of patients. Follow-up studies are warranted to validate our findings.
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Doenças Cardiovasculares , Adulto , Brasil/epidemiologia , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Estudos Transversais , Fatores de Risco de Doenças Cardíacas , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Fatores de Risco , Adulto JovemRESUMO
Since the introduction of episodic and prophylactic treatments with safer factor concentrates, the life expectancy of people with haemophilia (PwH) has improved considerably. Ageing-related diseases such as cardiovascular disease (CVD) have also become more prevalent in PwH. This cross-sectional study aimed to evaluate CVD risk factors and estimate 10-year risk for CVD events among PwH. Male patients ≥ 30 years were interviewed and examined. Blood tests were performed at the local laboratory. Eighty-two patients were included, of whom 83% had haemophilia A and half had severe disease. Median age at study entry was 43.0 years (interquartile range [IQR], 36.0-51.3). Prevalence of obesity, systemic arterial hypertension (SAH) and diabetes mellitus were 16%, 60% and 16%, respectively. Hypertriglyceridaemia, hypercholesterolaemia and low HDL blood levels were present in 18%, 41% and 30% of patients, respectively. Metabolic syndrome was found in 37%. The Framingham Risk Score showed that 39% of PwH had a high risk of developing cardiovascular events in the following 10 years. We conclude that, in this cohort, PwH have a higher prevalence of SAH when compared with Brazilian men without haemophilia and about two-fifths have a high risk of developing a CVD event in the following 10 years.
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Doenças Cardiovasculares , Hemofilia A , Adulto , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/fisiopatologia , Estudos Transversais , Feminino , Hemofilia A/sangue , Hemofilia A/complicações , Hemofilia A/epidemiologia , Hemofilia A/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de RiscoRESUMO
INTRODUCTION AND OBJECTIVES: Primary biliary cholangitis (PBC) is a chronic cholestatic autoimmune disease that disrupts the cholesterol metabolism. Our aim was to investigate the frequency of dyslipidemias and to evaluate the risk of cardiovascular events in a historic cohort of patients with PBC. PATIENTS: All patients attended from 2000 to 2009 with histological diagnosis of PBC were included and were compared with healthy controls. The 10-year cardiovascular risk was estimated by the Framingham risk score. RESULTS: Fifty four patients with PBC were included and compared to 106 controls. Differences in total cholesterol (263.8±123.9mg/dl vs. 199.6±40, p=0.0001), LDL-cholesterol (179.3±114.8 vs. 126.8±34.7, p=0.0001), HDL-cholesterol (62.4±36.2mg/dl vs. 47.3±12.3, p=0.0001) and triglycerides (149.1±59.1mg/dl vs. 126.4±55.4, p=0.001) were found. Hypercholesterolemia (>240mg/dl) was found in 52.4% of the patients with PBC vs. 11% in the control group, high LDL-cholesterol (160-189mg/dl) in 45.2% of the patients with PBC vs. 10% in controls and hyperalphalipoproteinemia (HDL-cholesterol >60mg/dl) in 45.2% of the patients with PBC vs. 16% in controls. The 10-year cardiovascular risk was 5.3%±5.9 in the patients with PBC and 4.1%±5.7 in the control group (p=0.723, IC 95%=0.637-1.104). Only one cardiovascular event (stroke) in a patient with PBC was registered in a mean follow up time of 57.9±36.5 months. CONCLUSIONS: Marked derangements in serum lipids and a high frequency of dyslipidemias are found in patients with PBC, however, these do not increase the risk of cardiovascular events.
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HDL-Colesterol/sangue , LDL-Colesterol/sangue , Dislipidemias/sangue , Cirrose Hepática Biliar/sangue , Triglicerídeos/sangue , Adulto , Fatores Etários , Idoso , Pressão Arterial , Doenças Cardiovasculares/epidemiologia , Estudos de Casos e Controles , Diabetes Mellitus/epidemiologia , Dislipidemias/epidemiologia , Feminino , Humanos , Hipercolesterolemia/sangue , Hipercolesterolemia/epidemiologia , Hiperlipoproteinemias/sangue , Hiperlipoproteinemias/epidemiologia , Cirrose Hepática Biliar/epidemiologia , Masculino , Pessoa de Meia-Idade , Medição de Risco , Fatores Sexuais , Fumar/epidemiologia , Acidente Vascular Cerebral/epidemiologiaRESUMO
An appropriate and precise identification of high-risk individuals to develop cardiovascular diseases (CVD) is of high importance to reduce these kinds of diseases, a major health concern worldwide. Therefore, the aim of this research was to evaluate prognostic CVD biomarkers in Mexican women exposed to inorganic arsenic via drinking water. Then, a cross-sectional study including 190 women was achieved. Urinary arsenic (UAs) levels were analyzed as exposure biomarker to that metalloid. While, plasma asymmetric dimethylarginine (ADMA), adipocyte fatty acid-binding protein (FABP4), adiponectin, and chemerin levels, hypertriglyceridemic waist (HW) phenotype, atherogenic index of plasma (AIP), and Framingham risk score (FRS) were assessed as prognostic CVD biomarkers. Mean UAs level detected in the evaluated urinary samples was 45.0⯱â¯40.0⯵g/g creatinine. In addition, mean plasma ADMA, FABP4, chemerin and adiponectin levels were 0.68⯵mol/L, 20.3â¯ng/mL, 12.5⯵g/mL, and 255â¯ng/mL, correspondingly. Approximately, 54% of women participants displayed an HW phenotype. Regarding AIP and FRS values, 0.12⯱â¯0.15 and 7.50⯱â¯8.00 were found, respectively. Besides, strong and significant associations (pâ¯<â¯0.05) between UAs and AIP, ADMA, and FABP4 were distinguished. Also, after a multivariate analysis, the association between those variables persisted after adjustment for traditional risk factors of CVD. In conclusion, according to the results found in this research, the most sensible CVD biomarkers distinguished in this study were AIP, ADMA, and FABP4. Nevertheless, more studies are necessary to confirm the results found in this investigation.
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Arsênio/toxicidade , Doenças Cardiovasculares , Exposição Ambiental/efeitos adversos , Poluentes Químicos da Água/toxicidade , Adulto , Idoso , Arginina/análogos & derivados , Arginina/sangue , Arsênio/urina , Biomarcadores/sangue , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/urina , Estudos Transversais , Água Potável/análise , Exposição Ambiental/análise , Proteínas de Ligação a Ácido Graxo/sangue , Feminino , Humanos , Masculino , México , Pessoa de Meia-Idade , Análise Multivariada , Valor Preditivo dos Testes , Fatores de Risco , Inquéritos e Questionários , Poluentes Químicos da Água/urinaRESUMO
OBJECTIVES: To investigate whether life course exposure to adverse socioeconomic positions (SEP) as well as maintaining a low SEP or decreasing the SEP intra- and intergeneration was associated with an increased 10-year cardiovascular disease (CVD) risk predicted by the Framingham Risk Score. METHODS: This is a cross-sectional analysis of baseline data (2008-2010) of 13,544 active workers from ELSA-Brasil cohort. Maternal education, leg length, social class of first occupation and education were used to evaluate childhood, youth and adulthood SEP. RESULTS: After considering adulthood SEP, exposure to early-life low SEP remained associated with an increased 10-year CVD risk. The 10-year CVD risk also rose as the number of exposures to low SEP throughout life increased. Compared to individuals in high-stable intragenerational trajectory, those in upward, downward, or stable low trajectory presented higher 10-year CVD risk. Increasing individuals' SEP over generation showed no increased risk of 10-year CVD risk compared to individuals in high-stable trajectory. CONCLUSIONS: Childhood may be a critical period for exposures to social adversities. Life course low SEP may also affect the 10-year CVD risk via accumulation of risk and social mobility.
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Adultos Sobreviventes de Eventos Adversos na Infância/estatística & dados numéricos , Doenças Cardiovasculares/epidemiologia , Disparidades nos Níveis de Saúde , Classe Social , Adulto , Idoso , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Mobilidade SocialRESUMO
ABSTRACT Chronic kidney disease (CKD) increases cardiovascular disease (CVD) risk development. However, the mechanisms of reduced kidney function with CVD risk are unclear. This study aimed to investigate the association between kidney function and Framingham risk score (FRS) in participants with traditional cardiovascular risk factors and normal estimated glomerular filtration rate (eGFR) > 60 mL/min/1.73 m² in an admixed population of Brazil. The participants were divided into three groups according to FRS: low risk group with 0% to <10%, moderate risk group with ≥10% to 20% and high risk group with >20%. The eGFR was calculated using Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI). Data from participants were collected by questionnaire, and blood and urine samples were collected to analyze biochemical markers. A total of 214 subjects aged 53±10 years old was collected. There were 77 individuals in low risk group, 59 in moderate risk group and 78 in high-risk group. Mean eGFRCKD-EPI was 89.39±15.05 mL/min/1.73 m² and 90.74±16.17 mL/min/1.73 m2 when race adjustment. The results indicated that there is an increasing the cardiovascular risk with a decreased of eGFR, conforming to a significant inverse correlation observed between eGFR and FRS with Spearman correlation (R²=-0.256, p<0.001; R²=-0.224, p=0.001, when adjusted for race). There was a statistically significant difference in eGFRCKD-EPI (p<0.001) and eGFRCKD-EPI with race adjustment (p=0.002) among risk groups. The data suggests that the reduction eGFR is associated with elevated FRS among Brazilian adults without CKD. Furthermore, the results suggest that race adjustment it's not necessary in Brazilian population.
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Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Fatores de Risco , Insuficiência Renal Crônica/complicações , Doenças Cardiovasculares/complicações , Estatística como Assunto , Taxa de Filtração GlomerularRESUMO
The aims of this study are to determine the prevalence of coronary atherosclerosis in acromegalic patients and to investigate the relationship between the coronary artery calcium score (CS) and acromegaly status and clinical parameters [Framingham risk score (FRS)]. Fifty-six acromegalic patients and paired non-acromegalic volunteers were stratified according to the FRS into low-, intermediate-, and high-risk groups. CS was assessed using multidetector computed tomography. The patients were considered to have controlled or active acromegaly at the time they were submitted to evaluation. Sixty-six percent of acromegalic patients exhibited arterial hypertension, 36 % had diabetes mellitus, and 34 % had hypercholesterolemia. The median FRS and the median risk for cardiovascular event within the next 10 years were similar in the acromegalics and the controls. The median total CS and CS >75th percentile didn't differ significantly between these groups. In patients with controlled acromegaly, a low, intermediate, or high FRS risk was observed in 86, 14, and 0 %, respectively. In patients with active disease, a low, intermediate, or high FRS risk was verified in 94, 3, and 3 %, respectively, and differences between the controlled and active groups were not significant. Seventy-two percent of the patients had total CS = 0, and there were no differences between the controlled and active groups. The risk of coronary artery disease in acromegalic patients, determined according to FRS and CS, is low despite the high prevalence of metabolic abnormalities.
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Acromegalia/epidemiologia , Doença da Artéria Coronariana/epidemiologia , Adulto , Idoso , Brasil/epidemiologia , Estudos de Casos e Controles , Estudos Transversais , Feminino , Hormônio do Crescimento/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Medição de Risco , Índice de Gravidade de Doença , Adulto JovemRESUMO
Objetivos: Determinar el riesgo clínico para desarrollar Hipertensión Arterial según la puntuación predictiva acorto plazo de Framingham en estudiantes de la carrera Médico y Cirujano del Centro Universitario de Oriente. Métodos: Este estudio evalúa el riesgo clínico de desarrollar Hipertensión Arterial en los próximos 4 años, según el score de riesgo de Framingham en los estudiantes de medicina del Centro Universitario de Oriente durante el año 2012. Resultados: Se presentan un riesgo global de 4.2 % según los criterios de Framingham para desarrollar hipertensión arterial en los próximos 4 años. Encontrando cinco veces másriesgo de desarrollar la enfermedad en el sexo masculino (3.58%) que para el sexo femenino (0.70%). Conclusiones: Los resultados muestran un riesgo importante de desarrollar Hipertensión Arterial a e da destempranas en los estudiantes de medicina del Centro Universitario de Oriente.
Objectives: to determine the clinical risk of developing hypertension according to the short-term predictive score Framingham students from the Medical School of Campus of Northwestern of Universidad de San Carlos (CUNORI). Methods: This study evaluates the clinical risk of Hypertension in the next 4 yearsaccording to the Framingham risk score in medical students of CUNORI in 2012. Results overall risk of 4.2%are presented according to the Framingham criteria for developing hypertension in the next 4 years. We Found five times the risk of developing the disease in males (3.58%) than for females (0.70%). Conclusions: The results show a significant risk of developing arterial hypertension at early ages in medical students of CUNORI.
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Humanos , Hipertensão/complicações , Hipertensão/diagnóstico , Fatores de Risco , Estudantes de MedicinaRESUMO
Objetivo: verificar o risco de desenvolvimento de doença cardiovascular através do Escore de Risco de Framingham(ERF) e sua associação com indicadores antropométricos e sócio-demográficos em uma determinada população. Método:estudo transversal que avaliou 100 indivíduos por intermédio de entrevista presencial, na qual foram coletados osseguintes dados: sócio-demográficos, antropométricos, pressão arterial sistêmica e exames bioquímicos de HDL e colesterol.Resultados: a população era maioria feminina (64%), com idade média de 44 anos. 74% da amostra pertenciamà faixa etária de 25 a 55 anos, 42% dos indivíduos apresentaram de 9 a 11 anos de estudo, 15% eram fumantes, sendomais frequente nos homens. Em relação à antropometria, 41% apresentou sobrepeso e 22% obesidade, sem diferençaestatística entre os sexos, na circunferência da cintura, 53% apresentou risco aumentado, sendo mais prevalente no sexofeminino, assim como a RCQ, com risco aumentado em 55% nas mulheres. Para o ERF, a amostra apresentou 14% deindivíduos com risco intermediário/alto, independente do sexo (p>0,05), observando-se associação significativa apenascom idade e o hábito de fumar. Conclusão: Apesar de a amostra estudada ter apresentado alteração em todos os parâmetrosantropométricos avaliados, não houve associação destes com o ERF, porém estudos reportam a importância doERF e das variáveis antropométricas como instrumentos para o diagnóstico e prevenção de doenças cardiovasculares.Sendo assim, é necessário desenvolver, validar ou adaptar este e/ou outros Escores de Risco para a população brasileirae verificar outros fatores que influenciam o desenvolvimento de DCV na população estudada devido à alteração dosparâmetros antropométricos encontrados.
Objective: to ascertain the risk of developing cardiovascular disease by the Framingham Risk Score (FRS) and itsassociation with anthropometric and socio-demographic factors in a certain population. Method: Cross-sectionalstudy evaluated 100 individuals through personal interview, in which the following data were collected: sociodemographic,anthropometric, blood pressure, and biochemical and HDL cholesterol. Results: the population wasmostly female (64%) with a mean age of 44 years. 74% of the sample belonged to the age group 25-55 years 42%of patients had 9-11 years of schooling, 15% were smokers, were more frequent in men. In relation to anthropometry,41% were overweight and 22% obese, with no statistical difference between the sexes, in waist circumference,53% showed increased risk, being more prevalent in females, and WHR with risk increased by 55% in women. Forthe ERF, the sample showed 14% of individuals with intermediate risk / high, regardless of sex (p> 0.05), observinga significant association only with age and smoking. Conclusion: although the sample has made changes inall anthropometric parameters were not associated with these ERF, but studies report the importance of ERF andanthropometric variables as instruments for the diagnosis and prevention of cardiovascular disease. Therefore, it isnecessary to develop, validate or adapt this and / or other risk scores for the Brazilian population and check other factorsthat influence the development of CVD in this population due to the change of anthropometric parameters found
RESUMO
BACKGROUND: Framingham risk scores (FRS) were validated in a mostly Caucasian population. Evaluation of subclinical atherosclerosis by carotid ultrasound may improve ascertainment of risk in nonwhite populations. This study aimed to evaluate carotid intima-media thickness (cIMT) and carotid plaquing among Mexican Americans, and to correlate these markers with coronary risk factors and the FRS. METHODS/RESULTS: Participants (n = 141) were drawn from the Cameron County Hispanic Cohort. Carotid artery ultrasound was performed and cIMT measured. Carotid plaque was defined as areas of thickening >50% of the thickness of the surrounding walls. Mean age was 53.1 ± 11.7 years (73.8% female). Most were overweight or obese (88.7%) and more than half (53.2%) had the metabolic syndrome. One third (34.8%) had abnormal carotid ultrasound findings (either cIMT ≥75th percentile for gender and age or presence of plaque). Among those with abnormal carotid ultrasound, the majority were classified as being at low 10-year risk for cardiovascular events. Carotid ultrasound reclassified nearly a third of the cohort as being at high risk. This discordance between 10-year FRS and carotid ultrasound was noted whether risk was assessed for hard coronary events or global risk. Concordance between FRS and carotid ultrasound findings was best when long-term (30-year) risk was assessed and no subject with an abnormal carotid ultrasound was categorized as low risk by the 30-year FRS algorithm. CONCLUSIONS: Integration of carotid ultrasound findings to coronary risk assessments and use of longer term prediction models may provide better risk assessment in this minority population, with earlier initiation of appropriate therapies.
Assuntos
Aterosclerose/etnologia , Artérias Carótidas/diagnóstico por imagem , Doenças das Artérias Carótidas/etnologia , Previsões , Americanos Mexicanos , Medição de Risco/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Aterosclerose/diagnóstico por imagem , Doenças das Artérias Carótidas/diagnóstico por imagem , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Texas/epidemiologia , Ultrassonografia , Adulto JovemRESUMO
INTRODUÇÃO: Pacientes com lúpus eritematoso sistêmico (LES) apresentam aproximadamente cinco vezes maior risco de morte por causa cardiovascular se comparados com a população geral. Os fatores de risco cardiovascular (RCV) tradicionais não explicam por si só este aumento do RCV no LES. Até o momento não há um instrumento que consiga identificar precocemente o aumento do maior RCV nesta população. OBJETIVO: Avaliar a utilidade do escore de Framingham de RCV em pacientes com e sem LES. PACIENTES E MÉTODOS: Foram estudados 80 pacientes do sexo feminino com diagnóstico de LES e 60 mulheres no grupo controle sem doenças reumatológicas. Foi aplicado o Escore de RCV de Framingham para estimar o risco de mortalidade por DCV em 10 anos. RESULTADOS: Pacientes com LES apresentavam índice de massa corpórea (IMC) (26,8 ± 6,2 versus 24,9 ± 3,8), níveis de triglicerídeos (159,3 ± 103,7 versus 113,8 ± 50,3) e pressão arterial diastólica (84,3 ± 11,5 versus 79,1 ± 12,0) mais elevados quando comparados ao grupo controle (P < 0,05). Hipertensão arterial estava presente em 56 por cento das pacientes com LES e em 33 por cento no grupo controle (P < 0,05). Apesar das diferenças encontradas entre os grupos, ambos apresentavam 1 por cento de RCV pelo escore de Framingham. Quando comparamos aquelas com risco > 10 por cento, não encontramos diferenças estatisticamente significativas (P > 0,05). CONCLUSÕES: Pacientes com e sem LES possuem o mesmo risco de apresentar infarto do miocárdio ou mortalidade coronariana em 10 anos, apesar da maior mortalidade cardiovascular nas pacientes com LES. O escore de risco de Framingham não é uma escala que consiga estimar o risco aumentado de DCV em mulheres com LES.
INTRODUCTION: The risk of death from cardiovascular disease is nearly five times greater in patients with systemic lupus erythematosus (SLE) than in the general population. Traditional risk factors for cardiovascular disease do not explain this increase. An instrument for early identification of increased risk of cardiovascular disease in this population does not exist. OBJECTIVE: The objective of the present study was to evaluate the usefulness of the Framingham risk score to determine the risk of cardiovascular disease in SLE patients compared to normal individuals. PATIENTS AND METHODS: Eighty female patients with SLE and 60 women without rheumatic disorders participated in this study. The Framingham risk score was used to estimate the 10-year mortality secondary to cardiovascular disease. RESULTS: Body mass index (BMI) (26.8 ± 6.2 vs. 24.9 ± 3.8), triglyceride levels (159.3 ± 103.7 vs. 113.8 ± 50.3), and diastolic blood pressure (84.3 ± 11.5 vs. 79.1 ± 12.0) were higher in SLE patients than in the control group (P < 0.05). Hypertension was observed in 56 percent of SLE patients and in 33 percent of the control group (P < 0.05). Despite the differences observed between both groups, the risk of cardiovascular disease according to the Framingham risk score was similar in both groups, i.e., 1 percent. Statistically significant differences were not observed when individuals whose risk was >10 percent were compared (P > 0.05). CONCLUSIONS: Although SLE patients have a higher cardiovascular mortality rate, the risk of myocardial infarction or mortality from coronary artery disease in 10 years in SLE patients is similar to that of patients without rheumatic diseases. The Framingham risk score cannot estimate the increased risk of cardiovascular disease in women with SLE.
Assuntos
Humanos , Feminino , Doenças Cardiovasculares , Doença da Artéria Coronariana , Lúpus Eritematoso Sistêmico , Lúpus Eritematoso Sistêmico/complicações , Medição de Risco , Fatores de RiscoRESUMO
O objetivo deste estudo foi determinar a prevalência da síndrome metabólica e identificar variáveis relacionadas a motoristas profissionais em trânsito na Rodovia BR-116. Foram avaliados 258 motoristas com medida do índice de massa corporal (IMC), circunferência abdominal, pressão arterial, triglicérides, colesterol total e frações e proteína C reativa. Avaliou-se a síndrome metabólica de acordo com a I Diretriz Brasileira de Diagnóstico e Tratamento da Síndrome Metabólica. O nível de significância adotado foi p < 0,05. Foram utilizadas as análises uni e multivariadas. Verificou-se que a idade dos motoristas foi de 37,5 ± 10,1 anos, 82 por cento tinham IMC > 25 kg/m², 58 por cento circunferência abdominal > 94 cm, 9 por cento colesterol total > 240 mg/dL, 10 por cento LDL-c > 160 mg/dL; 23 por cento HDL-c < 40 mg/dL, 22 por cento triglicérides > de 200 mg/dL, 7 por cento glicemia > 110 mg/dL e 19 por cento proteína C reativa > 0,5 mg/dL. A prevalência da hipertensão arterial foi de 37 por cento, 9 por cento apresentaram médio/alto escore de risco de Framingham e 24 por cento com síndrome metabólica. A análise de regressão logística indicou a associação independente da síndrome metabólica para as variáveis: IMC (OR = 1,4007 IC 95 por cento 1,192-1,661), hábito de verificar o colesterol (OR = 0,1020 IC 0,017-0,589) e escore de risco de Framingham (OR = 26,3 IC 2,520-276,374). Verificou-se presença expressiva de fatores de risco cardiovasculares e da síndrome metabólica na população estudada.
The objective of this study was to determine the Metabolic Syndrome prevalence as well as identify variables related in truck drivers who work on Highway BR-116 (São Paulo, Brazil). A total of 258 truck drivers were assessed and the variables studied were: body mass index, waist circumference, blood pressure, triglycerides, total and fraction cholesterol, glycemia and C reactive protein. Cardiovascular disease risk was evaluated by Framingham's risk score whereas the Metabolic Syndrome based on the First Brazilian Guideline for Diagnosis and Treatment of the Metabolic Syndrome. The significance level adopted was p< 0.05 and univariate and multivariate analysis were applied. The average age was of 37.5±10.1. According to the anthropometric data, it was observed body mass index >25 kg/m² in 82 percent, waist circumference >94 cm in 58 percent, total cholesterol >240mg/dL in 9 percent, LDL-c >160mg/dL in 10 percent; HDL-c <40mg/dL in 20 percent, triglycerides >200mg/dL in 22 percent, glycemia >110mg/dL in 7 percent, and C reactive protein >0.5 mg/dL in 19 percent. Hypertension prevalence was 37 percent, 9 percent were identified at the highest/medium Framingham's risk score and 24 percent showed Metabolic Syndrome. The logistical regression analysis indicated independent association of the Metabolic Syndrome for the following variables (OD odds ratio, CI confidence interval at 95 percent): body mass index (OR = 1.4007 CI 95 percent 1.192-1.661), use to check cholesterol (OR = 0.1020 CI 0.017-0.589) and Framingham's risk score (OR = 26.389 CI 2.520-276.374). As a conclusion, it was observed a quite expressive prevalence of cardiovascular risk factors as well as Metabolic Syndrome in truck drivers.