Cardiovascular Prevention and Pharmacotherapy

Original Article

Cardiovascular risk assessment of newborns in Nigeria using the atherogenic index of plasma and its associations with gestational age and birth weight: a cross-sectional hospital-based study: Obinna Victory Obaji, Uche Charles Adizua, Ndubuisi Kennedy Chukwudi, Daberechi Kenneth Adiele, Justus Uchenna Onu; Received October 8, 2023 Accepted March 28, 2024 Published online April 26, 2024; DOI: https://doi.org/10.36011/cpp.2024.6.e9 [Epub ahead of print]

86 View
9 Download

Abstract PDF: Background
The prevalence of atherosclerotic cardiovascular disease is rising, and its onset from childhood is widely studied. Prematurity and low birth weight were associated with higher atherogenic risk when assessed using some lipid ratios. However, the atherogenic index of plasma (AIP), a sensitive marker for atherosclerosis is understudied in newborns. Utilizing AIP, this study aimed to determine atherogenic risk prevalence among newborns and its association with gestational age and birth weight.
Methods
Newborns were consecutively recruited, and their lipid profiles were determined. The AIP was calculated as the logarithm to base 10 (log10) of the ratio of molar concentrations of triglyceride to high-density lipoprotein cholesterol. The atherogenic risk was operationalized using AIP: high, >0.24; medium, 0.1–0.24; and low/no risk, <0.1. The relationship between AIP values, gestational age, and birth weight was analyzed using Pearson correlation.
Results
The mean AIP of the 167 newborns studied was –0.35±0.34, which is within the global reference range. Three (1.8%), 10 (6.0%), and 154 (92.2%) newborns were in the high, medium, and low/no atherogenic risk categories, respectively. Hence, 13 newborns (7.8%) had medium to high atherogenic risk. AIP had a moderate significantly positive relationship only with gestational age (r=0.35, P<0.001).
Conclusions
The study found an atherogenic risk prevalence of 7.8% using AIP in newborns which, contrary to previous studies that used other ratios, has no significant association with birth weight, correlating positively with gestational age, though is lowest in late preterms. Follow-up studies will elucidate these findings.

Review Article

Recent evidence on target blood pressure in patients with hypertension: Hack-Lyoung Kim; Cardiovasc Prev Pharmacother. 2024;6(1):17-25. Published online January 22, 2024; DOI: https://doi.org/10.36011/cpp.2024.6.e3

600 View
22 Download

Abstract PDF: Hypertension is a significant risk factor for a variety of cardiovascular diseases, including stroke, coronary artery disease, heart failure, and peripheral arterial disease. Achieving and maintaining a specific target blood pressure (BP) is crucial for effectively reducing the risk associated with these conditions. This involves customizing treatments to meet the individual needs of patients with hypertension, ensuring that each person receives the most appropriate care for their particular circumstances. Previously, based on the findings from the ACCORD (Action to Control Cardiovascular Risk in Diabetes) study conducted over the past decade, the target BP for patients with hypertension was set at <140/90 mmHg, regardless of the patient's risk profile. However, new insights from reanalyzed data of studies such as the SPRINT (Systolic Blood Pressure Intervention Trial), the STEP (Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients) study, and ACCORD subgroup reanalysis have led to a change in this approach. These studies support a more aggressive target BP of <130/80 mmHg, especially for high-risk patients. The purpose of this article is to offer a thorough review of these updated recommendations and to explain the reasoning behind the revised target BP guidelines for individuals with hypertension.

Original Article

Modifiable risk factors for coronary artery disease in the Indonesian population: a nested case-control study: Anggoro Budi Hartopo, Maria Patricia Inggriani, Brilliant Winona Jhundy, Jajah Fachiroh, Putri Tiara Rosha, Ratri Kusuma Wardani, Fatwa Sari Tetra Dewi; Cardiovasc Prev Pharmacother. 2023;5(1):24-34. Published online January 31, 2023; DOI: https://doi.org/10.36011/cpp.2023.5.e3

1,959 View
85 Download

Abstract PDF: Background
There is a lack of data on modifiable coronary artery disease (CAD) risk factors in the Indonesian population, hindering the implementation of assessments and prevention programs in this population. This study investigated modifiable risk factors for CAD among Indonesians by comparing them between CAD-proven patients and healthy subjects from a similar population.
Methods
In this nested, matched case-control study, the cases were patients from a referral hospital in Yogyakarta, Indonesia and the controls were respondents in a population surveillance system in Yogyakarta, Indonesia. The cases were 421 patients who had undergone coronary angiography, showing significant CAD. The sex- and age-matched controls were 842 respondents from the Universitas Gadjah Mada Health and Health and Demographic Surveillance System Sleman who indicated no CAD presence on a questionnaire. The modifiable CAD risk factors compared between cases and controls were diabetes mellitus, hypertension, central obesity, smoking history, physical inactivity, and less fruit and vegetable intake. A multivariate regression model was applied to determine independent modifiable risk factors for CAD, expressed as adjusted odds ratios (AORs).
Results
A multivariate analysis model of 1,263 subjects including all modifiable risk factors indicated that diabetes mellitus (AOR, 3.32; 95% confidence interval [CI], 2.09–5.28), hypertension (AOR, 2.52; 95% CI, 1.76–3.60), former smoking (AOR, 4.18; 95% CI, 2.73–6.39), physical inactivity (AOR, 15.91; 95% CI, 10.13–24.99), and less fruit and vegetable intake (AOR, 5.42; 95% CI, 2.84–10.34) independently and significantly emerged as risk factors for CAD.
Conclusions
Hypertension, diabetes mellitus, former smoking, physical inactivity, and less fruit and vegetable intake were independent and significant modifiable risk factors for CAD in the Indonesian population.

Review Article

Body Weight Change and Cardiovascular Disease: Effect of Weight Gain, Weight Loss, and Weight Cycling: Jung-Hwan Cho, Eun-Jung Rhee, Won-Young Lee; Cardiovasc Prev Pharmacother. 2021;3(4):73-81. Published online October 31, 2021; DOI: https://doi.org/10.36011/cpp.2021.3.e12

3,764 View
115 Download
1 Citations

Abstract PDF

Obesity is an independent risk factor for the development and progression of cardiovascular disease (CVD). Various cardiovascular outcomes are related to the association between body weight change and CVD. Metabolically healthy obese individuals could have a better prognosis in terms of cardiovascular morbidity and mortality than metabolically unhealthy obese individuals. Smoking cessation causes significant weight gain and consequent deterioration of the metabolic profile despite not impairing the cardiovascular benefits. Intentional weight loss has a consistent cardiovascular protective effect, but unintentional weight loss due to progressive catabolism and loss of muscle mass could be associated with poor cardiovascular outcomes. Obese individuals who are successful in losing weight with subsequent regain (weight cycling) could have an unfavorable cardiometabolic profile and the risk of CVD. Further studies are needed to evaluate the impact of weight changes on CVD by identifying unknown pathophysiology and to decide appropriate management and interventions for various phenotypes of weight change.

Citations

Citations to this article as recorded by

Investigating the efficacy and feasibility of using a whole-of-diet approach to lower circulating levels of C-reactive protein in postmenopausal women: a mixed methods pilot study
Stephanie Cowan, Aimee Dordevic, Andrew J. Sinclair, Helen Truby, Surbhi Sood, Simone Gibson
Menopause.2023; 30(7): 738. CrossRef

Original Article

Relationship between Retinal Nerve Fiber Layer Defects and Coronary Artery Calcium Score in Patients at Risk for Cardiovascular Disease: Chan Joo Lee, Joo Youn Shin, Jaewon Oh, Sang-Hak Lee, Seok-Min Kang, Sungha Park, Suk Ho Byeon; Cardiovasc Prev Pharmacother. 2021;3(4):95-105. Published online October 31, 2021; DOI: https://doi.org/10.36011/cpp.2021.3.e11

2,353 View
26 Download

Abstract PDF: Background
Noninvasive fundus imaging may provide useful information on blood vessels. This study investigated the relationship between localized retinal nerve fiber layer defects (RNFLDs) and vascular biomarkers.
Methods
This study included 1,316 participants without cardiovascular disease who were registered in a cardiovascular high-risk cohort. Examined vascular biomarkers included central hemodynamics, carotid-femoral pulse wave velocity (cfPWV), left ventricular hypertrophy (LVH) on electrocardiogram, and coronary artery calcium score (CACS). Fundus photography and optical coherence tomography were used to evaluate RNFLDs. The associations between RNFLDs and established high-risk cutoff points for each biomarker (central blood pressure [BP] ≥125/80 mmHg, central pulse pressure [PP] ≥50 mmHg, cfPWV ≥10 m/s, presence of LVH, and CACS ≥300) were assessed.
Results
RNFLD was identified in 394 participants (29.9%) who had higher fasting glucose level, lower renal function, and higher BP than those without RNFLDs. Additionally, central BP, central PP, cfPWV, CACS, and the percentage of subjects with LVH were higher in the RNFLD group. After adjusting for confounders, RNFLDs were not associated with LVH or an elevated central BP, central PP, or cfPWV. However, they were associated with an elevated CACS (odds ratio, 1.44; 95% confidence interval, 1.04–2.00; p=0.029).
Conclusions
Non-glaucomatous localized RNFLDs were associated with elevated CACS. Therefore, evaluating RNFLDs using fundus imaging may aid in the assessment of cardiovascular disease risk.

First
Prev
Page of 1
Next
Last

Search