Motoric cognitive risk syndrome and cardiovascular diseases and risk factors in the Canadian population: Results from the baseline assessment of the Canadian longitudinal study on aging

BackgroundMotoric Cognitive Risk Syndrome (MCR) is a pre-dementia syndrome. The aim of this study was to examine whether there is: 1) an association between MCR and cardiovascular diseases and risk factors (CVDRF) in the Canadian population, and 2) a specific MCR-related CVDRF profile (i.e., cardiovascular diseases (CVD) versus cardiovascular risk factors (CVRF) versus both) when comparing different age groups.MethodsA total of 29,569 participants free of dementia were recruited in the Canadian Longitudinal Study on Aging. Participants were categorized into groups by their age and MCR status (with MCR versus without MCR). Overweight/obese, smoking, waist to hip circumference ratio (WHCR), systolic blood pressure and diastolic blood pressure levels were CVRF. Diabetes type I and II, hypertension, heart disease and attack, peripheral vascular disease, angina, stroke and rhythmic disease were CVD.ResultsA higher prevalence of CVRF in MCR was shown in the youngest age groups (i.e., 45–54 and 55–64) compared to the other age groups. MCR was positively associated with CVDRF, except in the oldest age group (i.e., ≥75). In this group, the only significant association with CVRF was with diastolic blood pressure, which was negatively associated with MCR. Diabetes and hypertension were not associated with MCR.ConclusionsMCR is associated with CVDRF in both younger and older individuals. A stronger association was present for CVRF factors in younger adults and for CVD in older adults.     

Prevalence of malnutrition and associated metabolic risk factors for cardiovascular disease in older adults from Northwest Mexico

This cross-sectional study assessed the prevalence of malnutrition and several metabolic risk factors for cardiovascular disease in 287 apparently healthy older adults from Northwest Mexico. Also, the impact of overweight and obesity on metabolic risk factors was assessed. Nutritional status was determined using serum albumin levels and anthropometry. Vitamin status was also assessed. Metabolic risk factors for cardiovascular disease were evaluated. The prevalence of undernutrition was 15.3%. Also, vitamin E deficiency was common (18%). On the contrary, 44.9% of men and women were in overweight and 24% were obese. A 50.9% of the older adults had hypertension, 52.6% hypercholesterolemia (HC), 38.3% hypertriglyceridemia (HTG), 26.1% impaired fasting glucose and 26.1% impaired glucose tolerance (IGT). HC and low-density-lipoprotein-cholesterol (LDL-C) were significantly more prevalent in women than in men. Mean adjusted values of fasting glucose, high-density-lipoprotein-cholesterol (HDL-C), total cholesterol (TC)/HDL-C ratio ≥5, triglycerides (TG) and diastolic blood pressure (DBP) were significantly higher in subjects with body mass index (BMI) ≥ 25.0 kg/m². Undernutrition, obesity and vitamin E deficiency, as well as several metabolic risk factors for cardiovascular disease coexisted in this studied group. Overweight and obesity were the most prevalent findings. BMI ≥ 25 kg/m² was the common factor explaining most of the metabolic abnormalities. However, due to the sample size and the design of the study, the results must be seen with caution and cannot be generalized.     

学龄期儿童心血管疾病危险因素现状调查

目的：为了解城市学龄期儿童心血管疾病危险因素的现状。方法：对长沙市 ４９５ 名９～１４ 岁儿童的血压、血脂、血糖、肥胖、膳食与运动习惯以及心血管病家族史等心血管疾病危险因素进行调查。结果：血压偏高检出率为４．８４％ ,血脂单项指标异常检出率为０．４０％ ～１７．３７％ ,总异常检出率为２１．８２％ 。３７．７５％ 儿童血脂水平超过膳食干预的推荐值。１．０１％ 儿童的空腹血糖≥６．７２ｍ ｍ ｏｌ／ Ｌ。４．６５％ 儿童超重度≥２０％ ,体重指数≥２４ 者占３．６３％ 。大部分儿童摄入脂肪及胆固醇较多,２２．６２％ 的儿童缺乏体育锻炼,５７．７８％ 家庭中有吸烟者,２６．８６％ 有心血管疾病家族史。结论：加强儿童时期心血管病危险因素的监测与干预势在必行。     

库欣综合征患者代谢紊乱及心血管危险因素分析

对173例库欣综合征患者的临床资料进行回顾性分析,并比较35例手术前后资料,发现库欣综合征常合并多种代谢紊乱及心血管危险因素,疾病治愈、皮质醇水平恢复正常后仍可能存在与活动期类似的代谢紊乱和心血管危险因素.     

Homocysteine lowering and cardiovascular disease risk: lost in translation

Studies of the general population have suggested that high homocysteine levels are associated with cardiovascular morbidity and mortality. In chronic kidney disease, homocysteine levels rise, and cardiovascular risk increases with declining kidney function. While some studies in this population have found an association between elevated homocysteine and cardiovascular risk, others have noted that this association is largely attenuated by adjustment for kidney function, and several studies of patients with kidney failure have found that lower homocysteine levels predict mortality. Homocysteine levels can be lowered with folate, vitamin B6 and vitamin B12. Three large, randomized, controlled trials of patients with pre-existing cardiovascular disease and two smaller, randomized, controlled trials of patients with kidney failure failed to detect any cardiovascular benefit from homocysteine-lowering vitamins. Several more interventional trials are ongoing, but the available data thus far do not support screening for or treatment of hyperhomocysteinemia.     

三明市三元区公务员心血管危险因素的分析

目的:研究三明市三元区公务员心血管病危险因素的情况,以便指导其防治工作.方法:分别从2005年和2010年体检对象中随机选择年龄为30～89岁的公务员,测量血压、血脂、血糖3种心血管病危险因素,询问病史,进行统计分析.结果:(1)随着年龄的增长,心血管病危险因素的检出率在逐渐升高;女性在50岁之前的检出率较低,50岁之...     

1994年和2004年华中师范大学副高职以上人群心血管危险因素的分析

目的:研究华中师范大学副高职称以上群体1994年、2004年心血管病危险因素的变化情况,指导这一群体心血管病的防治工作。方法:分别于1994年和2004年体检对象中选择年龄为30~89岁、副高职称以上的教职工,测量血压、血脂和血糖3种心血管病危险因素,询问病史;整理数据,采用SPSS10·0统计软件处理数据。结果:随着年龄的增长,心血管病危险因素的检出率在逐步增加;女性在50岁之前的检出率较低,50岁之后,各种心血管病危险因素的检出率明显升高;与10年前相比,2004年各种心血管病危险因素检出率均明显增高(P<0·01)。结论:高血压、高脂血症和糖尿病是高校教职工的高发病,应加强这一人群的健康教育,做好心血管病的防治工作。     

高校社区中老年人群心血管病危险因素持探讨

目的：探讨高校社区中老年人群心血管病发病的危险因素。方法：对武汉大学社区1999年底中老年人群体检资料进行统计、分析,并分析体重指数（BMI,kg/m^2)及某些不良生活习惯对心脑血管病及其危险因素发生率的影响。结果：BMI≥25心血管病及其危险因素发生率呈上升趋势（P＜0．01或P＜0．05）,某些不良生活习惯也明显增加心血管病及其危险因素的发生率。结论：为中老年人群减肥,或控制其钠盐摄入及饮酒量,就可降低心血管病的发病率。     

1992-2002年北京一组队列人群心血管病危险因素变化趋势研究

目的评价北京地区队列人群1992--2002年10年心血管病危险因素变化趋势。方法于1992年和2002年分别对同一组个体,按照世界卫生组织MONICA方案心血管病危险因素调查方法进行调查。对血压、体重指数、腰围、臀围、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和甘油三酯、血糖、高血压患病率、治疗率和控制率的变化进行比较。结果（1）1992-2002年相同年龄组（45～54岁和55～64岁）比较心血管病危险因素水平呈显著升高的趋势。（2）1992年理想血压者,2002年有19．0％的人成为高血压患者;正常血压者,45．3％的人成为高血压患者。（3）1992年血脂正常者,2002年有43．8％的人成为血脂异常者。（4）1992年体重指数正常者,2002年有37．0％的人成为超重者;腰围正常者,有43．7％的人成为高腰围者。（5）1992年无代谢综合征者,2002年有14．6％的人成为有代谢综合征者。结论本队列人群10年心血管病危险因素水平明显上升,其主要危险因素均与生活方式密切相关。改变不良生活方式是控制和减慢主要危险因素上升的速度和减少心血管病发病的关键。     

大连市獐子岛地区心血管疾病危险因素的流行病学调查

目的了解獐子岛地区居民心血管疾病的危险因素发生情况,为实施心血管疾病干预措施提供依据。方法按年龄性别随机分层抽取獐子岛镇18岁以上常驻居民(≥5年)1024例,进行心血管疾病危险因素流行病学调查,并对35~59岁人群用"国人缺血性心血管病十年发病危险度评估表"进行评估,对结果进行统计学分析。结果(1)高血压、高总胆固醇、高低密度脂蛋白胆固醇、低高密度脂蛋白胆固醇、高三酰甘油、糖尿病、高尿酸血症患病率依次为43.8%、28.4%、12.4%、9.4%、21.7%、7.2%、9.8%。吸烟率27.1%,超重率56.3%,高摄盐率56.2%。(2)具有1个以上危险因素的个体占89.8%,无同时≥8个以上危险因素的个体。男性具有1个以上危险因素者比例大于女性,差异具有统计学意义(P<0.01)。(3)10年缺血性心血管病发病危险度<10%(低危):男性为96.3%,女性为94.4%;≥20%(高危):男性为1.5%,女性为0.4%。不同性别10年缺血性心血管病发病危险度在中高危以上(≥10%)检出率差异无统计学意义(P>0.05)。结论獐子岛地区心血管疾病危险因素的人群比例高,应积极加强对心血管疾病危险因素干预。     

Adiponectin and the cardiovascular system: from risk to disease

Adiponectin is known to play a role in fatty acid and glucose metabolism through a change in insulin sensitivity and activation of fuel oxidation by AMP-activated protein kinase. Adiponectin can be considered an important factor able to modulate the adipovascular axis which, through genomic and environmental influences, affects the cardiovascular risk milieu, from the pre-metabolic syndrome — through the metabolic syndrome — to the overt atherosclerotic process and its clinical manifestations. Hypoadiponectinaemia can be viewed as an early sign of a complex cardiovascular risk factor predisposing to the atherosclerosis process as well as a contributing factor accelerating the progress of the atherosclerotic plaque. In addition, adiponectin per se holds a protective role thanks to its anti-inflammatory and antiatherogenic properties. The early identification of patients “at cardiovascular risk” means in the current practice to search for indexes of metabolic derangements and pro-inflammatory status (adiponectin) from adolescence and childhood.     

Plasma renin and risk of cardiovascular disease and mortality: the Framingham Heart Study.

AIMS: Previous studies relating plasma renin to cardiovascular disease (CVD) and mortality yielded conflicting results. We related plasma renin to incidence of CVD and mortality in 3408 individuals (mean age 59; 53% women) and in a hypertensive subset (n = 1413). METHODS AND RESULTS: On follow-up (mean 7.1 years), 176 participants (122 hypertensives) developed CVD and 215 individuals (127 hypertensives) died. Overall, log-renin was associated with mortality [multivariable-adjusted hazards ratio (HR) per SD increment: in whole sample, 1.14, 95% confidence interval (CI) 1.00-1.30, P = 0.046; hypertensives, 1.16, 95% CI 1.00-1.35, P = 0.046], but relations varied over time (P < 0.02). Log-renin was associated with mortality at 2.5 years of follow-up (HR per SD increment: whole sample at 2.5 years, 1.23, 95% CI 1.04-1.45; hypertensives at 2 years, 1.28, 95% CI 1.06-1.54), but not during longer follow-up (HR per SD increment at 5 years: whole sample, 1.02, 95% CI 0.80-1.29; hypertensives, 0.98, 95% CI 0.74-1.30). The time-dependent relation of renin and mortality risk was maintained upon excluding participants with prevalent CVD. Renin was not associated with CVD incidence (HR per SD increment log-renin: whole sample, 0.99, 95% CI 0.85-1.14; hypertensives, 0.96, 95% CI 0.82-1.12). CONCLUSION: Higher plasma renin was associated with greater short-term mortality but not with CVD incidence in the community.     

中国民航飞行员心血管病可控危险因素的流行病学调查

目的 了解中国民航飞行员心血管病可控危险因素的发生情况,为实施心血管疾病干预措施提供依据.方法 以整群抽样的方法抽取中国民航飞行员进行心血管病可控危险因素的流行病学调查,对不同地区、年龄民航飞行员的高血压、高总胆固醇、高甘油三酯、低高密度脂蛋白胆固醇和糖尿病的患病率,吸烟率,超重或肥胖率进行比较.结果 (1)共抽取中国民航飞行员5012名,分析其中资料完整有效者4684名.(2)中国民航飞行员高血压、高总胆固醇、高甘油三酯、低高密度脂蛋白胆固醇和糖尿病的患病率依次为8.07%、7.47%、14.45%、27.63%和0.43%,吸烟率为66.45%,超重或肥胖率为49.64%.(3)不同地区民航飞行员高血压、高总胆固醇、高甘油三酯、低高密度脂蛋白胆固醇的患病率,吸烟率,超重或肥胖率差异均有统计学意义(P均<0.01);不同年龄段民航飞行员高血压、高总胆固醇、高甘油三酯患病率,吸烟率,超重或肥胖率差异有统计学意义(P均<0.01),低高密度脂蛋白胆固醇患病率差异无统计学意义(P>0.05).(4)具有1个及以上心血管病可控危险因素的民航飞行员占88.96%,具有2个及以上心血管病可控危险因素的民航飞行员占54.46%,无同时具有≥7个心血管病可控危险因素的民航飞行员.不同地区之间具有2个及以上心血管病可控危险因素的飞行员比例差异具有统计学意义(P<0.01);不同年龄之间具有2个及以上心血管病可控危险因素的飞行员比例差异具有统计学意义(P<0.01).结论 中国民航飞行员具有心血管病可控危险因素的比例高,应积极加强对心血管病可控危险因素的干预.

Abstract：

Objective To investigate the status of controllable risk factors of cardiovascular disease in Chinese pilots. Methods Pilots in seven regions of China were selected with cluster sampling.The rates of hypertension, diabetes mellitus,smoking and abnormal body mass index(BMI) as well as levels of total cholesterol, triglyceride and high density lipoprotein-cholesterol were obtained. Results (1)A total of 5012 pilots were selected and 4684 pilots whose data were effective were studied.(2) The prevalence rates of hypertension, high total cholesterol, triglyceride, low high density lipoprotein-cholesterol and diabetes mellitus were 8.07%,7.47%,14.45%,27.63% and 0.43%, respectively.The rate of smoking was 66.45%.The rat of increased BMI was 49.64%.(3) Significant difference existed on the rates of hypertension, total cholesterol, triglyceride, low high density lipoprotein-cholesterol,smoking and abnormal BMI among pilots from different regions (all P<0.01).There was also a significant difference between the rates of hypertension, total cholesterol, triglyceride, smoking and abnormal BMI in different age groups (all P<0.01).The rate of low high density lipoprotein-cholesterol was similar in different age groups (P>0.05).(4) 88.96% of the participants had at least one controllable risk factor.54.46% of the participants had at least two controllable risk factors.None of the participants had more than seven risk factors.There was a significant difference between the rates of pilots who have more than two controllable risk factors in different regions (P<0.01).There was a significant difference between the rates of pilots who have more than two risk factors in different age groups(P<0.01). Conclusions There was high prevalence of controllable cardiovascular risk factors in Chinese pilots.Active intervention targeting these cardiovascular disease risk factors needs to be considered to reduce the risk of developing cardiovascular disease in Chinese pilots.     

非酒精性脂肪性肝病在心血管疾病发生发展中的作用

随着经济水平的提高、饮食结构和生活方式的改变,非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)的发病率不断上升,逐渐成为全球慢性肝病的主要病因.心血管疾病(cardiovascular disease,CVD)作为NAFLD患者的主要死亡原因,越来越多的研究发现两者之间存在相关性;NAFLD患者CVD发生发展的风险更大,其机制可能与血管和内皮细胞功能障碍、胆汁酸代谢、氧化应激、全身炎症反应和肾素-血管紧张素系统的激活等相关.其中,代谢综合征在两者联系中发挥了重要的作用.因此,早期识别NAFLD患者心血管疾病相关危险因素,进而减少心血管相关并发症,对于改善该类患者的预后至关重要.     

Life course socioeconomic conditions,adulthood risk factors and cardiovascular mortality among men and women: A 17-year follow up of the GLOBE study

Background

Our goal was to study associations between childhood socioeconomic position (SEP), adulthood SEP, adulthood risk factors and cardiovascular disease (CVD) mortality, by investigating the critical period and pathway models.

Methods

The prospective GLOBE study in the Netherlands, with baseline data from 1991, was linked with cause of death register data from Statistics Netherlands in 2007. At baseline, respondents reported information on childhood SEP (i.e. occupational level of respondent's father), adulthood SEP (educational level), and adulthood risk factors (health behaviours, material circumstances, and psychosocial factors). Analyses included 4894 men and 5572 women. Data were analysed by Cox proportional hazard ratios (HR) with CVD mortality as the outcome.

Results

Childhood SEP was associated with CVD mortality among men with the lowest childhood SEP only (HR 1.32, 95% CI 1.00–1.74), and not among women. The majority of childhood SEP inequalities in CVD mortality among men (88%) were explained by material, behavioural and psychosocial risk factors in adulthood, and adulthood SEP. This was mostly due to the association of childhood SEP with adulthood SEP, and the interrelations of adulthood SEP with risk factors, and partly via the direct association of childhood SEP with adulthood risk factors, independent of adulthood SEP.

Conclusion

This study supports the pathway model for men, but found no evidence that socioeconomic conditions in childhood are critical for CVD mortality in later life independent of adulthood conditions. Developing effective methods to reduce material and behavioural risk factors among lower socioeconomic groups should be a top priority in cardiovascular disease prevention.     

Frailty syndrome and all-cause mortality in demented patients: the Italian Longitudinal Study on Aging

Cognition has already been considered as a component of frailty, and it has been demonstrated that it is associated with adverse health outcomes. We estimated the prevalence of frailty syndrome in an Italian older population and its predictive role on all-cause mortality and disability in nondemented subjects and in demented patients. We evaluated 2,581 individuals recruited from the Italian Longitudinal Study on Aging, a population-based sample of 5,632 subjects, aged 65–84 years old. Participants received identical baseline evaluation at the 1st survey (1992–1993) and were followed at 2nd (1995–1996) and 3rd survey (2000–2001). A phenotype of frailty according to partially modified measurement of Cardiovascular Health Study criteria was operationalized. The overall prevalence of frailty syndrome in this population-based study was 7.6% (95% confidence interval (CI) 6.55–8.57). Frail individuals noncomorbid or nondisable were 9.1% and 39.3%, respectively, confirming an overlap but not concordance in the co-occurrence among these conditions. Frailty was associated with a significantly increased risk of all-cause mortality over a 3-year follow-up (hazard ratio (HR) 1.98, 95% confidence interval (CI) 1.52–2.60) and over a 7-year follow-up (HR 1.74, 95% CI 1.44–2.16), but with significant increased risk of disability only over a 3-year follow-up (HR 1.32, 95% CI 1.06–1.86 over a 3-year follow-up and HR 1.16, 95% CI 0.88–1.56 over a 7-year follow-up). Frail demented patients were at higher risk of all-cause mortality over 3- (HR 3.33, 95% CI 1.28–8.29) and 7-year follow-up periods (HR 1.89, 95% CI 1.10–3.44), but not of disability. Frailty syndrome was a short-term predictor of disability in nondemented older subjects and short- and long-term predictor of all-cause mortality in nondemented and demented patients.     

Sex differences in the impact of nonalcoholic fatty liver disease on cardiovascular risk factors

Background and aims

Information on sex differences in the association of nonalcoholic fatty liver disease (NAFLD) with cardiovascular disease (CVD) risk factors is scarce. We examined whether men exhibit greater differences in established CVD risk factors between NAFLD and non-NAFLD than women.