225 research outputs found
An association between TRP64ARG polymorphism of the B3 adrenoreceptor gene and some metabolic disturbances
<p>Abstract</p> <p>Backgrounds</p> <p>B3 adrenoreceptors (ADRB3) are abundant in adipose tissue and play the role in its metabolism and lipolysis. Some variants of the ADRB3 gene may predispose subjects for the development obesity and metabolic abnormalities in the setting of modern sedentary lifestyle. ADRB3 gene polymorphism association with metabolic disturbances has never been studied before in the ethnic Kyrgyz population.</p> <p>Aim</p> <p>To study an association between Trp64Arg polymorphism of the ADRB3 and metabolic syndrome (MS) components in an ethnic Kyrgyz group.</p> <p>Materials and methods</p> <p>213 Ethnic Kyrgyz volunteers over the age of 30 were enrolled in the study. The assessment plan for each individual comprised of general physical and anthropometric exams as well as laboratory tests (glucose, lipid panel, insulin) and genotyping by Trp64Arg polymorphism of the ADRB3. MS diagnosis was consistent with modified ATP III criteria (2005). Logistic regression analysis was performed to test the potential independent association between Arg64 allele with obesity, abdominal obesity (AO) and arterial hypertension (AH).</p> <p>Results</p> <p>Trp64Arg polymorphism of the ADRB3 was assessed in 213 individuals (145 men, 68 women) aged 30-73 (mean age 50.7 ± 7.6). Arg64 allele frequency was 0.239; ADRB3 genotype distribution among participants was: Trp64 homozygotes 54.5%, Trp64Arg 43.2% and Arg64 homozygotes 2.3%. There was an association between Trp64Arg и Arg64Arg genotypes and higher BMI, WC and obesity frequency (p < 0.00009), AO (p < 0.01), type 2 diabetes mellitus (DM) (p < 0.005) and lower high density cholesterol (HDL-C) level (p < 0.03). The logistic regression analysis showed the correlation of the Arg64 allele with obesity (OR 3.159; 95% CI 1.789-5.577) and AO (OR 1.973; 95% CI 1.118-3.481). The association between Arg64 allele and AH lost its significance after adjustment for obesity.</p> <p>Conclusion</p> <p>Arg64 allele of the ADRB3 gene in the studied group has an association with MS components such as obesity, AO and decreased HDL-C level.</p
Alcohol consumption patterns across Europe and adherence to the European guidelines in coronary patients : findings from the ESC-EORP EUROASPIRE V survey
Background and aims: Alcohol consumption is an important risk factor for cardiovascular morbidity and mortality worldwide. The highest levels of alcohol consumption are observed in Europe, where alcohol as contributing cause of coronary heart disease (CHD) is also most significant. We aimed to describe alcohol consumption patterns across European regions and adherence to the current guidelines in patients with a recent CHD event.
Methods: The ESC-EORP survey (EUROASPIRE V) has been conducted in 2016-2017 at 131 centers in 27 Eu-ropean countries in 7350 patients with a recent CHD. Median alcohol consumption, as well as the proportion of abstainers and excessive drinkers (i.e. >70 g/week for women and >140 for men, as recommended by the European guidelines on cardiovascular prevention), was calculated for each region. To assess adherence to guidelines, proportions of participants who were advised to reduce excessive alcohol consumption and participants who were incorrectly not advised were calculated per region.
Results: Mean age was 64 years (SD: 9.5), 75% were male. Abstention rates were 53% in males and 77% in females, whereas excessive drinking was reported by 9% and 5% of them, respectively. Overall, 57% of the participants were advised to reduce alcohol consumption. In the total population, 3% were incorrectly not advised, however, this percentage differed per region (range: 1%-9%). In regions where alcohol consumption was highest, participants were less often advised to reduce their consumption.
Conclusion: In this EUROASPIRE V survey, the majority of CHD patients adhere to the current drinking guidelines, but substantial heterogeneity exists between European regions
Management of dyslipidaemia in patients with coronary heart disease: Results from the ESC-EORP EUROASPIRE V survey in 27 countries
De Backer, G., Jankowski, P., Kotseva, K., Mirrakhimov, E., Reiner, Ž., Rydén, L., Tokgözoğlu, L., Wood, D., De Bacquer, D., EUROASPIRE V collaborators, Writing Committee, Scientific Steering/ Executive Committee, Coordinating centre, Diabetes centre, Data management centre, Statistical analysis centre, Central laboratory, & Study centres, organisations, investigators and other research personnel (National Co-ordinators in each country are indicated by asterisk (2019). Management of dyslipidaemia in patients with coronary heart disease: Results from the ESC-EORP EUROASPIRE V survey in 27 countries. Atherosclerosis, 285, 135–146. https://doi.org/10.1016/j.atherosclerosis.2019.03.014
Background and aims: One of the objectives of the ESC-EORP EUROASPIRE V survey is to determine how well
European guidelines on the management of dyslipidaemias are implemented in coronary patients.
Methods: Standardized methods were used by trained technicians to collect information on 7824 patients from
130 centers in 27 countries, from the medical records and at a visit at least 6 months after hospitalization for a
coronary event. All lipid measurements were performed in one central laboratory. Patients were divided into
three groups: on high-intensity LDL-C-lowering-drug therapy (LLT), on low or moderate-intensity LLT and on no
LLT.
Results: At the time of the visit, almost half of the patients were on a high-intensity LLT. Between hospital
discharge and the visit, LLT had been reduced in intensity or interrupted in 20.8% of the patients and had been
started or increased in intensity in 11.7%. In those who had interrupted LLT or had reduced the intensity,
intolerance to LLT and the advice of their physician were reported as the reason why in 15.8 and 36.8% of the
cases, respectively. LDL-C control was better in those on a high-intensity LLT compared to those on low or
moderate intensity LLT. LDL-C control was better in men than women and in patients with self-reported diabetes.
Conclusions: The results of the EUROASPIRE V survey show that most coronary patients have a less than optimal
management of LDL-C. More professional strategies are needed, aiming at lifestyle changes and LLT adapted to
the need of the individual patient
Alcohol consumption patterns across Europe and adherence to the European guidelines in coronary patients: Findings from the ESC-EORP EUROASPIRE V survey
Background and aims: Alcohol consumption is an important risk factor for cardiovascular morbidity and mortality
worldwide. The highest levels of alcohol consumption are observed in Europe, where alcohol as contributing
cause of coronary heart disease (CHD) is also most significant. We aimed to describe alcohol consumption
patterns across European regions and adherence to the current guidelines in patients with a recent CHD event.
Methods: The ESC-EORP survey (EUROASPIRE V) has been conducted in 2016–2017 at 131 centers in 27 European countries in 7350 patients with a recent CHD. Median alcohol consumption, as well as the proportion of
abstainers and excessive drinkers (i.e. >70 g/week for women and >140 for men, as recommended by the
European guidelines on cardiovascular prevention), was calculated for each region. To assess adherence to
guidelines, proportions of participants who were advised to reduce excessive alcohol consumption and participants who were incorrectly not advised were calculated per region.
Results: Mean age was 64 years (SD: 9.5), 75% were male. Abstention rates were 53% in males and 77% in females, whereas excessive drinking was reported by 9% and 5% of them, respectively. Overall, 57% of the participants were advised to reduce alcohol consumption. In the total population, 3% were incorrectly not advised,
however, this percentage differed per region (range: 1%–9%). In regions where alcohol consumption was
highest, participants were less often advised to reduce their consumption.
Conclusion: In this EUROASPIRE V survey, the majority of CHD patients adhere to the current drinking guidelines, but substantial heterogeneity exists between European regions
2016 ESC/EAS Guidelines for the Management of Dyslipidaemias
The Task Force for the Management of Dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS) Developed with the special contribution of the European Assocciation for Cardiovascular Prevention & Rehabilitation (EACPR) ABI : ankle-brachial inde
Global, regional, and national burden of chronic kidney disease, 1990–2017 : a systematic analysis for the Global Burden of Disease Study 2017
Background
Health system planning requires careful assessment of chronic kidney disease (CKD) epidemiology, but data for morbidity and mortality of this disease are scarce or non-existent in many countries. We estimated the global, regional, and national burden of CKD, as well as the burden of cardiovascular disease and gout attributable to impaired kidney function, for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. We use the term CKD to refer to the morbidity and mortality that can be directly attributed to all stages of CKD, and we use the term impaired kidney function to refer to the additional risk of CKD from cardiovascular disease and gout.
Methods
The main data sources we used were published literature, vital registration systems, end-stage kidney disease registries, and household surveys. Estimates of CKD burden were produced using a Cause of Death Ensemble model and a Bayesian meta-regression analytical tool, and included incidence, prevalence, years lived with disability, mortality, years of life lost, and disability-adjusted life-years (DALYs). A comparative risk assessment approach was used to estimate the proportion of cardiovascular diseases and gout burden attributable to impaired kidney function.
Findings
Globally, in 2017, 1·2 million (95% uncertainty interval [UI] 1·2 to 1·3) people died from CKD. The global all-age mortality rate from CKD increased 41·5% (95% UI 35·2 to 46·5) between 1990 and 2017, although there was no significant change in the age-standardised mortality rate (2·8%, −1·5 to 6·3). In 2017, 697·5 million (95% UI 649·2 to 752·0) cases of all-stage CKD were recorded, for a global prevalence of 9·1% (8·5 to 9·8). The global all-age prevalence of CKD increased 29·3% (95% UI 26·4 to 32·6) since 1990, whereas the age-standardised prevalence remained stable (1·2%, −1·1 to 3·5). CKD resulted in 35·8 million (95% UI 33·7 to 38·0) DALYs in 2017, with diabetic nephropathy accounting for almost a third of DALYs. Most of the burden of CKD was concentrated in the three lowest quintiles of Socio-demographic Index (SDI). In several regions, particularly Oceania, sub-Saharan Africa, and Latin America, the burden of CKD was much higher than expected for the level of development, whereas the disease burden in western, eastern, and central sub-Saharan Africa, east Asia, south Asia, central and eastern Europe, Australasia, and western Europe was lower than expected. 1·4 million (95% UI 1·2 to 1·6) cardiovascular disease-related deaths and 25·3 million (22·2 to 28·9) cardiovascular disease DALYs were attributable to impaired kidney function.
Interpretation
Kidney disease has a major effect on global health, both as a direct cause of global morbidity and mortality and as an important risk factor for cardiovascular disease. CKD is largely preventable and treatable and deserves greater attention in global health policy decision making, particularly in locations with low and middle SDI
The global burden of falls: Global, regional and national estimates of morbidity and mortality from the Global Burden of Disease Study 2017
Background: Falls can lead to severe health loss including death. Past research has shown that falls are an important cause of death and disability worldwide. The Global Burden of Disease Study 2017 (GBD 2017) provides a comprehensive assessment of morbidity and mortality from falls. Methods: Estimates for mortality, years of life lost (YLLs), incidence, prevalence, years lived with disability (YLDs) and disability-adjusted life years (DALYs) were produced for 195 countries and territories from 1990 to 2017 for all ages using the GBD 2017 framework. Distributions of the bodily injury (eg, hip fracture) were estimated using hospital records. Results: Globally, the age-standardised incidence of falls was 2238 (1990-2532) per 100 000 in 2017, representing a decline of 3.7% (7.4 to 0.3) from 1990 to 2017. Age-standardised prevalence w
Primary prevention efforts are poorly developed in people at high cardiovascular risk: A report from the European Society of Cardiology EURObservational Research Programme EUROASPIRE V survey in 16 European countries
Background: European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE)
V in primary care was carried out by the European Society of Cardiology EURObservational Research Programme in
2016–2018. The main objective was to determine whether the 2016 Joint European Societies’ guidelines on cardiovascular disease prevention in people at high cardiovascular risk have been implemented in clinical practice.
Methods: The method used was a cross-sectional survey in 78 centres from 16 European countries. Patients without a
history of atherosclerotic cardiovascular disease either started on blood pressure and/or lipid and/or glucose lowering
treatments were identified and interviewed 6 months after the start of medication.
Results: A total of 3562 medical records were reviewed and 2759 patients (57.6% women; mean age 59.0 11.6 years)
interviewed (interview rate 70.0%). The risk factor control was poor with 18.1% of patients being smokers, 43.5%
obese (body mass index 30 kg/m2
) and 63.8% centrally obese (waist circumference 88 cm for women, 102 cm for
men). Of patients on blood pressure lowering medication 47.0% reached the target of <140/90 mm Hg (<140/85 mm Hg
in people with diabetes). Among treated dyslipidaemic patients only 46.9% attained low density lipoprotein-cholesterol
target of <2.6 mmol/l. Among people treated for type 2 diabetes mellitus, 65.2% achieved the HbA1c target of <7.0%.
Conclusion: The primary care arm of the EUROASPIRE V survey revealed that large proportions of people at high
cardiovascular disease risk have unhealthy lifestyles and inadequate control of blood pressure, lipids and diabetes. Thus,
the potential to reduce the risk of future cardiovascular disease throughout Europe by improved preventive cardiology
programmes is substantial
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