This study assessed the prevalence of traditional cardiovascular disease risk factors in 119 adolescent smokers, compared to an age-matched sample of non-smokers. Participants were assessed for body mass index (BMI), relative body fat, systolic/diastolic/mean arterial blood pressure, total serum cholesterol, aerobic fitness, family (parents or siblings) smoking habits and history of cardiovascular disease. The results showed that BMI and relative body fat were significantly increased, while aerobic fitness was significantly decreased in smokers. Male smokers further demonstrated increased diastolic blood pressure and mean arterial pressure. Smokers also showed increased prevalence for family smoking habits and cardiovascular disease history. Prevalence rates for all other cardiovascular disease risk factors were increased in smokers, but the differences between groups did not reach statistical significance. It is concluded that the studied adolescent smokers demonstrated a higher risk for developing cardiovascular disease later in life, compared to their non-smoking counterparts.
Hypertensive patients still face a considerable risk of cardiovascular disease in spite of drug treatment in many studies. This may partly be explained by metabolic disturbances, both primarily linked to hypertension but also secondarily influenced by anti-hypertensive drugs themselves. In order to evaluate residual cardiovascular risk factors we investigated 1915 treated hypertensives (912 males, 1003 females) attending 128 health centres from all parts of Sweden. Mean blood pressure was 148/91 mmHg for males and 151/90 for females, but a substantial proportion of all patients were not well controlled, having a diastolic blood pressures > or = 100 mmHg (17% males, 12% females). Total cholesterol and HDL-cholesterol were 6.03 and 1.25 mmol l-1 for males, and 6.40 and 1.50 for females. The corresponding figures for serum triglycerides were 2.03 and 1.72 mmol l-1, respectively. In all, 38% of the hypertensives had hypercholesterolaemia (> or = 6.5 mmol l-1) and 27% hypertriglyceridaemia (> or = 2.3 mmol l-1). The lipid/lipoprotein findings may also be influenced by the various anti-hypertensive drugs used in Sweden. The prevalence of smoking and diabetes mellitus were 25% and 11% for men, and for women 24% and 9%. In conclusion, Swedish hypertensives show evidence of significant residual cardiovascular risk factors in spite of treatment. This may be of importance for future relative and absolute cardiovascular risk. It is time to re-evaluate the effectiveness of our management and care of hypertensive patients.
We have studied hypertension, obesity, diabetes and hypercholesterolaemia in those aged 45-79 years in the Cretan low risk population of Spili (n = 249; attendance 82%) to see if these conditions interacted in the same way as previously described for high risk populations. Hypertension, diabetes, obesity, and hypercholesterolaemia were found to be at least as prevalent in Spili as in Sweden. Furthermore, the previously described 'Metabolic Syndrome X', with insulin resistance and hyperinsulinaemia as a common denominator also seemed to exist in the Spili population where patients with these conditions had higher insulin and C-peptide levels than normals. Our finding should be viewed against the low prevalence of past myocardial infarction in Cretan men from Spili reported by us and confirming the results of the Seven Countries Study.
Comment In: Eur Heart J. 1993 Jan;14(1):1438432284
To make qualitative and quantitative analyses of phenotypical characteristics and to study a spectrum and frequency of mutations in LDLR and APOB genes in patients with familial heterozygous hypercholesterolemia (FHHC).
Clinical symptoms of FHHC were studied in males and females. Mutations were detected with PCR, analysis of SSCP of all the exones of LDLR gene and a fragment of exone 26 of APOB gene with subsequent sequestration of DNA fragments with anomalous electrophoretic motility, analysis of restriction fragments length polymorphism.
LDLR gene mutations were detected in 50%, of APOB gene in 2.6% patients with FHHC, 70% of LDLR gene mutations have never been discovered before. Three known mutations were detected in the APOB gene: R3500Q (1.9% cases), H3543Y (0.55%), R3531C (0.15%). Incidence of coronary heart disease in untreated FHHC patients is 61.5%, of myocardial infarction--31%. Life span of both males and females with FHHC was subnormal, especially of men (median: 53 years in 95% CI, 49.2-56.8 years and 62 years in 95% CI 59.2-64.8 years, respectively). Incidence rate of basic clinical symptoms increased with age and significantly correlated with LDLP cholesterol.
Frequency and severity of clinical symptoms and complications in FHHC and in Russian population agree with those of the European countries. The same occurs with frequency and mutations of the APOB gene, while mutations of the LDLR gene in 70% cases are unique for Russian population and are not described in other countries. This makes impossible to use foreign test kits for FHHC diagnosis in Russia.
The authors researched the changes in the prevalence of hypertension and major risk factors (overweight, obesity, smoking and high cholesterol) in men of young age--officers of the Eastern Military District during the five-year dynamic observation (2009-2014). 1043 servicemen were selected for the survey. 96.5% of selected servicemen or 1011 people agreed to take part in the survey, the average age was from 25 to 45 years. It was found that among young men the prevalence of hypertension decreased to 24.4%; this result is lower than in the group of civilian population of the same age. It was also found that commitment to healthy lifestyle has increased and the prevalence of the most common risk factors (overweight and obesity, hypercholesterolemia, smoking, alcohol consumption) has decreased but in comparison with the civil population prevalence of modifiable risk factors remains high. The study showed that during the reform of the Armed Forces of the Russian Federation and the inherent strength of military labour remains high, which can not but affect the health officers, 95.5% identified hypertensive patients in our study, young men 35 years with 1st stage of the disease.
This descriptive study assessed the prevalence, perceptions and practices of community residents concerning three risk factors most commonly associated with coronary heart disease: smoking behaviour, hypertension and elevated blood cholesterol/dietary factors. One thousand questionnaires were randomly mailed to residents with a response rate of 48.1%. Results indicated that residents identify smoking and dietary factors as major risks for the development of heart disease. Although the prevalence of hypertension and the frequency of blood pressure screening was similar to other provincial and community surveys that investigated cardiac behaviours, differences were found with the prevalence of smoking behaviour, the frequency of blood cholesterol screening, and knowledge and practices of dietary behaviour. As a result of the study, target groups have been identified and programs have been recommended to meet community needs.
We compared the ability of very high levels of nonfasting cholesterol and triglycerides to predict risk of myocardial infarction and total mortality.
Prospective study from 1976 to 1978 until 2007.
Danish general population.
Randomly selected population of 7581 women and 6391 men, of whom 768 and 1151 developed myocardial infarction and 4398 and 4416 died, respectively. Participation rate was 72%, and follow-up was 100% complete. Less than 2% of participants were taking lipid-lowering therapy.
BACKGROUND: Serum cholesterol levels, blood pressure, and smoking are the classic coronary risk factors, but what determines whether a myocardial infarction will be fatal or not? OBJECTIVE: To investigate cardiovascular risk factors that may influence survival in subjects with coronary heart disease (myocardial infarction and sudden death). SUBJECTS AND METHODS: All inhabitants aged 35 to 52 years in Finnmark County, Norway, were invited to a cardiovascular survey in 1974-1975 and/or 1977-1978. Attendance rate was 90.5%. A total of 6995 men and 6320 women were followed up for 14 years with regard to incident myocardial infarction and sudden death. Predictors for 28-day case fatality rate after first myocardial infarction were analyzed. RESULTS: During 186 643 person-years, 635 events among men and 125 events among women were registered. The case fatality rate was 31.6% in men and 28.0% in women (P =.50). Among men (women) with baseline systolic blood pressure lower than 140 mm Hg, the 28-day case fatality rate was 24.5% (22.6%), among those with systolic blood pressure of 140 through 159 mm Hg, the case fatality rate was 35.6% (28.2%), and among those with systolic blood pressure of 160 mm Hg or higher, the case fatality rate was 48.2% (41.7%). Of the 760 subjects with myocardial infarction, 348 died during follow-up. In Cox regression analysis, systolic blood pressure at baseline was strongly related to death (relative risk per 15 mm Hg, 1.22; 95% confidence interval, 1.13-1.31). Daily smoking at baseline (relative risk, 1.40; 95% confidence interval, 1.07-1.85) and age at time of event (relative risk per 5 years, 1.12; 95% confidence interval, 1.01-1.24) were additional significant risk factors, while total serum and high-density lipoprotein cholesterol levels were unrelated to survival. Similar results were obtained with diastolic blood pressure in the model. CONCLUSIONS: Preinfarction blood pressure was an important predictor of case fatality rate in myocardial infarction. Daily smoking and age were additional significant predictors.