Cardiovascular risk factors among older persons with cognitive frailty in middle income country

BACKGROUND Cognitive frailty,characterized by the coexistence of cognitive impairment and physical frailty,represents a multifaceted challenge in the aging population.The role of cardiovascular risk factors in this complex interplay is not yet fully understood.AIM To investigate the relationships between cardiovascular risk factors and older persons with cognitive frailty by pooling data from two cohorts of studies in Malaysia.METHODS A comprehensive approach was employed,with a total of 512 communitydwelling older persons aged 60 years and above,involving two cohorts of older persons from previous studies.Datasets related to cardiovascular risks,namely sociodemographic factors,and cardiovascular risk factors,including hypertension,diabetes,hypercholesterolemia,anthropometric characteristics and biochemical profiles,were pooled for analysis.Cognitive frailty was defined based on the Clinical Dementia Rating scale and Fried frailty score.Cardiovascular risk was determined using Framingham risk score.Statistical analyses were conducted using SPSS version 21.RESULTS Of the study participants,46.3%exhibited cognitive frailty.Cardiovascular risk factors including hypertension(OR:1.60;95%CI:1.12-2.30),low fat-free mass(OR:0.96;95%CI:0.94-0.98),high percentage body fat(OR:1.04;95%CI:1.02-1.06),high waist circumference(OR:1.02;95%CI:1.01-1.04),high fasting blood glucose(OR:1.64;95%CI:1.11-2.43),high Framingham risk score(OR:1.65;95%CI:1.17-2.31),together with sociodemographic factors,i.e.,being single(OR 3.38;95%CI:2.26-5.05)and low household income(OR 2.18;95%CI:1.44-3.30)were found to be associated with cognitive frailty.CONCLUSION Cardiovascular-risk specific risk factors and sociodemographic factors were associated with risk of cognitive frailty,a prodromal stage of dementia.Early identification and management of cardiovascular risk factors,particularly among specific group of the population might mitigate the risk of cognitive frailty,hence preventing dementia.

Cardiovascular diseases in European ethnic minorities: Beyond the traditional cardiovascular risk factors

This editorial is intended to be a reflection on cardiovascular disease(CVD)burden in European ethnic minorities.In some European countries,ethnic minority realities,due to their recent appearance,are still to be studied in depth.The experience of several European countries,where the migration processes started earlier,even more than a century ago,can help by being an example.Many studies have shown that major differences in CVD burden exist not only between countries,but also within the same country when considering different social strata and ethnic groups.The CV risk factors underlying heart disease have been well established.Important epidemiological studies have helped us understand that the underlying causes of heart disease as well as the behaviors that can help prevent them are the same.We are now well aware that CVD should be treated by considering a holistic approach.This is why the social determinants(SDs)of health that may worsen the disease burden or that,vice versa,may improve the treatment,and even more significantly,the prognosis of a patient’s illness should be taken into consideration.For ethnic minority patients,this holistic,hermeneutic approach is of importance.Several SDs of health that influence CVDs have been identified but their relevance for the health of ethnic minorities has not yet been clearly defined.In some European countries,most ethnic minorities are largely also religious minorities.Only a few studies have evaluated the role of religion,which is an important SD that affects the probability of having CV risk factors and diseases.Adolescents,particularly those belonging to the second generation,seem to be the weak link.If we believe that these young people are really citizens of their country of birth,then a way of recognizing their belonging to the community starts from a will to better understand their condition,in order to assist them while they grow physically and mentally.Thinking about safeguarding the health of this population should be more than a health task,rather a goal of social justice.

Assessment of Diabetes Control Level and Associated Cardiovascular Risk Factors

Introduction: Cardiovascular diseases are the leading cause of mortality in type 2 diabetics patients. Our work aimed to assess the level of control of type 2 diabetes and associated cardiovascular risk factors. Patients and study method: This was an observational cross-sectional study of type 2 diabetics patients. The parameters studied were: sociodemographic data, lifestyle, anthropometric data, levels of control of diabetes by the level of HbA1C, blood pressure measured at the office and cholesterol. Results: 326 type 2 diabetics patients were collected. The sex-ratio was 0.35. The average age of the patients was 58 ± 11 years. A physical inactivity remained present in 79 patients (24.23%), 2 patients (0.61%) continued to smoke. The prevalence of obesity was 21.16% (n = 69) or 25% of women and 10.4% of men (p = 0.01). Abdominal obesity was observed in 151 patients (46.31%), 139 of whom were female and 12 male (p = 0.001). Diabetes was sufficiently controlled in 65.34% of patients (n = 213) while cholesterolemia and hypertension were controlled in 33.44% and 8.33% of patients respectively. Conclusion: Type 2 diabetes was frequently associated with other cardiovascular risk factors. Control of diabetes and these factors was insufficient. Therapeutic education of type 2 diabetics patients needed to be improved.

Prevalence of Major Cardiovascular Risk Factors and Cardiovascular Disease in Women in China: Surveillance Efforts

In this study, we aimed to assess the relationship of socioeconomic status and acculturation with cardiovascular disease （CVD） risk profiles and CVD and examine the CVD risk factors associated with CVD. We used data from the 2010 China Chronic Disease and Risk Factor Surveillance surveys, which consisted of a nationally representative sample of women. The following prevalence was found： myocardial infarction （MI）：

Clustering of Cardiovascular Risk Factors and Diabetes： A Prospective Cohort Study on the Inner Mongolian Population in China

Objective To evaluate the effect of clustering of cardiovascular risk factors（CVRFs） on type 2 diabetes mellitus（T2 DM） incidence and identify some high predictive clusters in the Inner Mongolian population in China. Methods A total of 1,884 Mongolian individuals aged 20 years or above were followed up from 2002 to 2013 and included in the final analysis. We categorized the participants into two subgroups according to the study outcome event. A Cox proportional hazards model was used to evaluate the effect of clustering of CVRFs on the incidence of T2 DM. Areas under the curve were used to compare the effect of every cluster on T2 DM and identify those having higher predictive value. Results We found 203 persons with T2 DM. Subjects with incident T2 DM tended to be older, had a higher prevalence of drinking, had higher systolic and diastolic pressures; total cholesterol, triglyceride, low-density lipoprotein cholesterol, and C-reactive protein levels; waist circumference; body mass index; and heart rate and lower HDL-C level than did those without T2 DM. The multivariable adjusted hazard ratio（95% confidence interval） of T2 DM was calculated based on comparisons with subjects with 0 CVRFs; in participants with 2 and ≥ 3 factors, the adjusted hazard ratios were 2.257（1.448, 3.518） and 3.316（2.119, 5.188）, respectively. Conclusion The clustering of CVRFs increased the risk of T2 DM. On the basis of fast heart rate, the cluster of abdominal obesity and other CVRFs had higher predictive value for T2 DM than the other three CVRF clusters.

Control of Cardiovascular Risk Factors in the Semi-Urban Population of Guéoul in Senegal

Introduction: Cardiovascular disease is a global public health problem. In Africa, they are increasingly common, however, data on the control of cardiovascular risk factors in the general Senegalese population are rare. The aim of this work was to assess the level of control of cardiovascular risk factors in semi-urban areas in the municipality of Guéoul in Senegal. Patients and methods: This is a cross-sectional, descriptive and exhaustive survey carried out from 3 November to 3 December 2012 among the population aged at least 35 years and living for more than 6 months in the commune of Gueoul. It was conducted using the WHO STEPS approach to study the prevalence of cardiovascular risk factors and assess their level of control. We looked at clinical history, lifestyle, and anthropometric data. Blood pressure was measured at both arms and fasting blood samples were taken for blood glucose, cholesterol and triglycerides. Results: We examined 1.411 subjects (1052 women) averaging 48.5 ± 12.7 years of age. The main cardiovascular risk factors were dyslipidemia (61%), sedentary (56%), abdominal obesity (53.9%), high blood pressure (46.4%) and diabetes (7.2%). Dyslipidemia was known in 22 subjects, 6 of whom were on treatment with dyslipidemia control in 1 subject (16.7%). Hypertension was known in 266 subjects. Of these, 205 subjects were prescribed medical treatment, 26 of whom were well controlled (12.7%). The level of hypertension control was lower in subjects at high cardiovascular risk (p = 0.0001) and those with a family history of hypertension (p = 0.001). The male gender (p = 0.24), the short duration of progression of hypertension (p = 0.95) and the noncompliance of the diet (p = 0.176) were not significantly associated with poor control of hypertension. In diabetics, subjects on oral antidiabetic drugs had met fasting glucose targets in 65.5% of cases according to the recommendations of the American Diabetes Association and in 58.6% according to those of the International Diabetes Federation (p = 0.0001). Age, regular physical activity and insulin treatment were not significantly related to fasting blood sugar control. Conclusion: Our study found inadequate control and high prevalence of cardiovascular risk factors in the general Senegalese population. This situation could be a cause of aggravation of cardiovascular diseases in Senegal and should promote to improve their management.

Cardiovascular Risk Factors among Outpatients: An Alarming Sign of the Epidemiological Transition in Developing Country?

Background: Noncommunicable diseases are the leading cause of death in the world and low and middle-income countries suffer from preventable premature death. The aim of this study was to assess the risk factors for non- communicable disease (NCDs) in general and particular cardiovascular diseases (CVDs) among the outpatients of our department of medicine. Methods: We performed a cross-sectional study from April to December 2017 by the consecutive enrollment of outpatients who attended in our department of medicine of Hôpital Sominé DOLO de Mopti, Mali. Clinical and laboratory data were measured for cardiovascular risk assessment. Framingham Risk Score (FRS) and Systemic Coronary Risk Estimation (SCORES) were computed by using Framingham and SCORE equations. Metabolic syndrome was defined using the harmonized criteria from the International Diabetes Federation (IDF) and the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI). Data were captured in excel and analyzed with R version 4.0.3. The statistical significance was set at p = 0.05. Results: A total of 292 patients were enrolled in this study. The prevalence of traditional cardiovascular risk factors was 36.64%, 21.57%, 14.04%, and 13.01% for high blood pressure, hyperglycemia, smoking, and alcohol consumption, respectively. The metabolic syndrome accounted for 23.63%. The mean body mass index was 26.10 ± 7 kg/m2. The overall 10-year risk for cardiovascular events or death was 26.3% and 8.6% according to the FRS and SCORE equation, respectively. The 10-year risk of cardiovascular events according to the FRS was significantly higher in subjects aged 50 and above compared to subjects aged under 50 years, 34.46% vs 13.16%, p < 0.001. Likewise, the 10-year risk for cardiovascular death according to SCORE equation was also significantly higher in subjects aged 50 and above compared to subjects under 50 years, 9.43% vs 2.09%, p = 0.02. Regarding gender, the FRS was significantly higher in men compared to women 49.50% vs 7.84%, p < 0.001. This same trend was observed with the SCORE, 14.67% vs 4.13%, p = 0.03. Conclusion: Our data corroborate the increasing prevalence of cardiovascular risk factors in SSA. A comprehensive cardiovascular risk factors assessment should be implemented in all stages of health facilities and a longitudinal follow-up could help shed a light on the epidemiology of NCDs in general and particularly CVDs and thereby improve their control policies in SSA.

Prevalence of Cardiovascular Risk Factors in Chronic Hemodialysis Patients at the University Hospital Center of Point G in Bamako, Mali

Introduction: A cardiovascular risk factor (FDRCV) is defined as a physiological, pathological or environmental attribute or characteristic that results in an increased likelihood of developing cardiovascular disease in the individual in whom it is detected. The objective of this study was to determine the prevalence of cardiovascular risk factors in hemodialysis patients on hemodialysis at the University Hospital of Point G. Patients and Methods: This was a cross-sectional descriptive study with prospective data collection from March 3, 2009 to March 5, 2010 (13 months). Included were all patients with end-stage renal disease (ESRD) receiving chronic hemodialysis in the Nephrology and Hemodialysis Department of the University Hospital of Point G during the study period. Results: Eighty-eight patients were enrolled. The M/F sex ratio was 1.26. The mean age was 41.32 years with extremes of 17 and 81 years. The classic cardiovascular risk factors in order of frequency were: hypertension (90.9%), sedentary lifestyle (71.6%), male sex (54.5%), age ≥ 55 years (21.6%), obesity (13.6%), diabetes (8%), tobacco (8%), alcohol (3.4%). Cardiovascular risk factors related to CKD were: anemia (98.9%), phosphocalcic disorders (85.2%), arteriovenous fistula (AVF) (80%), lipid abnormalities (36.5%), hydrosodium inflation (29.5%). Predominant cardiovascular complications were hypertensive heart disease (62.5%), acute pulmonary oedema (APO) (50%), rhythm disorders (23.9%), coronary insufficiency (18.2%). The mortality rate was 17%. Conclusion: Cardiovascular risk factors are frequent in chronic hemodialysis. They contribute to the excess mortality of these patients. Adequate management of these risk factors can slow down serious cardiovascular complications and reduce the risk of mortality in this fragile population.

What Happens to Modifiable Cardiovascular Risk Factors over Time in Type 2 Diabetes? Experience from a Developing Country under Standard of Care Conditions

Introduction: The complications of diabetes mellitus are the main reason for the morbidity associated with this condition, its cost, and its effect on quality of life. We have previously reported on the high prevalence of complications on a cohort of diabetic subjects. In the current study, we inquire what happens to the risk factors associated with these complications over time. Methods: The study is a prospective observational report over a two-year period where patients presented to the outpatient clinic for their usual care and had laboratory tests, retinal exams, and clinical assessment. They were treated as per American Diabetes Association guidelines in the outpatient department of the American University of Beirut. Results: Out of 220 subjects, 200 completed the two-year evaluation. There was no change in metabolic indices such as HbA1C, BMI, or smoking rates. However, there was mild, but significant improvement in LDL-C levels and blood pressure control. In parallel, there was an increase in the use of statins and ARB/ACEI category. However, their use remained much lower than in the reported literature. The population fared worse than the National Health Assessment and Nutrition Examination Survey (NHANES) population in most diabetes quality of care measures. The predicted 10-year vascular risk was 19%, similar to the calculated risk in a German population study. Conclusion: The lack of significant metabolic improvement points to a lack of effective lifestyle implementation measures, as well as to an under utilization of medical therapy. The approach to complications prevention needs to be more intense and multidisciplinary in nature in order to improve the patients’ outcome.

Effects of Orlistat - induced Weight Loss on Cardiovascular Risk Factors in Obese Chinese Subjects

Objectives To observe the influence of weight loss induced by orlistat on several cardiovascular diseases risk factors in obese Chinese subjects. Methods Sixty obese Chinese patients participated in a 24 week clinical trial. Participants were prescribed a slightly hypocaloric diet and exercise, then they were randomly assigned double -blind treatment with either orlistat 120 mg three times a day or placebo. Their body weight, blood pressure, fasting glucose, insulin, HbA1c, and serum lipid profile were performed before and after the weight loss intervention. Results After 24 weeks, orlistat -treated group lost more of their body weight than placebo group (6. 66 ± 0. 52 kg, 8. 44±4.08% and 1. 98 ± 0. 44 kg, 2. 44±1. 74 % , respectively, P < 0. 05) . Moreover, after treatment, orlistat - treated patients showed significant decreases in serum levels of total cholesterol, low density lipoprotein - cholesterol and high density lipoprotein - cholesterol ( P < 0.01), but in placebo group we found no change. Both systolic blood pressure and diastolic blood pressure fell significantly in orlistat - treated group. Fasting glucose and HOMA - IR in orlistat - treated group was distinctly reduced if compared with placebo group. Conclusions Weight loss resulting from orlistat treatment and slightly hypocaloric diet has produced favorable effects on several cardiovascular risk factors in obese Chinese subjects.

Prehypertension, Hypertension and Associated Cardiovascular Risk Factors among Adult Congolese Urban Dwellers: Results of the Vitaraa Study

Objective: To assess the prevalence of prehypertension and hypertension, their determinants and associated cardiovascular risk factors in Congolese urban dwellers. Methods: From July 2007 to March 2008, we collected information on lifestyle habits, medical history and anthropometric data in 1292 household members of Adoula Quarter, Kinshasa, aged 20 years or more, 731 women (56.6%). We obtained measurements of BP, blood glucose, serum lipids and qualitative proteinuria. We defined blood pressure categories according to JNC7 classification and used logistic regression analyses to assess their independent determinants. We obtained age adjustment of continuous and categorical variables using GLM and Genmod procedures, respectively. Results: Prehypertension was observed in 30.3% of subjects, 34.9% of men and 26.7% of women (P = 0.0045). The prevalence of hypertension amounted to 30.9% with no difference between genders. Participants with prehypertension had average age, BMI and waist circumference intermediate between those with normal BP and hypertensive subjects. Their glucose and lipids levels were similar to those of normotensives. The prevalence of prehypertension amounted to 33% at age 20 - 29 years and decreased to 16.7% at ≥60 years whereas the prevalence of hypertension increased from 11.2% to 71.4%. The rates of diabetes mellitus were similar accross blood pressure catogo- ries whilst prevalences of overweight/obesity, abdominal adiposity, dyslipidemia and metabolic syndrome significatively increased (P = 0.05 or less). Among participants with prehypertension, 73% had two or more additional cardiovascular risk factors. In the logistic model the probability of prehypertension was higher in men (OR: 1.429;95% CI: 1.099 - 1.857) and participants with overweight/obesity (OR: 1.666;1.146 - 2.422), lower in participants aged ≥ 55 years (0.427;0.267 - 0.683) and those with high fruit intake (0.691;0.488 - 0.977). The probability of hypertension was higher in participants aged ≥ 55 years (OR: 6.988;4.561 - 10.706), overweight/obesity (2.263;1.704 - 3.004), those with high vegetables consumption (1.152;1.003 - 1.324) and faster pulse rate (1.013;1.002 - 1.025). Conclusion: Our results suggest that fruit consumption and control of over-weight are important issues for prevention of cardiovascular disease in sub-Saharan Africa where high blood pressure is the main driver of the current epidemic.

Relationship of Body Mass Index, Waist Circumference and Cardiovascular Risk Factors in Chinese Adult

Objective To compare the relative risk of waist circumference （WC） and/or BMI on cardiovascular risk factors. Methods A cross-sectional data of 41 087 adults （19 567 male and 21 520 female） from the 2002 China National Nutrition and Health Survey were examined. According to the obesity definition of WGOC （BMI, 24 kg/m^2 and 28 kg/m^2; WC, male 85 cm and 95 cm for male, 80 cm and 90 cm for female）, the study population were divided into 9 groups. The prevalence and odds ratio （ORs） of cardiovascular disease （CVD） risk factors （hypertension, high fasting plasma glucose and dyslipidemia） were compared among these 9 groups. Stepwise linear regression analyses were used to compare the likelihood of BMI and/or WC on CVD risk factors. Results Both the indexes levels and the odds ratios of CVD risk factors were significantly increased （decreased for HDL-C levels） along with the increase of WC and/or BMI, even when the effect of age, sex, income, education, sedentary activity and dietary factors were adjusted. The variances （R2） in CVD risk factors explained by WC only and BMI only were quite similar, but a little bit larger when WC and BMI were combined. The standard fl was higher of BMI when predicting systolic BP and was higher of WC when predicting TG, TC and HDL. Conclusions BMI and WC had independent effects on CVD risk factors and combination of BMI and WC would be more predictive. Findings from the present study provided substantive evidence for the WGOC recommendation of a combined use of BMI and WC classifications.

Waist Circumference Reference Values for Screening Cardiovascular Risk Factors in Chinese Children and Adolescents

Objectives To explore the optimal threshold values of waist circumference （WC） for detecting cardiovascular （CV） risk factors among Chinese children and adolescents. Methods Association of WC with CV risk factors was studied among 65 898 children aged 7-18 years whose data were pooled from nine previous studies in China. CV risk factors in this study included hypertension （blood pressure above 95 percentile levels）, dyslipidemia （with one or more of the following three indexes： TG ≥ 1.7 mmol/L, TC ≥ 5.18 mmol/L, and HDL-C ≤ 1.04 mmol/L） and elevated glucose level （fasting plasma glucose ≥5.6 mmol/L）. Receive-operating characteristic analysis （ROC） and logistic regression were employed to derive optimal age- and sex-specific waist circumference references for predicting CV risk factors. Results A slight increasing trend of CV risk factors was observed starting from the 75th percentile of waist circumference in the study population, while a remarkable increasing trend occurred from the 90th percentile. The optimal waist circumference thresholds for predicting high blood pressures were at the 75th percentile for both boys and girls, which was at the 90th percentiles for detecting at least two of the above three CV risk factors. In comparison with children with waist circumference below the 75th percentile, the odds ratio of two CV risk factors doubled among children with waist circumference between the 75th and the 90th percentile, and increased by 6 times among children with waist circumference above the 90th percentile. The trend of high blood pressure increasing with waist circumference remained significant after having been stratified by BMI category. Conclusion The 75th and the 90th percentiles of WC are the optimal cut-off points for predicting an increased and a substantially increased risk of CV factors in Chinese children and adolescents, respectively.

Cardiovascular risk factors for acute stroke: Risk profiles in the different subtypes of ischemic stroke

Timely diagnosis and control of cardiovascular risk factors is a priority objective for adequate primary and secondary prevention of acute stroke. Hypertension, atrial fibrillation and diabetes mellitus are the most common risk factors for acute cerebrovascular events, although novel risk factors, such as sleep-disordered breathing, inflammatory markers or carotid intima-media thickness have been identified. However, the cardiovascular risk factors profile differs according to the different subtypes of ischemic stroke. Atrial fibrillation and ischemic heart disease are more frequent in patients with cardioembolic infarction, hypertension and diabetes in patients with lacunar stroke, and vascular peripheral disease, hypertension, diabetes, previous transient ischemic attack and chronic obstructive pulmonary disease in patients with atherothrombotic infarction. This review aims to present updated data on risk factors for acute ischemic stroke as well as to describe the usefulness of new and emerging vascular risk factors in stroke patients.

Frequency of Cardiovascular Risk Factors in Systemic Lupus Erythematosus: A Case-Control Study in a Department of Internal Medicine in Sub-Saharan Africa

Background: The morbidity and mortality of systemic lupus erythematosus are largely due to accelerated atherosclerosis. This is partly related to the high prevalence of traditional cardiovascular risk factors. The aim of our study was to determine the frequency of these factors in lupus patients compared to a control population in a department of internal medicine. Methods: We realized a case-control study in patients with systemic lupus erythematosus according to ACR criteria in 1997. Patients were matched by age and gender with controls subjects without autoimmune disease. We studied the frequency of traditional cardiovascular risk factors in both populations. The study was done in the department of internal medicine of Aristide Le Dantec teaching Hospital, in Senegal, during the period from August 2017 to December 2018. The statistical analysis was performed with SPSS 23.0 software and the level of significance was retained for a p-value Results: We recruited 100 subjects including 50 patients and 50 controls. The mean age was 33.5 ± 11.3 years in cases and 33.3 ± 11.3 years in controls. Dyslipidemia was significantly associated with systemic lupus erythematosus (p = 0.009). Levels of triglycerides (p Conclusion: Traditional cardiovascular risk factors including dyslipidemia and hyperuricemia were more common in patients. Similarly, renal failure was associated with lupus.

Changing trends of cardiovascular risk factors among Indians:a review of emerging risks

The global burden of disease due to cardiovascular diseases(CVDs) is escalating,and the changing trends of CVD risk factors are identified among Indians experiencing rapid health transition.Contributory causes include:growing population with demographic shifts and altered age profile,socio-economic factors,lifestyle changes due to urbanization.Indians are also having genetic predisposition to cardiovascular diseases and adult are susceptible to vascular disease linking possible gene-environment interactions influencing ethnic diversity.Altered diets with more of junk foods along with diminished physical activity are additive factors contributing to the acceleration of CVD epidemics,along with all form of tobacco use.The pace of health transition,however,varies across geographical regions from urban to rural population with consequent variations in the relative burdens of the dominant CVDs.A comprehensive public health response must be looked to plan over all strategies to integrate policies and programs that effectively impact on the multiple determinants of CVDs to provide protection over the life span through primordial,primary and secondary prevention.Populations as well as individuals at risk must be protected through initiatives,enable nutritionbased preventive strategies to protect and promote cardiovascular health.

An Updated Mini Review on Grapefruit: Interactions with Drugs, Obesity and Cardiovascular Risk Factors

The paper examines the effects of grapefruit consumption in relation to drugs, obesity and cardiovascular risk factors. The review includes the most updated studies found in Pub-Med. The grapefruit effect refers to the ability of grapefruit juice and supplements to interact with a wide variety of pharmaceuticals, either enhancing or limiting their systemic availability. Due to altering the active dosage of the pharmaceutical, Grapefruit juice is commonly not allowed to be used alongside with many drugs. Naringin is the most important one, which can inhibit absorption of some drugs but more commonly 6’7’-dihydroxybergamottin, which inhibits CYP3A4. Lately, grapefruit has been found both in rats and adults to reduce body weight, blood pressure, improve lipid and hepatic profile and decrease platelet aggregation. These promising results must be followed by additional studies in order to add to the importance of the role and effects of grapefruit as part of our diet.

Physical activity and cardiovascular risk factors in university students in the city of Leon, Mexico

Objectives: Recent changes in life style have increased obesity, smoking and sedentary habits in the entire population. Obesity and overweight frequency have trebled in Mexico in the last few decades. The presence and frequency of cardiovascular risk factors were determined in students at the Universidad DeLa Salle Bajío, both newly admitted and in advanced years. Material and methods: Anthropometric variables, serum glucose, total cholesterol levels, blood hemoglobin and hematocrit were obtained and assessed in 4814 students, 1507 recently admitted and 1507 advanced students. Results: The prevalence of obesity was 15.3%, sedentariness 33.8%, hypercholesterolemia 8.16%, smoking habits 15.8%, and alcohol consumption 12.1%. Body mass index (BMI) (23.5 ± 4 vs. 22.7 ± 4), waist/ abdomen index (0.84 ± 0.06 vs. 0.83 ± 0.06) and serum cholesterol (3.54 mmol/L ± 0.79 vs. 3.98 mmol/L ± 0.77) were greater in the advanced students

Cardiovascular Risk Factors and Epicardial Adipose Tissue Measured by Chest Computed Tomography in Healthy Adults

Background: Epicardial adipose tissue (EAT) may produce several cytokines contributed to coronary atherosclerosis. EAT was measured by transthoracic echocardiography or 3 dimensional cardiac computed tomography (CT) on previous studies. We aimed to evaluate the correlation between EAT thickness and cardiovascular risk factors in healthy adults. Method: We collected clinical, biochemical information from 469 subjects (371 men and 98 women) who visited our health promotion center. EAT thickness was measured by chest CT on the free wall of the right ventricle. Result: The mean EAT thickness was 2.47 ± 1.64 mm in total of 469 subjects. EAT thickness was significantly correlated to age, weight, body mass index (BMI), total body fat, systolic and diastolic blood pressure, total cholesterol, low density lipoprotein (LDL)-cholesterol, and fasting glucose in men and to age, height, weight, BMI, total body fat, systolic and diastolic blood pressure, triglycerides, C-reactive protein (CRP), and fasting glucose in women. Multivariate analysis showed that age, BMI, systolic blood pressure, fasting glucose were the variables that independently correlated to EAT thickness in men. But there was no significant independent variable in women. Conclusion: In our study, EAT thickness measured with chest CT in healthy individuals correlates with cardiovascular risk factors in men.

Relationship changes in lifestyle, cardiovascular risk factors, and mental health in Japanese workers: A four-year follow up with high-risk and population strategies of the occupational health promotion (HIPOP-OHP) study

Background: Cardiovascular diseases (CVD) are major causes of death in Japan, and controlling the risk factors for CVD is an important public health task. Lifestyle factors, for example, diet and stress, have impacts on risk factors such as hypertension and hyperlipidemia. Deterioration of mental health is related to CVD pathogenesis. Aim: We investigated the relationships between levels of mental health, 4-year changes in lifestyle, and CVD risk factors among Japanese workers, using the SF-36 (Japanese version), which is a comprehensive scale measuring health-related quality of life. We hypothesized that workers’ mental health levels would influence 4-year changes in their lifestyles and CVD risk factors. Methods: Data from the High-Risk and Population Strategy for Occupational Health Promotion (HIPOP-OHP) study, which were collected by examination and administration of the SF-36, were used. The relationships between mental health levels at baseline, lifestyle chan- ges, and cardiovascular risk factors were longitudinally analyzed. Subjects with total SF-36 scores ≥65 were classified as the “Good Mental Health Group,” and those with total scores <65 were classified as the “Poor Mental Health Group.” Results: Multiple logistic regression analyses showed that, as compared to people who had poor mental health, those who had good mental health at baseline had a significantly higher probability of good maintenance of improvements in body mass index, (OR = 1.20, 95% CI: 1.03 - 1.39), blood pressure (OR = 1.20, 95% CI: 1.01 - 1.43), total cholesterol (OR = 1.07, 95% CI: 0.86 - 1.33) and HDL cholesterol (OR = 1.26, 95% CI: 1.07 - 1.47). Conclusion: Japanese workers with good mental health tend to improve or maintain good lifestyle conditions and minimize CVD risk factors, while those with poor mental health generally have difficulty improving their lifestyles and lowering their CVD risk.