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.

Prevalence of Cardiovascular Risk Factors and Heart Diseases within the Urban and Rural Communities of the Town of Bougouni and Its Surroundings (Southern Mali): A Comparative Study

In Mali, few studies have been conducted on the prevalence of cardiovascular risk factors and diseases according to place of residence. The aim of this study was to assess the prevalence of risk factors and cardiovascular diseases according to residents in town of Bougouni and its rural area (southern Mali). Methods: This was a retrospective descriptive study from February 2019 to March 2024. All patients who visited the “CENTRE MEDICAL DE BOUGOUNI” clinic with known or suspected heart disease during the study period were included. Data were collected from medical records. Incomplete or unusable records were excluded. Data were processed using SPS version 22 software. Results: we included 452 patients with an average age of 50 ± 19 years. High blood pression has been found in 42.70% of cases, with higher prevalence in urban areas (47.01%) than in rural areas (41.50%). Diabetes and smoking were found respectively 5.31% and 8.19% in our population. The prevalence of diabetes was higher in urban areas (5.97%) than rural area (5.35%). smoking prevalence was higher in rural areas (8.49%) than urban areas (6.72%). Alcoholism was found in 2.21% of cases with a little difference between rural area (2.24%) and urban area (2.20%). 31.63% of our patients had no cardiovascular factor. Dyspnea was the reason of consultation in 5.75% of cases and atypical precordialgia in 13.72%. Headaches and dizziness in 8.63% of cases and 21.90% of patients presented other non-specific symptoms. Diagnosis of idiopathic dilated cardiomyopathy was found in 23.45% of cases with higher prevalence in rural areas (28.30%) than urban areas (13.43%). Ischaemic heart disease accounted for 9.29% of cases with a higher prevalence in rural areas (10.38%) than in urban areas (6.71%). PPCMs accounted for 5.98% of cases, with a slight increase in urban areas (6.66%) compared with rural areas (5.68%). Rheumatic valvulopathy accounted for 2.21% of cases;2.84% in rural areas and 0.74% in urban areas. Other valvular diseases accounted for 3.76% of cases;4.73% in rural areas and 1.48% in urban areas. Right heart diseases accounted for 3.98% of cases and stroke for 1.77%. Conclusion: The prevalence of cardiovascular risk factors and heart diseases is high in the rural and urban population of the town of Bougouni and its surroundings (Mali). Excepted smoking, the prevalence of other CV risk factors is higher in urban areas, whereas the prevalence of idiopathic dilated cardiomyopathy and ischemic heart disease is higher in rural areas. These data could serve as a basis for developing tailored preventive strategies, depending on the place of residence.

Assessment of Cardiovascular Risk Factors During Pregnancy: A Multicenter Study in West Africa, Dakar, Senegal

Context: Non-communicable diseases, including hypertension, are major causes of complications during pregnancy, posing significant risks to maternal and fetal health. Pregnancy increases cardiovascular risks, particularly through the development of gestational hypertension and preeclampsia, requiring early screening and close monitoring to prevent adverse outcomes. Objectives: This study aimed to evaluate the frequency of cardiovascular risk factors in pregnant women in Senegal and identify associated socio-behavioral and economic determinants. Methodology: A descriptive, analytical cross-sectional study with prospective data collection was conducted over three months (April 10 to July 10, 2023). The study included pregnant women aged 15 and older from three public hospital maternity wards in Senegal. We studied sociodemographic aspects, cardiovascular risk factors, and collected information on previous and current pregnancies, including the number of pregnancies, parity, miscarriages, the number of prenatal consultations, and the number of fetuses. Written consent was obtained. A p-value ≤ 0.05 was considered statistically significant. Results: A total of 222 pregnant women were enrolled, representing 28% of prenatal consultations. The average age was 29.18 years (range 15 - 47). Most participants (90%) lived in Dakar suburbs, 74.20% had no medical coverage, 84% worked in the informal sector (p = 0.043), and 18% had no education. Among them, 30.63% were in their first pregnancy, 34% were nulliparous, and 3.15% were grand multiparous. The average number of prenatal visits was 3.5, with about 40% having more than four visits. Risk factors included hypertension (17%), more prevalent in women over 30 (p = 0.043), diabetes (4%), and smoking (2%). Conclusion: The study highlights critical prenatal health needs and socio-economic challenges faced by pregnant women, emphasizing the need for targeted strategies to improve healthcare access and health education.

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.

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.

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.

Comparative study for cardiovascular risk factors of rheumatoid arthritis and osteoarthritis

Objective： To compare the difference of cardiovascular risk factors in patients with rheumatoid arthritis （RA） and osteoarthritis （OA）. Methods： A retrospective analysis was performed to compare the difference of cardiovascular factors between 44 patients with RA and 36 patients with OA in terms of their gender, age, body mass index, course of disease, carotid ultrasound related indicators, homocysteine, blood lipid levels, inflammation index, echocardiographic index, etc. Results： （1） General situation： there was no significant difference between two groups in terms of gender and age （P 〉 0.05）. However, body mass index of OA group was significantly higher than that of RA group and the course of disease of RA group was significantly longer than that of OA group （P = 0.024）. （2） Laboratory index： the level of homocysteine of RA group was significantly higher than that of OA group （P = 0.002）. Though there was no significant difference between these two groups in terms of total cholesterol, triglyceride, low density lipoprotein, apolipoprotein B and high density lipoprotein （P 〉 0.05）, the level of apolipoprotein A1 of RA group was significantly lower than that of OA group （P 〈 0.001） and the level of lipoprotein A of RA group was significantly higher than that of OA group （P 〈 0.001）. The levels of erythrocyte sedimentation rate and C reactive protein of group RA were significantly higher than those of OA group （P 〈 0.001）. （3） Stroke volume and ejection fraction of echocardiography of RA patients were significantly lower than those of OA patients （P = 0.022, P = 0.009）. However, there was no significant difference between two groups in terms of aortic diameter, left atrial diameter, left ventricular end diastolic diameter, left ventricular end systolic diameter, left ventricular posterior wall thickness, left ventricular fractional shortening, right ventricular diameter, right atrial diameter, and interventricular septum thickness （P 〉 0.05）. Though significant difference in carotid artery plaque incidence between the two groups was not observed （P 〉 0.05）, the incidence of carotid artery thickening and carotid artery middle thickness were significantly different between the two groups （P 〈 0.001）. Conclusion： The rate for the occurrence of cardiovascular events in patients with RA was higher than those with OA. Additionally, effective control of RA patients’ conditions has the potential to reduce the risk of cardiovascular events.

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.

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.

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.

Circulating Lipoproteins Mediate the Association Between Cardiovascular Risk Factors and Cognitive Decline:A Community‑Based Cohort Study

Cardiovascular health metrics are now widely recognized as modifable risk factors for cognitive decline and dementia.Metabolic perturbations might play roles in the linkage of cardiovascular diseases and dementia.Circulating metabolites profling by metabolomics may improve understanding of the potential mechanism by which cardiovascular risk factors contribute to cognitive decline.In a prospective community-based cohort in China(n=725),312 serum metabolic phenotypes were quantifed,and cardiovascular health score was calculated including smoking,exercise,sleep,diet,body mass index,blood pressure,and blood glucose.Cognitive function assessments were conducted in baseline and follow-up visits to identify longitudinal cognitive decline.A better cardiovascular health was signifcantly associated with lower risk of concentration decline and orientation decline(hazard ratio(HR):0.84–0.90;p<0.05).Apolipoprotein-A1,high-density lipoprotein(HDL)cholesterol,cholesterol ester,and phospholipid concentrations were signifcantly associated with a lower risk of longitudinal memory and orientation decline(p<0.05 and adjusted-p<0.20).Mediation analysis suggested that the negative association between health status and the risk of orientation decline was partly mediated by cholesterol ester and total lipids in HDL-2 and-3(proportion of mediation:7.68–8.21%,both p<0.05).Cardiovascular risk factors were associated with greater risks of cognitive decline,which were found to be mediated by circulating lipoproteins,particularly the medium-size HDL components.These fndings underscore the potential of utilizing lipoproteins as targets for early stage dementia screening and intervention.

Predictive Ability of Hypertriglyceridemic Waist,Hypertriglyceridemic Waist-to-Height Ratio,and Waist-to-Hip Ratio for Cardiometabolic Risk Factors Clustering Screening among Chinese Children and Adolescents

Objective Hypertriglyceridemic waist(HW),hypertriglyceridemic waist-to-height ratio(HWHtR),and waist-to-hip ratio(WHR)have been shown to be indicators of cardiometabolic risk factors.However,it is not clear which indicator is more suitable for children and adolescents.We aimed to investigate the relationship between HW,HWHtR,WHR,and cardiovascular risk factors clustering to determine the best screening tools for cardiometabolic risk in children and adolescents.Methods This was a national cross-sectional study.Anthropometric and biochemical variables were assessed in approximately 70,000 participants aged 6–18 years from seven provinces in China.Demographics,physical activity,dietary intake,and family history of chronic diseases were obtained through questionnaires.ANOVA,χ2 and logistic regression analysis was conducted.Results A significant sex difference was observed for HWHtR and WHR,but not for HW phenotype.The risk of cardiometabolic health risk factor clustering with HW phenotype or the HWHtR phenotype was significantly higher than that with the non-HW or non-HWHtR phenotypes among children and adolescents(HW:OR=12.22,95%CI:9.54-15.67;HWHtR:OR=9.70,95%CI:6.93-13.58).Compared with the HW and HWHtR phenotypes,the association between risk of cardiometabolic health risk factors(CHRF)clustering and high WHR was much weaker and not significant(WHR:OR=1.14,95%CI:0.97-1.34).Conclusion Compared with HWHtR and WHR,the HW phenotype is a more convenient indicator with higher applicability to screen children and adolescents for cardiovascular risk factors.

Risk factors in cardiovascular patients:Challenges and opportunities to improve secondary prevention

BACKGROUND Effective management of major cardiovascular risk factors is of great importance to reduce mortality from cardiovascular disease(CVD).The Survey of Risk Factors in Coronary Heart Disease(SURF CHD)II study is a clinical audit of the recording and management of CHD risk factors.It was developed in collaboration with the European Association of Preventive Cardiology and the European Society of Cardiology(ESC).Previous studies have shown that control of major cardiovascular risk factors in patients with established atherosclerotic CVD is generally inadequate.Azerbaijan is a country in the South Caucasus,a region at a very high risk for CVD.AIM To assess adherence to ESC recommendations for secondary prevention of CVD based on the measurement of both modifiable major risk factors and their therapeutic management in patients with confirmed CHD at different hospitals in Baku(Azerbaijan).METHODS Six tertiary health care centers participated in the SURF CHD II study between 2019 and 2021.Information on demographics,risk factors,physical and laboratory data,and medications was collected using a standard questionnaire in consecutive patients aged≥18 years with established CHD during outpatient visits.Data from 687 patients(mean age 59.6±9.58 years;24.9%female)were included in the study.RESULTS Only 15.1%of participants were involved in cardiac rehabilitation programs.The rate of uncontrolled risk factors was high:Systolic blood pressure(BP)(SBP)(54.6%),low-density lipoprotein cholesterol(LDL-C)(86.8%),diabetes mellitus(DM)(60.6%),as well as overweight(66.6%)and obesity(25%).In addition,significant differences in the prevalence and control of some risk factors[smoking,body mass index(BMI),waist circumference,blood glucose(BG),and SBP]between female and male participants were found.The cardiovascular health index score(CHIS)was calculated from the six risk factors:Non-or ex-smoker,BMI<25 kg/m2,moderate/vigorous physical activity,controlled BP(<140/90 mmHg;140/80 mmHg for patients with DM),controlled LDL-C(<70 mg/dL),and controlled BG(glycohemoglobin<7%or BG<126 mg/dL).Good,intermediate,and poor categories of CHIS were identified in 6%,58.3%,and 35.7%of patients,respectively(without statistical differences between female and male patients).CONCLUSION Implementation of the current ESC recommendations for CHD secondary prevention and,in particular,the control rate of BP,are insufficient.Given the fact that patients with different comorbid pathologies are at a very high risk,this is of great importance in the management of such patients.This should be taken into account by healthcare organizers when planning secondary prevention activities and public health protection measures,especially in the regions at a high risk for CVD.A wide range of educational products based on the Clinical Practice Guidelines should be used to improve the adherence of healthcare professionals and patients to the management of CVD risk factors.