Cholesterol-lowering efficacy linked to CHD risk factors?

1997 ◽  
Vol 1100 (1) ◽  
pp. 16-16
2019 ◽  
Vol 17 (6) ◽  
pp. 591-594 ◽  
Author(s):  
John C. Stevenson ◽  
Sophia Tsiligiannis ◽  
Nick Panay

Cardiovascular disease, and particularly coronary heart disease (CHD), has a low incidence in premenopausal women. Loss of ovarian hormones during the perimenopause and menopause leads to a sharp increase in incidence. Although most CHD risk factors are common to both men and women, the menopause is a unique additional risk factor for women. Sex steroids have profound effects on many CHD risk factors. Their loss leads to adverse changes in lipids and lipoproteins, with increases being seen in low density lipoprotein (LDL) cholesterol and triglycerides, and decreases in high density lipoprotein (HDL) cholesterol. There is a reduction in insulin secretion and elimination, but increases in insulin resistance eventually result in increasing circulating insulin levels. There are changes in body fat distribution with accumulation in central and visceral fat which links to the other adverse metabolic changes. There is an increase in the incidence of hypertension and of type 2 diabetes mellitus, both major risk factors for CHD. Oestrogens have potent effects on blood vessels and their loss leads to dysfunction of the vascular endothelium. All of these changes result from loss of ovarian function contributing to the increased development of CHD. Risk factor assessment in perimenopausal women is recommended, thereby permitting the timely introduction of lifestyle, hormonal and therapeutic interventions to modify or reverse these adverse changes.


2017 ◽  
Vol 31 (1) ◽  
pp. 165-184 ◽  
Author(s):  
Sharon M. Cruise ◽  
John Hughes ◽  
Kathleen Bennett ◽  
Anne Kouvonen ◽  
Frank Kee

Objective: The aim of this study is to examine the prevalence of coronary heart disease (CHD)–related disability (hereafter also “disability”) and the impact of CHD risk factors on disability in older adults in the Republic of Ireland (ROI) and Northern Ireland (NI). Method: Population attributable fractions were calculated using risk factor relative risks and disability prevalence derived from The Irish Longitudinal Study on Ageing and the Northern Ireland Health Survey. Results: Disability was significantly lower in ROI (4.1% vs. 8.8%). Smoking and diabetes prevalence rates, and the fraction of disability that could be attributed to smoking (ROI: 6.6%; NI: 6.1%), obesity (ROI: 13.8%; NI: 11.3%), and diabetes (ROI: 6.2%; NI: 7.2%), were comparable in both countries. Physical inactivity (31.3% vs. 54.8%) and depression (10.2% vs. 17.6%) were lower in ROI. Disability attributable to depression (ROI: 16.3%; NI: 25.2%) and physical inactivity (ROI: 27.5%; NI: 39.9%) was lower in ROI. Discussion: Country-specific similarities and differences in the prevalence of disability and associated risk factors will inform public health and social care policy in both countries.


Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Nina P Paynter ◽  
Raji Balasubramanian ◽  
Shuba Gopal ◽  
Franco Giulianini ◽  
Leslie Tinker ◽  
...  

Background: Prior studies of metabolomic profiles and coronary heart disease (CHD) have been limited by relatively small case numbers and scant data in women. Methods: The discovery set examined 371 metabolites in 400 confirmed, incident CHD cases and 400 controls (frequency matched on age, race/ethnicity, hysterectomy status and time of enrollment) in the Women’s Health Initiative Observational Study (WHI-OS). All selected metabolites were validated in a separate set of 394 cases and 397 matched controls drawn from the placebo arms of the WHI Hormone Therapy trials and the WHI-OS. Discovery used 4 methods: false-discovery rate (FDR) adjusted logistic regression for individual metabolites, permutation corrected least absolute shrinkage and selection operator (LASSO) algorithms, sparse partial least squares discriminant analysis (PLS-DA) algorithms, and random forest algorithms. Each method was performed with matching factors only and with matching plus both medication use (aspirin, statins, anti-diabetics and anti-hypertensives) and traditional CHD risk factors (smoking, systolic blood pressure, diabetes, total and HDL cholesterol). Replication in the validation set was defined as a logistic regression coefficient of p<0.05 for the metabolites selected by 3 or 4 methods (tier 1), or a FDR adjusted p<0.05 for metabolites selected by only 1 or 2 methods (tier 2). Results: Sixty-seven metabolites were selected in the discovery data set (30 tier 1 and 37 tier 2). Twenty-six successfully replicated in the validation data set (21 tier 1 and 5 tier 2), with 25 significant with adjusting for matching factors only and 11 significant after additionally adjusting for medications and CHD risk factors. Validated metabolites included amino acids, sugars, nucleosides, eicosanoids, plasmologens, polyunsaturated phospholipids and highly saturated triglycerides. These include novel metabolites as well as metabolites such as glutamate/glutamine, which have been shown in other populations. Conclusions: Multiple metabolites in important physiological pathways with robust associations for risk of CHD in women were identified and replicated. These results may offer insights into biological mechanisms of CHD as well as identify potential markers of risk.


1976 ◽  
Vol 11 (10) ◽  
pp. 113-121 ◽  
Author(s):  
William P. Castelli

2002 ◽  
Vol 88 (5) ◽  
pp. 573-579 ◽  
Author(s):  
Peter Sanderson ◽  
Yvonne E. Finnegan ◽  
Christine M. Williams ◽  
Philip C. Calder ◽  
Graham C. Burdge ◽  
...  

The UK Food Standards Agency convened a group of expert scientists to review current research investigating whether n-3 polyunsaturated fatty acids (PUFA) from plant oils (α-linolenic acid; ALA) were as beneficial to cardiovascular health as the n-3 PUFA from the marine oils, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). The workshop also aimed to establish priorities for future research. Dietary intake of ALA has been associated with a beneficial effect on CHD; however, the results from studies investigating the effects of ALA supplementation on CHD risk factors have proved equivocal. The studies presented as part of the present workshop suggested little, if any, benefit of ALA, relative to linoleic acid, on risk factors for cardiovascular disease; the effects observed with fish-oil supplementation were not replicated by ALA supplementation. There is a need, therefore, to first prove the efficacy of ALA supplementation on cardiovascular disease, before further investigating effects on cardiovascular risk factors. The workshop considered that a beneficial effect of ALA on the secondary prevention of CHD still needed to be established, and there was no reason to look further at existing CHD risk factors in relation to ALA supplementation. The workshop also highlighted the possibility of feeding livestock ALA-rich oils to provide a means of increasing the dietary intake in human consumers of EPA and DHA.


2018 ◽  
Vol 97 (4) ◽  
pp. 310-314 ◽  
Author(s):  
Sergey A. Maksimov ◽  
M. V. Tabakaev ◽  
A. N. Chigisova ◽  
G. V. Artamonova

Material and methods. Three groups of men working in Kemerovo region were formed: 694 “white-collar”, 1674 “blue-collar” and 1612 “coal-miners”. To form the comparison group we used data from the Russian research ESSE-RF in the Kemerovo region (700 men). The following cardiovascular risk factors were assessed: hypercholesterolemia, hypertriglyceridemia, hyperglycemia, obesity, hypertension, smoking, and education level. The coronary heart disease (CHD) was diagnosed on the basis of ECG changes on the Minnesota code, Rose questionnaire, and myocardial infarction. According to the frequency of risk factors and their contribution to the probability of developing the coronary heart disease, there was calculated the total burden of CHD risk factors (Maksimov S.A. et al., 2015). Results .The burden of CHD risk factors in the general population up to 51 years accounts for 308 conventional units. There is a variety of risk factors frequency in the working groups, both inside the groups and in comparison with the general population. Consequently, there are differences in values of CHD risk factors burdens. The “blue-collar” burdens of CHD risk factors corresponding to the general population (304 conventional units). In “white-collar” and “miners” this parameter is lower, respectively, 266 and 259 conventional units. After 50 years, the total burden of CHD risk factors in the population increased to 472 conventional units (1.5 times). Differences of this index in the working groups to the general population after 50 years also increased. Conclusion. The working population is characterized by the low total burden of CHD risk factors compared with the general population. After 50 years, these differences increase, which indicates the deterioration of health with age, stimulates the individual to the termination of employment or the ongoing the work as the healthiest individuals. The lowest rates of CHD risk factors burden have been reported in “miners”, the average - in “white collar”, maximum - in “blue-collar”.


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