scholarly journals Sex, Prescribing Practices and Guideline Recommended, Blood Pressure, and LDL Cholesterol Targets at Baseline in the BARI 2D Trial

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Michelle F. Magee ◽  
Jacqueline E. Tamis-Holland ◽  
Jiang Lu ◽  
Vera A. Bittner ◽  
Maria Mori Brooks ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Sex Differences ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Prescribing Practices ◽  
Cvd Risk ◽  
Established Coronary Artery Disease ◽  
Reductase Inhibitors ◽  
Artery Disease ◽  
Coa Reductase

Background.Research has shown less aggressive treatment and poorer control of cardiovascular disease (CVD) risk factors in women than men.Methods.We analyzed sex differences in pharmacotherapy strategies and attainment of goals for hemoglobin A1c (HbA1c), blood pressure (BP), and low density lipoprotein cholesterol (LDL-C) in patients with type 2 diabetes and established coronary artery disease enrolled into the BARI 2D trial.Results.Similar numbers of drugs were prescribed in both women and men. Women were less frequent on metformin or sulfonylurea and more likely to take insulin and to be on higher doses of hydroxymethylglutaryl-CoA reductase inhibitors (statins) than men. After adjusting for baseline differences and treatment prescribed, women were less likely to achieve goals for HbA1c (OR = 0.71, 95% CI 0.57, 0.88) and LDL-C (OR = 0.64, 95% CI 0.53, 0.78). More antihypertensives were prescribed to women, and yet BP ≤ 130/80 mmHg did not differ by sex.Conclusions.Women entering the BARI 2D trial were as aggressively treated with drugs as men. Despite equivalent treatment, women less frequently met targets for HbA1c and LDL-C. Our findings suggest that there may be sex differences in response to drug therapies used to treat diabetes, hypertension, and hyperlipidemia.

scholarly journals Sex Differences in Primary and Secondary Prevention of Cardiovascular Disease in China

Circulation ◽  
2020 ◽  
Vol 141 (7) ◽  
pp. 530-539 ◽  
Author(s):  
Shijun Xia ◽  
Xin Du ◽  
Lizhu Guo ◽  
Jing Du ◽  
Clare Arnott ◽  
...  
Keyword(s):  
Sex Differences ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Education Level ◽  
Lipid Lowering ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Primary And Secondary Prevention ◽  
Cvd Risk ◽  
Cvd Prevention

Background: Despite improvements in diagnostic and therapeutic interventions to combat cardiovascular disease (CVD) in recent decades, there are significant ongoing access gaps and sex disparities in prevention that have not been adequately quantified in China. Methods: A representative, cross-sectional, community-based survey of adults (aged ≥45 years) was conducted in 7 geographic regions of China between 2014 and 2016. Logistic regression models were used to determine sex differences in primary and secondary CVD prevention, and any interaction by age, education level, and area of residence. Data are presented as adjusted odds ratios (ORs) and 95% CIs. Results: Of 47 841 participants (61.3% women), 5454 (57.2% women) had established CVD and 9532 (70.5% women) had a high estimated 10-year CVD risk (≥10%). Only 48.5% and 48.6% of women and 39.3% and 59.8% of men were on any kind of blood pressure (BP)–lowering medication, lipid-lowering medication, or antiplatelet therapy for primary and secondary prevention, respectively. Women with established CVD were significantly less likely than men to receive BP-lowering medications (OR, 0.79 [95% CI, 0.65–0.95]), lipid-lowering medications (OR, 0.69 [95% CI, 0.56–0.84]), antiplatelets (OR, 0.53 [95% CI, 0.45–0.62]), or any CVD prevention medication (OR, 0.62 [95% CI, 0.52–0.73]). Women with established CVD, however, had better BP control (OR, 1.31 [95% CI, 1.14–1.50]) but less well-controlled low-density lipoprotein cholesterol (OR, 0.66 [95% CI, 0.57–0.76]), and were less likely to smoke (OR, 13.89 [95% CI, 11.24–17.15]) and achieve physical activity targets (OR, 1.92 [95% CI, 1.61–2.29]). Conversely, women with high CVD risk were less likely than men to have their BP, low-density lipoprotein cholesterol, and bodyweight controlled (OR, 0.46 [95% CI, 0.38–0.55]; OR, 0.60 [95% CI, 0.52–0.69]; OR, 0.55 [95% CI, 0.48–0.63], respectively), despite a higher use of BP-lowering medications (OR, 1.21 [95% CI, 1.01–1.45]). Younger patients (<65 years) with established CVD were less likely to be taking CVD preventive medications, but there were no sex differences by area of residence or education level. Conclusions: Large and variable gaps in primary and secondary CVD prevention exist in China, particularly for women. Effective CVD prevention requires an improved overall nationwide strategy and a special emphasis on women with established CVD, who have the greatest disparity and the most to benefit.

HMG-CoA reductase inhibitors suppress macrophage growth induced by oxidized low density lipoprotein

1997 ◽  
Vol 133 (1) ◽  
pp. 51-59 ◽  
Author(s):  
Masakazu Sakai ◽  
Shozo Kobori ◽  
Takeshi Matsumura ◽  
Takeshi Biwa ◽  
Yoshihiro Sato ◽  
...  
Keyword(s):  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Low Density ◽  
Oxidized Low Density Lipoprotein ◽  
Hmg Coa Reductase ◽  
Reductase Inhibitors ◽  
Hmg Coa Reductase Inhibitors ◽  
Coa Reductase

scholarly journals Risk Factors for Polyvascular Involvement in Patients With Peripheral Artery Disease: A Mendelian Randomization Study

2020 ◽  
Vol 9 (24) ◽  
Author(s):  
Ozan Dikilitas ◽  
Benjamin A. Satterfield ◽  
Iftikhar J. Kullo
Keyword(s):  
Blood Pressure ◽  
Lipid Content ◽  
Mendelian Randomization ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Very Low Density Lipoprotein ◽  
Low Density ◽  
Peripheral Artery ◽  
Artery Disease ◽  
Intermediate Density

Background Atherosclerosis in >1 vascular bed (ie, polyvascular disease), often a feature of peripheral artery disease (PAD), is associated with high morbidity and mortality. We sought to identify risk factors for polyvascular involvement in patients with PAD. Methods and Results We performed 2‐sample Mendelian randomization using an inverse‐variance‐weighted approach, to assess 60 exposures including size and lipid content of atherogenic lipoproteins, blood pressure, glycated hemoglobin, and smoking as causal mediators for polyvascular disease in patients with PAD. Genetic instruments for these exposures were obtained from prior genome‐wide association studies. Patients with PAD were from the Mayo Vascular Disease Biorepository, and polyvascular disease (ie, concomitant coronary heart disease, cerebrovascular disease, and/or abdominal aortic aneurysm) was ascertained by validated phenotyping algorithms. Of 3279 patients with PAD, 61% had polyvascular disease. Genetically predicted levels of the lipid content and/or particle measures of very small and small size very low‐density lipoprotein, intermediate‐density lipoprotein, and large low‐density lipoprotein were associated with polyvascular disease: odds ratios (OR) of 1.80 (95% CI, 1.23–2.61), 1.70 (95% CI, 1.17–2.61), and 1.40 (95% CI, 1.09–1.80) per 1 SD increase in genetically determined levels, respectively. Both genetically predicted diastolic and systolic blood pressure were associated with polyvascular disease; OR per 10 mm Hg genetic increase in diastolic and systolic blood pressure were 1.66 (95% CI, 1.19–2.33) and 1.31 (95% CI, 1.07–1.60), respectively. Conclusions Lifetime exposure to increased lipid content and levels of very small and small very low‐density lipoprotein, intermediate‐density lipoprotein, and large low‐density lipoprotein particles as well as elevated blood pressure are associated with polyvascular involvement in patients with PAD. Reduction in levels of such exposures may limit progression of atherosclerosis in patients with PAD.

scholarly journals Association of Fitness and Fatness with Clustered Cardiovascular Disease Risk Factors in Nigerian Adolescents

2020 ◽  
Vol 17 (16) ◽  
pp. 5861
Author(s):  
Danladi I. Musa ◽  
Abel L. Toriola ◽  
Daniel T. Goon ◽  
Sunday U. Jonathan
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Risk Factor ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Cvd Risk ◽  
Standardized Residuals

Purpose: This study examinedthe independent and joint association of fitness and fatness with clustered cardiovascular disease risk (CVDrs) in 11–18 year-old Nigerian adolescents. Methods: A hundred and ninety seven adolescents (100 girls and 97 boys) were evaluated forfitness, fatness and CVDrs. Fitness was evaluated with the progressive aerobic cardiovascular endurance run test while fatness was assessed using body mass index. A clustered CVDrs was computed from the standardized residuals of total cholesterol, high density lipoprotein cholesterol, Low density lipoprotein cholesterol, triglycerides, plasma glucose, systolic blood pressure, and diastolic blood pressure. Regression models controlling for waist circumference assessed the association of fitness and fatness with CVDrs. Results: Prevalence of clustered CVD risk was 7.1% (girls = 3.0%; boys = 4.1%). Based on risk factor abnormalities, 52.8% of participants had one or more CVD risk factor abnormalities with more boys (27.4%) affected. Low fitness was associated with clustered CVDrs in both girls (R2 = 9.8%, β = −0.287, p = 0.05) and boys (R2 = 17%, β = −0.406, p < 0.0005). Fatness was not associated with the CVDrs in both sexes. After controlling for all the variables in the model, only fitness (R2 = 10.4%) and abdominal fat (R2 = 19.5%) were associated with CVDrs respectively. Unfit girls were 3.2 (95% CI = 1.31–7.91, p = 0.011) times likely to develop CVD risk abnormality compared to their fit counterparts. The likelihood of unfit boys developing CVD risk abnormality was 3.9 (95% CI = 1.15–10.08, p = 0.005) times compared to their fit peers. Conclusions: Fitness but not fatness was a better predictor of CVDrs in Nigerian boys and girls. The result of this study suggests that any public health strategies aimed at preventing or reversing the increasing trends of CVD risk in adolescents should emphasize promotion of aerobic fitness.

The Role of Statin Therapy in Primary Hyperlipidemia and Mixed Dyslipidemia

2011 ◽  
Vol 07 (01) ◽  
pp. 23 ◽  
Author(s):  
Sergio Fazio ◽  
Keyword(s):  
Risk Factors ◽  
Low Density Lipoprotein ◽  
Age Groups ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Phase Iii ◽  
Cvd Risk ◽  
Mixed Dyslipidemia ◽  
The Us ◽  
Coa Reductase

In the US, ischemic cardiovascular disease (CVD) and stroke combined are the major cause of death for all age groups older than 55 years. Preventive approaches are based on the management of all risk factors and co-morbidities. The management guidelines for the lipid risk factors focus on lowering low-density lipoprotein cholesterol (LDL-C) levels. Statins, which inhibit cholesterol synthesis via blockade of the enzyme 3-hydroxy-3-methylglutaryl co-enzyme A (HMG-CoA) reductase, are the drug of choice for LDL-C control. Currently, there are three generic and four branded statins. Pitavastatin, the latest statin to be approved by the US Food and Drug Administration (FDA) (2009), has the lipid indications of the other statins but is not indicated for CVD risk reduction. It is available in 1 mg, 2 mg, and 4 mg doses, with the recommended starting dose of 2 mg being equivalent to 20 mg of simvastatin and 10 mg of atorvastatin, and superior to 20 mg of pravastatin. Pitavastatin 2 mg reduces LDL-C levels by 39 %, apolipoprotein B by 31 %, total cholesterol by 28 % and triglycerides by 16 %, and raises high-density lipoprotein cholesterol (HDL-C) by 6 %. In phase III clinical trials, pitavastatin 4 mg decreases LDL-C by up to 45 %. Pitavastatin has a unique metabolism, with little processing by cytochrome P450 (CYP) and none by CYP3A4, and thus it may display less CYP-mediated drug interaction than other statins. However, the FDA has determined that pitavastatin should not be taken with cyclosporine. Pitavastatin should be limited to 1 mg daily with erythromycin and 2 mg daily with rifampin. Preliminary vascular investigations have suggested benefits in line with those obtained by other statins.

Sign in / Sign up

Export Citation Format

Share Document