scholarly journals The Strategy to Prevent and Regress the Vascular Calcification in Dialysis Patients

2017 ◽  
Vol 2017 ◽  
pp. 1-11 ◽  
Author(s):  
Nai-Ching Chen ◽  
Chih-Yang Hsu ◽  
Chien-Liang Chen
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Bone Turnover ◽  
Cardiovascular Risk Factors ◽  
Vascular Calcification ◽  
Sodium Thiosulfate ◽  
Pressure Control ◽  
Arterial Calcification ◽  
Low Bone Turnover ◽  
High Bone

The high prevalence of arterial calcification in end-stage renal disease (ESRD) is far beyond the explanation by common cardiovascular risk factors such as aging, diabetes, hypertension, and dyslipidemia. The finding relies on the fact that vascular and valvular calcifications are predictors of cardiovascular diseases and mortality in persons with chronic renal failure. In addition to traditional cardiovascular risk factors such as diabetes mellitus and blood pressure control, other ESRD-related risks such as phosphate retention, excess calcium, and prolonged dialysis time also contribute to the development of vascular calcification. The strategies are to reverse “calcium paradox” and lower vascular calcification by decreasing procalcific factors including minimization of inflammation (through adequate dialysis and by avoiding malnutrition, intravenous labile iron, and positive calcium and phosphate balance), correction of high and low bone turnover, and restoration of anticalcification factor balance such as correction of vitamin D and K deficiency; parathyroid intervention is reserved for severe hyperparathyroidism. The role of bone antiresorption therapy such as bisphosphonates and denosumab in vascular calcification in high-bone-turnover disease remains unclear. The limited data on sodium thiosulfate are promising. However, if calcification is to be targeted, ensure that bone health is not compromised by the treatments.

scholarly journals Gender Difference in Blood Pressure Control and Cardiovascular Risk Factors with Diagnosed Hypertension

2021 ◽  
pp. 275-280
Author(s):  
Tarique Shahzad Chachar ◽  
Ummama Laghari ◽  
Ghullam Mustafa Mangrio ◽  
Abdul Ghaffar Dars ◽  
Ruqayya Farhad ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Pressure Control ◽  
Health Sciences ◽  
Low Density Lipoprotein Cholesterol ◽  
Male And Female

Objective: Our study was designed to compare the gender difference in Blood Pressure Control and Cardiovascular Risk Factors in patients of Liaquat University of Medical and Health Sciences Jamshoro Pakistan. Methodology: This cross-sectional study was conducted in  Liaquat University of Medical and Health Sciences Jamshoro Pakistan from December 2019 to December 2020. Blood pressure was measured twice by trained physicians using aneroid sphygmomanometers after a standardized protocol. Patients were asked to sit with both feet on the floor for ≥5 minutes before the first BP measurement. Both the two BP measurements were taken 60 seconds apart.  For this research we defined hypertension as systolic BP ≥140 mm Hg, diastolic BP ≥90 mm Hg. Results:  We conducted a comparison between Hypertensive and nonhypertensive participants of the male and female groups. High blood pressure increased the level of uric acid in both male and female groups (351 ± 92 vs 303 ± 75). We observed that the hypertensive male population reported a high prevalence of cardiovascular risk factors due to  increase amount of total cholesterol level, triglyceride and low-density lipoprotein cholesterol (5.45 ± 1.01, 1.42 ±  0.85,  2.56 ± 0.70) than females (5.15 ± 0.91, 1.29 ± 0.87, 2.30 ± 0.63). Conclusion: Our results concluded that the male hypertensive population is more prone to future cardiovascular risk due to increased amount of total cholesterol levels, triglycerides, and low-density lipoprotein cholesterol, and sex hormones (androgens).

scholarly journals The Prevalence of Cardiovascular Risk Factors among Polish Soldiers: The Results from the MIL-SCORE Program

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Grzegorz Gielerak ◽  
Paweł Krzesiński ◽  
Katarzyna Piotrowicz ◽  
Piotr Murawski ◽  
Andrzej Skrobowski ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Pressure Control ◽  
Cross Sectional Study ◽  
Lipoprotein Cholesterol ◽  
Risk Scores ◽  
Cross Sectional

The MIL-SCORE (Equalization of Accessibility to Cardiology Prophylaxis and Care for Professional Soldiers) program was designed to assess the prevalence and management of cardiovascular risk factors in a population of Polish soldiers. We aimed to describe the prevalence of cardiovascular risk factors in the MIL-SCORE population with respect to age. This observational cross-sectional study enrolled 6440 soldiers (97% male) who underwent a medical history, physical examination, and laboratory tests to assess cardiovascular risk. Almost half of the recruited soldiers were past or current smokers (46%). A sedentary lifestyle was reported in almost one-third of those over 40 years of age. The prevalence of hypertension in a subgroup over 50 years of age was almost 45%. However, the percentage of unsatisfactory blood pressure control was higher among soldiers below 40 years of age. The prevalence of overweight and obese soldiers increased with age and reached 58% and 27%, respectively, in those over 50 years of age. Total cholesterol was increased in over one-half of subjects, and the prevalence of abnormal low-density lipoprotein cholesterol was even higher (60%). Triglycerides were increased in 36% of soldiers, and low high-density lipoprotein cholesterol and hyperglycemia were reported in 13% and 16% of soldiers, respectively. In the >50 years of age subgroup, high and very high cardiovascular risk scores were observed in almost one-third of soldiers. The relative risk assessed in younger subgroups was moderate or high. The results from the MIL-SCORE program suggest that Polish soldiers have multiple cardiovascular risk factors and mirror trends seen in the general population. Preventive programs aimed at early cardiovascular risk assessment and modification are strongly needed in this population.

scholarly journals Assessing Quality Improvement Capacity in Primary Care Practices

2019 ◽  
Author(s):  
Michael Parchman ◽  
Melissa L. Anderson ◽  
Katie F Coleman ◽  
LeAnn Michaels ◽  
Linnaea Schuttner ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Primary Care ◽  
Quality Improvement ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Prior Experience ◽  
Pressure Control ◽  
Care Practices ◽  
Primary Care Practices

Abstract Background: Healthy Hearts Northwest (H2N) is a study of external support strategies to build quality improvement (QI) capacity in primary care with a focus on cardiovascular risk factors: appropriate aspirin use, blood pressure control, and tobacco screening/cessation. Methods: To guide practice facilitator support, experts in practice transformation identified seven domains of QI capacity and mapped items from a previously validated medical home assessment tool to them. A practice facilitator (PF) met with clinicians and staff in each practice to discuss each item on the Quality Improvement Capacity Assessment (QICA) resulting in a practice-level response to each item. We examined the association between the QICA total and sub-scale scores, practice characteristics, a measure of prior experience with managing practice change, and performance on clinical quality measures (CQMs) for the three cardiovascular risk factors. Results: The QICA score was associated with prior experience managing change and moderately associated with two of the three CQMs: aspirin use (r=0.16, p=0.049) and blood pressure control (r=0.18, p=0.013). Rural practices and those with 2-5 clinicians had lower QICA scores. PFs notes provide examples of high scoring practices devoting time and attention to quality improvement whereas low scoring practices did not. Conclusions: The QICA is useful for assessing QI capacity within a practice and may serve as a guide for both facilitators and primary care practices in efforts to build this capacity and improve measures of clinical quality.

Abstract P238: Cardiovascular Risk Factors for Intimal and Medial Calcification in a High-risk Population

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Eva Hendriks ◽  
Sabine Zwakenberg ◽  
Pim de Jong ◽  
Jan Westerink ◽  
Gert Jan de Borst ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Lower Extremity ◽  
Cardiovascular Risk Factors ◽  
Regression Models ◽  
Arterial Calcification ◽  
Crural Arteries ◽  
Medial Calcification

Introduction: Arterial calcification is associated with an increased cardiovascular risk. Intimal calcification has long been held responsible for this association, whereas the role of medial calcification was unclear. Hypothesis: We hypothesize that the risk factor profile in patients with high cardiovascular risk differs for those with intimal or medial calcification of the lower extremity arteries. Methods: We conducted a cross-sectional study of 203 patients included in the Second Manifestations of ARTerial Disease (SMART) study, comprising of patients with CVD as well as patients at high risk for CVD, who underwent CT (computed tomography) scanning of the lower extremities. Calcification in the femoral and crural arteries was scored as absent, dominant intimal, dominant medial or indistinguishable according to a previously validated algorithm scoring linearity and circularity. We fitted multinomial regression models assessing the associations of cardiovascular risk factors with different patterns of calcification. Results: No calcification was present in 18% for the femoral and 28% for the crural arteries, while prevalence of intimal calcification was 44% and 38%. Medial calcification prevalences were 25% and 20% for the femoral and crural arteries, respectively. We found considerable consistency in the predominant calcification pattern of the crural and femoral arteries (linear weighted Cohen’s kappa [0.41, 95%CI 0.29-0.52]). Patients with dominant medial calcification were older, more often male and more often had diabetes than patients with intimal calcification. Conversely, patients with intimal calcification were more often smokers than patients with medial calcification. In multinomial logistic regression models, age was a significant risk factor for all types of calcification compared with no calcification. Male sex was associated with an increased risk of medial calcification [OR femoral 10.37, 95%CI 2.14-50.32], but not with intimal or indistinguishable calcification, compared with no calcification. Current smoking was associated with intimal calcification[OR femoral 3.25, 95%CI 0.98;10.83], but not with medial calcification. No significant relationships were found with other cardiovascular risk factors. Conclusions: Within the same individual, a predominant arterial calcification type (intimal or medial) often exists throughout the lower extremity. These patterns of calcification appear to have different associated risk factor profiles.

Fractional excretion of phosphorus and vascular calcification in stage 3 chronic kidney disease

2018 ◽  
Vol 67 (3) ◽  
pp. 674-680 ◽  
Author(s):  
Manuel Jiménez Villodres ◽  
Guillermo García Gutiérrez ◽  
Patricia García Frías ◽  
José Rioja Villodres ◽  
Mónica Martín Velázquez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Cardiovascular Risk ◽  
Kidney Disease ◽  
Cardiovascular Risk Factors ◽  
Vascular Calcification ◽  
Fractional Excretion ◽  
X Rays ◽  
Abdominal Radiography ◽  
Vascular Comorbidity

The role of renal excretion of Pi in relation to vascular calcification (VC) in patients in the early stages of chronic kidney disease (CKD) is controversial. Thus, we determine the relation between fractional excretion of phosphorus (FEP) and VC, measured using two methods in a cross-sectional study of patients with stage 3 CKD. We recorded demographic data, anthropometry, comorbidities and active treatment. We measured 24-hour urine FEP and, in serum, measured fibroblast growth factor 23 (FGF23), α-Klotho, intact parathyroid hormone (iPTH), calcium and phosphorus. VC was measured by lateral abdominal radiography (Kauppila index (KI)) and CT of the abdominal aorta (measured in Agatston units). In 57% of subjects, abnormal VC was present when measured using CT, and in only 17% using lateral abdominal radiography. Factors associated with VC using CT were age, cardiovascular risk factors, vascular comorbidity, microalbuminuria and levels of FGF23, phosphorus and calcium x phosphorus product (CaxP); although only age (OR 1.25, 95% CI 1.11 to 1.41), smoking (OR 21.2, CI 4.4 to 100) and CaxP (OR 1.21, CI 1.06 to 1.37) maintained the association in a multivariate analysis. By contrast, only age (OR 1.35, 95% CI 1.07 to 1.74), CaxP (OR 1.14, CI 1.13 to 1.92) and FEP (OR 1.07,95% CI 1004 to 1.14) were associated with abnormal VC in the lateral abdominal radiography. In conclusion, in patients with stage 3 CKD, the detection of VC by abdominal CT is more sensitive than conventional X-rays. Moreover, CaxP is associated with cardiovascular risk factors and vascular comorbidity; quantification of FEPi in these patients provides additional clinical information in advanced VC detected by KI.

scholarly journals The relationship of breast arterial calcification detected in mammographic examinations with cardiovascular diseases, cardiovascular risk factors, parity, and breastfeeding

2016 ◽  
Vol 46 ◽  
pp. 641-645 ◽  
Author(s):  
Kadihan YALÇIN ŞAFAK ◽  
Ayşegül ERATALAY ◽  
Ebru DÜLGER İLİŞ ◽  
Neslihan UMARUSMAN TANJU ◽  
Begüm Damla ŞENCAN ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Diseases ◽  
Cardiovascular Risk Factors ◽  
Arterial Calcification ◽  
Relationship Of ◽  
The Relationship

scholarly journals Assessing Quality Improvement Capacity in Primary Care Practices

2019 ◽  
Author(s):  
Michael Parchman ◽  
Melissa L. Anderson ◽  
Katie F Coleman ◽  
LeAnn Michaels ◽  
Linnaea Schuttner ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Primary Care ◽  
Quality Improvement ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Blood Pressure Control ◽  
Prior Experience ◽  
Pressure Control ◽  
Practice Level

Abstract Background Healthy Hearts Northwest (H2N) is a study of external support strategies to build quality improvement (QI) capacity in primary care with a focus on cardiovascular risk factors: appropriate aspirin use, blood pressure control, and tobacco screening/cessation. Methods To guide practice facilitator support, experts in practice transformation identified seven domains of QI capacity and mapped items from a previously validated medical home assessment tool to them. A practice facilitator (PF) met with clinicians and staff in each practice to discuss each item on the Quality Improvement Capacity Assessment (QICA) resulting in a practice-level response to each item. We examined the association between the QICA total and sub-scale scores, practice characteristics, a measure of prior experience with managing practice change, and performance on clinical quality measures (CQMs) for the three cardiovascular risk factors. Field notes kept by the PFs from practices with high and low QICA scores were compared. Results The QICA score was associated with prior experience managing change and two of the three CQMs: aspirin use (r=0.16, p=0.049) and blood pressure control (r=0.18, p=0.013). Rural practices and those with 2-5 clinicians had lower QICA scores. PFs notes provide examples of high scoring practices devoting time and attention to quality improvement whereas low scoring practices did not. Conclusions The QICA is useful for both assessing QI capacity within a practice and for guiding PFs and practices in efforts to build this capacity. Further work is needed to understand how PFs and practices tailored their work in response to this practice-level assessment and how practices used it to improve their QI capacity.

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