Alzheimer's disease (AD) is the most common type of dementia and typically manifests through a progressive loss of episodic memory and cognitive function, subsequently causing language and ...visuospatial skills deficiencies, which are often accompanied by behavioral disorders such as apathy, aggressiveness and depression. The presence of extracellular plaques of insoluble β-amyloid peptide (Aβ) and neurofibrillary tangles (NFT) containing hyperphosphorylated tau protein (P-tau) in the neuronal cytoplasm is a remarkable pathophysiological cause in patients' brains. Approximately 70% of the risk of developing AD can be attributed to genetics. However, acquired factors such as cerebrovascular diseases, diabetes, hypertension, obesity and dyslipidemia increase the risk of AD development. The aim of the present minireview was to summarize the pathophysiological mechanism and the main risk factors for AD. As a complement, some protective factors associated with a lower risk of disease incidence, such as cognitive reserve, physical activity and diet will also be addressed.
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Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Hypertensive disorders of pregnancy (HDP), including gestational hypertension and preeclampsia, are associated with an increased risk of CVD.
The purpose of this study was to evaluate associations ...between HDP and long-term CVD and identify the proportion of the association mediated by established CVD risk factors.
Parous participants without CVD in the Nurses' Health Study II (n = 60,379) were followed for incident CVD from first birth through 2017. Cox proportional hazards models estimated HRs and 95% CIs for the relationship between HDP and CVD, adjusting for potential confounders, including prepregnancy body mass index, smoking, and parental history of CVD. To evaluate the proportion of the association jointly accounted for by chronic hypertension, hypercholesterolemia, type 2 diabetes, and changes in body mass index, we used the difference method.
Women with HDP in first pregnancy had a 63% higher rate of CVD (95% CI: 1.37-1.94) compared with women with normotensive pregnancies. This association was mediated by established CVD risk factors (proportion mediated = 64%). The increased rate of CVD was higher for preeclampsia (HR: 1.72; 95% CI: 1.42-2.10) than gestational hypertension (HR: 1.41; 95% CI: 1.03-1.93). Established CVD risk factors accounted for 57% of the increased rate of CVD for preeclampsia but 84% for gestational hypertension (both P < 0.0001).
Established CVD risk factors arising after pregnancy explained most (84%) of the increased risk of CVD conferred by gestational hypertension and 57% of the risk among women with preeclampsia. Screening for chronic hypertension, hypercholesterolemia, type 2 diabetes, and overweight/obesity after pregnancy may be especially helpful in CVD prevention among women with a history of HDP.
Featured Cover Kačar, Mark; Rijavec, Matija; Šelb, Julij ...
Clinical & experimental allergy/Clinical and experimental allergy,
April 2023, 2023-04-00, 20230401, Letnik:
53, Številka:
4
Journal Article
Recenzirano
Odprti dostop
The cover image is based on the Review Article Clonal mast cell disorders and hereditary α‐tryptasemia as risk factors for anaphylaxis by Mark Kačar et al., https://doi.org/10.1111/cea.14264.
Life's Simple 7 (LS7) is an easily calculated and interpreted metric of cardiovascular health based on 7 domains: smoking, diet, physical activity, body mass index, blood pressure, cholesterol, and ...fasting glucose. The Life's Essential 8 (LE8) metric was subsequently introduced, adding sleep metrics and revisions of the previous 7 domains. Although calculating LE8 requires additional information, we hypothesized that it would be a more reliable index of cardiovascular health.
Both the LS7 and LE8 metrics yield scores with higher values indicating lower risk. These were calculated among 11 609 Black and White participants free of baseline cardiovascular disease (CVD) in the Reasons for Geographic and Racial Differences in Stroke study, enrolled in 2003 to 2007, and followed for a median of 13 years. Differences in 10-year risk of incident CVD (coronary heart disease or stroke) were calculated as a function LS7, and LE8 scores were calculated using Kaplan-Meier and proportional hazards analyses. Differences in incident CVD discrimination were quantified by difference in the c-statistic.
For both LS7 and LE8, the 10-year risk was approximately 5% for participants around the 99th percentile of scores, and a 4× higher 20% risk for participants around the first percentile. Comparing LS7 to LE8, 10-year risk was nearly identical for individuals at the same relative position in score distribution. For example, the "cluster" of 2013 participants with an LS7 score of 7 was at the 35.8th percentile in distribution of LS7 scores, and had an estimated 10-year CVD risk of 8.4% (95% CI, 7.2%-9.8%). In a similar location in the LE8 distribution, the 1457 participants with an LE8 score of 60±2.5 at the 39.4th percentile of LE8 scores had a 10-year risk of CVD of 8.5% (95% CI, 7.1%-10.1%), similar to the cluster defined by LS7. The age-race-sex adjusted c-statistic of the LS7 model was 0.691 (95% CI, 0.667-0.705), and 0.695 for LE8 (95% CI, 0.681-0.709) (
for difference, 0.12).
Both LS7 and LE8 were associated with incident CVD, with discrimination of the 2 indices practically indistinguishable. As a simpler metric, LS7 may be favored for use by the general population and clinicians.
Background: In clinical practice, anthropometric measures other than BMI are rarely measured yet may be more predictive of cardiovascular (CV) risk. We analyzed the placebo group of the REWIND CV ...outcomes trial to compare several anthropometric measures as baseline predictors for cardiovascular disease (CVD)-related outcomes in participants with type 2 diabetes. Methods: Data from the REWIND trial placebo group (N=4952) were analyzed. All participants had T2D, were aged >50, and had either a previous CV event or CV risk factors and a BMI of >23 kg/m2. Cox proportional hazard models were used to investigate if BMI, waist-to-hip ratio (WHR), and waist circumference (WC) were significant risk factors for major adverse CV events (MACE)-3, CVD-related mortality, all-cause mortality, and heart failure (HF). Models were adjusted for age and sex, and additional baseline factors selected by LASSO method. Results are presented for 1 standard deviation increase of the respective anthropometric factor. Results: There were 663 MACE-3 events, 346 CVD-related deaths, 592 all-cause deaths, and 226 events of HF during the median follow-up of 5.4 years. WHR and WC, but not BMI, were identified as independent risk factors for MACE-3 (hazard ratio HR for WHR: 1.11 95% CI 1.03 to 1.21; p=0.009; HR for WC: 1.12 95% CI 1.02 to 1.22; p=0.012). WC adjusted for hip circumference (HC) showed the strongest association with MACE-3 compared to WHR, WC, or BMI unadjusted for each other (HR: 1.25 95% CI 1.06 to 1.49; p=0.009). Results for CVD-related mortality and all-cause mortality were similar. HF was predicted by WC and BMI, but not WHR (HR for WC: 1.34 95% CI 1.16 to 1.54; p<0.001; HR for BMI: 1.33 95% CI 1.17 to 1.50; p<0.001). Conclusions: In this post hoc analysis of the REWIND placebo group, WHR and WC were predictors of MACE-3, CVD-related mortality, and all-cause mortality; BMI was not. These findings indicate the need for anthropometric measures that consider body fat distribution when assessing CV risk.
Cardiovascular diseases (CVDs) are the global public health problem which has been associated with increasing prevalence of modifiable CVDs risk factors. This study aimed to describe the prevalence ...and knowledge of modifiable CVDs risk factors among vulnerable population of Central Tanzania.
A community-based cross-sectional study design was employed. A total of 749 participants were interviewed. The socio-demographic information and modifiable CVDs risk factors (behavioral and biological) were measured using a modified World Health Organization (WHO) STEPwise approach for chronic disease risk factor surveillance. Knowledge of modifiable CVDs risk factors was measured by comprehensive heart disease knowledge questionnaire. Descriptive statistics were used to describe the knowledge and prevalence of modifiable CVDs risk factors. Logistic regression analysis was used to determine the factors associated with adequate knowledge of CVDs risk factors.
The prevalence of béhavioral risk factors were; current smokers and alcohol consumers were 4.4% and 18.0% respectively, use of raw salt was 43.7%, consumption of fruit/vegetables < 5 days per week was 56.9%. The prevalence of Biological CVDs risk factors was as follows: Overall, 63.5% (33.3% overweight and 29.9% obese) were overweight or obese, 4.5% were diabetic and 43.4% were hypertensive. Only 35.4% of participants had adequate knowledge of CVDs risk factors. Being a male (AOR = 1.44, 95%CI = 1.01-2.06, p < .05), having primary education (AOR = 6.43, 95%CI = 2.39-17.36, p < .0001), being employed (AOR = 1.59, 95%CI = 1.00-2.52, p < .05), ever checked blood pressure (AOR = 0.59, 95%CI = 0.42-0.84, p < .001), family history of hypertension (AOR = 0.38, 95%CI = 0.25-0.57, p < .0001) determined adequate knowledge of CVDs risk factors.
This study has revealed a high prevalence of modifiable CVDs risk factors and low knowledge of CVDs risk factors. Community health promotion interventions to increase population knowledge of CVDs risk factors are recommended for the efficacious reduction of CVDs in the country.
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