Gender-specific association between pulse pressure and C-reactive protein in a Chinese population
|
|
- Bruno Page
- 5 years ago
- Views:
Transcription
1 (2005) 19, & 2005 Nature Publishing Group All rights reserved /05 $ ORIGINAL ARTICLE Gender-specific association between pulse pressure and C-reactive protein in a Chinese population XLi 1, H Zhang 1, J Huang 1, S Xie 2, J Zhu 2, S Jiang 1,YLi 3 and J-G Wang 3 1 Section of Hypertension and Cardiovascular Epidemiology, Department of Cardiology, Jiangsu Provincial Hospital, Nanjing Medical University, Nanjing, China; 2 Taicang 2nd Hospital, Taicang, Jiangsu Province, China; 3 Center for Epidemiological Studies and Clinical Trials, Ruijin Hospital, Shanghai Institute of Hypertension, Shanghai Second Medical University, Shanghai, China There is growing evidence that low-grade chronic inflammation, as reflected by the raised serum concentration of C-reactive protein, might be a risk factor for hypertension, in particular in women. We therefore investigated gender-specific associations of systolic and diastolic blood pressure and pulse pressure with serum C-reactive protein concentration in a Chinese population sample. In 463 participants, we measured serum C-reactive protein concentration using a highsensitivity immunonephelometric latex-enhanced assay. We performed single and multiple linear regression analyses. The 224 male and 239 female subjects were of similar age (51.0 years) and had similar levels of systolic blood pressure (124.7 mmhg) and pulse pressure (47.1 mmhg), but men, compared with women, had higher diastolic blood pressure (79.6 vs 75.8 mmhg; Po0.0001) and body mass index (24.3 vs 23.4 kg/m 2 ; P ¼ 0.003). Both before and after adjustment for age, age 2, body mass index, current smoking, alcohol intake, and use of antihypertensive drugs, pulse pressure was significantly associated with serum C-reactive protein concentration in women (Pp0.002) but not in men (P40.10; P ¼ 0.02 for interaction between gender and serum C-reactive protein). In women, with one-fold increase in serum C-reactive protein concentration, pulse pressure was 1.94 mmhg higher. The categorical analyses confirmed our findings. With similar adjustments applied, women in the fourth quartile, compared with those in the lowest quartile, had a 7.6 mmhg higher pulse pressure (95% confidence interval mmhg; P ¼ ). Furthermore, when women were analysed according to menopausal status, the association between pulse pressure and C-reactive protein was only significant in postmenopausal (Pp0.04), but not in premenopausal, subjects (PX0.21). In conclusion, taken together with the previous gender-specific observations on carotid lesions and hypertension, our finding suggests that chronic low-grade inflammation might play a role in the widening of pulse pressure in Chinese women. This cross-sectional observation warrants further investigation in prospective studies. (2005) 19, doi: /sj.jhh Published online 27 January 2005 Keywords: blood pressure; pulse pressure; C-reactive protein; Chinese; gender; menopause Introduction Hypertension is one of the most powerful risk factors for stroke and coronary heart disease. 1 In older persons, pulse pressure is a better cardiovascular risk predictor than systolic or diastolic blood pressure. 2 7 Systolic pressure increases with age until the eighth or ninth decade of life, whereas Correspondence: Dr J-G Wang, Center for Epidemiological Studies and Clinical Trials, Ruijin Hospital, Shanghai Institute of Hypertension, Ruijin 2nd Road 197, Shanghai , China. jiguangwang@netscape.net or Dr X Li, Department of Cardiology, Jiangsu Provincial Hospital, Guangzhou Road 300, Nanjing , China. Received 14 August 2004; revised 19 November 2004; accepted 21 November 2004; published online 27 January 2005 diastolic pressure rises only until middle age and then either levels off or slightly decreases, explaining why pulse pressure and the prevalence of isolated systolic hypertension increase with aging. 8,9 In the elderly, the widening of pulse pressure is mainly due to increased arterial stiffness. 10 However, the predisposing or precipitating factors of this process remain under investigation. There is growing evidence that low-grade chronic inflammation, as reflected by increased serum C-reactive protein concentration, is a predictor of atherosclerotic disorders, 11 and might also be a risk factor for human hypertension. 12 Indeed, several recent studies have demonstrated significant and independent positive associations of blood pressure and pulse pressure with serum C-reactive protein
2 294 Pulse pressure and C-reactive protein concentration A prospective study in women found that the incidence of hypertension was associated with increased serum C-reactive protein. 18 Furthermore, in the Framingham heart study, carotid intima-media thickness, which is closely related to systolic blood pressure and pulse pressure, 19 is associated with serum C-reactive protein concentration only in women, but not in men. 20 We therefore investigated gender-specific associations of systolic and diastolic blood pressure, and pulse pressure with the serum concentration of highsensitivity C-reactive protein in a Chinese population sample. Laboratory methods Venous blood was sampled after overnight fast. All biochemical measurements were performed in the central laboratory of the Jiangsu Provincial Hospital, Nanjing Medical University Hospital (Nanjing, China). C-reactive protein was measured using a high-sensitivity immunonephelometric latexenhanced assay on a BN II analyser (BNA, Dade Bering). Serum creatinine and uric acid were measured using Jaffé s method and the uricase method, 21 respectively (Chemistry Analyser AU2700, Olympus Medical Engineering Company, Tokyo, Japan). Methods Study population We performed the present study in Taicang, a city 50 km west of Shanghai, China. The Taicang study was conducted according to the principles outlined in the Helsinki declaration for investigation of human subjects. The Institutional Review Board of the Jiangsu Provincial Hospital, Nanjing Medical University approved the study protocol. All subjects gave written informed consent. We recruited nuclear families via specialized hypertension clinics using hypertensive family members as index persons. Nuclear families had to consist of either one parent and at least two offspring, or two parents and one or more siblings. The minimum age for participation was 18 years. In 2003, 493 subjects were enrolled. The participation rate among the subjects contacted was 93.5%. In all, 29 subjects had incomplete anthropometrical (n ¼ 10), blood pressure (n ¼ 1), or biochemical (n ¼ 18) measurements. In addition, we excluded one subject with laboratory signs of rheumatic activity. Thus, the number of subjects included in the present analysis totalled to 463. Field work All subjects were first invited for technical examinations in the outpatient clinic and then visited in their homes 1 2 weeks later. On each of these two occasions, blood pressure was measured five times consecutively after 5 min rest in the sitting position by sphygmomanometry. For the present analysis, we averaged these 10 blood pressure readings. Hypertension was diagnosed if the average of the 10 blood pressure readings was at least 140 mmhg systolic or 90 mmhg diastolic, or if the subjects were on antihypertensive medication. We used a questionnaire to collect information on medical history (including stroke, coronary heart disease consisting of myocardial infarction and angina pectoris, and other diseases), smoking habits, alcohol intake, and use of medications. Statistical methods We used SAS version 8.1 (SAS Institute, Cary, NC, USA) for database management and statistical analysis. Measurements with a skewed distribution were normalized by logarithmic transformation. Means and proportions were compared with the standard normal z-test and Fisher s exact test, respectively. Correlation coefficients were calculated using Pearson s method. We searched for possible correlates using stepwise multiple regression with the P-value for covariables to enter and stay in the model set at We used analysis of covariance and multiple linear regression to test associations of interest, while controlling for covariables. We adjusted blood pressure components for age and age 2 because the association between blood pressure and age was curvilinear. We performed statistical tests for interaction between gender (0, women; 1, men) or menopausal status (0, premenopausal; 1, postmenopausal) and serum C-reactive protein concentration by including these variables and their crossproduct term in the same model. Results Characteristics of the participants The 224 male and 239 female participants were of similar age (51.0 years; Table 1), and had similar systolic blood pressure (124.7 mmhg) and pulse pressure (47.1 mmhg), but men, compared with women, had significantly higher diastolic blood pressure (79.6 vs 75.8 mmhg; Po0.0001) and body mass index (24.3 vs 23.4 kg/m 2, P ¼ 0.003). The study sample included 191 (41.3%) hypertensive patients of whom 172 took antihypertensive drugs (calcium-channel blockers, n ¼ 103; diuretics, n ¼ 83; angiotensin-converting enzyme inhibitors, n ¼ 56; b-blockers, n ¼ 55; angiotensin II type 1 receptor blockers, n ¼ 2; and various combination tablets with very low doses of hydrochlorothiazide, reserpine, and dihydralazine, n ¼ 21). In all, 15 (3.2%) subjects had symptoms or signs suggestive of coronary heart disease (n ¼ 14) or a history of
3 Pulse pressure and C-reactive protein Table 1 Characteristics of the participants 295 Variables a Men (n ¼ 224) Women (n ¼ 239) P Age (years) Body mass index (kg/m 2 ) Systolic pressure (mmhg) b Diastolic pressure (mmhg) b o Pulse pressure (mmhg) Taking antihypertensive drugs (%) 84 (37.5) 88 (36.8) 0.88 Diabetic patients (%) c 32 (14.3) 20 (8.4) 0.04 Stroke (%) 4 (1.8) 5 (2.1) 0.81 Coronary heart disease (%) d 10 (4.5) 5 (2.1) 0.15 Use of aspirin (%) 2 (0.9) 5 (2.1) 0.29 Current smoking (%) 82 (36.6) 2 (0.8) o Alcohol intake (%) 93 (41.5) 6 (2.5) o Serum total cholesterol (mmol/l) Serum creatinine (mmol/l) o Serum uric acid (mmol/l) o Serum C-reactive protein (mg/dl) e 1.37 ( ) 1.32 ( ) 0.60 a Values are arithmetic means7s.d., geometric means (95% confidence interval), or number of subjects (%). b Mean of 10 blood pressure readings (five at outpatient clinic and five at subjects homes). c Use of antidiabetic agents or a fasting plasma glucose X7.1 mmol/l. 31 d Patients with a history of myocardial infarction or symptoms or signs suggestive of coronary heart disease. e Unadjusted geometric means (95% confidence interval). myocardial infarction (n ¼ 1), and nine (1.9%) had a history of stroke. Seven (1.5%) subjects took aspirin for cardiovascular prevention, and only one (0.2%) subject took statin. A total of 124 (51.9%) women reported natural (n ¼ 122) and surgical (n ¼ 2) menopause. None of the female subjects took oral contraceptives or hormone replacement therapy. In stepwise multiple regression, we considered gender, age, body mass index, waist-to-hip ratio, current smoking, alcohol intake, white blood cell count, serum concentrations of uric acid and total cholesterol, diabetes mellitus, and use of angiotensin-converting enzyme inhibitors, b-blockers, calcium-channel blockers, or diuretics as potential correlates of serum C-reactive protein concentration. Of these variables, gender (r ¼ 0.16, P ¼ 0.001), age (r ¼ 0.12, P ¼ 0.02), waist-to-hip ratio (r ¼ 0.13, P ¼ 0.008), white blood cell count (r ¼ 0.21, Po0.0001), serum uric acid (r ¼ 0.19, P ¼ ), and use of b-blockers (r ¼ 0.12, P ¼ 0.01) entered the model. After adjustment for the other significant correlates, serum C-reactive protein concentration was higher in men than in women (geometric mean 1.73 vs 1.30 mg/dl), and in users of b-blockers than in nonusers (1.72 vs 1.30 mg/dl). In women, after adjustment for age, serum C-reactive protein concentration was higher in postmenopausal than premenopausal subjects (1.60 vs 1.06 mg/dl, P ¼ 0.02). Association between blood pressure components and serum C-reactive protein In single regression, pulse pressure in women and systolic blood pressure in both sexes were significantly (Pp0.01) associated with serum C-reactive protein concentration (Table 2). The associations were significantly more pronounced in women than in men for systolic blood pressure (P ¼ 0.05) as well as pulse pressure (P ¼ 0.004; Figure 1). After adjustment for age, age 2, body mass index, and use of antihypertensive drugs in both sexes and also for current smoking and alcohol intake in men, these associations were weakened (Table 2). Nonetheless, the association between pulse pressure and serum C-reactive protein concentration in women remained statistically significant (P ¼ 0.002). The interaction between gender and serum C-reactive protein concentration in relation to pulse pressure also reached statistical significance (P ¼ 0.02). In women, with one-fold increase in serum C-reactive protein concentration, pulse pressure was 1.94 mmhg higher. In further analyses, we stratified men and women separately by quartiles of serum C-reactive protein concentration. With similar adjustments applied, women in the fourth quartile, compared with those in the lowest quartile, had significantly higher levels of systolic blood pressure ( þ 5.67 mmhg, 95% confidence interval mmhg; P ¼ 0.03) and pulse pressure ( þ 7.62 mmhg, 95% confidence interval mmhg; P ¼ ). We did not find any significant between-quartile differences in men (P40.12; Table 3 and Figure 2). Furthermore, these categorical analyses demonstrated a significant interaction between gender and serum C-reactive protein concentration in relation to pulse pressure (P ¼ 0.005; Figure 2), but not systolic pressure (P ¼ 0.06). We did not observe any significant interaction between menopausal status and C-reactive protein in relation to pulse pressure in either continuous or categorical analyses (PX0.21). Nonetheless, we
4 Pulse pressure and C-reactive protein 296 Table 2 Associations of systolic and diastolic blood pressure and pulse pressure with one-fold increase in serum C-reactive protein concentration by gender Unadjusted analyses Adjusted analyses a r Regression coefficient7s.e. P Partial r Regression coefficient7s.e. P Men (n ¼ 224) Systolic blood pressure (mmhg) Diastolic blood pressure (mmhg) Pulse pressure (mmhg) Women (n ¼ 239) Systolic blood pressure (mmhg) o Diastolic blood pressure (mmhg) Pulse pressure (mmhg) o a The analyses were adjusted for age, age 2, body mass index, and use of antihypertensive drugs in both sexes and also for current smoking and alcohol intake in men. values were 0.84 (0.66) and 1.95 ( 2.65 to 6.55) mmhg, respectively. We performed sensitivity analyses in 200 male and 208 female participants who did not take b-blockers. With similar adjustments applied, these analyses confirmed our gender-specific observations in all subjects. Cardiovascular risk of increased serum C-reactive protein concentration Figure 1 Unadjusted association between pulse pressure and serum C-reactive protein concentration in men (closed symbols with solid regression line; r ¼ 0.11; P ¼ 0.10) and women (open symbols with dashed regression line; r ¼ 0.34; Po0.0001) separately. P ¼ for interaction between gender and serum C-reactive protein concentration. analysed postmenopausal and premenopausal women separately, because of the menopause-based significant difference in serum C-reactive protein concentration. With similar adjustments applied, the association between pulse pressure and C-reactive protein was only significant in postmenopausal women (Pp0.04) but not in premenopausal subjects (PX0.21). In 124 postmenopausal women, pulse pressure was 2.13 (s.e., 1.00) mmhg higher with one-fold increment in serum C-reactive protein concentration, and 9.89 (95% confidence interval ) mmhg higher in women in quartile 4 as compared with those in quartile 1. In 115 premenopausal women, the corresponding In 61 (13.2%) subjects, serum C-reactive protein concentration was higher than 3.0 mg/dl. These subjects had a higher prevalence of hypertension than those with a serum C-reactive protein concentration below 3.0 mg/dl (54.1 vs 39.3%, P ¼ 0.03). However, after adjustment for gender, age, body mass index, current smoking, and alcohol intake, the prevalence of hypertension was not significantly (PX0.43) associated with serum C-reactive protein concentration in all subjects, nor in men or women separately. The prevalence of cardiovascular complications (n ¼ 24) was similar in subjects with a serum C-reactive protein beyond or below 3.0 mg/dl (PX0.50). Discussion Our new finding was that pulse pressure was associated with serum C-reactive protein concentration in Chinese women, but not in men. The significant association in women was independent of age, body mass index, and use of antihypertensive drugs, and seemed slightly more prominent in postmenopausal subjects, who also had higher serum C-reactive protein concentration than premenopausal women. Several previous studies demonstrated a significant association between pulse pressure and C-reactive protein, but none of these studies reported results in men and women separately
5 Pulse pressure and C-reactive protein Table 3 Systolic and diastolic blood pressure and pulse pressure by gender and quartiles of the serum C-reactive protein concentration 297 Quartiles of serum C-reactive protein a P for trend Men (n ¼ 224) Quartile 1 (n ¼ 56) Quartile 2 (n ¼ 56) Quartile 3 (n ¼ 56) Quartile 4 (n ¼ 56) Serum C-reactive protein (mg/dl) Systolic blood pressure (mmhg) Diastolic blood pressure (mmhg) Pulse pressure (mmhg) Women (n ¼ 239) Quartile 1 (n ¼ 60) Quartile 2 (n ¼ 60) Quartile 3 (n ¼ 60) Quartile 4 (n ¼ 59) Serum C-reactive protein (mg/dl) Systolic blood pressure (mmhg) Diastolic blood pressure (mmhg) Pulse pressure (mmhg) a Values are means7s.e., adjusted for age, age 2, body mass index, and use of antihypertensive drugs in both sexes and also for current smoking and alcohol intake in men. Figure 2 Mean pulse pressure according to quartiles of the serum C-reactive protein concentration in men (closed symbols with solid line) and women (open symbols with dashed line) separately. Values were adjusted for age, age 2, body mass index, and use of antihypertensive drugs in both sexes and also for current smoking and alcohol intake in men. Vertical lines denote s.e. s. P-values for trend and for interaction (P-int) between gender and C-reactive protein are given. For the number of subjects in each quartile, see Table 3. In two studies conducted in healthy American 14 or European 22 men and women, pulse pressure was associated with C-reactive protein, independent of systolic and diastolic pressure 14 or mean blood pressure. 22 However, in stroke survivors 13 or nevertreated hypertensive patients, 15 the positive association between pulse pressure and C-reactive protein was mainly driven by systolic blood pressure. These studies did not specifically explore the association between pulse pressure and C-reactive protein. 16,23 However, several of these studies showed that systolic but not diastolic blood pressure was associated with serum C-reactive protein level, 23 suggesting an association with pulse pressure. Thus, current literature evidence supports an association between pulse pressure and C-reactive protein. Our finding was in line with the prospective analysis of the Framingham heart study on the association between carotid atherosclerosis and serum C-reactive protein concentration. 19 In the offspring cohort of the Framingham heart study, C- reactive protein at baseline significantly predicted carotid stenosis and intima-media thickening at 4 years of follow-up in 1665 women, but not in 1508 men. 19 Carotid stenosis and intima-media thickening are closely correlated with the widening of pulse pressure, 19 which is in fact the consequence of an increased stiffness of the large arteries. 10 In addition, in a large Korean study, the association between the risk of hypertension and a higher serum C-reactive protein concentration was significantly greater in 3534 women than in 4813 men. 16 Considering the similar results of previous population studies on carotid atherosclerosis 19 and hypertension, 16 our gender-specific observation was probably not a chance finding due to the relatively small sample size. Why pulse pressure was associated with C-reactive protein in women but not in men remains to be elucidated. It is known that exogenous female hormones used as oral contraceptives or replacement therapy may increase serum C-reactive protein concentration, 24,25 and activate the renin angiotensin aldosterone system. 26 The activation of the renin angiotensin aldosterone system may lead to an increase in blood pressure. However, none of the female participants in our study used hormonal medication. It is also known that endogenous female hormones exert protective effects on the cardiovascular system. 27 Our insignificant findings in premenopausal women might be due to their low levels of serum C-reactive protein. In contrast, without cardiovascular protection by endogenous female hormones in women after menopause, the increased serum C-reactive protein
6 298 concentration might lead to an increased pulse pressure. Our study was cross-sectional, and hence was unable to establish a causal relationship between pulse pressure and C-reactive protein. Our hypothesis is that chronic low-grade inflammation as a risk factor for atherosclerosis 19 and endothelial dysfunction 12 in women might lead to increased pulse pressure. Inflammation is increasingly recognized as a cardiovascular risk factor. The circulatory markers of inflammation predict cardiovascular disease, such as stroke and coronary heart disease, 28,29 and are associated with several traditional cardiovascular risk factors including hypertension. 30 The recently published population-based prospective study in women showed that C-reactive protein predicted the incidence of hypertension, 18 and provided direct support for a cause effect relationship between blood pressure and C-reactive protein. However, since hypertension is a reversible cardiovascular risk factor, it is also possible that high blood pressure induces inflammation, and increases serum C-reactive protein concentration. 13 Finally, the possibility that high pulse pressure and a raised serum C-reactive protein concentration are just bystanders in high-risk patients cannot be entirely excluded. In conclusion, taken together with the previous gender-specific observations on carotid lesions 19 and hypertension, 16 our finding suggests that chronic low-grade inflammation, as reflected by an increased serum C-reactive protein concentration, might play a role in the widening of pulse pressure in Chinese women. This cross-sectional observation warrants further investigation in prospective studies. Acknowledgements The study was supported by a grant (2002) from Natural Science Foundation of Jiangsu Province (Nanjing, China). We acknowledge the expert assistance of Drs Lirong Liang and Zhenzhen Wang from Nanjing Medical University (Nanjing, China) and Dr Lifang Liu from the Department of Geriatrics, General Hospital of the Air Force (Beijing, China). References Pulse pressure and C-reactive protein 1 Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002; 360: Franklin SS et al. Hemodynamic patterns of agerelated changes in blood pressure. The Framingham Heart Study. Circulation 1997; 96: Blacher J et al. Pulse pressure not mean pressure determines cardiovascular risk in older hypertensive patients. Arch Intern Med 2000; 160: Sesso HD et al. Systolic and diastolic blood pressure, pulse pressure, and mean arterial pressure as predictors of cardiovascular disease risk in men. Hypertension 2000; 36: Benetos A et al. A decrease in diastolic blood pressure combined with an increase in systolic blood pressure is associated with a higher cardiovascular mortality in men. J Am Coll Cardiol 2001; 35: Kostis JB et al. Association of increased pulse pressure with the development of heart failure in SHEP. Am J Hypertens 2001; 14: Domanski M et al. Cardiovascular risk assessment using pulse pressure in the first national health and nutrition examination survey (NHANES I). Hypertension 2001; 38: Staessen J, Amery A, Fagard R. Editorial review. Isolated systolic hypertension in the elderly. J Hypertens 1990; 8: Franklin SS et al. Predominance of isolated systolic hypertension among middle-aged and elderly US hypertensives. Analysis based on National Health and Nutrition Examination Survey (NHANES) III. Hypertension 2001; 37: Safar ME, Levy BI, Struijker-Boudier H. Current perspectives on arterial stiffness and pulse pressure in hypertension and cardiovascular diseases. Circulation 2003; 107: Ridker PM. High-sensitivity C-reactive protein: potential adjunct for global risk assessment in the primary prevention of cardiovascular disease. Circulation 2001; 103: Bautista LE. Inflammation, endothelial dysfunction, and the risk of high blood pressure: epidemiologic and biological evidence. J Hum Hypertens 2003; 17: Di Napoli M, Papa F. Association between blood pressure and C-reactive protein levels in acute ischemic stroke. Hypertension 2003; 42: Abramson JL, Weintraub WS, Vaccarino V. Association between pulse pressure and C-reactive protein among apparently healthy US adults. Hypertension 2002; 39: Schillaci G et al. Increased C-reactive protein concentrations in never-treated hypertension: the role of systolic and pulse pressures. J Hypertens 2003; 21: Sung KC et al. High sensitivity C-reactive protein as an independent risk factor for essential hypertension. Am J Hypertens 2003; 16: Bautista LE et al. Is C-reactive protein an independent risk factor for essential hypertension? J Hypertens 2001; 19: Sesso HD et al. C-reactive protein and the risk of developing hypertension. JAMA 2003; 290: Zanchetti A et al. Systolic and pulse pressures (but not diastolic blood pressure and serum cholesterol) are associated with alterations in carotid intima-media thickness in the moderately hypercholesterolaemic hypertensive patients of the Plaque Hypertension Lipid Lowering Italian Study. J Hypertens 2001; 19: Wang TJ et al. Association of C-reactive protein with carotid atherosclerosis in men and women: the Framingham Heart Study. Arterioscler Thromb Vasc Biol 2002; 22: Praetorius E. Enzymatic method for determination of uric acid by ultraviolet spectrophotometry. Scand J Clin Lab Invest 1949; 1:
7 22 Amar J et al. Relationship between C reactive protein and pulse pressure is not mediated by atherosclerosis or aortic stiffness. J Hypertens 2004; 22: Yamada S et al. Distribution of serum C-reactive protein and its association with atherosclerotic risk factors in a Japanese population: Jichi Medical School Cohort Study. Am J Epidemiol 2001; 153: Dreon DM, Slavin JL, Phinney SD. Oral contraceptive use and increased plasma concentration of C-reactive protein. Life Sci 2003; 73: Kluft C, Leuven JA, Helmerhorst FM, Krans HM. Proinflammatory effects of oestrogens during use of oral contraceptives and hormone replacement treatment. Vascul Pharmacol 2002; 39: Oelkers W et al. Effects of a new oral contraceptive containing an antimineralocorticoid progestogen, drospirenone, on the renin aldosterone system, body weight, blood pressure, glucose tolerance, and lipid metabolism. J Clin Endocrinol Metab 1995; 80: Pulse pressure and C-reactive protein 27 Mendelsohn ME, Karas RH. The protective effects of estrogen on the cardiovascular system. N Engl J Med 1999; 340: Ridker PM, Hennekens CH, Buring JE, Rifai N. C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women. N Engl J Med 2000; 342: Ridker PM et al. Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. N Engl J Med 1997; 336: Ford ES. C-reactive protein concentration and cardiovascular disease risk factors in children: findings from the National Health and Nutrition Examination Survey Circulation 2003; 108: Alberti KGMM, Zimmer PZ, for the WHO Consultation. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: Diagnosis and classification of diabetes mellitus. Provisional report of a WHO consultation. Diabet Med 1998; 15:
ORIGINAL INVESTIGATION. C-Reactive Protein Concentration and Incident Hypertension in Young Adults
ORIGINAL INVESTIGATION C-Reactive Protein Concentration and Incident Hypertension in Young Adults The CARDIA Study Susan G. Lakoski, MD, MS; David M. Herrington, MD, MHS; David M. Siscovick, MD, MPH; Stephen
More informationASSOCIATION OF SYSTEMIC INFLAMMATION WITH ARTERIAL STIFFNESS IN HYPERTENSION
ASSOCIATION OF SYSTEMIC INFLAMMATION WITH ARTERIAL STIFFNESS IN HYPERTENSION Jung-Sun Kim a and Sungha Park a,b, a Division of Cardiology, b Cardiovascular Genome Center, Yonsei Cardiovascular Center,
More informationOverview of the outcome trials in older patients with isolated systolic hypertension
Journal of Human Hypertension (1999) 13, 859 863 1999 Stockton Press. All rights reserved 0950-9240/99 $15.00 http://www.stockton-press.co.uk/jhh Overview of the outcome trials in older patients with isolated
More informationThe Framingham Coronary Heart Disease Risk Score
Plasma Concentration of C-Reactive Protein and the Calculated Framingham Coronary Heart Disease Risk Score Michelle A. Albert, MD, MPH; Robert J. Glynn, PhD; Paul M Ridker, MD, MPH Background Although
More informationNomogram of the Relation of Brachial-Ankle Pulse Wave Velocity with Blood Pressure
801 Original Article Nomogram of the Relation of Brachial-Ankle Pulse Wave Velocity with Blood Pressure Akira YAMASHINA, Hirofumi TOMIYAMA, Tomio ARAI, Yutaka KOJI, Minoru YAMBE, Hiroaki MOTOBE, Zydem
More informationA: Epidemiology update. Evidence that LDL-C and CRP identify different high-risk groups
A: Epidemiology update Evidence that LDL-C and CRP identify different high-risk groups Women (n = 27,939; mean age 54.7 years) who were free of symptomatic cardiovascular (CV) disease at baseline were
More informationEstrogens vs Testosterone for cardiovascular health and longevity
Estrogens vs Testosterone for cardiovascular health and longevity Panagiota Pietri, MD, PhD, FESC Director of Hypertension Unit Athens Medical Center Athens, Greece Women vs Men Is there a difference in
More informationAssociations of blood pressure with carotid intima-media thickness in elderly Finns with diabetes mellitus or impaired glucose tolerance
(2003) 17, 705 711 & 2003 Nature Publishing Group All rights reserved 0950-9240/03 $25.00 www.nature.com/jhh ORIGINAL ARTICLE Associations of blood pressure with carotid intima-media thickness in elderly
More informationPrognostic significance of blood pressure measured in the office, at home and during ambulatory monitoring in older patients in general practice
(2005) 19, 801 807 & 2005 Nature Publishing Group All rights reserved 0950-9240/05 $30.00 www.nature.com/jhh ORIGINAL ARTICLE Prognostic significance of blood pressure measured in the office, at home and
More informationRelationship between Arterial Stiffness and the Risk of Coronary Artery Disease in Subjects with and without Metabolic Syndrome
243 Original Article Hypertens Res Vol.30 (2007) No.3 p.243-247 Relationship between Arterial Stiffness and the Risk of Coronary Artery Disease in Subjects with and without Metabolic Syndrome Yutaka KOJI
More informationegfr > 50 (n = 13,916)
Saxagliptin and Cardiovascular Risk in Patients with Type 2 Diabetes Mellitus and Moderate or Severe Renal Impairment: Observations from the SAVOR-TIMI 53 Trial Supplementary Table 1. Characteristics according
More informationResearch Article Comparison of Different Anthropometric Measurements and Inflammatory Biomarkers
International Inflammation Volume 2012, Article ID 124693, 5 pages doi:10.1155/2012/124693 Research Article Comparison of Different Anthropometric Measurements and Inflammatory Biomarkers Yaron Arbel,
More informationShort stature is an inflammatory disadvantage among middle-aged Japanese men
Environ Health Prev Med (2016) 21:361 367 DOI 10.1007/s12199-016-0538-y REGULAR ARTICLE Short stature is an inflammatory disadvantage among middle-aged Japanese men Yuji Shimizu 1,2 Hiroyuki Yoshimine
More informationSlide notes: References:
1 2 3 Cut-off values for the definition of hypertension are systolic blood pressure (SBP) 135 and/or diastolic blood pressure (DBP) 85 mmhg for home blood pressure monitoring (HBPM) and daytime ambulatory
More informationAutonomic nervous system, inflammation and preclinical carotid atherosclerosis in depressed subjects with coronary risk factors
Autonomic nervous system, inflammation and preclinical carotid atherosclerosis in depressed subjects with coronary risk factors Carmine Pizzi 1 ; Lamberto Manzoli 2, Stefano Mancini 3 ; Gigliola Bedetti
More information290 Biomed Environ Sci, 2016; 29(4):
290 Biomed Environ Sci, 2016; 29(4): 290-294 Letter to the Editor Prevalence and Predictors of Hypertension in the Labor Force Population in China: Results from a Cross-sectional Survey in Xinjiang Uygur
More informationEffects of coexisting hypertension and type II diabetes mellitus on arterial stiffness
(2004) 18, 469 473 & 2004 Nature Publishing Group All rights reserved 0950-9240/04 $30.00 www.nature.com/jhh ORIGINAL ARTICLE Effects of coexisting hypertension and type II diabetes mellitus on arterial
More informationLow fractional diastolic pressure in the ascending aorta increased the risk of coronary heart disease
(2002) 16, 837 841 & 2002 Nature Publishing Group All rights reserved 0950-9240/02 $25.00 www.nature.com/jhh ORIGINAL ARTICLE Low fractional diastolic pressure in the ascending aorta increased the risk
More informationIschemic heart disease is the leading cause of
The impact of C-Reactive Protein: A Look at the Most Recent Studies and Trials By Davinder S. Jassal, MD, FRCPC; and Blair O Neill, MD, FRCPC, FACC Ischemic heart disease is the world s leading killer,
More informationΥπέρταση στις γυναίκες
Υπέρταση στις γυναίκες Ελένη Τριανταφυλλίδη Διευθύντρια ΕΣΥ Καρδιολογίας Υπεύθυνη Αντιυπερτασικού Ιατρείου Β Πανεπιστημιακή Καρδιολογική Κλινική Νοσοκομείο ΑΤΤΙΚΟΝ Cardiovascular disease is the Europe
More information47 Hypertension in Elderly
47 Hypertension in Elderly YOU DO NOT HEAL OLD AGE; YOU PROTECT IT; YOU PROMOTE IT; YOU EXTEND IT Sir James Sterling Ross Abstract: The prevalence of hypertension rises with age and the complications secondary
More informationCho et al., 2009 Journal of Cardiology (2009), 54:
Endothelial Dysfunction, Increased Carotid Artery Intima-media Thickness and Pulse Wave Velocity, and Increased Level of Inflammatory Markers are Associated with Variant Angina Cho et al., 2009 Journal
More informationSupplementary Online Content
Supplementary Online Content Kavousi M, Leening MJG, Nanchen D, et al. Comparison of application of the ACC/AHA guidelines, Adult Treatment Panel III guidelines, and European Society of Cardiology guidelines
More informationClinical Recommendations: Patients with Periodontitis
The American Journal of Cardiology and Journal of Periodontology Editors' Consensus: Periodontitis and Atherosclerotic Cardiovascular Disease. Friedewald VE, Kornman KS, Beck JD, et al. J Periodontol 2009;
More informationHospital and 1-year outcome after acute myocardial infarction in patients with diabetes mellitus and hypertension
(2003) 17, 665 670 & 2003 Nature Publishing Group All rights reserved 0950-9240/03 $25.00 www.nature.com/jhh ORIGINAL ARTICLE Hospital and 1-year outcome after acute myocardial infarction in patients with
More informationCharacteristics and Future Cardiovascular Risk of Patients With Not-At- Goal Hypertension in General Practice in France: The AVANT AGE Study
ORIGINAL PAPER Characteristics and Future Cardiovascular Risk of Patients With Not-At- Goal Hypertension in General Practice in France: The AVANT AGE Study Yi Zhang, MD, PhD; 1 Helene Lelong, MD; 2 Sandrine
More informationSupplementary Appendix
Supplementary Appendix This appendix has been provided by the authors to give readers additional information about their work. Supplement to: Solomon SD, Uno H, Lewis EF, et al. Erythropoietic response
More information300 Biomed Environ Sci, 2018; 31(4):
300 Biomed Environ Sci, 2018; 31(4): 300-305 Letter to the Editor Combined Influence of Insulin Resistance and Inflammatory Biomarkers on Type 2 Diabetes: A Population-based Prospective Cohort Study of
More informationCross-sectional data have shown positive associations between
Blood Pressure Increase and Incidence of Hypertension in Relation to Inflammation-Sensitive Plasma Proteins Gunnar Engström, Lars Janzon, Göran Berglund, Peter Lind, Lars Stavenow, Bo Hedblad, Folke Lindgärde
More informationIntermediate Methods in Epidemiology Exercise No. 4 - Passive smoking and atherosclerosis
Intermediate Methods in Epidemiology 2008 Exercise No. 4 - Passive smoking and atherosclerosis The purpose of this exercise is to allow students to recapitulate issues discussed throughout the course which
More informationManagement of Hypertension
Clinical Practice Guidelines Management of Hypertension Definition and classification of blood pressure levels (mmhg) Category Systolic Diastolic Normal
More informationThe role of physical activity in the prevention and management of hypertension and obesity
The 1 st World Congress on Controversies in Obesity, Diabetes and Hypertension (CODHy) Berlin, October 26-29 2005 The role of physical activity in the prevention and management of hypertension and obesity
More informationArterial function and longevity Focus on the aorta
Arterial function and longevity Focus on the aorta Panagiota Pietri, MD, PhD, FESC Director of Hypertension Unit Athens Medical Center Athens, Greece Secrets of longevity Secrets of longevity Unveiling
More informationVascular calcification in patients with Diabetes Mellitus. Dr Jamie Bellinge University of Western Australia Royal Perth Hospital
Vascular calcification in patients with Diabetes Mellitus Dr Jamie Bellinge University of Western Australia Royal Perth Hospital Risk of cardiovascular disease Cardiovascular disease; - Stroke - Coronary
More informationHDL-C. J Jpn Coll Angiol, 2008, 48: NIPPON DATA80, MEGA study, JELIS, dyslipidemia, risk assessment chart
Online publication March 25, 2009 48 6 2007 2007 HDL-C LDL-C HDL-C J Jpn Coll Angiol, 2008, 48: 463 470 NIPPON DATA80, MEGA study, JELIS, dyslipidemia, risk assessment chart 1987 NIPPON DATA80 Iso 10 MRFIT
More informationStopping oral contraceptives: an effective blood pressure-lowering intervention in women with hypertension
(2005) 19, 451 455 & 2005 Nature Publishing Group All rights reserved 0950-9240/05 $30.00 www.nature.com/jhh ORIGINAL ARTICLE Stopping oral contraceptives: an effective blood pressure-lowering intervention
More informationPrimary Prevention of Stroke
Primary Prevention of Stroke Dr Chris Ellis Cardiologist Green Lane CVS Service, Auckland City Hospital & Auckland Heart Group, Mercy Hospital, Auckland 67 Pages Long, 735 References 29 Sub-Headings for
More informationDietary Fatty Acids and the Risk of Hypertension in Middle-Aged and Older Women
07/14/2010 Dietary Fatty Acids and the Risk of Hypertension in Middle-Aged and Older Women First Author: Wang Short Title: Dietary Fatty Acids and Hypertension Risk in Women Lu Wang, MD, PhD, 1 JoAnn E.
More informationManaging HTN in the Elderly: How Low to Go
Managing HTN in the Elderly: How Low to Go Laxmi S. Mehta, MD, FACC The Ohio State University Medical Center Assistant Professor of Clinical Internal Medicine Clinical Director of the Women s Cardiovascular
More informationRisk Assessment of developing type 2 diabetes mellitus in patient on antihypertensive medication
41 Research Article Risk Assessment of developing type 2 diabetes mellitus in patient on antihypertensive medication Amarjeet Singh*, Sudeep bhardwaj, Ashutosh aggarwal Department of Pharmacology, Seth
More informationWeintraub, W et al NEJM March Khot, UN et al, JAMA 2003
Global risk hscrp Should not be included in a Global Cardiovascular Risk Assessment. Jodi Tinkel, MD Assistant Professor Director of Cardiac Rehabilitation Associate Program Director, Cardiovascular Medicine
More informationAssociation between pulse pressure, carotid intima media thickness and carotid and/or iliofemoral plaque in hypertensive patients
(2004) 18, 325 331 & 2004 Nature Publishing Group All rights reserved 0950-9240/04 $25.00 www.nature.com/jhh ORIGINAL ARTICLE Association between pulse pressure, carotid intima media thickness and carotid
More informationHigh-dose monotherapy vs low-dose combination therapy of calcium channel blockers and angiotensin receptor blockers in mild to moderate hypertension
(2005) 19, 491 496 & 2005 Nature Publishing Group All rights reserved 0950-9240/05 $30.00 www.nature.com/jhh ORIGINAL ARTICLE High-dose monotherapy vs low-dose combination therapy of calcium channel blockers
More informationVal-MARC: Valsartan-Managing Blood Pressure Aggressively and Evaluating Reductions in hs-crp
Página 1 de 5 Return to Medscape coverage of: American Society of Hypertension 21st Annual Scientific Meeting and Exposition Val-MARC: Valsartan-Managing Blood Pressure Aggressively and Evaluating Reductions
More informationWhat s In the New Hypertension Guidelines?
American College of Physicians Ohio/Air Force Chapters 2018 Scientific Meeting Columbus, OH October 5, 2018 What s In the New Hypertension Guidelines? Max C. Reif, MD, FACP Objectives: At the end of the
More informationCan Arterial Stiffness Be Reversed? And If So, What Are the Benefits?
...SYMPOSIUM PROCEEDINGS... Can Arterial Stiffness Be Reversed? And If So, What Are the Benefits? Based on a presentation by Michel E. Safar, MD Presentation Summary Systolic and diastolic blood pressure
More informationIndependent association between inflammatory markers (C-reactive protein, interleukin-6, and TNF-a) and essential hypertension
(2005) 19, 149 154 & 2005 Nature Publishing Group All rights reserved 0950-9240/05 $30.00 www.nature.com/jhh ORIGINAL ARTICLE Independent association between inflammatory markers (C-reactive protein, interleukin-6,
More informationNon alcoholic fatty liver disease and atherosclerosis Raul Santos, MD
Non alcoholic fatty liver disease and atherosclerosis Raul Santos, MD Sao Paulo Medical School Hospital Sao Paulo, Brazil Disclosure Honoraria received for consult and/or speaker : Astra Zeneca, Amgen,
More informationHypoinsulinemia is strongly associated with coronary artery calcification (CAC) assessed by multislice computed tomography
Hypoinsulinemia is strongly associated with coronary artery calcification (CAC) assessed by multislice computed tomography Yohei Oda 1, Muhei Tanaka 2, Michiaki Fukui 2, Sei Tsunoda 1, Satoshi Akabame
More informationTHE C-REACTIVE PROTEIN IS A
ORIGINAL CONTRIBUTION C-Reactive Protein and the Risk of Developing Hypertension Howard D. Sesso, ScD, MPH Julie E. Buring, ScD Nader Rifai, PhD Gavin J. Blake, MD, MPH J. Michael Gaziano, MD, MPH Paul
More informationEpidemiological studies indicate that a parental or family
Maternal and Paternal History of Myocardial Infarction and Risk of Cardiovascular Disease in Men and Women Howard D. Sesso, ScD, MPH; I-Min Lee, MBBS, ScD; J. Michael Gaziano, MD, MPH; Kathryn M. Rexrode,
More informationModerate alcohol consumption is associated with decreased
Alcohol Consumption and Plasma Concentration of C-Reactive Protein Michelle A. Albert, MD, MPH; Robert J. Glynn, PhD; Paul M Ridker, MD, MPH Background Moderate alcohol intake has been associated with
More informationCARDIOVASCULAR RISK FACTORS & TARGET ORGAN DAMAGE IN GREEK HYPERTENSIVES
CARDIOVASCULAR RISK FACTORS & TARGET ORGAN DAMAGE IN GREEK HYPERTENSIVES C. Liakos, 1 G. Vyssoulis, 1 E. Karpanou, 2 S-M. Kyvelou, 1 V. Tzamou, 1 A. Michaelides, 1 A. Triantafyllou, 1 P. Spanos, 1 C. Stefanadis
More informationLong-Term Care Updates
Long-Term Care Updates August 2015 By Darren Hein, PharmD Hypertension is a clinical condition in which the force of blood pushing on the arteries is higher than normal. This increases the risk for heart
More informationThe problem of uncontrolled hypertension
(2002) 16, S3 S8 2002 Nature Publishing Group All rights reserved 0950-9240/02 $25.00 www.nature.com/jhh The problem of uncontrolled hypertension Department of Public Health and Clinical Medicine, Norrlands
More informationJUPITER NEJM Poll. Panel Discussion: Literature that Should Have an Impact on our Practice: The JUPITER Study
Panel Discussion: Literature that Should Have an Impact on our Practice: The Study Kaiser COAST 11 th Annual Conference Maui, August 2009 Robert Blumberg, MD, FACC Ralph Brindis, MD, MPH, FACC Primary
More informationVA/DoD Clinical Practice Guideline for the Diagnosis and Management of Hypertension - Pocket Guide Update 2004 Revision July 2005
VA/DoD Clinical Practice Guideline for the Diagnosis and Management of Hypertension - Pocket Guide Update 2004 Revision July 2005 1 Any adult in the health care system 2 Obtain blood pressure (BP) (Reliable,
More informationDanno d organo bersaglio e rischio CV. Persiste un ruolo prognostico oltre la patologia d organo?
Danno d organo bersaglio e rischio CV. Persiste un ruolo prognostico oltre la patologia d organo? Prof. Massimo Salvetti Clinica Medica University of Brescia Percieved risk Actual risk Sehestedt et al,
More informationClinical Investigation and Reports. Predictive Value of Noninvasive Measures of Atherosclerosis for Incident Myocardial Infarction
Clinical Investigation and Reports Predictive Value of Noninvasive Measures of Atherosclerosis for Incident Myocardial Infarction The Rotterdam Study Irene M. van der Meer, MD, PhD; Michiel L. Bots, MD,
More informationArterial Age and Shift Work
340 Arterial Age and Shift Work Ioana Mozos 1*, Liliana Filimon 2 1 Department of Functional Sciences, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania 2 Department of Occupational
More informationHypertension Update Background
Hypertension Update Background Overview Aaron J. Friedberg, MD Assistant Professor, Clinical Division of General Internal Medicine The Ohio State University Wexner Medical Center Management Guideline Comparison
More informationThe Relationship Between Blood Pressure and C-Reactive Protein in the Multi-Ethnic Study of Atherosclerosis (MESA)
Journal of the American College of Cardiology Vol. 46, No. 10, 2005 2005 by the American College of Cardiology Foundation ISSN 0735-1097/05/$30.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2005.07.050
More informationJohn J.P. Kastelein MD PhD Professor of Medicine Dept. of Vascular Medicine Academic Medial Center / University of Amsterdam
Latest Insights from the JUPITER Study John J.P. Kastelein MD PhD Professor of Medicine Dept. of Vascular Medicine Academic Medial Center / University of Amsterdam Inflammation, hscrp, and Vascular Prevention
More informationFive chapters 1. What is CVD prevention 2. Why is CVD prevention needed 3. Who needs CVD prevention 4. How is CVD prevention applied 5. Where should CVD prevention be offered Shorter, more adapted to clinical
More informationThe investigation of serum lipids and prevalence of dyslipidemia in urban adult population of Warangal district, Andhra Pradesh, India
eissn: 09748369, www.biolmedonline.com The investigation of serum lipids and prevalence of dyslipidemia in urban adult population of Warangal district, Andhra Pradesh, India M Estari, AS Reddy, T Bikshapathi,
More informationUpdate on Lipid Management in Cardiovascular Disease: How to Understand and Implement the New ACC/AHA Guidelines
Update on Lipid Management in Cardiovascular Disease: How to Understand and Implement the New ACC/AHA Guidelines Paul Mahoney, MD Sentara Cardiology Specialists Lipid Management in Cardiovascular Disease
More informationYuqing Zhang, M.D., FESC Department of Cardiology, Fu Wai Hospital. CAMS & PUMC, Beijing, China
What Can We Learn from the Observational Studies and Clinical Trials of Prehypertension? Yuqing Zhang, M.D., FESC Department of Cardiology, Fu Wai Hospital. CAMS & PUMC, Beijing, China At ARIC visit 4
More informationCentral pressures and prediction of cardiovascular events in erectile dysfunction patients
Central pressures and prediction of cardiovascular events in erectile dysfunction patients N. Ioakeimidis, K. Rokkas, A. Angelis, Z. Kratiras, M. Abdelrasoul, C. Georgakopoulos, D. Terentes-Printzios,
More informationOptimizing risk assessment of total cardiovascular risk What are the tools? Lars Rydén Professor Karolinska Institutet Stockholm, Sweden
Optimizing risk assessment of total cardiovascular risk What are the tools? Lars Rydén Professor Karolinska Institutet Stockholm, Sweden Cardiovascular Disease Prevention (CVD) Three Strategies for CVD
More informationMandana Nikpour 1,2, Murray B Urowitz 1*, Dominique Ibanez 1, Paula J Harvey 3 and Dafna D Gladman 1. Abstract
RESEARCH ARTICLE Open Access Importance of cumulative exposure to elevated cholesterol and blood pressure in development of atherosclerotic coronary artery disease in systemic lupus erythematosus: a prospective
More informationHypertension Update. Aaron J. Friedberg, MD
Hypertension Update Aaron J. Friedberg, MD Assistant Professor, Clinical Division of General Internal Medicine The Ohio State University Wexner Medical Center Background Diagnosis Management Overview Guideline
More informationAppendix This appendix was part of the submitted manuscript and has been peer reviewed. It is posted as supplied by the authors.
Appendix This appendix was part of the submitted manuscript and has been peer reviewed. It is posted as supplied by the authors. Appendix to: Banks E, Crouch SR, Korda RJ, et al. Absolute risk of cardiovascular
More informationCardiovascular Complications of Diabetes
VBWG Cardiovascular Complications of Diabetes Nicola Abate, M.D., F.N.L.A. Professor and Chief Division of Endocrinology and Metabolism The University of Texas Medical Branch Galveston, Texas Coronary
More informationCorrespondence should be addressed to Huijuan Zhang;
Hindawi Diabetes Research Volume 2017, Article ID 3510275, 6 pages https://doi.org/10.1155/2017/3510275 Research Article Serum 25-Hydroxyvitamin D3 Levels Are Associated with Carotid Intima-Media Thickness
More informationInflammation in Renal Disease
Inflammation in Renal Disease Donald G. Vidt, MD Inflammation is a component of the major modifiable risk factors in renal disease. Elevated high-sensitivity C-reactive protein (hs-crp) levels have been
More informationHypertension in the Elderly. John Puxty Division of Geriatrics Center for Studies in Aging and Health, Providence Care
Hypertension in the Elderly John Puxty Division of Geriatrics Center for Studies in Aging and Health, Providence Care Learning Objectives Review evidence for treatment of hypertension in elderly Consider
More informationPrevalence of Low Low-Density Lipoprotein Cholesterol With Elevated High Sensitivity C-Reactive Protein in the U.S.
Journal of the American College of Cardiology Vol. 53, No. 11, 2009 2009 by the American College of Cardiology Foundation ISSN 0735-1097/09/$36.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2008.12.010
More informationHypertension and obesity. Dr Wilson Sugut Moi teaching and referral hospital
Hypertension and obesity Dr Wilson Sugut Moi teaching and referral hospital No conflict of interests to declare Obesity Definition: excessive weight that may impair health BMI Categories Underweight BMI
More informationDiabetes and Cardiovascular Risks in the Polycystic Ovary Syndrome
Diabetes and Cardiovascular Risks in the Polycystic Ovary Syndrome John E. Nestler, M.D. William Branch Porter Professor of Medicine Chair, Department of Internal Medicine Virginia Commonwealth University
More informationImproved control for confounding using propensity scores and instrumental variables?
Improved control for confounding using propensity scores and instrumental variables? Dr. Olaf H.Klungel Dept. of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences
More informationCedars Sinai Diabetes. Michael A. Weber
Cedars Sinai Diabetes Michael A. Weber Speaker Disclosures I disclose that I am a Consultant for: Ablative Solutions, Boston Scientific, Boehringer Ingelheim, Eli Lilly, Forest, Medtronics, Novartis, ReCor
More informationHypertension Update Clinical Controversies Regarding Age and Race
Hypertension Update Clinical Controversies Regarding Age and Race Allison Helmer, PharmD, BCACP Assistant Clinical Professor Auburn University Harrison School of Pharmacy July 22, 2017 DISCLOSURE/CONFLICT
More informationHIGH LDL CHOLESTEROL IS NOT AN INDEPENDENT RISK FACTOR FOR HEART ATTACKS AND STROKES
HIGH LDL CHOLESTEROL IS NOT AN INDEPENDENT RISK FACTOR FOR HEART ATTACKS AND STROKES A study published in the British Medical Journal shows that not only is high LDL cholesterol not a risk factor for all-caused
More informationPrediction of Cardiovascular Disease in suburban population of 3 municipalities in Nepal
Prediction of Cardiovascular Disease in suburban population of 3 municipalities in Nepal Koju R, Gurung R, Pant P, Humagain S, Yogol CM, Koju A, Manandhar K, Karmacharya B, Bedi TRS Address for Correspondence:
More informationHYPERTENSION AND OBESITY IN RELATION TO HIGH SENSITIVITY C-REACTIVE PROTEIN AND LIPID PROFILE IN IRAQI PATIENTS
Journal of Al-Nahrain University Vol.12 (4), December, 2009, pp.145-150 Science HYPERTENSION AND OBESITY IN RELATION TO HIGH SENSITIVITY C-REACTIVE PROTEIN AND LIPID PROFILE IN IRAQI PATIENTS Esam Noori
More informationProf. Samir Morcos Rafla Alexandria Univ. Cardiology Dept.
Obesity as a risk factor for Atrial Fibrillation Prof. Samir Morcos Rafla Alexandria Univ. Cardiology Dept. CardioAlex 2010 smrafla@hotmail.com 1 Obesity has reached epidemic proportions in the United
More informationStable Ischemic Heart Disease. Ivan Anderson, MD RIHVH Cardiology
Stable Ischemic Heart Disease Ivan Anderson, MD RIHVH Cardiology Outline Review of the vascular biology of atherosclerosis Why not just cath everyone with angina? Medical management of ischemic cardiomyopathy
More information4/7/ The stats on heart disease. + Deaths & Age-Adjusted Death Rates for
+ Update on Lipid Management Stacey Gardiner, MD Assistant Professor Division of Cardiovascular Medicine Medical College of Wisconsin + The stats on heart disease Over the past 10 years for which statistics
More informationEffectiveness of Add-On Low-Dose Diuretics in Combination Therapy for Hypertension: Losartan/Hydrochlorothiazide vs. Candesartan/Amlodipine
831 Original Article Hypertens Res Vol.3 (27) No.9 p.831-837 Effectiveness of Add-On Low-Dose Diuretics in Combination Therapy for Hypertension: Losartan/Hydrochlorothiazide vs. Candesartan/Amlodipine
More informationJNC Evidence-Based Guidelines for the Management of High Blood Pressure in Adults
JNC 8 2014 Evidence-Based Guidelines for the Management of High Blood Pressure in Adults Table of Contents Why Do We Treat Hypertension? Blood Pressure Treatment Goals Initial Therapy Strength of Recommendation
More informationSUPPLEMENTAL MATERIAL
SUPPLEMENTAL MATERIAL A Meta-analysis of LDL-C, non-hdl-c, and apob as markers of cardiovascular risk. Slide # Contents 2 Table A1. List of candidate reports 8 Table A2. List of covariates/model adjustments
More informationDrinking over the life-course and health effects. Annie Britton Alcohol Lifecourse Project University College London
Drinking over the life-course and health effects Annie Britton Alcohol Lifecourse Project University College London CLOSER 22 nd March 2018 H H H C C O H H H The UK Medical Research Council Alcohol Research
More informationJournal of the American College of Cardiology Vol. 48, No. 2, by the American College of Cardiology Foundation ISSN /06/$32.
Journal of the American College of Cardiology Vol. 48, No. 2, 2006 2006 by the American College of Cardiology Foundation ISSN 0735-1097/06/$32.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2006.03.043
More informationCandesartan Antihypertensive Survival Evaluation in Japan (CASE-J) Trial of Cardiovascular Events in High-Risk Hypertensive Patients
1/5 This site became the new ClinicalTrials.gov on June 19th. Learn more. We will be updating this site in phases. This allows us to move faster and to deliver better services. Show less IMPORTANT: Listing
More informationVascular Compliance is Reduced in Geriatric People with Angiographic Coronary Atherosclerosis
The Journal of International Medical Research 2009; 37: 1443 1449 Vascular Compliance is Reduced in Geriatric People with Angiographic Coronary Atherosclerosis B-A YOU 1, H-Q GAO 1, G-S LI 2, X-Y HUO 1
More informationData Alert #2... Bi o l o g y Work i n g Gro u p. Subject: HOPE: New validation for the importance of tissue ACE inhibition
Vascular Bi o l o g y Work i n g Gro u p c/o Medical Education Consultants, In c. 25 Sy l van Road South, We s t p o rt, CT 06880 Chairman: Carl J. Pepine, MD Professor and Chief Division of Cardiovascular
More informationREPORT FROM THE CANADIAN CHRONIC DISEASE SURVEILLANCE SYSTEM:
REPORT FROM THE CANADIAN CHRONIC DISEASE SURVEILLANCE SYSTEM: PROTECTING AND EMPOWERING CANADIANS TO IMPROVE THEIR HEALTH TO PROMOTE AND PROTECT THE HEALTH OF CANADIANS THROUGH LEADERSHIP, PARTNERSHIP,
More informationSpotty Calcification as a Marker of Accelerated Progression of Coronary Atherosclerosis : Insights from Serial Intravascular Ultrasound
Spotty Calcification as a Marker of Accelerated Progression of Coronary Atherosclerosis : Insights from Serial Intravascular Ultrasound Department of Cardiovascular Medicine Heart and Vascular Institute
More information