Cardiovascular risk factors

Another study (84), which enrolled men and women between the ages of 21—55 who had mild hypertension and no recognizable cardiovascular risk factors, showed no significant differences in mortaUty between dmg- and placebo-treated patients. Significant reductions in hypertensive complications were noted, but atherosclerotic complications were not reduced. 

Criteria for initiation of drug treatment now take into consideration total cardiovascular risk rather than blood pressure alone, such that treatment is now recommended for persons whose blood pressure is in the normal range but still bear a heavy burden of cardiovascular risk factors. Thus, the role of simultaneous reduction of multiple cardiovascular risk factors in improving prognosis in hypertensive patients is stressed. In addition, more aggressive blood pressure goals are recommended for hypertensive patients with comorbid conditions such as diabetes mellitus or renal insufficiency. 

WAGNER J D, CEFALU W T, ANTHONY M S, LITWAK K N, ZHANG L and CLARKSON T B (1997) Dietary soy protein and estrogen replacement therapy improve cardiovascular risk factors and decrease aortic cholesteryl ester content in ovariectomized cynomolgus monkeys. ... 

Trout, D.L. (1991). Vitamin C and cardiovascular risk factors. Am. J. Clin. Nutr. 53, 322S-325S. 

Laboratory Tests The following tests may indicate additional cardiovascular risk factors or poor control of diabetes. Elevated fasting lipid panel Elevated fasting blood glucose Hemoglobin A1c greater than 7.0%... 

Patients with diabetes and hypertension should initially be treated with either P-blockers, ACE inhibitors, ARBs, diuretics, or calcium channel blockers. There is a general consensus that therapy focused on RAAS inhibition by ACE inhibitors or ARBs may be optimal if the patient has additional cardiovascular risk factors such as left ventricular hypertrophy or chronic kidney disease.2,3,59,67... 

Factors that predispose an individual to IHD are listed in Table 4—2. Hypertension, diabetes, dyslipidemia, and cigarette smoking are associated with endothelial dysfunction and potentiate atherosclerosis of the coronary arteries. The risk for IHD increases two-fold for every 20 mm Hg increment in systolic blood pressure and up to eight-fold in the presence of diabetes.5,6 Physical inactivity and obesity independently increase the risk for IHD, in addition to predisposing individuals to other cardiovascular risk factors (e.g., hypertension, dyslipidemia, and diabetes). 

Patients with multiple risk factors, particularly those with diabetes, are at the greatest risk for IHD. Metabolic syndrome is a constellation of cardiovascular risk factors related to hypertension, abdominal obesity, dyslipidemia, and insulin... 

A thorough medical history and physical exam are necessary to ascertain cardiovascular risk factors and to exclude non-ischemic... 

The results of these trials demonstrate that ERT or HRT should not be prescribed for the prevention of CHD or in patients with preexisting CHD. For women suffering from vasomotor symptoms with a history of CHD, including CHD risk factors, alternative therapies should be considered. Additionally, lifestyle modifications should be implemented, and therapies to treat risk factors such as hypertension and hyperlipidemia should be prescribed. It is important to note that the average age of women included in the HERS and the WHI trials was 67 and 63 years, respectively. Therefore, these trials were unable to assess the true risk in younger, potentially healthier women with fewer cardiovascular risk factors. 

The prevalence of obesity in older adults is increasing therefore, it should not be surprising that more cardiovascular risk factors are present in this group of individuals. Additionally, obesity is a major predictor of functional limitation and mobility problems in older persons. Age alone should not prejudice the clinician from treating geriatric patients, whereas the benefits of cardiovascular health and functionality should be considered. Treatments should be initiated that minimize adverse effects on bone health and nutritional status and should include dietary and activity modifications.6... 

Geisel J, Hennen B, Hubner U, Knapp JP, Herrmann W. The impact of hyperho-mocysteinemia as a cardiovascular risk factor in the prediction of coronary heart disease. Clin Chem Lab Med 2003 41(11) 1513—1517. 

Kirkby H. Gyntclbcrg F. 1985. Blood pressure and other cardiovascular risk factors of long-term exposure to lead. Scand J Work - Environ Health 11 15-19. 

These findings suggest that CNT exposure should be evaluated as a potential cardiovascular risk factor. It should be noted, however, that no thrombosis or other adverse effects on the cardiovascular homeostasis were reported after intravenous injection in healthy animals, when this administration route was used for investigating the biokinetics of CNTs [119-126]. 

Radhika G, Sudha V, Mohan Sathya R, Ganesan A and Mohan V. 2008. Association of fruit and vegetable intake with cardiovascular risk factors in urban south Indians. Br J Nutr 99(2) 398-405. 

A complete history and physical examination should assess (1) presence or absence of cardiovascular risk factors or definite cardiovascular disease in the individual (2) family history of premature cardiovascular disease or lipid disorders (3) presence or absence of secondary causes of hyperlipidemia, including concurrent medications and (4) presence or absence of xanthomas, abdominal pain, or history of pancreatitis, renal or liver disease, peripheral vascular disease, abdominal aortic aneurysm, or cerebral vascular disease (carotid bruits, stroke, or transient ischemic attack). 

Near-normal glycemia reduces the risk of microvascular disease complications, but aggressive management of traditional cardiovascular risk factors (i.e., smoking cessation, treatment of dyslipidemia, intensive blood pressure control, antiplatelet therapy) is needed to reduce macrovascular disease risk. 

Aerobic exercise can improve insulin resistance and glycemic control in most patients and may reduce cardiovascular risk factors, contribute to weight loss or maintenance, and improve well-being. Exercise should be started slowly in previously sedentary patients. Older patients and those with atherosclerotic disease should have a cardiovascular evaluation prior to beginning a substantial exercise program. 

Assessment for influenza and pneumococcal vaccine administration and assessment and management of other cardiovascular risk factors (e.g., smoking and antiplatelet therapy) are components of sound preventive medicine strategies. 

The isolate is penicillin sensitive (MIC less than or equal to 0.1 mcg/mL). / There are no cardiovascular risk factors such as heart failure, aortic insufficiency, or conduction abnormalities. 

Chen FPL, Lee N, Wang CH, Soong YK (1998) Effects of hormone replacement therapy on cardiovascular risk factors in postmenopausal women. Fertil Steril 69 267-273... 

Sundell, I. B., Nilsson, T. K., Hallmans, G., Hellsten, G., and Dahlen, G. H., Interrelationships between plasma levels of plasminogen activator inhibitor, tissue plasminogen activator, lipoprotein (a) and established cardiovascular risk factors in a North Swedish population. Atherosclerosis (Shannon, Irel.) 80, 9-16 (1989). 

AntheneUi RM, Despres IP (2004) Effects of Rimonabant in the reduction of major cardiovascular risk factors. Results from the STRATUS-US trial (smoking cessation in smokers motivated to quit), American College of Cardiology 53rd Annual Scientific Session, New Orleans, LA Arroyo M, Markou A, Robbins TW, Everitt B1 (1999) Acquisition, maintenance and reinstatement of intravenous cocaine self-administration under a second-order schedule of reinforcement in rats effects of conditioned cues and continuous acces to cocaine. Psychopharmacology 140 331-344... 

Myllykangas, L., Polikoski, T., Sulkava, R., et al. (2000) Cardiovascular risk factors and Alzheimer s disease a genetic association study in a popular aged 85 or over. Neurosci. Lett., 292, 195-198. 

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