1,721,284 research outputs found
Markers of liver injury and clinical outcomes in COVID-19 patients:A systematic review and meta-analysis
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Ambient temperature or seasonal variations in blood pressure:how important is this in sub-Saharan Africa?
No full textIncreasing prevalence of high blood pressure in lean rural populations in sub-saharan Africa:is high salt consumption a contributing factor?
No full textRelative peak exercise oxygen pulse is related to sudden cardiac death, cardiovascular and all-cause mortality in middle-aged men
Get PDFBackground: Preliminary evidence suggests that peak exercise oxygen pulse – peak oxygen uptake/heart rate-, a variable obtained during maximal cardiopulmonary exercise testing and a surrogate of stroke volume, is a predictor of mortality. We aimed to assess the associations of peak exercise oxygen pulse with sudden cardiac death, fatal coronary heart disease and cardiovascular disease and all-cause mortality. Design: A prospective study. Methods: Peak exercise oxygen pulse was assessed in a maximal cycling test at baseline in 2227 middle-aged men of the Kuopio Ischaemic Heart Disease cohort study using expired gas variables and electrocardiograms. Relative peak exercise oxygen pulse was obtained by dividing the absolute value by body weight. Results: During a median follow-up of 26.1 years 1097 subjects died; there were 220 sudden cardiac deaths, 336 fatal coronary heart diseases and 505 fatal cardiovascular diseases. Relative peak exercise oxygen pulse (mean 19.5 (4.1) mL per beat/kg/102) was approximately linearly associated with each outcome. Comparing extreme quartiles of relative peak exercise oxygen pulse, hazard ratios (95% confidence intervals) for sudden cardiac death, fatal coronary heart disease and cardiovascular disease, and all-cause mortality on adjustment for cardiovascular risk factors were 0.55 (0.36–0.83), 0.58 (0.42–0.81), 0.60 (0.46–0.79) and 0.59 (0.49–0.70), respectively (P<0.001 for all). The hazard ratios were unchanged on further adjustment for C-reactive protein and the use of beta-blockers. The addition of relative peak exercise oxygen pulse to a cardiovascular disease mortality risk prediction model significantly improved risk discrimination (C-index change 0.0112; P¼0.030). Conclusion: Relative peak exercise oxygen pulse measured during maximal exercise was linearly and inversely associated with fatal cardiovascular and all-cause mortality events in middle-aged men. In addition, relative peak exercise oxygen pulse provided significant improvement in cardiovascular disease mortality risk assessment beyond conventional risk factors
A potential case for the routine assessment of cardiorespiratory fitness level in clinical practice
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Can a healthy dietary pattern alone prevent venous thromboembolism in the general population?
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Serum total bilirubin levels and coronary heart disease - Causal association or epiphenomenon?
Get PDFObservational epidemiological evidence supports a linear inverse and independent association between serum total bilirubin levels and coronary heart disease (CHD) risk, but whether this association is causal remains to be ascertained. A Mendelian randomization approach was employed to test whether serum total bilirubin is causally linked to CHD. The genetic variant rs6742078 - well known to specifically modify levels of serum total bilirubin and accounting for up to 20% of the variance in circulating serum total bilirubin levels - was used as an instrumental variable. In pooled analysis of estimates reported from published genome-wide association studies, every copy of the T allele of rs6742078 was associated with 0.42 standard deviation (SD) higher levels of serum total bilirubin (95% confidence interval, 0.40 to 0.43). Based on combined data from the Coronary Artery Disease Genome wide Replication and Meta-analyses and the Coronary Artery Disease (C4D) Genetics Consortium involving a total of 36,763 CHD cases and 76,997 controls, the odds ratio for CHD per copy of the T allele was 1.01 (95% confidence interval, 0.99 to 1.04). The odds ratio of CHD for a 1 SD genetically elevated serum total bilirubin level was 1.03 (95% confidence interval, 0.98 to 1.09). The current findings casts doubt on a strong causal association of serum total bilirubin levels with CHD. The inverse associations demonstrated in observational studies may be driven by biases such as unmeasured confounding and/or reverse causation. However, further research in large-scale consortia is needed.</p
Is “re-calibration” of standard cardiovascular disease (CVD) risk algorithms the panacea to improved CVD risk prediction and prevention?
Get PDFThis editorial refers to ‘Equalization of four cardiovascular risk algorithms after systematic recalibration: individual-participant meta-analysis of 86 prospective studies’, by L. Pennells et al., doi:10.1093/eurheartj/ehy653
Cardiovascular risk in a rural adult West African population:is resting heart rate also relevant?
No full textINTRODUCTION: Elevated resting heart rate (RHR) is a neglected marker in cardiovascular risk factor studies of sub-Saharan African populations. This study aimed to determine the prevalence of elevated RHR and other risk factors for cardiovascular disease (CVD) and to investigate any associations between RHR and these risk factors in a rural population in Ghana.DESIGN: Cross-sectional analysis.METHODS: A total of 574 adults aged between 18-65 years were randomly sampled from a population register. Data collected included those on sociodemographic variables and anthropometric, blood pressure (BP), and RHR measurements. Within-person variability in RHR was calculated using data from repeat measurements taken 2 weeks apart.RESULTS: Of study participants, 36% were male. Prevalence of casual high BP was 19%. In the population, 10% were current cigarette smokers and habitual alcohol use was high at 56%. As measured by body mass index, 2% were obese and 14% had abdominal obesity. RHR was elevated (>90 bpm) in 19%. Overall, 79% of study participants were found to have at least one CVD risk factor. RHR was significantly associated with age, waist circumference, and BP. Individuals with an elevated RHR had a higher risk (OR 1.94, 95% CI 1.15-3.26%, p = 0.013) of casual high BP compared with participants with normal RHR independently of several established CVD risk factors. The regression dilution ratio of RHR was 0.75 (95% CI 0.62-0.89).CONCLUSIONS: Significant associations were observed between RHR and several established cardiovascular risk factors. Prospective studies are needed in sub-Saharan African populations to establish the potential value of RHR in cardiovascular risk assessment.</p
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