0000000000133147
AUTHOR
G. Pichler
LDL particle size and composition and incident cardiovascular disease in a South-European population: The Hortega-Liposcale Follow-up Study.
Abstract Background The association of low-density lipoprotein (LDL) particle composition with cardiovascular risk has not been explored before. The aim was to evaluate the relationship between baseline LDL particle size and composition (proportions of large, medium and small LDL particles over their sum expressed as small-LDL %, medium-LDL % and large-LDL %) and incident cardiovascular disease in a population-based study. Methods Direct measurement of LDL particles was performed using a two-dimensional NMR-technique (Liposcale®). LDL cholesterol was assessed using both standard photometrical methods and the Liposcale® technique in a representative sample of 1162 adult men and women from Sp…
Immune-unreactive urinary albumin as a predictor of cardiovascular events: The Hortega Study
Background: We aimed to determine if immune-unreactive albumin excretion (IURAE) is associated with cardiovascular (CV) events in a representative sample of a general population from Spain.Methods: We included 1297 subjects (mean age ± standard error 48.0 ± 0.2 years, 48% females), who participated in the Hortega Follow-Up Study. The primary endpoint was incidence of fatal and non-fatal CV events. Urinary albumin excretion (UAE) was measured in spot voided urine, frozen at -80°C, by immunonephelometry [immune-reactive albumin excretion (IRAE)] and by high-performance liquid chromatography (HPLC) [total albumin excretion (AE)]. IURAE was calculated as the difference between HPLC measurements…
Urine cadmium levels and albuminuria in a general population from Spain: A gene-environment interaction analysis
Background: The interaction of cadmium with genes involved in oxidative stress, cadmium metabolism and transport pathways on albuminuria can provide biological insight on the relationship between cadmium and albuminuria at low exposure levels. Objectives: We tested the hypothesis that specific genotypes in candidate genes may confer increased susceptibility to cadmium exposure. Methods: Cadmium exposure was estimated by inductively coupled plasma mass spectrometry (ICPMS) in urine from 1397 men and women aged 18–85years participating in the Hortega Study, a representative sample of a general population from Spain. Urine albumin was measured by automated nephelometric immunochemistry. Abnorm…
Should we look for silent pulmonary embolism in patients with deep venous thrombosis?
Background Asymptomatic or silent pulmonary embolism (S-PE) in patients with deep vein thrombosis has been the focus of numerous publications with the objective of determining the incidence of S-PE and assessing whether its existence has any clinical or therapeutic consequences that outweigh the risks associated with the diagnostic tests performed and the increased healthcare costs. The objectives were to assess the incidence of S-PE using computed tomography angiogram (CTA), to understand the epidemiological factors that might trigger embolism, and to assess whether D-dimer (DD) predicts the existence of S-PE’s. Methods A prospective and consecutive assessment of 103 hospitalized patients …
Blood DNA Methylation and Incident Coronary Heart Disease
IMPORTANCE American Indian communities experience a high burden of coronary heart disease (CHD). Strategies are needed to identify individuals at risk and implement preventive interventions. OBJECTIVE To investigate the association of blood DNA methylation (DNAm) with incident CHD using a large number of methylation sites (cytosine-phosphate-guanine [CpG]) in a single model. DESIGN, SETTING, AND PARTICIPANTS This prospective study, including a discovery cohort (the Strong Heart Study [SHS]) and 4 additional cohorts (the Women's Health Initiative [WHI], the Framingham Heart Study [FHS], the Atherosclerosis Risk in Communities Study ([ARIC]-Black, and ARIC-White), evaluated 12 American Indian…
Glomerular Filtration Rate in Renal Damage
Renal function is mainly represented by the glomerular filtration (GF), which is dependent on the number and function of the nephrons. Glomerular filtration declines progressively after the third decade with a progressive loss of 1 % per year. In addition to diseases producing direct damage in the glomerular structures, high blood pressure values, diabetes, and dyslipidemia are the main factors increasing the rate of GF decline over the years. Other functional parameters of the kidney such as renal plasma flow or tubular functions are not measured in daily practice in hypertension and are not related to risk for cardiovascular disease (CVD).
Association of Arsenic Exposure With Cardiac Geometry and Left Ventricular Function in Young Adults
Background: Arsenic exposure has been related to numerous adverse cardiovascular outcomes. The aim of this study was to investigate the cross-sectional and prospective association between arsenic exposure with echocardiographic measures of left ventricular (LV) geometry and functioning. Methods: A total of 1337 young adult participants free of diabetes mellitus and cardiovascular disease were recruited from the SHFS (Strong Heart Family Study). The sum of inorganic and methylated arsenic concentrations in urine (ΣAs) at baseline was used as a biomarker of arsenic exposure. LV geometry and functioning were assessed using transthoracic echocardiography at baseline and follow-up. Results: Mea…
Proteinuria-Microalbuminuria in Renal Damage
Proteinuria (P) usually results from an insult in the glomerular and/or tubular structures of the kidney. It has been considered a marker of risk not only to develop renal insufficiency but also to suffer cardiovascular events, based on prospective studies carried out in the general population as well as in diabetic and hypertensive patients [1]. In fact, proteinuria has been considered a strong marker of risk and an intermediate endpoint during treatment [2, 3].
Other Methods to Assess Renal Damage
Although glomerular filtration rate (GFR) and proteinuria remain gold standard in the evaluation of renal target organ damage, imaging techniques and image-derived parameters allow for both assessment of renal function and estimation of cardiovascular risk. Enhancement in digital image processing permits dynamic measurement of renal vascular and intraparenchymal processes in real time. The most relevant in terms of clinical use to assess hypertension-induced organ damage are the renal resistive index (RRI), renal calcium score, and functional magnetic resonance imaging.
Cohort profile: the Hortega Study for the evaluation of non-traditional risk factors of cardiometabolic and other chronic diseases in a general population from Spain
PURPOSE: The Hortega Study is a prospective study, which investigates novel determinants of selected chronic conditions with an emphasis on cardiovascular health in a representative sample of a general population from Spain. PARTICIPANTS: In 1997, a mailed survey was sent to a random selection of public health system beneficiaries assigned to the University Hospital Rio Hortega's catchment area in Valladolid (Spain) (n=11 423, phase I), followed by a pilot examination in 1999-2000 of 495 phase I participants (phase II). In 2001-2003, the examination of 1502 individuals constituted the Hortega Study baseline examination visit (phase III, mean age 48.7 years, 49% men, 17% with obesity, 27% cu…
Cardiac magnetic resonance-derived fibrosis, strain and molecular biomarkers of fibrosis in hypertensive heart disease
Aims Myocardial fibrosis is a relevant component of hypertensive heart disease (HHD). Novel cardiovascular magnetic resonance (CMR) imaging techniques have shown potential in quantification of diffuse cardiac fibrosis, with T1 mapping, and estimating preclinical cardiac dysfunction, with strain analysis. Molecular biomarkers of fibrosis have been related with clinical outcomes and histologically proven myocardial fibrosis. The relationship between these CMR-imaging techniques and circulating biomarkers is not fully understood. Methods and results CMR was performed on a 3T scanner in 36 individuals with HHD. Extracellular volume fraction (ECV) and the partition coefficient were assessed usin…
Pulse pressure amplification and its determinants
Background. Pulse pressure (PP) amplification expressed as the peripheral-to-central PP ratio has gained importance in the assessment of cardiovascular phenotypes and cardiovascular risk. The aim of the present study was to assess the relationship between PP amplification, large vessel parameters and peripheral blood pressure (BP) to gain insights into the amplification phenomenon. Methods. Peripheral BP, central BP and carotid-femoral pulse wave velocity (cfPWV) were assessed using the OMRON M6, SphygmoCor and Complior devices, respectively, in 741 adults attending the hypertension outpatient clinic. Analysis of covariance, partial correlations and multiple linear regression models were pe…