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Resistant Hypertension and Related Outcomes in a Cohort of Patients with Cardiorenal Multimorbidity Hospitalized in an Internal Medicine Ward. 在内科病房住院的心肾多病患者的顽固性高血压及其相关结局
IF 3 Q2 Medicine Pub Date : 2023-11-01 Epub Date: 2023-11-27 DOI: 10.1007/s40292-023-00609-x
Antonietta Gigante, Rosario Cianci, Claudia Brigato, Michele Melena, Erika Acquaviva, Ludovica Toccini, Chiara Pellicano, Edoardo Rosato, Maurizio Muscaritoli

Introduction: Resistant hypertension (RH) is characterized by the failure to reach a goal blood pressure despite the administration of three medications at maximally tolerated doses, one of which being a diuretic. RH can be observed in a variety of clinical conditions, such as heart failure and reduced renal function and may confer high cardiovascular risk.

Aim: To evaluate the prevalence of RH and its association with clinical outcomes; the primary outcome was in-hospital mortality and the composite outcome was all-cause of mortality and morbidity in a cohort of patients with cardiorenal multimorbidity hospitalized in an internal medicine ward.

Methods: We conducted a retrospective analysis of consecutive hypertensive patients with cardiorenal multimorbidity. The composite outcome incorporated all-cause of in-hospital mortality and occurrence of sepsis, pulmonary embolism, acute coronary syndrome, stroke and renal replacement therapy.

Results: We collected data in 141 inpatients with a mean age of 77 years ± 10 (males 65.9 %), estimated glomerular filtration rate of 34 ± 18.6 ml/min with length of stay of 17 ± 12 days. The prevalence of RH was 52.4%. In-hospital mortality was observed in 24 patients (17%) and the composite outcome occurred in 87 patients (61.7%) and among these 74 (85.1%) were patients with RH. Free survival for composite outcome was significantly higher in patients without RH than patients with RH (log rank 7.52, p = 0.006). Resistant hypertension was a risk factor for composite outcome [HR 1.857(C.I. 1.170-2.946, p = 0.009)].

Conclusion: In patients with cardiorenal multimorbidity there is a high proportion of RH that represents a risk factor for composite outcome but not for in-hospital mortality.

导读:顽固性高血压(RH)的特点是,尽管以最大耐受剂量使用了三种药物,其中一种是利尿剂,但仍未能达到目标血压。RH可以在各种临床情况下观察到,如心力衰竭和肾功能下降,并可能导致心血管疾病的高风险。目的:评价RH患病率及其与临床预后的关系;主要结局是住院死亡率,复合结局是在内科病房住院的心肾多重疾病患者的全因死亡率和发病率。方法:我们对连续合并心肾多病的高血压患者进行回顾性分析。综合结果包括全因住院死亡率和脓毒症、肺栓塞、急性冠状动脉综合征、中风和肾脏替代治疗的发生。结果:我们收集了141例住院患者的资料,平均年龄为77岁±10岁(男性占65.9%),估计肾小球滤过率为34±18.6 ml/min,住院时间为17±12天。RH患病率为52.4%。住院死亡24例(17%),出现复合结局的87例(61.7%),其中RH患者74例(85.1%)。无RH患者的自由生存率显著高于RH患者(log rank 7.52, p = 0.006)。顽固性高血压是复合结局的危险因素[HR 1.857(C.I.)]1.170-2.946, p = 0.009)]。结论:在心肾多病患者中,RH的比例很高,这是复合结局的危险因素,但不是院内死亡率的危险因素。
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引用次数: 0
Psychometric Properties of a Brief Version of the Perception of Risk of Heart Disease Scale in an Italian Sample. 意大利样本中心脏病风险感知量表的心理测量特性。
IF 3 Q2 Medicine Pub Date : 2023-09-01 Epub Date: 2023-10-17 DOI: 10.1007/s40292-023-00603-3
Debora Rosa, Martino Francesco Pengo, Roberta Adorni, Grzegorz Bilo, Gianfranco Parati, Patrizia Steca

Introduction: The number of Italian citizens unaware of their risk of cardiovascular disease it is still very high.

Aim: This study aimed to translate and preliminarily validate a brief Italian version of the Perception of Risk of Heart Disease Scale (PRHDS).

Methods: PRHDS was culturally adapted to the Italian context. Then, the scale was administered to 772 healthy adults. By randomly dividing the sample into two subsamples, we tested the scale dimensionality through Exploratory Factor Analysis (EFA) followed by Confirmatory Factor Analysis (CFA). Finally, we evaluated internal consistency.

Results: Psychometric properties of the scale were appropriate. EFA and CFA evidenced a unidimensional structure of a brief version of the scale, composed of six items. Internal consistency was adequate.

Conclusions: Italian version of the brief PRHDS is a promising self-report questionnaire to measure cardiovascular risk perception among Italian adults.

引言:不知道自己患心血管疾病风险的意大利公民数量仍然很高。目的:本研究旨在翻译并初步验证心脏病风险感知量表(PRHDS)的意大利语版本。方法:PRHDS在文化上适应意大利语环境。然后,将该量表应用于772名健康成年人。通过将样本随机分为两个子样本,我们通过探索性因素分析(EFA)和验证性因素分析来测试量表维度。最后,我们评估了内部一致性。结果:量表的心理测量特性是适当的。全民教育和CFA证明了由六个项目组成的简式量表的一维结构。内部一致性是足够的。结论:意大利版的简要PRHDS是一种很有前途的自我报告问卷,用于测量意大利成年人的心血管风险感知。
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引用次数: 0
Prognostic Clinical Phenotypes of Patients with Acute Decompensated Heart Failure. 急性失代偿性心力衰竭患者的预后临床表型。
IF 3 Q2 Medicine Pub Date : 2023-09-01 Epub Date: 2023-09-05 DOI: 10.1007/s40292-023-00598-x
Tanya Mohammadi, Said Tofighi, Babak Mohammadi, Shadi Halimi, Farshad Gharebakhshi

Introduction: Acute decompensated heart failure (AHF) is a clinical syndrome with a poor prognosis.

Aim: This study was conducted to identify clusters of inpatients with acute decompensated heart failure that shared similarities in their clinical features.

Methods: We analyzed data from a cohort of patients with acute decompensated heart failure hospitalized between February 2013 and January 2017 in a Department of Cardiology. Patients were clustered using factorial analysis of mixed data. The clusters (phenotypes) were then compared using log-rank tests and profiled using a logistic model. In total, 458 patients (255; 55.7% male) with a mean (SD) age of 72.7 (11.1) years were included in the analytic dataset. The demographic, clinical, and laboratory features were included in the cluster analysis.

Results: The two clusters were significantly different in terms of time to mortality and re-hospitalization (all P < 0.001). Cluster profiling yielded an accurate discriminating model (AUC = 0.934). Typically, high-risk patients were elderly females with a lower estimated glomerular filtration rate and hemoglobin on admission compared to the low-risk phenotype. Moreover, the high-risk phenotype had a higher likelihood of diabetes type 2, transient ischemic attack/cerebrovascular accident, previous heart failure or ischemic heart disease, and a higher serum potassium concentration on admission. Patients with the high-risk phenotype were of higher New York Heart Association functional classes and more positive in their medication history.

Conclusions: There are two phenotypes among patients with decompensated heart failure, high-risk and low-risk for mortality and re-hospitalization. They can be distinguished by easy-to-measure patients' characteristics.

引言:急性失代偿性心力衰竭是一种预后不良的临床综合征。目的:本研究旨在确定具有相似临床特征的急性失代偿性心力衰竭住院患者集群。方法:我们分析了2013年2月至2017年1月在心内科住院的急性失代偿性心力衰竭患者的队列数据。使用混合数据的析因分析对患者进行聚类。然后使用对数秩检验对聚类(表型)进行比较,并使用逻辑模型进行分析。分析数据集中总共包括458名患者(255名;55.7%为男性),平均(SD)年龄为72.7(11.1)岁。聚类分析包括人口统计学、临床和实验室特征。结果:两个聚类在死亡率和再次住院时间方面存在显著差异(均P<0.001)。聚类分析产生了准确的判别模型(AUC=0.934)。通常,高危患者是老年女性,与低风险表型相比,其入院时的肾小球滤过率和血红蛋白估计值较低。此外,高危表型患2型糖尿病、短暂性脑缺血发作/脑血管意外、既往心力衰竭或缺血性心脏病的可能性更高,入院时血清钾浓度更高。具有高危表型的患者具有较高的纽约心脏协会功能分类,且其用药史更为阳性。结论:失代偿性心力衰竭患者有两种表型,即死亡和再次住院的高风险和低风险。它们可以通过易于测量的患者特征来区分。
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引用次数: 0
Epicardial Fat Volume as a Good Predictor for Multivessel Coronary Artery Disease. 心外膜脂肪体积是多血管冠状动脉疾病的良好预测指标。
IF 3 Q2 Medicine Pub Date : 2023-09-01 Epub Date: 2023-09-19 DOI: 10.1007/s40292-023-00590-5
Eman S El Shahawy, Asmaa A Hassan, Mohamed S El Shahawy

Introduction: Epicardial adipose tissue may have an important role in the pathogenesis of coronary artery disease (CAD).

Aim: We aimed to study the association between epicardial fat volume (EFV) and presence of obstructive as well as multivessel CAD.

Methods: A total of 87 adult subjects with suspected CAD who underwent both quantified by multidetector computerized tomography (MDCT) and Invasive Coronary Angiography (ICA) were enrolled in this observational study. EVF was measured by MDCT by calculating the sum of cross- sectional areas of fat multiplied by slice thickness. EFV measurement and its association with the presence of obstructive CAD (defined as coronary artery stenosis > 70%) was evaluated.

Results: Overall, 89.6% patients had obstructive CAD with higher EFV as compared to 10.3% patients with non-obstructive CAD (57 ± 20.14 cm3 vs. 44 ± 7.4 cm3; P < 0.001). Furthermore, EFV was significantly increased in group II as compared with group I (74 ± 24.3 ml vs. 53 ± 16.2 ml; P < 0.003). On the hand, the coronary calcium score (CAC) was insignificantly increased in group II as compared with group I (486.1 vs. 211.2; P = 0.10). Multivariate analysis revealed that, EFV might be an independent risk factor for not only the presence of obstructive CAD (odds ratio [OR], 1.062; 95% CI 1.018- 1.108; P < 0.005) but also in predicting multivessel disease affection.

Conclusions: Our results demonstrated that, EFV was significantly increased not only with obstructive CAD, independent of other traditional risk factors and CAC score, but also it can be considered a good predictor of multivessel disease occurrence.

引言:心外膜脂肪组织可能在冠状动脉疾病(CAD)的发病机制中发挥重要作用。目的:我们旨在研究心外膜脂肪体积(EFV)与梗阻性和多血管CAD之间的关系。方法:共有87名疑似CAD的成年受试者参加了这项观察性研究,他们接受了多探测器计算机断层扫描(MDCT)和有创冠状动脉造影(ICA)的量化。EVF是通过MDCT计算脂肪横截面积之和乘以切片厚度来测量的。EFV测量及其与梗阻性CAD(定义为冠状动脉狭窄)的相关性 > 70%)。结果:总体而言,89.6%的患者患有EFV较高的梗阻性CAD,而非梗阻性CAD患者为10.3%(57 ± 20.14 cm3与44 ± 7.4立方厘米;P 结论:我们的研究结果表明,EFV不仅在梗阻性CAD中显著增加,与其他传统危险因素和CAC评分无关,而且可以被认为是多血管疾病发生的良好预测指标。
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引用次数: 0
Risk of Arterial Hypertension After COVID-19 Recovery. COVID-19康复后动脉高血压的风险
IF 3 Q2 Medicine Pub Date : 2023-09-01 Epub Date: 2023-08-27 DOI: 10.1007/s40292-023-00597-y
Tomoyuki Kawada
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引用次数: 0
Efficacy and Safety of Azelnidipine as an Antihypertensive Compared to Amlodipine: A Systematic Review and Meta-analysis. 与氨氯地平相比,阿泽尼地平降压的有效性和安全性:系统评价和荟萃分析。
IF 3 Q2 Medicine Pub Date : 2023-09-01 Epub Date: 2023-09-28 DOI: 10.1007/s40292-023-00601-5
Debkumar Pal, Shampa Maji, Rituparna Maiti

Introduction: Azelnidipine is one of the newer Calcium Channel Blockers (CCB) approved in China, Japan, and India. Some studies have found that the blood pressure-lowering effect of azelnidipine is more than amlodipine, and others found the effect similar.

Aim: This meta-analysis was conducted to evaluate the efficacy of azelnidipine in managing hypertensive patients by lowering Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), and Heart Rate (HR) as compared to amlodipine.

Methods: PubMed/MEDLINE, Google Scholar, PROQUEST, and International Clinical Trial Registry Platform (ICTRP) were searched for published articles to evaluate the clinical efficacy of azelnidipine in the management of hypertension patients. Data were extracted from the selected 11 randomized clinical trials (RCTs). The risk of bias 2 (RoB2) tool was used for the quality assessment of the included studies, and the random-effects model was used to estimate the effect size.

Results: There were no statistically significant differences in the reduction of SBP (Mean Difference, MD: - 1.07; 95% CI: - 4.10, 1.95, p-value: 0.49) and DBP (MD: 0.27; 95% CI: - 2.66, 3.20, p-value: 0.86) between both the drugs. In terms of HR reduction, there was a statistically significant difference (MD: - 3.63; 95% CI: - 5.27, - 2.00, p-value: < 0.0001) between both drugs. Egger's test excluded any publication bias for the included studies (p = 0.21). Meta-regression excluded the effect of the duration of treatment on outcome parameters.

Conclusion: Though no significant difference between azelnidipine and amlodipine was found, in terms of reduction in SBP and DBP, azelnidipine reduced heart rate significantly compared to amlodipine.

Prospero registration: CRD42023390361.

简介:阿泽尼地平是中国、日本和印度批准的新型钙通道阻滞剂之一。一些研究发现,阿泽尼地平的降压作用比氨氯地平更大,另一些研究发现效果相似。目的:本荟萃分析旨在评估与氨氯地平相比,阿泽尼地平通过降低收缩压(SBP)、舒张压(DBP)和心率(HR)来治疗高血压患者的疗效。方法:检索PubMed/MEDLINE、Google Scholar、PROQUEST和国际临床试验注册平台(ICTRP)发表的文章,评价阿泽尼地平治疗高血压患者的临床疗效。数据取自选定的11项随机临床试验(RCT)。偏倚风险2(RoB2)工具用于纳入研究的质量评估,随机效应模型用于估计效应大小。结果:SBP的降低没有统计学上的显著差异(平均差异,MD:- 1.07;95%CI:- 4.10,1.95,p值:0.49)和DBP(MD:0.27;95%置信区间:- 2.66,3.20,p值:0.86)。在HR降低方面,存在统计学显著差异(MD:- 3.63;95%CI:- 5.27- 2.00,p值:结论:虽然阿泽尼地平和氨氯地平之间没有显著差异,但在SBP和DBP的降低方面,阿泽尼平与氨氯地平相比显著降低了心率。Prospero注册号:CRD42023390361。
{"title":"Efficacy and Safety of Azelnidipine as an Antihypertensive Compared to Amlodipine: A Systematic Review and Meta-analysis.","authors":"Debkumar Pal,&nbsp;Shampa Maji,&nbsp;Rituparna Maiti","doi":"10.1007/s40292-023-00601-5","DOIUrl":"10.1007/s40292-023-00601-5","url":null,"abstract":"<p><strong>Introduction: </strong>Azelnidipine is one of the newer Calcium Channel Blockers (CCB) approved in China, Japan, and India. Some studies have found that the blood pressure-lowering effect of azelnidipine is more than amlodipine, and others found the effect similar.</p><p><strong>Aim: </strong>This meta-analysis was conducted to evaluate the efficacy of azelnidipine in managing hypertensive patients by lowering Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), and Heart Rate (HR) as compared to amlodipine.</p><p><strong>Methods: </strong>PubMed/MEDLINE, Google Scholar, PROQUEST, and International Clinical Trial Registry Platform (ICTRP) were searched for published articles to evaluate the clinical efficacy of azelnidipine in the management of hypertension patients. Data were extracted from the selected 11 randomized clinical trials (RCTs). The risk of bias 2 (RoB2) tool was used for the quality assessment of the included studies, and the random-effects model was used to estimate the effect size.</p><p><strong>Results: </strong>There were no statistically significant differences in the reduction of SBP (Mean Difference, MD: - 1.07; 95% CI: - 4.10, 1.95, p-value: 0.49) and DBP (MD: 0.27; 95% CI: - 2.66, 3.20, p-value: 0.86) between both the drugs. In terms of HR reduction, there was a statistically significant difference (MD: - 3.63; 95% CI: - 5.27, - 2.00, p-value: < 0.0001) between both drugs. Egger's test excluded any publication bias for the included studies (p = 0.21). Meta-regression excluded the effect of the duration of treatment on outcome parameters.</p><p><strong>Conclusion: </strong>Though no significant difference between azelnidipine and amlodipine was found, in terms of reduction in SBP and DBP, azelnidipine reduced heart rate significantly compared to amlodipine.</p><p><strong>Prospero registration: </strong>CRD42023390361.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41112951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Telemedicine and Digital Medicine in the Clinical Management of Hypertension and Hypertension-Related Cardiovascular Diseases: A Position Paper of the Italian Society of Arterial Hypertension (SIIA). 远程医疗和数字医学在高血压和高血压相关心血管疾病的临床管理:意大利动脉高血压学会(SIIA)的立场文件。
IF 3 Q2 Medicine Pub Date : 2023-09-01 Epub Date: 2023-08-18 DOI: 10.1007/s40292-023-00595-0
Pietro Minuz, Fabio Lucio Albini, Egidio Imbalzano, Raffaele Izzo, Stefano Masi, Martino F Pengo, Giacomo Pucci, Filippo Scalise, Massimo Salvetti, Giuliano Tocci, Arrigo Cicero, Guido Iaccarino, Carmine Savoia, Leonardo Sechi, Gianfranco Parati, Claudio Borghi, Massimo Volpe, Claudio Ferri, Guido Grassi, Maria Lorenza Muiesan

High blood pressure is the leading cause of death and disability globally and an important treatable risk factor for cardiovascular, cerebrovascular and chronic kidney diseases. Digital technology, including mobile health solutions and digital therapy, is expanding rapidly in clinical medicine and has the potential to improve the quality of care and effectiveness of drug treatment by making medical interventions timely, tailored to hypertensive patients' needs and by improving treatment adherence. Thus, the systematic application of digital technologies could support diagnosis and awareness of hypertension and its complications, ultimately leading to improved BP control at the population level. The progressive implementation of digital medicine in the national health systems must be accompanied by the supervision and guidance of health authorities and scientific societies to ensure the correct use of these new technologies with consequent maximization of the potential benefits. The role of scientific societies in relation to the rapid adoption of digital technologies, therefore, should encompass the entire spectrum of activities pertaining to their institutional role: information, training, promotion of research, scientific collaboration and advice, evaluation and validation of technological tools, and collaboration with regulatory and health authorities.

高血压是全球死亡和致残的主要原因,也是心血管、脑血管和慢性肾脏疾病的重要可治疗风险因素。包括移动健康解决方案和数字治疗在内的数字技术在临床医学中迅速发展,通过及时、针对高血压患者的需求进行医疗干预,并提高治疗依从性,有可能提高护理质量和药物治疗的有效性。因此,数字技术的系统应用可以支持对高血压及其并发症的诊断和认识,最终改善人群层面的血压控制。在国家卫生系统中逐步实施数字医疗的同时,必须得到卫生当局和科学协会的监督和指导,以确保正确使用这些新技术,从而最大限度地发挥潜在效益。因此,科学学会在快速采用数字技术方面的作用应包括与其机构作用有关的所有活动:信息、培训、促进研究、科学合作和咨询、技术工具的评估和验证,以及与监管和卫生当局的合作。
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引用次数: 0
Arterial Stiffness in Overweight and Obesity: Association with Sex, Age, and Blood Pressure. 超重和肥胖的动脉僵硬:与性别、年龄和血压的关系。
IF 3 Q2 Medicine Pub Date : 2023-09-01 Epub Date: 2023-07-28 DOI: 10.1007/s40292-023-00593-2
John G Eikås, Eva Gerdts, Hilde Halland, Helga Midtbø, Dana Cramariuc, Ester Kringeland

Introduction: Obesity has been associated with increased arterial stiffness. Sex-differences in arterial stiffness in obesity have been less explored.

Aim: To explore sex-differences in arterial stiffness by applanation tonometry in 323 women and 225 with overweight and obesity, free of cardiovascular disease.

Methods: Covariables of arterial stiffness were identified in multivariable linear regression analyses in the total cohort and separately in women and men.

Results: In the total study cohort, women had higher augmentation pressure (AP) and augmentation index (AIx), and lower carotid-femoral pulse wave velocity (cf-PWV) than men, independent of confounders (all p < 0.001). In sex-specific analyses, higher AP was associated with higher age and 24-hours systolic blood pressure (BP), and with lower heart rate in women (all p < 0.001), and with higher age and BP in men (all p < 0.001). Similarly, higher AIx was associated with higher age and BP, and lower body mass index (BMI) and heart rate in women (all p < 0.05), and with higher age in men (all p < 0.001). Higher cf-PWV correlated with higher age and BP in women (all p < 0.005), and additionally with higher heart rate and non-smoking in men (all p < 0.05). When replacing BMI with waist-hip ratio, higher waist-hip ratio was associated with higher cf-PWV in men only (p < 0.05).

Conclusions: Among subjects with overweight and obesity, AP and AIx were higher in women, and cf-PWV was higher in men. Age and 24-hours systolic BP were the main factors associated with arterial stiffness in both sexes, while measures of adiposity had little impact on arterial stiffness.

引言:肥胖与动脉硬化增加有关。肥胖患者动脉硬化的性别差异研究较少。目的:探讨323名超重和肥胖、无心血管疾病的女性和225名超重和超重和肥胖女性动脉硬化的性别差异。方法:在总队列中以及在女性和男性中分别进行多变量线性回归分析,以确定动脉硬化的共变量。结果:在整个研究队列中,女性的增强压(AP)和增强指数(AIx)高于男性,颈动脉-股动脉脉搏波速度(cf-PWV)低于男性,与混杂因素无关(均p 结论:在超重和肥胖的受试者中,女性的AP和AIx较高,男性的cf PWV较高。年龄和24小时收缩压是男女动脉硬化的主要因素,而肥胖程度对动脉硬化的影响很小。
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引用次数: 0
The Results of the URRAH (Uric Acid Right for Heart Health) Project: A Focus on Hyperuricemia in Relation to Cardiovascular and Kidney Disease and its Role in Metabolic Dysregulation. URRAH(尿酸对心脏健康的权利)项目的结果:关注与心血管和肾脏疾病相关的高尿酸血症及其在代谢失调中的作用。
IF 3 Q2 Medicine Pub Date : 2023-09-01 Epub Date: 2023-10-04 DOI: 10.1007/s40292-023-00602-4
Alessandro Maloberti, Alessandro Mengozzi, Elisa Russo, Arrigo Francesco Giuseppe Cicero, Fabio Angeli, Enrico Agabiti Rosei, Carlo Maria Barbagallo, Bruno Bernardino, Michele Bombelli, Federica Cappelli, Edoardo Casiglia, Rosario Cianci, Michele Ciccarelli, Massimo Cirillo, Pietro Cirillo, Giovambattista Desideri, Lanfranco D'Elia, Raffaella Dell'Oro, Rita Facchetti, Claudio Ferri, Ferruccio Galletti, Cristina Giannattasio, Loreto Gesualdo, Guido Iaccarino, Luciano Lippa, Francesca Mallamaci, Stefano Masi, Maria Masulli, Alberto Mazza, Maria Lorenza Muiesan, Pietro Nazzaro, Gianfranco Parati, Paolo Palatini, Paolo Pauletto, Roberto Pontremoli, Nicola Riccardo Pugliese, Fosca Quarti-Trevano, Marcello Rattazzi, Gianpaolo Reboldi, Giulia Rivasi, Massimo Salvetti, Valerie Tikhonoff, Giuliano Tocci, Andrea Ungar, Paolo Verdecchia, Francesca Viazzi, Massimo Volpe, Agostino Virdis, Guido Grassi, Claudio Borghi

The relationship between Serum Uric Acid (UA) and Cardiovascular (CV) diseases has already been extensively evaluated, and it was found to be an independent predictor of all-cause and cardiovascular mortality but also acute coronary syndrome, stroke and heart failure. Similarly, also many papers have been published on the association between UA and kidney function, while less is known on the role of UA in metabolic derangement and, particularly, in metabolic syndrome. Despite the substantial number of publications on the topic, there are still some elements of doubt: (1) the better cut-off to be used to refine CV risk (also called CV cut-off); (2) the needing for a correction of UA values for kidney function; and (3) the better definition of its role in metabolic syndrome: is UA simply a marker, a bystander or a key pathological element of metabolic dysregulation?. The Uric acid Right for heArt Health (URRAH) project was designed by the Working Group on uric acid and CV risk of the Italian Society of Hypertension to answer the first question. After the first papers that individuates specific cut-off for different CV disease, subsequent articles have been published responding to the other relevant questions. This review will summarise most of the results obtained so far from the URRAH research project.

血清尿酸(UA)与心血管疾病(CV)之间的关系已经得到了广泛的评估,它被发现是全因和心血管死亡率的独立预测因子,也是急性冠状动脉综合征、中风和心力衰竭的独立预测因素。同样,也发表了许多关于UA与肾功能之间关系的论文,而对UA在代谢紊乱,特别是代谢综合征中的作用知之甚少。尽管有大量关于该主题的出版物,但仍存在一些疑问:(1)用于细化CV风险的更好的截止值(也称为CV截止值);(2) 需要校正肾功能的UA值;以及(3)更好地定义其在代谢综合征中的作用:UA只是代谢失调的标志物、旁观者还是关键病理因素?。尿酸健康权(URRAH)项目是由意大利高血压学会尿酸和心血管风险工作组设计的,旨在回答第一个问题。在第一篇论文对不同心血管疾病的具体界限进行了个性化研究之后,随后的文章也发表了,对其他相关问题做出了回应。本综述将总结URRAH研究项目迄今为止获得的大部分结果。
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引用次数: 3
Trends in Serum Total Cholesterol and High Total Cholesterol Prevalence Among Royal Thai Army Personnel in Thailand, 2017-2022. 2017-2022年泰国皇家泰国军队人员血清总胆固醇和高总胆固醇患病率趋势
IF 3 Q2 Medicine Pub Date : 2023-09-01 Epub Date: 2023-08-22 DOI: 10.1007/s40292-023-00596-z
Boonsub Sakboonyarat, Jaturon Poovieng, Kanlaya Jongcherdchootrakul, Phutsapong Srisawat, Panadda Hatthachote, Mathirut Mungthin, Ram Rangsin

Introduction: High total cholesterol (TC) is a robust-documented risk factor for atherosclerosis cardiovascular diseases. Approximately one-fourth (23.5%) of Thai civilians had high TC. However, the information on high TC among the Royal Thai Army (RTA) personnel is limited.

Aim: The study aimed to identify the trends in serum TC and high TC prevalence among RTA personnel from 2017 to 2022.

Methods: A serial cross-sectional study from 2017 to 2022 was conducted. A total of 318,353 active-duty RTA personnel aged 35-60 years were included in the study. High TC was defined as fasting TC ≥ 240 mg/dL. A multivariable log-binomial regression analysis was performed to investigate factors associated with high TC.

Results: The overall age- and sex-adjusted high TC prevalence was 26.3% in 2017 and dropped to 22.9% in 2020; then, it increased to 26.4% in 2022 (p for quadratic trend < 0.001). Younger-aged RTA personnel have significantly rising trends in sex-adjusted high TC prevalence over 6 years. In the south, the age- and sex-adjusted high TC prevalence was 24.4% in 2017 and substantially rose to 33.6% in 2022 (p for quadratic trend < 0.001). Meanwhile, in the northeast, it rose by 3.6% over 6 years. High body mass index, high blood pressure, and hyperglycemia were associated with high TC prevalence among this population.

Conclusion: High TC was a common essential health issue among RTA personnel. Rising trends in mean serum TC and high TC prevalence from 2017 to 2022 were discovered, especially in younger participants and those residing in the south and northeast.

引言:高总胆固醇(TC)是动脉粥样硬化性心血管疾病的一个强有力的风险因素。大约四分之一(23.5%)的泰国平民患有高TC。然而,泰国皇家陆军(RTA)人员中关于高TC的信息有限。目的:本研究旨在确定2017年至2022年RTA人员血清TC和高TC患病率的趋势。共有318353名年龄在35-60岁之间的现役RTA人员被纳入研究。高TC定义为空腹TC≥240 mg/dL。对高TC相关因素进行了多变量对数二项回归分析。结果:2017年,经年龄和性别调整的总高TC患病率为26.3%,2020年降至22.9%;然后,它在2022年增加到26.4%(二次趋势p)结论:高TC是RTA人员中常见的基本健康问题。从2017年到2022年,平均血清TC和高TC患病率呈上升趋势,尤其是在年轻参与者和居住在南部和东北部的人中。
{"title":"Trends in Serum Total Cholesterol and High Total Cholesterol Prevalence Among Royal Thai Army Personnel in Thailand, 2017-2022.","authors":"Boonsub Sakboonyarat,&nbsp;Jaturon Poovieng,&nbsp;Kanlaya Jongcherdchootrakul,&nbsp;Phutsapong Srisawat,&nbsp;Panadda Hatthachote,&nbsp;Mathirut Mungthin,&nbsp;Ram Rangsin","doi":"10.1007/s40292-023-00596-z","DOIUrl":"10.1007/s40292-023-00596-z","url":null,"abstract":"<p><strong>Introduction: </strong>High total cholesterol (TC) is a robust-documented risk factor for atherosclerosis cardiovascular diseases. Approximately one-fourth (23.5%) of Thai civilians had high TC. However, the information on high TC among the Royal Thai Army (RTA) personnel is limited.</p><p><strong>Aim: </strong>The study aimed to identify the trends in serum TC and high TC prevalence among RTA personnel from 2017 to 2022.</p><p><strong>Methods: </strong>A serial cross-sectional study from 2017 to 2022 was conducted. A total of 318,353 active-duty RTA personnel aged 35-60 years were included in the study. High TC was defined as fasting TC ≥ 240 mg/dL. A multivariable log-binomial regression analysis was performed to investigate factors associated with high TC.</p><p><strong>Results: </strong>The overall age- and sex-adjusted high TC prevalence was 26.3% in 2017 and dropped to 22.9% in 2020; then, it increased to 26.4% in 2022 (p for quadratic trend < 0.001). Younger-aged RTA personnel have significantly rising trends in sex-adjusted high TC prevalence over 6 years. In the south, the age- and sex-adjusted high TC prevalence was 24.4% in 2017 and substantially rose to 33.6% in 2022 (p for quadratic trend < 0.001). Meanwhile, in the northeast, it rose by 3.6% over 6 years. High body mass index, high blood pressure, and hyperglycemia were associated with high TC prevalence among this population.</p><p><strong>Conclusion: </strong>High TC was a common essential health issue among RTA personnel. Rising trends in mean serum TC and high TC prevalence from 2017 to 2022 were discovered, especially in younger participants and those residing in the south and northeast.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10039748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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High Blood Pressure & Cardiovascular Prevention
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