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Novel Risk Factors (novel + risk_factor)
Selected AbstractsAttenuating CV risk factors in patients with diabetes: clinical evidence to clinical practiceDIABETES OBESITY & METABOLISM, Issue 2002Alan J. Garber Abstract Individuals with diabetes are at high risk of cardiovascular (CV) disease, a risk that is significantly greater in the presence of traditional CV risk factors (hyperlipidaemia, hypertension, prothrombotic state). Glucose control and management of these risk factors decreases but does not eliminate CV events, reflecting the complexity of atherosclerosis. Novel risk factors (C-reactive protein, lipoprotein a, homocysteine, and endothelial dysfunction) have been proposed and are potentially modifiable. However, clinical trials data are not yet available to guide therapy. At this time, no single agent can achieve adequate risk reduction in patients with diabetes. Even with the use of multiple agents and classes of agents to manage CV risk, 75% of patients with diabetes are expected to die from CV causes. Despite the recent advances in primary and secondary prevention of CV events, new approaches are needed. Data from the Heart Outcomes Prevention Evaluation (HOPE) trial demonstrated that CV risk can be further reduced by the addition of the ACE inhibitor ramipril to the existing treatment regimen of high-risk patients with diabetes. [source] Diurnal temperature range as a novel risk factor for COPD deathRESPIROLOGY, Issue 7 2008Guixiang SONG Background and objective: Although the relationship between day-to-day temperature changes and COPD mortality is well established, it is not known whether temperature variation within one day, that is diurnal temperature range (DTR), is a risk factor for acute COPD death, independent of the absolute temperature level. Methods: In a time-series study, the relationship between DTR and daily COPD mortality between 2001 and 2004 in Shanghai, China was assessed. A semi-parametric generalized additive model was used to allow for long-term and seasonable trends in COPD mortality, as well as variation in air pollution and weather. Results: There was a significant association between DTR and daily COPD mortality. A 1°C increase in the 4-day moving average for DTR corresponded to a 1.25% (95% confidence interval: 0.35,2.15) increase in COPD mortality. Conclusion: These findings suggest that DTR is a novel risk factor for acute COPD death. [source] Emerging concepts in cardiovascular disease risk assessment: Where do women fit in?JOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 9 2009Adjunct Instructor, CRNP Cardiovascular Nurse Practitioner, Deborah Gleeson MSN Abstract Purpose: To highlight the current limitations in the assessment of cardiovascular disease (CVD) risk for women. This article will offer the reader information on the current process for assessing CVD risk in women, the pitfalls associated with this current strategy, and the role of novel risk factors. Data sources: Extensive review of the medical literature in the area of women's cardiovascular health. Conclusions: The assessment of CVD risk for women is currently an evolving science. Limitations in the ability of the Framingham score to accurately estimate risk in women from diverse populations are increasingly recognized. Vastly different treatment goals between the genders for similar levels of risk factors have led to a re-evaluation of this strategy in women. While the Framingham score is still useful for guiding cholesterol treatment goals, the current preventive guidelines for women emphasize assessing a woman's risk throughout her lifetime. The future development of tools for improved risk stratification that incorporate novel risk factors may in fact improve our ability to appropriately risk stratify women to evidence-based therapies. Implications for practice: Utilizing the Framingham Risk Assessment Tool and further CVD risk stratification using novel markers such as high sensitivity C-reactive protein, family history, and functional capacity may identify unique subsets of women at higher risk for CVD. Nurse practitioners can be instrumental in this assessment, education, and treatment of women at risk for CVD. [source] Relation between vascular risk factors and cognition at age 75ACTA NEUROLOGICA SCANDINAVICA, Issue 2 2006P. Fischer Objective ,, Recent trends in dementia research emphasize that not only cerebrovascular events but also vascular risk factors induce, favour or cause cognitive impairment and Alzheimer's disease. Material and methods ,, We evaluated vascular risk factors (blood pressure, LDL cholesterol, HDL cholesterol, triglycerides, HbA1c, homocysteine, lipoprotein(a), fibrinogen, C-reactive protein and smoking habits) in a community-based cohort of 75-year-old individuals of two districts in Vienna (247 men, 359 women) and correlated these risk factors with overall cognition. Results ,, Pathological vascular risk factors were found frequently in the age cohort. However, the expected associations between the Mini-Mental State Examination and any cardiovascular risk factors were missing. Only individuals with a positive history of smoking showed lower cognitive capacities. Conclusions ,, We assume that cognitive dysfunction in old age is connected to factors other than the known classical and novel risk factors for the development of cardiovascular disease. [source] Association between serum lipoprotein (a) level and progression of non-proliferative diabetic retinopathy in Type 2 diabetesACTA OPHTHALMOLOGICA, Issue 5 2009Hideharu Funatsu Abstract. Purpose:, To investigate independent risk factors related to the progression of non-proliferative diabetic retinopathy (NPDR) for Japanese Type 2 diabetic patients. Methods:, One hundred and six patients with NPDR were followed up for 2 years. Diabetic retinopathy (DR) was determined by colour fundus photography. Multivariate logistic regression analysis was performed to assess variables independently associated with the progression of NPDR. Serum concentrations of novel risk factors for atherosclerotic vascular disease, including lipoprotein (a) [Lp(a)] and fibrinogen, were measured. Results:, Thirty-three patients (31%) had progressed by two scale steps or more in 2 years. The progression of NPDR was significantly associated with HbA1c [odds ratio (OR) 2.12; 95% confidence interval (CI) 1.14,4.87], systolic blood pressure (OR 1.72; 95% CI 1.14,2.91), Lp(a) (OR 2.70; 95% CI 1.09,5.12) and fibrinogen (OR 1.68; 95% CI 1.03,3.08). Multivariate logistic regression analysis showed that HbA1c (OR 1.74; 95% CI 1.12,3.21) and Lp(a) level (OR 1.90; 95% CI 1.06,4.33) were significant and independent predictors of the progression of NPDR. Conclusion:, These data suggest that serum Lp(a) level is an independent risk factor for the progression of NPDR in Type 2 diabetes patients. We recommend that further prospective validation of our findings be undertaken to confirm these observations. [source] Assessing coronary heart disease risk with traditional and novel risk factorsCLINICAL CARDIOLOGY, Issue S3 2004Peter W. F. Wilson M.D. Cardiovascular disease is the leading cause of death in the industrialized world, and a number of well-characterized factors, including advanced age, hypertension, dyslipidemia, diabetes, and smoking, contribute to cardiovascular risk. Integration of these factors using the Framingham calculation estimates the absolute 10-year risk for coronary heart disease (CHD), which can be used to guide therapy. Recent studies have demonstrated that additional markers, including elevated lipoprotein(a), homocysteine, sitosterol, and particularly C-reactive protein (CRP), are also associated with increased risk for CHD. In particular, high-sensitivity CRP has been shown to identify patients with high CHD risk who may not have elevated low-density lipoprotein cholesterol (LDL-C) and may add to the predictive value of the Framing-ham functions for CHD risk assessment. Assessment of global risk is particularly important in lipid management, as the LDL-C target goals are determined by risk category. [source] | ||||||||||