EVALUATING THE RELATIONSHIPS OF CIRCULATORY MEASURES WITH ESTIMATION OF CARDIOVASCULAR ENDURANCE USING A NON-EXERCISE MODEL IN YOUNG ASYMPTOMATIC MALES AND FEMALES
M.A. Alomari (1), D.M. Shqair (2), K. Alawneh (3), O.F. Khabour (4), M.E. Nazzal (5), E.F. Keewan (6)
1 Division of Physical Therapy, Department of Allied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
2 Department of Nutrition, Jordan University of Science and Technology, Irbid, Jordan
3 Division of Rheumatology, Department of Medicine, King Abdulla Hospital
4 Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid, Jordan
5 Department of Rehabilitation Medicine, Faculty of Medicine, Jordan University of Science and Technology
6 Department of Physiology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
Introduction: The diagnostic value of graded exercise testing for cardiovascular (CV) diseases (CVD) screening in asymptomatic individuals was recognized sometime ago. However, the risk, time constrains, inconvenience, and cost associated with exercise testing prevent from using the maximal oxygen consumption (VO2max) measure frequently. A recent model is proposed to estimate VO2max without exercise. This study, examined the relationships of the non-exercise model (NM) with circulatory measures of blood pressure (BP) including diastolic (DBP), and mean (MAP), as well as forearm resting blood flow (RBf), and vascular resistance (RVr), and post-occlusion blood flow (OcBf) in 188 young (18-40 years) asymptomatic males (M) and females (F).
Methods: The equation used to estimate VO2max was: [Gender(female=0; male=1)*2.77]-[Age*0.10]-[BMI*0.17]-[resting heart rate(HR)*0.03]+[PAlevel*1]+18.07. Automated auscultatory was used to measure BP and HR whereas strain-gauge plethysmography was used to measure RBf, RVr, and OcBf after 20 minutes of supine resting.
Results: Estimated VO2max correlated with DBP (F: r=-0.3; p=0.005, M: r=-0.2; p=0.03), and MAP (F: r=-0.2; p=0.005, M: r=-0.2; p=0.04) as well as RBf (r=0.2; p=0.02), OcBf (r=0.3; p=0.02) and RVr (r=-0.2; p=0.03). Additionally, the ANOVA revealed differences in OcBf (p=0.000), and RVr (p=0.05) between the poor, average, and high NMVO2max groups.
Discussion: The results show relationships of NMVO2max with circulatory measures confirming previous findings using direct VO2max. The relationships further demonstrate the importance of CV endurance for maintaining circulatory health. Since BP measures are established risk factors and components of the metabolic syndrome, these relationships further add to the scientific and clinical values of NM.
CARDIOVASCULAR DISEASE (CVD) RISK FACTOR AND HIGH COSTS OF CVD IN MEXICAN AMERICANS WITH DIABETES MELLITUS
J. Aponte (1)
1 Hunter College, New York, USA
Context: One of the primary macrovascular complications in people with diabetes mellitus (DM) is cardiovascular disease (CVD). CVD is the most costly complication of DM. Costs of DM and macrovascular complications are 2.7 times higher than costs of DM without complications.
Objectives: Low-density-lipoproteon (LDL) is an independent risk factor of CVD and the primary macrovascular complication of DM. The National Health and Nutrition Examination Survey (NHANES) 1999-2000 and NHANES 2001-2002 were utilized to examine and compare LDL levels in Mexican Americans (MA) with DM.
Methods: The NHANES 1999-2000 and NHANES 2001-2002 data sets were utilized in this study. Descriptive statistics and Chi-squares were computed. The sample comprised participants who self identified as MA, being told by a doctor as having DM, and between 20-74 years of age. LDL was the variable measured in this study.
Results: The findings showed that even though changes in both, normal LDL levels (<100 mg/dl) and elevated LDL levels (>100 mg/dl) were not significant (p=0.8129-0.9132), there was a slight decrease in people with elevated LDL levels (>100 mg/dl) from the NHANES 1999-2000 (74%) to the NHANES 2001-2002 (66%) (p=0.8129). Although there was an 8% decrease in elevated LDL levels (> 100 mg/dl), over 50% of those with an elevated LDL level were at high risk for CVD.
Conclusion/Implications: This study shows that MA with DM are at high risk for CVD. Therefore, future research should include studies identifying specific cultural factors relative to the management of DM and risk factors for CVD.
CARDIOVASCULAR SAFETY OF LIRAGLUTIDE: A POOLED ANALYSIS FROM PHASE II AND III LIRAGLUTIDE CLINICAL DEVELOPMENT STUDIES
Y.Y. Huang (1), S.P. Marso (2), A.C. Moses (3), M.J. Zychma (3), J.B. Buse (4)
1 Chang Gung Memorial Hospital, Taiwan
2 Saint Luke’s Mid America Heart and Vascular Institute, Kansas City, MO
3 Novo Nordisk, Bagsværd, Denmark
4 University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC
Introduction: Liraglutide is a human glucagon-like peptide-1 analog approved for patients with type 2 diabetes. The US FDA currently recommends analysis of major adverse cardiovascular events (MACE) for new anti-diabetes drugs. The objective of this work was to perform a retrospective MACE analysis of the liraglutide development studies.
Methods: Pooled analysis of patients in all completed intermediate/long-term randomized trials plus open label extensions of liraglutide drug development studies. Individuals with and without type 2 diabetes age 18-80, hemoglobin A1c 7-11% and BMI <45 kg/m2 exposed to liraglutide 0.045-3.0 mg/day, active control or placebo were included. MACE (death, MI or stroke) were retrospectively identified using medical dictionary for regulatory activities terms with 3 search categories of varied sensitivity that were based on the number of search terms associated with MI and stroke.
Results: In 15 phase 2 and 3 trials including 6,638 patients, there were a total of 44, 43, and 32 serious MACE using broad, narrow and custom search criteria, respectively. After expert evaluation, 39, 39 and 31 serious MACE identified using broad, narrow and custom criteria, respectively, were adjudicated as MACE. The point estimate of the incidence ratio for MACE associated with liraglutide was <1.0 for each MedDRA search.
Conclusions: In each MACE analysis, the point estimates for liraglutide was <1.0 and upper 95% CI was <1.8, a specified upper bound in FDA guidance for new anti-diabetes drugs. Liraglatide will be prospectively evaluated in LEADERTM, a large scale, international, randomized controlled cardiovascular outcomes trial.
SURVEYING SIZE OF NECK CIRCUMFERENCE OF HIGHER STANDARD AND ITS RELATION WITH HYPERGLYCEMIA IN THE PATIENT SUFFERING FROM CORONARY ARTERY DISEASE IN THE HOSPITALS AFFILIATED WITH TEHRAN CITY UNIVERSITIES OF MEDICAL SCIENCES IN 2010 ACADEMIC YEAR
S. Nasrollah (1), S.A. Jalal Manesh (2), S. Mohammad Zadeh (2), M. Mahmoody (3)
1 Medical-Surgical Nursing Department, Faculty of Nursing and Midwifery, Islamic Azad University of Medical Sciences, Tehran Branch, Tehran, Iran
2 Faculty of Nursing and Midwifery, Islamic Azad University of Medical Sciences, Tehran Branch, Tehran, Iran
3 School of Health, Tehran University of Medical Science, Tehran, Iran
Introduction: The most prevalent coronary disease is coronary artery disease that is lead to death, disability and economic costs more than any other disease and prevalent of risk factors of this disease is increased rapidly worldwide. Hyperglycemia is one of the risk factors of this disease. General objective of this research is determining size of neck circumference of higher standard and its relation with Hyperglycemia in the patient suffering from coronary artery disease.
Methods: Present research is a descriptive-analytical study. 200 women and 200 men were selected by Poisson sampling method. Data were collected by an interview and documentation form in 2 parts: Demographics and clinical examination (fasting blood sugar, neck circumference). This form were filled out through interview with patients and measurement of the researcher.
Results: It revealed that 85% of men and 84/4% of women under study bear of higher standard neck circumference and there were a significant relation (p<0.05) between the size of higher standard neck with fasting blood sugar (FBS) of patients (men and women) suffering from coronary artery disease. Also a significant relation (p<0.05) were seen between those having a higher standard neck size with hyperglycemia in control of their individualized factors like age, job, education, records of higher blood sugar, consumption of blood sugar reducing pharmaceuticals, consumption of insulin, and blood sugar suffering duration.
Conclusion: With respect to the relationship between higher-standard neck and hyperglycemia in people with coronary artery disease, providing appropriate educational programs in this regard is suggested.
THE EFFECTS OF PREHYPERTENSION AND DIABETIC MELLITUS ON MYOCARDIAL INFARCTION IN IRANIAN ADULTS: A POPULATION BASE STUDY
K. Sayehmiri (1), F.Aziz (2)
1 Ilam University of Medical Sciences, Ilam, Iran
2 Research Institute for Endocrine Sciences, Shahid Beheshti University (M.C), Tehran, Iran
Object: To investigate the association of preHypertension and diabetic mellitus with the risk of myocardial infarction (MI) in man and female 30 years and over.
Methods: In the TLGS cohort study included 5187 Iranian adults at Tehran city aged 30 to 90 years at baseline. The mean duration of follow up was 6.5 years. Analysis was done using Cox proportional hazard regression and accelerated failure time models.
Results: The TGLS cohort had 83 MI. The annually incidences of MI were 3.91/1000 for men and 1.58/1000 for women in the TGLS. Prevalence of preHypertension (130<SBP<140 or 80<DBP<80) was 35.7%. The age and sex adjusted relative risk of MI in patients with PreHypertension at baseline was1.1 (95% CI: .6to 2.1) times compared with normal group (SBP<130, and DBP<80) so preHepertention increase the risk of MI about 10%. The attribute risk fraction for population (AFP) for SBP and DBP was 31.4% and 14.3% respectively.
The age and sex adjusted relative risk of MI in patients with FBS>126 at baseline was 5.4(95% CI: 3.45 to 8.44) times compared with FBS < 126 .Attribute risk fraction (AR) for exposed group(FBS>126) was 85.4% and attribute risk fraction for population(AFP) was 37.1.Conclusions: PreHypertention and diabetic mellitus remains as an important risk factor for MI in men and women aged 30 years and older.