Cardiovascular disease (CVD) impacts hundreds of millions of people each year and is the main cause of death worldwide, with atherosclerosis being its most frequent form of manifestation. Low-density lipoproteins (LDL) have already been established as a significant cardiovascular risk factor, but more recent studies have shown that small, dense LDLs are the ones more frequently associated with a higher overall risk for developing atherosclerotic cardiovascular disease. Ever since atherogenic phenotypes were defined for the first time, LDL subfractions have been continuously analyzed in order to identify those with a higher atherogenic profile that could further become not only high-accuracy, effective prognostic biomarkers, but also treatment targets for novel lipid-lowering molecules. This review sets out to comprehensively evaluate the association between various LDL-subfractions and the risk of further developing major adverse cardiovascular events, by assessing both genetical and clinical features and focusing on their physiopathological characteristics, chemical composition, and global ability to predict long-term cardiovascular risk within the general population. Further research is required in order to establish the most beneficial range of LDL-C levels for both primary and secondary prevention, as well as to implement LDL subfraction testing as a routine protocol, separately from the general assessment of the other traditional cardiovascular risk factors.
Objectives: This national representative survey sought to assess hypertension's prevalence, awareness, treatment and control in Romania. Methods: A representative sample (by age, sex and residence) of 1477 Romanian adults (51.19 ± 16.61 years, range 18–80 years, 59.9% women) was multimodally evaluated during two study visits. Hypertension was defined as SBP at least 140 mmHg and/or DBP at least 90 mmHg or previously diagnosed hypertension, regardless of BP. Awareness was defined by knowledge of previous hypertension diagnosis or of current use of antihypertensive treatment. Treatment was defined by antihypertensive medication taken at least 2 weeks prior to enrolment. Control was defined as SBP less than 140 mmHg and DBP less than 90 mmHg at both visits in treated hypertensive patients. Results: Hypertension prevalence was 46% (n = 680) consisting of 81.02% (n = 551) known hypertensive patients and 18.98% (n = 129) newly diagnosed hypertensive patients. Awareness, treatment and control of hypertension were: 81% (n = 551), 83.8% (n = 462) and 39.2% (n = 181). Conclusion: Despite numerous pandemic-related obstacles in conducting a national survey, SEPHAR IV updates hypertension epidemiological data of a high-cardiovascular-risk Eastern-European population. This study confirms previous predictions of hypertension prevalence, treatment and control, which remain unfavourable because of unsatisfactory control of promoting factors.
Objective: Cardiovascular diseases are the leading cause of death globally, despite significant advances in diagnosis and treatment. Among the multiple already well-known cardiovascular risk factors, hypertension, diabetes mellitus type II and dyslipidaemia are the most frequent and show the best correlations with the risk of further developing a major cardiovascular event. The main objective consists in identifying the potential particularities that diabetes could have on the lipid profile in hypertensive patients, while also discovering bio-markers with a higher potential accuracy of predicting further major cardiovascular events, using NMR spectroscopy. Design and method: We have selected a group of 30 hypertensive patients and a control group of 17 otherwise healthy individuals in order to assess the influence of diabetes on the lipid panel in hypertensive patients. A blood sample of 6 mL was collected before and after meals and 5 types of NMR spectroscopy experiments were performed for each sample. Results: It was noted that the fasten triglycerides levels, VLDL and IDL particle number, apolipoprotein A1, A2, B100 levels, as well as the ratio apolipoprotein B100/apolipoprotein A1 are all potentially useful markers that could be successfully used to differentiate between the strictly hypertensive patients and the ones that associate type II diabetes mellitus. The study also confirmed once more our previous reports that the fasting status upon sampling has little influence on the lipid panel final values. Conclusions: We have evaluated the lipid panel differences induced by diabetes mellitus type II in hypertensive patients and we have compared the results with an otherwise healthy control group. We have identified the NMR spectroscopy markers that could be able to spot subtle differences in the lipid profiles of the two study groups (two hypertensive groups, one consisting in strictly hypertensive patients, the other one including hypertensive patients with already known type II diabetes mellitus), even when LDL levels have been lowered to normal levels due to statin treatment. We have once more concluded that the patient's fasting status has no influence on the final analysis.
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