Cardiovascular Risk Factor Profiles and Disease in Black Compared to Other Africans with Chronic Kidney Disease

Hsu, Hon-Chun; Robinson, Chanel; Woodiwiss, Angela J.; Norton, Gavin R.; Dessein, Patrick H

doi:10.1155/2021/8876363

Cited by 5 publications

(13 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our study design was previously reported. [10][11][12][13] Briefly, 46 consecutive black CKD participants including 19 non-dialysis and 27 dialysis patients were enrolled at the Milpark Hospital in Johannesburg, South Africa. Patients with active infection or/and cancer were excluded.…”

Section: Study Participantsmentioning

confidence: 99%

“…We recorded demographic characteristics, traditional cardiovascular risk factors and cardiovascular events as previously reported [10][11][12][13] and detailed in the Supplementary Data Methods. Mean or distending arterial blood pressure for the peripheral waveform was determined electronically by the SphygmoCor device (see below) and using the formula…”

Section: Baseline Characteristics Including Traditional Cardiovascula...mentioning

confidence: 99%

“…Central haemodynamic assessments were determined from central arterial pressure recordings obtained from pulse wave analysis by applanation tonometry and SphygmoCor software as previously described [10][11][12][13] and detailed in the Supplementary Data Methods. We recorded aortic pulse wave velocity (PWV) as an index of arterial stiffness, forward wave pressure (Pf), reflected wave pressure (Pb), central systolic blood pressure (CSBP) and central pulse pressure (CPP).…”

Section: Arterial Functionmentioning

confidence: 99%

“…Measurement details were reported previously. [10][11][12][13] Intra-observer echocardiographic measurement variability is low in our setting with Pearson's correlation coefficients and variances (mean % difference (SD)) for left ventricular end-diastolic diameter, septal wall thickness, posterior wall thickness, E and e' of 0.92, 0.72, 0.76, 0.88 and 0.93 (p < 0.0001 for all), and −0.41 (4.16), 0.45 (7.74), 1.74 (6.08), 0.16 (9.95) and −1.46 (8.58), respectively. 16 Participants were examined in the partial left decubitus position.…”

Section: Echocardiographymentioning

confidence: 99%

“…In this study, we performed pulse wave analysis and echocardiography in black African CKD patients and matched healthy controls. [10][11][12] We determined early diastolic mitral annulus displacement velocity (e') and inflow velocity (E) by tissue and pulsed Doppler, respectively. E' was used as a measure of active relaxation, and we calculated E/e' as an index of left ventricular filling pressure or passive relaxation.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Aortic Stiffness and Pulsatile Pressures as Potential Mediators of Chronic Kidney Disease Induced Impaired Diastolic Function

Hsu¹,

Tade²,

Norton³

et al. 2022

IJNRD

Self Cite

View full text Add to dashboard Cite

We assessed whether aortic stiffness and pulsatile pressures can mediate chronic kidney disease (CKD)-associated impaired diastolic function. Participants and Methods: In 276 black Africans including 46 CKD (19 non-dialysis; 27 dialysis) and 230 control subjects, pulse wave velocity (PWV) estimated aortic stiffness and pulsatile pressures (forward and backward wave pressure, central systolic blood pressure (CSBP) and pulse pressure (CPP)) were determined by applanation tonometry; e' as an index of left ventricular active relaxation and E/e' as a measure of left ventricular filling pressure or passive relaxation were evaluated by echocardiography. Results: In age, sex, traditional cardiovascular risk factor and mean arterial pressure (MAP) adjusted regression models, CKD was inversely associated with e' (p = 0.03) and directly with E/e' (p < 0.01). The CKD-e' relationship was attenuated and no longer significant (p = 0.31) upon additional adjustment for aortic PWV but not pulsatile pressures (p = 0.03-0.05). In product of coefficient mediation analysis, PWV accounted for 47.6% of the CKD-e' association. CSBP (22.9%) and CPP (18.6%) but not PWV (11.3%) accounted for a significant and relevant proportion of the CKD-E/e' relationship. However, CKD remained strongly associated with E/e' independent of aortic function measures (p < 0.01). Treatable covariates that were or tended to be consistently associated with diastolic function included MAP (p < 0.01) and diabetes (p = 0.02-0.07) for the CKD-e' and CKD-E/e' relations, respectively. Conclusion: Aortic stiffness rather than pulsatile pressures mediates CKD-related impaired left ventricular active relaxation. By contrast, aortic pulsatile pressures (and not stiffness) contribute to CKD-related left ventricular filling pressures but do not fully account for the respective association.

show abstract

Section: Study Participantsmentioning

confidence: 99%

Section: Baseline Characteristics Including Traditional Cardiovascula...mentioning

confidence: 99%

Section: Arterial Functionmentioning

confidence: 99%

Section: Echocardiographymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Aortic Stiffness and Pulsatile Pressures as Potential Mediators of Chronic Kidney Disease Induced Impaired Diastolic Function

Hsu¹,

Tade²,

Norton³

et al. 2022

IJNRD

Self Cite

View full text Add to dashboard Cite

show abstract

Stroke and its correlates among patients on maintenance hemodialysis in Cameroon

Teuwafeu,

Halle,

Kenfack

et al. 2023

Hemodialysis International

View full text Add to dashboard Cite

BackgroundEnd‐stage kidney disease is an independent risk factor for stroke; however, the relationship between hemodialysis and stroke in Sub‐Saharan Africa has not been established.ObjectiveTo evaluate the incidence, associated factors, and clinical outcome of stroke among patients undergoing maintenance hemodialysis in Cameroon.MethodsA hospital‐based retrospective study using data from the medical files of 1060 patients on maintenance hemodialysis (given twice a week) was conducted. Patients with stroke prior to starting hemodialysis were excluded. Socio‐demographic data, comorbidities, dialysis parameters, and data concerning the diagnosis of stroke were retrieved and analyzed.ResultsThe dialysis vintage (duration of time on dialysis) averaged 11.4 ± 9.2 months. The incidence of stroke was 6.1 events per 1000 patient‐years, with hemorrhagic stroke being most common (66%). Eighty percent of strokes occurred before the 30th month of dialysis. Sixty percent of strokes occurred within 24 h of a dialysis session. Predictive factors for stroke were diabetes mellitus (p = 0.026), heart failure (p = 0.045), poor dialysis compliance (p = 0.001), and short vintage (p = 0.001). The overall mortality rate was 52% and was higher for hemorrhagic stroke (60%). The leading causes of death were multiple organ failure and sepsis.ConclusionThe incidence of stroke is high among hemodialysis patients in Cameroon and hemorrhagic stroke is the commonest type. Diabetes and heart failure triple the risk of stroke. Mortality in patients who suffered a stroke was high.

show abstract

Disease-modifying anti-rheumatic drugs improve the cardiovascular profile in patients with rheumatoid arthritis

Giachi

Cugno²,

Gualtierotti³

2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

Rheumatoid arthritis (RA) is a chronic inflammatory disease affecting about 0. 5–1% of the adult population and manifesting as persistent synovitis, systemic inflammation and production of autoantibodies. Patients affected by RA not only experience chronic disease progression, but are also burdened by a 1.5-fold increased cardiovascular (CV) risk, which is comparable to the risk experienced by patients with type 2 diabetes mellitus. RA patients also have a higher incidence and prevalence of coronary artery disease (CAD). Although RA patients frequently present traditional CV risk factors such as insulin resistance and active smoking, previous studies have clarified the pivotal role of chronic inflammation–driven by proinflammatory cytokines such as interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-alpha)–in accelerating the process of atherosclerosis and impairing the coagulation system. Over the last years, a number of studies have shown that disease-modifying anti-rheumatic drugs (DMARDs) reducing the inflammatory state in general improve the CV risk, however some drugs may carry some apparent negative effects. Thus, RA is a model of disease in which targeting inflammation may counteract the progression of atherosclerosis and reduce CV risk. Clinical and experimental evidence indicates that the management of RA patients should be tailored based on the positive and negative effects of DMARDs on CV risk together with the individual traditional CV risk profile. The identification of genetic, biochemical and clinical biomarkers, predictive of evolution and response to treatment, will be the next challenge for a precision approach to reduce the burden of the disease.

show abstract

Cardiovascular Risk Factor Profiles and Disease in Black Compared to Other Africans with Chronic Kidney Disease

Cited by 5 publications

References 34 publications

Aortic Stiffness and Pulsatile Pressures as Potential Mediators of Chronic Kidney Disease Induced Impaired Diastolic Function

Aortic Stiffness and Pulsatile Pressures as Potential Mediators of Chronic Kidney Disease Induced Impaired Diastolic Function

Stroke and its correlates among patients on maintenance hemodialysis in Cameroon

Disease-modifying anti-rheumatic drugs improve the cardiovascular profile in patients with rheumatoid arthritis

Contact Info

Product

Resources

About