Longitudinal Changes in Vascular Risk Markers and Mortality Rates among a Latino Population with Hypertension

Abstract

T he search for novel clinical markers in order to improve the prediction of cardiovascular disease (CVD) beyond traditional risk factors is an ongoing area of research. Whereas risk factors such as tobacco abuse, hyperlipidemia, and diabetes mellitus are currently used to calculate global CVD risk, 1 they are not equally predictive in all subgroups of race 2 and sex, 3 and they are even less reliable predictors of noncoronary vascular disease, which is more prevalent in nonwhite populations.2 This might be particularly relevant among Latinos, who are among the fastest-growing minority groups, expanding at 4 times the rate of the rest of the United States' population. 4 Although circulating inflammatory biomarkers such as high-sensitivity C-reactive protein (hs-CRP) have been shown to improve CVD risk discrimination, validation cohorts have included just 1% Latino subjects. 5 In addition, elevation in these circulating biomarkers varies significantly with race and ethnicity, 6 so their diagnostic usefulness in the Latino population remains unknown. Recently, the use of physiologic tools such as pulse-wave velocity (PWV) for estimating vascular stiffness has been shown to improve the accuracy of risk stratification. Specifically, a meta-analysis of more than 17,000 patients suggests that the addition of arterial PWV to traditional 10-year CVD risk calculation improves the net reclassification index.7 Notably, the results of this study showed improved risk categorization to the greatest degree among younger individuals and those labeled as having intermediate global risk. Reclassifying intermediate-risk patients as high-or low-risk, when measures of arterial stiffness are taken into account, therefore has potentially important implications for initiating or withholding therapeutic interventions. The role of arterial stiffness in improving CVD prediction is promising; however, to date, it has not been adequately evaluated among populations of lower socioeconomic status.

Vascular Markers among Young Women with CVD Risk Factors

“…This study found that no association was observed between CIMT, PWVcf, and AI. This finding is in contrast with the study by Pflederer et al (2016), which found that there was an association between CIMT and PWV among hypertensive subjects aged 61.7±9.5 years old, with more severe CVD risk factors, such as being on antihypertensive medication, having DM, and with chronic renal failure. The current findings were in line with a previous study by Koivistoinen et al (2012).…”

Human Oral Buccal Microbiomes Are Associated with Farmworker Status and Azinphos-Methyl Agricultural Pesticide Exposure

“…have not been investigated in this cohort to date. Hispanics have a disproportionate disease burden for many common diseases related to vasculature (i.e., diabetes and cardiovascular disease) (82)(83)(84)(85)(86)(87)(88)(89)(90) that have also been shown to have microbiome-related disease variables in many other experimental contexts (91)(92)(93)(94)(95)(96)(97)(98)(99)(100)(101)(102)(103)(104). Dental health, bacterial infection, and peripheral vascular disease have many independent associations (105), and some of the etiology could be affected by systemic loosening of tight junctions as induced by organophosphates (78).…”