Sex-specific risk factors for cardiovascular disease in women-making cardiovascular disease real

Merz, C. Noel Bairey; Ramineni, Tina; Leong, Derek

doi:10.1097/hco.0000000000000543

Cited by 28 publications

(24 citation statements)

References 49 publications

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“…Therefore, postmenopausal women are at increased risk of CV complications compared to premenopausal women [22] . In our study, the crude incidence rates for CV events were lower in female groups compared with male groups, as in other studies (Table 2), [21] which might result in no significant association between variation in BP components and occurrence of CV events in female groups.…”

Section: Discussionsupporting

confidence: 57%

“…The reasons why there was no significant relation between change of BP components and CV events in the hypertensive female populations have not been elucidated. However, it is well-known that there are differences in prevalence of HTN and incidence of CV events between men and women [21] . Moreover, women are considered to be protected from most CV events compared to men, and the risk for CV events accelerates after menopause.…”

Section: Discussionmentioning

confidence: 99%

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The effects of blood pressure components on cardiovascular events in a Korean hypertensive population according to age and sex

Kang¹,

Lee²,

et al. 2019

Medicine

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There is no known study regarding the usefulness of each blood pressure (BP) component based on stratification by age and sex for predicting cardiovascular (CV) events among hypertensive populations without chronic kidney disease (CKD) or diabetes mellitus (DM). This study was performed to investigate the association of BP components and CV events in a Korean hypertensive population according to age and sex. A total of 22,853 Korean hypertensive participants without CKD and DM were stratified into six groups according to age [40–49, 50–59, and 60 years or older] and sex. In each group, multivariate Cox proportional regression analysis was performed to reveal the associations of BP components [systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP) and pulse pressure (PP)] with CV events. The increase in PP and decrease in DBP were significantly associated with increase of CV events in males, but neither BP component was significantly associated with risk of CV events in females. When subjects were stratified by age and sex, an increase of SBP or PP was significantly related to the increased risk of CV events in 40's male group, and only the elevation of PP was significantly associated with increase in incidence of CV events in 50's male group, while a decrease in DBP was significantly associated with increased risk of CV events in older male group. In addition, there were no the significant associations with the incidence of CV events in MAP, after stratification according to age and sex. In conclusion, this study suggests that, in hypertensive populations, BP management may need to be performed after full consideration of age and sex.

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Section: Discussionsupporting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

The effects of blood pressure components on cardiovascular events in a Korean hypertensive population according to age and sex

Kang¹,

Lee²,

et al. 2019

Medicine

View full text Add to dashboard Cite

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“…According to numerous studies, in postmenopausal women a worse lipid profile is observed in comparison to premenopausal ones [85][86][87]. CKD women experience kidney dysfunction-mediated premature menopause.…”

Section: Postmenopausal Womenmentioning

confidence: 99%

The Role and Function of HDL in Patients with Chronic Kidney Disease and the Risk of Cardiovascular Disease

Rysz

Gluba-Brzózka

Rysz-Górzyńska

et al. 2020

IJMS

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Chronic kidney disease (CKD) is a worldwide health problem with steadily increasing occurrence. Significantly elevated cardiovascular morbidity and mortality have been observed in CKD. Cardiovascular diseases are the most important and frequent cause of death of CKD patients globally. The presence of CKD is related to disturbances in lipoprotein metabolism whose consequences are dyslipidemia and the accumulation of atherogenic particles. CKD not only fuels the reduction of high-density lipoprotein (HDL) cholesterol concentration, but also it modifies the composition of this lipoprotein. The key role of HDL is the participation in reverse cholesterol transport from peripheral tissues to the liver. Moreover, HDL prevents the oxidation of low-density lipoprotein (LDL) cholesterol by reactive oxygen species (ROS) and protects against the adverse effects of oxidized LDL (ox-LDL) on the endothelium. Numerous studies have demonstrated the ability of HDL to promote the production of nitric oxide (NO) by endothelial cells (ECs) and to exert antiapoptotic and anti-inflammatory effects. Increasing evidence suggests that in patients with chronic inflammatory disorders, HDLs may lose important antiatherosclerotic properties and become dysfunctional. So far, no therapeutic strategy to raise HDL, or alter the ratio of HDL subfractions, has been successful in slowing the progression of CKD or reducing cardiovascular disease in patients either with or without CKD.

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“…Additionally, there may be differences in the prevention, recognition, and care of cardiovascular disease between men and women. Previous literature has reported that physicians are less likely to discuss with women cardiovascular disease risk and provide quality preventative care or refer for cardiac catheterization when presenting with chest pain compared to men, and historically, women have been excluded from cardiovascular clinical trials [41][42][43]. Additionally, participants who identified as NH black or Hispanic experienced more cardiovascular hospitalizations than NH white participants.…”

Section: Plos Medicinementioning

confidence: 99%

Hospitalizations among adults with chronic kidney disease in the United States: A cohort study

et al. 2020

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Background Adults with chronic kidney disease (CKD) are hospitalized more frequently than those without CKD, but the magnitude of this excess morbidity and the factors associated with hospitalizations are not well known. Methods and findings Data from 3,939 participants enrolled in the Chronic Renal Insufficiency Cohort (CRIC) Study between 2003 and 2008 at 7 clinical centers in the United States were used to estimate primary causes of hospitalizations, hospitalization rates, and baseline participant factors associated with all-cause, cardiovascular, and non-cardiovascular hospitalizations during a median follow up of 9.6 years. Multivariable-adjusted Poisson regression was used to identify factors associated with hospitalization rates, including demographics, blood pressure, estimated glomerular filtration rate (eGFR), and proteinuria. Hospitalization rates in CRIC were compared with rates in the Nationwide Inpatient Sample (NIS) from 2012. Of the 3,939 CRIC participants, 45.1% were female, and 41.9% identified as non-Hispanic black, with a mean age of 57.7 years, and the mean eGFR is 44.9 ml/min/1.73m2. CRIC participants had an unadjusted overall hospitalization rate of 35.0 per 100 person-years (PY) [95% CI: 34.3 to 35.6] and 11.1 per 100 PY [95% CI: 10.8 to 11.5] for cardiovascular-related causes. All-cause, non-cardiovascular, and cardiovascular hospitalizations were associated with older age (≥65 versus 45 to 64 years), more proteinuria (≥150 to <500 versus <150 mg/g), higher systolic blood pressure (≥140 versus 120 to <130 mmHg), diabetes (versus no diabetes), and lower eGFR (<60 versus ≥60 ml/min/1.73m2). Non-Hispanic black (versus non-Hispanic white) race/ethnicity was associated with higher risk for cardiovascular hospitalization [rate ratio (RR) 1.25, 95% CI: 1.16 to 1.35, p-value < 0.001], while risk among females was lower [RR 0.89, 95% CI: 0.83 to 0.96, p-value = 0.002]. Rates of cardiovascular hospitalizations were higher among those with ≥500 mg/g of proteinuria irrespective of eGFR. The most common causes of hospitalization were related to cardiovascular (31.8%), genitourinary (8.7%), digestive (8.3%), endocrine, nutritional or metabolic (8.3%), and respiratory (6.7%) causes. Hospitalization rates were higher in CRIC than the NIS, except for non-cardiovascular hospitalizations among individuals aged >65 years. Limitations of the study include possible misclassification by diagnostic codes, residual confounding, and potential bias from healthy volunteer effect due to its observational nature. Conclusions In this study, we observed that adults with CKD had a higher hospitalization rate than the general population that is hospitalized, and even moderate reductions in kidney function were associated with elevated rates of hospitalization. Causes of hospitalization were predominantly related to cardiovascular disease, but other causes contributed, particularly, genitourinary, digestive, and endocrine, nutritional, and metabolic illnesses. High levels of proteinuria were observed to have the largest association with hospitalizations across a wide range of kidney function levels.

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Sex-specific risk factors for cardiovascular disease in women-making cardiovascular disease real

Cited by 28 publications

References 49 publications

The effects of blood pressure components on cardiovascular events in a Korean hypertensive population according to age and sex

The effects of blood pressure components on cardiovascular events in a Korean hypertensive population according to age and sex

The Role and Function of HDL in Patients with Chronic Kidney Disease and the Risk of Cardiovascular Disease

Hospitalizations among adults with chronic kidney disease in the United States: A cohort study

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