What is the role of non-invasive measurements of atherosclerosis in individual cardiovascular risk prediction?

Abstract

Oestrogen therapy is the gold standard treatment for hot flushes/night sweats, but it and oestrogen/progestin are not suitable for all women. MPA (medroxyprogesterone acetate) reduces hot flushes, but its effectiveness compared with oestrogen is unknown. In the present study, oral oestrogen [CEE (conjugated equine oestrogen)] and MPA were compared for their effects on hot flushes in a planned analysis of a secondary outcome for a 1-year randomized double-blind parallel group controlled trial in an urban academic medical centre. Participants were healthy menstruating women prior to hysterectomy/ovariectomy for benign disease. A total of 41 women {age, 45 (5) years [value is mean (S.D.)]} were enrolled; 38 women were included in this analysis of daily identical capsules containing CEE (0.6 mg/day) or MPA (10 mg/day). Demographic variables did not differ at baseline. Daily data provided the number of night and day flushes compared by group. The vasomotor symptom day-to-day intensity change was assessed by therapy assignment. Hot flushes/night sweats were well controlled in both groups, one occurred on average every third day and every fourth night. Mean/day daytime occurrences were 0.363 and 0.187 with CEE and MPA respectively, but were not significantly different (P=0.156). Night sweats also did not differ significantly (P=0.766). Therapies were statistically equivalent (within one event/24 h) in the control of vasomotor symptoms. Day-to-day hot flush intensity decreased with MPA and tended to remain stable with CEE (P<0.001). In conclusion, this analysis demonstrates that MPA and CEE are equivalent and effective in the control of the number of hot flushes/night sweats immediately following premenopausal ovariectomy.

Correlations of Different Structural and Functional Characteristics of Arterial Wall With Traditional Cardiovascular Risk Factors in Healthy People of Different Age. Part 1

“…Все они отражают развитие атеросклеротического процесса. Эн-дотелиальная дисфункция является наиболее ранним и пре-имущественно функциональным нарушением артериаль-ной стенки, связанным с атеросклерозом [14]. ЭЗВД отра-жает NO-зависимую вазодилятацию после искусственно вы-званной гипоксемии, тем самым оценивает локальную биодоступность NO.…”

“…В нашем исследовании ЭЗВД<10% встречалась чаще других изменений, у каждого четверто-го участника в младшей возрастной группе. В отличие от ЭЗВД ТКИМ отражает более выраженные структурные атеро-склеротические изменения артериальной стенки [14]. Уве-Correlations between parameters of arterial wall Взаимосвязь параметров артериальной стенки events occurring [19].…”

“…EDVD<10% was found more often than other alterations in our study: in every 4th participant in the younger group. As opposed to EDVD, IMT reflects more significant structural atherosclerotic lesions of arterial wall [14]. Increased carotid IMT correlated with CVD risk [17], severity of coronary atherosclerosis [18] and risk for negative cardiovascular растной группе.…”

“…All these parameters reflect the development of the atherosclerotic process. Endothelial dysfunction is the earliest and mainly functional arterial wall lesion related to atherosclerosis [14]. EDVD reflects NO-dependent vasodilation after artificially induced hypoxia, thus it allows estimation of NO local bioaccessibility.…”

Multifunctional Role of TRAIL in Atherosclerosis and Cardiovascular Disease

“…Flow-mediated dilatation (FMD) is a representative method of non-invasive evaluation of endothelial function. This ultrasound-based method quantifies vasodilatation in response to NO production from endothelial cells induced by shear stress (Corretti et al, 2002;Patel and Celermajer, 2006;Ter Avest et al, 2007). Since in vitro findings have suggested various biological effects of TRAIL on endothelial cells (as described previously), investigation of the association between TRAIL and endothelial function is of interest.…”