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Association between cardiovascular risk level and the incidence of stroke among Spanish working population: results from the icaria study
Abstracts / Atherosclerosis 235 (2014) e84–e191
consisted of 3 triggers: water avoidance, damp bedding and restraint stress. Every weekday, the stress group was subjected to these triggers in a randomly assigned order during 6 hours for 15 weeks. Results: Mental stress resulted in decreased survival of the ApoE-/Fbn1C1039G+/- mice from 71% to 50% at 25 weeks of WD. Plaque size and percentage of necrotic core in the proximal ascending aorta (Aoprox) were not affected by mental stress. However, plaque composition in the Aoprox was altered. The amount of macrophages was significantly increased (control: 1.50.3%, stress: 3.00.6%; p¼0.021) and type I collagen was decreased (control: 4.30.4%, stress: 2.70.5%; p¼0.021). The thickness of the fibrous cap was reduced from 12.81.6 mm in the control group to 6.51.0 mm in the stress group (p¼0.014). Moreover, mental stress led to an increased frequency of myocardial infarctions (control: 41%, stress: 67%) and a decreased septal wall thickness (control: 152452 mm, stress: 132350 mm; p¼0.013). The degree of perivascular fibrosis of the coronary arteries was elevated (control: 367%, stress: 677%; p¼0.006). Conclusion: Mental stress increased the mortality rate in the ApoE-/Fbn1C1039G+/- mouse model by promoting plaque instability and myocardial infarction.
e117
year follow-up to identify new episodes of CVD in workers without previous cardiovascular disease. The CVR was calculated according to SCORE model for low-risk European countries. Moderate to high CVR was defined as SCORE 4%. The incidence of CVD events per 100,000 workers (ICD-9-CM 430-438) was calculated. Negative binomial regression analysis was performed to determine the association of CVR with the incidence of CVD. Results: The incidence of CVD in the sample was 12.90 / 100,000 workers (95% CI 10.22 to 15.58). Having a moderate-high CVR level was associated with a significant increase in the incidence of CVD events during 1-year follow-up, after adjusting for gender and age (OR 4.42 95% CI 2.65 - 7.36).
Table: Negative binomial regression analysis on the risk of an episode of temporary disability from cerebrovascular disease in the year after the baseline assessment, depending on the level of cardiovascular risk (SCORE). Variable
Count Ratio
IC 95%
Model I: Raw Cardiovascular risk (SCORE)
12 - Environmental and psychosocial stressors in cardiovascular disease EAS-0523. ASSOCIATION OF ATHEROGENIC DYSLIPIDEMIA WITH CARDIOVASCULAR RISK IN SPANISH WORKING POPULATION: RESULTS FROM THE ICARIA STUDY
Moderate-High
9.51
Low
1
6.20 – 14.58
Model II: Gender and age adjusted Cardiovascular risk (SCORE)
P. González-Santosa, P. Valdivielsoa, M. Cabrerab, L. Quevedo-Aguadob, M.A. Sánchez-Chaparroa, E. Calvo-Bonachob University of Malaga, Hospital Virgen de la Victoria, Málaga, Spain; b Health Project Department, Ibermutuamur, Madrid, Spain a
Objectives: The aim of this study was to assess how far atherogenic dyslipidemia (AD) is linked to cardiovascular risk (CVR). Methods: Observational cross-sectional study of 70,609 workers (71.5 % male (M), 28.5 % female (F), mean age 39.2 10), who attended medical checkups and agreed to participate. Plasma samples were analysed in a central laboratory. AD definition used was: triglycerides 150 mg/dl and HDL cholesterol <40 mg/dl (M)/<50 mg/dl (F). The possible association with CVR was assessed, according to European SCORE model for low risk-population. Results: AD was significantly associated with moderate-high CVR [OR 1.30 (1.15-1.48)], independently of obesity, alcohol consumption, and even LDL cholesterol. However, most of the AD subjects were classified as low risk. Conclusion: These results suggest that AD may be responsible, at least in part, for the residual risk, independently of other parameters associated with insulin resistance, and may help to improve cardiovascular risk stratification. 12 - Environmental and psychosocial stressors in cardiovascular disease EAS-0522. ASSOCIATION BETWEEN CARDIOVASCULAR RISK LEVEL AND THE INCIDENCE OF STROKE AMONG SPANISH WORKING POPULATION: RESULTS FROM THE ICARIA STUDY P. Valdivielsoa, C. Catalina-Romerob, M.A. Sánchez-Chaparroa, P. González-Santosa, M. Cabrerab, E. Calvo-Bonachob a University of Malaga, Hospital Virgen de la Victoria, Málaga, Spain; b Health Project Department, Ibermutuamur, Madrid, Spain
Objectives: To describe the incidence of cerebrovascular disease (CVD) in the Spanish working population and its association with the previous level of cardiovascular risk (CVR). Methods: Prospective cohort study on 690,138 workers (71.7% male), mean age 35.5 10.75 years. Basal CVR (SCORE) was assessed, performing a 1-
Moderate-High
4.42
Low
1
2.65 – 7.36
Conclusion: Despite increasing incidence by age, proportion of the Spanish working population affected by CVD is far from negligible. A moderate to high CVR is associated with a more than three times higher risk of having a CVD during the subsequent year, regardless of sex and age. 13 - Endothelial cells and function EAS-0511. FMD, PAT AND SERUM NO MEASUREMENT OF ENDOTHELIAL FUNCTION IN PATIENTS WITH PERIPHERAL ARTERIAL DISEASE R.B. Allana, C.L. Delaneya, M.D. Millerb, J.I. Sparka a
Vascular Surgery, Flinders University, Adelaide, Australia; Dietetics, Flinders University, Adelaide, Australia
b
Nutrition and
Objectives: Nitric oxide (NO) mediated endothelial function (EF) is known to decrease with age and in the presence of peripheral artery disease (PAD). The respective contributions of age and disease to this decrease are unclear. It is also unclear which method is most appropriate for assessment of EF is this population. The aim of this study was to compare EF in PAD patients and age matched controls using flow-mediated dilatation (FMD), peripheral artery tonometry (PAT) and serum NO. Methods: 25 patients (mean age: 72.4 years, M:F 18:7) with established PAD (ABI<0.9,) were studied. These patients were compared to an age and gender matched group of 25 control subjects (mean age: 72.4 years, M:F 18:7) with no history of cardiovascular events and no evidence of PAD (ABI0.9). EF was assessed using FMD (%dilatation), PAT (reactive hyperemia index [RHI]); and serum NO (mM). Results: FMD in PAD patients was reduced (mean 2.50%) compared to controls (4.37%) (p¼0.034)]. RHI in PAD patients was also reduced (mean 1.78) compared to controls (2.11)(p¼0.005)]. NO levels were not significantly different (mean 11.76 mM in PAD versus 14.61 mM in controls) (p¼0.662)]. No correlation was seen between any of the three measurement methods.
consisted of 3 triggers: water avoidance, damp bedding and restraint stress. Every weekday, the stress group was subjected to these triggers in a randomly assigned order during 6 hours for 15 weeks. Results: Mental stress resulted in decreased survival of the ApoE-/Fbn1C1039G+/- mice from 71% to 50% at 25 weeks of WD. Plaque size and percentage of necrotic core in the proximal ascending aorta (Aoprox) were not affected by mental stress. However, plaque composition in the Aoprox was altered. The amount of macrophages was significantly increased (control: 1.50.3%, stress: 3.00.6%; p¼0.021) and type I collagen was decreased (control: 4.30.4%, stress: 2.70.5%; p¼0.021). The thickness of the fibrous cap was reduced from 12.81.6 mm in the control group to 6.51.0 mm in the stress group (p¼0.014). Moreover, mental stress led to an increased frequency of myocardial infarctions (control: 41%, stress: 67%) and a decreased septal wall thickness (control: 152452 mm, stress: 132350 mm; p¼0.013). The degree of perivascular fibrosis of the coronary arteries was elevated (control: 367%, stress: 677%; p¼0.006). Conclusion: Mental stress increased the mortality rate in the ApoE-/Fbn1C1039G+/- mouse model by promoting plaque instability and myocardial infarction.
e117
year follow-up to identify new episodes of CVD in workers without previous cardiovascular disease. The CVR was calculated according to SCORE model for low-risk European countries. Moderate to high CVR was defined as SCORE 4%. The incidence of CVD events per 100,000 workers (ICD-9-CM 430-438) was calculated. Negative binomial regression analysis was performed to determine the association of CVR with the incidence of CVD. Results: The incidence of CVD in the sample was 12.90 / 100,000 workers (95% CI 10.22 to 15.58). Having a moderate-high CVR level was associated with a significant increase in the incidence of CVD events during 1-year follow-up, after adjusting for gender and age (OR 4.42 95% CI 2.65 - 7.36).
Table: Negative binomial regression analysis on the risk of an episode of temporary disability from cerebrovascular disease in the year after the baseline assessment, depending on the level of cardiovascular risk (SCORE). Variable
Count Ratio
IC 95%
Model I: Raw Cardiovascular risk (SCORE)
12 - Environmental and psychosocial stressors in cardiovascular disease EAS-0523. ASSOCIATION OF ATHEROGENIC DYSLIPIDEMIA WITH CARDIOVASCULAR RISK IN SPANISH WORKING POPULATION: RESULTS FROM THE ICARIA STUDY
Moderate-High
9.51
Low
1
6.20 – 14.58
Model II: Gender and age adjusted Cardiovascular risk (SCORE)
P. González-Santosa, P. Valdivielsoa, M. Cabrerab, L. Quevedo-Aguadob, M.A. Sánchez-Chaparroa, E. Calvo-Bonachob University of Malaga, Hospital Virgen de la Victoria, Málaga, Spain; b Health Project Department, Ibermutuamur, Madrid, Spain a
Objectives: The aim of this study was to assess how far atherogenic dyslipidemia (AD) is linked to cardiovascular risk (CVR). Methods: Observational cross-sectional study of 70,609 workers (71.5 % male (M), 28.5 % female (F), mean age 39.2 10), who attended medical checkups and agreed to participate. Plasma samples were analysed in a central laboratory. AD definition used was: triglycerides 150 mg/dl and HDL cholesterol <40 mg/dl (M)/<50 mg/dl (F). The possible association with CVR was assessed, according to European SCORE model for low risk-population. Results: AD was significantly associated with moderate-high CVR [OR 1.30 (1.15-1.48)], independently of obesity, alcohol consumption, and even LDL cholesterol. However, most of the AD subjects were classified as low risk. Conclusion: These results suggest that AD may be responsible, at least in part, for the residual risk, independently of other parameters associated with insulin resistance, and may help to improve cardiovascular risk stratification. 12 - Environmental and psychosocial stressors in cardiovascular disease EAS-0522. ASSOCIATION BETWEEN CARDIOVASCULAR RISK LEVEL AND THE INCIDENCE OF STROKE AMONG SPANISH WORKING POPULATION: RESULTS FROM THE ICARIA STUDY P. Valdivielsoa, C. Catalina-Romerob, M.A. Sánchez-Chaparroa, P. González-Santosa, M. Cabrerab, E. Calvo-Bonachob a University of Malaga, Hospital Virgen de la Victoria, Málaga, Spain; b Health Project Department, Ibermutuamur, Madrid, Spain
Objectives: To describe the incidence of cerebrovascular disease (CVD) in the Spanish working population and its association with the previous level of cardiovascular risk (CVR). Methods: Prospective cohort study on 690,138 workers (71.7% male), mean age 35.5 10.75 years. Basal CVR (SCORE) was assessed, performing a 1-
Moderate-High
4.42
Low
1
2.65 – 7.36
Conclusion: Despite increasing incidence by age, proportion of the Spanish working population affected by CVD is far from negligible. A moderate to high CVR is associated with a more than three times higher risk of having a CVD during the subsequent year, regardless of sex and age. 13 - Endothelial cells and function EAS-0511. FMD, PAT AND SERUM NO MEASUREMENT OF ENDOTHELIAL FUNCTION IN PATIENTS WITH PERIPHERAL ARTERIAL DISEASE R.B. Allana, C.L. Delaneya, M.D. Millerb, J.I. Sparka a
Vascular Surgery, Flinders University, Adelaide, Australia; Dietetics, Flinders University, Adelaide, Australia
b
Nutrition and
Objectives: Nitric oxide (NO) mediated endothelial function (EF) is known to decrease with age and in the presence of peripheral artery disease (PAD). The respective contributions of age and disease to this decrease are unclear. It is also unclear which method is most appropriate for assessment of EF is this population. The aim of this study was to compare EF in PAD patients and age matched controls using flow-mediated dilatation (FMD), peripheral artery tonometry (PAT) and serum NO. Methods: 25 patients (mean age: 72.4 years, M:F 18:7) with established PAD (ABI<0.9,) were studied. These patients were compared to an age and gender matched group of 25 control subjects (mean age: 72.4 years, M:F 18:7) with no history of cardiovascular events and no evidence of PAD (ABI0.9). EF was assessed using FMD (%dilatation), PAT (reactive hyperemia index [RHI]); and serum NO (mM). Results: FMD in PAD patients was reduced (mean 2.50%) compared to controls (4.37%) (p¼0.034)]. RHI in PAD patients was also reduced (mean 1.78) compared to controls (2.11)(p¼0.005)]. NO levels were not significantly different (mean 11.76 mM in PAD versus 14.61 mM in controls) (p¼0.662)]. No correlation was seen between any of the three measurement methods.