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Women and factors contributing to coronary heart disease
102
Fridm: 28 May 1999 Poster presentation: Apolipoproteins str~wturefunction and genetics
CORRELATION BETWEEN ARTERIAL BLOOD PRESSURE AND METABOLIC RISK FACTORS IN THE ELDERLY POPULATION: THE BRISIGHELLA STUDY
Risk factolal
M.P. Panourgia, C. Borghi 1, A. Dormi, M.C. Grippo+ S. Rimondi, A. Gaddi.
Centro A terosclerosi G.C. Descovich: t Clinica lvtedica III Dip. Medicina Clinica e Biotecnologia Applicata Policlinico S. Orsola Un&ersitd degli studi di Bologna. Italy Objective: In many studies a correlation has been found between arterial blood pressure and metabolic profile. (i.e. Lopes H.E 1997, Nami R. 19921. The aim of this research was to estimate the relationship between some metabolic factors (LDL-cholesterol, HDL-cholesterol, serum uric acid, fasting glucose), systolic ISBP) and diastolic blood pressure (DBPI in the elderly population enrolled in the Brisighella Study. Methods: The Brisighella Study is an epidemiological survey on the risk of cardiovascular diseases that started in 1972 and was arranged in two phases: a) an observational phase (1972-19861 and b) a preventiveintervention phase that was started in 1986 and is still in progress. The elderly population (n = 441, male/female ratio = 231/2101 was selected from the general population (all subjects aged >14 years) by considering all the subjects aged >60 years in 1992 and who underwent all the planned clinical controls in 1980, 1984. 1988, 19921. The relative frequencies of sample age distribution are as follows (data in 19921:60~5 = 0.20, 66-70 = 0.29, 71-75 = 0.23, 76-80 = 0.18, 81-85 = 0.09, >85 = 0.01. Results: We found a strong positive correlation between fasting blood glucose and SBP in 1984 (b = 0.13, t = 3.19, p = 0.00151, 1988 (b = 0.17, t = 3.83, p = 0.0001) and, in 1992 (b = 0.17. t = 3.72, b = 0.0002). Blood glucose was also correlated with DBP in 1984 (b = 0.06, t = 2.80, p = 0.0053) and 1988 (b = 0.06, t = 2.55, p = 0.011). SBP, DBP were strongly correlated with serum uric acid (UA) in 1980. 1984, but not in the subsequent controls (SBP/UA 1980; b = 0.31. t = 3.62, p = 0.0003. SBP/UA 1984; b = 0.25, t = 3.62, p = 0.0003. DBP/UA 1980; b - 0.018, t = 3.35, p = 0.007). An significant correlation has been found between SBP and plasma lipids, particularly in the female subgroup and this findings were limited to some selected years of observation 11984: SBP vs LDL-C: b = 0.05. t = 2.87, p = 0.004. 1988: SBP vs HDL-C; b = 0.20, t = 2.26, p = 0.007; 1988: SBP vs TG; b = 0.056, t = 3.64, p = 0.0003). A correlation has been also reported between DBP and LDL-C in 1984 (b = 0.02, t = 2.15, p = 0.0321 and with HDL-C in 1988 (b = 0.09, t = 2.18, p = 0.02). Conclusions: The present data suggest the existence of a significant correlation between blood pressure values and UA, plasma lipids and s. glucose in the population of Brisighella. In particular, the correlation with UA was stronger before the nutritional intervention that started in 1986 during the second phase of the study. The strength of the positive correlation with serum lipids decreases with the ageing of the population. Conversely the correlation between s. glucose and blood pressure was always found in the overall population as well as in the different subgroups thus confirming previous findings in the literature.
CARDIOVASCULAR RISK FACTORS IN THE ELDERLY: THE "FOSSALTA" STUDY M. Scanferlato, E. Bagolin, G. Sartore, P. Spinella I , A. Gallo 1, G. Ma77anti. Division of Medicine. S. Dond di Piave Hospital, Venice:
t General Practitioner, Fossalta di Piaue, Venice, Italy Epidemiologic studies have clearly established several risk factors connected to the development of cardiovascular diseases (CDI. Few data are known on this matter in old individuals. The goal of the present study is to investigate the predominance of cardiovascular risk factors in the elderly population living in Fossalta, a country town situated in the Northeastern pan of Italy. Until now 300 subjects (114 men and 186 women), aged 65 to 80 years, have been studied. The frequency distribution on risk factors in percentages and number of individuals is shown in the table. Cardiovascular risk factors have a high prevalence in this population. Sedentary lifestyle, family history of CD, hypercholesterolemia and obesity are the most common ones. Although these risk factors are shared by both sexes, the all of them, except for cigarette smoking and uric acid, have a higher frequence among women. A~er completing the study, the breaking up of the data will be necessary to identify the importance of every single risk factor and to fix the strategy for a primary and secondary prevention on this particular population.
Percentage Frequency Total In)
Men In)
Women In)
Family history o f C D
65% (I9~,1
55°/~ (63)
72°. (t33)
Hypertension
28% (851
23% 1261
32% 1591
Cigarette smoking
10% ( 291
18% ( 21 )
4"° 181 280o ( 52 I
Diabetes
24 *,i, ( 731
18% 1211
SedentaD' lifestyle
65*,, 11961
53*',, 16111
730, 11361
Obesity
35.,~ 1105}
3500 (401
3500 (651
Total cholest. > 200 mg/dl
40% 11201
30% 1341
46% 186l
LDL cholesl. > 130 mgTdl
43% 11281
40°,, 1461
44°0 1821
HDL choh:'s.l. < 35 mg;dl
9% 1271
4% (4)
12°'o 1231
Tngtycend~.~ > 1711 mg/dl
9% 1281
7% 18)
[ 1°o 12111
Fibrinogen > 450 mg/dl
I(~,. 1291
10% [ I I )
113°', ( 181
Uric Acid > 7 mg/dl
8% 1231
I1% 1131
5% II111
WOMEN AND FACTORS CONTRIBUTING TO CORONARY HEART DISEASE N. Kipshidze, N. Kakauridze, M. Jebashvili. Institute q[ Therap.v. Tbilisi.
Georgia Hormon disbalance in menopause women is a risk factor for atherosclerosis and coronary heart disease. The hormonal change in women begins from premenopausal period. So, the aim of this study is to evaluate the coronary. risk factors in 15 premenopausal women (40-48 years1 - I group, and in 15 women with CHD (postmenopausal women 50-60 yearl - 11 group. before I-) and after (+1 "High Cholesterol breakfast". The data show, that Total Cholesterol is: in I group 6.63±1.31 ( - ) and 6.87±1.92 (+); in I1 group 7.255_1.86 (-) and 9.7+:2.12 (+l. [~-Iipoprotein and LDL-cholesterol significantly increased after breakfast as in I group as well as in 11 groups HDL-Ch in I group is 1.84+:0.87 (-) and 0.76+0.07 I+1; in II group 0.94 +:0.32 (-) and 0.42+0.12 (+). Dyslipidemia began in premenopausal period and aggravate in menopause and present high risk for CHD. Nutritional cholesterol increases dislipidemia in both groups, but more significantly in II group, than in 1 group. The similar change provoked by nutritional load in both groups showed that premenopausal women may be pick out as high risk population for CHD developing and needing long-term dietary intervation.
Poster presentation: Apolipoproteins structure function and genetics ASSOCIATION OF PLASMA LIPID LEVELS WITH APOLIPOPROTEIN E POLYMORPHISM IN NIDDM A. Kalina 1, C.S. Szalai 2, I. Hermanyi a, E Szaboki 1, T. Troznai 4, L. Romics5, A. Csaszar5. I CardioloKv Department of Hungarian
Raihvavs Hospital. Budapest." 2Laboratory of Helm Pal Children Hospital. Budapest." 33"t Department of Medicine "of Elizabeth Hospital. Budapest: 4Gerontology Department of Semmehveis Medical UniversiO" Budapest; 53"1 Department of Medicine of Semmelweis Medical Universio: Budapest. Hunga~. ' The authors examined the apolipoprotein-E (apoE) allele frequencies and their relation to the lipid levels of 300 (120 males, 180 females) patients with NIDDM (mean age 72.7 years, 45-90) treated with diet and sulfanylurea, without receiving antilipidemic treatment (cholesterol {mean+SD mmol/I}: 6.28+1.35, LDL-cholesterol: 4.09+:1.01, HDLcholesterol: 1.00+0.40, triglyceride: 2.11+:1.80, HgbAlc {mean + SD%): 6.99+:0.89). ApoE genotype was identified with allele specific PCR and restriction endonuclease. Our findings were compared to 100 (31 males, 69 females) elderly (mean age: 70.3, 52-83) healthy people (cholesterol: 5.90+:0.90, LDL: 3.98+1.21, HDL: 1.114-0.38, triglyceride: 1.20+:0.40, HgbAlc+6.2+0.60) and 100 (45 males, 55 females) young (mean age: 40.2, 30-50) healthy people (cholesterol: 5.40+:0.75, LDL: 3.77+1.10, HDL: 1.07+0.44, triglyceride: 1.25+:0.44, HgbAIc: 5.89+:0.33). The distribution of most frequent phenotypes was in the diabetes group E2/3 = 8.66%, E3/3 = 78.33%, E3/4 = 12.66%, in the elderly group E2/3 = 10.%, E3/3 = 78%, E3/4 = 12% and in the young group E2/3 = 12%, E3/3 = 62%, E3/4 = 25%. The triglyceride levels were significantly higher (both p < 0.001, Two way ANOVA test) in patients with NIDDM in the E3/4 phenotype (3.34+1.49) as compared to the E3/3 ( 1.72+: 1.01 ) and E2/3 (2.15+ 1.65). The cholesterol levels in elderly group with the E2/3) (4.79+:0.72) were significantly lower
71st EAS Congress and Satellite Symposia
Fridm: 28 May 1999 Poster presentation: Apolipoproteins str~wturefunction and genetics
CORRELATION BETWEEN ARTERIAL BLOOD PRESSURE AND METABOLIC RISK FACTORS IN THE ELDERLY POPULATION: THE BRISIGHELLA STUDY
Risk factolal
M.P. Panourgia, C. Borghi 1, A. Dormi, M.C. Grippo+ S. Rimondi, A. Gaddi.
Centro A terosclerosi G.C. Descovich: t Clinica lvtedica III Dip. Medicina Clinica e Biotecnologia Applicata Policlinico S. Orsola Un&ersitd degli studi di Bologna. Italy Objective: In many studies a correlation has been found between arterial blood pressure and metabolic profile. (i.e. Lopes H.E 1997, Nami R. 19921. The aim of this research was to estimate the relationship between some metabolic factors (LDL-cholesterol, HDL-cholesterol, serum uric acid, fasting glucose), systolic ISBP) and diastolic blood pressure (DBPI in the elderly population enrolled in the Brisighella Study. Methods: The Brisighella Study is an epidemiological survey on the risk of cardiovascular diseases that started in 1972 and was arranged in two phases: a) an observational phase (1972-19861 and b) a preventiveintervention phase that was started in 1986 and is still in progress. The elderly population (n = 441, male/female ratio = 231/2101 was selected from the general population (all subjects aged >14 years) by considering all the subjects aged >60 years in 1992 and who underwent all the planned clinical controls in 1980, 1984. 1988, 19921. The relative frequencies of sample age distribution are as follows (data in 19921:60~5 = 0.20, 66-70 = 0.29, 71-75 = 0.23, 76-80 = 0.18, 81-85 = 0.09, >85 = 0.01. Results: We found a strong positive correlation between fasting blood glucose and SBP in 1984 (b = 0.13, t = 3.19, p = 0.00151, 1988 (b = 0.17, t = 3.83, p = 0.0001) and, in 1992 (b = 0.17. t = 3.72, b = 0.0002). Blood glucose was also correlated with DBP in 1984 (b = 0.06, t = 2.80, p = 0.0053) and 1988 (b = 0.06, t = 2.55, p = 0.011). SBP, DBP were strongly correlated with serum uric acid (UA) in 1980. 1984, but not in the subsequent controls (SBP/UA 1980; b = 0.31. t = 3.62, p = 0.0003. SBP/UA 1984; b = 0.25, t = 3.62, p = 0.0003. DBP/UA 1980; b - 0.018, t = 3.35, p = 0.007). An significant correlation has been found between SBP and plasma lipids, particularly in the female subgroup and this findings were limited to some selected years of observation 11984: SBP vs LDL-C: b = 0.05. t = 2.87, p = 0.004. 1988: SBP vs HDL-C; b = 0.20, t = 2.26, p = 0.007; 1988: SBP vs TG; b = 0.056, t = 3.64, p = 0.0003). A correlation has been also reported between DBP and LDL-C in 1984 (b = 0.02, t = 2.15, p = 0.0321 and with HDL-C in 1988 (b = 0.09, t = 2.18, p = 0.02). Conclusions: The present data suggest the existence of a significant correlation between blood pressure values and UA, plasma lipids and s. glucose in the population of Brisighella. In particular, the correlation with UA was stronger before the nutritional intervention that started in 1986 during the second phase of the study. The strength of the positive correlation with serum lipids decreases with the ageing of the population. Conversely the correlation between s. glucose and blood pressure was always found in the overall population as well as in the different subgroups thus confirming previous findings in the literature.
CARDIOVASCULAR RISK FACTORS IN THE ELDERLY: THE "FOSSALTA" STUDY M. Scanferlato, E. Bagolin, G. Sartore, P. Spinella I , A. Gallo 1, G. Ma77anti. Division of Medicine. S. Dond di Piave Hospital, Venice:
t General Practitioner, Fossalta di Piaue, Venice, Italy Epidemiologic studies have clearly established several risk factors connected to the development of cardiovascular diseases (CDI. Few data are known on this matter in old individuals. The goal of the present study is to investigate the predominance of cardiovascular risk factors in the elderly population living in Fossalta, a country town situated in the Northeastern pan of Italy. Until now 300 subjects (114 men and 186 women), aged 65 to 80 years, have been studied. The frequency distribution on risk factors in percentages and number of individuals is shown in the table. Cardiovascular risk factors have a high prevalence in this population. Sedentary lifestyle, family history of CD, hypercholesterolemia and obesity are the most common ones. Although these risk factors are shared by both sexes, the all of them, except for cigarette smoking and uric acid, have a higher frequence among women. A~er completing the study, the breaking up of the data will be necessary to identify the importance of every single risk factor and to fix the strategy for a primary and secondary prevention on this particular population.
Percentage Frequency Total In)
Men In)
Women In)
Family history o f C D
65% (I9~,1
55°/~ (63)
72°. (t33)
Hypertension
28% (851
23% 1261
32% 1591
Cigarette smoking
10% ( 291
18% ( 21 )
4"° 181 280o ( 52 I
Diabetes
24 *,i, ( 731
18% 1211
SedentaD' lifestyle
65*,, 11961
53*',, 16111
730, 11361
Obesity
35.,~ 1105}
3500 (401
3500 (651
Total cholest. > 200 mg/dl
40% 11201
30% 1341
46% 186l
LDL cholesl. > 130 mgTdl
43% 11281
40°,, 1461
44°0 1821
HDL choh:'s.l. < 35 mg;dl
9% 1271
4% (4)
12°'o 1231
Tngtycend~.~ > 1711 mg/dl
9% 1281
7% 18)
[ 1°o 12111
Fibrinogen > 450 mg/dl
I(~,. 1291
10% [ I I )
113°', ( 181
Uric Acid > 7 mg/dl
8% 1231
I1% 1131
5% II111
WOMEN AND FACTORS CONTRIBUTING TO CORONARY HEART DISEASE N. Kipshidze, N. Kakauridze, M. Jebashvili. Institute q[ Therap.v. Tbilisi.
Georgia Hormon disbalance in menopause women is a risk factor for atherosclerosis and coronary heart disease. The hormonal change in women begins from premenopausal period. So, the aim of this study is to evaluate the coronary. risk factors in 15 premenopausal women (40-48 years1 - I group, and in 15 women with CHD (postmenopausal women 50-60 yearl - 11 group. before I-) and after (+1 "High Cholesterol breakfast". The data show, that Total Cholesterol is: in I group 6.63±1.31 ( - ) and 6.87±1.92 (+); in I1 group 7.255_1.86 (-) and 9.7+:2.12 (+l. [~-Iipoprotein and LDL-cholesterol significantly increased after breakfast as in I group as well as in 11 groups HDL-Ch in I group is 1.84+:0.87 (-) and 0.76+0.07 I+1; in II group 0.94 +:0.32 (-) and 0.42+0.12 (+). Dyslipidemia began in premenopausal period and aggravate in menopause and present high risk for CHD. Nutritional cholesterol increases dislipidemia in both groups, but more significantly in II group, than in 1 group. The similar change provoked by nutritional load in both groups showed that premenopausal women may be pick out as high risk population for CHD developing and needing long-term dietary intervation.
Poster presentation: Apolipoproteins structure function and genetics ASSOCIATION OF PLASMA LIPID LEVELS WITH APOLIPOPROTEIN E POLYMORPHISM IN NIDDM A. Kalina 1, C.S. Szalai 2, I. Hermanyi a, E Szaboki 1, T. Troznai 4, L. Romics5, A. Csaszar5. I CardioloKv Department of Hungarian
Raihvavs Hospital. Budapest." 2Laboratory of Helm Pal Children Hospital. Budapest." 33"t Department of Medicine "of Elizabeth Hospital. Budapest: 4Gerontology Department of Semmehveis Medical UniversiO" Budapest; 53"1 Department of Medicine of Semmelweis Medical Universio: Budapest. Hunga~. ' The authors examined the apolipoprotein-E (apoE) allele frequencies and their relation to the lipid levels of 300 (120 males, 180 females) patients with NIDDM (mean age 72.7 years, 45-90) treated with diet and sulfanylurea, without receiving antilipidemic treatment (cholesterol {mean+SD mmol/I}: 6.28+1.35, LDL-cholesterol: 4.09+:1.01, HDLcholesterol: 1.00+0.40, triglyceride: 2.11+:1.80, HgbAlc {mean + SD%): 6.99+:0.89). ApoE genotype was identified with allele specific PCR and restriction endonuclease. Our findings were compared to 100 (31 males, 69 females) elderly (mean age: 70.3, 52-83) healthy people (cholesterol: 5.90+:0.90, LDL: 3.98+1.21, HDL: 1.114-0.38, triglyceride: 1.20+:0.40, HgbAlc+6.2+0.60) and 100 (45 males, 55 females) young (mean age: 40.2, 30-50) healthy people (cholesterol: 5.40+:0.75, LDL: 3.77+1.10, HDL: 1.07+0.44, triglyceride: 1.25+:0.44, HgbAIc: 5.89+:0.33). The distribution of most frequent phenotypes was in the diabetes group E2/3 = 8.66%, E3/3 = 78.33%, E3/4 = 12.66%, in the elderly group E2/3 = 10.%, E3/3 = 78%, E3/4 = 12% and in the young group E2/3 = 12%, E3/3 = 62%, E3/4 = 25%. The triglyceride levels were significantly higher (both p < 0.001, Two way ANOVA test) in patients with NIDDM in the E3/4 phenotype (3.34+1.49) as compared to the E3/3 ( 1.72+: 1.01 ) and E2/3 (2.15+ 1.65). The cholesterol levels in elderly group with the E2/3) (4.79+:0.72) were significantly lower
71st EAS Congress and Satellite Symposia