C-reactive protein mediates the association of liver fat and carotid intima–media thickness in healthy men and men with the metabolic syndrome and/or uncomplicated type 2 diabetes

Zijl, N.J. van der; Muskiet, Marcel H.A.; Tushuizen, Maarten E.; Rijzewijk, Luuk J.; Schindhelm, Roger K.; Moors, C.C.M.; Goossens, Gijs H.; Blaak, Ellen E.; Pouwels, Petra J. W.; Diamant, Michaëla

doi:10.1016/j.dsx.2010.05.018

Cited by 1 publication

(2 citation statements)

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“…This would include primary prevention patients, who may be so classified as a result of relatively insensitive techniques, but in whom the process is already under way. While unproven, preliminary evidence suggests that when CRP levels are elevated, especially in patients with metabolic syndrome, residual risk is likely to be high, a correlation may exist with CIMT, and the response to rosuvastatin may be greater 279,280…”

Section: Statins In Primary Preventionmentioning

confidence: 99%

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Primary prevention of coronary heart disease: integration of new data, evolving views, revised goals, and role of rosuvastatin in management. A comprehensive survey

Kones¹

2011

DDDT

218

145

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A recent explosion in the amount of cardiovascular risk and incipient, undetected subclinical cardiovascular pathology has swept across the globe. Nearly 70% of adult Americans are overweight or obese; the prevalence of visceral obesity stands at 53% and continues to rise. At any one time, 55% of the population is on a weight-loss diet, and almost all fail. Fewer than 15% of adults or children exercise sufficiently, and over 60% engage in no vigorous activity. Among adults, 11%–13% have diabetes, 34% have hypertension, 36% have prehypertension, 36% have prediabetes, 12% have both prediabetes and prehypertension, and 15% of the population with either diabetes, hypertension, or dyslipidemia are undiagnosed. About one-third of the adult population, and 80% of the obese, have fatty livers. With 34% of children overweight or obese, prevalence having doubled in just a few years, type 2 diabetes, hypertension, dyslipidemia, and fatty livers in children are at their highest levels ever. Half of adults have at least one cardiovascular risk factor. Not even 1% of the population attains ideal cardiovascular health. Despite falling coronary death rates for decades, coronary heart disease (CHD) death rates in US women 35 to 54 years of age may now be increasing because of the obesity epidemic. Up to 65% of patients do not have their conventional risk biomarkers under control. Only 30% of high risk patients with CHD achieve aggressive low density lipoprotein (LDL) targets. Of those patients with multiple risk factors, fewer than 10% have all of them adequately controlled. Even when patients are titrated to evidence-based targets, about 70% of cardiac events remain unaddressed. Undertreatment is also common. About two-thirds of high risk primary care patients are not taking needed medications for dyslipidemia. Poor patient adherence, typically below 50%, adds further difficulty. Hence, after all such fractional reductions are multiplied, only a modest portion of total cardiovascular risk burden is actually being eliminated, and the full potential of risk reduction remains unrealized. Worldwide the situation is similar, with the prevalence of metabolic syndrome approaching 50%. Primordial prevention, resulting from healthful lifestyle habits that do not permit the appearance of risk factors, is the preferred method to lower cardiovascular risk. Lowering the prevalence of obesity is the most urgent matter, and is pleiotropic since it affects blood pressure, lipid profiles, glucose metabolism, inflammation, and atherothrombotic disease progression. Physical activity also improves several risk factors, with the additional potential to lower heart rate. Given the current obstacles, success of primordial prevention remains uncertain. At the same time, the consequences of delay and inaction will inevitably be disastrous, and the sense of urgency mounts. Since most CHD events arise in a large subpopulation of low- to moderate-risk individuals, identifying a high proportion of those who will go on to develop events with accuracy remains...

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Section: Statins In Primary Preventionmentioning

confidence: 99%

“…While unproven, preliminary evidence suggests that when CRP levels are elevated, especially in patients with metabolic syndrome, residual risk is likely to be high, a correlation may exist with CIMT, and the response to rosuvastatin may be greater. 279 , 280 …”

Section: Statins In Primary Preventionmentioning

confidence: 99%