Providing Evidence for Subclinical CVD in Risk Assessment

Blaha, Michael J.; Yeboah, Joseph; Rifai, Mahmoud Al; Liu, Kiang; Kronmal, Richard A.; Greenland, Philip

doi:10.1016/j.gheart.2016.08.003

Cited by 34 publications

(10 citation statements)

References 58 publications

(50 reference statements)

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“…Low CVH scores may primarily contribute to chronic subclinical damage, leading to CVDs via subclinical impairments. Previous studies have largely focused on the association of subclinical stages with each individual behaviour or health factor [ 28 ]. However, many of these factors coexist or occur in aggregation and thus may be interwoven into multiple biologically related pathways.…”

Section: Discussionmentioning

confidence: 99%

Ideal cardiovascular health and the subclinical impairments of cardiovascular diseases: a cross-sectional study in central south China

Wang

Zhu

et al. 2017

BMC Cardiovasc Disord

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BackgroundIdeal cardiovascular health (CVH) is related to a low cardiovascular disease risk profile. This study aimed to investigate CVH metrics with both the biomarkers and markers of subclinical impairments of cardiovascular diseases (CVDs) in subjects from central south China.MethodsThe ideal CVH score (non-smoking status; ideal body mass index; regular physical activity; healthy diet; and an optimal serum cholesterol, blood pressure, and glucose profile; 1 point for each; total score: 0–7) was collected from 3009 participants without a history of CVDs. Subclinical biomarkers were assessed using C-reactive protein, homocysteine, and microalbuminuria. The presence of subclinical disease markers was defined as having at least one of the following: increased carotid intima-media thickness, carotid plaque, left ventricular hypertrophy, left ventricular systolic dysfunction, or a reduced ankle-brachial index. The association of biomarkers and markers with the CVH score was evaluated using multivariate logistic regression and linear regression analyses.ResultsOnly 0.2% of the study participants met all 7 ideal CVH metrics (CVH score = 7). Compared to the female participants, the male participants had poorer CVH profiles and a higher incidence of subclinical lesions (P < 0.05). In the fully adjusted models, per 1-unit increase in the CVH score was inversely associated with the biomarker levels (β = -0.092 – -0.224, P < 0.05 for all) and the odds of the presence of markers (odds ratio, 0.808; 95% confidence interval, 0.755–0.865). Similar relationships were observed in the gender subgroups and were stronger in the females.ConclusionA clear inverse association was observed between the biomarkers or markers of subclinical impairments and the CVH score in a central south Chinese population, implying the importance of ideal CVH for the primordial prevention of CVDs.Electronic supplementary materialThe online version of this article (10.1186/s12872-017-0697-9) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Ideal cardiovascular health and the subclinical impairments of cardiovascular diseases: a cross-sectional study in central south China

Wang

Zhu

et al. 2017

BMC Cardiovasc Disord

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“…Compared with other nontraditional markers (e.g. carotid intimal thickness, ankle-brachial index, C-reactive protein), CAC is consistently the single best predictor of ASCVD risk [17][18][19].…”

Section: Coronary Artery Calcificationmentioning

confidence: 99%

Coronary artery calcium scoring: an evidence‐based guide for primary care physicians

Cheong¹,

Wilson

Spann

et al. 2020

J. Intern. Med.

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“…This has renewed interest in determining the burden of subclinical disease in patients with ED [1]. In particular, there is increasing interest in the coronary artery calcium (CAC) score, which has been endorsed by recent ACC/AHA guidelines for further risk stratification of the intermediate-risk patient and shown to be the single best predictor of cardiovascular risk [15, 16]. However, limited studies to date have examined CAC scores in patients with ED.…”

Section: Recent Studies On the Relationship Interaction And Temporamentioning

confidence: 99%

Vascular Erectile Dysfunction and Subclinical Cardiovascular Disease

Gowani

Uddin

Mirbolouk

et al. 2017

Curr Sex Health Rep

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Purpose of review We review the recent literature on the hypothesized temporal relationship between subclinical cardiovascular disease (CVD), vascular erectile dysfunction (ED), and clinical CVD. In addition, we combine emerging research with expert consensus guidelines such as The Princeton Consensus III to provide a preventive cardiologist’s perspective toward an ideal approach to evaluating and managing CVD and ED risk in patients. Recent findings Development of ED was found to occur during the progression from subclinical CVD to clinical CVD. A strong association was observed between subclinical CVD as assessed by coronary artery calcium (CAC) and carotid plaque and subsequent ED, providing evidence for the role of subclinical CVD in predicting ED. ED is also identified as a substantial independent risk factor for overt clinical CVD, and ED symptoms may precede CVD symptoms by 2–3 years. Summary Given the body of evidence on the relationship between subclinical CVD, ED, and clinical CVD we recommend that all men with vascular ED should undergo cardiovascular risk assessment. We further recommend using CAC scores for advanced risk assessment in patients at low-intermediate to intermediate risk (5–20% CVD risk), with risk driving subsequent lifestyle and pharmacologic treatment decisions.

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Providing Evidence for Subclinical CVD in Risk Assessment

Cited by 34 publications

References 58 publications

Ideal cardiovascular health and the subclinical impairments of cardiovascular diseases: a cross-sectional study in central south China

Ideal cardiovascular health and the subclinical impairments of cardiovascular diseases: a cross-sectional study in central south China

Coronary artery calcium scoring: an evidence‐based guide for primary care physicians

Vascular Erectile Dysfunction and Subclinical Cardiovascular Disease

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