W B Kannel

..Global risk assessment can identify high-risk overweight candidates for CHD who most urgently need correction of associated risk factors, as well as sustained weight reduction...

..They require weight control and exercise, as well as specific choices of antihypertensive agents...

..To compare implications of Angina Pectoris (AP) and Intermittent Claudication (IC) as indicators of clinical atherosclerosis in other vascular territories...

..In conclusion, these data suggest that a more rigorous focus on these conventional risk factors and the lifestyle behaviors that promote them has great potential to reduce the burden of coronary artery disease worldwide...

..Multivariable risk stratification is now recognized as essential in efficiently identifying likely candidates for CVD and quantifying the hazard...

..Patients with this condition of isolated systolic hypertension have been shown to benefit from antihypertensive treatment...

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..In conclusion, our observations suggested that the TG/HDL cholesterol ratio was an imperfect surrogate for IR and its associated CHD risk, and it was only slightly better than the total/HDL cholesterol ratio for this purpose...

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..Novel protease inhibitors, which have minimal effects on lipid profiles, may have a role in the long-term management of the human immunodeficiency virus...

..The chief hazard of AF is embolic stroke, which is increased four- to fivefold, and in advanced age, it becomes a dominant stroke risk factor. AF also carries a doubled mortality rate...

..The chief hazard of AF is embolic stroke, which is increased four- to fivefold, assuming great importance in advanced age when it becomes a dominant factor. AF is associated with about a doubling of mortality...

..More attention needs to be afforded the absolute risk reduction attainable and must recognize that the number needed to treat to prevent one event increases the lower the lipid value, the lower global risk and the healthier the subject...

..It may be concluded that fibrinogen and CRP determination may be useful screening tools to identify individuals at added risk for thrombotic complications of CVD...

..Atrial fibrillation (AF) causes substantial morbidity. It is uncertain whether AF is associated with excess mortality independent of associated cardiac conditions and risk factors...

..Long-term blood pressure (BP) progression and its importance as a predictor of clinical outcome have not been well characterized across different periods...

..Information is limited regarding the absolute and relative risk of cardiovascular disease in persons with high-normal blood pressure (systolic pressure of 130 to 139 mm Hg, diastolic pressure of 85 to 89 mm Hg, or both)...

..It is important to appreciate that the average remaining life expectancy after achieving 80 years is about 8 years...

..We aimed to establish the best frequency of BP screening by assessing the rates and determinants of progression to hypertension...

..The degree of clustering for common metabolic coronary disease risk factors is not well known, the antecedents of clustering are not well studied, and the impact of such clusters on coronary risk has not been assessed systematically...

..Congestive heart failure (CHF) is an increasing public health problem...

..The impact of atrial fibrillation (AF) on mortality, stroke, and medical costs is unknown...

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..Additional studies addressing the pathogenesis, prevention, and optimal management of the joint occurrence of AF and CHF appear warranted...

..CONCLUSIONS: Antecedent BP contributes to the future risk of ischemic stroke. Optimal prevention of late-life stroke will likely require control of midlife BP...

..Clinical trials indicate that a sizable proportion of adults have multiple borderline coronary risk factors and may benefit from treatment...

..The causes and characteristics of cognitive decline after stroke are poorly defined, because most studies have relied on the diagnosis of dementia after stroke, without measurement of prestroke cognitive function...

..We tested the hypothesis that leptin levels are associated with greater risk of CHF, CVD, and mortality in elderly individuals...

..Risk stratification may facilitate cost-effective approaches to management...

..Hypertensive patients are more appropriately targeted for therapy by such risk stratification and the goal of the therapy should be to improve the multivariate risk profile...

..CONCLUSIONS: Metabolic syndrome is more prevalent than diabetes and a significant independent risk factor for stroke in people without diabetes. Prevention and control of MetS and its components are likely to reduce stroke incidence...

..The predominant component of uncontrolled hypertension resides in systolic blood pressure...

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..To our knowledge, no single investigation concerning the long-term effects of overweight status on the risk for hypertension, hypercholesterolemia, diabetes mellitus, and cardiovascular sequelae has been reported...

..02) and diastolic pressure 4 years later (P=0.04). In summary, serum UA level was an independent predictor of hypertension incidence and longitudinal BP progression at short-term follow-up in our community-based sample...

..Given the high prevalence of obesity in the United States, strategies to promote optimal body weight may reduce the population burden of heart failure...

..The present report presents a single multivariable risk function that predicts risk of developing all CVD and of its constituents...

..The long-term risk for developing hypertension is best described by the lifetime risk statistic. The lifetime risk for hypertension and trends in this risk over time are unknown...

..The goal of therapy should be to improve the multivariate risk profile as well as the level of the blood pressure...

..In such patients, ISH should be considered controlled when their global CVD risk is reduced to below the average for their age...

..CONCLUSION: These risk scores can be used to estimate the absolute risk of an adverse event in individuals with AF, which may be helpful in counseling patients and making treatment decisions...

..There is a need for particular attention to glucose intolerance, abdominal obesity, and blood lipids, and a need for a great sense of urgency when hypertension is associated with diabetes or promotes left ventricular hypertrophy...

..The results of this study suggest that improved control of risk factors has lowered stroke incidence but emphasize the need for continued primary prevention efforts...

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..Recent cross-sectional studies have suggested that higher serum sodium levels may be a marker of elevated blood pressure. It is unclear whether serum sodium levels are related to the risk of developing hypertension in the community...

..The lifetime risk (LTR) of stroke has not been reported for the United States population; such data would assist public education and health planning...

..IC incidence has declined since 1950, but mortality has remained high and unchanged. Factors contributing to the declining incidence of IC need clarification...

..Trial data indicate that preventive measures benefit obese diabetics even more than nondiabetics...

..Although declines in coronary heart disease (CHD) mortality have been noted, there is still uncertainty about the magnitude of the decline and whether the trend is similar for sudden cardiac death (SCD)...

..We aimed to develop a risk score to predict individuals' absolute risk of developing the condition, and to provide a framework for researchers to assess new risk markers...

..AAC appears to be useful for risk stratification in patients at intermediate CHD risk...

..Finally, the use of this unique sample to study genotype and environment interactions is described...

..We related plasma renin to incidence of CVD and mortality in 3408 individuals (mean age 59; 53% women) and in a hypertensive subset (n = 1413)...

..Trials of risk factor modification in the elderly indicate that decades of exposure to modifiable risk factors can be countered by measures implemented late in life...

..In our community-based sample, longer electrocardiographic QRS was associated with increased CHF risk, consistent with the hypothesis that depolarization delay may increase CHF risk...

..The relations of lipid concentrations to heart failure (HF) risk have not been elucidated comprehensively...

..Out-of-hospital coronary heart disease deaths overestimated sudden cardiac death by 47%, suggesting that out-of-hospital coronary heart disease death rates derived from death certificates should be interpreted with caution...

..Color-coded charts were prepared that show the exact probability of CHD corresponding to each combination of risk factors, shown in separate cells on the chart...

..In women, the ratio is also a good CHD predictor, but a combination of a high ratio accompanied by high LDL cholesterol may warrant more aggressive therapy...

..Recalibration of Framingham functions could permit various regions of the world to adapt Framingham tools to local populations...

..Increased pulse pressure, a reflection of aortic stiffness, increases cardiac load and may increase AF risk...

..Higher blood pressure and BMI in midlife are harbingers of increased risk of heart failure in later life. Early risk factor modification may decrease heart failure burden...

..To determine whether multivariable risk factor assessment can be as successful in developing disease prevention strategies in patients with ocular hypertension as it has been in patients at risk for coronary heart disease (CHD)...

..A combined effort of health-influencing and health-governing bodies is needed on all levels to address the CVD problem in the Latino/Hispanic population...

..To determine the scope, impact, and health care limitations relative to cardiovascular disease (CVD) in the Latino-Hispanic population...