P W F Wilson

..Prediction models for cardiovascular events and cardiovascular death in patients with established cardiovascular disease are not generally available...

..Performance criteria for risk estimation include discrimination, calibration, and reclassification, and newer heart disease risk factors and biomarkers can be evaluated in the context of existing risk estimation approaches...

..To review published data on vascular disease- and diabetes-related outcomes related to adiposity and metabolic risk factors...

..Previous reports have focused on traditional cardiovascular risk factors; less information has been available on the role of overweight and obesity...

..Strategies such as these might enhance screening and prevention programs but require validation. Testing the usefulness of low-cost prediction models in developing regions is the next logical step in carrying this concept forward...

....

..The relationship of circulating levels of high-sensitivity C-reactive protein (CRP) with cardiovascular disease (CVD) risk, particularly with consideration of effects at intermediate levels of risk, has not been fully assessed...

....

..Prediction rules for type 2 diabetes mellitus (T2DM) have been developed, but we lack consensus for the most effective approach...

..However, most of these studies have been conducted in high-income countries (HICs) and lack representation from low- and middle-income countries (LMICs), which bear >80% of the global burden of cardiovascular disease...

....

..We investigated whether there were differences in diabetes care in the Veterans Administration (VA), where health care access should be relatively uniform...

..We investigated the association of serum resistin concentrations with risk for incident heart failure (HF) in humans...

..We compared analytical approaches to estimate the added value of myocardial perfusion single-photon emission computed tomography (MPS) variables in estimating coronary artery disease (CAD) outcomes...

..Studies on the incidence and predictors of heart failure (HF) are often restricted to elderly persons or identify only inpatient cases...

..The race- and sex-specific epidemiology of incident heart failure (HF) among a contemporary elderly cohort are not well described...

..The recently developed and internally validated Health ABC HF model uses 9 routinely available clinical variables to determine incident heart failure risk. In this study, we sought to externally validate the Health ABC HF model...

....

..It is unclear whether measures of glycemic status beyond fasting glucose (FG) levels improve incident heart failure (HF) prediction in patients without history of diabetes mellitus (DM)...

..66), suggesting an equivalent ability to risk stratify by gender. In conclusion, this meta- and pooled analysis revealed that CAC screening is equally accurate in stratifying risk in women and men...

..The prevalences of both hypertension and vitamin D insufficiency are high in the United States. Recent clinical trials and animal studies have suggested that vitamin D insufficiency may be associated with elevated blood pressure...

..We examined whether this differential CHD risk might, in part, be attributable to the sizes of lipoprotein particles or concentrations of lipoprotein subclasses...

....

....

..Finally, study designs for obesity therapy, including populations, control arms, sample size, and duration of therapy, are discussed...

..Serum C-reactive protein (CRP) level is a heritable complex trait that predicts incident cardiovascular disease. We investigated the clinical and genetic sources of interindividual variability in serum CRP...

..Metabolic risk conferred by adiposity may be due to associated risk factor clustering...

..Elevated PAI-1 levels may be associated with an increased risk for diabetes as a marker for underlying endothelial dysfunction rather than by a direct effect of genetically mediated elevated levels...

..CONCLUSIONS: Improved insulin sensitivity may be one mechanism by which higher dietary magnesium intake may reduce the risk of developing type 2 DM...

..Metabolic syndrome increases the risk for type 2 diabetes and cardiovascular disease (CVD) and may be associated with insulin resistance...

..We hypothesized that duration of diabetes is an important predictor of incident CHD among people with diabetes...

..69, p = 0.01). In conclusion, the Personal HEART score identifies 10-year risk for CHD based on self-report data, is similar in predictive ability to the FRS and European SCORE, and has the potential for easy self-assessment...

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

..91 (95% CI=0.77, 1.05), respectively. The results suggest that obesity is an independent risk factor in White people, and additional study of body size and disease progression is necessary in the assessment of racial disparities...

..It is uncertain to what extent high C-reactive protein (CRP) concentrations reflect the presence of inflammatory conditions in the community...

..We assessed the lifetime risk of cardiovascular disease (CVD) among individuals with and without obesity and diabetes...

..0 and 34.9 kg/m(2). We investigated the relative contributions of BMI and WC toward identifying risk of adverse vascular events in a community-based sample...

..09-1.77). We conclude that in this community-based sample, plasma markers of endothelial dysfunction increased risk of incident diabetes independent of other diabetes risk factors including obesity, insulin resistance, and inflammation...

..Assessment of global risk is particularly important in lipid management, as the LDL-C target goals are determined by risk category...

..Toward this end, we believe experts in the fields of epidemiology, prevention, vascular biology, and clinical cardiology should be convened to begin discussing the merits of this proposal...

..Prior studies were limited by small sample sizes and selection bias and none compared the diagnostic performance of these peptides in men and women...

..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...

..CONCLUSIONS: Obese individuals have low circulating natriuretic peptide levels, which may contribute to their susceptibility to hypertension and hypertension-related disorders...

..Thus, it has been difficult to evaluate the relative contribution of each cardiovascular risk factor to systemic oxidative stress and to determine whether such risk factors act independently and are applicable to the general population...

..It is unclear whether cytokine levels can predict the incidence of CHF in asymptomatic individuals...

..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...

..Given that both a high cereal fiber content and lower glycemic index are attributes of whole-grain foods, recommendation to increase whole-grain intake may reduce the risk of developing the metabolic syndrome...

..S. By any criteria, subjects with the metabolic syndrome are more insulin resistant and at increased predicted risk for CHD versus those without the metabolic syndrome...

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

..CONCLUSION: Increased intakes of whole grains may reduce disease risk by means of favorable effects on metabolic risk factors...

..Determination of C-reactive protein (CRP) level has been suggested to improve cardiovascular disease (CVD) risk assessment. This study examines the utility of CRP levels to assess CVD risk in a community setting...

..The objective was to investigate risk for CVD, CHD, and T2DM according to metabolic syndrome traits...

....

....

..These data support the hypothesis that the INS VNTR is a genetic risk factor for type 2 diabetes, with the TT genotype accounting for about 6.6% of cases in the FHS population...

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

..Inflammation (assessed by C-reactive protein [CRP]) and the metabolic syndrome (MetS) are associated with cardiovascular disease (CVD), but population-based data are limited...

..We hypothesized that diabetic patients would have higher remnant levels than nondiabetic patients...

..We sought to determine the clinical factors and heritability associated with inflammation measured as circulating levels of soluble-intercellular adhesion molecule-1 (sICAM-1) in a community-based cohort...

..Adipose tissue-derived adipokines may contribute to insulin resistance...

..97; 95% confidence interval, 0.90-1.05). CONCLUSION: In this large, population-based cohort, baseline and long-term average serum total cholesterol levels were not associated with the risk for incident AD...

....

..1) or death (hazards ratio, 1.4; 95% confidence interval, 0.9-2.1) was observed. CONCLUSIONS: A low ABI is associated with risk of stroke or transient ischemic attack in the elderly. These results need to be confirmed in larger studies...

..Estimation of risk for cardiovascular events is a dynamic field, and current approaches will likely be modified as newer information is obtained...

..Whereas increased small LDL particle number identified the MetSyn with high sensitivity, a higher small LDL particle number was not associated with greater CVD event rates in people with the MetSyn...

..Evidence is conflicting regarding the performance of apolipoproteins vs traditional lipids for predicting coronary heart disease (CHD) risk...

..The association between increased body mass index and waist-to-hip ratio and prothrombotic factors and impaired fibrinolysis suggests that obesity is a risk factor whose effect is mediated in part by a prothrombotic state...

..Family history is used to infer the risk for heart disease; however, little is known about the accuracy of family history reports...

..Additional investigations are warranted to confirm these findings...

..CONCLUSIONS: Elevated serum concentrations of aCLs, independently of other cardiovascular risk factors, significantly predict the risk of future ischemic stroke and TIA in women but not in men...

..Obesity, insulin resistance, and apolipoprotein E (APOE) genotype have all been associated with coronary heart disease. We examined the interaction between obesity and APOE genotype in determining fasting insulin and glucose levels...

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