Browsing by Subject "cardiovascular risk"

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  • Mikkola, Ilona; Hagnäs, Maria; Hartsenko, Jelena; Kaila, Minna; Winell, Klas (2020)
    Aims To investigate whether the use of a personalized care plan is associated with clinical outcomes of type 2 diabetes (T2D) treatment in real-world. Methods Quality of treatment was assessed using data from a yearly sample of patients with T2D visiting primary care health centres in 2012–2016. Patients were divided into three groups: 1) patient has a copy of their personalized care plan, 2) care plan exists in the patient record only or 3) patient has no care plan. Data on smoking, laboratory tests, systolic blood pressure (sBP) and statin use were collected. We compared the outcomes between the three groups in terms of proportions of patients achieving the clinical targets recommended by international guidelines. Results Evaluable data were available for 10,403 patients. Of these, 1,711 (16%) had a copy of their personalized care plan, and 3,623 (35%) had no care plan. Those who had a copy of their care plan were significantly more likely than those without to achieve the sBP target (odds ratio [OR] 1.39, 95% confidence interval [CI] 1.29–1.51, p
  • Hakala, JO; Pahkala, K; Juonala, M; Salo, P; Kahonen, M; Hutri-Kahonen, N; Lehtimaki, T; Laitinen, TP; Jokinen, E; Taittonen, L; Tossavainen, P; Viikari, JSA; Raitakari, OT; Rovio, SP (2021)
    Background: Cardiovascular risk factors, such as high blood pressure, adverse serum lipids, and elevated body mass index in midlife, may harm cognitive performance. It is important to note that longitudinal accumulation of cardiovascular risk factors since childhood may be associated with cognitive performance already since childhood, but the previous evidence is scarce. We studied the associations of cardiovascular risk factors from childhood to midlife, their accumulation, and midlife cognitive performance. Methods: From 1980, a population-based cohort of 3596 children (3-18 years of age) have been repeatedly followed up for 31 years. Blood pressure, serum lipids, and body mass index were assessed in all follow-ups. Cardiovascular risk factor trajectories from childhood to midlife were identified using latent class growth mixture modeling. Cognitive testing was performed in 2026 participants 34 to 49 years of age using a computerized test. The associations of the cardiovascular risk factor trajectories and cognitive performance were studied for individual cardiovascular risk factors and cardiovascular risk factor accumulation. Results: Consistently high systolic blood pressure (beta=-0.262 SD [95% CI, -0.520 to -0.005]) and serum total cholesterol (beta=-0.214 SD [95% CI, -0.365 to -0.064]) were associated with worse midlife episodic memory and associative learning compared with consistently low values. Obesity since childhood was associated with worse visual processing and sustained attention (beta=-0.407 SD [95% CI, -0.708 to -0.105]) compared with normal weight. An inverse association was observed for the cardiovascular risk factor accumulation with episodic memory and associative learning (P for trend=0.008; 3 cardiovascular risk factors: beta=-0.390 SD [95% CI, -0.691 to -0.088]), with visual processing and sustained attention (P for trend Conclusions: Longitudinal elevated systolic blood pressure, high serum total cholesterol, and obesity from childhood to midlife were inversely associated with midlife cognitive performance. It is important to note that the higher the number of cardiovascular risk factors, the worse was the observed cognitive performance. Therefore, launching preventive strategies against cardiovascular risk factors beginning from childhood might benefit primordial promotion of cognitive health in adulthood.
  • Iso-Markku, Paula; Kaprio, Jaakko; Lindgren, Noora; Rinne, Juha O.; Vuoksimaa, Eero (2022)
    Background higher educational attainment and less midlife cardiovascular risk factors are related to better old-age cognition. Whether education moderates the association between cardiovascular risk factors and late-life cognition is not known. We studied if higher education provides resilience against the deteriorative effects of higher middle-age body mass index (BMI) and a combination of midlife cardiovascular risk factors on old-age cognition. Methods the study population is the older Finnish Twin Cohort (n = 4,051, mean age [standard deviation, SD] = 45.5 years [6.5]). Cardiovascular risk factors and education were studied at baseline with questionnaires in 1975, 1981 and/or 1990 (participation rates of 89, 84 and 77%, respectively). Cognition was evaluated with telephone interviews (participation rate 67%, mean age [SD] =73.4 [2.9] years, mean follow-up [SD] = 27.8 [6.0] years) in 1999-2017. We studied the main and interactive effects of education and BMI/dementia risk score on late-life cognition with linear regression analysis. The study design was formulated before the pre-defined analyses. Results years of education moderated the association between BMI with old-age cognition (among less educated persons, BMI-cognition association was stronger [B = -0.24 points per BMI unit, 95% CI -0.31, -0.18] than among more educated persons [B = -0.06 points per BMI unit, 95% CI -0.16, 0.03], P-interaction < 0.01). There was a similar moderating effect of education on dementia risk score consisting of cardiovascular risk factors (P < 0.001). Conclusions our results support the cognitive reserve hypothesis. Those with higher education may tolerate the deteriorative effects of midlife cardiovascular risk factors on old-age cognition better than those with lower education.
  • Svedenkrans, Jenny; Ekblom, Örjan; Domellöf, Magnus; Fellman, Vineta; Norman, Mikael; Bohlin, Kajsa (2020)
    Physical activity (PA) can prevent cardiovascular diseases. Because of increased risks of impairments affecting motor activity, PA in children born preterm may differ from that in children born at term. In this prospective cohort study, we compared objectively measured PA in 71 children born extremely preterm (
  • Kraus, W.E.; Yates, T.; Tuomilehto, J.; Sun, J.-L.; Thomas, L.; Mcmurray, J.J.V.; Bethel, M.A.; Holman, R.R. (2018)
    Objective: Physical activity is related to clinical outcomes, even after adjusting for body mass, but is rarely assessed in randomized clinical trials. Research design and methods: We conducted an observational analysis of data from the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research trial, in which a total of 9306 people from 40 countries with impaired glucose tolerance and either cardiovascular disease or cardiovascular risk factors were randomized to receive nateglinide or placebo, in a 2-by-2 factorial design with valsartan or placebo. All were asked to also participate in a detailed lifestyle modification programme and followed-up for a median of 6.4 years with progression to diabetes as a co-primary end point. Seven-day ambulatory activity was assessed at baseline using research-grade pedometers. We assessed whether the baseline amount of physical activity was related to subsequent development of diabetes in individuals with impaired glucose tolerance. Results: Pedometer data were obtained on 7118 participants and 35.0% developed diabetes. In an unadjusted analysis each 2000-step increment in the average number of daily steps, up to 10 000, was associated with a 5.5% lower risk of progression to diabetes (HR 0.95, 95%CI 0.92 to 0.97), with >6% relative risk reduction after adjustment. Conclusions: Physical activity should be measured objectively in pharmacologic trials as it is a significant but underappreciated contributor to diabetes outcomes. It should be a regular part of clinical practice as well. © 2018 Author(s) (or their employer(s).
  • Ek, Viktoria (Helsingin yliopisto, 2018)
    Background: The metabolic syndrome predisposes for cardiovascular disease and is characterized by abdominal obesity, dyslipidemia, insulin resistance, hypertension and prothrombotic and proinflammatory states. All obese people do not, however, develop metabolic syndrome. Subcutaneous adipose tissue (SAT) hypertrophy have been linked to metabolic complications in obesity. The aim in this study was to asses if high dietary fructose consumption has an impact on SAT adipocyte size and whether adipocyte size is a metabolic determinant in obese males with metabolic syndrome. Methods: To evaluate the effects of fructose, 34 obese male subjects consumed fructose-sweetened beverages containing 75 g fructose/day for 12 weeks. Subcutaneous abdominal adipose tissue was obtained with needle aspiration technique and adipocyte sizes were measured under a light microscope. Changes in liver fat and cardiometabolic risk parameters were also analyzed. Results: Added dietary fructose intake for 12 weeks did not affect the SAT adipocyte size in subjects with obesity (P=0,417). Subjects showed increased levels of triglycerides (P=0,034) and increased liver fat content (P=0,011) after fructose intervention. Subgroups of subjects with large and small adipocytes (under or over the median value) responded differently to fructose consumption in respect of liver fat gain. Conclusion: SAT adipocyte size was not a major determinant of metabolic health in obese men with features of the metabolic syndrome. Added dietary fructose 75 g per day for 12 weeks did not result in changes in adipocyte size but subgroup of subjects showing decrease in adipocyte size during fructose intervention gained in liver fat. The inability of the SAT adipocytes to expand may play a role in development of the metabolic syndrome in these subjects.