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- 발행기관 : American Heart Association, Inc. (검색결과 153 건)
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Kelly, Tanika N.,Takeuchi, Fumihiko,Tabara, Yasuharu,Edwards, Todd L.,Kim, Young Jin,Chen, Peng,Li, Huaixing,Wu, Ying,Yang, Chi-Fan,Zhang, Yonghong,Gu, Dongfeng,Katsuya, Tomohiro,Ohkubo, Takayoshi,Gao American Heart Association, Inc. 2013 Hypertension Vol.62 No.5
<P>We conducted a genome-wide association study meta-analysis of mean arterial pressure and pulse pressure among 26 600 East Asian participants (stage 1) followed by replication study of up to 28 783 participants (stage 2). For novel loci, statistical significance was determined by a <I>P</I><5.0×10<SUP>–8</SUP> in joint analysis of stage 1 and stage 2 data. For loci reported by the previous mean arterial and pulse pressure genome-wide association study meta-analysis in Europeans, evidence of transethnic replication was determined by consistency in effect direction and a Bonferroni-corrected <I>P</I><1.4×10<SUP>–3</SUP>. No novel loci were identified by the current study. Five independent mean arterial pressure variants demonstrated robust evidence for transethnic replication including rs17249754 at <I>ATP2B1</I> (<I>P</I>=7.5×10<SUP>–15</SUP>), rs2681492 at <I>ATP2B1</I> (<I>P</I>=3.4×10<SUP>–7</SUP>), rs11191593 at <I>NT5C2</I> (1.1×10<SUP>–6</SUP>), rs3824755 at <I>CYP17A1</I> (<I>P</I>=1.2×10<SUP>–6</SUP>), and rs13149993 at <I>FGF5</I> (<I>P</I>=2.4×10<SUP>–4</SUP>). Two additional variants showed suggestive evidence of transethnic replication (consistency in effect direction and <I>P</I><0.05), including rs319690 at <I>MAP4</I> (<I>P</I>=0.014) and rs1173771 at <I>NPR3</I> (<I>P</I>=0.018). For pulse pressure, robust evidence of replication was identified for 2 independent variants, including rs17249754 at <I>ATP2B1</I> (<I>P</I>=1.2×10<SUP>–5</SUP>) and rs11191593 at <I>NT5C2</I> (<I>P</I>=1.1×10<SUP>–3</SUP>), with suggestive evidence of replication among an additional 2 variants including rs3824755 at <I>CYP17A1</I> (<I>P</I>=6.1×10<SUP>–3</SUP>) and rs2681492 at <I>ATP2B1</I> (<I>P</I>=9.0×10<SUP>–3</SUP>). Replicated variants demonstrated consistency in effect sizes between East Asian and European samples, with effect size differences ranging from 0.03 to 0.24 mm Hg for mean arterial pressure and from 0.03 to 0.21 mm Hg for pulse pressure. In conclusion, we present the first evidence of transethnic replication of several mean arterial and pulse pressure loci in an East Asian population.</P>
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Huxley, Rachel R,Barzi, Federica,Lam, Tai Hing,Czernichow, Sebastien,Fang, Xianghua,Welborn, Tim,Shaw, Jonathan,Ueshima, Hirotsugu,Zimmet, Paul,Jee, Sun Ha,Patel, Jeetesh V,Caterson, Ian,Perkovic, Vla American Heart Association, etc.] 2011 CIRCULATION - Vol.124 No.19
<P>Previous studies have suggested that there is a novel dyslipidemic profile consisting of isolated low high-density lipoprotein cholesterol (HDL-C) level that is associated with increased risk of coronary heart disease, and that this trait may be especially prevalent in Asian populations.</P>
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Kim, Soyeun,Shin, Dong Wook,Yun, Jae Moon,Hwang, Yunji,Park, Sue K.,Ko, Young-Jin,Cho, BeLong American Heart Association, Inc. 2016 Hypertension Vol.67 No.3
<P>The importance of adherence to antihypertensive treatments for the prevention of cardiovascular disease has not been well elucidated. This study evaluated the effect of antihypertensive medication adherence on specific cardiovascular disease mortality (ischemic heart disease [IHD], cerebral hemorrhage, and cerebral infarction). Our study used data from a 3% sample cohort that was randomly extracted from enrollees of Korean National Health Insurance. Study subjects were aged 20 years, were diagnosed with hypertension, and started newly prescribed antihypertensive medication in 2003 to 2004. Adherence to antihypertensive medication was estimated as the cumulative medication adherence. Subjects were divided into good (cumulative medication adherence, 80%), intermediate (cumulative medication adherence, 50%-80%), and poor (cumulative medication adherence, <50%) adherence groups. We used time-dependent Cox proportional hazards models to evaluate the association between medication adherence and health outcomes. Among 33728 eligible subjects, 670 (1.99%) died of coronary heart disease or stroke during follow-up. Patients with poor medication adherence had worse mortality from IHD (hazard ratio, 1.64; 95% confidence interval, 1.16-2.31; P for trend=0.005), cerebral hemorrhage (hazard ratio, 2.19; 95% confidence interval, 1.28-3.77; P for trend=0.004), and cerebral infarction (hazard ratio, 1.92; 95% confidence interval, 1.25-2.96; P for trend=0.003) than those with good adherence. The estimated hazard ratios of hospitalization for cardiovascular disease were consistent with the mortality end point. Poor medication adherence was associated with higher mortality and a greater risk of hospitalization for specific cardiovascular diseases, emphasizing the importance of a monitoring system and strategies to improve medication adherence in clinical practice.</P>
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Moon, Jae Hoon,Lim, Soo,Han, Ji Won,Kim, Kyoung Min,Choi, Sung Hee,Park, Kyong Soo,Kim, Ki Woong,Jang, Hak Chul American Heart Association, Inc. 2015 Stroke Vol.46 No.4
<P><B>Background and Purpose—</B></P><P>We investigated the association between cardiovascular risk factors, including carotid intima-media thickness (CIMT), and future risk of mild cognitive impairment (MCI) and dementia in elderly subjects.</P><P><B>Methods—</B></P><P>We conducted a population-based prospective study as a part of the Korean Longitudinal Study on Health and Aging. Our study included 348 participants who were nondemented at the baseline (mean age, 71.7±6.3 years) and underwent cognitive evaluation at the 5-year follow-up. Baseline cardiovascular risk factors were compared according to the development of MCI or dementia during the study period.</P><P><B>Results—</B></P><P>At the baseline evaluation, 278 subjects were cognitively normal and 70 subjects had MCI. Diagnoses of cognitive function either remained unchanged or improved during the study period in 292 subjects (nonprogression group), whereas 56 subjects showed progression of cognitive impairment to MCI or dementia (progression group). The progression group exhibited a higher prevalence of hypertension and greater CIMT compared with the nonprogression group. Other baseline cardiovascular risk factors, including sex, body mass index, diabetes mellitus, insulin resistance, total cholesterol, waist-to-hip ratio, visceral fat, pulse wave velocity, and ankle-brachial index, were not significantly different between 2 groups. The association between greater baseline CIMT and the progression of cognitive impairment was maintained after adjustment for conventional baseline risk factors of cognitive impairment. Greater baseline CIMT was also independently associated with the development of MCI in the subjects whose baseline cognitive function was normal.</P><P><B>Conclusions—</B></P><P>Greater baseline CIMT was independently associated with the risk of cognitive impairment, such as MCI and dementia in elderly subjects.</P>
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Hinkle, Janice L.,Becker, Kyra J.,Kim, Jong S.,Choi-Kwon, Smi,Saban, Karen L.,McNair, Norma,Mead, Gillian E. American Heart Association, Inc. 2017 Stroke Vol.48 No.7
<P>At least half of all stroke survivors experience fatigue; thus, it is a common cause of concern for patients, caregivers, and clinicians after stroke. This scientific statement provides an international perspective on the emerging evidence surrounding the incidence, prevalence, quality of life, and complex pathogenesis of poststroke fatigue. Evidence for pharmacological and nonpharmacological interventions for management are reviewed, as well as the effects of poststroke fatigue on both stroke survivors and caregivers.</P>
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Chung, Jong-Won,Hwang, Jaechun,Lee, Mi Ji,Cha, Jihoon,Bang, Oh Young American Heart Association, Inc. 2016 Stroke Vol.47 No.7
<P>Background and Purpose-Although statin use has been linked to the stabilization of systemic atherosclerosis, its effect on symptomatic intracranial atherosclerotic plaques has yet to be explored. We hypothesized that premorbid statin use is associated with plaque instability in intracranial arteries and may lead to differential patterns (size and distribution) of ischemic lesions in patients with acute intracranial atherosclerotic stroke. Methods-One hundred and thirty-six patients with acute infarcts caused by intracranial atherosclerotic stroke underwent high-resolution magnetic resonance imaging. Patients were categorized into 3 groups based on their premorbid statin use: nonuser, low-dose user, and high-dose user, according to the 2013 American College of Cardiology/American Heart Association guidelines on blood cholesterol. Symptomatic lesions in intracranial arteries were analyzed using high-resolution magnetic resonance imaging for vascular morphology (degree of stenosis, remodeling index, and wall index) and plaque activation (pattern and volume of enhancement). The cortical distribution and volume of ischemic brain lesions were measured using diffusion-weighted imaging. Results-Among the enrolled patients, 38 (27.94%) were taking statins before the index stroke (22 low-dose statins and 16 high-dose statins). The degree of stenosis, remodeling index, and wall index did not differ between the 3 groups. However, the volume of plaque enhancement was significantly lower in statin users (nonuser, 33.26 +/- 40.72; low-dose user, 13.15 +/- 17.53; high-dose user, 3.13 +/- 5.26; P=0.002). Premorbid statin use was associated with a higher prevalence of nonembolic stroke and a decrease in large cortical infarcts (P=0.012). Conclusions-Premorbid statin usage is independently associated with reduced plaque enhancement and a decrease in large cortical lesions in patients with intracranial atherosclerotic stroke.</P>
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Bae, Jang-Ho,Kim, Wuon-Shik,Rihal, Charanjit S.,Lerman, Amir American Heart Association 2006 Arteriosclerosis, thrombosis, and vascular biology Vol.26 No.10
<P>OBJECTIVE: We assessed the clinical significance of intima (IT), media (MT), and intima-media (IMT) thickness of the common carotid artery using B-mode ultrasonographic image processing. METHODS AND RESULTS: One hundred seventy consecutive patients underwent common carotid artery scanning using high-resolution ultrasonography. A total of 150 patients could be analyzed off-line using ultrasonographic image processing, devised for individual measurement of IT, MT, and IMT. By univariate analysis, IT (range, 0.27 to 0.41 mm) was associated with age, whereas MT (range, 0.27 to 0.74 mm) and IMT (range, 0.49 to 1.12 mm) were associated with age, fibrinogen, and creatinine. Among atherosclerosis risk factors, hypertension was associated with thickness of all 3 layers, whereas smoking was associated with IT only. By multivariate analysis, IT was associated with age, hypertension, and smoking, whereas MT and IMT were associated with age, hypertension, and blood urea nitrogen level. CONCLUSIONS: Carotid IT is associated with smoking, whereas age and hypertension are associated with thickness of all 3 arterial layers. Our results suggest a differential response of the vasculature to systemic risk factors.</P>
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Low Systolic Blood Pressure and Vascular Mortality Among More Than 1 Million Korean Adults
Yi, Sang-Wook,Mok, Yejin,Ohrr, Heechoul,Yi, Jee-Jeon,Yun, Young Duk,Park, Jihwan,Jee, Sun Ha American Heart Association 2016 Circulation Vol.133 No.24
<P>Background-The association between low systolic blood pressure (SBP) and vascular disease is unclear, especially in nonclinical populations. Methods and Results-We studied 1 235 246 individuals who participated in routine medical examinations between 1992 and 1995. The hazard ratios (HRs) were adjusted for potential confounders. During 22.7 million person-years of follow-up, 34 816 individuals died of atherosclerotic vascular diseases. An increase in SBP was directly related to an increase in vascular mortality at SBP above approximate to 100 mmHg. The group with the lowest SBP (<90 mm Hg) had a higher HR for mortality from atherosclerotic vascular disease (HR, 1.53; 95% confidence interval, 1.15-2.03) in comparison with those with an SBP of 90 to 99 mm Hg. The HR associated with the lowest SBP was 2.54 (95% confidence interval, 1.51-4.29) for ischemic heart disease and 1.21 (95% confidence interval, 0.79-1.85) for stroke. Regarding stroke subtype, mortality from hemorrhagic stroke (HR per 10 mm Hg increase, 0.53; 95% confidence interval, 0.29-0.96), rather than mortality from ischemic stroke (HR per 10 mm Hg increase, 1.00; 95% confidence interval, 0.51-1.97), was inversely associated with SBP when SBP fell to <100 mm Hg. Even when excluding the first 5 years of follow-up, the HRs associated with the lowest SBP did not decrease. The inverse association between SBP and vascular mortality in the range <100 mm Hg tended to be apparent in people aged 60 to 95 years in comparison with individuals aged 30 to 59 years. Conclusions-J-curve associations exist between SBP and vascular mortality, which reach a nadir at approximate to 100 mm Hg. SBP of <90 mm Hg may portend death from vascular disease, particularly from ischemic heart disease.</P>
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Risk Factors Associated With the Presence of Unruptured Intracranial Aneurysms
Kang, Hyun Goo,Kim, Bum Joon,Lee, Jisung,Kim, Mi-Jung,Kang, Dong-Wha,Kim, Jong S.,Kwon, Sun U. American Heart Association, Inc. 2015 Stroke Vol.46 No.11
<P><B>Background and Purpose—</B></P><P>With the increased investigation of cerebral arteries using magnetic resonance angiography in the general population, the detection of unruptured intracranial aneurysms (UIAs) has increased. Understanding the distribution and factors associated with UIAs might be helpful for understanding the pathomechanism.</P><P><B>Methods—</B></P><P>Subjects who underwent magnetic resonance angiography with a health examination at the Health Screening and Promotion Center were enrolled. The incidence and risk factors of UIAs (age, sex, hypertension, diabetes mellitus, smoking, alcohol, and coronary artery disease) were investigated by comparing patients with and without UIAs. These risk factors were also investigated by the UIA location, distal internal carotid artery, anterior cerebral artery and middle cerebral artery (MCA), MCA bifurcation, anterior and posterior communicating artery, and posterior circulation.</P><P><B>Results—</B></P><P>Among 187 166 subjects who received health examination, 18 954 underwent magnetic resonance angiography. Of them, 367 (1.93%) had UIAs. Age (odds ratio [OR], 1.02; <I>P</I>=0.003), women (OR, 2.00; <I>P</I><0.001), hypertension (OR, 2.21; <I>P</I><0.001), smoking (OR, 1.66; <I>P</I>=0.001), and coronary artery disease (OR, 0.23; <I>P</I><0.001) were independently associated with the presence of UIAs. Hypertension was associated with most UIAs, except for those located at sidewalls (anterior cerebral artery and MCA). MCA aneurysms were associated with old age and smoking. Distal internal carotid artery, posterior communicating artery, and MCA-bifurcation aneurysms were associated with female sex. Anterior communicating artery aneurysms were associated with smoking and alcohol. Posterior circulation UIAs were only associated with hypertension. Coronary artery disease was negatively associated with anterior circulation aneurysms.</P><P><B>Conclusions—</B></P><P>The risk factors for UIAs differ by their location, compared with the control. Interestingly, the presence of coronary artery disease was protective against the presence of UIAs.</P>
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