Vascular Health and Risk Management最新文献

{"title":"Post-Stroke Aspiration Pneumonia in Riyadh, Saudi Arabia: A Retrospective Cohort Study.","authors":"Naser Alotaibi, Mohammed A Aldriweesh, Latifah Aldohayan, Malak Almutairi, Shadin Mansour Aldhalaan, Badr Hamed Bin Khashman, Jerayed Khalid AlJerayed, Zaid Fahad Alsaaran, Nouran Y Taher, Ali Alaklabi, Salih A Bin Salih","doi":"10.2147/VHRM.S600102","DOIUrl":"10.2147/VHRM.S600102","url":null,"abstract":"<p><strong>Purpose: </strong>Stroke is a leading cause of morbidity among patients with neurological disorders. Post-stroke aspiration pneumonia (AP) represents a serious complication associated with high mortality. This study investigated the incidence and outcomes of AP at a tertiary care center.</p><p><strong>Patients and methods: </strong>Retrospectively, among 5921 adult patients admitted with ischemic or hemorrhagic stroke between February 2016 and January 2024, 118 who developed post-stroke aspiration pneumonia within the same admission or at a 90-day period were identified and analyzed. Univariate and multivariate analyses were done.</p><p><strong>Results: </strong>Among 5921 stroke patients, 118 developed post-stroke AP. The mean age was 69.5 ± 12.5 years, and 71 (60.2%) were male. Hypertension (72.9%) and diabetes mellitus (63.6%) were the most prevalent comorbidities. Ischemic stroke accounted for 79.7%, and the median NIHSS was 9 (IQR 4-15). The median pre-morbid mRS was 2 (IQR 0-5). Dysphagia was diagnosed in 54.2%, and a swallowing assessment was performed and documented in 73.5%. Common presenting features included fever (55.9%), altered consciousness (47.5%), and cough (43.2%). Median time from stroke to AP was 6 days (IQR 2-22). ICU admission was required in 46.6%, mechanical ventilation in 24.1%, and 58.5% were bedridden. In-hospital mortality was 22.0%. On multivariate logistic regression, lower GCS score was the only independent predictor of mortality (OR 0.777, 95% CI 0.629-0.959, p = 0.019).</p><p><strong>Conclusion: </strong>Post-stroke AP remains a significant complication, with a notable mortality rate. A lower GCS score independently predicted mortality, whereas ICU admission was significant only in the univariate analysis. The overall incidence of AP in our study was lower than rates reported in other populations, possibly reflecting differences in clinical practices, patient characteristics, or variability in diagnostic ascertainment rather than a true reduction in incidence.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"600102"},"PeriodicalIF":3.2,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13271105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CHA₂DS₂-VASc and CHA₂DS₂-VA Scores as Predictors of Short- and Long-Term Mortality Following Transvenous Lead Extraction.","authors":"Celina Wojciechowska, Łukasz Tułecki, Wojciech Jacheć, Dorota Nowosielecka, Paweł Wojciechowski, Anna Polewczyk, Andrzej Kutarski","doi":"10.2147/VHRM.S590625","DOIUrl":"10.2147/VHRM.S590625","url":null,"abstract":"<p><strong>Background: </strong>Multimorbidity significantly affects prognosis in patients after transvenous lead extraction (TLE). The CHA₂DS₂-VASc and CHA₂DS₂-VA scores, widely used for stroke risk stratification in atrial fibrillation, include clinical factors that are also associated with long-term mortality.</p><p><strong>Purpose: </strong>To evaluate the usefulness of the CHA₂DS₂-VASc and CHA₂DS₂-VA scores in predicting short- and long-term mortality in patients following non-laser TLE.</p><p><strong>Methods: </strong>This retrospective study included 3822 patients who underwent non-laser TLE between March 2006 and April 2023 at high-volume centres. The median follow-up was 1848 days (Q1-Q3: 815-3146 days). Patients were stratified into two groups according to CHA₂DS₂-VASc score (<3 vs. ≥3). 30-day, 1-year, and 3-year, and overall follow-up mortality were assessed. Cox proportional hazards models were used to identify independent predictors of death during short and long follow-up.</p><p><strong>Results: </strong>Patients with CHA₂DS₂-VASc ≥3 had significantly higher mortality at 30 days 1 year, 3 years, and during overall follow-up compared with those scoring <3. A cut-off ≥3 showed 80.6% sensitivity and 62.3% specificity for predicting 3-year mortality. Mortality increased progressively with higher CHA₂DS₂-VASc scores (Spearman's r = 0.983, p<0.001). The multivariate Cox regression demonstrated that number of points on CHA₂DS₂-VASc and CHA₂DS₂-VA scores were independent predictors long-term mortality, alongside Charlson comorbidity index, atrial fibrillation, infective TLE indications, and renal dysfunction. Each 1-point increase in the CHA₂DS₂VA score was associated with an 11.7% increase in the risk of death. In sex-specific analysis, the risk increased by 33.0% per point in females (HR 1.330; p<0.001) and by 20.6% in males (HR 1.206; p<0.001).</p><p><strong>Conclusion: </strong>CHA₂DS_2-VASc and CHA₂DS_2-VA score may be a useful tool for predicting the risk of death during long-term observation of patients after TLE. Incorporation of this score into clinical decision-making may improve risk stratification and support individualized management of patients undergoing TLE.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"590625"},"PeriodicalIF":3.2,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13269031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Albumin Level Predicts Systemic Arterial Stiffening Mediated Partially by Change in Lean Body Mass: A Retrospective Cohort Study in General Japanese Population.","authors":"Daiji Nagayama, Osamu Horikawa, Yasuhiro Watanabe, Kentaro Fujishiro, Kenji Suzuki, Masahiro Ohira, Kohji Shirai, Atsuhito Saiki","doi":"10.2147/VHRM.S610441","DOIUrl":"10.2147/VHRM.S610441","url":null,"abstract":"<p><strong>Background and aim: </strong>Serum albumin level (albumin) is inversely associated with the risk of cardiovascular disease (CVD) mortality. Additionally, the decline in lean body mass partially mediates the age-related vascular dysfunction. We aimed to clarify the interaction between albumin, lean body mass and vascular function in the general Japanese population.</p><p><strong>Methods: </strong>This study analyzed three-year longitudinal data (n=5,253) obtained from Japanese urban residents receiving consecutive annual health screenings. Participants with a history of CVD and/or any chronic wasting diseases were excluded. Skeletal muscle mass was assessed using estimated lean body mass index (eLBMI). Systemic arterial stiffness was assessed using the cardio-ankle vascular index (CAVI), with high CAVI defined as CAVI ≥9.0.</p><p><strong>Results: </strong>Among serum protein parameters, albumin showed a stronger inverse correlation with CAVI (r = -0.191) compared to total protein and albumin/globulin ratio. Age correlated positively with CAVI and negatively with albumin. In multiple regression analysis, 1 standard deviation increase in albumin was negatively associated with high CAVI (odds ratio = 0.78), independent of aging and traditional CVD risk factors. Jonckheere-Terpstra trend test revealed a significant inverse trend in change in CAVI over three years (ΔCAVI) among the stratified baseline albumin groups, whereas no significant trend was observed among the stratified age groups. Baseline albumin was negatively associated with ΔCAVI, which was partially mediated by ΔeLBMI after adjusting for age (mediation rate, 3.4%).</p><p><strong>Conclusion: </strong>As serum albumin level predicts CAVI mediated by changes in lean body mass, appropriate nutrition management aimed at enhancing skeletal muscle mass may be useful for reliable prevention of CVD.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"610441"},"PeriodicalIF":3.2,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13264986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148259150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clustering Analysis of Ankle-Brachial Index Related Metabolic and Body Composition Profiles Using K-Means Approach.","authors":"Heri Kristianto, Paulus Lucky Tirma Irawan, Akhiyan Hadi Susanto, Kemala Andhini Kusumaayu, Delvira Audy Susita, Illa Billah, Nasywa Zahra Aprillisna, Nabila Ramadhani","doi":"10.2147/VHRM.S604116","DOIUrl":"10.2147/VHRM.S604116","url":null,"abstract":"<p><strong>Purpose: </strong>The Ankle-brachial Index (ABI) is a non-invasive diagnostic tool used to assess peripheral perfusion disorders. However, the increasing number of clinical parameters involved in ABI assessment may complicate clinical decision-making. This study aimed to explore clustering of metabolic and body composition profiles in relation to ankle-brachial index (ABI) values using a K-means approach to identify patterns associated with peripheral perfusion.</p><p><strong>Patients and methods: </strong>A cross-sectional study was conducted using primary and secondary data from 1093 participants collected from community health centres, hospitals, and academic institutions in the Malang region between 2023 and 2025. Thirteen clinical and metabolic parameters were analysed, including age, blood pressure, blood glucose, lipid profile, uric acid, and body composition indices. ABI was measured using vascular Doppler ultrasound, and body composition was assessed using bioelectrical impedance analysis. K-means clustering was performed using the K-means algorithm, both with and without feature selection based on the gain ratio method. Cluster quality was evaluated using the Elbow Method and Silhouette Score.</p><p><strong>Results: </strong>The optimal clustering solution was identified at k = 2 for both approaches. Feature selection reduced the number of parameters from 13 to 7 and improved cluster quality, with the Silhouette Score increasing from 0.503 to 0.559. Visceral fat, resting metabolism, body mass index, body fat, skeletal muscle, subcutaneous fat, and cell age were the most influential parameters in distinguishing patient clusters. The resulting clusters represented distinct metabolic risk profiles, ranging from healthier individuals to those with elevated cardiometabolic risk.</p><p><strong>Conclusion: </strong>K-means clustering identifies distinct metabolic and body composition profiles associated with ankle-brachial index (ABI) values. These clusters represent data-driven patterns and should be interpreted as descriptive associations rather than diagnostic or predictive categories. The findings provide exploratory insights into metabolic characteristics related to peripheral perfusion and suggest that metabolic and body composition parameters may help group ABI into distinct profiles. This approach may have potential relevance in nursing practice by supporting clinical consideration; however, further validation is required.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"604116"},"PeriodicalIF":3.2,"publicationDate":"2026-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13252039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148228422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peri-Operative Surgical and Anaesthetic Predictors of Autogenous Arteriovenous Fistula (AVF) Maturation: A Retrospective Cohort Analysis.","authors":"Paulina Bruessel, Denna Fryer, Ché Marfleet, Theresia Klarissa, Samantha Khoo, Gert Frahm-Jensen","doi":"10.2147/VHRM.S591189","DOIUrl":"10.2147/VHRM.S591189","url":null,"abstract":"<p><strong>Objective: </strong>The maturation of autogenous arteriovenous fistulas (AVFs) remains unpredictable despite being the preferred vascular access for haemodialysis. Early identification of at-risk AVFs could improve outcomes and reduce unnecessary interventions. The 2019 Kidney Disease Outcomes Quality Initiative (KDOQI) recommends a volume flow (Qa) threshold of >500 mL/min, replacing the 2006 >600 mL/min benchmark, as a marker of fistula health. This study evaluates whether perioperative and follow-up Qa measurements are associated with AVF maturation, with particular focus on pre-operative and immediate post-operative Qa, which remain underexplored. The influence of anaesthetic and demographic factors was also assessed.</p><p><strong>Methods: </strong>This single-centre retrospective cohort study included 31 patients undergoing AVF creation. Inflow artery Qa was measured pre-operatively, immediately post-operatively, and at follow-up. Demographics, comorbidities, anaesthetic parameters, and AVF characteristics were obtained from clinical records. Successful maturation was defined as Qa ≥500 mL/min on duplex ultrasound at six weeks and the ability to sustain dialysis (two-needle access for ≥ two-thirds of sessions in the first month without functional concerns).</p><p><strong>Results: </strong>Of 31 AVFs created, 22 (71%) matured by follow-up, either directly (n = 15, median Qa 1050 mL/min) or after fistuloplasty (n = 7, median Qa 800 mL/min). Nine (29%) failed to mature of which six did not undergo fistuloplasty (median Qa 270 mL/min), and three failed despite fistuloplasty (median Qa 332 mL/min). Successful AVFs demonstrated higher median Qa pre-operatively (91 vs 70 mL/min, p = 0.08), post-operatively (495 vs 234 mL/min, p = 0.02), and at follow-up (925 vs 280 mL/min, p < 0.001). The majority of AVF with Qa >700 mL/min at follow-up matured (OR 22.17, 95% CI 3.25-151.3, p = 0.002). No significant associations were found with age, smoking, diabetes, or anaesthetic factors.</p><p><strong>Conclusion: </strong>Perioperative Qa measurement is a practical, low-cost predictor of AVF maturation. The >500 mL/min Qa threshold supports current KDOQI guidance. Pre-operative Qa differences represent a promising area for future research, while demographic and anaesthetic factors showed limited predictive value.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"591189"},"PeriodicalIF":3.2,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13199606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148035548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring a Prediction Model Based on Patient Record Data in Carotid Stenosis Risk Assessment.","authors":"Kjersti Hervik, Tom Wilsgaard, Truls Myrmel, Knut Eivind Kjorstad","doi":"10.2147/VHRM.S598268","DOIUrl":"10.2147/VHRM.S598268","url":null,"abstract":"<p><strong>Introduction: </strong>Digitalised patient records represent a large potential source of real-world data. Nevertheless, confidentiality and data protection has made big data extraction from patient journals impossible in the past. Future options for free text reading by artificial intelligence might enable data extraction while maintaining confidentiality. In turn this could enable improvement in risk predictions. However, it remains unclear whether free-text data constitute an appropriate data source for this purpose, or whether this data source can be incorporated into a clinically applicable risk prediction tool using an appropriate statistical model. We aim to investigate this for stroke risk in patients with carotid stenosis.</p><p><strong>Methods: </strong>A test dataset of patients with carotid stenosis, based on free text data, was manually established. Parameters of choice were extracted from digital patient records to assess their performance in the prediction of individual risk profile. The dataset is applied to evaluate a proposed statistical model including time dependency of specific variables and multiple endpoint analysis, comparing this to the results from a traditional Cox regression analysis.</p><p><strong>Results: </strong>392 symptomatic and 471 asymptomatic patients with carotid stenosis were included in the analysis, where respectively 49 repeat events and 56 first stroke events attributed to the carotid stenosis occurred. The suggested extended regression model shows a statistically significant risk of a high degree carotid stenosis lesion on the risk of an attributable stroke, which was not demonstrated by use of a traditional Cox regression analysis. For a stenosis of 70-99%, asymptomatic patients with a right sided carotid stenosis had a hazard ratio (HR) 4.98 for a right sided event, and for left sided carotid stenosis a HR 5.23 for a left sided event. Symptomatic patients were found to have a HR of 2.25 for a recurrent event, as many received protective treatment. This is suggested to imply improved risk prediction by an advanced statistical model.</p><p><strong>Discussion: </strong>In this article a description of the data set and the methods behind our model choice has been the main emphasis, in order to evaluate its suitability for this purpose. Analysis of model performance by concordance analysis and Brier score has been published in a separate article.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"598268"},"PeriodicalIF":3.2,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13197216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148017560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Anemia with Mortality and Functional Prognosis in Patients with First-Ever Ischemic Stroke: A Retrospective Cohort Study in Tunisia.","authors":"Houssem Slimen, Anis Hassine, Arwa Rekik, Emna Jarrar, Amal Hajkacem, Yosra Dhaha, Amina Bouatay, Sana Ben Amor","doi":"10.2147/VHRM.S574755","DOIUrl":"10.2147/VHRM.S574755","url":null,"abstract":"<p><strong>Introduction: </strong>There is significant debate surrounding whether anemia should be considered a prognostic factor for stroke. The aim of this study was to assess the impact of anemia on the outcomes after the first ischemic stroke (IS), based on the Hemoglobin (Hb) levels and IS etiology.</p><p><strong>Materials and methods: </strong>We conducted a retrospective study in our department of Neurology including patients presenting with a first ever IS admitted in our Neurovascular unit between January 2023 and December 2023. Vascular risk factors and clinical presentations were documented. Mortality and outcomes (modified Rankin scores= mRS) were evaluated at three and six months. All parameters assessed were compared between anemic and non-anemic patients. Then, we examined the association between stroke outcomes, severity, etiology and type of anemia.</p><p><strong>Results: </strong>We included 549 patients with a mean age of 63.7±12 years. Anemic patients (27.9%) were older (p< 0.001) and were less likely to be smokers, consistent with the known effect of smoking on increasing Hb levels. On multivariate analysis, anemia was associated with more severe clinical presentations at onset (p=0.001) and with increased mRS during follow-up. Independent of the severity and type of anemia, patients diagnosed with anemia in both the acute phase and at six months had a significantly higher mortality rate, respectively, p=0.02 and p=0.04.</p><p><strong>Conclusion: </strong>Anemia is a common biological finding among IS patients and is associated with more severe clinical presentations, poorer functional outcomes, and increased mortality, suggesting a potential role as a prognostic marker that warrants further investigation.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"574755"},"PeriodicalIF":3.2,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13180801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147975604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal Trends and Geographic Associations of Circulatory Disease Hospitalizations Among Young Adults in Almaty and the Turkestan Region, 2018-2024.","authors":"Khandulla Nakipov, Kamilya Kedelbayeva, Balnur Omarova, Ainash Oshibayeva, Gulnaz Nuskabayeva, Maiya Zhakupova, Hur Hassoy","doi":"10.2147/VHRM.S592401","DOIUrl":"10.2147/VHRM.S592401","url":null,"abstract":"<p><strong>Background: </strong>This study aims to assess temporal trends and geographic differences in hospitalization rates for circulatory system diseases among adults aged 18-44 years in Almaty and the Turkestan region.</p><p><strong>Methods: </strong>This study analyzed hospitalization data for circulatory diseases (ICD-10 I00-I99) among adults aged 18-44 years in Almaty, Turkestan city, and rural Turkestan from 2018 to 2024. Crude hospitalization rates per 100,000 population were calculated using official population denominators, and admissions were classified as urgent or planned. The outcome was annual hospitalization counts stratified by year, sex, diagnosis, and geographic location. After detecting overdispersion in Poisson regression, a negative binomial model was applied, providing improved model fit and estimation of incidence rate ratios (IRRs).</p><p><strong>Results: </strong>Hospitalization rates declined substantially through 2022, particularly in Almaty, followed by an increase by 2024. In contrast, the Turkestan region showed more moderate declines, with consistently higher hospitalization rates compared to Almaty. Cerebrovascular and hypertensive diseases were the leading contributors across regions. Urgent admissions accounted for the majority of hospitalizations. Regression analysis demonstrated significant associations with time, age, diagnostic category, and geographic location, with the highest rates observed in rural Turkestan and the lowest in Almaty. No significant sex differences were observed.</p><p><strong>Conclusion: </strong>Hospitalization patterns for circulatory diseases among young adults varied across regions and over time, with a decline observed until 2022 followed by a rebound by 2024. These findings reflect statistically observed associations and should be interpreted cautiously, as they are based on aggregated data and do not establish causal relationships.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"592401"},"PeriodicalIF":3.2,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13180383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147975635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Associations Between Metabolic Risk Burden and the Cardio-Ankle Vascular Index (CAVI) in Japan Using Health-Check Cohort.","authors":"Yuzo Horibuchi, Larbi Aluariachy, Reiko Yamaura, Hideko Kasahara, Shoichiro Tsugane, Tsutomu Yamazaki","doi":"10.2147/VHRM.S601750","DOIUrl":"10.2147/VHRM.S601750","url":null,"abstract":"<p><strong>Purpose: </strong>The cardio-ankle vascular index (CAVI) is a blood pressure-independent indicator of arterial stiffness. Although CAVI is associated with metabolic risk factors, longitudinal evidence clarifying their relative impact remains limited. This study aimed to examine longitudinal associations between metabolic abnormalities and CAVI in a Japanese health check-up population, focusing on MetS components and waist circumference (WC) status.</p><p><strong>Patients and methods: </strong>A total of 13,724 adults (7060 men and 6664 women) who underwent annual health check-ups at the International University of Health and Welfare Narita Hospital between 2020 and 2024 were included. Linear mixed-effects models were used to evaluate longitudinal changes in CAVI according to MetS components (blood pressure, glucose, lipids, and WC). Secondary analyses examined CAVI changes by MetS status, WC strata (WC (+)/WC (-)), metabolic risk count (0-3) and sex.</p><p><strong>Results: </strong>Older age and male sex were independently associated with higher CAVI. Blood pressure and glucose abnormalities showed the strongest associations with elevated CAVI, whereas lipid risk had a modest effect and WC was inversely associated with CAVI. CAVI increased annually overall, but increased more slowly among participants with blood pressure risk. Time interactions for glucose, lipid and WC risk were not significant. MetS was associated with higher baseline CAVI, but longitudinal time interactions did not differ significantly by MetS status. In WC-stratified analyses, baseline CAVI increased stepwise with accumulation of metabolic risk factors in both WC (+) and WC (-) groups, including a substantial WC (-)-subgroup-particularly women-with multiple metabolic risks and elevated CAVI.</p><p><strong>Conclusion: </strong>Longitudinal follow-up revealed modest CAVI progression with attenuated slopes among participants with high-baseline CAVI, indicating that baseline CAVI captures cumulative vascular injury rather than accelerated short-term change. CAVI may complement WC-centered screening by identifying non-obese individuals-especially women-with elevated longitudinal vascular risk.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"601750"},"PeriodicalIF":3.2,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13168901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147943107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral Small Vessel Disease Burden in Saudi Arabia: Epidemiology, Risk Determinants, and Neuroimaging Characteristics.","authors":"Thamer S Alhowaish, Khalid Bin Aziz, Basel Al Anazi, Fahad Alhargan, Alaa Mathkour, Elan Homoud, Amjad M Alakel, Eman Barjas Alotaibi, Nedaa AlAmri, Noura AlRaeesi, Sameeha Fallatah, Ajmal Anversha","doi":"10.2147/VHRM.S594270","DOIUrl":"10.2147/VHRM.S594270","url":null,"abstract":"<p><strong>Background: </strong>Cerebral small vessel disease (CSVD) is a major contributor to stroke, cognitive impairment, and gait disturbance. Data describing its burden and determinants in Middle Eastern populations remain limited. This study aimed to estimate the prevalence, clinical predictors, and neuroimaging characteristics of CSVD among adults undergoing brain MRI in Saudi Arabia and to examine associations with vascular risk factors and antihypertensive therapy.</p><p><strong>Methods: </strong>We conducted a retrospective cross-sectional study of adults aged 40-70 years who underwent brain MRI at King Abdulaziz Medical City, Riyadh, between January 2018 and January 2019. CSVD markers were identified according to the STandards for ReportIng Vascular changes on nEuroimaging (STRIVE) criteria, and white matter hyperintensities were graded using the Fazekas scale. Multivariable logistic regression models were constructed to identify factors independently associated with CSVD.</p><p><strong>Results: </strong>Among 644 participants undergoing brain MRI, CSVD was identified in 36.5% of patients. Prevalence increased markedly with age, rising from 18.2% in individuals aged 40-50 years to 54.1% in those aged 60-70 years (p < 0.001). In the multivariable etiological model, hypertension emerged as the strongest independent vascular predictor of CSVD. White matter hyperintensities were the most frequent imaging manifestation and increased in severity with advancing age. Among hypertensive patients, certain antihypertensive classes, particularly calcium channel blockers and ACE inhibitor/ARB monotherapy, were associated with lower odds of CSVD compared with untreated hypertension.</p><p><strong>Conclusion: </strong>In this MRI-based clinical cohort from Saudi Arabia, CSVD was present in more than one-third of adults aged 40-70 years undergoing neuroimaging. Disease prevalence increased substantially with advancing age and vascular comorbidities. These findings highlight the importance of vascular risk factor control and provide important regional data on the clinical and imaging profile of CSVD in Middle Eastern populations.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"594270"},"PeriodicalIF":3.2,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13159943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147933850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}