American journal of preventive cardiology最新文献

{"title":"Absolute impact of lipid levels on coronary heart disease in a real-world primary prevention cohort of 730,236 people","authors":"Lia Alves-Cabratosa ,&nbsp;Lidia Guzmán ,&nbsp;Jordi Blanch ,&nbsp;Marc Comas-Cufí ,&nbsp;María García-Gil ,&nbsp;Lluís Zacarías-Pons ,&nbsp;Ruth Martí-Lluch ,&nbsp;Anna Ponjoan ,&nbsp;Gina Domínguez-Armengol ,&nbsp;Francesc Ribas-Aulinas ,&nbsp;Èric Tornabell-Noguera ,&nbsp;Luis García-Ortiz ,&nbsp;Rafel Ramos","doi":"10.1016/j.ajpc.2025.101059","DOIUrl":"10.1016/j.ajpc.2025.101059","url":null,"abstract":"<div><h3>Background and aims</h3><div>The impact of the association of LDL-c levels with coronary heart disease is unambiguous in people with previous cardiovascular disease. In primary prevention, however, it has been poorly studied. We analyzed the impact of the association of lipid levels with coronary heart disease in a population with no previous cardiovascular disease. We included potential variations by sex and age.</div></div><div><h3>Methods</h3><div>Retrospective cohort analysis of records from the SIDIAP Catalan database, Spain. We selected ≥35-year-olds without previous cardiovascular disease or lipid-lowering medications. The LDL, HDL, and triglycerides levels were the exposure and coronary heart disease was the outcome. Cox regression and Lin additive models estimated the relative and absolute associations, respectively.</div></div><div><h3>Results</h3><div>We analyzed the records from 730,236 participants; follow-up: 6.7 years; mean (SD) age: 58.5 (13.9) years, and 42.2 % of them were men. The overall CHD incidence rate was 3.47 (3.42–3.52) events per 1000 person-years; it was higher in men than in women, with 4.98 (4.88–5.07) and 2.39 (2.33–2.45) events per 1000 person-years, respectively. One mmol/L increase in LDL-c, HDL-c, and TGs showed HRs (95 %CI) of 1.26 (1.24–1.29), 0.60 (0.57–0.63), and 1.16 (1.13–1.19), respectively. The absolute differences for LDL-c and TGs were less than one additional CHD event per 1000 person-years; and two fewer events for HDL-c.</div></div><div><h3>Conclusions</h3><div>The moderate to low increment in the incidence of CHD by 1 mmol/L of lipid increase represented low numbers of additional events in this low-risk Mediterranean population.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101059"},"PeriodicalIF":4.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144714103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparative analysis of cardiovascular disease mortality trends attributable to risk factors in the United States and globally from 1990 to 2019: an analysis of the Global Burden of Disease Study 2019","authors":"George W. Hafzalla ,&nbsp;Dmitry Abramov ,&nbsp;Michael D. Shapiro ,&nbsp;Abdul Mannan Khan Minhas","doi":"10.1016/j.ajpc.2025.101064","DOIUrl":"10.1016/j.ajpc.2025.101064","url":null,"abstract":"<div><h3>Background</h3><div>Trends in cardiovascular disease (CVD) mortality from key risk factors both in the United States (US) and globally have not been well characterized.</div></div><div><h3>Methods</h3><div>This analysis utilized Global Burden of Disease (GBD) 2019 data to determine age-standardized mortality rates (ASMR) and disability-adjusted life years (DALYs) for CVDs attributed to risk factors in the US and globally. Total percentage change (TPC, 95 % CI) was calculated to assess temporal trends in CVD mortality and disease burden related to key risk factors, examining two periods: 1990–2010 and 2010–2019.</div></div><div><h3>Results</h3><div>Overall CVD mortality declined in the US and globally from 1990–2019. CVD mortality declined globally by a TPC of -0.24 (-0.26 to -0.22) between 1990–2010 but only by -0.11 (-0.15 to -0.07) between 2010–2019. Similar changes were seen in the US. CVD mortality attributed to common risk factors, including dietary risks, high LDL-c, kidney dysfunction, smoking, and secondhand smoking, changed significantly between 2010–2019 compared to the prior two decades, with slower declines in CVD mortality both globally and in the US. Furthermore, CVD mortality attributed to high body mass index, elevated fasting plasma glucose, and elevated systolic blood pressure in the US plateaued from 2010–2019. Trends in DALYs attributed to these risk factors paralleled those observed for mortality.</div></div><div><h3>Conclusions</h3><div>Despite major reductions in CVD mortality and disease burden from 1990 to 2010, mortality linked to key risk factors plateaued globally and in the US after 2010. Continued public health efforts targeting key risk factors are needed to further reduce CVD-related mortality and disability.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101064"},"PeriodicalIF":4.3,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144703859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing a specialized cardiogenomics team for lipid disorders: Insights from a single large health system","authors":"Natasha Vartak ,&nbsp;Dorota Gruber ,&nbsp;Bani Azari ,&nbsp;Zahid Ahmad ,&nbsp;Xueqi Huang ,&nbsp;Joanna Fishbein ,&nbsp;Benjamin Hirsh ,&nbsp;Julia Frangeskos ,&nbsp;Eugenia Gianos","doi":"10.1016/j.ajpc.2025.101066","DOIUrl":"10.1016/j.ajpc.2025.101066","url":null,"abstract":"<div><div>Genetic testing for lipid disorders can improve cardiovascular risk stratification in patients and their families, however it remains infrequently used in clinical practice. Perceived obstacles related to cost, insurance, and implementation of services may account for some of the limited use. Integration of a cardiogenomics team can streamline genetic testing, counseling, and insurance approval. In order to assess the utility and feasibility of genetic testing in clinical care, we conducted a retrospective chart review of 99 patients referred to our cardiogenomics team for lipid abnormalities and personal and/or family history of atherosclerotic cardiovascular disease from July 2018 to August 2022. Of the 18 patients with pathogenic variants, 50 % had a modification made to therapy and overall experienced greater reductions in LDL-C compared to those with negative results. Most patients did not require prior authorization and had genetic testing covered by insurance. Our study shows that access to genetic testing is feasible, warranting a renewed focus on implementation with further research to understand the clinical impact and socioeconomic barriers to such programs.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101066"},"PeriodicalIF":4.3,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144713307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sarcopenia and cardiovascular disease among adults with cardiovascular-kidney-metabolic syndrome stages 0-3: A prospective cohort study","authors":"Yupeng Wei ,&nbsp;Xiaopeng Hu","doi":"10.1016/j.ajpc.2025.101060","DOIUrl":"10.1016/j.ajpc.2025.101060","url":null,"abstract":"<div><h3>Background</h3><div>Substantial evidence has demonstrated the correlation between sarcopenia and cardiovascular disease (CVD). However, it remains uncertain whether this correlation exists in individuals with cardiovascular-kidney-metabolic (CKM) syndrome.</div></div><div><h3>Methods</h3><div>This study used data from the China Health and Retirement Longitudinal Study (CHARLS). Sarcopenia state was determined according to the Asian Working Group for Sarcopenia 2019 criteria. Muscle mass was estimated by the height‐adjusted muscle mass. Cox proportional hazard models were employed to calculate the hazard ratio (HR) and 95 % confidence interval (95 % CI.</div></div><div><h3>Results</h3><div>A total of 7428 participants (mean age: 59.0 years; male: 47.6 %) were included in this study. Of these, non-sarcopenia, possible sarcopenia, and sarcopenia individuals were 4398 (59.2 %), 2162 (29.1 %), and 869 (11.7 %), respectively. During a median follow-up of 9.0 years, participants with possible sarcopenia (HR: 1.32, 95 % CI: 1.19–1.47) and sarcopenia (HR: 1.45, 95 % CI: 1.23–1.72) exhibited an increased risk of incident CVD compared to those with non-sarcopenia. Higher quintiles of muscle mass presented significantly increased risks of incident CVD than those with the lowest quintile (quintile 2: HR 1.34, 95 % CI 1.15–1.56; quintile 3: HR 1.41, 95 % CI 1.19–1.67; quintile 4: HR 1.71, 95 % CI 1.40–2.09; quintile 5: HR 2.20, 95 % CI 1.75–2.77). The dose-response curve indicated a positive linear association between muscle mass and incident CVD (P for overall &lt;0.001, P for nonlinear = 0.795).</div></div><div><h3>Conclusion</h3><div>Both possible sarcopenia and sarcopenia were associated with an increased risk of incident CVD among individuals with CKM syndrome stages 0–3.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101060"},"PeriodicalIF":4.3,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood pressure reduction by gender and menopause status among hypertensive participants of a mobile health cardiovascular risk self-management program","authors":"Jayne Morgan ,&nbsp;Walter Roberts ,&nbsp;Helena Lyson ,&nbsp;Morgan Meadows ,&nbsp;Elizabeth Ofili ,&nbsp;Martha Gulati ,&nbsp;Erin D. Michos","doi":"10.1016/j.ajpc.2025.101057","DOIUrl":"10.1016/j.ajpc.2025.101057","url":null,"abstract":"<div><h3>Background</h3><div>Despite being the leading cause of death for women in the United States, cardiovascular disease (CVD) in this population remains underrecognized, understudied, underdiagnosed, and undertreated. CVD risk is particularly pronounced in postmenopausal women. The current study evaluates the effectiveness of an mHealth cardiovascular risk self-management program in improving blood pressure (BP) control among women, especially during and after the onset of menopause.</div></div><div><h3>Methods</h3><div>We used real-world data from hypertensive users of a mobile health (mHealth) application for CVD risk self-management to evaluate sex differences in treatment responses. We further compared BP reductions by menopause status for a subset of users whose menopause status was known.</div></div><div><h3>Results</h3><div>A total of 48,121 participants were included in the analysis (mean age: 51.8 ± 11.0 years, 55.3 % women, mean baseline systolic BP: 135.5 ± 17.3 mmHg, mean baseline diastolic BP: 85.3 ± 11.6 mmHg). The primary analysis found that women users showed a larger reduction in BP compared to men (<em>p</em> &lt; 0.05). Although perimenopausal and postmenopausal women started with higher baseline BP than premenopausal women (<em>p</em> &lt; 0.001), all groups showed comparable reductions in systolic BP.</div></div><div><h3>Conclusion</h3><div>There were clinically meaningful reductions in BP among participants of an mHealth app, with women showing greater BP reductions than men. Findings suggest that targeted, sex-specific health information and digital coaching can be effective in reducing cardiovascular risk among women during and after menopause.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101057"},"PeriodicalIF":4.3,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144694645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of heart failure and subtypes with biomarker-calibrated protein intake: Women’s health initiative cohort study","authors":"Muhammad Baig ,&nbsp;Ali A Khan ,&nbsp;Miremad Moafi-Madani ,&nbsp;Mary B. Roberts ,&nbsp;Matthew Allison ,&nbsp;Karen C. Johnson ,&nbsp;Michael J. LaMonte ,&nbsp;Aabiha Kermani ,&nbsp;Yasaa Mohammad ,&nbsp;Charles B. Eaton","doi":"10.1016/j.ajpc.2025.101051","DOIUrl":"10.1016/j.ajpc.2025.101051","url":null,"abstract":"<div><h3>Introduction</h3><div>Heart failure (HF) is a growing epidemic, with risk of HF with preserved ejection fraction (HFpEF) significantly higher in post-menopausal women compared to men. Data on its association with dietary protein intake is limited.</div></div><div><h3>Methods</h3><div>To study the association of dietary protein intake with risk of HF and its subtypes in post-menopausal women, we included post-menopausal women from Women’s Health Initiative’s (WHI) HF cohort. Protein intake was assessed from the biomarker measurements in the WHI Nutrient Biomarker Study (WHI-NBS), and its calibration on Food-Frequency-Questionnaire (FFQ) based protein intake. Cox-proportional hazards regression analysis was used to study associations.</div></div><div><h3>Results</h3><div>Total of 14,789 women were included with a mean age (SD) of 62 (7) years and follow-up of 14 (8) years. Participants were predominantly African American (48.5 %). Multivariable Cox-proportional hazards regression model adjusted for age, education, income, race/ethnicity, physical activity, smoking, alcohol, prevalent and incident CHD, hypertension, hyperlipidemia, and atrial fibrillation showed elevated risk of total incident hospitalized HF and HFpEF with higher intake of dietary protein across all quintiles (Q2-Q5) compared to Q1 in a dose-response relationship (HR of HF, Q5 compared to Q1: 2.26, 95 % CI: 1.66, 3.09, <em>P</em>&lt;.0001; HR of HFpEF, Q5 compared to Q1: 2.50, 95 % CI 1.62, 3.84, <em>P</em>&lt;.0001). When stratified by BMI, HF and HFpEF risk was elevated across quintiles of BMI &gt; 30, indicating BMI may be an effect modifier.</div></div><div><h3>Conclusion</h3><div>In conclusion, higher protein intake is associated with increased risk of HF and HFpEF, particularly in obese participants.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101051"},"PeriodicalIF":4.3,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144656481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to dietary guidelines is associated with a lower risk of long-term cardiovascular mortality after myocardial infarction: a prospective analysis in the Alpha Omega Cohort","authors":"Esther Cruijsen ,&nbsp;Iris van Damme ,&nbsp;Anniek C. van Westing ,&nbsp;Nadia E. Bonekamp ,&nbsp;Charlotte Koopal ,&nbsp;Frank L.J. Visseren ,&nbsp;Johanna M. Geleijnse","doi":"10.1016/j.ajpc.2025.101056","DOIUrl":"10.1016/j.ajpc.2025.101056","url":null,"abstract":"<div><h3>Aims</h3><div>Dietary guidelines specifically for patients with atherosclerotic cardiovascular disease (CVD) were investigated in relation to long-term mortality after myocardial infarction (MI).</div></div><div><h3>Methods</h3><div>We included 4365 MI patients of the prospective Dutch Alpha Omega Cohort (60–80 years, 80 % male). We created the Dutch Healthy Diet-Cardiovascular Disease (DHD-CVD) index, based on the 2023 Dutch dietary guidelines for CVD patients with dietary data from a validated 203-item questionnaire. Hazard Ratios (HRs) for CVD-related and all-cause mortality across quartiles of the DHD-CVD index (ref=Q1, low diet quality) and per 1-SD increment were estimated using multivariable Cox regression models. Effect modification by health determinants was examined through stratification. Numbers needed to eat (NNE) were calculated as 1 divided by the 10-year risk reduction between extreme quartiles.</div></div><div><h3>Results</h3><div>The mean DHD-CVD score was 88.9 ± 14.8. During a median follow-up of 14.6 years (56,037 person-years), 2869 deaths occurred, including 1112 from CVD. High vs. low diet quality was associated with a 22 % lower risk of CVD mortality (HR:0.78, 95 %CI: 0.66, 0.93), with an HR of 0.91 (95 %CI:0.86, 0.97) per 1-SD. For all-cause mortality, HRs were 0.84 (0.76, 0.94) for high vs low and 0.93 (0.90, 0.97) per 1-SD. Associations for CVD mortality were more pronounced in patients with obesity or impaired kidney function. The NNE was 13 for CVD mortality and 77 for all-cause mortality.</div></div><div><h3>Conclusion</h3><div>Better adherence to dietary guidelines for CVD patients was associated with lower CVD and all-cause mortality risks after MI and could be an effective strategy to lower cardiovascular risk.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101056"},"PeriodicalIF":4.3,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144596336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preeclampsia: Insights into pathophysiological mechanisms and preventive strategies","authors":"Chiara Martini ,&nbsp;Zeeba Saeed ,&nbsp;Paola Simeone ,&nbsp;Stefano Palma ,&nbsp;Mirella Ricci ,&nbsp;Allegra Arata ,&nbsp;Anna Sorella ,&nbsp;Rossella Liani ,&nbsp;Fabrizio Ricci ,&nbsp;Francesco D’Antonio ,&nbsp;Anna Vittoria Mattioli ,&nbsp;Sabina Gallina ,&nbsp;Francesca Santilli ,&nbsp;Giulia Renda","doi":"10.1016/j.ajpc.2025.101054","DOIUrl":"10.1016/j.ajpc.2025.101054","url":null,"abstract":"<div><div>Preeclampsia is a hypertensive disorder of pregnancy associated with significant maternal and fetal complications. Its pathogenesis involves endothelial dysfunction, abnormal placentation, and coagulation abnormalities, leading to increased thrombotic and hemorrhagic risks. This narrative review provides an in-depth overview of the pathophysiological mechanisms underlying preeclampsia, with a particular focus on its thrombotic and hemorrhagic complications. Treatment strategies are explored, with emphasis on the role of low-dose aspirin in reducing early-onset preeclampsia. However, aspirin’s effectiveness varies based on dosage and timing, with higher doses showing greater benefit in preventing severe preeclampsia. Despite aspirin’s widespread use, further optimization of its therapeutic role remains necessary to enhance maternal and fetal outcomes.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101054"},"PeriodicalIF":4.3,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144656480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographics of lipoprotein(a) and stroke: The UK biobank","authors":"Andrew S. Kao ,&nbsp;Jonathan Kermanshahchi ,&nbsp;Shamim Khosrowjerdi ,&nbsp;Alexander C. Razavi ,&nbsp;Jacqueline Levene ,&nbsp;Mikaila Reyes ,&nbsp;Parveen Garg ,&nbsp;W.T. Longstreth Jr. ,&nbsp;Kristiina Rannikmae ,&nbsp;Cathie Sudlow ,&nbsp;Michael Tsai ,&nbsp;Sotirios Tsimikas ,&nbsp;Anum Saeed ,&nbsp;Harpreet S. Bhatia","doi":"10.1016/j.ajpc.2025.101055","DOIUrl":"10.1016/j.ajpc.2025.101055","url":null,"abstract":"<div><h3>Introduction</h3><div>Lipoprotein(a) [Lp(a)] is associated with ischemic stroke, but the strength of association based on demographic differences remains unclear. We aimed to investigate the association between Lp(a)&gt;125 nmol/L and stroke by age, sex, and racial/ethnic subgroups.</div></div><div><h3>Methods</h3><div>Using data from the UK Biobank, we included 353,309 participants with an Lp(a) measurement without a history of atherosclerotic cardiovascular disease (ASCVD). Stroke was defined as ischemic stroke or hemorrhagic stroke (with subtypes subarachnoid hemorrhage and intracerebral hemorrhage). Cox proportional hazards models were used to evaluate the association between elevated Lp(a) and stroke (ischemic or hemorrhagic), adjusted for ASCVD risk factors, race/ethnicity, lipid lowering therapy, antiplatelet and anticoagulation medications. Outcomes were defined using ICD-10 codes.</div></div><div><h3>Results</h3><div>The study population consisted of 55.7 % women and 94 % White individuals with average age of 56 years. The median Lp(a) level was 20.9 [IQR 9.5, 61.4] nmol/L and prevalence of Lp(a) &gt;125 nmol/L was 11.1 % (<em>n</em> = 39,067). Over a median follow-up of 13.8 [13.1, 14.5] years, there were 5002 (1.4 %) ischemic strokes and 1462 (0.4 %) hemorrhagic strokes. Lp(a) &gt; 125 nmol/L was associated with increased risk for ischemic stroke (HR 1.12, 95 % CI 1.02–1.22, <em>P</em> = 0.019), but not hemorrhagic stroke (HR 0.95, 95 % CI 0.79–1.13, <em>P</em> = 0.545). The association between Lp(a)&gt;125 nmol/L and ischemic stroke did not vary by age (p-interaction=0.691) or race/ethnicity (p-interaction 0.526) but did vary by sex (p-interaction=0.041) with an association among men (HR 1.20, 95 % CI 1.07–1.36) but not among women.</div></div><div><h3>Conclusion</h3><div>Lp(a) is independently associated with ischemic stroke, with variation by sex but not age or race/ethnicity. Lp(a) was not significantly associated with hemorrhagic stroke.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101055"},"PeriodicalIF":4.3,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144571739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Triglyceride-glucose index threshold for cardiovascular mortality in hypertensive individuals - URRAH project","authors":"Lanfranco D’Elia ,&nbsp;Ferruccio Galletti ,&nbsp;Masulli Maria ,&nbsp;Agostino Virdis ,&nbsp;Edoardo Casiglia ,&nbsp;Valerie Tikhonoff ,&nbsp;Fabio Angeli ,&nbsp;Carlo Maria Barbagallo ,&nbsp;Michele Bombelli ,&nbsp;Federica Cappelli ,&nbsp;Rosario Cianci ,&nbsp;Michele Ciccarelli ,&nbsp;Arrigo F G Cicero ,&nbsp;Massimo Cirillo ,&nbsp;Pietro Cirillo ,&nbsp;Giovambattista Desideri ,&nbsp;Claudio Ferri ,&nbsp;Loreto Gesualdo ,&nbsp;Cristina Giannattasio ,&nbsp;Guido Grassi ,&nbsp;Claudio Borghi","doi":"10.1016/j.ajpc.2025.101053","DOIUrl":"10.1016/j.ajpc.2025.101053","url":null,"abstract":"<div><h3>Aims</h3><div>The triglyceride-glucose (TyG) index is a surrogate marker of insulin resistance (IR). Data regarding this topic is constantly increasing, however, few and heterogeneous data are available on the relationship between this index and cardiovascular mortality risk in hypertensive populations. In this context, we aimed to explore the relationship between TyG and cardiovascular mortality in a large sample of hypertensive individuals from the URRAH cohort.</div></div><div><h3>Methods</h3><div>A total of 12,275 hypertensive participants without previous cardiovascular events were included in this analysis. The risk of cardiovascular mortality was evaluated by the Cox regression analysis and competing risk regression analysis.</div></div><div><h3>Results</h3><div>During a median follow-up of 10.5 years, 2151 deaths occurred, of which 986 were from cardiovascular disease. A linear association between TyG and cardiovascular mortality was found, in particular for a 1-standard deviation increase in TyG there was a significantly increased risk of 33 % (<em>p</em> &lt; 0.0001). Furthermore, after stratification by the optimal cut-off point (4.54 Units), participants with TyG above the cut-off had a significantly increased risk of 67 % of cardiovascular mortality when compared with those with TyG below the cut-off (<em>p</em> &lt; 0.0001). These results were also confirmed after adjustment for potential confounders.</div></div><div><h3>Conclusions</h3><div>The results of this study indicate that this TyG threshold is predictive of an increased risk of cardiovascular mortality in a large sample of hypertensive individuals. This cut-off can identify individuals at higher mortality risk in already high-risk patients, with a low-cost and simple non-invasive marker.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101053"},"PeriodicalIF":4.3,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144534891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}