Cheese consumption in relation to cardiovascular risk factors among Iranian adults- IHHP Study

BACKGROUND/OBJECTIVE: It is expected that dairy products such as cheeses, which are the main source of cholesterol and saturated fat, may lead to the development or increase the risk of cardiovascular and metabolic diseases; however, the results of different studies are inconsistent. This study was conducted to assess the association between cheese consumption and cardiovascular risk factors in an Iranian adult population. SUBJECTS/METHODS: Information from the Isfahan Healthy Heart Program (IHHP) was used for this cross-sectional study with a total of 1,752 participants (782 men and 970 women). Weight, height, waist and hip circumference measurement, as well as fasting blood samples were gathered and biochemical assessments were done. To evaluate the dietary intakes of participants a validated food frequency questionnaire, consists of 49 items, was completed by expert technicians. Consumption of cheese was classified as less than 7 times per week and 7-14 times per week. RESULTS: Higher consumption of cheese was associated with higher C-Reactive Protein (CRP), apolipoprotein A and high density lipoprotein cholesterol (HDL-C) level but not with fasting blood sugar (FBS), total cholesterol, low density lipoprotein cholesterol (LDL-C), triglyceride (TG) and apolipoprotein B. Higher consumption of cheese was positively associated with consumption of liquid and solid oil, grain, pulses, fruit, vegetable, meat and dairy, and negatively associated with Global Dietary Index. After control for other potential confounders the association between cheese intake and metabolic syndrome (OR: 0.81; 96%CI: 0.71-0.94), low HDL-C level (OR: 0.87; 96%CI: 0.79-0.96) and dyslipidemia (OR: 0.88; 96%CI: 0.79-0.98) became negatively significant. CONCLUSION: This study found an inverse association between the frequency of cheese intake and cardiovascular risk factors; however, further prospective studies are required to confirm the present results and to illustrate its mechanisms.

Body mass index or microalbuminuria, which one is more important for the prediction and prevention of diastolic dysfunction in non diabetic hypertensive patients?

Numerous studies have now demonstrated that heart failure with a normal ejection fraction [HFnlEF] is common. Hypertension is also the most commonly associated cardiac condition in patients with HFnlEF. Despite the observed link between microalbuminuria, obesity, and cardiovascular disorders, this question has remained-Which is more important for the prediction and prevention of diastolic dysfunction in non diabetic hypertensive patients?' The current study was a cross section study conducted on a total of 126 non diabetic hypertensive patients screened to identify those with hypertension. Urine creatinine was measured by the picric acid method and urine albumin content was measured by a sensitive, nephelometric technique. The urinary albumin/creatinine ratio [UACR] was determined as an indicator of microalbuminuria. Complete two dimensional, doppler, and tissue doppler echocardiography was performed and the recording of the diastolic function parameters was carried out. High body mass index and high systolic blood pressure were positively correlated with the appearance of left ventricular hypertrophy, whereas, the UACR index had no significant relationship with hypertrophy. Multivariable analysis also showed that advanced age and systolic blood pressure were significantly associated with the E/E annulus parameter. According to our investigation obesity is more important than microalbuminuria for the prediction and prevention of diastolic dysfunction in non diabetic hypertensive patients

Pharmacological treatment, lifestyle modification and awareness in coronary artery and cerebrovascular disease patients

Cardiovascular diseases [CVD] and cerebrovascular diseases [CeVD] are large and growing problems in low- and middle-income populations. Secondary prevention, which can reduce the risk of recurrent CVD includes changes in lifestyle, pharmacological interventions and revascularization procedures. The aim of the first phase of this project was to perform situation analysis and identify gaps in secondary prevention of major cardiovascular diseases. This study estimated the physicians' awareness and the patients' knowledge and behavior towards CVD and CeVD complications. It also assessed the efficacy of methods for decreasing recurrent events. A sample of consecutive patients was selected from the outpatient units of the health care facilities selected for the study. Stratified random sampling of primary and secondary private and public health care facilities in cities and villages was performed to select 449 eligible cases. A total of 257 men and 192 women were selected. The inclusion criteria were as follows: Age above 21 years, established diagnosis of CVD and/or CeVD defined as any of the following alone or in combination with others: previous myocardial infarction, stable/unstable angina, percutaneous transluminal coronary angioplasty [PTCA], coronary artery bypass graft [CABG], stroke, transient ischemic attack [TIA], and/or carotid arterectomy. The patients were included if their first event had occurred more than a month, but no earlier than three years before the study. The prevalence of high systolic and diastolic blood pressure was 40.1% and 26.9% respectively in MI patients, and 70.1% and 51.2% respectively in CeVD patients. In most of the patients, fasting blood sugar and total cholesterol were within the normal range. Among MI patients, 93.9%, 68.5% and 48.2% were already taking aspirin, beta-blockers and statins, respectively. Among CeVD patients, 79.9%, 61.1% and 23.2% were taking aspirin, beta-blockers and statins, respectively. Blood pressure had been managed in 94.9% and 93.7% of MI and CeVD patients, respectively. Among MI patients, 85.8% and 83.2% had correct behavior towards blood sugar and cholesterol control and 68% had adequate knowledge of the risk of recurrent events. Secondary prevention of vascular diseases should be regarded as a key component of public health strategies to reduce the rising burden of CVD and CeVD in Iran

The association of smoking with components of the metabolic syndrome in non-diabetic patients

<p><b>INTRODUCTION</b>There is limited evidence about the association between smoking and metabolic syndrome (MS). The aim of this study was to assess the association of smoking with MS components.</p><p><b>MATERIALS AND METHODS</b>As part of the baseline survey of a community-based study, we studied 5,573 non-diabetic men. All participants were interviewed and underwent physical examinations and blood collection.</p><p><b>RESULTS</b>The study participants comprised 1,625 smokers and 3,948 non-smokers, with a mean age of 38.07 +/- 14.85 years. Serum low-density lipoprotein-cholesterol (LDL-C) and triglycerides (TG) were higher in smokers than in non-smokers (LDLC: 115.34 +/- 39.03 vs 112.65 +/- 40.94 mg/dL, respectively, P = 0.015 and TG: 175.13 +/- 102.05 vs 172.32 +/- 116.83 mg/dL, respectively, P = 0.005). Body mass index, waist circumference and waist-hip ratio were lower in smokers than in non-smokers. Mean systolic and diastolic blood pressures were significantly lower in smokers than in non-smokers (systolic: 112.06 +/- 15.888 vs 117.25 +/- 17.745 mmHg, respectively, P = 0.000; diastolic: 73.66 +/- 10.084 vs 76.23 +/- 10.458 mmHg, respectively, P = 0.000). The percentage of individuals with 2 MS components was higher in smokers than in non-smokers (39.64% vs 33.00%, respectively, P = 0.000). However, the percentage of non-smokers with 3 MS components was higher than in smokers (49.62 % vs 43.82%, respectively, P = 0.000).</p><p><b>CONCLUSIONS</b>Our findings support the hypothesis that lifestyle factors such as smoking can adversely affect MS components. However, we should acknowledge that these differences may have resulted from the large sample sizes studied and may not be clinically significant. The lower prevalence of some MS components in smokers than in nonsmokers might be because of their lower anthropometric measures.</p>

Evaluation of autoantibody against modified LDL levels in patients with cardioovascular diseases

Atherosclrosis is a process that initiated with hypercholestrolemia and fatty streak formation. Previous studies showed oxidative modification of LDL render immunogenic and autoantibodies to epitopes of oxidized LDL. Oxidized LDL [OX-LDL], has antigenic properties. Antibodies against oxidized LDL have been proposed to be independent predictors of atherosclerosis development. The main aims of the current study were to compare antibody titers to different types of oxidized LDL [Cu+2-LDL, Malondialdehyde-LDL] and Native-LDL between angiographically documented coronary patients, non-documented patients and healthy subjects. Correlation between autoantibodies against oxidized LDL and increased risks of cardiovascular diseases has been shown. As a case-control study, we evaluated angiographically documented coronary patients, non-documented patients and healthy subjects to measure anti-OX-LDL autoantibody levels. Enzyme-linked immunosorbent assay was used to measure anti-OX-LDL autoantibodies. ANOVA test used for statistical analysis. Titers of anti-Malondialdehydo-LDL autoantibodies were 3.55 +/- 0.415, 0.361 +/- 0.20, 0.093 +/- 0.078 respectively in each group [P<0.005]. There was not statistically meaningful difference, between native-LDL and Cu+2-LDL antibodies. It seems the titre of autoantibodies against OX-LDL considered as a predictor of progression of atherosclerosis. Our data provide further support for a role of oxidatively modified LDL in atherogenesis