OBJECTIVE: The aim of this analysis was to analyze the presence of the most important cardiovascular (CV) risk factors and to discuss patterns of LDL cholesterol management in the population studied. METHODS: We enrolled 961 males, average age of 42.9 ± 4.7, and 851 females, average age of 51.2 ± 3.6. Data on personal, pharmacological and family history, and laboratory examinations were collected. Cardiovascular (CV) risk was calculated using the Systematic Coronary Risk Evaluation (SCORE) algorithm with modifications according to the guidelines. RESULTS: The distribution of CV risk in the observed cohort was as follows: 24% of the subjects had low, 51% moderate, 17% high and 8% very high risk. The percentage of patients who reached target values of LDL cholesterol was dramatically lower in the groups with very high (1%) and high (3%) risk than in the groups with moderate (14%) or low risk (59%). Dyslipidemia was newly identified in 20% of both sexes. Arterial hypertension was newly diagnosed in 8% of males and 5% of females, and type 2 diabetes mellitus was newly diagnosed in 3% of both the males and females. Dyslipidemia was present in 39% of males and 41% of females; arterial hypertension in 43% of males and 45% of females, and type 2 diabetes mellitus was diagnosed in 11% of the subjects of both sexes. 49% of males and 31% of females were overweight and 32% of both genders were obese. There were 36% of male smokers and 22% of female smokers. 48% of the participants were pharmacologically treated. Non-pharmacological treatment was recommended to 62% of male and to 65% of female participants. Pharmacological intervention was started in 53% of males and 51% of females. In both gender antihypertensive treatment with angiotensin-converting enzyme (ACE) inhibitors (29% of males and 27% of females) and lipid lowering therapy with a statin (28% of males, 27% of females) were the most commonly initiated treatments. In the subgroup of the 101 patients with LDL cholesterol levels > 5 mmol/L 56% were not treated with a statin. The analysis of relationship between the positive family history of any of the followed CV risks showed significant increases of the risk for arterial hypertension, type 2 diabetes mellitus and dyslipidemia. CONCLUSION: European guidelines suggest general screening for risk factors, including analysis of lipid profiles in the population of 40-year-old males and 50-year-old or postmenopausal women. Our study documents high prevalence and incidence of CV risk factors together with insufficient control of the risk factors in Czech patients of this age range. This finding suggests that preventive examinations should be undertaken earlier (e.g., in 30-year-old males and 40-year-old women). Exact timing of the preventive check-ups to yield the best cost-benefit ratio needs to be verified.
- MeSH
- antihypertenziva terapeutické užití MeSH
- diabetes mellitus 2. typu farmakoterapie epidemiologie MeSH
- dospělí MeSH
- dyslipidemie farmakoterapie epidemiologie MeSH
- hypertenze farmakoterapie epidemiologie MeSH
- incidence MeSH
- inhibitory ACE terapeutické užití MeSH
- kardiovaskulární nemoci farmakoterapie epidemiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- obezita farmakoterapie epidemiologie MeSH
- prevalence MeSH
- průzkumy a dotazníky MeSH
- rizikové faktory MeSH
- senioři MeSH
- statiny terapeutické užití MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
The aim of this review was to summarize data regarding amaranth as a potential component of lifestyle modification to improve cardiovascular risk profiles by modifying cardiovascular risk factors such as cholesterol, diabetes, and hypertension. PubMed was searched for appropriate articles. The main inclusion criteria for articles were as follows: interventions with amaranth; conducted in humans or animals or in vitro; and reported serum lipids and lipoprotein levels, and antidiabetic, antihypertensive, and antioxidant abilities. The outcome measures were changes in serum lipids and the presence of antidiabetic, antihypertensive, and antioxidant activity. A total of 33 articles were included herein. Regarding hypolipidemic activity, most studies investigated the effect of intervention with amaranth in animals, and fewer studies were performed in humans. Most studies in animal models demonstrated the ability of amaranth to decrease total cholesterol and low-density lipoprotein cholesterol. Pilot studies in humans were not convincing regarding amaranth's lipid-lowering activity. Based on this search, it is not clear which constituents are potentially responsible for the hypocholesterolemic effect of amaranth. Some authors tend to think that squalene can play a role in this effect, whereas others suggest that different components of amaranth are of greater importance (eg, sterols, oil fractions rich in fatty acids, proteins, amino acids, or fiber) for its hypocholesterolemic effect. It is possible that several constituents are jointly responsible for this action. Regarding the antidiabetic, antihypertensive, and antioxidant activities, most studies were performed in vitro and showed good potential for all three biological effects. Future research should focus on clarifying the effect of amaranth on high-density lipoprotein cholesterol, identifying the constituents responsible for these beneficial effects, and providing more data regarding its use in humans, ideally using randomized controlled trials. The antidiabetic, antihypertensive, and antioxidant activities found in vitro should be confirmed further in animal or human models.
- MeSH
- amarant metabolismus MeSH
- cholesterol krev MeSH
- dieta metody MeSH
- jedlá semena metabolismus MeSH
- kardiovaskulární nemoci metabolismus prevence a kontrola MeSH
- lidé MeSH
- lipidy krev MeSH
- riziko MeSH
- životní styl * MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
Rozvoj aterosklerózy je celoživotní proces. Pacienti sfamiliární hypercholesterolemií (FH) mají při pozdě stanovené diagnóze výskyt kardiovaskulární (KV) příhody o20–30 let dříve než běžná populace. Geneze aterosklerotických změn začíná již prenatálně. Vliv hypercholesterolemie matky napozdější rozvoj aterosklerotických lézí upotomků není ještě přesně vyjasněn. Jakkoli snižování koncentrace cholesterolu upacientek sFH během gravidity může být přínosem pro plod imatku, není vsoučasné době hypolipidemická farmakoterapie kromě pryskyřic vtěhotenství indikována. Sohledem naceloživotní expozici výrazně zvýšeným koncentracím LDL cholesterolu jsou pacienti sFH jasnými kandidáty aktivního screeningu vpopulaci. Aktuální nastavení screeningových aktivit se řídí evropskými doporučeními. Průzkum realizovaný vordinacích českých praktických lékařů upacientů vevěkových kategoriích, kdy evropské autority doporučují plošné stanovení KV rizika, ukázal vysokou prevalenci významných rizikových faktorů, adokonce inezanedbatelné zastoupení osob smanifestním KV onemocněním. Nadruhou stranu ale vsoučasnosti doporučované uspořádání strategie kčasné identifikaci rizikových osob vČR můžeme považovat zasprávně nastavené, neboť začíná již vdětském věku tzv. selektivním screeningem vpostižených rodinách. Důslednou implementací doporučení aedukací populace kvyužívání preventivních strategií lze dále zlepšit výsledky prevence komplikací aterosklerózy.
The development of atherosclerosis is alife‑long process. Patients with familial hypercholesterolaemia (FH) at alate diagnosis have ahistory of cardiovascular events 20‑30 years earlier than the normal population. The genesis of atherosclerotic changes begins prenatally. The effect of maternal hypercholesterolemia on later development of atherosclerotic lesions inoffspring is not yet fully clarified. Although lowering cholesterol levels in patients with FH during pregnancy may result in both fetal and maternal benefits, hypolipidemic drug therapy except for resins is not indicated during pregnancy. With regard to lifelong exposure to significantly elevated LDL cholesterol levels, patients with FH are clear candidates for active screening in the population. Current screening settings are governed by European recommendations. Asurvey conducted in the practice of Czech GPs in patients in the age brackets, where European authorities recommend an area assessment of the CVD risk, has shown ahigh prevalence of significant risk factors and even asignificant number of people with manifest CVD. Onthe other hand, the current organization of the strategy for the early identification of risk persons in the Czech Republic can be regarded as properly set, as it starts already in childhood by so‑called selective screening in affected families. By thoroughly implementing recommendations and educating the population to use preventive strategies, it is possible to improve the results of the prevention of atherosclerosis.
- MeSH
- ateroskleróza etiologie genetika MeSH
- hyperlipoproteinemie typ II * diagnóza farmakoterapie genetika MeSH
- LDL-cholesterol krev normy MeSH
- lidé MeSH
- primární prevence MeSH
- rizikové faktory MeSH
- statiny farmakologie škodlivé účinky terapeutické užití MeSH
- těhotenství MeSH
- vývoj plodu fyziologie genetika MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- přehledy MeSH
- MeSH
- dospělí MeSH
- epidemiologické studie MeSH
- hodnocení rizik MeSH
- hypercholesterolemie epidemiologie MeSH
- kardiovaskulární nemoci * epidemiologie MeSH
- LDL-cholesterol MeSH
- lidé středního věku MeSH
- lidé MeSH
- prevalence MeSH
- primární prevence MeSH
- průzkumy a dotazníky MeSH
- rizikové faktory * MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Geografické názvy
- Česká republika MeSH
- Publikační typ
- abstrakt z konference MeSH
Amaranth was identified as a possible component of an anti-sclerotic diet. To date, particular substances responsible for this effect have not been exactly specified. Squalene, which is contained in amaranth, could be responsible for this effect. However, there are also other potential substances and the hypolipidemic effect of amaranth can be caused by a synergistic effect of several components. This study investigated and compared the impact of amaranth flour and squalene on the total cholesterol (CHOL(TOT)) and LDL cholesterol (CHOL(LDL)) levels in mice with dyslipidemia induced by a cholesterol- and sugar-rich diet. The experiment included 40 inbred mice (C57Bl/6J SPF). After a 7-days acclimatization period, animals were divided into four groups by random. Individual groups were fed different diets for 49 days: control (group C), high energy diet (group HED), high energy diet with amaranth flour (group HED+A) and high energy diet with squalene (group HED+S). The sugar- and cholesterol-rich diet in HED resulted in the significant increase in the levels of CHOL(TOT) by 125% (P < 0.05) and CHOL(LDL) by 304% (P < 0.05), and at the same time in a decrease of HDL cholesterol (CHOL(HDL)) levels by 58% (P < 0.05) compared to group C. To the contrary, amaranth flour enriched diet in group HED+A led to a decrease of CHOL(TOT) levels by 33% (P < 0.05) and CHOL(LDL) by 37% (P < 0.05), compared to HED. Both, amaranth flour and squalene, had a positive impact on CHOL(HDL) levels. Compared to group HED, there was a 47% increase in HED+A and a 60% increase in HED+S. Results proved the favorable impact of amaranth flour on the levels of total cholesterol CHOL(TOT) and also on CHOL(LDL). Furthermore, the results imply that amaranth flour contains besides squalene other substances, which can actively participate in its hypolipidemic effect.
- MeSH
- amarant * chemie MeSH
- cholesterol krev MeSH
- dieta škodlivé účinky klasifikace MeSH
- dyslipidemie krev etiologie terapie MeSH
- energetický příjem MeSH
- mouka MeSH
- myši inbrední C57BL MeSH
- myši MeSH
- náhodné rozdělení MeSH
- organismy bez specifických patogenů MeSH
- skvalen farmakologie MeSH
- zvířata MeSH
- Check Tag
- mužské pohlaví MeSH
- myši MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
