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REFLECTIONS rtensio n
Hypertension Global Newsletter #3 Hype
propeptide of procollagen type I (PICP). This integrated Hype
CLINICAL PEARLS FROM THE FACULTY
approach of imaging and chemical biomarkers may enable n oisnetr
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PROF. CHAVEZ DISCUSS HIS clinicians to more accurately prevent HF in patients with HHD.
THOUGHTS ON THE PRACTICALITY
OF INCORPORATING IMAGING AND Incorporating precision medicine in the management of
CIRCULATING BIOMARKERS FOR patients with HHD through the selection of personalized
THE NONINVASIVE DIAGNOSIS OF MI therapies aimed not only at BP control and LVH regression,
FIBROSIS. but also at the prevention and reduction of MIF, (for example
through the combination of losartan and torasemide) may
reduce the risk of HF. The proposed myocardial-focused
paradigm of personalized treatment is based on limited clinical
trials and there is a need for a broader research agenda
and larger prospective RCT to validate that serum PICP is a
definitive biomarker in HHD, and that PICP-targeted therapy
leads to decreased development of HF in patients with HHD.
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FOR THE LINK TO FULL ARTICLE
Childhood cardiovascular risk factors and adult cardiovascular events.
Jacobs DR Jr, et al. N Engl J Med. 2022 May 19;386(20):1877-1888.
Cardiovascular risk factors in childhood, including BMI, What is a z-score?
cholesterol level, triglycerides, SBP, and youth smoking, are The number of standard deviations from the
known to predict subclinical CV events in adulthood, but mean value of the reference population
links to clinical events are lacking. This prospective cohort
study involved participants in the International Childhood A positive z-score means the data point is
Cardiovascular Cohort (i3C) Consortium and evaluated above average
childhood risk factors (at the ages of three to 19 years) with CV
events in adulthood after a mean follow-up of 35 years. A negative z-score means the data point is
below average
The results of the i3C Consortium Outcomes Study included
seven cohorts from the United States, Finland, and Australia.
Study outcomes were fatal CV events and fatal or nonfatal CV
events. The five risk factors were analyzed to create age- and
sex-standardized z-scores.
In the analysis of 319 fatal CV events among 38,589
participants, the hazard ratios ranged from 1.30 (95% CI
1.14–1.47) per unit increase in the z-score for total cholesterol
level to 1.61 (95% CI 1.21–2.13) for youth smoking (yes vs. no).
The results were similar in the analysis of 779 fatal or nonfatal
CV events among 20,656 participants who could be evaluated
for this outcome.
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