BACKGROUND: It is important to gain insight into opportunities for secondary prevention of cardiovascular disease. Our aim was to investigate levels and trends in cardiovascular risk factors and... Show moreBACKGROUND: It is important to gain insight into opportunities for secondary prevention of cardiovascular disease. Our aim was to investigate levels and trends in cardiovascular risk factors and drug treatment in Dutch post-myocardial infarction (MI) patients between 2002 and 2006 and to make comparisons with the EUROASPIRE surveys (1999-2007). METHODS: We analysed data from 4837 post-MI patients (aged 69 years, 78% men) from 32 Dutch hospitals, using baseline cross-sectional data from the Alpha Omega Trial. RESULTS: Between 2002 and 2006, significant declines were found in the prevalence of smoking (23% to 16%, p < 0.001), hypercholesterolaemia (≥5 mmol/l; 54% to 27%, p < 0.0001) and hypertension (≥140/90 mmHg; 58% to 48%, p < 0.001). The prevalence of antithrombotic drugs was high (97%). The prevalence of lipid-modifying drugs and antihypertensives was high, and increased (74% to 90%, p < 0.0001 and 82% to 93%, p < 0.001, respectively). The prevalence of obesity (27%) was high in 2002 and decreased to 24% in 2006, albeit not significantly. Diabetes prevalence was high and increased between 2002 and 2006 (18% to 22%, p = 0.02). In comparison with EUROASPIRE patients, who were on average 8-10 years younger, our study in 2006 included patients with lower levels of obesity, hypertension, hypercholesterolaemia, diabetes and lower use of antiplatelets and β-blockers, but similar levels of lipid-modifying drugs. CONCLUSIONS: This study showed that older Dutch post-MI patients were adequately treated with drugs, and that risk factors reached lower levels than in the younger EUROASPIRE patients. However, there is room for improvement in diet and lifestyle, given the high prevalence of smoking, obesity, and diabetes. Show less
Purpose: To study age-related change in aortic stiffness in patients with Marfan syndrome (MFS) versus healthy volunteers using velocity-encoded (VE) MRI. Materials and Methods: Twenty-five MFS... Show morePurpose: To study age-related change in aortic stiffness in patients with Marfan syndrome (MFS) versus healthy volunteers using velocity-encoded (VE) MRI. Materials and Methods: Twenty-five MFS patients (age range, 18-63 years; mean age 36 +/- 14 years, 13 men) and 25 age-/gender-matched healthy volunteers were examined with VE-MRI. Aortic stiffness was expressed by pulse wave velocity (PWV), assessed in the proximal and distal part of the aorta and in the total aorta. PWV was compared between patients and volunteers and age-relation was determined by linear regression. Results: PWV was significantly higher in all parts of the aorta in patients when compared with healthy volunteers (proximal aorta 5.7 +/- 1.5 m/s versus 4.8 +/- 0.9 m/s, distal aorta 6.4 +/- 2.4 m/s versus 5.0 +/- 1.2 m/s and total aorta 5.9 +/- 1.7 m/s versus 4.9 +/- 1.1 m/s, all P < 0.004). PWV correlated significantly with age (Pearson R between 0.45 and 0.94). Only in the proximal aorta, the increase in PWV with age was significantly higher in patients (7 +/- 2 cm/s increase with age) than in volunteers (3 +/- 1 cm/s Increase, P = 0.03); in the distal or total aorta, the increase in PWV with age was not different between patients and volunteers. Conclusion: Velocity-encoded MRI detects more pronounced age-related aortic stiffening in the proximal aorta in MFS patients versus healthy volunteers, suggesting more severe wall disease in MFS. Show less
