Effect of 24 weeks of statin therapy on systemic and vascular inflammation in HIV-infected subjects receiving antiretroviral therapy. Quercetin reduces systolic blood pressure and plasma oxidised low-density lipoprotein concentrations in overweight subjects with a high-cardiovascular disease risk phenotype: a double-blinded, placebo-controlled cross-over study. Raisins and additional walking have distinct effects on plasma lipids and inflammatory cytokines The Influence of Triclosan on Biomarkers of Cardiovascular Risk in Patients in the Cardiovascular and Periodontal Study (CAPS): A Randomized Controlled Trial. Lipoprotein(a) as a cardiovascular risk factor: current status Physical activity and cardiovascular mortality risk: possible protective mechanisms? A high intake of trans fatty acids has little effect on markers of inflammation and oxidative stress in humans. Markers of inflammation and cardiovascular disease: application to clinical and public health practice: A statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Effects of eicosapentaenoic acid and docosahexaenoic acid on cardiovascular disease risk factors: a randomized clinical trial. Association between cholesterol synthesis/absorption markers and effects of cholesterol lowering by atorvastatin among patients with high risk of coronary heart disease[S] Genetic variation at the LDL receptor and HMG-CoA reductase gene loci, lipid levels, statin response, and cardiovascular disease incidence in PROSPER. Cumulative inflammation associates with asymmetric dimethylarginine in rheumatoid arthritis: a 6 year follow-up study. Interaction between Mediterranean diet and statins on mortality risk in patients with cardiovascular disease: Findings from the Moli-sani Study. 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Combined influence of cardiorespiratory fitness and body mass index on cardiovascular disease risk factors among 8-18 year old youth: The Aerobics Center Longitudinal Study. Effects of soluble fiber (Plantago ovata husk) on plasma lipids, lipoproteins, and apolipoproteins in men with ischemic heart disease. Effect of intensive lipid-lowering therapy on cardiovascular outcome in patients with and those without inflammatory joint disease. Effect of a plant stanol ester-containing spread, placebo spread, or Mediterranean diet on estimated cardiovascular risk and lipid, inflammatory and haemostatic factors. Effect of Sesamin Supplementation on Cardiovascular Risk Factors in Women with Rheumatoid Arthritis Effects of dietary strawberry powder on blood lipids and inflammatory markers in obese human subjects. Increased cardiovascular disease mortality associated with excessive exercise in heart attack survivors. Exchanging a few commercial, regularly consumed food items with improved fat quality reduces total cholesterol and LDL-cholesterol: a double-blind, randomised controlled trial. Baseline characteristics of participants in the JUPITER trial, a randomized placebo-controlled primary prevention trial of statin therapy among individuals with low low-density lipoprotein cholesterol and elevated high-sensitivity C-reactive protein. [The effect of omega-3 fatty acids on risk factors for cardiovascular diseases]. Rationale and Design of the Standard Versus Intensive Statin Therapy for Hypercholesterolemic Patients with Diabetic Retinopathy (EMPATHY) Study: a Randomized Controlled Trial. The effects of ezetimibe on surrogate markers of cholesterol absorption and synthesis in Japanese patients with dyslipidemia. Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial: design and methods. Angiotensin Converting Enzyme Inhibitor and HMG-CoA Reductase Inhibitor as Adjunct Treatment for Persons with HIV Infection: A Feasibility Randomized Trial Depression, inflammation, and incident cardiovascular disease in women with suspected coronary ischemia: the National Heart, Lung, and Blood Institute-sponsored WISE study. One-year consumption of a grape nutraceutical containing resveratrol improves the inflammatory and fibrinolytic status of patients in primary prevention of cardiovascular disease. Severe Hypoglycemia and Cardiovascular Disease Incidence in Type 1 Diabetes Association Between Urinary Albumin Excretion and Low-density Lipoprotein Heterogeneity Following Treatment of Type 2 Diabetes Patients with the Dipeptidyl Peptidase-4 Inhibitor, Vildagliptin: A Pilot Study A randomized trial of the effect of statin and fibrate therapy on arterial function in CKD. 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Food patterns, inflammation markers and incidence of cardiovascular disease: the Malmö Diet and Cancer study. Atorvastatin Therapy Modulates Telomerase Activity in Patients Free of Atherosclerotic Cardiovascular Diseases Efficacy of a Therapeutic Lifestyle Change/Step 2 diet in moderately hypercholesterolemic middle-aged and elderly female and male subjects. Effects of 4 weeks of atorvastatin administration on the antiinflammatory cytokine interleukin-10 in patients with unstable angina. A genetic variant of PPARA modulates cardiovascular risk biomarkers after milk consumption. Soy protein reduces serum LDL cholesterol and the LDL cholesterol:HDL cholesterol and apolipoprotein B:apolipoprotein A-I ratios in adults with type 2 diabetes. Do trans fatty acids from industrially produced sources and from natural sources have the same effect on cardiovascular disease risk factors in healthy subjects? Results of the trans Fatty Acids Collaboration (TRANSFACT) study. 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BACKGROUND Human immunodeficiency virus (HIV)-infected individuals are at increased risk of cardiovascular disease ( CVD ) due in part to inflammation . Statins decrease inflammation in the general population , but their effect during HIV infection is largely unknown . METHODS This is an ongoing r and omized , double-blinded , placebo-controlled trial to evaluate the effect of statin therapy on inflammatory markers during HIV infection . Subjects received rosuvastatin 10 mg daily or placebo for 24 weeks . Subjects were receiving stable ( > 12 weeks ) antiretroviral therapy and had a low-density lipoprotein ( LDL ) cholesterol level of ≤130 mg/dL and evidence of heightened immune activation or inflammation . This was a prespecified interim analysis . RESULTS A total of 147 subjects were enrolled ( 78 % were male , 70 % were black , and the median age was 47 years ) . By 24 weeks , LDL cholesterol levels had decreased in the statin group , compared with an increase in the placebo group ( -28 % vs + 3.8 % ; P < .01 ) . A 10 % reduction in the lipoprotein-associated phospholipase A2 ( Lp-PLA2 ) level was seen in the statin group , compared with a 2 % reduction in the placebo group ( P < .01 ) . In multivariable regression , receipt of statin treatment and having a nadir CD4(+ ) T-cell count of ≤100 cell/µL were the only statistically significant predictors of a decrease in Lp-PLA2 level . Markers of systemic inflammation did not change significantly between groups . CONCLUSIONS Twenty-four weeks of rosuvastatin therapy significantly decreased the level of Lp-PLA2 , a vascular-specific , inflammatory enzyme that predicts cardiovascular events in the general population . Statins may hold promise as a means of attenuating CVD risk in HIV-infected individuals by decreasing Lp-PLA2 levels Regular consumption of flavonoids may reduce the risk for CVD . However , the effects of individual flavonoids , for example , quercetin , remain unclear . The present study was undertaken to examine the effects of quercetin supplementation on blood pressure , lipid metabolism , markers of oxidative stress , inflammation , and body composition in an at-risk population of ninety-three overweight or obese subjects aged 25 - 65 years with metabolic syndrome traits . Subjects were r and omised to receive 150 mg quercetin/d in a double-blinded , placebo-controlled cross-over trial with 6-week treatment periods separated by a 5-week washout period . Mean fasting plasma quercetin concentrations increased from 71 to 269 nmol/l ( P < 0.001 ) during quercetin treatment . In contrast to placebo , quercetin decreased systolic blood pressure ( SBP ) by 2.6 mmHg ( P < 0.01 ) in the entire study group , by 2.9 mmHg ( P < 0.01 ) in the subgroup of hypertensive subjects and by 3.7 mmHg ( P < 0.001 ) in the subgroup of younger adults aged 25 - 50 years . Quercetin decreased serum HDL-cholesterol concentrations ( P < 0.001 ) , while total cholesterol , TAG and the LDL : HDL-cholesterol and TAG : HDL-cholesterol ratios were unaltered . Quercetin significantly decreased plasma concentrations of atherogenic oxidised LDL , but did not affect TNF-alpha and C-reactive protein when compared with placebo . Quercetin supplementation had no effects on nutritional status . Blood parameters of liver and kidney function , haematology and serum electrolytes did not reveal any adverse effects of quercetin . In conclusion , quercetin reduced SBP and plasma oxidised LDL concentrations in overweight subjects with a high-CVD risk phenotype . Our findings provide further evidence that quercetin may provide protection against CVD Background Raisins are a significant source of dietary fiber and polyphenols , which may reduce cardiovascular disease ( CVD ) risk by affecting lipoprotein metabolism and inflammation . Walking represents a low intensity exercise intervention that may also reduce CVD risk . The purpose of this study was to determine the effects of consuming raisins , increasing steps walked , or a combination of these interventions on blood pressure , plasma lipids , glucose , insulin and inflammatory cytokines . Results Thirty-four men and postmenopausal women were matched for weight and gender and r and omly assigned to consume 1 cup raisins/d ( RAISIN ) , increase the amount of steps walked/d ( WALK ) or a combination of both interventions ( RAISINS + WALK ) . The subjects completed a 2 wk run-in period , followed by a 6 wk intervention . Systolic blood pressure was reduced for all subjects ( P = 0.008 ) . Plasma total cholesterol was decreased by 9.4 % for all subjects ( P < 0.005 ) , which was explained by a 13.7 % reduction in plasma LDL cholesterol ( LDL-C ) ( P < 0.001 ) . Plasma triglycerides ( TG ) concentrations were decreased by 19.5 % for WALK ( P < 0.05 for group effect ) . Plasma TNF-α was decreased from 3.5 ng/L to 2.1 ng/L for RAISIN ( P < 0.025 for time and group × time effect ) . All subjects had a reduction in plasma sICAM-1 ( P < 0.01 ) . Conclusion This research shows that simple lifestyle modifications such as adding raisins to the diet or increasing steps walked have distinct beneficial effects on CVD risk BACKGROUND Triclosan toothpaste is effective in controlling plaque and gingivitis and slowing progression of periodontitis ; however , its influence on inflammatory biomarkers of cardiovascular disease ( CVD ) , as well as on kidney and liver function , is unknown . METHODS Patients recruited from the Cardiovascular Unit at Prince Charles Hospital , Brisbane , Australia , were r and omized to triclosan ( n = 193 ) or placebo ( n = 190 ) groups and assessed for total cholesterol ( TC ) , high density lipoprotein ( HDL ) and low density lipoprotein ( LDL ) cholesterol , triglycerides , C-reactive protein , erythrocyte sedimentation rate ( ESR ) , hemoglobin , total white cell count ( WCC ) , estimated glomerular filtration rate ( eGFR ) , and liver function enzymes , annually for 5 years . A st and ard mixed model for each marker included group , sex , age , hypertension , diabetes , periodontal status , statin and anti-inflammatory drug use , and smoking as covariates . Changes in eGFR , WCC , and ESR were further analyzed using transition modeling . RESULTS Triclosan toothpaste led to a greater decrease in TC ( P = 0.03 ) , LDL cholesterol ( P = 0.04 ) , and HDL cholesterol ( P = 0.05 ) than placebo toothpaste . ESR increased at a slower rate in the triclosan group ( P ≈ 0.06 ) and was less likely to increase and more likely to improve in males on statins but not anti-inflammatory drugs in the triclosan group versus the placebo group . Markov modeling of the binary response for eGFR ( greater than or less than/equal to the baseline median value ) showed that patients with diabetes in the placebo group were significantly ( P ≈ 0.05 ) more likely to deteriorate than either patients with diabetes in the triclosan group or patients without diabetes in each group . CONCLUSIONS These data suggest that triclosan toothpaste may influence some inflammatory biomarkers of CVD , but not kidney or liver function . However , it is unclear if this influence is clinical ly significant Aims The aims of the study were , first , to critically evaluate lipoprotein(a ) [ Lp(a ) ] as a cardiovascular risk factor and , second , to advise on screening for elevated plasma Lp(a ) , on desirable levels , and on therapeutic strategies . Methods and results The robust and specific association between elevated Lp(a ) levels and increased cardiovascular disease (CVD)/coronary heart disease ( CHD ) risk , together with recent genetic findings , indicates that elevated Lp(a ) , like elevated LDL-cholesterol , is causally related to premature CVD/CHD . The association is continuous without a threshold or dependence on LDL- or non-HDL-cholesterol levels . Mechanistically , elevated Lp(a ) levels may either induce a prothrombotic/anti-fibrinolytic effect as apolipoprotein(a ) resembles both plasminogen and plasmin but has no fibrinolytic activity , or may accelerate atherosclerosis because , like LDL , the Lp(a ) particle is cholesterol-rich , or both . We advise that Lp(a ) be measured once , using an isoform-insensitive assay , in subjects at intermediate or high CVD/CHD risk with premature CVD , familial hypercholesterolaemia , a family history of premature CVD and /or elevated Lp(a ) , recurrent CVD despite statin treatment , ≥3 % 10-year risk of fatal CVD according to European guidelines , and /or ≥10 % 10-year risk of fatal + non-fatal CHD according to US guidelines . As a secondary priority after LDL-cholesterol reduction , we recommend a desirable level for Lp(a ) < 80th percentile ( less than ∼50 mg/dL ) . Treatment should primarily be niacin 1–3 g/day , as a meta- analysis of r and omized , controlled intervention trials demonstrates reduced CVD  by niacin treatment . In extreme cases , LDL-apheresis is efficacious in removing Lp(a ) . Conclusion We recommend screening for elevated Lp(a ) in those at intermediate or high CVD/CHD risk , a desirable level < 50 mg/dL as a function of global cardiovascular risk , and use of niacin for Lp(a ) and CVD/CHD risk reduction INTRODUCTION The biological mechanisms through which increased physical activity or structured exercise training lowers the risk of recurrent cardiac events are incompletely understood . We examined the extent to which modification of primary risk markers explains the association between physical activity and cardiovascular death in participants with diagnosed cardiovascular disease ( CVD ) . METHODS AND RESULTS In a prospect i ve study of 1429 participants with physician-diagnosed CVD living in Engl and and Scotl and ( age = 66.5 ± 11.1 yr ( mean ± SD ) , 54.2 % men ) , we measured physical activity and several risk markers ( body mass index , total-to-HDL cholesterol ratio , diagnosed diabetes , systolic blood pressure , resting heart rate , C-reactive protein ) at baseline . The main outcome was CVD death . There were a total of 446 all-cause deaths during an average of 7.0 ± 3.1 yr of follow-up , of which 213 were attributed to cardiovascular causes . Participation in moderate to vigorous physical activity at least three sessions per week was associated with lower risk of CVD death ( hazard ratio = 0.61 , 95 % confidence interval = 0.38 - 0.98 ) . Physically active participants demonstrated significantly lower levels of body mass index , diabetes , and inflammatory risk ( C-reactive protein ) . Metabolic ( body mass index , total-to-HDL cholesterol ratio , and physician-diagnosed diabetes ) and inflammatory risk factors explained an estimated 12.8 % and 15.4 % , respectively , of the association between physical activity and CVD death . CONCLUSIONS Physical activity may reduce the risk of secondary CVD events , in part , by improving metabolic and inflammatory risk markers Consumption of industrial trans fatty acids ( iTFA ) increases LDL cholesterol , decreases HDL cholesterol , and is strongly associated with a higher risk of cardiovascular disease ( CVD ) . However , changes in circulating cholesterol can not explain the entire effect . Therefore , we studied whether iTFA and conjugated linoleic acid ( CLA ) affect markers of inflammation and oxidative stress .  Sixty-one healthy adults consumed each of 3 diets for 3 wk , in r and om order . Diets were identical except for 7 % of energy provided by oleic acid ( control diet ) , iTFA , or CLA . At the end of the 3 wk , we measured plasma inflammatory markers IL-6 , C-reactive protein , tumor necrosis factor receptors I and II ( TNF-RI and -RII ) , monocyte chemotactic protein-1 and E-selectin , and urinary 8-iso-PGF(2α ) , a marker of lipid peroxidation . Consumption of iTFA caused 4 % lower TNF-RI concentrations and 6 % higher E-selectin concentrations compared with oleic acid ( control ) and had no significant effect on other inflammatory markers . CLA did not significantly affect inflammatory markers . The urine concentration of 8-iso-PGF(2α ) [ geometric mean ( 95 % CI ) ] was greater after the iTFA [ 0.54 ( 0.48 , 0.60 ) nmol/mmol creatinine ] and the CLA [ 1.2 ( 1.1 , 1.3 ) nmol/mmol creatinine ] diet periods than after the control period [ 0.45 ( 0.41 , 0.50 ) nmol/mmol creatinine ; P < 0.05 ] . In conclusion , high intakes of iTFA and CLA did not substantially affect plasma concentrations of inflammatory markers , but they increased the urine 8-iso-PGF(2α ) concentration . However , it is unlikely this plays a major role in the mechanism by which iTFA increase the risk of CVD . However , more research is needed to fully underst and the implication s of these findings In 1998 , the American Heart Association convened Prevention Conference V to examine strategies for the identification of high-risk patients who need primary prevention . Among the strategies discussed was the measurement of markers of inflammation.1  The Conference concluded that “ many of these markers ( including inflammatory markers ) are not yet considered applicable for routine risk assessment because of : ( 1 ) lack of measurement st and ardization , ( 2 ) lack of consistency in epidemiological findings from prospect i ve studies with endpoints , and ( 3 ) lack of evidence that the novel marker adds to risk prediction over and above that already achievable through the use of established risk factors . ” The National Cholesterol Education Program Adult Treatment Panel III Guidelines identified these markers as emerging risk factors,1a which could be used as an optional risk factor measurement to adjust estimates of absolute risk obtained using st and ard risk factors . Since these publications , a large number of peer- review ed scientific reports have been published relating inflammatory markers to cardiovascular disease ( CVD ) . Several commercial assays for inflammatory markers have become available . As a consequence of the exp and ing research base and availability of assays , the number of inflammatory marker tests ordered by clinicians for CVD risk prediction has grown rapidly . Despite this , there has been no consensus from professional societies or governmental agencies as to how these assays of markers of inflammation should be used in clinical practice . On March 14 and 15 , 2002 , a workshop titled “ CDC/AHA Workshop on Inflammatory Markers and Cardiovascular Disease : Applications to Clinical and Public Health Practice ” was convened in Atlanta , Ga , to address these issues . The goals of this workshop were to determine which of the currently available tests should be used ; what results should be used to define high risk ; which patients should be tested ; and the indications for which the tests would be most useful . These BACKGROUND Eicosapentaenoic acid ( EPA ) and docosahexaenoic acid ( DHA ) , the primary omega-3 fatty acids in fish oil , have been shown to reduce cardiovascular disease ( CVD ) risk . OBJECTIVE This study aim ed to examine the independent effects of EPA and DHA on lipid and apolipoprotein levels , as well as on inflammatory biomarkers of CVD risk , using doses often used in the general population . DESIGN A blinded , r and omized 6-week trial was performed in 121 healthy , normolipidemic subjects who received olive oil placebo 6g/d , EPA 600mg/d , EPA 1800mg/d , or DHA 600mg/d .  The EPA was derived from genetically modified yeast . RESULTS The subjects tolerated the supplements well with no safety issues ; and the expected treatment-specific increases in plasma EPA and DHA levels were observed . Compared to placebo , the DHA group had significant decreases in postpr and ial triglyceride ( TG ) concentrations ( -20 % , -52.2mg/dL , P=0.03 ) , significant increases in fasting and postpr and ial low-density lipoprotein cholesterol ( LDL-C ) ( + 18.4 % , 17.1mg/dL , P=0.001 ) , with no significant changes in inflammatory biomarkers . No significant effects were observed in the EPA 600mg/d group . The high-dose EPA group had significant decreases in lipoprotein-associated phospholipase A2 concentrations ( Lp-PLA2 ) ( -14.1 % , -21.4ng/mL , P=0.003 ) . CONCLUSIONS The beneficial effects of EPA 1800mg/d on CVD risk reduction may relate in part to the lowering of Lp-PLA2 without adversely affecting LDL-C. In contrast , DHA decreased postpr and ial TG , but raised LDL-C. Our observations indicate that these dietary fatty acids have divergent effects on cardiovascular risk markers No indices are currently available to facilitate clinicians to identify patients who need either statin monotherapy or statin-ezetimibe combined treatment . We aim ed to investigate whether cholesterol synthesis and absorption markers can predict the cholesterol-lowering response to statin . Total 306 statin-naïve patients with high risk of coronary heart disease ( CHD ) were treated with atorvastatin 20 mg/day for 1 month . Cholesterol synthesis and absorption markers and LDL cholesterol ( LDL-C ) levels were measured before and after treatment . Atorvastatin decreased LDL-C by 36.8 % ( range : decrease of 74.5 % to increase of 31.9 % ) . Baseline cholesterol synthesis marker lathosterol and cholesterol absorption marker campesterol codetermined the effect of atorvastatin treatment . The effect of cholesterol lowering by atorvastatin was significantly associated with baseline lathosterol levels but modified bidirectionally by baseline campesterol levels . In patients with the highest baseline campesterol levels , atorvastatin treatment decreased cholesterol absorption by 46.1 % , which enhanced the effect of LDL-C lowering . Atorvastatin treatment increased cholesterol absorption by 52.3 % in those with the lowest baseline campesterol levels , which attenuated the effect of LDL-C reduction . Especially those with the highest lathosterol but the lowest campesterol levels at baseline had significantly less LDL-C reduction than those with the same baseline lathosterol levels but the highest campesterol levels ( 27.3 % versus 42.4 % , P = 0.002 ) . These results suggest that combined patterns of cholesterol synthesis /absorption markers , rather than each single marker , are potential predictors of the LDL-C-lowering effects of atorvastatin in high-risk CHD patients Our purpose was to evaluate associations of single nucleotide polymorphisms ( SNPs ) at the low density lipoprotein ( LDL ) receptor ( LDLR C44857 T , minor allele frequency ( MAF ) 0.26 , and A44964 G , MAF 0.25 , both in the untranslated region ) and HMG-CoA reductase ( HMGCR i18 T > G , MAF 0.019 ) gene loci with baseline lipid values , statin-induced LDL-cholesterol ( C ) lowering response , and incident coronary heart disease ( CHD ) and cardiovascular disease ( CVD ) on trial . Our population consisted of 5804 elderly men and women with vascular disease or one or more vascular disease risk factors , who were r and omly allocated to pravastatin or placebo .  Other risk factors and apolipoprotein ( apo ) E phenotype were controlled for in the analysis . Despite a prior report , no relationships with the HMGCR SNP were noted . For the LDLR SNPs C44857 T and A44964 G we noted significant associations of the rare alleles with baseline LDL-C and triglyceride levels , a modest association of the C44857 T with LDL-C lowering to pravastatin in men , and significant associations with incident CHD and CVD of both SNPs , especially in men on pravastatin . Our data indicate that genetic variation at the LDLR locus can affect baseline lipids , response to pravastatin , and CVD risk in subjects placed on statin treatment OBJECTIVE The aim of the present study was to investigate the associations of cumulative inflammatory burden ( assessed by serial measurements of inflammatory markers ) and classical cardiovascular disease ( CVD ) risk factors with  asymmetric dimethylarginine ( ADMA )  in a large prospect i ve cohort of patients with established RA . METHODS Two hundred and one RA patients [ 155 females , median age 67 years ( range 59 - 73 ) ] were assessed at baseline ( 2006 ) for the presence of classical CVD risk factors and determination of systemic inflammation by CRP and ESR . Global CVD risk was identified by the Framingham Risk Score and the Reynolds Risk Score . At follow-up ( 2012 ) ,  ADMA levels were measured by ELISA . A quarterly measurement of CRP and ESR for each year the patient was in the study was used to produce an average area under the curve ( AAUC ) for ESR and CRP . RESULTS Regression analysis revealed that baseline ESR in 2006 and the AAUC of ESR and CRP all had significant positive relationships with current ADMA ( P = 0.004 , P < 0.001 and P = 0.002 , respectively ) . Baseline CRP in 2006 was not a significant predictor of ADMA ( P = 0.093 ) , although this relationship was in the same direction as the other factors . These results remained consistent after adjustment for classical CVD risk factors . CONCLUSION Cumulative inflammatory burden is positively associated with  ADMA levels , suggesting a potential pathogenic mechanism through which chronic systemic inflammation exerts deleterious effects on nitric oxide metabolism and endothelial homeostasis . This association is independent of classical CVD risk factors BACKGROUND Statins are prescribed for patients with cardiovascular disease ( CVD ) , along with the recommendation of adopting healthy diets . We evaluated the independent and the combined effect of statins and Mediterranean diet ( MD ) towards mortality risk in patients with previous CVD by using real-life data from a population -based prospect i ve cohort . METHODS Longitudinal analysis on 1180 subjects ( mean age 67.7 ± 10 ) with prior CVD at enrollment in the Moli-sani Study and followed up for 7.9 y ( median ) .  Adherence to MD was appraised by a Mediterranean diet score .  Hazard ratios ( HR ) with 95 % confidence intervals ( 95 % CI ) were calculated by multivariable Cox regression and competing risk models . RESULTS Multivariable risk estimates associated with a 2-point increase in MD score were 0.84 ( 95 % CI 0.70 - 1.00 ) , 0.77 ( 0.61 - 0.97 ) and 0.70 ( 0.52 - 0.93 ) for overall , cardiovascular and coronary artery disease (CAD)/cerebrovascular deaths , respectively  . Statins were not associated with death risk . Subjects combining statins and average-high adherence to MD had much lower than expected risk of cardiovascular and CAD/cerebrovascular mortality ( p for interaction = 0.045 and 0.0015 , respectively ) as compared to those neither using statins nor having average-high MD . The combination of average-high MD and statins was associated in a likely synergistic way with reduced low- grade inflammation , but not with blood cholesterol . CONCLUSIONS MD lowered the risk of all-cause , cardiovascular and CAD/cerebrovascular mortality CVD patients , net of statins . In the same population , statins  reduced CVD death risk only in combination with MD . Low- grade inflammation , rather than lipids , is likely to be on the pathway of the interaction between MD and statins towards mortality risk Aims A r and omized , double-blind , placebo-controlled study was conducted to investigate the safety and efficacy of mipomersen , an apolipoprotein B-100 ( apoB ) synthesis inhibitor , in patients who are statin intolerant and at high risk for cardiovascular disease ( CVD ) . Methods and results Thirty-three subjects , not receiving statin therapy because of statin intolerance , received a weekly subcutaneous dose of 200 mg mipomersen or placebo ( 2:1 r and omization ) for 26 weeks . The primary endpoint was per cent change in LDL cholesterol ( LDL-c ) from the baseline to Week 28 . The other efficacy endpoints were per cent change in apoB and lipoprotein a [ Lp(a ) ] . Safety was determined using the incidence of treatment-emergent adverse events ( AEs ) and clinical laboratory evaluations . After 26 weeks of mipomersen  administration , LDL-c was reduced by 47 ± 18 % ( P < 0.001 vs. placebo ) . apoB and Lp(a ) were also significantly reduced by 46 and 27 % , respectively ( P < 0.001 vs. placebo ) . Four mipomersen ( 19 % ) and two placebo subjects ( 17 % ) discontinued dosing prematurely due to AEs . Persistent liver transaminase increases ≥3 × the upper limit of normal were observed in seven ( 33 % ) subjects assigned to mipomersen . In selected subjects , liver fat content was assessed , during and after treatment , using magnetic resonance spectroscopy . Liver fat content in these patients ranged from 0.8 to 47.3 % . Liver needle biopsy was performed in two of these subjects , confirming hepatic steatosis with minimal inflammation or fibrosis . Conclusion The present data suggest that mipomersen is a potential therapeutic option in statin-intolerant patients at high risk for CVD . The long-term follow-up of liver safety is required . Clinical Trial Registration : Clinical Trials.gov identifier : Background GlycA , a novel protein glycan biomarker of N‐acetyl side chains of acute‐phase proteins , was recently associated with incident cardiovascular disease ( CVD ) in healthy women . Whether GlycA predicts CVD events in the setting of statin therapy in men and women without CVD but with evidence of chronic inflammation is unknown . Methods and Results In the Justfication for the Use of Statins in Prevention : an Intervention Trial Evaluating Rosuvastatin ( JUPITER ) trial ( NCT00239681 ) , participants with low‐density lipoprotein cholesterol < 130 mg/dL and high‐sensitivity C‐reactive protein ( hsCRP ) ≥2 mg/L were r and omized to rosuvastatin 20 mg/day or placebo . GlycA was quantified by nuclear magnetic resonance spectroscopy in 12 527 before r and omization and 10 039 participants at 1 year . A total of 310 first primary CVD events occurred during maximum follow‐up of 5.0 years ( median , 1.9 ) . GlycA changed minimally after 1 year on study treatment : 6.8 % and 4.7 % decrease in the rosuvastatin and placebo groups , respectively . Overall , baseline GlycA levels were associated with increased risk of CVD : multivariable‐adjusted hazard ratio ( HR ) per SD increment , 1.20 ( 95 % CI , 1.08–1.34 ; P=0.0006 ) . After additionally adjusting for hsCRP , this was slightly attenuated ( HR , 1.18 ; 95 % CI , 1.04–1.35 ; P=0.01 ) . On‐treatment GlycA levels were also associated with CVD ; corresponding multivariable‐adjusted HRs per SD before and after additionally adjusting for hsCRP : 1.27 ( 95 % CI , 1.13–1.42 ; P<0.0001 ) and 1.24 ( 95 % CI , 1.07–1.44 ; P=0.004 ) , respectively . Tests for heterogeneity by treatment arm were not significant ( P for interaction , > 0.20 ) . Conclusion In the JUPITER trial , increased levels of GlycA were associated with an increased risk of CVD events independent of traditional risk factors and hsCRP . Clinical Trials Registration URL : http://www . clinical trials.gov . Unique identifier : NCT00239681 Objective : To evaluate associations between traditional cardiovascular disease ( CVD ) risk factors , inflammatory markers and markers of HIV disease activity with ultrasonographic measures of CVD risk in patients with HIV who are not receiving antiretroviral therapy ( ART ) . Design : Cross-sectional , baseline evaluation of ART-naive HIV-infected individuals without known CVD or diabetes mellitus enrolled in a r and omized ART treatment trial . Methods : Prior to ART initiation ,  carotid artery intima – media thickness ( CIMT ) and brachial artery flow-mediated dilation ( FMD ) were measured . Additional parameters included CD4 cell count , HIV viral load , body composition , lipoproteins and inflammatory markers . Associations with common CIMT , bifurcation CIMT , presence of carotid artery lesions and brachial artery FMD were evaluated . Results : The 331 enrolled individuals were a median ( first – third quartile ) of 36 ( 28–45 ) years old .  Common and bifurcation CIMT values were higher and lesions more prevalent with older age ( P < 0.001 ) . FMD was lower with older age ( P = 0.009 ) . Those with a Framingham Risk Score of at least 6 % per 10 years ( N = 44 ) had higher common and bifurcation CIMT ( P < 0.001 ) , carotid lesion prevalence ( P < 0.001 ) and lower FMD ( P = 0.035 ) . Independent associations with common CIMT were identified for increasing age , height , weight , small low-density lipoprotein ( LDL ) particles and black race ; these were similar for bifurcation CIMT . Presence of carotid artery lesions was associated with increasing age , presence of metabolic syndrome , interleukin-6 and lower HIV-1 RNA . Conclusion : In a contemporary cohort of ART-naive HIV-infected individuals , ultrasonographic measures of CVD risk were more strongly associated with traditional risk factors than CD4 cell counts , HIV replication or inflammatory markers BACKGROUND Observational data suggest that low 25-hyroxyvitamin D is associated with cardiovascular disease ( CVD ) and its risk factors include diabetes , metabolic syndrome , insulin resistance , hypertension , microalbuminuria and inflammation . We examined the differences between risk factors of CVD before and after treatment with calcitriol in type 2 diabetic patients with vitamin D deficiency . METHODS This study was a clinical trial consisting of 119 type 2 diabetic patients . Forty three patients had vitamin D insufficiency ( 25 OH D less than 30 ng/dl ) who underwent calcitriol treatment  with 0.5 microgram per day for 8 weeks . Blood pressure , fasting blood sugar ( FBS ) , glycosylated hemoglobin ( HbA1C ) , lipid profile , high sensitive C-reactive protein ( HsCRP ) , Homocysteine and albumin to creatinine ratio were measured , before and after the treatment period . Then the two sets of results were compared with each other . RESULTS Following treatment with  calcitriol HbA1C , total cholesterol , low density lipoprotein(LDL ) , high density lipoprotein(HDL ) and diastolic blood pressure decreased significantly ( p = 0.01 , 0.01 , 0.04 , 0.001 and 0.04 respectively ) but the changes in other parameters were not significant . CONCLUSION Replacement of vitamin D may have a beneficial effect on some of the risk factors of CVD in diabetic patients Increased intake of marine long-chain n-3 PUFA ( n-3 LCPUFA ) may decrease the risk of CVD and reduce mortality by lowering serum TAG and blood pressure ( BP ) . Furthermore , n-3 LCPUFA may affect novel CVD risk markers related to inflammation and vascular function . The objective of the present study was to examine the effect of farmed trout on novel and traditional CVD risk markers in healthy men , and to evaluate whether this was affected by the aquacultural feed regime . We performed a parallel , 8-week intervention study in which sixty-eight healthy male volunteers were r and omised to consume either a daily meal with 150 g farmed trout raised on either marine or vegetable-based feed , or a reference meal containing 150 g chicken . Twenty-four hour BP , pulse wave velocity , augmentation index , fatty acid composition of erythrocyte ( RBC ) , and concentrations of TAG , HDL-cholesterol , LDL-cholesterol , glucose , insulin , C-reactive protein ( CRP ) and other markers of inflammation were measured at weeks 0 and 8 . RBC content of total n-3 LCPUFA , both EPA and DHA , was significantly higher among men consuming trout raised on marine feed compared with men consuming the  vegetable-fed trout or chicken . The three intervention groups did not differ significantly with respect to any of the other outcome variables , although there were trends towards associations between the changes in RBC n-3 LCPUFA and those in BP and CRP . In the present study , we conclude that we could not confirm the fish oil-induced reduction in CVD risk markers after daily consumption of trout with high or low n-3 LCPUFA content . However , trout raised on vegetable-based feed had less pronounced impact on RBC n-3 LCPUFA status OBJECTIVE The Diabetes Prevention Program demonstrated the ability to delay or prevent type 2 diabetes in participants with impaired glucose tolerance ( IGT ) . Participants with IGT are at high risk for cardiovascular disease ( CVD ) , with a marked increase in the number and severity of CVD risk factors . We prospect ively assessed the impact of our interventions on hypertension , dyslipidemia , and CVD events . RESEARCH DESIGN AND METHODS The study group consisted of 3,234 individuals with IGT r and omly assigned to receive intensive lifestyle intervention , metformin , or placebo . Annual assessment of blood pressure , lipids , electrocardiogram , and CVD events was undertaken . RESULTS Hypertension was present in 30 % of participants at study entry and then increased in the placebo and metformin groups , although it significantly decreased with intensive lifestyle intervention . Triglyceride levels fell in all treatment groups , but fell significantly more with intensive lifestyle intervention . Total cholesterol and LDL cholesterol levels were similar among treatment groups . Intensive lifestyle intervention significantly increased the HDL cholesterol level and reduced the cumulative incidence of the proatherogenic LDL phenotype B. At 3 years of follow-up , the use for pharmacologic therapy to achieve established goals in the intensive lifestyle group was 27 - 28 % less for hypertension and 25 % less for hyperlipidemia compared with placebo and metformin groups . Over an average of 3 years , 89 CVD events from 64 participants were positively adjudicated study wide , with no differences among treatment groups . CONCLUSIONS Lifestyle intervention improves CVD risk factor status compared with placebo and metformin therapy . Although no differences in CVD events were noted after 3 years , achieved risk factor modifications suggest that longer intervention may reduce CVD event rates OBJECTIVES To examine markers of inflammation in 9- and 15-year-olds with high waist circumference and compare these with controls , and to examine the relationships between inflammatory markers and cardiovascular disease ( CVD ) risk factors . METHODS Cross-sectional analysis of data from 2 299 Norwegian 9- and 15-year-olds participating in the " Physical activity among Norwegian Children Study " . In each sex and age group , the 10 participants with the highest waist circumference ( HW ) were selected ( n=40 ) for analyses , and a r and om sample of 40 participants within the same groups were included as controls . Inflammatory markers included C-reactive protein ( CRP ) , leptin , adiponectin , plasminogen activator inhibitor-1 ( PAI-1 ) , tumor necrosis factor-alpha ( TNF-alpha ) , hepatocyte growth factor ( HGF ) , resistin and interleukin-6 ( IL-6 ) . The CVD risk factors included blood pressure , glucose , insulin , triglycerides and high density lipoprotein cholesterol . RESULTS HW participants had elevated levels of CRP ( mean difference 1.50 mg/l ; 95 % confidence interval [ CI ] 0.33 to 2.66 ) , PAI-1 ( mean difference 13.3 ng/ml ; 95 % CI 4.1 to 22.5 ) and HGF ( mean difference 0.29 ng/ml ; 95 % CI 0.07 to 0.51 ) compared with controls . All CVD risk factors differed between the HW group and controls . The CVD risk factors were not associated with TNFalpha or IL-6 , but CRP , HGF and PAI-1 were related to the metabolic risk score . CONCLUSIONS Low grade systemic inflammation is already present in youth with high waist circumference . CRP , HGF and PAI-1 may be related to the adverse overall metabolic risk profile observed in these children and adolescents OBJECTIVE The purpose of this study was to examine differences in cardiovascular disease ( CVD ) risk factors across four cross-tabulated groups of cardiorespiratory fitness and body mass index in 8- to 18-year-old children and adolescents . METHODS The sample included 296 boys and 188 girls ( mean age=15.7 years ) participating in the Aerobics Center Longitudinal Study . Participants were cross tabulated into four groups using a median split of age-adjusted treadmill time to exhaustion ( TM ) and body mass index ( BMI ) . Group differences in CVD risk factors ( blood pressure [ BP ] , fasting total cholesterol [ TC ] , low density lipoprotein-cholesterol [ LDL-C ] , high density lipoprotein-cholesterol [ HDL-C ] , TC : HDL-C , triglycerides [ TG ] , glucose , and a metabolic syndrome score ) were examined by ANCOVA , controlling for age . RESULTS In males , significant differences across groups were observed for systolic BP , mean arterial pressure ( MAP ) , TC , LDL-C , TC : HDL-C and the metabolic syndrome score ( p<0.05 ) . In females , only TG was significantly different across groups ( p<0.05 ) . A trend for significance was also observed for DBP and TG in males ( p=0.09 to 0.11 ) and diastolic BP , MAP , HDL-C , and the metabolic syndrome score in females ( p=0.14 to 0.16 ) . In general , males and females in the low BMI group , either fit or unfit , had lower BP and blood lipid values than those in the high BMI group . In both sexes , the high BMI /low fit group had the highest ( most adverse ) metabolic syndrome score . CONCLUSION This study utilized a unique approach to examine the possible interaction of fitness and fatness on CVD risk factors in children and adolescents . The results provide some evidence for the consideration of both variables when interpreting CVD risk factors in young people BACKGROUND New dietary strategies to reduce cardiovascular disease ( CVD ) risk include the addition of fiber to the diet . The effect of soluble-fiber consumption derived from Plantago ovata husk on lipid risk factors in patients with CVD is unknown . OBJECTIVE We compared the effects of soluble fiber ( P. ovata husk ) with those of insoluble fiber ( P. ovata seeds ) on plasma lipid , lipoprotein , and apolipoprotein ( apo ) concentrations within a CVD secondary prevention program . DESIGN In a r and omized , crossover , controlled , single-blind design , 28 men with CVD ( myocardial infa rct ion or stable angina ) and an LDL-cholesterol concentration < /=3.35 mmol/L consumed for 8 wk , under controlled conditions , a low-saturated-fat diet supplemented with 10.5 g P. ovata husk/d or 10.5 g P. ovata seeds/d . Fasting plasma lipid concentrations and polymorphisms of genes involved in lipid metabolism , such as apo A-IV , apo E , and fatty acid-binding protein , were measured . RESULTS Plasma triacylglycerol decreased ( 6.7 % ; P < 0.02 ) , the ratio of apo B 100 to apo A-I decreased ( 4.7 % ; P < 0.02 ) , and apo A-I increased ( 4.3 % ; P < 0.01 ) in the P. ovata husk consumers . Compared with the intake of insoluble fiber , the intake of P. ovata husk increased HDL-cholesterol concentrations by 6.7 % ( P = 0.006 ) and decreased the ratio of total to HDL cholesterol and of LDL to HDL cholesterol by 10.6 % ( P = 0.002 ) and 14.2 % ( P = 0.003 ) , respectively . CONCLUSION In the secondary prevention of CVD , P. ovata husk intake induces a more beneficial effect on the cardiovascular lipid risk-factor profile than does an equivalent intake of insoluble fiber OBJECTIVE To examine the effect of intensive lipid-lowering therapy on a composite cardiovascular outcome ( cardiovascular disease [ CVD ] ) , consisting of mortality and morbidity end points , in patients with inflammatory joint disease ( rheumatoid arthritis [ RA ] , ankylosing spondylitis [ AS ] , or psoriatic arthritis [ PsA ] ) by post hoc analysis of 2 prospect i ve trials of statins with a secondary end point of CVD outcome ( the Treating to New Targets [ TNT ] and Incremental Decrease in End Points Through Aggressive Lipid Lowering [ IDEAL ] studies ) . METHODS Of the 18,889 patients participating in the 2 trials , 199 had RA , 46 had AS , and 35 had PsA.  Lipid-lowering therapy consisted of an intensive regimen of atorvastatin 80 mg or a conventional/low-dose regimen of atorvastatin 10 mg or simvastatin 20 - 40 mg . The median duration of followup was nearly 5 years . Changes in lipid levels were examined by analyses of covariance . The effect on CVD was examined by Cox regression analyses , and heterogeneity tests were performed . RESULTS Patients with RA and those with AS had lower baseline cholesterol levels than patients without inflammatory joint disease ( least squares mean ± SEM 180.7 ± 2.3 mg/dl and 176.5 ± 4.7 mg/dl , respectively , versus 185.6 ± 0.2 mg/dl ; P = 0.03 and P = 0.05 , respectively ) . Statin treatment led to a comparable decrease in lipid levels and a 20 % reduction in overall risk of CVD in both patients with and those without inflammatory joint disease . CONCLUSION Our findings indicate that patients with and those without inflammatory joint disease experience comparable lipid-lowering effects and CVD risk reduction after intensive treatment with statins BACKGROUND AND AIMS Mediterranean diet is associated with a reduced risk for cardiovascular disease ( CVD ) . Use of plant stanols decreases low density lipoprotein cholesterol ( LDL-C ) concentrations . We compared the effects of the Mediterranean diet and plant stanol esters on vascular risk factors and estimated CVD ( eCVD ) risk . METHODS AND RESULTS In this prospect i ve , r and omized , placebo-controlled study , 150 mildly hypercholesterolaemic subjects were r and omized to  Mediterranean diet , a spread containing plant stanol esters ( 2 g/day ) or a placebo spread . Vascular risk factors were assessed every month for 4 months and the eCVD risk was calculated using the PROspect ive- Cardiovascular-Munster ( PROCAM ) , Framingham , and Reynolds risk engines . Placebo had no significant effect on risk factors or eCVD risk . Mediterranean diet gradually induced a significant reduction in total cholesterol ( TC ) , LDL-C , triglycerides , high sensitivity C-reactive protein ( hsCRP ) , blood pressure and eCVD risk ( 24 - 32 % ) . The plant stanol ester spread reduced ( by 1 month ) TC ( -14 % ) , LDL-C ( -16 % ) , hsCRP ( -17 % ) , and estimated CVD risk ( 26 - 30 % ) . eCVD risk reduction was sustained at 4th months when the gradual Mediterranean diet eCVD risk reduction became comparable to that of the stanol group . CONCLUSIONS Plant stanol esters yielded an early , by 1st treatment month , reduction of eCVD risk that result ed from a TC , LDL-C , and hsCRP decrease . eCVD risk reduction on the Mediterranean diet result ed from a change in several CVD risk factors and equaled that of plant stanol at 4 months . The consumption of plant stanol esters by moderately hypercholesterolaemic patients may be a useful option to reduce CVD risk in those who do not adopt a Mediterranean diet Objective : Rheumatoid arthritis ( RA ) is an inflammatory disease with increased mortality from cardiovascular disease ( CVD ) . Oxidative stress has a critical role in the pathogenesis of RA and CVD . Sesamin , the main lignin constituent of sesame , has several antioxidant and anti-inflammatory effects . This study aim ed to investigate the effects of sesamin supplementation on anthropometric indices , lipid profile , blood pressure , and oxidative stress markers in women with RA . Methods : In this r and omized , double-blind , placebo-controlled clinical trial , 44 patients with RA were r and omly divided into 2 groups ( intervention and control ) . Patients consumed 200 mg/day sesamin supplement and placebo in the intervention and control groups , respectively , for 6 weeks ( spring 2014 ) . At baseline and at the end of the study , anthropometric indices and blood pressure were assessed . Serum concentrations of lipid profile , malondialdehyde ( MDA ) , and total antioxidant capacity ( TAC ) were also determined . Results : At the end of study , sesamin supplementation significantly decreased serum levels of MDA ( p = 0.018 ) and increased TAC and high-density lipoprotein cholesterol ( HDL-C ) levels in patients with RA ( p = 0.020 and p = 0.007 , respectively ) . In the sesamin group , the mean of weight , body mass index , waist-to-hip ratio , body fat , systolic blood pressure , and the concentration of other lipid profiles ( triglycerides , total cholesterol , and low-density lipoprotein cholesterol [ LDL-C ] ) were also significantly decreased at the end of study compared to baseline values ( p < 0.05 ) . However , the difference between the 2 groups was not statistically significant in this regard ( p > 0.05 ) . Conclusion : Sesamin exhibited a protective effect on cardiovascular risk factors in patients with RA . However , further investigation is suggested Obesity is a strong risk factor for the development of CVD , hypertension and type 2 diabetes . The overall goal of the present pilot study was to feed strawberries , in the form of freeze-dried powder , to obese subjects to determine whether dietary strawberries beneficially altered lipid profiles and reduced blood markers of inflammation compared with a control intervention . A total of twenty healthy subjects ( thirteen females and seven males ) aged between 20 and 50 years with a BMI between 30 and 40 kg/m2 completed the present 7-week double-blind , r and omised , cross-over trial . Each subject received a prepared diet 7 d/week for 7 weeks consisting of approximately 35 % of energy from fat , 20 % protein , 45 % carbohydrate and 14 g fibre . Blood was collected on days 1 and 8 for baseline information . After the first week , subjects were r and omly assigned to the strawberry powder ( equivalent to four servings of frozen strawberries ) or control ( strawberry-flavoured ) intervention for 3 weeks . For the remaining 3 weeks , subjects crossed over to the opposite intervention . Blood was collected again at the end of weeks 3 , 4 , 6 and 7 . A comprehensive chemistry panel , lipid profile analyses and measurement of inflammatory mediators were performed for each blood draw . A 3-week dietary intervention with strawberry powder  reduced plasma concentrations of cholesterol and small HDL-cholesterol particles , and increased LDL particle size in obese subjects ( P < 0·05 ) . Dietary strawberry powder  reduced risk factors for CVD , stroke and diabetes in obese volunteers , suggesting a potential role for strawberries as a dietary means to decrease obesity-related disease OBJECTIVE To test whether greater exercise is associated with progressively lower mortality after a cardiac event . PATIENTS AND METHODS We used Cox proportional hazard analyses to examine mortality vs estimated energy expended by running or walking measured as metabolic equivalents ( 3.5 mL O2/kg per min per day or metabolic equivalent of task-h/d [ MET-h/d ] ) in 2377 self-identified heart attack survivors , where 1 MET-h/d is the energy equivalent of running 1 km/d . Mortality surveillance via the National Death Index included January 1991 through December 2008 . RESULTS A total of 526 deaths  occurred during an average prospect i ve follow-up of 10.4 years , 376 ( 71.5 % ) of which were related to cardiovascular disease ( CVD ) ( International Statistical Classification of Diseases , 10th Revision codes I00-I99 ) . CVD-related mortality compared with the lowest exercise group decreased by 21 % for 1.07 to 1.8 MET-h/d of running or walking ( P=.11 ) , 24 % for 1.8 to 3.6 MET-h/d ( P=.04 ) , 50 % for 3.6 to 5.4 MET-h/d ( P=.001 ) , and 63 % for 5.4 to 7.2 MET-h/d ( P<.001 ) but decreased only 12 % for ≥7.2 MET-h/d ( P=.68 ) . These data represent a 15 % average risk reduction per MET-h/d for CVD-related mortality through 7.2 MET-h/d ( P<.001 ) and a 2.6-fold risk increase above 7.2 MET-h/d ( P=.009 ) . Relative to the risk reduction at 7.2 MET-h/d , the risk for ≥7.2 MET-h/d increased 3.2-fold ( P=.006 ) for all ischemic heart disease (IHD)-related mortalities but was not significantly increased for non-IHD-CVD , arrhythmia-related CVD , or non-CVD-related mortalities . CONCLUSION Running or walking  decreases CVD mortality risk progressively at most levels of exercise in patients after a cardiac event , but the benefit of exercise  on CVD mortality and IHD deaths is attenuated at the highest levels of exercise ( running : above 7.1 km/d or walking briskly : 10.7 km/d ) The healthy Nordic diet has been previously shown to have health beneficial effects among subjects at risk of CVD . However , the extent of food changes needed to achieve these effects is less explored . The aim of the present study was to investigate the effects of exchanging a few commercially available , regularly consumed key food items ( e.g. spread on bread , fat for cooking , cheese , bread and cereals ) with improved fat quality on total cholesterol , LDL-cholesterol and inflammatory markers in a double-blind r and omised , controlled trial . In total , 115 moderately hypercholesterolaemic , non-statin-treated adults ( 25 - 70 years ) were r and omly assigned to an experimental diet group ( Ex-diet group ) or control diet group ( C-diet group ) for 8 weeks with commercially available food items with different fatty acid composition ( replacing SFA with mostly n-6 PUFA ) . In the Ex-diet group , serum total cholesterol ( P<0·001 ) and LDL-cholesterol ( P<0·001 ) were reduced after 8 weeks , compared with the C-diet group . The difference in change between the two groups at the end of the study was -9 and -11 % in total cholesterol and LDL-cholesterol , respectively . No difference in change in plasma levels of inflammatory markers ( high-sensitive C-reactive protein , IL-6 , soluble TNF receptor 1 and interferon-γ ) was observed between the groups . In conclusion , exchanging a few regularly consumed food items with improved fat quality reduces total cholesterol , with no negative effect on levels of inflammatory markers . This shows that an exchange of a few commercially available food items was easy and manageable and led to clinical ly relevant cholesterol reduction , potentially affecting future CVD risk The Justification for the Use of statins in Primary prevention : an Intervention Trial Evaluating Rosuvastatin ( JUPITER ) is a r and omized , double-blind , placebo-controlled primary prevention trial of statin therapy among persons with average to low levels of low-density lipoprotein ( LDL ) cholesterol who are at increased cardiovascular risk due to elevated plasma concentrations of the inflammatory biomarker high-sensitivity C-reactive protein ( hs-CRP ) . A total of 17,802 persons with LDL cholesterol<130 mg/dl ( 3.36 mmol/L ) and hs-CRP > or=2 mg/L were recruited from 26 countries and r and omly allocated to 20 mg/day rosuvastatin or placebo . In contrast to previous studies of statin therapy in primary prevention , JUPITER is evaluating a group with modest plasma concentrations of LDL cholesterol ( median 108 mg/dl , interquartile range 94 to 119 ) . Further , the trial includes 6,801 women ( 38.2 % ) and 5,577 participants with metabolic syndrome ( 32.1 % ) . Thus , in addition to broadening our underst and ing of statin therapy and inflammation , the JUPITER trial will provide important and clinical ly relevant information on primary prevention among patients who do not currently qualify for lipid-lowering therapy . In conclusion , as 20 mg of rosuvastatin can reduce LDL cholesterol by up to 50 % , JUPITER will also provide crucial safety data for several thous and patients who should achieve LDL cholesterol levels<50 mg/dl on a long-term basis UNLABELLED Cardiovascular disease ( CVD ) is associated with dyslipidemia and frequently with insulin resistance , both of which are in general no alleviated by antilipidemic drugs . Our objective was to examine whether a dietary supplement containing omega-3 fatty acids ( n-3 FA ) can reduce the levels of serum lipids , fasting insulin and glucose in documented CVD patients treated by statins or  bezafibrates .  In a double-blind placebo-controlled trial of parallel design , 52 patients , age 69.2 years + /- 3.6 treated by antilipidemic drugs  , were r and omly assigned to receive daily 7 gr of a dietary concentrated supplement containing 67 % n-3 FA ( 185 mg EPA and 465 mg/g DHA ) in a form of spread ( Yamega Ltd , Israel ) or olive oil spread ( placebo ) and recommended to reduce the consumption of omega-6 fatty acids for 12 weeks . The average values + /- SD before and after dietary supplementations were compared . RESULTS 44 patients ( 23 in the n-3 FA group ) completed the study . In the n-3FA group we observed a significant decrease ( p < 0.05 ) of total cholesterol ( 12.2 % ) . LDL-cholesterol ( 16.8 % ) , triglycerides ( 36.1 % ) , insulin in hyperinsulinemic subjects ( > 20 microunits/ml ) ( 34.9 % ) , and no significant changes in HDL-cholesterol and glucose . No hyperglycemia was detected . In the olive oil group we observed a significant decrease ( p < 0.05 ) in the LDL-cholesterol values of 15.5 % and no significant changes in the other parameters . No side effects were reported during the study in any of the participants . Our findings demonstrate that the incorporation of the dietary supplement containing EPA and DHA omega-3 fatty acids reduces significantly the above risk factors for CVD AIM Hyperlipidemia and diabetic retinopathy increase the risk of cardiovascular disease ( CVD ) . The st and ard versus intEnsive statin therapy for hypercholesteroleMic Patients with diAbetic retinopaTHY ( EMPATHY ) study examines whether intensive lipid-lowering therapy is superior to st and ard therapy in reducing the incidence of cardiovascular events in patients with hyperlipidemia and diabetic retinopathy , but without a history of coronary artery disease . METHODS Patients who had elevated low-density lipoprotein cholesterol ( LDL-C ) and diabetic retinopathy without a history of coronary artery disease were eligible for the study . Patients were r and omly assigned in a 1:1 ratio to receive intensive or st and ard therapy . Patients are being treated with monotherapy with 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitor ( statin ) for a maximum of 5.5 years to achieve the following LDL-C target : ＜70 mg/dL for the intensive therapy group or ≥100 and ＜120 mg/dL for the st and ard therapy group . The primary endpoint is a composite of incidence of CVD and death from CVD . RESULTS Between May 2010 and October 2013 , 5,995 patients were assessed for eligibility , and 5,144 were assigned to the study treatment ( 2,571 and 2,573 in the intensive and st and ard therapy groups , respectively ) , and baseline data were analyzed from 5,107 ( 2,550 in the intensive therapy group and 2,557 in the st and ard therapy group ) . CONCLUSIONS This is the first study assessing the benefits of intensive statin therapy in patients with hypercholesterolemia and diabetic retinopathy in a primary prevention setting . Furthermore , this study evaluates the appropriateness of the treat-to-target approach because all patients are treated to achieve specific LDL-C targets by titrating statin therapy . CLINICAL TRIAL REGISTRATION NUMBER UMIN000003486 AIM To demonstrate the clinical benefit of inhibiting intestinal cholesterol absorption , we evaluated the effects of ezetimibe on surrogate markers of cholesterol absorption and synthesis , lipid and glucose metabolism , and markers of obesity and inflammation . METHODS A total of 120 patients with dyslipidemia ( 46 men ; mean age 66.5 years ) , who had not achieved the low density lipoprotein cholesterol ( LDL-C ) goal recommended by the Japan Atherosclerosis Society Guideline despite diet and exercise or any statin therapy , were enrolled and additionally treated with ezetimibe ( 10 mg/day ) for 12 weeks . RESULTS Compared to the baseline , LDL-C was reduced by 19.2 % ( p<0.001 ) after ezetimibe monotherapy and by 24.7 % ( p<0.001 ) after co-administration with ezetimibe and any statin . Ezetimibe therapy decreased cholesterol absorption markers and increased a cholesterol synthesis marker . Treatment with ezetimibe reduced the fasting serum insulin level ( p<0.05 ) and HbA1c ( p<0.05 ) , increased serum adiponectin ( p<0.01 ) , and showed a significant decrease of high-sensitive C-reactive protein ( hsCRP , p<0.01 ) . No adverse events occurred during the study . CONCLUSION Thus , cholesterol absorption inhibition by ezetimibe is an important therapeutic strategy since LDL-C and cholesterol absorption markers had a positive correlation . Ezetimibe not only reduced the serum LDL-C level but also improved glucose metabolism as well as obesity and inflammation markers . These findings support the benefit of ezetimibe as a new option for the treatment of dyslipidemia Most patients with type 2 diabetes mellitus develop cardiovascular disease ( CVD ) , with substantial loss of life expectancy . Nonfatal CVD contributes greatly to excess healthcare costs and decreased quality of life in patients with diabetes . The current epidemic of obesity has raised expectations that CVD associated with type 2 diabetes will become an even greater public health challenge . Despite the importance of this health problem , there is a lack of definitive data on the effects of the intensive control of glycemia and other CVD risk factors on CVD event rates in patients with type 2 diabetes . The Action to Control Cardiovascular Risk in Diabetes ( ACCORD ) trial is a r and omized , multicenter , double 2 x 2 factorial design study involving 10,251 middle-aged and older participants with type 2 diabetes who are at high risk for CVD events because of existing CVD or additional risk factors . ACCORD is testing the effects of 3 medical treatment strategies to reduce CVD morbidity and mortality . All participants are in the glycemia trial , which is testing the hypothesis that a therapeutic strategy that targets a glycosylated hemoglobin ( HbA1c ) level of < 6.0 % will reduce the rate of CVD events more than a strategy that targets an HbA1c level of 7.0%-7.9 % . The lipid trial includes 5,518 of the participants , who receive either fenofibrate or placebo in a double-masked fashion to test the hypothesis of whether , in the context of good glycemic control , a therapeutic strategy that uses a fibrate to increase high-density lipoprotein cholesterol and lower triglyceride levels together with a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor ( statin ) to lower low-density lipoprotein cholesterol will reduce the rate of CVD events compared with a strategy that uses a statin plus a placebo . The blood pressure trial includes the remaining 4,733 participants and tests the hypothesis that a therapeutic strategy that targets a systolic blood pressure of < 120 mm Hg in the context of good glycemic control will reduce the rate of CVD events compared with a strategy that targets a systolic blood pressure of < 140 mm Hg . The primary outcome measure for all 3 research questions is the first occurrence of a major CVD event , specifically nonfatal myocardial infa rct ion , nonfatal stroke , or cardiovascular death . Upon the expected completion of participant follow-up in 2009 , the ACCORD trial should document for the first time the benefits and risks of intensive glucose control , intensive blood pressure control , and the combination of fibrate and statin drugs in managing blood lipids in high-risk patients with type 2 diabetes Background Treatments that reduce inflammation and cardiovascular disease ( CVD ) risk among individuals with HIV infection receiving effective antiretroviral therapy ( ART ) are needed . Design and Methods We conducted a 2 × 2 factorial feasibility study of lisinopril ( L ) ( 10 mg daily ) vs L-placebo in combination with pravastatin ( P ) ( 20 mg daily ) vs P-placebo among participants receiving ART with undetectable HIV RNA levels , a Framingham 10 year risk score ( FRS ) ≥3 % , and no indication for ACE-I or statin therapy . Tolerability and adherence were evaluated . Longitudinal mixed models assessed changes in blood pressure ( BP ) , blood lipids , and inflammatory biomarkers from baseline through months 1 and 4 . Results Thirty-seven participants were r and omized and 34  [ lisinopril/pravastatin ( n = 9 ) , lisinopril/P-placebo ( n = 8) , L-placebo/pravastatin ( n = 9 ) , L-placebo/P-placebo ( n = 8) ] attended at least one follow-up visit . Participants were 97 % male , 41 % white , 67 % were current smokers , and 65 % were taking a protease inhibitor . Median age was 48 years , CD4 count 483 cells/mm3 , FRS 7.79 % , total cholesterol 184 mg/dL , and LDL-C 95 mg/dL. There was no treatment difference for pravastatin vs P-placebo  in total cholesterol , LDL-C , or any of the inflammatory biomarkers . Participants r and omized to lisinopril vs. L-placebo had significant declines in diastolic BP ( −3.3 mmHg , p = 0.05 ) , hsCRP ( −0.61 µg/mL , p = 0.02 ) and TNF-α ( −0.17 pg/mL , p = 0.04 ) . Participants taking lisinopril vs L-placebo were more likely to report missed doses ( 88 vs 35 % ; p = 0.001 ) and have adherence < 90 % by pill count ( 42 vs. 0 % ; p = 0.02 ) . Few participants from either group reported side effects ( n = 3 vs. n = 1 ) . Conclusions The modest BP changes and decreased adherence with lisinopril and absence of lipid differences with pravastatin suggest future studies of these drug classes should consider a run-in period to assess adherence and use a different statin . Our results also indicate that ACE-I therapy may have anti-inflammatory benefits for ART-treated persons with HIV infection and this should be further evaluated . Trial Registration Clinical Trials.gov OBJECTIVES The purpose of this study was to examine prospect ively whether inflammation explains the relationship between depression and cardiovascular disease ( CVD ) . BACKGROUND It is unclear whether inflammation is a mechanism linking depression to CVD . METHODS We measured C-reactive protein ( CRP ) and interleukin (IL)-6  in 559 women with suspected coronary ischemia who completed the Beck Depression Inventory ( BDI ) at baseline and were followed over 5.9 years . We considered indicators of past and current depression to classify women into 3 groups : 1 ) depression , having both elevated depressive symptoms ( BDI > or = 10 ) and a previous diagnosis of depression requiring treatment ; 2 ) possible depression , having either indicator but not both ; and 3 ) no depression , having neither indicator of depression . The main outcome was incidence of CVD events ( hospital stays for nonfatal myocardial infa rct ion , stroke , congestive heart failure , and CVD-related mortality ) . RESULTS Compared with women without depression , women with depression had a 70 % higher CRP ( p = 0.0008 ) and a 25 % higher IL-6 ( p = 0.04 ) , whereas women with possible depression had 30 % higher CRP ( p = 0.02 ) and 28 % higher IL-6 ( p = 0.01 ) . Depression was a significant predictor of CVD ( hazard ratio 2.58 , p = 0.0009 ) , but possible depression was not ( hazard ratio 1.12 , p = 0.68 ) . Adjustment for other patient factors did not substantially affect the results . Addition of CRP decreased the estimate for depression by 13 % and addition of IL-6 decreased it by 4 % . Both depression and inflammatory biomarkers remained independent predictors of outcome . CONCLUSIONS Despite their robust association with depression , inflammatory biomarkers explain only a small portion of the association between depression and CVD incidence The search for complementary treatments in primary prevention of cardiovascular disease ( CVD ) is a high-priority challenge . Grape and wine polyphenol resveratrol confers CV benefits , in part by exerting anti-inflammatory effects . However , the evidence in human long-term clinical trials has yet to be established . We aim ed to investigate the effects of a dietary resveratrol-rich grape supplement on the inflammatory and fibrinolytic status of subjects at high risk of CVD and treated according to current guidelines for primary prevention of CVD . Seventy-five patients undergoing primary prevention of CVD participated in this triple-blinded , r and omized , parallel , dose-response , placebo-controlled , 1-year follow-up trial . Patients , allocated in 3 groups , consumed placebo ( maltodextrin ) , a resveratrol-rich grape supplement ( resveratrol 8 mg ) , or a conventional grape supplement lacking resveratrol , for the first 6 months and a double dose for the next 6 months . In contrast to placebo and conventional grape supplement , the resveratrol-rich grape supplement  significantly decreased high-sensitivity C-reactive protein ( -26 % , p = 0.03 ) , tumor necrosis factor-α ( -19.8 % , p = 0.01 ) , plasminogen activator inhibitor type 1 ( -16.8 % , p = 0.03 ) , and interleukin-6/interleukin-10 ratio ( -24 % , p = 0.04 ) and increased anti-inflammatory interleukin-10 ( 19.8 % , p = 0.00 ) . Adiponectin ( 6.5 % , p = 0.07 ) and soluble intercellular adhesion molecule-1 ( -5.7 % , p = 0.06 ) tended to increase and decrease , respectively . No adverse effects were observed in any patient . In conclusion , 1-year consumption of a resveratrol-rich grape supplement  improved the inflammatory and fibrinolytic status in patients who were on statins for primary prevention of CVD and at high CVD risk ( i.e. , with diabetes or hypercholesterolemia plus ≥1 other CV risk factor ) . Our results show for the first time that a dietary intervention with grape resveratrol could complement the gold st and ard therapy in the primary prevention of CVD OBJECTIVE Frequent episodes of severe hypoglycemia may increase the risk of cardiovascular disease ( CVD ) in people with diabetes . Our aim was to study the relationship between severe hypoglycemic episodes and CVD incidence in subjects with type 1 diabetes , and further , to assess if markers of inflammation/endothelial injury were enhanced in individuals who experienced hypoglycemic episodes . RESEARCH DESIGN AND METHODS The prospect i ve study included 2,181 type 1 diabetic patients from the EURODIAB Prospect i ve Complications Study . At baseline , frequency of  self-reported severe hypoglycemia  , defined as episodes serious enough to require the help of another person , was assessed based on responses to a patient question naire . Both fatal/nonfatal CVD was assessed 7.3 years after baseline examination . At the follow-up visit , data on both severe and nonsevere hypoglycemic episodes in the previous year were collected through a question naire and markers of inflammation/stress response/endothelial injury measured by enzyme-linked immunosorbent assays in the 531 subjects of the nested case-control study , including 363 case subjects with one or more complications of diabetes and 168 control subjects with no evidence of any complication . RESULTS During the follow-up period , 176 patients had incident CVD . Logistic regression analysis showed that severe hypoglycemia at the baseline examination was not associated with incidence of CVD ( adjusted odds ratios [ 95 % CI ] : one to two episodes , 0.87 [ 0.55–1.37 ] ; three or more episodes , 1.09 [ 0.68–1.75 ] ) . Furthermore , follow-up serum levels of markers of endothelial damage/inflammation were not cross-sectionally associated with the frequency of hypoglycemic episodes . CONCLUSIONS Taken together our data do not support the hypothesis that in type 1 diabetes , severe hypoglycemia increases the risk of CVD Background Few data exist as to whether dipeptidyl peptidase (DPP)-4 inhibitors affect cardio-renal interaction , which is a strong independent prognostic factor for cardiovascular disease ( CVD ) , in diabetic patients . We evaluated the effects of a DPP-4 inhibitor on atherogenic low-density lipoprotein ( LDL ) heterogeneity and albuminuria in diabetics as an indicator of the severity of diabetic nephropathy . Methods Type 2 diabetes patients ( n = 47 ) inadequately controlled with diabetes therapy were treated with vildagliptin 50 mg bid for 8 weeks . LDL heterogeneity was evaluated on the basis of the patients ’ small dense ( sd ) LDL levels and sd-LDL proportion ( sd-LDL/LDL cholesterol [ LDL-C ] ) . The level of albuminuria was evaluated on the basis of the urinary albumin-to-creatinine ratio ( UACR ) . Results After 8 weeks of treatment , there was no significant change in serum LDL-C level , but the serum sd-LDL level had decreased significantly by 8.8 % , and the UACR had also decreased significantly by 44.6 % . Triglyceride (TG)-metabolism-related markers ( TG , remnant-like particle cholesterol , apolipoprotein [ apo ] B , apoC-2 , and apoC-3 ) had decreased significantly . The Δ ( absolute change from baseline ) sd-LDL values correlated positively with ΔTG-metabolism-related markers , but not with the Δ hemoglobin ( Hb ) A1c or Δ fasting blood sugar ( ΔFBS ) . Furthermore , multivariate regression analysis revealed that Δsd-LDL proportion , but not ΔHbA1c or ΔFBS , was an independent predictor of ΔUACR ( β = 0.292 , p = 0.0016 ) . Conclusions Although this was a single-arm study , treatment of type 2 diabetes with vildagliptin might prevent the progression of CVD complicating diabetes by improving LDL heterogeneity , and it might improve renal function by decreasing albuminuria . A r and omized controlled trial is warranted BACKGROUND Although patients with chronic kidney disease ( CKD ) are at increased risk of cardiovascular disease ( CVD ) , the roles of lipid-modifying therapies in decreasing CVD risk are unclear . Our aim is to compare the effects of statin and fibrate therapy on arterial function as a risk marker of CVD . STUDY DESIGN Double-blind , r and omized , placebo-controlled , parallel-group study . SETTING & PARTICIPANTS Ambulatory patients with stages 3 to 5 CKD . INTERVENTION 6 weeks of atorvastatin , 40 mg/d , or gemfibrozil , 600 mg twice daily , with placebo . OUTCOMES & MEASUREMENTS Primary outcome was arterial function assessed by means of endothelial-dependent flow-mediated dilatation ( FMD ) and small-artery compliance ( C2 ) . Secondary outcomes included endothelial-independent glyceryl trinitrate-mediated dilatation ( GTNMD ) , large-artery compliance ( C1 ) , and levels of lipids , lipoproteins , and oxidized low-density lipoprotein , as well as markers of insulin resistance and inflammation . RESULTS Compared with placebo , atorvastatin significantly decreased low-density lipoprotein ( -52 % ) , triglyceride ( -30 % ) , and oxidized low-density lipoprotein levels ( -41 % ; P < 0.0001 ) . Gemfibrozil significantly decreased triglyceride levels ( -40 % ) and increased high-density lipoprotein levels ( + 20 % ; P < 0.0001 ) . Neither atorvastatin nor gemfibrozil had a significant effect on markers of insulin resistance or inflammation . There was no significant change in FMD , GTNMD , or C1 with either atorvastatin or gemfibrozil . There was improvement in C2 with atorvastatin ( + 1.1 mL/mm Hg x 100 ) compared with placebo ( P = 0.024 ) , but not with gemfibrozil compared with placebo . LIMITATIONS Small sample size leading to inadequate power , short duration of therapy , and use of a heterogeneous group of patients with CKD and dialysis patients . CONCLUSION In patients with advanced CKD , atorvastatin is associated with improvement in dyslipidemia and small-artery stiffness , but not endothelial function .  Gemfibrozil improves dyslipidemia , but has no effect on arterial function Purpose Arterial inflammation and vascular calcification are regarded as early prognostic markers of cardiovascular disease ( CVD ) . In this study we investigated the relationship between CVD risk and arterial inflammation ( 18F-FDG PET/CT imaging ) , vascular calcification metabolism ( Na18F PET/CT imaging ) , and vascular calcium burden ( CT imaging ) of the thoracic aorta in a population at low CVD risk . Methods Study participants underwent blood pressure measurements , blood analyses , and 18F-FDG and Na18F PET/CT imaging . In addition , the 10-year risk for development of CVD , based on the Framingham risk score ( FRS ) , was estimated . CVD risk was compared across quartiles of thoracic aorta 18F-FDG uptake , Na18F uptake , and calcium burden on CT . Results A total of 139 subjects ( 52 % men , mean age 49 years , age range 21 – 75 years , median FRS 6 % ) were evaluated . CVD risk was , on average , 3.7 times higher among subjects with thoracic aorta Na18F uptake in the highest quartile compared with those in the lowest quartile of the distribution ( 15.5 % vs. 4.2 % ; P < 0.001 ) . CVD risk was on average , 3.7 times higher among subjects with a thoracic aorta calcium burden on CT in the highest quartile compared with those in the lowest two quartiles of the distribution ( 18.0 % vs. 4.9 % ; P < 0.001 ) . CVD risk was similar in subjects in all quartiles of thoracic aorta 18F-FDG uptake . Conclusion Our findings indicate that an unfavourable CVD risk profile is associated with marked increases in vascular calcification metabolism and vascular calcium burden of the thoracic aorta , but not with arterial inflammation AIMS High-risk subjects with elevated C-reactive protein ( CRP ) are at high risk for cardiovascular events and frequently require potent statins or combined lipid-lowering therapy to achieve lipid targets and decrease inflammation . Our study aim ed at evaluating the effects of three lipid-modifying therapies on LDL-cholesterol , CRP levels and markers of cholesterol absorption and synthesis . MAIN METHODS A prospect i ve intervention study was performed in high cardiovascular risk individuals receiving atorvastatin 10 mg daily for four weeks . Those with CRP≥2.0mg/L were r and omized to another four-week treatment period with atorvastatin 40 mg , ezetimibe 10 mg or the combination of atorvastatin 40 mg / ezetimibe 10 mg  . Lipids , markers of cholesterol absorption ( campesterol and β-sitosterol ) , and synthesis ( desmosterol ) , as well as CRP were quantified at baseline and end of study . KEY FINDINGS One hundred and twenty two individuals were included .  Atorvastatin alone or combined with ezetimibe  reduced both LDL-cholesterol and CRP ( P<0.002 vs. baseline ; Wilcoxon ) ; ezetimibe did not modify CRP . Ezetimibe-based therapies  reduced absorption markers and their ratios to cholesterol ( P<0.0001 vs. baseline , for all ; Wilcoxon ) , whereas atorvastatin alone increased campesterol/cholesterol and β-sitosterol/cholesterol ratios ( P<0.05 vs. baseline ; Wilcoxon ) . In addition , ezetimibe also increased desmosterol and desmosterol/cholesterol ratio ( P<0.0001 vs. baseline ; Wilcoxon ) . SIGNIFICANCE These results contribute to underst and ing the link between cellular cholesterol homeostasis , inflammation and lipid-modifying therapies . Our findings highlight the broader benefit of combined therapy with a potent statin and ezetimibe  decreasing inflammation , and preventing increase in cholesterol bio synthesis , an effect not observed with ezetimibe alone Background Obesity is associated with a chronic low- grade inflammatory state , insulin resistance , and endothelial dysfunction , all of which contribute to increased risk of cardiovascular disease . We hypothesized that gastric bypass would produce rapid improvements in endothelial function , reduce inflammation , and lead to a decrease in cardiovascular risk . Methods We performed a prospect i ve study of morbidly obese patients who underwent laparoscopic Roux-en-Y gastric bypass ( RYGB ) .  Clinical data , biochemical markers of inflammation , and parameters indicative of cardiovascular risk were collected preoperatively and at 3 and 6 months postoperatively . Metabolic and inflammatory mediators that were quantified included C-reactive protein , fibrinogen , PAI-1 , IL-6 , IL-10 , IL-1Ra , adiponectin , leptin , triglycerides , total cholesterol , HDL , LDL , glucose , insulin , and HbA1c . Brachial artery reactivity testing ( BART ) was performed to assess peripheral arterial endothelial function , and Framingham cardiovascular risk score ( FRS ) was calculated on all study participants pre- and postoperatively . Results Fifteen patients ( 11 female ) were enrolled ( age = 49.2 ± 10.4 years ; BMI = 48.1 ± 5.3 kg/m2 ) . Six months post RYGB , mean BMI decreased to 35.4 ± 4.5 , corresponding to 51.7 % excess weight loss ( P < 0.001 ) . Mean waist circumference decreased significantly from 132 cm at baseline to 110 cm at 3 months ( P = 0.003 ) and 107 cm at 6 months ( P < 0.001 ) . Six months after RYGB , weight loss led to significant improvements in clinical parameters indicative of cardiovascular disease or risk , including brachial artery diameter , endothelial independent vasodilation , and FRS . Favorable improvements in the proinflammatory markers CRP ( P = 0.01 ) and leptin ( P = 0.005 ) , the anti-inflammatory mediator adiponectin ( P = 0.002 ) , and insulin sensitivity ( HOMA-IR , P = 0.007 ) were evident at 3 months . At 6 months , improvements in CRP , leptin , and fasting insulin were maintained and fibrinogen levels also decreased ( P = 0.047 ) . Adiponectin continued to increase at 6 months ( P = 0.004 ) . Conclusion Gastric bypass is associated with early reversal of endothelial dysfunction , a more favorable inflammatory milieu , and , most importantly , a reduction in cardiovascular risk BACKGROUND The relation between measures of oxidation of lipid particles and cardiovascular disease has not been extensively investigated prospect ively on a population basis . METHODS A community cohort of 1192 men and 1427 women with measures of IgG antibodies to oxidized LDL were followed 8 years for the development of initial coronary heart disease ( CHD ) and cardiovascular disease ( CVD ) events . RESULTS Levels of IgG autoantibodies to a form of oxidized LDL were significantly associated with age in both sexes , positively with fibrinogen in men and negatively with HDL cholesterol in women . In sex-specific models that adjusted for age alone or those that adjusted for age , cholesterol , HDL cholesterol , smoking , and diabetes mellitus , there was no relation between level of antibodies to oxidized LDL and the development of CHD or CVD . CONCLUSION Autoantibodies to oxidized LDL were strongly related to age and were not related to incident CHD or CVD over 8 years of follow up BACKGROUND Soluble-fiber beta-glucan derived from oats can reduce cardiovascular disease ( CVD ) risk through reductions in total and LDL cholesterol .  Barley-derived beta-glucan may also improve serum cholesterol , but large quantities are required for clinical significance . OBJECTIVE This trial investigated whether a beta-glucan-enriched form of barley can favorably modify cholesterol and other markers of CVD and diabetes risk . DESIGN Eighteen mildly hyperlipidemic ( + /- SD : 4.0 + /- 0.6 mmol LDL cholesterol/L ) men with a mean ( + /- SD ) body mass index ( in kg/m(2 ) ) of 27.4 + /- 4.6 were r and omly assigned in this single-blind , 2 x 4-wk trial to either the treatment arm [ 8.1 - 11.9 g beta-glucan/d ( scaled to body weight ) ] or the control arm ( isoenergetic dose of 6.5 - 9.2 g glucose/d ) . After a washout period of 4 wk , dietary regimens were crossed over . The trial took place in a long-stay metabolic facility , and all foods were provided ( 38 % of energy from fat ) . Fasted blood sample s were collected on days 0 , 1 , 7 , 14 , 21 , 28 , and 29 in both study arms . An oral-glucose-tolerance test was carried out on days 0 and 29 . RESULTS There was no significant change ( Delta ) in total ( Delta = -0.08 mmol/L , -1.3 % ) , LDL ( Delta = -0.15 mmol/L , -3.8 % ) , or HDL ( Delta = 0 mmol/L ) cholesterol or in triacylglycerol ( Delta = 0.18 mmol/L ) , fasting glucose ( Delta = -0.05 mmol/L ) , or postpr and ial glucose when analyzed between treatments ( P > 0.05 ; ANOVA ) . CONCLUSION The effect of beta-glucan-enriched barley on lipid profile was highly variable between subjects , and there was no evidence of a clinical ly significant improvement in CVD risk across this group of mildly hyperlipidemic men Purpose Bilberries are abundant in polyphenols . Dietary polyphenols have been associated with strategies for prevention and treatment of chronic inflammatory diseases . We investigated the effect of bilberry juice on serum and plasma biomarkers of inflammation and antioxidant status in subjects with elevated levels of at least one risk factor for cardiovascular disease ( CVD ) . Methods In a r and omized controlled trial , participants consumed either bilberry juice ( n = 31 ) or water ( n = 31 ) for 4 weeks . Results Supplementation with bilberry juice result ed in significant decreases in plasma concentrations of C-reactive protein ( CRP ) , interleukin (IL)-6 , IL-15 , and monokine induced by INF-γ ( MIG ) . Unexpectedly , an increase in the plasma concentration of tumor nuclear factor-α ( TNF-α ) was observed in the bilberry group . CRP , IL-6 , IL15 , MIG , and TNF-α are all target genes of nuclear factor- kappa B ( NF-κB ) , —a transcription factor that is crucial in orchestrating inflammatory responses . Plasma quercetin and p-coumaric acid increased in the bilberry group , otherwise no differences were observed for clinical parameters , oxidative stress or antioxidant status . Furthermore , we studied the effect of polyphenols from bilberries on lipopolysaccharide (LPS)-induced NF-κB activation in a monocytic cell line . We observed that quercetin , epicatechin , and resveratrol inhibited NF-κB activation . Conclusions These findings suggest that supplementation with bilberry polyphenols may modulate the inflammation processes . Further testing of bilberry supplementation as a potential strategy in prevention and treatment of chronic inflammatory diseases is warranted Purpose Recent trial results are in favor of aggressive lipid lowering using high dose statins in patients needing secondary prevention . It is unclear whether these effects are solely due to more extensive lipid lowering or the result of the potentially anti-inflammatory properties of statins . We aim ed to determine whether aggressive compared with conventional statin therapy is more effective in reducing systemic markers of inflammation and oxidative stress . Material s and methods This was a multi-centre , double-blind , placebo-controlled trial . Patients with previous cardiovascular disease , who did not achieve low density lipoprotein ( LDL ) cholesterol levels < 2.6 mmol/l on conventional statin therapy ( simvastatin 40 mg ) were r and omized to continue with simvastatin 40 mg or to receive atorvastatin 40 mg for 8 weeks and thereafter atorvastatin 80 mg for the final 8 weeks ( aggressive treatment ) . Lipids , C-reactive protein , soluble cellular adhesion molecules , neopterin , von Willebr and Factor , and antibodies against oxidized LDL were measured at baseline and after 16 weeks . Results Lipid levels decreased significantly in the aggressive treatment group ( LDL-C reduction 20.8 % ; P < 0.001 ) , whereas a slight increase was observed in the conventional group ( LDL-C increase 3.7 % ; P = 0.037 ) . A significant reduction in antibodies against oxidized LDL was seen in the aggressive ( 13.4 % ; P < 0.001 ) and the conventional ( 26.8 % ; P < 0.001 ) group , but there was no difference between groups ( P = 0.25 ) . Furthermore , no significant differences in change in other biomarkers was observed between both groups . Conclusions This study does not support the hypothesis that a more profound reduction in inflammatory and oxidative stress contributes to the benefits of aggressive statin therapy AIMS Recently , markers of inflammation , haemostasis , and blood rheology have received much attention as risk factors for coronary heart disease and stroke . However , their role in peripheral arterial disease ( PAD ) is not well established and some of them , including the pro-inflammatory cytokine interleukin-6 ( IL-6 ) , have not been examined before in prospect i ve epidemiological studies . METHODS AND RESULTS In the Edinburgh Artery Study , we studied the development of PAD in the general population and evaluated 17 potential blood markers as predictors of incident PAD . At baseline ( 1987 ) , 1519 men and women free of PAD aged 55 - 74 were recruited . After 17 years , 208 subjects had developed symptomatic PAD . In analysis adjusted for cardiovascular risk factors and baseline cardiovascular disease ( CVD ) , only C-reactive protein , fibrinogen , lipoprotein ( a ) , and haematocrit [ hazard ratio ( 95 % CI ) corresponding to an increase equal to the inter-tertile range 1.30 ( 1.08 , 1.56 ) , 1.16 ( 1.05 , 1.17 ) , 1.22 ( 1.04 , 1.44 ) , 1.22 ( 1.08 , 1.38 ) ] were significantly ( P < 0.01 ) associated with PAD . However , these markers provided very little prognostic information for incident PAD to that obtained by cardiovascular risk factors and the ankle brachial index . Other markers including IL-6 , intracellular adhesion molecule 1 , d-dimer , tissue plasminogen activator antigen , and plasma and blood viscosities showed weak associations , which were considerably attenuated when CVD risk factors were accounted for . CONCLUSIONS Our prospect i ve data showed that several inflammatory , haemostatic , and rheological markers are associated with incident PAD ; however , their clinical utility is likely to be limited . Future research is necessary to vali date the importance of these biomarkers explicitly on PAD and to address the causality of the reported associations Background Cardiovascular disease ( CVD ) is the leading cause of death in China and worldwide . Whole grain oats can reduce risk of CVD by reducing total and LDL-cholesterol , major risk factors for CVD . While this association has been established in many population s , data from Asian population s is limited . Thus , this study investigated the impact of oat consumption on cholesterol levels in Chinese adults . Male and female data from this work were previously published separately in m and arin in two Chinese journals . The combined male and female data were reanalyzed and are presented here . Methods A r and omized , controlled , parallel-arm study was conducted at Beijing Hospital , Beijing china . Subjects were adults ( men and women ) with mild to moderate hypercholesterolemia . The oat group ( n=85 ) consumed 100grams of instant oat cereal versus the control group ( n=81 ) who consumed 100grams of wheat flour-based noodles daily for 6weeks . Laboratory and anthropometric measurements were conducted at baseline and at the end of the 6-week intervention . Results Dietary fiber intake increased significantly in the oat group compared to the control group at the end of the 6-week intervention . Total- , LDL-cholesterol and waist circumference decreased significantly in the oat group compared to the control . HDL-cholesterol decreased significantly in the control group versus the oat group . There were no significant changes in blood pressure , other anthropometric or laboratory measures between the two groups at the end of the intervention . Conclusions Instant oatmeal consumed daily for 6 weeks significantly increased fiber intake and decreased major risk factors for CVD in Chinese adults with hypercholesterolemia . Increased consumption of whole grains , including oats , should continue to be encouraged AIMS To estimate the potential effectiveness of different " high-risk " and " population " approaches to the primary prevention of  cardiovascular disease ( CVD ) in middle-aged British men , after correction for regression dilution bias . METHODS AND RESULTS We used a combination of cohort and r and omised controlled trial evidence to estimate the effectiveness of high-risk strategies , based on the identification of high-risk factors or high absolute risk , and strategies based on population -wide reductions in cholesterol and blood pressure . High-risk strategies were potentially effective but would need to be used widely to have a substantial effect on CVD in the population . Aggressive pharmacological treatment ( using statins , beta-blockers , ACE-inhibitors and aspirin ) in individuals with a 10-year Framingham event risk of > or=30 % ( 6 % of population ) would have reduced major CVD by at most 11 % . This figure increased to 34 % at a > or=20 % treatment threshold ( 26 % of population ) . In contrast , modest downwards shifts in the population distributions of serum total cholesterol and systolic blood pressure led to marked expected reductions in major CVD . Taking regression dilution bias into account , 10 % reductions in long-term mean blood cholesterol and blood pressure could have reduced major CVD by 45 % . CONCLUSIONS If high-risk strategies are to have a major impact on CVD in the population , they need to be more widely used than previously envisaged . Population -wide reduction of major risk factors is needed if CVD is to be substantially reduced BACKGROUND Moderate red wine has been shown to reduce cardiovascular disease ( CVD ) risk , however the effects on certain CVD risk factors are unclear . In this study we have investigated the effects of dealcoholised red wine ( DRW ) and full-complement red wine ( RW ) on several cardiovascular risk factors in mildly hypercholesterolaemic postmenopausal women . OBJECTIVES To eluci date whether the chronic consumption of red wine polyphenols improves risk factors associated with CVD in hypercholesterolaemic postmenopausal women . DESIGN Forty-five hypercholesterolaemic postmenopausal women were r and omly assigned to consume 400 mL/day of either water , DRW or RW for 6 weeks following a 4-week washout . Fasting measures of lipids , lipoproteins , insulin and glucose were taken at 0 and 6 weeks . RESULTS DRW consumption had no effect of fasting concentrations of lipids , lipoproteins , insulin and glucose . However , chronic consumption of RW significantly reduced fasting LDL cholesterol concentrations by 8 % and increased HDL cholesterol concentrations by 17 % in hypercholesterolaemic postmenopausal women . CONCLUSIONS Collectively , regular consumption of full-complement red wine reduces CVD risk by improving fasting lipid levels in hypercholesterolaemic postmenopausal women . This study uniquely demonstrated the LDL cholesterol-lowering effects of red wine in individuals at high CVD risk , which has not previously been shown Background Flaxseed has received attention for its anti-inflammatory and antioxidant role . The present study hypothesizes if flaxseed added to a weight loss diet could improve the lipid and metabolic profiles and decrease risk factors related to cardiovascular disease . Methods In a prospect i ve , single blinded 42 days protocol , subjects were allocated into two groups with low carbohydrates intake : GriceLC ( 35 % of carbohydrate and 60 g of raw rice powder per day ) and GflaxLC ( 32 % of carbohydrate and 60 g of flaxseed powder per day ) . Blood pressure , anthropometric measures and serum levels of isoprostane , C-reactive protein , Tumor Necrosis Factor-alpha , glucose , lipidic profile , uric acid , adiponectin , leptin and insulin were measured at baseline and at the end of interventions . Serum and urinary enterodiol and enterolactione were also measured . Results A total of 27 men with cardiovascular risk factors were evaluated , with mean age of 33 ± 10 years to GriceLC and 40 ± 9 years to GflaxLC . Both groups experienced weight loss and systolic blood pressure reduction . A decrease in inflammatory markers ( CRP and TNF-α ) was observed after flaxseed intake ( mean decrease of 25 % and 46 % for GflaxLC respectively ) . All groups also showed improvement in levels of total cholesterol , LDL-c , uric acid and adiponectin . Only GflaxLC group showed a decrease in triglyceride levels . Conclusion This study suggests that flaxseed added to a weight loss diet could be an important nutritional strategy to reduce inflammation markers such as CRP and TNF-α . Trial registration Clinical Trials.gov NCT02132728 Background : Vitamin D deficiency is prevalent among women , including patients with polycystic ovary syndrome ( PCOS ) . Some studies have suggested that vitamin D may have a role in cardiovascular disease ( CVD ) . There is very limited data on the vitamin D effect on CVD risk factors in women with PCOS and vitamin D deficiency . Aim : To investigate the effect of cholecalciferol on CVD risk factors in PCOS women with vitamin D deficiency . Methods : The study was a r and omized , placebo-controlled , double blinded trial . Fifty PCOS women with vitamin D deficiency ( vitamin D , no.=24 ; placebo , no.=26 ) aged 20–40 yr , were r and omly assigned to receive 3 oral capsules of 50 , 000 IU vitamin D3 or a placebo ( one capsule every 20 days ) for two months . Serum vitamin D , PTH , lipid profile , apolipoprotein AI ( APO-AI ) , and high sensitive C- reactive protein ( hs-CRP ) were measured at baseline and after treatment . Results : Vitamin D3 therapy in PCOS patients , increased serum vitamin D ( 7.00±2.80 to 22.9±6.14 ng/ml ) , decreased serum total cholesterol ( 196.6±32.8 to 179.1±34.1 mg/dl ) , triglyceride ( 156.8±73.0 to 130.5±56.5 mg/dl ) , and VLDL ( 31.4±14.6 to 26.1 ±11.3 mg/dl ) levels significantly ( p<0.05 ) , but it did not affect serum HDL-cholesterol , LDL-cholesterol , APO-AI , and hs-CRP concentrations . There was no change in variables in the placebo group . Conclusions : Our study showed that vitamin D3 therapy had beneficial effects on some CVD risk factors in PCOS patients with vitamin D deficiency . The trial was registered at I RCT .ir ( I RCT 138904113140N2 ) Previous studies have reported an association between a more pro-inflammatory diet profile and various chronic metabolic diseases . The Dietary Inflammatory Index ( DII ) was used to assess the inflammatory potential of nutrients and foods in the context of a dietary pattern . We prospect ively examined the association between the DII and the incidence of cardiovascular disease ( CVD : myocardial infa rct ion , stroke or cardiovascular death ) in the PREDIMED ( Prevención con Dieta Mediterránea ) study including 7216 high-risk participants . The DII was computed based on a vali date d 137-item food frequency question naire . Multivariate-adjusted hazard ratios ( HR ) and 95 % confidence intervals of CVD risk were computed across quartiles of the DII where the lowest ( most anti-inflammatory ) quartile is the referent . Risk increased across the quartiles ( i.e. , with increasing inflammatory potential ) : HRquartile2 = 1.42 ( 95%CI = 0.97–2.09 ) ; HRquartile3 = 1.85 ( 1.27–2.71 ) ; and HRquartile4 = 1.73 ( 1.15–2.60 ) . When fit as continuous the multiple-adjusted hazard ratio for each additional st and ard deviation of the DII was 1.22 ( 1.06–1.40 ) . Our results provide direct prospect i ve evidence that a pro-inflammatory diet is associated with a higher risk of cardiovascular clinical events BACKGROUND Chronic kidney disease ( CKD ) is associated with an increased risk of incident cardiovascular disease ( CVD ) ; however , the role of statins for the primary prevention of acute cardiovascular events in patients with CKD and the effect of statins on kidney function loss in persons without prevalent CVD have not been studied . STUDY DESIGN Post hoc analysis of the Air Force/Texas Coronary Atherosclerosis Prevention Study . SETTING & PARTICIPANTS Multicenter , r and omized , double-blind , placebo-controlled trial of 5,608 men and 997 women without CVD r and omly assigned to treatment with lovastatin or placebo .  INTERVENTION Placebo or lovastatin , 20 mg/d . OUTCOMES & MEASUREMENTS First major acute cardiovascular event in participants with mild CKD and kidney function loss in persons with or without CKD .  Estimated glomerular filtration rate was calculated using the 4-variable Modification of Diet in Renal Disease Study equation . RESULTS At baseline ,  mean estimated glomerular filtration rate in participants with CKD ( n = 304 ) was 53.0 + /- 6.0 mL/min/1.73 m(2 ) . After an average follow-up of 5.3 + /- 0.8 years , the incidence of a fatal and nonfatal CVD event was lower in participants with CKD receiving lovastatin than in those receiving placebo ( adjusted relative risk [ RR ] , 0.31 ; 95 % CI , 0.13 - 0.72 ; P = 0.01 ) . Tests for interaction suggested that the benefit of lovastatin was independent of the presence of CKD . Lovastatin did not reduce the annualized mean decrease in estimated glomerular filtration rate ( -1.3 + /- 0.07 vs -1.4 + /- 0.07 mL/min/1.73 m(2)/y , respectively ; P = 0.1 ) or the frequency of a > or = 25 % decrease in kidney function ( adjusted RR , 1.10 ; 95 % CI , 0.96 - 1.28 ; P = 0.2 ) or incident CKD ( adjusted RR , 1.04 ; 95 % CI , 0.86 - 1.27 ; P = 0.6 ) . LIMITATIONS Unable to determine the cause and duration of kidney disease , and information regarding proteinuria was not available . CONCLUSIONS Lovastatin is effective for the primary prevention of CVD in patients with CKD , but is not effective in decreasing kidney function loss in persons with no CVD Inflammation and endothelial activation are associated with an increased risk of CVD and epidemiological evidence suggests an association between levels of markers of inflammation or endothelial activation and the intake of fruit . Also , vitamin E , a fat-soluble antioxidant , has anti-inflammatory properties . We performed a r and omised 2 x 2 factorial , crossover trial to determine the effect of orange and blackcurrant juice ( 500 ml/d ) and vitamin E ( 15 mg RRR-alpha-tocopherol/d ) supplementation on markers of inflammation and endothelial activation in forty-eight patients with peripheral arterial disease . Patients were r and omly allocated to two dietary supplements from the four possible combinations of juice and vitamin E : juice+vitamin E ; juice+placebo ; reference beverage ( sugar drink)+vitamin E ; and reference beverage+placebo . The supplementations were given for 28 d , separated by a 4-week wash-out period . Analysis of main effects showed that juice decreased C-reactive protein ( CRP ) by 11 % and fibrinogen by 3 % while the reference drink increased CRP by 13 % and fibrinogen by 2 % ( P<0.008 and P<0.002 , respectively ) . No significant differences were measured for IL-6 and the endothelial activation markers von Willebr and factor , tissue-plasminogen activator and plasmin activator inhibitor-1 .  Vitamin E supplementation had no significant effects on the various markers . We observed no significant interaction between juice and vitamin E. In this study , orange and blackcurrant juice reduced markers of inflammation , but not markers of endothelial activation , in patients with peripheral arterial disease , relative to sugar drinks OBJECTIVE Type 2 diabetes is associated with increased plasma concentrations of coagulation and inflammation markers . Different studies have shown that treatment with hydroxymethylglutaryl-CoA reductase inhibitors ( statins ) is associated with antithrombotic and anti-inflammatory effects in addition to a cholesterol-lowering effect . Our objective was to evaluate the effect of pravastatin ( 40 mg/day ) on coagulation and inflammation markers in type 2 diabetic patients . RESEARCH DESIGN AND METHODS This was an open , r and omized , crossover study design ed with an 8-week intervention period . The study group was comprised of 50 patients with type 2 diabetes ( median HbA(1c ) 7.1 % ) and serum total cholesterol of 5 - 10 mmol/l . We evaluated plasma levels of fibrinogen , F1 + 2 , D-dimer , soluble tissue factor ( sTF ) , von Willebr and Factor antigen ( vWFag ) , and C-reactive protein ( CRP ) in blood sample s drawn after fasting on day 1 and after 8 and 16 weeks . RESULTS Significant reductions of total cholesterol ( -22 % ; P < 0.001 ) , LDL cholesterol ( -32 % ; P < 0.001 ) , and triglycerides ( -10 % ; P < 0.05 ) were achieved after 8 weeks of treatment with pravastatin . In addition , significant reductions of plasma levels of F1 + 2 ( -4.4 % ; P < 0.05 ) , vWFag ( -5.3 % ; P < 0.05 ) , and sTF ( -3.4 % ; P < 0.05 ) were observed after treatment with pravastatin . Furthermore , plasma levels of CRP were also significantly reduced ( -13 % ; P < 0.05 ) . Levels of fibrinogen and D-dimer did not decrease after treatment with pravastatin . CONCLUSIONS The results indicated that pravastatin reduces levels of coagulation and inflammation markers in type 2 diabetic patients . These antithrombotic and anti-inflammatory effects of treatment with statins could play a role in reducing cardiovascular complications in type 2 diabetic patients Background : Patients with schizophrenia ( SZ ) are generally overweight or obese and have several metabolic disorders . Additionally , such patients have a lower life expectancy and the main cause of their increased mortality is cardiovascular disease ( CVD ) . The objective of this study was to determine the efficacy of resveratrol supplementation on serum glucose and CVD risk factors in individuals with SZ . Methods and Results : This is a four-week r and omized , double-blind controlled trial ( registration No. : NCT 02062190 ) in which 19 men with a diagnosis of SZ , aged 18 to 65 , were assigned to either a resveratrol supplement group ( 200 mg/day ) or a placebo group ( 200 mg/day ) . In short , we did not observe significant changes after resveratrol supplementation . In the placebo group , we found a significant increase in total cholesterol levels ( p = 0.024 ) and in LDL-cholesterol ( p = 0.002 ) , as well as a decrease in body fat percentage ( p = 0.038 ) . The placebo group also showed an increase in triglycerides ( 9.19 % ) and a reduction in HDL-cholesterol ( 4.88 % ) . In the resveratrol group , triglycerides decreased ( 7.64 % ) . Conclusion : In summary , oral resveratrol in reasonably low dosages ( 200 mg daily ) brought no differences to body weight , waist circumference , glucose , and total cholesterol . It was possible to note that the lipid profile in the placebo group worsened and , although no significant differences were found , we can assume that resveratrol might prevent lipid profile damage and that the intervention affected the lipoprotein metabolism at various levels Background — Persons of lower socioeconomic status have greater cardiovascular risk than those of higher socioeconomic status . However , the mechanism through which socioeconomic status affects cardiovascular disease ( CVD ) is uncertain . Virtually no data are available that examine the prospect i ve association between novel inflammatory and hemostatic CVD risk indicators , socioeconomic status , and incident CVD events . Methods and Results — We assessed the relationship between 2 indicators of socioeconomic status ( education and income ) , traditional and novel CVD risk factors ( high sensitivity C-reactive protein , soluble intercellular adhesion molecule-1 , fibrinogen , and homocysteine ) , and incident CVD events among 22 688 apparently healthy female health professionals participating in the Women 's Health Study . These women were followed up for 10 years for the development of myocardial infa rct ion , ischemic stroke , coronary revascularization , and cardiovascular death . More educated women were less likely to be smokers ; had a lower prevalence of hypertension , diabetes , and obesity ; and were more likely to participate in vigorous physical activity than less educated women . At baseline , median total cholesterol , low-density lipoprotein , triglyceride , C-reactive protein , intercellular adhesion molecule-1 , fibrinogen , and homocysteine levels for women in 5 categories of education ( < 2 years of nursing education , 2 to < 4 years of nursing education , a bachelor 's degree , a master 's degree , and a doctoral degree ) and 6 categories of income [ ≤$19 999 , $ 20 000 to $ 29 999 , $ 30 000 to $ 39 999 , $ 40 000 to $ 49 999 , $ 50 000 to $ 99 999 , and ≥$100 000 ) decreased progressively with increasing education or income levels ( all P<0.001 ) , whereas an opposite pattern was observed for high-density lipoprotein ( P<0.001 ) . Overall , in age-adjusted Cox proportional hazards models , the relative risk of incident CVD events decreased with increasing education ( 1.0 , 0.7 , 0.5 , 0.4 , and 0.5 ; P for trend < 0.001 ) and income ( 1.0 , 1.0 , 0.9 , 0.7 , 0.6 , and 0.4 ; P for trend < 0.001 ) categories . In multivariate models that assessed the impact of traditional and novel CVD risk factors on the relationship between education/income and CVD events , the relative hazard of incident CVD associated with a 1-category-higher level of education changed from 0.79 in age- and race-adjusted analysis to 0.89 in fully adjusted analysis . The 11 % lower risk per 1 category of education remained significant ( P for trend=0.006 ) , suggesting that controlling for both novel and traditional risk factors could not explain the protective effect of education . A similar analysis for income revealed that its relationship with CVD events was explained largely by these noted risk factors . Conclusions — In this prospect i ve analysis , we observed a decrease in incident CVD events with increasing levels of education and income . In contrast to the relationship between income and CVD events , the relationship of CVD events with education was explained only partially by traditional and novel risk factors for CVD BACKGROUND Epidemiologic studies suggest that garlic may have beneficial effects on risk factors associated with cardiovascular disease ( CVD ) . However , these findings are not unambiguously supported by r and omized placebo-controlled clinical trials . OBJECTIVE We sought to investigate the effects of a chemically well-characterized garlic preparation on biomarkers for inflammation , endothelial function , and lipid metabolism in subjects with risk factors for CVD . DESIGN This was a double-blind , r and omized , placebo-controlled trial in 90 overweight [ body mass index ( in kg/m2 ) > 24.5 ] subjects aged 40 - 75 y who smoked > 10 cigarettes/d . The subjects were r and omly assigned to 3 parallel treatment groups : garlic powder ( 2.1 g/d ) , atorvastatin ( 40 mg/d ) , or placebo . Duplicate measurements were performed at baseline and after 1 and 3 mo of treatment . Treatments were compared with analysis of covariance with baseline as the covariate , and differences between the treatments were reported as mean percentage difference and corresponding 97.5 % CI . RESULTS None of the variables showed significant differences between the garlic-treated and the placebo groups . In contrast , compared with the placebo group , atorvastatin treatment result ed in significantly lower plasma concentrations of C-reactive protein ( 20.2 % ; 1.7 % , 35.3 % ) , total cholesterol ( 37.2 % ; 33.1 % , 41.1 % ) , LDL cholesterol ( 52.7 % ; 47.9 % , 57.1 % ) , triacylglycerols ( 31.9 % ; 20.8 % , 41.5 % ) , and tumor necrosis factor alpha ( TNF-alpha ; 41.9 % ; 19.0 % , 58.3 % ) and increased the ratio of ex vivo whole blood lipopolysaccharide-stimulated to nonstimulated TNF-alpha concentrations ( 109.7 % ; 37.9 % , 218.9 % ) . CONCLUSION We conclude that a chemically well-characterized garlic preparation has no significant effect on inflammatory biomarkers , endothelial function , or lipid profile in normolipidemic subjects with risk factors for CVD Background Statins are frequently administered to reduce low-density lipoprotein cholesterol ( LDL-C ) and vascular inflammation , because LDL-C and high sensitive C-reactive protein ( hs-CRP ) are associated with high risk for cardiovascular events . When statins do not reduce LDL-C to desired levels in high-risk patients with coronary artery disease ( CAD ) , ezetimibe can be added or the statin dose can be increased . However , which strategy is more effective for treating patients with CAD has not been established . The present study compares anti-inflammatory effects and lipid profiles in patients with CAD and similar LDL-C levels who were treated by increasing the statin dose or by adding ezetimibe to the original rosuvastatin dose to determine the optimal treatment for such patients . Methods 46 patients with high-risk CAD and LDL-C and hs-CRP levels of > 70 mg/dL and > 1.0 mg/L , respectively , that were not improved by 4 weeks of rosuvastatin ( 2.5 mg/day ) were r and omly assigned to receive 10 mg ( R10 , n = 24 ) of rosuvastatin or 2.5 mg/day of rosuvastatin combined with 10 mg/day of ezetimibe ( R2.5/E10 , n = 22 ) for 12 weeks . The primary endpoint was a change in hs-CRP . Results Baseline characteristics did not significantly differ between the groups . At 12 weeks , LDL-C and inflammatory markers ( hs-CRP , interleukin-6 , tumour necrosis factor-alpha and pentraxin 3 ) also did not significantly differ between the two groups ( LDL-C : R10 vs. R2.5/E10 : -19.4 ± 14.2 vs. -22.4 ± 14.3 mg/dL ) . However , high-density lipoprotein cholesterol ( HDL-C ) was significantly improved in the R10 , compared with R2.5/E10 group ( 4.6 ± 5.9 vs. 0.0 ± 6.7 mg/dL ; p < 0.05 ) . Conclusion Both enhanced therapies exerted similar anti-inflammatory effects under an equal LDL-C reduction in patients with high-risk CAD despite 2.5 mg/day of rosuvastatin . However , R10 elevated HDL-C more effectively than R2.5/E10.Trial registration BACKGROUND Patients with chronic kidney disease ( CKD ) are at significant risk for cardiovascular disease ( CVD ) . The National Kidney Foundation developed clinical practice guidelines ( Kidney Disease Outcomes Quality Initiative ) for targeting low-density lipoprotein cholesterol ( LDL-C ) goals . OBJECTIVE This study evaluated the extent to which these guidelines were adhered to among patients with CKD and to examine factors associated with the attainment of LDL-C goals . METHODS In this cross-sectional study we evaluated patients with a glomerular filtration rate of 15 to 59 mL/min per 1.73 m² . Patients with previous CVD , who were receiving dialysis , or were post kidney transplant were excluded . Administrative data bases were used to determine the percentage of patients with a fasting lipid profile performed within the previous year , the percentage who attained a LDL-C goal less than 100 mg/dL , and to determine lipid-lowering medications prescribed . Logistic regression analysis was used to identify factors associated with LDL-C goal attainment . RESULTS Of the 4541 patients evaluated , 3157 ( 69.5 % ) had a fasting lipid profile performed within the previous year . Overall , 60.8 % attained a LDL-C less than 100 mg/dL. Among patients at goal , 72.2 % were taking lipid-lowering therapy compared with 37.9 % of those not at goal ( P < .01 ) . Characteristics independently associated with LDL-C goal attainment were increasing age , male gender , increasing chronic disease score , history of diabetes , and statin use . CONCLUSION Although most patients were screened and attained LDL-C goal , there was room for improvement . Statin use was independently associated with LDL-C goal attainment . Future prospect i ve studies should focus on evaluating clinical outcomes of lipid-lowering interventions within the CKD population Chronic HIV infection is associated with increased risk of cardiovascular disease ( CVD ) , including in patients with virological suppression . Persistent innate immune activation may contribute to the development of CVD via activation of monocytes in these patients . We investigated whether changes in monocyte phenotype predict sub clinical atherosclerosis in virologically suppressed HIV-positive individuals with low cardiovascular risk . We enroled 51 virologically suppressed HIV-positive individuals not receiving protease inhibitors or statins and 49 age-matched uninfected controls in this study .  Carotid artery intima-media thickness ( cIMT ) was used as a surrogate marker for CVD , and traditional risk factors , including Framingham risk scores , were recorded . Markers of monocyte activation ( CD14 , CD16 , CCR2 , CX3CR1 , CD38 , HLA-DR and CD11b ) were measured in whole-blood sample s by flow cytometry . Associations were assessed using univariate and multivariate median regressions . Median cIMT was similar between HIV-positive and HIV-negative participants ( P=0.3 ) , although HIV-positive patients had significantly higher Framingham risk score ( P=0.009 ) and systemic inflammation . Expression of two monocyte markers , CD11b and CX3CR1 , independently predicted carotid artery thickness in HIV-positive individuals after controlling for Framingham risk score ( P=0.025 and 0.015 , respectively ) . These markers were not predictive of carotid artery thickening in controls . Our study indicates that monocyte surface markers may serve as novel predictors of CVD in HIV-positive individuals and is consistent with an important role for monocyte activation in the progression of HIV-related cardiovascular pathology OBJECTIVES To examine the associations between food patterns constructed using cluster analysis and markers of systemic and vascular inflammation , and incident cardiovascular disease ( CVD ) after 13 years of follow-up . DESIGN Population -based , prospect i ve cohort study . SETTING AND SUBJECTS Cluster analysis identified six food patterns from 43 food group variables among 4999 subjects , aged 45 - 68 years , who participated in the Malmö Diet and Cancer cardiovascular programme between 1991 and 1994 .  Lipoprotein-associated phospholipase A(2 ) ( Lp-PLA(2 ) ) , C-reactive protein concentration and white blood cell ( WBC ) count were measured using blood sample s at baseline . Incidence of CVD ( coronary events and ischaemic stroke ) was monitored over 13 years of follow-up . RESULTS The fibre-rich bread pattern was associated with favourable effects on WBC count in women , and the low-fat and high-fibre pattern with favourable effects on Lp-PLA(2 ) mass in women , and on Lp-PLA(2 ) activity in men . However , the milk fat and sweets and cakes patterns were both associated with adverse effects ; the former on WBC count in women and on Lp-PLA(2 ) mass in men , and the latter on WBC count and Lp-PLA(2 ) mass in women . The milk fat and sweets and cakes patterns were associated with increased CVD risk in women . CONCLUSIONS The results of this study support the present Nordic dietary recommendations indicating that diets rich in high-fibre , low-fat and low-sugar foods are favourably associated with markers of inflammation and , potentially , with CVD risk Background : Telomerase activity ( TA ) is considered as the biomarker for cardiovascular aging and cardiovascular diseases ( CVDs ) . Recent studies suggest a link between statins and telomere biology that may be explained by anti-inflammatory actions of statins and their positive effect on TA . Until now , this effect has not been investigated in prospect i ve r and omized studies . We hypothesized that 12 months of atorvastatin therapy increased TA in peripheral blood mononuclear cells . Methods : In a r and omized , placebo-controlled study 100 hypercholesterolemic patients , aged 35–75 years , free of known CVDs and diabetes mellitus type 2 received 20 mg of atorvastatin daily or placebo for 12 months .  TA was measured by quantitative polymerase chain reaction . Results : At study end , 82 patients had sufficient peripheral blood mononuclear cells needed for longitudinal analysis . TA expressed as natural logarithms changed from 0.46 ± 0.05 to 0.68 ± 0.06 ( p = 0.004 ) in the atorvastatin group and from 0.67 ± 0.06 to 0.60 ± 0.07 ( p = 0.477 ) in the control group . In multiple regression analysis , atorvastatin therapy was the only independent predictor ( p = 0.05 ) of the changes in TA independently of markers of chronic inflammation and oxidative stress . Atorvastatin therapy was associated with increases in interleukin-6 within the normal range and a tendency toward reduction in blood urea . Conclusion : These initial observations suggest atorvastatin can act as telomerase activator and potentially as effective geroprotector . Trial registration : The trial was registered in IS RCT N registry IS RCT N55050065 Lifestyle modification to decrease cardiovascular disease ( CVD ) risk has recently been reaffirmed by both the National Cholesterol Education Program and American Heart Association ( AHA ) . Using a r and omized crossover design , the Therapeutic Lifestyle Change (TLC)/Step 2 diet relative to a typical Western diet was assessed in 36 moderately hypercholesterolemic subjects in a clinical setting under isoweight conditions .  Mean lipoprotein and apolipoprotein levels ( fasting and non-fasting ) , fatty acid profiles , parameters of HDL metabolism , and glucose homeostasis were determined . Relative to the Western diet , the TLC/Step 2 diet result ed in 11 % and 7 % lower LDL cholesterol ( LDL-C ) and HDL cholesterol ( HDL-C ) , respectively , with no significant change in TG levels or total cholesterol-HDL-C ratio . Similar responses were observed in the non-fasting state . Linoleic ( 18:2n-6c ) and alpha-linolenic ( 18:3n-3 ) acids increased at the expense of oleic acid ( 18:1n-9c ) in the cholesteryl ester , TG , and phospholipid subfractions . The dietary changes had no significant effect on fractional esterification rate of HDL , phospholipid transfer protein ( PLTP ) , or cholesterol ester transfer protein activities , or glucose and insulin levels .  Female and male subjects responded similarly . The TLC/Step 2 diet result ed in a decrease in some CVD risk factors and no apparent adverse effects in others Atherosclerosis is currently considered a chronic inflammatory disease of the vessel wall . Systemic markers of inflammation have been shown to be of significant prognostic relevance for assessing the risk of atherosclerotic disease progression (1)(2)(3)(4 ) . Previous data showed that proinflammatory markers , such as C-reactive protein ( CRP ) , play an important role in acute coronary events (5)(6)(7 ) and that decreased plasma concentrations of antiinflammatory cytokines , for example , interleukin-10 ( IL-10 ) were also associated with acute coronary syndrome ( ACS ) (8)(9)(10 ) . Statins , 3-hydroxy-3-methyglutaryl-coenzyme A reductase inhibitors , represent a well-established class of drugs that effectively lower serum cholesterol concentrations and are widely used for the treatment of cardiovascular disease (11)(12)(13 ) . In addition to their cholesterol-lowering activity , statins have been demonstrated to possess pleiotropic effects , including antiinflammatory effects (14)(15)(16)(17 ) . Results obtained in numerous investigations have suggested that administration of statins could modify concentrations of CRP and other proinflammatory cytokines with a concurrent decrease in cardiovascular events . However , the potential influence of statins on the antiinflammatory cytokine IL-10 in patients with ACS has not been investigated . In the present study , 42 patients with unstable angina ( UA ) were r and omly assigned immediately after admission to st and ard therapy  plus either 20 mg/day atorvastatin or placebo . The st and ard therapy included aspirin , beta-blockers , heparin/low – molecular-weight heparin , angiotensin-converting enzyme inhibitors , and oral nitrates . The protocol s of the study were approved by the Ethics Review Board of the Hospital , and all patients gave written , informed consent . The patients with UA presented with  ischemic chest pain  at rest in the absence of extracardiac cause with ST-segment depression ≥0.1 mV in 2 or more contiguous leads on 12-lead electrocardiograms at administration . Echocardiography was performed in all patients to exclude patients with an impaired left OBJECTIVE The association of dairy food consumption with the risk for developing cardiovascular disease ( CVD ) has been investigated in many studies , but results often have been contradictory . The aim of the present study was to determine whether genetic polymorphisms are associated with interindividual variation in the response of CVD risk biomarker values after milk consumption . METHODS Fourteen single nucleotide polymorphisms ( SNPs ) in nine genes related to lipid metabolism were examined in 161 volunteers r and omly allocated to consume either 500 mL/d of skimmed ( S ) or semi-skimmed ( SS ) milk for 1 year in addition to their usual diets .  Total cholesterol/high-density lipoprotein cholesterol ( TC/HDL-C ) and low-density lipoprotein/HDL-C ratios were used as biomarkers of CVD risk . Three-way repeated- measures analysis of variance was used to examine the effect of time , treatment ( S or SS ) , and genotype on these biomarkers . RESULTS A TT genotype for the proliferator-activated receptor alpha polymorphism ( PPARA rs135549 SNP ) was significantly associated with a reduction in the TC/HDL and LDL/HDL ratios after 12 mo of S milk intake ( mean reduction -0.29 , 95 % confidence interval [ CI ] , -0.63 to 0.05 ; P = 0.0015 and -0.31 , 95 % CI , -0.58 to -0.03 ; P = 0.0005 , respectively ) . However , no differences were observed after consuming either S or SS milk in the C allele carriers . CONCLUSIONS Saturated fatty acid consumption has long been linked to an increased risk for CVD ; indeed , the consumption of saturated fat-free products is recommended as a means of reducing this risk . However , the present results suggest that many individuals might not benefit from such general recommendations . Genetic analysis of PPARA rs135549 might help identify those individuals who are more likely to benefit from reducing the saturated fatty acid content of their diet Type 2 diabetes is highly prevalent in North America and is associated with increased risk of cardiovascular disease ( CVD ) . Evidence supports a role for soy protein in the reduction of serum lipids related to CVD risk ; however , few studies have focused on adults with type 2 diabetes who are not on lipid-lowering medications and /or do not have diabetic complications . The purpose of this study was to determine the effect of soy protein isolate ( SPI ) consumption on serum lipids in adults with diet-controlled type 2 diabetes . Using a double-blind , r and omized , crossover , placebo-controlled intervention study design , adults with diet-controlled type 2 diabetes ( n = 29 ) consumed SPI ( 80 mg/d aglycone isoflavones ) or milk protein isolate ( MPI ) for 57 d each separated by a 28-d washout period . Twenty-four-hour urine sample s were collected on d 54 - 56 of each treatment for analysis of isoflavones and blood was collected on d 1 and 57 of each treatment and analyzed for serum lipids and apolipoproteins . SPI consumption increased urinary isoflavones compared with MPI . SPI consumption reduced serum LDL cholesterol ( P = 0.04 ) , LDL cholesterol : HDL cholesterol ( P = 0.02 ) , and apolipoprotein B : apolipoprotein A-I ( P = 0.05 ) compared with MPI . SPI did not affect serum total cholesterol , HDL cholesterol , triacylglycerol , apolipoprotein B , or apolipoprotein A-I. These data demonstrate that consumption of soy protein can modulate some serum lipids in a direction beneficial for CVD risk in adults with type 2 diabetes BACKGROUND The consumption of monounsaturated trans fatty acids ( TFAs ) increases the risk of cardiovascular disease ( CVD ) . Putative differences between the effects of TFAs from industrially produced and natural sources on CVD risk markers were not previously investigated in healthy subjects . OBJECTIVE We aim ed to compare the effects of TFAs from industrially produced and natural sources on HDL and LDL cholesterol , lipoprotein particle size and distribution , apolipoproteins , and other lipids in healthy subjects . DESIGN In a r and omized , double-blind , controlled , crossover design , 46 healthy subjects ( 22 men and 24 women ) consumed food items containing TFAs ( 11 - 12 g/d , representing approximately 5 % of daily energy ) from the 2 sources . RESULTS Forty subjects ( 19 men and 21 women ) completed the study . Compared with TFAs from industrially produced sources , TFAs from natural sources significantly ( P = 0.012 ) increased HDL cholesterol in women but not in men . Significant ( P = 0.001 ) increases in LDL-cholesterol concentrations were observed in women , but not in men , after the consumption of TFAs from natural sources . Apolipoprotein (apo)B and apoA1 concentrations confirmed the changes observed in LDL and HDL cholesterol . Analysis of lipoprotein subclass showed that only large HDL and LDL concentrations were modified by TFAs from natural sources but not by those from industrially produced sources . CONCLUSIONS This study shows that TFAs from industrially produced and from natural sources have different effects on CVD risk factors in women . The HDL cholesterol-lowering property of TFAs seems to be specific to industrial sources . However , it is difficult in the present study to draw a conclusion about the effect of TFAs from either source on absolute CVD risk in these normolipidemic subjects . The mechanism underlying the observed sex- and isomer-specific effects warrants further investigation BACKGROUND High-dose statins are used in acute coronary syndromes ( ACS ) to reduce inflammation . The aim of the study was the evaluation of the influence of low-dose atorvastatin ( 20 mg ) on selected inflammatory parameters and clinical outcomes after ACS . METHODS Seventy eight patients ( pts ) with ACS were r and omly divided into group A ( 39 pts ) taking atorvastatin , and group NA ( 39 pts ) not taking any statin for the following six weeks . C-reactive protein ( CRP ) , interleukin-6 ( IL-6 ) , monocyte chemoattractant protein-1 ( MCP-1 ) and tumour necrosis factor alpha ( TNFa ) levels were measured on the first and the fifth days and six weeks after ACS . RESULTS There was no significant CRP and IL-6 level decrease in group A ( CRP--62 % ; IL-6 - 73 % ) or group NA ( CRP-44 % ; IL-6 - 62 % ) . There was also no significant change in TNFa levels . The MCP-1 level finally reached the level of significant difference ( p < 0.04 ) . Cardiovascular events ( MACE ) and the restenosis rates did not differ between the groups . CONCLUSIONS Low-dose atorvastatin does not have a significant influence on cooling down inflammation in ACS , and MCP-1 can be used as an early indicator of statin anti-inflammatory activity . Furthermore , it does not reduce MACE or restenosis rates despite its influence on MCP-1 levels A line of epidemiological studies suggests that the accumulation of coronary risk factors promotes the progression of coronary atherosclerosis . Recent clinical studies showed that aggressive low-density lipoprotein ( LDL ) cholesterol-lowering therapy using statins could regress coronary atheroma and reduce major cardiovascular events . Additionally , therapy that controlled amlodipine-based blood pressure reduced major cardiovascular events in patients with hypertension compared with an atenolol-based regimen . An open-label r and omized multicenter study is primarily planned to evaluate the changes in coronary atheroma volume using intravascular ultrasonography 18–24 months after intensive lowering of LDL-cholesterol and blood pressure compared with a st and ard therapy indicated by current guidelines in Japanese patients with coronary artery disease ( CAD ) . The secondary endpoints include changes in serum lipid levels , inflammatory markers , glucose markers and blood pressure .  In total , 100 subjects with CAD who are undergoing percutaneous coronary intervention will be tested . The MILLION study will provide new evidence and therapeutic st and ards for the prevention of CAD in Japanese patients by controlling both LDL-C levels and blood pressure OBJECTIVE —Cardiovascular disease ( CVD ) mortality has decreased in men but not in women with diabetes . We investigated whether sex differences in control and treatment of CVD risk factors might underlie this disparity . RESEARCH DESIGN AND METHODS —We performed cross-sectional analyses from a cohort of patients with diabetes sample d from 10 U.S. managed care health plans . Study end points included not being in control for CVD risk factors ( ≥140 mmHg for systolic blood pressure [ SBP ] , ≥3.35 mmol/l for LDL cholesterol , and ≥8.0 % for A1C ) and the intensity of medication management ( number of medication classes ) for patients not in control . Logistic regression models with r and om intercepts were used to adjust probabilities of control and management for demographics , clinical characteristics , and clustering within health plans . RESULTS —There were 1,315 women and 1,575 men with a history of CVD and 3,415 women and 2,516 men without a history of CVD . Among patients with CVD , adjusted estimated probabilities for not being in control and risk differences varied significantly between men and women for SBP ( men 41.2 % , women 46.6 % ; risk difference −5.4 % [ 95 % CI −9.5 to −1.3 ] ) and LDL cholesterol ( men 22.4 % , women 28.3 % ; risk difference −5.9 % [ −9.9 to −1.8 ] ) . There were no significant sex differences in intensity of medication management for patients not in control . In patients without CVD there were no significant differences in control or intensity of medication management . CONCLUSIONS —In diabetic patients with CVD , poorer control of SBP and LDL cholesterol for women may contribute to the sex disparity in CVD mortality trends BACKGROUND We evaluated markers of inflammation and endothelial dysfunction and their associations with incident cardiovascular disease ( CVD ) , all-cause mortality and progression of coronary artery calcium ( CAC ) in patients with type 2 diabetes ( T2D ) and microalbuminuria but without known coronary artery disease ( CAD ) . METHODS Prospect i ve study including 200 patients receiving multifactorial treatment .  Markers of inflammation ( TNF-ɑ , sICAM-1 , sICAM-3 , hsCRP , SAA , IL-1β , IL-6 , IL-8 ) and endothelial dysfunction ( thrombomodulin , sVCAM-1 , sICAM-1 , sICAM-3 , sE-selectin , sP-selectin ) were measured at baseline . Adjustment included traditional CVD risk factors , and full adjustment additionally NT-proBNP and CAC . The " SQRT method " assessed CAC progression after 5.8years , and cut-point was an annualised difference > 2.5 . RESULTS Occurrence of CVD ( n=40 ) and all-cause mortality ( n=26 ) was traced after 6.1years . In adjusted and fully adjusted Cox models , TNF-ɑ was a determinant of CVD and all-cause mortality ( p≤0.007 ) . Further , in adjusted and fully adjusted logistic regression , TNF-ɑ was related to CAC progression ( p≤0.042 ) . Of the other biomarkers , sICAM-3 and thrombomodulin were also associated with both endpoints ( p≤0.046 ) , IL-1β with CVD endpoints ( p=0.021 ) , and sVCAM-1 and sICAM-1 with all-cause mortality ( p≤0.005 ) . Higher composite z-scores including all markers of inflammation and endothelial dysfunction were associated with CVD and all-cause mortality ( p≤0.008 ) . CONCLUSIONS In patients with T2D and microalbuminuria without known CAD and receiving multifactorial treatment , biomarkers of inflammation and endothelial dysfunction were independently associated with CVD , all-cause mortality and CAC progression . Especially TNF-ɑ was a robust determinant , even after adjusting for NT-proBNP and CAC CONTEXT Polycystic ovary syndrome ( PCOS ) is associated with the metabolic syndrome and , consequently , with a potentially increased risk of cardiovascular disease ( CVD ) and related mortality later in life . Studies regarding CVD and mortality in PCOS women well into the postmenopausal age are lacking . OBJECTIVE Our objective was to examine whether postmenopausal PCOS women differ from controls regarding cardiovascular risk factors , myocardial infa rct ion ( MI ) , stroke and mortality . DESIGN AND SETTING We conducted , at a university hospital , a prospect i ve study of 35 PCOS women ( 61 - 79 yr ) and 120 age-matched controls . The study was performed 21 yr after the initial study . PARTICIPANTS Twenty-five PCOS women ( Rotterdam criteria ) and 68 controls participated in all examinations . Data on morbidity were based on 32 of 34 PCOS women and on 95 of 119 controls . INTERVENTIONS INTERVENTIONS included reexamination , interviews , and data from the National Board of Health and Welfare and from the Hospital Discharge Registry . MAIN OUTCOME MEASURES Blood pressure , glucose , insulin , triglycerides , total cholesterol , high- and low-density lipoprotein , apolipoprotein A1 and B , fibrinogen , and plasminogen activator inhibitor antigen were studied . Incidences of MI , stroke , hypertension , diabetes , cancer , cause of death , and age at death were recorded . RESULTS PCOS women had a higher prevalence of hypertension ( P = 0.008 ) and higher triglyceride levels ( P = 0.012 ) than controls . MI , stroke , diabetes , cancer , and mortality prevalence was similar in the two cohorts with similar body mass index . CONCLUSIONS The well-described cardiovascular/metabolic risk profile in pre- and perimenopausal PCOS women does not entail an evident increase in cardiovascular events during the postmenopausal period
Our meta‐ analysis showed beneficial effects  of statin use  on reducing inflammatory markers in patients with MetS and related disorders
& NA ; Current evidence suggests that statin use decreases the incidence of cardiovascular diseases ( CVD ) through reducing LDL cholesterol and decreasing inflammation .
Metabolic syndrome ( MetS ) is usually associated with increased inflammatory markers and increased risk of CVD .