Population Attributable Risk of Hyperuricemia in Hypertension Incidence in 20-74-Year-Old Population during a 10-Year Longitudinal Cohort: Yazd Healthy Heart Cohort.

BACKGROUND: The population attributable risk (PAR) percent has used widely in public health policy. We aimed to calculate the attribute risk of hypertension due to hyperuricemia by Levin's formulas compare to direct PAR calculation method. METHODS: This was a sub-study of Yazd Healthy Heart Cohort (YHHC). Overall, 1256 normotensive individuals were enrolled through multistage randomized cluster sampling and followed up for mean 9.8 years, from 2005-2015. The threshold cutoff point of the hyperuricemia was considered equal and more than 75th percentile that equal to 5.5 mg/dl for men and 4.3mg/dl for women. To calculate the attributable risk of hyperuricemia in developing hypertension, two methods were applied. Levin's formulas and direct PAR estimation by population risk calculation via exposure prevalence weighted formula. Multiple logistic regression was used for estimate of odds ratio (OR) of hyperuricemia in developing hypertension. We calculated Relative Risk (RR) from OR. The data were analyzed using SPSS software version 16. A significant level of 0.05 was considered. RESULTS: Hypertension developed in 44.7% of individuals with uric acid level ≥ 75th percentile vs. 35.6% of other individuals (P=0.024). Attributable risk (AR) of hyperuricemia in hypertension incidence was 9.1%. PAR of hyperuricemia for hypertension incidence by using two methods mentioned before was 6%, 5.8% respectively. CONCLUSION: The results of the study confirmed the noticeable contribution of hyperuricemia as an independent other risk factor for the occurrence of hypertension. PAR of hyperuricemia for hypertension incidence by using two methods almost near was 6%, 5.8% respectively.

The incidence rate of diabetes mellitus (type II) and its related risk factors: A 10-year longitudinal study of Yazd Healthy Heart Cohort (YHHC), Iran.

BACKGROUND AND OBJECTIVES: Diabetes Mellitus (DM) is a metabolic disease characterized by chronic hyperglycemia, which occurs due to insufficient production of insulin by the pancreas or resistance to insulin produced by the body. The most dangerous and Long-term complications of diabetes include renal failure, heart failure, cardiovascular disease, stroke, diabetic foot ulcers, and diabetic neuropathy. MATERIALS AND METHODS: This longitudinal cohort study was conducted on 1641 non-diabetic people of 2000 participants enrolled in phase I of Yazd Healthy Heart project (YHHP) aged 20-74 year-old resident of the city of Yazd. They were selected randomly through cluster sampling method and included in follow up a project for ten years (2004-2014). In order to analyze the data, Chi-Square, independent t-test and logistic regression statistical models were used through the SPSS Ver20. RESULTS: The incidence rate of DM type II among the people aged 20-74 years in Yazd was 21.4 per 1000 of a population-year. Univariate analysis revealed that the relative risk of DM incidence increased by smoking, increasing BMI, abdominal obesity, hypertension, and increased cholesterol, triglyceride and uric acid levels (p < 0.0001). Variables with a significant p-value < 0.05 using the univariate analysis were included in the logistic regression model. Age, family history of diabetes mellitus in relatives, abdominal obesity, triglyceride values greater than 150 and uric acid more than the 75th percentile were recognized as independent risk factors of diabetes. CONCLUSION: In the present study, Age, family history of DM, abdominal obesity, high triglycerides, and high uric acid are the most important risk factors for diabetes.

Ascorbic acid effect on CIN incidence in diabetic patient after coronary angiography.

BACKGROUND: This study aims to investigate the antioxidant effect of vitamin C in preventing contrast-induced nephropathy (CIN) in diabetic patients after catheterization. MATERIALS AND METHODS: In a double blinded, randomized controlled trial, 90 diabetic patients who were referred for cardiac catheterization were randomly allocated into two arms of vitamin C (A) and placebo (B). The treatment arm (A) received 2 g of vitamin C orally 2 h before catheterization and the control group (B) received 2 g of oral placebo. Six hours before catheterization, patients received fluid resuscitation with normal saline (CIN was considered as a 25% rise in creatinine (Cr) level or an increase of 0.5 mg/dL in earlier creatinine). CIN was compared between groups. Before andthree days after catheterization. Serum Bun - Cr was measured and GFR were calculated. The results were compared between the two groups. Six hours before catheterization, patients received fluid resuscitation with normal saline CIN was compare between arms. RESULTS: Mean GFR in group (A) before procedure was respectively 69.82±19.26 and after the treatment was 81.51±27.40 (P=0.001). But in group (B) it was 74.18±24.41 and 75.20±29.65 (P=0.747). Contrast-induced nephropathy was observed in 10 patients (12.3%) including 3 patients (7.7%) in group (A) and (16.7%, 7 patients) in group (B) (P=0.315). CONCLUSION: Ascorbic acid intake in diabetic patients prior to use of contrast agents can be effective in maintaining GFR, but the incidence of contrast-induced nephropathy is not associated with the consumption of ascorbic acid.

Endovascular treatment of post-traumatic pseudoaneurysms of ulnar and radial artery.

Aneurysm can develop in all arteries of the human body. Pseudoaneurysm induced by trauma is known as a rare condition in peripheral arteries. This complication is known as late sequelae of trauma. The incidence of pseudoaneurysm in upper extremities artery is less than lower extremities. Atherosclerotic aneurysms are often seen in large arteries and by aging, but pseudoaneurysm can be seen in penetrating or blunt trauma in patients of every age or every location. Delayed treatment of pseudoaneurysm leads to bleeding, venous edema at the extremities and compression on the adjacent nerve as a result of pseudoaneurysm enlargement. Early diagnosis of pseudoaneurysm is very important, because this complication can induce disabilities such as upper extremities and finger loss. Peripheral arteries pseudoaneurysm in distal locations especially in brachial artery and forearm can cause a thrombotic complication in hands and fingers.