The Journal of Cardiovascular Diseases

Postpartum Cardiovascular Risk in Women with Hypertensive Disorders of Pregnancy

Hira Hassan — 2025-09-10

Abstract

Objective: To evaluate the postpartum cardiovascular risk in women with hypertensive disorders of pregnancy (HDP), focusing on blood pressure, high-sensitivity C-reactive protein (hs-CRP), metabolic syndrome, and left ventricular hypertrophy (LVH) to assess long-term cardiovascular complications.

Methodology: A retrospective cohort study was conducted at the Department of Cardiology, Hayatabad Medical Complex Peshawar from June 2023 to June 2024. A total of 160 women were included, with 80 women in the HDP group and 80 women in the control group. Data on blood pressure, hs-CRP, proteinuria, LVH, and metabolic syndrome were collected and analysed. Statistical analyses included t-tests for continuous variables and Chi-square tests for categorical variables.

Results: The study revealed significant differences between the HDP and control groups. Systolic blood pressure was higher in the HDP group (155.8 ± 8.4 mmHg) compared to the control group (119.2 ± 6.9 mmHg, p < 0.0001). Diastolic blood pressure was also elevated in the HDP group (100.2 ± 6.1 mmHg) versus the control group (77.3 ± 5.7 mmHg, p < 0.0001). High-sensitivity C-reactive protein (hs-CRP) levels were significantly higher in the HDP group (7.4 ± 2.6 mg/L) compared to controls (2.1 ± 0.9 mg/L, p < 0.0001). Left ventricular hypertrophy (LVH) was present in 36% of HDP patients, compared to 10% in the control group (p = 0.0013). Additionally, 55% of women with HDP had metabolic syndrome, versus 26% in the control group (p = 0.0045). These findings highlight the elevated cardiovascular risks in women with HDP.

Conclusion: Women with HDP face significantly elevated cardiovascular risks postpartum. These findings underscore the importance of early screening and postpartum cardiovascular monitoring for women with HDP to mitigate long-term cardiovascular complications.

Distal Vessel Injury and Hematoma Formation in ADR Strategies: An Angiographic Observational Study

Syed Kashif Ur Rahman — 2025-09-10

Abstract

Objective: To evaluate the impact of distal vessel injury and hematoma formation on the procedural success of Antegrade Dissection and Re-Entry (ADR) strategies in chronic total occlusion (CTO) interventions, with a focus on advanced angiographic imaging techniques.

Methodology: A retrospective observational study was conducted at the Department of Cardiology, Hayatabad Medical Complex, Peshawar, from June 2024 to December 2024. A total of 150 patients were included, with a sample size determined using the WHO sample size calculation. Data was collected on distal vessel injury, hematoma formation, and procedural success, along with patient demographics and risk factors. Statistical analysis was performed using descriptive statistics, Chi-square tests, T-tests, and logistic regression with p-values set at <0.05.

Results: Among 150 patients, 120 (80%) had successful procedural outcomes, with 30 (20%) experiencing complications. The success rate for patients with distal vessel injury was 70% (p = 0.002), while those with hematoma formation had a success rate of 72.5% (p = 0.03). Angiographic assessments showed 45% had subintimal hematomas, and a significant association was found between distal vessel injury and hematoma formation (p = 0.01). Follow-up revealed a 6% recurrence rate for patients without complications and an 18% recurrence rate for those with complications (p = 0.04).

Conclusion: Distal vessel injury and hematoma formation significantly impact ADR procedural success. Advanced angiographic imaging plays a crucial role in minimizing complications and improving outcomes. Future studies should explore better management strategies for these complications.

Cardiovascular risk assessment among general population of District Sialkot

Rabiah Mahwish — 2025-09-10

Background: Cardiovascular diseases (CVD) continue to be a predominant worldwide contributor to illness and death.

Objective: To determine cardiovascular risk assessment among general population of District Sialkot.

Methods: A descriptive cross-sectional study was conducted from May- October2024 among general population of District Sialkot. 384 participants from were recruited through non probability purposive sampling technique. A modified standardized tool “cardiovascular risk assessment questionnaire” was used. It has two parts. Part 1 for the respondent and part 2 for the practitioner. Data was collected after approval of institutional review board and written informed consent was obtained from each participant. SPSS version 26 was used to analyze the data. Frequency and percentages were calculated for the qualitative characteristics, such as gender, marital status, education level, employment status and total cardiovascular risk. Mean and standard deviation was used for the quantitative variables, such as age, income and BMI.

Results: The mean age of the respondents was 41.7 +12 years and majority of them 76.8% were married. Only 24(6.3%) attendants were categorized as low risk for cardiovascular diseases. Majority of the participants 133(34.6%) were assessed as having moderate risk of cardiovascular diseases. High risk for cardiovascular diseases were labelled to a good number of participants 104(27.1%). Participants123(32.0%) were with very high risk.

Conclusion: Majority of the participants were assessed as having moderate risk of total cardiovascular risk assessment. High risk for cardiovascular diseases were labeled to a good number of participants. Less than half of participants were with very high risk

ASSOCIATION OF WAIST-HIP RATIO WITH SEVERE CORONARY ARTERY DISEASE IN PATIENTS UNDERGOING CORONARY ANGIOGRAPHY IN A TERTIARY CARE HOSPITAL

Muhammad Asim Saddique — 2025-09-10

Introduction: Association of increased waist-hip ratio with severe coronary artery disease has not been determined among our local population. As changing lifestyles have affected anthropometric measurements of population, these associations need to be addressed.

Objective: Objectives were to determine the association of increased waist-hip ratio with the severity of coronary artery disease.

Study Design: Case control study

Study Setting: Study was conducted in Department of Cardiology, Jinnah Hospital, Lahore.

Materials and Methods: Total of 360 patients of male population were enrolled in the study.180 male cases having severe coronary artery disease (stenosis of > 50% in a major epicardial coronary artery) were taken and increased waist-hip ratio was determined. It was assessed at the time of inclusion into study. Similarly, 180 male controls were taken from same population. A waist-hip ratio of more than 0.95 was taken as increased waist-hip ratio. Odds ratio was calculated to determine the association of increased waist hip ratio with severe coronary artery disease.

Results: In our sampled population, when we cross tabulated cases and controls with waist to hip ratio above 0.95, we came up with an odd ratio (OR) of 3.49 at p value of 0.028 (significant). It showed that Waist/Hip ratio > 0.95 had not equally distributed among cases and controls. There was significant effect of being smoker but no effect of being obese and family history of coronary artery disease on this association.

Conclusion: It is concluded that in our sampled population we reject the null hypothesis that there is no association of increased waist-hip ratio with severe coronary artery disease and accept the alternate hypothesis that there is an association found between Waist/Hip ratio > 0.95, as odds ratio came out 3.5 with P value=0.02 (Significant).

Comparison: The Effect of Professional Examination Stress on Blood Pressure, Heart Rate and White Blood Cells

Farah Rehman — 2025-09-10

ABSTRACT:

Background: A study to compare the effect of professional examination stress on blood pressure, heart rate and white blood cells among medical students during their study of medical sciences -the walk to the exam is always a burdened for medical students.

Aim: To compare the heart rate, blood pressure, and white blood cells resulting from professional examination stress among students in a public medical college.

Methods: Participant enrollment took place after collecting consent from the entire participant pool of public medical college students in Lahore. The data acquisition utilized pre-designed performa. Analyzing the data by using SPSS version 27 included frequency and percentage results as qualitative outcomes. Quantitative data is presented as Mean±SD. The research used Independent sample t along with paired t-test and chi-square test to analyze results at a significant level of p-value ?5%.

Results: Total 283 female participants showed different degree of stress level during examination period. The average age of research participants as 23.67±0.45 with age range 20-28 years. Students those having history of psychiatry as 101(35.69%) and hypertensive students were as 82(28.98%). From the second to final years were chosen for the study as they were exposed to professional exams during their period in the college. Most of the participants enrolled in the study were from 3rd Prof with 101 students constituting 35.69% of the total. The examination stress caused subjects' heart rates to rise from 69.23 ± 6.69 bpm before test time to 77.05±4.70 bpm after the test period. The study recorded BP levels between 116.08±3.78 mmHg to 118.02±5.98 mmHg for systolic BP (P=0.003) and between 70.11±5.99 mmHg to 75.00±4.85 mmHg for diastolic BP (P=0.000) after examination stress. The research data reveals a statistically important change in Mean arterial BP (P=0.004). The count of White blood cells was 7215.67±678.12 x103/?L before examination while an examination stress revealed 8745.24±677.26 x103/?L. Mean white blood cell levels display a statistically noteworthy alteration (P=0.001).

Conclusion: Examination stress has negative effects on student’s physical and mental wellness as researchers observed that medical students face blood pressure changes, heart rate fluctuations and white blood cell variations. Therefore, young medical students require proper stress-coping strategies to be established.

Keywords: Blood Pressure, Heart Rate, White Blood Cells, Examination Stress

Finerenone in Heart Failure: Promise and Practicalities for South Asia

Syed Sarmad Hussain — 2025-10-10

Endovascular Revascularization of Chronic Total Aortoiliac Occlusion Using Kissing Balloon Stenting in a 63-Year-Old Female: A Case Report

Syed Sarmad Hussain — 2025-10-10

We report a case of a 63-year-old hypertensive female with no prior cardiovascular or peripheral arterial disease history, who presented with new-onset bilateral leg pain and intermittent claudication. CT angiography revealed chronic total occlusion of the infrarenal abdominal aorta, bilateral common iliac arteries, and bilateral external iliac arteries. With preserved distal runoff through patent femoral arteries, she underwent successful endovascular revascularization using bilateral kissing balloon expandable stents. Post-procedure angiography confirmed excellent luminal restoration with resolution of symptoms. This case demonstrates the feasibility and efficacy of the kissing balloon technique as a minimally invasive alternative to open surgery in complex aortoiliac occlusions, even in patients without traditional PAD risk factors.