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Background and aims The American Heart Association proposed 7 ideal cardiovascular health metrics (Life's Simple 7 [LS7]) namely, not smoking, body mass index

Objective: Patients with chronic obstructive pulmonary disease (COPD) commonly present with cardiovascular disease (CVD). We investigated the association between COPD exacerbations and major cardiovascular (CV) events in a COPD population with a history of CVD.Methods: This population-based and register-based cohort study identified all Danish COPD patients aged ≥ 40 years who visited a hospital-based, pulmonary outpatient clinic for COPD between 1st January, 2010, and 31st December, 2016, from a nationwide COPD registry. Patients with a history of a major CV event 36‒6 months prior to their COPD measurement date and no CV event 6 months before this date were included. During a 6-month assessment period, the risks of a new CV event (hospitalization with fatal/non-fatal stroke, myocardial infarction, or heart failure) and moderate and severe COPD exacerbations were evaluated. Odds ratios with 95% confidence intervals for CV events and death were estimated using adjusted logistic regression models.Results: Of the 1501 COPD patients included, 55% experienced a COPD exacerbation and 13% experienced both an exacerbation and a CV event during follow-up (6 months). The odds of a CV event were 1.5 times higher in patients with a moderate exacerbation and more than 6-times higher in those with a severe exacerbation vs patients with no exacerbation(s). The majority of CV events occurred within 30 days post exacerbation in patients who experienced both an exacerbation and a CV event. In total, 113 patients died during the study period: 28% of deaths were caused by CVD and 72% by reasons other than CVD, mostly COPD.Conclusion: In patients with known CVD, severe COPD exacerbations are associated with increased odds of major CV events that occur within 30 days post exacerbation, highlighting the need to prevent exacerbations in COPD patients with concomitant CVD to potentially improve both respiratory and CV health.Keywords: concomitant cardiovascular disease, respiratory health, cardiovascular health, prevention, real-world evidence Objective: Patients with chronic obstructive pulmonary disease (COPD) commonly present with cardiovascular disease (CVD). We investigated the association between COPD exacerbations and major cardiovascular (CV) events in a COPD population with a history of CVD.Methods: This population-based and register-based cohort study identified all Danish COPD patients aged >= 40 years who visited a hospital-based, pulmonary outpatient clinic for COPD between 1st January, 2010, and 31st December, 2016, from a nationwide COPD registry. Patients with a history of a major CV event 36-6 months prior to their COPD measurement date and no CV event 6 months before this date were included. During a 6-month assessment period, the risks of a new CV event (hospitalization with fatal/ non-fatal stroke, myocardial infarction, or heart failure) and moderate and severe COPD exacerbations were evaluated. Odds ratios with 95% confidence intervals for CV events and death were estimated using adjusted logistic regression models.Results: Of the 1501 COPD patients included, 55% experienced a COPD exacerbation and 13% experienced both an exacerbation and a CV event during follow-up (6 months). The odds of a CV event were 1.5 times higher in patients with a moderate exacerbation and more than 6-times higher in those with a severe exacerbation vs patients with no exacerbation(s). The majority of CV events occurred within 30 days post exacerbation in patients who experienced both an exacerbation and a CV event. In total, 113 patients died during the study period: 28% of deaths were caused by CVD and 72% by reasons other than CVD, mostly COPD.Conclusion: In patients with known CVD, severe COPD exacerbations are associated with increased odds of major CV events that occur within 30 days post exacerbation, highlighting the need to prevent exacerbations in COPD patients with concomitant CVD to potentially improve both respiratory and CV health.

Background: Cardiovascular fitness is strongly linked with metabolic risk; however, research is limited in preschool children. Although there is currently no simple validated measure of fitness in preschool children, heart rate recovery has been highlighted as an easily accessible and non-invasive predictor of cardiovascular risk in school-aged children and adolescents. We aimed to investigate whether heart rate recovery was associated with adiposity and blood pressure in 5-year-olds.Study design: This is a secondary analysis of 272 5-year-olds from the ROLO (Randomised cOntrol trial of LOw glycaemic index diet in pregnancy to prevent recurrence of macrosomia) Kids study. Three-minute step tests were completed by 272 participants to determine heart rate recovery duration. Body mass index (BMI), circumferences, skinfold thickness, heart rate, and blood pressure were collected. Independentt-tests, Mann-Whitney U, and Chi-square tests were used to compare participants. Linear regression models examined associations between heart rate recovery and child adiposity. Confounders included child sex, age at study visit, breastfeeding, and perceived effort in the step test.Results: The median (IQR) age at the study visit was 5.13 (0.16) years. 16.2% (n = 44) had overweight and 4.4% (n = 12) had obesity based on their BMI centile. Boys had a quicker mean (SD) heart rate recovery after the step test than girls (112.5 (47.7) seconds vs. 128.8 (62.5) seconds,p = 0.02). Participants with a slower recovery time (> 105 s) had higher median (IQR) sum of skinfolds (35.5 (11.8) mm vs. 34.0 (10.0) mm,p = 0.02) and median (IQR) sum of subscapular and triceps skinfold (15.6 (4.4) mm vs. 14.4 (4.0) mm,p = 0.02) compared to participants with a quicker recovery time. After adjusting for confounders (child sex, age at study visit, breastfeeding, effort in the step test), linear regression analyses revealed heart rate recovery time after stepping was positively associated with sum of skinfolds (B = 0.034, 95% CI: 0.01, 0.06,p = 0.007).Conclusion: Child adiposity was positively associated with heart rate recovery time after the step test. A simple stepping test could be used as a non-invasive and inexpensive fitness tool in 5-year-olds. Additional research is needed to validate the ROLO Kids step test in preschool children.

Firefighters perform strenuous work in dangerous and unpredictable environments requiring optimal physical conditioning. The aim of this study was to investigate the association between physical fitness and cardiovascular health (CVH) in firefighters. This cross-sectional study systematically recruited 309 full-time male and female firefighters between the ages of 20 to 65 years in Cape Town, South Africa. Physical fitness was assessed using absolute (abV̇O2max) and relative oxygen consumption (relVO2max), grip and leg strength, push-ups and sit-ups, sit-and-reach for flexibility and lean body mass (LBM). CVH encompassed age, smoking, blood pressure (BP), blood glucose, lipid profile, body mass index, body fat percentage (BF%), and waist circumference. Linear regressions and logistic regressions were applied. Multivariable analysis indicated that relVO2max was associated with systolic BP (p < 0.001), diastolic BP (p < 0.001), non-fasting blood glucose (p < 0.001), and total cholesterol (p = 0.037). Poor CVH index was negatively associated with relV̇O2max (p < 0.001), leg strength (p = 0.019), and push-ups (p = 0.012). Furthermore, age was inversely associated with V̇O2max (p < 0.001), push-up and sit-up capacity (p < 0.001), and sit-and-reach (p < 0.001). BF% was negatively associated with abV̇O2max (p < 0.001), grip and leg strength (p < 0.001), push-ups (p = 0.008), sit-ups (p < 0.001), and LBM (p < 0.001). Cardiorespiratory fitness, muscular strength, and muscular endurance were significantly associated with a better overall CVH profile.

My technical work and my STS research are connected through a commonly used medical device: the pulse oximeter. Pulse oximeters have two main capabilities, and my technical project and research paper each focus on one. Pulse oximeters are popularly used to monitor the oxygen saturation of a patient’s blood. My STS research paper explores these oxygen saturation measurements and the subsequent diagnostic capabilities of pulse oximeters in diverse patient populations. As a lesser known feature, pulse oximeters can also measure the blood volume changes in peripheral circulation using a technique called photoplethysmography (PPG). My technical project contains a pulse oximeter component that uses these blood volume change waveforms collected from PPG methods to develop a heart disease risk assessment. While my technical project and my research paper focus on two different diagnostic capabilities, they both originate from the same pulse oximeter device. My technical project focuses on the development of a pulse waveform analysis instrument for cardiovascular heart disease assessment. My capstone team worked to improve upon a prototype of a device that non-invasively and accurately measures pulse waveform velocity and calculates a patient’s risk of death from cardiovascular heart disease. Our ultimate goal is to make the device accessible, cost-effective, and easy to use for individuals who may not possess an engineering or medical background. In addition to the device development, we conducted a patient study at the cardiovascular wing of UVA Health to collect data using our instrument. We hope to verify the accuracy and precision of the collected pulse waveforms and the resulting predicted risk measurements in order to work towards preventing premature deaths from cardiovascular disease. My STS research paper investigates the link between the racial bias embedded in pulse oximeters and the differential COVID-19 treatments based on race. Drawing on the concept of technological politics, my argument is that pulse oximeters used in hospitals during the COVID-19 pandemic performed social and political work by privileging patients with lighter skin tones and marginalizing patients with darker skin tones. My paper explores pulse oximetry’s historical and modern neglect of racial and ethnic minorities and the missed diagnoses, treatment eligibility, and adverse outcomes for different races during the COVID-19 pandemic. The goal of my research is to highlight the role medical devices such as pulse oximeters play in the exacerbation of racial inequalities in order to work towards eliminating racial biases in healthcare. Working on both my technical project and my STS research paper simultaneously has been very illuminating and added great value to both projects. The research I conducted for my STS paper helped me understand how popular medical devices such as the pulse oximeter can actually perform political work through the racial biases embedded in it and how important it is to integrate equitable design principles into device development. As my technical work involved developing a device with a pulse oximeter component, it was crucial to understand the politics pulse oximeters possessed to ensure the developed device would not follow the same racial biases. Additionally, collecting patient data and observing healthcare in action at the UVA hospital for my technical project helped me to understand pulse oximeter technology’s role in medicine for my research paper. In conclusion, the intersection between my research and technical work has brought insights and actions to improve both projects in terms of engineering and societal impacts.

Dans le monde, une naissance sur 10 est prématurée, se produisant avant 37 semaines de gestation, et environ 1% sont très prématurées (37 semaines de gestation). C’est la population étudiée dans les chapitres 3 à 5. Le chapitre 3 présente une diminution de la capacité aérobie à l’effort chez les sujets nés prématurément et explore les facteurs y contribuant, incluant des paramètres hémodynamiques cardiaques. Le chapitre 4 examine la perception de la santé et l’utilisation des services de santé dans cette cohorte et comment ceux-ci sont influencés ou non par les paramètres de santé objectifs identifiés précédemment dans le cadre de l’étude HAPI. Le chapitre 5 présente un plaidoyer en faveur d’un suivi médical à long terme des individus nés très prématurément dont les arguments proviennent de témoignages des participants de l’étude HAPI. Enfin, le chapitre 6 présente les résultats de l’étude HAPI Fit qui avait pour but d’évaluer les effets chez de jeunes adultes nés très prématurément d’une intervention de 14 semaines en activité physique principalement sur la capacité aérobie maximale et secondairement sur les paramètres de santé cardiovasculaire. L’ensemble de ces résultats permet de brosser un portrait des conséquences cardiovasculaires à long terme de la prématurité et des moyens disponibles pour les mitiger. La dissémination de ces résultats à la population ciblée et à ses soignants constitue la base sur laquelle pourront se bâtir de futurs programmes de prévention dans cette population à risque., Worldwide, one in ten births is preterm, occurring before the 37th week of gestation, and approximately 1% are very preterm (37 weeks of gestation). This is the population studied in chapters 3 to 5. Chapter 3 presents a diminished maximal aerobic capacity in subjects born preterm and explores contributing factors, including cardiac hemodynamic parameters. Chapter 4 examines health perception and healthcare use in the cohort and how these are influenced or not by objective health measurements previously performed in the HAPI study. Chapter 5 advocates for long-term medical follow-up in young adults born preterm, using testimonials from participants in the HAPI cohort. Finally, chapter 6 presents results from the HAPI Fit study which aimed to evaluate the effects in young adults born very preterm of a 14-week exercise intervention on their maximal aerobic capacity and cardiovascular health parameters. Overall, these results allow us to paint a global picture of long-term cardiovascular consequences of prematurity and of possible ways to mitigate them. Dissemination of these results to the target population and their healthcare providers constitute the basis of future prevention programs in this new at-risk population.

Aims: People with type 1 diabetes have a higher risk for cardiovascular disease (CVD). Reduced heart rate variability (HRV) is a clinical marker for CVD. In this observational study using continuous HRV measurement across 26 days, we investigated whether psychological stressors (diabetes distress, depressive symptoms) and glycaemic parameters (hypo- and hyperglycaemic exposure, glycaemic variability and HbA 1c) are associated with lower HRV in people with type 1 diabetes. Methods: Data from the non-interventional prospective DIA-LINK1 study were analysed. At baseline, depressive symptoms and diabetes distress were assessed. Glucose values and HRV were recorded daily for 26 days using continuous glucose monitoring (CGM) and a wrist-worn health tracker respectively. Multilevel modelling with participant as nesting factor was used to analyse associations between day-to-day HRV and diabetes distress, depressive symptoms and CGM-derived parameters. Results: Data from 149 participants were analysed (age: 38.3 ± 13.1 years, HbA 1c: 8.6 ± 1.9%). Participants with elevated diabetes distress had a significantly lower HRV across the 26 days compared to participants without elevated distress (β = −0.28; p = 0.004). Elevated depressive symptoms were not significantly associated with HRV (β = −0.18; p = 0.074). Higher daily exposure to hyperglycaemia (β = −0.44; p = 0.044), higher average exposure to hypoglycaemia (β = −0.18; p = 0.042) and higher HbA 1c (β = −0.20; p = 0.018) were associated with reduced HRV across the 26 days. Sensitivity analysis with HRV averaged across all days corroborated these results. Conclusions: Diabetes distress is a clinically meaningful psychosocial stressor that could play a role in the cardiovascular health of people with type 1 diabetes. These findings highlight the need for integrated psychosocial care in diabetes management.

(1) Background: Studies have reported the effectiveness of light therapy in various medical conditions. Our pilot study aimed to assess the effect of Maharishi light therapy (MLT) on physiological parameters, such as the heart rate (HR), HR variability (HRV), blood pressure (BP), BP variability (BPV), and the retinal microvasculature of healthy participants; (2) Methodology: Thirty (14 males and 16 females) healthy, non-smoking participants between 23 and 71 years old (46 +/- 18 years) were included in this randomized crossover study. Each participant was tested with a placebo (using LED light) and gem lights, 24 h apart. Hemodynamic parameters were recorded during the session, and 24 h heart rate and BP levels were assessed via mobile devices. Retinal vascular responses were captured with fundus images and the subsequent analysis of retinal vessel widths. A linear model, using repeated measures ANOVA, was used to compare the responses across the sexes and to assess the effect of the MLT; (3) Results: Changes in the central retinal artery equivalent (CRAE) (p < 0.001) and central retinal vein equivalent (CRVE) (p = 0.002) parameters were observed. CRAE and CRVE decreased under MLT and increased under the placebo condition from before to after. However, the baseline values of the participants already differed significantly before the application of any therapy, and the variation in the retinal vessel diameters was already large in the baseline measurements. This suggests that the observed effect results may only reflect naturally occurring fluctuations in the microcirculation and not the effect of MLT. Furthermore, no significant effects were observed in any other investigated parameters; (4) Conclusion: Our study with healthy participants finds significant changes in retinal parameters, but the biological variation in the baseline measurements was large to begin with. This suggests that the observed effect results only reflect naturally occurring fluctuations in the microcirculation and not the effect of MLT. However, in the future, larger studies in which MLT is applied for longer periods and/or in patients with different diseases could discover the physiological impacts of this type of therapy. We are grateful to all the participants who attended this study, as well as to all the staff at the Medical University of Graz who helped to run this study

Background We investigated the change of coronary atherosclerosis with long-term exposure to fine particulate matter of aerodynamic diameter Methods Subjects undergoing serial CCTAs between January 2007 and December 2017 (n = 3,127) were analyzed. Each individual's cumulative amount of PM2.5 exposure between the two CCTAs was evaluated by Kriging interpolation and zonal analysis, considering the time interval between the two CCTAs. The main outcome was progression of coronary artery calcium (CAC) with additional semiquantitative analysis on the changes in the severity and composition of atherosclerotic plaques. Results The CAC scores increased by 30.8 Agatston units per-year under a median PM2.5 concentration 24.9μg/m3 and tended to increase with the cumulative amount of PM2.5 exposure (r = 0.321, p Conclusions Cumulative exposure to air pollution is associated with the progression of diffuse coronary calcification, the importance of which may be more significant than other traditional cardiovascular risk factors. Further investigations into the causality between PM2.5 and coronary atherosclerosis are warranted to improve global cardiovascular health.

Polyphenols have gained significant attention in protecting several chronic diseases, such as cardiovascular diseases (CVDs). Accumulating evidence indicates that polyphenols have potential protective roles for various CVDs. Hypertension (HTN) is among the hazardous CVDs accounting for nearly 8.5 million deaths worldwide. HTN is a complex and multifactorial disease and a combination of genetic susceptibility and environmental factors play major roles in its development. However, the underlying regulatory mechanisms are still elusive. Polyphenols have shown to cause favourable and beneficial effects in the management of HTN. Noncoding RNAs (ncRNAs) as influential mediators in modulating the biological properties of polyphenols, have shown significant footprints in CVDs. ncRNAs control basic functions in virtually all cell types relevant to the cardiovascular system and, thus, a direct link with blood pressure (BP) regulation is highly probable. Recent evidence suggests that a number of ncRNAs, including main small ncRNAs, microRNAs (miRNAs) and long ncRNAs (lncRNAs), play crucial roles with respect to the antihypertensive effects of polyphenols. Indeed, targeting lncRNAs by polyphenols will be a novel and promising strategy in the management of HTN. Herein, we reviewed the effects of polyphenols in HTN. Additionally, we emphasized on the potential effects of polyphenols on regulations of main ncRNAs, which imply the role of polyphenols in regulating ncRNAs in order to exert protective effects and thus proposing them as new targets for HTN treatment. Polyphenols have gained significant attention in protecting several chronic diseases, such as cardiovascular diseases (CVDs). Accumulating evidence indicates that polyphenols have potential protective roles for various CVDs. Hypertension (HTN) is among the hazardous CVDs accounting for nearly 8.5 million deaths worldwide. HTN is a complex and multifactorial disease and a combination of genetic susceptibility and environmental factors play major roles in its development. However, the underlying regulatory mechanisms are still elusive. Polyphenols have shown to cause favourable and beneficial effects in the management of HTN. Noncoding RNAs (ncRNAs) as influential mediators in modulating the biological properties of polyphenols, have shown significant footprints in CVDs. ncRNAs control basic functions in virtually all cell types relevant to the cardiovascular system and, thus, a direct link with blood pressure (BP) regulation is highly probable. Recent evidence suggests that a number of ncRNAs, including main small ncRNAs, microRNAs (miRNAs) and long ncRNAs (lncRNAs), play crucial roles with respect to the antihypertensive effects of polyphenols. Indeed, targeting lncRNAs by polyphenols will be a novel and promising strategy in the management of HTN. Herein, we reviewed the effects of polyphenols in HTN. Additionally, we emphasized on the potential effects of polyphenols on regulations of main ncRNAs, which imply the role of polyphenols in regulating ncRNAs in order to exert protective effects and thus proposing them as new targets for HTN treatment.

The association between dairy product consumption and cardiovascular health remains highly debated. We quantitatively synthesized prospective cohort evidence on the associations between dairy consumption and risk of hypertension (HTN), coronary heart disease (CHD), and stroke. We systematically searched PubMed, Embase, and Web of Science through August 1, 2020, to retrieve prospective cohort studies that reported on dairy consumption and risk of HTN, CHD, or stroke. We used random-effects models to calculate the pooled RR and 95% CI for the highest compared with the lowest category of intake and for a 1-serving/d increase in consumption. We rated the quality of evidence using NutriGrade. Fifty-five studies were included. Total dairy consumption was associated with a lower risk of HTN (RR for highest compared with lowest level of intake: 0.91, 95% CI: 0.86, 0.95, I(2) = 73.5%; RR for 1-serving/d increase: 0.96, 95% CI: 0.94, 0.97, I(2) = 66.5%), CHD (highest compared with lowest level of intake: 0.96, 95% CI: 0.92, 1.00, I(2) = 46.6%; 1-serving/d increase: 0.98, 95% CI: 0.95, 1.00, I(2) = 56.7%), and stroke (highest compared with lowest level of intake: 0.90, 95% CI: 0.85, 0.96, I(2) = 60.8%; 1-serving/d increase: 0.96, 95% CI: 0.93, 0.99, I(2) = 74.7%). Despite moderate to considerable heterogeneity, these associations remained consistent across multiple subgroups. Evidence on the relation between total dairy and risk of HTN and CHD was of moderate quality and of low quality for stroke. Low-fat dairy consumption was associated with lower risk of HTN and stroke and high-fat dairy with a lower risk of stroke. Milk, cheese, or yogurt consumption showed inconsistent associations with the cardiovascular outcomes in high compared with low intake and dose–response meta-analyses. Total dairy consumption was associated with a modestly lower risk of hypertension, CHD, and stroke. Moderate to considerable heterogeneity was observed in the estimates, and the overall quality of the evidence was low to moderate.

The paper provides a review of current regulatory documents of international organizations, which deals with the organizational aspects of optimizing physical activity among children. It is shown that according to the World Health Organization (WHO; 2015), the major causes of death are cardiovascular diseases and their complications, the formation of which is most strongly associated with obesity, which has its roots in childhood. The global WHO recommendations for physical activity to promote health (2010) and the guidelines of the American Heart Association regarding the organization of physical activity among children (2014) are provided. The criteria of selecting the type of physical activity for children and adolescents according to the Centers for Disease Control and Prevention (2011) are presented. The results of the WHO working group activity to end childhood obesity (2015) were analyzed. The need for a multisectoral government, educational and social activities was stressed., В статье приведен обзор текущих регламентирующих документов международных организаций, посвященный организационным вопросам оптимизации физической активности детей. Показано, что, по данным Всемирной организации здравоохранения (ВОЗ; 2015), основной причиной смертности населения являются кардиоваскулярные заболевания и их осложнения, формирование которых в наибольшей степени связано с ожирением, имеющим корни в детском возрасте. Приведены глобальные рекомендации ВОЗ относительно физической активности для укрепления здоровья (2010) и рекомендации Американской кардиологической ассоциации относительно организации физической активности детей (2014). Представлены критерии выбора типа физической активности для детей и подростков по данным Centers for Disease Control and Prevention (2011). Проанализированы результаты работы рабочей группы ВОЗ по прекращению детского ожирения (2015). Сделаны акценты на необходимости проведения мультисекторальных государственных, образовательных и социальных мероприятий., У статті наведено огляд поточних регламентуючих документів міжнародних фахових товариств, присвячений організаційним питанням оптимізації фізичної активності дітей. Показано, що, за даними Всесвітньої організації охорони здоров’я (ВООЗ; 2015), основною причиною смертності населення є кардіоваскулярні захворювання та їх ускладнення, формування яких найбільшою мірою пов’язане з ожирінням, що має коріння в дитячому віці. Наведено глобальні рекомендації ВООЗ щодо фізичної активності для зміцнення здоров’я (2010) та рекомендації Американської кардіологічної асоціації стосовно організації фізичної активності дітей (2014). Наведено критерії вибору типу фізичної активності для дітей і підлітків за даними Centers for Disease Control and Prevention (2011). Проаналізовано результати звіту робочої групи ВООЗ із припинення дитячого ожиріння (2015). Зроблено акценти на необхідності проведення мультисекторальних державних, освітніх і соціальних заходів.

Background Sodium, potassium, and the balance between these 2 nutrients are associated with hypertension and cardiovascular disease, and prevalence of these conditions increases with age. However, limited information is available on these intakes among older adults. Objective Our aim was to explore the socioeconomic and health factors associated with usual sodium and potassium intakes and the sodium to potassium (Na:K) ratio of older adults. Design This was a cross-sectional, secondary analysis of the 2011-2012, 2013-2014, and 2015-2016 National Health and Nutrition Examination Survey. Participants/setting This study included the data of 5,104 adults 50 years and older, with at least one reliable 24-hour dietary recall and an estimated glomerular filtration rate ≥60 mL/min/1.73 m2. Main outcome measures Sodium and potassium intake, as absolute intake, density (per 1,000 kcal) and ratio of Na:K intake. Statistical analyses We used t tests and χ2 tests to examine significant differences in intakes on a given day by characteristics. Linear and logistic regression models were used to assess associations of socioeconomic and health characteristics with usual sodium and potassium intakes, determined using the National Cancer Institute method. Results Only 26.2% of participants consumed Conclusions Participants consumed too much sodium and not enough potassium, based on current recommendations. A higher Na:K ratio was significantly associated with established risk factors for cardiovascular disease. The study findings suggest that more research on cardiovascular health should include both sodium and potassium, as well as balance between these nutrients.

Objectives The main objective of this study is to understand how diet affects performance and cardiovascular health in a group of women participating in a demanding aerobic race such as marathon, compared to men. Methods Fifteen women participating in the Barcelona Marathon-2016 were recruited to participate in the study. A group of men (n = 15) that performed the same marathon race was selected. Anthropometric parameters and diet records were collected before the race. Circulating parameters were analyzed 24¿h-pre-race, immediately after the race and 48¿h-post-race. These included certain minerals, lipid profile, muscle damage, inflammatory and cardiovascular health markers. Results Diets were very similar in the men and women, with inadequate amounts of carbohydrates and proteins for endurance events. Creatine kinase (CK; a muscle damage marker) and C-reactive protein (CRP; a marker of inflammation) remained elevated 48¿h post-race in all participants, but was significant in women (641 vs. 143¿U/L for CK and 5.8 vs. 0.7 mg/dL for CRP). Cardiac markers (high sensitivity troponin T (Hs-TnT), suppression of tumorigenicity and N-terminal pro B-type natriuretic peptide) increased post-race and returned to pre-race values after 48¿h in men and women. In particular, Hs-TnT (marker of myocyte stress) increased from 2.2 to 62.5 ng/L post-race in women and from 3.1 to 52.9 ng/L in men. Finally, circulating lipid parameters were at borderline unhealthy levels in both sexes. Conclusion Structural and functional cardiac advantages that women display compared to men in aerobic efforts are not manifested when diet is not adequately designed.

Ischemic preconditioning (IPC) has shown positive effects in endurance-type sports among healthy young individuals; however, its effects in endurance-type exercises in older adults have not been explored. We aimed to examine the acute effects of a single session of IPC prior to an endurance-type exercise on cardiovascular- and physical-function-related parameters in sedentary older adults. A pilot study with a time-series design was carried out. Nine participants were enrolled consecutively in the following intervention groups: (i) SHAM (sham IPC + walking) and (ii) IPC (IPC + walking) groups. The main outcomes were resting systolic (SBP) and diastolic (DBP) blood pressure, heart rate (HR), peripheral oxygen saturation (SpO2), maximum isometric voluntary contraction (MIVC), endurance performance, and perceived fatigue. After the intervention, the IPC group showed a significant reduction in SBP, whereas SpO2 decreased in the SHAM group. The IPC group maintained quadriceps MIVC levels, whereas these levels dropped in the SHAM group. No changes in DBP, resting HR, endurance, or fatigue in any group were observed. These findings are of interest for the promotion of cardiovascular and physical health in older people.

The American Heart Association recently published an updated algorithm for quantitative assessments of cardiovascular health (CVH) metrics, namely Life’s Essential 8 (LE8). This study aimed to compare the predictive value between Life’s Simple 7 (LS7) and LE8 and predict the likelihood of major adverse cardiac events (MACEs) in patients undergoing percutaneous coronary intervention (PCI) to determine the utility of the LE8 in predicting CVH outcomes. A total of 339 patients with acute coronary syndrome (ACS) who had undergone PCI were enrolled to assess the CVH scores using the LS7 and LE8. Multivariable Cox regression analysis was employed to evaluate the predictive value of the two different CVH scoring systems at 2 years for MACEs. Multivariable Cox regression analysis revealed that both the LS7 and LE8 scores were protective factors for MACEs (HR = 0.857, [95%CI: 0.78–0.94], HR = 0.964, [95%CI: 0.95–0.98]; p < 0.05, respectively). Receiver operator characteristic analysis indicated that the area under the curve (AUC) of LE8 was higher than that of LS7 (AUC: 0.662 vs. 0.615, p < 0.05). Lastly, in the LE8 score, diet, sleep health, serum glucose levels, nicotine exposure, and physical activity were found to be correlated with MACEs (HR = 0.985, 0.988, 0.993, 0.994, 0.994, respectively). Our study established that LE8 is a more reliable assessment system for CVH. This population-based prospective study reports that an unfavorable cardiovascular health profile is associated with MACEs. Future research is warranted to evaluate the effectiveness of optimizing diet, sleep health, serum glucose levels, nicotine exposure, and physical activity in reducing the risk of MACEs. In conclusion, our findings corroborated the predictive value of Life’s Essential 8 and provided further evidence for the association between CVH and the risk of MACEs.

Measures of cardiovascular health (CVH) assessed by a combination of behavioral and biological factors has shown protective associations with all-cause mortality. The mechanisms underlying these associations have not been fully elucidated. In this study, we characterized the plasma proteomics profile of CVH and tested whether specific proteins mediated the associations between CVH and all-cause mortality in participants of the InCHIANTI study. Of the 1301 proteins tested, 92 proteins were associated with CVH (22 positively, 70 negatively). Proteins most strongly associated with CVH included leptin (LEP), fatty acid binding protein 3 (FABP3), Angiopoietin-2 (ANGPT2), and growth-differential factor 15 (GDF15). Of the 92 CVH-associated proteins, 33 proteins significantly mediated the associations between CVH and all-cause mortality, with percent mediation ranging from 5 to 30%. The most significant mediating proteins were GDF15 and insulin-like growth factor 2 (IGFBP2). Proteins associated with better CVH were enriched for proteins that reflect the suppression of the complement coagulation and GH/IGF pathways.

Little is known about brain aging or dementia in nonindustrialized environments that are similar to how humans lived throughout evolutionary history. This paper examines brain volume (BV) in middle and old age among two indigenous South American populations, the Tsimane and Moseten, whose lifestyles and environments diverge from those in high-income nations. With a sample of 1,165 individuals aged 40 to 94, we analyze population differences in cross-sectional rates of decline in BV with age. We also assess the relationships of BV with energy biomarkers and arterial disease and compare them against findings in industrialized contexts. The analyses test three hypotheses derived from an evolutionary model of brain health, which we call the embarrassment of riches (EOR). The model hypothesizes that food energy was positively associated with late life BV in the physically active, food-limited past, but excess body mass and adiposity are now associated with reduced BV in industrialized societies in middle and older ages. We find that the relationship of BV with both non-HDL cholesterol and body mass index is curvilinear, positive from the lowest values to 1.4 to 1.6 SDs above the mean, and negative from that value to the highest values. The more acculturated Moseten exhibit a steeper decrease in BV with age than Tsimane, but still shallower than US and European populations. Lastly, aortic arteriosclerosis is associated with lower BV. Complemented by findings from the United States and Europe, our results are consistent with the EOR model, with implications for interventions to improve brain health.

Ο σκοπός αυτής της εργασίας ήταν η σύγκριση της ταχύτητας σφυγμικού κύματος (PWV) σε ηρεμία σε αθλήτριες διαφορετικών υδάτινων αθλημάτων, συμπεριλαμβανομένης της κολύμβησης, της υδατοσφαίρισης και της κωπηλασίας. Η ταχύτητα σφυγμικού κύματος θεωρείται δείκτης της καρδιαγγειακής υγείας και αποτελεί σημαντικό προγνωστικό παράγοντα κινδύνου καρδιαγγειακής νόσου. Στη μελέτη συμμετείχαν 60 ενήλικες αθλήτριες του υγρού στίβου (κολύμβηση, υδατοσφαίριση, κωπηλασία) ηλικίας από 17-25 ετών και προπονητικής ηλικίας τουλάχιστον 2 ετών, από αθλητικούς συλλόγους της Θεσσαλονίκης καθώς και 20 μη ασκούμενες γυναίκες που αποτελέσαν την ομάδα ελέγχου, οι οποίες δεν είχαν καμία συστηματική εκγύμναση τα τελευταία 2 έτη. Πραγματοποιήθηκε καταγραφή των σωματομετρικών χαρακτηριστικών των συμμετεχόντων στη μελέτη (ύψος, βάρος), μέτρηση της αρτηριακής πίεσης ηρεμίας με ηλεκτρονικό πιεσόμετρο ακριβείας και εν συνεχεία μέτρηση της ταχύτητας του σφυγμικού κύματος με τη συσκευή Complior (ALAM MEDICAL Vincennes, France). Η μέτρηση της PWV έγινε στην ηρεμία, στη δεξιά καρωτιδο-μηριαία αρτηρία και μία φορά. Η στατιστική επεξεργασία των δεδομένων της μελέτης πραγματοποιήθηκε με το στατιστικό πρόγραμμα SPSS σε περιβάλλον Windows. Τα αποτελέσματα έδειξαν ότι η ομάδα της κολύμβησης (5,7±1,8 m/sec) είχε σημαντικά χαμηλότερη ταχύτητα σφυγμικού κύματος συγκριτικά με την ομάδα υδατοσφαίρισης (7,02±1,6 m/sec) (p=0,015) αλλά και από την ομάδα ελέγχου (6,7±0,8 m/sec) χωρίς, ωστόσο, η τελευταία αυτή διαφορά να είναι σημαντική (p=0,082). Με την ομάδα της κωπηλασίας οι διαφορές δεν ήταν στατιστικά σημαντικές (6,4 ±1,4 m/sec) (p=0,330). Επίσης, τα αποτελέσματα αυτής της μελέτης έδειξαν ότι η ομάδα ελέγχου είχε υψηλότερη καρδιακή συχνότητα (HR) από όλες τις αθλήτριες, ενώ δεν είχαν σημαντική διαφορά σε άλλους δείκτες, όπως η μέση (MAP), η συστολική (SBP), η διαστολική αρτηριακή πίεση (DBP) και η πίεση σφυγμού (PP). Αυτά τα ευρήματα υποδηλώνουν ότι μπορεί να υπάρχουν διαφορές στην αρτηριακή σκληρία και την καρδιαγγειακή υγεία μεταξύ των αθλητριών υγρού στίβου ανάλογα με το άθλημα που συμμετέχουν. Ωστόσο, απαιτείται περαιτέρω έρευνα ιδιαίτερα για την αξιολόγηση των μακροπρόθεσμων επιπτώσεων των διαφορετικών αθλημάτων υγρού στίβου στην υγεία του αρτηριακού δένδρου των αθλητριών., The purpose of this study was to compare the pulse wave velocity (PWV) at rest in female athletes from different water sports, including swimming, water polo, and rowing. PWV is considered an indicator of cardiovascular health and a significant prognostic risk factor for cardiovascular disease. The study involved 60 adult female athletes in water sports (swimming, water polo, rowing) aged 17-25 years and with at least 2 years of training experience, from sports clubs in Thessaloniki, Greece, as well as 20 non-exercising women who formed the control group, who had not engaged in any systematic exercise in the past 2 years. The participants' anthropometric characteristics (height, weight) were recorded, their resting blood pressure was measured with a precise electronic sphygmomanometer, and the PWV was measured with the Complior device (ALAM MEDICAL Vincennes, France). PWV was measured once at rest in the right carotid-femoral artery. Data analysis was performed using the statistical program SPSS in a Windows environment. The results showed that the swimming team (5.7 ± 1.8 m/sec) had significantly lower PWV compared to the water polo team (7.02 ± 1.6 m/sec) (p=0.015) as well as from the control group (6.7 ± 0.8 m/sec), however this difference was not significant (p=0.082). Compared to the rowing team, the differences were not statistically significant (6.4 ± 1.4 m/sec) (p=0.330). Additionally, the results of this study showed that the control group had higher heart rate (HR) than all the athletes, while they did not have a significant difference in other parameters such as the mean (MAP), the systolic (SBP), the diastolic blood pressure (DBP), and the pulse pressure (PP). These findings suggest that there may be differences in arterial stiffness and cardiovascular health among female water athletes depending on the sport they practice. However, further research is required to determine the long-term effects of different water sports on arterial health in female athletes.

This project seeks to understand psychological well-being within a national sample of midlife and older adults by interrogating perspectives on a life well-lived from respondents themselves. Using data from a subset of respondents from the Midlife in the United States (MIDUS) Study, we investigated responses to the open-ended question, “What do you do to make your life go well?” Data were available from the MIDUS Core and MIDUS Refresher biomarker samples (combined N = 2,118). We developed a coding scheme to identify broad code groups (e.g., positive relationships) and specific codes (e.g., emotional intimacy) in each open-ended response. A team of judges indicated the presence of code groups and codes for each response. Initial findings suggested the presence of 13 code groups including positive relationships, faith, family, health maintenance, hobbies, integrity, enjoyment, and coping, among others. The frequency of endorsement for these code groups have already been examined as a function of race, educational attainment, and health. Now, the proposed work seeks to investigate the frequency of endorsement of specific codes (nested within code groups), as well as the patterning of specific codes in relation to social structural factors (i.e., education and race) and health (i.e., cardiovascular health, general physical health, chronic conditions, functional limitations). We hypothesize that some codes may be similarly endorsed across race and educational attainment, whereas other themes will be more common among those with certain socioeconomic backgrounds. We also hypothesize that certain code groups will be correlated with health outcomes. This project aims to enhance our understanding of psychological well-being and has the potential to identify new topics for future research on well-being and health.

Objective The role of ideal cardiovascular health (CVH) metrics in developing hearing loss remains uncertain. Thus, our objective was to analyze the connection between hearing loss and ideal CVH metrics in a 10-year retrospective cohort. Study design Retrospective cohort study. Setting A health management center in Taiwan. Participants Participants who underwent the first annual health check-up between 2000 and 2006 and with a follow-up check-up more than ten years later. Main outcome measures Hearing thresholds were measured at 500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz. Individuals with a best ear pure-tone audiometry four-frequency average of >25 dB HL were defined as having hearing loss. The ideal CVH metrics were classified into 7 categories based on the American Heart Association's definition. The associations of hearing loss with the sum of the ideal CVH metrics and each ideal CVH metric were examined by multiple logistic regression analysis. Results The present study consisted of 6,974 participants. The 10-year follow-up showed that the odds ratio (OR) of hearing loss was 0.74 for participants with 5-7 ideal CVH metrics (95% CI, 0.59-0.93, p=0.01) compared to those with 0-2 ideal CVH metrics. Among the CVH metrics, participants with an ideal smoking status might have reduced odds of developing hearing loss; the OR was 0.72 (95% CI, 0.58-0.89, p=0.003). Conclusions Participants with an increased number of ideal CVH metrics and better performance on the smoking metric had a significantly protective effect regarding hearing loss development.

Background Point-of-care testing (POCT) has applications across medical specialties and holds promise to improve patient care. While cardiovascular medicine has been attractive for POCT applications in recent years, little is known about how cardiovascular health professionals perceive them. Objective The objective of our study was to examine differences in perceptions and attitudes towards POCTs between cardiovascular health professionals compared to other healthcare professionals. Methods We surveyed healthcare professionals to assess perceptions of POCT usage and their benefits and concerns between October 2019 and March 2020. Questions regarding POCT perceptions were assessed on a 5-point Likert scale. Results We received a total of 148 survey responses; of the responders, 52% were male, 59% were physicians, and 50% worked in a hospital setting. We found that cardiology professionals were less likely, compared to other specialties, to view POCTs as improving patient management or reducing errors. These cardiology professionals were not constrained by resources or a lack of investment opportunities to implement these technologies. Conclusion This study provides a better understanding of perceptions about POCTs among healthcare specialists. To improve patient outcomes through the adoption and usage of POCTs, greater collaboration is advised among key industry and healthcare stakeholders.

Background Metabolic and bariatric surgery (MBS) has demonstrated improvements in diabetes and cardiovascular health. The effect of MBS on the risk of ischemic stroke remains unclear. Objectives The goal of this study was to determine the risk of stroke following MBS compared with patients with obesity who qualified for but did not undergo MBS. Setting The Mariner Database, a national claims database. Methods We identified patients with body mass index (BMI) ≥40 or those with a BMI and a qualifying co-morbidity, who underwent MBS between 2010 to 2019. Similar patients who did not undergo MBS served as controls. Coarsened exact matching was performed followed by logistic regression analysis to determine the effect of BMS on stroke risk. Results A total of 70 622 BMS patients and 1 320 182 MBS-eligible controls were identified. After matching, the 1-year stroke risk among MBS patients (n = 56 514) versus controls (n = 56 514) was .6% versus 1.2% (OR .54, 95% CI .47–.61). The 5-year stroke risk for MBS (n = 27619) versus control (n = 27619) was 2.8% versus 3.6% (OR .78, 95% CI .65–.90). Conclusion MBS appears to reduce the risk of stroke following surgery. To our knowledge, this is the largest sample size in a study of ischemic cerebrovascular disease in bariatric surgery.

Despite cardiovascular disease (CVD) being the leading cause of death of women globally, research on CVD over the past several decades has focused primarily on men. CVD research has led to progress in diagnosis and treatment, medical education, and public awareness; however, few of these advances have applied specifically to women’s cardiovascular health. There is a paucity of sex- and gender-specific educational material regarding CVD in clinical training programs for physicians. The irregularity in integrated curricula across medical schools in Canada may be a factor in persistent disparities in clinical care and outcomes experienced by women, compared with men. In response to this gap, the Training and Education Working Group of the Canadian Women’s Heart HealthAlliance undertook the planning, development, and dissemination of a Canadian Women's Heart Health Education Course. The development of the course was guided by a 6-step approach for curriculum development for medical education, which included conducting a needs assessment, determining and prioritizing content, setting goals and objectives, selecting educational strategies, implementation, and evaluation. Résumé: Bien que les maladies cardiovasculaires (MCV) soient la principale cause de décès chez les femmes dans le monde, la recherche sur les MCV au cours des dernières décennies a été centrée principalement sur les hommes. La recherche sur les MCV a permis de faire des progrès en matière de diagnostic et de traitement, de formation médicale et de sensibilisation du public; toutefois, peu de ces progrès touchaient spécifiquement la santé cardiovasculaire des femmes. Les programmes de formation clinique des médecins ne comportent que peu de matériel éducatif sur les MCV propre à chaque sexe et à chaque genre. Il est possible que l’irrégularité des programmes de formation intégrés des écoles de médecine au Canada contribue aux disparités persistantes dans les soins prodigués aux femmes et les résultats cliniques obtenus chez celles-ci, comparativement aux hommes. Pour combler cette lacune, le Groupe de travail sur la formation et l’éducation de l’Alliance canadienne de santé cardiaque pour les femmes a entrepris la planification, la préparation et la diffusion de l’Initiative nationale de sensibilisation à la santé cardiaque des femmes. La conception de l’Initiative a été guidée par une approche en six volets axée sur l’élaboration d’un programme de formation médicale, qui comprenait une évaluation des besoins, la détermination et la hiérarchisation du contenu, la formulation des buts et des objectifs, la sélection des stratégies de formation, ainsi que la mise en œuvre et les modalités d’évaluation.

Cardiovascular diseases (CVDs) are the leading cause of death, with more than 16 million of deaths per year. The World Health Organization (WHO) proposed a global plan for the prevention and control of Noncommunicable Diseases (NCDs) where is stated that actions for the risk mitigation for CVDs should begin with a full cardiovascular risk assessment during routine medical practice. Two main obstacles exist to this end; first there is no easy to use, universally accepted “gold-standard” indicator of arterial injury and cardiac disfunction; secondly, there is the need for the distribution of easy-to-use, cost-effective devices that allow for the monitoring of such indicators. One of the known indicators, the carotid-femoral pulse wave velocity (cfPWV), was proposed as the “gold-standard” measurement for arterial stiffness in the guidelines for management of arterial hypertension in 2007. Non-invasive sensors, such as photoplethysmography (PPG), planar tonometry or sphygmomanometer-cuff devices, can be used to this end. Within this framework, NMT, S.A. developed a noninvasive device for the monitoring and assessment of cardiovascular health. The VasoCheck® device comprises a suite of 4 wireless PPG sensors that allow for the recording and real time monitoring of the blood pulse waveform. The experience gathered during tests, validations, and measurement campaigns; the user feedback; the need to address a hardware obsolescence and to take the next steps for medical device certification and industrialization, along with the introduction of additional features, led to this project. For improving the device, the best practices for system development, requirements for verification, validation and certification of medical devices were reviewed., As well as the state-of-the art in the cardiac and blood pulse recording technology. The main aims of the work started by baselining the device at hardware, firmware, and architecture levels, (i.e., PPG sensors, communication modules, power supply, and ancillaries). Device limitations were investigated, and a development path was set. Existing units were subject to incremental improvements resulting in increased resilience. The integration of new sensor types was evaluated, specifically MEMS type microphones. A critical design review (CDR) was made., Several modules were redesigned and documented in a design-for-production paradigm, with increase roughness and to facilitate factory level assembly, serviceability, and recycling. A new architecture was developed to accommodate for multiple sensor types and to allow integration with future cloud-based health diagnostic support tools. Protocols for testing, calibration, maintenance were created. Ready-to-manufacture deliverables were complied. Finally, the necessary steps for medical device certification were identified and the process was started when it became possible. As doenças cardiovasculares (CVD) são uma das principais causas de mortes a nível global, com mais de 16 milhões de mortes por ano. A organização mundial da saúde (OMS) propôs um plano global para a prevenção e controlo de Doenças Não Transmissíveis (NCDs) onde se afirma que as ações para a mitigação dos riscos para as CVD devem começar com uma avaliação completa dos riscos cardiovasculares durante a prática médica de rotina. Existem dois grandes obstáculos para este fim; em primeiro lugar, não existe um indicador "gold-standard" de utilização simples e universalmente aceite para lesões arteriais e disfunção cardíaca; em segundo lugar, a necessidade de distribuição de dispositivos fáceis de usar, eficazes e de custo reduzido que permitam a monitorização desses indicadores. Um possível indicador é a velocidade da onda de pulso carótida-femoral (cfPWV). Este foi proposto, em 2007, como o indicador de referência para rigidez arterial nas orientações para a gestão da hipertensão arterial. Sensores não invasivos, como a fotopletismografia (PPG), a tonometria planar ou os dispositivos do tipo esfigmomanómetro, podem ser utilizados para este fim. Neste âmbito, a NMT, S.A. desenvolveu um dispositivo não invasivo para a monitorização e avaliação da saúde cardiovascular. O dispositivo VasoCheck® compreende um conjunto de 4 sensores PPG sem fios que permitem a gravação e monitorização em tempo real da forma de onda de pulso cardíaco. A experiência adquirida durante testes clínicos de validação e medição; feedback dos técnicos; a necessidade de abordar a obsolescência do hardware e de dar os próximos passos para a certificação e industrialização do dispositivo médico, juntamente com o desejo da introdução de funcionalidades adicionais no dispositivo, levou á criação deste projeto. Com este fim foram revistas as melhores práticas de desenvolvimento de produto, requisitos para a verificação, validação e certificação de dispositivos médicos, bem como o estado da arte na tecnologia de gravação da onda de pulso cardíaca. O projeto iniciou-se com a caracterização do funcionamento do dispositivo em condições nominais, a nível de hardware, firmware e arquitetura (isto é, sensores PPG, módulos de comunicação e fonte de alimentação). As limitações do dispositivo foram identificadas, e foi traçado um plano para o desenvolvimento do dispositivo. As unidades existentes foram sujeitas a melhoramentos incrementais que resultaram num aumento significativo da fiabilidade dessas unidades. Foi estudada a integração de novos tipos de sensores, nomeadamente microfones eletrónicos. Foi feita uma revisão crítica do produto (CDR), vários módulos foram redesenhados e documentados num paradigma de desenho para produção, para maior robustez do produto e incorporando soluções para facilitar a montagem, manutenção e reciclagem. Uma nova arquitetura foi desenvolvida para acomodar vários tipos de sensores e permitir a integração com futuras ferramentas de suporte de diagnóstico de saúde baseadas em serviços na nuvem. Foram criados protocolos para testes, calibração, manutenção. Finalmente, foram identificadas as medidas necessárias para a certificação do dispositivo médico e este processo foi avançado tanto quanto possível.

The study examined the effects of exercise on health-fitness, health related quality of life (HRQOL), and psychological measures in college-aged smokers. Outcomes included HRQOL, hemodynamic, anthropometric, lung function, and cardiorespiratory endurance. Sixty physically inactive college-aged male smokers (18–30 years) were randomly assigned into three groups: high-intensity interval training (HIIT), continuous aerobic training (CAT), and a control (CON). Both HIIT and CAT groups completed 8 weeks of non-consecutive cycling sessions thrice weekly. The CON group were not subjected to the exercise intervention. Sixty participants met the inclusion criteria. Of these, 48 (HIIT: n = 18, CAT: n = 16, CON: n = 14) participants completed the study and were included in the final analysis. Compared to CON, HIIT significantly (p = 0.01) improved forced expiratory flow (FEF_75%) more than the CAT group (p = 0.29). HIIT provided a significant (p = 0.04) improvement in FEF_75% compared to CAT. Recovery heart rate (RHR) was significantly improved in participants assigned to HIIT (p = 0.00) and CAT (p = 0.002) groups compared with the CON. A significant difference in RHR was found in HIIT compared to CAT. The study findings indicate that both HIIT and CAT exercise interventions significantly improve markers of lung function and cardiorespiratory endurance, respectively. However, findings suggested that HIIT should be the preferred form of exercise regime among college-aged smokers for more significant, healthier benefits.

Purpose: The aim of this study was to examine the cross-sectional and longitudinal associations of 24-h movement behaviors (sleep, sedentary behavior (SB), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA)) with body composition and cardiometabolic health in i) early and ii) late pregnancy (gestational weeks 14 and 37). Methods: This observational study utilized cross-sectional (n = 273) and longitudinal data (n = 242) from the HealthyMoms trial. Time spent in movement behaviors over seven consecutive 24-h periods (ActiGraph wGT3x-BT accelerometer), body composition (Bod Pod), and cardiometabolic health indicators (glucose levels, homeostatic model for insulin resistance (HOMA-IR), systolic and diastolic blood pressure, metabolic syndrome (MetS) score) were measured in early and late pregnancy. Results: In early pregnancy, reallocating time to MVPA from LPA, SB, and sleep was associated with lower MetS score (adjusted γ = −0.343, P = 0.002). Correspondingly, reallocating time to LPA from SB and sleep in early pregnancy was associated with lower body weight (adjusted γ = −5.959, P = 0.047) and HOMA-IR (adjusted γ = −0.557, P = 0.031) at the same time point. Furthermore, reallocating time to LPA from SB and sleep in early pregnancy was associated with lower fat mass index (adjusted γ = −0.668, P = 0.028), glucose levels (adjusted γ = −0.315, P = 0.006),HOMA-IR (adjusted γ = −0.779, P = 0.004), and MetS score (adjusted γ = −0.470, P = 0.027) in late pregnancy. The changes in behaviors throughout pregnancy were not associated with body weight, body composition, andMetS score in late pregnancy. Conclusions: Our results demonstrated that increasing LPA or MVPA while reducing SB and sleep was associated with lower weight and more favorable cardiometabolic health in early pregnancy. In contrast, LPA in early pregnancy seems to be a stimulus of enough intensity to improve body composition and cardiometabolic health indicators in late pregnancy., Swedish Research Counci 2016-01147, Swedish Research Council for Health, Working Life and Welfare (Forte) 2017-00088 2018-01410, Bo and Vera Ax:son Johnsons' Foundation, Strategic Research Area Health Care Science, Karolinska Institutet/Umea University, Swedish Society of Medicine, Karolinska Institutet, Lions Forskningsfond, ALF Grants, Region OEstergoetland LIO-893101 LIO-941191 M. L

Growing evidence suggests that childhood trauma is associated with poorer cardiovascular health in adulthood, but few studies have examined potential mediators of these associations. We examined the links between different forms of childhood trauma (i.e., abuse, neglect, cumulative trauma) and cardiovascular health and explored potential mediators. Cross-sectional data from 1,251 participants in the National Survey of Midlife Development in the United States’ II Biomarker Project were analyzed. Path analyses were conducted to examine the associations between childhood trauma and cardiovascular health (i.e., American Heart Association’s Life’s Simple 7 [LS7] score). Depressive symptoms and sleep quality were explored as potential mediators, and exploratory analyses examined whether these associations were moderated by sex. Women reported more severe childhood emotional and sexual abuse and emotional neglect, p < .001 to p = .018, and higher LS7 scores, p = .027, than men. Path analyses demonstrated the total effects of increasing severity of all forms of childhood trauma with LS7 scores were significant, and cumulative childhood trauma was inversely associated with LS7 score Bs = −0.306– −0.076, p < .001–p = .048. The range of total effects of different forms of childhood trauma on LS7 scores mediated by depressive symptoms and sleep quality was 26.8%–57.5%. Sex moderated the associations between all forms of childhood trauma and cardiovascular health. Longitudinal studies are needed that examine mediators of the associations between childhood trauma and cardiovascular health. Findings suggest sex-specific, trauma-informed approaches for cardiovascular disease prevention in adults exposed to childhood trauma may be needed.

Peanuts are known to contain nutrients that deliver cardiovascular and health benefits. One such compound is oleic acid, an omega-9 monounsaturated fatty acid, which occurs naturally in peanuts in the concentration range 40–55% m/m, while some varieties are known to contain oleic acid above 75% m/m. These high oleic peanuts have been shown to have cardiovascular health benefit by lowering lipid levels. Breeders are therefore interested in selecting for peanuts with high oleic acid content in a rapid, non-destructive manner. Near infrared spectra acquired on single peanut kernels was used to classify the kernels as either high oleic content or normal, low oleic content, by means of partial least squares discriminant analysis with an overall error rate in classification of 3.3%.

Background Cardiovascular disease is a critical public health issue and a growing body of literature on relationships and health point to individuals’ interactions and involvement with family members as significant correlates of cardiovascular outcomes. However, less is known about the implications of daily encounters with family members on cardiovascular health outcomes and how the associations vary across adulthood. Purpose The aims of this study were to examine the associations of positive and negative daily experiences with family members with comprehensive measures of cardiovascular health and to further explore how age moderates these associations. Methods This study used data from the Midlife in the United States (MIDUS) II and MIDUS Refresher. The sample was composed of respondents who participated in two subprojects of MIDUS, namely the National Study of Daily Experiences (NSDE) and Biomarker Project (N = 1,312). Indices of cardiovascular health included inflammatory markers, autonomic functioning, and Life’s Simple 7 scores. Results Results showed that the associations between daily family experiences and cardiovascular outcomes differed by age. Having more daily negative experiences with family members was associated with better cardiovascular health outcomes among young adults and worse cardiovascular outcomes among older adults. Having more daily positive experiences was also associated with lower heart rate variability for older adults. Conclusions Results revealed that contrary to the general assumption that negative experiences have health-damaging effects, frequent involvement with family members in daily life, even negative ones, may be indicative of active engagement in life that could be health promoting for younger adults.

Aging is associated with an increased prevalence of subclinical atherosclerosis and stiffening of the arterial walls (arteriosclerosis). These 2 coexisting conditions are mitigated by the presence of ideal cardiovascular health (optimal levels of fasting blood glucose, cholesterol, resting blood pressure, body mass index, no smoking, good dietary quality, and regular physical activity). We hypothesized that the concomitant presence of subclinical atherosclerosis (coronary artery calcification), arteriosclerosis (higher carotid-femoral pulse wave velocity), and suboptimal cardiovascular health is associated with increased risk of cardiovascular disease relative to the absence of these 3 conditions. We tested our hypothesis in the community-based Framingham Heart Study cohort (N=2580, mean age 52 years, 49% women). We classified participants based on (1) the presence versus absence of coronary artery calcium; (2) higher (>sex-specific median) carotid-femoral pulse wave velocity; (3) poor cardiovascular health (score 0–7). Thus, participants could have no abnormalities (referent group), 1, 2, or 3 suboptimal measures. We used Cox regression to relate the number of suboptimal measures (0–3) to the incidence of cardiovascular disease during follow-up (median 14 years). Cardiovascular disease incidence rates/1000 person-years in groups with 0 to 3 suboptimal measures were 1.93 (95% CI, 1.28–2.90), 4.68 (95% CI, 3.48–6.29), 8.93 (95% CI, 6.99–11.41), and 18.26 (95% CI, 14.65–22.77), respectively. Compared with the group with no abnormalities, corresponding multivariable-adjusted hazards ratios for cardiovascular disease were 1.81, 2.18, and 3.71, respectively ( P

Purpose The association between CVD risk factors and mortality is well established, however, current tools for addressing subgroups have focused on the overall burden of disease. The identification of risky combinations of characteristics may lead to a better understanding of physiologic pathways that underlie morbidity and mortality in older adults. Methods Participants included 5067 older adults from the Cardiovascular Health Study, followed for up to 6 years. Using latent class analysis (LCA), we created CV damage phenotypes based on probabilities of abnormal brain infarctions, major echocardiogram abnormalities, N-terminal probrain natriuretic peptide, troponin T, interleukin-6, c reactive-protein, galectin-3, cystatin C. We assigned class descriptions based on the probability of having an abnormality among risk factors, such that a healthy phenotype would have low probabilities in all risk factors. Participants were assigned to phenotypes based on the maximum probability of membership. We used Cox-proportional hazards regression to evaluate the association between the categorical CV damage phenotype and all-cause and CVD-mortality. Results The analysis yielded 5 CV damage phenotypes consistent with the following descriptions: healthy (59%), cardio-renal (11%), cardiac (15%), multisystem morbidity (6%), and inflammatory (9%). All four phenotypes were statistically associated with a greater risk of all-cause mortality when compared with the healthy phenotype. The multisystem morbidity phenotype had the greatest risk of all-cause death (HR: 4.02; 95% CI: 3.44, 4.70), and CVD-mortality (HR: 4.90, 95% CI: 3.95, 6.06). Conclusions Five CV damage phenotypes emerged from CVD risk factor measures. CV damage across multiple systems confers a greater mortality risk compared to damage in any single domain.

A diet high in saturated fatty acids (SFA) is a suspected contributor to atherosclerotic cardiovascular disease (ASCVD) risk, in large part because of an effect to raise the low-density lipoprotein cholesterol (LDL-C) concentration. Most dietary guidance from health authorities advocates limiting intake of SFA, particularly for people with clinical ASCVD, dyslipidemia, or diabetes mellitus. However, recent reviews have highlighted controversies regarding SFA intake and cardiovascular health. This brief editorial commentary includes a discussion of the evidence regarding SFA intake and cardiovascular health, outlines gaps in the available evidence, and proposes tentative conclusions based on what is known today about SFA consumption and ASCVD risk. Results from observational studies demonstrate that dietary patterns with lower average intakes of SFA are associated with favorable cardiovascular outcomes. Additionally, although the number of randomized controlled trials testing the effects of reducing SFA intake on ASCVD outcomes is limited, the available evidence supports the view that replacing SFA with unsaturated fatty acids, particularly polyunsaturated fatty acids, may reduce ASCVD risk. Beyond raising LDL-C and atherogenic lipoprotein particle concentrations, higher intakes of SFA may influence pathways affecting inflammation, cardiac rhythm, hemostasis, apolipoprotein CIII production, and high-density lipoprotein function. However, the impacts of these effects on ASCVD risk remain uncertain. In the authors' view, the totality of the evidence supports the current recommendation to limit SFA intake to10% of total daily energy for the general healthy population and further (e.g., to 5-6% of total daily energy) for patients with hypercholesterolemia.

[Purpose] The purpose of this study was to propose potential preventive measures against future mobility impairments and muscle loss in healthy young adults by comprehensively evaluating their status of frailty, locomotive syndrome, and sarcopenia. [Participants and Methods] A total of 83 Japanese young adults were enrolled in this study and evaluated using the diagnostic criteria for frailty (Japanese version of the Cardiovascular Health Study), locomotive syndrome (calculated as scores of the LOCOMO-25, the stand-up test, and two-step test), and sarcopenia (handgrip strength, usual gait test, skeletal muscle index). [Results] The prevalence of frailty-prefrailty (45.9%) was higher than that of presarcopenia (22.3%) and locomotive syndrome (14.1%). The prevalence of combinations of frailty-prefrailty and presarcopenia; frailty-prefrailty and locomotive syndrome; and frailty-prefrailty, locomotive syndrome, and pre-sarcopenia was 9.4%, 4.7%, and 3.5%, respectively. [Conclusion] Only 40% of the participants did not meet the three diagnostic criteria. On the other hand, there were not many participants with sarcopenia and/or locomotive syndrome diagnoses, suggesting that the improvement in intrinsic skeletal muscle mass rather than physical function is important for healthy Japanese young adults and could possibly be protective against future mobility or muscle-loss disorders.

As global temperatures continue to rise, extreme heat events are becoming more frequent and intense. Extreme heat affects cardiovascular health as it is associated with a greater risk of adverse cardiovascular events, especially for adults with preexisting cardiovascular diseases. Nonetheless, the pathophysiology underlying the association between extreme heat and cardiovascular risk remains understudied. Furthermore, specific recommendations to mitigate the effects of extreme heat on cardiovascular health remain limited to guide clinical practice within the context of a warming climate. The overall objective of this review article is to raise awareness that extreme heat poses a risk for cardiovascular health. Specifically, the review discusses why cardiovascular healthcare professionals should care about extreme heat, how extreme heat affects cardiovascular health, and recommendations to minimise the cardiovascular consequences of extreme heat. Future research directions are also provided to further our understating of the cardiovascular health consequences of extreme heat. A better awareness and understanding of the cardiovascular consequences of extreme heat will help cardiovascular health professionals assess the risk and optimise the care of their patients exposed to an increasingly warm climate.

This narrative review examines the impact of cigarette smoking and the use of other tobacco and nicotine products on cardiovascular disease. Smoking increases the incidence of both acute and chronic cardiovascular diseases, and the harmful effects are substantially and relatively quickly reversible after quitting. Recommended cessation treatment includes offering pharmacotherapy, counseling which should emphasize the rapid risk reduction that occurs after quitting and adequate follow-up contacts. Although most research on cardiovascular disease in relation to tobacco use has focused upon cigarette smoking, we also review available data related to other combustible tobacco products, smokeless tobacco, electronic nicotine delivery systems and second-hand smoke. We discuss the implications of smoking on clinical management of patients with heart disease and newer developments with potential relevance to treatment of such patients.

Unhealthy food choices and poor diet have a significant impact on development and progression of cardiovascular disease. Further, plant-based diets have been shown to mitigate cardiovascular risk factors and improve the health status of patients with cardiovascular disease. Currently, hospitals spend substantial healthcare dollars on food expenditures for inpatient services and recent pushes by the American Heart Association (AHA) and American College of Cardiology (ACC) encourage predominantly or full plant-based diets. The University of Florida has been one of the first institutions to incorporate a fully plant-based menu offering to their inpatient population. Herein, we discuss the program instituted at UF, the challenges faced while making this institutional change, and our solutions to these obstacles. The success of our plant-based initiative can serve as a foundation for other healthcare institutions to incorporate plant-based menu programs.

Aims To systematically review and meta-analyze the impact of aquatic exercise (AE) on cardiovascular health in patients with type 2 diabetes mellitus (T2DM).Material and methods Relevant literature about AE in patients with T2DM up to May 25, 2021, were collected from the PubMed, the Cochrane, EMBASE, Web of Science, and Ovid databases. The main outcomes were 6‑min walking distance (6MWD) and maximal oxygen uptake (VO2max). Secondary outcomes were resting heart rate (RHR) and resting systolic (RSBP) and diastolic blood pressures (RDBP).Results 12 articles including 320 participants were identified. Among them, three trials compared AE to land-based exercise (LE), six compared AE to non-intervention control (Ctrl), and three were pre- / post-AE design without a control group. Meta-analysis showed that compared with baseline, VO2max increased (WMD=0.71, 95 %CI 0.47 to 0.94), while RHR, RSBP and RDBP declined (WMD=–5.88, 95 %CI –6.88 to –4.88; WMD=–5.76, 95 %CI –7.75 to –3.78; WMD= -2.48, 95 %CI –3.83 to –1.13, respectively) post-AE. 6WMD and VO2max increased (WMD=127.00, 95 %CI 49.26 to 204.74; WMD=2.02, 95 %CI 1.66 to 2.38, respectively) and RHR declined (WMD=-4.20, 95 %CI –6.36 to –2.03, AE vs Ctrl) when AE was compared to Ctrl. There were no significant differences in the above indicators between AE and LE.Conclusions AE, like LE, increases VO2max, and reduces RHR, RSBP, and RDBP. These responses may improve cardiovascular health in patients with T2DM. However, more data are needed to confirm the effect of AE on 6MWD in T2DM patients.

BorowieckaMonika, Góralczyk Wanesa, Zając Marlena, Brzezińska Agnieszka. Red meat and different dietary patterns and cardiovascular health - the review.Journal of Education, Health and Sport. 2021;11(9):282-288. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.09.034 https://apcz.umk.pl/JEHS/article/view/JEHS.2021.11.09.034 https://zenodo.org/record/5515183 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 05.09.2021. Revised: 12.09.2021. Accepted: 18.09.2021. RED MEAT AND DIFFERENT DIETARY PATTERNS AND CARDIOVASCULAR HEALTH - THE REVIEW Monika Borowiecka1, Wanesa Góralczyk1, Marlena Zając1, Agnieszka Brzezińska1 1Medical University of Lublin, Aleje Racławickie Street 1, 20-059 Lublin Monika Borowiecka; monnikaborowiecka@gmail.com; ORCID: 0000-0003-2612-7838; Wanesa Góralczyk; wanesagoralczyk@gmail.com; ORCID: 0000-0001-5804-2869; Marlena Zając; marlenzajac11@gmail.com; ORCID: 0000-0002-6251-0175; Agnieszka Brzezińska; brzezinska2agnieszka@gmail.com; ORCID: 0000-0001-5730-8813 Summary Introduction:Cardiovascular diseases are in a majority of health issues worldwide. Dietary habits have been extensively studied in the cardiovascular area since they are responsible for improvement or deterioration of that system condition. One of the most commonly mentioned product is red meat, both processed and unprocessed. Brief description of the state of knowledge:The aim of this review was to present currently available knowledge in the online database PubMed about consumption of red meat and cardiovascular health.The article covers scientific papers which indicate to the risk factor, which is intake of processed and unprocessed meat, and eventually incidents of CVD. It is also claimed that effects of consumption that group of protein may be dependent of its dosage. Conclusions:The review support an assumption that dietary patterns, in this case red meat, processed and unprocessed, play a significant role in being CVD risk factors. Besides, that influence should be measured more precisely and new scientific tools for tracking dietary habits should be input. Key words:cardiovascular disease, red meat, processed meat, unprocessed meat

Photo elicitation offers novel opportunities to augment the qualitative research toolbox. The use of photographs can enrich connections with participants, and empower them to be creative and engaged to communicate their insights, priorities, and perspectives. There is growing evidence of the effective use of photo elicitation in health research, with emerging interest in the cardiovascular community. Careful study planning, including attention to equipment, participant training, photograph selection, data collection, and ethical consideration, is essential. Detailed reporting of the study design and rationale for use of photographs, conceptual thinking underpinnings, elicitation process, and analytical plan contribute to strengthening the methodological approach.

Dogs possess the ability to obtain essential nutrients, established by the Association of American Feed Control Officials (AAFCO), from both animal- and plant-based ingredients. There has been a recent increase in the popularity of diets that limit or completely exclude certain plant-based ingredients. Examples of these diets include 'ancestral' or 'evolutionary' diets, raw meat-based diets and grain-free diets. As compared to animal sources, plant-derived ingredients (including vegetables, fruits, grains, legumes, nuts and seeds) provide many non-essential phytonutrients with some data suggesting they confer health benefits. This review aims to assess the strength of current evidence on the relationship between the consumption of plant-based foods and phytonutrients (such as plant-derived carotenoids, polyphenols and phytosterols) and biomarkers of health and diseases (such as body weight/condition, gastrointestinal health, immune health, cardiovascular health, visual function and cognitive function) from clinical trials and epidemiological studies. This review highlights the potential nutritional and health benefits of including plant-based ingredients as a part of balanced canine diets. We also highlight current research gaps in existing studies and provide future research directions to inform the impact of incorporating plant-based ingredients in commercial or home-prepared diets.

BACKGROUND: In 2013, there was an estimation of greater than 4.5 million Afghan refugees who had migrated to the least developed countries. Over one million are legally registered in Iran. We assessed the heart health status as described by the American Heart Association (AHA) in the Afghan refugee populace. METHODS: This cross-sectional survey was carried out on 1,634 Afghan refugees, including 746 males (45.7%) and 888 females (54.3%), selected through a convenience sampling method in 2016. The American Heart Association's seven cardiovascular health metrics were evaluated to specify the status of heart health in Afghan refugees. Differences with age and sex were analyzed using the χ(2) test. RESULTS: Only one (0.1%) participant met the ideal for all seven cardiovascular health metrics. No significant differences were found between women and men in meeting the ideal criteria for more than five cardiovascular health metrics. As age increased, the proportion of refugees who met the ideal for more than five cardiovascular health metrics declined. CONCLUSIONS: Refugees were not meeting the ideal cardiovascular health for some of the assessed metrics. Intervention to improve and monitor heart health in Afghan refugees is needed.

Objetivo: identificar os fatores de risco cardiovascular entre estudantes de enfermagem de uma universidade pública do interior do Amazonas, Brasil. Método: estudo transversal e descritivo com abordagem quantitativa, realizado com 42 estudantes de Enfermagem. Foram aplicados três instrumentos: um questionário elaborado especificamente para o estudo e dois padronizados e validados, o International Physical Activity Questionnaire (IPAQ) e o Questionário simplificado para avaliação do consumo de alimentos marcadores de risco cardiovascular. Resultados: os fatores de risco cardiovascular mais prevalentes foram: histórico familiar para Hipertensão Arterial Sistêmica (61,9%) e Diabetes Mellitus (40,4%), consumo de álcool (50,0%), estresse (73,8%), sobrepeso e obesidade (38,0%), prática de atividade fí­sica insuficiente ativo e sedentário (50,0%) e consumo de alimentos marcadores de risco cardiovascular (elevado e excessivo) (30,9%). Conclusão: a identificação dos fatores de risco cardiovasculares nos universitários poderá guiar as ações voltadas para a promoção da saúde cardiovascular.

Colonization and enforced genocidal strategies have collectively fractured and changed Indigenous people by attempting to erase and dismiss their voices and knowledge. Nearly a decade ago, we were reminded by Dr Ku Young of the cardiovascular health disparities, in evidence among Indigenous people in Canada. compared with White people. He went on to say that beyond a biomedical understanding of this health status is the ongoing impact of long-standing marginalization and oppression faced by Indigenous people. Limited attention has been afforded to advance our understanding of these colonial impacts on Indigenous people and their heart health. This article contributes to our collective understanding of Indigenous people and their cardiac health by covering the following topics: layers of foundational truths of relevance to healthcare contexts and Indigenous people; a critical reflection of Western (biomedical) perspectives concerning cardiac health among Indigenous people; and materials from 2 studies, funded by the Canadian Institutes of Health Research, in which Indigenous voices and experiences were privileged concerning the heart and caring for the heart. In the final section, 3 topics are offered as starting points for self-reflection and acts of reconciliation within healthcare practice, decision-making, and research: reflections on self and one’s worldview; anti-racist healthcare practice; and 2-eyed seeing approaches to work within healthcare contexts. A common thread is the imperative for “un-silencing” Indigenous people’s voices, experiences, and knowledge, which is a requirement if addressing the identified cardiovascular health disparities is truly a health priority., Graphical abstract

Background/Aims: We aimed to assess the validity of the Korean translated version of the Clinical Frailty Scale (CFS) in determining the frailty status in geriatric outpatients.Methods: The records of 123 ambulatory outpatients who had undergone CFS and comprehensive geriatric assessments (CGAs) including measurements for the Cardiovascular Health Study (CHS) frailty scale and the frailty index (CGA-FI) were analyzed. Correlations between CFS, CHS frailty scale, and CGA-FI were assessed. The ability of CFS to classify frailty status was calculated using the CHS frailty scale and CGA-FI as references.Results: The mean CFS score was 3.2 in the study population, with a mean age of 77.49 years (45.5% men). Individuals with higher CFS scores were older, had a greater burden of chronic diseases, and worse daily functions and cognitive performance. CFS scores positively correlated with CGA-FI (B = 0.78, p < 0.001) and CHS frailty scale (B = 0.67, p < 0.001) scores. For CFS, C-statistics to classify frailty by CGA-FI and CHS scale were 0.905 and 0.826, respectively. The cut-off value of CFS ≥ 4 maximized Youden’s J to classify frailty by both the CHS scale and CGAFI.Conclusions: The CFS is a valid screening tool to assess the frailty status in outpatients of a geriatric clinic in Korea. As a simple and quick measure, the CFS may facilitate frailty assessments in real-world clinical practice.

Introducción: El índice de carga alostática (ICA) provee un posible abordaje para medir la influencia acumulada de los factores psicosociales en la salud y el bienestar, mediante indicadores del funcionamiento de sistemas potencialmente afectados. Actualmente no se dispone de un conjunto estándar de biomarcadores para medir la carga alostática en estudios de salud ocupacional. Objetivo: Sugerir un indicador integral de la carga alostática factible de obtener mediante el examen médico ocupacional de rutina. Material y método: Se realizó un estudio exploratorio en 55 trabajadores del tercer nivel de atención de salud. Se seleccionaron biomarcadores secundarios que forman parte del protocolo de exámenes médicos ocupacionales para medir la carga alostática. Se evaluó la relación entre la carga alostática y los factores de riesgo relacionados con la salud cardiovascular, la vulnerabilidad al estrés y la presencia de síntomas de estrés. Resultados: Valores elevados de carga alostática correlacionaron de forma significativa con una salud cardiovascular pobre y una mayor presencia de síntomas de estrés. Conclusiones: Los resultados sugieren la utilidad de emplear biomarcadores secundarios para medir la carga alostática en el contexto del examen médico ocupacional. Introduction: The Allostatic Load Index (ALI), originally developed in 1997 by Seeman et al., provides a possible approach to measure the cumulative influence of psychosocial factors on health and well-being, using indicators of the functioning of potentially affected systems. Currently, there is no standard set of biomarkers to measure allostatic load in occupational health studies. Objectives: To suggest a comprehensive indicator of allostatic load that can be obtained through a routine occupational medical examination. Material and method: An exploratory study was carried out in 55 workers from the third level of health care attention. Secondary biomarkers that are part of the protocol for occupational medical examinations were selected to measure allostatic load. The relationship between allostatic load and risk factors related to cardiovascular health, vulnerability to stress, and the presence of stress symptoms were evaluated. Results: High values of allostatic load correlated significantly with poor cardiovascular health and a greater presence of stress symptoms. Conclusions: The results suggest the usefulness of using secondary biomarkers to measure allostatic load in the context of the occupational medical examination.