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Purpose: To explore the possibility that a Palaeolithic diet, i.e. one that corresponds to what was available in any of the ecological niches of pre-agricultural humans (1.5 million-10,000 years bp ), is optimal in the prevention of age-related degenerative disease. Design: Literature review. Materials and Methods: Between 1985 and December 2002, more than 200 scientific journals in medicine, nutrition, biology and anthropology were systematically screened for relevant papers. Computer-based searches and studies of reference lists in journals and books provided a vast number of additional papers. Results: Increasing evidence suggests that a Palaeolithic diet based on lean meat, fish, vegetables and fruit may be effective in the prevention and treatment of common Western diseases. Avoiding dairy products, margarine, oils, refined sugar and cereals, which provide 70% or more of the dietary intake in northern European populations, may be advisable. Atherosclerosis is highly dependent on dietary manipulation in animal experiments. Atherogenic dietary factors include fat (any type) and casein, and hypothetically cereals. Stroke, ischaemic heart disease and type 2 diabetes seem largely preventable by way of dietary changes in a Palaeolithic direction. And insulin resistance, which may have far-reaching clinical implications as a cause of unregulated tissue growth, may also respond to an ancestral diet. Conclusions: Lean meat, fish, vegetables and fruit may be optimal, rather than a strictly vegetarian diet, in the prevention of cardiovascular disease, diabetes and insulin resistance. [ABSTRACT FROM AUTHOR]

The aim of the present study is to analyze the data indicating an association between high salt intake and the gastrointestinal microbiota in the development of salt-sensitive hypertension in animals and men. It is also, to discuss the preventive effects of exercise on gut-induced hypertension by favorably modifying the composition of gut microbiota. Salt sensitivity is quite common, accounting for 30%–60% in hypertensive subjects. Recently, a novel cause for salt-sensitive hypertension has been discovered through the action of gut microbiota by the secretion of several hormones and the action of short chain fatty acids (SCFAs). In addition, recent studies indicate that exercise might favorably modify the adverse effects of gut microbiota regarding their effects on BP. To identify the role of gut microbiota on the incidence of hypertension and CVD and the beneficial effect of exercise, a Medline search of the English literature was conducted between 2018 and 2023 and 42 pertinent papers were selected. The analysis of data from the selected papers disclosed that the gut microbiota contribute significantly to the development of salt-sensitive hypertension and that exercise modifies their gut composition and ameliorates their adverse effects on BP. [ABSTRACT FROM AUTHOR]

Sodium-glucose cotransporter 2 inhibitors (SGLT2is, gliflozins), the most recent oral antihyperglycaemic agents, provide a cardiorenal protection, an effect independent of their glucose-lowering potency. The antihyperglycaemic potency of SGLT2is was compared with that of dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1 receptor agonists, especially when added to metformin monotherapy. Main results of cardiovascular/renal outcome trials with SGLT2is were summarized in different populations: patients with type 2 diabetes mellitus (T2DM) with or without established cardiovascular disease, patients (with or without T2DM) with heart failure (with reduced or preserved left ventricular ejection fraction) and in patients (with or without T2DM) with chronic kidney disease (CKD, including stage 4). Original papers and meta-analyses of these different trials have consistently reported a reduction in hospitalization for heart failure (alone or combined with cardiovascular mortality) and a reduced progression of CKD, with an overall good safety profile. Global use of SGLT2is has increased over time but remains suboptimal despite clinically relevant cardiovascular and renal protection, particularly in patients most likely to benefit. SGLT2is has proven both positive benefit–risk balance and cost-effectiveness in at risk patients. New prospects are expected in other complications, i.e. metabolic-associated fatty liver disease and neurodegenerative disorders. [ABSTRACT FROM AUTHOR]

This paper intended to review the data regarding the multipotential effects of the sodium-glucose cotransporter 2 (SGLT 2) inhibitors, their cardiovascular effects, and their mechanism of action. The SGLT2 inhibitors exert their beneficial antidiabetic and cardioprotective effects through increased glucose excretion from the kidneys, blood pressure and weight lowering, vasodilation and other potential beneficial effects. They have been used for the treatment of patients with type 2 diabetes mellitus (T2DM) as well as in patients with cardiovascular disease (CVD), coronary artery disease (CAD),and heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF). To get a better understanding of their mechanism of action for their multiple cardiovascular protective effects, a Medline search of the English language literature was conducted between 2015 and February 2022 and 46 pertinent papers were selected. The analysis of data clearly demonstrated that the use of the SGLT2 inhibitors besides their antidiabetic effects, provide additional protection against CVD, CAD, and HFrEF and HFpEF, and death, but not stroke, in both diabetic and non-diabetic patients. Therefore, they should be preferably used for the treatment of patients with T2DM with preexisting CVD, CAD, and HFrEF and HFpEF [ABSTRACT FROM AUTHOR]

This paper examines whether the use of blood pressure medication has an influence on social inequalities in blood pressure levels. In Norway, cardiovascular disease has for decades been associated with high mortality and social inequalities. High blood pressure is an important risk factor in this aspect, and prescription drugs have been established as a standard treatment of hypertension. We have seen population blood pressure levels fall, blood pressure inequality levels remaining stabile, and medication use increase. The paper uses panel data from the Nord-Trøndelag Health Study linked with registry data on education and income. Results from fixed effects regression analyses indicate that blood pressure medication overall has a levelling effect. The traditional social gradient is mainly found among non-users of medication. With blood pressure medication being plausibly at a late stage of its diffusion, these findings give some support to the hierarchical diffusion model, while they also imply the need for equal access to sufficient blood pressure treatment. [ABSTRACT FROM AUTHOR]

Amidst the growing focus on men’s health, physical activity (PA) initiatives have demonstrated efficacy in engaging men and providing opportunities to enhance wellbeing outcomes. It is important to capture the characteristics of male populations who attend these initiatives as it yields important implications in terms of reach, design and implementation. This paper presents the pre-adoption characteristics of participants at a site of Football Cooperative (FC), a community-based PA initiative in Ireland. The research sought to ascertain whether the participants involved were an at-risk group in terms of cardiovascular disease (CVD) risk factors (i.e. PA levels, waist circumference, aerobic fitness, diet, smoking, alcohol and sleep quality). Recruitment occurred before and during a return to play period, after a lowering of COVID-19 restrictions in May 2021. Purposeful sampling was used to recruit participants. Fitness and anthropometric data were collected, along with self-report survey data including demographics and wellbeing indicators. A total of n = 71 completed the self-report survey and were predominantly white Irish (95.8%) and married (84.6%). The majority (83.1%) of participants had ≥ 3 CVD risk factors where 66.1% had a waist circumference (WC) of ≥ 94 cm, indicating a high mortality risk. This research suggests that the gendered approach employed by the FC initiative engages a target demographic of at-risk males. While this demonstrates promise in terms of tackling CVD risk, further research that focuses on translating the initiative to engage men at risk of social and economic disadvantage is recommended to enhance the impact of the FC approach. [ABSTRACT FROM AUTHOR]

Dietary intake of caffeine has significantly increased in recent years, and beneficial and harmful effects of caffeine have been extensively studied. This paper reviews antioxidant and anti-inflammatory activities of caffeine as well as its protective effects on cardiovascular diseases, obesity, diabetes mellitus, cancers, and neurodegenerative and liver diseases. In addition, we summarize the side effects of long-term or excessive caffeine consumption on sleep, migraine, intraocular pressure, pregnant women, children, and adolescents. The health benefits of caffeine depend on the amount of caffeine intake and the physical condition of consumers. Moderate intake of caffeine helps to prevent and modulate several diseases. However, the long-term or over-consumption of caffeine can lead to addiction, insomnia, migraine, and other side effects. In addition, children, adolescents, pregnant women, and people who are sensitive to caffeine should be recommended to restrict/reduce their intake to avoid potential adverse effects. [ABSTRACT FROM AUTHOR]

The paper explores how paid and unpaid labor history over the life course influence women's cardiovascular disease. U.S. women comprise about 50% of the paid workforce and perform the majority of unpaid labor. However, the influence of women's work on their health is under-researched. Our sample was drawn from the Women's Health Initiative Observational Study, a cohort of post-menopausal women in the U.S. aged 50–79 at recruitment. Women were categorized into five groups according to paid labor history: worked in paid jobs consistently throughout adult life; left the workforce early; entered the workforce later; discontinuous work history; never worked outside the home. Live birth history (none, at least one, missing) served as a proxy for unpaid labor in prime age. Cox proportional hazard models were used to estimate the hazard ratio of CVD associated with different paid work histories. We then assessed the effect of unpaid labor on the relation between paid labor and CVD. Paid labor participation was not associated with CVD risk among women without unpaid labor after adjusting for age, education, and birth cohort. Among those with unpaid demands, leaving the workforce early or having discontinuous work history was protective. In this U.S. sample, the association between paid work participation history and CVD risk depends on the presence of unpaid labor. Our results demonstrate the necessity of including work – paid and unpaid – in consideration of women's health. [ABSTRACT FROM AUTHOR]

Public health and individual health care are increasingly oriented towards managing risks. This 'surveillance medicine' does not target present illnesses but aims to prevent possible future conditions, greatly expanding the number of people implicated in medical interventions. In this paper, I interrogate the everyday experience of being at risk of illness. First, I suggest that we lack a comprehensive account of this experience, because current ways to characterise this phenomenon tend to equate risk with (chronic) illness and patient status. I then report a case study designed to avoid this starting point. I conducted interviews with laypersons with varying levels of elevated cholesterol, a common risk factor for cardiovascular diseases, who were recruited from a consumer panel in Finland in 2015. I found three elements that structure the health risk experience: the intangible nature of risk, the probabilistic character of risk estimates, and the ambivalent status of risk in terms of health and illness. While these findings overlap with previous literature in many ways, detaching health risk from illness foregrounds health management instead of patient behaviour. These findings call for caution in approaching health risk uncritically through illness categories or patient status, and I invite researchers to critically examine such elements in other cases and contexts. [ABSTRACT FROM AUTHOR]

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Currently, diet-related diseases such as diabetes, obesity, hypertension, and cardiovascular diseases account for 70% of all global deaths. To counteract the rising prevalence of non-communicable diseases governments are investing in persuasive educational campaigns toward the ingestion of fresh fruits and vegetables. The intake of dietary polyphenols abundant in Mediterranean and Nordic-type diets holds great potential as nutritional strategies in the management of diet-related diseases. However, the successful implementation of healthy nutritional strategies relies on a pleasant sensory perception in the mouth able to persuade consumers to adopt polyphenol-rich diets and on a deeper understanding on the chemical modifications, that affect not only their chemical properties but also their physical interaction with epithelial lipids and in turn their permeability, location within the lipid bilayer, toxicity and biological activity, and fate during absorption at the gastro-intestinal epithelium, transport in circulation and delivery to the endothelium. In this paper, we review the current knowledge on the interactions between polyphenols and their metabolites with membrane lipids in artificial membranes and epithelial cell models (oral, stomach, gut and endothelium) and the findings from polyphenol-lipid interactions to physiological processes such as oral taste perception, gastrointestinal absorption and endothelial health. Finally, we discuss the limitations and challenges associated with the current experimental approaches in membrane and cell model studies and the potential of polyphenol-rich diets in the quest for personalized nutritional strategies ("personalized nutrition") to assist in the prevention, treatment, and management of non-communicable diseases in an increasingly aged population. [ABSTRACT FROM AUTHOR]

Background: The effects of birthweight (the Barker hypothesis) and growth trajectory in early life on the incidence of cardiovascular disease (CVD) and its risk factors in later life have been investigated in a number of studies. Objective: To undertake a systematic review and cryptanalysis of the association of low birthweight (LBW) and the postnatal growth trajectory with CVD and its risk factors. Methods: English-language publications in PubMed, ISI Web of Science and Scopus were searched. Initially, two independent reviewers identified relevant papers in several steps and the quality of papers was then determined by a validated quality-appraisal checklist. Results: By applying maximum sensitivity, 7259 paper were identified, 382 of which were duplicates and 1273 were considered to be relevant to the topic. Then, after title and abstract review, 628 irrelevant papers were excluded; 26 papers were added after reference-checking. Then, 250 other papers were deleted after full text review. Finally, 39 relevant papers remained and were entered into the systematic review. Overall, 79·6% of all CVD risk factors reported in primary studies of the rapid catch-up growth hypothesis were statistically significant, whereas the corresponding figure was 58·5% for the effects of LBW (Barker hypothesis). Conclusions: This systematic review highlights the importance of low birthweight in increasing the risk of CVD and its risk factors in later life. The results support rapid postnatal catch-up growth of LBW neonates as a more important factor than LBW alone in CVD and its risk factors. [ABSTRACT FROM AUTHOR]

Introduction: Hyperhomocysteinemia has been considered as a risk factor for systemic atherosclerosis, cardiovascular disease (CVD) and stroke and many epidemiologic and case-controlled studies have demonstrated its association with these complications. In addition, treatment of hyperhomocysteinemia with folic acid ± B vitamins prevents the development of atherosclerosis, CVD and strokes. However, subsequent prospective, randomized, placebo-controlled trials have not shown an association of high homocysteine levels or their lowering with treatment with the incidence of atherosclerosis, CVD or strokes, due possibly, to the fortification of flower with folic acid. Therefore, at present, there is a controversy regarding the significance of homocysteine as a risk factor for CVD and stroke and whether patients should be routinely screened for homocysteine. Areas covered: For these reasons, a focused Medline search of the English language literature was conducted between 2010 and 2017 using the terms, homocysteine, risk factor, atherosclerosis, cardiovascular disease, stroke, treatment, and 38 papers with pertinent information were selected. Expert commentary: The review of data disclosed that there is a great controversy regarding the significance of homocysteine as a risk factor for CVD and stroke. The data from these papers together with collateral literature will be discussed in this mini review. [ABSTRACT FROM AUTHOR]

Non-communicable diseases (NCDs), including cardiovascular diseases (CVD), hypertension and diabetes together with HIV infection are among the major public health concerns worldwide. Health services for HIV and NCDs require health systems that provide for people’s chronic care needs, which present an opportunity to coordinate efforts and create synergies between programs to benefit people living with HIV and/or AIDS and NCDs. This review included studies that reported service integration for HIV and/or AIDS with coronary heart diseases, chronic CVD, cerebrovascular diseases (stroke), hypertension or diabetes. We searched multiple databases from inception until October 2015. Articles were screened independently by two reviewers and assessed for risk of bias. 11,057 records were identified with 7,616 after duplicate removal. After screening titles and abstracts, 14 papers addressing 17 distinct interventions met the inclusion criteria. We categorized integration models by diseases (HIV with diabetes, HIV with hypertension and diabetes, HIV with CVD and finally HIV with hypertension and CVD and diabetes). Models also looked at integration from micro (patient focused integration) to macro (system level integrations). Most reported integration of hypertension and diabetes with HIV and AIDS services and described multidisciplinary collaboration, shared protocols, and incorporating screening activities into community campaigns. Integration took place exclusively at the meso-level, with no micro- or macro-level integrations described. Most were descriptive studies, with one cohort study reporting evaluative outcomes. Several innovative initiatives were identified and studies showed that CVD and HIV service integration is feasible. Integration should build on existing protocols and use the community as a locus for advocacy and health services, while promoting multidisciplinary teams, including greater involvement of pharmacists. There is a need for robust and well-designed studies at all levels – particularly macro-level studies, research looking at long-term outcomes of integration, and research in a more diverse range of countries. [ABSTRACT FROM PUBLISHER]

Positive psychological attributes, such as gratitude, play a critical role in improving cardiovascular health outcomes. Gratitude not only enhances psychological, and physical well-being but may also alter biomarkers of risk for cardiovascular disease. However, there are limited studies examining this. This paper provides a state-of-the-science review of the literature examining links between gratitude and cardiovascular health outcomes (biomarkers and adherence). Data sources included PubMed, Web of Science, and PsycINFO. Results of 13 studies (from an original pool of 234), both experimental (n = 11) and non-experimental (n = 2) show that gratitude positively impacts biomarkers such as endothelial dysfunction, prognostic inflammatory markers, and improves adherence to health behaviors. Heart disease produces immense health and economic burden in the United States and globally. These novel findings demonstrate that gratitude can be a low-cost intervention in health care that can lead to improved health behaviors and better cardiovascular outcomes for patients living with cardiovascular disease. [ABSTRACT FROM AUTHOR]

This article aims to study the application of multi-functional nano-materials combined with sports rehabilitation training in the diagnosis and treatment of cardiovascular diseases. This paper uses multi-functional nano-materials combined with sports rehabilitation training methods to record the physical condition of patients with cardiovascular diseases after the illness. Use intelligent monitoring system to design network nodes, and use network technology to carry out real-time data transmission of the physical conditions of patients with cardiovascular diseases, so as to ensure the real-time transmission of patients' physical conditions, to achieve real-time understanding of the recovery status of patients with cardiovascular diseases, and whether they adapt This therapy. Then compared with the traditional cardiovascular patients' own feelings, to judge the feasibility of multifunctional nanotechnology combined with sports rehabilitation training, so as to the multifunctional nanotechnology combined with sports rehabilitation training in cardiovascular medicine Technology improvements and upgrades. Research data shows that multi-functional nanomaterials combined with sports rehabilitation training can greatly increase the speed of new blood vessel disease review. Research data shows that multifunctional nanomaterials combined with sports rehabilitation training combine disease-related protein and nucleic acid molecules in the body with precision-targeted nanomedicine, and at the same time transfer function-related organic macromolecules and peptides to the site of effect to protect them It is degraded by enzymes and not immune to rejection, so that they cross biological barriers, and then achieve the effect of diagnosis and treatment of cardiovascular disease. It has improved the recovery rate by about 20% and has an important role in promoting the diagnosis and treatment of cardiovascular diseases. [ABSTRACT FROM AUTHOR]

Introduction: Coffee is the most widely consumed beverage, next to water. However, there has been a long-standing controversy regarding its safety on blood pressure (BP) and cardiovascular disease (CVD) and intuitively, physicians dissuaded their patients from coffee drinking. Areas covered: This controversy was, primarily, based on older prospective studies or case reports, which showed a positive association of coffee drinking with the incidence of hypertension and CVD. In contrast to these reports, recent, well controlled, studies have demonstrated either a neutral or beneficial effect of moderate coffee consumption (3-4 cups/day), on BP, CVD, heart failure (HF), cardiac arrhythmias, or diabetes mellitus (DM). For the preparation of this special report, an English language focused search of the Medline database was conducted between 2010 and 2016 on studies with data on effect on the coffee consumption in patients with high BP, CVD, HF, cardiac arrhythmias or DM. Of the 94 abstracts reviewed, 34 pertinent papers were selected, and the findings from these papers together with collateral literature will be discussed in this special report. Expert commentary: Based on the evidence from these studies, coffee consumption in moderation, is safe and is beneficial in both healthy persons as well as patients with high BP, CVD, HF, cardiac arrhythmias or DM. Therefore, coffee restriction is not warranted for these patients, although some caution should be exercised. [ABSTRACT FROM AUTHOR]

Introduction: Although several lipid-lowering drugs are available, they are not sufficient for some patients. Bempedoic acid is a small molecule adenosine triphosphate-citrate lyase inhibitor indicated for the treatment of adults with hypercholesterolemia.Areas Covered: We performed a systematic review of the literature using PubMed database, and the following keywords were used: 'bempedoic acid,' 'hypercholesterolemia,' and 'adenosine triphosphate citrate lyase.' The chemical property, mechanism of action, pharmacokinetics, clinical efficacy, and safety of bempedoic acid are introduced in this paper.Expert Opinion: Bempedoic acid can modulate the metabolism of cholesterol. Clinical trials indicated that bempedoic acid could significantly reduce low-density lipoprotein cholesterol levels. Bempedoic acid was well tolerated. [ABSTRACT FROM AUTHOR]

A systematic review and meta-analysis of prospective cohort studies was conducted to examine the association of potato consumption and risk of all-cause, cancer and cardiovascular mortality in adults. We searched PubMed, Scopus databases up to September 2018 for all relevant published papers. All analyses were performed on HRs or RRs and 95% CIs. In twenty prospective studies, 25,208 cases were reported for all-cause mortality, 4877 for cancer mortality and 2366 for CVD mortality. No significant association was found between potato consumption and risk of all-cause (0.90; 95% CI: 0.8, 1.02, p = 0.096) and cancer (1.09; 95% CI: 0.96, 1.24, P = 0.204) mortality. In addition, no significant linear association was found between each 100 g/d increments in potato consumption and risk of all-cause (P = 0.7) and cancer (P = 0.09) mortality. Moreover, nonlinear association between potato consumption and risk of cancer mortality was non-significant (P-nonlinearity = 0.99). In addition, two of three studies which examined the association of potato consumption with CVD mortality did not find any significant relationship. There was no evidence for publication bias in this study. We failed to find significant association between potato consumption and risk of mortality. Further studies are required to confirm this issue. [ABSTRACT FROM AUTHOR]

Considerable controversy exists regarding the association between calcium intake and mortality risk. Therefore, this study aimed to summarize available findings on the associations of total, dietary and supplemental calcium intake with all-cause, CVD, and cancer mortality. We searched PubMed, Scopus, Embase, and ISI Web of Knowledge until February 2020 to identify eligible publications. Random-effects models were used to calculate pooled effect sizes (ESs) and 95% confidence intervals (CIs) for highest versus lowest categories of calcium intake and to incorporate variation between studies. Linear and non-linear dose-response analyses were done to evaluate the dose-response relations between calcium intake and mortality. 36 publications were included in this systematic review and 35 in the meta-analysis. During the follow-up periods ranging from 4.2 to 28 years, the total number of deaths from all causes was 163,657 (83703 from CVD and 83929 from cancer). Total calcium intake was associated with a lower risk of CVD mortality (Pooled ES for highest v lowest category: 0.91; 95% CI: 0.83–0.99, I2=68.1%, P < 0.001). Dietary calcium intake was associated with a lower risk of all-cause mortality (Pooled ES for highest v lowest category: 0.95; 95% CI: 0.92–0.99, I2=62.1%, P < 0.001). Supplemental calcium intake was not significantly associated with risk of all-cause, CVD and cancer mortality. In the dose-response analysis, there was evidence of nonlinear association between calcium intake and risk of all-cause, CVD, and cancer mortality. In conclusion, a non-linear association between calcium intake with all-cause, CVD, and cancer mortality risk was observed in this meta-analysis. Moderate intake of total (1000–1800), dietary (600–1200), and supplemental calcium (600–1200) was inversely significantly associated with mortality risk but higher calcium intake was not associated with a lower risk of mortality. [ABSTRACT FROM AUTHOR]

Objectives: The present paper aimed to assist physicians in the accurate choice among second-generation agents (SGAs) for patients with cardiovascular disease (CVD). Methods: We reviewed the published pharmacokinetic (PK) and pharmacodynamic (PD) clinical data that report potential -or absence of- drug interactions between second-generation agents (SGAs) and CVD drugs most commonly used in cardiology, including antiplatelet drugs and anticoagulants, statins, beta-blockers, angiotensin-converting enzyme inhibitors, calcium channel blockers, diuretics and the antiarrhythmic drugs amiodarone and digoxin. We also reviewed the cardiovascular safety profile that has been published for each class of SGAs and side effects reported by patients with CVD. Results: Most relevant PK/PD data about SGAs and CVD drugs are based on small studies or detailed case reports. In many cases, the drug interactions are at most assessed in healthy volunteers so that the clinical relevance of findings needs further investigation in patients with CVD. Case reports of serious, sometimes fatal reactions due to concomitant administration of certain drugs require careful consideration. The major cardiac side effects of SGAs include HR increase, postural hypotension and slight prolongation of the intraventricular conduction time and QT interval. On normal dosage of antidepressants, both advanced heart block and ventricular arrhythmias could occur in patients with severe heart disease, together with clinically important loss of myocardial contractile force. Conclusions: Data reported in the present review should help physicians about their decision-making processes that govern SGAs use in CVD patients. [ABSTRACT FROM AUTHOR]

Aim: The present paper intends in the first place to clarify the confusing terminology for describing the vascular pathology of the placental bed in relation to long-term risk of cardiovascular disease.Methods: Systematic review of relevant topics.Results: The maternal blood supply to the placenta is achieved by some 100 utero-placental spiral arteries with an outside diameter varying between 200 and 600 microns. Defective physiological changes of the myometrial segment of utero-placental spiral arteries and, particularly in preeclampsia associated to hypertensive disease, the presence of atherosclerosis in their proximal segment are a cause of obstructive vascular pathology. On the other hand, basal arteries which supply the inner myometrium and basal decidua are not affected by physiological change and maintain their musculoelastic structure. They can be identified by their external diameter of less than 120 microns. Acute atherosis is an aspecific vascular lesion that occurs in basal as well as spiral arteries inside, as well as outside, the placental bed in association with a variety of obstetrical conditions.Conclusions: An increased risk of future cardiovascular disease, should be linked to atherosis or, at a later stage, atherosclerosis of utero-placental spiral arteries, rather than to that of decidual basal arteries. [ABSTRACT FROM AUTHOR]

Since the late 1970s, scientific evidence has accumulated showing that pet ownership can have positive effects on people's physical and mental wellbeing. This paper reviews the current state of affairs regarding the relationship between companion animals and human health, focusing on both the physical and psychological health outcomes related to human-animal interactions. Although designed to set the general scene on the link between animals and human wellbeing, research specific to older adults is highlighted where relevant. A particular emphasis is placed on disorders prevalent in modern-day society, notably cardiovascular disease and depression. The possible mechanisms by which companion animals might be able to enhance human wellbeing and quality of life are discussed, focusing on routes including, amongst others, the provision of companionship, social lubrication, and improvements to physical fitness. The role of the social bonding hormone, oxytocin, in facilitating attachment to our pets and the implications for human health is also discussed. Inconsistencies in the literature and methodological limitations are highlighted throughout. It is concluded that future human-animal interaction experiments should aim to account for the confounding variables that are inherent in studies of this nature. [ABSTRACT FROM AUTHOR]

Overweight and obesity in children and adults have significantly risen in the US and worldwide due to biological, environmental, and cultural drivers and account for about 2.1 billion people. In addition, obesity, even metabolically healthy, is a major risk factor for the metabolic syndrome, diabetes mellitus, dyslipidemia, and hypertension, all significant causes of cardiovascular disease (CVD), coronary heart disease (CHD) heart failure (HF) and stroke. However, despite these causative effects, overweight and obesity frequently, confer protection in patients with established CVD, CHD, HF, and hypertension, compared to normal weight persons, the so-called 'obesity paradox'. This phenomenon though is not unique, because other studies have not shown a protective effect of overweight and obesity in such patients. These controversial effects of obesity are mostly due to the use of different indices of obesity by the various studies. Most studies have used the body mass index (BMI) as an index of obesity, which is a poor index for total fat or fat distribution. In order to get a better perspective on the true nature of the obesity paradox, a Medline and Embase search of the English language literature was contacted from 2012 to 2018, using the terms, overweight, obesity, obesity paradox, CVD, HF, and hypertension. From this search, 37 pertinent papers were selected and their findings together with collateral literature will be discussed in this review. The analysis of data suggests that the existence of the obesity paradox is questionable based on the single use of BMI as a measure of obesity. The use of waist circumference and waist to hip ratio are better indices of obesity and should be used together with the BM. [ABSTRACT FROM AUTHOR]

In the past, the beneficial effects of fermented foods on health were unknown, and so people primarily used fermentation to preserve foods, enhance shelf life, and improve flavour. Fermented foods became an important part of the diet in many cultures, and over time fermentation has been associated with many health benefits. Because of this, the fermentation process and the resulting fermented products have recently attracted scientific interest. In addition, microorganisms contributing to the fermentation process have recently been associated with many health benefits, and so these microorganisms have become another focus of attention. Lactic acid bacteria (LAB) have been some of the most studied microorganisms. During fermentation, these bacteria synthesize vitamins and minerals, produce biologically active peptides with enzymes such as proteinase and peptidase, and remove some non-nutrients. Compounds known as biologically active peptides, which are produced by the bacteria responsible for fermentation, are also well known for their health benefits. Among these peptides, conjugated linoleic acids (CLA) have a blood pressure lowering effect, exopolysaccharides exhibit prebiotic properties, bacteriocins show anti-microbial effects, sphingolipids have anti-carcinogenic and anti-microbial properties, and bioactive peptides exhibit anti-oxidant, anti-microbial, opioid antagonist, anti-allergenic, and blood pressure lowering effects. As a result, fermented foods provide many health benefits such as anti-oxidant, anti-microbial, anti-fungal, anti-inflammatory, anti-diabetic and anti-atherosclerotic activity. However, some studies have shown no relationship between fermented foods and health benefits. Therefore, this paper aims to investigate the health effects of fermented foods. [ABSTRACT FROM AUTHOR]

Peritoneal dialysis (PD) serves as a vital renal replacement therapy for patients with end-stage kidney disease (ESKD). γ-Gamma-glutamyl transferase (γ-GGT) is a recognized predictor of oxidative stress and mortality. This study aimed to assess the prognostic significance of γ-GGT in predicting all-cause and cardiovascular mortality among PD patients. A retrospective study was conducted, enrolling 640 PD patients from a single center. The one-year, three-year, and five-year mortality rates for all causes and cardiovascular causes were evaluated. Kaplan–Meier survival analysis and multivariate Cox regression analysis were performed. Within five years of initiating PD, the observed all-cause mortality rates at one, three, and five years were 11.72%, 16.09%, and 23.44%, while cardiovascular mortality rates were 2.97%, 7.34%, and 11.09%, respectively. Lower γ-GGT levels were associated with decreased all-cause mortality during one-, three-, and five-year follow-ups, along with reduced cardiovascular mortality in the first and third years, as indicated by Kaplan–Meier analysis on median γ-GGT groupings. Multivariate Cox regression analysis showed significantly decreased hazard ratios (HRs) for one- to five-year all-cause mortality and cardiovascular mortality in the lower γ-GGT group compared to higher groups. However, when sex differences were eliminated using separate tertile groupings for males and females, only the one- and three-year all-cause mortality rates demonstrated significantly reduced hazard ratios (HRs) in the lower γ-GGT groups. This retrospective study suggests that γ-GGT levels have prognostic significance in predicting one- and three-year all-cause mortality among PD patients when accounting for sex differences. [ABSTRACT FROM AUTHOR]

Objective: Measurement of dietary total antioxidant capacity (DTAC) is considered a new holistic dietary approach and assesses total antioxidants present in the overall diet. Our aim was to perform a comprehensive review of the literature on the association between DTAC and cardiovascular disease (CVD) risk factors. Methods: PubMed, Web of Science, and Scopus were used to conduct a comprehensive search for articles published on this topic through September 2017. There was no limit on earliest year of publication. The search was based on the following keywords: dietary total antioxidant capacity, nonenzymatic antioxidant capacity, total radical-trapping antioxidant parameter, ferric reducing ability of plasma, oxygen radical absorbance capacity, Trolox equivalent antioxidant capacity, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), total cholesterol (TC), waist circumference (WC), insulin resistance, homeostatic model assessment of insulin resistance (HOMA-IR), insulin, obesity, glucose, C-reactive protein (CRP), blood pressure (BP), and body mass index. In total, 16 papers were identified for inclusion in the present systematic review. Results: Most well-designed studies that evaluated associations between DTAC and CVD risk factors showed inverse associations for fasting blood glucose, CRP, BP, and WC and positive associations for HDL-C. However, there was no association between DTAC and LDL-C or TC in any of the studies. Results regarding the association of DTAC with insulin, HOMA-IR, high-sensitivity CRP, and TG in the published literature were inconsistent. Conclusions: Findings indicated a substantial association between high DTAC and most CVD-related risk factors. [ABSTRACT FROM AUTHOR]

Statins are the first line of pharmacologic treatment for the management of hypercholesterolemia in patients at risk for atherosclerotic cardiovascular (CV) disease. In recent years, several randomized, controlled trials (RCTs) and observational studies have reported increased risk for new-onset type 2 diabetes mellitus (T2D) with statin treatment, particularly with use of high-intensity statins that reduce low-density lipoprotein cholesterol (LDL-C) by 50% or more. This paper summarizes the data from RCTs and observational studies for statin-associated T2D risk, and puts into perspective this evidence, weighed against the established benefits of statin therapy for CV risk reduction. In RCTs, the increase in T2D risk with statin therapy appears to be attributable mainly to those with major T2D risk factors. The increase in incidence of T2D in those with major risk is approximately 25% for statin use, compared to placebo, and for intensive statin therapy compared to moderate-intensity statin therapy. However, in those with major T2D risk factors, the number of CV disease events prevented for each excess case of T2D is close to or greater than one, indicating that the risk-benefit ratio still strongly favors use of statin therapy, or intensive statin therapy, for patients with sufficient CV disease risk to warrant cholesterol-lowering drug therapy. Recommendations are summarized for evaluation of the T2D risk factor profile before initiation of and during statin therapy. In addition, the importance of lifestyle management and other preventive measures is emphasized for management of risks for both T2D and CV disease events in patients receiving statin therapy. [ABSTRACT FROM AUTHOR]

Meat is an important food for human nutrition, by especially providing high-quality protein and also some essential micronutrients, in front iron, zinc, and vitamin B12. However, a high intake of red and processed meat is associated with an increased risk for diseases, especially type 2 diabetes and colorectal cancer, as several epidemiological studies and meta-analyses have shown. This review summarizes meta-analyses of publications studying the association between red and processed meat intake and type 2 diabetes, cardiovascular diseases, colorectal and other cancers, and all-cause mortality. Various potential mechanisms involved in the increased disease risk are discussed. Furthermore, the beneficial effects of healthy alternatives for meat, like fish, nuts, vegetables and fruits, pulses and legumes, whole grains, and dairy products are reviewed by including selected papers and recent meta-analyses. [ABSTRACT FROM AUTHOR]

Introduction: Cardiovascular disease (CVD) is the leading noncommunicable disease and main cause of death worldwide. Traditionally, blood has been the sample of choice for biomarker discovery, however, urine has roused great interest in recent years as a source of biomarkers. Sample collection is simple, non-invasive, and there is the possibility of implementing minimal cost tests in primary care settings. Areas covered: In this review, we systematically searched PubMed for proteomic studies of CVD, with the criteria that urine was included as a biological sample. Based on these criteria, and after manual curation, 47 research papers were included: 8 for coronary artery disease, 5 for angina, 15 for myocardial infarction, 23 for heart failure, and 4 for cerebrovascular disease. Expert commentary: Urinary biomarkers of early, asymptomatic stages of the disease would have a great impact on CVD morbidity and mortality, as widespread screening could be implemented at a reduced cost, allowing high-risk individuals to be identified and treated in a timely manner. An approach involving multiple biomarkers is necessary, as a single biomarker is unlikely to be sensitive/specific enough. By assessing a range of peptides there is the potential to detect changes in many pathways involved in the pathogenesis of CVDs. [ABSTRACT FROM PUBLISHER]

Background: C-reactive protein is an acute-phase protein that has been found in association with adiposity and cardiovascular disease risk. In this paper, the objective was to assess the relationship of C-reactive protein to four anthropometric measurements: body mass index, waist-to-height ratio, C index, and waist circumference.Methods: A cross-sectional random sample of the Study of Cardiovascular Risk in Adolescents (Portuguese acronym "ERICA") was included in the study. The analysis was adjusted for the complex sampling design. Poisson regression models with robust variance were used to estimate a multivariate-adjusted prevalence rate ratio expressing the relationship of each anthropometric measure to C-reactive protein. We evaluated adolescents aged 12 to 17 years participating in the capital of Porto Alegre, Brazil.Results: In all, 778 adolescents were included (60% female, 58% aged 15-17 years). Waist-to-height ratio was found to be the strongest adiposity marker associated with C-reactive protein even after adjusting for age, sex, smoking, physical activity, and insulin resistance (prevalence rate ratio = 7.09; 95% confidence interval, 5.01-9.18; p < 0.001).Conclusions: Waist-to-height ratio is a strong predictor of C-reactive protein in adolescents in Porto Alegre, Brazil. [ABSTRACT FROM AUTHOR]

Novel lipid-lowering therapies are being introduced. Few studies exist of the real-world effectiveness of adenosine-tri-phosphate citrate lyase inhibition with bempedoic acid. This study audited bempedoic acid therapy in 216 consecutive patients from three hospital centres – a university hospital (n = 77) and two district general hospitals (n = 106 and 33). Cardiovascular disease (CVD) risk factors, prescription qualification criteria, efficacy and adverse effects were assessed. The population was aged 65.9 ± 11.0 years, 42% were male, 25% had type 2 diabetes, and 31% had familial hypercholesterolaemia. CVD was present in 19% and multibed vascular disease in 8%. Statin intolerance was reported in 92%. Bempedoic acid reduced total cholesterol by 1.58 ± 1.44 mmol/L (20%), LDL-C by 1.37 ± 1.31 mmol/L (27%), triglycerides by 0.22 mmol/L (2%) with an 0.06 mmol/L (1%) increase in HDL-C after 22 ± 9 months follow-up. An LDL-C <2.5 mmol/L was achieved in 40% and <2 mmol/L in 20%. Efficacy (r2 =.33) was predicted by baseline LDL-C (β =.54; p <.001). No significant changes were seen in transaminases, creatinine, creatine kinase, urate or HbA1c. Treatment was discontinued by 33% of patients and occurred due to myalgia (43%), lack of efficacy (16%) and gastrointestinal adverse effects (15%). No cases of gout were observed. In a logistic regression only the number of previous drug classes not tolerated (β = 1.60; p =.009) was a contributing factor to discontinuation. This audit suggests that bempedoic acid therapy is effective but that adverse effects and discontinuation are common. This suggests nocebo effects might be generalizable to all lipid-lowering drug therapies in susceptible individuals. [ABSTRACT FROM AUTHOR]

Considerable and convincing global data from cohorts across the health spectrum (i.e. apparently healthy to known disease) indicate that cardiorespiratory fitness (CRF) is a major predictor of overall and cardiovascular disease (CVD)-survival, seemingly with greater prognostic resolution compared to other traditional CVD risk factors. Therefore, the assessment of CRF in research and clinical settings is of major importance. In this manuscript, we review the technology of measuring CRF assessed by the 'gold standard,' cardiopulmonary exercise testing (CPET), as well as with various other methods (e.g. estimated metabolic equivalents, 6-minute walk tests, shuttle tests, and non-exercise equations that estimate CRF), all of which provide significant prognostic information for CVD- and all-cause survival. The literature through May 2024 has been cited. The promotion of physical activity in efforts to improve levels of CRF is needed throughout the world to improve lifespan and, more importantly, healthspan. The routine assessment of CRF should be considered a vital sign that is routinely assessed in clinical practice. [ABSTRACT FROM AUTHOR]

The finite element (FE) method is a powerful investigative tool in the field of biomedical engineering, particularly in the analysis of medical devices such as coronary stents whose performance is extremely difficult to evaluate in vivo. In recent years, a number of FE studies have been carried out to simulate the deployment of coronary stents, and the results of these studies have been utilised to assess and optimise the performance of these devices. The aim of this paper is to provide a thorough review of the state-of-the-art research in this area, discussing the aims, methods and conclusions drawn from a number of significant studies. It is intended that this paper will provide a valuable reference for future research in this area. [ABSTRACT FROM AUTHOR]

To date, the world’s leading cause of death amongst women is cardiovascular disease. Polycystic ovary syndrome (PCOS) is associated with an unfavorable cardiometabolic profile in early life. Apart from dyslipidemia, obesity and onset of type 2 diabetes mellitus, androgens are thought to influence cardiovascular health. The question rises whether women with PCOS are truly at risk for cardiovascular disease in later life. In this review paper, we aim to reflect on this assumed relation based on studies in different stages of life in women with PCOS. Cardiovascular risk factors (type 2 diabetes mellitus, obesity and metabolic syndrome), surrogate outcomes (flow-mediated dilation, carotid intima-media thickness and coronary artery calcium) and clinical long-term outcomes (cardiovascular disease and mortality) will be summarized. Data on cardiovascular disease and mortality in peri- and postmenopausal women with PCOS appear to be controversial. Whether androgens have a protective or unfavorable influence on the manifestation of cardiovascular disease remains uncertain. The need for large, prospective, well-phenotyped cohort studies of women with PCOS is high. Only then will we be able to answer this research question. [ABSTRACT FROM PUBLISHER]

The COVID-19 pandemic has forced many cardiac rehabilitation centres to focus more on the remote delivery of cardiac rehabilitation (CR) components. This increased focus and the lessons learned from this period could enhance the implementation of telerehabilitation and increase the participation in CR in Belgium. We conducted a survey between April and May 2020 about the implementation of telerehabilitation services during the COVID-19 pandemic. The electronic questionnaire was sent via email to the heads of 42 Belgian CR centres. Three reminders via email were sent during the study period. 27 CR centres (64%) returned completed questionnaires after three mailings. 52% of the CR centres provided remote CR services during the lockdown due to the COVID-19 pandemic. All CR centres that provided remote CR services delivered exercise training. The most used medium to deliver the CR components were online videos (71%) followed by online information on the website (64%) and emails (64%). It is interesting that the COVID-19 pandemic has encouraged many CR centres to implement remote delivery of CR components. This can help to speed up the research and implementation of telerehabilitation in daily clinical practice. The COVID-19 pandemic could be the push for a large multicentre implementation study that could prove that telerehabilitation is feasible and effective in the Belgian setting. [ABSTRACT FROM AUTHOR]

The first surge of the ongoing COVID-19 pandemic led to a shutdown of all non-urgent medical services such as cardiac rehabilitation. Therefore, centres had to develop remote and innovative ways to deliver the core components of CR during this shutdown. This increase in usage of remote rehabilitation services provides a chance to assess patients' experiences and willingness-to-pay of remote CR sessions. This was a prospective single-centre study. From 17 July 2020, to 19 August 2020, we conducted an anonymous survey about the patient experiences of the cardiac telerehabilitation services provided at Jessa Hospital Hasselt during the COVID-19 pandemic. A link to an electronic questionnaire was sent via email to 155 patients who were invited to participate in the cardiac telerehabilitation sessions during the closure of the rehabilitation centre due to COVID-19. Fifty-five patients (35% of all invited patients) did participate in remote CR and completed the questionnaire. The mean age of the respondents was 65.4 ± 10.5 years, 63% were male and 70% of the participants were retired. A total of 91% possessed a smartphone and all those patients used their smartphone regularly to send text messages. Ninety-four per cent of the participants were satisfied with the provided telerehabilitation sessions and 70% of the participants would be prepared to pay for these sessions like for centre-based CR sessions. Twenty per cent of patients would even prefer the telerehabilitation sessions above centre-based CR sessions. Most patients believed that remote CR could be an option after the COVID-19 pandemic when it is combined with centre-based CR sessions. Patients are willing to pay the same amount for a telerehabilitation session as a centre-based CR session. This demonstrates that highly motivated patients are open to shift certain parts of CR from face-to-face interactions to digital interactions. [ABSTRACT FROM AUTHOR]

Lipid testing for atherosclerotic cardiovascular disease (ASCVD) risk is often performed every 4–6 years, but we hypothesized that the optimum time interval may vary depending on baseline risk. Using lipid values and other risk factors from the National Health and Nutrition Examination Survey (NHANES) (n = 9,704), we calculated a 10-year risk score with the pooled-cohort equations. Future risk scores were predicted by increasing age and projecting systolic blood pressure (SBP) and lipid changes, using the mean-percentile age group change in NHANES for SBP (n = 17,329) and the Lifelines Cohort study for lipids (n = 133,540). The crossing of high and intermediate-risk thresholds were calculated by time to determine optimum intervals for lipid testing. Time to crossing risk thresholds depends on baseline risk, but the mean increase in the risk score plateaus at 1% per year for those with a baseline 10-year risk greater than 15%. Based on these findings, we recommend the following maximum time intervals for lipid testing: baseline risk < 15%: 5-years, 16%: 4-years, 17%: 3-years, 18%: 2-years, and 19%: ≤1-year. Testing patients for lipids who have a higher baseline risk more often could identify high-risk patients sooner, allowing for earlier and more effective therapeutic intervention. [ABSTRACT FROM AUTHOR]

This study assessed the clinical efficacy of nirmatrelvir plus ritonavir (NMV-r) in treating patients with COVID-19 who have preexisting cardiovascular diseases (CVDs). Patients with underlying CVDs and COVID-19 were included from the TriNetX network. We employed a 1:1 propensity score matching to create two comparable cohorts: patients receiving NMV-r and those not receiving NMV-r. The primary outcome was the composite outcome of all-cause hospitalization or death within 30 days. Propensity score matching yielded two matched cohorts of 10,847 patients each. The composite outcomes of all-cause hospitalization or death within 30 days were 2.2% (239 patients) in the NMV-r cohort and 4.7% (512 patients) in the control cohort, indicating reduced risk in the NMV-r cohort (hazard ratio [HR], 0.475; 95% confidence interval [CI], 0407–0.533). The NMV-r cohort exhibited lower risks of all-cause hospitalization (HR, 0.525; 95% CI, 0.449–0.615) and mortality (HR, 0.113; 95% CI, 0.052–0.246) compared with the control group. A similar trend was observed across most of the subgroups. Our findings indicate that NMV-r to treat COVID-19 could reduce all-cause hospitalization and death in patients with CVDs. [ABSTRACT FROM AUTHOR]

Objectives: Peritoneal dialysis (PD) serves as a vital renal replacement therapy for patients with end-stage kidney disease (ESKD). γ-Gamma-glutamyl transferase (γ-GGT) is a recognized predictor of oxidative stress and mortality. This study aimed to assess the prognostic significance of γ-GGT in predicting all-cause and cardiovascular mortality among PD patients. Methods: A retrospective study was conducted, enrolling 640 PD patients from a single center. The one-year, three-year, and five-year mortality rates for all causes and cardiovascular causes were evaluated. Kaplan–Meier survival analysis and multivariate Cox regression analysis were performed. Results: Within five years of initiating PD, the observed all-cause mortality rates at one, three, and five years were 11.72%, 16.09%, and 23.44%, while cardiovascular mortality rates were 2.97%, 7.34%, and 11.09%, respectively. Lower γ-GGT levels were associated with decreased all-cause mortality during one-, three-, and five-year follow-ups, along with reduced cardiovascular mortality in the first and third years, as indicated by Kaplan–Meier analysis on median γ-GGT groupings. Multivariate Cox regression analysis showed significantly decreased hazard ratios (HRs) for one- to five-year all-cause mortality and cardiovascular mortality in the lower γ-GGT group compared to higher groups. However, when sex differences were eliminated using separate tertile groupings for males and females, only the one- and three-year all-cause mortality rates demonstrated significantly reduced hazard ratios (HRs) in the lower γ-GGT groups. Conclusion: This retrospective study suggests that γ-GGT levels have prognostic significance in predicting one- and three-year all-cause mortality among PD patients when accounting for sex differences. [ABSTRACT FROM AUTHOR]

Abstract: Obesity (BMI greater than 30.0 kg/m2) is always a trending public health problem and different studies have linked it to the development of heart diseases. However, overweight (BMI between 25.0 kg/m2 and less than 30.0 kg/m2) has very few studies linking it to the development of heart diseases, coupled with the overweight/obesity paradox phenomena which still causes controversy. Therefore, the purpose of this paper is to determine the relationship between overweight and congestive heart failure/coronary heart diseases in the United States. To determine this relationship, the 2011–2012 National Health and Nutrition Examination Survey (NHANES) dataset, which surveyed 9756 individuals in the United States was utilized. The dataset was analyzed using Software for Statistics and Data Software (STATA) and Pearson's chi-squared test. The p-value using the t-test command in STATA for all these variables was <0.001, which indicated that there is a significant relationship between overweight and congestive heart failure/coronary heart disease across gender, ethnicity, and socioeconomic status. Although the development of congestive heart failure/coronary heart disease in overweight individuals was confirmed with this study, it is surprising to realize that the socioeconomic status of an individual also plays a role. Further research is necessary to determine how a lower or higher socioeconomic status causes overweight leading to heart diseases. [ABSTRACT FROM AUTHOR]

The seeds of the plants of the Fabaceae, commonly known as “grain legumes” or “pulses,” are major foodstuffs in most countries. In addition, these seeds may also provide some health benefits, in particular in the area of hypercholesterolemia and hypertension prevention. Whereas the hypocholesterolemic activity of soy protein has been well known for decades and was finally supported by the health claim by the U.S. Food and Drug Administration in 1999, similar information on non-soy legumes is scarce. This paper reviews all such available data from animal models and human trials as well as information on the mechanism of action provided byin vitrostudies, mainly on cell cultures or assays on specific enzymes. This body of data indicates that a regular consumption of grain legumes may be useful both for the prevention of hypercholesterolemia and hypertension. More investigations are needed, however, for elucidating the mechanism of action and the actual effective components in legumes. [ABSTRACT FROM PUBLISHER]

Magnetic Drug Targeting (MDT) is of particular interest to researchers because of its good loading efficiency, targeting accuracy, and versatile use in vivo. Cardiovascular Disease (CVD) is a global chronic disease with a high mortality rate, and the development of more precise and effective treatments is imminent. A growing number of studies have begun to explore the feasibility of MDT in CVD, but an up-to-date systematic summary is still lacking. This review discusses the current research status of MDT from guiding magnetic fields, magnetic nanocarriers, delivery channels, drug release control, and safety assessment. The current application status of MDT in CVD is also critically introduced. On this basis, new insights into the existing problems and future optimization directions of MDT are further highlighted. [ABSTRACT FROM AUTHOR]

Underserved populations are at increased risk for obesity and related cardiovascular disease, type 2 diabetes, and other chronic diseases. Lack of access to healthy foods, sedentary behaviour, and other social environmental factors contribute to disease risk. Yup'ik Alaska Native communities are experiencing lifestyle changes that are likely to affect their cardiometabolic risks. Barrera & Castro's Cultural Adaptation Framework was used to adapt an evidence-based intervention (EBI) originally designed for Latino communities for use in Yup'ik communities. Focus groups and key informant interviews were held in two Yup'ik communities. Major themes included causes of obesity, barriers and facilitators to healthy foods and physical activity, and intervention ideas. The adaptation process was guided by a Community Planning Group of Yup'ik women and included information gathering, preliminary adaptation design, preliminary adaptation tests, and adaptation refinement. Two of the adapted educational modules were pilot tested. Involving community members as co-researchers in cultural adaptation is vital for an EBI to be effective in another population. Small group gatherings led by local lay health workers are culturally appropriate and may be an effective health promotion model in Yup'ik communities. Social environmental factors affecting healthy food availability and physical activity need further exploration. [ABSTRACT FROM AUTHOR]

The current review is to describe the definition and prevalence of resistant arterial hypertension (RAH), the difference between refractory hypertension, patient characteristics and major risk factors for RAH, how RAH is diagnosed, prognosis and outcomes for patients. According to the WHO, approximately 1.28 billion adults aged 30–79 worldwide have arterial hypertension, and over 80% of them do not have blood pressure (BP) under control. RAH is defined as above-goal elevated BP despite the concurrent use of 3 or more classes of antihypertensive drugs, commonly including a long-acting calcium channel blocker, an inhibitor of the renin-angiotensin system (angiotensin-converting enzyme inhibitor or angiotensin receptor blocker), and a thiazide diuretic administered at maximum or maximally tolerated doses and at appropriate dosing frequency. RAH occurs in nearly 1 of 6 hypertensive patients. It often remains unrecognised mainly because patients are not prescribed ≥3 drugs at maximal doses despite uncontrolled BP. RAH distinctly increases the risk of developing coronary artery disease, heart failure, stroke and chronic kidney disease and confers higher rates of major adverse cardiovascular events as well as increased all-cause mortality. Timely diagnosis and treatment of RAH may mitigate the associated risks and improve short and long-term prognosis. Resistant arterial hypertension is a serious condition that leads to severe cardiovascular complications, such as heart attack, stroke and death. It is defined as above-goal elevated blood pressure despite the concurrent use of 3 or more classes of antihypertensive medications administered at maximum or maximally tolerated doses and at appropriate dosing frequency. Non-adherence to antihypertensive medications must be excluded before resistant arterial hypertension is diagnosed. Blood pressure should be measured appropriately. A person should sit in a comfortable chair with back supported, both feet flat on the ground, and legs uncrossed for at least 5 min before blood pressure measurement. A cuff length is supposed to be at least 80% and a width of at least 40% of the arm circumference. Placing the cuff directly on the skin of the upper arm at the level of the heart. Obtaining 3 readings 1 min apart. Discarding the first reading and taking the mean of the second and third readings Resistant arterial hypertension should be distinguished from refractory hypertension, when blood pressure remains uncontrolled on maximal or near-maximal therapy of 5 or more antihypertensive agents of different classes. [ABSTRACT FROM AUTHOR]

To evaluate the effects of various initiation time points and durations of hormone therapy (HT) on cardiovascular and metabolic parameters of premenarche, primary ovarian insufficiency (POI) mouse model, induced by 4-vinylcyclohexene diepoxide. A total of 50 mice at 4 weeks of age were developed into POI mouse model, further randomly categorized into 5 groups: control group without any intervention; no HT group with only high-fat diet (NT); group 1 with delayed estradiol treatment (T1); group 2 with on-time, continuous estradiol treatment (T2); and group 3 with on-time estradiol treatment but early stop (T3). Cardiovascular risk and metabolic parameters were measured. Presenting with similar body weights, blood glucose levels of T1, T2, and T3 were all significantly lower than NT (p <.001). Serum total cholesterol and insulin were also significantly lower in all HT groups than in NT, especially in T2 (p <.001). For serum low-density lipoprotein-cholesterol, only T2 resulted in the statically lower level than those of NT, T1, and T3 (p <.001). Aortic thickness was significantly increased with aggravated fibrotic change of the intima in NT, and such consequence was significantly ameliorated in HT groups, mostly lowered in T2 (p <.05). Last, serum pro-inflammatory cytokines were significantly low in the HT groups than in NT, especially in T2 with the lowest level (p <.05). On-time, continuous E2 treatment immediately after a biologic estrogen deprivation event significantly reduced metabolic and cardiovascular risks in young, pre-menarche female mouse models of POI, confirming decreased serum levels of pro-inflammatory cytokines. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease (CVD) is the leading cause of death. Oxidative stress is an important pathological process of a variety of CVDs. Xinshuaining preparation has a therapeutic effect on the heart failure. However, the anti-oxidative stress role of Xinshuaining preparation in H9c2 cells is still unclear. Methods: The medicated serum of Xinshuaining preparation was acquired and utilized to hatch with H2 O2-induced H9c2 cells. Main components in the Xinshuaining preparation were analyzed by liquid chromatography-mass spectrometry (LC/MS). The effect of medicated serum on the cell viability, apoptosis rate, the oxidative stress indicators (SOD, GSH-Px, and MDA), mitochondrial membrane potential (MMP), and ROS level was evaluated by CCK-8, flow cytometry, commercial biochemical detection kits, and JC-1 staining. Additionally, the associated mechanism was determined by the detection of the protein levels (PI3K, phosphorylated PI3K, Akt, phosphorylated Akt, and Nrf-2) through western blot assays, which was also further assessed with the application of LY294002. Results: The medicated serum of Xinshuaining preparation notably increased the H2O2-reduced, the cell viability, the concentration of SOD and GSH-Px, MMP level and the relative protein expression level of phosphorylated PI3K and Akt and Nrf-2, while dampened the H2O2-elevated the level of the cell apoptosis rate, MDA, and ROS. However, Xinshuaining preparation on the cell viability, apoptosis, and oxidative stress was notably antagonized by LY294002 pre-treatment. Conclusions: The medicated serum of Xinshuaining preparation increased the cell viability and suppressed apoptosis and oxidative stress via the PI3K/Akt/Nrf-2 signaling pathway. [ABSTRACT FROM AUTHOR]

Background and objective: Epidemiological research have displayed that dietary intake rich in lycopene, an antioxidant, is negatively correlated with the risk of cardiovascular disease (CVD). This study aimed to investigate whether the intervention with different concentrations of lycopene could attenuate H2O2-induced oxidative stress injury in human vascular endothelial cells (VECs). Methods: The human VECs HMEC-1 and ECV-304 were incubated with a final concentration of 300 µmol/L H2O2, followed by they were incubated with lycopene at doses of 0.5, 1, or 2 µm. Subsequently, cell proliferation, cytotoxicity, cell adhesion, reactive oxygen species (ROS) contents, adhesion molecule expression, oxidative stress levels, pro-inflammatory factor production, the apoptosis protein levels, and the silent information regulator-1 (SIRT1)/nuclear factor erythroid 2-related factor 2 (Nrf2)/heme oxygenase-1 (HO-1) pathway protein levels were tested by CCK-8 kit, lactate dehydrogenase (LDH) kit, immunofluorescence labeling, cell surface enzyme immunoassays (EIA), enzyme-linked immunosorbent assay (ELISA), as well as Western blot assays, respectively. Results: Under H2O2 stimulation, HMEC-1 and ECV-304 cell proliferation and the SIRT1/Nrf2/HO-1 pathway protein expression were significantly reduced, whereas cytotoxicity, apoptosis, cell adhesion molecule expression, pro-inflammatory and oxidative stress factors production were apparently encouraged, which were partially countered by lycopene intervention in a dose-dependent manner. Conclusion: Lycopene alleviates H2O2-induced oxidative damage in human VECs by reducing intracellular ROS levels, inflammatory factor production, cell adhesiveness, and apoptosis rate under oxidative stress conditions through activation of the SIRT1/Nrf2/HO-1 pathway. [ABSTRACT FROM AUTHOR]

Background: Exercise prescriptions by clinicians to patients with cardiovascular disease (CVD) often disagree with recommendations, thus requiring improvement. Aim: To assess whether exercise prescriptions by physiotherapists to patients with CVD are better in agreement with European (ESC/EAPC) recommendations when the EXPERT (EXercise Prescription in Everyday practice & Rehabilitative Training) Training tool is used for digital educational training. Design: In a prospective non-randomized intervention study. Methods: Twenty-three belgian physiotherapists first prescribed exercise intensity, frequency, session duration, program duration and exercise type (endurance or strength training) for the same three patient cases, from which the agreement with ESC/EAPC recommendations (based on a maximal score of 60/per case: agreement score) was assessed. Next, they completed a onemonth digital training by using the EXPERT Training tool and completed 31 ± 13 training cases. The EXPERT tool is a training and decision support system that automatically generates a (personalised) exercise prescription according to the patient's characteristics, thus integrating the exercise prescriptions for different CVDs and risk factors, all based on ESC/EAPC recommendations. Thereafter, the same three patient cases as at entry of study were filled out again, with reassessment of level of agreement with ESC/EAPC recommendations. Results: After using the EXPERT Training tool, the physiotherapists prescribed significantly greater exercise frequencies, program durations and total exercise volumes in all three patient cases (p < 0.05). In cases 1, 2 and 3, the agreement score increased from 29 ± 9 (out of 60), 28 ± 9, and 34 ± 7 to 41 ± 9, 41 ± 10, and 45 ± 8, respectively (p < 0.001). Hence, the total agreement score increased from 91 ± 17 (out of 180) to 127 ± 19 (p < 0.001, +44 ± 32%). A lower starting agreement score and younger age correlated with a greater improvement in total agreement score (p < 0.05). Conclusions: Exercise prescriptions to patients with CVD, generated by physiotherapists, are significantly better in agreement with European recommendations when the EXPERT Training tool is used, indicating its educational potential. [ABSTRACT FROM AUTHOR]