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Background: Hypertensive disorders of pregnancy (HDP) are a major cause of maternal morbidity and mortality, and their association with increased cardiovascular disease (CVD) risk represents a major public health concern. However, assessing CVD risk in women with a history of these conditions presents unique challenges, especially when studies are carried out using routinely collected data. Objectives: To summarise and describe key challenges related to the design and conduct of administrative studies assessing CVD risk in women with a history of HDP and provide concrete recommendations for addressing them in future research. Methods: This is a methodological guidance paper. Results: Several conceptual and methodological factors related to the data‐generating mechanism and study conceptualisation, design/data management and analysis, as well as the interpretation and reporting of study findings should be considered and addressed when designing and carrying out administrative studies on this topic. Researchers should develop an a priori conceptual framework within which the research question is articulated, important study variables are identified and their interrelationships are carefully considered. Conclusions: To advance our understanding of CVD risk in women with a history of HDP, future studies should carefully consider and address the conceptual and methodological considerations outlined in this guidance paper. In highlighting these challenges, and providing specific recommendations for how to address them, our goal is to improve the quality of research carried out on this topic. [ABSTRACT FROM AUTHOR]

Background: According to World Health Organization (WHO) estimates, there are currently 1.1 billion tobacco smokers worldwide. This study follows the need for change in the increasing trend of lifestyle-related diseases and the lack of extensive studies on the pattern of smoking. Methods: In the current study, an electronic database search was conducted to identify studies that examined the impact of smoking on internal diseases from the beginning of February 2018 to the end of December 2021. After eliminating numerous articles based on their titles and abstracts, 273 articles pertinent to the study's objectives were selected. Due to the inadequacy of the target audience and the inclusion and exclusion criteria, 239 of the remaining articles were eliminated. The 44 remaining articles were examined more closely. Results: Each cigarette produces more than 7,000 chemicals. Many of these substances are toxic, and about 69 of them can cause cancer. For every 15 cigarettes you smoke, a mutation occurs in the body. Mutations are the cause of cancer. Studies have shown a clear relationship between dose and response, with a sharp increase in the risk of arterial disease in heavy smokers. In countries where approximately 30% of the population smokes, 50% of arterial disease can be attributed to smoking. Conclusion: Smoking increases the risk of cardiovascular disease (CVD) and lung disease, and leads to an increased risk of lung, throat, stomach, and bladder cancer, and many other cancers. One of the most important organs in the body that can be disrupted by smoking is the heart.

Abstract Background People who have been incarcerated have high rates of cardiovascular risk factors, such as hypertension and smoking, and cardiovascular disease (CVD) is a leading cause of hospitalizations and mortality in this population. Despite this, little is known regarding what pathways mediate the association between incarceration exposure and increased rates of CVD morbidity and especially what incarceration specific factors are associated with this risk. The objective of this study is to better understand CVD risk in people exposed to incarceration and the pathways by which accumulate cardiovascular risk over time. Methods and Analysis The Justice-Involved Individuals Cardiovascular Disease Epidemiology (JUSTICE) study is a prospective cohort study of individuals released from incarceration with known cardiovascular risk factors. We are recruiting 500 individuals within three months after release from jail/prison. At baseline we are assessing traditional risk factors for CVD, including diet, exercise, and smoking, and exposure to incarceration-related policies, psychosocial stress, and self-efficacy. Cardiovascular risk factors are measured at baseline through point of care testing. We are following these individuals for the 12 months following the index release from incarceration with re-evaluation of psychosocial factors and clinical risk factors every 6 months. Using these data, we will estimate the direct and indirect latent effects of incarceration on cardiovascular risk factors and the paths via which these effects are mediated. We will also model the anticipated 10-year burden of CVD incidence, health care use, and mortality associated with incarceration. Discussion Our study will identify factors associated with CVD risk factor control among people released from incarceration. Our measurement of incarceration-related exposures, psychosocial factors, and clinical measures of cardiovascular risk will allow for identification of unique targets for intervention to modify CVD risk in this vulnerable population.

Growing evidence has demonstrated exercise as an effective way to promote cardiovascular health and protect against cardiovascular diseases However, the underlying mechanisms of the beneficial effects of exercise have yet to be elucidated. Animal exercise studies are widely used to investigate the key mechanisms of exercise-induced cardiovascular protection. However, standardized procedures and well-established evaluation indicators for animal exercise models are needed to guide researchers in carrying out effective, high-quality animal studies using exercise to prevent and treat cardiovascular diseases. In our review, we present the commonly used animal exercise models in cardiovascular research and propose a set of standard procedures for exercise training, emphasizing the appropriate measurements and analysis in these chronic exercise models. We also provide recommendations for optimal design of animal exercise studies in cardiovascular research, including the choice of exercise models, control of exercise protocols, exercise at different stages of disease, and other considerations, such as age, sex, and genetic background. We hope that this position paper will promote basic research on exercise-induced cardiovascular protection and pave the way for successful translation of exercise studies from bench to bedside in the prevention and treatment of cardiovascular diseases.

Heart disease can be life-threatening if not detected and treated at an early stage. The electrocardiogram (ECG) plays a vital role in classifying cardiovascular diseases, and often physicians and medical researchers examine paper-based ECG images for cardiac diagnosis. An automated heart disease prediction system might help to classify heart diseases accurately at an early stage. This study aims to classify cardiac diseases into five classes with paper-based ECG images using a deep learning approach with the highest possible accuracy and the lowest possible time complexity. This research consists of two approaches. In the first approach, five deep learning models, InceptionV3, ResNet50, MobileNetV2, VGG19, and DenseNet201, are employed. In the second approach, an integrated deep learning model (InRes-106) is introduced, combining InceptionV3 and ResNet50. This model is developed as a deep convolutional neural network capable of extracting hidden and high-level features from images. An ablation study is conducted on the proposed model altering several components and hyperparameters, improving the performance even further. Before training the model, several image pre-processing techniques are employed to remove artifacts and enhance the image quality. Our proposed hybrid InRes-106 model performed best with a testing accuracy of 98.34%. The InceptionV3 model acquired a testing accuracy of 90.56%, the ResNet50 89.63%, the DenseNet201 88.94%, the VGG19 87.87%, and the MobileNetV2 achieved 80.56% testing accuracy. The model is trained with a k-fold cross-validation technique with different k values to evaluate the robustness further. Although the dataset contains a limited number of complex ECG images, our proposed approach, based on various image pre-processing techniques, model fine-tuning, and ablation studies, can effectively diagnose cardiac diseases.

• Standard procedures and appropriate assessment of exercise are proposed for the commonly used animal models related to chronic exercise (e.g., treadmill running, voluntary wheel running, swimming exercise, and resistance exercise) in cardiovascular research. • Optimal design of animal exercise studies in cardiovascular research should consider the choice of exercise models, control of exercise protocols, exercise at different stages of disease, and other factors, such as age, sex, and genetic background. • An optimal design for studying exercise-induced physiological cardiac growth and its related beneficial effects against cardiovascular diseases is presented. Growing evidence has demonstrated exercise as an effective way to promote cardiovascular health and protect against cardiovascular diseases However, the underlying mechanisms of the beneficial effects of exercise have yet to be elucidated. Animal exercise studies are widely used to investigate the key mechanisms of exercise-induced cardiovascular protection. However, standardized procedures and well-established evaluation indicators for animal exercise models are needed to guide researchers in carrying out effective, high-quality animal studies using exercise to prevent and treat cardiovascular diseases. In our review, we present the commonly used animal exercise models in cardiovascular research and propose a set of standard procedures for exercise training, emphasizing the appropriate measurements and analysis in these chronic exercise models. We also provide recommendations for optimal design of animal exercise studies in cardiovascular research, including the choice of exercise models, control of exercise protocols, exercise at different stages of disease, and other considerations, such as age, sex, and genetic background. We hope that this position paper will promote basic research on exercise-induced cardiovascular protection and pave the way for successful translation of exercise studies from bench to bedside in the prevention and treatment of cardiovascular diseases. [Display omitted] [ABSTRACT FROM AUTHOR]

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The Coronavirus Disease 2019 (COVID-19) has had a continuous and robust impact on world health. The resulting COVID-19 pandemic has had a devastating physical, mental and fiscal impact on the millions of people living with noncommunicable diseases (NCDs). In addition to older age, people living with CVD, stroke, obesity, diabetes, kidney disease, and hypertension are at a particularly greater risk for severe forms of COVID-19 and its consequences. Meta-analysis indicates that hypertension, diabetes, chronic kidney disease, and thrombotic complications have been observed as both the most prevalent and most dangerous co-morbidities in COVID-19 patients. And despite the nearly incalculable physical, mental, emotional, and economic toll of this pandemic, forthcoming public health figures continue to place cardiovascular disease as the number one cause of death across the globe in the year 2020. The world simply cannot wait for the next pandemic to invest in NCDs. Social determinants of health cannot be addressed only through the healthcare system, but a more holistic multisectoral approach with at its basis the Sustainable Development Goals (SDGs) is needed to truly address social and economic inequalities and build more resilient systems. Yet there is reason for hope: the 2019 UN Political Declaration on UHC provides a strong framework for building more resilient health systems, with explicit calls for investment in NCDs and references to fiscal policies that put such investment firmly within reach. By further cementing the importance of addressing circulatory health in a future Framework Convention on Emergency Preparedness, WHO Member States can take concrete steps towards a pandemic-free future. As the chief representatives of the global circulatory health community and patients, the Global Coalition for Circulatory Health calls for increased support for the healthcare workforce, global vaccine equity, embracing new models of care and digital health solutions, as well as fiscal policies on unhealthy commodities to support these investments.

Background: Seafarers are at an increased risk of developing cardiovascular diseases (CVDs), potentially due to a stressful working environment and behavioral risk factors. To develop better prevention strategies, it is important to elucidate the extent of this risk. Therefore, we conducted a systematic literature review on CVD in seafarers. Method: We conducted systematic searches in five databases. All studies investigating CVDs among occupational seafarers, published in articles or conference papers, were eligible for inclusion. The identified records were screened and reviewed by two independent researchers, who also evaluated the methodological quality of the included studies. Results: Three thousand nine hundred and seventeen records qualified for screening, and 55 were eligible for inclusion. Most of the studies were observational, including cohort, frequency, incidence or prevalence studies, and review of case records. Around half were assessed at risk of biased findings. Participants in the studies were primarily from North America or the European continent and work onboard transportation vessels. Many studies investigated CVDs as a cause of death, focusing on conditions such as CVD, ischemic heart disease, and myocardial infarction. Frequency of CVD conditions varied but indicate that seafarers face a greater risk compared to the reference populations or control groups. Environmental factors were mainly investigated as risk factors. Conclusion: Our results indicate a higher risk of CVDs among seafarers compared to reference or control groups. However, due to the variable quality of the evidence, well‐designed studies are needed to establish the causes of cardiovascular mortality and morbidity in seafarers and to investigate behavioral aspects of cardiovascular risk. [ABSTRACT FROM AUTHOR]

Abstract Coronavirus Disease 2019 (COVID‐19) has infected more than 3.0 million people worldwide and killed more than 200,000 as of April 27, 2020. In this White Paper, we address the cardiovascular co‐morbidities of COVID‐19 infection; the diagnosis and treatment of standard cardiovascular conditions during the pandemic; and the diagnosis and treatment of the cardiovascular consequences of COVID‐19 infection. In addition, we will also address various issues related to the safety of healthcare workers and the ethical issues related to patient care in this pandemic.

Proteins play a crucial role in metabolism, in maintaining fluid and acid-base balance and antibody synthesis. Dietary proteins are important nutrients and are classified into: 1) animal proteins (meat, fish, poultry, eggs and dairy), and, 2) plant proteins (legumes, nuts and soy). Dietary modification is one of the most important lifestyle changes that has been shown to significantly decrease the risk of cardiovascular (CV) disease (CVD) by attenuating related risk factors. The CVD burden is reduced by optimum diet through replacement of unprocessed meat with low saturated fat, animal proteins and plant proteins. In view of the available evidence, it has become acceptable to emphasize the role of optimum nutrition to maintain arterial and CV health. Such healthy diets are thought to increase satiety, facilitate weight loss, and improve CV risk. Different studies have compared the benefits of omnivorous and vegetarian diets. Animal protein related risk has been suggested to be greater with red or processed meat over and above poultry, fish and nuts, which carry a lower risk for CVD. In contrast, others have shown no association of red meat intake with CVD. The aim of this expert opinion recommendation was to elucidate the different impact of animal vs vegetable protein on modifying cardiometabolic risk factors. Many observational and interventional studies confirmed that increasing protein intake, especially plant-based proteins and certain animal-based proteins (poultry, fish, unprocessed red meat low in saturated fats and low-fat dairy products) have a positive effect in modifying cardiometabolic risk factors. Red meat intake correlates with increased CVD risk, mainly because of its non-protein ingredients (saturated fats). However, the way red meat is cooked and preserved matters. Thus, it is recommended to substitute red meat with poultry or fish in order to lower CVD risk. Specific amino acids have favourable results in modifying major risk factors for CVD, such as hypertension. Apart from meat, other animal-source proteins, like those found in dairy products (especially whey protein) are inversely correlated to hypertension, obesity and insulin resistance. [ABSTRACT FROM AUTHOR]

Despite significant advances in the diagnosis and treatment of cardiovascular diseases, recent calls have emphasized the unmet need to improve precision-based approaches in cardiovascular disease. Although some studies provide preliminary evidence of the diagnostic and prognostic potential of circulating coding and non-coding RNAs, the complex RNA biology and lack of standardization have hampered the translation of these markers into clinical practice. In this position paper of the CardioRNA COST action CA17129, we provide recommendations to standardize the RNA development process in order to catalyse efforts to investigate novel RNAs for clinical use. We list the unmet clinical needs in cardiovascular disease, such as the identification of high-risk patients with ischaemic heart disease or heart failure who require more intensive therapies. The advantages and pitfalls of the different sample types, including RNAs from plasma, extracellular vesicles, and whole blood, are discussed in the sample matrix, together with their respective analytical methods. The effect of patient demographics and highly prevalent comorbidities, such as metabolic disorders, on the expression of the candidate RNA is presented and should be reported in biomarker studies. We discuss the statistical and regulatory aspects to translate a candidate RNA from a research use only assay to an in-vitro diagnostic test for clinical use. Optimal planning of this development track is required, with input from the researcher, statistician, industry, and regulatory partners. [ABSTRACT FROM AUTHOR]

Background: According to World Health Organization (WHO) estimates, there are currently 1.1 billion tobacco smokers worldwide. This study follows the need for change in the increasing trend of lifestyle-related diseases and the lack of extensive studies on the pattern of smoking. Methods: In the current study, an electronic database search was conducted to identify studies that examined the impact of smoking on internal diseases from the beginning of February 2018 to the end of December 2021. After eliminating numerous articles based on their titles and abstracts, 273 articles pertinent to the study's objectives were selected. Due to the inadequacy of the target audience and the inclusion and exclusion criteria, 239 of the remaining articles were eliminated. The 44 remaining articles were examined more closely. Results: Each cigarette produces more than 7,000 chemicals. Many of these substances are toxic, and about 69 of them can cause cancer. For every 15 cigarettes you smoke, a mutation occurs in the body. Mutations are the cause of cancer. Studies have shown a clear relationship between dose and response, with a sharp increase in the risk of arterial disease in heavy smokers. In countries where approximately 30% of the population smokes, 50% of arterial disease can be attributed to smoking. Conclusion: Smoking increases the risk of cardiovascular disease (CVD) and lung disease, and leads to an increased risk of lung, throat, stomach, and bladder cancer, and many other cancers. One of the most important organs in the body that can be disrupted by smoking is the heart. [ABSTRACT FROM AUTHOR]

In present study, we developed a highly sensitive, electrochemical immunosensor based on fullerene C 60 -modified disposable graphite paper (GP) electrode for determination of Suppression of Tumorigenicity 2 (ST2) in human serum. The synthesis of the ST2 immunosensor was monitored with electrochemical impedance spectroscopy (EIS), cyclic voltammetry (CV) techniques and single frequency impedance (SFI) technique which is utilized for the specific interaction between anti-ST2 and ST2 antigen. Moreover, the morphological alteration of each GP surface was examined by scanning electron microscopy (SEM), SEM-energy dispersive X-ray spectroscopy (EDX) and atomic force microscopy (AFM). All parameters such as fullerene C 60 concentration, antibody concentration and antibody incubation time were optimized. Analytical characteristics such as linear determination range, repeatability, reproducibility, regeneration and surface coverage were determined for the immunosensor. The ST2 electrochemical immunosensor had excellent repeatability, reproducibility and a wide detection range (from 0.1 fg mL−1 to 100 fg mL−1). The proposed immunosensor also had low limit of detection (LOD) and limit of quantification (LOQ) values of 0.124 fg mL−1 and 0.414 fg mL−1, respectively. The proposed immunosensor was applied to real samples to test applicability in clinical practice. Image 1 • The electrochemical immunosensor designed a practical, low-cost and sensitive method for determination of Suppression of Tumorigenicity 2. • ST2 immunosensor exhibited high analytical performance with a linear range 0.1 fg mL−1 – 100 fg mL−1 and low detection limit (1.28 fg mL−1). • Single-use graphite paper electrodes were firstly used to detection ST2 antigen for a novel biosensor system. [ABSTRACT FROM AUTHOR]

Inflammation is a marker of arterial disease stemming from cholesterol-dependent to -independent molecular mechanisms. In recent years, the role of inflammation in atherogenesis has been underpinned by pharmacological approaches targeting systemic inflammation that have led to a significant reduction in cardiovascular disease (CVD) risk. Although the use of nutraceuticals to prevent CVD has largely focused on lipid-lowering (e.g, red-yeast rice and omega-3 fatty acids), there is growing interest and need, especially now in the time of coronavirus pandemic, in the use of nutraceuticals to reduce inflammatory markers, and potentially the inflammatory CVD burden, however, there is still not enough evidence to confirm this. Indeed, diet is an important lifestyle determinant of health and can influence both systemic and vascular inflammation, to varying extents, according to the individual nutraceutical constituents. Thus, the aim of this Position Paper is to provide the first attempt at recommendations on the use of nutraceuticals with effective anti-inflammatory properties. [ABSTRACT FROM AUTHOR]

The cardiovascular system is significantly affected in coronavirus disease-19 (COVID-19). Microvascular injury, endothelial dysfunction, and thrombosis resulting from viral infection or indirectly related to the intense systemic inflammatory and immune responses are characteristic features of severe COVID-19. Pre-existing cardiovascular disease and viral load are linked to myocardial injury and worse outcomes. The vascular response to cytokine production and the interaction between severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and angiotensin-converting enzyme 2 receptor may lead to a significant reduction in cardiac contractility and subsequent myocardial dysfunction. In addition, a considerable proportion of patients who have been infected with SARS-CoV-2 do not fully recover and continue to experience a large number of symptoms and post-acute complications in the absence of a detectable viral infection. This conditions often referred to as 'post-acute COVID-19' may have multiple causes. Viral reservoirs or lingering fragments of viral RNA or proteins contribute to the condition. Systemic inflammatory response to COVID-19 has the potential to increase myocardial fibrosis which in turn may impair cardiac remodelling. Here, we summarize the current knowledge of cardiovascular injury and post-acute sequelae of COVID-19. As the pandemic continues and new variants emerge, we can advance our knowledge of the underlying mechanisms only by integrating our understanding of the pathophysiology with the corresponding clinical findings. Identification of new biomarkers of cardiovascular complications, and development of effective treatments for COVID-19 infection are of crucial importance. [ABSTRACT FROM AUTHOR]

Heart disease can be life-threatening if not detected and treated at an early stage. The electrocardiogram (ECG) plays a vital role in classifying cardiovascular diseases, and often physicians and medical researchers examine paper-based ECG images for cardiac diagnosis. An automated heart disease prediction system might help to classify heart diseases accurately at an early stage. This study aims to classify cardiac diseases into five classes with paper-based ECG images using a deep learning approach with the highest possible accuracy and the lowest possible time complexity. This research consists of two approaches. In the first approach, five deep learning models, InceptionV3, ResNet50, MobileNetV2, VGG19, and DenseNet201, are employed. In the second approach, an integrated deep learning model (InRes-106) is introduced, combining InceptionV3 and ResNet50. This model is developed as a deep convolutional neural network capable of extracting hidden and high-level features from images. An ablation study is conducted on the proposed model altering several components and hyperparameters, improving the performance even further. Before training the model, several image pre-processing techniques are employed to remove artifacts and enhance the image quality. Our proposed hybrid InRes-106 model performed best with a testing accuracy of 98.34%. The InceptionV3 model acquired a testing accuracy of 90.56%, the ResNet50 89.63%, the DenseNet201 88.94%, the VGG19 87.87%, and the MobileNetV2 achieved 80.56% testing accuracy. The model is trained with a k-fold cross-validation technique with different k values to evaluate the robustness further. Although the dataset contains a limited number of complex ECG images, our proposed approach, based on various image pre-processing techniques, model fine-tuning, and ablation studies, can effectively diagnose cardiac diseases. [ABSTRACT FROM AUTHOR]

Abstract High-sensitivity C-reactive protein (hs-CRP) has been regarded as a risk predictor of cardiovascular disease (CVD). Despite there are many methods to detect hs-CRP, quantitative, rapid, convenient, multiplex and highly sensitive measurement of it is still a challenge for point-of-care applications. In this study, we developed a paper-based ELISA to detect hs-CRP and the sensitive chemiluminescence was applied as detection signal. In this developed assay method, CRP concentration and chemiluminescence intensity were linearly correlated (r = 0.999) with a limit of detection (LOD) as low as 0.49 ng mL−1, which was comparable to that of conventional ELISA and superior to most of the current reported POCT methods for detection of hs-CRP. The precision of the assay was confirmed for low coefficient of variations, less than 7% for intra-assay and less than 10% for inter-assay. In clinical sample analysis, the results of hs-CRP detected by this assay were in good accordance with which obtained by commercial high sensitivity ELISA kit for in vitro diagnosis (r = 0.975). This assay required only 4 μL of sample and could be finished in less than 30 min. It may therefore be employed as a rapid pre-screening tool to identify patients with elevated risk of CVD. Graphical abstract Image 1 Highlights • A chemiluminescence p-ELISA for detection of hs-CRP with the LOD of 0.49 ng mL−1. • Biotin-streptavidin system has been employed to improve the sensitivity of the assay. • Detection with less sample volume (4 μL) in shorter period of time (less than 30 min). • This assay has successfully detected hs-CRP in clinical serum samples. [ABSTRACT FROM AUTHOR]

People living with HIV (PWH) are at higher risk for cardiovascular disease (CVD) and stroke in comparison to their non-infected counterparts. The ABCS (aspirin-blood pressure control-cholesterol control-smoking cessation) reduce atherosclerotic (ASCVD) risk in the general population, but little is known regarding strategies for promoting the ABCS among PWH. Guided by the Consolidated Framework for Implementation Research (CFIR), we designed multilevel implementation strategies that target PWH and their clinicians to promote appropriate use of the ABCS based on a 10-year estimated ASCVD risk. Implementation strategies include patient coaching, automated texting, peer phone support, academic detailing and audit and feedback for the patient's clinician. We are evaluating implementation through a stepped wedge cluster randomized trial based on the Reach-Effectiveness-Adoption-Maintenance/Qualitative-Evaluation-for-Systematic-Translation (RE-AIM/QuEST) mixed methods framework that integrates quantitative and qualitative assessments. The primary outcome is change in ASCVD risk. Findings will have important implications regarding strategies for reducing ASCVD risk among PWH. [ABSTRACT FROM AUTHOR]

Abstract: Familial hypercholesterolemia (FH) affects on average 1 in 500 individuals in European countries, and it is estimated that FH in Poland may affect more than 80,000 people. However, in Poland, only about 20% of the population is estimated to have been diagnosed with FH, of which only a small number receive adequate treatment. FH results in more rapid development of atherosclerosis and is associated with a high risk of cardiovascular events. Atherosclerosis develops beginning in childhood in patients with FH and reaches advanced stages before clinical manifestations develop. Inadequate diagnostics and treatment of FH in Polish children suggests a need for raising the level of awareness and understanding of the condition in both society and among health professionals. These recommendations present the current epidemiological status, guidelines for diagnosing FH in Polish children and adolescents, and effective treatment options. [Copyright &y& Elsevier]

Abstract: A substantial body of evidence has implicated several aspects of diet in the pathogenesis of elevated blood pressure (BP). Well-established risk factors for elevated BP include excess salt intake, low potassium intake, excess weight, high alcohol consumption, and suboptimal dietary pattern. African Americans are especially sensitive to the BP-raising effects of excess salt intake, insufficient potassium intake, and suboptimal diet. In this setting, dietary changes have the potential to substantially reduce racial disparities in BP and its consequences. In view of the age-related rise in BP in both children and adults, the direct, progressive relationship of BP with cardiovascular-renal diseases throughout the usual range of BP, and the worldwide epidemic of BP-related disease, efforts to reduce BP in nonhypertensive as well as hypertensive individuals are warranted. In nonhypertensives, dietary changes can lower BP and delay, if not prevent, hypertension. In uncomplicated stage I hypertension, dietary changes serve as initial treatment before drug therapy. In hypertensive individuals already on drug therapy, lifestyle modifications can further lower BP. The current challenge is designing and implementing effective clinical and public health interventions that lead to sustained dietary changes among individuals and more broadly in the general population. [Copyright &y& Elsevier]

Abstract: A substantial body of evidence has implicated several aspects of diet in the pathogenesis of elevated blood pressure (BP). Well-established risk factors for elevated BP include excess salt intake, low potassium intake, excess weight, high alcohol consumption, and suboptimal dietary pattern. African Americans are especially sensitive to the BP-raising effects of excess salt intake, insufficient potassium intake, and suboptimal diet. In this setting, dietary changes have the potential to substantially reduce racial disparities in BP and its consequences. In view of the age-related rise in BP in both children and adults, the direct, progressive relationship of BP with cardiovascular-renal diseases throughout the usual range of BP, and the worldwide epidemic of BP-related disease, efforts to reduce BP in nonhypertensive as well as hypertensive individuals are warranted. In nonhypertensives, dietary changes can lower BP and delay, if not prevent, hypertension. In uncomplicated stage I hypertension, dietary changes serve as initial treatment before drug therapy. In hypertensive individuals already on drug therapy, lifestyle modifications can further lower BP. The current challenge is designing and implementing effective clinical and public health interventions that lead to sustained dietary changes among individuals and more broadly in the general population. [Copyright &y& Elsevier]

Telemedicine is the provision of health care services, through the use of information and communication technology, in situations where the health care professional and the patient, or 2 health care professionals, are not in the same location. It involves the secure transmission of medical data and information, through text, sound, images, or other forms needed for the prevention, diagnosis, treatment, and follow-up of a patient. First data on implementation of telemedicine for the diagnosis and treatment of acute myocardial infarction date from more than 10 years ago. Telemedicine has a potential broad application to the cardiovascular disease continuum and in many branches of cardiology, at least including heart failure, ischemic heart disease and arrhythmias. Telemedicine might have an important role as part of a strategy for the delivery of effective health care for patients with cardiovascular disease. In this document the Working Group on Telecardiology and Informatics of the Italian Society of Cardiology intends to remark some key-points regarding potential benefit achievable with the implementation of telemedicine support in the continuum of cardiovascular disease. [ABSTRACT FROM AUTHOR]

Modern life and the Western industrial diet has enhanced the reduction of magnesium in our food, which may contribute to a marginal or absolute magnesium deficiency. Magnesium deficiency is evident in, among others, the elderly population, those after myocardial infarction and/or chronic heart failure, and diabetics. In Israel, over 60% of the drinking water originates from desalinated seawater lacking magnesium, which may cause hypomagnesemia. Magnesium deficiency can easily be treated by magnesium supplementation if we are aware of the situation. This paper summarizes the magnesium chapter in a position paper published in April 2021 by the Israeli Cardiology Society together with the Israeli Dietetic Association. It summarizes evidencebased nutritional recommendations for prevention and treatment of cardiovascular disease, with emphasis on the level of evidence and practical recommendations according to the European Society of Cardiology definitions. The best recommendation is to increase consumption of magnesium-rich food, such as leafy green vegetables (mainly spinach), nuts, avocado, whole grains, legumes (e.g., beans, peas and soy beans), chocolate and certain seafood. However, for people who do not get sufficient magnesium from their diet completing the daily amount, as needed, with supplements of up to 600 mg/day should be considered. In addition, serum magnesium levels should be checked at least every six months in patients with heart failure, people taking diuretic therapy, and people taking proton-pump inhibitors. In addition, it may be beneficial to add magnesium following myocardial infarction in people with hypertension and in heart failure patients in order to reduce cardiovascular morbidity and mortality (class of recommendation IIa, level of evidence B). [ABSTRACT FROM AUTHOR]

[Display omitted] • The electrochemical immunosensor designed very stable, low-cost and sensitive method for determination of Creatine Kinase. • CK immunosensor exhibited high analytical performance with a linear range 0.150 pg/mL and low detection limit (0.045 pg/mL). • Disposable graphite paper electrodes were firstly used to detection CK antigen for a novel biosensor system. • The optimization was performed for all fabrication steps of the electrochemical biosensor system. The enzyme creatine kinase (CK) is one of the most well-established biomarkers in cardiovascular disease. For acute myocardial infarction (AMI) diagnosis, CK has a clinical comorbidity rate of 90%. This study has developed a novel electrochemical immunosensor using disposable graphite paper electrodes (GP). The GP electrodes were modified with gold nanoparticles (AuNP) to facilitate CK detection. Afterwards, GP electrodes were covalently immobilized with 6-mercapto-1-hexanol (6-MH), resulting in self-assembled monolayers (SAMs). Then, the electrodes were formed with a 3-Glycidyloxypropyltrimethoxysilane (3-GOPE) agent. Afterwards, the electrodes were immobilized with anti-CK (antibody creatine kinase) protein. In the final immobilization step, BSA (bovine serum albumin) protein was used to block non-covalent interactions. All parameters of the proposed immunosensor were optimized, including concentrations and incubation times. Analytical characteristics such as square wave voltammetry, linear determination range, repeatability, reproducibility, and regeneration of biosensors were determined. All characterization steps were monitored by electrochemical impedance spectroscopy (EIS), cyclic voltammetry (CV). Moreover, the single frequency impedance (SFI) technique interacted with anti-CK and CK antigens. Furthermore, the proposed immunosensor was characterized using scanning electron microscopy (SEM). The proposed immunosensor exhibited a wide detection range (0.1–50 pg mL−1), and low limit of detection (LOD), and a low limit of quantification (LOQ); 0.045 pg mL−1 and 0.171 pg mL−1, respectively. Finally, the developed biosensor was tried in an actual blood sample, which showed it could be utilized in clinical applications. [ABSTRACT FROM AUTHOR]

Introduction and aim. Antiplatelet therapy constitutes a crucial part of cardiovascular disease (CVD) prevention. Although CVDs were long associated with men, we now know they critically affect women. Nevertheless, there is insufficient and inconsistent data on the effect of monotherapy with aspirin or P2Y12 inhibitor and of dual antiplatelet therapy on females. This review was conducted to summarize the current knowledge and to assess whether sex-specific antiplatelet therapy is required. Material and methods. A literature search was performed using PubMed and Mendeley. Evaluation of abstracts from databases was followed by detailed analysis of 60 papers. It was discussed i) how sex affects platelet biology and response to antiplatelet agents, ii) how sex and gender differences translate into clinical challenges and iii) how women's cardiological care might be improved. Analysis of literature. Evidence from multiple trials suggest that women and men exhibit heterogenous baseline platelet reactivity and respond to antiplatelet therapy in a different way, which is reflected by laboratory results and clinical outcomes. Sex disparities in diagnostic process, medicine prescription, therapy course and clinical outcomes have been reported, suggesting that women suffering from CVD may not receive equitable care. Conclusion. Further investigations with appropriate representation of women are required to understand the complex nature of sex-specific platelet response. As far as guidelines recommend the same treatment strategies in both sexes, there is a need to advocate equality in management of females and males with CVD. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to compare the effects of medium light roast (MLR) and medium roast (MR) paper-filtered coffee on cardiovascular risk factors in healthy volunteers. Methods: This randomized crossover trial compared the effects of consuming three or four cups (150 mL) of MLR or MR coffee per day for 4 wk in 20 healthy volunteers. Plasma lipids, lipoprotein( a) (Lp[a]), total homocysteine, and endothelial dysfunction-related inflammation biomarkers, serum glycemic biomarkers, and blood pressure were measured at baseline and after each intervention. Results: Both roasts increased plasma total cholesterol, low-density lipoprotein-cholesterol, and soluble vascular cell adhesion molecule-1 (sVCAM-1) concentrations (10%, 12%, and 18% for MLR; 12%, 14%, and 14% for MR, respectively) (P < 0.05). MR also increased high-density lipoporteincholesterol concentration by 7% (P = 0.003). Plasma fibrinogen concentration increased 8% after MR intake (P = 0.01), and soluble E-selectin increased 12% after MLR intake (P = 0.02). No changes were observed for Lp(a), total homocysteine, glycemic biomarkers, and blood pressure. Conclusion: Moderate paper-filtered coffee consumption may have an undesirable effect on plasma cholesterol and inflammation biomarkers in healthy individuals regardless of its antioxidant content. [ABSTRACT FROM AUTHOR]

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 present article for improving strategies and interventions for cardiovascular prevention in Italy represents the collaborative work of several scientific societies that recognize their own role and mission in the field of prevention of cardiovascular diseases. It originates from the need, felt in many European and non-European countries, as well as at the level of the EU, to rapidly promote strategies and interventions to better prevent cardiovascular diseases. The main reason for producing this article is represented by the growing clinical and socioeconomic impact that cardiovascular diseases will have in Italy in the next few years. This, in fact, will bring serious problems regarding the ability to sustain the entire national healthcare system in Italy. This article reviews some of the major data available on projections of cardiovascular diseases and their social and economic burden. This article represents a White Paper, and it is conceived as a new starting point, proposing general specific interventions, addressed to decision-makers, stakeholders, institutions, citizens, physicians, healthcare workers, organizations and industries. These proposals are listed, and briefly discussed, leading to the development of a 'call-to-action', aimed at reducing the incidence of cardiovascular diseases and their impact on the healthcare system, even in the short to medium term. [ABSTRACT FROM AUTHOR]

Abstract: Since heterozygous familial hypercholesterolemia (HeFH) is a disease that exposes the individual from birth onwards to severe hypercholesterolemia with the development of early cardiovascular disease, a clear consensus on the management of this disease in young patients is necessary. In Belgium, a panel of paediatricians, specialists in (adult) lipid management, general practitioners and representatives of the FH patient organization agreed on the following common recommendations. [1.] Screening for HeFH should be performed only in children older than 2 years when HeFH has been identified or is suspected (based on a genetic test or clinical criteria) in one parent. [2.] The diagnostic procedure includes, as a first step, the establishment of a clear diagnosis of HeFH in one of the parents. If this precondition is satisfied, a low-density-lipoprotein cholesterol (LDL-C) level above 3.5mmol/L (135mg/dL) in the suspected child is predictive for differentiating affected from non-affected children. [3.] A low saturated fat and low cholesterol diet should be started after 2 years, under the supervision of a dietician or nutritionist. [4.] The pharmacological treatment, using statins as first line drugs, should usually be started after 10 years if LDL-C levels remain above 5mmol/L (190mg/dL), or above 4mmol/L (160mg/dL) in the presence of a causative mutation, a family history of early cardiovascular disease or severe risk factors. The objective is to reduce LDL-C by at least 30% between 10 and 14 years and, thereafter, to reach LDL-C levels of less than 3.4mmol/L (130mg/dL). Conclusion: The aim of this consensus statement is to achieve more consistent management in the identification and treatment of children with HeFH in Belgium. [Copyright &y& Elsevier]

Summary The modern scientific study of physical activity began soon after World War II and focused on the epidemic of cardiovascular disease that was beginning to engulf the Western world. Early ‘exercise prescriptions’ then specified intense bouts of vigorous activity as the most effective way to maintain cardiovascular fitness and ‘heart health’. Doctors and other health professionals then grew concerned that progressively fewer individuals were heeding this advice at a time when physical activity from manual work was becoming less common. Evidence was also emerging in the late 1980s that the value of accumulated, moderately intense activities, now of increasing importance during leisure time, may have been overlooked, or at least underplayed, in the prevention of heart disease, diabetes and some cancers. Perhaps in population terms adherence to moderate ‘lifestyle’ activities would be better than to the earlier vigorous recommendations. Social policy therefore shifted in the United States in 1996; the US Surgeon General's report set out the basic public health message of ‘30 min of moderate activity five, and preferably all, days of the week’. This recommendation was broadly adopted throughout much of the Western world. How this change in health strategy might impact on unhealthy weight gain and the growing obesity epidemic was given little attention. Here we examine how post-war public health policy in physical activity developed in an attempt primarily to prevent cardiovascular disease. In the following article we examine why too little attention may have been given to unhealthy weight gain and investigate how this may have happened. Then we consider how much physical activity – and of what kind – is needed to prevent unhealthy weight gain. [ABSTRACT FROM AUTHOR]

Objective: To scope how the Australian Bureau of Statistics Socio-Economic Indexes for Areas (SEIFA) has been applied to measure socio-economic status (SES) in peer-reviewed cardiovascular disease (CVD) research. Methods: The Joanna Briggs Institute's scoping review methodology was used. Results: The search retrieved 2788 unique citations, and 49 studies were included. Studies were heterogeneous in their approach to analysis using SEIFA. Not all studies provided information as to what version was used and how SEIFA was applied in analysis. Spatial unit of analysis varied between studies, with participant postcode most frequently applied. Study quality varied. Conclusions: The use of SEIFA in Australian CVD peer-reviewed research is widespread, with variations in the application of SEIFA to measure SES as an exposure. There is a need to improve the reporting of how SEIFA is applied in the methods sections of research papers for greater transparency and to ensure accurate interpretation of CVD research. What is known about the topic? A socio-economic status (SES) gradient is well established for cardiovascular disease (CVD). Research has generally applied two approaches to classifying SES: at an individual level using income, education or occupation data, and at an area level using a range of existing socio-economic information, including the Australian Bureau of Statistics (ABS) Socio-Economic Indexes for Areas (SEIFA). What does this paper add? This review examined how SEIFA has been applied to measure SES in Australian peer-reviewed CVD research and to identify any variations in research practice. What are the implications for practitioners? It is recommended that researchers provide a clear explanation in the methods section of research papers as to which SEIFA version and index was applied, how it was applied, at what spatial unit, and whether the spatial unit was an ABS or non-ABS unit. [ABSTRACT FROM AUTHOR]