Exercise for Prevention and Relief of Cardiovascular Disease: Prognoses, Mechanisms, and Approaches

Agglomerated serum albumin adsorbed protocatechuic acid coated superparamagnetic iron oxide nanoparticles as a theranostic agent

Iron oxide nanoparticles have been one of the most widely used nanomaterials in biomedical applications. However, the incomplete understanding of the toxicity mechanisms limits their use in diagnosis and treatment processes. Many parameters are associated with their toxicity such as size, surface modification, solubility, concentration and immunogenicity. Further research needs to be done to address toxicity-related concerns and to increase its effectiveness in various applications. Herein, colloidally stable nanoparticles were prepared by coating magnetic iron oxide nanoparticles (MIONPs) with protocatechuic acid (PCA) which served as a stabilizer and a linkage for a further functional layer. A new perfusion agent with magnetic imaging capability was produced by the adsorption of biocompatible passivating agent macro-aggregated albumin (MAA) on the PCA-coated MIONPs. PCA-coated MIONPs were investigated using infrared spectroscopy, thermogravimetric analysis and dynamic light scattering while adsorption of MAA was analysed by transmission electron microscopy, Fourier-transform infrared spectroscopy and x-ray diffraction methods. Magnetic measurements of samples indicated that all samples showed superparamagnetic behaviour. Cytotoxicity results revealed that the adsorption of MAA onto PCA-coated MIONPs provided an advantage by diminishing their toxicity against the L929 mouse fibroblast cell line compared to bare Fe₃O₄.

Moderate-Intensity Exercise Maintains Redox Homeostasis for Cardiovascular Health

It is well known that exercise is beneficial for cardiovascular health. Oxidative stress is the common pathological basis of many cardiovascular diseases. The overproduction of free radicals, both reactive oxygen species and reactive nitrogen species, can lead to redox imbalance and exacerbate oxidative damage to the cardiovascular system. Maintaining redox homeostasis and enhancing anti-oxidative capacity are critical mechanisms by which exercise protects against cardiovascular diseases. Moderate-intensity exercise is an effective means to maintain cardiovascular redox homeostasis. Moderate-intensity exercise reduces the risk of cardiovascular disease by improving mitochondrial function and anti-oxidative capacity. It also attenuates adverse cardiac remodeling and enhances cardiac function. This paper reviews the primary mechanisms of moderate-intensity exercise-mediated redox homeostasis in the cardiovascular system. Exploring the role of exercise-mediated redox homeostasis in the cardiovascular system is of great significance to the prevention and treatment of cardiovascular diseases.

Benefits in Cardiac Function from a Remote Exercise Program in Children with Obesity

Physical activity (PA) is a crucial factor in preventing and treating obesity and related complications. In this one-arm pre−post longitudinal prospective study, we evaluated the effects of a 12-week online supervised training program on cardiac morphology, function and blood pressure (BP) in children with obesity. The training program consisted of three sessions per week, each lasting 60 min. Advanced echocardiographic imaging (tissue Doppler and longitudinal strain analysis) was used to detect subclinical changes in heart function. Categorical variables were described as counts and percentages; quantitative variables as the mean and standard deviation (SD) as they were normally distributed (Shapiro−Wilks test). Pre−post comparisons were made with a paired t-test. A total of 27/38 (71%) enrolled patients (18M/9F, 11 ± 2 years) completed the training protocol and were considered in the analysis. At baseline, no hypertensive patient was noted; all echocardiographic variables were within the normal range. After training, we observed a significant reduction in BP parameters, including systolic BP values and Z-score, diastolic BP values, centiles and Z-score, and mean arterial pressure (all p < 0.05). Significant variations in echocardiographic interventricular septum (IVSd) thickness (p = 0.011), IVSd Z-score (p = 0.001), left ventricular (LV) end-diastolic diameter (p = 0.045), LV posterior wall thickness Z-score (p = 0.017), and LV global longitudinal strain (p = 0.016) were detected. No differences in LV diastolic function and right ventricular strain were noted. PA plays a decisive role in improving BP control and has benefits on left ventricle systolic function, representing a strategic approach to limit CV risk. Online exercise could be an excellent method of training in children with obesity.

Prevalence of physical activity levels and perceived benefits of and barriers to physical activity among Jordanian patients with coronary heart disease: A cross-sectional study

Background

Many studies published in other countries have identified certain perceived benefits of and barriers to physical activity among patients with coronary heart disease. Nevertheless, there is no data about the issue relating to Jordanian patients with coronary heart disease.

Objective

This study aimed to describe the prevalence of levels of physical activity, the benefits of and barriers to physical activity as perceived by Jordanian patients with coronary heart disease, and the relationship between physical activity and perceived benefits of and barriers to physical activity. In addition, it focused on examining the influence of selected sociodemographic and health characteristics on physical activity and the perceived benefits of and barriers to physical activity.

Methods

A cross-sectional design was performed on a sample of 400 patients with coronary heart disease. They were given a list of perceived benefits of and barriers to physical activity and asked to what extent they disagreed or agreed with each.

Results

Jordanian patients with coronary heart disease perceived various benefits of and barriers to physical activity. Most of these benefits were physiologically related (average mean = 5.7, SD = 0.7). The most substantial barriers to physical activity as perceived by the patients were "feeling anxiety," "not enough time," "lack of interest," "bad weather," and "feeling of being uncomfortable." Sociodemographic and health characteristics that significantly influenced perceived barriers to physical activity were age, gender, health perception, chest pain frequency, education, job, caring responsibilities, ability to travel alone, smoking, and previous and current physical activity behavior.

Conclusion

This study demonstrates that patients with coronary heart disease have perceived physiological benefits of physical activity and have perceived motivational, physical health, and environmental barriers to physical activity, which is significant in developing intervention strategies that aim to maximize patients' participation in physical activity and overcome barriers to physical activity.

VH-4-A Bioactive Peptide from Soybean and Exercise Training Constrict Hypertension in Rats through Activating Cell Survival and AMPKα1, Sirt1, PGC1α, and FoX3α

Hypertension is a chronic disease related to age, which affects tens of millions of people around the world. It is an important risk factor that causes myocardial infarction, heart failure, stroke, and kidney damage. Bioactive peptide VHVV (VH-4) from soybean has shown several biological activities. Physical exercise is a cornerstone of non-pharmacologic treatment for hypertension and has established itself as an effective and complementary strategy for managing hypertension. The present study evaluates the efficacy of VH-4 supplement and swimming exercise training in preventing hypertension in spontaneously hypertensive rats (SHR). SHR animals were treated with VH-4 (25 mg/kg by intraperitoneal administration) and swimming exercise (1 h daily) for eight weeks, and the hemodynamic parameters, histology, and cell survival pathway protein expression were examined. In SHR rats, increased heart weight, blood pressure, and histological aberrations were observed. Cell survival protein p-PI3K and p-AKT and antiapoptosis proteins Bcl2 and Bcl-XL expression decreased in SHR animals. SIRT1 and FOXO3 were decreased in hypertensive rats. Both bioactive peptide VH-4 treatment and swimming exercise training in hypertensive rats increased the cell survival proteins p-PI3K and p-AKT and AMPKα1, Sirt1, PGC1α, and FoX3α proteins. Soy peptide VH-4, along with exercise, acts synergistically and prevents hypertension by activating cell survival and AMPKα1, Sirt1, PGC1α, and FoX3α proteins.

Estrogen signaling as a bridge between the nucleus and mitochondria in cardiovascular diseases

Cardiovascular diseases (CVDs) are the leading cause of morbidity and mortality worldwide. Epidemiological studies indicate that pre-menopausal women are more protected against the development of CVDs compared to men of the same age. This effect is attributed to the action/effects of sex steroid hormones on the cardiovascular system. In this context, estrogen modulates cardiovascular function in physiological and pathological conditions, being one of the main physiological cardioprotective agents. Here we describe the common pathways and mechanisms by which estrogens modulate the retrograde and anterograde communication between the nucleus and mitochondria, highlighting the role of genomic and non-genomic pathways mediated by estrogen receptors. Additionally, we discuss the presumable role of bromodomain-containing protein 4 (BRD4) in enhancing mitochondrial biogenesis and function in different CVD models and how this protein could act as a master regulator of estrogen protective activity. Altogether, this review focuses on estrogenic control in gene expression and molecular pathways, how this activity governs nucleus-mitochondria communication, and its projection for a future generation of strategies in CVDs treatment.

Irisin, an Effective Treatment for Cardiovascular Diseases?

Irisin, as one of the myokines induced by exercise, has attracted much attention due to its important physiological functions such as white fat browning, the improvement in metabolism, and the alleviation of inflammation. Despite the positive role that irisin has been proven to play in the prevention and treatment of cardiovascular diseases, whether it can become a biomarker and potential target for predicting and treating cardiovascular diseases remains controversial, given the unreliability of its detection methods, the uncertainty of its receptors, and the species differences between animals and humans. This paper was intended to review the role of irisin in the diagnosis and treatment of cardiovascular diseases, the potential molecular mechanism, and the urgent problems to be solved in hopes of advancing our understanding of irisin as well as providing data for the development of new and promising intervention strategies by discussing the causes of contradictory results.

The Path of a Cardiac Patient-From the First Symptoms to Diagnosis to Treatment: Experiences from the Tertiary Care Center in Poland

Cardiovascular diseases (CVDs) are major concerns in the healthcare system. An individual diagnostic approach and personalized therapy are key areas of an effective therapeutic process. The major aims of this study were: (1) to assess leading patient problems related to symptoms, diagnosis, and treatment of CVDs, (2) to examine patients' opinions about the healthcare system in Poland, and (3) to provide a proposal of practical solutions. The 27-point author's questionnaire was distributed in the Cardiology Department of the Tertiary Care Centre between 2nd September-13th November 2021. A total of 132 patients were recruited, and 82 (62.12%; nmale = 37, 45.12%; nfemale = 45, 54.88%) was finally included. The most common CVDs were arrhythmias and hypertension (both n = 43, 52.44%). 23 (28.05%) patients had an online appointment. Of the patients, 66 (80.49%) positively assessed and obtained treatment, while 11 (13.41%) patients declared they received a missed therapy. The participants identified: (1) waiting time (n = 31; 37.80%), (2) diagnostic process (n = 18; 21.95%), and (3) high price with limited availability of drugs (n = 12; 14.63%) as the areas that needed the strongest improvement. Younger patients more often negatively assessed doctor visits (30-40 yr.; p = 0.02) and hospital interventions (40-50 yr.; p = 0.008). Older patients (50-60 years old) less often negatively assessed the therapeutic process (p = 0.01). The knowledge of the factors determining patient adherence to treatment and satisfaction by Medical Professionals is crucial in providing effective treatment. Areas that require the strongest improvement are: (1) waiting time for an appointment and diagnosis, (2) limited availability and price of drugs, and (3) prolonged, complicated diagnostic process. Providing practical solutions is a crucial aspect of improving CVDs therapy.

The economic imperatives for technology enabled wellness centered healthcare

A 2020 World Health Organization report underscored the impact of rising healthcare spending globally and questioned the long-term economic sustainability of current funding models. Increases in costs associated with care of late-stage irreversible diseases and the increasing prevalence of debilitating neurodegenerative disorders, coupled with increases in life expectancy are likely to overload the healthcare systems in many nations within the next decade if not addressed. One option for sustainability of the healthcare system is a change in emphasis from illness to wellness centered care. An attractive model is the P4 (Predictive, Preventative, Personalized and Participatory) medicine approach. Recent advances in connected health technology can help accelerate this transition; they offer prediction, diagnosis, and monitoring of health-related parameters. We explain how to integrate such technologies with conventional approaches and guide public health policy toward wellness-based care models and strategies to relieve the escalating economic burdens of managed care.

The Impact of Exercise on Redox Equilibrium in Cardiovascular Diseases

Cardiovascular diseases constitute the most important public health problem in the world. They are characterized by inflammation and oxidative stress in the heart and blood. Physical activity is recognized as one of the best ways to prevent these diseases, and it has already been applied in treatment. Physical exercise, both aerobic and anaerobic and single and multiple, is linked to the oxidant–antioxidant imbalance; however, this leads to positive adaptive changes in, among others, the increase in antioxidant capacity. The goal of the paper was to discuss the issue of redox equilibrium in the human organism in the course of cardiovascular diseases to systemize updated knowledge in the context of exercise impacts on the organism. Antioxidant supplementation is also an important issue since antioxidant supplements still have great potential regarding their use as drugs in these diseases.

Effects of antipsychotics on triglyceride trajectories and its implications in CVD: A longitudinal cohort study

Background

Although the association between short-term antipsychotics exposure and triglycerides (TG) levels has been confirmed, the effects of long-term antipsychotics exposure on TG trajectories and its implications in cardiovascular disease (CVD) remains largely unknown.

Methods

A total of 39,988 participants with at least 3 TG measurements between January 2014 and February 2021 were included in this longitudinal study, with a median follow-up was 4.48 years. A latent class growth mixed model (LCGMM) was used to identify TG trajectories. Based on the LCGMM parameters, we calculated the area under the curve (AUC) and estimated the effect of antipsychotics on AUC and TG trajectory slopes. The primary outcome was CVD events. We also investigated and compared the association between antipsychotics and CVD in subgroups stratified by TG trajectory and TG levels.

Findings

A total of 11,543 CVD events were documented and the incidence density was 64.64 per 1000 person-years. We identified two TG trajectories labeled as inverse-U shape (30.77%, n=12306) and low-decreasing (69.23%, n=27682). The antipsychotic exposure increased total AUC by 13% and increased the slopes of TG trajectories before age 48 years. In the inverse-U and low-decreasing group, the adjusted hazard ratios (HRs) and 95% confidence intervals (CI) for antipsychotics associated with CVD were 1.40 (1.21-1.62) and 1.29 (1.14-1.45), respectively, and the difference between the two trajectory groups become larger with the increase of the antipsychotic exposure. The association of antipsychotics with CVD (HR=1.72, 95%CI: 1.36-2.19) in inverse-U trajectory and high TG group was stronger than that in other subgroups.

Interpretation

Long-term antipsychotic exposure increased the TG burden and TG increase rate early in life. The strength of the association between antipsychotics and CVD risk in the inverse-U group was stronger than that in the low-decreasing group.

Funding

The National Key Research and Development Program of China, Shandong Province Major Science and Technology Innovation Project, and National Natural Science Foundation of China.

Metabolic syndrome: Operational definitions and aerobic and resistance training benefits on physical and metabolic health in children and adolescents

BACKGROUND

The variation in parameters for childhood metabolic syndrome (MetS) has hindered the development of a consensus for the diagnostic criteria in this group. Despite these inconsistencies, it is accepted that exercise can ameliorate the deleterious effects of MetS. However, direct comparison between aerobic versus resistance exercise on MetS symptomology in adolescents is lacking.

AIM

Aim of this review was to discuss controversies associated with current MetS operation definitions in adolescents and present a review summarizing longitudinal studies relevant to the influence of aerobic and resistance training on children with MetS.

METHODS

Reviews of PubMed and Web of Science were conducted to identify literature focusing on the influence of aerobic and resistance training on children with MetS. Selected manuscripts featured longitudinal research only.

RESULTS

A universally accepted definition of MetS for the pediatric population has yet to be established. As such, consensus regarding diagnostic criteria for MetS among children is lacking despite the presence of various descriptions in the literature. Though studies support the importance of aerobic and resistance exercise to combat comorbidities associated with MetS, longitudinal studies investigating the benefits of each exercise type among adolescents are limited and inconsistent.

CONCLUSION

An improved understanding of the impact of aerobic and resistance training on children with MetS is clinically relevant because it may facilitate more appropriate exercise recommendations for children with MetS. Additional large cohort studies are warranted to determine optimal exercise type.

Women Have Lower Mortality Than Men After Attending a Long-Term Medically Supervised Exercise Program

PURPOSE

Medically supervised exercise programs (MSEPs) are equally recommended for men and women with cardiovascular disease (CVD). Aware of the lower CVD mortality in women, we hypothesized that among patients attending a MSEP, women would also have better survival.

METHODS

Data from men and women, who were enrolled in a MSEP between 1994 and 2018, were retrospectively analyzed. Sessions included aerobic, resistance, flexibility and balance exercises, and cardiopulmonary exercise test was performed. Date and underlying cause of death were obtained. Kaplan-Meier methods and Cox proportional hazards regression were used for survival analysis.

RESULTS

A total of 2236 participants (66% men, age range 33-85 yr) attended a median of 52 (18, 172) exercise sessions, and 23% died during 11 (6, 16) yr of follow-up. In both sexes, CVD was the leading cause of death (39%). Overall, women had a more favorable clinical profile and a longer survival compared to men (HR = 0.71: 95% CI, 0.58-0.85; P < .01). When considering those with coronary artery disease and similar clinical profile, although women had a lower percentage of sex- and age-predicted maximal oxygen uptake at baseline than men (58 vs 78%; P < .01), after adjusting for age, women still had a better long-term survival (HR = 0.68: 95% CI, 0.49-0.93; P = .02).

CONCLUSION

Survival after attendance to a long-term MSEP was better among women, despite lower baseline cardiorespiratory fitness. Future studies should address whether men and women would similarly benefit when participating in an MSEP.

Understanding factors influencing uptake of healthy lifestyle practices among adults following a community cardiovascular disease prevention programme in Mukono and Buikwe districts in Uganda: A qualitative study

Introduction

Healthy lifestyle practices including physical activity, healthy diets, non-smoking, reduced alcohol consumption and stress reduction are important in the prevention of metabollic CVD risk factors such as hypertension, overweight and obesity, diabetes and hyperlipidaemia. Owing to current lifestyle changes, the increasing burden of CVD and importance of healthy behaviours, the need for strategies to increase uptake of healthy lifestyles among sub-Saharan African populations are apparent. This study explored the factors influencing uptake of healthy lifestyle practices among adults following implementation of a community CVD prevention programme.

Methods

This was a descriptive qualitative study conducted among purposively selected adults who had engaged in a community CVD prevention programme. Data were collected using in-depth interviews, which were audio recorded and transcribed verbatim. Study transcripts were read into NVIVO 12.6 software for coding and analysis guided by thematic analysis following the semantic approach.

Results

This study found variations in uptake of healthy lifestyle practices for CVD prevention with most changes reported for dietary behaviour especially in vegetable and fruit intake, reduction of salt intake and fats and oils consumption. Changes in physical activity were also notable. On the other hand, participants were slow in making changes in alcohol consumption, smoking behaviours and stress reduction. The barriers to uptake of healthy lifestyle practices were individual such as limited capability or skills, structural such as limited physical activity facilities, and social such as cultural and peer influence. Relatedly, the facilitators of practices uptake were individual including knowledge and personal determination to change, and social including social support from family and the community.

Conclusions

Insights from understanding the uptake of lifestyle practices should guide planning and design of community programmes with an emphasis on removing barriers and strengthening facilitators building on the intermediate motivating factors and considering individual needs and expectations.

Exercise training worsens cardiac performance in males but does not change ejection fraction and improves hypertrophy in females in a mouse model of metabolic syndrome

BACKGROUND

Metabolic syndrome (MetS) refers to a cluster of co-existing cardio-metabolic risk factors, including visceral obesity, dyslipidemia, hyperglycemia with insulin resistance, and hypertension. As there is a close link between MetS and cardiovascular diseases, we aimed to investigate the sex-based differences in MetS-associated heart failure (HF) and cardiovascular response to regular exercise training (ET).

METHODS

High-fat diet-fed male and female APOB-100 transgenic (HFD/APOB-100, 3 months) mice were used as MetS models, and age- and sex-matched C57BL/6 wild-type mice on standard diet served as healthy controls (SD/WT). Both the SD/WT and HFD/APOB-100 mice were divided into sedentary and ET groups, the latter running on a treadmill (0.9 km/h) for 45 min 5 times per week for 7 months. At month 9, transthoracic echocardiography was performed to monitor cardiac function and morphology. At the termination of the experiment at month 10, blood was collected for serum low-density lipoprotein (LDL)- and high-density lipoprotein (HDL)-cholesterol measurements and homeostatic assessment model for insulin resistance (HOMA-IR) calculation. Cardiomyocyte hypertrophy and fibrosis were assessed by histology. Left ventricular expressions of selected genes associated with metabolism, inflammation, and stress response were investigated by qPCR.

RESULTS

Both HFD/APOB-100 males and females developed obesity and hypercholesterolemia; however, only males showed insulin resistance. ET did not change these metabolic parameters. HFD/APOB-100 males showed echocardiographic signs of mild HF with dilated ventricles and thinner walls, whereas females presented the beginning of left ventricular hypertrophy. In response to ET, SD/WT males developed increased left ventricular volumes, whereas females responded with physiologic hypertrophy. Exercise-trained HFD/APOB-100 males presented worsening HF with reduced ejection fraction; however, ET did not change the ejection fraction and reversed the echocardiographic signs of left ventricular hypertrophy in HFD/APOB-100 females. The left ventricular expression of the leptin receptor was higher in females than males in the SD/WT groups. Left ventricular expression levels of stress response-related genes were higher in the exercise-trained HFD/APOB-100 males and exercise-trained SD/WT females than exercise-trained SD/WT males.

CONCLUSIONS

HFD/APOB-100 mice showed sex-specific cardiovascular responses to MetS and ET; however, left ventricular gene expressions were similar between the groups except for leptin receptor and several stress response-related genes.

The Dynamic Interplay of Healthy Lifestyle Behaviors for Cardiovascular Health

PURPOSE OF REVIEW

The recent rise in cardiovascular disease (CVD) deaths in the USA has sparked interest in identifying and implementing effective strategies to reverse this trend. Healthy lifestyle behaviors (i.e., healthy diet, regular physical activity, achieve and maintain a healthy weight, avoid tobacco exposure, good quality sleep, avoiding and managing stress) are the cornerstone for CVD prevention.

RECENT FINDINGS

Achieving all of these behaviors significantly benefits heart health; however, even small changes lower CVD risk. Moreover, there is interplay among healthy lifestyle behaviors where changing one may result in concomitant changes in another behavior. In contrast, the presence of one or more unhealthy lifestyle behaviors may attenuate changing another lifestyle behavior(s) (poor diet, inadequate physical activity, overweight/obesity, poor sleep quality, tobacco exposure, and poor stress management). It is important to assess all of these lifestyle behaviors with patients to plan an intervention program that is best positioned for adherence.

Evaluation of Health-Promoting Behaviors in the Prevention of Cardiovascular Diseases in the Preschool Children of Polish Health Care Professionals

BACKGROUND

The aim of the study was to evaluate the health-promoting behavior of the preschool children (aged 3-6 y) of Polish health care professionals (HCPs).

METHODS

The study was conducted by means of quantitative research on a group of 386 individuals, using an Internet-based survey.

RESULTS

The ideal cardiovascular health model was determined in the case of 22 children (5.6%). The collected data revealed that, when regarding the recommended level of physical activity, children from HCP families meet the American Heart Association criteria much more often than their peers from other study populations (56.5% vs. 16.6%). In our study, more girls than boys participated in organized activities (60.2% vs. 50.3%, p = 0.05). There was no correlation between achieving adequate levels of physical activity and the BMI (p > 0.1). Overweight children had a more balanced diet than children with a normal body weight (p = 0.009).

CONCLUSIONS

The obtained results allowed us to make the conclusion that there is a need to implement educational and preventive measures on a large scale, while some health-promoting behaviors, especially those concerning proper nutrition, require major modifications, even in HCP families.

Cardiovascular Risk Factors and Physical Activity for the Prevention of Cardiovascular Diseases in the Elderly

Cardiovascular diseases create an important burden on the public health systems, especially in the elderly, mostly because this group of patients frequently suffer from multiple comorbidities. Accumulating cardiovascular risk factors during their lifetime has a detrimental effect on an older adult's health status. The modifiable and non-modifiable cardiovascular risk factors are very diverse, and are frequently in a close relationship with the metabolic comorbidities of the elderly, mainly obesity and Diabetes Mellitus. In this review, we aim to present the most important cardiovascular risk factors which link aging and cardiovascular diseases, starting from the pathophysiological links between these factors and the aging process. Next, we will further review the main interconnections between obesity and Diabetes Mellitus and cardiovascular diseases of the elderly. Lastly, we consider the most important aspects related to prevention through lifestyle changes and physical activity on the occurrence of cardiovascular diseases in the elderly.

Association between Health-Related Physical Fitness and Risk of Dyslipidemia in University Staff: A Cross-Sectional Study and a ROC Curve Analysis

Background: This study aimed to assess the relationship between dyslipidemia (DL) risk and health-related physical fitness (HPF) and evaluated the prognostic value of HPF for risk of DL. Methods: A total of 776 university staff members were recruited, of which 407 were females, and 369 males. Blood samples and HPF tests were collected from all participants after 12 h fasting. Results: The prevalence of DL was 41.77% and 51.49% in female and male university staff members, respectively, and there was no significant difference between genders (χ2 = 2.687, p = 0.101). According to the logistic regression analysis, age, male sex, GLU, hypertension, BMI, BF, WHtR, and LAP were significant risk factors for DL (p < 0.05), VCI and, SAR were significant protective factors for DL (p < 0.05), and SMI, GS, and VG were not significantly associated with the risk of DL. The area under the receiver-operating characteristic (ROC) curve (AUC) analysis indicated that, LAP (AUC: 0.730, 95CI%: 0.697–0.762), WHtR (AUC: 0.626, 95CI%: 0.590–0.660), and BMI (AUC: 0.599, 95CI%: 0.563–0.634) are valid predictors of DL, and LAP and WHtR perform better than BMI (Z = 8.074, p < 0.001) in predicting DL in male and female university staff members. Conclusion: The risk of DL is significantly related to body composition, cardiorespiratory fitness, and flexibility. LAP and WHtR perform better than BMI in predicting risk of DL in male and female university staff members.

The Dose-Response Relationships of Different Dimensions of Physical Activity with Daily Physical Function and Cognitive Function in Chinese Adults with Hypertension: A Cross-Sectional Study

OBJECTIVE

The purpose of this study was to explore the dose-response relationships of different dimensions of physical activity (intensity, time, frequency, capacity, and metabolic equivalent) with daily physical function (DPF) and cognitive function (CF) in Chinese adults with hypertension.

METHODS

The 6216 hypertensive patients included in this study were from the China Health and Retirement Longitudinal Study (CHARLS), which was conducted in 2015. Physical activity (PA) was divided into vigorous PA (VPA), moderate PA (MPA), and light PA (LPA). Linear regression models and binary logistic regression models were established to assess the associations with indicators.

RESULTS

Patients with VPA have a lower probability of impaired DPF; however, patients with VPA had lower CF scores. Patients with nearly all the aspects of MPA have lower rates of impaired DPF and higher CF scores (p < 0.05). Patients with LPA have a lower probability of impaired DPF and higher CF scores. In addition, patients with between 1800 and 2999 MET-minutes per week had the lowest rates of impaired DPF (OR = 0.10, 95% CI 0.02, 0.39) and the highest CF scores (β = 3.28, 95% CI 2.25, 4.31).

CONCLUSIONS

This study found that patients with hypertension with moderate-intensity physical activity (nearly all aspects) and LPA had better DPF and CF. The best daily physical function and CF was with METs of 1800-2999 min per week. However, VPA should be recommended with caution in Chinese adults with hypertension.

Ethyl acetate fraction of Cola hispida leaf protects against doxorubicin-induced myocardial injury in male albino rats

Background

Cardiovascular diseases have continued to be the leading cause of death globally. In addition, some of the drugs used in the treatment of the diseases present some adverse effects which limit the usefulness of such drugs. Thus, there is a need for novel drugs whose side effect is either minimal or non-existent. The presence of bioactive compounds in Cola hispida leaf is of great significance in the treatment and management of cardiovascular conditions. This study investigated the cardio-protective potential against doxorubicin (Dox)-induced cardiac infarction in rats.

Results

Dox induction resulted to muscle fiber degeneration in Dox-treated rats hence revealed significant (p < 0.05) elevation in the serum level of cardio biomarker enzymes and lipid peroxidation profile while significant (p < 0.05) fall in cardiac enzymatic antioxidant levels were observed relative to the normal control. Pre-treatment with ethyl acetate fraction of Cola hispida leaf expressed cardio-protective potentials against Dox-induced cardiotoxicity by significantly (p < 0.05) lowering the levels of cardiac biomarker enzymes towards normal, building up the activities of subdued antioxidant enzymes and depleting its malondialdehyde level. Histopathology photomicrograph of the heart tissues expressed myxomatous degeneration but was ameliorated through the administration of the fraction.

Conclusion

In accordance with the findings from this study, the administration of ethyl acetate fraction of Cola hispida leaf is effective against Dox-induced redox imbalance due to its enriched antioxidant phytoconstituents.

Long Non-Coding RNAs in Cardiovascular Diseases: Potential Function as Biomarkers and Therapeutic Targets of Exercise Training

Despite advances in treatments and therapies, cardiovascular diseases (CVDs) remain one of the leading causes of death worldwide. The discovery that most of the human genome, although transcribed, does not encode proteins was crucial for focusing on the potential of long non-coding RNAs (lncRNAs) as essential regulators of cell function at the epigenetic, transcriptional, and post-transcriptional levels. This class of non-coding RNAs is related to the pathophysiology of the cardiovascular system. The different expression profiles of lncRNAs, in different contexts of CVDs, change a great potential in their use as a biomarker and targets of therapeutic intervention. Furthermore, regular physical exercise plays a protective role against CVDs; on the other hand, little is known about its underlying molecular mechanisms. In this review, we look at the accumulated knowledge on lncRNAs and their functions in the cardiovascular system, focusing on the cardiovascular pathology of arterial hypertension, coronary heart disease, acute myocardial infarction, and heart failure. We discuss the potential of these molecules as biomarkers for clinical use, their limitations, and how the manipulation of the expression profile of these transcripts through physical exercise can begin to be suggested as a strategy for the treatment of CVDs.

Women's Lives Matter-The Critical Need for Women to Prioritize Optimal Physical Activity to Reduce COVID-19 Illness Risk and Severity

Physical activity (PA) is beneficial for the health and wellness of individuals and societies. During an infectious disease pandemic, such as the one caused by COVID-19, social distancing, quarantines, and lockdowns are used to reduce community spread of the disease. Unfortunately, such nonpharmacological interventions or physical risk mitigation measures also make it challenging to engage in PA. Reduced PA could then trigger physiological changes that affect both mental and physical health. In this regard, women are more likely to experience physical and psychological distress. PA is a safe and effective nonpharmacological modality that can help prevent and manage several mental and physical health problems when performed correctly. PA might even confer benefits that are directly related to decreasing COVID-19 morbidity and mortality in women. In this review, we summarize why optimal PA must be a priority for women during the COVID-19 pandemic. We then discuss chronic COVID-19 illness and its impact on women, which further underscores the need for worldwide preventive health strategies that include PA. Finally, we discuss the importance of vaccination against COVID-19 for women, as part of prioritizing preventive healthcare and an active lifestyle.

Nordic Walking at Maximal Fat Oxidation Intensity Decreases Circulating Asprosin and Visceral Obesity in Women With Metabolic Disorders

OBJECTIVE

Excess visceral adipose tissue is associated with insulin resistance and other metabolic disorders, including deregulation of adipokine secretion, which may be corrected by aerobic exercise training. Asprosin is a novel adipokine responsible for the regulation of appetite and the release of glucose from the liver, and its levels are pathologically elevated in obesity. The aim of the study was to evaluate the effects of 8-week Nordic walking (NW) training at maximal fat oxidation intensity (FAT max ) on changes in body mass, as well as those in insulin resistance and asprosin levels among young women with visceral obesity and metabolic disorders.

MATERIALS AND METHODS

The study was completed by 14 women (30.14 ± 3.63 years) representing low levels of physical activity, visceral obesity (waist circumference 105.50 ± 14.87 cm, BMI 33.85 ± 5.48 kg/m2) and with metabolic disorders, who for 8 weeks (three times a week, 60 min), participated in NW training at the FAT max intensity (61.92 ± 6.71% HR max , 42.33 ± 8.69% VO2max) controlled on the basis of heart rate (114.21 ± 14.10 bpm).

RESULTS

After 4 and 8 weeks of NW training, a significant decrease in the concentration of asprosin, waist and hip circumference (HC), waist-to-height ratio and body adiposity index (BAI) (p < 0.05, large effect size) were found.

CONCLUSION

The 8-week NW training at an FAT max intensity decreases the concentration of asprosin in the blood as well as visceral obesity in young women with metabolic disorders.

Effects of Continuous Yoga on Body Composition in Obese Adolescents

Overweight/obesity is a pressing international health concern, and conventional treatments demonstrate poor long-term efficacy. Several studies have shown that yoga can control risk factors for cardiovascular disease, obesity, and psychosocial stress. The present study aimed to assess the effect of continuous yoga (asanas, pranayama, and Surya Namaskar yoga) on body composition in overweight participants. Forty adolescents with obesity were enrolled in this study. The study was conceived as a prospective, single-center, single-blinded randomized controlled trial. The participants were divided into 2 groups: the intervention group (n = 20), which undertook a continuous yoga practice, and the control group (n = 20). Body composition, including body weight (BW), body mass index (BMI), body fat mass (BFM), and muscle mass, was evaluated using tetrapolar bioelectrical impedance (BIA). Our results showed that the mean BMI and BFM of the yoga intervention group were significantly decreased at week 8 and week 12. The muscle mass of the yoga group continued to improve at a rate of 0.515 per week, which was statistically significant. In conclusion, a continuous yoga practice had a tendency to decrease BMI and BFM and increase muscle mass. These findings demonstrate intervention effectiveness similar to that observed in other clinical research and indicate that continuous yoga practice may be used as an alternative therapy for obesity prevention and health promotion in adolescents with obesity.

Self-Reported Modifiable Risk Factors of Cardiovascular Disease among Older Adults in Malaysia: A Cross-Sectional Study of Prevalence and Clustering

The co-occurrence of multiple modifiable risk factors increases the risk of cardiovascular disease (CVD) morbidity or mortality. This study examines the prevalence and clustering of self-reported modifiable CVD risk factors among older adults in Malaysia. A total of 7117 adults aged ≥50 years participated in the National Health and Morbidity Survey (NHMS) 2018: Elderly Health, a community-based cross-sectional survey. Data were collected using a standardized structured questionnaire. Multivariable logistic regression was used to determine the factors associated with the clustering of self-reported modifiable CVD risk factors. The prevalence of self-reported diabetes, hypertension, hypercholesterolemia, overweight/obesity, and current smoking was 23.3%, 42.2%, 35.6%, 58.4%, and 17.5%, respectively. Overall, the prevalence of clustering of ≥1, ≥2, and ≥3 modifiable CVD risk factors was 83.3%, 75.4%, and 62.6%, respectively. Multivariable logistic regression analysis showed that men, 60–69 age group, urban dwellers, having no formal education, unemployed/retirees/homemakers, and being physically inactive were independently associated with self-reported modifiable CVD risk factors clustering. There are also ethnic differences in self-reported modifiable CVD risk factors clustering. Our findings underscore the necessity of targeted interventions and integrated strategies for early detection and treatment of modifiable CVD risk factors among older adults, considering age, sex, ethnicity, and socioeconomic status.

Food Addiction, Saturated Fat Intake, and Body Mass Index in Peruvian Adults: A Cross-Sectional Survey

Background

Cardiovascular diseases (CVDs) constitute one of the main public health problems and represent a greater risk of mortality and morbidity for the world population. The objective of the study was to determine food addiction, saturated fat intake, and body mass index (BMI) in Peruvian adults.

Materials and Methods

A cross-sectional online survey was applied to 394 Peruvian adults over 18 years old residing in the three regions of the country. Participant data was collected through a prestructured online electronic survey. Food addiction was assessed using the Yale Food Addiction Scale self-administered questionnaire. A validated food frequency questionnaire was used to measure saturated fat intake. Finally, the sociodemographic and anthropometric variables were collected through a registration form.

Results

There were no significant differences in food addiction between men and women (p < 0.05). More than half of the participants who presented food addiction are overweight (54.1%, p < 0.001). The highest proportion of those who had a high intake of saturated fat had a food addiction (62.6%, p < 0.001). The highest percentage of men who were overweight was higher compared to women (49.7% vs. 38.4%, p < 0.05).

Conclusion

The findings of this study suggest that addictive eating behaviors and high saturated fat intake should be considered as part of efforts to prevent problems related to eating, obesity, and CVD.

[Physical exercise impact on variables related to emotional and functional well-being in older adults]

BACKGROUND AND AIM

The benefits of the physical exercise in aging, and specially in frailty, have been associated with reduced risk of mortality, chronic disease, and cognitive and functional impairments. Multi-component training, which combines strength, endurance, balance, and gait training, represents the most beneficial kind of physical exercise in older adults.

METHODS

Given the effectiveness of the multi-component training, a physical exercise program «Actívate» (based on the methodology Vivifrail), with the focus on «active aging», was conducted in the present study. Forty-nine older adults over 60 years participated in this program.

RESULTS

The physical exercise intervention led to a reduction in diastolic blood pressure, pain threshold and sleep disturbances (e. g. hypersomnia) (t ≥ 2.72, p < 0.01), as well as an increase of walking speed (t = 7.84, p ≤ 0.001). Further, quality of life factors (GENCAT scale), like emotional well-being, personal development, physical well-being, self-determination, and social inclusion, were greater after intervention (t ≥ -2.06, p < 0.05).

CONCLUSIONS

These findings underline the benefits of multi-component training in functionality of older adults, and further, provide relevant aspects about the modulation of pain perception, sleep disturbances, social factors and physical and emotional well-being. Physical exercise programs such as «Actívate» should be promoted, in order to encourage healthy lifestyle habits, in the older adults' population.

Association of exercise participation levels with cardiometabolic health and quality of life in individuals with hepatitis C

Objective

Hepatitis C virus (HCV) infection is associated with an increased risk of cardiovascular disease (CVD) and reduced health-related quality of life (HRQoL). Although physical activity (PA)/exercise has been shown to reduce CVD risk and improve HRQoL in patients with liver disease, there is limited data in HCV. We aimed to explore the association between PA/exercise levels, CVD risk and HRQoL in patients with HCV and assess individuals’ attitudes to PA/exercise.

Design

Cross-sectional observational study recruiting consecutive patients with HCV from viral hepatitis clinics. Data were collected on CVD risk factors, anthropometry, HRQoL and the Exercise Benefits and Barriers Scale (EBBS).

Results

86 patients were recruited (71% men, 94% white, age 52±13 years); 49% of the cohort self-reported to be currently active. Although HRQoL was reduced across the cohort, patients that were regularly ‘active’ reported significantly higher HRQoL scores across Short-Form 36v2 domains compared with their inactive counterparts (p<0.05). Metabolic and cardiovascular characteristics were no different between groups stratified by PA/exercise status (p>0.05). EBBS scores were similar in the ‘active’ versus ‘inactive’ groups, however, patients categorised as ‘active’ scored significantly higher on the psychological outlook and social interaction subscales (p<0.05) than those that were ‘inactive’. There were significant associations between EBBS scores and HRQoL (p<0.05).

Conclusions

PA/exercise is associated with increased HRQoL in patients with HCV irrespective of clinical parameters. Addressing specific motivators/barriers to exercise for patients will be key to designing effective PA/exercise interventions in this patient population to ensure maximum uptake and adherence.

Exercise-mitigated sex-based differences in aging: from genetic alterations to heart performance

The prevalence of cardiovascular diseases dramatically increases with age; therefore, striving to maintain a physiological heart function is particularly important. Our aim was to study the voluntary exercise-evoked cardioprotective effects in aged male and female rats, from genetic alterations to changes in heart performance. We divided 20-month-old female and male Wistar rats to control and running groups. After the 12-wk-long experimental period, echocardiographic measurements were performed. Afterwards, hearts were either removed for biochemical measurements or mounted into a Langendorff-perfusion system to detect infarct size. The following genes and their proteins were analyzed from heart: catechol-O-methyltransferase (Comt), endothelin-1 (Esm1), Purkinje cell protein-4 (Pcp4), and osteoglycin (Ogn). Recreational exercise caused functional improvements; however, changes were more prominent in males. Cardiac expression of Comt and Ogn was reduced as a result of exercise in aged males, whereas Pcp4 and Esm1 showed a marked overexpression, along with a markedly improved diastolic function. The key result of this study is that exercise enhanced the expression of the Pcp4 gene and protein, a recently described regulator of calcium balance in cardiomyocytes, and suppressed Comt and Ogn gene expression, which has been associated with impaired cardiac function. In addition, as a result of exercise, a significant improvement was observed in the size of infarct elicited by left anterior descending coronary artery occlusion. Our results clearly show that age and sex-dependent changes were both apparent in key proteins linked to cardiovascular physiology. Exercise-moderated fundamental genetic alterations may have contributed to the functional adaptation of the heart.NEW & NOTEWORTHY Voluntary exercise has proved to be an effective therapeutic tool to improve cardiac function in aged rats with clearly visible sex differences. Long-term exercise is associated with decreased Ogn and Comt expression and enhanced presence of Pcp4 and Esm1 genes. Sex-dependent changes were also observed in the expression of the cardiovascular key proteins. Fundamental alterations in gene and protein expression may contribute to the improvement of cardiac performance.

The effectiveness of exercise training in treating venous thromboembolism: a systematic review

This study aims to (1) evaluate the clinical safety of an exercise-based rehabilitation intervention for patients with venous thromboembolism (VTE); (2) separately summarize the effects of exercise training in deep vein thrombosis (DVT), pulmonary embolism (PE) and postthrombotic syndrome (PTS) survivors; and (3) identify commonly used exercise prescriptions and describe treatment progression. The Medline, Cochrane Library, and Embase databases were searched for randomized control trials and cohort studies published prior to February 2020 comparing exercise training interventions with non-exercise interventions for patients with VTE. Two reviewers independently reviewed and appraised the risk of bias of each study. Nine articles were included for review, five of which were randomized clinical trials, while three were prospective cohort studies, and one was a retrospective cohort trial. The results showed that exercise-based rehabilitation training was safe for patients diagnosed with VTE, including patients with DVT, PE, and PTS, but offered limited evidence to support the use of regular exercise as an intervention to improve exercise capacity in patients with VTE. Exercise-based rehabilitation in VTE survivors is clearly an emerging field with a lack of large, adequately powered randomized controlled trials. Existing evidence suggests that exercise is safe, but evidence to support exercise therapy as a replacement for standard care in all VTE patients is insufficient. Prescription and progression patterns should be tailored for individuals based on health conditions and functional deficits.

Impact of Physical Activity and Weight Loss on Fat Mass, Glucose Metabolism, and Inflammation in Older African Americans with Osteoarthritis

(1) Background: There are currently very few interventions performed within a community setting that compare the effects of physical activity (PA) versus PA plus weight loss on cancer and chronic disease risk in older African Americans. Therefore, we investigated the impact of an 8 week (24 session) PA intervention compared to a PA plus weight loss intervention on fat mass, glucose metabolism, and markers of inflammation in older, overweight and obese African Americans. (2) Methods: Subjects were randomized to a PA (n = 83) or PA plus weight loss (n = 72) intervention that met three times weekly for 8 weeks. At baseline and post-intervention, anthropometrics, body composition, systemic inflammation (high-sensitivity C-reactive protein, tumor necrosis factor-α, and interleukin 6), fasting glucose, insulin and homeostasis model assessment-insulin resistance (HOMA-IR) were determined. (3) Results: Subjects had a mean age of 67 years (SD = 5.3) and were mostly women (88%). The PA plus weight loss group lost more total and visceral fat than the PA group (−4.0% vs. +0.6% and −4.1% vs. +3.7%, respectively, p < 0.01 for both). Changes in inflammation and glucose metabolism were similar between groups post-intervention. Within the PA plus weight loss group only, serum insulin and HOMA-IR decreased significantly. (4) Conclusions: PA combined with weight loss can decrease total and visceral fat mass and improve insulin sensitivity, confirming that these cancer- and chronic disease-related risk factors are influenced by relatively modest lifestyle changes in the short term.

Gut microbiome and cardiovascular disease

PURPOSE OF REVIEW

This review aims to highlight the association between gut microbiome and cardiovascular disease (CVD) with emphasis on the possible molecular mechanisms by which how gut microbiome contributes to CVD.

RECENT FINDINGS

Increasingly, the roles of gut microbiome in cardiovascular health and disease have gained much attention. Most of the investigations focus on how the gut dysbiosis contributes to CVD risk factors and which gut microbial-derived metabolites mediate such effects.

SUMMARY

In this review, we discuss the molecular mechanisms of gut microbiome contributing to CVD, which include gut microbes translocalization to aortic artery because of gut barrier defect to initiate inflammation and microbial-derived metabolites inducing inflammation-signaling pathway and renal insufficiency. Specifically, we categorize beneficial and deleterious microbial-derived metabolites in cardiovascular health. We also summarize recent findings in the gut microbiome modulation of drug efficacy in treatment of CVD and the microbiome mechanisms by which how physical exercise ameliorates cardiovascular health. Gut microbiome has become an essential component of cardiovascular research and a crucial consideration factor in cardiovascular health and disease.

Eating behavior affects cardio-metabolic risk in high school teenagers in a developing country

BACKGROUND Modernization negatively changes lifestyle, characterized by excessive eating and reduced energy consumption, and concurrently increases the cardiometabolic risk. This study was aimed to evaluate the association between eating behavior and cardio-metabolic risk factors including body mass index (BMI) in percentile, blood pressure (BP) in percentile, waist circumference, and heart rate in total subjects and gender sub-groups. METHODS This analytical cross-sectional study was done from July to November 2018. High schools in four provinces of Indonesia and students were selected using purposive sampling. Subjects’ profiles were collected from interview and cardio-metabolic parameters were measured at the study sites. Data were analyzed with chi-square and independent t-test. RESULTS Subjects who were overweight/obese and had high BP accounted for 27.1% and 9.3–12.0% of the total subjects (n = 768), respectively. Subjects who having breakfast tended to have lower BMI (p = 0.006), and the lower consumption of western meals had lower heart rate (p = 0.02). Male subjects had more meal frequency and had less quantity of snacks than female subjects (p<0.001). Male subjects with routine intake of vegetables had low heart rate (p = 0.03). Female subjects with routine breakfast had better BMI (p<0.001), and lower diastolic BP (p = 0.004) and waist circumference (p = 0.02), whereas those who consumed Western meals had higher heart rate (p = 0.046) and waist circumference (p = 0.001). CONCLUSIONS Eating behaviors are likely to affect cardio-metabolic risk factors, and the effects vary within gender groups.

Exercise-Induced Regulation of Redox Status in Cardiovascular Diseases: The Role of Exercise Training and Detraining

Although low levels of reactive oxygen species (ROS) are beneficial for the organism ensuring normal cell and vascular function, the overproduction of ROS and increased oxidative stress levels play a significant role in the onset and progression of cardiovascular diseases (CVDs). This paper aims at providing a thorough review of the available literature investigating the effects of acute and chronic exercise training and detraining on redox regulation, in the context of CVDs. An acute bout of either cardiovascular or resistance exercise training induces a transient oxidative stress and inflammatory response accompanied by reduced antioxidant capacity and enhanced oxidative damage. There is evidence showing that these responses to exercise are proportional to exercise intensity and inversely related to an individual’s physical conditioning status. However, when chronically performed, both types of exercise amplify the antioxidant defense mechanism, reduce oxidative stress and preserve redox status. On the other hand, detraining results in maladaptations within a time-frame that depends on the exercise training intensity and mode, as high-intensity training is superior to low-intensity and resistance training is superior to cardiovascular training in preserving exercise-induced adaptations during detraining periods. Collectively, these findings suggest that exercise training, either cardiovascular or resistance or even a combination of them, is a promising, safe and efficient tool in the prevention and treatment of CVDs.

Measuring physical performance in university students

Physical activity could be an effective way to prevent obesity and cardiovascular disease.

OBJECTIVE

The aim of our study was to evaluate physical performance in Chinese university students to offer a basis for preventing obesity.

METHODS

A cross-sectional study was conducted for evaluate physical performance, including the standing long jump, 50-meter dash, and pull-up/sit-up test.

RESULTS

The overall mean time of the 50-meter dash, standing long jump distance, and mean number of pull-ups was 7.98 seconds, 2.2773 meters, and 4.1041, respectively. For female students, the overall mean time for the 50-meter dash, standing long jump distance, and mean number of sit-ups was 9.89 seconds, 2.6191 meters, and 26.7997, respectively.

CONCLUSION

Our study suggests that physical performance in Chinese university students is poor; related departments should pay more attention to the physical health of university students.