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Bedarida T, Baron S, Vessieres E, Vibert F, Ayer A, Marchiol-Fournigault C, Henrion D, Paul JL, Noble F, Golmard JL, Beaudeux JL, Cottart CH, Nivet-Antoine V. High-protein-low-carbohydrate diet: deleterious metabolic and cardiovascular effects depend on age. Am J Physiol Heart Circ Physiol 2014; 307:H649-57. [PMID: 25015969 DOI: 10.1152/ajpheart.00291.2014] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
High-protein-low-carbohydrate (HP-LC) diets have become widespread. Yet their deleterious consequences, especially on glucose metabolism and arteries, have already been underlined. Our previous study (2) has already shown glucose intolerance with major arterial dysfunction in very old mice subjected to an HP-LC diet. The hypothesis of this work was that this diet had an age-dependent deleterious metabolic and cardiovascular outcome. Two groups of mice, young and adult (3 and 6 mo old), were subjected for 12 wk to a standard or to an HP-LC diet. Glucose and lipid metabolism was studied. The cardiovascular system was explored from the functional stage with Doppler-echography to the molecular stage (arterial reactivity, mRNA, immunohistochemistry). Young mice did not exhibit any significant metabolic modification, whereas adult mice presented marked glucose intolerance associated with an increase in resistin and triglyceride levels. These metabolic disturbances were responsible for cardiovascular damages only in adult mice, with decreased aortic distensibility and left ventricle dysfunction. These seemed to be the consequence of arterial dysfunctions. Mesenteric arteries were the worst affected with a major oxidative stress, whereas aorta function seemed to be maintained with an appreciable role of cyclooxygenase-2 to preserve endothelial function. This study highlights for the first time the age-dependent deleterious effects of an HP-LC diet on metabolism, with glucose intolerance and lipid disorders and vascular (especially microvessels) and cardiac functions. This work shows that HP-LC lead to equivalent cardiovascular alterations, as observed in very old age, and underlines the danger of such diet.
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Affiliation(s)
- Tatiana Bedarida
- Unite Mixte de Recherche-S 1140 Institut National de la Santé et de la Recherche Médicale, Faculty of Pharmacy, Paris Descartes University, Paris, France
| | - Stephanie Baron
- Department of Physiology, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Unite Mixte de Recherche-S U970 Institut National de la Santé et de la Recherche Médicale, Faculty of Medicine, Paris Descartes University, Paris, France;
| | - Emilie Vessieres
- Centre National de la Recherche Scientifique Unite Mixte de Recherche 6214, Institut National de la Santé et de la Recherche Médicale U1083, Angers University, Angers, France
| | - Francoise Vibert
- Unite Mixte de Recherche-S 1139 Institut National de la Santé et de la Recherche Médicale, Faculty of Pharmacy, Paris Descartes University, Paris, France
| | - Audrey Ayer
- Centre National de la Recherche Scientifique Unite Mixte de Recherche 6214, Institut National de la Santé et de la Recherche Médicale U1083, Angers University, Angers, France
| | | | - Daniel Henrion
- Centre National de la Recherche Scientifique Unite Mixte de Recherche 6214, Institut National de la Santé et de la Recherche Médicale U1083, Angers University, Angers, France
| | - Jean-Louis Paul
- Department of Biochemistry, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; EA 4529, Faculty of Pharmacy, Paris Sud University, Chatenay-Malabry, France
| | - Florence Noble
- Institut National de la Santé et de la Recherche Médicale 705 Centre National de la Recherche Scientifique Unite Mixte de Recherche 8206, Faculty of Pharmacy, Paris Descartes University, Paris, France
| | - Jean-Louis Golmard
- ER4/EA 3974, Modeling in Clinical Research, Pierre and Marie Curie University, Paris, France
| | - Jean-Louis Beaudeux
- Unite Mixte de Recherche-S 1139 Institut National de la Santé et de la Recherche Médicale, Faculty of Pharmacy, Paris Descartes University, Paris, France; Clinical Biochemistry, Necker Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Charles-Henry Cottart
- Unite Mixte de Recherche-S 1139 Institut National de la Santé et de la Recherche Médicale, Faculty of Pharmacy, Paris Descartes University, Paris, France; Unite Mixte de Recherche 1151 Institut National de la Santé et de la Recherche Médicale, Institut Necker-Enfants Malades, Paris Descartes University, Paris, France
| | - Valerie Nivet-Antoine
- Unite Mixte de Recherche-S 1140 Institut National de la Santé et de la Recherche Médicale, Faculty of Pharmacy, Paris Descartes University, Paris, France; Department of Biochemistry, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
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Abstract
Atrial fibrillation (AF) is a common clinical problem in elderly patients and especially in those with heart failure (HF). It is a major risk factor for serious cardiovascular events, such as stroke, HF and premature death. Both the prevalence and incidence of AF increase with age and its prevalence in the United States are estimated at more than 2.2 million, with nearly 75% of patients aged >65 years. Aging-related atrial remodeling with fibrosis, dilation and mitochondrial DNA mutations predispose elderly patients to AF. Current management options for AF, including rate control and anticoagulation therapy, can be successfully applied to the elderly population. New antiarrhythmic and anticoagulation medications such as dronedarone and dabigatran, respectively, can impact the approach to therapy in the elderly. Non-pharmacological options such as catheter-based ablation have also gained prominence and have been incorporated into the guidelines for management of AF. However, more trials in the elderly and very elderly segments are needed to clarify the safety and long-term efficacy of the new treatment options.
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Dhalla NS, Rangi S, Babick AP, Zieroth S, Elimban V. Cardiac remodeling and subcellular defects in heart failure due to myocardial infarction and aging. Heart Fail Rev 2013; 17:671-81. [PMID: 21850540 DOI: 10.1007/s10741-011-9278-7] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Although several risk factors including hypertension, cardiac hypertrophy, coronary artery disease, and diabetes are known to result in heart failure, elderly subjects are more susceptible to myocardial infarction and more likely to develop heart failure. This article is intended to discuss that cardiac dysfunction in hearts failing due to myocardial infarction and aging is associated with cardiac remodeling and defects in the subcellular organelles such as sarcolemma (SL), sarcoplasmic reticulum (SR), and myofibrils. Despite some differences in the pattern of heart failure due to myocardial infarction and aging with respect to their etiology and sequence of events, evidence has been presented to show that subcellular remodeling plays a critical role in the occurrence of intracellular Ca(2+)-overload and development of cardiac dysfunction in both types of failing heart. In particular, alterations in gene expression for SL and SR proteins induce Ca(2+)-handling abnormalities in cardiomyocytes, whereas those for myofibrillar proteins impair the interaction of Ca(2+) with myofibrils in hearts failing due to myocardial infarction and aging. In addition, different phosphorylation mechanisms, which regulate the activities of Ca(2+)-cycling proteins in SL and SR membranes as well as Ca(2+)-binding proteins in myofibrils, become defective in the failing heart. Accordingly, it is suggested that subcellular remodeling involving defects in Ca(2+)-handling and Ca(2+)-binding proteins as well as their regulatory mechanisms is intimately associated with cardiac remodeling and heart failure due to myocardial infarction and aging.
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Affiliation(s)
- Naranjan S Dhalla
- Institute of Cardiovascular Sciences, St. Boniface General Hospital Research Centre, 351 Tache Avenue, Winnipeg, MB, Canada.
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Man JP, Epstein AE. Ventricular arrhythmias: device therapy and ablation. Clin Geriatr Med 2012; 28:679-91. [PMID: 23101577 DOI: 10.1016/j.cger.2012.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
There are few randomized, well-controlled studies to guide decision making with respect to the treatment of ventricular arrhythmias in the elderly treated with either device implantation or catheter ablation. Although some data are conflicting, the elderly appear to have a greater degree of risk related to treatment compared with younger ones; however, this increased risk is in part a consequence of age itself and comorbid conditions. Conversely, in terms of benefit, although the data may again be mixed, there is ample information indicating that age should not contraindicate aggressive treatment when accepted indications for intervention exist.
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Affiliation(s)
- Jonathan P Man
- Electrophysiology Section, Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania, 3400 Spruce Street, 9 Founders Pavilion, Philadelphia, PA 19104, USA
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Nair S, Ren J. Autophagy and cardiovascular aging: lesson learned from rapamycin. Cell Cycle 2012; 11:2092-9. [PMID: 22580468 DOI: 10.4161/cc.20317] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
The biological aging process is commonly associated with increased risk of cardiovascular diseases. Several theories have been put forward for aging-associated deterioration in ventricular function, including attenuation of growth hormone (insulin-like growth factors and insulin) signaling, loss of DNA replication and repair, histone acetylation and accumulation of reactive oxygen species. Recent evidence has depicted a rather unique role of autophagy as another important pathway in the regulation of longevity and senescence. Autophagy is a predominant cytoprotective (rather than self-destructive) process. It carries a prominent role in determination of lifespan. Reduced autophagy has been associated with aging, leading to accumulation of dysfunctional or damaged proteins and organelles. To the contrary, measures such as caloric restriction and exercise may promote autophagy to delay aging and associated comorbidities. Stimulation of autophagy using rapamycin may represent a novel strategy to prolong lifespan and combat aging-associated diseases. Rapamycin regulates autophagy through inhibition of the nutrient-sensing molecule mammalian target of rapamycin (mTOR). Inhibition of mTOR through rapamycin and caloric restriction promotes longevity. The purpose of this review is to recapitulate some of the recent advances in an effort to better understand the interplay between rapamycin-induced autophagy and decelerating cardiovascular aging.
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Affiliation(s)
- Sreejayan Nair
- Division of Pharmaceutical Sciences and Center for Cardiovascular Research and Alternative Medicine, University of Wyoming, Laramie, WY USA.
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Jugdutt BI. Clinical effectiveness of telmisartan alone or in combination therapy for controlling blood pressure and vascular risk in the elderly. Clin Interv Aging 2010; 5:403-16. [PMID: 21152242 PMCID: PMC2998248 DOI: 10.2147/cia.s6709] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Elderly patients (age ≥ 65 years) with hypertension are at high risk for vascular complications, especially when diabetes is present. Antihypertensive drugs that inhibit the renin-angiotensin system have been shown to be effective for controlling blood pressure in adult and elderly patients. Importantly, renin-angiotensin system inhibitors were shown to have benefits beyond their classic cardioprotective and vasculoprotective effects, including reducing the risk of new-onset diabetes and associated cardiovascular effects. The discovery that the renin-angiotensin system inhibitor and angiotensin II type 1 (AT(1)) receptor blocker (ARB), telmisartan, can selectively activate the peroxisome proliferator-activated receptor-γ (PPARγ, an established antidiabetic drug target) provides the unique opportunity to prevent and treat cardiovascular complications in high-risk elderly patients with hypertension and new-onset diabetes. Two large clinical trials, ONTARGET (Ongoing Telmisartan Alone in combination with Ramipril Global Endpoint Trial) and TRANSCEND (Telmisartan Randomized AssessmeNt Study in ACE-I iNtolerant subjects with cardiovascular disease) have assessed the cardioprotective and antidiabetic effects of telmisartan. The collective data suggest that telmisartan is a promising drug for controlling hypertension and reducing vascular risk in high-risk elderly patients with new-onset diabetes.
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Affiliation(s)
- Bodh I Jugdutt
- Division of Cardiology, Department of Medicine, University of Alberta and Hospital, Edmonton, Canada.
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