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Kuchi Bhotla H, Meyyazhagan A, Pushparaj K, Pappuswamy M, Chaudhary A, Arumugam VA, Balasubramanian B, Ragu Varman D, Orlacchio A, Rengasamy KRR. Prevalence of Cardiovascular Diseases in South Asians: Scrutinizing Traditional Risk Factors and Newly Recognized Risk Factors Sarcopenia and Osteopenia/Osteoporosis. Curr Probl Cardiol 2024; 49:102071. [PMID: 37690535 DOI: 10.1016/j.cpcardiol.2023.102071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 09/04/2023] [Indexed: 09/12/2023]
Abstract
One of the primary reasons for complications and death worldwide are cardiovascular diseases (CVDs), with a death toll of approximately 18 million per year. CVDs include cardiomyopathy, hypertension, ischemic heart disease, coronary heart disease, myocardial infarction, heart attack, hearth failure, etc. Over 80% of the CVD mortality is recorded from lower and middle-income countries. Records from the past decade have highlighted the increase of CVDs among the South Asian populations, and the prime purpose of the review is to jot down the reasons for the steep spike in CVDs. Studies analyzing the causative factors for the increase of CVDs in South Asians are still to be verified. Apart from known predisposing and lifestyle factors, other emerging risk factors associated with CVDs, namely the musculoskeletal diseases sarcopenia and osteopenia, should be tracked to tackle research gaps in upcoming analyses. This requires loads of scientific efforts. With proper monitoring, the raising alarm that the CVD burden generates can be reduced. This review discusses the already established signs and recognizes important clues to the emerging etiology of CVDs in the Asian population and prevention measures to keep it at bay.
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Affiliation(s)
- Haripriya Kuchi Bhotla
- Department of Life Science, CHRIST (Deemed to be University), Bengaluru, Karnataka, India
| | - Arun Meyyazhagan
- Department of Life Science, CHRIST (Deemed to be University), Bengaluru, Karnataka, India; Dipartimento di Medicina e Chirurgia, Università di Perugia, Perugia, Italy
| | - Karthika Pushparaj
- Department of Zoology, School of Biosciences, Avinashilingam Institute for Home Science and Higher Education for Women, Coimbatore, Tamil Nadu, India
| | - Manikantan Pappuswamy
- Department of Life Science, CHRIST (Deemed to be University), Bengaluru, Karnataka, India
| | - Aditi Chaudhary
- Department of Life Science, CHRIST (Deemed to be University), Bengaluru, Karnataka, India
| | - Vijaya Anand Arumugam
- Department of Human Genetics and Molecular Biology, Bharathiar University, Coimbatore, Tamil Nadu, India
| | | | - Durairaj Ragu Varman
- Department of Pharmacology and Toxicology, School of Medicine, Virginia Commonwealth University, Richmond, VA
| | - Antonio Orlacchio
- Laboratorio di Neurogenetica, Centro Europeo di Ricerca sul Cervello (CERC), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Santa Lucia, Rome, Italy; Dipartimento di Medicina e Chirurgia, Università di Perugia, Perugia, Italy
| | - Kannan R R Rengasamy
- Laboratory of Natural Products and Medicinal Chemistry (LNPMC), Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS), Thandalam, Chennai, India.
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Flora GD, Nayak MK. A Brief Review of Cardiovascular Diseases, Associated Risk Factors and Current Treatment Regimes. Curr Pharm Des 2020; 25:4063-4084. [PMID: 31553287 DOI: 10.2174/1381612825666190925163827] [Citation(s) in RCA: 177] [Impact Index Per Article: 44.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 09/16/2019] [Indexed: 12/22/2022]
Abstract
Cardiovascular diseases (CVDs) are the leading cause of premature death and disability in humans and their incidence is on the rise globally. Given their substantial contribution towards the escalating costs of health care, CVDs also generate a high socio-economic burden in the general population. The underlying pathogenesis and progression associated with nearly all CVDs are predominantly of atherosclerotic origin that leads to the development of coronary artery disease, cerebrovascular disease, venous thromboembolism and, peripheral vascular disease, subsequently causing myocardial infarction, cardiac arrhythmias or stroke. The aetiological risk factors leading to the onset of CVDs are well recognized and include hyperlipidaemia, hypertension, diabetes, obesity, smoking and, lack of physical activity. They collectively represent more than 90% of the CVD risks in all epidemiological studies. Despite high fatality rate of CVDs, the identification and careful prevention of the underlying risk factors can significantly reduce the global epidemic of CVDs. Beside making favorable lifestyle modifications, primary regimes for the prevention and treatment of CVDs include lipid-lowering drugs, antihypertensives, antiplatelet and anticoagulation therapies. Despite their effectiveness, significant gaps in the treatment of CVDs remain. In this review, we discuss the epidemiology and pathology of the major CVDs that are prevalent globally. We also determine the contribution of well-recognized risk factors towards the development of CVDs and the prevention strategies. In the end, therapies for the control and treatment of CVDs are discussed.
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Affiliation(s)
- Gagan D Flora
- Department of Internal Medicine, University of Iowa, Iowa City, IA 52242, United States
| | - Manasa K Nayak
- Department of Internal Medicine, University of Iowa, Iowa City, IA 52242, United States
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Soenarta AA, Buranakitjaroen P, Chia Y, Chen C, Nailes J, Hoshide S, Minh HV, Park S, Shin J, Siddique S, Sison J, Sogunuru GP, Sukonthasarn A, Tay JC, Teo BW, Turana Y, Verma N, Wang T, Zhang Y, Wang J, Kario K. An overview of hypertension and cardiac involvement in Asia: Focus on heart failure. J Clin Hypertens (Greenwich) 2020; 22:423-430. [PMID: 31955506 PMCID: PMC8029815 DOI: 10.1111/jch.13753] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 09/22/2019] [Indexed: 08/31/2023]
Abstract
Cardiovascular Disease (CVD) is the leading cause of deaths worldwide, contributing to about 30% of all deaths. Half of the cases of CVD are estimated in Asia, the world's most populous continent. Hypertension, a major modifiable risk factor for CVD, results in more deaths than any other CV risk factors in the Asian regions. The total number of patients with hypertension is likely to grow as the population ages. The proportion of the elderly population aged 65 years or more in Asia is expected to increase from 7.4% in 2015 to 10.9% in 2030. It is important to note that more than half (54%) of the world's population live in Asia. Aside of being the biggest single risk factor for global deaths, hypertension is also an important precursor and most common risk factor of heart failure (HF). An increase in HF prevalence is clearly related to the rapid epidemiological transition caused by changes in lifestyle in Asian countries. However, the availability of data on HF burden and health care delivery is limited in Asia compared with Europe and North America. This reality has driven the working group of Asian experts for example the HOPE Asia Network to concentrate on hypertension as risk factors for CVD, with the mission to improve the management of hypertension resulting in organ protection toward a goal of achieving "ZERO" CV event in Asia. This paper aims to give an overview regarding the heart problems caused by hypertension in Asia, focus on HF.
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Affiliation(s)
- Arieska Ann Soenarta
- Department of Cardiology and Vascular MedicineFaculty of MedicineUniversity of Indonesia‐National Cardiovascular CenterJakartaIndonesia
| | - Peera Buranakitjaroen
- Department of MedicineFaculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Yook‐Chin Chia
- Department of Medical SciencesSchool of Healthcare and Medical SciencesSunway UniversityBandar SunwayMalaysia
- Department of Primary Care MedicineFaculty of MedicineUniversity of MalayaKuala, LumpurMalaysia
| | - Chen‐Huan Chen
- Department of MedicineSchool of Medicine National Yang‐Ming UniversityTaipeiTaiwan
| | - Jennifer Nailes
- University of the East Ramon Magsaysay Memorial Medical Center Inc.Quezon CityPhilippines
| | - Satoshi Hoshide
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | - Huynh Van Minh
- Department of Internal MedicineUniversity of Medicine and PharmacyHue UniversityHue CityVietnam
| | - Sungha Park
- Division of CardiologyCardiovascular HospitalYonsei Health SystemSeoulKorea
| | - Jinho Shin
- Faculty of Cardiology ServiceHanyang University Medical CenterSeoulKorea
| | | | - Jorge Sison
- Section of CardiologyDepartment of MedicineMedical Center ManilaManilaPhilippines
| | - Guru Prasad Sogunuru
- MIOT International HospitalChennaiIndia
- College of Medical SciencesKathmandu UniversityBharatpurNepal
| | - Apichard Sukonthasarn
- Cardiology DivisionDepartment of Internal MedicineFaculty of MedicineChiang Mai UniversityChiang MaiThailand
| | - Jam Chin Tay
- Department of General MedicineTan Tock Seng HospitalSingapore CitySingapore
| | - Boon Wee Teo
- Division of Nephrology Department of MedicineYong Loo Lin School of MedicineSingapore CitySingapore
| | - Yuda Turana
- Faculty of Medicine and Health SciencesAtma Jaya Catholic University of IndonesiaJakartaIndonesia
| | - Narsingh Verma
- Department of PhysiologyKing George's Medical UniversityLucknowIndia
| | - Tzung‐Dau Wang
- Department of Internal MedicineNational Taiwan University College of MedicineTaipei CityTaiwan
| | - Yu‐Qing Zhang
- Divisions of Hypertension and Heart FailureFu Wai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Ji‐Guang Wang
- Department of HypertensionCentre for Epidemiological Studies and Clinical TrialsShanghai Key Laboratory of HypertensionThe Shanghai Institute of HypertensionRuijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Kazuomi Kario
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
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Sharma A, Singh AP, Harikumar SL. Development and optimization of nanoemulsion based gel for enhanced transdermal delivery of nitrendipine using box-behnken statistical design. Drug Dev Ind Pharm 2020; 46:329-342. [PMID: 31976777 DOI: 10.1080/03639045.2020.1721527] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Objective: The purpose of present research was to develop and statistically optimize nitrendipine nanoemulsion gel for transdermal delivery using box-behnken statistical design.Method: The nanoemulsion formulations bearing nitrendipine were prepared by application of ternary phase diagram and spontaneous emulsification method. Box-behnken design was employed for the optimization of nitrendipine loaded nanoemulsion. The independent variables were oil, surfactant and co-surfactant while globule size, drug content and zeta potential were dependent variables. The optimized nanoemulsion formulation was incorporated into gel and evaluated for in-vitro release, ex-vivo permeation studies, confocal laser scanning microscopy, skin irritation and histopathological studies.Results: The optimized formulation through box-behnken statistical design showed globule size of 20.43 ± 1.50 nm, drug content of 97.05 ± 1.77% and zeta potential of -15.45 ± 0.35 mV. The ex-vivo study confirmed the enhanced delivery of nitrendipine from nanoemulsion gel than compare to drug solution by virtue of better permeation and solubility. Nanoemulsion gel was proved significantly superior by confocal laser scanning microscopy for satisfactory permeation and distribution of gel, deep into the rat skin. The optimized gel was found with no allergic dermal effects and was proved safe by histopathological studies for transdermal application.Conclusions: Results reveals that developed nitrendipine nanoemulsion gel overcomes the limitation of low penetration and accentuate permeation through albino Wistar rat skin. It was concluded that nanoemulsion gel could be utilized as a potential carrier for transdermal delivery of nitrendipine.
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Affiliation(s)
- Abhishek Sharma
- Research scholar, I.K. Gujral Punjab Technical University, Jalandhar, India
| | - A P Singh
- Research and Development, I.K. Gujral Punjab Technical University, Jalandhar, India
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Venkataraman R, Rashid M, Shashikantha B, Soumya A, Vijayan G, Manuel GG, Islam S. Prescribing pattern of antihypertensive medication and adherence to Joint National Commission-8 guidelines in a rural tertiary care Indian teaching hospital. J Basic Clin Physiol Pharmacol 2019; 31:jbcpp-2019-0133. [PMID: 31503542 DOI: 10.1515/jbcpp-2019-0133] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 07/12/2019] [Indexed: 12/26/2022]
Abstract
Background Antihypertensive medications are one among the most highly used drugs across the globe as well as in India, and their prescribing pattern will be erratic despite the various clinical guidelines. Few studies address the pattern and adherence to the standard treatment guidelines in India. This study aimed to review the prescribing pattern of antihypertensive medications in a rural tertiary care teaching Indian hospital and to investigate the adherence to the Joint National Commission-8 (JNC-8) guidelines on prevention, detection, evaluation, and treatment of hypertension in adults. Methods A prospective observational study was conducted among the participants from four different inpatient wards who are aged >18 years, without gender restriction. The prescription pattern was reviewed and adherence to the JNC-8 guidelines was also assessed. A purposive sampling technique was adopted and descriptive statistics were used in Statistical Package for the Social Sciences v16. Results Of the 101 participants included in the study, 62 (61.39%) were female, 23.76% were aged <30 and >60 years, and the other 52.48% belong to the range of 30-60 years. As per JNC-8 guidelines, 4.95%, 17.82%, 44.55%, and 32.67% of patients were classified as normal, pre-hypertensive, stage I, and stage II, respectively. Most of them (31.68%) were free from comorbidities. The most (23.76%) prescribed drug was calcium channel blocker (CCB), and 15.84% of the patients received combination therapy. Treatment was effective in 70.30% of the patients through analyzing their blood pressure even though the adherence to the JNC-8 guidelines was only in 54.46%. Conclusions Our study revealed that CCB was the most prescribed drug, and in spite of the only 50% adherence rate, treatment was effective in the majority of the population. The treatment outcome can be improved if the adherence rate is increased further.
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Affiliation(s)
- Rajesh Venkataraman
- Department of Pharmacy Practice, Sri Adichunchanagiri College of Pharmacy, Adichunchanagiri Hospital and Research Center, Adichunchanagiri University, Nagamangala, Karnataka 571448, India
| | - Muhammed Rashid
- Department of Pharmacy Practice, Sri Adichunchanagiri College of Pharmacy, Adichunchanagiri Hospital and Research Center, Adichunchanagiri University, BG Nagara,Nagamangala, Karnataka 571448, India, Mobile: +91-9886880633
| | - Bhat Shashikantha
- Department of General Medicine, Adichunchanagiri Institute of Medical Science, Adichunchanagiri Hospital and Research Center, Adichunchanagiri University, BG Nagara,Nagamangala, Karnataka 571448, India
| | - Ayyappankalathil Soumya
- Department of Pharmacy Practice, Sri Adichunchanagiri College of Pharmacy, Adichunchanagiri Hospital and Research Center, Adichunchanagiri University, Nagamangala, Karnataka 571448, India
| | - Greeshma Vijayan
- Department of Pharmacy Practice, Sri Adichunchanagiri College of Pharmacy, Adichunchanagiri Hospital and Research Center, Adichunchanagiri University, Nagamangala, Karnataka 571448, India
| | - Gloriya Grifth Manuel
- Department of Pharmacy Practice, Sri Adichunchanagiri College of Pharmacy, Adichunchanagiri Hospital and Research Center, Adichunchanagiri University, Nagamangala, Karnataka 571448, India
| | - Shahinur Islam
- Department of Pharmacy Practice, Sri Adichunchanagiri College of Pharmacy, Adichunchanagiri Hospital and Research Center, Adichunchanagiri University, Nagamangala, Karnataka 571448, India
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Polak-Iwaniuk A, Harasim-Symbor E, Gołaszewska K, Chabowski A. How Hypertension Affects Heart Metabolism. Front Physiol 2019; 10:435. [PMID: 31040794 PMCID: PMC6476990 DOI: 10.3389/fphys.2019.00435] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 03/29/2019] [Indexed: 01/15/2023] Open
Abstract
Hypertension is one of the most frequently observed cardiovascular diseases, which precedes heart failure in 75% of its cases. It is well-established that hypertensive patients have whole body metabolic complications such as hyperlipidemia, hyperglycemia, decreased insulin sensitivity or diabetes mellitus. Since myocardial metabolism is strictly dependent on hormonal status as well as substrate milieu, the above mentioned disturbances may affect energy generation status in the heart. Interestingly, it was found that hypertension induces a shift in substrate preference toward increased glucose utilization in cardiac muscle, prior to structural changes development. The present work reports advances in the aspect of heart metabolism under high blood pressure conditions, including human and the most common animal models of hypertension.
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Affiliation(s)
| | - Ewa Harasim-Symbor
- Department of Physiology, Medical University of Białystok, Białystok, Poland
| | | | - Adrian Chabowski
- Department of Physiology, Medical University of Białystok, Białystok, Poland
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