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Hu FB. Diet strategies for promoting healthy aging and longevity: An epidemiological perspective. J Intern Med 2024; 295:508-531. [PMID: 37867396 PMCID: PMC10939982 DOI: 10.1111/joim.13728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Abstract
In recent decades, global life expectancies have risen significantly, accompanied by a marked increase in chronic diseases and population aging. This narrative review aims to summarize recent findings on the dietary factors influencing chronic diseases and longevity, primarily from large cohort studies. First, maintaining a healthy weight throughout life is pivotal for healthy aging and longevity, mirroring the benefits of lifelong, moderate calorie restriction in today's obesogenic food environment. Second, the specific types or food sources of dietary fat, protein, and carbohydrates are more important in influencing chronic disease risk and mortality than their quantity. Third, some traditional diets (e.g., the Mediterranean, Nordic, and Okinawa) and contemporary dietary patterns, such as healthy plant-based diet index, the DASH (dietary approaches to stop hypertension) diet, and alternate healthy eating index, have been associated with lower mortality and healthy longevity. These patterns share many common components (e.g., a predominance of nutrient-rich plant foods; limited red and processed meats; culinary herbs and spices prevalent in global cuisines) while embracing distinct elements from different cultures. Fourth, combining a healthy diet with other lifestyle factors could extend disease-free life expectancies by 8-10 years. While adhering to core principles of healthy diets, it is crucial to adapt dietary recommendations to individual preferences and cultures as well as nutritional needs of aging populations. Public health strategies should aim to create a healthier food environment where nutritious options are readily accessible, especially in public institutions and care facilities for the elderly. Although further mechanistic studies and human trials are needed to better understand molecular effects of diet on aging, there is a pressing need to establish and maintain long-term cohorts studying diet and aging in culturally diverse populations.
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Affiliation(s)
- Frank B. Hu
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115. USA
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Howard G, Cushman M, Blair J, Wilson NR, Yuan Y, Safford MM, Levitan EB, Judd SE, Howard VJ. Comparative Discrimination of Life's Simple 7 and Life's Essential 8 to Stratify Cardiovascular Risk: Is the Added Complexity Worth It? Circulation 2024; 149:905-913. [PMID: 37830200 PMCID: PMC10948319 DOI: 10.1161/circulationaha.123.065472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 09/19/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND Life's Simple 7 (LS7) is an easily calculated and interpreted metric of cardiovascular health based on 7 domains: smoking, diet, physical activity, body mass index, blood pressure, cholesterol, and fasting glucose. The Life's Essential 8 (LE8) metric was subsequently introduced, adding sleep metrics and revisions of the previous 7 domains. Although calculating LE8 requires additional information, we hypothesized that it would be a more reliable index of cardiovascular health. METHODS Both the LS7 and LE8 metrics yield scores with higher values indicating lower risk. These were calculated among 11 609 Black and White participants free of baseline cardiovascular disease (CVD) in the Reasons for Geographic and Racial Differences in Stroke study, enrolled in 2003 to 2007, and followed for a median of 13 years. Differences in 10-year risk of incident CVD (coronary heart disease or stroke) were calculated as a function LS7, and LE8 scores were calculated using Kaplan-Meier and proportional hazards analyses. Differences in incident CVD discrimination were quantified by difference in the c-statistic. RESULTS For both LS7 and LE8, the 10-year risk was approximately 5% for participants around the 99th percentile of scores, and a 4× higher 20% risk for participants around the first percentile. Comparing LS7 to LE8, 10-year risk was nearly identical for individuals at the same relative position in score distribution. For example, the "cluster" of 2013 participants with an LS7 score of 7 was at the 35.8th percentile in distribution of LS7 scores, and had an estimated 10-year CVD risk of 8.4% (95% CI, 7.2%-9.8%). In a similar location in the LE8 distribution, the 1457 participants with an LE8 score of 60±2.5 at the 39.4th percentile of LE8 scores had a 10-year risk of CVD of 8.5% (95% CI, 7.1%-10.1%), similar to the cluster defined by LS7. The age-race-sex adjusted c-statistic of the LS7 model was 0.691 (95% CI, 0.667-0.705), and 0.695 for LE8 (95% CI, 0.681-0.709) (P for difference, 0.12). CONCLUSIONS Both LS7 and LE8 were associated with incident CVD, with discrimination of the 2 indices practically indistinguishable. As a simpler metric, LS7 may be favored for use by the general population and clinicians.
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Affiliation(s)
- George Howard
- Department of Biostatistics, University of Alabama at Birmingham (UAB) School of Public Health, Birmingham, AL
| | - Mary Cushman
- Department of Medicine, University of Vermont Larner College of Medicine, Burlington, VT
| | - Jessica Blair
- Department of Biostatistics, University of Alabama at Birmingham (UAB) School of Public Health, Birmingham, AL
| | - Nicole R. Wilson
- Department of Biostatistics, University of Alabama at Birmingham (UAB) School of Public Health, Birmingham, AL
| | - Ya Yuan
- Department of Biostatistics, University of Alabama at Birmingham (UAB) School of Public Health, Birmingham, AL
| | - Monika M. Safford
- Department of Internal Medicine, Weill Cornell Medical Center, New York, NY
| | - Emily B. Levitan
- Department of Epidemiology, UAB School of Public Health, Birmingham, AL
| | - Suzanne E. Judd
- Department of Biostatistics, University of Alabama at Birmingham (UAB) School of Public Health, Birmingham, AL
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Mahowald MK, Esmail K, Ezzeddine FM, Choi C, Mieszczanska H, Velarde G. Sex Disparities in Cardiovascular Disease. Methodist Debakey Cardiovasc J 2024; 20:107-119. [PMID: 38495656 PMCID: PMC10941692 DOI: 10.14797/mdcvj.1328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 01/30/2024] [Indexed: 03/19/2024] Open
Abstract
Cardiovascular disease is the leading cause of death in women. It remains underdiagnosed, undertreated, and portends worse outcomes in women than men. Disparities exist in every stage of science, from bench research to the editorial board of major journals and in every cardiovascular subspecialty. This review summarizes differences in cardiovascular risk factors and disparities in management and outcomes of ischemic heart disease, heart failure, aortic stenosis, and atrial fibrillation. It also provides an overview of female representation as participants and leaders of clinical trials, editorial boards, and academic institutions. Strategies to overcome these disparities are proposed with examples of successful programs.
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Affiliation(s)
| | - Khadeeja Esmail
- University of Florida College of Medicine, Jacksonville, Florida, US
| | | | - Calvin Choi
- University of Florida College of Medicine, Jacksonville, Florida, US
| | | | - Gladys Velarde
- University of Florida College of Medicine, Jacksonville, Florida, US
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Toivonen E, Lee E, Leppänen MH, Laitinen T, Kähönen M, Lakka TA, Haapala EA. The associations of depressive symptoms and perceived stress with arterial health in adolescents. Physiol Rep 2024; 12:e15986. [PMID: 38519264 PMCID: PMC10959692 DOI: 10.14814/phy2.15986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/06/2024] [Accepted: 03/14/2024] [Indexed: 03/24/2024] Open
Abstract
Cardiovascular and mental diseases are among the most important global health problems, but little is known on the associations between mental and arterial health in adolescents. Therefore, we investigated the associations of arterial health with depressive symptoms and perceived stress in adolescents. A total of 277 adolescents, 151 boys, 126 girls, aged 15-17 years participated in the study. Depressive symptoms were assessed using the Beck Depression Inventory and perceived stress by the Cohen Perceived Stress Scale. Arterial health was assessed by measures from carotid ultrasonography (carotid intima-media thickness, Young's Elastic Modulus, carotid artery distensibility, stiffness index), impedance cardiography (pulse wave velocity, cardio-ankle vascular index), and pulse contour analysis (reflection index, stiffness index). The data were analyzed using linear regression models adjusted for age and sex. Depressive symptoms or perceived stress were not associated with indices of arterial health in the whole study group (β = -0.08 to 0.09, p > 0.05), in boys (β = -0.13 to 0.10, p > 0.05) or in girls (standardized regression coefficient β = -0.16 to 0.08, p > 0.05). We found no associations of depressive symptoms and perceived stress with arterial health in adolescents. These observations suggest that the association between mental and arterial health problems develop in later life.
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Affiliation(s)
- Emmi Toivonen
- Faculty of Sports and Health SciencesUniversity of JyväskyläJyväskyläFinland
| | - Earric Lee
- Faculty of Sports and Health SciencesUniversity of JyväskyläJyväskyläFinland
- Institut de Cardiologie de MontréalMontréalQCCanada
- École de kinésiologie et des sciences de l’activité physiqueUniversité de MontréalMontréalQCCanada
| | - Marja H. Leppänen
- Institute of Biomedicine, University of Eastern FinlandKuopio CampusKuopioFinland
| | - Tomi Laitinen
- Department of Clinical Physiology and Nuclear ImagingUniversity of Eastern Finland and Kuopio University HospitalKuopioFinland
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital and Faculty of Medicine and Health TechnologyTampere UniversityTampereFinland
| | - Timo A. Lakka
- Institute of Biomedicine, University of Eastern FinlandKuopio CampusKuopioFinland
- Department of Clinical Physiology and Nuclear ImagingUniversity of Eastern Finland and Kuopio University HospitalKuopioFinland
- Foundation for Research in Health Exercise and NutritionKuopio Research Institute of Exercise MedicineKuopioFinland
| | - Eero A. Haapala
- Faculty of Sports and Health SciencesUniversity of JyväskyläJyväskyläFinland
- Institute of Biomedicine, University of Eastern FinlandKuopio CampusKuopioFinland
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Thermidor S, Gaballa D, Hentz R, Fishbein J, Vaidean G, Weinberg C, Pachtman S, Blitz MJ, Grayver E, Gianos E. Clinical, Sociodemographic, and Neighborhood Characteristics Associated with Adverse Pregnancy Outcomes. J Womens Health (Larchmt) 2024; 33:308-317. [PMID: 38061042 DOI: 10.1089/jwh.2023.0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024] Open
Abstract
Background: Cardiovascular risk is increased by a history of adverse pregnancy outcomes (APOs). Efforts to understand and prevent these adverse outcomes may improve both fetal and birthing persons' outcomes in the peripartum period, and over the patient's lifetime. This study aims to assess the association of clinical, sociodemographic, and economic neighbor-hood factors with preterm birth (PTB) and APOs (the composite of stillbirth, small for gestation age, and low birthweight). Materials and Methods: This is a cross-sectional study using the electronic medical records of deliveries from seven Northwell Health hospitals between January 1, 2018 and July 31, 2020. There were 62,787 deliveries reviewed in this study. Deliveries that were not the first for the patient during the study period and multiple gestational pregnancies were excluded. Patients with incomplete data on outcome were also excluded. Main outcomes were PTB and composite APOs. Measures included history of PTB, hypertension, diabetes, body mass index, race/ethnicity, age, preferred language, marital status, parity, health insurance, and median income, percent unemployment, and mean household size by zip code. Results: Of the 62,787 deliveries, 43.3% were from white, Non-Hispanic, and Non-Latino patients. There were 4,552 (7.2%) PTBs and 8,634 (13.8%) APOs. Patients enrolled in public insurance had higher odds of PTB (odds ratio [OR] 1.15, 95% CI 1.06-1.24) and APOs (OR 1.19, 95% CI 1.12-1.25). There was a statistically significant association of both PTB (p = 0.037) and APOs (p = 0.005) when comparing patients that live in a zip code with a median income over 100k to those with an income <100k. In addition, living in a zip code within the second quintile of unemployment was associated with lower odds of APOs (OR 0.92, 95% CI 0.84-0.99). Conclusions: Numerous sociodemographic and clinical factors are associated with both PTB and APOs. Tailored programs addressing these disparities may improve outcomes in pregnant persons.
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Affiliation(s)
- Sadiya Thermidor
- Department of Cardiology, Lenox Hill Hospital/Northwell, New York, New York, USA
- Department of Medicine, NYC Health & Hospitals/Kings County, Brooklyn, New York, USA
- Department of Medicine, SUNY Downstate, Brooklyn, New York, USA
| | - Dianna Gaballa
- Department of Cardiology, Deborah Heart and Lung Center, Brown Mills, New Jersey, USA
| | - Roland Hentz
- Institute of Health Systems Science, Feinstein Institutes for Medical Research, Long Island, New York, USA
| | - Joanna Fishbein
- Office of Academic Affairs, Northwell Health, Long Island, New York, USA
| | - Georgeta Vaidean
- Division of Medical and Population Health Sciences Education and Research, Department of Translational Medicine, Florida International University/Herbert Wertheim School of Medicine, Miami, Florida, USA
| | - Catherine Weinberg
- Department of Cardiology, Lenox Hill Hospital/Northwell, New York, New York, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Long Island, New York, USA
| | - Sarah Pachtman
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Long Island Jewish Medical Center/Northwell, Queens, New York, USA
| | - Matthew J Blitz
- Institute of Health Systems Science, Feinstein Institutes for Medical Research, Long Island, New York, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Long Island, New York, USA
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwell Health, Long Island, New York, USA
| | - Evelina Grayver
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Long Island, New York, USA
- Katz Institute for Women's Health/Northwell, Long Island, New York, USA
- Department of Cardiology, North Shore University Hospital/Northwell, Long Island, New York, USA
| | - Eugenia Gianos
- Department of Cardiology, Lenox Hill Hospital/Northwell, New York, New York, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Long Island, New York, USA
- Katz Institute for Women's Health/Northwell, Long Island, New York, USA
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Toribio-Fernandez R, Ceron C, Tristão-Pereira C, Fernandez-Nueda I, Perez-Castillo A, Fernandez-Ferro J, Moro MA, Ibañez B, Fuster V, Cortes-Canteli M. Oral anticoagulants: A plausible new treatment for Alzheimer's disease? Br J Pharmacol 2024; 181:760-776. [PMID: 36633908 DOI: 10.1111/bph.16032] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/02/2023] [Accepted: 01/06/2023] [Indexed: 01/13/2023] Open
Abstract
Alzheimer's disease (AD) and cardiovascular disease (CVD) are strongly associated. Both are multifactorial disorders with long asymptomatic phases and similar risk factors. Indeed, CVD signatures such as cerebral microbleeds, micro-infarcts, atherosclerosis, cerebral amyloid angiopathy and a procoagulant state are highly associated with AD. However, AD and CVD co-development and the molecular mechanisms underlying such associations are not understood. Here, we review the evidence regarding the vascular component of AD and clinical studies using anticoagulants that specifically evaluated the development of AD and other dementias. Most studies reported a markedly decreased incidence of composite dementia in anticoagulated patients with atrial fibrillation, with the highest benefit for direct oral anticoagulants. However, sub-analyses by differential dementia diagnosis were scarce and inconclusive. We finally discuss whether anticoagulation could be a plausible preventive/therapeutic approach for AD and, if so, which would be the best drug and strategy to maximize clinical benefit and minimize potential risks. LINKED ARTICLES: This article is part of a themed issue From Alzheimer's Disease to Vascular Dementia: Different Roads Leading to Cognitive Decline. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v181.6/issuetoc.
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Affiliation(s)
- Raquel Toribio-Fernandez
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD), Madrid, Spain
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain
| | - Carlos Ceron
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain
| | | | - Irene Fernandez-Nueda
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain
| | - Ana Perez-Castillo
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Instituto de Investigaciones Biomédicas "Alberto Sols" (CSIC-UAM), Madrid, Spain
| | - Jose Fernandez-Ferro
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD), Madrid, Spain
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain
- Stroke Unit, Neurology Service, Hospital Universitario Rey Juan Carlos (HURJC), Madrid, Spain
| | - Maria Angeles Moro
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain
| | - Borja Ibañez
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD), Madrid, Spain
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain
- CIBER de enfermedades cardiovasculares (CIBERCV), ISCIII, Madrid, Spain
| | - Valentin Fuster
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Marta Cortes-Canteli
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD), Madrid, Spain
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
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Ruthirakuhan M, Swardfager W, Xiong L, MacIntosh BJ, Rabin JS, Lanctôt KL, Ottoy J, Ramirez J, Keith J, Black SE. Investigating the impact of hypertension with and without diabetes on Alzheimer's disease risk: A clinico-pathological study. Alzheimers Dement 2024. [PMID: 38425134 DOI: 10.1002/alz.13717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 01/02/2024] [Accepted: 01/04/2024] [Indexed: 03/02/2024]
Abstract
INTRODUCTION Hypertension and diabetes are common cardiovascular risk factors that increase Alzheimer's disease (AD) risk. However, it is unclear whether AD risk differs in hypertensive individuals with and without diabetes. METHODS Cognitively normal individuals (N = 11,074) from the National Alzheimer's Coordinating Center (NACC) were categorized as having (1) hypertension with diabetes (HTN+/DM+), (2) hypertension without diabetes (HTN+/DM-), or (3) neither (HTN-/DM-). AD risk in HTN+/DM+ and HTN+/DM- was compared to HTN-/DM-. This risk was then investigated in those with AD neuropathology (ADNP), cerebral amyloid angiopathy (CAA), cerebrovascular neuropathology (CVNP), arteriolosclerosis, and atherosclerosis. Finally, AD risk in HTN-/DM+ was compared to HTN-/DM-. RESULTS Seven percent (N = 830) of individuals developed AD. HTN+/DM+ (hazard ratio [HR] = 1.31 [1.19-1.44]) and HTN+/DM- (HR = 1.24 [1.17-1.32]) increased AD risk compared to HTN-/DM-. AD risk was greater in HTN+/DM+ with ADNP (HR = 2.10 [1.16-3.79]) and CAA (HR = 1.52 [1.09-2.12]), and in HTN+/DM- with CVNP (HR = 1.54 [1.17-2.03]). HTN-/DM+ also increased AD risk (HR = 1.88 [1.30-2.72]) compared to HTN-/DM-. DISCUSSION HTN+/DM+ and HTN+/DM- increased AD risk compared to HTN-/DM-, but pathological differences between groups suggest targeted therapies may be warranted based on cardiovascular risk profiles. HIGHLIGHTS AD risk was studied in hypertensive (HTN+) individuals with/without diabetes (DM+/-). HTN+/DM+ and HTN+/DM- both had an increased risk of AD compared to HTN-/DM-. Post mortem analysis identified neuropathological differences between HTN+/DM+ and HTN+/DM-. In HTN+/DM+, AD risk was greater in those with AD neuropathology and CAA. In HTN+/DM-, AD risk was greater in those with cerebrovascular neuropathology.
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Affiliation(s)
- Myuri Ruthirakuhan
- Dr. Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Walter Swardfager
- Dr. Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Lisa Xiong
- Dr. Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Bradley J MacIntosh
- Dr. Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer S Rabin
- Dr. Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Harquail Centre for Neuromodulation, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Krista L Lanctôt
- Dr. Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Julie Ottoy
- Dr. Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Joel Ramirez
- Dr. Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Julia Keith
- Dr. Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Sandra E Black
- Dr. Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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Hidalgo-Lozada GM, Villarruel-López A, Nuño K, García-García A, Sánchez-Nuño YA, Ramos-García CO. Clinically Effective Molecules of Natural Origin for Obesity Prevention or Treatment. Int J Mol Sci 2024; 25:2671. [PMID: 38473918 DOI: 10.3390/ijms25052671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 02/21/2024] [Accepted: 02/22/2024] [Indexed: 03/14/2024] Open
Abstract
The prevalence and incidence of obesity and the comorbidities linked to it are increasing worldwide. Current therapies for obesity and associated pathologies have proven to cause a broad number of adverse effects, and often, they are overpriced or not affordable for all patients. Among the alternatives currently available, natural bioactive compounds stand out. These are frequently contained in pharmaceutical presentations, nutraceutical products, supplements, or functional foods. The clinical evidence for these molecules is increasingly solid, among which epigallocatechin-3-gallate, ellagic acid, resveratrol, berberine, anthocyanins, probiotics, carotenoids, curcumin, silymarin, hydroxy citric acid, and α-lipoic acid stand out. The molecular mechanisms and signaling pathways of these molecules have been shown to interact with the endocrine, nervous, and gastroenteric systems. They can regulate the expression of multiple genes and proteins involved in starvation-satiety processes, activate the brown adipose tissue, decrease lipogenesis and inflammation, increase lipolysis, and improve insulin sensitivity. This review provides a comprehensive view of nature-based therapeutic options to address the increasing prevalence of obesity. It offers a valuable perspective for future research and subsequent clinical practice, addressing everything from the molecular, genetic, and physiological bases to the clinical study of bioactive compounds.
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Affiliation(s)
| | - Angelica Villarruel-López
- Department of Pharmacobiology, University Center for Exact and Engineering Sciences, University of Guadalajara, Guadalajara 44430, Mexico
| | - Karla Nuño
- Department of Psychology, Education and Health, ITESO Jesuit University of Guadalajara, Guadalajara 45604, Mexico
| | - Abel García-García
- Institute of Science and Technology for Health Innovation, Guadalajara 44770, Mexico
- Department of Medical Clinic, Health Sciences University Center, University of Guadalajara, Guadalajara 44340, Mexico
| | - Yaír Adonaí Sánchez-Nuño
- Department of Pharmacobiology, University Center for Exact and Engineering Sciences, University of Guadalajara, Guadalajara 44430, Mexico
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González-Lorenzo Ó, Franco Pelaez JA, Kallmeyer A, Nieto L, Esteban L, Pello A, Aceña Á, Aldamiz G, Tuñón J. Non-coronary atherosclerosis: a marker of poor prognosis in patients undergoing coronary artery bypass surgery. Front Cardiovasc Med 2024; 11:1305162. [PMID: 38464841 PMCID: PMC10921089 DOI: 10.3389/fcvm.2024.1305162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 02/02/2024] [Indexed: 03/12/2024] Open
Abstract
Introduction The presence of non-coronary atherosclerosis (NCA) in patients with coronary artery disease is associated with a poor prognosis. We have studied whether NCA is also a predictor of poorer outcomes in patients undergoing coronary artery bypass grafting (CABG). Materials and methods This is an observational study involving 567 consecutive patients who underwent CABG. Variables and prognosis were analysed based on the presence or absence of NCA, defined as previous stroke, transient ischaemic attack (TIA), or peripheral artery disease (PAD) [lower extremity artery disease (LEAD), carotid disease, previous lower limb vascular surgery, or abdominal aortic aneurysm (AAA)]. The primary outcome was a combination of TIA/stroke, acute myocardial infarction, new revascularization procedure, or death. The secondary outcome added the need for LEAD revascularization or AAA surgery. Results One-hundred thirty-eight patients (24%) had NCA. Among them, traditional cardiovascular risk factors and older age were more frequently present. At multivariate analysis, NCA [hazard ratio (HR) = 1.84, 95% confidence interval (CI) 1.27-2.69], age (HR = 1.35, 95% CI 1.09-1.67, p = 0.004), and diabetes mellitus (HR = 1.50, 95% CI 1.05-2.15, p = 0.025), were positively associated with the development of the primary outcome, while estimated glomerular filtration rate (HR = 0.86, 95% CI 0.80-0.93, p = 0.001) and use of left internal mammary artery (HR = 0.36, 95% CI 0.15-0.82, p = 0.035), were inversely associated with this outcome. NCA was also an independent predictor of the secondary outcome. Mortality was also higher in NCA patients (27.5% vs. 9%, p < 0.001). Conclusions Among patients undergoing CABG, the presence of NCA doubled the risk of developing cardiovascular events, and it was associated with higher mortality.
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Affiliation(s)
| | | | - Andrea Kallmeyer
- Department of Cardiology, IIS-Fundación Jiménez Díaz, Madrid, Spain
| | - Luis Nieto
- Department of Cardiology, IIS-Fundación Jiménez Díaz, Madrid, Spain
| | - Laura Esteban
- Department of Cardiology, IIS-Fundación Jiménez Díaz, Madrid, Spain
| | - Ana Pello
- Department of Cardiology, IIS-Fundación Jiménez Díaz, Madrid, Spain
| | - Álvaro Aceña
- Department of Cardiology, IIS-Fundación Jiménez Díaz, Madrid, Spain
- Faculty of Medicine, Autónoma University, Madrid, Spain
| | - Gonzalo Aldamiz
- Department of Cardiac Surgery, IIS-Fundación Jiménez Díaz, Madrid, Spain
| | - José Tuñón
- Department of Cardiology, IIS-Fundación Jiménez Díaz, Madrid, Spain
- Faculty of Medicine, Autónoma University, Madrid, Spain
- Laboratory Department of Vascular Pathology, IIS-Fundación Jiménez Díaz, Madrid, Spain
- CIBERCV, ISCIII, Madrid, Spain
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10
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Zhang H, Guo Y, Hua G, Guo C, Gong S, Li M, Yang Y. Exercise training modalities in prediabetes: a systematic review and network meta-analysis. Front Endocrinol (Lausanne) 2024; 15:1308959. [PMID: 38440785 PMCID: PMC10911289 DOI: 10.3389/fendo.2024.1308959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 01/19/2024] [Indexed: 03/06/2024] Open
Abstract
Background Lifestyle modification based on exercise intervention is still the primary way to delay or reverse the development of diabetes in patients with prediabetes. However, there are still challenges in setting up a detailed exercise prescription for people with prediabetes. This study mainly ranks exercise prescriptions by comparing the improvement of glucose and lipid metabolism and the level of weight loss in patients. Method All studies on exercise intervention in prediabetes were identified by searching five electronic databases. Risk assessment and meta-analysis were performed on eligible studies. Results Twenty-four studies involving 1946 patients with prediabetes and seven exercise intervention models were included in the final analysis. The meta-analysis showed that exercise of any type was more effective for glycemic control in prediabetes than no exercise. However, the changes in blood glucose were moderate. In prediabetes, combining moderate-intensity aerobic exercise with low-to moderate-load resistance training showed the most significant improvements in glycosylated hemoglobin (HbA1c), body mass index (BMI), body weight (BW), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL) (P-score=0.82; 0.70; 0.87; 1; 0.99), low-to moderate-load resistance training showed the most significant improvements in fasting blood glucose (FBG) (P-score=0.98), the vigorous-intensity aerobic exercise showed the most significant improvements in 2-hour post-meal blood glucose (2hPG) and systolic blood pressure (SBP) (P-score=0.79; 0.78), and moderate-intensity aerobic exercise showed the most significant improvements in diastolic blood pressure (DBP) (P-score=0.78). Conclusion In summary, moderate-intensity aerobic exercise, low-to moderate-load resistance training and the combination of both have beneficial effects on glycemic control, weight loss, and cardiovascular health in patients with prediabetes. These findings provide valuable guidance for rehabilitation clinicians and patients alike to follow. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, identifier CRD 42021284922.
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Affiliation(s)
- Hang Zhang
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yuting Guo
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Guangshun Hua
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chenyang Guo
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Simiao Gong
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong, China
| | - Min Li
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yan Yang
- Medical Department of The Third Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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11
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Zatloukal J, Zylla S, Markus MRP, Ewert R, Gläser S, Völzke H, Albrecht D, Friedrich N, Nauck M, Peterson LR, Jiang X, Schaffer JE, Felix SB, Dörr M, Bahls M, Gross S. The Association Between C24:0/C16:0 Ceramide Ratio and Cardiorespiratory Fitness is Robust to Effect Modifications by Age and Sex. Adv Biol (Weinh) 2024:e2300633. [PMID: 38342586 DOI: 10.1002/adbi.202300633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Indexed: 02/13/2024]
Abstract
Ceramides and cardiorespiratory (CR) fitness are both related to cardiovascular diseases. The associations of three blood plasma ceramides (C16:0, C22:0, and C24:0) with CR fitness in the population-based Study of Health in Pomerania (SHIP-START-1; n = 1,102; mean age 50.3 years, 51.5% women) are investigated. In addition, subgroup analysis according to age (≥54 years) and sex (female/male) is performed. Ceramides are quantified by liquid chromatography/mass spectrometry (LC/MS). CR fitness is assessed by a cardiopulmonary exercise test. Sex and age independent associations are found for higher levels of C24:0 and C24:0/C16:0 ratio with higher maximal oxygen consumption (VO2 peak) kg-1 and oxygen consumption at the anaerobic threshold (VO2 @AT1 ) as well as for the relation of C24:0/C16:0 with maximum workload (Wattmax kg-1 ). In contrast, age/sex subgroup specific inverse associations with Wattmax kg-1 are found in women <54 years for C22:0, while a positive association in men ≥54 years. Higher levels of C24:0 are associated with higher Wattmax kg-1 , except for women <54 years, where no significant association can be found. The findings suggest that the use of single ceramides as cardiovascular biomarkers may be inferior, compared to ceramide ratio C24:0/C16:0. Therefore C24:0/C16:0 ratio may be a more suitable and robust cardiovascular biomarker and should be preferred over single ceramides.
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Affiliation(s)
- Jule Zatloukal
- Dept. of Internal Medicine B, University Medicine Greifswald, 17475, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), 17475, Partner-site Greifswald, Germany
| | - Stephanie Zylla
- German Centre for Cardiovascular Research (DZHK), 17475, Partner-site Greifswald, Germany
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, 17475, Greifswald, Germany
| | - Marcello R P Markus
- Dept. of Internal Medicine B, University Medicine Greifswald, 17475, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), 17475, Partner-site Greifswald, Germany
| | - Ralf Ewert
- Dept. of Internal Medicine B, University Medicine Greifswald, 17475, Greifswald, Germany
| | - Sven Gläser
- Dept. of Internal Medicine B, University Medicine Greifswald, 17475, Greifswald, Germany
- Clinic for Internal Medicine, Vivantes Klinikum Spandau/Neukölln, 12351, Berlin, Germany
| | - Henry Völzke
- German Centre for Cardiovascular Research (DZHK), 17475, Partner-site Greifswald, Germany
- Institute of Community Medicine, University Medicine Greifswald, 17475, Greifswald, Germany
| | - Diana Albrecht
- Institute of Community Medicine, University Medicine Greifswald, 17475, Greifswald, Germany
- Leibniz Institute for Plasma Science and Technology, 17489, Greifswald, Germany
| | - Nele Friedrich
- German Centre for Cardiovascular Research (DZHK), 17475, Partner-site Greifswald, Germany
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, 17475, Greifswald, Germany
| | - Matthias Nauck
- German Centre for Cardiovascular Research (DZHK), 17475, Partner-site Greifswald, Germany
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, 17475, Greifswald, Germany
| | - Linda R Peterson
- Division of Cardiology, Department of Medicine, Washington University, St Louis, MO, 63110, USA
| | - Xuntian Jiang
- Division of Cardiology, Department of Medicine, Washington University, St Louis, MO, 63110, USA
| | - Jean E Schaffer
- Joslin Diabetes Center, Harvard Medical School, Boston, MA, 02215, USA
| | - Stephan B Felix
- Dept. of Internal Medicine B, University Medicine Greifswald, 17475, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), 17475, Partner-site Greifswald, Germany
| | - Marcus Dörr
- Dept. of Internal Medicine B, University Medicine Greifswald, 17475, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), 17475, Partner-site Greifswald, Germany
| | - Martin Bahls
- Dept. of Internal Medicine B, University Medicine Greifswald, 17475, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), 17475, Partner-site Greifswald, Germany
| | - Stefan Gross
- Dept. of Internal Medicine B, University Medicine Greifswald, 17475, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), 17475, Partner-site Greifswald, Germany
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12
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Ferreira NV, Gonçalves NG, Szlejf C, Goulart AC, de Souza Santos I, Duncan BB, Schmidt MI, Barreto SM, Caramelli P, Feter N, Castilhos RM, Drager LF, Lotufo P, Benseñor I, Suemoto CK. Optimal cardiovascular health is associated with slower cognitive decline. Eur J Neurol 2024; 31:e16139. [PMID: 38015440 DOI: 10.1111/ene.16139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 10/19/2023] [Accepted: 10/23/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Life's Simple 7, a lifestyle and cardiovascular index associated with cognition, has been updated to Life's Essential 8 (LE8) to include sleep. LE8 has been related to cardiovascular outcomes but its association with cognition is unclear. METHODS In this longitudinal analysis of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), LE8 score was based on health behaviors (diet, physical activity, nicotine exposure, and sleep health) as well as health-related factors (body mass index, blood lipids, blood glucose, and blood pressure). Cognition was assessed in three waves, 4 years apart, using the Consortium to Establish a Registry for Alzheimer's Disease - Word List, semantic and phonemic verbal fluency, the Trail-Making Test B (TMT-B), and a global composite score. We used linear mixed-model analysis, inverse probability weighting, and interaction analysis. RESULTS At baseline, the mean age of the study cohort was 51.4 ± 8.9 years, 56% were women, and 53% were White. Higher baseline LE8 scores were associated with slower decline in global cognition (β = 0.001, 95% confidence interval [CI] 0.001, 0.002; p < 0.001), memory (β = 0.001, 95% CI 0.000, 0.002; p = 0.013), verbal fluency (β = 0.001, 95% CI 0.000, 0.002; p = 0.003), and TMT-B (β = 0.004, 95% CI 0.003, 0.005; p < 0.001). This association was mainly driven by LE8 health factors, particularly blood glucose and blood pressure. Age, sex, and race were modifiers of the association between LE8 and global cognitive decline (p < 0.001), suggesting it was more pronounced in older, male, and Black participants. CONCLUSIONS Higher baseline LE8 scores were associated with slower global and domain-specific cognitive decline during 8 years of follow-up, mainly due to health factors such as blood glucose and blood pressure. Sociodemographic factors were modifiers of this association.
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Affiliation(s)
- Naomi Vidal Ferreira
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
- Faculdade Adventista da Amazonia, Benevides, Brazil
| | | | - Claudia Szlejf
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Alessandra C Goulart
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Itamar de Souza Santos
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
- Department of Internal Medicine, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Bruce B Duncan
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Maria Inês Schmidt
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Sandhi Maria Barreto
- Deparment of Preventive and Social Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Paulo Caramelli
- Behavioral and Cognitive Research Group, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Natan Feter
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Luciano F Drager
- Unidade de Hipertensão, Instituto do Coracao (InCor), Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
- Unidade de Hipertensão, Disciplina de Nefrologia, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Paulo Lotufo
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Isabela Benseñor
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Claudia Kimie Suemoto
- Division of Geriatrics, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
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13
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Abbasi H, Fahimfar N, Surkan PJ, Azadbakht L. Dietary total, plant, and animal protein intake in relation to cardiovascular outcomes and inflammatory factors in elderly men: A cross-sectional study. Food Sci Nutr 2024; 12:1230-1244. [PMID: 38370059 PMCID: PMC10867484 DOI: 10.1002/fsn3.3837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 10/31/2023] [Accepted: 11/03/2023] [Indexed: 02/20/2024] Open
Abstract
The source and amount of protein intake may influence cardiovascular and inflammatory risk, especially in elders who are often more vulnerable. However, findings on elders have been contradictory. Therefore, we examined the association between dietary total, plant, and animal protein intake in relation to cardiovascular outcomes and inflammatory factors in elderly men. The present cross-sectional study included 357 elderly men. A validated and reliable food frequency questionnaire (FFQ) was used to assess dietary intake. All biochemical factors including triglycerides (TG), fasting blood sugar (FBS), high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL6), and tumor necrosis factor-α (TNF-α) were measured. Waist circumference (WC) and blood pressure (BP) were also assessed. A significant inverse association was found between animal protein intake and systolic blood pressure (SBP; OR: 0.62; 95% CI: 0.42, 0.91; ptrend = .014). There were significant inverse associations between plant protein intake and WC (OR: 0.34; 95% CI: 0.17, 0.68; ptrend < .001), FBS (OR: 0.51; 95% CI: 0.29, 0.89; ptrend = .018) and Hs-CRP (OR: 0.39; 95% CI: 0.21, 0.70; ptrend = .002). Moreover, significant inverse associations were also found between total protein intake and SBP (OR: 0.54; 95% CI: 0.33, 0.86; ptrend = .010) and total protein and Hs-CRP (OR: 0.50; 95% CI: 0.28, 0.88; ptrend = .015). In elderly men, a high dietary intake of plant protein was associated with lower odds of having high WC, FBS, and Hs-CRP. In addition, high dietary intake of animal protein was associated with higher odds of having a high SBP level, which was explained by higher intake of dairy products.
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Affiliation(s)
- Hanieh Abbasi
- Department of Community Nutrition, School of Nutritional Sciences and DieteticsTehran University of Medical SciencesTehranIran
| | - Noushin Fahimfar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences InstituteTehran University of Medical SciencesTehranIran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Pamela J. Surkan
- Department of International HealthJohn Hopkins School of Public HealthBaltimoreMarylandUSA
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and DieteticsTehran University of Medical SciencesTehranIran
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences InstituteTehran University of Medical SciencesTehranIran
- Department of Community Nutrition, School of Nutrition and Food ScienceIsfahan University of Medical SciencesIsfahanIran
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14
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Berges P, Schrader B, Vaske B, Bohling A, Lüders S, Elsässer A, Schrader J. [Influence of the Corona pandemic on cardiovascular risk factors - Data from 1775 participants of the ELITE study before and during the Corona pandemic]. Dtsch Med Wochenschr 2024; 149:e11-e18. [PMID: 37995721 PMCID: PMC10805539 DOI: 10.1055/a-2201-6772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
BACKGROUND The COVID-19 pandemic and its interventions have led to a deficit in medical care and changes in people's lifestyles, which has consequently changed cardio- and cerebrovascular primary and secondary prevention. The existing data are mainly based on surveys. In addition to the problem of the accuracy of self-assessments, the pandemic per se and the massive public reporting may have biased the data.Only a few publications have compared data collected before the pandemic with results during the pandemic. The ELITE study has regularly monitored risk factors (RF) and psychosocial parameters (stress, depression, well-being, diet, brain performance, exercise) in over 5000 participants for years. From this study, data were analyzed from 1775 individuals collected before the onset and again during the pandemic (06/05/2020-25/01/2022). Thus, baseline values were unaffected by the pandemic. RESULTS As expected, both improvements and worsening of the collected parameters were found. Blood pressure and depressive symptoms worsened significantly more often, with women more frequently affected. Weight and stress levels also increased more often than they improved. Only physical activity showed a slight increase. 24.1 % showed only deteriorations and no improvements in these parameters. In contrast, 19.6 % showed improvements exclusively. In the group with only worsening, there was a significant increase in individuals with the risk factors (RF) hypertension, obesity, elevated LDL cholesterol, nicotine, and diabetes mellitus. This resulted in an increase in individuals with 2 or more RF. In contrast, the number of individuals with 2 and more RF decreased in the group with only improvements. Strikingly, individuals with risk factors improved more frequently. CONCLUSION A not insignificant part of the population experienced significant worsening of RF during the pandemic. This particularly affected blood pressure and depressive symptoms, and more often women.
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Affiliation(s)
- Paulina Berges
- Universitätsklinik für Innere Medizin – Kardiologie, Klinikum Oldenburg
| | - Bastian Schrader
- Universitätsklinik für Innere Medizin – Kardiologie, Klinikum Oldenburg
| | - Bernhard Vaske
- Institut für Herz-Kreislauf-Forschung (INFO), Cloppenburg
| | - Annabelle Bohling
- Universitätsklinik für Innere Medizin – Kardiologie, Klinikum Oldenburg
| | - Stephan Lüders
- Klinik für Nephrologie, Innere Medizin, St.-Josefs-Hospital, Cloppenburg
- Klinik für Nephrologie und Rheumatologie, Universitätsmedizin Göttingen
| | - Albrecht Elsässer
- Universitätsklinik für Innere Medizin – Kardiologie, Klinikum Oldenburg
| | - Joachim Schrader
- Universitätsklinik für Innere Medizin – Kardiologie, Klinikum Oldenburg
- Institut für Herz-Kreislauf-Forschung (INFO), Cloppenburg
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15
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Kloner RA, Burnett AL, Miner M, Blaha MJ, Ganz P, Goldstein I, Kim NN, Kohler T, Lue T, McVary KT, Mulhall JP, Parish SJ, Sadeghi-Nejad H, Sadovsky R, Sharlip ID, Rosen RC. Princeton IV consensus guidelines: PDE5 inhibitors and cardiac health. J Sex Med 2024; 21:90-116. [PMID: 38148297 DOI: 10.1093/jsxmed/qdad163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/22/2023] [Accepted: 10/24/2023] [Indexed: 12/28/2023]
Abstract
BACKGROUND In 1999, 1 year after the approval of the first oral phosphodiesterase type 5 (PDE5) inhibitor for the treatment of erectile dysfunction (ED), the first Princeton Consensus Conference was held to address the clinical management of men with ED who also had cardiovascular disease. These issues were readdressed in the second and third conferences. In the 13 years since the last Princeton Consensus Conference, the experience with PDE5 inhibitors is more robust, and recent new data have emerged regarding not only safety and drug-drug interactions, but also a potential cardioprotective effect of these drugs. AIM In March 2023, an interdisciplinary group of scientists and practitioners met for the fourth Princeton Consensus Guidelines at the Huntington Medical Research Institutes in Pasadena, California, to readdress the cardiovascular workup of men presenting with ED as well as the approach to treatment of ED in men with known cardiovascular disease. METHOD A series of lectures from experts in the field followed by Delphi-type discussions were developed to reach consensus. OUTCOMES Consensus was reached regarding a number of issues related to erectile dysfunction and the interaction with cardiovascular health and phosphodiesterase-5 inhibitors. RESULTS An algorithm based on recent recommendations of the American College of Cardiology and American Heart Association, including the use of computed tomography coronary artery calcium scoring, was integrated into the evaluation of men presenting with ED. Additionally, the issue of nitrate use was further considered in an algorithm regarding the treatment of ED patients with coronary artery disease. Other topics included the psychological effect of ED and the benefits of treating it; the mechanism of action of the PDE5 inhibitors; drug-drug interactions; optimizing use of a PDE5 inhibitors; rare adverse events; potential cardiovascular benefits observed in recent retrospective studies; adulteration of dietary supplements with PDE5 inhibitors; the pros and cons of over-the-counter PDE5 inhibitors; non-PDE5 inhibitor therapy for ED including restorative therapies such as stem cells, platelet-rich plasma, and shock therapy; other non-PDE5 inhibitor therapies, including injection therapy and penile prostheses; the issue of safety and effectiveness of PDE5 inhibitors in women; and recommendations for future studies in the field of sexual dysfunction and PDE5 inhibitor use were discussed. CLINICAL IMPLICATIONS Algorithms and tables were developed to help guide the clinician in dealing with the interaction of ED and cardiovascular risk and disease. STRENGTHS AND LIMITATIONS Strengths include the expertise of the participants and consensus recommendations. Limitations included that participants were from the United States only for this particular meeting. CONCLUSION The issue of the intersection between cardiovascular health and sexual health remains an important topic with new studies suggesting the cardiovascular safety of PDE5 inhibitors.
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Affiliation(s)
- Robert A Kloner
- Department of Cardiovascular Research Pasadena, Huntington Medical Research Institutes, CA 91105, United States
- Department of Medicine, Keck School of Medicine at University of Southern California, Los Angeles, CA, United States
| | - Arthur L Burnett
- Department of Urology, Johns Hopkins University, Baltimore, MD, United States
| | - Martin Miner
- Men's Health Center, Miriam Hospital, Providence, RI, United States
| | - Michael J Blaha
- Cardiology and Epidemiology, Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD, United States
| | - Peter Ganz
- Department of Medicine (PG); Department of Urology (TL, IDS); Department of Psychiatry and Behavioral Sciences, (RCR), University of California, San Francisco, San Francisco, CA, United States
| | - Irwin Goldstein
- Department of Sexual Medicine, Institute for Sexual Medicine, Alvarado Hospital, San Diego, CA, United States
| | - Noel N Kim
- Department of Sexual Medicine, Institute for Sexual Medicine, Alvarado Hospital, San Diego, CA, United States
| | | | - Tom Lue
- Department of Medicine (PG); Department of Urology (TL, IDS); Department of Psychiatry and Behavioral Sciences, (RCR), University of California, San Francisco, San Francisco, CA, United States
| | - Kevin T McVary
- Center for Male Health, Stritch School of Medicine at Loyola University Medical Center, Maywood, IL, United States
| | - John P Mulhall
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Sharon J Parish
- Weill Cornell Medicine, New York, NY, United States
- Department of Medicine and Psychiatry White Plains, Westchester Behavioral Health Center, NewYork-Presbyterian Hospital, NY, United States
| | - Hossein Sadeghi-Nejad
- Department of Urology NY, NYU Langone Grossman School of Medicine, NY, United States
| | - Richard Sadovsky
- Department of Family and Community Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, United States
| | - Ira D Sharlip
- Department of Medicine (PG); Department of Urology (TL, IDS); Department of Psychiatry and Behavioral Sciences, (RCR), University of California, San Francisco, San Francisco, CA, United States
| | - Raymond C Rosen
- Department of Medicine (PG); Department of Urology (TL, IDS); Department of Psychiatry and Behavioral Sciences, (RCR), University of California, San Francisco, San Francisco, CA, United States
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16
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Kulovic-Sissawo A, Tocantins C, Diniz MS, Weiss E, Steiner A, Tokic S, Madreiter-Sokolowski CT, Pereira SP, Hiden U. Mitochondrial Dysfunction in Endothelial Progenitor Cells: Unraveling Insights from Vascular Endothelial Cells. Biology (Basel) 2024; 13:70. [PMID: 38392289 PMCID: PMC10886154 DOI: 10.3390/biology13020070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/18/2024] [Accepted: 01/19/2024] [Indexed: 02/24/2024]
Abstract
Endothelial dysfunction is associated with several lifestyle-related diseases, including cardiovascular and neurodegenerative diseases, and it contributes significantly to the global health burden. Recent research indicates a link between cardiovascular risk factors (CVRFs), excessive production of reactive oxygen species (ROS), mitochondrial impairment, and endothelial dysfunction. Circulating endothelial progenitor cells (EPCs) are recruited into the vessel wall to maintain appropriate endothelial function, repair, and angiogenesis. After attachment, EPCs differentiate into mature endothelial cells (ECs). Like ECs, EPCs are also susceptible to CVRFs, including metabolic dysfunction and chronic inflammation. Therefore, mitochondrial dysfunction of EPCs may have long-term effects on the function of the mature ECs into which EPCs differentiate, particularly in the presence of endothelial damage. However, a link between CVRFs and impaired mitochondrial function in EPCs has hardly been investigated. In this review, we aim to consolidate existing knowledge on the development of mitochondrial and endothelial dysfunction in the vascular endothelium, place it in the context of recent studies investigating the consequences of CVRFs on EPCs, and discuss the role of mitochondrial dysfunction. Thus, we aim to gain a comprehensive understanding of mechanisms involved in EPC deterioration in relation to CVRFs and address potential therapeutic interventions targeting mitochondrial health to promote endothelial function.
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Affiliation(s)
- Azra Kulovic-Sissawo
- Perinatal Research Laboratory, Department of Obstetrics and Gynaecology, Medical University of Graz, Auenbruggerplatz 14, 8036 Graz, Austria
- Research Unit Early Life Determinants (ELiD), Medical University of Graz, Auenbruggerplatz 14, 8036 Graz, Austria
| | - Carolina Tocantins
- Perinatal Research Laboratory, Department of Obstetrics and Gynaecology, Medical University of Graz, Auenbruggerplatz 14, 8036 Graz, Austria
- Research Unit Early Life Determinants (ELiD), Medical University of Graz, Auenbruggerplatz 14, 8036 Graz, Austria
- CNC-UC-Center for Neuroscience and Cell Biology, University of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-504 Coimbra, Portugal
- Doctoral Programme in Experimental Biology and Biomedicine (PDBEB), Institute for Interdisciplinary Research (IIIUC), University of Coimbra, 3004-531 Coimbra, Portugal
| | - Mariana S Diniz
- Perinatal Research Laboratory, Department of Obstetrics and Gynaecology, Medical University of Graz, Auenbruggerplatz 14, 8036 Graz, Austria
- Research Unit Early Life Determinants (ELiD), Medical University of Graz, Auenbruggerplatz 14, 8036 Graz, Austria
- CNC-UC-Center for Neuroscience and Cell Biology, University of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-504 Coimbra, Portugal
- Doctoral Programme in Experimental Biology and Biomedicine (PDBEB), Institute for Interdisciplinary Research (IIIUC), University of Coimbra, 3004-531 Coimbra, Portugal
| | - Elisa Weiss
- Perinatal Research Laboratory, Department of Obstetrics and Gynaecology, Medical University of Graz, Auenbruggerplatz 14, 8036 Graz, Austria
- Research Unit Early Life Determinants (ELiD), Medical University of Graz, Auenbruggerplatz 14, 8036 Graz, Austria
| | - Andreas Steiner
- Perinatal Research Laboratory, Department of Obstetrics and Gynaecology, Medical University of Graz, Auenbruggerplatz 14, 8036 Graz, Austria
- Research Unit Early Life Determinants (ELiD), Medical University of Graz, Auenbruggerplatz 14, 8036 Graz, Austria
| | - Silvija Tokic
- Research Unit of Analytical Mass Spectrometry, Cell Biology and Biochemistry of Inborn Errors of Metabolism, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Auenbruggerplatz 34, 8036 Graz, Austria
| | - Corina T Madreiter-Sokolowski
- Division of Molecular Biology and Biochemistry, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Austria
| | - Susana P Pereira
- CNC-UC-Center for Neuroscience and Cell Biology, University of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-504 Coimbra, Portugal
- Laboratory of Metabolism and Exercise (LaMetEx), Research Centre in Physical Activity, Health and Leisure (CIAFEL), Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sports, University of Porto, 4200-450 Porto, Portugal
| | - Ursula Hiden
- Perinatal Research Laboratory, Department of Obstetrics and Gynaecology, Medical University of Graz, Auenbruggerplatz 14, 8036 Graz, Austria
- Research Unit Early Life Determinants (ELiD), Medical University of Graz, Auenbruggerplatz 14, 8036 Graz, Austria
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Podzolkov V, Bragina A, Tarzimanova A, Vasilyeva L, Shvedov I, Druzhinina N, Rodionova Y, Ishina T, Akyol I, Maximova V, Cherepanov A. Association of COVID-19 and Arterial Stiffness Assessed using Cardiovascular Index (CAVI). Curr Hypertens Rev 2024; 20:CHYR-EPUB-137612. [PMID: 38258773 DOI: 10.2174/0115734021279173240110095037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/23/2023] [Accepted: 12/19/2023] [Indexed: 01/24/2024]
Abstract
BACKGROUND COVID-19 is characterized by an acute inflammatory response with the formation of endothelial dysfunction and may affect arterial stiffness. Studies of cardio-ankle vascular index in COVID-19 patients with considered cardiovascular risk factors have not been conducted. OBJECTIVE The purpose of our study was to assess the association between cardio-ankle vascular index and COVID-19 in hospitalized patients adjusted for known cardiovascular risk factors. METHODS A cross-sectional study included 174 people hospitalized with a diagnosis of moderate COVID-19 and 94 people without COVID-19. Significant differences in the cardio-ankle vascular index values measured by VaSera VS - 1500N between the two groups were analyzed using parametric (Student's t-criterion) and nonparametric (Mann-Whitney) criteria. Independent association between COVID-19 and an increased cardio-ankle vascular index ≥ 9.0 adjusted for known cardiovascular risk factors was assessed by multivariate logistic regression. RESULTS There were significantly higher values of the right cardio-ankle vascular index 8.10 [7.00;9.40] and the left cardio-ankle vascular index 8.10 [6.95;9.65] in patients undergoing inpatient treatment for COVID-19 than in the control group - 7.55 [6.60;8.60] and 7.60 [6.60;8.70], respectively. A multivariate logistic regression model adjusted for age, hypertension, plasma glucose level, glomerular filtration rate and diabetes mellitus showed a significant association between increased cardio-ankle vascular index and COVID-19 (OR 2.41 [CI 1.09;5.30]). CONCLUSION Hospitalized patients with COVID-19 had significantly higher cardio-ankle vascular index values compared to the control group. An association between an increased cardio-ankle vascular index and COVID-19 was revealed, independent of age, hypertension, plasma glucose level, glomerular filtration rate and diabetes mellitus.
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Affiliation(s)
- Valery Podzolkov
- Sechenov First Moscow State Medical University (Sechenov University), Russia
| | - Anna Bragina
- Sechenov First Moscow State Medical University (Sechenov University), Russia
| | - Aida Tarzimanova
- Sechenov First Moscow State Medical University (Sechenov University), Russia
| | - Lyubov Vasilyeva
- Sechenov First Moscow State Medical University (Sechenov University), Russia
| | - Ilya Shvedov
- Sechenov First Moscow State Medical University (Sechenov University), Russia
| | - Natalya Druzhinina
- Sechenov First Moscow State Medical University (Sechenov University), Russia
| | - Yulia Rodionova
- Sechenov First Moscow State Medical University (Sechenov University), Russia
| | - Tatiana Ishina
- Sechenov First Moscow State Medical University (Sechenov University), Russia
| | - Iuliia Akyol
- Sechenov First Moscow State Medical University (Sechenov University), Russia
| | - Valentina Maximova
- Sechenov First Moscow State Medical University (Sechenov University), Russia
| | - Alexandr Cherepanov
- Sechenov First Moscow State Medical University (Sechenov University), Russia
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Felis-Giemza A, Moskal M, Proc K, Guzera Z, Stajszczyk M, Palej K, Chmurzyńska K, Wiland P, Batko K, Batko B. Multicenter evaluation of tofacitinib retention and safety in rheumatoid arthritis - why cardiovascular risk factors do not equate to overt risk. Reumatologia 2024; 61:414-423. [PMID: 38322101 PMCID: PMC10839916 DOI: 10.5114/reum/175626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 11/21/2023] [Indexed: 02/08/2024] Open
Abstract
Introduction This multicenter, real-world, retrospective cohort study aimed to assess the effectiveness and safety of tofacitinib (TOFA) in rheumatoid arthritis (RA). Material and methods Two hundred nine patients with active RA treated with TOFA, unresponsive to at least 2 conventional synthetic disease-modifying drugs, were recruited. Clinical characteristics were extracted from an electronic registry and supplemented with manual chart review and data linkage with ambulatory care. Drug retention and reasons for discontinuation were evaluated. Results Median (interquartile range) follow-up in the whole sample was 16.9 (5.93-31.7) months. Mean (standard deviation) age was 51.44 (±11.84) years, with female predominance (n = 168, 80.4%). Only 30 patients (14.4%) had no pre-existing traditional cardiovascular (CV) risk factor at TOFA initiation. Tofacitinib retention rates were high, with median survival estimated at 89.3% at 6 months, 82.4% at 12 months, and 60.4% at 24 months. Ineffectiveness was the primary cause of discontinuation (n = 50). The rate of adverse events (AEs) was relatively low, with lipid abnormalities, blood count alterations, and infectious events among the most common. No major adverse CV event was reported. The incidence rate of AEs necessitating treatment switch was 60.34 (95% CI: 37-92) per 1,000 person-years of follow-up. Presence of multiple (> 3) CV risk factors was associated with lower odds of TOFA retention and treatment effectiveness. Conclusions Tofacitinib demonstrated high retention rates and a favorable safety profile in RA patients, including those with traditional CV risk factors. Tofacitinib may be a valuable treatment option for RA patients when combined with individualized CV risk management. Further studies are warranted to explore the long-term effects of TOFA and its CV impact in larger populations.
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Affiliation(s)
- Anna Felis-Giemza
- Biologic Therapy Center, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - Mateusz Moskal
- Department of Rheumatology and Immunology, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski University, Krakow, Poland
| | - Krzysztof Proc
- Clinical Department of Rheumatology and Internal Medicine, University Clinical Hospital in Wroclaw, Poland
| | - Zbigniew Guzera
- Świętokrzyskie Centrum Reumatologii, St. Luke Hospital, Konskie, Poland
| | - Marcin Stajszczyk
- Department of Rheumatology and Autoimmune Diseases, Silesian Center for Rheumatology, Orthopedics and Rehabilitation, Ustron, Poland
| | - Karolina Palej
- Biologic Therapy Center, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - Kornelia Chmurzyńska
- Department of Connective Tissue Diseases, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - Piotr Wiland
- Department of Rheumatology and Internal Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Krzysztof Batko
- Department of Research and Development, Medicine Economy Law Society (MELS) Foundation, Krakow, Poland
| | - Bogdan Batko
- Department of Rheumatology and Immunology, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski University, Krakow, Poland
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Verstraeten R, Vos‐Seda AG, Boateng D, Scheuermaier K, Tempelman H, Barth RE, Devillé W, Coutinho RA, Venter F, Grobbee DE, Klipstein‐Grobusch K. No Evidence for an Association of HIV and Antiviral Treatment With Changes in Framingham Cardiovascular Risk Score in the Ndlovu Cohort Study. J Am Heart Assoc 2024; 13:e029637. [PMID: 38214319 PMCID: PMC10926821 DOI: 10.1161/jaha.123.029637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 11/22/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND HIV and antiretroviral therapy (ART) have been associated with increased cardiovascular disease (CVD) risk in high-income countries. The authors studied the longitudinal association between HIV and ART and nonlaboratory Framingham Risk Score (FRS) in a middle-income country. METHODS AND RESULTS This longitudinal analysis of the NCS (Ndlovu Cohort Study), South Africa used baseline to 36-month follow-up data. Demographics, HIV, ART status, and cardiometabolic measures were obtained. FRS was used as a CVD risk measure. Through linear mixed models, FRS trends over time and the association with HIV were studied. Analysis included 1136 participants, with 609 (54%) having HIV, and 495 (81%) taking ART. At baseline, 9.8% of participants had a high FRS. People living with HIV (PLHIV) had a 3.2% lower FRS than HIV-negative participants (P<0.001). FRS increased similarly for both groups over time. Other factors associated with FRS were secondary and higher education (ß value: -0.075, P<0.001; ß value: -0.084, P<0.001) and alcohol consumption (ß value: 0.011, P<0.001). CONCLUSIONS CVD risk increased for all participants over 36 months, suggesting classic risk factors rather than HIV status or ART to be drivers of CVD risk. People living with HIV had a significantly lower FRS than their HIV-negative counterparts, possibly related to HIV itself or a more frequent interaction with healthcare services. No association of HIV and ART with changes in FRS over 36 months was observed, suggesting the need for research using clinical endpoints to elucidate the effects of HIV and ART on CVD risk. Population-based prevention of CVD risk factors in sub-Saharan Africa is warranted, regardless of HIV status.
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Affiliation(s)
- Rita Verstraeten
- Julius Global Health, Julius Center for Health Sciences and Primary CareUniversity Medical Center, Utrecht UniversityUtrechtThe Netherlands
- BionamiX, Department of Data Analysis and Mathematical ModellingGhent UniversityGhentBelgium
| | - Alinda G. Vos‐Seda
- Julius Global Health, Julius Center for Health Sciences and Primary CareUniversity Medical Center, Utrecht UniversityUtrechtThe Netherlands
- Ezintsha, Faculty of Health SciencesUniversity of WitwatersrandJohannesburgSouth Africa
| | - Daniel Boateng
- Julius Global Health, Julius Center for Health Sciences and Primary CareUniversity Medical Center, Utrecht UniversityUtrechtThe Netherlands
- School of Public HealthKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Karine Scheuermaier
- Julius Global Health, Julius Center for Health Sciences and Primary CareUniversity Medical Center, Utrecht UniversityUtrechtThe Netherlands
- Wits Sleep Laboratory, Brain Function Research Group, School of Physiology, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | | | - Roos E. Barth
- Department of Infectious DiseaseUniversity Medical Center Utrecht, Utrecht UniversityUtrechtThe Netherlands
| | - Walter Devillé
- Julius Global Health, Julius Center for Health Sciences and Primary CareUniversity Medical Center, Utrecht UniversityUtrechtThe Netherlands
| | - Roel A. Coutinho
- Julius Global Health, Julius Center for Health Sciences and Primary CareUniversity Medical Center, Utrecht UniversityUtrechtThe Netherlands
- PharmAccess FoundationAmsterdamThe Netherlands
| | - Francois Venter
- Ezintsha, Faculty of Health SciencesUniversity of WitwatersrandJohannesburgSouth Africa
| | - Diederick E. Grobbee
- Julius Global Health, Julius Center for Health Sciences and Primary CareUniversity Medical Center, Utrecht UniversityUtrechtThe Netherlands
| | - Kerstin Klipstein‐Grobusch
- Julius Global Health, Julius Center for Health Sciences and Primary CareUniversity Medical Center, Utrecht UniversityUtrechtThe Netherlands
- Institute of Tropical Medicine, University of TübingenTübingenGermany
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
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Kgosidialwa O, Newman C, Carmody L, McGrath B, O’Shea PM, Dunne F. Abnormal Glucose Tolerance in Women Diagnosed With Gestational Diabetes (WHO 2013) 10 Years After Index Pregnancy. J Endocr Soc 2024; 8:bvae013. [PMID: 38328480 PMCID: PMC10849116 DOI: 10.1210/jendso/bvae013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Indexed: 02/09/2024] Open
Abstract
Context It is not clear if the risk of abnormal glucose tolerance (AGT) is attenuated in the long-term in women diagnosed with gestational diabetes (GDM) using the World Health Organization (WHO) 2013 criteria and who have received appropriate treatment during pregnancy. Objective We aimed to assess the long-term prevalence of AGT and other cardiovascular disease (CVD) risk factors in this cohort. Methods A retrospective cohort follow-up study was conducted of 37 and 107 women diagnosed with and without GDM respectively using the WHO 2013 criteria between June 2010 and December 2010. Women were invited to attend our center, where they underwent a 75-g oral glucose tolerance test, blood and urine collection, body measurements, and electrocardiography. Main outcome measure included the development of AGT using the American Diabetes Association criteria. Results Sixteen (43.2%) women with GDM compared to 5 (4.7%) women with normal glucose tolerance (NGT) at index pregnancy had AGT (P < .001). In the GDM group, 10 (27.0%), 7 (18.9%), and 4 (10.8%) women had impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and type 2 diabetes mellitus (T2DM), respectively. In the NGT group, 2 (1.9%), 3 (2.8%), and 1 (0.9%) woman had IFG, IGT, and T2DM, respectively. Women with AGT also had an unfavorable metabolic profile including obesity, hypertension, insulin resistance, and dyslipidemia. Conclusion Women treated for GDM (WHO 2013 criteria) remain at increased risk for developing AGT and adverse CVD risk factors as early as a decade after diagnosis. Continued efforts are needed to accurately follow this population to address modifiable risk factors.
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Affiliation(s)
- Oratile Kgosidialwa
- College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, H91TK33, Ireland
| | - Christine Newman
- College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, H91TK33, Ireland
| | - Louise Carmody
- College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, H91TK33, Ireland
| | - Brian McGrath
- College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, H91TK33, Ireland
| | - Paula M O’Shea
- College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, H91TK33, Ireland
| | - Fidelma Dunne
- College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, H91TK33, Ireland
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Hoffmann M, Rossi F, Benes Lima L, King C. Frontotemporal disorders: the expansive panoply of syndromes and spectrum of etiologies. Front Neurol 2024; 14:1305071. [PMID: 38264092 PMCID: PMC10803619 DOI: 10.3389/fneur.2023.1305071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/06/2023] [Indexed: 01/25/2024] Open
Abstract
Background Frontotemporal lobe disorders (FTD) are amongst the most common brain neurodegenerative disorders. Their relatively covert, frequently subtle presentations and diverse etiologies, pose major challenges in diagnosis and treatments. Recent studies have yielded insights that the etiology in the majority are due to environmental and sporadic causes, rather than genetic in origin. Aims To retrospectively examine the cognitive and behavioral impairments in the veteran population to garner the range of differing syndrome presentations and etiological subcategories with a specific focus on frontotemporal lobe disorders. Methodology The design is a retrospective, observational registry, case series with the collection of epidemiological, clinical, cognitive, laboratory and radiological data on people with cognitive and behavioral disorders. Inclusion criteria for entry were veterans evaluated exclusively at Orlando VA Healthcare System, neurology section, receiving a diagnosis of FTD by standard criteria, during the observation period dated from July 2016 to March 2021. Frontotemporal disorders (FTD) were delineated into five clinical 5 subtypes. Demographic, cardiovascular risk factors, cognitive, behavioral neurological, neuroimaging data and presumed etiological categories, were collected for those with a diagnosis of frontotemporal disorder. Results Of the 200 patients with FTD, further cognitive, behavioral neurological evaluation with standardized, metric testing was possible in 105 patients. Analysis of the etiological groups revealed significantly different younger age of the traumatic brain injury (TBI) and Gulf War Illness (GWI) veterans who also had higher Montreal Cognitive Assessment (MOCA) scores. The TBI group also had significantly more abnormalities of hypometabolism, noted on the PET brain scans. Behavioral neurological testing was notable for the findings that once a frontotemporal disorder had been diagnosed, the four different etiological groups consistently had abnormal FRSBE scores for the 3 principal frontal presentations of (i) abulia/apathy, (ii) disinhibition, and (iii) executive dysfunction as well as abnormal Frontal Behavioral Inventory (FBI) scores with no significant difference amongst the etiological groups. The most common sub-syndromes associated with frontotemporal syndromes were the Geschwind-Gastaut syndrome (GGS), Klüver-Bucy syndrome (KBS), involuntary emotional expression disorder (IEED), cerebellar cognitive affective syndrome (CCA), traumatic encephalopathy syndrome (TES) and prosopagnosia. Comparisons with the three principal frontal lobe syndrome clusters (abulia, disinhibition, executive dysfunction) revealed a significant association with abnormal disinhibition FRSBE T-scores with the GGS. The regression analysis supported the potential contribution of disinhibition behavior that related to this complex, relatively common behavioral syndrome in this series. The less common subsyndromes in particular, were notable, as they constituted the initial overriding, presenting symptoms and syndromes characterized into 16 separate conditions. Conclusion By deconstructing FTD into the multiple sub-syndromes and differing etiologies, this study may provide foundational insights, enabling a more targeted precision medicine approach for future studies, both in treating the sub-syndromes as well as the underlying etiological process.
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Affiliation(s)
- Michael Hoffmann
- University of Central Florida, Orlando, FL, United States
- Roskamp Institute, Sarasota, FL, United States
- Orlando VA Healthcare System, Orlando, FL, United States
| | - Fabian Rossi
- University of Central Florida, Orlando, FL, United States
- Orlando VA Healthcare System, Orlando, FL, United States
| | - Lourdes Benes Lima
- University of Central Florida, Orlando, FL, United States
- Roskamp Institute, Sarasota, FL, United States
| | - Christian King
- University of Central Florida, Orlando, FL, United States
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Su Y, Wang F, Wang M, He S, Yang X, Luan Z. Effects of blood flow restriction training on muscle fitness and cardiovascular risk of obese college students. Front Physiol 2024; 14:1252052. [PMID: 38235388 PMCID: PMC10791898 DOI: 10.3389/fphys.2023.1252052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 12/12/2023] [Indexed: 01/19/2024] Open
Abstract
Purpose: The aim of this study was to investigate the effect of blood flow restriction (BFR) combined with low-intensity resistance training (RT) on cardiovascular risk factors in obese individuals. Methods: Twenty-six male obese college students were recruited and randomly assigned to a control group (CON, n = 8), a low-intensity RT group (RT, n = 9), and a combined BFR training and low-intensity RT group (BFRT, n = 9). Results: The subjects in BFRT group showed significant reductions in body fat percentage and waist-to-hip ratio and a significant increase in lean mass and muscle mass; the peak torque, peak power, and endurance ratio of knee extensors and elbow flexors were significantly upregulated; the root mean square (RMS) for the medial femoral muscle, lateral femoral muscle and biceps significantly increased; the diastolic blood pressure (DBP) showed a significant decrease. The BFRT group also showed significant up-regulations in RMS of the difference between the adjacent R-R intervals (RMSSD), high-frequency power (HF) of parasympathetic modulatory capacity, the standard deviation of R-R intervals (SDNN) of overall heart rate variability (HRV) changes and low-frequency power (LF) of predominantly sympathetic activity. In addition, glycated hemoglobin (HbA1C), insulin resistance index (HOMA-IR) and fasting blood glucose (FBG) were all significantly downregulated in BFRT group. In parallel, low-density lipoprotein (LDL-C) significantly reduced while high-density lipoprotein (HDL-C) significantly increased in BFRT group. Conclusion: BFR combined with low-intensity RT training effectively improved body composition index, increased muscle mass, improved neuromuscular activation, enhanced muscle strength and endurance, which in turn improved abnormal glucolipid metabolism and enhanced cardiac autonomic regulation.
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Affiliation(s)
- Yanhong Su
- Key Laboratory of Sports Human Science in Liaoning Province, College of Physical Education, Liaoning Normal University, Dalian, China
| | - Fuqing Wang
- Key Laboratory of Sports Human Science in Liaoning Province, College of Physical Education, Liaoning Normal University, Dalian, China
| | - Meng Wang
- Key Laboratory of Sports Human Science in Liaoning Province, College of Physical Education, Liaoning Normal University, Dalian, China
| | - Shiyong He
- Key Laboratory of Sports Human Science in Liaoning Province, College of Physical Education, Liaoning Normal University, Dalian, China
| | - Xiaolei Yang
- Key Laboratory of Sports Human Science in Liaoning Province, College of Physical Education, Liaoning Normal University, Dalian, China
| | - Zhilin Luan
- Advanced Institute for Medical Sciences, Dalian Medical University, Dalian, China
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Lin CR, Tsai PA, Wang C, Chen JY. The Association between Uric Acid and Metabolic Syndrome in a Middle-Aged and Elderly Taiwanese Population: A Community-Based Cross-Sectional Study. Healthcare (Basel) 2024; 12:113. [PMID: 38201018 PMCID: PMC10778807 DOI: 10.3390/healthcare12010113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/11/2023] [Accepted: 12/13/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is a prevalent health condition in Taiwan that places individuals at higher risk of cardiovascular disease, diabetes, and stroke. Therefore, the identification of risk factors associated with MetS is crucial. The aim of this study was to investigate the association of uric acid and MetS in a Taiwanese community with a middle-aged and elderly population. METHODS This cross-sectional study enrolled residents aged 50-90 years living in one community. All of the subjects received a standardized personal interview, including a structured questionnaire, anthropometric measurements, and blood samples were collected for laboratory testing. MetS was defined as excess waist circumference, high blood pressure, high blood sugar, high serum triglycerides, and low serum high-density lipoprotein (HDL). Multiple logistic regression models were used to evaluate uric acid tertiles associated with MetS. RESULTS A total of 400 subjects were enrolled in the analysis. The overall prevalence of MetS was 35.8%. The prevalence of MetS increased gradually with increasing serum uric acid levels (p value < 0.001). A significant association between uric acid and cardiometabolic risk factors was confirmed, with a Pearson's correlation coefficient for waist circumference of 0.30 (p < 0.001), a coefficient for systolic blood pressure of 0.13 (p = 0.01), a coefficient for triglycerides of 0.33 (p < 0.001), and a coefficient for high-density lipoprotein of -0.30 (p < 0.001). The adjusted odds ratio (OR) of the high uric acid tertile level for MetS was 2.48 (95% CI = 1.31-4.71, p = 0.01). The area under the ROC curve (AUC) for uric acid in predicting MetS was 0.621 (p < 0.001). CONCLUSIONS The prevalence of MetS in our study population is high. High serum uric acid levels are independently associated with the presence of MetS among the middle-aged and elderly Taiwanese population.
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Affiliation(s)
- Chun-Ru Lin
- Department of Medical Education, Chang Gung Memorial Hospital, Linkou Branch, No. 5, Fuxing Street, Guishan District, Taoyuan City 333423, Taiwan (P.-A.T.); (C.W.)
| | - Po-An Tsai
- Department of Medical Education, Chang Gung Memorial Hospital, Linkou Branch, No. 5, Fuxing Street, Guishan District, Taoyuan City 333423, Taiwan (P.-A.T.); (C.W.)
| | - Che Wang
- Department of Medical Education, Chang Gung Memorial Hospital, Linkou Branch, No. 5, Fuxing Street, Guishan District, Taoyuan City 333423, Taiwan (P.-A.T.); (C.W.)
| | - Jau-Yuan Chen
- Department of Family Medicine, Chang-Gung Memorial Hospital, Linkou Branch, Taoyuan City 333423, Taiwan
- College of Medicine, Chang-Gung University, Taoyuan City 333323, Taiwan
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24
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Zúñiga D, Balasubramanian S, Mehmood KT, Al-Baldawi S, Zúñiga Salazar G. Hypothyroidism and Cardiovascular Disease: A Review. Cureus 2024; 16:e52512. [PMID: 38370998 PMCID: PMC10874251 DOI: 10.7759/cureus.52512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2024] [Indexed: 02/20/2024] Open
Abstract
Hypothyroidism is an endocrine disorder more commonly in older adults. Simultaneously, this population has an increased incidence of cardiovascular risk factors and disease, which remains the leading cause of death worldwide. Thyroid hormones (THs) promote adequate function of the cardiovascular system as they exert their effects through receptors located in the myocardium and the vasculature. In hypothyroidism, this homeostasis is disrupted, which leads to the emergence of pathogenic pathways that accelerate the progression of cardiovascular disease and aggravate its outcomes in these individuals. This article has reviewed existing literature on the relationship between hypothyroidism and cardiovascular disease (CVD). We have explored the pathogenic mechanisms linking both conditions and highlighted the prevalence of cardiovascular risk factors as well as the increased incidence of cardiovascular events in overt and subclinical diseases. Furthermore, indications of hormone replacement therapy in subclinical disease and its efficacy in reducing CVD morbidities in a particular subset of patients have been discussed.
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Affiliation(s)
- Diego Zúñiga
- Medicine, Universidad Católica de Santiago de Guayaquil, Guayaquil, ECU
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Kalka C, Keo HH, Ingwersen M, Knoechel J, Hoppe H, Do DD, Schumacher M, Diehm N. Men with erectile dysfunction (ED) should be screened for cardiovascular risk factors - Cost-benefit considerations in Swiss men. VASA 2024; 53:68-76. [PMID: 38047756 DOI: 10.1024/0301-1526/a001105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Background: Current evidence indicates that erectile dysfunction (ED) is an independent risk factor for future cardiovascular events. This study aimed to estimate the cost-effectiveness of screening and subsequent preventive treatment for cardiovascular risk factors among men newly diagnosed with ED from the Swiss healthcare system perspective. Methods: Based on known data on ED and cardiovascular disease (CVD) prevalence and incidence costs and effects of a screening intervention for cardiovascular risk including corresponding cardiovascular prevention in men with ED were calculated for the Swiss population over a period of 10 years. Results: Screening and cardiovascular prevention over a period of 10 years in Swiss men with ED of all seriousness degrees, moderate and severe ED only, or severe ED only can probably avoid 41,564, 35,627, or 21,206 acute CVD events, respectively. Number needed to screen (NNS) to prevent one acute CVD event is 30, 23, and 10, respectively. Costs for the screening intervention are expected to be covered at the seventh, the fifth, and the first year, respectively. Conclusion: Screening and intervention for cardiovascular risk factors in men suffering from ED is a cost-effective tool not only to strengthen prevention and early detection of cardiovascular diseases but also to avoid future cardiovascular events.
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Affiliation(s)
- Christoph Kalka
- Vascular Institute Central Switzerland, Aarau, Switzerland
- University of Cologne, Germany
| | - Hak-Hong Keo
- Vascular Institute Central Switzerland, Aarau, Switzerland
- Department of Angiology, University Hospital of Basel, Switzerland
| | - Maja Ingwersen
- Department of Radiology, Friedrich-Schiller-University, Jena University Hospital, Jena, Germany
| | - Jonas Knoechel
- Vascular Institute Central Switzerland, Aarau, Switzerland
| | - Hanno Hoppe
- University of Lucerne, Switzerland
- University of Bern, Switzerland
| | - Dai-Do Do
- Vascular Institute Central Switzerland, Aarau, Switzerland
- University of Bern, Switzerland
| | | | - Nicolas Diehm
- Vascular Institute Central Switzerland, Aarau, Switzerland
- University of Bern, Switzerland
- University of Applied Sciences Furtwangen, Villingen-Schwenningen, Germany
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Garcia-Silva J, Borrego IRS, Navarrete NN, Peralta-Ramirez MI, Águila FJ, Caballo VE. Efficacy of cognitive-behavioural therapy for lifestyle modification in metabolic syndrome: a randomised controlled trial with a 18-months follow-up. Psychol Health 2024; 39:195-215. [PMID: 35345950 DOI: 10.1080/08870446.2022.2055023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 03/14/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To test the efficacy of cognitive-behavioural therapy (CBT) for lifestyle modification in patients with metabolic syndrome (MetS). DESIGN 76 MetS patients completed this clinical trial, with 18 months follow-up. 45 participants from the experimental group (EG - CBT) and 31 to the control group (CG - usual care). The CBT programme was performed by a psychologist in a face-to-face group format, during 12 weekly sessions lasting 90 minutes. The intervention for the CG consisted of workshops with basic information about MetS and it's associated cardiovascular risk. MAIN OUTCOME MEASURES Efficacy of (CBT) in (MetS) patients. RESULTS Results showed reduction in weight (mean difference - MD -2.633, 95%CI [-4.322, -0.943]; p<.003), waist circumference (MD -2.944, 95%CI [-5.090, -0.798]; p<.008), body mass index (MD -0.915, 95%CI [-1.494, -0.335]; p<.003), systolic (MD -0.046, 95%CI [-0.685, -0.023]; p<.0002) diastolic blood pressure (MD -4.777, 95%CI [-7.750, -1.804]; p<.002), and cardiovascular risk score after 18 months. An increase in adherence to the Mediterranean diet and assertiveness and a reduction in anger were observed in EG. The CG did not show any significant differences. CONCLUSION The CBT focused on changes in lifestyle seems to be effective in the reduction of MetS and cardiovascular risk factors. TRIAL REGISTRATION Registered at clinicaltrials.gov (NCT02949622) - PROMETS (Multimodal Intervention Program for Patients with Metabolic Syndrome).
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Affiliation(s)
- Jaqueline Garcia-Silva
- Department of Personality, Assessment and Psychological Treatment, School of Psychology, University of Granada, Granada, Spain
| | | | - Nuria Navarrete Navarrete
- Clinical Management Unit, Department of Internal Medicine, University Hospital Complex of Granada, Granada, Spain
| | - María Isabel Peralta-Ramirez
- Department of Personality, Assessment and Psychological Treatment, School of Psychology, University of Granada, Granada, Spain
- CIMCYC: Centre for Mind, Brain and Behavioural Research, University of Granada, Granada, Spain
| | - Fernando Jaén Águila
- Hypertension and Vascular Risk Unit, Department of Internal Medicine, University Hospital Complex of Granada, Granada, Spain
| | - Vicente E Caballo
- Department of Personality, Assessment and Psychological Treatment, School of Psychology, University of Granada, Granada, Spain
- CIMCYC: Centre for Mind, Brain and Behavioural Research, University of Granada, Granada, Spain
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Arabi Z, Tawhari M, Alghamdi AA, Alnasrullah A. Lipid Management in Kidney Transplant Recipients Per KDIGO and American Heart Association Guidelines: A Single-Center Experience. Saudi J Med Med Sci 2024; 12:47-53. [PMID: 38362088 PMCID: PMC10866382 DOI: 10.4103/sjmms.sjmms_95_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 06/20/2023] [Accepted: 08/16/2023] [Indexed: 02/17/2024]
Abstract
Background The 2013 Kidney Disease: Improving Global Outcomes (KDIGO) guidelines recommends statin treatment for all adult kidney transplant recipients (KTRs), except those aged <30 years of age and without prior cardiovascular risk factors (CVRF), but does not specify on-treatment low-density lipoprotein cholesterol (LDL) target levels. The 2018 American Heart Association (AHA) guidelines addressed the management of hyperlipidemia in the general population based on an individualized approach of the CVRF with a specific on-treatment LDL target. Objective To analyze dyslipidemia management according to the recommendations of the KDIGO and AHA guidelines. Methods This retrospective study included all KTRs who underwent transplantation between January 2017 and May 2020 at King Abdulaziz Medical Center, Riyadh, Saudi Arabia. The rate of statins prescription in general, rate of statins prescription among KTRs per their CVRF, and rate of achieving the proposed LDL goals, as defined by the AHA, were analyzed. Results A total of 287 KTRs were included. Of the 214 (74.6%) patients aged ≥30 years, 80% received a statin. Statins were prescribed in 93% and 96% of KTRs with diabetes or coronary artery disease, respectively. In patients aged ≥30 years, LDL targets, per AHA guidelines, were achieved in 62% with a target of 2.6 mmol/l, and in 19% with a target of 1.8 mmol/l. Statin therapy resulted in non-significant changes in the mean LDL values from baseline to 12 months after transplantation (P = 0.607), even when only patients prescribed statin after transplantation were included (P = 0.34). Conclusion By applying the KDIGO guidelines, a high rate of statin prescriptions was achieved among KTRs with multiple CVRF and KTRs in general. However, a significant proportion of these KTRs did not achieve the LDL targets proposed by the AHA guidelines, suggesting that higher-intensity statins would be required to achieve these targets.
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Affiliation(s)
- Ziad Arabi
- Division of Nephrology, Department of Medicine, King Abdulaziz Medical City, Ministry of National Guard – Health Affairs, Riyadh, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Mohammed Tawhari
- Division of Nephrology, Department of Medicine, King Abdulaziz Medical City, Ministry of National Guard – Health Affairs, Riyadh, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Abdullah Ashour Alghamdi
- Division of Nephrology, Department of Medicine, King Abdulaziz Medical City, Ministry of National Guard – Health Affairs, Riyadh, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Ahmad Alnasrullah
- Division of Nephrology, Department of Medicine, King Abdulaziz Medical City, Ministry of National Guard – Health Affairs, Riyadh, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
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Kuckuck S, Lengton R, Boon MR, Boersma E, Penninx BWJH, Kavousi M, van Rossum EFC. Long-term glucocorticoids in relation to the metabolic syndrome and cardiovascular disease: A systematic review and meta-analysis. J Intern Med 2024; 295:2-19. [PMID: 37926862 DOI: 10.1111/joim.13739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
The striking link of Cushing's syndrome with the metabolic syndrome (MetS) and cardiovascular disease (CVD) suggests that long-term exposure to extremely high cortisol levels catalyzes cardiometabolic deterioration. However, it remained unclear whether the findings from the extreme glucocorticoid overabundance observed in Cushing's syndrome could be translated into more subtle variations in long-term glucocorticoid levels among the general population, for example, due to chronic stress. Here, we performed a systematic review (PROSPERO: CRD42023425541) of evidence regarding the role of subtle variations in long-term biological stress, measured as levels of scalp hair cortisol (HairF) and cortisone (HairE), in the context of MetS and CVD in adults. We also performed a meta-analysis on the cross-sectional difference in HairF levels between individuals with versus without CVD. Seven studies were included regarding MetS, sixteen regarding CVD, and one regarding both. Most articles indicated a strong, consistent cross-sectional association of higher HairF and HairE levels with CVD, which was confirmed by our meta-analysis for HairF (eight studies, SMD = 0.48, 95% confidence intervals [CIs]: 0.16-0.79, p = 0.0095). Moreover, these relationships appear largely independent of standard risk factors. Age seems relevant as the effect seems stronger in younger individuals. Results regarding the associations of HairF and HairE with MetS were inconsistent. Altogether, long-term biological stress, measured as HairF and HairE, is associated with the presence of CVD, and less consistently with MetS. Prospective studies need to evaluate the directionality of this relationship and determine whether HairF and HairE can be used in addition to standard risk factors in predicting future cardiometabolic deterioration.
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Affiliation(s)
- Susanne Kuckuck
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
- Obesity Center CGG, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Robin Lengton
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
- Obesity Center CGG, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Mariëtte R Boon
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
- Obesity Center CGG, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Eric Boersma
- Department of Cardiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry and Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Elisabeth F C van Rossum
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
- Obesity Center CGG, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
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Cacic AM, Schulz FI, Germing U, Dietrich S, Gattermann N. Molecular and clinical aspects relevant for counseling individuals with clonal hematopoiesis of indeterminate potential. Front Oncol 2023; 13:1303785. [PMID: 38162500 PMCID: PMC10754976 DOI: 10.3389/fonc.2023.1303785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 11/28/2023] [Indexed: 01/03/2024] Open
Abstract
Clonal hematopoiesis of indeterminate potential (CHIP) has fascinated the medical community for some time. Discovered about a decade ago, this phenomenon links age-related alterations in hematopoiesis not only to the later development of hematological malignancies but also to an increased risk of early-onset cardiovascular disease and some other disorders. CHIP is detected in the blood and is characterized by clonally expanded somatic mutations in cancer-associated genes, predisposing to the development of hematologic neoplasms such as MDS and AML. CHIP-associated mutations often involve DNA damage repair genes and are frequently observed following prior cytotoxic cancer therapy. Genetic predisposition seems to be a contributing factor. It came as a surprise that CHIP significantly elevates the risk of myocardial infarction and stroke, and also contributes to heart failure and pulmonary hypertension. Meanwhile, evidence of mutant clonal macrophages in vessel walls and organ parenchyma helps to explain the pathophysiology. Besides aging, there are some risk factors promoting the appearance of CHIP, such as smoking, chronic inflammation, chronic sleep deprivation, and high birth weight. This article describes fundamental aspects of CHIP and explains its association with hematologic malignancies, cardiovascular disorders, and other medical conditions, while also exploring potential progress in the clinical management of affected individuals. While it is important to diagnose conditions that can lead to adverse, but potentially preventable, effects, it is equally important not to stress patients by confronting them with disconcerting findings that cannot be remedied. Individuals with diagnosed or suspected CHIP should receive counseling in a specialized outpatient clinic, where professionals from relevant medical specialties may help them to avoid the development of CHIP-related health problems. Unfortunately, useful treatments and clinical guidelines for managing CHIP are still largely lacking. However, there are some promising approaches regarding the management of cardiovascular disease risk. In the future, strategies aimed at restoration of gene function or inhibition of inflammatory mediators may become an option.
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Affiliation(s)
- Anna Maria Cacic
- Department of Hematology, Oncology and Clinical Immunology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine Universität Düsseldorf, Düsseldorf, Germany
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Düsseldorf, Germany
| | - Felicitas Isabel Schulz
- Department of Hematology, Oncology and Clinical Immunology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine Universität Düsseldorf, Düsseldorf, Germany
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Düsseldorf, Germany
| | - Ulrich Germing
- Department of Hematology, Oncology and Clinical Immunology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine Universität Düsseldorf, Düsseldorf, Germany
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Düsseldorf, Germany
| | - Sascha Dietrich
- Department of Hematology, Oncology and Clinical Immunology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine Universität Düsseldorf, Düsseldorf, Germany
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Düsseldorf, Germany
| | - Norbert Gattermann
- Department of Hematology, Oncology and Clinical Immunology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine Universität Düsseldorf, Düsseldorf, Germany
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Düsseldorf, Germany
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Datta BK, Coughlin SS, Gummadi A, Mehrabian D, Ansa BE. Perceived Social Support and Cardiovascular Risk Among Nonelderly Adults in the United States. Am J Cardiol 2023; 209:146-153. [PMID: 37865124 DOI: 10.1016/j.amjcard.2023.09.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/17/2023] [Accepted: 09/27/2023] [Indexed: 10/23/2023]
Abstract
Hypertension, diabetes mellitus, dyslipidemia, and obesity are major risk factors of cardiovascular diseases. A recent study projected a marked surge in these cardiometabolic conditions in the United States by the year 2060, posing a challenge for cardiovascular disease management in the coming years. This study aimed to explore and quantify the relation of a key psychosocial factor, social support, with the cardiovascular risk factors among nonelderly US adults (aged 18 to 64 years). Using data on 19,827 adults from the 2021 National Health Interview Survey, we assessed whether lower level of social support was associated with higher likelihood of having cardiovascular risks. We found that for subjects who "rarely/never" received social support, the adjusted odds of having hypertension, high cholesterol, and diabetes were 1.42 (95% confidence interval [CI] 1.20 to 1.67), 1.39 (95% CI 1.18 to 1.65), and 1.53 (95% CI 1.22 to 1.91) times those of subjects "always" receiving support, respectively. Further, compared with the base outcome of no CV risk, the adjusted relative risks of having 3+ cardiovascular risks for subjects "rarely/never" receiving support were 1.91 (95% CI 1.49 to 2.46) times that of those "always" receiving support. These results were robust across socioeconomic status condition sub-groups manifested by educational attainment and income. In conclusion, our findings suggest that social support may be considered as a critical part of the comprehensive efforts to mitigate the future burden of cardiovascular diseases in the United States.
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Affiliation(s)
- Biplab Kumar Datta
- Institute of Public and Preventive Health, Augusta University, Augusta, Georgia; Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, Georgia.
| | - Steven S Coughlin
- Institute of Public and Preventive Health, Augusta University, Augusta, Georgia; Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Aneesha Gummadi
- Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Daniel Mehrabian
- Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Benjamin E Ansa
- Institute of Public and Preventive Health, Augusta University, Augusta, Georgia
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Smith CE, Kukolja J. Prevalence and risk factors of ischemic monocular vision loss and concurrent brain ischemia. Eur Stroke J 2023; 8:982-988. [PMID: 37593943 PMCID: PMC10683730 DOI: 10.1177/23969873231191577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 07/09/2023] [Indexed: 08/19/2023] Open
Abstract
INTRODUCTION We performed a retrospective cohort study to identify predictors of concurrent asymptomatic brain ischemia in patients with ischemic monocular vision loss. PATIENTS AND METHODS An inpatient database research of admissions to the Helios University Hospital Wuppertal, Germany between 01/2016 and 12/2020 was conducted. Inclusion criteria were confirmed diagnosis of transient monocular vision loss (MVL), retinal artery occlusion (RAO), and magnetic resonance imaging (MRI) of the brain within 10 days of MVL. Silent brain ischemia (SBI) was defined as diffusion restrictions with corresponding reduced apparent diffusion coefficient in MRI and an absence of neurological deficits besides those complying with MVL in clinical examination. The prevalence and cardiovascular predictors of SBI were analyzed with logistic regression and an artificial neural network. RESULTS One hundred fourteen out of 475 patients treated with monocular vision loss were included in this study. The mean age was 67.7 ± 13.6 years. 48.2% were male and 47.4% had RAO. MRI scan of the brain was performed after 3.9 ± 2.3 days and detected SBI in 17%. Age ⩾67 years, cardiac etiology of MVL, and cerebral ischemia in medical history were revealed as predictors of SBI in MRI. CONCLUSIONS Patients older than 66 years, with a suspected cardiac embolism as the cause of RAO and previous cerebral ischemia, are more likely to present SBI in cerebral MRI. Therefore, MR imaging, particularly in these patients, can be useful.
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Affiliation(s)
- Cathy E Smith
- Department of Neurology and Clinical Neurophysiology, Helios University Hospital Wuppertal, Wuppertal, Germany
- Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Juraj Kukolja
- Department of Neurology and Clinical Neurophysiology, Helios University Hospital Wuppertal, Wuppertal, Germany
- Faculty of Health, Witten/Herdecke University, Witten, Germany
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32
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Britton RC, Beamish NF. The Impact of Testosterone Therapy on Cardiovascular Risk Among Postmenopausal Women. J Endocr Soc 2023; 8:bvad132. [PMID: 38178905 PMCID: PMC10765381 DOI: 10.1210/jendso/bvad132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Indexed: 01/06/2024] Open
Abstract
Purpose To summarize the current state of knowledge surrounding the impact of testosterone therapy on cardiovascular risk factors in postmenopausal women. Methodology In this scoping review, a comprehensive search of peer-reviewed literature was conducted in adherence to a methodological framework comprising 4 distinct stages: conceptualizing a comprehensive search strategy, screening relevant publications, extracting pertinent data, and organizing and synthesizing the resultant findings. The search used electronic databases, including MEDLINE, Embase, and Google Scholar, to ensure an exhaustive survey of the available literature. Results The database search yielded 150 articles, including systematic reviews, registered trials, and peer-reviewed studies, of which 48 duplicates were removed. Following the title/abstract screening, 36 publications were included in the full-text review. On completion of the full-text review, using the inclusion/exclusion criteria, 29 articles were excluded and 7 remained for data extraction and qualitative synthesis. Main Conclusion Existing research provides promising insights into the benefits of low-dose testosterone therapy, typically combined with estrogen therapy. These benefits may include positive impacts on body composition, functional capacity, insulin sensitivity, inflammatory markers, and cholesterol. However, there remains a substantial lack of knowledge surrounding the effects and mechanisms behind testosterone therapy in postmenopausal women in relation to its impacts on cardiovascular risk. High-quality, evidence-based clinical intervention research is needed to investigate testosterone therapy's potential implication on cardiovascular risk factors in post-menopausal women.
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Affiliation(s)
- Rhys C Britton
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - Nicole F Beamish
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario K7L 3N6, Canada
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Urriza-Trejo S, Hurtazo H, Palacios J, Cruz-Soto M. The Association of Insomnia and Stress on Cardiovascular Risk Factors during COVID-19 Confinement in the Mexican Population. Int J Environ Res Public Health 2023; 20:7135. [PMID: 38063565 PMCID: PMC10706477 DOI: 10.3390/ijerph20237135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/25/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023]
Abstract
During the pandemic confinement, the WHO changed the term "social distancing" to "physical distancing", to help people deal with the lack of social contact. As a result, there was an increase in mental health problems, including insomnia and stress, with a negative impact on cardiovascular health. The objective of this research was to identify the association between insomnia and stress and cardiovascular risk (CVR) during the pandemic in a sample of the general population in Mexico; the participants were chosen using the non-probabilistic method. The data were obtained from an online questionnaire about medical histories focused on cardiovascular risk, according to the Official Mexican Standards and Regulations for patients' clinical records, NOM-004-SSA3-2012, along with an index for the severity of insomnia, measured with a seven-item guide, and an instrument to measure stress. The data were analyzed with descriptive statistics for several different variables: sociodemographics, stress, insomnia, and cardiovascular risk. Cardiovascular risk was compared to insomnia and stress variables, which led to statistically significant differences and correlations between the variables. Participants were divided into four groups with respect to CVR, from low to very high CVR. This research demonstrated that women were more susceptible to stress and cardiovascular risk. However, stress was a more major indicator of CVR than insomnia, but in the high and very high CVR groups, insomnia contributed along with stress; coping strategies reduced the risk in the high CVR group but did not function as expected with respect to reducing risk in the very high CVR group. These findings suggest that sleep patterns and mental health alterations present during the pandemic may persist even when the pandemic was declared as having ended and may contribute to increases in cardiovascular risk in the long-term.
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Affiliation(s)
| | | | | | - Martha Cruz-Soto
- Escuela de Ciencias de la Salud, Campus Querétaro, Universidad del Valle de México, Boulevard Juriquilla No. 1000 A, Delegación Santa Rosa Jáuregui, Querétaro 76230, Mexico; (S.U.-T.); (H.H.); (J.P.)
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Yu J, Xia J, Xu D, Wang Y, Yin S, Lu Y, Xia H, Wang S, Sun G. Effect of skipping breakfast on cardiovascular risk factors: a grade-assessed systematic review and meta-analysis of randomized controlled trials and prospective cohort studies. Front Endocrinol (Lausanne) 2023; 14:1256899. [PMID: 38089630 PMCID: PMC10715426 DOI: 10.3389/fendo.2023.1256899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 10/31/2023] [Indexed: 12/18/2023] Open
Abstract
Skipping breakfast is one of the most prevalent irregular eating habits. Several pieces of evidence have reported the association between breakfast omission and a higher risk of cardiovascular diseases. Numerous publications have focused on the impact of skipping breakfast on various cardiovascular risk factors. Therefore, the current systematic review and meta-analysis aimed to assess this impact, especially with regard to anthropometric measurements, serum lipid profiles, blood pressure, and glycemic control indicators. A comprehensive search was performed in PubMed, Web of Science, Embase, Scopus, and the Cochrane Central Register of Controlled Trials up to 1 April 2023. A total of 11 eligible trials were identified to evaluate the combined effects of skipping breakfast. Final integrated results demonstrated that breakfast omission significantly decreased the body weight (mean difference = -0.66, 95% CI: -1.09 to -0.24, p = 0.002, I2 = 0.0) and increased the level of serum low-density lipoprotein cholesterol (LDL-C) (mean difference = 9.89, 95% CI: 5.14 to 14.63, p = 0.000, I2 = 17.3). Subgroup analysis also revealed potential factors that may affect the outcomes, for example, the physiological condition of participants, duration, gender, and type of breakfast. In conclusion, skipping breakfast may reduce body weight while increasing the level of serum LDL-C at the same time. In view of the limited trials, further studies are needed to expound the role of breakfast omission in cardiovascular diseases.
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Affiliation(s)
- Junhui Yu
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, China
- Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
| | - Jiayue Xia
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, China
- Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
| | - Dengfeng Xu
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, China
- Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
| | - Yuanyuan Wang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, China
- Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
| | - Shiyu Yin
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, China
- Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
| | - Yifei Lu
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, China
- Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
| | - Hui Xia
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, China
- Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
| | - Shaokang Wang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, China
- Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
| | - Guiju Sun
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, China
- Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
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Trzeciak BG, Kowalczyk W, Grymek S, Gutknecht P, Siebert J. Cardiovascular risk factors among Polish employees of uniformed services. Int J Occup Med Environ Health 2023; 36:656-671. [PMID: 37962060 DOI: 10.13075/ijomeh.1896.02205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2023] Open
Abstract
OBJECTIVES Employees of uniformed services (EoUS) were screened for cardiovascular risk factors. MATERIAL AND METHODS A total of 1138 EoUS (age M±SD 49.9±6.0 years) and 263 controls (age M±SD 54.4±9.7 years) under the care of the cardiology clinic in Gdańsk, Poland, were included in the study. Medical history and blood samples were collected, and a physical examination was performed. Ten-year cardiovascular risk of death was calculated using the systematic coronary risk evaluation (SCORE) risk algorithm for high-risk countries. RESULTS Significantly higher values of mean systolic and mean diastolic blood pressure, mean total cholesterol level and mean BMI were recorded among the EoUS compared to controls (M±SD 141.7±11.6 mm Hg vs. 135.5±11.0 mm Hg, p < 0.001; 90.1±5.9 mm Hg vs. 84.5±6.8 mm Hg, p < 0.001; 6.01±0.76 mmol vs. 5.44±0.87 mmol, p < 0.001; 29.3±4.7 vs. 29.0±4.1, p < 0.001, respectively). Smoking cigarettes was most frequently reported by the youngest group (20-39 years old) - 47.7% and it was significantly higher in the entire EoUS group compared to control group (35.5% vs. 16.7%, p = 0.001). The occurrence of observed risk factors (blood pressure ≥140/90 mm Hg, total cholesterol concentration >5 mmol, smoking,) was significantly higher among EoUS compared to controls (92.1% vs. 57.8%, p < 0.001; 89.0% vs. 66.9%, p < 0.001; 35.5% vs. 16.7%, p < 0.001, respectively). In the male group, the mean calculated ten-year risk of fatal cardiovascular events, the percentage of high calculated risk, and very high risk were higher in the EoUS group compared to controls (M±SD 4.44±3.49 vs. 4.23±3.86, p = 0.001; 23.7% vs. 20.2%, p = 0.007; 7.4% vs. 6.5%, p = 0.03, respectively). CONCLUSIONS The prevalence of all identified risk factors was found to be higher among employees of uniformed services when compared to the control group. The presence of these risk factors within the population of uniformed service employees results in a greater risk of mortality from cardiovascular diseases. Int J Occup Med Environ Health. 2023;36(5):656-71.
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Affiliation(s)
- Bartosz G Trzeciak
- Medical University of Gdansk, Gdańsk, Poland (Intercollegiate University Centre for Cardiology Fahrenheit Universities, Department of Family Medicine)
| | - Waldemar Kowalczyk
- Pomeranian Regional Medical Commission in Gdańsk of the Ministry of Interior and Administration, Gdańsk, Poland
| | - Szymon Grymek
- Gdańsk University of Technology, Gdańsk, Poland (Institute of Mechanics and Machine Design, Faculty of Mechanical Engineering and Ship Technology)
| | - Piotr Gutknecht
- Medical University of Gdansk, Gdańsk, Poland (Intercollegiate University Centre for Cardiology Fahrenheit Universities, Department of Family Medicine)
| | - Janusz Siebert
- Medical University of Gdansk, Gdańsk, Poland (Intercollegiate University Centre for Cardiology Fahrenheit Universities, Department of Family Medicine)
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Zhao L, Ingram DK, Gumpricht E, De Paoli T, Teong XT, Liu B, Mori TA, Heilbronn LK, Roth GS. Effects of an Unripe Avocado Extract on Glycaemic Control in Individuals with Obesity: A Double-Blinded, Parallel, Randomised Clinical Trial. Nutrients 2023; 15:4812. [PMID: 38004206 PMCID: PMC10674186 DOI: 10.3390/nu15224812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/14/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Unripe avocados (Persea americana) are naturally enriched in mannoheptulose (MH), which is a candidate caloric restriction mimetic. OBJECTIVES To evaluate the effects of a diet supplement made from unripe avocado on glucose tolerance, and cardiometabolic risk factors in free-living nondiabetic adults with obesity. METHODS In a double-blinded, randomised controlled trial, 60 adults (female n = 47, age 48 ± 13 years, BMI 34.0 ± 2.6 kg/m2) were stratified by sex and randomised to avocado extract (AvX, 10 g finely ground, freeze-dried unripe avocado) or placebo (10 g finely ground cornmeal plus 5% spinach powder) daily, for 12 weeks. The primary outcome was a change in glucose area under the curve (AUC) in response to a 75 g oral glucose tolerance test. A post-hoc analysis was subsequently performed in a subgroup with insulin AUC above the median of baseline values after removal of participants >2 SD from the mean. RESULTS There were no between-group differences in glucose AUC (p = 0.678), insulin AUC (p = 0.091), or cardiovascular outcomes. In the subgroup analysis, insulin AUC was lower in AxV versus placebo (p = 0.024). CONCLUSIONS Daily consumption of unripe avocado extract enriched in MH did not alter glucose tolerance or insulin sensitivity in nondiabetic adults with obesity, but the data provided preliminary evidence for a benefit in insulin AUC in a subgroup of participants with elevated baseline postprandial insulin levels.
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Affiliation(s)
- Lijun Zhao
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5005, Australia; (L.Z.); (X.T.T.); (B.L.); (L.K.H.)
- Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
| | - Donald K. Ingram
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA 70808, USA
| | | | | | - Xiao Tong Teong
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5005, Australia; (L.Z.); (X.T.T.); (B.L.); (L.K.H.)
- Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
| | - Bo Liu
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5005, Australia; (L.Z.); (X.T.T.); (B.L.); (L.K.H.)
- Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
| | - Trevor A. Mori
- Discipline of Internal Medicine, Medical School, University of Western Australia, Perth, WA 6000, Australia;
| | - Leonie K. Heilbronn
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5005, Australia; (L.Z.); (X.T.T.); (B.L.); (L.K.H.)
- Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
| | - George S. Roth
- Prolongevity Technologies LLC, Pylesville, MD 21132, USA;
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Sánchez-Bacaicoa C, Santano-Mogena E, Rico-Martín S, Rey-Sánchez P, Juárez-Vela R, Sánchez Muñoz-Torrero JF, López-Espuela F, Calderón-García JF. Association between Asymptomatic Hyperuricemia with Adiposity Indices: A Cross-Sectional Study in a Spanish Population. Nutrients 2023; 15:4798. [PMID: 38004193 PMCID: PMC10675342 DOI: 10.3390/nu15224798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/14/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023] Open
Abstract
INTRODUCTION New anthropometric indices have been developed as an alternative to body mass index (BMI) and waist circumference (WC) to assess body mass and visceral fat. Asymptomatic hyperuricemia is considered an independent cardiovascular risk factor. Currently, little is known about the relationship between asymptomatic hyperuricemia and several new anthropometric indices. This study aimed to assess the association between the presence of asymptomatic hyperuricemia and anthropometric indices, both novel and traditional. METHODS This study analyzed 1094 Spanish subjects who consecutively visited the cardiovascular risk consultation of the University Hospital San Pedro de Alcántara of Cáceres, Spain, between June 2021 and September 2022. Anthropometric measures, including traditional and novel indices, were determined. The asymptomatic hyperuricemia group was defined according to serum uric acid levels. RESULTS All the anthropometric indices studied, including new and traditional, were significantly greater among patients with asymptomatic hyperuricemia, except for WWI. In multiple linear regression analysis, serum uric acid levels were significantly correlated with BMI, WHR, WHtR, AVI, BAI, BRI, CUN-BAE, and WWI but not ABSI or CI. In the univariate analysis, all indices were associated with asymptomatic hyperuricemia (p < 0.05); however, only WHtR (adjusted OR: 2.93; 95% CI: 1.03-8.37; p = 0.044), AVI (adjusted OR: 1.46; 95% CI: 1.04-2.04; p = 0.026), and BRI (adjusted OR: 1.66; 95% CI: 1.19-2.32; p = 0.003) were significantly associated in multivariate analysis. Finally, WHtR, AVI, and BRI provided the largest AUCs. CONCLUSIONS Our findings showed that WHtR, AVI, and BRI were independently positively associated with asymptomatic hyperuricemia and could be good predictors.
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Affiliation(s)
| | - Esperanza Santano-Mogena
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, 10003 Cáceres, Spain; (E.S.-M.); (P.R.-S.); (F.L.-E.); (J.F.C.-G.)
| | - Sergio Rico-Martín
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, 10003 Cáceres, Spain; (E.S.-M.); (P.R.-S.); (F.L.-E.); (J.F.C.-G.)
| | - Purificación Rey-Sánchez
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, 10003 Cáceres, Spain; (E.S.-M.); (P.R.-S.); (F.L.-E.); (J.F.C.-G.)
| | - Raúl Juárez-Vela
- Department of Nursing, Faculty of Health Sciences, University of La Rioja, 26006 Logroño, Spain;
| | | | - Fidel López-Espuela
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, 10003 Cáceres, Spain; (E.S.-M.); (P.R.-S.); (F.L.-E.); (J.F.C.-G.)
| | - Julián F. Calderón-García
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, 10003 Cáceres, Spain; (E.S.-M.); (P.R.-S.); (F.L.-E.); (J.F.C.-G.)
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Wang S, Adamian R, Heredia K, Elahi A, McCleary P, Hopkins W. Cardiovascular Youth for Life: Prevalence of Acquired Cardiovascular Diseases in the Adult Population With Down Syndrome. Am J Cardiol 2023; 207:10-12. [PMID: 37722195 DOI: 10.1016/j.amjcard.2023.08.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 09/20/2023]
Affiliation(s)
- Sean Wang
- Larner College of Medicine, University of Vermont, Burlington, Vermont.
| | - Robert Adamian
- Larner College of Medicine, University of Vermont, Burlington, Vermont
| | - Kiana Heredia
- Larner College of Medicine, University of Vermont, Burlington, Vermont
| | - Aria Elahi
- Larner College of Medicine, University of Vermont, Burlington, Vermont
| | - Paul McCleary
- Larner College of Medicine, University of Vermont, Burlington, Vermont
| | - William Hopkins
- Department of Medicine, Cardiovascular Medicine, University of Vermont Medical Center, Burlington, Vermont
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Koblinsky ND, Carmichael PH, Belleville S, Fiocco AJ, Gaudreau P, Greenwood CE, Kergoat MJ, Morais JA, Presse N, Laurin D, Ferland G. Associations between circulating cardiovascular disease risk factors and cognitive performance in cognitively healthy older adults from the NuAge study. Front Aging Neurosci 2023; 15:1274794. [PMID: 38020779 PMCID: PMC10668121 DOI: 10.3389/fnagi.2023.1274794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 09/26/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Cardiovascular disease risk factors (CVRFs) contribute to the development of cognitive impairment and dementia. Methods This study examined the associations between circulating CVRF biomarkers and cognition in 386 cognitively healthy older adults (mean age = 78 ± 4 years, 53% females) selected from the Quebec Longitudinal Study on Nutrition and Successful Aging (NuAge). Memory, executive function, and processing speed were assessed at baseline and 2-year follow-up. CVRF biomarkers included total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), triglycerides, glucose, insulin, high sensitivity C-reactive protein (hs-CRP), homocysteine, protein carbonyls, and cortisol. Linear mixed models were used to determine associations between individual CVRF biomarkers and cognition at both time points. Results HDL-C was most consistently associated with cognition with higher values related to better performance across several domains. Overall, stronger and more consistent relationships between CVRF biomarkers and cognition were observed in females relative to males. Discussion Findings suggest that increases in the majority of circulating CVRFs are not associated with worse cognition in cognitively healthy older adults.
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Affiliation(s)
- Noah D. Koblinsky
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
| | - Pierre-Hugues Carmichael
- Center d’excellence sur le Vieillissement de Québec, Center de Recherche du Center Hospitalier Universitaire (CHU) de Québec-Université Laval and VITAM-Center de Recherche en Santé Durable, Center Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) de la Capitale Nationale, Québec, QC, Canada
| | - Sylvie Belleville
- Center de Recherche de l’Institut Universitaire de Gériatrie de Montréal, CIUSSS du Center-Sud-de-l’Île-de-Montréal, Montreal, QC, Canada
| | - Alexandra J. Fiocco
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
| | - Pierrette Gaudreau
- Center de Recherche du Center Hospitalier de l’Université de Montréal and Faculté de Médecine, Université de Montréal, Montreal, QC, Canada
| | - Carol E. Greenwood
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | | | - José A. Morais
- Division of Geriatrics, McGill University, Montreal, QC, Canada
| | - Nancy Presse
- Center de Recherche du Center Hospitalier de l’Université de Montréal and Faculté de Médecine, Université de Montréal, Montreal, QC, Canada
- Faculté de Médecine et des Sciences de la Santé de l’Université de Sherbrooke, Sherbrooke, QC, Canada
- Center de Recherche sur le Vieillissement du CIUSSS de l’Estrie-Center Hospitalier Universitaire de Sherbrooke (CHUS), Sherbrooke, QC, Canada
| | - Danielle Laurin
- Center d’excellence sur le Vieillissement de Québec, Center de Recherche du Center Hospitalier Universitaire (CHU) de Québec-Université Laval and VITAM-Center de Recherche en Santé Durable, Center Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) de la Capitale Nationale, Québec, QC, Canada
- Faculté de Pharmacie, Institut sur le Vieillissement et la Participation Sociale des Aînés and Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Montreal, ON, Canada
| | - Guylaine Ferland
- Montreal Heart Institute Research Center, and Département de Nutrition, Université de Montréal, Montreal, QC, Canada
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Sacramento-Pacheco J, Sánchez-Gómez MB, Gómez-Salgado J, Novo-Muñoz MM, Duarte-Clíments G. Prevalence of Cardiovascular Risk Factors in Spain: A Systematic Review. J Clin Med 2023; 12:6944. [PMID: 37959409 PMCID: PMC10650307 DOI: 10.3390/jcm12216944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 10/30/2023] [Accepted: 11/03/2023] [Indexed: 11/15/2023] Open
Abstract
Cardiovascular diseases are the leading cause of death in Spain, according to data from the National Institute of Statistics, with the lack of control of cardiovascular risk factors (CVRF) being the main contributing factor. The CVRFs of greatest clinical interest are high blood pressure (HBP), smoking, diabetes mellitus (DM2), overweight, obesity, hypercholesterolaemia, and sedentary lifestyle. The main objective of this review was to compare the prevalence of the different CVRFs according to population-based studies carried out in Spain. For this, a systematic review based on publications assessing CVRFs in the adult population and estimating their national prevalence was conducted. Pubmed and Dialnet databases were consulted, and the selected articles were analysed using the Critical Appraisal Skills Programme Español (CASPe) tool for cohort studies and the Berra et al. tool for cross-sectional studies. A total of 33 studies were obtained from the autonomous regions of Andalusia, the Canary Islands, Castilla-Leon, Castilla-La Mancha, Catalonia, Extremadura, the Balearic Islands, Madrid, Murcia, and Navarra. In all the population-based studies, there was a greater representation of women in the sample. The most prevalent CVRFs differed across the studies according to the autonomous region targeted, with dyslipidaemia, sedentary lifestyle, high blood pressure, hypercholesterolaemia, overweight, and obesity standing out. Numerous differences exist between the studies included in this review, such as the age range, the CVRFs analysed and their prevalence, and remarkable aspects such as the over-representation of the female sex in all cases. It can be concluded that, based on the presented results, the prevalence of CVRFs in Spain varies according to the autonomous region, the sex of the individual, and the studied age range.
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Affiliation(s)
- Jennifer Sacramento-Pacheco
- Nuestra Señora de Candelaria Nursing University School, University of La Laguna, 38010 San Cristóbal de La Laguna, Spain
- Europa Sur Educational Centre (CESUR Tenerife), 38006 Santa Cruz de Tenerife, Spain
| | - María Begoña Sánchez-Gómez
- Cátedra de Enfermería, Universidad de La Laguna, 38200 San Cristóbal de La Laguna, Spain
- Cieza Este Health Centre, Area IX, Servicio Murciano de Salud, 30530 Murcia, Spain
| | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, 21071 Huelva, Spain
- Safety and Health Postgraduate Program, Universidad Espíritu Santo, Guayaquil 092301, Ecuador
| | - María Mercedes Novo-Muñoz
- Department of Nursing, Faculty of Health Sciences, University of La Laguna, 38200 San Cristóbal de La Laguna, Spain
| | - Gonzalo Duarte-Clíments
- Cátedra de Enfermería, Universidad de La Laguna, 38200 San Cristóbal de La Laguna, Spain
- Case Management, Area IX, Servicio Murciano de Salud, 30530 Murcia, Spain
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Nagao A, Chikasawa Y, Sawada A, Kanematsu T, Yamasaki N, Takedani H, Nojima M, Fujii T, Suzuki N, Matsushita T, Higasa S, Amano K. Haemophilia and cardiovascular disease in Japan: Low incidence rates from ADVANCE Japan baseline data. Haemophilia 2023; 29:1519-1528. [PMID: 37806778 DOI: 10.1111/hae.14876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 08/15/2023] [Accepted: 09/19/2023] [Indexed: 10/10/2023]
Abstract
INTRODUCTION With the increasing life expectancy of people with haemophilia, the risk of cardiovascular disease (CVD) and thrombotic events has become a growing concern. Longitudinal studies on the incidence and risk factors of CVD in this population are limited, and optimal prevention and treatment strategies are yet to be established. AIM This study aimed to present the baseline data of a prospective longitudinal study focusing on a subset of Japanese patients with haemophilia, specifically investigated the incidence, risk factors and treatment modalities for CVD and thrombotic diseases in people aged 40 years in Japan over 10 years through the ADVANCE Japan study. METHODS The ADVANCE Japan study is a prospective multicentre cohort study involving 600 adult individuals with haemophilia A/B aged 40 years in Japan. The primary endpoint was the incidence of CVD, with secondary endpoints encompassing anticoagulant use, mortality rates, and comparison with the general population. RESULTS Baseline data from the 600 participants revealed that thrombotic events occurred in 13 individuals (2.2%), mostly in those with haemophilia A. Atrial fibrillation was observed in 11 participants (1.8%). Hypertension and dyslipidaemia were identified as the prevalent risk factors. Various prophylactic treatments were employed, and no severe bleeding events were observed during the study period. CONCLUSION This study provides vital baseline data for a 10-year prospective investigation of CVD and thrombotic disease risk in people with haemophilia. These findings will contribute to refining prevention and treatment approaches and improving patients' quality of life.
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Affiliation(s)
- Azusa Nagao
- Department of Blood Coagulation, Ogikubo Hospital, Tokyo, Japan
| | - Yushi Chikasawa
- Department of Laboratory Medicine, Tokyo Medical University, Tokyo, Japan
| | - Akihiro Sawada
- Department of Respiratory Medicine and Hematology, Hyogo Medical University, Hyogo, Japan
| | - Takeshi Kanematsu
- Department of Clinical Laboratory, Nagoya University Hospital, Aichi, Japan
| | - Naoya Yamasaki
- Division of Transfusion Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Hideyuki Takedani
- National Hospital Organization Tsuruga Medical Center, Department of Physiotherapy, Fukui, Japan
| | - Masanori Nojima
- Center for Translational Research, The Institute of Medical Science Hospital, The University of Tokyo, Tokyo, Japan
| | - Teruhisa Fujii
- Division of Transfusion Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Nobuaki Suzuki
- Department of Transfusion Medicine, Nagoya University Hospital, Aichi, Japan
| | - Tadashi Matsushita
- Department of Transfusion Medicine, Nagoya University Hospital, Aichi, Japan
| | - Satoshi Higasa
- Department of Respiratory Medicine and Hematology, Hyogo Medical University, Hyogo, Japan
| | - Kagehiro Amano
- Department of Laboratory Medicine, Tokyo Medical University, Tokyo, Japan
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Raharinavalona SA, Miandrisoa RM, Raherison RE, Razanamparany T, Andrianasolo RL, Rakotomalala ADP. Prevalence and factors associated with carotid atherosclerosis in a Malagasy population with Type 2 diabetes mellitus: A cross-sectional retrospective study. Endocrinol Diabetes Metab 2023; 6:e457. [PMID: 37817456 PMCID: PMC10638618 DOI: 10.1002/edm2.457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 09/25/2023] [Accepted: 09/30/2023] [Indexed: 10/12/2023] Open
Abstract
AIM Our study aims to determine the prevalence and factors associated with carotid atherosclerosis in Malagasy Type 2 diabetes mellitus (T2DM). METHODS This was a cross-sectional retrospective study, carried out over a period of 30 months. The diagnosis of carotid atherosclerosis is established by the presence of a carotid plaque increased carotid intima-media thickness ≥1.1 mm on Doppler ultrasound. RESULTS We included 132 T2DM. The prevalence of carotid atherosclerosis was 63.6% (38.6% carotid plaque and 25% intima-media thickening). After univariate analysis, the factors associated with carotid atherosclerosis were age ≥70 years (3.28 [1.18-10, 62]), previous intake of oral antidiabetics (0.33 [0.14-0.73]), insulin (0.28 [0.11-0.66]) and angiotensin receptor blocker (0.45 [0.20-0.98]), and current smoking (5.93 [1.64-32.6]). After adjustment for age and gender, previous intake of oral antidiabetics (0.29 [0.13-0.64]), insulin (0.27 [0.12-0.61]) and angiotensin receptor blocker (0.40 [0.19-0.86]), and current smoking (5.98 [1.61-22.1]) were associated with carotid atherosclerosis. CONCLUSION Smoking cessation, education on therapeutic compliance and comprehensive management of all cardiovascular risk factors and T2DM are therefore essential in order to reduce the occurrence of carotid atherosclerosis.
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Affiliation(s)
| | - Rija Mikhaël Miandrisoa
- Cardiovascular Diseases and Internal Medicine departmentsSoavinandriana Hospital CenterAntananarivoMadagascar
| | - Rija Eric Raherison
- Endocrinology DepartmentJoseph Raseta Befelatanana University Hospital CenterAntananarivoMadagascar
| | - Thierry Razanamparany
- Endocrinology DepartmentJoseph Raseta Befelatanana University Hospital CenterAntananarivoMadagascar
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Hiles M, Simmons A, Hilleman D, Gibson CA, Backes JM. Atherosclerotic Cardiovascular Disease in Women: Providing Protection With Lipid-altering Agents. Clin Ther 2023; 45:1127-1136. [PMID: 37770308 DOI: 10.1016/j.clinthera.2023.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 06/07/2023] [Accepted: 08/29/2023] [Indexed: 09/30/2023]
Abstract
PURPOSE Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death in women, yet it remains underdiagnosed, undertreated, and understudied in women compared with men. Although estrogen has provided observational evidence of cardioprotection, randomized controlled trials using hormone replacement therapy have generally produced unfavorable results. METHODS For this narrative review, a literature search was performed using the key words cardiovascular disease, women, and dyslipidemia in PubMed and Google Scholar with no date limitations. References within each article were also reviewed for additional relevant articles. FINDINGS Sex-specific risk factors and underrecognized conditions more predominant in women elevate ASCVD risk, creating further clinical challenges, such as the need for accurate risk stratification, compared with in men. Dyslipidemia frequently manifests or worsens during the menopausal transition. Therefore, identification during midlife and implementing lipid-lowering strategies to reduce ASCVD risk is imperative. Women have historically been poorly represented in cardiovascular (CV) outcome trials. However, more recent studies and meta-analyses have indicated that lipid-lowering therapies are equally effective in women and produce similar reductions in CV events and total mortality. Major cholesterol guidelines address many of the challenges that clinicians face when assessing ASCVD risk in women. Key points specific to women include obtaining a detailed history of pregnancy-related conditions, identification of common autoimmune disorders associated with systemic inflammation, and use of 10-year ASCVD risk calculators and imaging modalities (coronary artery calcium) to optimize ASCVD assessment. In terms of treatment, similar to men, women with existing ASCVD or high-risk primary prevention patients should be treated aggressively to achieve ≥50% LDL-C reductions and/or LDL-C goals as low as <55 mg/dL. Appropriate lipid-lowering therapies include high-intensity statins with or without ezetimibe and proprotein convertase subtilisin kexin/type 9 inhibitors. Women with lower ASCVD risk may be considered for low- to moderate-intensity statin therapy (approximately 30%-50% LDL-C reduction). All women, regardless of ASCVD risk category, should implement therapeutic lifestyle changes, which improve many common age-related cardiometabolic conditions. IMPLICATIONS Although ASCVD and current risk factor trends in women are concerning, numerous evidence-based approaches are available to protect women with ASCVD risk from life-changing CV events.
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Affiliation(s)
- Megan Hiles
- Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas
| | - Ashley Simmons
- Department of Cardiovascular Medicine, University of Kansas Medical Center, Kansas City, Kansas
| | - Daniel Hilleman
- Creighton University School of Pharmacy and Health Professions, Omaha, Nebraska
| | - Cheryl A Gibson
- Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas
| | - James M Backes
- Departments of Pharmacy Practice and Medicine, Atherosclerosis and LDL-Apheresis Center, University of Kansas Medical Center, Kansas City, Kansas.
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Mick PT, Kabir R, Pichora-Fuller MK, Jones C, Moxham L, Phillips N, Urry E, Wittich W. Associations Between Cardiovascular Risk Factors and Audiometric Hearing: Findings From the Canadian Longitudinal Study on Aging. Ear Hear 2023; 44:1332-1343. [PMID: 37122082 PMCID: PMC10583941 DOI: 10.1097/aud.0000000000001370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 02/25/2023] [Indexed: 05/02/2023]
Abstract
OBJECTIVES The objectives of the study were to determine, among a population-based sample of Canadian adults, if risk factors for cardiovascular disease (alone and in combination) were associated with hearing loss. Cross-sectional and longitudinal associations (the latter with about 3 years of follow-up) were examined. Risk factors considered included diabetes, dyslipidemia, hypertension, obesity, and smoking. We also aimed to determine if associations were modified by sex and age group (45 to 54, 55 to 64, 65 to 74, and 75 to 86 years old at baseline). DESIGN A secondary analysis of data collected for the Canadian Longitudinal Study on Aging was performed. Data were collected in two waves, the first between 2012 and 2015, and the second between 2015 and 2018. Hearing was measured using screening air-conduction pure-tone audiometry. The outcome of interest was defined as the mid-frequency (1000, 2000, 3000, and 4000 Hz) pure-tone average for both ears. Diabetes was defined based on self-reported physician diagnosis, use of diabetes medications, or a hemoglobin A1c level ≥6.5%. Dyslipidemia was determined by blood lipid profile as defined using the Canadian guidelines for the diagnosis and treatment of dyslipidemia (low-density lipoprotein cholesterol ≥3.5 mmol/L or non-high-density lipoprotein cholesterol ≥4.3 mmol/L). Hypertension was determined by self-reported physician diagnosis or an average systolic blood pressure ≥140 mm Hg or an average diastolic blood pressure ≥90 mm Hg. Obesity was defined as a waist-to-height ratio ≥0.6. Smoking history was determined by self-report (current/former/never-smoker). Two composite measures of cardiovascular risk were also constructed: a count of the number of risk factors and a general cardiovascular risk profile (Framingham) score. Independent associations between risk factors for cardiovascular disease and hearing were determined using multivariable regression models. Survey weights were incorporated into the analyses. All results were disaggregated by sex. Effect modification according to age was determined using multiplicative interaction terms between the age group and each of the risk factor variables. A complete case (listwise deletion) approach was performed for the primary analysis. We then repeated the multivariable regression analyses using multiple imputation using chained equations to determine if the different approaches to dealing with missing data qualitatively changed the outcomes. RESULTS In longitudinal analyses, hypertension and the general cardiovascular risk profile score were associated with greater loss of hearing over the 3-year follow-up period for both sexes. In addition, smoking in males and obesity in females were associated with faster rates of hearing decline. In cross-sectional analyses, smoking, obesity, diabetes, and composite measures were each independently associated with worse hearing for both sexes (although for females, obesity was only associated with hearing loss in the 55 to 64-year-old age group). The results were similar for the complete case and multiple imputation approaches, but more cross-sectional associations were observed using multiple imputation. CONCLUSIONS Diabetes, obesity, hypertension, and smoking were associated with hearing loss. Higher combinations of risk factors increased the risk of hearing loss. Further studies are needed to confirm age and sex differences and whether interventions to address these risk factors could slow the progression of hearing loss in older adults.
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Affiliation(s)
- Paul Thomas Mick
- Department of Surgery, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Rasel Kabir
- Department of Surgery, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | | | - Charlotte Jones
- Southern Medical Program Faculty of Medicine, University of British Columbia, Kelowna, British Columbia, Canada
| | - Lindy Moxham
- Department of Surgery, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Natalie Phillips
- Department of Psychology, Concordia University, Montreal, Province of Quebec, Canada
| | - Emily Urry
- Research & Development, Sonova AG, Stäfa, Switzerland
| | - Walter Wittich
- École d'optométrie, School of Optometry, Université de Montréal, Montréal, Province of Quebec, Canada
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45
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Baghdadi G, Shidfar F, Dehnad A. The effect of pomegranate consumption on cardiovascular risk factors in hemodialysis patients: A systematic review of clinical trials. Phytother Res 2023; 37:4963-4975. [PMID: 37485775 DOI: 10.1002/ptr.7961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/12/2023] [Accepted: 06/30/2023] [Indexed: 07/25/2023]
Abstract
Patients undergoing maintenance dialysis have a significantly higher incidence of cardiovascular disease (CVD) compared with the general population. CVD is the most common cause of morbidity and mortality among hemodialysis patients, and has been attributed, among other causes, to increased oxidative stress, inflammation, hypertension and dyslipidemia. Pomegranate, a popular fruit worldwide, has demonstrated health benefits such as antioxidative, antidiabetic, antihypertensive, antihyperlipidemic and anti-inflammatory effects. In this systematic review of clinical trials, we aim to summarize the effect of different parts of pomegranate and the effects of its use on CVD risk factors in hemodialysis patients. PubMed/MEDLINE, EMBASE, Scopus, and Web of Science were searched to identify eligible clinical trials up to December 2021. Ultimately, seven clinical trials were included in this study. Different parts of pomegranate used in these trials were pomegranate juice, pomegranate extract and pomegranate peel extract. The duration of the studies varied from one dialysis session to 1 year. Our results showed that different parts of pomegranate may have anti-hypertensive, antioxidant, anti-inflammatory effects and improve lipid profile by decreasing TG (triglycerides) and increasing HDL-C (high-density lipoprotein cholesterol) in hemodialysis patients. However, due to limited number of studies, more clinical trials need to be performed.
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Affiliation(s)
- Ghazal Baghdadi
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Farzad Shidfar
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
- Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Afsaneh Dehnad
- Department of English Language, School of Health Management and Information Sciences, Center for Educational Research in Medical Sciences (CERMS), Iran University of Medical Sciences, Tehran, Iran
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Riera-Molist N, Assens-Tauste M, Roura-Poch P, Guimerà-Gallent M, Santos-López JM, Serra-Millas M, Frau-Rosselló N, Gallego-Peña E, Foguet-Boreu Q. A Cardiovascular Risk Optimization Program in People With Schizophrenia: A Pilot Randomized Controlled Clinical Trial. J Psychiatr Pract 2023; 29:456-468. [PMID: 37948170 PMCID: PMC10631505 DOI: 10.1097/pra.0000000000000743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
BACKGROUND Cardiovascular disease is one of the leading causes of premature death in people with schizophrenia. Some modifiable factors that have been implicated include unhealthy lifestyle, medication side effects, and physical comorbidities. The goal of this study was to assess the efficacy of a 6-month, multifactorial cardiovascular risk intervention to reduce cardiovascular risk (CVR) in people with schizophrenia. METHODS We conducted a 2-arm, parallel, randomized clinical trial in a regional mental health center. Participants with at least 1 poorly controlled cardiovascular risk factor (CVRF) (hypertension, diabetes mellitus, hypercholesterolemia, or tobacco smoking) were randomly assigned to the intervention group or to a control group. The subjects in the intervention group received a patient-centered approach that included promoting a healthy lifestyle, pharmacological management of CVRFs, psychotropic drug optimization, and motivational follow-up [Programa d'optimització del RISc CArdiovascular (PRISCA)]. The main outcome was change in CVR as assessed using the Framingham-REGICOR function, after 6 months compared with the baseline in both groups. RESULTS Forty-six participants were randomly assigned to the PRISCA group (n=23) or the control group (n=23). The most prevalent CVRFs at baseline were hypercholesterolemia (84.8%) and tobacco smoking (39.1%). The PRISCA group showed a significant reduction in the REGICOR score (-0.96%; 95% CI: -1.60 to -0.32, P=0.011) after 6 months (relative risk reduction of 20.9%), with no significant changes in the control group (0.21%; 95% CI: -0.47 to 0.89, P=0.706). In the PRISCA group, low-density lipoprotein cholesterol also decreased significantly (-27.14 mg/dL; 95% CI: -46.28 to -8.00, P=0.008). CONCLUSION A patient-centered, multifactorial cardiovascular risk intervention improved CVR in people with schizophrenia after 6 months, which was achieved mainly by improving the lipid profile.
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47
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Hirschberg AL. Hyperandrogenism and Cardiometabolic Risk in Pre- and Postmenopausal Women-What Is the Evidence? J Clin Endocrinol Metab 2023:dgad590. [PMID: 37886900 DOI: 10.1210/clinem/dgad590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Indexed: 10/28/2023]
Abstract
Hyperandrogenism in women, such as polycystic ovary syndrome, ovarian hyperthecosis, congenital adrenal hyperplasia, and androgen-secreting tumors, are all associated with increased prevalence of cardiovascular risk factors that include type 2 diabetes, hypertension, dyslipidemia, and metabolic syndrome. However, it is not clear whether this also implies enhanced risk of cardiovascular disease and mortality. Furthermore, the involvement of obesity and menopausal status for cardiometabolic risk in these women has not been elucidated. Based on the most recent systematic reviews and meta-analyses, this review summarizes the latest scientific evidence. To conclude, hyperandrogenism in premenopausal women is associated with enhanced prevalence of cardiovascular risk factors, as well as increased risk of cardiovascular disease and mortality, independently of body mass index. In contrast, elevated cardiovascular risk factors and increased risk of myocardial infarction and stroke in hyperandrogenic postmenopausal women are dependent on obesity. Furthermore, the overall risk of cardiovascular disease and coronary artery disease in hyperandrogenic postmenopausal women is similar to controls. The reason for a reduced cardiometabolic risk after menopause in hyperandrogenic women compared to nonhyperandrogenic women is not clear. It can be speculated that the difference in endocrine balance and metabolic status between women with and without hyperandrogenism might decrease after menopause because hyperandrogenism usually improves with age, whereas menopausal transition itself is associated with androgen dominance and abdominal obesity. Although we have gained increased knowledge about cardiometabolic risks in women with hyperandrogenism, it must be acknowledged that the quality of data is overall low. More research is needed, especially longer and larger follow-up studies in women with hyperandrogenism of different etiologies and phenotypes.
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Affiliation(s)
- Angelica Lindén Hirschberg
- Department of Women's and Children's Health, Karolinska Institutet and Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, SE-171 76 Stockholm, Sweden
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Sinjari HY. Prevalence, clinical profile, and risk factors of peripheral artery disease in an Iraqi cohort of chronic kidney disease. Medicine (Baltimore) 2023; 102:e35577. [PMID: 37904421 PMCID: PMC10615509 DOI: 10.1097/md.0000000000035577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/19/2023] [Indexed: 11/01/2023] Open
Abstract
Peripheral artery disease (PAD) is prevalent in patients with chronic kidney disease (CKD) and is associated with substantial morbidity, mortality, and a lower quality of life. This study aimed to determine the prevalence of PAD, clinical profile, and related risk factors among patients with CKD in Iraq (a low-to middle-income country). A cross sectional study comprised 175 CKD patients, of them 60% were male, their mean age was 56 ± 12.5 years, attending Nephrology unit, Hawler Teaching Hospital, Erbil, Iraq between march 2022 and November 2022. Data on demographic and baseline characteristics were collected. Laboratory tests were performed. All participants underwent a detailed history and clinical examination. Vascular lesions in the lower limbs were assessed using the ankle-brachial index. PAD was diagnosed based on an ankle-brachial index value ˂ 0.9, relevant symptoms, and clinical findings. Forty-nine patients (28%) had PAD, and only 17 (34.7%) were symptomatic. PAD was significantly associated with older age (P = .008), male sex (P = .039), diabetes (P = .012), and hypertension (P = .023). In addition, PAD prevalence was significantly higher in patients with prior coronary artery disease (P < .001), advanced CKD stages (P .032), low estimated glomerular filtration rate (P .03), albuminuria (P .002), elevated glycated hemoglobin (P .04), and high sensitive C-reactive protein (P < .001). No significant association was detected between PAD and body mass index, smoking, CKD duration, cerebrovascular disease, dyslipidemia, albumin, creatinine, hemoglobin, total PTH, and phosphate. Peripheral artery disease was prevalent in patients with CKD in Iraq, and the most affected patients were asymptomatic. Older age, male sex, hypertension, diabetes, prior coronary artery disease, advanced CKD stages, albuminuria, higher glycated hemoglobin level, and increased high-sensitivity C-reactive protein level were identified as risk factors. Early detection of occult PAD might enhance efforts toward proper prevention and treatment.
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Affiliation(s)
- Hussein Yousif Sinjari
- Department of Internal Medicine, Hawler Medical University, Erbil, Iraq
- Nephrology Unit, Hawler Teaching Hospital, Erbil, Iraq
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Troensegaard H, Khoury J, Westerberg AC, Tonstad S, Roeters van Lennep J, Veierød MB, Iversen PO, Holven KB, Retterstøl K. Protocol for a 20-year follow-up after a randomized controlled trial of a Mediterranean diet in pregnancy: maternal and offspring risk factors for cardiovascular disease. Front Pediatr 2023; 11:1256815. [PMID: 37920793 PMCID: PMC10619653 DOI: 10.3389/fped.2023.1256815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 10/02/2023] [Indexed: 11/04/2023] Open
Abstract
Background An inadequate maternal diet during pregnancy can impair offspring health and may increase the risk of cardiovascular disease later in life. The purpose of the proposed study is to assess the risk factors associated with cardiovascular disease in both mothers and their offspring 20 years following their participation in a Mediterranean diet intervention trial during pregnancy. Methods The "Cardiovascular Risk Reduction Diet In Pregnancy" (CARRDIP) study was a randomized controlled trial performed between 1999 and 2001. The participants were randomized to adhere to either a Mediterranean diet or their regular diet during pregnancy. An extensive amount of data such as diet information, ultrasound measurements, anthropometry, and biomarkers from these mothers during pregnancy and their offspring in the neonatal period were collected. The mother-offspring pairs (n = 269) from the CARRDIP study will be invited to participate in a clinical examination and blood sample collection. This follow-up study, conducted 20 years after the original CARRDIP study, will investigate cardiovascular risk factors in mothers and offspring. The primary outcome will be the blood pressure of the offspring. In addition, the study will explore various aspects of cardiovascular health, including metabolic and inflammatory status, clinical history, and body composition of the participants. Discussion Previous studies investigating the effects of nutrition during pregnancy on maternal and offspring health have been either observational studies, animal studies, or randomized controlled trials with a follow-up period of less than 5 years. This project aims to study the long-term effects of dietary intervention during pregnancy on maternal and offspring cardiovascular risk markers. Clinical Trial Registration Clinicaltrials.gov, identifier (NCT05030922).
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Affiliation(s)
- Hannibal Troensegaard
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Janette Khoury
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Ane C. Westerberg
- Department of Obstetrics, Division of Obstetrics and Gynaecology, Oslo University Hospital Rikshospitalet, Oslo, Norway
- School of Health Sciences, Kristiania University College, Oslo, Norway
| | - Serena Tonstad
- Department of Preventive Cardiology, Oslo University Hospital, Oslo, Norway
| | - Jeanine Roeters van Lennep
- Department of Internal Medicine, Erasmus MC Cardiovascular Institute, University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Marit B. Veierød
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Per Ole Iversen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Department of Haematology, Oslo University Hospital, Oslo, Norway
| | - Kirsten B. Holven
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Norwegian National Advisory Unit on Familial Hypercholesterolemia, Oslo University Hospital, Oslo, Norway
| | - Kjetil Retterstøl
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- The Lipid Clinic, Department of Medicine, Oslo University Hospital, Oslo, Norway
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50
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Pallarés-Carratalá V, Ruiz-García A, Serrano-Cumplido A, Arranz-Martínez E, Divisón-Garrote JA, Moyá-Amengual A, Escobar-Cervantes C, Barrios V. Prevalence Rates of Arterial Hypertension According to the Threshold Criteria of 140/90 or 130/80 mmHg and Associated Cardiometabolic and Renal Factors: SIMETAP-HTN Study. Medicina (Kaunas) 2023; 59:1846. [PMID: 37893564 PMCID: PMC10608132 DOI: 10.3390/medicina59101846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 09/29/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023]
Abstract
Background and objectives: Arterial hypertension (HTN) is the leading preventable cause of atherosclerotic cardiovascular diseases (ASCVD) and death from all causes. This study aimed to determine the prevalence rates of HTN diagnosed according to the threshold diagnostic criteria 130/80 mmHg and 140/90 mmHg, to compare blood pressure (BP) control, and to evaluate their associations with cardiovascular diseases and cardiometabolic and renal risk factors. Materials and Methods: This was a cross-sectional observational study conducted in primary care with a population-based random sample: 6588 people aged 18.0-102.8 years. Crude and adjusted prevalence rates of HTN were calculated. BP control was compared in HTN patients with and without ASCVD or chronic kidney disease (CKD). Their associations with cardiovascular diseases and cardiometabolic and renal factors were assessed using bivariate and multivariate analysis. Results: Adjusted prevalence rates of HTN diagnosed according to 140/90 and 130/90 criteria were 30.9% (32.9% male; 29.7% female) and 54.9% (63.2% male; 49.3% female), respectively. BP < 130/80 mmHg was achieved in 60.5% of HTN patients without ASCVD or CKD according to 140/90 criterion, and 65.5% according to 130/80 criterion. This BP-control was achieved in 70% of HTN patients with ASCVD and 71% with CKD, according to both criteria. Coronary heart disease (CHD), heart failure, atrial fibrillation, stroke, diabetes, prediabetes, low glomerular filtration rate (eGFR), hyperuricemia, hypercholesterolemia, obesity, overweight, and increased waist-to-height ratio were independently associated with HTN according to both criteria. Conclusions: Almost a third of the adult population has HTN according to the 140/90 criterion, and more than half according to the 130/90 criterion, with a higher prevalence in men. The main clinical conditions associated with HTN were heart failure, diabetes, CHD, low eGFR, and obesity.
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Affiliation(s)
- Vicente Pallarés-Carratalá
- Health Surveillance Unit, Mutual Insurance Union, 12004 Castellon, Spain
- Department of Medicine, Jaume I University, 12006 Castellon, Spain
| | - Antonio Ruiz-García
- Lipids and Cardiovascular Prevention Unit, Pinto University Health Centre, Pinto, 28320 Madrid, Spain
- Department of Medicine, European University of Madrid, Villaviciosa de Odon, 28670 Madrid, Spain
| | | | | | | | | | | | - Vivencio Barrios
- Ramon y Cajal University Hospital, 28034 Madrid, Spain;
- Department of Medicine, Alcala University, 28801 Madrid, Spain
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