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Sample records for atherothrombotic cardiovascular disease

  1. Oxidative Risk for Atherothrombotic Cardiovascular Disease

    PubMed Central

    Leopold, Jane A.; Loscalzo, Joseph

    2009-01-01

    In the vasculature, reactive oxidant species including reactive oxygen, nitrogen, or halogenating species, and thiyl, tyrosyl, or protein radicals, may oxidatively modify lipids and proteins with deleterious consequences for vascular function. These biologically active free radical and non-radical species may be produced by increased activation of oxidant-generating sources and/or decreased cellular antioxidant capacity. Once formed, these species may engage in reactions to yield more potent oxidants that promote transition of the homeostatic vascular phenotype to a pathobiological state that is permissive for atherothrombogenesis. This dysfunctional vasculature is characterized by lipid peroxidation and aberrant lipid deposition, inflammation, immune cell activation, platelet activation, thrombus formation, and disturbed hemodynamic flow. Each of these pathobiological states is associated with an increase in the vascular burden of free radical species-derived oxidation products and, thereby, implicates increased oxidant stress in the pathogenesis of atherothrombotic vascular disease. PMID:19751821

  2. Relation of fish oil supplementation to markers of atherothrombotic risk in patients with cardiovascular disease not receiving lipid-lowering therapy.

    PubMed

    Franzese, Christopher J; Bliden, Kevin P; Gesheff, Martin G; Pandya, Shachi; Guyer, Kirk E; Singla, Anand; Tantry, Udaya S; Toth, Peter P; Gurbel, Paul A

    2015-05-01

    Fish oil supplementation (FOS) is known to have cardiovascular benefits. However, the effects of FOS on thrombosis are incompletely understood. We sought to determine if the use of FOS is associated with lower indices of atherothrombotic risk in patients with suspected coronary artery disease (sCAD). This is a subgroup analysis of consecutive patients with sCAD (n=600) enrolled in the Multi-Analyte, Thrombogenic, and Genetic Markers of Atherosclerosis study. Patients on FOS were compared with patients not on FOS. Lipid profile was determined by vertical density gradient ultracentrifugation (n=520), eicosapentaenoic acid+docosahexaenoic acid was measured by gas chromatography (n=437), and AtherOx testing was performed by immunoassay (n=343). Thromboelastography (n=419), ADP- and collagen-induced platelet aggregation (n=137), and urinary 11-dehydrothromboxane B2 levels (n=259) were performed immediately before elective coronary angiography. In the total population, FOS was associated with higher eicosapentaenoic acid+docosahexaenoic acid content (p<0.001), lower triglycerides (p=0.04), total very low-density lipoprotein cholesterol (p=0.002), intermediate-density lipoprotein cholesterol (p=0.02), and AtherOx levels (p=0.02) but not in patients on lipid-lowering therapy. Patients not on lipid-lowering therapy taking FOS had lower very low-density lipoprotein cholesterol, intermediate-density lipoprotein cholesterol, remnant lipoproteins, triglycerides, low-density lipoprotein cholesterol, AtherOx levels, collagen-induced platelet aggregation, thrombin-induced platelet-fibrin clot strength, and shear elasticity (p<0.03 for all). In clopidogrel-treated patients, there was no difference in ADP-induced aggregation between FOS groups. Patients on FOS had lower urinary 11-dehydrothromboxane B2 levels regardless of lipid-lowering therapy (p<0.04). In conclusion, the findings of this study support the potential benefit of FOS for atherothrombotic risk reduction in sCAD with the greatest benefit in patients not receiving lipid-lowering therapy. Future prospective studies to compare FOS with lipid-lowering therapy and to assess the independent effects of FOS on thrombogenicity are needed. PMID:25759102

  3. Endothelial Progenitor Cells Predict Cardiovascular Events after Atherothrombotic Stroke and Acute Myocardial Infarction. A PROCELL Substudy

    PubMed Central

    Cuadrado-Godia, Elisa; Regueiro, Ander; Nez, Julio; Daz-Ricard, Maribel; Novella, Susana; Oliveras, Anna; Valverde, Miguel A.; Marrugat, Jaume; Ois, Angel; Giralt-Steinhauer, Eva; Sanchs, Juan; Escolar, Gins; Hermenegildo, Carlos; Roquer, Jaume

    2015-01-01

    Introduction The aim of this study was to determine prognostic factors for the risk of new vascular events during the first 6 months after acute myocardial infarction (AMI) or atherothrombotic stroke (AS). We were interested in the prognostic role of endothelial progenitor cells (EPC) and circulating endothelial cells (CEC) Methods Between February 2009 and July 2012, 100 AMI and 50 AS patients were consecutively studied in three Spanish centres. Patients with previously documented coronary artery disease or ischemic strokes were excluded. Samples were collected within 24h of onset of symptoms. EPC and CEC were studied using flow cytometry and categorized by quartiles. Patients were followed for up to 6 months. NVE was defined as new acute coronary syndrome, transient ischemic attack (TIA), stroke, or any hospitalization or death from cardiovascular causes. The variables included in the analysis included: vascular risk factors, carotid intima-media thickness (IMT), atherosclerotic burden and basal EPC and CEC count. Multivariate survival analysis was performed using Cox regression analysis. Results During follow-up, 19 patients (12.66%) had a new vascular event (5 strokes; 3 TIAs; 4 AMI; 6 hospitalizations; 1 death). Vascular events were associated with age (P = 0.039), carotid IMT?0.9 (P = 0.044), and EPC count (P = 0.041) in the univariate analysis. Multivariate Cox regression analysis showed an independent association with EPC in the lowest quartile (HR: 10.33, 95%CI (1.2287.34), P = 0.032] and IMT?0.9 [HR: 4.12, 95%CI (1.2113.95), P = 0.023]. Conclusions Basal EPC and IMT?0.9 can predict future vascular events in patients with AMI and AS, but CEC count does not affect cardiovascular risk. PMID:26332322

  4. Cardiovascular Disease

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Cardiovascular disease (CVD), particularly CHD (coronary heart disease) and stroke, remain the leading causes of death of women in America and most developed countries. In recent years the rate of CVD has declined in men but not in women. This is contributed to by an under-recognition of women’s C...

  5. Infection and Cardiovascular Disease

    ClinicalTrials.gov

    2016-02-17

    Cardiovascular Diseases; Coronary Disease; Cerebrovascular Accident; Heart Diseases; Myocardial Infarction; Infection; Chlamydia Infections; Cytomegalovirus Infections; Helicobacter Infections; Atherosclerosis

  6. Obesity and cardiovascular disease.

    PubMed

    Jokinen, E

    2015-02-01

    Cardiovascular disease is the most common cause of mortality in rich countries and today it has the same meaning for health care as the epidemics of past centuries had for medicine in earlier times: 50% of the population in these countries die of cardiovascular disease. The amount of cardiovascular disease is also increasing in the developing countries together with economic growth. By 2015 one in three deaths will globally be due to cardiovascular diseases. Coronary heart disease is a chronic disease that starts in childhood, even if the symptoms first occur in the middle age. The risks for coronary heart disease are well-known: lipid disorders, especially high serum LDL-cholesterol concentration, high blood pressure, tobacco smoking, obesity, diabetes, male gender and physical inactivity. Obesity is both an independent risk factor for cardiovascular disease but is also closely connected with several other risk factors. This review focuses on the connection between overweight or obesity and cardiovascular disease. PMID:25387321

  7. Cardiovascular Disease and Diabetes

    MedlinePLUS

    ... Blood Pressure Tools & Resources Stroke More Cardiovascular Disease & Diabetes Updated:Mar 23,2016 The following statistics speak ... survey. This content was last reviewed August 2015. Diabetes • Home • About Diabetes • Why Diabetes Matters Introduction Cardiovascular ...

  8. Epidemiology of Atherosclerosis and the Potential to Reduce the Global Burden of Atherothrombotic Disease.

    PubMed

    Herrington, William; Lacey, Ben; Sherliker, Paul; Armitage, Jane; Lewington, Sarah

    2016-02-19

    Atherosclerosis is a leading cause of vascular disease worldwide. Its major clinical manifestations include ischemic heart disease, ischemic stroke, and peripheral arterial disease. In high-income countries, there have been dramatic declines in the incidence and mortality from ischemic heart disease and ischemic stroke since the middle of the 20th century. For example, in the United Kingdom, the probability of death from vascular disease in middle-aged men (35-69 years) has decreased from 22% in 1950 to 6% in 2010. Most low- and middle-income countries have also reported declines in mortality from stroke over the last few decades, but mortality trends from ischemic heart disease have been more varied, with some countries reporting declines and others reporting increases (particularly those in Eastern Europe and Asia). Many major modifiable risk factors for atherosclerosis have been identified, and the causal relevance of several risk factors is now well established (including, but not limited to, smoking, adiposity, blood pressure, blood cholesterol, and diabetes mellitus). Widespread changes in health behaviors and use of treatments for these risk factors are responsible for some of the dramatic declines in vascular mortality in high-income countries. In order that these declines continue and are mirrored in less wealthy nations, increased efforts are needed to tackle these major risk factors, particularly smoking and the emerging obesity epidemic. PMID:26892956

  9. Cardiovascular Disease Screenings

    MedlinePLUS

    ... service covered? Search Medicare.gov for covered items Cardiovascular disease screenings How often is it covered? Medicare Part ... video) Medicare & You: women's health (video) Medicare & You: heart disease (video) Medicare & You: Million Hearts initiative (video) Return ...

  10. Understanding cardiovascular disease

    MedlinePLUS

    ... of plaque. Narrow arteries reduce or block blood flow. When blood and oxygen can't get to the legs, it can injure nerves and tissue. High blood pressure (hypertension) is a cardiovascular disease that ...

  11. Testosterone and Cardiovascular Disease

    PubMed Central

    Tambo, Amos; Roshan, Mohsin H.K.; Pace, Nikolai P.

    2016-01-01

    Cardiovascular disease [CVD] is a leading cause of mortality accounting for a global incidence of over 31%. Atherosclerosis is the primary pathophysiology underpinning most types of CVD. Historically, modifiable and non-modifiable risk factors were suggested to precipitate CVD. Recently, epidemiological studies have identified emerging risk factors including hypotestosteronaemia, which have been associated with CVD. Previously considered in the realms of reproductive biology, testosterone is now believed to play a critical role in the cardiovascular system in health and disease. The actions of testosterone as they relate to the cardiac vasculature and its implication in cardiovascular pathology is reviewed. PMID:27014372

  12. [Cancer and cardiovascular disease].

    PubMed

    Lahoz, Carlos; Valdivielso, Pedro; González-Alegre, María Teresa; García-Iglesias, María Francisca; Estirado, Eva; Mostaza, José M

    2015-01-01

    Survivors of cancer have a shorter survival in the long term partly due to the increase in cardiovascular diseases (CVD). Some chemotherapy drugs, thoracic and cranial radiotherapy and above all the transplantation of hematopoietic cells are associated with an increase in the incidence of cardiovascular events compared with general population. Some of these treatments favor the development of a metabolic syndrome that could be the intermediary between these treatments and the development of CVD. It is recommended for cancer survivors to promote healthy lifestyles and the strict control of cardiovascular risk factors. PMID:25772547

  13. Testosterone and Cardiovascular Disease.

    PubMed

    Kloner, Robert A; Carson, Culley; Dobs, Adrian; Kopecky, Stephen; Mohler, Emile R

    2016-02-01

    Testosterone (T) is the principal male sex hormone. As men age, T levels typically fall. Symptoms of low T include decreased libido, vasomotor instability, and decreased bone mineral density. Other symptoms may include depression, fatigue, erectile dysfunction, and reduced muscle strength/mass. Epidemiology studies show that low levels of T are associated with more atherosclerosis, coronary artery disease, and cardiovascular events. However, treating hypogonadism in the aging male has resulted in discrepant results in regard to its effect on cardiovascular events. Emerging studies suggest that T may have a future role in treating heart failure, angina, and myocardial ischemia. A large, prospective, long-term study of T replacement, with a primary endpoint of a composite of adverse cardiovascular events including myocardial infarction, stroke, and/or cardiovascular death, is needed. The Food and Drug Administration recently put additional restrictions on T replacement therapy labeling and called for additional studies to determine its cardiac safety. PMID:26846952

  14. Epigenetics and cardiovascular disease

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Despite advances in the prevention and management of cardiovascular disease (CVD), this group of multifactorial disorders remains a leading cause of mortality worldwide. CVD is associated with multiple genetic and modifiable risk factors; however, known environmental and genetic influences can only...

  15. Epigenetics and cardiovascular disease.

    PubMed

    Webster, Andrew L H; Yan, Matthew Shu-Ching; Marsden, Philip A

    2013-01-01

    A commonly-assumed paradigm holds that the primary genetic determinant of cardiovascular disease resides within the DNA sequence of our genes. This paradigm can be challenged. For example, how do sequence changes in the non-coding region of the genome influence phenotype? Why are all diseases not shared between identical twins? Part of the answer lies in the fact that the environment or exogenous stimuli clearly influence disease susceptibility, but it was unclear in the past how these effects were signalled to the static DNA code. Epigenetics is providing a newer perspective on these issues. Epigenetics refers to chromatin-based mechanisms important in the regulation of gene expression that do not involve changes to the DNA sequence per se. The field can be broadly categorized into three areas: DNA base modifications (including cytosine methylation and cytosine hydroxymethylation), post-translational modifications of histone proteins, and RNA-based mechanisms that operate in the nucleus. Cardiovascular disease pathways are now being approached from the epigenetic perspective, including those associated with atherosclerosis, angiogenesis, ischemia-reperfusion damage, and the cardiovascular response to hypoxia and shear stress, among many others. With increasing interest and expanding partnerships in the field, we can expect new insights to emerge from epigenetic perspectives of cardiovascular health. This paper reviews the principles governing epigenetic regulation, discusses their presently-understood importance in cardiovascular disease, and considers the growing significance we are likely to attribute to epigenetic contributions in the future, as they provide new mechanistic insights and a host of novel clinical applications. PMID:23261320

  16. Alcohol and cardiovascular diseases.

    PubMed

    Klatsky, Arthur L

    2009-05-01

    With respect to cardiovascular disorders, epidemiologic studies support the hypothesis of increased risks among heavy alcohol drinkers and indicate a lower risk among lighter drinkers. Increased cardiovascular risks of heavy drinking include cardiomyopathy, systemic hypertension, supraventricular arrhythmias, hemorrhagic stroke and heart failure that is not associated with coronary artery disease (CAD). Light-to-moderate drinking is probably unrelated to increased risk of any cardiovascular condition and is related to lower risks of CAD, ischemic stroke and CAD-related heart failure. A protective alcohol-CAD hypothesis is supported by plausible biological mechanisms attributable to ethyl alcohol. Possible nonalcohol beneficial components in wine (especially red) could explain the extra protection of wine, but a healthier pattern of drinking or more favorable risk traits in wine drinkers may also be involved. Advice regarding the advisability of alcohol drinking for health needs to be individualized according to specific risks and benefits. PMID:19419257

  17. Lycopene and cardiovascular disease.

    PubMed

    Arab, L; Steck, S

    2000-06-01

    Considerable evidence suggests that lycopene, a carotenoid without provitamin A activity found in high concentrations in a small set of plant foods, has significant antioxidant potential in vitro and may play a role in preventing prostate cancer and cardiovascular disease in humans. Tomato products, including ketchup, tomato juice, and pizza sauce, are the richest sources of lycopene in the US diet, accounting for >80% of the total lycopene intake of Americans. Unlike other carotenoids, lycopene is not consistently lower among smokers than among nonsmokers, suggesting that any possible preventive activity is not as an antioxidant. Instead, lycopene may have a cholesterol synthesis-inhibiting effect and may enhance LDL degradation. Available evidence suggests that intimal wall thickness and risk of myocardial infarction are reduced in persons with higher adipose tissue concentrations of lycopene. The question of whether lycopene helps to prevent cardiovascular disease can only be answered by a trial specifically evaluating its effectiveness in this area. PMID:10837319

  18. Interplay between ultrastructural findings and atherothrombotic complications in type 2 diabetes mellitus.

    PubMed

    Soma, Prashilla; Pretorius, Etheresia

    2015-01-01

    Accelerated atherosclerosis is the main underlying factor contributing to the high risk of atherothrombotic events in patients with diabetes mellitus and atherothrombotic complications are the main cause of mortality. Like with many bodily systems, pathology is observed when the normal processes are exaggerated or uncontrolled. This applies to the processes of coagulation and thrombosis as well. In diabetes, in fact, the balance between prothrombotic and fibrinolytic factors is impaired and thus the scale is tipped towards a prothrombotic and hypofibrinolytic milieu, which in association with the vascular changes accompanying plaque formation and ruptures, increases the prevalence of ischaemic events such as angina and myocardial infarction. Apart from traditional, modifiable risk factors for cardiovascular disease like hypertension, smoking, elevated cholesterol; rheological properties, endogenous fibrinolysis and impaired platelet activity are rapidly gaining significance in the pathogenesis of atherosclerosis especially in diabetic subjects. Blood clot formation represents the last step in the athero-thrombotic process, and the structure of the fibrin network has a role in determining predisposition to cardiovascular disease. It is no surprise that just like platelets and fibrin networks, erythrocytes have been shown to play a role in coagulation as well. This is in striking contrast to their traditional physiological role of oxygen transport. In fact, emerging evidence suggests that erythrocytes enhance functional coagulation properties and platelet aggregation. Among the spectrum of haematological abnormalities in diabetes, erythrocyte aggregation and decreased deformability of erythrocytes predominate. More importantly, they are implicated in the pathogenesis of microvascular complications of diabetes. The morphology of platelets, fibrin networks and erythrocytes are thus essential role players in unravelling the pathogenesis of cardiovascular complications in diabetic subjects. PMID:26228646

  19. Arsenic and cardiovascular disease.

    PubMed

    States, J Christopher; Srivastava, Sanjay; Chen, Yu; Barchowsky, Aaron

    2009-02-01

    Chronic arsenic exposure is a worldwide health problem. Although arsenic-induced cancer has been widely studied, comparatively little attention has been paid to arsenic-induced vascular disease. Epidemiological studies have shown that chronic arsenic exposure is associated with increased morbidity and mortality from cardiovascular disease. In addition, studies suggest that susceptibility to arsenic-induced vascular disease may be modified by nutritional factors in addition to genetic factors. Recently, animal models for arsenic-induced atherosclerosis and liver sinusoidal endothelial cell dysfunction have been developed. Initial studies in these models show that arsenic exposure accelerates and exacerbates atherosclerosis in apolipoprotein E-knockout mice. Microarray studies of liver mRNA and micro-RNA abundance in mice exposed in utero suggest that a permanent state of stress is induced by the arsenic exposure. Furthermore, the livers of the arsenic-exposed mice have activated pathways involved in immune responses suggesting a pro-hyperinflammatory state. Arsenic exposure of mice after weaning shows a clear dose-response in the extent of disease exacerbation. In addition, increased inflammation in arterial wall is evident. In response to arsenic-stimulated oxidative signaling, liver sinusoidal endothelium differentiates into a continuous endothelium that limits nutrient exchange and waste elimination. Data suggest that nicotinamide adenine dinucleotide phosphate oxidase-derived superoxide or its derivatives are essential second messengers in the signaling pathway for arsenic-stimulated vessel remodeling. The recent findings provide future directions for research into the cardiovascular effects of arsenic exposure. PMID:19015167

  20. Arsenic and Cardiovascular Disease

    PubMed Central

    States, J. Christopher; Srivastava, Sanjay; Chen, Yu; Barchowsky, Aaron

    2009-01-01

    Chronic arsenic exposure is a worldwide health problem. Although arsenic-induced cancer has been widely studied, comparatively little attention has been paid to arsenic-induced vascular disease. Epidemiological studies have shown that chronic arsenic exposure is associated with increased morbidity and mortality from cardiovascular disease. In addition, studies suggest that susceptibility to arsenic-induced vascular disease may be modified by nutritional factors in addition to genetic factors. Recently, animal models for arsenic-induced atherosclerosis and liver sinusoidal endothelial cell dysfunction have been developed. Initial studies in these models show that arsenic exposure accelerates and exacerbates atherosclerosis in apolipoprotein Eknockout mice. Microarray studies of liver mRNA and micro-RNA abundance in mice exposed in utero suggest that a permanent state of stress is induced by the arsenic exposure. Furthermore, the livers of the arsenic-exposed mice have activated pathways involved in immune responses suggesting a pro-hyperinflammatory state. Arsenic exposure of mice after weaning shows a clear dose-response in the extent of disease exacerbation. In addition, increased inflammation in arterial wall is evident. In response to arsenic-stimulated oxidative signaling, liver sinusoidal endothelium differentiates into a continuous endothelium that limits nutrient exchange and waste elimination. Data suggest that nicotinamide adenine dinucleotide phosphate oxidasederived superoxide or its derivatives are essential second messengers in the signaling pathway for arsenic-stimulated vessel remodeling. The recent findings provide future directions for research into the cardiovascular effects of arsenic exposure. PMID:19015167

  1. Slow breathing and cardiovascular disease.

    PubMed

    Chaddha, Ashish

    2015-01-01

    Cardiovascular disease is the leading cause of death for both men and women worldwide. Much emphasis has been placed on the primary and secondary prevention of cardiovascular disease. While depression and anxiety increase the risk of developing cardiovascular disease, cardiovascular disease also increases the risk of developing anxiety and depression. Thus, promoting optimal mental health may be important for both primary and secondary prevention of cardiovascular disease. Like lowering blood pressure, lipids, and body weight, lowering anger and hostility and improving depression and anxiety may also be an important intervention in preventive cardiology. As we strive to further improve cardiovascular outcomes, the next bridge to cross may be one of offering patients nonpharmacologic means for combating daily mental stress and promoting mental health, such as yoga and pranayama. Indeed, the best preventive cardiovascular medicine may be a blend of both Western and Eastern medicine. PMID:26170595

  2. Childhood obesity and cardiovascular disease

    PubMed Central

    Bridger, Tracey

    2009-01-01

    Childhood obesity has reached epidemic proportions. Many of these children have risk factors for later disease, including cardiovascular disease. For optimal cardiovascular health, health care professionals must be able to identify children and youth at risk and provide appropriate support as needed. The present article reviews the current medical literature on obesity and cardiovascular disease risk factors in the paediatric population, the long-term cardiovascular consequences of childhood obesity and the importance of early life. Recommendations promoting optimal cardiovascular health in all children and youth are discussed. PMID:20190900

  3. [Inflammasome and cardiovascular diseases].

    PubMed

    Connat, J-L

    2011-02-01

    NOD-like receptors (NLRs) constitute a recently identified family of intracellular pattern recognition receptors which contains more than 20 members in mammals. Some of the NLRs, the NALP subfamily, constituted from 14 members, many of them without actual identified role, form multiproteic complex known as inflammasome, that initiate inflammation by processing inactive pro-caspase-1 to its active form, allowing the cleavage and subsequent activation of pro-IL-1? and pro-IL-18. We review the identified roles of NLRs in pathologies and argue for the role of inflammasome in the development of cardiovascular diseases. The atherogenic cytokines IL-1? and IL-18 are matured in NLRPs inflammasomes. Immunocytochemistry shows that Nlrp3 inflammasome is expressed in plaques, upregulated and activated in the CD11b(+)Gr1(high) atherosclerosis-prone monocyte subset and modulated by oxLDL in murine macrophages. These results provide an unexpected role for Nlrp3 inflammasome in atherosclerosis. PMID:20800829

  4. CARDIOVASCULAR DISEASE: PREVENTION AND REHABILITATION

    PubMed Central

    Kitowski, Vincent J.

    1978-01-01

    Cardiovascular related diseases are the major cause of death in the United States. The primary goal of the physician should be prevention of these diseases; however, once problems occur, a definitive rehabilitation program must be instituted in addition to the medical and surgical treatment. Although risk factors for the development of cardiovascular disease are numerous, statistical reports suggest that control of these factors might delay or prevent such development. This presentation describes the recommended Physical Medicine and Rehabilitation Program for high-risk patients or those with existing cardiovascular disease. The basis of the physical fitness and rehabilitation program is controlled progression-of-energy-expenditure physical activity and exercise in metabolic equivalents (METS). Education plays a key role in decreasing the incidence of cardiovascular disease, and should start at an early age. Adults at high risk of developing cardiovascular disease should be offered medically supervised physical fitness exercise programs, with monitoring where necessary. PMID:15216046

  5. Cardiovascular Disease Prevalence and Mortality

    EPA Science Inventory

    This indicator describes data on cardiovascular disease (CVD) prevalence and deaths across the U.S. for the time periods 19972009 and 19792007, respectively. Cardiovascular disease, which is the leading cause of death and disability in the U.S., may be partly...

  6. Cardiovascular Disease Prevalence and Mortality

    EPA Science Inventory

    This indicator describes data on cardiovascular disease (CVD) prevalence and deaths across the U.S. for the time periods 1997–2009 and 1979–2007, respectively. Cardiovascular disease, which is the leading cause of death and disability in the U.S., may be partly...

  7. Flavonols and cardiovascular disease.

    PubMed

    Perez-Vizcaino, Francisco; Duarte, Juan

    2010-12-01

    Flavonols, and specially quercetin, are widely distributed in plants and are present in considerable amounts in fruits and vegetables. In addition to their anti-oxidant effect, flavonols interfere with a large number of biochemical signaling pathways and, therefore, physiological and pathological processes. There is solid evidence that, in vitro, quercetin and related flavonols exert endothelium-independent vasodilator effects, protective effect on nitric oxide and endothelial function under conditions of oxidative stress, platelet antiaggregant effects, inhibition of LDL oxidation, reduction of adhesion molecules and other inflammatory markers and prevention of neuronal oxidative and inflammatory damage. The metabolites of quercetin show partial protective effects on endothelial function and LDL oxidation. Quercetin produces undisputed antihypertensive and antiatherogenic effects, prevents endothelial dysfunction and protects the myocardium from ischemic damage. It has no clear effects on serum lipid profile and on insulin resistance. Human intervention trials with isolated flavonols demonstrate an antihypertensive effect. The meta-analysis of epidemiological studies show an inverse association between flavonol (together with flavone) intake and coronary heart disease and stroke. Therefore, although there is no solid proof yet, a substantial body of evidence suggests that quercetin may prevent the most common forms of cardiovascular disease contributing to the protective effects afforded by fruits and vegetables. PMID:20837053

  8. Ghrelin and Cardiovascular Diseases

    PubMed Central

    Zhang, Gaigai; Yin, Xinhua; Qi, Yongfen; Pendyala, Lakshmana; Chen, Jack; Hou, Dongming; Tang, Chaoshu

    2010-01-01

    Ghrelin, a newly discovered bioactive peptide, is a natural endogenous ligand of the growth hormone (GH) secretagogue receptor and initially identified as a strong stimulant for the release of GH. Subsequent research has shown that ghrelin and its various receptors are ubiquitous in many other organs and tissues. Moreover, they participate in the regulation of appetite, energy, bodyweight, metabolism of glucose and fat, as well as modulation of gastrointestinal, cardiovascular, pulmonary, immune functions and cell proliferation/apoptosis. Increasing evidence has demonstrated that ghrelin has a close relationship with cardiovascular system. Ghrelin and its receptors are widely distributed in cardiovascular tissues, and there is no doubt that the effects of ghrelin in the cardiovascular system are mediated not only via its growth-hormone-releasing effect but also by its direct effects on the heart. Exogenous administration of ghrelin can dilate peripheral blood vessels, constrict coronary artery, improve endothelial function, as well as inhibit myocardial cell apoptosis. So, ghrelin may have cardiovascular protective effect, including lowering of blood pressure, regulation of atherosclerosis, and protection from ischemia/reperfusion injury as well as improving the prognosis of myocardial infarction and heart failure. Some of these new functions of ghrelin may provide new potential therapeutic opportunities for ghrelin in cardiovascular medicine. In this paper, we will review the existing evidence for cardiovascular effects of ghrelin, including the cardiovascular function, the variations in ghrelin plasma levels in pathophysiologicalogical conditions, the possible protective mechanisms of ghrelin, as well as its future potential therapeutic roles. PMID:21286280

  9. Thioredoxins in cardiovascular disease.

    PubMed

    Whayne, Thomas F; Parinandi, Narasimham; Maulik, Nilanjana

    2015-11-01

    Key thioredoxin (Trx) system components are nicotinamide adenine dinucleotide phosphate (NADPH), Trx reductase (TrxR), and Trx. TrxR catalyzes disulfide reduction in Trx with NADPH as cofactor. Because Trx is an antioxidant, oxidative stress results in an increase in Trx, which has a reduced disulfide component. If Trx is suppressed, oxidative stress in higher. In contrast a decrease in oxidative stress is associated with low Trx levels. Trx is involved in inflammation, apoptosis, embryogenesis, and cardiovascular disease (CVD). This review focuses on the Trx system in CVD. Abnormal Trx binding occurs in mouse familial combined hyperlipidemia; however, this has not been confirmed in humans. Congestive heart failure is a manifestation of many CVDs, which may be improved by attenuating oxidative stress through the suppression of Trx and decreased reactive oxygen species. Angiotensin II is associated with hypertension and other CVDs, and its receptor blockade results in decreased oxidative stress with reduced Trx levels. Inflammation is a major causative factor of CVDs, and myocarditis as an example, is associated with increased Trx levels. Vascular endothelial dysfunction has an association with CVD. This dysfunction is alleviated by hormone replacement therapy, which involves decreased oxidative stress and Trx levels. Diabetes mellitus has a major association with CVDs; increase in Trx levels may reflect insulin resistance. Identification of Trx system abnormalities may lead to innovative approaches to treat multiple CVDs and other pathologies. PMID:26417924

  10. Ceruloplasmin and cardiovascular disease

    NASA Technical Reports Server (NTRS)

    Fox, P. L.; Mazumder, B.; Ehrenwald, E.; Mukhopadhyay, C. K.

    2000-01-01

    Transition metal ion-mediated oxidation is a commonly used model system for studies of the chemical, structural, and functional modifications of low-density lipoprotein (LDL). The physiological relevance of studies using free metal ions is unclear and has led to an exploration of free metal ion-independent mechanisms of oxidation. We and others have investigated the role of human ceruloplasmin (Cp) in oxidative processes because it the principal copper-containing protein in serum. There is an abundance of epidemiological data that suggests that serum Cp may be an important risk factor predicting myocardial infarction and cardiovascular disease. Biochemical studies have shown that Cp is a potent catalyst of LDL oxidation in vitro. The pro-oxidant activity of Cp requires an intact structure, and a single copper atom at the surface of the protein, near His(426), is required for LDL oxidation. Under conditions where inhibitory protein (such as albumin) is present, LDL oxidation by Cp is optimal in the presence of superoxide, which reduces the surface copper atom of Cp. Cultured vascular endothelial and smooth muscle cells also oxidize LDL in the presence of Cp. Superoxide release by these cells is a critical factor regulating the rate of oxidation. Cultured monocytic cells, when activated by zymosan, can oxidize LDL, but these cells are unique in their secretion of Cp. Inhibitor studies using Cp-specific antibodies and antisense oligonucleotides show that Cp is a major contributor to LDL oxidation by these cells. The role of Cp in lipoprotein oxidation and atherosclerotic lesion progression in vivo has not been directly assessed and is an important area for future studies.

  11. Anthocyanins in cardiovascular disease.

    PubMed

    Wallace, Taylor C

    2011-01-01

    Anthocyanins are a group of abundant and widely consumed flavonoid constituents that occur ubiquitously in the plant kingdom, providing the bright red-orange to blue-violet colors present in many fruit- and vegetable-based food products. Their intake has been estimated to be up to 9-fold higher than that of other dietary flavonoids. Anthocyanins have become increasingly important to the food industry as their use as natural alternatives to artificial colors has become widespread and knowledge of their health-promoting properties has become more evident. Epidemiological studies suggest that increased consumption of anthocyanins lowers the risk of cardiovascular disease (CVD), the most common cause of mortality among men and women. Anthocyanins frequently interact with other phytochemicals, exhibiting synergistic biological effects but making contributions from individual components difficult to decipher. Over the past 2 decades, many peer-reviewed publications have demonstrated that in addition to their noted in vitro antioxidant activity, anthocyanins may regulate different signaling pathways involved in the development of CVD. This review summarizes the latest developments on the bioavailability/bioactivity and CVD preventative activities of anthocyanins, including results from in vitro cell culture and in vivo animal model systems as related to their multiple proposed mechanisms of action. Limited yet promising data from epidemiological studies and human clinical trials are also presented. Future studies aimed at enhancing the absorption of anthocyanins and characterizing their metabolic and/or breakdown products are necessary to ultimately evaluate their use for protection/prevention against the development of CVD. PMID:22211184

  12. Hypertriglyceridemia and Cardiovascular Diseases: Revisited

    PubMed Central

    Han, Seung Hwan; Nicholls, Stephen J; Sakuma, Ichiro; Zhao, Dong

    2016-01-01

    Residual cardiovascular risk and failure of high density lipoprotein cholesterol raising treatment have refocused interest on targeting hypertriglyceridemia. Hypertriglyceridemia, triglyceride-rich lipoproteins, and remnant cholesterol have demonstrated to be important risk factors for cardiovascular disease; this has been demonstrated in experimental, genetic, and epidemiological studies. Fibrates can reduce cardiovascular event rates with or without statins. High dose omega-3 fatty acids continue to be evaluated and new specialized targeting treatment modulating triglyceride pathways, such as inhibition of apolipoprotein C-III and angiopoietin-like proteins, are being tested with regard to their effects on lipid profiles and cardiovascular outcomes. In this review, we will discuss the role of hypertriglyceridemia, triglyceride-rich lipoproteins and remnant cholesterol on cardiovascular disease, and the potential implications for treatment stargeting hypertriglyceridemia. PMID:27014342

  13. Expression profiling of cardiovascular disease

    PubMed Central

    2004-01-01

    Cardiovascular disease is the most important cause of morbidity and mortality in developed countries, causing twice as many deaths as cancer in the USA. The major cardiovascular diseases, including coronary artery disease (CAD), myocardial infarction (MI), congestive heart failure (CHF) and common congenital heart disease (CHD), are caused by multiple genetic and environmental factors, as well as the interactions between them. The underlying molecular pathogenic mechanisms for these disorders are still largely unknown, but gene expression may play a central role in the development and progression of cardiovascular disease. Microarrays are high-throughput genomic tools that allow the comparison of global expression changes in thousands of genes between normal and diseased cells/tissues. Microarrays have recently been applied to CAD/MI, CHF and CHD to profile changes in gene expression patterns in diseased and non-diseased patients. This same technology has also been used to characterise endothelial cells, vascular smooth muscle cells and inflammatory cells, with or without various treatments that mimic disease processes involved in CAD/MI. These studies have led to the identification of unique subsets of genes associated with specific diseases and disease processes. Ongoing microarray studies in the field will provide insights into the molecular mechanism of cardiovascular disease and may generate new diagnostic and therapeutic markers. PMID:15588496

  14. Vitamin D and cardiovascular disease.

    PubMed

    Norman, P E; Powell, J T

    2014-01-17

    Vitamin D plays a classical hormonal role in skeletal health by regulating calcium and phosphorus metabolism. Vitamin D metabolites also have physiological functions in nonskeletal tissues, where local synthesis influences regulatory pathways via paracrine and autocrine mechanisms. The active metabolite of vitamin D, 1?,25-dihydroxyvitamin D, binds to the vitamin D receptor that regulates numerous genes involved in fundamental processes of potential relevance to cardiovascular disease, including cell proliferation and differentiation, apoptosis, oxidative stress, membrane transport, matrix homeostasis, and cell adhesion. Vitamin D receptors have been found in all the major cardiovascular cell types including cardiomyocytes, arterial wall cells, and immune cells. Experimental studies have established a role for vitamin D metabolites in pathways that are integral to cardiovascular function and disease, including inflammation, thrombosis, and the renin-angiotensin system. Clinical studies have generally demonstrated an independent association between vitamin D deficiency and various manifestations of degenerative cardiovascular disease including vascular calcification. However, the role of vitamin D supplementation in the management of cardiovascular disease remains to be established. This review summarizes the clinical studies showing associations between vitamin D status and cardiovascular disease and the experimental studies that explore the mechanistic basis for these associations. PMID:24436433

  15. Mitochondrial cytopathies and cardiovascular disease.

    PubMed

    Dominic, Elizabeth A; Ramezani, Ali; Anker, Stefan D; Verma, Mukesh; Mehta, Nehal; Rao, Madhumathi

    2014-04-01

    The global epidemic of cardiovascular disease remains the leading cause of death in the USA and across the world. Functional and structural integrity of mitochondria are essential for the physiological function of the cardiovascular system. The metabolic adaptation observed in normal heart is lost in the failing myocardium, which becomes progressively energy depleted leading to impaired myocardial contraction and relaxation. Uncoupling of electron transfer from ATP synthesis leads to excess generation of reactive species, leading to widespread cellular injury and cardiovascular disease. Accumulation of mitochondrial DNA mutation has been linked to ischaemic heart disease, cardiomyopathy and atherosclerotic vascular disease. Mitochondria are known to regulate apoptotic and autophagic pathways that have been shown to play an important role in the development of cardiomyopathy and atherosclerosis. A number of pharmacological and non-pharmacological treatment options have been explored in the management of mitochondrial diseases with variable success. PMID:24449718

  16. Stem cells and cardiovascular disease.

    PubMed

    Abbott, J Dawn; Giordano, Frank J

    2003-01-01

    Several recent discoveries have shifted the paradigm that there is no potential for myocardial regeneration and have fueled enthusiasm for a new frontier in the treatment of cardiovascular disease-stem cells. Fundamental to this emerging field is the cumulative evidence that adult bone marrow stem cells can differentiate into a wide variety of cell types, including cardiac myocytes and endothelial cells. This phenomenon has been termed stem cell plasticity and is the basis for the explosive recent interest in stem cell-based therapies. Directed to cardiovascular disease, stem cell therapy holds the promise of replacing lost heart muscle and enhancing cardiovascular revascularization. Early evidence of the feasibility of stem cell therapy for cardiovascular disease came from a series of animal experiments demonstrating that adult stem cells could become cardiac muscle cells (myogenesis) and participate in the formation of new blood vessels (angiogenesis and vasculogenesis) in the heart after myocardial infarction. These findings have been rapidly translated to ongoing human trials, but many questions remain. This review focuses on the use of adult bone marrow-derived stem cells for the treatment of ischemic cardiovascular disease and will contrast how far we have come in a short time with how far we still need to go before stem cell therapy becomes routine in cardiovascular medicine. PMID:12900745

  17. Monocyte Heterogeneity in Cardiovascular Disease

    PubMed Central

    Libby, Peter; Nahrendorf, Matthias; Swirski, Filip K.

    2013-01-01

    Only a few decades ago, students of the pathophysiology of cardiovascular disease paid little heed to the involvement of inflammation and immunity. Multiple lines of evidence now point to the participation of innate and adaptive immunity and inflammatory signaling in a variety of cardiovascular conditions. Hence, interest has burgeoned in this intersection. This review will focus on the contribution of innate immunity to both acute injury to the heart muscle itself, notably myocardial infarction, and to chronic inflammation in the artery wall, namely atherosclerosis, the cause of most myocardial infarctions. Our discussion of the operation of innate immunity in cardiovascular diseases will focus on functions of the mononuclear phagocytes with special attention to emerging data regarding the participation of different functional subsets of these cells in cardiovascular pathophysiology. PMID:23839097

  18. Pharmacogenomics and Cardiovascular Disease

    PubMed Central

    Weeke, Peter; Roden, Dan M.

    2014-01-01

    Variability in drug responsiveness is a sine qua non of modern therapeutics, and the contribution of genomic variation is increasingly recognized. Investigating the genomic basis for variable responses to cardiovascular therapies has been a model for pharmacogenomics in general and has established critical pathways and specific loci modulating therapeutic responses to commonly used drugs such as clopidogrel, warfarin, and statins. In addition, genomic approaches have defined mechanisms and genetic variants underlying important toxicities with these and other drugs. These findings have not only resulted in changes to the product labels but also have led to development of initial clinical guidelines that consider how to facilitate incorporating genetic information to the bedside. This review summarizes the state of knowledge in cardiovascular pharmacogenomics and considers how variants described to date might be deployed in clinical decision making. PMID:23689943

  19. TGFβ Signaling and Cardiovascular Diseases

    PubMed Central

    Pardali, Evangelia; ten Dijke, Peter

    2012-01-01

    Transforming growth factor β (TGFβ) family members are involved in a wide range of diverse functions and play key roles in embryogenesis, development and tissue homeostasis. Perturbation of TGFβ signaling may lead to vascular and other diseases. In vitro studies have provided evidence that TGFβ family members have a wide range of diverse effects on vascular cells, which are highly dependent on cellular context. Consistent with these observations genetic studies in mice and humans showed that TGFβ family members have ambiguous effects on the function of the cardiovascular system. In this review we discuss the recent advances on TGFβ signaling in (cardio)vascular diseases, and describe the value of TGFβ signaling as both a disease marker and therapeutic target for (cardio)vascular diseases. PMID:22253564

  20. Fatty acids and cardiovascular disease.

    PubMed

    Lecerf, Jean-Michel

    2009-05-01

    Fatty acids have been classified into "good" or "bad" groups according to their degree of unsaturation or whether they are "animal fat" or "vegetable fat". Today, it appears that the effects of fatty acids are complex and vary greatly according to the dose and the nature of the molecule. Monounsaturated fatty acids are still considered as having a "neutral" status, but any benefits may be related to the chemical environment of the source food or the associated overall food pattern. Controversy surrounds omega-6 polyunsaturated fatty acids, because even though they lower LDL cholesterol levels, excessive intakes do not appear to be correlated with cardiovascular benefit. The omega-3 fatty acids are known to exert cardiovascular protective effects. Dairy fat and its cardiovascular impact are being evaluated. This review examines the existing literature on the relationships between the different fatty acids and cardiovascular disease. PMID:19386031

  1. Functional foods and cardiovascular disease.

    PubMed

    Hasler, C M; Kundrat, S; Wool, D

    2000-11-01

    Functional foods are foods that, by virtue of physiologically active food components, provide health benefits beyond basic nutrition. Many functional foods have been found to be potentially beneficial in the prevention and treatment of cardiovascular disease, the leading cause of mortality in the United States. These foods include soybeans, oats, psyllium, flaxseed, garlic, tea, fish, grapes, nuts, and stanol- and sterol ester enhanced margarine. When eaten in adequate amounts on a consistent basis, these foods may aid in decreasing the risk of cardiovascular disease by several potential mechanisms: lowering blood lipid levels, improving arterial compliance, reducing low-density lipoprotein oxidation, decreasing plaque formation, scavenging free radicals, and inhibiting platelet aggregation. PMID:11122780

  2. Laser therapy in cardiovascular disease

    NASA Astrophysics Data System (ADS)

    Rindge, David

    2009-02-01

    Cardiovascular disease is the number one cause of death worldwide. It is broadly defined to include anything which adversely affects the heart or blood vessels. One-third of Americans have one or more forms of it. By one estimate, average human life expectancy would increase by seven years if it were eliminated. The mainstream medical model seeks mostly to "manage" cardiovascular disease with pharmaceuticals or to surgically bypass or reopen blocked vessels via angioplasty. These methods have proven highly useful and saved countless lives. Yet drug therapy may be costly and ongoing, and it carries the risk of side effects while often doing little or nothing to improve underlying health concerns. Similarly, angioplasty or surgery are invasive methods which entail risk. Laser therapy1 regenerates tissue, stimulates biological function, reduces inflammation and alleviates pain. Its efficacy and safety have been increasingly well documented in cardiovascular disease of many kinds. In this article we will explore the effects of laser therapy in angina, atherosclerosis, coronary artery disease, hypertension, hyperlipidemia, myocardial infarction, stroke and other conditions. The clinical application of various methods of laser therapy, including laserpuncture and transcutaneous, supravascular and intravenous irradiation of blood will be discussed. Implementing laser therapy in the treatment of cardiovascular disease offers the possibility of increasing the health and wellbeing of patients while reducing the costs and enhancing safety of medical care.

  3. Ionizing radiation and cardiovascular disease.

    PubMed

    Hoel, David G

    2006-09-01

    For more than 15 years the A-bomb survivor studies have shown increased noncancer mortality due to radiation exposures. The most prominent cause of this increase is circulatory disease mortality. Although the estimated relative risk is less than for solid cancers (1.2 versus 1.6 per Sv), there are measurable increases in cardiovascular disease mortality at doses greater than 0.5 Sv. The evidence for circulatory diseases in mortality studies of occupational cohorts exposed to external radiation is less compelling. It is generally accepted that atherosclerosis is an inflammatory disease of the arteries and a risk factor for myocardial infarction. Immunological markers for inflammatory disease have been shown to be dose related in A-bomb survivors. Evidence from animal studies reveals increased cardiovascular mortality and arterial endothelial damage from both neutron and, to a lesser extent, gamma exposures. PMID:17119211

  4. [Occupational cardiovascular diseases and phlebopathies].

    PubMed

    Picciotto, D

    2010-01-01

    The focus of the occupational physician to diseases of the cardiovascular system has always been high in relation to the presence in the work of specific risk factors, but also because of the high incidence and prevalence of disease in the general population cardiology chronic-degenerative diseases. The non-specificity and multifactorial diseases of the cardiovascular system, make an etiologic diagnosis of occupational disease extremely difficult. For this reason, increasingly, the occupational physician is faced with the specialist cardiologist on diseases that can be defined as work-related. Among the clinical conditions most frequently encountered by the occupational physician, considered to include hypertension, ischemic heart disease and arrhythmias. Exposure to work risk factors such as: high or low temperatures, the MMC, exposure to electromagnetic fields, and also those related to organization and psycho-social, including night work and work-related stress related, or exposure to chemicals such as organic solvents, especially halogenated, or nitrates, or carbon monoxide, are an aggravating factor in the clinical context of cardiovascular disease primarily unrelated to the etiology. All this underlines also the issue of fitness to work with high risk of accidents for the worker himself and to others, especially the suspension work, driving of vehicles in general, the roles of monitoring and oversight to senior management. From the above, the importance of careful assessment by the occupational physician and the need for good cooperation with the specialist cardiologist, for the formulation of the assessment of suitability for specific tasks. PMID:21438248

  5. Developmental Origins of Cardiovascular Disease

    PubMed Central

    Yeung, Edwina H.; Robledo, Candace; Boghossian, Nansi; Zhang, Cuilin; Mendola, Pauline

    2014-01-01

    Although cardiovascular disease has traditionally been viewed as a condition of aging individuals, increasing focus has turned to its developmental origins. Since birthweight has been related to cardiovascular disease risk, research into factors such as gravid conditions that affect fetal growth have grown. Associations between maternal diabetes and childhood obesity from sibling studies suggest a causal role but prospective studies of gestational diabetes remain mixed. Preeclampsia and increased offspring blood pressure has been consistently observed but evidence for other cardiovascular outcomes is lacking. While maternal obesity is associated with childhood obesity, causality remains unclear and paternal obesity should be investigated as an independent risk factor. Environmental chemical exposures in utero, particularly obesogens, are now emerging as another concern, as is conception by infertility treatment. Few studies have investigated subclinical measures of endothelial function or atherosclerosis and more research in these areas may help reveal the underlying pathogenesis. PMID:25364653

  6. [Nicotine replacement therapy in cardiovascular disease].

    PubMed

    Szyszka, Andrzej; Religa, Lilianna; Fa?dyga, Jolanta

    2010-01-01

    Smoking is well established and important risk factor for cardiovascular disease. Cessation of smoking clearly decreases the risk of cardiovascular events. Nicotine is known to be the addicting component of tobacco products. Nicotine replacement therapy (NRT) increases the probability of quitting smoking. Studies have indicating no increase in cardiovascular events in smokers with known cardiovascular disease. PMID:21360907

  7. Antioxidant vitamins and cardiovascular disease.

    PubMed

    Nez-Crdoba, Jorge M; Martnez-Gonzlez, Miguel A

    2011-01-01

    Cardiovascular disease represents an unparalleled proportion of the global burden of disease and will remain the main cause of mortality for the near future. Fortunately, most premature cardiovascular deaths are preventable. Therefore, prevention becomes vital and diet has shown beneficial effects to protect from CVD (CVD). Fruits and vegetables are dietary sources of natural antioxidants and it is generally accepted that antioxidants in these foods are key in explaining the inverse association between fruits and vegetables intake and the risk of developing a cardiovascular event or having elevated levels of cardiovascular risk factors. Available evidence supports the central role of oxidative stress in the atherosclerosis process and the correlation between increased oxidative stress and vascular disease. Theoretically, antioxidants in fruits and vegetables are important in inhibiting oxidative mechanisms that lead to various degenerative diseases including CVD. However, results from many interventional trials using antioxidants given as supplements have not been concordant with previous positive findings from observational epidemiologic cohort studies. The present manuscript gives a brief overview of the relationship between natural antioxidants (specially vitamin C, vitamin E and beta-carotene) intake and the risk of CVD. PMID:21506930

  8. Cardiovascular disease and environmental exposure.

    PubMed Central

    Rosenman, K D

    1979-01-01

    This paper reviews the possible association between cardiovascular disease and occupational and environmental agents. The effects of carbon monoxide, fibrogenic dusts, carbon disulphide, heavy metals, noise, radiation, heat, cold, solvents and fluorocarbons are discussed. New directions for investigation are suggested. PMID:465378

  9. Prevention of cardiovascular disease.

    PubMed Central

    Haines, A.; Patterson, D.; Rayner, M.; Hyland, K.

    1992-01-01

    1. Major risk factors for coronary heart disease (CHD) are smoking, blood pressure and blood cholesterol and they interact in a multiplicative fashion. Family history of premature coronary heart disease and lack of exercise also contribute. Obesity increases risk probably mainly by its effect on blood cholesterol and blood pressure. Heavy alcohol consumption is a risk factor for stroke. 2. Prevention may be opportunistic or in specially organized clinics, the latter being less likely to result in the attendance of high risk individuals. 3. Worthwhile reductions in cigarette smoking can be achieved by brief advice and follow-up. Literature on smoking and other aspects of prevention is available from the district health education department. 4. Risk scores can be used to calculate the risk of coronary heart disease. They can help to indicate the advisability of measurement of blood cholesterol and to focus limited resources on those at highest risk by helping to define a 'special care group'. 5. Indications for measuring blood cholesterol are: a family history of premature coronary heart disease or hyperlipidaemia, personal history of coronary heart disease, clinical evidence of raised lipids (xanthelasma, corneal arcus under 50, xanthomas at any age), a high risk of coronary heart disease according to a risk score. Many would also include those under treatment for hypertension and diabetes. 6. Dietary advice can moderately reduce blood cholesterol. The proportion of calories from fat should be reduced from the current average of around 40% to a maximum of 33%. Dietary advice should be tailored to the patient's current diet. An increase in vegetables and fruit can be generally advocated. 7. Regular exercise has a worthwhile role to play in prevention. Rapid walking, jogging and swimming may all be suitable, as may be heavy gardening and housework. 8. A small proportion of patients may require lipid-lowering drugs. These include resins (cholestyramine and colestipol), fibrates (eg bezafibrate and gemfibrozil) and more recently HMG CoA inhibitors (eg simvastatin). The HMG CoA inhibitors produce large falls in cholesterol and may become first line drugs in future. Because of the current controversy about the effect of lipid-lowering drugs on total mortality, many believe that they should be reserved for those at the highest risk, for example patients with familial hypercholesterolaemia or with pre-existing coronary heart disease and a high plasma cholesterol (> 7.8 mmol/L). 9. The special care group defined by the practice should be offered regular follow-up.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:1345159

  10. The Impact of C Reactive Protein on Global Cardiovascular Risk on Patients with Coronary Artery Disease

    PubMed Central

    Cozlea, D.L.; Farcas, D.M.; Nagy, A.; Keresztesi, A.A.; Tifrea, Ramona; Cozlea, L.; Cara?ca, E.

    2013-01-01

    Introduction. Cardiovascular disease (CVD) is the major cause of premature death worldwide. Hundreds of risk factors have been associated with cardiovascular disease. Recent extensive evidence supports inflammation as a key pathogenetic mechanism in the development and progression of atherosclerosis and in triggering clinical atherothrombotic CVD events. C-reactive protein (CRP) is one possible marker of vascular inflammation and plays a direct role in promoting vascular inflammation, vessel damage and clinical CVD events. Material and method. The purpose of this study was to evaluate the correlation between CRP level and the global cardiovascular risk. We evaluated 100 patients with cardiovascular risk factors, using the systematic coronary risk evalution (SCORE) charts for high risk regions of Europe and we determined the CRP level, using the nephelometric method. Results. By their SCORE chart, 44% of the patients are in the moderate risk category, and almost 40% in the high risk category, the rest of them (16%) are in the low and very high risk category. A statistically significant p value (p<0.05) was observed between patients with CRP<10mg/L, who had a lower sistolic blood pressure than patients with CRP?10mg/L, Conclusion. The CRP level over 10mg/L is correlated with an over 4% risk of developing a fatal CVD in 10 years. The acute phase reactant, CRP, a simple downstream marker of inflammation, has now emerged as a major cardiovascular risk factor. PMID:24778862

  11. Protein nitration in cardiovascular diseases.

    PubMed

    Turko, Illarion V; Murad, Ferid

    2002-12-01

    There is growing evidence that cardiovascular disease is associated with progressive changes in the production of free radicals and radical-derived reactive species. These intermediates react with all major cellular constituents and may serve several physiological and pathophysiological functions. The nitration of protein tyrosine residues has been used as a footprint for in vivo production of radical and nonradical reactive species. Tyrosine nitration may alter protein function and metabolism and therefore, provides for further dysfunctional changes. This review focuses on an appearance of tyrosine nitrated proteins in cardiovascular tissues under different settings of cardiovascular disease. Sources of reactive species, putative mechanisms of protein nitration in vivo, as well as protein nitration under normal physiological conditions, are also described. The goal of this review is to attract more attention to identification of specific proteins, which undergo tyrosine nitration and to study a correlation between their altered function and pathology. Understanding how protein nitration affects disease progression may offer a unique option for design of antioxidant therapy for the treatment of cardiovascular complications. At the same time, protein nitration can be a biological marker of efficiency of antioxidant therapy. PMID:12429871

  12. Nonalcoholic fatty liver disease and cardiovascular disease

    PubMed Central

    Liu, Hong; Lu, Hong-Yun

    2014-01-01

    Nonalcoholic fatty liver disease (NAFLD) and cardiovascular disease (CVD) are two diseases that are common in the general population. To date, many studies have been conducted and demonstrate a direct link between NAFLD and CVD, but the exact mechanisms for this complex relationship are not well established. A systematic search of the PubMed database revealed that several common mechanisms are involved in many of the local and systemic manifestations of NAFLD and lead to an increased cardiovascular risk. The possible mechanisms linking NAFLD and CVD include inflammation, oxidative stress, insulin resistance, ectopic adipose tissue distribution, dyslipidemia, endothelial dysfunction, and adiponectin, among others. The clinical implication is that patients with NAFLD are at an increased risk of CVD and should undergo periodic cardiovascular risk assessment. PMID:25024598

  13. The liver and the kidney: two critical organs influencing the atherothrombotic risk in metabolic syndrome.

    PubMed

    Carbone, F; Montecucco, F; Mach, F; Pontremoli, R; Viazzi, F

    2013-11-01

    The increased atherothrombotic risk in patients with metabolic syndrome (MetS) has been classically explained by the multiplicative effect of systemic concomitant pro-atherosclerotic factors. In particular, centripetal obesity, dyslipidaemia, glucose intolerance, hypertension (differently combined in the diagnosis of the disease) would be expected to act as classical cardiovascular risk conditions underlying accelerated atherogenesis. In order to better understand specific atherosclerotic pathophysiology in MetS, emerging evidence focused on the alterations in different organs that could serve as both pathophysiological targets and active players in the disease. Abnormalities in adipose tissue, heart and arteries have been widely investigated in a variety of basic research and clinical studies in MetS. In this narrative review, we focus on pathophysiological activities of the liver and kidney. Considering its key role in metabolism and production of soluble inflammatory mediators (such as C-reactive protein [CRP]), the liver in MetS has been shown to be altered both in its structure and function. In particular, a relevant amount of the fat accumulated within this organ has been shown to be associated with different degrees of inflammation and potential insulin resistance. In humans, non-alcoholic fatty liver disease (NAFLD) has been described as the hepatic manifestation of MetS. In an analogous manner, epidemiological evidence strongly suggested a "guilty" association between MetS and chronic kidney disease (CKD). Some biomarkers of hepatic (such as C-reactive protein, TNF-alpha or other cytokines) and renal diseases (such as uric acid) associated with MetS might be particularly useful to better manage and prevent the atherothrombotic risk. PMID:23966104

  14. Genomics in Cardiovascular Disease

    PubMed Central

    Roberts, Robert; Marian, A.J.; Dandona, Sonny; Stewart, Alexandre F.R.

    2013-01-01

    A paradigm shift towards biology occurred in the 1990s subsequently catalyzed by the sequencing of the human genome in 2000. The cost of DNA sequencing has gone from millions to thousands of dollars with sequencing of ones entire genome costing only $1,000. Rapid DNA sequencing is being embraced for single gene disorders, particularly for sporadic cases and those from small families. Transmission of lethal genes such as associated with Huntingtons disease can, through in-vitro fertilization, avoid passing it on to ones offspring. DNA sequencing will meet the challenge of elucidating the genetic predisposition for common polygenic diseases, especially in determining the function of the novel common genetic risk variants and identifying the rare variants, which may also partially ascertain the source of the missing heritability. The challenge for DNA sequencing remains great, despite human genome sequences being 99.5% identical, the 3 million single nucleotide polymorphisms (SNPs) responsible for most of the unique features add up to 60 new mutations per person which, for 7 billion people, is 420 billion mutations. It is claimed that DNA sequencing has increased 10,000 fold while information storage and retrieval only 16 fold. The physician and health user will be challenged by the convergence of two major trends, whole genome sequencing and the storage/retrieval and integration of the data. PMID:23524054

  15. Cardiovascular complications of pediatric chronic kidney disease

    PubMed Central

    2006-01-01

    Cardiovascular disease (CVD) mortality is a leading cause of death in adult chronic kidney disease (CKD), with exceptionally high rates in young adults, according to the Task Force on Cardiovascular Disease. Recent data indicate that cardiovascular complications are already present in children with CKD. This review summarizes the current literature on cardiac risk factors, mortality and morbidity in children with CKD. PMID:17120060

  16. Chronic obstructive pulmonary disease and cardiovascular disease.

    PubMed

    Bhatt, Surya P; Dransfield, Mark T

    2013-10-01

    Chronic obstructive pulmonary disease (COPD) is an inflammatory disease of the lung associated with progressive airflow limitation and punctuated by episodes of acute exacerbation. There is growing recognition that the inflammatory state associated with COPD is not confined to the lungs but also involves the systemic circulation and can impact nonpulmonary organs. Epidemiologic and mechanistic studies indicate that COPD is associated with a high frequency of coronary artery disease, congestive heart failure and cardiac arrhythmias, independent of shared risk factors. Possible pathways include complex interrelationships between chronic low-grade systemic inflammation and oxidative stress as well as shared risk factors such as age, cigarette smoking, and environmental pollutants. In this review, we provide an overview of the epidemiologic data linking COPD with cardiovascular disease, comment on the interrelationships among COPD, inflammation, and cardiovascular disease, and highlight diagnostic and therapeutic challenges. PMID:23727296

  17. Vitamin D and Cardiovascular Disease.

    PubMed

    Wang, Thomas J

    2016-01-14

    Vitamin D is best known for its influence on skeletal health. There is growing recognition, however, that vitamin D has nonskeletal actions, which could have important implications for understanding the consequences of vitamin D deficiency. In epidemiologic studies, vitamin D deficiency has been consistently associated with an increased risk for cardiovascular disease and hypertension. Disruption of vitamin D signaling in animal models promotes hypertension, cardiac hypertrophy, and atherosclerosis. This evidence has led to the initiation of prospective randomized trials of vitamin D supplementation in individuals at risk for cardiovascular disease. The results of these trials should help to guide strategies for screening and management of vitamin D deficiency in the clinic and at the population level. PMID:26768241

  18. Oral infections and cardiovascular disease.

    PubMed

    Kholy, Karim El; Genco, Robert J; Van Dyke, Thomas E

    2015-06-01

    Oral infections are the most common diseases of mankind. Numerous reports have implicated oral infections, particularly periodontitis, as a risk factor for atherosclerotic cardiovascular disease (CVD). In this review we examine the epidemiology and biologic plausibility of this association with an emphasis on oral bacteria and inflammation. Longitudinal studies of incident cardiovascular events clearly show excess risk for CVD in individuals with periodontitis. It is likely that systemic exposure to oral bacteria impacts upon the initiation and progression of CVD through triggering of inflammatory processes. Given the high prevalence of periodontitis, any risk attributable to future CVD is important to public health. Unraveling the role of the oral microbiome in CVD will lead to new preventive and treatment approaches. PMID:25892452

  19. The programming of cardiovascular disease.

    PubMed

    Thornburg, K L

    2015-10-01

    In spite of improving life expectancy over the course of the previous century, the health of the U.S. population is now worsening. Recent increasing rates of type 2 diabetes, obesity and uncontrolled high blood pressure predict a growing incidence of cardiovascular disease and shortened average lifespan. The daily >$1billion current price tag for cardiovascular disease in the United States is expected to double within the next decade or two. Other countries are seeing similar trends. Current popular explanations for these trends are inadequate. Rather, increasingly poor diets in young people and in women during pregnancy are a likely cause of declining health in the U.S. population through a process known as programming. The fetal cardiovascular system is sensitive to poor maternal nutritional conditions during the periconceptional period, in the womb and in early postnatal life. Developmental plasticity accommodates changes in organ systems that lead to endothelial dysfunction, small coronary arteries, stiffer vascular tree, fewer nephrons, fewer cardiomyocytes, coagulopathies and atherogenic blood lipid profiles in fetuses born at the extremes of birthweight. Of equal importance are epigenetic modifications to genes driving important growth regulatory processes. Changes in microRNA, DNA methylation patterns and histone structure have all been implicated in the cardiovascular disease vulnerabilities that cross-generations. Recent experiments offer hope that detrimental epigenetic changes can be prevented or reversed. The large number of studies that provide the foundational concepts for the developmental origins of disease can be traced to the brilliant discoveries of David J.P. Barker. PMID:26173733

  20. Cocoa, chocolate, and cardiovascular disease.

    PubMed

    Galleano, Monica; Oteiza, Patricia I; Fraga, Cesar G

    2009-12-01

    A significant body of evidence demonstrates that diets rich in fruits and vegetables promote health and attenuate, or delay, the onset of various diseases, including cardiovascular disease, diabetes, certain cancers, and several other age-related degenerative disorders. The concept that moderate chocolate consumption could be part of a healthy diet has gained acceptance in past years based on the health benefits ascribed to selected cocoa components. Specifically, cocoa as a plant and chocolate as food contain a series of chemicals that can interact with cell and tissue components, providing protection against the development and amelioration of pathological conditions. The most relevant effects of cocoa and chocolate have been related to cardiovascular disease. The mechanisms behind these effects are still under investigation. However, the maintenance or restoration of vascular NO production and bioavailability and the antioxidant effects are the mechanisms most consistently supported by experimental data. This review will summarize the most recent research on the cardiovascular effects of cocoa flavanols and related compounds. PMID:19701098

  1. Genetic testing in cardiovascular diseases

    PubMed Central

    Arndt, Anne-Karin; MacRae, Calum A.

    2014-01-01

    Purpose of review The review is designed to outline the major developments in genetic testing in the cardiovascular arena in the past year or so. This is an exciting time in genetic testing as whole exome and whole genome approaches finally reach the clinic. These new approaches offer insight into disease causation in families in which this might previously have been inaccessible, and also bring a wide range of interpretative challenges. Recent findings Among the most significant recent findings has been the extent of physiologic rare coding variation in the human genome. New disease genes have been identified through whole exome studies in neonatal arrhythmia, congenital heart disease and coronary artery disease that were simply inaccessible with other techniques. This has not only shed light on the challenges of genetic testing at this scale, but has also sharply defined the limits of prior gene-panel focused testing. As novel therapies targeting specific genetic subsets of disease become available, genetic testing will become a part of routine clinical care. Summary The pace of change in sequencing technologies has begun to transform clinical medicine, and cardiovascular disease is no exception. The complexity of such studies emphasizes the importance of real-time communication between the genetics laboratory and genetically informed clinicians. New efforts in data and knowledge management will be central to the continued advancement of genetic testing. PMID:24717670

  2. Management and Outcomes Among Chinese Hospitalized Patients With Established Cardiovascular Disease or Multiple Risk Factors.

    PubMed

    Yang, Jingang; Yang, Yuejin; Gu, Hongqiu; Li, Wei; Hu, Dayi

    2016-02-01

    We assessed the management and outcomes among hospitalized patients with coronary artery disease (CAD), stroke, peripheral artery disease (PAD), or with multiple (?2) cardiovascular (CV) risk factors (multiple risk factors [MRFs]). We retrospectively studied 3732 hospitalized patients of either CV disease or ?2 risk factors for atherothrombosis from October 2004 to January 2005. Outcomes included CV death, myocardial infarction (MI), stroke, and hospitalization for atherothrombotic events. About one-third had disease involving ?1 vascular bed. Medication was more intense in patients with CAD than in others. The lowest use of statins and antiplatelet treatment was in the PAD-only group. Patients with PAD experienced a higher CV mortality (5.1%) than the patients with CAD (3.73%) or stroke (4.1%), P < .001. Cardiovascular death ranged from 1.2% for patients with MRFs, 2.8% for patients with 1-bed disease, 4.7% for patients with 2-bed disease to 6.4% for patients with 3-bed disease (P for trend <.001). For hospitalized patients with established atherosclerotic arterial disease, a substantial increase in CV event rates occurs with increasing numbers of affected arterial beds. Patients with PAD were at an especially high risk. PMID:25922196

  3. Reactive Oxygen Species in Cardiovascular Disease

    PubMed Central

    Sugamura, Koichi; Keaney, John F.

    2011-01-01

    Based on the ‘free-radical theory’ of disease, researchers have been trying to elucidate the role of oxidative stress from free radicals in cardiovascular disease. Considerable data indicate that ROS and oxidative stress are important features of cardiovascular diseases including atherosclerosis, hypertension, and congestive heart failure. However, blanket strategies with antioxidants to ameliorate cardiovascular disease have not generally yielded favorable results. However, our understanding or reactive oxygen species has evolved to the point that we now realize these species have important roles in physiology as well as pathophysiology. Thus, it is overly simplistic to assume a general antioxidant strategy will yield specific effects on cardiovascular disease. Indeed, there are several sources of reactive oxygen species that are known to be active in the cardiovascular system. This review will address our understanding of reactive oxygen species sources in cardiovascular disease and both animal and human data defining how reactive oxygen species contribute to physiology and pathology. PMID:21627987

  4. Cocoa, chocolate and cardiovascular disease

    PubMed Central

    Galleano, Monica; Oteiza, Patricia I.; Fraga, Cesar G.

    2009-01-01

    A significant body of evidence demonstrates that diets rich in fruit and vegetables promote health, and attenuate, or delay, the onset of various diseases, including cardiovascular disease (CVD), diabetes, certain cancers, and several other age-related degenerative disorders. The concept that moderate chocolate consumption could be part of a healthy diet has gained acceptance in the last years based on the health benefits ascribed to selected cocoa components. Specifically, cocoa as a plant and chocolate as food contain a series of chemicals that can interact with cell and tissue components providing protection against the development and amelioration of pathological conditions. The most relevant effects of cocoa and chocolate have been related to CVD. The mechanisms behind these effects are still under investigation. However the maintenance or restoration of vascular NO production and bioavailability and the antioxidant effects are the mechanisms most consistently supported by experimental data. This review will summarize the most recent research on the cardiovascular effects of cocoa flavanoles and related compounds. PMID:19701098

  5. Iron deficiency and cardiovascular disease.

    PubMed

    von Haehling, Stephan; Jankowska, Ewa A; van Veldhuisen, Dirk J; Ponikowski, Piotr; Anker, Stefan D

    2015-11-01

    Iron deficiency affects up to one-third of the world's population, and is particularly common in elderly individuals and those with certain chronic diseases. Iron excess can be detrimental in cardiovascular illness, and research has now also brought anaemia and iron deficiency into the focus of cardiovascular medicine. Data indicate that iron deficiency has detrimental effects in patients with coronary artery disease, heart failure (HF), and pulmonary hypertension, and possibly in patients undergoing cardiac surgery. Around one-third of all patients with HF, and more than one-half of patients with pulmonary hypertension, are affected by iron deficiency. Patients with HF and iron deficiency have shown symptomatic improvements from intravenous iron administration, and some evidence suggests that these improvements occur irrespective of the presence of anaemia. Improved exercise capacity has been demonstrated after iron administration in patients with pulmonary hypertension. However, to avoid iron overload and T-cell activation, it seems that recipients of cardiac transplantations should not be treated with intravenous iron preparations. PMID:26194551

  6. Cardiovascular Disease and Cancer: Student Awareness Activities.

    ERIC Educational Resources Information Center

    Meyer, James H., Comp.

    Awareness activities pertaining to cancer and cardiovascular disease are presented as a supplement for high school science classes. The exercises can be used to enrich units of study dealing with the circulatory system, the cell, or human diseases. Eight activities deal with the following topics: (1) cardiovascular disease risk factors; (2)

  7. Sugars, hypertriglyceridemia, and cardiovascular disease.

    PubMed

    Fried, Susan K; Rao, Salome P

    2003-10-01

    Short-term studies consistently show that raising the carbohydrate content of the diet increases serum triacylglycerol concentrations. As compared with starches, sugars (particularly sucrose and fructose) tend to increase serum triacylglycerol concentrations by approximately 60%. The magnitude of the effect depends on other aspects of the diet, including the total amount of carbohydrate and the types of fat, carbohydrate, and fiber, but definitive studies to describe the dose-response relations are not available. Longer-term studies show that some high-carbohydrate diets are not associated with increased fasting serum triacylgycerol concentrations. However, sedentary subjects with upper-body and visceral obesity who have the metabolic syndrome tend to be at higher risk for hypertriglyceridemia in response to high-sucrose and high-carbohydrate diets; moderate weight loss mitigates the effect. Hyperinsulinemia or insulin resistance may play a role in promoting higher rates of VLDL synthesis and hypertriglyceridemia in obesity, but the mechanisms remain unclear. The effect of fructose in promoting triacylglycerol synthesis is independent of insulinemia, however. In terms of the long-term effects of diets high in sugars on the risk of cardiovascular disease, available epidemiologic evidence indicates no association of sugars or total carbohydrate intake per se, but high dietary glycemic load is associated with higher serum triacylglycerol concentrations and greater risk of coronary heart disease in women. Studies are needed to delineate the independent effects of dietary sugars and glycemic load on serum triacylglycerol concentrations in lean and obese men and women and to determine whether the elevations in fasting and fed concentrations of serum triacylglycerol with high-carbohydrate and high-sugars diets are associated with increased risk of cardiovascular disease. PMID:14522752

  8. Cardiovascular disease after cancer therapy

    PubMed Central

    Aleman, Berthe M.P.; Moser, Elizabeth C.; Nuver, Janine; Suter, Thomas M.; Maraldo, Maja V.; Specht, Lena; Vrieling, Conny; Darby, Sarah C.

    2014-01-01

    Improvements in treatment and earlier diagnosis have both contributed to increased survival for many cancer patients. Unfortunately, many treatments carry a risk of late effects including cardiovascular diseases (CVDs), possibly leading to significant morbidity and mortality. In this paper we describe current knowledge of the cardiotoxicity arising from cancer treatments, outline gaps in knowledge, and indicate directions for future research and guideline development, as discussed during the 2014 Cancer Survivorship Summit organised by the European Organisation for Research and Treatment of Cancer (EORTC). Better knowledge is needed of the late effects of modern systemic treatments and of radiotherapy to critical structures of the heart, including the effect of both radiation dose and volume of the heart exposed. Research elucidating the extent to which treatments interact in causing CVD, and the mechanisms involved, as well as the extent to which treatments may increase CVD indirectly by increasing cardiovascular risk factors is also important. Systematic collection of data relating treatment details to late effects is needed, and great care is needed to obtain valid and generalisable results. Better knowledge of these cardiac effects will contribute to both primary and secondary prevention of late complications where exposure to cardiotoxic treatment is unavoidable. Also surrogate markers would help to identify patients at increased risk of cardiotoxicity. Evidence-based screening guidelines for CVD following cancer are also needed. Finally, risk prediction models should be developed to guide primary treatment choice and appropriate follow up after cancer treatment. PMID:26217163

  9. Subclinical Hypothyroidism and Cardiovascular Disease

    PubMed Central

    Suh, Sunghwan

    2015-01-01

    Subclinical hypothyroidism (SCH) is a common disorder that is characterized by elevated thyroid-stimulating hormone levels in conjunction with free thyroxine concentrations within the normal reference range. Thyroid hormones are known to affect the heart and vasculature and, as a result, the impact of SCH on the cardiovascular (CV) system has recently become an important topic of research. Strong evidence points to a link between SCH and CV risk factors such as alterations in blood pressure, lipid levels, and atherosclerosis. Additionally, accumulating evidence indicates that SCH is associated with metabolic syndrome and heart failure. The present review proposes that SCH may be a potentially modifiable risk factor of CV disease and mortality. However, large-scale clinical trials with appropriate power investigating the risks and benefits of SCH treatment are required to determine whether these benefits can be achieved with levothyroxine therapy. PMID:26248862

  10. Polyphenols, Inflammation, and Cardiovascular Disease

    PubMed Central

    Tangney, Christy; Rasmussen, Heather E.

    2013-01-01

    Polyphenols are compounds found in foods such as tea, coffee, cocoa, olive oil, and red wine and have been studied to determine if their intake may modify cardiovascular disease (CVD) risk. Historically, biologic actions of polyphenols have been attributed to antioxidant activities, but recent evidence suggests that immunomodulatory and vasodilatory properties of polyphenols may also contribute to CVD risk reduction. These properties will be discussed, and recent epidemiological evidence and intervention trials will be reviewed. Further identification of polyphenols in foods and accurate assessment of exposures through measurement of biomarkers (i.e., polyphenol metabolites) could provide the needed impetus to examine the impact of polyphenol-rich foods on CVD intermediate outcomes (especially those signifying chronic inflammation) and hard endpoints among high risk patients. Although we have mechanistic insight into how polyphenols may function in CVD risk reduction, further research is needed before definitive recommendations for consumption can be made. PMID:23512608

  11. Antioxidants, inflammation and cardiovascular disease

    PubMed Central

    Mangge, Harald; Becker, Kathrin; Fuchs, Dietmar; Gostner, Johanna M

    2014-01-01

    Multiple factors are involved in the etiology of cardiovascular disease (CVD). Pathological changes occur in a variety of cell types long before symptoms become apparent and diagnosis is made. Dysregulation of physiological functions are associated with the activation of immune cells, leading to local and finally systemic inflammation that is characterized by production of high levels of reactive oxygen species (ROS). Patients suffering from inflammatory diseases often present with diminished levels of antioxidants either due to insufficient dietary intake or, and even more likely, due to increased demand in situations of overwhelming ROS production by activated immune effector cells like macrophages. Antioxidants are suggested to beneficially interfere with diseases-related oxidative stress, however the interplay of endogenous and exogenous antioxidants with the overall redox system is complex. Moreover, molecular mechanisms underlying oxidative stress in CVD are not fully elucidated. Metabolic dybalances are suggested to play a major role in disease onset and progression. Several central signaling pathways involved in the regulation of immunological, metabolic and endothelial function are regulated in a redox-sensitive manner. During cellular immune response, interferon γ-dependent pathways are activated such as tryptophan breakdown by the enzyme indoleamine 2,3-dioxygenase (IDO) in monocyte-derived macrophages, fibroblasts, endothelial and epithelial cells. Neopterin, a marker of oxidative stress and immune activation is produced by GTP-cyclohydrolase I in macrophages and dendritic cells. Nitric oxide synthase (NOS) is induced in several cell types to generate nitric oxide (NO). NO, despite its low reactivity, is a potent antioxidant involved in the regulation of the vasomotor tone and of immunomodulatory signaling pathways. NO inhibits the expression and function of IDO. Function of NOS requires the cofactor tetrahydrobiopterin (BH4), which is produced in humans primarily by fibroblasts and endothelial cells. Highly toxic peroxynitrite (ONOO-) is formed solely in the presence of superoxide anion (O2-). Neopterin and kynurenine to tryptophan ratio (Kyn/Trp), as an estimate of IDO enzyme activity, are robust markers of immune activation in vitro and in vivo. Both these diagnostic parameters are able to predict cardiovascular and overall mortality in patients at risk. Likewise, a significant association exists between increase of neopterin concentrations and Kyn/Trp ratio values and the lowering of plasma levels of vitamin-C, -E and -B. Vitamin-B deficiency is usually accompanied by increased plasma homoycsteine. Additional determination of NO metabolites, BH4 and plasma antioxidants in patients with CVD and related clinical settings can be helpful to improve the understanding of redox-regulation in health and disease and might provide a rationale for potential antioxidant therapies in CVD. PMID:24976919

  12. Cardiovascular effects of thyroid disease.

    PubMed

    Sangster, Jodi K; Panciera, David L; Abbott, Jonathan A

    2013-07-01

    Thyroid hormones have many effects on cardiovascular function, and deficiency or excess of thyroid hormones can result in cardiac dysfunction. Abnormalities of the cardiovascular system are often identified during examination of hyperthyroid and hypothyroid patients. This article addresses the effects of thyroid hormones on the cardiovascular system and the clinical relevance of the cardiovascular response to thyroid dysfunction. In addition, treatment recommendations are presented. PMID:23677842

  13. Cardiovascular disease in systemic sclerosis

    PubMed Central

    Cannarile, Francesca; Valentini, Valentina; Mirabelli, Giulia; Alunno, Alessia; Terenzi, Riccardo; Luccioli, Filippo; Bartoloni, Elena

    2015-01-01

    Cardiovascular (CV) system involvement is a frequent complication of autoimmune diseases such as systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). It still remains unclear if a premature atherosclerosis (ATS) occurs even in systemic sclerosis (SSc). Although microvascular disease is a hallmark of SSc, in the last few years a number of studies highlighted a higher prevalence of macrovascular disease in SSc patients in comparison to healthy individuals and these data have been correlated with a poorer prognosis. The mechanisms promoting ATS in SSc are not fully understood, but it is believed to be secondary to multi-system organ inflammation, endothelial wall damage and vasculopathy. Both traditional risk factors and endothelial dysfunction have been proposed to participate to the onset and progression of ATS in such patients. In particular, endothelial cell injury induced by anti-endothelial antibodies, ischemia/reperfusion damage, immune-mediated cytotoxicity represent the main causes of vascular injury together with an impaired vascular repair mechanism that determine a defective vasculogenesis. Aim of this review is to analyse both causes and clinical manifestations of macrovascular involvement and ATS in SSc. PMID:25705640

  14. Cardiovascular Involvement in Autoimmune Diseases

    PubMed Central

    Amaya-Amaya, Jenny

    2014-01-01

    Autoimmune diseases (AD) represent a broad spectrum of chronic conditions that may afflict specific target organs or multiple systems with a significant burden on quality of life. These conditions have common mechanisms including genetic and epigenetics factors, gender disparity, environmental triggers, pathophysiological abnormalities, and certain subphenotypes. Atherosclerosis (AT) was once considered to be a degenerative disease that was an inevitable consequence of aging. However, research in the last three decades has shown that AT is not degenerative or inevitable. It is an autoimmune-inflammatory disease associated with infectious and inflammatory factors characterized by lipoprotein metabolism alteration that leads to immune system activation with the consequent proliferation of smooth muscle cells, narrowing arteries, and atheroma formation. Both humoral and cellular immune mechanisms have been proposed to participate in the onset and progression of AT. Several risk factors, known as classic risk factors, have been described. Interestingly, the excessive cardiovascular events observed in patients with ADs are not fully explained by these factors. Several novel risk factors contribute to the development of premature vascular damage. In this review, we discuss our current understanding of how traditional and nontraditional risk factors contribute to pathogenesis of CVD in AD. PMID:25177690

  15. Aspirin for the Primary Prevention of Cardiovascular Disease: In Need of Clarity.

    PubMed

    Miedema, Michael D; Huguelet, Joseph; Virani, Salim S

    2016-01-01

    Aspirin remains one of the most extensively studied cardiovascular medications in the history of medicine. However, despite multiple, well-designed, large randomized controlled trials evaluating the potential of aspirin to prevent cardiovascular events in individuals without known cardiovascular disease (CVD), the role of aspirin in primary prevention is currently unclear. The initial aspirin trials included largely low-risk individuals with primary outcomes mostly focused on myocardial infarction (MI) and stroke, and showed a significant reduction in these CVD outcomes, especially MI. The more recently conducted trials have focused on older, higher CVD risk populations with high rates of lipid-lowering and antihypertensive medications use. These studies have used broader CVD outcomes as their primary end points and have failed to show a significant benefit of aspirin therapy in primary prevention. The exact reasons for the lack of efficacy in these recent trials are unclear but may be related to low rate of atherothrombotic events relative to other CVD events in the populations studied. Four large randomized controlled trials are currently underway which should provide some clarity in determining the optimal use of aspirin in the primary prevention of CVD. PMID:26753770

  16. Polypill treatments for cardiovascular diseases.

    PubMed

    Webster, Ruth; Rodgers, Anthony

    2016-01-01

    Cardiovascular disease (CVD) is the leading cause of mortality globally. Effective CVD preventive medications are available including statin, blood pressure-lowering and antiplatelet medications; however most people do not take these drugs long term. Fixed-dose combination pills ("polypills") have been shown, in several clinical trials, to improve adherence to these recommended medications, with corresponding improvements in risk factors such as blood pressure and LDL-cholesterol. In patients not taking all modalities of recommended CVD preventive therapies, polypill-based strategies could importantly contribute to global CVD control strategies. The largest benefits are seen in those who are under-treated at baseline, rather than those who are already taking the individual components separately: simplified step-up is more important than pill count reduction. Despite the potential benefits for patients and payers, only a few polypills are available due to market failure in the funding of research and development for affordable non-communicable disease medicines. Regulatory paradigms have focused on substitution indications among patients already taking component medications; however, this is the population that is likely to receive the least benefit from a polypill-based strategy. Greater health impact is likely if focus is given to patients who have indications for all polypill components, but currently do not receive the benefits of recommended medicines long term. PMID:26558898

  17. A novel peptide adropin in cardiovascular diseases.

    PubMed

    Li, Liang; Xie, Wei; Zheng, Xi-Long; Yin, Wei-Dong; Tang, Chao-Ke

    2016-01-30

    Cardiovascular diseases, such as atherosclerosis and hypertension, are the major cause of mortality and morbidity in the world. Adropin was first discovered in 2008 by Kumar and his coworkers. Adropin, encoded by the Energy Homeostasis Associated gene, is expressed in many tissues and organs, such as pancreatic tissue, liver, brain, kidney, endocardium, myocardium, and epicardium. In this review, we have summarized recent data suggesting the roles of adropin in several major cardiovascular diseases. Increasing evidence suggests that adropin is a potential regulator of cardiovascular functions and plays a protective role in the pathogenesis and development of cardiovascular diseases. However, further studies are needed to elucidate the specific mechanisms underlying the association between adropin and cardiovascular diseases. PMID:26683354

  18. Protein carbamylation and cardiovascular disease.

    PubMed

    Verbrugge, Frederik H; Tang, W H Wilson; Hazen, Stanley L

    2015-09-01

    Carbamylation constitutes a posttranslational modification of proteins or amino acids and results from different pathways in vivo. First is the non-enzymatic reaction between isocyanic acid, a decomposition product of urea, and either the N-terminus or the ?-amino group of lysine residues. Isocyanic acid levels, while low in vivo, are in equilibrium with urea and are thus increased in chronic and end-stage renal diseases. An alternative pathway involves the leukocyte heme protein myeloperoxidase, which catalyzes the oxidation of thiocyanate in the presence of hydrogen peroxide, producing isocyanate at inflammation sites. Notably, plasma thiocyanate levels are increased in smokers, and leukocyte-driven protein carbamylation occurs both within human and animal atherosclerotic plaques, as well as on plasma proteins. Protein carbamylation is considered a hallmark of molecular aging and is implicated in many pathological conditions. Recently, it has been shown that carbamylated low-density lipoprotein (LDL) induces endothelial dysfunction via lectin-like-oxidized LDL receptor-1 activation and increased reactive oxygen species production, leading to endothelial nitric oxide synthase uncoupling. Moreover, carbamylated LDL harbors atherogenic activities, including both binding to macrophage scavenger receptors inducing cholesterol accumulation and foam-cell formation, as well as promoting vascular smooth muscle proliferation. In contrast, high-density lipoprotein loses its anti-apoptotic activity after carbamylation, contributing to endothelial cell death. In addition to involvement in atherogenesis, protein carbamylation levels have emerged as a particularly strong predictor of both prevalent and incident cardiovascular disease risk. Recent studies also suggest that protein carbamylation may serve as a potential therapeutic target for the prevention of atherosclerotic heart disease. PMID:26061545

  19. Protein Carbamylation and Cardiovascular Disease

    PubMed Central

    Verbrugge, Frederik H.; Tang, W.H. Wilson; Hazen, Stanley L.

    2015-01-01

    Carbamylation constitutes a posttranslational modification of proteins or amino acids and results from different pathways in vivo. First is the non-enzymatic reaction between isocyanic acid, a decomposition product of urea, and either the N-terminus or ?-amino group of lysine residues. Isocyanic acid levels, while low in vivo, are in equilibrium with urea, and are thus increased in chronic and end-stage renal diseases. An alternative pathway involves the leukocyte haem protein myeloperoxidase, which catalyses the oxidation of thiocyanate in the presence of hydrogen peroxide, producing isocyanate at inflammation sites. Notably, plasma thiocyanate levels are increased in smokers, and leukocyte-driven protein carbamylation occurs both within human and animal atherosclerotic plaques, as well as on plasma proteins. Protein carbamylation is considered a hallmark of molecular aging and is implicated in many pathological conditions. Recently, it has been shown that carbamylated low-density lipoprotein (LDL) induces endothelial dysfunction via lectin-like-oxidized LDL receptor-1 activation and increased reactive oxygen species production, leading to endothelial nitric oxide synthase uncoupling. Moreover, carbamylated LDL harbours atherogenic activities, including both binding to macrophage scavenger receptors inducing cholesterol accumulation and foam cell formation, as well as promoting vascular smooth muscle proliferation. In contrast, high-density lipoprotein loses its anti-apoptotic activity after carbamylation, contributing to endothelial cell death. In addition to involvement in atherogenesis, protein carbamylation levels have emerged as a particularly strong predictor of both prevalent and incident cardiovascular disease risk. Recent studies also suggest that protein carbamylation may serve as a potential therapeutic target for the prevention of atherosclerotic heart disease. PMID:26061545

  20. Air Pollution Exposure and Cardiovascular Disease

    PubMed Central

    Lee, Byeong-Jae; Kim, Bumseok

    2014-01-01

    Ambient air pollution (AAP) and particulate matters (PM) have been closely associated with adverse health effects such as respiratory disease and cardiovascular diseases. Previous studies have examined the adverse health effects associated with short- and long-term exposure to AAP and outdoor PM on respiratory disease. However, the effect of PM size (PM2.5 and PM10) on cardiovascular disease has not been well studied. Thus, it remains unclear how the size of the inhalable particles (coarse, fine, or ultrafine) affects mortality and morbidity. Airborne PM concentrations are commonly used for ambient air quality management worldwide, owing to the known effects on cardiorespiratory health. In this article, we assess the relationship between cardiovascular diseases and PM, with a particular focus on PM size. We discuss the association of PM2.5 and PM10, nitrogen dioxide (NO2), and elemental carbon with mortality and morbidity due to cardiovascular diseases, stroke, and altered blood pressure, based on epidemiological studies. In addition, we provide evidence that the adverse health effects of AAP and PM are more pronounced among the elderly, children, and people with preexisting cardiovascular and respiratory conditions. Finally, we critically summarize the literature pertaining to cardiovascular diseases, including atherosclerosis and stroke, and introduce potential studies to better understand the health significance of AAP and PM on cardiovascular disease. PMID:25071915

  1. Immunity, atherosclerosis and cardiovascular disease

    PubMed Central

    2013-01-01

    Atherosclerosis, the major cause of cardiovascular disease (CVD), is a chronic inflammatory condition with immune competent cells in lesions producing mainly pro-inflammatory cytokines. Dead cells and oxidized forms of low density lipoproteins (oxLDL) are abundant. The major direct cause of CVD appears to be rupture of atherosclerotic plaques. oxLDL has proinflammatory and immune-stimulatory properties, causes cell death at higher concentrations and contains inflammatory phospholipids with phosphorylcholine (PC) as an interesting epitope. Antibodies against PC (anti-PC) may be atheroprotective, one mechanism being anti-inflammatory. Bacteria and virus have been discussed, but it has been difficult to find direct evidence, and antibiotic trials have not been successful. Heat shock proteins could be one major target for atherogenic immune reactions. More direct causes of plaque rupture include pro-inflammatory cytokines, chemokines, and lipid mediators. To prove that inflammation is a cause of atherosclerosis and CVD, clinical studies with anti-inflammatory and/or immune-modulatory treatment are needed. The potential causes of immune reactions and inflammation in atherosclerosis and how inflammation can be targeted therapeutically to provide novel treatments for CVD are reviewed. PMID:23635324

  2. Dioxins and Cardiovascular Disease Mortality

    PubMed Central

    Humblet, Olivier; Birnbaum, Linda; Rimm, Eric; Mittleman, Murray A.; Hauser, Russ

    2008-01-01

    Objective In this systematic review we evaluated the evidence on the association between dioxin exposure and cardiovascular disease (CVD) mortality in humans. Data sources and extraction We conducted a PubMed search in December 2007 and considered all English-language epidemiologic studies and their citations regarding dioxin exposure and CVD mortality. To focus on dioxins, we excluded cohorts that were either primarily exposed to polychlorinated biphenyls or from the leather and perfume industries, which include other cardiotoxic coexposures. Data synthesis We included results from 12 cohorts in the review. Ten cohorts were occupationally exposed. We divided analyses according to two well-recognized criteria of epidemiologic study quality: the accuracy of the exposure assessment, and whether the exposed population was compared with an internal or an external (e.g., general population) reference group. Analyses using internal comparisons with accurate exposure assessments are the highest quality because they minimize both exposure misclassification and confounding due to workers being healthier than the general population (“healthy worker effect”). The studies in the highest-quality group found consistent and significant dose-related increases in ischemic heart disease (IHD) mortality and more modest associations with all-CVD mortality. Their primary limitation was a lack of adjustment for potential confounding by the major risk factors for CVD. Conclusions The results of this systematic review suggest that dioxin exposure is associated with mortality from both IHD and all CVD, although more strongly with the former. However, it is not possible to determine the potential bias, if any, from confounding by other risk factors for CVD. PMID:19057694

  3. Impact of Mendelian Inheritance in Cardiovascular Disease

    PubMed Central

    McBride, Kim L.; Garg, Vidu

    2010-01-01

    Cardiovascular disease is a leading cause of mortality worldwide. While the etiology for the majority of cardiovascular disease is presumed to be a combination of genetic and environmental factors, developments in our understanding of the basic biology of cardiac disorders have been greatly advanced through discoveries made studying heart diseases that exhibit Mendelian forms of inheritance. Most of these diseases primarily affect children and young adults and include cardiomyopathies, arrhythmias, aortic aneurysms and congenital heart defects. The discovery of the genetic etiologies for these diseases have had significant impact on our understanding of more complex forms of cardiovascular disease and in some cases led to novel diagnostic and treatment modalities. In this review, we will summarize these seminal genetic discoveries, highlighting a few that have resulted in significant impact on human disease, and discuss the potential utility of studying Mendelian-inherited heart disease with the development of new genetic technologies and our increased understanding of the human genome. PMID:20958326

  4. Heart Disease, Stroke, or Other Cardiovascular Disease and Adult Vaccination

    MedlinePLUS

    ... Disease, Stroke, or Other Cardiovascular Disease and Adult Vaccination Recommend on Facebook Tweet Share Compartir Vaccines are ... have immunity to this disease Learn about adult vaccination and other health conditions Asplenia Diabetes Type 1 ...

  5. Anthocyanins in Cardiovascular Disease1

    PubMed Central

    Wallace, Taylor C.

    2011-01-01

    Anthocyanins are a group of abundant and widely consumed flavonoid constituents that occur ubiquitously in the plant kingdom, providing the bright red-orange to blue-violet colors present in many fruit- and vegetable-based food products. Their intake has been estimated to be up to 9-fold higher than that of other dietary flavonoids. Anthocyanins have become increasingly important to the food industry as their use as natural alternatives to artificial colors has become widespread and knowledge of their health-promoting properties has become more evident. Epidemiological studies suggest that increased consumption of anthocyanins lowers the risk of cardiovascular disease (CVD), the most common cause of mortality among men and women. Anthocyanins frequently interact with other phytochemicals, exhibiting synergistic biological effects but making contributions from individual components difficult to decipher. Over the past 2 decades, many peer-reviewed publications have demonstrated that in addition to their noted in vitro antioxidant activity, anthocyanins may regulate different signaling pathways involved in the development of CVD. This review summarizes the latest developments on the bioavailability/bioactivity and CVD preventative activities of anthocyanins, including results from in vitro cell culture and in vivo animal model systems as related to their multiple proposed mechanisms of action. Limited yet promising data from epidemiological studies and human clinical trials are also presented. Future studies aimed at enhancing the absorption of anthocyanins and characterizing their metabolic and/or breakdown products are necessary to ultimately evaluate their use for protection/prevention against the development of CVD. PMID:22211184

  6. [Air pollution and cardiovascular disease].

    PubMed

    Haber, Guy; Witberg, Guy; Danenberg, Haim

    2007-10-01

    Cardiovascular atherothrombosis is the most common cause of death globally, with several well-known risk factors. Air pollution is a byproduct of fuel combustion by motor vehicles, power plants and industrial factories. It is composed of gases, fluids and particulate matter (PM) of different sizes, which include basic carbon, organic carbonic molecules and metals such as vanadium, nickel, zinc and iron. These particles are subdivided by their median size, a major contributing factor for their capability to enter the human body through the respiratory system. Most of the epidemiological studies have shown correlation between acute and long-term exposure to air pollution elements and cardiovascular morbidity in general, and angina pectoris and acute myocardial infarction specifically. Physiological studies have found different arrhythmias as the etiologic cause of cardiovascular morbidity and mortality following exposure to air pollution. A major finding was a decline in heart rate variability, a phenomenon known as endangering for cardiovascular morbidity and mortality, especially in patients after acute myocardial infarction. To date, several pathways have been proposed, including a hypercoagulable state following an inflammatory response, cardiac nervous autonomic disequilibrium, endothelial dysfunction with blood vessel contraction and direct toxic impact on cardiac muscle. Additional research is needed for clarifying the pathophysiological pathways by which air pollution affects the cardiovascular system. That might allow forthcoming with preventive measures and correct treatment, and hence a decrease in cardiovascular morbidity and mortality. Another important target is dose-outcome correlation curves for safety threshold calculation as a basis for air pollution regulations. PMID:17990383

  7. Geochemical environments, trace elements, and cardiovascular diseases

    PubMed Central

    Masironi, R.; Miesch, A. T.; Crawford, M. D.; Hamilton, E. I.

    1972-01-01

    Cardiovascular diseases are often found to be associated with certain physicochemical characteristics of the environment—namely, the hardness of the water and the types of rock and soil underlying the area. Areas supplied with soft water usually have higher cardiovascular death rates than do areas supplied with hard water. Evidence linking cardiovascular diseases with the geochemistry of rocks and soils is more limited. The nature of these associations is still speculative but it is possible that certain trace elements are involved, some being beneficial and others harmful. Further epidemiological studies to identify these various trace elements are desirable. PMID:4539410

  8. [Body mass index and cardiovascular events: the "obesity paradox"].

    PubMed

    Andreotti, Felicita; Rio, Teresa; Lavorgna, Alberto; Coluzzi, Giulio; Santucci, Eleonora; Cecchetti, Silvia; Pennestrì, Faustino; Crea, Filippo

    2009-10-01

    Excessive body mass among healthy subjects carries an increased risk of subsequent cardiovascular events. Excess weight implies the presence of white, viscero-abdominal fat, that promotes insulin-resistance, is infiltrated by macrophages, and is less differentiated compared to subcutaneous or brown fat. Conversely, among patients with cardiovascular disease, slim patients have a greater risk of recurrent atherothrombotic events than fatter patients ("obesity paradox"). Lean patients with cardiovascular disease, on average, have more comorbidities and haemorrhagic complications than their heavier counteparts, and probably they conceal predisposing factors that are still unknown and therefore difficult to treat. PMID:20030166

  9. Biomarkers of cardiovascular disease risk in women.

    PubMed

    Manson, JoAnn E; Bassuk, Shari S

    2015-03-01

    Cardiovascular disease (CVD), including coronary heart disease and stroke, is the leading cause of death among U.S. women and men. Established cardiovascular risk factors such as smoking, diabetes, hypertension, and elevated total cholesterol, and risk prediction models based on such factors, perform well but do not perfectly predict future risk of CVD. Thus, there has been much recent interest among cardiovascular researchers in identifying novel biomarkers to aid in risk prediction. Such markers include alternative lipids, B-type natriuretic peptides, high-sensitivity troponin, coronary artery calcium, and genetic markers. This article reviews the role of traditional cardiovascular risk factors, risk prediction tools, and selected novel biomarkers and other exposures in predicting risk of developing CVD in women. The predictive role of novel cardiovascular biomarkers for women in primary prevention settings requires additional study, as does the diagnostic and prognostic utility of cardiac troponins for acute coronary syndromes in clinical settings. Sex differences in the clinical expression and physiology of metabolic syndrome may have implications for cardiovascular outcomes. Consideration of exposures that are unique to, or more prevalent in, women may also help to refine cardiovascular risk estimates in this group. PMID:25487190

  10. Cardiovascular physiology and diseases of amphibians.

    PubMed

    Heinz-Taheny, Kathleen M

    2009-01-01

    The class Amphibia includes three orders of amphibians: the anurans (frogs and toads), urodeles (salamanders, axolotls, and newts), and caecilians. The diversity of lifestyles across these three orders has accompanying differences in the cardiovascular anatomy and physiology allowing for adaptations to aquatic or terrestrial habitats, pulmonic or gill respiration, hibernation, and body elongation (in the caecilian). This article provides a review of amphibian cardiovascular anatomy and physiology with discussion of unique species adaptations. In addition, amphibians as cardiovascular animal models and commonly encountered natural diseases are covered. PMID:19131029

  11. Serum triglycerides and risk of cardiovascular disease.

    PubMed

    Boullart, A C I; de Graaf, J; Stalenhoef, A F

    2012-05-01

    Dyslipidemia, especially elevated serum levels of cholesterol, is causally related to cardiovascular disease. The specific role of triglycerides has long been controversial. In this article we discuss the role of serum triglycerides in relation to the risk of cardiovascular disease. First, the (patho)physiology of triglycerides is described, including the definition and a short summary of the primary and secondary causes of hypertriglyceridemia. Furthermore, we will give an overview of the published epidemiological studies concerning hypertriglyceridemia and cardiovascular disease to support the view that triglyceride-rich lipoproteins are an independently associated risk factor. Finally, treatment strategies and treatment targets are discussed. This article is part of a Special Issue entitled Triglyceride Metabolism and Disease. PMID:22015388

  12. Air pollution and cardiovascular disease.

    PubMed

    Nogueira, J Braz

    2009-06-01

    Air pollution is associated with increased cardiovascular morbidity and mortality. Recent experimental and epidemiologic studies show that particulate matter (PM) air pollution with PM10 or inhalable (thoracic) particles (mean aerodynamic diameter < 10 microm) is most consistently linked with acute and chronic cardiovascular effects. Fine (PM2.5) and ultrafine (PM0.1) particles (aerodynamic diameter < 2.5 and < 0.1 microm) are able to reach the small airways and terminal alveoli, and PM0.1 can also be translocated directly into the systemic circulation. PM2.5 and PM0.1 are mainly formed by fossil fuel combustion and are the main components of exhaust emissions from motor vehicles. A variety of biological mechanisms responsible for adverse cardiovascular outcomes associated with PM have been described, including the release of pro-oxidative and pro-inflammatory mediators from the lungs into the circulation, autonomic nervous system imbalance, and the direct actions on the heart and vasculature of ultrafine particles translocated into the systemic circulation. The induction of oxidative stress by these particles may be central to all of these putative pathways that trigger coagulation and thrombosis, increased heart rate and reduced heart rate variability, endothelial dysfunction, arterial vasoconstriction, apoptosis, and hypertension. In chronic exposures these alterations favor the development and progression of atherosclerosis and possibly of hypertension in the long term, and in the short term acute exposures contribute to plaque instability, affect various traditional risk factors and trigger acute cardiovascular events (myocardial ischemia and infarction, stroke, heart failure, arrhythmias, and sudden death), particularly in high-risk subjects. There are currently also significant concerns with the risks of engineered nanoparticles. PMID:19697799

  13. Method of thermography in diagnosing cardiovascular diseases

    NASA Astrophysics Data System (ADS)

    Lazyuk, D. G.; Sidorenko, I. V.; Krushevskaya, T. V.

    1996-05-01

    We investigated the possibility of using infrared thermography (IT) in diagnosing the commonest cardiovascular diseases: ischemic heart disease (IHD) and hypertensive disease (HD). We show that the IT method allows one to evaluate the condition of peripheral blood flow, but the results of examination depend greatly on the presence of accompanying diseases (osteochondrosis, varicosis). The IT method is not specific enough to evaluate the functional state of a myocardium.

  14. Association between Cardiovascular Drugs and Chronic Kidney Disease in Non-Institutionalized Elderly Patients.

    PubMed

    Becquemont, Laurent; Bauduceau, Bernard; Benattar-Zibi, Linda; Berrut, Gilles; Bertin, Philippe; Bucher, Sophie; Corruble, Emmanuelle; Danchin, Nicolas; al-Salameh, Abdallah; Derumeaux, Genevive; Doucet, Jean; Falissard, Bruno; Forette, Francoise; Hanon, Olivier; Pasquier, Florence; Pinget, Michel; Ourabah, Rissane; Piedvache, Celine

    2015-08-01

    Concern about the renal safety of commonly used cardiovascular drugs with demonstrated clinical benefit appears to be an obstacle to their use in the elderly. The objective was to describe the relationship between cardiovascular drugs and chronic kidney disease (CKD) in elderly individuals in the real-life setting. This is an ancillary study of the prospective non-interventional S.AGE (aged individuals) cohort. General physicians were free to prescribe any drug their patients needed. The participants were non-institutionalized patients aged 65years and older treated by their primary physician for either chronic pain or atrial fibrillation or type 2 diabetes mellitus. The estimated glomerular filtration rate (eGFR) derived from the CKD-EPI formula was determined at inclusion and every year during 2years of follow-up. This study comprised 2505 patients aged 77.86.2years. At inclusion, the factors associated with CKD (eGFR<60ml/min/1.73m(2) ) in multivariate analysis were age, female gender, hypertension, heart failure, history of atherothrombotic disease and renin angiotensin system blockers, loop diuretics and calcium channel inhibitors. Introduction of each of these three drug classes during the follow-up period led to only a small decrease in the eGFR: -3.812.7 (p<0.0006), -2.212.0 (p<0.003) and -1.013.4ml/min./1.73m(2) (NS), respectively. Only the introduction of loop diuretics was associated with CKD (OR 1.91, 95% CI: 1.25-2.90; p=0.002). Renal safety of cardiovascular drugs in the elderly appears acceptable and should not be a barrier to their use. PMID:25594245

  15. Cardiovascular complications in inflammatory bowel disease

    PubMed Central

    Schicho, Rudolf; Marsche, Gunther; Storr, Martin

    2015-01-01

    Over the past years, a growing number of studies have indicated that patients suffering from inflammatory bowel disease (IBD) have an increased risk of developing cardiovascular disease. Both are chronic inflammatory diseases and share certain pathophysiological mechanisms that may influence each other. High levels of cytokines, C-reactive protein (CRP), and homocysteine in IBD patients may lead to endothelial dysfunction, an early sign of atherosclerosis. IBD patients, in general, do not show the typical risk factors for cardiovascular disease but changes in lipid profiles similar to the ones seen in cardiovascular events have been reported recently. Higher levels of coagulation factors frequently occur in IBD which may predispose to arterial thromboembolic events. Finally, the gut itself may have an impact on atherogenesis during IBD through its microbiota. Microbial products are released from the inflamed mucosa into the circulation through a leaky barrier. The induced rise in proinflammatory cytokines could contribute to endothelial damage, artherosclerosis and cardiovascular events. Although large retrospective studies favor a link between IBD and cardiovascular diseases the mechanisms behind still remain to be determined. PMID:25642719

  16. Epigenetics and Cardiovascular Disease in Diabetes.

    PubMed

    Pasquier, Jennifer; Hoarau-Vchot, Jessica; Fakhro, Khalid; Rafii, Arash; Abi Khalil, Charbel

    2015-12-01

    Type 2 diabetes has become a major health issue worldwide. Chronic hyperglycemia induces a low-grade inflammation that, on top of other mechanisms, leads to endothelial dysfunction. Mounting evidence suggests that DNA methylation, post-translational modifications of histones, and long non-coding RNAs play an important role in the initiation, maintenance, and progression of both macro- and micro-vascular complications of diabetes. Long-term exposure to hyperglycemia induces epigenetic changes that could become irreversible, a phenomenon known as the 'metabolic memory.' Whether epigenetic-based therapies could be used to slow or limit the progression of cardiovascular disease remains unclear. While non-coding RNAs are currently investigated as potential biomarkers that predict diabetic cardiovascular disease incidence and progression, their therapeutic role is only hypothetical. In this review, we highlight the latest findings in experimental and clinical studies relevant to epigenetics and cardiovascular disease in diabetes. PMID:26458379

  17. Autophagy and oxidative stress in cardiovascular diseases

    PubMed Central

    Mei, Yu; Thompson, Melissa D.; Cohen, Richard A.; Tong, XiaoYong

    2014-01-01

    Autophagy is a highly conserved degradation process by which intracellular components, including soluble macromolecules (e.g. nucleic acids, proteins, carbohydrates, and lipids) and dysfunctional organelles (e.g. mitochondria, ribosomes, peroxisomes, and endoplasmic reticulum) are degraded by the lysosome. Autophagy is orchestrated by the autophagy related protein (Atg) composed protein complexes to form autophagosomes, which fuse with lysosomes to generate autolysosomes where the contents are degraded to provide energy for cell survival in response to environmental and cellular stress. Autophagy is an important player in cardiovascular disease development such as atherosclerosis, cardiac ischemia/reperfusion, cardiomyopathy, heart failure and hypertension. Autophagy in particular contributes to cardiac ischemia, hypertension and diabetes by interaction with reactive oxygen species generated in endoplasmic reticulum and mitochondria. This review highlights the dual role of autophagy in cardiovascular disease development. Full recognition of autophagy as an adaptive or maladaptive response would provide potential new strategies for cardiovascular disease prevention and management. PMID:24834848

  18. Microparticles as Potential Biomarkers of Cardiovascular Disease

    PubMed Central

    França, Carolina Nunes; Izar, Maria Cristina de Oliveira; do Amaral, Jônatas Bussador; Tegani, Daniela Melo; Fonseca, Francisco Antonio Helfenstein

    2015-01-01

    Primary prevention of cardiovascular disease is a choice of great relevance because of its impact on health. Some biomarkers, such as microparticles derived from different cell populations, have been considered useful in the assessment of cardiovascular disease. Microparticles are released by the membrane structures of different cell types upon activation or apoptosis, and are present in the plasma of healthy individuals (in levels considered physiological) and in patients with different pathologies. Many studies have suggested an association between microparticles and different pathological conditions, mainly the relationship with the development of cardiovascular diseases. Moreover, the effects of different lipid-lowering therapies have been described in regard to measurement of microparticles. The studies are still controversial regarding the levels of microparticles that can be considered pathological. In addition, the methodologies used still vary, suggesting the need for standardization of the different protocols applied, aiming at using microparticles as biomarkers in clinical practice. PMID:25626759

  19. Lifestyle and cardiovascular disease in Japan.

    PubMed

    Iso, Hiroyasu

    2011-01-01

    The aim was to give on overview of the profile of cardiovascular disease, vascular pathology and the relationships between lifestyle and cardiovascular disease in Japanese. Compared with the United States and Europe, the higher mortality from stroke and lower mortality from coronary heart disease constitute a unique cardiovascular profile for Japan. A selective review of population-based pathology, trend and prospective cohort studies was performed to clarify the characteristics of cardiovascular disease and vascular pathology, trends in the incidence and mortality of cardiovascular disease, and the relationships between lifestyle and cardiovascular disease among Japanese adults. Since the 1970s, mortality from coronary heart disease as well as stroke has declined substantially in Japan, probably due to a major decline in blood pressure levels and for men a more recent decline in smoking, in spite of an increase in body mass index and total cholesterol levels. However, the decline in mortality was smaller and plateaued in middle-aged men aged 30-49 in the metropolitan cities of Tokyo and Osaka. The incidence of coronary heart disease has increased among middle-aged men residing in the suburbs of Osaka. As for the associations between lifestyle and cardiovascular disease, higher sodium, lower calcium and lower animal protein content in the diet and for men higher alcohol consumption may account for the higher prevalence of hypertension and higher risk of stroke for Japanese than for western populations. On the other hand, lower saturated fat (meat) and higher n3 polyunsaturated fat (fish) in the Japanese diet may contribute to the lower prevalence of hypercholesterolemia and lower risk of coronary heart disease among Japanese. Japan is unique among developed countries in that coronary heart disease mortality has been low and has continued to decline, while stroke mortality has declined substantially. However, a recent trend for coronary heart disease incidence to increase among urban men is a cause for concern as a potential source of future problems for public health and clinical practice in Japan. PMID:21307610

  20. Space radiation and cardiovascular disease risk.

    PubMed

    Boerma, Marjan; Nelson, Gregory A; Sridharan, Vijayalakshmi; Mao, Xiao-Wen; Koturbash, Igor; Hauer-Jensen, Martin

    2015-12-26

    Future long-distance space missions will be associated with significant exposures to ionizing radiation, and the health risks of these radiation exposures during manned missions need to be assessed. Recent Earth-based epidemiological studies in survivors of atomic bombs and after occupational and medical low dose radiation exposures have indicated that the cardiovascular system may be more sensitive to ionizing radiation than was previously thought. This has raised the concern of a cardiovascular disease risk from exposure to space radiation during long-distance space travel. Ground-based studies with animal and cell culture models play an important role in estimating health risks from space radiation exposure. Charged particle space radiation has dense ionization characteristics and may induce unique biological responses, appropriate simulation of the space radiation environment and careful consideration of the choice of the experimental model are critical. Recent studies have addressed cardiovascular effects of space radiation using such models and provided first results that aid in estimating cardiovascular disease risk, and several other studies are ongoing. Moreover, astronauts could potentially be administered pharmacological countermeasures against adverse effects of space radiation, and research is focused on the development of such compounds. Because the cardiovascular response to space radiation has not yet been clearly defined, the identification of potential pharmacological countermeasures against cardiovascular effects is still in its infancy. PMID:26730293

  1. Space radiation and cardiovascular disease risk

    PubMed Central

    Boerma, Marjan; Nelson, Gregory A; Sridharan, Vijayalakshmi; Mao, Xiao-Wen; Koturbash, Igor; Hauer-Jensen, Martin

    2015-01-01

    Future long-distance space missions will be associated with significant exposures to ionizing radiation, and the health risks of these radiation exposures during manned missions need to be assessed. Recent Earth-based epidemiological studies in survivors of atomic bombs and after occupational and medical low dose radiation exposures have indicated that the cardiovascular system may be more sensitive to ionizing radiation than was previously thought. This has raised the concern of a cardiovascular disease risk from exposure to space radiation during long-distance space travel. Ground-based studies with animal and cell culture models play an important role in estimating health risks from space radiation exposure. Charged particle space radiation has dense ionization characteristics and may induce unique biological responses, appropriate simulation of the space radiation environment and careful consideration of the choice of the experimental model are critical. Recent studies have addressed cardiovascular effects of space radiation using such models and provided first results that aid in estimating cardiovascular disease risk, and several other studies are ongoing. Moreover, astronauts could potentially be administered pharmacological countermeasures against adverse effects of space radiation, and research is focused on the development of such compounds. Because the cardiovascular response to space radiation has not yet been clearly defined, the identification of potential pharmacological countermeasures against cardiovascular effects is still in its infancy. PMID:26730293

  2. Cardiovascular risk factors and disease in women.

    PubMed

    Gill, Sharon K

    2015-05-01

    Coronary artery disease and stroke predominantly affect older women as opposed to younger women, but the risk factors that contribute to atherosclerotic cardiovascular disease risk often start in young women. Young women with polycystic ovary syndrome (PCOS), with migraine, and who use oral contraceptive pills (OCPs) have short-term increases in thrombotic complications that can result in coronary events or stroke. Attention should be focused on risk reduction in women of all ages. Screening for and discussing diabetes, hypertension, obesity, smoking, migraine, PCOS, and pregnancy complication history and discussing the pros and cons of hormone and statin medications are part of reducing cardiovascular risk for women. PMID:25841599

  3. Cardiovascular disease in the antiphospholipid syndrome.

    PubMed

    Amaya-Amaya, Jenny; Rojas-Villarraga, Adriana; Anaya, Juan-Manuel

    2014-10-01

    The prevalence of cardiovascular disease (CVD) in antiphospholipid syndrome (APS) varies from one series to another depending on the definition of CVD and tools used for its detection. Atherosclerosis, the usual cause of CVD, starts when the endothelium becomes damaged and is considered to be an autoimmune-inflammatory disease. The excessive cardiovascular events observed in patients with APS are not fully explained by traditional risk factors. Therefore, several novel risk factors contribute to the development of premature CVD and accelerated vascular damage in those patients. Herein, the significance and outcomes of CVD in APS are reviewed. PMID:25228729

  4. Regulatory T cells in cardiovascular diseases.

    PubMed

    Meng, Xiao; Yang, Jianmin; Dong, Mei; Zhang, Kai; Tu, Eric; Gao, Qi; Chen, Wanjun; Zhang, Cheng; Zhang, Yun

    2016-03-01

    Inflammation is essential in the initial development and progression of many cardiovascular diseases involving innate and adaptive immune responses. The role of CD4(+)CD25(+)FOXP3(+) regulatory T (TREG) cells in the modulation of inflammation and immunity has received increasing attention. Given the important role of TREG cells in the induction and maintenance of immune homeostasis and tolerance, dysregulation in the generation or function of TREG cells can trigger abnormal immune responses and lead to pathology. A wealth of evidence from experimental and clinical studies has indicated that TREG cells might have an important role in protecting against cardiovascular disease, in particular atherosclerosis and abdominal aortic aneurysm. In this Review, we provide an overview of the roles of TREG cells in the pathogenesis of a number of cardiovascular diseases, including atherosclerosis, hypertension, ischaemic stroke, abdominal aortic aneurysm, Kawasaki disease, pulmonary arterial hypertension, myocardial infarction and remodelling, postischaemic neovascularization, myocarditis and dilated cardiomyopathy, and heart failure. Although the exact molecular mechanisms underlying the cardioprotective effects of TREG cells are still to be elucidated, targeted therapies with TREG cells might provide a promising and novel future approach to the prevention and treatment of cardiovascular diseases. PMID:26525543

  5. Sleep duration, cardiovascular disease, and proinflammatory biomarkers

    PubMed Central

    Grandner, Michael A; Sands-Lincoln, Megan R; Pak, Victoria M; Garland, Sheila N

    2013-01-01

    Habitual sleep duration has been associated with cardiometabolic disease, via several mechanistic pathways, but few have been thoroughly explored. One hypothesis is that short and/or long sleep duration is associated with a proinflammatory state, which could increase risk for cardiovascular and metabolic diseases. This hypothesis has been largely explored in the context of experimental sleep deprivation studies which have attempted to demonstrate changes in proinflammatory markers following acute sleep loss in the laboratory. Despite the controlled environment available in these studies, samples tend to lack generalization to the population at large and acute sleep deprivation may not be a perfect analog for short sleep. To address these limitations, population based studies have explored associations between proinflammatory markers and habitual sleep duration. This review summarizes what is known from experimental and cross-sectional studies about the association between sleep duration, cardiovascular disease, and proinflammatory biomarkers. First, the association between sleep duration with both morbidity and mortality, with a focus on cardiovascular disease, is reviewed. Then, a brief review of the potential role of proinflammatory markers in cardiovascular disease is presented. The majority of this review details specific findings related to specific molecules, including tumor necrosis factor-α, interleukins-1, -6, and -17, C-reactive protein, coagulation molecules, cellular adhesion molecules, and visfatin. Finally, a discussion of the limitations of current studies and future directions is provided. PMID:23901303

  6. Metabolic biomarkers for predicting cardiovascular disease

    PubMed Central

    Montgomery, Jana E; Brown, Jeremiah R

    2013-01-01

    Cardiac and peripheral vascular biomarkers are increasingly becoming targets of both research and clinical practice. As of 2008, cardiovascular-related medical care accounts for greater than 20% of all the economic costs of illness in the United States. In the age of burgeoning financial pressures on the entire health care system, never has it been more important to try to understand who is at risk for cardiovascular disease in order to prevent new events. In this paper, we will discuss the cost of cardiovascular disease to society, clarify the definition of and need for biomarkers, offer an example of a current biomarker, namely high-sensitivity C-reactive protein, and finally examine the approval process for utilizing these in clinical practice. PMID:23386789

  7. Sedentary Behavior and Cardiovascular Disease

    MedlinePLUS Videos and Cool Tools

    ... reading health news for healthier living. Related MedlinePlus Health Topics Ergonomics Vascular Diseases About MedlinePlus Site Map ... Rockville Pike, Bethesda, MD 20894 U.S. Department of Health and Human Services National Institutes of Health Page ...

  8. Polychlorinated biphenyls and links to cardiovascular disease.

    PubMed

    Perkins, Jordan T; Petriello, Michael C; Newsome, Bradley J; Hennig, Bernhard

    2016-02-01

    The pathology of cardiovascular disease is multi-faceted, with links to many modifiable and non-modifiable risk factors. Epidemiological evidence now implicates exposure to persistent organic pollutants, such as polychlorinated biphenyls (PCBs), with an increased risk of developing diabetes, hypertension, and obesity; all of which are clinically relevant to the onset and progression of cardiovascular disease. PCBs exert their cardiovascular toxicity either directly or indirectly via multiple mechanisms, which are highly dependent on the type and concentration of PCBs present. However, many PCBs may modulate cellular signaling pathways leading to common detrimental outcomes including induction of chronic oxidative stress, inflammation, and endocrine disruption. With the abundance of potential toxic pollutants increasing globally, it is critical to identify sensible means of decreasing associated disease risks. Emerging evidence now implicates a protective role of lifestyle modifications such as increased exercise and/or nutritional modulation via anti-inflammatory foods, which may help to decrease the vascular toxicity of PCBs. This review will outline the current state of knowledge linking coplanar and non-coplanar PCBs to cardiovascular disease and describe the possible molecular mechanism of this association. PMID:25877901

  9. Advanced Tracers in PET Imaging of Cardiovascular Disease

    PubMed Central

    Zhang, Wei; Wu, Hua; Liu, Gang

    2014-01-01

    Cardiovascular disease is the leading cause of death worldwide. Molecular imaging with targeted tracers by positron emission tomography (PET) allows for the noninvasive detection and characterization of biological changes at the molecular level, leading to earlier disease detection, objective monitoring of therapies, and better prognostication of cardiovascular diseases progression. Here we review, the current role of PET in cardiovascular disease, with emphasize on tracers developed for PET imaging of cardiovascular diseases. PMID:25389529

  10. Advanced tracers in PET imaging of cardiovascular disease.

    PubMed

    Li, Yesen; Zhang, Wei; Wu, Hua; Liu, Gang

    2014-01-01

    Cardiovascular disease is the leading cause of death worldwide. Molecular imaging with targeted tracers by positron emission tomography (PET) allows for the noninvasive detection and characterization of biological changes at the molecular level, leading to earlier disease detection, objective monitoring of therapies, and better prognostication of cardiovascular diseases progression. Here we review, the current role of PET in cardiovascular disease, with emphasize on tracers developed for PET imaging of cardiovascular diseases. PMID:25389529

  11. Tetrahydrobiopterin in Cardiovascular Health and Disease

    PubMed Central

    Bendall, Jennifer K.; Douglas, Gillian; McNeill, Eileen; Channon, Keith M.

    2014-01-01

    Abstract Tetrahydrobiopterin (BH4) functions as a cofactor for several important enzyme systems, and considerable evidence implicates BH4 as a key regulator of endothelial nitric oxide synthase (eNOS) in the setting of cardiovascular health and disease. BH4 bioavailability is determined by a balance of enzymatic de novo synthesis and recycling, versus degradation in the setting of oxidative stress. Augmenting vascular BH4 levels by pharmacological supplementation has been shown in experimental studies to enhance NO bioavailability. However, it has become more apparent that the role of BH4 in other enzymatic pathways, including other NOS isoforms and the aromatic amino acid hydroxylases, may have a bearing on important aspects of vascular homeostasis, inflammation, and cardiac function. This article reviews the role of BH4 in cardiovascular development and homeostasis, as well as in pathophysiological processes such as endothelial and vascular dysfunction, atherosclerosis, inflammation, and cardiac hypertrophy. We discuss the therapeutic potential of BH4 in cardiovascular disease states and attempt to address how this modulator of intracellular NO-redox balance may ultimately provide a powerful new treatment for many cardiovascular diseases. Antioxid. Redox Signal. 20, 3040–3077. PMID:24294830

  12. Breast cancer therapy-associated cardiovascular disease.

    PubMed

    Zagar, Timothy M; Cardinale, Daniela M; Marks, Lawrence B

    2016-03-01

    Breast cancer treatments have evolved over the past decades, although several widely used treatments have adverse cardiac effects. Radiotherapy generally improves the survival of women with breast cancer, although its deleterious cardiovascular effects pose competing risks of morbidity and/or mortality. In the past, radiation-associated cardiovascular disease was a phenomenon considered to take more than a decade to manifest, but newer research suggests that this latency is much shorter. Knowledge of coronary anatomy relative to the distribution of the delivered radiation dose has improved over time, and as a result, techniques have enabled this risk to be decreased. Studies continue to be performed to better understand, prevent and mitigate against radiation-associated cardiovascular disease. Treatments such as anthracyclines, which are a mainstay of chemotherapy for breast cancer, and newer targeted agents such as trastuzumab both have established risks of cardiotoxicity, which can limit their effectiveness and result in increased morbidity and/or mortality. Interest in whether β-blockers, statins and/or angiotensin-converting enzyme (ACE)-inhibitors might have therapeutic and/or preventative effects in these patients is currently increasing. This Review summarizes the incidence, risks and effects of treatment-induced cardiovascular disease in patients with breast cancer and describes strategies that might be used to minimize this risk. PMID:26598943

  13. MicroRNAs and Cardiovascular Disease

    PubMed Central

    Baldn, ngel

    2013-01-01

    MicroRNAs (miRNAs) regulate gene expression by binding to their targets and promoting RNA degradation and/or inhibiting protein translation. In recent years, miRNAs have revolutionized our understanding of gene regulatory networks, providing new prospective tools to manage disease. Atherosclerosis and other cardiovascular diseases are a leading cause of disability and death in the US and in other western populations and pose an enormous burden on our healthcare system. Altered lipid homeostasis in liver or in the artery wall, and disruption of endothelial and smooth muscle cell function have been shown to contribute to the onset and progression of cardiovascular disease. This review focuses on recent advances in the field of vascular biology- and lipid metabolism-related miRNomics. PMID:24563824

  14. Adipocytokines in relation to cardiovascular disease.

    PubMed

    Van de Voorde, Johan; Pauwels, Bart; Boydens, Charlotte; Decaluw, Kelly

    2013-11-01

    Adipose tissue can be considered as a huge gland producing paracrine and endocrine hormones, the adipo(cyto)kines. There is growing evidence that these adipo(cyto)kines may link obesity to cardiovascular diseases. The excessive adipocyte hypertrophy in obesity induces hypoxia in adipose tissue. This leads to adiposopathy, the process that converts "healthy" adipose tissue to "sick" adipose tissue. This is accompanied by a change in profile of adipo(cyto)kines released, with less production of the "healthy" adipo(cyto)kines such as adiponectin and omentin and more release of the "unhealthy" adipo(cyto)kines, ultimately leading to the development of cardiovascular diseases. The present review provides a concise and general overview of the actual concepts of the role of adipo(cyto)kines in endothelial dysfunction, hypertension, atherosclerosis and heart diseases. The knowledge of these concepts may lead to new tools to improve health in the next generations. PMID:23866981

  15. Cardiovascular disease risk in women with migraine

    PubMed Central

    2013-01-01

    Background Studies suggest a higher prevalence of unfavourable cardiovascular risk factors amongst migraineurs, but results have been conflicting. The aim of this study was to investigate traditional and newly recognized risk factors as well as other surrogate markers of cardiovascular risk in obese and normal weight women with migraine. Methods Fifty-nine adult female probands participated in this casecontrol study. The sample was divided into normal weight and obese migraineurs and age- and body mass index-matched control groups. The following cardiovascular risk factors were analyzed: serum levels of lipids, fasting glucose, and insulin; insulin resistance; blood pressure; smoking (categorized as current, past or never); Framingham 10-year risk of general cardiovascular disease score; C-reactive protein; family history of cardiovascular disease; physical activity; sleep disturbances; depression; and bioelectrical impedance phase angle. The means of continuous variables were compared using Students t-test for independent samples or the MannWhitney U-test (for 2 groups) and ANOVA or the Kruskal-Wallis test (for 4 groups) depending on the distribution of data. Results All migraineurs were sedentary irrespective of nutritional status. Migraineurs had higher depression scores and shorter sleep duration, and obese migraineurs, in particular, had worse sleep quality scores. Insulin resistance and insulinaemia were associated with obesity, and obese migraineurs had lower HDL-c than normal weight controls and migraineurs. Also, the Framingham risk score was higher in obese migraineurs. Conclusion These findings suggest that female migraineurs experience marked inactivity, depression, and some sleep disturbance, that higher insulin resistance and insulinaemia are related to obesity, and that obesity and migraine probably exert overlapping effects on HDL-c levels and Framingham 10-year cardiovascular risk. PMID:24011175

  16. [Endogenous formaldehyde and cardiovascular diseases].

    PubMed

    Zhang, Feng-Wen; Du, Jun-Bao; Tang, Chao-Shu

    2010-02-01

    Endogenous formaldehyde is produced via semicarbazide-sensitive amine oxidase-catalyzed deamination of methylamine. It widely exists in a variety of tissues and cells in animals. It has been confirmed that endogenous formaldehyde is involved in the neural degeneration, immune disease and tumor process. Adipocytes, vascular endothelial cells and smooth muscle cells are rich in enzyme to generate formaldehyde-semicarbazide-sensitive amine oxidase (SSAO). Formaldehyde may cause cytotoxicity, which induces vascular endothelial injury and mediates multiple factor-induced pathogenic process of vascular injury. It plays important role in atherosclerosis, diabetes mellitus and diabetic complication. PMID:21417009

  17. Myocardial Biomarkers for Prediction of Cardiovascular Disease

    PubMed Central

    Sundstrm, Johan

    2009-01-01

    The identification of those persons in the population who have the highest risk of future cardiovascular events is important for targeting intensive preventive efforts. This can be reliably done using a handful of long since established risk factors. The unmet need for new molecular biomarkers for prediction of cardiovascular events in the general population is therefore low. In order for a new biomarker to be used clinically for risk prediction, a statistically significant association of levels of the biomarker to adverse outcome is not enough, but the biomarker should also be demonstrated to add discriminative capacity beyond established risk factors. In contrast to the limited value of new biomarkers for risk prediction, their usefulness for unraveling the pathophysiology of cardiovascular disease is large. The myocardium is the source of a vast number of interesting biomarkers, of which a few may be useful for risk prediction in the general population. Two of these, troponin-I and the N-terminal fragment of brain natriuretic peptide, have passed tests of added discriminatory value. Numerous other biomarkers produced by cardiomyocytes or non-cardiomyocytes in the myocardium are promising, and if they are not proven useful for risk prediction, they will unquestionably enhance our understanding of cardiovascular disease. PMID:19773613

  18. Diterpenes: a therapeutic promise for cardiovascular diseases.

    PubMed

    Tirapelli, Carlos R; Ambrosio, Sergio R; da Costa, Fernando B; de Oliveira, Ana M

    2008-01-01

    The research, development and use of natural products as therapeutic agents, especially those derived from plants, have been increasing in recent years. There has been great deal of focus on the naturally occurring antispasmodic phytochemicals as potential therapy for cardiovascular diseases. Naturally occurring diterpenes exert several biological activities such as anti-inflammatory action, antimicrobial and antispasmodic activities. Several diterpenes have been shown to have pronounced cardiovascular effects, for example, grayanotoxin I produces positive inotropic responses, forskolin is a well-known activator of adenylate cyclase, eleganolone and 14-deoxyandrographolide exhibit vasorelaxant properties and marrubenol inhibits smooth muscle contraction by blocking L-type calcium channels. In the last few years, we have investigated the biological activity of kaurane and pimarane-type diterpenes, which are the main secondary metabolites isolated from the roots of Viguiera robusta and V. arenaria, respectively. These diterpenoids exhibit vasorelaxant action and inhibit the vascular contractility mainly by blocking extracellular Ca(2+) influx. Moreover, kaurane and pimarane-type diterpenes decreased mean arterial blood pressure in normotensive rats. Diterpenes likely fulfil the definition of a pharmacological preconditioning class of compounds and give hope for the therapeutic use in cardiovascular diseases. This article will review patents, structure-activity relationship, pharmacology, antihypertensive efficiency, and the vascular mechanisms underlying the effects of diterpenes. Careful examination of the cardiovascular effects exhibited by kaurane and pimarane-type diterpenes will be provided. PMID:18221123

  19. Iron hypothesis of cardiovascular disease: still controversial.

    PubMed

    Aursulesei, Viviana; Cozma, A; Krasniqi, A

    2014-01-01

    Iron hypothesis has been a controversial subject for over 30 years as many studies support its role as a risk factor for cardiovascular disease, while other studies found no evidence to support it. The conflicting results are accounted for by the non-homogeneity of trial design in terms of population inclusion criteria and different endpoints, non-uniform use of parameters for assessing iron role, and incomplete understanding of the mechanisms of action. The nature of iron is dual, being of crucial importance for the human body, but also toxic as "free iron" induces oxidative stress. Under physiological conditions, there are efficient and complex mechanisms against iron-induced oxidative stress, which could be reproduced for creating new, intelligent antioxidants. Iron depletion improves the cardiovascular prognosis only if serum concentration is at the lowest limit of normal ranges. However, low iron levels and the type of dietary iron intake correlate with atherosclerotic cardiovascular disease, influence the ischemic endpoints in the elderly, and exert negative impact on heart failure prognosis. So far, the causal relation and involved mechanisms are not fully elucidated. Iron overload is a difficult and frequent condition, involving the cardiovascular system by specific pathogenic pathways, therefore determining a particular form of restrictive cardiomyopathy and vaso-occlusive arterial damage. PMID:25581946

  20. 42 CFR 410.17 - Cardiovascular disease screening tests.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Cardiovascular disease screening tests. 410.17... § 410.17 Cardiovascular disease screening tests. (a) Definition. For purposes of this subpart, the... Part B covers cardiovascular disease screening tests when ordered by the physician who is treating...

  1. 42 CFR 410.17 - Cardiovascular disease screening tests.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Cardiovascular disease screening tests. 410.17... § 410.17 Cardiovascular disease screening tests. (a) Definition. For purposes of this subpart, the... Part B covers cardiovascular disease screening tests when ordered by the physician who is treating...

  2. 42 CFR 410.17 - Cardiovascular disease screening tests.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Cardiovascular disease screening tests. 410.17... § 410.17 Cardiovascular disease screening tests. (a) Definition. For purposes of this subpart, the... Part B covers cardiovascular disease screening tests when ordered by the physician who is treating...

  3. 42 CFR 410.17 - Cardiovascular disease screening tests.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Cardiovascular disease screening tests. 410.17... § 410.17 Cardiovascular disease screening tests. (a) Definition. For purposes of this subpart, the... Part B covers cardiovascular disease screening tests when ordered by the physician who is treating...

  4. 42 CFR 410.17 - Cardiovascular disease screening tests.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Cardiovascular disease screening tests. 410.17... § 410.17 Cardiovascular disease screening tests. (a) Definition. For purposes of this subpart, the... Part B covers cardiovascular disease screening tests when ordered by the physician who is treating...

  5. The link between chronic kidney disease and cardiovascular disease

    PubMed Central

    Said, Sarmad; Hernandez, German T.

    2014-01-01

    Context: It is well known that patients with chronic kidney disease (CKD) have a strong risk of cardiovascular disease (CVD). However, the excess risk of cardiovascular disease in patients with CKD is only partially explained by the presence of traditional risk factors, such as hypertension and diabetes mellitus. Evidence Acquisitions: Directory of Open Access Journals (DOAJ), Google Scholar, PubMed, EBSCO and Web of Science has been searched. Results: Chronic kidney disease even in its early stages can cause hypertension and potentiate the risk for cardiovascular disease. However, the practice of intensive blood pressure lowering was criticized in recent systematic reviews. Available evidence is inconclusive but does not prove that a blood pressure target of less than 130/80 mmHg as recommended in the guidelines improves clinical outcomes more than a target of less than 140/90 mmHg in adults with CKD. Conclusions: The association between CKD and CVD has been extensively documented in the literature. Both CKD and CVD share common traditional risk factors, such as smoking, obesity, hypertension, diabetes mellitus, and dyslipidemia. However, cardiovascular disease remains often underdiagnosed und undertreated in patients with CKD. It is imperative that as clinicians, we recognize that patients with CKD are a group at high risk for developing CVD and cardiovascular events. Additional studies devoted to further understand the risk factors for CVD in patients with CKD are necessary to develop and institute preventative and treatment strategies to reduce the high morbidity and mortality in patients with CKD. PMID:25093157

  6. Mannan-Binding Lectin in Cardiovascular Disease

    PubMed Central

    Cedzy?ski, Maciej

    2014-01-01

    Cardiovascular disease remains the leading cause of mortality and morbidity worldwide so research continues into underlying mechanisms. Since innate immunity and its potent component mannan-binding lectin have been proven to play an important role in the inflammatory response during infection and ischaemia-reperfusion injury, attention has been paid to its role in the development of cardiovascular complications as well. This review provides a general outline of the structure and genetic polymorphism of MBL and its role in inflammation/tissue injury with emphasis on associations with cardiovascular disease. MBL appears to be involved in the pathogenesis of atherosclerosis and, in consequence, coronary artery disease and also inflammation and tissue injury after myocardial infarction and heart transplantation. The relationship between MBL and disease is rather complex and depends on different genetic and environmental factors. That could be why the data obtained from animal and clinical studies are sometimes contradictory proving not for the first time that innate immunity is a double-edge sword, sometimes beneficial and, at other times disastrous for the host. PMID:24877121

  7. Strain Echocardiography in Acute Cardiovascular Diseases

    PubMed Central

    Favot, Mark; Courage, Cheryl; Ehrman, Robert; Khait, Lyudmila; Levy, Phillip

    2016-01-01

    Echocardiography has become a critical tool in the evaluation of patients presenting to the emergency department (ED) with acute cardiovascular diseases and undifferentiated cardiopulmonary symptoms. New technological advances allow clinicians to accurately measure left ventricular (LV) strain, a superior marker of LV systolic function compared to traditional measures such as ejection fraction, but most emergency physicians (EPs) are unfamiliar with this method of echocardiographic assessment. This article discusses the application of LV longitudinal strain in the ED and reviews how it has been used in various disease states including acute heart failure, acute coronary syndromes (ACS) and pulmonary embolism. It is important for EPs to understand the utility of technological and software advances in ultrasound and how new methods can build on traditional two-dimensional and Doppler techniques of standard echocardiography. The next step in competency development for EP-performed focused echocardiography is to adopt novel approaches such as strain using speckle-tracking software in the management of patients with acute cardiovascular disease. With the advent of speckle tracking, strain image acquisition and interpretation has become semi-automated making it something that could be routinely added to the sonographic evaluation of patients presenting to the ED with cardiovascular disease. Once strain imaging is adopted by skilled EPs, focused echocardiography can be expanded and more direct, phenotype-driven care may be achievable for ED patients with a variety of conditions including heart failure, ACS and shock. PMID:26823931

  8. Noninvasive Test Detects Cardiovascular Disease

    NASA Technical Reports Server (NTRS)

    2007-01-01

    At NASA's Jet Propulsion Laboratory (JPL), NASA-developed Video Imaging Communication and Retrieval (VICAR) software laid the groundwork for analyzing images of all kinds. A project seeking to use imaging technology for health care diagnosis began when the imaging team considered using the VICAR software to analyze X-ray images of soft tissue. With marginal success using X-rays, the team applied the same methodology to ultrasound imagery, which was already digitally formatted. The new approach proved successful for assessing amounts of plaque build-up and arterial wall thickness, direct predictors of heart disease, and the result was a noninvasive diagnostic system with the ability to accurately predict heart health. Medical Technologies International Inc. (MTI) further developed and then submitted the technology to a vigorous review process at the FDA, which cleared the software for public use. The software, patented under the name Prowin, is being used in MTI's patented ArterioVision, a carotid intima-media thickness (CIMT) test that uses ultrasound image-capturing and analysis software to noninvasively identify the risk for the major cause of heart attack and strokes: atherosclerosis. ArterioVision provides a direct measurement of atherosclerosis by safely and painlessly measuring the thickness of the first two layers of the carotid artery wall using an ultrasound procedure and advanced image-analysis software. The technology is now in use in all 50 states and in many countries throughout the world.

  9. Immunological probes in cardiovascular disease.

    PubMed Central

    Haber, E

    1982-01-01

    The immune system has long been recognised as playing a central role in the organism's defence against infectious diseases and possibly the development of neoplasia. The active stimulation of the immune system by immunisation and the passive administration of antitoxins have a venerable history in medicine. Yet the concept that antibodies may be used to modify physiological or pharmacological effects or may act as diagnostic agents in the living organisms has only recently come to be recognised. Advances, both in an understanding of the structural chemistry of the antibody molecule and in the ability to culture antibody-producing cells, now permit the selection and production of homogeneous antibodies and their smaller fragments in quantity by means other than conventional immunisation. These innovations will allow the development of a new pharmacology based on the remarkable resolving power of the antibody combining site. Antibodies or their fragments are shown to inhibit the pressor action of renin, to neutralise the pharmacological actions of digitalis, to block the beta-adrenergic receptor, and to detect and image myocardial infarcts. Images PMID:6119995

  10. Lycopene and cardiovascular diseases: an update.

    PubMed

    Mordente, A; Guantario, B; Meucci, E; Silvestrini, A; Lombardi, E; Martorana, G E; Giardina, B; Bhm, V

    2011-01-01

    Cardiovascular disease (CVD) is the leading cause of death in Western societies and accounts for up to a third of all deaths worldwide. In comparison to the Northern European or other Western countries, the Mediterranean area has lower rates of mortality from cardiovascular diseases and cancer, and this is attributed, at least in part, to the so-called Mediterranean diet, which is rich in plantderived bioactive phytochemicals. Identification of the active constituents of the Mediterranean diet is therefore crucial to the formulation of appropriate dietary guidelines. Lycopene is a natural carotenoid found in tomato, an essential component of the Mediterranean diet, which, although belonging to the carotenoid family, does not have pro-vitamin A activity but many other biochemical functions as an antioxidant scavenger, hypolipaemic agent, inhibitor of pro-inflammatory and pro-thrombotic factors, thus potentially of benefit in CVD. In particular, the review intends to conduct a systematic analysis of the literature (epidemiological studies and interventional trials) in order to critically evaluate the association between lycopene (or tomato products) supplementation and cardiovascular diseases and/or cardiovascular disease risk factors progression, and to prepare provision of evidence-based guidelines for patients and clinicians. Several reports have appeared in support of the role of lycopene in the prevention of CVD, mostly based on epidemiological studies showing a dose-response relationship between lycopene and CVD. A less clear and more complex picture emerges from the interventional trials, where several works have reported conflicting results. Although many aspects of lycopene in vivo metabolism, functions and clinical indications remain to be clarified, supplementation of low doses of lycopene has been already suggested as a preventive measure for contrasting and ameliorating many aspects of CVD. PMID:21291369

  11. Brain and cardiovascular diseases: common neurogenic background of cardiovascular, metabolic and inflammatory diseases.

    PubMed

    Szczepanska-Sadowska, E; Cudnoch-Jedrzejewska, A; Ufnal, M; Zera, T

    2010-10-01

    In spite of significant progress in pharmacotherapy the incidence of newly diagnosed cases of cardiovascular diseases and cardiovascular morbidity is alarmingly high. Treatment of hypertension or heart failure still remains a serious challenge. Continuous attempts are made to identify the mechanisms that decide about susceptibility to pathogenic factors, and to determine effectiveness of a specific therapeutic approach. Coincidence of cardiovascular diseases with metabolic disorders and obesity has initiated intensive research for their common background. In the recent years increasing attention has been drawn to disproportionately greater number of depressive disorders and susceptibility to stress in patients with coronary artery disease. An opposite relationship, i.e. a greater number of sudden cardiovascular complications in patients with depression, has been also postulated. Progress in functional neuroanatomy and neurochemistry provided new information about the neural network responsible for regulation of cardiovascular functions, metabolism and emotionality in health and under pathological conditions. In this review we will focus on the role of neuromodulators and neurotransmitters engaged in regulation of the cardiovascular system, neuroendocrine and metabolic functions in health and in pathogenesis of cardiovascular diseases and obesity. Among them are classical neurotransmitters (epinephrine and norepinephrine, serotonin, GABA), classical (CRH, vasopressin, neuropeptide Y) and newly discovered (orexins, apelin, leptin IL-1beta, TNF-alpha, ghrelin) neuropeptides, gasotransmitters, eicozanoids, endocannabinoids, and some other compounds involved in regulation of neuroendocrine, sympatho-adrenal and parasympathetic nervous systems. Special attention is drawn to those factors which play a role in immunology and inflammatory processes. Interaction between various neurotransmitter/neuromodulatory systems which may be involved in integration of metabolic and cardiovascular functions is analyzed. The survey gives evidence for significant disturbances in release or action of the same mediators in hypertension heart failure, obesity, diabetes mellitus, metabolic syndrome, starvation, chronic stress, depression and other psychiatric disorders. With regard to the pathogenic background of the cardiovascular diseases especially valuable are the studies showing inappropriate function of angiotensin peptides, vasopressin, CRH, apelin, cytokines and orexins in chronic stress, cardiovascular and metabolic diseases. The studies surveyed in this review suggest that multiple brain mechanisms interact together sharing the same neural circuits responsible for adjustment of function of the cardiovascular system and metabolism to current needs. PMID:21081794

  12. [Insulin resistance, metabolic syndrome and cardiovascular diseases].

    PubMed

    Zeman, M; Zk, A; Vecka, M; Tvrzick, E

    2005-01-01

    The article summarizes the nature and causes of the insulin resistance, its relation to the metabolic syndrome, and to the cardiovascular diseases. Insulin resistance can be defined as a set of abnormal clinical symptoms accompanied by lower tissue sensitivity to insulin. Metabolic syndrome, whose major components are impairments of glucose homeostase, obesity, dyslipidemia and arterial hypertension, represents an important risk factor for the development of diabetes mellitus type 2 and for the development of cardiovascular diseases. Possible factors, which can influence those relations, e.g., chronic inflammations, endothelial dysfunction and oxidation stress are discussed. The primary aims for the positive influencing the metabolic syndrome is the prevention of the development of diabetes mellitus type 2 and that of cardiovascular diseases. To approach those goals, the use of non-pharmacologic means (diet, appropriate physical activity) and pharmacologic (treatment of dyslipidemia, namely by statins and fibrates; management of hypertension, specifically by angiotensin-converging enzyme inhibitors, by angiotensin-receptor blockers, by glitazoe administration and by antithrombotic treatment) can be recommended. PMID:15981981

  13. Aptamers as Therapeutics in Cardiovascular Diseases

    PubMed Central

    Wang, Pu; Yang, Yunan; Hong, Hao; Zhang, Yin; Cai, Weibo; Fang, Dianchun

    2011-01-01

    With many advantages over other therapeutic agents such as monoclonal antibodies, aptamers have recently emerged as a novel and powerful class of ligands with excellent potential for diagnostic and therapeutic applications. Typically generated through Systematic Evolution of Ligands by EXponential enrichment (SELEX), aptamers have been selected against a wide range of targets such as proteins, phospholipids, sugars, nucleic acids, as well as whole cells. DNA/RNA aptamers are single-stranded DNA/RNA oligonucleotides (with a molecular weight of 5–40 kDa) that can fold into well-defined 3D structures and bind to their target molecules with high affinity and specificity. A number of strategies have been adopted to synthesize aptamers with enhanced in vitro/in vivo stability, aiming at potential therapeutic/diagnostic applications in the clinic. In cardiovascular diseases, aptamers can be developed into therapeutic agents as anti-thrombotics, anti-coagulants, among others. This review focuses on aptamers that were selected against various molecular targets involved in cardiovascular diseases: von Willebrand factor (vWF), thrombin, factor IX, phospholamban, P-selectin, platelet-derived growth factor, integrin αvβ3, CXCL10, vasopressin, among others. With continued effort in the development of aptamer-based therapeutics, aptamers will find their niches in cardiovascular diseases and significantly impact clinical patient management. PMID:21848510

  14. Phytochemicals from plants to combat cardiovascular disease.

    PubMed

    Vasanthi, H R; ShriShriMal, N; Das, D K

    2012-01-01

    For many decades, the use of synthetic chemicals as drugs has been effective in the treatment of most diseases. Moreover, from ancient to modern history, many traditional plant based medicines are playing an important role in health care. Phytochemicals are natural bioactive compounds found in vegetables, fruits, medicinal plants, aromatic plants, leaves, flowers and roots which act as a defense system to combat against diseases. The phytochemicals from natural products cover a diverse range of chemical entities such as polyphenols, flavonoids, steroidal saponins, organosulphur compounds and vitamins. A number of bioactive compounds generally obtained from terrestrial plants such as isoflavones, diosgenin, resveratrol, quercetin, catechin, sulforaphane, tocotrienols and carotenoids are proven to reduce the risk of cardiovascular diseases and aid in cardioprotection which is the leading cause of death globally. The cardioprotective effects of the various phytochemicals are perhaps due to their antioxidative, antihypercholesteroemic, antiangiogenic, anti-ischemic, inhibition of platelet aggregation and anti inflammatory activities that reduce the risk of cardiovascular disorders. The multi-faceted role of the phytochemicals is mediated by its structure-function relationship and can be considered as leads for cardiovascular drug design in future. This review summarizes the findings of recent studies on selected phytochemicals as prophylactic and therapeutic agents in cardioprotection. PMID:22414106

  15. Yoga and meditation in cardiovascular disease.

    PubMed

    Manchanda, S C; Madan, Kushal

    2014-09-01

    Yoga is a holistic mind-body intervention aimed at physical, mental, emotional and spiritual well being. Several studies have shown that yoga and/or meditation can control risk factors for cardiovascular disease like hypertension, type II diabetes and insulin resistance, obesity, lipid profile, psychosocial stress and smoking. Some randomized studies suggest that yoga/meditation could retard or even regress early and advanced coronary atherosclerosis. A recent study suggests that transcendental meditation may be extremely useful in secondary prevention of coronary heart disease and may reduce cardiovascular events by 48% over a 5-year period. Another small study suggests that yoga may be helpful in prevention of atrial fibrillation. However, most studies have several limitations like lack of adequate controls, small sample size, inconsistencies in baseline and different methodologies, etc. and therefore large trials with improved methodologies are required to confirm these findings. However, in view of the existing knowledge and yoga being a cost-effective technique without side effects, it appears appropriate to incorporate yoga/meditation for primary and secondary prevention of cardiovascular disease. PMID:24464106

  16. Concise Review: Cell Therapy and Tissue Engineering for Cardiovascular Disease

    PubMed Central

    Haraguchi, Yuji; Shimizu, Tatsuya; Yamato, Masayuki

    2012-01-01

    Cardiovascular disease is a major cause of morbidity and mortality, especially in developed countries. Various therapies for cardiovascular disease are investigated actively and are performed clinically. Recently, cell-based regenerative medicine using several cell sources has appeared as an alternative therapy for curing cardiovascular diseases. Scaffold-based or cell sheet-based tissue engineering is focused as a new generational cell-based regenerative therapy, and the clinical trials have also been started. Cell-based regenerative therapies have an enormous potential for treating cardiovascular disease. This review summarizes the recent research of cell sources and cell-based-regenerative therapies for cardiovascular diseases. PMID:23197760

  17. [Resistance training for patients with cardiovascular diseases].

    PubMed

    Wonisch, Manfred; Marko, Christiane; Niebauer, Josef; Pokan, Rochus; Schmid, Peter; Wiesinger, Elmar

    2012-05-01

    Physical training is part of the recommendations for prevention and rehabilitation of cardiovascular and metabolic diseases. The main focus was on endurance training for a long time. However, a positive effect of strength training has also been found for patients with with a wide spectrum of diseases. Beside the improvement of muscle strength similar positive effects as with endurance training have been documented. Moreover, improvements of quality of life and mobility have been found, mainly for older patients. Resistance training is safe and can be recommended to a wide range of patients including those with reduced left ventricular function. PMID:22623045

  18. The Role of Immunogenicity in Cardiovascular Disease

    PubMed Central

    Jan, Michael; Virtue, Anthony T.; Pansuria, Meghanaben; Liu, Jingshan; Xiong, Xinyu; Fang, Pu; Meng, Shu; Wang, Hong; Yang, Xiao-Feng

    2012-01-01

    Recently, many of the complexities associated with cardiovascular diseases (CVD) have been unlocked. However, despite these breakthroughs, CVD and its related complications are the leading contributors of morbidity and mortality worldwide, which indicates the shortcomings of current treatment regimens and the need for continued research. Published data within the field clearly indicates that CVD are built on inflammation and autoimmune platforms, though a strong, fundamental understanding of the mechanisms remains elusive. Areas such as the mechanisms underlying increased immunogenicity of self-proteins in the cardiovascular system, the roles of immunogenic auto-antigens in eliciting inflammatory autoimmune responses, and the immunosuppressive mechanisms involved in controlling inflammatory and autoimmune cardiovascular diseases remain to be well-understood. We will delve into these topics and the advancements made within the field in this review. Specifically, we will concentrate on the innate and adaptive immune responses mediating immunogenicity; the mechanisms of inflammation and autoimmunity in atherogenesis; the mechanisms of inflammation and autoimmunity in diabetic atherosclerosis; immunogenicity and stem cell therapy; as well as immunogenicity and immunosuppression. In depth examination and comprehension of these topics will provide insight into the recent progress of the field and bring to the forefront potentially novel therapeutic avenues. PMID:24511305

  19. Carbon dioxide balneotherapy and cardiovascular disease

    NASA Astrophysics Data System (ADS)

    Pagourelias, Efstathios D.; Zorou, Paraskevi G.; Tsaligopoulos, Miltiadis; Athyros, Vasilis G.; Karagiannis, Asterios; Efthimiadis, Georgios K.

    2011-09-01

    Carbon dioxide (CO2) balneotherapy is a kind of remedy with a wide spectrum of applications which have been used since the Middle Ages. However, its potential use as an adjuvant therapeutic option in patients with cardiovascular disease is not yet fully clarified. We performed a thorough review of MEDLINE Database, EMBASE, ISI WEB of Knowledge, COCHRANE database and sites funded by balneotherapy centers across Europe in order to recognize relevant studies and aggregate evidence supporting the use of CO2 baths in various cardiovascular diseases. The three main effects of CO2 hydrotherapy during whole body or partial immersion, including decline in core temperature, an increase in cutaneous blood flow, and an elevation of the score on thermal sensation, are analyzed on a pathophysiology basis. Additionally, the indications and contra-indications of the method are presented in an evidence-based way, while the need for new methodologically sufficient studies examining the use of CO2 baths in other cardiovascular substrates is discussed.

  20. Heavy Metal Poisoning and Cardiovascular Disease

    PubMed Central

    Alissa, Eman M.; Ferns, Gordon A.

    2011-01-01

    Cardiovascular disease (CVD) is an increasing world health problem. Traditional risk factors fail to account for all deaths from CVD. It is mainly the environmental, dietary and lifestyle behavioral factors that are the control keys in the progress of this disease. The potential association between chronic heavy metal exposure, like arsenic, lead, cadmium, mercury, and CVD has been less well defined. The mechanism through which heavy metals act to increase cardiovascular risk factors may act still remains unknown, although impaired antioxidants metabolism and oxidative stress may play a role. However, the exact mechanism of CVD induced by heavy metals deserves further investigation either through animal experiments or through molecular and cellular studies. Furthermore, large-scale prospective studies with follow up on general populations using appropriate biomarkers and cardiovascular endpoints might be recommended to identify the factors that predispose to heavy metals toxicity in CVD. In this review, we will give a brief summary of heavy metals homeostasis, followed by a description of the available evidence for their link with CVD and the proposed mechanisms of action by which their toxic effects might be explained. Finally, suspected interactions between genetic, nutritional and environmental factors are discussed. PMID:21912545

  1. Redox signaling in cardiovascular health and disease

    PubMed Central

    Madamanchi, Nageswara R.; Runge, Marschall S.

    2013-01-01

    Spatiotemporal regulation of the activity of a vast array of intracellular proteins and signaling pathways by reactive oxygen species (ROS) governs normal cardiovascular function. However, data from experimental and animal studies strongly support that dysregulated redox signaling, resulting from hyper-activation of various cellular oxidases or mitochondrial dysfunction, is integral to the pathogenesis and progression of cardiovascular disease (CVD). In this review, we address how redox signaling modulates the protein function, the various sources of increased oxidative stress in CVD, and the labyrinth of redox-sensitive molecular mechanisms involved in the development of atherosclerosis, hypertension, cardiac hypertrophy and heart failure, and ischemia–reperfusion injury. Advances in redox biology and pharmacology for inhibiting ROS production in specific cell types and subcellular organelles combined with the development of nanotechnology-based new in vivo imaging systems and targeted drug delivery mechanisms may enable fine-tuning of redox signaling for the treatment and prevention of CVD. PMID:23583330

  2. Psychosocial Stress and Cardiovascular Disease: Pathophysiological Links

    PubMed Central

    Bairey Merz, C. Noel; Dwyer, James; Nordstrom, Cheryl K.; Walton, Kenneth G.; Salerno, John W.; Schneider, Robert H.

    2010-01-01

    The remarkable decline in cardiovascular disease (CVD) experienced in developed countries over the last 40 years appears to have abated. Currently, many CVD patients continue to show cardiac events despite optimal treatment of traditional risk factors. This evidence suggests that additional interventions, particularly those aimed at nontraditional factors, might be useful for continuing the decline. Psychosocial stress is a newly recognized (nontraditional) risk factor that appears to contribute to all recognized mechanisms underlying cardiac events, specifically, (a) clustering of traditional cardiovascular risk factors, (b) endothelial dysfunction, (c) myocardial ischemia, (d) plaque rupture, (e) thrombosis, and (f) malignant arrhythmias. A better understanding of the behavioral and physiologic associations between psychosocial stress and CVD will assist researchers in identifying effective approaches for reducing or reversing the damaging effects of stress and may lead to further reductions of CVD morbidity and mortality. PMID:12165968

  3. Screening for cardiovascular disease before kidney transplantation.

    PubMed

    Palepu, Sneha; Prasad, G V Ramesh

    2015-12-24

    Pre-kidney transplant cardiac screening has garnered particular attention from guideline committees as an approach to improving post-transplant success. Screening serves two major purposes: To more accurately inform transplant candidates of their risk for a cardiac event before and after the transplant, thereby informing decisions about proceeding with transplantation, and to guide pre-transplant management so that post-transplant success can be maximized. Transplant candidates on dialysis are more likely to be screened for coronary artery disease than those not being considered for transplantation. Thorough history and physical examination taking, resting electrocardiography and echocardiography, exercise stress testing, myocardial perfusion scintigraphy, dobutamine stress echocardiography, cardiac computed tomography, cardiac biomarker measurement, and cardiac magnetic resonance imaging all play contributory roles towards screening for cardiovascular disease before kidney transplantation. In this review, the importance of each of these screening procedures for both coronary artery disease and other forms of cardiac disease are discussed. PMID:26722655

  4. Screening for cardiovascular disease before kidney transplantation

    PubMed Central

    Palepu, Sneha; Prasad, G V Ramesh

    2015-01-01

    Pre-kidney transplant cardiac screening has garnered particular attention from guideline committees as an approach to improving post-transplant success. Screening serves two major purposes: To more accurately inform transplant candidates of their risk for a cardiac event before and after the transplant, thereby informing decisions about proceeding with transplantation, and to guide pre-transplant management so that post-transplant success can be maximized. Transplant candidates on dialysis are more likely to be screened for coronary artery disease than those not being considered for transplantation. Thorough history and physical examination taking, resting electrocardiography and echocardiography, exercise stress testing, myocardial perfusion scintigraphy, dobutamine stress echocardiography, cardiac computed tomography, cardiac biomarker measurement, and cardiac magnetic resonance imaging all play contributory roles towards screening for cardiovascular disease before kidney transplantation. In this review, the importance of each of these screening procedures for both coronary artery disease and other forms of cardiac disease are discussed. PMID:26722655

  5. Risk Assessment and Management of the Mother with Cardiovascular Disease.

    PubMed

    Hebson, Camden; Saraf, Anita; Book, Wendy M

    2016-03-01

    Chronic medical conditions account for most nonobstetrical pregnancy-related maternal complications. Preconception counseling of women with cardiovascular disease can be aided by an understanding of cardiovascular physiology in pregnancy and risk scores to guide management. PMID:26876118

  6. Diabetic Cardiovascular Disease Induced by Oxidative Stress.

    PubMed

    Kayama, Yosuke; Raaz, Uwe; Jagger, Ann; Adam, Matti; Schellinger, Isabel N; Sakamoto, Masaya; Suzuki, Hirofumi; Toyama, Kensuke; Spin, Joshua M; Tsao, Philip S

    2015-01-01

    Cardiovascular disease (CVD) is the leading cause of morbidity and mortality among patients with diabetes mellitus (DM). DM can lead to multiple cardiovascular complications, including coronary artery disease (CAD), cardiac hypertrophy, and heart failure (HF). HF represents one of the most common causes of death in patients with DM and results from DM-induced CAD and diabetic cardiomyopathy. Oxidative stress is closely associated with the pathogenesis of DM and results from overproduction of reactive oxygen species (ROS). ROS overproduction is associated with hyperglycemia and metabolic disorders, such as impaired antioxidant function in conjunction with impaired antioxidant activity. Long-term exposure to oxidative stress in DM induces chronic inflammation and fibrosis in a range of tissues, leading to formation and progression of disease states in these tissues. Indeed, markers for oxidative stress are overexpressed in patients with DM, suggesting that increased ROS may be primarily responsible for the development of diabetic complications. Therefore, an understanding of the pathophysiological mechanisms mediated by oxidative stress is crucial to the prevention and treatment of diabetes-induced CVD. The current review focuses on the relationship between diabetes-induced CVD and oxidative stress, while highlighting the latest insights into this relationship from findings on diabetic heart and vascular disease. PMID:26512646

  7. Diabetic Cardiovascular Disease Induced by Oxidative Stress

    PubMed Central

    Kayama, Yosuke; Raaz, Uwe; Jagger, Ann; Adam, Matti; Schellinger, Isabel N.; Sakamoto, Masaya; Suzuki, Hirofumi; Toyama, Kensuke; Spin, Joshua M.; Tsao, Philip S.

    2015-01-01

    Cardiovascular disease (CVD) is the leading cause of morbidity and mortality among patients with diabetes mellitus (DM). DM can lead to multiple cardiovascular complications, including coronary artery disease (CAD), cardiac hypertrophy, and heart failure (HF). HF represents one of the most common causes of death in patients with DM and results from DM-induced CAD and diabetic cardiomyopathy. Oxidative stress is closely associated with the pathogenesis of DM and results from overproduction of reactive oxygen species (ROS). ROS overproduction is associated with hyperglycemia and metabolic disorders, such as impaired antioxidant function in conjunction with impaired antioxidant activity. Long-term exposure to oxidative stress in DM induces chronic inflammation and fibrosis in a range of tissues, leading to formation and progression of disease states in these tissues. Indeed, markers for oxidative stress are overexpressed in patients with DM, suggesting that increased ROS may be primarily responsible for the development of diabetic complications. Therefore, an understanding of the pathophysiological mechanisms mediated by oxidative stress is crucial to the prevention and treatment of diabetes-induced CVD. The current review focuses on the relationship between diabetes-induced CVD and oxidative stress, while highlighting the latest insights into this relationship from findings on diabetic heart and vascular disease. PMID:26512646

  8. Inflammation modulation and cardiovascular disease prevention.

    PubMed

    Awan, Zuhier; Genest, Jacques

    2015-06-01

    Heart disease and stroke represent the major burden of health worldwide and account for a staggering 17 million deaths yearly. This pandemic is, in great part preventable through simple and modifiable preventive measures such as smoking cessation, healthy eating, regular activity and weight loss. In patients with established atherosclerotic vascular disease, lipid lowering agent have had a major impact on reducing risk, along with pharmacological treatment of elevated blood pressure and the use of anti-thrombotic medication. Despite these advances, there remains a significant residual risk and newer approaches are required to decrease atherosclerosis. Innate and acquired immunity play a pivotal role in the initiation, progression and instability of the atherosclerotic plaque. The remarkable complexity of the immune system makes it difficult to target a single pathway for the prevention of cardiovascular disease. Nevertheless, recent data points to possible therapeutic targets that may decrease atherosclerosis, without increasing the risk of infection, decreasing immune surveillance for cancers and without undue toxicity. Here we discuss the clinical trials and registry data associated with the use of inflammation modulation and cardiovascular disease and the ongoing major clinical trial that may change the clinical medicine and preventive cardiology. The selective inhibition of interleukin 1? and the use of low-dose methotrexate are now undergoing large outcome-driven clinical trials to answer these questions. PMID:24711609

  9. Colchicine for secondary prevention of cardiovascular disease.

    PubMed

    Nidorf, Stefan M; Eikelboom, John W; Thompson, Peter L

    2014-03-01

    Preliminary evidence demonstrating that adding 0.5 mg of colchicine per day to statin and antiplatelet therapy reduced the risk of acute coronary events in patients with stable coronary artery disease has raised the hope that it may prove effective for the long-term secondary prevention of cardiovascular disease. The ability of colchicine to suppress blood levels of inflammatory mediators and prevent cholesterol-crystal-induced neutrophil-mediated inflammation implicated in the progression and instability of atherosclerosis adds plausibility to this clinical observation. Early intestinal intolerance in some patients is well recognized, but clinical experience gained over more than half a century with the continuous use of colchicine for the prevention of neutrophil-mediated inflammation in patients with familial Mediterranean fever and gout indicates that low-dose long-term therapy is safe. Nonetheless, before colchicine can be recommended for the secondary prevention of cardiovascular disease, further studies are required to confirm its safety and efficacy in a broad range of patients with coronary disease, and to determine whether doses of colchicine less than 0.5 mg/day might be effective and even better tolerated. Trials exploring the role of colchicine in the treatment of patients with acute coronary syndromes would also be of special interest but may require the use of doses higher than those used for long-term secondary prevention. PMID:24425060

  10. Polysaccharide Nanosystems for Future Progress in Cardiovascular Pathologies

    PubMed Central

    Silva, Amanda Karine Andriola; Letourneur, Didier; Chauvierre, Cédric

    2014-01-01

    Natural polysaccharides have received a lot of attention in the biomedical field. Indeed, sources of polysaccharides, extracted or produced from plants, bacteria, fungi or algae, are diverse and renewable. Moreover, recent progresses in polysaccharide chemistry and nanotechnologies allow elaborating new dedicated nanosystems. Polysaccharide-based nanosystems may be designed for interacting in several biological processes. In particular, the atherothrombotic pathology is highly concerned by polysaccharide-mediated recognition. Atherothrombotic diseases, regardless of the anatomical localization, remain the main causes of morbidity and mortality in the industrialized world. This review intends to provide an overview on polysaccharide-based nanosystems as drug delivery systems and targeted contrast agents for molecular imaging with an emphasis on the treatment and imaging of cardiovascular pathologies. PMID:24723980

  11. Polysaccharide nanosystems for future progress in cardiovascular pathologies.

    PubMed

    Silva, Amanda Karine Andriola; Letourneur, Didier; Chauvierre, Cdric

    2014-01-01

    Natural polysaccharides have received a lot of attention in the biomedical field. Indeed, sources of polysaccharides, extracted or produced from plants, bacteria, fungi or algae, are diverse and renewable. Moreover, recent progresses in polysaccharide chemistry and nanotechnologies allow elaborating new dedicated nanosystems. Polysaccharide-based nanosystems may be designed for interacting in several biological processes. In particular, the atherothrombotic pathology is highly concerned by polysaccharide-mediated recognition. Atherothrombotic diseases, regardless of the anatomical localization, remain the main causes of morbidity and mortality in the industrialized world. This review intends to provide an overview on polysaccharide-based nanosystems as drug delivery systems and targeted contrast agents for molecular imaging with an emphasis on the treatment and imaging of cardiovascular pathologies. PMID:24723980

  12. Obstructive sleep apnea, hypertension and cardiovascular diseases.

    PubMed

    Gonzaga, C; Bertolami, A; Bertolami, M; Amodeo, C; Calhoun, D

    2015-12-01

    Obstructive sleep apnea (OSA) is characterized by recurrent episodes of partial (hypopnea) or complete interruption (apnea) in breathing during sleep due to airway collapse in the pharyngeal region. OSA and its cardiovascular consequences have been widely explored in observational and prospective studies. Most evidence verifies the positive relationship between OSA and hypertension, coronary artery disease, atrial fibrillation, stroke and heart failure. However, more studies are needed to better assess the impact of OSA, and possible benefit of treatment with continuous positive airway pressure (CPAP) on dyslipidemia, type 2 diabetes, insulin resistance and cardiovascular mortality. The leading pathophysiological mechanisms involved in the changes triggered by OSA, include intermittent hypoxemia and re-oxygenation, arousals and changes in intrathoracic pressure. Hypertension is strongly related with activation of the sympathetic nervous system, stimulation of the renin-angiotensin-aldosterone system and impairment of endothelial function. The high prevalence of OSA in the general population, hypertensive patients and especially obese individuals and patients resistant to antihypertensive therapy, highlights the need for effective screening, diagnosis and treatment of OSA to decrease cardiovascular risk. PMID:25761667

  13. Improved Cardiovascular Disease Outcomes in Older Adults.

    PubMed

    Forman, Daniel E; Alexander, Karen; Brindis, Ralph G; Curtis, Anne B; Maurer, Mathew; Rich, Michael W; Sperling, Laurence; Wenger, Nanette K

    2016-01-01

    Longevity is increasing and the population of older adults is growing. The biology of aging is conducive to cardiovascular disease (CVD), such that prevalence of coronary artery disease, heart failure, valvular heart disease, arrhythmia and other disorders are increasing as more adults survive into old age. Furthermore, CVD in older adults is distinctive, with management issues predictably complicated by multimorbidity, polypharmacy, frailty and other complexities of care that increase management risks (e.g., bleeding, falls, and rehospitalization) and uncertainty of outcomes. In this review, state-of-the-art advances in heart failure, acute coronary syndromes, transcatheter aortic valve replacement, atrial fibrillation, amyloidosis, and CVD prevention are discussed. Conceptual benefits of treatments are considered in relation to the challenges and ambiguities inherent in their application to older patients. PMID:26918183

  14. Improved Cardiovascular Disease Outcomes in Older Adults

    PubMed Central

    Forman, Daniel E.; Alexander, Karen; Brindis, Ralph G.; Curtis, Anne B.; Maurer, Mathew; Rich, Michael W.; Sperling, Laurence; Wenger, Nanette K.

    2016-01-01

    Longevity is increasing and the population of older adults is growing. The biology of aging is conducive to cardiovascular disease (CVD), such that prevalence of coronary artery disease, heart failure, valvular heart disease, arrhythmia and other disorders are increasing as more adults survive into old age.  Furthermore, CVD in older adults is distinctive, with management issues predictably complicated by multimorbidity, polypharmacy, frailty and other complexities of care that increase management risks (e.g., bleeding, falls, and rehospitalization) and uncertainty of outcomes.  In this review, state-of-the-art advances in heart failure, acute coronary syndromes, transcatheter aortic valve replacement, atrial fibrillation, amyloidosis, and CVD prevention are discussed.  Conceptual benefits of treatments are considered in relation to the challenges and ambiguities inherent in their application to older patients. PMID:26918183

  15. Use of complementary therapies in cardiovascular disease.

    PubMed

    Prasad, Kavita; Sharma, Varun; Lackore, Kandace; Jenkins, Sarah M; Prasad, Abhiram; Sood, Amit

    2013-02-01

    The aim of the present study was to assess the use of complementary and alternative medicine (CAM) treatments in outpatients with cardiovascular disease and their interest in future use. The increasing popularity of CAM therapies highlights the need to explore their use among patients with cardiovascular disease. Data were collected with a prospective, point-of-care, anonymous, 17-question survey about basic medical information and previous use and interest in the future use of dietary supplements and other CAM interventions among patients undergoing outpatient cardiology evaluation at a Midwestern tertiary care center. The survey was completed by 1,055 patients (655 men, 351 women; mean age 63.5 years) of whom 98.1% were white. Of these, 36.8% had cardiac symptoms for >10 years, 48.2% had coronary artery disease, and 82.5% reported use of CAM therapies. Of these patients, 75.4% reported using dietary supplements, 31.5% chiropractic therapy, 23.9% mind-body therapies, and 19.2% massage. Only 14.4% had discussed the use of CAM treatments with their physicians. The top 4 treatments used for cardiac symptoms were relaxation techniques, stress management, meditation, and guided imagery. Also, 48.6% were interested in participating in a future clinical trial of an alternative treatment. The great majority of patients seen in current practice use CAM therapies, and a large proportion expressed an interest in participating in research with CAM therapies. In conclusion, research directed with an integrative approach to cardiovascular care might prove beneficial when designing future studies. PMID:23186602

  16. Alcohol, cardiovascular diseases and diabetes mellitus.

    PubMed

    Klatsky, Arthur L

    2007-03-01

    Disparities in associations of alcohol consumption to various cardiovascular conditions lead to separate consideration of several. These include (1) Alcoholic cardiomyopathy from chronic heavy drinking in susceptible persons. (2) Higher blood pressure (hypertension) in some heavier drinkers. (3) A relation of drinking to higher risk of hemorrhagic stroke but to lower risk of ischemic stroke. (4) Certain arrhythmias, especially among binge drinkers. (5) An inverse relation of alcohol use to coronary artery disease. A causal hypothesis of protection is strengthened by plausible mechanisms. The coronary disease data impact upon total mortality statistics, such that lighter drinkers are at slightly lower risk than abstainers of death within a given time period. (6) An inverse relation of drinking to type 2 (adult onset) diabetes mellitus in several recent studies. Because of close relations to cardiovascular disorders, diabetes is considered virtual cardiovascular "equivalent". (7) Composites of (1-6) result in a complex association between alcohol and the common heart failure syndrome. International comparisons suggest wine is more protective against coronary disease than liquor or beer. Reports of antioxidants, endothelial relaxants, and antithrombotic activity in wine (especially red) support hypothetical benefit from non-alcohol wine components. However, prospective population studies show apparent protection from beer, wine, or liquor. Thus, some suggest that favorable traits or drinking patterns of wine drinkers might explain the international comparison findings. Amount of alcohol taken is a crucial consideration in alcohol-health relations. Advice to concerned persons needs to take into account individual risk/benefit factors in drinkers or potential drinkers. PMID:17363263

  17. Mitochondrial dynamics, mitophagy and cardiovascular disease.

    PubMed

    Vsquez-Trincado, Csar; Garca-Carvajal, Ivonne; Pennanen, Christian; Parra, Valentina; Hill, Joseph A; Rothermel, Beverly A; Lavandero, Sergio

    2016-02-01

    Cardiac hypertrophy is often initiated as an adaptive response to haemodynamic stress or myocardial injury, and allows the heart to meet an increased demand for oxygen. Although initially beneficial, hypertrophy can ultimately contribute to the progression of cardiac disease, leading to an increase in interstitial fibrosis and a decrease in ventricular function. Metabolic changes have emerged as key mechanisms involved in the development and progression of pathological remodelling. As the myocardium is a highly oxidative tissue, mitochondria play a central role in maintaining optimal performance of the heart. 'Mitochondrial dynamics', the processes of mitochondrial fusion, fission, biogenesis and mitophagy that determine mitochondrial morphology, quality and abundance have recently been implicated in cardiovascular disease. Studies link mitochondrial dynamics to the balance between energy demand and nutrient supply, suggesting that changes in mitochondrial morphology may act as a mechanism for bioenergetic adaptation during cardiac pathological remodelling. Another critical function of mitochondrial dynamics is the removal of damaged and dysfunctional mitochondria through mitophagy, which is dependent on the fission/fusion cycle. In this article, we discuss the latest findings regarding the impact of mitochondrial dynamics and mitophagy on the development and progression of cardiovascular pathologies, including diabetic cardiomyopathy, atherosclerosis, damage from ischaemia-reperfusion, cardiac hypertrophy and decompensated heart failure. We will address the ability of mitochondrial fusion and fission to impact all cell types within the myocardium, including cardiac myocytes, cardiac fibroblasts and vascular smooth muscle cells. Finally, we will discuss how these findings can be applied to improve the treatment and prevention of cardiovascular diseases. PMID:26537557

  18. Disease Activity in Inflammatory Bowel Disease Is Associated with Increased Risk of Myocardial Infarction, Stroke and Cardiovascular Death A Danish Nationwide Cohort Study

    PubMed Central

    Kristensen, Sren Lund; Ahlehoff, Ole; Lindhardsen, Jesper; Erichsen, Rune; Jensen, Gunnar Vagn; Torp-Pedersen, Christian; Nielsen, Ole Haagen; Gislason, Gunnar Hilmar; Hansen, Peter Riis

    2013-01-01

    Purpose Chronic inflammatory diseases have been linked to increased risk of atherothrombotic events, but the risk associated with inflammatory bowel disease (IBD) is unclear. We therefore examined the risk of myocardial infarction (MI), stroke, and cardiovascular death in patients with IBD. Methods In a nationwide Danish population-based setting, a cohort of patients with incident IBD between 1996 and 2009 were identified in national registers. Hospitalizations with IBD as primary diagnosis, initiation of biological treatment and dispensed prescriptions of corticosteroids were all used as surrogate markers for disease activity, with flares classified as the first 120 days after diagnosis of IBD, and 120 days after a new corticosteroid prescription, biological treatment or IBD hospitalization, respectively. Continued corticosteroid prescriptions or IBD hospitalizations were defined as persistent activity, and periods free of such events were defined as remissions. Poisson regression was used to examine risk of MI, stroke, and cardiovascular death using a matched population-based comparison cohort as reference Results We identified 20,795 IBD patients with a mean age of 40.3 years that were matched according to age and sex with 199,978 controls. During the study period, there were 365 patients with MI, 454 with stroke, and 778 with cardiovascular death. Patients with IBD had an overall increased risk of MI (rate ratio [RR] 1.17 [95% confidence interval 1.051.31]), stroke (RR 1.15 [1.041.27], and cardiovascular death (RR 1.35 [1.251.45]). During flares and persistent IBD activity the RRs of MI increased to 1.49 (1.161.93) and 2.05 (1.582.65), the RRs of stroke to 1.53 (1.221.92) and 1.55 (1.182.04) and for cardiovascular death 2.32 (2.012.68) and 2.50 (2.142.92). In remission periods, the risk of MI, stroke and cardiovascular death was similar to controls. Conclusion Inflammatory bowel disease is associated with increased risk of MI, stroke, and cardiovascular death during periods with active disease. PMID:23457642

  19. Glycemic index, cardiovascular disease, and obesity.

    PubMed

    Morris, K L; Zemel, M B

    1999-09-01

    Although Americans have decreased the percent of energy they consume from fat, obesity and obesity-related comorbidities have progressively increased. Less attention has been paid to the role of carbohydrates, especially carbohydrate source, in these metabolic diseases. However, recent epidemiologic studies demonstrate consistently higher rates of cardiovascular disease and type II diabetes in individuals deriving a greater percentage of energy from refined grains and simple carbohydrates than from whole grains. Differences in the metabolic response to carbohydrates can be classified by glycemic index (GI), the blood glucose response to a given food compared with a standard (typically white bread or glucose). Classification of carbohydrates as "simple" or "complex" is of little use in predicting GI, because GI is influenced by starch structure (amylose versus amylopectin), fiber content, food processing, physical structure of the food, and other macronutrients in the meal. Low-GI diets have been reported to lower postprandial glucose and insulin responses, improve lipid profiles, and increase insulin sensitivity. Moreover, high-GI diets stimulate de novo lipogenesis and result in increased adipocyte size, whereas low-GI diets have been reported to inhibit these responses. Thus, the GI of dietary carbohydrates appears to play an important role in the metabolic fate of carbohydrates and, consequently, may significantly affect the risk of cardiovascular disease, diabetes, and obesity. PMID:10568336

  20. Cardiovascular diseases: oxidative damage and antioxidant protection.

    PubMed

    Zhang, P-Y; Xu, X; Li, X-C

    2014-10-01

    Atherosclerosis, the hardening of arteries under oxidative stress is related to oxidative changes of low density lipoproteins (LDL). The antioxidants prevent the formation of oxidized LDL during atherogenesis. Perhaps more than one mechanism is involved in the atherosclerosis disease where LDL is oxidized in all the cells of arterial wall during the development of this disease. The oxidation of LDL produces lipid peroxidation products such as isoprostans from arachidonic, eicosapentaenoic and docosahexaenoic acids, oxysterols from cholesterol, hydroxyl fatty acids, lipid peroxides and aldehydes. The lipid peroxidation bioassay can serve as a marker for the risk of cardiovascular. An in vivo test of levels of oxidative lipid damage is an early prediction of development of cardiovascular disease (CVD). Serum paraoxonase (PON) activity is correlated to severity of the coronary artery disease. The antioxidants level in the serum and serum paraoxonase activity provides information for the risk of CVD. The antioxidant enzyme superoxide dismutase is responsible for dismutation of superoxide, a free radical chain initiator. The subcellular changes in the equilibrium in favor of free radicals can cause increase in the oxidative stress which leads to cardiomyopathy, heart attack or cardiac dysfunction. The oxidative damage and defense of heart disease has been reported where dietary antioxidants protect the free radical damage to DNA, proteins and lipids. The ascorbic acid, vitamin C is an effective antioxidant and high vitamin E intake can reduce the risk of coronary heart disease (CHD) by inhibition of atherogenic forms of oxidized LDL. The vitamin A and beta-carotene protect lipid peroxidation and provitamin-A activity. It has been recently suggested that the protection of oxidative damage and related CVD is best served by antioxidants found in the fruits and vegetables. The oxidative damage and antioxidant protection of CVD have been described here. PMID:25392110

  1. Native American medicine and cardiovascular disease.

    PubMed

    Nauman, Eileen

    2007-01-01

    Native American medicine provides an approach to the treatment of cardiovascular disease that is unique and that can complement modern medicine treatments. Although specific practices among the various Native American tribes (Nations) can vary, there is a strong emphasis on the power of shamanism that can be supplemented by the use of herbal remedies, sweat lodges, and special ceremonies. Most of the practices are passed down by oral tradition, and there is specific training regarding the Native American healer. Native American medicine has strong testimonial experiences to suggest benefit in cardiac patients; however, critical scientific scrutiny is necessary to confirm the validity of the benefits shown to date. PMID:17172882

  2. [Physical exercise training for cardiovascular diseases].

    PubMed

    Wienbergen, H; Hambrecht, R

    2012-08-01

    Clinical application of physical exercise has developed into an evidence-based therapeutic option for cardiovascular diseases, especially coronary artery disease (CAD) and chronic heart failure (CHF). In CAD regular physical exercise training partially corrects endothelial dysfunction and leads to an economization of left ventricular function. Meta-analyses have shown a reduction of angina pectoris symptoms and a decrease of total and cardiovascular mortality by regular aerobic exercise training. Endurance training for CHF reduces cardiac afterload by correcting peripheral endothelial dysfunction und leads to a better left ventricular function. In addition exercise training reduces the adrenergic tone and the stimulation of the renin-angiotensin-aldosterone system in CHF. Exercise training provides positive effects on the metabolism and function of skeletal muscle (e.g. reduced inflammation and oxidative stress). Supervised regular physical exercise training in CHF is safe and has improved the morbidity in clinical studies. Thus aerobic exercise training is an important component of therapeutic management of stable CAD and CHF with a class 1a recommendation in the current guidelines. PMID:22760599

  3. MACD: an imaging marker for cardiovascular disease

    NASA Astrophysics Data System (ADS)

    Ganz, Melanie; de Bruijne, Marleen; Nielsen, Mads

    2010-03-01

    Despite general acceptance that a healthy lifestyle and the treatment of risk factors can prevent the development of cardiovascular diseases (CVD), CVD are the most common cause of death in Europe and the United States. It has been shown that abdominal aortic calcifications (AAC) correlate strongly with coronary artery calcifications. Hence an early detection of aortic calcified plaques helps to predict the risk of related coronary diseases. Also since two thirds of the adverse events have no prior symptoms, possibilities to screen for risk in low cost imaging are important. To this end the Morphological Atherosclerotic Calcification Distribution (MACD) index was developed. In the following several potential severity scores relating to the geometrical outline of the calcified deposits in the lumbar aortic region are introduced. Their individual as well as their combined predictive power is examined and a combined marker, MACD, is constructed. This is done using a Cox regression analysis, also known as survival analysis. Furthermore we show how a Cox regression yields MACD to be the most efficient marker. We also demonstrate that MACD has a larger individual predictive power than any of the other individual imaging markers described. Finally we present that the MACD index predicts cardiovascular death with a hazard ratio of approximately four.

  4. Mitochondria, myocardial remodeling, and cardiovascular disease.

    PubMed

    Verdejo, Hugo E; del Campo, Andrea; Troncoso, Rodrigo; Gutierrez, Toms; Toro, Barbra; Quiroga, Clara; Pedrozo, Zully; Munoz, Juan Pablo; Garcia, Lorena; Castro, Pablo F; Lavandero, Sergio

    2012-12-01

    The process of muscle remodeling lies at the core of most cardiovascular diseases. Cardiac adaptation to pressure or volume overload is associated with a complex molecular change in cardiomyocytes which leads to anatomic remodeling of the heart muscle. Although adaptive at its beginnings, the sustained cardiac hypertrophic remodeling almost unavoidably ends in progressive muscle dysfunction, heart failure and ultimately death. One of the features of cardiac remodeling is a progressive impairment in mitochondrial function. The heart has the highest oxygen uptake in the human body and accordingly it has a large number of mitochondria, which form a complex network under constant remodeling in order to sustain the high metabolic rate of cardiac cells and serve as Ca(2+) buffers acting together with the endoplasmic reticulum (ER). However, this high dependence on mitochondrial metabolism has its costs: when oxygen supply is threatened, high leak of electrons from the electron transport chain leads to oxidative stress and mitochondrial failure. These three aspects of mitochondrial function (Reactive oxygen species signaling, Ca(2+) handling and mitochondrial dynamics) are critical for normal muscle homeostasis. In this article, we will review the latest evidence linking mitochondrial morphology and function with the process of myocardial remodeling and cardiovascular disease. PMID:22972531

  5. Sortilin and the risk of cardiovascular disease.

    PubMed

    Coutinho, Maria Francisca; Bourbon, Mafalda; Prata, Maria João; Alves, Sandra

    2013-10-01

    Plasma low-density lipoprotein cholesterol (LDL-C) levels are a key determinant of the risk of cardiovascular disease, which is why many studies have attempted to elucidate the pathways that regulate its metabolism. Novel latest-generation sequencing techniques have identified a strong association between the 1p13 locus and the risk of cardiovascular disease caused by changes in plasma LDL-C levels. As expected for a complex phenotype, the effects of variation in this locus are only moderate. Even so, knowledge of the association is of major importance, since it has unveiled a new metabolic pathway regulating plasma cholesterol levels. Crucial to this discovery was the work of three independent teams seeking to clarify the biological basis of this association, who succeeded in proving that SORT1, encoding sortilin, was the gene in the 1p13 locus involved in LDL metabolism. SORT1 was the first gene identified as determining plasma LDL levels to be mechanistically evaluated and, although the three teams used different, though appropriate, experimental methods, their results were in some ways contradictory. Here we review all the experiments that led to the identification of the new pathway connecting sortilin with plasma LDL levels and risk of myocardial infarction. The regulatory mechanism underlying this association remains unclear, but its discovery has paved the way for considering previously unsuspected therapeutic targets and approaches. PMID:23910371

  6. Lycopene Deficiency in Ageing and Cardiovascular Disease

    PubMed Central

    Petyaev, Ivan M.

    2016-01-01

    Lycopene is a hydrocarbon phytochemical belonging to the tetraterpene carotenoid family and is found in red fruit and vegetables. Eleven conjugated double bonds predetermine the antioxidant properties of lycopene and its ability to scavenge lipid peroxyl radicals, reactive oxygen species, and nitric oxide. Lycopene has a low bioavailability rate and appears in the blood circulation incorporated into chylomicrons and other apo-B containing lipoproteins. The recent body of evidence suggests that plasma concentration of lycopene is not only a function of intestinal absorption rate but also lycopene breakdown via enzymatic and oxidative pathways in blood and tissues. Oxidative stress and the accumulation of reactive oxygen species and nitric oxide may represent a major cause of lycopene depletion in ageing, cardiovascular disease, and type 2 diabetes mellitus. It has been shown recently that low carotenoid levels, and especially decreased serum lycopene levels, are strongly predictive of all-cause mortality and poor outcomes of cardiovascular disease. However, there is a poor statistical association between dietary and serum lycopene levels which occurs due to limited bioavailability of lycopene from dietary sources. Hence, it is very unlikely that nutritional intervention alone could be instrumental in the correction of lycopene and carotenoid deficiency. Therefore, new nutraceutical formulations of carotenoids with enhanced bioavailability are urgently needed. PMID:26881023

  7. Lycopene Deficiency in Ageing and Cardiovascular Disease.

    PubMed

    Petyaev, Ivan M

    2016-01-01

    Lycopene is a hydrocarbon phytochemical belonging to the tetraterpene carotenoid family and is found in red fruit and vegetables. Eleven conjugated double bonds predetermine the antioxidant properties of lycopene and its ability to scavenge lipid peroxyl radicals, reactive oxygen species, and nitric oxide. Lycopene has a low bioavailability rate and appears in the blood circulation incorporated into chylomicrons and other apo-B containing lipoproteins. The recent body of evidence suggests that plasma concentration of lycopene is not only a function of intestinal absorption rate but also lycopene breakdown via enzymatic and oxidative pathways in blood and tissues. Oxidative stress and the accumulation of reactive oxygen species and nitric oxide may represent a major cause of lycopene depletion in ageing, cardiovascular disease, and type 2 diabetes mellitus. It has been shown recently that low carotenoid levels, and especially decreased serum lycopene levels, are strongly predictive of all-cause mortality and poor outcomes of cardiovascular disease. However, there is a poor statistical association between dietary and serum lycopene levels which occurs due to limited bioavailability of lycopene from dietary sources. Hence, it is very unlikely that nutritional intervention alone could be instrumental in the correction of lycopene and carotenoid deficiency. Therefore, new nutraceutical formulations of carotenoids with enhanced bioavailability are urgently needed. PMID:26881023

  8. Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults

    MedlinePLUS

    ... Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults The U.S. Preventive Services ... PAD) and Cardiovascular Disease (CVD) Risk Assessment with Ankle Brachial Index (ABI) in Adults . This final recommendation ...

  9. Cardiovascular Diseases in HIV-infected Subjects (HIV-HEART Study)

    ClinicalTrials.gov

    2010-05-07

    Detection of Frequency, Severity and Progression of Cardiovascular Diseases in Patients With HIV-infection.; Effect on Cardiovascular Risk and Life Quality by Age, Gender, Classic Cardiovascular Risk Factors,; HIV-specific Cardiovascular Risk Factors, Cardiovascular Medication, Antiretroviral Medication

  10. Novel Treatments for Cardiovascular Disease Prevention

    PubMed Central

    Huffman, Mark D.; Bhatnagar, Deepak

    2014-01-01

    SUMMARY The purpose of this review is to describe novel pharmacologic and nonpharmacologic preventive therapies, as well as new strategies to improve delivery of available therapies. Cardiovascular disease (CVD) is the leading cause of death worldwide, and prevention plays a critical role in curbing the global epidemic. Despite available treatment for tobacco addiction, platelet inhibition, blood pressure, and lipid lowering for reduction of atherosclerotic disease, significant gaps in treatment of total CVD remain. We review a range of new preventive treatment options, including drugs for tobacco cessation, platelet/thrombotic inhibition, lipid- and blood pressure-lowering; nonpharmacologic options such as left atrial appendage closure devices and caloric restriction; and strategies such as fixed-dose combination drugs, laboratory screening for drug tailoring, and community-based prevention programs. CVD preventive research continues to evolve and provide clinicians and patients with novel pharmacologic and nonpharmacologic therapies, including new preventive strategies. PMID:21884014

  11. Cardiovascular Disease Among Alaska Native Peoples

    PubMed Central

    Jolly, Stacey E.; Howard, Barbara V.; Umans, Jason G.

    2013-01-01

    Although Alaska Native peoples were thought to be protected from cardiovascular disease (CVD), data now show that this is not the case, despite traditional lifestyles and high omega-3 fatty acid intake. In this article, the current understanding of CVD and its risk factors among Alaska Native peoples, particularly among the Yupik and Inupiat populations, will be discussed, using data from three major studies funded by the National Institutes of Health: Genetics of Coronary Artery Disease among Alaska Natives (GOCADAN), Center for Native Health Research (CANHR), and Education and Research Towards Health (EARTH). Data from these epidemiologic studies have focused concern on CVD and its risk factors among Alaska Native peoples. This review will summarize the findings of these three principal studies and will suggest future directions for research and clinical practice. PMID:24367710

  12. Role of connexin 43 in cardiovascular diseases.

    PubMed

    Michela, Pecoraro; Velia, Verrilli; Aldo, Pinto; Ada, Popolo

    2015-12-01

    Gap junctions (GJs) channels provide the basis for intercellular communication in the cardiovascular system for maintenance of the normal cardiac rhythm, regulation of vascular tone and endothelial function as well as metabolic interchange between the cells. They allow the transfer of small molecules and may enable slow calcium wave spreading, transfer of "death" or of "survival" signals. In the cardiomyocytes the most abundant isoform is Connexin 43 (Cx43). Alterations in Cx43 expression and distribution were observed in myocardium disease; i.e. in hypertrophic cardiomyopathy, heart failure and ischemia. Recent reports suggest the presence of Cx43 in the mitochondria as well, at least in the inner mitochondrial membrane, where it plays a central role in ischemic preconditioning. In this review, the current knowledge on the relationship between the remodeling of cardiac gap junctions and cardiac diseases are summarized. PMID:26499977

  13. Ketone body metabolism and cardiovascular disease

    PubMed Central

    Cotter, David G.; Schugar, Rebecca C.

    2013-01-01

    Ketone bodies are metabolized through evolutionarily conserved pathways that support bioenergetic homeostasis, particularly in brain, heart, and skeletal muscle when carbohydrates are in short supply. The metabolism of ketone bodies interfaces with the tricarboxylic acid cycle, β-oxidation of fatty acids, de novo lipogenesis, sterol biosynthesis, glucose metabolism, the mitochondrial electron transport chain, hormonal signaling, intracellular signal transduction pathways, and the microbiome. Here we review the mechanisms through which ketone bodies are metabolized and how their signals are transmitted. We focus on the roles this metabolic pathway may play in cardiovascular disease states, the bioenergetic benefits of myocardial ketone body oxidation, and prospective interactions among ketone body metabolism, obesity, metabolic syndrome, and atherosclerosis. Ketone body metabolism is noninvasively quantifiable in humans and is responsive to nutritional interventions. Therefore, further investigation of this pathway in disease models and in humans may ultimately yield tailored diagnostic strategies and therapies for specific pathological states. PMID:23396451

  14. Skin microvascular endothelial function as a biomarker in cardiovascular diseases?

    PubMed

    Hellmann, Marcin; Roustit, Matthieu; Cracowski, Jean-Luc

    2015-08-01

    Skin microvascular endothelial function is impaired in many cardiovascular diseases, and could be therefore considered as a representative vascular bed. However, today, available evidence allows considering skin microvascular endothelial function neither as a diagnostic biomarker nor as a prognostic biomarker in cardiovascular diseases. Large follow-up studies using standardized methods should now be conducted to assess the potential predictive value of skin microvascular function in cardiovascular diseases. PMID:26321284

  15. Sex Differences in the Developmental Origins of Cardiovascular Disease

    PubMed Central

    Intapad, Suttira; Ojeda, Norma B.; Dasinger, John Henry

    2014-01-01

    The Developmental Origins of Health and Disease (DOHaD) proposes that adverse events during early life program an increased risk for cardiovascular disease. Experimental models provide proof of concept but also indicate that insults during early life program sex differences in adult blood pressure and cardiovascular risk. This review will highlight the potential mechanisms that contribute to the etiology of sex differences in the developmental programming of cardiovascular disease. PMID:24583768

  16. Cardiovascular magnetic resonance in pericardial diseases

    PubMed Central

    Bogaert, Jan; Francone, Marco

    2009-01-01

    The pericardium and pericardial diseases in particular have received, in contrast to other topics in the field of cardiology, relatively limited interest. Today, despite improved knowledge of pathophysiology of pericardial diseases and the availability of a wide spectrum of diagnostic tools, the diagnostic challenge remains. Not only the clinical presentation may be atypical, mimicking other cardiac, pulmonary or pleural diseases; in developed countries a shift for instance in the epidemiology of constrictive pericarditis has been noted. Accurate decision making is crucial taking into account the significant morbidity and mortality caused by complicated pericardial diseases, and the potential benefit of therapeutic interventions. Imaging herein has an important role, and cardiovascular magnetic resonance (CMR) is definitely one of the most versatile modalities to study the pericardium. It fuses excellent anatomic detail and tissue characterization with accurate evaluation of cardiac function and assessment of the haemodynamic consequences of pericardial constraint on cardiac filling. This review focuses on the current state of knowledge how CMR can be used to study the most common pericardial diseases. PMID:19413898

  17. Perceptions of risk: understanding cardiovascular disease.

    PubMed

    Webster, Ruth; Heeley, Emma

    2010-01-01

    Cardiovascular disease (CVD) is still the leading cause of death and disability worldwide despite the availability of well-established and effective preventive options. Accurate perception of a patient's risk by both the patient and the doctors is important as this is one of the components that determine health-related behavior. Doctors tend to not use cardiovascular (CV) risk calculators and underestimate the absolute CV risk of their patients. Patients show optimistic bias when considering their own risk and consistently underestimate it. Poor patient health literacy and numeracy must be considered when thinking about this problem. Patients must possess a reasonably high level of understanding of numerical processes when doctors discuss risk, a level that is not possessed by large numbers of the population. In order to overcome this barrier, doctors need to utilize various tools including the appropriate use of visual aids to accurately communicate risk with their patients. Any intervention has been shown to be better than nothing in improving health understanding. The simple process of repeatedly conveying risk information to a patient has been shown to improve accuracy of risk perception. Doctors need to take responsibility for the accurate assessment and effective communication of CV risk in their patients in order to improve patient uptake of cardioprotective lifestyle choices and preventive medications. PMID:22312218

  18. Access to Care and Cardiovascular Disease Prevention

    PubMed Central

    Alcal, Hctor E.; Albert, Stephanie L.; Roby, Dylan H.; Beckerman, Jacob; Champagne, Philippe; Brookmeyer, Ron; Prelip, Michael L.; Glik, Deborah C.; Inkelas, Moira; Garcia, Rosa-Elenna; Ortega, Alexander N.

    2015-01-01

    Abstract Cardiovascular disease (CVD) is the leading killer of Americans. CVD is understudied among Latinos, who have high levels of CVD risk factors. This study aimed to determine whether access to health care (ie, insurance status and having a usual source of care) is associated with 4 CVD prevention factors (ie, health care utilization, CVD screening, information received from health care providers, and lifestyle factors) among Latino adults and to evaluate whether the associations depended on CVD clinical risk/disease. Data were collected as part of a community-engaged food environment intervention study in East Los Angeles and Boyle Heights, CA. Logistic regressions were fitted with insurance status and usual source of care as predictors of the 4 CVD prevention factors while controlling for demographics. Analyses were repeated with interactions between self-reported CVD clinical risk/disease and access to care measures. Access to health care significantly increased the odds of CVD prevention. Having a usual source of care was associated with all factors of prevention, whereas being insured was only associated with some factors of prevention. CVD clinical risk/disease did not moderate any associations. Although efforts to reduce CVD risk among Latinos through the Affordable Care Act could be impactful, they might have limited impact in curbing CVD among Latinos, via the law's expansion of insurance coverage. CVD prevention efforts must expand beyond the provision of insurance to effectively lower CVD rates. PMID:26313803

  19. Omega-3 fatty acids and cardiovascular disease.

    PubMed

    Jain, A P; Aggarwal, K K; Zhang, P-Y

    2015-01-01

    Cardioceuticals are nutritional supplements that contain all the essential nutrients including vitamins, minerals, omega-3-fatty acids and other antioxidants like a-lipoic acid and coenzyme Q10 in the right proportion that provide all round protection to the heart by reducing the most common risks associated with the cardiovascular disease including high low-density lipoprotein cholesterol and triglyceride levels and factors that contribute to coagulation of blood. Omega-3 fatty acids have been shown to significantly reduce the risk for sudden death caused by cardiac arrhythmias and all-cause mortality in patients with known coronary heart disease. Omega-3 fatty acids are also used to treat hyperlipidemia and hypertension. There are no significant drug interactions with omega-3 fatty acids. The American Heart Association recommends consumption of two servings of fish per week for persons with no history of coronary heart disease and at least one serving of fish daily for those with known coronary heart disease. Approximately 1 g/day of eicosapentaenoic acid plus docosahexaenoic acid is recommended for cardio protection. Higher dosages of omega-3 fatty acids are required to reduce elevated triglyceride levels (2-4 g/day). Modest decreases in blood pressure occur with significantly higher dosages of omega-3 fatty acids. PMID:25720716

  20. Testosterone and cardiovascular disease in men

    PubMed Central

    Morris, Paul D; Channer, Kevin S

    2012-01-01

    Despite regional variations in the prevalence of coronary artery disease (CAD), men are consistently more at risk of developing and dying from CAD than women, and the gender-specific effects of sex hormones are implicated in this inequality. This Perspectives' article reviews the current evidence regarding the cardiovascular effects of testosterone in men including an examination of the age-related decline in testosterone, the relationship between testosterone levels and coronary disease, coronary risk factors and mortality. We also review the vaso-active effects of testosterone, and discuss how these have been used in men with heart failure and angina. We discuss the cause' versus effect' controversy, regarding low testosterone levels in men with coronary heart disease, as well as concerns over the use of testosterone replacement therapy in middle aged and elderly men. The article concludes with a discussion regarding the future direction for work in this interesting area, including the relative merits of screening for, and treating hypogonadism with testosterone replacement therapy in men with heart disease. PMID:22522504

  1. Therapeutic potential of midkine in cardiovascular disease

    PubMed Central

    Kadomatsu, Kenji; Bencsik, Pter; Grbe, Anik; Csonka, Csaba; Sakamoto, Kazuma; Kishida, Satoshi; Ferdinandy, Pter

    2014-01-01

    Ischaemic heart disease, stroke and their pathological consequences are life-threatening conditions that account for about half of deaths in developed countries. Pathology of these diseases includes cell death due to ischaemia/reperfusion injury, vascular stenosis and cardiac remodelling. The growth factor midkine plays a pivotal role in these events. Midkine shows an acute cytoprotective effect in ischaemia/reperfusion injury at least in part via its anti-apoptotic effect. Moreover, while midkine promotes endothelial cell proliferation, it also recruits inflammatory cells to lesions. These activities eventually enhance angiogenesis, thereby preventing cardiac tissue remodelling. However, midkine's activity in recruiting inflammatory cells into the vascular wall also triggers neointima formation, and consequently, vascular stenosis. Moreover, midkine is induced in cancer tissues where it enhances angiogenesis. Therefore, midkine may promote tumour formation through its angiogenic and anti-apoptotic activity. This review focuses on the roles of midkine in ischaemic cardiovascular disease and their pathological consequences, that is angiogenesis, vascular stenosis, and cardiac remodelling, and discusses the possible therapeutic potential of modulation of midkine in these diseases. Linked Articles This article is part of a themed section on Midkine. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2014.171.issue-4 PMID:24286213

  2. The Link Between Obstructive Sleep Apnea and Cardiovascular Disease.

    PubMed

    Bauters, Fr; Rietzschel, Ernst R; Hertegonne, Katrien B C; Chirinos, Julio A

    2016-01-01

    Obstructive sleep apnea (OSA) is common in the general population and highly prevalent in patients with cardiovascular disease. In this paper, we review (1) the pathophysiological mechanisms of OSA that may causally contribute to cardiovascular disease; (2) current evidence regarding the association between OSA and hypertension, stroke, ischemic heart disease, heart failure, atrial fibrillation, and cardiovascular mortality; and (3) the impact of continuous positive airway pressure (CPAP) treatment on cardiovascular risk factors and outcomes. We emphasize the importance of obesity as a comorbidity of OSA and a confounder in the association between OSA and cardiovascular disease. We also discuss the importance of addressing obesity in patients with OSA, as a strategy to reduce the burden of cardiovascular risk factors in this population. Implications for the approach of patients' OSA in clinical practice and future research directions are discussed. PMID:26710793

  3. A Web Based Cardiovascular Disease Detection System.

    PubMed

    Alshraideh, Hussam; Otoom, Mwaffaq; Al-Araida, Aseel; Bawaneh, Haneen; Bravo, Jos

    2015-10-01

    Cardiovascular Disease (CVD) is one of the most catastrophic and life threatening health issue nowadays. Early detection of CVD is an important solution to reduce its devastating effects on health. In this paper, an efficient CVD detection algorithm is identified. The algorithm uses patient demographic data as inputs, along with several ECG signal features extracted automatically through signal processing techniques. Cross-validation results show a 98.29 % accuracy for the decision tree classification algorithm. The algorithm has been integrated into a web based system that can be used at anytime by patients to check their heart health status. At one end of the system is the ECG sensor attached to the patient's body, while at the other end is the detection algorithm. Communication between the two ends is done through an Android application. PMID:26293754

  4. Roles of STATs signaling in cardiovascular diseases

    PubMed Central

    Kishore, Raj; Verma, Suresh K.

    2012-01-01

    In cardiac and many other systems, chronic stress activates avfamily of structurally and functionally conserved receptors and their downstream signaling molecules that entail tyrosine, serine or threonine phosphorylation to transfer the messages to the genetic machinery. However, the activation of the Janus kinases (JAKs) and their downstream signal transducer and activator of transcription (STATs) proteins is both characteristic of and unique to cytokine and growth factor signaling which plays a central role in heart physiology. Dysregulation of JAK-STAT signaling is associated with various cardiovascular diseases. The molecular signaling and specificity of the JAK-STAT pathway are modulated at many levels by distinct regulatory proteins. Here, we review recent studies on the regulation of the STAT signaling pathway that will enhance our ability to design rational therapeutic strategies for stress-induced heart failure. PMID:24058760

  5. New and emerging biomarkers in cardiovascular disease.

    PubMed

    Cahill, Leah E; Bertoia, Monica L; Aroner, Sarah A; Mukamal, Kenneth J; Jensen, Majken K

    2015-11-01

    Cardiovascular disease (CVD) is the most common cause of death and disability worldwide. Therefore, great importance has been placed on the discovery of novel risk factors and metabolic pathways relevant in the prevention and management of CVD. Such research is ongoing and may continue to lead to better risk stratification of individuals and/or the development of new intervention targets and treatment options. This review highlights emerging biomarkers related to lipid metabolism, glycemia, inflammation, and cardiac damage, some of which show promising associations with CVD risk and provide further understanding of the underlying pathophysiology. However, their measurement methodology and assays will require validation and standardization, and it will take time to accumulate evidence of their role in CVD in various population settings in order to fully assess their clinical utility. Several of the novel biomarkers represent intriguing, potentially game-changing targets for therapy. PMID:26370699

  6. Sexual Therapy of Patients with Cardiovascular Disease

    PubMed Central

    Scalzi, Cynthia C.; Golden, Joshua S.; Loya, Fred

    1977-01-01

    Physical illness or disability inevitably has a damaging effect on sexual relationships. Physicians are usually unaware of the sexual consequences of illness on their patients, and lack experience in treating sexual dysfunctions. The report of treatment of a couple with serious cardiovascular disease illustrates the potential efficacy of brief sex therapy for improving the quality of a patient's life. If a primary physician lacks the skills to conduct sex therapy, he may collaborate with nonphysician therapists. The physician's knowledge of the physiological and psychological effects of a specific illness on his patient is essential to successful therapy. Often, simple education, encouragement or reassurance by the physician is enough to overcome the damaging effects of illness on a patient's sex life. PMID:613543

  7. Nutritional Recommendations for Cardiovascular Disease Prevention

    PubMed Central

    Eilat-Adar, Sigal; Sinai, Tali; Yosefy, Chaim; Henkin, Yaakov

    2013-01-01

    Lifestyle factors, including nutrition, play an important role in the etiology of Cardiovascular Disease (CVD). This position paper, written by collaboration between the Israel Heart Association and the Israel Dietetic Association, summarizes the current, preferably latest, literature on the association of nutrition and CVD with emphasis on the level of evidence and practical recommendations. The nutritional information is divided into three main sections: dietary patterns, individual food items, and nutritional supplements. The dietary patterns reviewed include low carbohydrate diet, low-fat diet, Mediterranean diet, and the DASH diet. Foods reviewed in the second section include: whole grains and dietary fiber, vegetables and fruits, nuts, soy, dairy products, alcoholic drinks, coffee and caffeine, tea, chocolate, garlic, and eggs. Supplements reviewed in the third section include salt and sodium, omega-3 and fish oil, phytosterols, antioxidants, vitamin D, magnesium, homocysteine-reducing agents, and coenzyme Q10. PMID:24067391

  8. Nutritional recommendations for cardiovascular disease prevention.

    PubMed

    Eilat-Adar, Sigal; Sinai, Tali; Yosefy, Chaim; Henkin, Yaakov

    2013-09-01

    Lifestyle factors, including nutrition, play an important role in the etiology of Cardiovascular Disease (CVD). This position paper, written by collaboration between the Israel Heart Association and the Israel Dietetic Association, summarizes the current, preferably latest, literature on the association of nutrition and CVD with emphasis on the level of evidence and practical recommendations. The nutritional information is divided into three main sections: dietary patterns, individual food items, and nutritional supplements. The dietary patterns reviewed include low carbohydrate diet, low-fat diet, Mediterranean diet, and the DASH diet. Foods reviewed in the second section include: whole grains and dietary fiber, vegetables and fruits, nuts, soy, dairy products, alcoholic drinks, coffee and caffeine, tea, chocolate, garlic, and eggs. Supplements reviewed in the third section include salt and sodium, omega-3 and fish oil, phytosterols, antioxidants, vitamin D, magnesium, homocysteine-reducing agents, and coenzyme Q10. PMID:24067391

  9. Dietary fibre, nuts and cardiovascular diseases.

    PubMed

    Salas-Salvad, Jordi; Bull, Mnica; Prez-Heras, Ana; Ros, Emilio

    2006-11-01

    Dietary fibre has a range of metabolic health benefits. Through a variety of mechanisms, dietary fibre, and the viscous variety in particular, slows down gastric emptying and intestinal transit, decreases the rate of intestinal carbohydrate absorption, and increases faecal bile acid excretion. Therefore, consumption of some types of soluble fibre can enhance satiety, which is associated with a lower BMI, and reduce blood cholesterol and the postprandial glucose response. Surprisingly, the consumption of insoluble fibre from whole grains, though metabolically inert, has been associated with a reduction in the risk of developing coronary heart disease and diabetes in epidemiological studies. The likely reason is that whole grains, like nuts, legumes and other edible seeds, contain many bioactive phytochemicals and various antioxidants. After cereals, nuts are the vegetable foods that are richest in fibre, which may partly explain their benefit on the lipid profile and cardiovascular health. PMID:17125533

  10. Prevention of cardiovascular disease in rheumatoid arthritis.

    PubMed

    Hollan, I; Dessein, P H; Ronda, N; Wasko, M C; Svenungsson, E; Agewall, S; Cohen-Tervaert, J W; Maki-Petaja, K; Grundtvig, M; Karpouzas, G A; Meroni, P L

    2015-10-01

    The increased risk of cardiovascular disease (CVD) in rheumatoid arthritis (RA) has been recognized for many years. However, although the characteristics of CVD and its burden resemble those in diabetes, the focus on cardiovascular (CV) prevention in RA has lagged behind, both in the clinical and research settings. Similar to diabetes, the clinical picture of CVD in RA may be atypical, even asymptomatic. Therefore, a proactive screening for subclinical CVD in RA is warranted. Because of the lack of clinical trials, the ideal CVD prevention (CVP) in RA has not yet been defined. In this article, we focus on challenges and controversies in the CVP in RA (such as thresholds for statin therapy), and propose recommendations based on the current evidence. Due to the significant contribution of non-traditional, RA-related CV risk factors, the CV risk calculators developed for the general population underestimate the true risk in RA. Thus, there is an enormous need to develop adequate CV risk stratification tools and to identify the optimal CVP strategies in RA. While awaiting results from randomized controlled trials in RA, clinicians are largely dependent on the use of common sense, and extrapolation of data from studies on other patient populations. The CVP in RA should be based on an individualized evaluation of a broad spectrum of risk factors, and include: 1) reduction of inflammation, preferably with drugs decreasing CV risk, 2) management of factors associated with increased CV risk (e.g., smoking, hypertension, hyperglycemia, dyslipidemia, kidney disease, depression, periodontitis, hypothyroidism, vitamin D deficiency and sleep apnea), and promotion of healthy life style (smoking cessation, healthy diet, adjusted physical activity, stress management, weight control), 3) aspirin and influenza and pneumococcus vaccines according to current guidelines, and 4) limiting use of drugs that increase CV risk. Rheumatologists should take responsibility for the education of health care providers and RA patients regarding CVP in RA. It is immensely important to incorporate CV outcomes in testing of anti-rheumatic drugs. PMID:26117596

  11. Mechanisms Linking Red Blood Cell Disorders and Cardiovascular Diseases

    PubMed Central

    2015-01-01

    The present paper aims to review the main pathophysiological links between red blood cell disorders and cardiovascular diseases, provides a brief description of the latest studies in this area, and considers implications for clinical practice and therapy. Anemia is associated with a special risk in proatherosclerotic conditions and heart disease and became a new therapeutic target. Guidelines must be updated for the management of patients with red blood cell disorders and cardiovascular diseases, and targets for hemoglobin level should be established. Risk scores in several cardiovascular diseases should include red blood cell count and RDW. Complete blood count and hemorheological parameters represent useful, inexpensive, widely available tools for the management and prognosis of patients with coronary heart disease, heart failure, hypertension, arrhythmias, and stroke. Hypoxia and iron accumulation cause the most important cardiovascular effects of sickle cell disease and thalassemia. Patients with congenital chronic hemolytic anemia undergoing splenectomy should be monitored, considering thromboembolic and cardiovascular risk. PMID:25710019

  12. CT angiography in the diagnosis of cardiovascular disease: a transformation in cardiovascular CT practice

    PubMed Central

    Al Moudi, Mansour; Cao, Yan

    2014-01-01

    Computed tomography (CT) angiography represents the most important technical development in CT imaging and it has challenged invasive angiography in the diagnostic evaluation of cardiovascular abnormalities. Over the last decades, technological evolution in CT imaging has enabled CT angiography to become a first-line imaging modality in the diagnosis of cardiovascular disease. This review provides an overview of the diagnostic applications of CT angiography (CTA) in cardiovascular disease, with a focus on selected clinical challenges in some common cardiovascular abnormalities, which include abdominal aortic aneurysm (AAA), aortic dissection, pulmonary embolism (PE) and coronary artery disease. An evidence-based review is conducted to demonstrate how CT angiography has changed our approach in the diagnosis and management of cardiovascular disease. Radiation dose reduction strategies are also discussed to show how CT angiography can be performed in a low-dose protocol in the current clinical practice. PMID:25392823

  13. Network Topology Reveals Key Cardiovascular Disease Genes

    PubMed Central

    Stojković, Neda; Radak, Djordje; Pržulj, Nataša

    2013-01-01

    The structure of protein-protein interaction (PPI) networks has already been successfully used as a source of new biological information. Even though cardiovascular diseases (CVDs) are a major global cause of death, many CVD genes still await discovery. We explore ways to utilize the structure of the human PPI network to find important genes for CVDs that should be targeted by drugs. The hope is to use the properties of such important genes to predict new ones, which would in turn improve a choice of therapy. We propose a methodology that examines the PPI network wiring around genes involved in CVDs. We use the methodology to identify a subset of CVD-related genes that are statistically significantly enriched in drug targets and “driver genes.” We seek such genes, since driver genes have been proposed to drive onset and progression of a disease. Our identified subset of CVD genes has a large overlap with the Core Diseasome, which has been postulated to be the key to disease formation and hence should be the primary object of therapeutic intervention. This indicates that our methodology identifies “key” genes responsible for CVDs. Thus, we use it to predict new CVD genes and we validate over 70% of our predictions in the literature. Finally, we show that our predicted genes are functionally similar to currently known CVD drug targets, which confirms a potential utility of our methodology towards improving therapy for CVDs. PMID:23977067

  14. Functional Foods as Modifiers of Cardiovascular Disease

    PubMed Central

    Johnston, Carol

    2009-01-01

    There is growing consensus that systemic inflammation is at the heart of cardiovascular disease (CVD). Inflammation is a key feature of the immune system, functioning to defend tissue integrity and function. However, chronic stimulation of inflammatory mediators leads to lasting vascular reactivity, insulin resistance, hyperlipidemia, and, subsequently, chronic disease. Dietary practices to minimize inflammatory stimuli and CVD risk include regular intakes of fatty fish rich in the eicosapentaenoic and docosahexaenoic acids that compete with the more pervasive membrane fatty acid, arachidonic acid, disrupting the metabolic cascades that stimulate inflammation. Another effective dietary strategy is to consume less arachidonic acid by reducing beef, poultry, fish, and eggs from the diet (e.g., adopting a vegetarian-like diet). Since oxidative stress plays a prominent role in immune system activation, regular ingestion of ample amounts of fruits and vegetables (8+ servings/d) rich in antioxidant compounds, the polyphenols, carotenoids, and vitamin C (e.g., citrus, tomatoes, berries, carrots, and greens), lowers inflammatory mediators and risk for chronic disease. Whole grains, legumes, and nuts have also been demonstrated in clinical trials to effectively reduce inflammatory mediators and risk for CVD. Hence, as proclaimed in antiquity, let food be thy medicine and medicine be thy food. PMID:20368755

  15. Cardiovascular disease in lupus: insights and updates

    PubMed Central

    Knight, Jason S.; Kaplan, Mariana J.

    2014-01-01

    Purpose of review With improved management of the classical disease manifestations of systemic lupus erythematosus (SLE), cardiovascular disease (CVD) has emerged as one of the most important causes of morbidity and mortality. This review in particular focuses on progress over the past year in clinical and basic aspects of SLE-driven accelerated atherosclerosis. Recent findings Both subclinical CVD and CV events continue to be recognized at increased frequency in previously unstudied lupus cohorts and populations. Novel associations have been identified between lupus CVD and cognitive impairment, depression, and low income status. In terms of pathogenesis, there is an ever-increasing focus on the innate immune system and, in particular, type I interferons (IFNs). Recent studies have drawn connections in both human and murine models between neutrophils, plasmacytoid dendritic cells, type I IFNs, and endothelial dysfunction. Whether treatments such as mycophenolate mofetil or statins have a role in prevention of lupus CVD is an area of intensive study. Summary CVD is a major complication of lupus and is now a leading cause of death among people living with this disease. As such, additional studies are needed in order to identify the most effective preventive strategies and most predictive vascular risk biomarkers. Type I IFNs may play a critical role in lupus CVD pathogenesis, and it is recommended that vascular outcomes be included in ongoing trials testing the efficacy of anti-IFN biologics. PMID:23846339

  16. Marital History and the Burden of Cardiovascular Disease in Midlife

    ERIC Educational Resources Information Center

    Zhang, Zhenmei

    2006-01-01

    This study examines the effects of marital history on the burden of cardiovascular disease in midlife. With use of data from the 1992 Health and Retirement Study, a series of nested logistic regression models was used to estimate the association between marital history and the likelihood of cardiovascular disease. Results suggest that, in midlife,

  17. Health-Related Quality of Life in Cardiovascular Disease.

    ERIC Educational Resources Information Center

    Kaplan, Robert M.

    1988-01-01

    Reviews several current approaches to the assessment of health outcomes in cardiovascular disease, including health-related quality of life. Offers a general health policy model as a method for comparing program options in cardiovascular disease that may have very different objectives. Uses examples from hypertension screening and treatment, heart

  18. Marital History and the Burden of Cardiovascular Disease in Midlife

    ERIC Educational Resources Information Center

    Zhang, Zhenmei

    2006-01-01

    This study examines the effects of marital history on the burden of cardiovascular disease in midlife. With use of data from the 1992 Health and Retirement Study, a series of nested logistic regression models was used to estimate the association between marital history and the likelihood of cardiovascular disease. Results suggest that, in midlife,…

  19. Cardiovascular disease and cognitive function in maintenance hemodialysis patients

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Cardiovascular disease (CVD) and cognitive impairment are common in dialysis patients. Given the proposed role of microvascular disease on cognitive function, particularly cognitive domains that incorporate executive functions, we hypothesized that prevalent systemic CVD would be associated with wor...

  20. A speedy cardiovascular diseases classifier using multiple criteria decision analysis.

    PubMed

    Lee, Wah Ching; Hung, Faan Hei; Tsang, Kim Fung; Tung, Hoi Ching; Lau, Wing Hong; Rakocevic, Veselin; Lai, Loi Lei

    2015-01-01

    Each year, some 30 percent of global deaths are caused by cardiovascular diseases. This figure is worsening due to both the increasing elderly population and severe shortages of medical personnel. The development of a cardiovascular diseases classifier (CDC) for auto-diagnosis will help address solve the problem. Former CDCs did not achieve quick evaluation of cardiovascular diseases. In this letter, a new CDC to achieve speedy detection is investigated. This investigation incorporates the analytic hierarchy process (AHP)-based multiple criteria decision analysis (MCDA) to develop feature vectors using a Support Vector Machine. The MCDA facilitates the efficient assignment of appropriate weightings to potential patients, thus scaling down the number of features. Since the new CDC will only adopt the most meaningful features for discrimination between healthy persons versus cardiovascular disease patients, a speedy detection of cardiovascular diseases has been successfully implemented. PMID:25587978

  1. Anaphylaxis and cardiovascular disease: therapeutic dilemmas.

    PubMed

    Lieberman, P; Simons, F E R

    2015-08-01

    Cardiovascular disease (CVD) increases the risk of severe or fatal anaphylaxis, and some medications for CVD treatment can exacerbate anaphylaxis. The aim of this article is to review the effect of anaphylaxis on the heart, the potential impact of medications for CVD on anaphylaxis and anaphylaxis treatment, and the cardiovascular effects of epinephrine. The therapeutic dilemmas arising from these issues are also discussed and management strategies proposed. PubMed searches were performed for the years 1990-2014 inclusive, using terms such as angiotensin-converting enzyme (ACE) inhibitors, adrenaline, allergic myocardial infarction, anaphylaxis, angiotensin-receptor blockers (ARBs), beta-adrenergic blockers, epinephrine, and Kounis syndrome. Literature analysis indicated that: cardiac mast cells are key constituents of atherosclerotic plaques; mast cell mediators play an important role in acute coronary syndrome (ACS); patients with CVD are at increased risk of developing severe or fatal anaphylaxis; and medications for CVD treatment, including beta-adrenergic blockers and ACE inhibitors, potentially exacerbate anaphylaxis or make it more difficult to treat. Epinephrine increases myocardial contractility, decreases the duration of systole relative to diastole, and enhances coronary blood flow. Its transient adverse effects include pallor, tremor, anxiety, and palpitations. Serious adverse effects (including ventricular arrhythmias and hypertension) are rare, and are significantly more likely after intravenous injection than after intramuscular injection. Epinephrine is life-saving in anaphylaxis; second-line medications (including antihistamines and glucocorticoids) are not. In CVD patients (especially those with ACS), the decision to administer epinephrine for anaphylaxis can be difficult, and its benefits and potential harms need to be carefully considered. Concerns about potential adverse effects need to be weighed against concerns about possible death from untreated anaphylaxis, but there is no absolute contraindication to epinephrine injection in anaphylaxis. PMID:25711241

  2. Computational Fluid Dynamics in Cardiovascular Disease

    PubMed Central

    2011-01-01

    Computational fluid dynamics (CFD) is a mechanical engineering field for analyzing fluid flow, heat transfer, and associated phenomena, using computer-based simulation. CFD is a widely adopted methodology for solving complex problems in many modern engineering fields. The merit of CFD is developing new and improved devices and system designs, and optimization is conducted on existing equipment through computational simulations, resulting in enhanced efficiency and lower operating costs. However, in the biomedical field, CFD is still emerging. The main reason why CFD in the biomedical field has lagged behind is the tremendous complexity of human body fluid behavior. Recently, CFD biomedical research is more accessible, because high performance hardware and software are easily available with advances in computer science. All CFD processes contain three main components to provide useful information, such as pre-processing, solving mathematical equations, and post-processing. Initial accurate geometric modeling and boundary conditions are essential to achieve adequate results. Medical imaging, such as ultrasound imaging, computed tomography, and magnetic resonance imaging can be used for modeling, and Doppler ultrasound, pressure wire, and non-invasive pressure measurements are used for flow velocity and pressure as a boundary condition. Many simulations and clinical results have been used to study congenital heart disease, heart failure, ventricle function, aortic disease, and carotid and intra-cranial cerebrovascular diseases. With decreasing hardware costs and rapid computing times, researchers and medical scientists may increasingly use this reliable CFD tool to deliver accurate results. A realistic, multidisciplinary approach is essential to accomplish these tasks. Indefinite collaborations between mechanical engineers and clinical and medical scientists are essential. CFD may be an important methodology to understand the pathophysiology of the development and progression of disease and for establishing and creating treatment modalities in the cardiovascular field. PMID:21949524

  3. Cardiovascular biomarkers in acute Kawasaki disease

    PubMed Central

    Sato, Yuichiro Z.; Molkara, Delaram P.; Daniels, Lori B.; Tremoulet, Adriana H.; Shimizu, Chisato; Kanegaye, John T.; Best, Brookie M.; Snider, James V.; Frazer, Jeffrey R.; Maisel, Alan; Burns, Jane C.

    2011-01-01

    Background Endomycocardial biopsies have demonstrated that subclinical myocarditis is a universal feature of acute Kawasaki disease (KD). Methods We investigated biochemical evidence of myocardial strain, oxidative stress, and cardiomyocyte injury in 55 acute KD subjects (30 with paired convalescent samples), 54 febrile control (FC), and 50 healthy control (HC) children by measuring concentrations of cardiovascular biomarkers. Results Levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and soluble ST2 (sST2) were elevated in acute vs. convalescent KD, FC, and HC (p≤0.0002), while γ-glutamyl transferase and alanine amino transferase as measures of oxidative stress were increased in acute vs. FC (p≤0.0008). Cardiac troponin I (cTnI) levels, using a highly sensitive assay, were elevated in 30% and 40% of paired acute and convalescent KD subjects, respectively, and normalized within two years of disease onset. NT-proBNP and sST2 negatively correlated with measures of diastolic function (MV E:A ratio and deceleration time), but only NT-proBNP positively correlated with the coronary artery Z score. Conclusions NT-proBNP and sST2 were elevated in acute KD subjects and correlated with impaired myocardial relaxation. These findings, combined with elevated levels of cTnI, suggest that both cardiomyocyte stress and cell death are associated with myocardial inflammation in acute KD. PMID:21777987

  4. Lipoprotein(a) in Cardiovascular Diseases

    PubMed Central

    Malaguarnera, Michele; Vacante, Marco; Russo, Cristina; Malaguarnera, Giulia; Antic, Tijana; Malaguarnera, Lucia; Bella, Rita; Pennisi, Giovanni; Galvano, Fabio; Frigiola, Alessandro

    2013-01-01

    Lipoprotein(a) (Lp(a)) is an LDL-like molecule consisting of an apolipoprotein B-100 (apo(B-100)) particle attached by a disulphide bridge to apo(a). Many observations have pointed out that Lp(a) levels may be a risk factor for cardiovascular diseases. Lp(a) inhibits the activation of transforming growth factor (TGF) and contributes to the growth of arterial atherosclerotic lesions by promoting the proliferation of vascular smooth muscle cells and the migration of smooth muscle cells to endothelial cells. Moreover Lp(a) inhibits plasminogen binding to the surfaces of endothelial cells and decreases the activity of fibrin-dependent tissue-type plasminogen activator. Lp(a) may act as a proinflammatory mediator that augments the lesion formation in atherosclerotic plaques. Elevated serum Lp(a) is an independent predictor of coronary artery disease and myocardial infarction. Furthermore, Lp(a) levels should be a marker of restenosis after percutaneous transluminal coronary angioplasty, saphenous vein bypass graft atherosclerosis, and accelerated coronary atherosclerosis of cardiac transplantation. Finally, the possibility that Lp(a) may be a risk factor for ischemic stroke has been assessed in several studies. Recent findings suggest that Lp(a)-lowering therapy might be beneficial in patients with high Lp(a) levels. A future therapeutic approach could include apheresis in high-risk patients in order to reduce major coronary events. PMID:23484137

  5. Chemerin in renal dysfunction and cardiovascular disease.

    PubMed

    Bonomini, Mario; Pandolfi, Assunta

    2016-02-01

    The potential involvement of chemerin in cardiovascular and renal dysfunction has recently been acknowledged. There are indeed many links between this protein and inflammation, atherosclerosis, and multiple obesity- and diabetes-related parameters such as body mass index, insulin resistance, and blood levels of insulin, cholesterol, triglycerides, and glucose. In addition, in the last few years, several reports have investigated the circulating chemerin levels and their pathophysiologic significance in chronic kidney disease populations. However, there are still gaps in our understanding of this matter, in particular as to whether elevated chemerin might be the cause behind, or simply mirror, a reduced renal function. The limitations of the present knowledge on chemerin may partly relate to the lack of specific antibodies for assessing the different active isoforms of the protein. Measuring its bioactive serum concentration, and achieving a precise overall pattern of the tissue-specific formation of different isoforms, with the use of suitable technology, will ultimately help define the role of chemerin in disease pathophysiology, or as a diagnostic or therapeutic marker. PMID:26545628

  6. A legal framework for preventing cardiovascular diseases.

    PubMed

    Perdue, Wendy C; Mensah, George A; Goodman, Richard A; Moulton, Anthony D

    2005-12-01

    Cardiovascular diseases are major contributors to death, disability, disparities, and reduced quality of life in the United States. Successful prevention and control of these diseases requires a comprehensive approach applied across multiple public health settings and in all life stages. Individual lifestyle and behavior change, as well as the broader social, environmental, and policy changes that enable healthy lifestyles, are necessary. Legal strategies can be powerful tools in this endeavor. This review presents seven such strategies applicable at the federal, state, and local levels that can be employed by healthcare providers, public health practitioners, legislators, and other policymakers. They include direct regulation, economic incentives and disincentives, indirect regulation through private enforcement, government as information provider, government as direct provider of services, government as employer and landlord, and laws directed at other levels of government. These strategies may be accomplished through legislation or administrative changes in practices or procedures. Effective use of these strategies requires a broader understanding of the advantages and limitations of legal frameworks and the importance of tailoring strategies to local conditions and resources. Examples of key roles that health professionals can play in advancing such an understanding are presented. PMID:16389140

  7. Type 1 diabetes and cardiovascular disease.

    PubMed

    Schnell, Oliver; Cappuccio, Francesco; Genovese, Stefano; Standl, Eberhard; Valensi, Paul; Ceriello, Antonio

    2013-01-01

    The presence of cardiovascular disease (CVD) in Type 1 diabetes largely impairs life expectancy. Hyperglycemia leading to an increase in oxidative stress is considered to be the key pathophysiological factor of both micro- and macrovascular complications. In Type 1 diabetes, the presence of coronary calcifications is also related to coronary artery disease. Cardiac autonomic neuropathy, which significantly impairs myocardial function and blood flow, also enhances cardiac abnormalities. Also hypoglycemic episodes are considered to adversely influence cardiac performance. Intensive insulin therapy has been demonstrated to reduce the occurrence and progression of both micro- and macrovascular complications. This has been evidenced by the Diabetes Control and Complications Trial (DCCT) / Epidemiology of Diabetes Interventions and Complications (EDIC) study. The concept of a metabolic memory emerged based on the results of the study, which established that intensified insulin therapy is the standard of treatment of Type 1 diabetes. Future therapies may also include glucagon-like peptide (GLP)-based treatment therapies. Pilot studies with GLP-1-analogues have been shown to reduce insulin requirements. PMID:24165454

  8. Diabetes Mellitus, Arterial Wall, and Cardiovascular Risk Assessment

    PubMed Central

    Kozakova, Michaela; Palombo, Carlo

    2016-01-01

    Diabetes mellitus is an independent risk factor for atherothrombotic cardiovascular disease. Adults with diabetes are two to four times more likely to develop heart disease or stroke than adults without diabetes. The two major features of diabetes, i.e., hyperglycemia and insulin-resistance, trigger arterial stiffening and increase the susceptibility of the arterial wall to atherosclerosis at any given age. These pathological changes in the arterial wall may provide a functional and structural background for cardiovascular events. The present paper provides a critical overview of the clinical evidence linking diabetes-related metabolic abnormalities to cardiovascular risk, debates the pathophysiologic mechanisms through which insulin resistance and hyperglycemia may affect the arterial wall, and discusses the associations between vascular biomarkers, metabolic abnormalities and cardiovascular events. PMID:26861377

  9. Diabetes Mellitus, ArterialWall, and Cardiovascular Risk Assessment.

    PubMed

    Kozakova, Michaela; Palombo, Carlo

    2016-01-01

    Diabetes mellitus is an independent risk factor for atherothrombotic cardiovascular disease. Adults with diabetes are two to four times more likely to develop heart disease or stroke than adults without diabetes. The two major features of diabetes, i.e., hyperglycemia and insulin-resistance, trigger arterial stiffening and increase the susceptibility of the arterial wall to atherosclerosis at any given age. These pathological changes in the arterial wall may provide a functional and structural background for cardiovascular events. The present paper provides a critical overview of the clinical evidence linking diabetes-related metabolic abnormalities to cardiovascular risk, debates the pathophysiologic mechanisms through which insulin resistance and hyperglycemia may affect the arterial wall, and discusses the associations between vascular biomarkers, metabolic abnormalities and cardiovascular events. PMID:26861377

  10. Positive emotion and cardiovascular disease in elderly people

    PubMed Central

    Ma, Lina; Li, Yun; Feng, Ming

    2015-01-01

    Cardiovascular disease in elderly people is a psychosomatic disease, but the research on the relationship between positive emotion and cardiovascular diseases is few. Most previous studies have focused on a range of health status changes caused by negative emotion but have ignored the role of positive emotion in elderly people. Positive emotion has been considered a protective factor against health problems in elderly people. Research shows that a significant relationship between positive emotion and blood pressure remains after adjusting for depression in elderly people. In this paper, we summarize the relationship between positive emotion and cardiovascular diseases in elderly people. PMID:26221206

  11. Acute exacerbation of chronic obstructive pulmonary disease: cardiovascular links.

    PubMed

    Laratta, Cheryl R; van Eeden, Stephan

    2014-01-01

    Chronic obstructive pulmonary disease (COPD) is a chronic, progressive lung disease resulting from exposure to cigarette smoke, noxious gases, particulate matter, and air pollutants. COPD is exacerbated by acute inflammatory insults such as lung infections (viral and bacterial) and air pollutants which further accelerate the steady decline in lung function. The chronic inflammatory process in the lung contributes to the extrapulmonary manifestations of COPD which are predominantly cardiovascular in nature. Here we review the significant burden of cardiovascular disease in COPD and discuss the clinical and pathological links between acute exacerbations of COPD and cardiovascular disease. PMID:24724085

  12. Acute Exacerbation of Chronic Obstructive Pulmonary Disease: Cardiovascular Links

    PubMed Central

    Laratta, Cheryl R.; van Eeden, Stephan

    2014-01-01

    Chronic obstructive pulmonary disease (COPD) is a chronic, progressive lung disease resulting from exposure to cigarette smoke, noxious gases, particulate matter, and air pollutants. COPD is exacerbated by acute inflammatory insults such as lung infections (viral and bacterial) and air pollutants which further accelerate the steady decline in lung function. The chronic inflammatory process in the lung contributes to the extrapulmonary manifestations of COPD which are predominantly cardiovascular in nature. Here we review the significant burden of cardiovascular disease in COPD and discuss the clinical and pathological links between acute exacerbations of COPD and cardiovascular disease. PMID:24724085

  13. Endurance exercise and resistance training in cardiovascular disease.

    PubMed

    Meka, Naga; Katragadda, Srikanth; Cherian, Biju; Arora, Rohit R

    2008-04-01

    Contrary to the age old taboo of exercise in cardiac patients, resistance training has been gaining importance recently as a safe, healthy fitness option in prevention of cardiovascular diseases, the leading killer disease in the population above 45 years in the United States. Endurance or aerobic exercise helps improve overall stamina and the ability of the heart to pump oxygenated blood in those with and without prior cardiovascular disease. In addition to modifying cardiovascular risks, resistance training has profound beneficial effects on improving muscle strength and endurance, preventing osteoporosis and improving quality of life both in the healthy and cardiovascular patients including women and heart failure patients. So resistance training should be regarded as a complementary fitness program rather that a substitute to endurance training. This review discusses the physiological phenomenon and benefits of exercise training programs on cardiovascular disease patients focusing on endurance exercise and resistance training. PMID:19124415

  14. HIV Infection and Cardiovascular Disease in Women

    PubMed Central

    Womack, Julie A.; Chang, Chung?Chou H.; So?Armah, Kaku A.; Alcorn, Charles; Baker, Jason V.; Brown, Sheldon T.; Budoff, Matthew; Butt, Adeel A.; Gibert, Cynthia; Goetz, Matthew Bidwell; Gottdiener, John; Gottlieb, Stephen; Justice, Amy C.; Leaf, David; McGinnis, Kathleen; Rimland, David; Rodriguez?Barradas, Maria C.; Sico, Jason; Skanderson, Melissa; Tindle, Hilary; Tracy, Russell P.; Warner, Alberta; Freiberg, Matthew S.

    2014-01-01

    Background HIV infection is associated with increased risk of cardiovascular disease (CVD) in men. Whether HIV is an independent risk factor for CVD in women has not yet been established. Methods and Results We analyzed data from the Veterans Aging Cohort Study on 2187 women (32% HIV infected [HIV+]) who were free of CVD at baseline. Participants were followed from their first clinical encounter on or after April 01, 2003 until a CVD event, death, or the last follow?up date (December 31, 2009). The primary outcome was CVD (acute myocardial infarction [AMI], unstable angina, ischemic stroke, and heart failure). CVD events were defined using clinical data, International Classification of Diseases, Ninth Revision, Clinical Modification codes, and/or death certificate data. We used Cox proportional hazards models to assess the association between HIV and incident CVD, adjusting for age, race/ethnicity, lipids, smoking, blood pressure, diabetes, renal disease, obesity, hepatitis C, and substance use/abuse. Median follow?up time was 6.0 years. Mean age at baseline of HIV+ and HIV uninfected (HIV?) women was 44.0 versus 43.2 years (P<0.05). Median time to CVD event was 3.1 versus 3.7 years (P=0.11). There were 86 incident CVD events (53%, HIV+): AMI, 13%; unstable angina, 8%; ischemic stroke, 22%; and heart failure, 57%. Incident CVD/1000 person?years was significantly higher among HIV+ (13.5; 95% confidence interval [CI]=10.1, 18.1) than HIV? women (5.3; 95% CI=3.9, 7.3; P<0.001). HIV+ women had an increased risk of CVD, compared to HIV? (hazard ratio=2.8; 95% CI=1.7, 4.6; P<0.001). Conclusions HIV is associated with an increased risk of CVD in women. PMID:25324353

  15. Lifestyle decreases risk factors for cardiovascular diseases.

    PubMed

    Slavcek, Jaroslav; Kittnar, Otomar; Fraser, Gary E; Medov, Eva; Konecn, Jana; Zizka, Robert; Dohnalov, Alena; Novk, Vladimir

    2008-12-01

    The morbidity and mortality of cardiovascular diseases is high in the developed countries. The lifestyle changes are capable to decrease it by 50%. The aim of the present study was to measure the parameters of some risk factors before and after a one-week NEW START rehabilitative retreat. 1349 volunteers, 320 men, 1029 woman, mean age 51 +/- 14.5 (SD) years participated in 30 rehabilitative retreats from 1999-2006 in the Czech Republic, using a low-fat, low-energy, lacto-ovo-vegetarian diet and exercise, in a stress-free environment. Body weight, height, BMI, blood pressure, heart rate, serum cholesterol and blood glucose were measured. Body weight decreased in 1223 measured persons from 71.2 +/- 14.38 (SD) to 70.6 +/- 14.02 kg (p<0.0001), BMI (1,046 measured persons) from 25.1 +/- 4.60 (SD) to 24.8+4.49 (SD) kg/m2 (p<0.0001), systolic blood pressure (1,218 persons) from 129.8 +/- 23.02 (SD) to 123.8 +/- 21.52 (SD) mmHg (p<0.0001), diastolic blood pressure (1210 persons) from 79.8 +/- 12.7 (SD) to 77.5 +/- 11.6 (SD) mmHg (p<0.0001), serum cholesterol (998 persons) from 4.86 +/- 0.95 (SD) to 4.32 +/- 0.77 (SD) mmol (p<0.0001), blood glucose (544 persons) from 4.31 +/- 1.59 (SD) to 3.88 +/- 1.33 (SD) mmol (p<0.0001). Heart rate was not significantly decreased. The parameters were lower in lacto-ovo vegetarians and Seventh-day Adventists than in controls who never observed the diet and avail the lifestyle programs. The parameters were nonsignificantly changed one year after finishing the retreat in the sample of 68 persons showing the positive effect of retreats. Our results showed, that the intake of a low-fat, low-energy diet, over the course of one week in a stress-free environment, had positive impact on the risk factors of cardiovascular diseases. PMID:19256282

  16. Relationship between vitamin D deficiency and cardiovascular disease

    PubMed Central

    Ku, Yan-Chiou; Liu, Mu-En; Ku, Chang-Sheng; Liu, Ta-Yuan; Lin, Shoa-Lin

    2013-01-01

    Epidemiological studies have found that low 25-hydroxyvitamin D levels may be associated with coronary risk factors and adverse cardiovascular outcomes. Additionally, vitamin D deficiency causes an increase in parathyroid hormone, which increases insulin resistance and is associated with diabetes, hypertension, inflammation, and increased cardiovascular risk. In this review, we analyze the association between vitamin D supplementation and the reduction in cardiovascular disease. The role of vitamin D deficiency in cardiovascular morbidity and mortality is still controversial, and larger scale, randomized placebo controlled trials are needed to investigate whether oral vitamin D supplementation can reduce cardiovascular risk. Given the low cost, safety, and demonstrated benefit of higher 25-hydroxyvitamin D levels, vitamin D supplementation should become a public health priority for combating common and costly chronic cardiovascular diseases. PMID:24109497

  17. Genetic risk factors and Mendelian randomization in cardiovascular disease.

    PubMed

    Swerdlow, Daniel I; Hingorani, Aroon D; Humphries, Steve E

    2015-05-01

    Cardiovascular disease encompasses several diverse pathological states that place a heavy burden on individual and population health. The aetiological basis of many cardiovascular disorders is not fully understood. Growing knowledge of the genetic architecture underlying coronary heart disease, stroke, cardiac arrhythmias and peripheral vascular disease has confirmed some suspected causal pathways in these conditions but also uncovered many previously unknown mechanisms. Here, we consider the contribution of genetics to the understanding of cardiovascular disease risk. We evaluate the utility and relevance of findings from genome-wide association studies and explore the role that Mendelian randomisation has to play in exploiting these. Mendelian randomisation permits robust causal inference in an area of research where this has been hampered by bias and confounding in observational studies. In doing so, it provides evidence for causal processes in cardiovascular disease that could represent novel targets for much-needed new drugs for disease prevention and treatment. PMID:25894797

  18. Angiotensin II receptors and drug discovery in cardiovascular disease

    PubMed Central

    Dasgupta, Chiranjib; Zhang, Lubo

    2010-01-01

    Hypertension is a syndrome beyond high blood pressure alone. Hypertension is one of the cardiovascular diseases that may cause cardiovascular remodeling and endothelial dysfunction. Angiotensin II type 1 (AT1R) and type 2 (AT2R) receptors are expressed in most organs and tissues and are implicated in hypertension, endothelial dysfunction, and cardiovascular diseases. Genetic and epigenetic manipulations of the renin angiotensin system play a critical role in programming of cardiovascular diseases, and certain variants of AT1R and AT2R are constitutively predisposed to higher cardiovascular risk and hypertension. The structure-function relationship of angiotensin receptors has been reviewed previously. So, in this review we focused on the structure, expression of angiotensin II receptors, their mode of action, role in cardiovascular pathobiology, and how cardiovascular diseases are programmed in utero. In addition, we described genetic variants of angiotensin receptors, and also discussed possible ways of therapeutic intervensions of Ang II stimulation. Collectively, this information may lead us to future new drug design against cardiovascular diseases. PMID:21147255

  19. Tuberculosis and Cardiovascular Disease: Linking the Epidemics

    PubMed Central

    Huaman, Moises A.; Henson, David; Ticona, Eduardo; Sterling, Timothy R.; Garvy, Beth A.

    2016-01-01

    The burden of tuberculosis and cardiovascular disease (CVD) is enormous worldwide. CVD rates are rapidly increasing in low- and middle-income countries. Public health programs have been challenged with the overlapping tuberculosis and CVD epidemics. Monocyte/macrophages, lymphocytes and cytokines involved in cellular mediated immune responses against Mycobacterium tuberculosis are also main drivers of atherogenesis, suggesting a potential pathogenic role of tuberculosis in CVD via mechanisms that have been described for other pathogens that establish chronic infection and latency. Studies have shown a pro-atherogenic effect of antibody-mediated responses against mycobacterial heat shock protein-65 through cross reaction with self-antigens in human vessels. Furthermore, subsets of mycobacteria actively replicate during latent tuberculosis infection (LTBI), and recent studies suggest that LTBI is associated with persistent chronic inflammation that may lead to CVD. Recent epidemiologic work has shown that the risk of CVD in persons who develop tuberculosis is higher than in persons without a history of tuberculosis, even several years after recovery from tuberculosis. Together, these data suggest that tuberculosis may play a role in the pathogenesis of CVD. Further research to investigate a potential link between tuberculosis and CVD is warranted. PMID:26835156

  20. Homocysteine, Iron and Cardiovascular Disease: A Hypothesis

    PubMed Central

    Baggott, Joseph E.; Tamura, Tsunenobu

    2015-01-01

    Elevated circulating total homocysteine (tHcy) concentrations (hyperhomocysteinemia) have been regarded as an independent risk factor for cardiovascular disease (CVD). However, several large clinical trials to correct hyperhomocysteinemia using B-vitamin supplements (particularly folic acid) have largely failed to reduce the risk of CVD. There is no doubt that a large segment of patients with CVD have hyperhomocysteinemia; therefore, it is reasonable to postulate that circulating tHcy concentrations are in part a surrogate marker for another, yet-to-be-identified risk factor(s) for CVD. We found that iron catalyzes the formation of Hcy from methionine, S-adenosylhomocysteine and cystathionine. Based on these findings, we propose that an elevated amount of non-protein-bound iron (free Fe) increases circulating tHcy. Free Fe catalyzes the formation of oxygen free radicals, and oxidized low-density lipoprotein is a well-established risk factor for vascular damage. In this review, we discuss our findings on iron-catalyzed formation of Hcy from thioethers as well as recent findings by other investigators on this issue. Collectively, these support our hypothesis that circulating tHcy is in part a surrogate marker for free Fe, which is one of the independent risk factors for CVD. PMID:25668155

  1. n-3 PUFAs in cardiovascular disease.

    PubMed

    Marchioli, Roberto; Levantesi, Giacomo

    2013-12-20

    Many large, randomised clinical trials and some meta-analyses have shown that treatment with n-3 polyunsaturated fatty acids (n-3 PUFAs) is associated with consistent benefits on cardiovascular (CV) events, primarily due to a reduction of coronary and CV deaths in patients with coronary heart disease. At variance with such evidence, some clinical trials and meta-analyses showing a neutral effect of n-3 PUFAs have been recently published, raising concern about the consistency of the evidence on the CV benefits of n-3 PUFAs. Several methodological and clinical aspects of these recent trials deserve to be considered. Indeed, the low rate of events or the overoptimistic expectations of the benefit of n-3 PUFAs used for sample size calculation led to an inadequate statistical power of several studies. The improvement of background medical therapy, serum baseline levels of n-3 PUFAs, and different doses and/or treatment duration might have downplayed the benefit of n-3 PUFAs. Similarly to old drugs shown to be effective some years ago, it is possible that the benefits of treatment with n-3 PUFAs are not as great in a modern CV prevention strategy so rich in many effective drugs compared with past trials testing CV drugs when less effective therapies were available. PMID:24012154

  2. Whole grains protect against atherosclerotic cardiovascular disease.

    PubMed

    Anderson, James W

    2003-02-01

    Atherosclerotic cardiovascular disease (ASCVD) is the most common cause of death in most Western countries. Nutrition factors contribute importantly to this high risk for ASCVD. Favourable alterations in diet can reduce six of the nine major risk factors for ASCVD, i.e. high serum LDL-cholesterol levels, high fasting serum triacylglycerol levels, low HDL-cholesterol levels, hypertension, diabetes and obesity. Wholegrain foods may be one the healthiest choices individuals can make to lower the risk for ASCVD. Epidemiological studies indicate that individuals with higher levels (in the highest quintile) of whole-grain intake have a 29 % lower risk for ASCVD than individuals with lower levels (lowest quintile) of whole-grain intake. It is of interest that neither the highest levels of cereal fibre nor the highest levels of refined cereals provide appreciable protection against ASCVD. Generous intake of whole grains also provides protection from development of diabetes and obesity. Diets rich in wholegrain foods tend to decrease serum LDL-cholesterol and triacylglycerol levels as well as blood pressure while increasing serum HDL-cholesterol levels. Whole-grain intake may also favourably alter antioxidant status, serum homocysteine levels, vascular reactivity and the inflammatory state. Whole-grain components that appear to make major contributions to these protective effects are: dietary fibre; vitamins; minerals; antioxidants; phytosterols; other phytochemicals. Three servings of whole grains daily are recommended to provide these health benefits. PMID:12740068

  3. Positron emission tomography in cardiovascular disease.

    PubMed

    Beanlands, R

    1996-10-01

    Positron emission tomography (PET) represents an advanced form of nuclear imaging technology. The use of positron emitting isotopes, such as C-11, O-15, N-13, and F-18 permit radiolabelling of naturally occurring compounds in the body or close analogues. This, combined with technical advantages of PET imaging, allow quantification of physiological processes in humans. PET has become established as the most accurate noninvasive means for the diagnosis of coronary artery disease using myocardial perfusion radiotracers, which include rubidium-82, N-13-amonia, and O-15-water. These approaches have also been applied for long term evaluation of the effects of therapy and for the quantification of myocardial bloodflow. Radiolabelling of metabolic substrates, including C-11 palmitate, C-11 acetate and F-18 flurodeoxyglucose (FDG) have permitted evaluation of myocardial metabolism. F-18 FDG PET imaging has been established as the best means for defining viable myocardium in patients with reduced ventricular function being considered for revascularization. FDG PET can also identify patients being considered for cardiac transplant, who may be candidates for revascularization. In this review, other applications for metabolic, autonomic nervous system and receptor imaging are also discussed. The availability of cardiac PET in Canada is currently limited. However, with the reducing costs of capital and more cost effectiveness data, PET may become more widely available. Cardiac PET imaging is established as a tremendous diagnostic tool for defining viable myocardium, assessment of perfusion and long term evaluation of therapy without invasive procedures. PET is also a vital research tool capable of evaluating flow, metabolism, myocardial receptors, autonomic nervous system and potentially radiolabelled drugs. Cardiac PET imaging will continue to provide important insight, expanding our understanding and treatment of patients with cardiovascular disease. PMID:9191475

  4. Gender differences in developmental programming of cardiovascular diseases.

    PubMed

    Dasinger, John Henry; Alexander, Barbara T

    2016-03-01

    Hypertension is a risk factor for cardiovascular disease, the leading cause of death worldwide. Although multiple factors contribute to the pathogenesis of hypertension, studies by Dr David Barker reporting an inverse relationship between birth weight and blood pressure led to the hypothesis that slow growth during fetal life increased blood pressure and the risk for cardiovascular disease in later life. It is now recognized that growth during infancy and childhood, in addition to exposure to adverse influences during fetal life, contributes to the developmental programming of increased cardiovascular risk. Numerous epidemiological studies support the link between influences during early life and later cardiovascular health; experimental models provide proof of principle and indicate that numerous mechanisms contribute to the developmental origins of chronic disease. Sex has an impact on the severity of cardiovascular risk in experimental models of developmental insult. Yet, few studies examine the influence of sex on blood pressure and cardiovascular health in low-birth weight men and women. Fewer still assess the impact of ageing on sex differences in programmed cardiovascular risk. Thus, the aim of the present review is to highlight current data about sex differences in the developmental programming of blood pressure and cardiovascular disease. PMID:26814204

  5. Role of adiponectin in metabolic and cardiovascular disease

    PubMed Central

    Lee, Sewon; Kwak, Hyo-Bum

    2014-01-01

    Under disease conditions including obesity (insulin resistance) and diabetes, dysregulation of adipokines such as tumor necrosis factor (TNF)-?, leptin, resistin, and adiponectin contribute to the development of metabolic and cardiovascular disease. Unlike other adipokines, adiponectin has been shown to be a therapeutic target for metabolic syndrome and cardiovascular disease. Circulating levels of adiponectin are markedly reduced in obese, diabetic, hypertensive, and coronary artery disease patients as well as experimental animal models of insulin resistance and diabetes. Recently, the small molecule adiponectin receptors (AdipoRs) agonist was discovered and suggested that the agonist is a novel therapeutic target for the treatment of type 2 diabetes linked to obesity in an experimental mouse model. This review will focus on signaling pathways involved in adiponectin and its receptors and the role of adiponectin in metabolic and cardiovascular disease including insulin resistance, cardiomyopathy, and cardiovascular dysfunction. PMID:24877038

  6. Cardiovascular effects of statins, beyond lipid-lowering properties.

    PubMed

    Mihos, Christos G; Pineda, Andres M; Santana, Orlando

    2014-10-01

    The 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors, better known as 'statins', are amongst the most widely used medications in the world. They have become a pivotal component in the primary and secondary prevention of coronary artery and vascular disease. However, a growing amount of evidence has suggested that statins also possess strong pleiotropic effects irrespective of their lipid-lowering properties, which include enhancement of endothelial function, anti-inflammatory and anti-atherothrombotic properties, and immunomodulation. The following provides a comprehensive and updated review of the clinical evidence regarding the pleiotropic effects of statins in cardiovascular disorders and their potential therapeutic benefits. PMID:24631782

  7. Nonviral gene delivery methods in cardiovascular diseases.

    PubMed

    Ruponen, Marika; Hyvnen, Zanna; Urtti, Arto; Yl-Herttuala, Seppo

    2005-01-01

    Nonviral gene delivery methods with naked plasmids and various plasmid carrier complexes have been used for intravascular, intramuscular and periadventitial gene delivery to cardiovascular system. Efficacy, homogenity and quality of the nonviral gene delivery complexes can be significantly affected by the way they are produced. This chapter presents basic methods to produce nonviral gene delivery complexes and describes common models to test their properties in cardiovascular applications in vivo. PMID:16028692

  8. Adipokines: A link between obesity and cardiovascular disease

    PubMed Central

    Nakamura, Kazuto; Fuster, Jos J.; Walsh, Kenneth

    2014-01-01

    Obesity is a risk factor for various cardiovascular diseases including hypertension, atherosclerosis, and myocardial infarction. Recent studies aimed at understanding the microenvironment of adipose tissue and its impact on systemic metabolism have shed light on the pathogenesis of obesity-linked cardiovascular diseases. Adipose tissue functions as an endocrine organ by secreting multiple immune-modulatory proteins known as adipokines. Obesity leads to increased expression of pro-inflammatory adipokines and diminished expression of anti-inflammatory adipokines, resulting in the development of a chronic, low-grade inflammatory state. This adipokine imbalance is thought to be a key event in promoting both systemic metabolic dysfunction and cardiovascular disease. This review will focus on the adipose tissue microenvironment and the role of adipokines in modulating systemic inflammatory responses that contribute to cardiovascular disease. PMID:24355497

  9. Nutrient supplements and cardiovascular disease – A heartbreaking story

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Observational data have identified negative associations between carotenoids, folic acid and vitamin E, or metabolites altered by these nutrients, and cardiovascular disease (CVD) risk. Despite biological plausibility, for the most part, data derived from nutrient supplement trials using moderate t...

  10. Cardiovascular Disease and Diet: Research Findings for Classroom Use.

    ERIC Educational Resources Information Center

    Roush, Robert E.

    1980-01-01

    Cardiovascular disease (CVD) is the major public health problem in the U.S. today. Health education teachers should take the initiative to teach others about the relationships of diet, personal attributes, metabolic disorders, and lifestyle characteristics to CVD. (JN)

  11. Cholesterol and Cardiovascular Disease in the Elderly. Facts and Gaps

    PubMed Central

    Félix-Redondo, Francisco J.; Grau, Maria; Fernández-Bergés, Daniel

    2013-01-01

    Hypercholesterolemia is a major cardiovascular risk factor that increases the incidence of atherosclerotic diseases in adults, although the association is less well established in the elderly. The role of statins is well characterized for the reduction of myocardial infarction incidence or death in individuals with a history or high risk of cardiovascular diseases, regardless of age. Therapeutic measures recommended to prevent cardiovascular diseases and to reduce cholesterol levels in the elderly, such as lifestyle changes and lipid-lowering drugs, particularly statins, are based on studies conducted in younger adults. This narrative review aims to summarize the main observational studies and randomized clinical trials that have studied the relationship between cholesterol and cardiovascular diseases and the potential benefits and drawbacks of statins use in elderly patients. PMID:23730531

  12. Nonalcoholic fatty liver disease is a novel predictor of cardiovascular disease

    PubMed Central

    Hamaguchi, Masahide; Kojima, Takao; Takeda, Noriyuki; Nagata, Chisato; Takeda, Jun; Sarui, Hiroshi; Kawahito, Yutaka; Yoshida, Naohisa; Suetsugu, Atsushi; Kato, Takahiro; Okuda, Junichi; Ida, Kazunori; Yoshikawa, Toshikazu

    2007-01-01

    AIM: To clarify whether nonalcoholic fatty liver disease (NAFLD) increases the risk of cardiovascular disease. METHODS: We carried out a prospective observational study with a total of 1637 apparently healthy Japanese men and women who were recruited from a health check-up program. NAFLD was diagnosed by abdominal ultrasonography. The metabolic syndrome (MS) was defined according to the modified National Cholesterol Education Program (NCEP) ATP III criteria. Five years after the baseline evaluations, the incidence of cardiovascular disease was assessed by a self-administered questionnaire. RESULTS: Among 1221 participants available for outcome analyses, the incidence of cardiovascular disease was higher in 231 subjects with NAFLD at baseline (5 coronary heart disease, 6 ischemic stroke, and 1 cerebral hemorrhage) than 990 subjects without NAFLD (3 coronary heart disease, 6 ischemic stroke, and 1 cerebral hemorrhage). Multivariate analyses indicated that NAFLD was a predictor of cardiovascular disease independent of conventional risk factors (odds ratio 4.12, 95% CI, 1.58 to 10.75, P = 0.004). MS was also independently associated with cardiovascular events. But simultaneous inclusion of NAFLD and MS in a multivariate model revealed that NAFLD but not MS retained a statistically significant correlation with cardiovascular disease. CONCLUSION: Although both of them were predictors of cardiovascular disease, NAFLD but not MS retained a statistically significant correlation with cardiovascular disease in a multivariate model. NAFLD is a strong predictor of cardiovascular disease and may play a central role in the cardiovascular risk of MS. PMID:17461452

  13. Cardiovascular disease in survivors of hematopoietic cell transplantation

    PubMed Central

    Armenian, Saro H.; Chow, Eric J.

    2013-01-01

    Hematopoietic cell transplantation (HCT) is increasingly offered as a curative option for many patients with hematologic malignancies. Improvements in HCT strategies and supportive care have resulted in a growing number of long-term survivors. However, these survivors are at increased risk of developing long-term debilitating chronic health conditions, including premature cardiovascular disease. These complications are more common than in the general population, and there are well-described associations between therapeutic exposures, traditional cardiovascular risk factors and subsequent cardiovascular disease risk. We present here an overview of the current state of knowledge regarding pathogenesis and risk factors for some of the more commonly occurring cardiovascular complications following HCT, highlighting existing surveillance recommendations and future directions for research to minimize cardiovascular morbidity in these survivors. PMID:24166350

  14. TRAIL as biomarker and potential therapeutic tool for cardiovascular diseases.

    PubMed

    Bernardi, Stella; Milani, Daniela; Fabris, Bruno; Secchiero, Paola; Zauli, Giorgio

    2012-08-01

    This review focuses on TNF-related apoptosis-inducing ligand (TRAIL), also called Apo2 ligand, a protein belonging to the TNF superfamily. TRAIL can be found either in its transmembrane or circulating form, and its mostly studied peripheral effect is the induction of cellular apoptosis. Here, we discuss the evidences supporting the use of TRAIL as biomarker of cardiovascular diseases as well as the evidences showing the potential beneficial therapeutic effects of TRAIL on cardiovascular diseases and diabetes. PMID:22676911

  15. Sleep Deficiency and Deprivation Leading to Cardiovascular Disease

    PubMed Central

    Kohansieh, Michelle; Makaryus, Amgad N.

    2015-01-01

    Sleep plays a vital role in an individual's mental, emotional, and physiological well-being. Not only does sleep deficiency lead to neurological and psychological disorders, but also the literature has explored the adverse effects of sleep deficiency on the cardiovascular system. Decreased quantity and quality of sleep have been linked to cardiovascular disease (CVD) risk factors, such as hypertension, obesity, diabetes, and dyslipidemia. We explore the literature correlating primary sleep deficiency and deprivation as a cause for cardiovascular disease and cite endothelial dysfunction as a common underlying mechanism. PMID:26495139

  16. Cardiovascular disease associated with human immunodeficiency virus: a review.

    PubMed

    Costa, Lusa Amado; Almeida, Ana G

    2015-01-01

    The cardiovascular manifestations of human immunodeficiency virus (HIV) infection have changed significantly following the introduction of highly active antiretroviral therapy (HAART) regimens. On one hand, HAART has altered the course of HIV disease, with longer survival of HIV-infected patients, and cardiovascular complications of HIV infection such as myocarditis have been reduced. On the other hand, HAART is associated with an increase in the prevalence of both peripheral and coronary arterial disease. As longevity increases in HIV-infected individuals, long-term effects, such as cardiovascular disease, are emerging as leading health issues in this population. In the present review article, we discuss HIV-associated cardiovascular disease, focusing on epidemiology, etiopathogenesis, diagnosis, prognosis, management and therapy. Cardiovascular involvement in treatment-naive patients is still important in situations such as non-adherence to treatment, late initiation of treatment, and/or limited access to HAART in developing countries. We therefore describe the cardiovascular consequences in treatment-naive patients and the potential effect of antiretroviral treatment on their regression, as well as the metabolic and cardiovascular implications of HAART regimens in HIV-infected individuals. PMID:26162286

  17. HDL particle number and size as predictors of cardiovascular disease

    PubMed Central

    Kontush, Anatol

    2015-01-01

    Previous studies indicate that reduced concentrations of circulating high-density lipoprotein (HDL) particles can be superior to HDL-cholesterol (HDL-C) levels as a predictor of cardiovascular disease. Measurements of HDL particle numbers, therefore, bear a potential for the improved assessment of cardiovascular risk. Furthermore, such measurement can be relevant for the evaluation of novel therapeutic approaches targeting HDL. Modern in-depth analyses of HDL particle profile may further improve evaluation of cardiovascular risk. Although clinical relevance of circulating concentrations of HDL subpopulations to cardiovascular disease remains controversial, the negative relationship between the number of large HDL particles and cardiovascular disease suggests that assessment of HDL particle profile can be clinically useful. Reduced mean HDL size is equally associated with cardiovascular disease in large-scale clinical studies. Since HDL-C is primarily carried in the circulation by large, lipid-rich HDL particles, the inverse relationship between HDL size and cardiovascular risk can be secondary to those established for plasma levels of HDL particles, HDL-C, and large HDL. The epidemiological data thereby suggest that HDL particle number may represent a more relevant therapeutic target as compared to HDL-C. PMID:26500551

  18. Flavonoid intake and cardiovascular disease mortality in a prospective cohort of US adults

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Background: Flavonoids are plant-based phytochemicals with cardiovascular protective properties. Few studies have comprehensively examined flavonoid classes in relation to cardiovascular disease mortality. We examined the association between flavonoid intake and cardiovascular disease (CVD) mortalit...

  19. Molecular imaging in cardiovascular disease: Which methods, which diseases?

    PubMed Central

    Lindner, Jonathan R.; Sinusas, Albert

    2014-01-01

    Techniques for in vivo assessment of disease-related molecular changes are being developed for all forms of non-invasive cardiovascular imaging. The ability to evaluate tissue molecular or cellular phenotype in patients has the potential to not only improve diagnostic capabilities but to enhance clinical care either by detecting disease at an earlier stage when it is more amenable to therapy, or by guiding most appropriate therapies. These new techniques also can be used in research programs in order to characterize pathophysiology and as a surrogate endpoint for therapeutic efficacy. The most common approach for molecular imaging involves the creation of novel-targeted contrast agents that are designed so that their kinetic properties are different in disease tissues. The main focus of this review is not to describe all the different molecular imaging approaches that have been developed, but rather to describe the status of the field and highlight some of the clinical and research applications that molecular imaging will likely provide meaningful benefit. Specific target areas include assessment of atherosclerotic disease, tissue ischemia, and ventricular and vascular remodeling. PMID:24092271

  20. Radiation as a Risk Factor for Cardiovascular Disease

    PubMed Central

    Moulder, John E.; Hopewell, John W.

    2011-01-01

    Abstract Humans are continually exposed to ionizing radiation from terrestrial sources. The two major contributors to radiation exposure of the U.S. population are ubiquitous background radiation and medical exposure of patients. From the early 1980s to 2006, the average dose per individual in the United States for all sources of radiation increased by a factor of 1.76.2?mSv, with this increase due to the growth of medical imaging procedures. Radiation can place individuals at an increased risk of developing cardiovascular disease. Excess risk of cardiovascular disease occurs a long time after exposure to lower doses of radiation as demonstrated in Japanese atomic bomb survivors. This review examines sources of radiation (atomic bombs, radiation accidents, radiological terrorism, cancer treatment, space exploration, radiosurgery for cardiac arrhythmia, and computed tomography) and the risk for developing cardiovascular disease. The evidence presented suggests an association between cardiovascular disease and exposure to low-to-moderate levels of radiation, as well as the well-known association at high doses. Studies are needed to define the extent that diagnostic and therapeutic radiation results in increased risk factors for cardiovascular disease, to understand the mechanisms involved, and to develop strategies to mitigate or treat radiation-induced cardiovascular disease. Antioxid. Redox Signal. 15, 19451956. PMID:21091078

  1. Extracellular Ribonucleic Acids (RNA) Enter the Stage in Cardiovascular Disease.

    PubMed

    Zernecke, Alma; Preissner, Klaus T

    2016-02-01

    Inflammatory and ischemic cardiovascular diseases, especially atherosclerosis and myocardial infarction, remain the number one cause of death in the Western world, whereas the therapeutic options currently available are still limited. Several recent findings have indicated that nucleic acids, particularly extracellular ribosomal RNA and micro-RNAs, significantly contribute to the adverse outcome of atherosclerosis, myocardial infarction, and other cardiovascular diseases. Extracellular RNAs act as novel danger-associated molecular pattern signals and potent cofactors in cardiovascular inflammation and thrombosis, particularly when accumulating in the extracellular space under tissue-damaging or pathological conditions. In this concise review article, the different entities of extracellular RNAs, their cellular sources, and their putative functional contribution to the pathogenesis of cardiovascular diseases will be discussed. In fact, it remains a tightrope walk for these polyanionic molecules outside cells to promote defense reactions on the one side but to provoke cardiovascular disease development on the other side, dependent on their concentration, the environmental conditions, and the cellular stimuli engaged. Thus, we will discuss the mechanisms and cellular responses by which extracellular RNAs operate between defense and disease. Finally, natural counteracting molecules, such as RNase1, will be focused on to elaborate their protective functions in the context of inflammatory and ischemic cardiovascular diseases with the possibility to apply them as novel interventional strategies. PMID:26846641

  2. Metabolic Syndrome, Chronic Kidney, and Cardiovascular Diseases: Role of Adipokines

    PubMed Central

    Tesauro, Manfredi; Canale, Maria Paola; Rodia, Giuseppe; Di Daniele, Nicola; Lauro, Davide; Scuteri, Angelo; Cardillo, Carmine

    2011-01-01

    Obesity is a chronic disease, whose incidence is alarmingly growing. It is associated with metabolic abnormalities and cardiovascular complications. These complications are clustered in the metabolic syndrome (MetS) leading to high cardiovascular morbidity and mortality. Obesity predisposes to diabetic nephropathy, hypertensive nephrosclerosis, and focal and segmental glomerular sclerosis and represents an independent risk factor for the development and progression of chronic kidney disease (CKD). Albuminuria is a major risk factor for cardiovascular diseases (CVDs). Microalbuminuria has been described as early manifestation of MetS-associated kidney damage and diabetic nephropathy. Obesity and MetS affect renal physiology and metabolism through mechanisms which include altered levels of adipokines such as leptin and adiponectin, oxidative stress, and inflammation. Secretory products of adipose tissue also deeply and negatively influence endothelial function. A better understanding of these interactions will help in designing more effective treatments aimed to protect both renal and cardiovascular systems. PMID:21403882

  3. [Cardiovascular diseases after kidney transplantation: an analysis of predisposing factors].

    PubMed

    Heule, H; Keusch, G; Uhlschmid, G; Largiadr, F; Binswanger, U

    1981-05-16

    Out of 512 recipients of kidney allotransplants 36 patients exhibiting cardiovascular complications (coronary artery disease, cerebrovascular accident, aneurysm of aorta, peripheral arterial occlusions) were compared with an age and sex matched group of recipients without cardiovascular problems. The following significant differences were observed in the study group versus the controls: high systolic and diastolic blood pressure, longer duration of hypertension before renal allografting, higher serum concentrations of cholesterol, triglycerides and uric acid, and an increased incidence of left ventricular hypertrophy and preexisting cardiovascular disease. No differences were found between the two groups as regards smoking habits, overweight, hyperparathyroidism, duration of hemodialysis treatment and type of kidney disease. Diabetes mellitus, family history of cardiovascular complications and hypertonic alterations of the eye fundus were more frequent, but not to a statistically significant extent, in the study group as compared to control patients. These findings show the need for regulation of blood pressure, hyperlipemia and hyperuricemia to ensure successful longterm rehabilitation after kidney allografting. PMID:6454962

  4. Low-Density-Lipoprotein Particle Size Predicts a Poor Outcome in Patients with Atherothrombotic Stroke

    PubMed Central

    Song, Tae-Jin; Cho, Hyun-Ji; Chang, Yoonkyung; Youn, Minjung; Shin, Min-Jeong; Jo, Inho; Heo, Ji Hoe

    2015-01-01

    Background and Purpose Low-density lipoprotein (LDL) particle size is considered to be one of the more important cardiovascular risk factors, and small LDL particles are known to have atherogenic potential. The aim of this study was to determine whether LDL particle size is associated with stroke severity and functional outcome in patients with atherothrombotic stroke. Methods Between January 2009 and May 2011, 248 patients with first-episode cerebral infarction who were admitted to our hospital within 7 days after symptom onset were prospectively enrolled. LDL particle size was measured using the nondenaturing polyacrylamide gradient gel electrophoresis assay. Stroke severity was assessed by applying the National Institutes of Health Stroke Scale (NIHSS) at admission. Functional outcome was investigated at 3 months after the index stroke using the modified Rankin Scale (mRS), and poor functional outcome was defined as an mRS score of ≥3. Results The LDL particle size in the 248 patients was 25.9±0.9 nm (mean±SD). LDL particle size was inversely correlated with the degree of cerebral artery stenosis (p=0.010). Multinomial multivariate logistic analysis revealed that after adjustment for age, sex, and variables with p<0.1 in univariate analysis, LDL particle size was independently and inversely associated with stroke severity (NIHSS score ≥5; reference, NIHSS score 0-2; odds ratio=0.38, p=0.028) and poor functional outcome (odds ratio=0.44, p=0.038). Conclusions The results of this study demonstrate that small LDL particles are independently correlated with stroke outcomes. LDL particle size is thus a potential biomarker for the prognosis of atherothrombotic stroke. PMID:25628741

  5. [Importance of dyslipidaemia in cardiovascular disease: a point of view].

    PubMed

    Ascaso, Juan F; Carmena, Rafael

    2015-01-01

    The authors present their view on the prevention of cardiovascular diseases, accepting the European ESC/EAS guidelines. They consider that the aim of the lipid control, based on LDL-C goals, is essential for the prevention and treatment of cardiovascular diseases. In subjects with metabolic syndrome (mainly, abdominal obesity, pre-diabetes and diabetes), the primary objective should be apoB or Non-HDL-C, which are better associated with cardiovascular risk. The treatment must be lifestyle changes and control of other risk factors. After calculating cardiovascular risk, statins are the first therapeutic step, with the strength and dose needed to achieve LDL-C goals. If targets are not achieved, ezetimibe or resins should be added. A new group of potent cholesterol-lowering agents, the PCSK-9 monoclonal antibodies, have recently been approved in Spain. Subjects at very high cardiovascular risk that have achieved LDL-C goals, or other objectives (apoB, Non-HDL-C), other drugs (fibrates, omega-3) capable of modifying triglycerides and HDL-C could be added, if necessary. Treatment to reduce cardiovascular risk and prevent cardiovascular disease has proven effective in all populations and at all age groups. Subjects older than 80years should be individually assessed, taking into consideration possible comorbidities. PMID:26363575

  6. Cardiovascular disease in Navajo Indians with type 2 diabetes.

    PubMed Central

    Hoy, W; Light, A; Megill, D

    1995-01-01

    Rates of both type 2 diabetes and cardiovascular disease have risen sharply in recent years among Navajo Indians, the largest reservation-based American Indian tribe, but the association between the two conditions is not entirely clear. Rates of cardiovascular disease and some possible associations in several hundred diabetic and non-diabetic Navajos were estimated. Nearly one-third (30.9 percent) of those with diabetes had formal diagnoses of cardiovascular disease--25.3 percent had heart disease, 4.4 percent had cerebrovascular disease, and 4.1 percent had peripheral vascular disease. (The percentages exceed the total because some people had more than one diagnosis. Age-adjusted rates were 5.2 times those of nondiabetics for heart disease, 10.2 times for cerebrovascular disease, and 6.8 times for peripheral vascular disease. Accentuation of risk was most marked in young diabetics and in female diabetics. Hypertensive diabetics had a twofold increase in heart disease and more than a fivefold increase in cerebral and peripheral vascular disease over nonhypertensive diabetics. Age, blood pressure, cholesterol levels, and albumenuria were independent risk factors for cardiovascular disease. Triglyceride levels or body weight were not. Male sex and diabetes duration were independent risk factors for cerebral and peripheral vascular disease but not for heart disease. In view of the impressive segregation of cardiovascular disease in the diabetic Navajo population, the prevention of diabetes through population-based health promotion seems basic to its containment. Over the short term, vigorous treatment of hypertension in subjects who are already diabetic is mandatory. PMID:7838949

  7. Transforming cardiovascular disease prevention in women: time for the Pygmalion construct to end.

    PubMed

    Wenger, Nanette K

    2015-01-01

    The transformation of cardiovascular disease prevention for women must address that a number of nontraditional atherosclerotic cardiovascular disease risk factors are unique to or predominant in women. As well, many traditional atherosclerotic cardiovascular disease risk factors impart differential risks for women and for men. Gender-specific risk assessment and management have the potential to improve atherosclerotic cardiovascular disease outcomes in women. PMID:25531091

  8. AMPK in cardiovascular health and disease

    PubMed Central

    Shirwany, Najeeb A; Zou, Ming-Hui

    2010-01-01

    Adenosine Monophosphate-activated Protein Kinase (AMPK), a serine/threonine kinase and a member of the Snf1/AMPK protein kinase family, consists of three protein subunits that together make a functional enzyme. AMPK, which is expressed in a number of tissues, including the liver, brain, and skeletal muscle, is allosterically activated by a rise in the AMP: ATP ratio (ie in a low ATP or energy depleted state). The net effect of AMPK activation is to halt energy consuming (anabolic) pathways but to promote energy conserving (catabolic) cellular pathways. AMPK has therefore often been dubbed the metabolic master switch. AMPK also plays a critical physiological role in the cardiovascular system. Increasing evidence suggest that AMPK might also function as a sensor by responding to oxidative stress. Mostly importantly, AMPK modulates endogenous antioxidant gene expression and/or suppress the production of oxidants. AMPK promotes cardiovascular homeostasis by ensuring an optimum redox balance on the heart and vascular tissues. Dysfunctional AMPK is thought to underlie several cardiovascular pathologies. Here we review this kinase from its structure and discovery to current knowledge of its adaptive and maladaptive role in the cardiovascular system. PMID:20711221

  9. Preparing nurses for leadership roles in cardiovascular disease prevention.

    PubMed

    Lanuza, Dorothy M; Davidson, Patricia M; Dunbar, Sandra B; Hughes, Suzanne; De Geest, Sabina

    2011-07-01

    Cardiovascular disease (CVD) is a critical global health issue, and cardiovascular nurses play a vital role in decreasing the global burden and contributing to improving outcomes in individuals and communities. Cardiovascular nurses require the knowledge, skills, and resources that will enable them to function as leaders in CVD. This article addresses the education, training, and strategies that are needed to prepare nurses for leadership roles in preventing and managing CVD. Building on the World Health Organization core competencies for 21st-century health care workers, the specific competencies of cardiovascular nurses working in prevention are outlined. These can be further strengthened by investing in the development of cultural, system change and leadership competencies. Mentorship is proposed as a powerful strategy for promoting the cardiovascular nursing role and equipping individual nurses to contribute meaningfully to health system reform and community engagement in CVD risk reduction. PMID:21762853

  10. Preparing nurses for leadership roles in cardiovascular disease prevention.

    PubMed

    Lanuza, Dorothy M; Davidson, Patricia M; Dunbar, Sandra B; Hughes, Suzanne; De Geest, Sabina

    2011-01-01

    Cardiovascular disease (CVD) is a critical global health issue, and cardiovascular nurses play a vital role in decreasing the global burden and contributing to improving outcomes in individuals and communities. Cardiovascular nurses require the knowledge, skills, and resources that will enable them to function as leaders in CVD. This article addresses the education, training, and strategies that are needed to prepare nurses for leadership roles in preventing and managing CVD. Building on the World Health Organization core competencies for 21st-century health care workers, the specific competencies of cardiovascular nurses working in prevention are outlined. These can be further strengthened by investing in the development of cultural, system change and leadership competencies. Mentorship is proposed as a powerful strategy for promoting the cardiovascular nursing role and equipping individual nurses to contribute meaningfully to health system reform and community engagement in CVD risk reduction. PMID:21659815

  11. [Treatment of thoracic malignancy accompanied with cardiovascular disease].

    PubMed

    Sasai, T; Sakakibara, S; Harada, A; Sasaki, K; Kato, Y; Matsuyama, K; Matsushima, S; Gomibuchi, M; Tanaka, S; Shouji, T

    1993-10-01

    We treated 10 cases of thoracic malignancy accompanied with cardiovascular disease. Among thoracic malignancy, 7 cases were lung cancer and 3 were esophageal cancer. Accompanied cardiovascular diseases were ischemic heart disease (2 cases), valvular disease (3 cases), WPW syndrome (1 case), aortic aneurysm (4 cases). The mean age was 66, ranged from 51 to 79. The simultaneous occurrence of the two lesions were observed in 6 cases and thoracic malignancy was diagnosed after a varying interval of time following surgery of cardiovascular disease in 4 cases. In cases of thoracic malignancy accompanied with heart disease, the treatment of heart disease should precede the operation of malignant disease to reduce the risk of surgery. For the patient with esophageal cancer, posterior mediastinal esophagostomy should be applied who may have heart surgery in future. In cases of coexisting malignancy and aortic aneurysm, the priority of treatment should be determined considering the size of aneurysm. If the transverse diameter of aneurysm is larger than 7 cm, there is a high risk of rupture, so surgery for the aneurysm precedes operation of malignant diseases. It is desirable to avoid concomitant operation of malignancy and cardiovascular disease. PMID:8230901

  12. Cardiovascular Risk Factors and Health Knowledge among Freshman College Students with a Family History of Cardiovascular Disease.

    ERIC Educational Resources Information Center

    Tamragouri, Ravikiran N.; And Others

    1986-01-01

    This study compared the cardiovascular health knowledge, perception of risk factors, and health behavior of 69 freshmen with a family history of cardiovascular disease with 154 freshmen without this history. Results are discussed. (Author/MT)

  13. Exposure to Agrochemicals and Cardiovascular Disease: A Review

    PubMed Central

    Sekhotha, Matome M.; Monyeki, Kotsedi D.; Sibuyi, Masezi E.

    2016-01-01

    Introduction: In the agricultural world there is a continuous loss of food, fiber and other commodities due to pests, disease and weeds before harvesting time. These losses had create lots of financial burden to the farm owners that might lead to shutting down of their daily business. Worldwide, there is an overall very high loss of agricultural products due to weeds growth alone. To counteract this problem most farmers resort to the use of agrochemicals to increase their production but compromising the health of their farmworkers. The purpose of the study will be to assess the relationship between the agrochemical particles and cardiovascular diseases among farmworkers. Method: Non-systematic review was used to collect data. The following database were use: Medline, EBSCO, and Science Direct to search for the existing journal articles. Results: This study addresses the relationship between agrochemicals particles and cardiovascular diseases in the farming industries using literature review. Discussion: Other researchers had already done an extensive research on the pathway of potential mechanisms linking the ultrafine particulate matter to cardiovascular diseases. The outcomes of those investigations were the clinical results of events that might lead to the development of myocardial infarction, congestive heart failure (CHF), stroke, arrhythmia and sudden death. Xenobiotic compounds that maybe implicated in the pathophysiology of human cardiovascular diseases, will be examined and included in this study. There is compelling evidence suggesting that toxic free radicals of pesticides play an important role in human health. Conclusion: There is a close relationship between agrochemicals particle and cardiovascular diseases. PMID:26901215

  14. The Role of Aspirin in the Prevention of Cardiovascular Disease

    PubMed Central

    Ittaman, Sunitha V.; VanWormer, Jeffrey J.; Rezkalla, Shereif H.

    2014-01-01

    Aspirin therapy is well-accepted as an agent for the secondary prevention of cardiovascular events and current guidelines also define a role for aspirin in primary prevention. In this review, we describe the seminal trials of aspirin use in the context of current guidelines, discuss factors that may influence the effectiveness of aspirin therapy for cardiovascular disease prevention, and briefly examine patterns of use. The body of evidence supports a role for aspirin in both secondary and primary prevention of cardiovascular events in selected population groups, but practice patterns may be suboptimal. As a simple and inexpensive prophylactic measure for cardiovascular disease, aspirin use should be carefully considered in all at-risk adult patients, and further measures, including patient education, are necessary to ensure its proper use. PMID:24573704

  15. Cocoa Polyphenols and Inflammatory Markers of Cardiovascular Disease

    PubMed Central

    Khan, Nasiruddin; Khymenets, Olha; Urpí-Sardà, Mireia; Tulipani, Sara; Garcia-Aloy, Mar; Monagas, María; Mora-Cubillos, Ximena; Llorach, Rafael; Andres-Lacueva, Cristina

    2014-01-01

    Epidemiological studies have demonstrated the beneficial effect of plant-derived food intake in reducing the risk of cardiovascular disease (CVD). The potential bioactivity of cocoa and its polyphenolic components in modulating cardiovascular health is now being studied worldwide and continues to grow at a rapid pace. In fact, the high polyphenol content of cocoa is of particular interest from the nutritional and pharmacological viewpoints. Cocoa polyphenols are shown to possess a range of cardiovascular-protective properties, and can play a meaningful role through modulating different inflammatory markers involved in atherosclerosis. Accumulated evidence on related anti-inflammatory effects of cocoa polyphenols is summarized in the present review. PMID:24566441

  16. Cardiovascular complications of radiation therapy for thoracic malignancies: the role for non-invasive imaging for detection of cardiovascular disease

    PubMed Central

    Groarke, John D.; Nguyen, Paul L.; Nohria, Anju; Ferrari, Roberto; Cheng, Susan; Moslehi, Javid

    2014-01-01

    Radiation exposure to the thorax is associated with substantial risk for the subsequent development of cardiovascular disease. Thus, the increasing role of radiation therapy in the contemporary treatment of cancer, combined with improving survival rates of patients undergoing this therapy, contributes to a growing population at risk of cardiovascular morbidity and mortality. Associated cardiovascular injuries include pericardial disease, coronary artery disease, valvular disease, conduction disease, cardiomyopathy, and medium and large vessel vasculopathyany of which can occur at varying intervals following irradiation. Higher radiation doses, younger age at the time of irradiation, longer intervals from the time of radiation, and coexisting cardiovascular risk factors all predispose to these injuries. The true incidence of radiation-related cardiovascular disease remains uncertain due to lack of large multicentre studies with a sufficient duration of cardiovascular follow-up. There are currently no consensus guidelines available to inform the optimal approach to cardiovascular surveillance of recipients of thoracic radiation. Therefore, we review the cardiovascular consequences of radiation therapy and focus on the potential role of non-invasive cardiovascular imaging in the assessment and management of radiation-related cardiovascular disease. In doing so, we highlight characteristics that can be used to identify individuals at risk for developing post-radiation cardiovascular disease and propose an imaging-based algorithm for their clinical surveillance. PMID:23666251

  17. Biomarkers: A Challenging Conundrum in Cardiovascular Disease.

    PubMed

    Libby, Peter; King, Kevin

    2015-12-01

    The use of biomarkers has proven utility in cardiovascular medicine and holds great promise for future advances, but their application requires considerable rigor in thinking and methodology. Numerous confounding factors can cloud the clinical and investigative uses of biomarkers. Yet, the thoughtful and critical use of biomarkers can doubtless aid discovery of new pathogenic pathways, identify novel therapeutic targets, and provide a bridge between the laboratory and the clinic. Biomarkers can provide diagnostic and prognostic tools to the practitioner. The careful application of biomarkers can also help design and guide clinical trials required to establish the efficacy of novel interventions to improve patient outcomes. Point of care testing, technological advances, such as microfluidic and wearable devices, and the power of omics approaches all promise to elevate the potential contributions of biomarkers to discovery science, translation, clinical trials, and the practice of cardiovascular medicine. PMID:26543097

  18. Serotonin in peripheral blood reflects oxidative stress and plays a crucial role in atherosclerosis: Novel insights toward holistic anti-atherothrombotic strategy.

    PubMed

    Sugiura, Tomonori; Dohi, Yasuaki; Yamashita, Sumiyo; Hirowatari, Yuji; Fujii, Satoshi; Ohte, Nobuyuki

    2016-03-01

    We enrolled 132 outpatients with cardiovascular risk factors to evaluate the serotonin levels in platelet-poor plasma (PPP) and whole blood (WB). PPP serotonin levels and PPP/WB serotonin ratio were significantly correlated with levels of oxidative stress measured by derivative reactive oxygen metabolites (d-ROM). Twenty-five subjects were revealed to have stable coronary artery disease (CAD), and the levels CRP, d-ROM, and PPP/WB serotonin ratio were significantly higher in subjects with CAD than in those without CAD. Logistic regression analysis performed with the endpoint of having CAD revealed that the PPP/WB serotonin ratio was independently associated with CAD (odds ratio 3.37, 95% confidence interval 1.04-10.9, P = 0.04). Receiver operating characteristic (ROC) curve analyses to discriminate subjects with CAD from those without CAD indicated that combining PPP/WB serotonin ratio and d-ROM improved diagnostic utility. Targeting the serotonin-oxidative stress axis as part of a holistic anti-atherothrombotic strategy could be beneficial for patients with atherosclerosis. PMID:26784327

  19. Tristetraprolin family proteins may prevent and treat cardiovascular diseases

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Cardiovascular disease (CVD) is the most deadly disease in the U. S., according to the American Heart Association statistics. CVD have been consistently ranked the No. 1 killer since 1900 (except 1918), accounted for 38.5% of all deaths in 2001, and was estimated to cost $368.4 billion in 2004 in t...

  20. Cardiovascular risk in pediatric-onset rheumatological diseases

    PubMed Central

    2013-01-01

    Cardiovascular morbidity and mortality are becoming major health concerns for adults with inflammatory rheumatic diseases. The enhanced atherogenesis in this patient population is promoted by the exposure to traditional risk factors as well as nontraditional cardiovascular insults, such as corticosteroid therapy, chronic inflammation and autoantibodies. Despite definite differences between many adult-onset and pediatric-onset rheumatologic diseases, it is extremely likely that atherosclerosis will become the leading cause of morbidity and mortality in this pediatric patient population. Because cardiovascular events are rare at this young age, surrogate measures of atherosclerosis must be used. The three major noninvasive vascular measures of early atherosclerosis - namely, flow-mediated dilatation, carotid intima-media thickness and pulse wave velocity - can be performed easily on children. Few studies have explored the prevalence of cardiovascular risk factors and even fewer have used the surrogate vascular measures to document signs of early atherosclerosis in children with pediatric-onset rheumatic diseases. The objective of this review is to provide an overview on cardiovascular risk and early atherosclerosis in pediatric-onset systemic lupus erythematosus, juvenile idiopathic arthritis and juvenile dermatomyositis patients, and to review cardiovascular preventive strategies that should be considered in this population. PMID:23731870

  1. Noncoding RNA in age-related cardiovascular diseases.

    PubMed

    Greco, Simona; Gorospe, Myriam; Martelli, Fabio

    2015-06-01

    Eukaryotic gene expression is tightly regulated transcriptionally and post-transcriptionally by a host of noncoding (nc)RNAs. The best-studied class of short ncRNAs, microRNAs, mainly repress gene expression post-transcriptionally. Long noncoding (lnc)RNAs, which comprise RNAs differing widely in length and function, can regulate gene transcription as well as post-transcriptional mRNA fate. Collectively, ncRNAs affect a broad range of age-related physiologic deteriorations and pathologies, including reduced cardiovascular vigor and age-associated cardiovascular disease. This review presents an update of our understanding of regulatory ncRNAs contributing to cardiovascular health and disease as a function of advancing age. We will discuss (1) regulatory ncRNAs that control aging-associated cardiovascular homeostasis and disease, (2) the concepts, approaches, and methodologies needed to study regulatory ncRNAs in cardiovascular aging and (3) the challenges and opportunities that age-associated regulatory ncRNAs present in cardiovascular physiology and pathology. This article is part of a Special Issue entitled "CV Aging". PMID:25640162

  2. Credit scores, cardiovascular disease risk, and human capital

    PubMed Central

    Israel, Salomon; Caspi, Avshalom; Belsky, Daniel W.; Harrington, HonaLee; Hogan, Sean; Houts, Renate; Ramrakha, Sandhya; Sanders, Seth; Poulton, Richie; Moffitt, Terrie E.

    2014-01-01

    Credit scores are the most widely used instruments to assess whether or not a person is a financial risk. Credit scoring has been so successful that it has expanded beyond lending and into our everyday lives, even to inform how insurers evaluate our health. The pervasive application of credit scoring has outpaced knowledge about why credit scores are such useful indicators of individual behavior. Here we test if the same factors that lead to poor credit scores also lead to poor health. Following the Dunedin (New Zealand) Longitudinal Study cohort of 1,037 study members, we examined the association between credit scores and cardiovascular disease risk and the underlying factors that account for this association. We find that credit scores are negatively correlated with cardiovascular disease risk. Variation in household income was not sufficient to account for this association. Rather, individual differences in human capital factors—educational attainment, cognitive ability, and self-control—predicted both credit scores and cardiovascular disease risk and accounted for ∼45% of the correlation between credit scores and cardiovascular disease risk. Tracing human capital factors back to their childhood antecedents revealed that the characteristic attitudes, behaviors, and competencies children develop in their first decade of life account for a significant portion (∼22%) of the link between credit scores and cardiovascular disease risk at midlife. We discuss the implications of these findings for policy debates about data privacy, financial literacy, and early childhood interventions. PMID:25404329

  3. Credit scores, cardiovascular disease risk, and human capital.

    PubMed

    Israel, Salomon; Caspi, Avshalom; Belsky, Daniel W; Harrington, HonaLee; Hogan, Sean; Houts, Renate; Ramrakha, Sandhya; Sanders, Seth; Poulton, Richie; Moffitt, Terrie E

    2014-12-01

    Credit scores are the most widely used instruments to assess whether or not a person is a financial risk. Credit scoring has been so successful that it has expanded beyond lending and into our everyday lives, even to inform how insurers evaluate our health. The pervasive application of credit scoring has outpaced knowledge about why credit scores are such useful indicators of individual behavior. Here we test if the same factors that lead to poor credit scores also lead to poor health. Following the Dunedin (New Zealand) Longitudinal Study cohort of 1,037 study members, we examined the association between credit scores and cardiovascular disease risk and the underlying factors that account for this association. We find that credit scores are negatively correlated with cardiovascular disease risk. Variation in household income was not sufficient to account for this association. Rather, individual differences in human capital factors—educational attainment, cognitive ability, and self-control—predicted both credit scores and cardiovascular disease risk and accounted for ∼45% of the correlation between credit scores and cardiovascular disease risk. Tracing human capital factors back to their childhood antecedents revealed that the characteristic attitudes, behaviors, and competencies children develop in their first decade of life account for a significant portion (∼22%) of the link between credit scores and cardiovascular disease risk at midlife. We discuss the implications of these findings for policy debates about data privacy, financial literacy, and early childhood interventions. PMID:25404329

  4. Therapeutic manipulation of glucocorticoid metabolism in cardiovascular disease

    PubMed Central

    Hadoke, Patrick WF; Iqbal, Javaid; Walker, Brian R

    2009-01-01

    The therapeutic potential for manipulation of glucocorticoid metabolism in cardiovascular disease was revolutionized by the recognition that access of glucocorticoids to their receptors is regulated in a tissue-specific manner by the isozymes of 11β-hydroxysteroid dehydrogenase. Selective inhibitors of 11β-hydroxysteroid dehydrogenase type 1 have been shown recently to ameliorate cardiovascular risk factors and inhibit the development of atherosclerosis. This article addresses the possibility that inhibition of 11β-hydroxsteroid dehydrogenase type 1 activity in cells of the cardiovascular system contributes to this beneficial action. The link between glucocorticoids and cardiovascular disease is complex as glucocorticoid excess is linked with increased cardiovascular events but glucocorticoid administration can reduce atherogenesis and restenosis in animal models. There is considerable evidence that glucocorticoids can interact directly with cells of the cardiovascular system to alter their function and structure and the inflammatory response to injury. These actions may be regulated by glucocorticoid and/or mineralocorticoid receptors but are also dependent on the 11β-hydroxysteroid dehydrogenases which may be expressed in cardiac, vascular (endothelial, smooth muscle) and inflammatory (macrophages, neutrophils) cells. The activity of 11β-hydroxysteroid dehydrogenases in these cells is dependent upon differentiation state, the action of pro-inflammaotory cytokines and the influence of endogenous inhibitors (oxysterols, bile acids). Further investigations are required to clarify the link between glucocorticoid excess and cardiovascular events and to determine the mechanism through which glucocorticoid treatment inhibits atherosclerosis/restenosis. This will provide greater insights into the potential benefit of selective 11β-hydroxysteroid dehydrogenase inhibitors in treatment of cardiovascular disease. PMID:19239478

  5. Epidemiology, risk factors and management of cardiovascular diseases in IBD.

    PubMed

    Singh, Siddharth; Kullo, Iftikhar J; Pardi, Darrell S; Loftus, Edward V

    2015-01-01

    IBD is an established risk factor for venous thromboembolism. In the past few years, studies have suggested that patients with IBD might also be at an increased risk of coronary heart disease and stroke. The increased risk is thought to be similar to the level of risk seen in patients with other chronic systemic inflammatory diseases such as rheumatoid arthritis. The risk of developing these conditions is particularly increased in young adults with IBD, and more so in women than in men. Conventional cardiovascular risk factors are not over-represented in patients with IBD, so the increased risk could be attributable to inflammation-mediated atherosclerosis. Patients with IBD often have premature atherosclerosis and have biochemical and genetic markers similar to those seen in patients with atherosclerotic cardiovascular disease. The role of chronic inflammation in IBD-associated cardiovascular disease merits further evaluation. Particular attention should be given to the increased risk observed during periods of increased disease activity and potential modification of the risk by immunosuppressive and biologic therapies for IBD that can modify the disease activity. In addition, preclinical studies suggest that cardiovascular medications such as statins and angiotensin-converting enzyme inhibitors might also favourably modify IBD disease activity, which warrants further evaluation. PMID:25446727

  6. Cardiovascular Disease and Rheumatoid Arthritis: An Update

    PubMed Central

    Charles-Schoeman, Christina

    2012-01-01

    Patients with rheumatoid arthritis (RA) suffer significantly increased cardiovascular (CV) morbidity and mortality when compared to the general population. Both traditional CV risk factors and high levels of systemic inflammation have been linked to the increased CV risk in RA patients, but significant uncertainty remains regarding the mechanisms through which these factors contribute to CVD. In addition, ongoing questions remain regarding how best to identify RA patients at high risk for CVD, and what primary and secondary prevention strategies are effective at influencing CV outcome. The current review summarizes recent research in this field. PMID:22791398

  7. Inflammation and cardiovascular disease: from pathogenesis to therapeutic target.

    PubMed

    Golia, Enrica; Limongelli, Giuseppe; Natale, Francesco; Fimiani, Fabio; Maddaloni, Valeria; Pariggiano, Ivana; Bianchi, Renatomaria; Crisci, Mario; D'Acierno, Ludovica; Giordano, Roberto; Di Palma, Gaetano; Conte, Marianna; Golino, Paolo; Russo, Maria Giovanna; Calabr, Raffaele; Calabr, Paolo

    2014-09-01

    Atherosclerosis represents the most common pathological substrate of coronary heart disease (CHD), and the characterization of the disease as a chronic low-grade inflammatory condition is now largely accepted. A number of mediators of inflammation have been widely studied, both as surrogate biomarkers and as causal agents, in the pathophysiological network of atherogenesis and plaque vulnerability. The epidemiological observation that biomarkers of inflammation are associated with clinical cardiovascular risk supports the theory that targeted anti-inflammatory treatment appears to be a promising strategy in reducing residual cardiovascular risk on the background of traditional medical therapy. A large number of randomized controlled trials have shown that drugs commonly used in cardiovascular disease (CVD), such as statins, may be effective in the primary and secondary prevention of cardiovascular events through an anti-inflammatory effect. Moreover, several anti-inflammatory drugs are being tested for their potential to reduce residual cardiovascular risk on the background of validated medical therapy for atherosclerotic disease. In this paper, we review relevant evidence with regard to the relationship between inflammation and CVD, from pathogenesis to therapeutic strategies. PMID:25037581

  8. MicroRNAs Expression Profiles in Cardiovascular Diseases

    PubMed Central

    Bronze-da-Rocha, Elsa

    2014-01-01

    The current search for new markers of cardiovascular diseases (CVDs) is explained by the high morbidity and mortality still observed in developed and developing countries due to cardiovascular events. Recently, microRNAs (miRNAs or miRs) have emerged as potential new biomarkers and are small sequences of RNAs that regulate gene expression at posttranscriptional level by inhibiting translation or inducing degradation of the target mRNAs. Circulating miRNAs are involved in the regulation of signaling pathways associated to aging and can be used as novel diagnostic markers for acute and chronic diseases such as cardiovascular pathologies. This review summarizes the biogenesis, maturation, and stability of miRNAs and their use as potential biomarkers for coronary artery disease (CAD), myocardial infarction (MI), and heart failure (HF). PMID:25013816

  9. Rheumatoid arthritis, cardiovascular disease and physical exercise: a systematic review.

    PubMed

    Metsios, G S; Stavropoulos-Kalinoglou, A; Veldhuijzen van Zanten, J J C S; Treharne, G J; Panoulas, V F; Douglas, K M J; Koutedakis, Y; Kitas, G D

    2008-03-01

    This systematic review investigates the effectiveness of exercise interventions in improving disease-related characteristics in patients with rheumatoid arthritis (RA). It also provides suggestions for exercise programmes suitable for improving the cardiovascular profile of RA patients and proposes areas for future research in the field. Six databases (Medline, Cochrane Library, CINAHL, Google Scholar, EMBASE and PEDro) were searched to identify publications from 1974 to December 2006 regarding RA and exercise interventions. The quality of the studies included was determined by using the Jadad scale. Initial searches identified 1342 articles from which 40 met the inclusion criteria. No studies were found investigating exercise interventions in relation to cardiovascular disease in RA. There is strong evidence suggesting that exercise from low to high intensity of various modes is effective in improving disease-related characteristics and functional ability in RA patients. Future studies are required to investigate the effects of exercise in improving the cardiovascular status of this patient population. PMID:18045810

  10. [The influence of testosterone on cardiovascular disease in men].

    PubMed

    Payer, J; Banrov, A

    2010-07-01

    The influence of testosterone on cardiovascular disease is recently discussed question. Testosterone modulates vascular reactivity by genomic and nongenomic modes of action, it has an impact on endothelial function, production of proinflamatory cytokines and lipid profiles. The possible role of sex hormone binding globulin (SHBG) in androgen action by plasmatic membrane receptors breaks "the free hormone hypothesis", especially when clinical trials reveal strong association between SHBG and risk factors of cardiovascular disease. The results of last clinical trials mention that androgen deficiency is associated with obesity, insulin resistance and dyslipidaemia. Large clinical trials demonstrated that androgen deficiency predict mortality in elderly men. Testosterone substitution restores vasoreactivity and endothelial function and could potentially reduce cardiovascular disease in men but to confirm this theory more large clinical trials are needed. PMID:20842916

  11. Cardiovascular disease occurrence in two close but different social environments

    PubMed Central

    2011-01-01

    Background Cardiovascular diseases estimate to be the leading cause of death and loss of disability-adjusted life years globally. Conventional risk factors for cardiovascular diseases only partly account for the social gradient. The purpose of this study was to compare the occurrence of the most frequent cardiovascular diseases and cardiovascular mortality in two close cities, the Twin cities. Methods We focused on the total population in two neighbour and equally sized cities with a population of around 135 000 inhabitants each. These twin cities represent two different social environments in the same Swedish county. According to their social history they could be labelled a "blue-collar" and a "white-collar" city. Morbidity data for the two cities was derived from an administrative health care register based on medical records assigned by the physicians at both hospitals and primary care. The morbidity data presented are cumulative incidence rates and the data on mortality for ischemic heart diseases is based on official Swedish statistics. Results The cumulative incidence of different cardiovascular diagnoses for younger and also elderly men and women revealed significantly differences for studied cardiovascular diagnoses. The occurrence rates were in all aspects highest in the population of the "blue-collar" twin city for both sexes. Conclusions This study revealed that there are significant differences in risk for cardiovascular morbidity and mortality between the populations in the studied different social environments. These differences seem to be profound and stable over time and thereby give implication for public health policy to initiate a community intervention program in the "blue-collar" twin city. PMID:21226912

  12. Neurocardiology: therapeutic implications for cardiovascular disease.

    PubMed

    Goldstein, David S

    2012-04-01

    The term "neurocardiology" refers to physiologic and pathophysiological interplays of the nervous and cardiovascular systems. This selective review provides an update about cardiovascular therapeutic implications of neurocardiology, with emphasis on disorders involving primary or secondary abnormalities of catecholamine systems. Concepts of scientific integrative medicine help understand these disorders. Scientific integrative medicine is not a treatment method or discipline but a way of thinking that applies systems concepts to acute and chronic disorders of regulation. Some of these concepts include stability by negative feedback regulation, multiple effectors, effector sharing, instability by positive feedback loops, allostasis, and allostatic load. Scientific integrative medicine builds on systems biology but is also distinct in several ways. A large variety of drugs and non-drug treatments are now available or under study for neurocardiologic disorders in which catecholamine systems are hyperfunctional or hypofunctional. The future of therapeutics in neurocardiology is not so much in new curative drugs as in applying scientific integrative medical ideas that take into account concurrent chronic degenerative disorders and interactions of multiple drug and non-drug treatments with each other and with those disorders. PMID:21108771

  13. Smoking denial in cardiovascular disease studies.

    PubMed

    Wallner-Liebmann, S J; Grammer, T B; Siekmeier, R; Mangge, H; Mrz, W; Renner, Wilfried

    2013-01-01

    Assessment of self-reported smoking behavior in cardiovascular studies may lead to inaccurate measures of nicotine exposure. A more objective measurement of nicotine exposure can be done by measurement of plasma cotinine levels. The aim of the present study was to define the rate of discordance between the self-reported smoking behavior and biochemically defined smoking status. Data from 3,316 patients hospitalized for coronary angiography, who completed a questionnaire on smoking behavior, were analyzed. As a biochemical assessment of smoking status we used a cut-off serum cotinine level of 15 ?g/l. Smoking denial, defined as a discrepancy between high cotinine levels and self-reported never- or ex-smoking status, was observed in 3.7 % of the study participants. In a logistic regression analysis with a step-wise inclusion of sex, age, CAD, previous MI, and educational level, only male sex (odds ratio male/female: 2.00, 95 % CI 1.22-3.33; p = 0.007) and age (odds ratio per year: 0.79, 95 % confidence interval 0.66-0.94, p = 0.008) were associated with smoking denial. In conclusion, a misclassification rate of 3.7 % in the evaluation of such an important risk factor may lead to blurred effects and favor false negative results. The results of the present study substantiate the importance of biochemical markers for smoking assessment in cardiovascular studies. PMID:23835955

  14. Antioxidants in Cardiovascular Therapy: Panacea or False Hope?

    PubMed Central

    Goszcz, Katarzyna; Deakin, Sherine J.; Duthie, Garry G.; Stewart, Derek; Leslie, Stephen J.; Megson, Ian L.

    2015-01-01

    Oxidative stress is a key feature of the atherothrombotic process involved in the etiology of heart attacks, ischemic strokes, and peripheral arterial disease. It stands to reason that antioxidants represent a credible therapeutic option to prevent disease progression and thereby improve outcome, but despite positive findings from in vitro studies, clinical trials have failed to consistently show benefit. The aim of this review is to re-appraise the concept of antioxidants in the prevention and management of cardiovascular disease. In particular, the review will explore the reasons behind failed antioxidant strategies with vitamin supplements and will evaluate how flavonoids might improve cardiovascular function despite bioavailability that is not sufficiently high to directly influence antioxidant capacity. As well as reaching conclusions relating to those antioxidant strategies that might hold merit, the major myths, limitations, and pitfalls associated with this research field are explored. PMID:26664900

  15. Mendelian Forms of Structural Cardiovascular Disease

    PubMed Central

    2013-01-01

    Clinical and molecular genetics are inextricably linked. In the last two decades genetic studies have revealed the causes of several forms of structural heart disease. Recent work is extending the insights from inherited arrhythmias and cardiomyopathies to other forms of heart disease. In this review we outline the current state of the art for the genetics of adult structural heart disease, in particular the cardiomyopathies, valvular heart disease and aortic disease. The general approaches are described with a focus on clinical relevance, while potential areas for imminent innovation in diagnosis and therapeutics are highlighted. PMID:24046092

  16. Sleep Disturbances and their Relationship to Cardiovascular Disease

    PubMed Central

    Quan, Stuart F.

    2009-01-01

    Sleep disturbances are a common problem with chronic insomnia occurring in 10% of the general adult population and obstructive sleep apnea present in 4% and 2% of middle-aged men and women respectively. In addition, Americans are sleeping fewer hours per night than they did 20 years ago. There is now increasing evidence that reductions and increases in sleep duration, and various sleep disorders including obstructive sleep apnea and insomnia may be causal factors in the development of cardiovascular disease. Some of the evidence linking disturbances of sleep with cardiovascular disease is described in this review. PMID:20161354

  17. [Mathematical modeling for conditionality of cardiovascular disease by housing conditions].

    PubMed

    Meshkov, N A

    2014-01-01

    There was studied the influence of living conditions (housing area per capita, availability of housing water supply, sewerage and central heating) on the morbidity of the cardiovascular diseases in child and adult population. With the method of regression analysis the morbidity rate was established to significantly decrease with the increase in the area of housing, constructed models are statistically significant, respectively, p = 0.01 and p = 0.02. There was revealed the relationship of the morbidity rate of cardiovascular diseases in children and adults with the supply with housing central heating (p = 0.02 and p = 0.009). PMID:25950060

  18. Migraine and cardiovascular disease: systematic review and meta-analysis

    PubMed Central

    2009-01-01

    Objective To evaluate the association between migraine and cardiovascular disease, including stroke, myocardial infarction, and death due to cardiovascular disease. Design Systematic review and meta-analysis. Data sources Electronic databases (PubMed, Embase, Cochrane Library) and reference lists of included studies and reviews published until January 2009. Selection criteria Case-control and cohort studies investigating the association between any migraine or specific migraine subtypes and cardiovascular disease. Review methods Two investigators independently assessed eligibility of identified studies in a two step approach. Disagreements were resolved by consensus. Studies were grouped according to a priori categories on migraine and cardiovascular disease. Data extraction Two investigators extracted data. Pooled relative risks and 95% confidence intervals were calculated. Results Studies were heterogeneous for participant characteristics and definition of cardiovascular disease. Nine studies investigated the association between any migraine and ischaemic stroke (pooled relative risk 1.73, 95% confidence interval 1.31 to 2.29). Additional analyses indicated a significantly higher risk among people who had migraine with aura (2.16, 1.53 to 3.03) compared with people who had migraine without aura (1.23, 0.90 to 1.69; meta-regression for aura status P=0.02). Furthermore, results suggested a greater risk among women (2.08, 1.13 to 3.84) compared with men (1.37, 0.89 to 2.11). Age less than 45 years, smoking, and oral contraceptive use further increased the risk. Eight studies investigated the association between migraine and myocardial infarction (1.12, 0.95 to 1.32) and five between migraine and death due to cardiovascular disease (1.03, 0.79 to 1.34). Only one study investigated the association between women who had migraine with aura and myocardial infarction and death due to cardiovascular disease, showing a twofold increased risk. Conclusion Migraine is associated with a twofold increased risk of ischaemic stroke, which is only apparent among people who have migraine with aura. Our results also suggest a higher risk among women and risk was further magnified for people with migraine who were aged less than 45, smokers, and women who used oral contraceptives. We did not find an overall association between any migraine and myocardial infarction or death due to cardiovascular disease. Too few studies are available to reliably evaluate the impact of modifying factors, such as migraine aura, on these associations. PMID:19861375

  19. [New insights into sodium in kidney and cardiovascular diseases].

    PubMed

    Descaillot, Lonard; Laville, Maurice

    2015-12-01

    Recent guidelines recommend a restriction of sodium intake below 2,4g/day (6g/day of NaCl) in general population to prevent arterial hypertension and cardiovascular disease. Three papers published in 2014 by The New England Journal of Medecine confirm the association between high sodium intake and arterial hypertension. However, marked sodium restriction is also associated with increased mortality. On the other hand, a diet rich in potassium, over 1.5g/day, is associated with less cardiovascular mortality, and less chronic kidney disease progression. PMID:26483286

  20. Reduced or modified dietary fat for preventing cardiovascular disease

    PubMed Central

    Hooper, Lee; Summerbell, Carolyn D; Thompson, Rachel; Sills, Deirdre; Roberts, Felicia G; Moore, Helen; Smith, George Davey

    2014-01-01

    Background Reduction and modification of dietary fats have differing effects on cardiovascular risk factors (such as serum cholesterol), but their effects on important health outcomes are less clear. Objectives To assess the effect of reduction and/or modification of dietary fats on mortality, cardiovascular mortality, cardiovascular morbidity and individual outcomes including myocardial infarction, stroke and cancer diagnoses in randomised clinical trials of at least 6 months duration. Search methods For this review update, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE, were searched through to June 2010. References of Included studies and reviews were also checked. Selection criteria Trials fulfilled the following criteria: 1) randomised with appropriate control group, 2) intention to reduce or modify fat or cholesterol intake (excluding exclusively omega-3 fat interventions), 3) not multi factorial, 4) adult humans with or without cardiovascular disease, 5) intervention at least six months, 6) mortality or cardiovascular morbidity data available. Data collection and analysis Participant numbers experiencing health outcomes in each arm were extracted independently in duplicate and random effects meta-analyses, meta-regression, sub-grouping, sensitivity analyses and funnel plots were performed. Main results This updated review suggested that reducing saturated fat by reducing and/or modifying dietary fat reduced the risk of cardiovascular events by 14% (RR 0.86, 95% CI 0.77 to 0.96, 24 comparisons, 65,508 participants of whom 7% had a cardiovascular event, I2 50%). Subgrouping suggested that this reduction in cardiovascular events was seen in studies of fat modification (not reduction - which related directly to the degree of effect on serum total and LDL cholesterol and triglycerides), of at least two years duration and in studies of men (not of women). There were no clear effects of dietary fat changes on total mortality (RR 0.98, 95% CI 0.93 to 1.04, 71,790 participants) or cardiovascular mortality (RR 0.94, 95% CI 0.85 to 1.04, 65,978 participants). This did not alter with sub-grouping or sensitivity analysis. Few studies compared reduced with modified fat diets, so direct comparison was not possible. Authors’ conclusions The findings are suggestive of a small but potentially important reduction in cardiovascular risk on modification of dietary fat, but not reduction of total fat, in longer trials. Lifestyle advice to all those at risk of cardiovascular disease and to lower risk population groups, should continue to include permanent reduction of dietary saturated fat and partial replacement by unsaturates. The ideal type of unsaturated fat is unclear. PMID:21735388

  1. MicroRNAs in platelet function and cardiovascular disease.

    PubMed

    McManus, David D; Freedman, Jane E

    2015-12-01

    Cardiovascular disease-a leading cause of morbidity and mortality among adults-is strongly influenced by platelet function through acute thrombotic and atherogenic mechanisms. Pathways that regulate platelet activity and lead to coronary occlusion are central to the pathogenesis of acute coronary syndromes. Platelet activation contributes to other thrombotic disorders and cardiovascular diseases, including stroke. Anucleate platelets are now understood to contain transcripts that might relate to other physiological or pathophysiological conditions, be released into the circulation, participate in protein formation, and engage in horizontal RNA transfer to other vascular cells. These platelet transcripts include microRNAs (miRNAs), which are small noncoding RNAs involved in many molecular processes, most notably regulation of gene expression. In platelets, these noncoding RNAs seem to participate in vascular homeostasis, inflammation, and platelet function. In addition, levels of platelet miRNAs in the circulation are associated with the presence or extent of cardiovascular diseases, such as atrial fibrillation and peripheral vascular disease. Accumulating data suggest mechanistic roles for platelet-derived miRNAs in haemostasis, thrombosis, and unstable coronary syndromes. In addition, evidence suggests that platelet-derived miRNAs might have important roles as biomarkers of cardiovascular disease susceptibility, prognosis, or treatment. PMID:26149483

  2. Circulating Markers of Liver Function and Cardiovascular Disease Risk.

    PubMed

    Targher, Giovanni; Byrne, Christopher D

    2015-11-01

    Measurement of serum concentrations of various liver enzymes and other nonenzymatic proteins and metabolites of heme metabolism (eg, bilirubin) is often undertaken in clinical practice. Measurement of these liver function tests is simple, quick, and relatively inexpensive. However, interpreting the liver function test results in patients without evidence of liver disease is often challenging. Concentrations of some of liver enzymes, such as γ-glutamyltransferase or alkaline phosphatase, and concentrations of liver-derived metabolites, such as bilirubin, may be influenced by metabolic processes beyond the liver, sometimes making interpretation of the test results difficult. This scenario frequently occurs both in individuals at risk of cardiovascular disease and in patients with known cardiovascular disease, often resulting in the clinicians ignoring the test results. In this brief review, we discuss the evidence for associations between key serum liver function tests and cardiovascular disease risk and where associations are robust; we provide an interpretation for possible mechanistic links between the liver function test and cardiovascular disease. PMID:25977566

  3. Drug treatment and cost of cardiovascular disease in Australia.

    PubMed

    Ademi, Zanfina; Liew, Danny; Chew, Derek; Conner, Greg; Shiel, Louise; Nelson, Mark; Soman, Ash; Steg, Gabriel; Bhatt, Deepak L; Reid, Christopher

    2009-01-01

    Australia's Pharmaceutical Benefits Scheme supports the use of effective drugs for the prevention and control of cardiovascular risk factors. However, there are little data available describing per person costs of medication in primary prevention and secondary prevention in the community. We aim to understand annual expenditure on cardiovascular medicines according to the level and extent of cardiovascular disease, using participants enrolled in the Reduction of Atherothrombosis for Continued Health (REACH) registry. 2873 participants were recruited into the REACH registry through 273 Australian general practices. Cardiovascular medicines review was undertaken at baseline. Average weighted costs of medications were estimated using government-reimbursed prices. Annual costs were stratified by disease extent and location. The annual mean cost of pharmaceuticals per person was 1307 AU dollars. The average reported medicine use per person across all states and participants groups varied significantly. Participants with cerebrovascular or peripheral arterial disease were prescribed less cardiovascular medication than those with coronary artery disease (CAD) (mean number of drugs 3.5 vs. 4.5, P < 0.0001) and (3.6 vs. 4.5, P < 0.0001), while those with risk factor alone had the same medication use as those with CAD (mean number 4.5). Medication use was lower in Western Australia in comparison to eastern States. Participants with existing cerebrovascular disease and peripheral vascular disease receive less preventive therapy than those with CAD or even risk factors alone. This observation is consistent across all mainland states. Given the evidence of the effectiveness and cost-effectiveness of treating all types of vascular diseases, the present study suggests that there is scope to improve the treatment of these high-risk participants in Australia. PMID:19689615

  4. Non-alcoholic fatty liver disease and cardiovascular risk.

    PubMed

    Brea, Angel; Puzo, José

    2013-08-20

    The term "Non-alcoholic fatty liver disease" (NAFLD) covers a series of liver lesions similar to those induced by alcohol, but not caused by alcohol use. The importance of NAFLD lies in the high prevalence in Western societies and, from the point of view of the liver, in its progression from steatosis to cirrhosis and liver cancer. More recently, NAFLD has been found to be associated with lipid metabolism disorders, the deposition of fat outside of the adipocytes, insulin resistance and Metabolic Syndrome. Also attributed to NAFLD is a heightened systemic pro-inflammatory state, which accelerates arteriosclerosis, thereby increasing cardiovascular risk and associated cardiovascular events. Here we provide an update to the etiopathogenesis of NAFLD, its influence on cardiovascular disease, and the treatment options. PMID:23141876

  5. Arsenic Exposure and Subclinical Endpoints of Cardiovascular Diseases

    PubMed Central

    Wu, Fen; Molinaro, Peter; Chen, Yu

    2014-01-01

    Mechanistic evidence suggests that arsenic exposure from drinking water increases the production of reactive oxygen species and influences inflammatory responses and endothelial nitric oxide homeostasis. These arsenic-induced events may lead to endothelial dysfunction that increases the risk of atherosclerosis and cardiovascular disease. We reviewed accumulating epidemiologic evidence that evaluated the association between arsenic exposure and intermediate markers and subclinical measures that predict future cardiovascular risk. Cross-sectional studies have indicated positive associations between high or low-to-moderate levels of arsenic exposure with indices of subclinical atherosclerosis, QT interval prolongation, and circulating markers of endothelial dysfunction. The evidence is limited for other intermediate endpoints such as markers of oxidative stress and inflammation, QT dispersion, and lipid profiles. Prospective studies are needed to enhance the causal inferences of arsenic's effects on subclinical endpoints of cardiovascular disease, especially at lower arsenic exposure levels. PMID:25013752

  6. Worldwide disparities in cardiovascular disease: Challenges and solutions.

    PubMed

    Okwuosa, Ike S; Lewsey, Sabra C; Adesiyun, Tolulope; Blumenthal, Roger S; Yancy, Clyde W

    2016-01-01

    The 20th century saw cardiovascular disease ascend as the leading cause of death in the world. In response to the new challenge that heart disease imposed, the cardiovascular community responded with ground breaking innovations in the form of evidence based medications that have improved survival, imaging modalities that allow for precise diagnosis and guide treatment; revascularization strategies that have not only reduced morbidity, but also improved survival following an acute myocardial infarction. However the benefits have not been distributed equitably and as a result disparities have arisen in cardiovascular care. There is tremendous data from the United States demonstrating the many phenotypical forms of disparities. This paper takes a global view of disparities and highlights that disparate care is not limited to the United States and it is another challenge that the medical community should rise and face head on. PMID:26433167

  7. Predicting cardiovascular mortality in chronic kidney disease (CKD) patients.

    PubMed

    Sun, Wenhui; Liu, Dahai; Gong, Ping; Shi, Xiaoyu; Wang, Yong; Wang, Ping; Gong, Weihua

    2014-01-01

    Cardiovascular mortality in chronic kidney disease (CKD) patients is a critical clinical challenge due to poor clinical outcome and increasing prevalence. Nephrologists and transplant specialists need suitable biomarkers to predict the occurrence of cardiovascular events and/or mortality in practice. At the technical level, development of a non-invasive repetitive sampling procedure is required to develop applicable biomarkers, offering a platform for clinicians to dynamically monitor the alteration of patient condition. Apart from specificity and sensitivity, the ideal biomarkers should be independent of various confounders such as sex, sex, age, kidney function, diabetes, and blood pressure. This article reviews recent studies on the identified potential biomarkers to analyze their predictive value and significance. The present study revealed that the identified potential biomarkers are involved in magnesium and phosphate metabolism, hormone dysregulation, pro-inflammatory process, and cardiovascular pathogenesis. Combined use of those biomarkers might allow early identification of subclinical cardiovascular system organ damage, effectively predict cardiovascular mortality, and significantly deepen our mechanistic understanding of the occurrence of cardiovascular events and mortality, which will help to develop preventive measures. PMID:25315215

  8. Epidemiologic Studies of Exercise and Cardiovascular Disease

    ERIC Educational Resources Information Center

    Montoye, Henry J.

    1977-01-01

    A physically more active life, while not being related to atherosclerosis, could enable some individuals to live longer with atherosclerosis before dying from or showing symptoms of coronary heart disease. (MJB)

  9. Lead, blood pressure, and cardiovascular disease in men and women

    SciTech Connect

    Schwartz, J. )

    1991-02-01

    Lead has been shown to be associated with elevated blood pressure in males in the NHANES 2 survey and in numerous other studies. This study confirms the association in males ages 20 to 74 and documents a singificant, although weaker, association in females as well. Prospective cardiovascular disease studies such as the Framingham study indicate that increases in blood pressure should be associated with increased risk of cardiovascular disease. Using electrocardiogram data from NHANES 2, this study confirms the expected association oflead with left ventricular hypertrophy. The logistic risk coefficients from the Framingham study can be combined with the study's association between lead and blood pressure to examine its implication for more serious outcomes. The results suggest that a halving of the population mean blood lead level would reduce myocardial infarctions by approximately 24,000 events per year and incidence of all cardiovascular disease by over 100,000. These numbers suggest a small attributable risk compared ot the vast incidence of cardiovascular disease in the US, but a large attributable risk compared to most environmental toxins. Several biological mechanisms have been identified, with different implications for the use of bone lead as an exposure measure.

  10. Heart muscle disease and cardiovascular magnetic resonance imaging.

    PubMed

    Sado, Daniel M; Fontana, Marianna; Moon, James C

    2014-07-01

    This article introduces the reader to the different types of heart muscle disease which are commonly encountered in clinical practice. It then discusses cardiovascular magnetic resonance and explains how it can help in the work up of these diverse conditions. PMID:25040517

  11. Associations between Eating Competence and Cardiovascular Disease Biomarkers

    ERIC Educational Resources Information Center

    Psota, Tricia L.; Lohse, Barbara; West, Sheila G.

    2007-01-01

    Objective: Explore the relationship between eating competence (EC) and biomarkers of risk for cardiovascular disease (CVD). Design: Secondary analysis of data collected for a larger, 2-way crossover clinical trial. Setting: Outpatient clinical research center. Participants: Forty-eight hypercholesterolemic (LDL cholesterol [greater than or equal]…

  12. Dietary Risk Factors and Their Modification in Cardiovascular Disease.

    ERIC Educational Resources Information Center

    Jeffery, Robert W.

    1988-01-01

    Provides an overview of dietary risk factors for cardiovascular disease, including diet sodium intake for hypertension and dietary fat and cholesterol for hypercholesterolemia, exacerbation of these conditions by obesity, and intervention strategies for their modification. Describes clinical strategies for modifying diet: education, skills

  13. BENEFITS OF DIETARY FIBER FOR CARDIOVASCULAR DISEASE AND DIABETES

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Cardiovascular disease (CVD) is the most common problem confronting those with type 2 diabetes mellitus. Diabetes, an independent risk factor for CVD, is associated with a high incidence of CVD and increased short-and long-term mortality. The nutritional approach to CVD and diabetes is an importa...

  14. Associations between Eating Competence and Cardiovascular Disease Biomarkers

    ERIC Educational Resources Information Center

    Psota, Tricia L.; Lohse, Barbara; West, Sheila G.

    2007-01-01

    Objective: Explore the relationship between eating competence (EC) and biomarkers of risk for cardiovascular disease (CVD). Design: Secondary analysis of data collected for a larger, 2-way crossover clinical trial. Setting: Outpatient clinical research center. Participants: Forty-eight hypercholesterolemic (LDL cholesterol [greater than or equal]

  15. Issues of fish consumption for cardiovascular disease risk reduction

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Increasing fish consumption is recommended for intake of omega-3 (n-3) fatty acids and to confer benefits for the risk reduction of cardiovascular disease (CVD). Most Americans are not achieving intake levels that comply with current recommendations. It is the goal of this review to provide an overv...

  16. Dietary modulators of statin efficacy in cardiovascular disease and cognition

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Cardiovascular disease remains the leading cause of morbidity and mortality in the United States and other developed countries, and is fast growing in developing countries, particularly as life expectancy in all parts of the world increases. Current recommendations for the prevention of cardiovascul...

  17. Hyperosmotic activation of CNS sympathetic drive: implications for cardiovascular disease

    PubMed Central

    Toney, Glenn M; Stocker, Sean D

    2010-01-01

    Evidence now indicates that exaggerated sympathetic nerve activity (SNA) significantly contributes to salt-sensitive cardiovascular diseases. Although CNS mechanisms that support the elevation of SNA in various cardiovascular disease models have been intensively studied, many mechanistic details remain unknown. In recent years, studies have shown that SNA can rise as a result of both acute and chronic increases of body fluid osmolality. These findings have raised the possibility that salt-sensitive cardiovascular diseases could result, at least in part, from direct osmosensory activation of CNS sympathetic drive. In this brief review we emphasize recent findings from several laboratories, including our own, which demonstrate that neurons of the forebrain organum vasculosum laminae terminalis (OVLT) play a pivotal role in triggering hyperosmotic activation of SNA by recruiting neurons in specific regions of the hypothalamus, brainstem and spinal cord. Although OVLT neurons are intrinsically osmosensitive and shrink when exposed to extracellular hypertonicity, it is not yet clear if these processes are functionally linked. Whereas acute hypertonic activation of OVLT neurons critically depends on TRPV1 channels, studies in TRPV1−/− mice suggest that acute and long-term osmoregulatory responses remain largely intact. Therefore, acute and chronic osmosensory transduction by OVLT neurons may be mediated by distinct mechanisms. We speculate that organic osmolytes such as taurine and possibly novel processes such as extracellular acidification could contribute to long-term osmosensory transduction by OVLT neurons and might therefore participate in the elevation of SNA in salt-sensitive cardiovascular diseases. PMID:20603334

  18. New cardiovascular targets to prevent late onset Alzheimer disease.

    PubMed

    Claassen, Jurgen A H R

    2015-09-15

    The prevalence of dementia rises to between 20% and 40% with advancing age. The dominant cause of dementia in approximately 70% of these patients is Alzheimer disease. There is no effective disease-modifying pharmaceutical treatment for this neurodegenerative disease. A wide range of Alzheimer drugs that appeared effective in animal models have recently failed to show clinical benefit in patients. However, hopeful news has emerged from recent studies that suggest that therapeutic strategies aimed at reducing cardiovascular disease may also reduce the prevalence of dementia due to Alzheimer disease. This review summarizes the evidence for this link between cardiovascular disease and late onset Alzheimer dementia. Only evidence from human research is considered here. Longitudinal studies show an association between high blood pressure and pathological accumulation of the protein amyloid-beta42, and an even stronger association between vascular stiffness and amyloid accumulation, in elderly subjects. Amyloid-beta42 accumulation is considered to be an early marker of Alzheimer disease, and increases the risk of subsequent cognitive decline and development of dementia. These observations could provide an explanation for recent observations of reduced dementia prevalence associated with improved cardiovascular care. PMID:25987416

  19. HypoxamiR Regulation and Function in Ischemic Cardiovascular Diseases

    PubMed Central

    Greco, Simona; Gaetano, Carlo

    2014-01-01

    Abstract Significance: MicroRNAs (miRNAs) are deregulated and play a causal role in numerous cardiovascular diseases, including myocardial infarction, coronary artery disease, hypertension, heart failure, stroke, peripheral artery disease, kidney ischemiareperfusion. Recent Advances: One crucial component of ischemic cardiovascular diseases is represented by hypoxia. Indeed, hypoxia is a powerful stimulus regulating the expression of a specific subset of miRNAs, named hypoxia-induced miRNAs (hypoxamiR). These miRNAs are fundamental regulators of the cell responses to decreased oxygen tension. Certain hypoxamiRs seem to have a particularly pervasive role, such as miR-210 that is virtually induced in all ischemic diseases tested so far. However, its specific function may change according to the physiopathological context. Critical Issues: The discovery of HypoxamiR dates back 6 years. Thus, despite a rapid growth in knowledge and attention, a deeper insight of the molecular mechanisms underpinning hypoxamiR regulation and function is needed. Future Directions: An extended understanding of the function of hypoxamiR in gene regulatory networks associated with cardiovascular diseases will allow the identification of novel molecular mechanisms of disease and indicate the development of innovative therapeutic approaches. Antioxid. Redox Signal. 21, 12021219. PMID:24053126

  20. Magnesium and cardiovascular complications of chronic kidney disease.

    PubMed

    Massy, Ziad A; Dreke, Tilman B

    2015-07-01

    Cardiovascular complications are the leading cause of death in patients with chronic kidney disease (CKD). Abundant experimental evidence suggests a physiological role of magnesium in cardiovascular function, and clinical evidence suggests a role of the cation in cardiovascular disease in the general population. The role of magnesium in CKD-mineral and bone disorder, and in particular its impact on cardiovascular morbidity and mortality in patients with CKD, is however not well understood. Experimental studies have shown that magnesium inhibits vascular calcification, both by direct effects on the vessel wall and by indirect, systemic effects. Moreover, an increasing number of epidemiologic studies in patients with CKD have shown associations of serum magnesium levels with intermediate and hard outcomes, including vascular calcification, cardiovascular events and mortality. Intervention trials in these patients conducted to date have had small sample sizes and have been limited to the study of surrogate parameters, such as arterial stiffness, vascular calcification and atherosclerosis. Randomized controlled trials are clearly needed to determine the effects of magnesium supplementation on hard outcomes in patients with CKD. PMID:25963594

  1. Vitamin D and cardiovascular disease: is the evidence solid?

    PubMed Central

    Al Mheid, Ibhar; Patel, Riyaz S.; Tangpricha, Vin; Quyyumi, Arshed A.

    2013-01-01

    Vitamin D deficiency, prevalent in 30–50% of adults in developed countries, is largely due to inadequate cutaneous production that results from decreased exposure to sunlight, and to a lesser degree from low dietary intake of vitamin D. Serum levels of 25-hydroxyvitamin D (25-OH D) <20 ng/mL indicate vitamin D deficiency and levels >30 ng/mL are considered optimal. While the endocrine functions of vitamin D related to bone metabolism and mineral ion homoeostasis have been extensively studied, robust epidemiological evidence also suggests a close association between vitamin D deficiency and cardiovascular morbidity and mortality. Experimental studies have demonstrated novel actions of vitamin D metabolites on cardiomyocytes, and endothelial and vascular smooth muscle cells. Low 25-OH D levels are associated with left ventricular hypertrophy, vascular dysfunction, and renin–angiotensin system activation. Despite a large body of experimental, cross-sectional, and prospective evidence implicating vitamin D deficiency in the pathogenesis of cardiovascular disease, a causal relationship remains to be established. Moreover, the cardiovascular benefits of normalizing 25-OH D levels in those without renal disease or hyperparathyroidism have not been established, and questions of an epiphenomenon where vitamin D status merely reflects a classic risk burden have been raised. Randomized trials of vitamin D replacement employing cardiovascular endpoints will provide much needed evidence for determining its role in cardiovascular protection. PMID:23751422

  2. Long-term trends in cardiovascular disease mortality and association with respiratory disease.

    PubMed

    Mercer, A J

    2016-03-01

    The recent decline in cardiovascular disease mortality in Western countries has been linked with changes in life style and treatment. This study considers periods of decline before effective medical interventions or knowledge about risk factors. Trends in annual age-standardized death rates from cerebrovascular disease, heart disease and circulatory disease, and all cardiovascular disease are reviewed for three phases, 1881-1916, 1920-1939, and 1940-2000. There was a consistent decline in the cerebrovascular disease death rate between 1891 and 2000, apart from brief increases after the two world wars. The heart disease and circulatory disease death rate was declining between 1891 and 1910 before cigarette smoking became prevalent. The early peak in cardiovascular mortality in 1891 coincided with an influenza pandemic and a peak in the death rate from bronchitis, pneumonia and influenza. There is also correspondence between short-term fluctuations in the death rates from these respiratory diseases and cardiovascular disease. This evidence of ecological association is consistent with the findings of many studies that seasonal influenza can trigger acute myocardial infarction and episodes of respiratory infection are followed by increased risk of cardiovascular events. Vaccination studies could provide more definitive evidence of the role in cardiovascular disease and mortality of influenza, other viruses, and common bacterial agents of respiratory infection. PMID:26243537

  3. Endocrine and metabolic changes affecting cardiovascular disease in dialysis patients.

    PubMed

    Shoji, Tetsuo; Emoto, Masanori; Nishizawa, Yoshiki; Inaba, Masaaki

    2015-03-01

    Protein-energy wasting plays an important role in the increased risk of mortality from cardiovascular disease in people with end-stage renal disease. Because protein-energy wasting is a condition of imbalance between anabolism and catabolism, endocrine and metabolic alterations that regulate such balance should be the possible target of intervention. Subjects with end-stage renal disease exhibit various changes in thyroid function, gonadal hormones, adrenal androgen, glucose metabolism, dyslipidemia, fatty acid composition, cholesterol absorption, and vitamin D. In this article, we briefly review the association of these alterations with mortality and cardiovascular disease in hemodialysis patients. Although some of them may be the adaptive response to the catabolic condition, these observational data are useful for risk stratification of patients and also for providing new ideas for possible prevention. PMID:25556309

  4. Chocolate and Prevention of Cardiovascular Disease: A Systematic Review

    PubMed Central

    Ding, Eric L; Hutfless, Susan M; Ding, Xin; Girotra, Saket

    2006-01-01

    Background Consumption of chocolate has been often hypothesized to reduce the risk of cardiovascular disease (CVD) due to chocolate's high levels of stearic acid and antioxidant flavonoids. However, debate still lingers regarding the true long term beneficial cardiovascular effects of chocolate overall. Methods We reviewed English-language MEDLINE publications from 1966 through January 2005 for experimental, observational, and clinical studies of relations between cocoa, cacao, chocolate, stearic acid, flavonoids (including flavonols, flavanols, catechins, epicatechins, and procynadins) and the risk of cardiovascular disease (coronary heart disease (CHD), stroke). A total of 136 publications were selected based on relevance, and quality of design and methods. An updated meta-analysis of flavonoid intake and CHD mortality was also conducted. Results The body of short-term randomized feeding trials suggests cocoa and chocolate may exert beneficial effects on cardiovascular risk via effects on lowering blood pressure, anti-inflammation, anti-platelet function, higher HDL, decreased LDL oxidation. Additionally, a large body of trials of stearic acid suggests it is indeed cholesterol-neutral. However, epidemiologic studies of serum and dietary stearic acid are inconclusive due to many methodologic limitations. Meanwhile, the large body of prospective studies of flavonoids suggests the flavonoid content of chocolate may reduce risk of cardiovascular mortality. Our updated meta-analysis indicates that intake of flavonoids may lower risk of CHD mortality, RR = 0.81 (95% CI: 0.71–0.92) comparing highest and lowest tertiles. Conclusion Multiple lines of evidence from laboratory experiments and randomized trials suggest stearic acid may be neutral, while flavonoids are likely protective against CHD mortality. The highest priority now is to conduct larger randomized trials to definitively investigate the impact of chocolate consumption on long-term cardiovascular outcomes. PMID:16390538

  5. A clinical perspective of obesity, metabolic syndrome and cardiovascular disease

    PubMed Central

    Lean, Mike EJ

    2016-01-01

    The metabolic syndrome is a condition characterized by a special constellation of reversible major risk factors for cardiovascular disease and type 2 diabetes. The main, diagnostic, components are reduced HDL-cholesterol, raised triglycerides, blood pressure and fasting plasma glucose, all of which are related to weight gain, specifically intra-abdominal/ectopic fat accumulation and a large waist circumference. Using internationally adopted arbitrary cut-off values for waist circumference, having metabolic syndrome doubles the risk of cardiovascular disease, but offers an effective treatment approach through weight management. Metabolic syndrome now affects 30–40% of people by age 65, driven mainly by adult weight gain, and by a genetic or epigenetic predisposition to intra-abdominal/ectopic fat accumulation related to poor intra-uterine growth. Metabolic syndrome is also promoted by a lack of subcutaneous adipose tissue, low skeletal muscle mass and anti-retroviral drugs. Reducing weight by 5–10%, by diet and exercise, with or without, anti-obesity drugs, substantially lowers all metabolic syndrome components, and risk of type 2 diabetes and cardiovascular disease. Other cardiovascular disease risk factors such as smoking should be corrected as a priority. Anti-diabetic agents which improve insulin resistance and reduce blood pressure, lipids and weight should be preferred for diabetic patients with metabolic syndrome. Bariatric surgery offers an alternative treatment for those with BMI ≥ 40 or 35–40 kg/m2 with other significant co-morbidity. The prevalence of the metabolic syndrome and cardiovascular disease is expected to rise along with the global obesity epidemic: greater emphasis should be given to effective early weight-management to reduce risk in pre-symptomatic individuals with large waists. PMID:26998259

  6. Insulin resistance: The linchpin between prediabetes and cardiovascular disease.

    PubMed

    Salazar, Martin R; Carbajal, Horacio A; Espeche, Walter G; Aizpura, Marcelo; Leiva Sisnieguez, Carlos E; Leiva Sisnieguez, Betty C; Stavile, Rodolfo N; March, Carlos E; Reaven, Gerald M

    2016-03-01

    The aim of this study was to test the hypothesis that cardiovascular disease occurs to the greatest extent in persons with prediabetes mellitus who are also insulin resistant. In 2003, 664 non-diabetic women (n?=?457) and men (n?=?207), aged 52??16 and 53??15?years, were surveyed during a programme for cardiovascular disease prevention. Fasting plasma glucose concentrations defined participants as having normal fasting plasma glucose (fasting plasma glucose <5.6?mmol/L) or prediabetes mellitus (fasting plasma glucose ?5.6 and <7.0?mmol/L). The tertile of prediabetes mellitus subjects with the highest fasting plasma insulin concentration was classified as insulin resistant. Baseline cardiovascular disease risk factors were accentuated in prediabetes mellitus versus normal fasting glucose, particularly in prediabetes mellitus/insulin resistant. In 2012, 86% of the sample were surveyed again, and the crude incidence for cardiovascular disease was higher in subjects with prediabetes mellitus versus normal fasting glucose (13.7 vs 6.0/100 persons/10?years; age- and sex-adjusted hazard ratio?=?1.88, p?=?0.052). In prediabetes mellitus, the crude incidences were 22.9 versus 9.6/100 persons/10?years in insulin resistant versus non-insulin resistant persons (age- and sex-adjusted hazard ratio?=?2.36, p?=?0.040). In conclusion, cardiovascular disease risk was accentuated in prediabetes mellitus/insulin resistant individuals, with a relative risk approximately twice as high compared to prediabetes mellitus/non-insulin resistant subjects. PMID:26802220

  7. A clinical perspective of obesity, metabolic syndrome and cardiovascular disease.

    PubMed

    Han, Thang S; Lean, Mike Ej

    2016-01-01

    The metabolic syndrome is a condition characterized by a special constellation of reversible major risk factors for cardiovascular disease and type 2 diabetes. The main, diagnostic, components are reduced HDL-cholesterol, raised triglycerides, blood pressure and fasting plasma glucose, all of which are related to weight gain, specifically intra-abdominal/ectopic fat accumulation and a large waist circumference. Using internationally adopted arbitrary cut-off values for waist circumference, having metabolic syndrome doubles the risk of cardiovascular disease, but offers an effective treatment approach through weight management. Metabolic syndrome now affects 30-40% of people by age 65, driven mainly by adult weight gain, and by a genetic or epigenetic predisposition to intra-abdominal/ectopic fat accumulation related to poor intra-uterine growth. Metabolic syndrome is also promoted by a lack of subcutaneous adipose tissue, low skeletal muscle mass and anti-retroviral drugs. Reducing weight by 5-10%, by diet and exercise, with or without, anti-obesity drugs, substantially lowers all metabolic syndrome components, and risk of type 2 diabetes and cardiovascular disease. Other cardiovascular disease risk factors such as smoking should be corrected as a priority. Anti-diabetic agents which improve insulin resistance and reduce blood pressure, lipids and weight should be preferred for diabetic patients with metabolic syndrome. Bariatric surgery offers an alternative treatment for those with BMI ≥ 40 or 35-40 kg/m(2) with other significant co-morbidity. The prevalence of the metabolic syndrome and cardiovascular disease is expected to rise along with the global obesity epidemic: greater emphasis should be given to effective early weight-management to reduce risk in pre-symptomatic individuals with large waists. PMID:26998259

  8. Should we treat chronic obstructive pulmonary disease as a cardiovascular disease?

    PubMed

    Rabinovich, Roberto A; MacNee, William

    2015-08-01

    Chronic obstructive pulmonary disease (COPD) is characterized by largely irreversible airflow limitation and is associated with several extrapulmonary manifestations and co-morbidities. Cardiovascular diseases are among the most frequent co-morbid conditions affecting patients with COPD and have important prognostic implications for hospitalization and mortality. In turn, COPD shares common risk factors with several cardiovascular diseases (i.e., smoking habit), while several features of COPD can predispose to cardiovascular disease (i.e., gas exchange abnormalities, polycythemia, systemic inflammation and sedentary lifestyle). Cardiovascular co-morbidities in patients with COPD are under-recognized and undertreated and should be actively sought and treated according to usual guidelines. This review will discuss the increased prevalence and prognostic implications of cardiovascular co-morbidities in patients with COPD. The effect of COPD on the outcomes in cardiovascular disease will also be highlighted and the pathogenic mechanisms that underlie cardiovascular co-morbidities in patients with COPD will also be reviewed. Finally, options for the management of cardiovascular co-morbidities in patients with COPD will be discussed. PMID:26190174

  9. Abnormalities in Alternative Splicing of Apoptotic Genes and Cardiovascular Diseases.

    PubMed

    Dlamini, Zodwa; Tshidino, Shonisani C; Hull, Rodney

    2015-01-01

    Apoptosis is required for normal heart development in the embryo, but has also been shown to be an important factor in the occurrence of heart disease. Alternative splicing of apoptotic genes is currently emerging as a diagnostic and therapeutic target for heart disease. This review addresses the involvement of abnormalities in alternative splicing of apoptotic genes in cardiac disorders including cardiomyopathy, myocardial ischemia and heart failure. Many pro-apoptotic members of the Bcl-2 family have alternatively spliced isoforms that lack important active domains. These isoforms can play a negative regulatory role by binding to and inhibiting the pro-apoptotic forms. Alternative splicing is observed to be increased in various cardiovascular diseases with the level of alternate transcripts increasing elevated in diseased hearts compared to healthy subjects. In many cases these isoforms appear to be the underlying cause of the disease, while in others they may be induced in response to cardiovascular pathologies. Regardless of this, the detection of alternate splicing events in the heart can serve as useful diagnostic or prognostic tools, while those splicing events that seem to play a causative role in cardiovascular disease make attractive future drug targets. PMID:26580598

  10. Abnormalities in Alternative Splicing of Apoptotic Genes and Cardiovascular Diseases

    PubMed Central

    Dlamini, Zodwa; Tshidino, Shonisani C.; Hull, Rodney

    2015-01-01

    Apoptosis is required for normal heart development in the embryo, but has also been shown to be an important factor in the occurrence of heart disease. Alternative splicing of apoptotic genes is currently emerging as a diagnostic and therapeutic target for heart disease. This review addresses the involvement of abnormalities in alternative splicing of apoptotic genes in cardiac disorders including cardiomyopathy, myocardial ischemia and heart failure. Many pro-apoptotic members of the Bcl-2 family have alternatively spliced isoforms that lack important active domains. These isoforms can play a negative regulatory role by binding to and inhibiting the pro-apoptotic forms. Alternative splicing is observed to be increased in various cardiovascular diseases with the level of alternate transcripts increasing elevated in diseased hearts compared to healthy subjects. In many cases these isoforms appear to be the underlying cause of the disease, while in others they may be induced in response to cardiovascular pathologies. Regardless of this, the detection of alternate splicing events in the heart can serve as useful diagnostic or prognostic tools, while those splicing events that seem to play a causative role in cardiovascular disease make attractive future drug targets. PMID:26580598

  11. [The relationship between gut microbiota and cardiovascular diseases].

    PubMed

    Gerardi, Viviana; Del Zompo, Fabio; D'Aversa, Francesca; Gasbarrini, Antonio

    2016-01-01

    The prevalence of cardiometabolic disorders (obesity, type 2 diabetes and cardiovascular disorders) is increasing globally and is a leading cause of mortality worldwide. Both genetics and environmental factors are involved in the pathogenesis of these disorders. Recent studies have shown that a state of dysbiosis may be implicated in body weight control, insulin resistance and cardio-metabolic risk factors, but the underlying mechanisms remain to be fully understood. Here we describe the possible role of the gut microbiota in cardiovascular diseases. PMID:26901254

  12. Nanoimaging in cardiovascular diseases: Current state of the art

    PubMed Central

    Deb, Suryyani; Ghosh, Kanjaksha; Shetty, Shrimati Dharmapal

    2015-01-01

    Nanotechnology has been integrated into healthcare system in terms of diagnosis as well as therapy. The massive impact of imaging nanotechnology has a deeper intervention in cardiology i.e. as contrast agents, to target vulnerable plaques with site specificity and in a theranostic approach to treat these plaques, stem cell delivery in necrotic myocardium, etc. Thus cardiovascular nanoimaging is not limited to simple diagnosis but also can help real time tracking during therapy as well as surgery. The present review provides a comprehensive description of the molecular imaging techniques for cardiovascular diseases with the help of nanotechnology and the potential clinical implications of nanotechnology for future applications. PMID:25963489

  13. The Role of Ezetimibe in the Treatment of Cardiovascular Disease.

    PubMed

    Agarwala, Anandita; Kajani, Zaid; Miedema, Michael D; Virani, Salim S

    2016-02-01

    Cardiovascular disease (CVD) is the leading cause of morbidity and mortality worldwide. Despite the success of treatment of CVD with statin therapy, a number of patients remain at high risk for CVD. Ezetimibe is a non-statin agent that inhibits intestinal cholesterol absorption, leading to reductions in low-density lipoprotein cholesterol (LDL-C). A number of clinical studies evaluating the use of ezetimibe therapy have resulted in discordant data regarding its safety and efficacy. In this review, we discuss the findings from these studies as well as potential indications for the use of ezetimibe for LDL-C lowering and cardiovascular event reduction. PMID:26792014

  14. Impact of kinins in the treatment of cardiovascular diseases.

    PubMed

    Regoli, Domenico; Plante, Gerard E; Gobeil, Fernand

    2012-07-01

    In recent years, ACE Inhibitors (ACEIs) and Angiotensin II receptor antagonists (also known as AT1 receptor antagonists (AT1-RAs), angiotensin receptor blockers (ARBs), or Sartans), have become the drugs of choice for the treatment of hypertension, heart and renal failure, coronary artery diseases, myocardial infarction and diabetes. By suppressing angiotensin and potentiating bradykinin effects, ACEIs and ARBs activate hemodynamic, metabolic and cellular mechanisms that not only reduce high blood pressure, but also protect the endothelium, the heart, the kidney and the brain, namely the target organs which are at risk in cardiovascular diseases. Major therapeutic benefits of these drugs are the reduction of cardiovascular events and the amelioration of the quality of life and of the patient survival. Results from large clinical trials have established that ACEIs and ARBs are efficient and safe drugs, suitable for the chronic treatments of cardiovascular diseases. Side effects are rare and easily manageable in most cases. The following is a brief review of the basic actions and mechanisms by which two opposing systems, the renin-angiotensin (RAS) and the kallikrein-kinin (KKS), interact in the regulation of cardiovascular and fluid homeostasis to keep the balance in healthy life and correct the imbalance in pathological conditions. Here we discuss how and why imbalances created by overactive RAS are best corrected by treatments with ACEI or AT1-RAs. PMID:22537664

  15. Impact of Diabetes on Cardiovascular Disease: An Update

    PubMed Central

    Matheus, Alessandra Saldanha de Mattos; Tannus, Lucianne Righeti Monteiro; Cobas, Roberta Arnoldi; Palma, Catia C. Sousa; Negrato, Carlos Antonio; Gomes, Marilia de Brito

    2013-01-01

    Cardiovascular diseases are the most prevalent cause of morbidity and mortality among patients with type 1 or type 2 diabetes. The proposed mechanisms that can link accelerated atherosclerosis and increased cardiovascular risk in this population are poorly understood. It has been suggested that an association between hyperglycemia and intracellular metabolic changes can result in oxidative stress, low-grade inflammation, and endothelial dysfunction. Recently, epigenetic factors by different types of reactions are known to be responsible for the interaction between genes and environment and for this reason can also account for the association between diabetes and cardiovascular disease. The impact of clinical factors that may coexist with diabetes such as obesity, dyslipidemia, and hypertension are also discussed. Furthermore, evidence that justify screening for subclinical atherosclerosis in asymptomatic patients is controversial and is also matter of this review. The purpose of this paper is to describe the association between poor glycemic control, oxidative stress, markers of insulin resistance, and of low-grade inflammation that have been suggested as putative factors linking diabetes and cardiovascular disease. PMID:23533715

  16. Surgical Robotics Research in Cardiovascular Disease

    SciTech Connect

    Pohost, Gerald M; Guthrie, Barton L; Steiner, Charles

    2008-02-29

    This grant is to support a research in robotics at three major medical centers: the University of Southern California-USC- (Project 1); the University of Alabama at Birmingham-UAB-(Project 2); and the Cleveland Clinic Foundation-CCF-(Project 3). Project 1 is oriented toward cardiovascular applications, while projects 2 and 3 are oriented toward neurosurgical applications. The main objective of Project 1 is to develop an approach to assist patients in maintaining a constant level of stress while undergoing magnetic resonance imaging or spectroscopy. The specific project is to use handgrip to detect the changes in high energy phosphate metabolism between rest and stress. The high energy phosphates, ATP and phosphocreatine (PCr) are responsible for the energy of the heart muscle (myocardium) responsible for its contractile function. If the blood supply to the myocardium in insufficient to support metabolism and contractility during stress, the high energy phosphates, particularly PCr, will decrease in concentration. The high energy phosphates can be tracked using phosphorus-31 magnetic resonance spectroscopy ({sup 31}P MRS). In Project 2 the UAB Surgical Robotics project focuses on the use of virtual presence to assist with remote surgery and surgical training. The goal of this proposal was to assemble a pilot system for proof of concept. The pilot project was completed successfully and was judged to demonstrate that the concept of remote surgical assistance as applied to surgery and surgical training was feasible and warranted further development. The main objective of Project 3 is to develop a system to allow for the tele-robotic delivery of instrumentation during a functional neurosurgical procedure (Figure 3). Instrumentation such as micro-electrical recording probes or deep brain stimulation leads. Current methods for the delivery of these instruments involve the integration of linear actuators to stereotactic navigation systems. The control of these delivery devices utilizes an open-loop configuration involving a team consisting of neurosurgeon, neurologist and neurophysiologist all present and participating in the decision process of delivery. We propose the development of an integrated system which provides for distributed decision making and tele-manipulation of the instrument delivery system.

  17. Developmental basis of adult cardiovascular diseases

    PubMed Central

    Markwald, Roger R.; Norris, Russell A.; Moreno-Rodriguez, Ricardo; Levine, Robert A.

    2012-01-01

    In this chapter, we review the working hypothesis that the roots of adult valvular heart disease (VHD) lie in embryonic development. Valvulogenesis is a complex process in which growth factors signal the process of endocardium-to-mesenchyme transformation (EMT) resulting in formation of prevalvular “cushions.” The post-EMT processes, whereby cushions are morphogenetically remolded into valve leaflets, are less well understood, but they require periostin. Mice with targeted deletion of periostin develop degenerative changes similar to human forms of VHD. Mitral valves are also abnormally elongated in hypertrophic cardiomyopathy (HCM), which plays an important role in clinical disease expression. However, the mechanism for this is unclear, but correlates with enhanced expression of periostin in a specific population of ventricular cells derived from the embryonic proepicardial organ, which accumulate at sites where valvular endocardial EMT is reactivated. Collectively, these findings suggest that developmental mechanisms underlie adult valve responses to genetic mutations in degenerative VHD and HCM. PMID:20201901

  18. Social class and cardiovascular disease: the contribution of work.

    PubMed

    Marmot, M; Theorell, T

    1988-01-01

    Low social class has been identified as a risk factor for coronary heart disease in highly industrialized countries. The authors discuss the social class concept in relation to psychosocial working conditions. Most of those psychosocial work characteristics that are of relevance to cardiovascular risk, namely, skill discretion, authority over decisions, and social support at work, are unevenly distributed across social classes--the lower the social class, the fewer the resources for coping with psychosocial stressors. Furthermore, biomedical risk factors for cardiovascular illness are also unevenly distributed across social class and associated with psychosocial work characteristics. The main conclusion is that part of the association between social class and cardiovascular illness risk may be due to differences in psychosocial work conditions. The psychosocial work conditions may affect the risk through either neuroendocrine mechanisms or lifestyle. Excessive tobacco smoking, for instance, may be enforced by poor working conditions. PMID:3235250

  19. Stem cell therapies in cardiovascular disease A realistic appraisal

    PubMed Central

    Partovian, Chohreh; Simons, Michael

    2008-01-01

    The possibility of reconstituting the damaged heart has introduced a new paradigm in cardiovascular biology and created the potential for a new therapeutic approach in the cardiovascular field, where there is a compelling need for innovative treatments. While the results of animal and early clinical studies are encouraging, the more direct use of cell-based therapies in patients is still long-reached. Gaps in our basic understanding of mechanisms, lack of important randomized, double blind, and controlled clinical trials, as well as technology development for cell production are among challenges to be overcome before full translation of cell based therapies in clinical arena. This review focuses on summarizing the latest knowledge in stem cell therapy for cardiovascular diseases. PMID:19343101

  20. Resveratrol in cardiovascular disease: what is known from current research?

    PubMed

    Wang, Hong; Yang, Yue-Jin; Qian, Hai-Yan; Zhang, Qian; Xu, Hui; Li, Jian-Jun

    2012-05-01

    Resveratrol is a well-known antioxidant that exists in grape skin/seed, red wine, and the root of Polygonum cuspidatum, a traditional Chinese and Japanese medicinal material. Studies have found that resveratrol has many interesting properties, including anti-carcinogenic properties, anti-microbial and antiviral effects, the ability to reverse dyslipidemia and obesity, the ability to attenuate hyperglycemia and hyperinsulinemia, and the ability to protect endothelial function. Heart failure is the final consequence of the majority of cardiovascular diseases, and resveratrol has been shown to directly attenuate heart contraction. The cardiovascular protective capacities of resveratrol are associated with multiple molecular targets and may lead to the development of novel therapeutic strategies for atherosclerosis, ischemia/reperfusion, metabolic syndrome, and heart failure. This article will mainly review recently published basic researches about the protective cardiovascular effects of resveratrol because these results may lead to the development of new clinical therapeutics in patients. PMID:21688187

  1. Are there genetic paths common to obesity, cardiovascular disease outcomes, and cardiovascular risk factors?

    PubMed

    Rankinen, Tuomo; Sarzynski, Mark A; Ghosh, Sujoy; Bouchard, Claude

    2015-02-27

    Clustering of obesity, coronary artery disease, and cardiovascular disease risk factors is observed in epidemiological studies and clinical settings. Twin and family studies have provided some supporting evidence for the clustering hypothesis. Loci nearest a lead single nucleotide polymorphism (SNP) showing genome-wide significant associations with coronary artery disease, body mass index, C-reactive protein, blood pressure, lipids, and type 2 diabetes mellitus were selected for pathway and network analyses. Eighty-seven autosomal regions (181 SNPs), mapping to 56 genes, were found to be pleiotropic. Most pleiotropic regions contained genes associated with coronary artery disease and plasma lipids, whereas some exhibited coaggregation between obesity and cardiovascular disease risk factors. We observed enrichment for liver X receptor (LXR)/retinoid X receptor (RXR) and farnesoid X receptor/RXR nuclear receptor signaling among pleiotropic genes and for signatures of coronary artery disease and hepatic steatosis. In the search for functionally interacting networks, we found that 43 pleiotropic genes were interacting in a network with an additional 24 linker genes. ENCODE (Encyclopedia of DNA Elements) data were queried for distribution of pleiotropic SNPs among regulatory elements and coding sequence variations. Of the 181 SNPs, 136 were annotated to ≥ 1 regulatory feature. An enrichment analysis found over-representation of enhancers and DNAse hypersensitive regions when compared against all SNPs of the 1000 Genomes pilot project. In summary, there are genomic regions exerting pleiotropic effects on cardiovascular disease risk factors, although only a few included obesity. Further studies are needed to resolve the clustering in terms of DNA variants, genes, pathways, and actionable targets. PMID:25722444

  2. Are There Genetic Paths Common to Obesity, Cardiovascular Disease Outcomes, and Cardiovascular Risk Factors?

    PubMed Central

    Rankinen, Tuomo; Sarzynski, Mark A.; Ghosh, Sujoy; Bouchard, Claude

    2015-01-01

    Clustering of obesity, coronary artery disease, and cardiovascular disease risk factors is observed in epidemiological studies and clinical settings. Twin and family studies have provided some supporting evidence for the clustering hypothesis. Loci nearest a lead single nucleotide polymorphism (SNP) showing genome-wide significant associations with coronary artery disease, body mass index, C-reactive protein, blood pressure, lipids, and type 2 diabetes mellitus were selected for pathway and network analyses. Eighty-seven autosomal regions (181 SNPs), mapping to 56 genes, were found to be pleiotropic. Most pleiotropic regions contained genes associated with coronary artery disease and plasma lipids, whereas some exhibited coaggregation between obesity and cardiovascular disease risk factors. We observed enrichment for liver X receptor (LXR)/retinoid X receptor (RXR) and farnesoid X receptor/RXR nuclear receptor signaling among pleiotropic genes and for signatures of coronary artery disease and hepatic steatosis. In the search for functionally interacting networks, we found that 43 pleiotropic genes were interacting in a network with an additional 24 linker genes. ENCODE (Encyclopedia of DNA Elements) data were queried for distribution of pleiotropic SNPs among regulatory elements and coding sequence variations. Of the 181 SNPs, 136 were annotated to ?1 regulatory feature. An enrichment analysis found over-representation of enhancers and DNAse hypersensitive regions when compared against all SNPs of the 1000 Genomes pilot project. In summary, there are genomic regions exerting pleiotropic effects on cardiovascular disease risk factors, although only a few included obesity. Further studies are needed to resolve the clustering in terms of DNA variants, genes, pathways, and actionable targets. PMID:25722444

  3. New Perspectives of Infections in Cardiovascular Disease

    PubMed Central

    Fong, Ignatius W

    2009-01-01

    Infections have been recognized as significant causes of cardiac diseases for many decades. Various microorganisms have been implicated in the etiology of these diseases involving all classes of microbial agents. All components of the heart structure can be affected by infectious agents, i.e. pericardium, myocardium, endocardium, valves, autonomic nervous system, and some evidence of coronary arteries. A new breed of infections have evolved over the past three decades involving cardiac implants and this group of cardiac infectious complications will likely continue to increase in the future, as more mechanical devices are implanted in the growing ageing population. This article will review the progress made in the past decade on understanding the pathobiology of these infectious complications of the heart, through advances in genomics and proteomics, as well as potential novel approach for therapy. An up-to-date, state-of-the-art review and controversies will be outlined for the following conditions: (i) perimyocarditis; (ii) infective endocarditis; (iii) cardiac device infections; (iv) coronary artery disease and potential role of infections. PMID:20436849

  4. Clinical and pathological manifestations of cardiovascular disease in rat models: the influence of acute ozone exposure

    EPA Science Inventory

    This paper shows that rat models of cardiovascular diseases have differential degrees of underlying pathologies at a young age. Rodent models of cardiovascular diseases (CVD) and metabolic disorders are used for examining susceptibility variations to environmental exposures. How...

  5. Influence of maternal dysmetabolic conditions during pregnancy on cardiovascular disease.

    PubMed

    Palinski, Wulf; Nicolaides, Eric; Liguori, Antonio; Napoli, Claudio

    2009-09-01

    Pathogenic factors associated with maternal hypercholesterolemia, obesity, and diabetic conditions during pregnancy influence fetal development and predispose offspring to cardiovascular disease. Animal models have established cause-effect relationships consistent with epidemiological findings in humans and have demonstrated, in principle, that interventions before or during pregnancy can reduce or prevent pathogenic in utero programming. However, little is known about the mechanisms by which maternal dysmetabolic conditions enhance disease susceptibility in offspring. Identification of these mechanisms is rendered more difficult by the fact that programming effects in offspring may be latent and may require conventional risk factors and inherited genetic co-factors to become clinically manifest. Given the increasing prevalence of maternal risk factors, which is expected to lead to a wave of cardiovascular disease in the coming decades, and the length of prospective studies on developmental programming in humans, greater-than-usual emphasis on experimental models and translational studies is necessary. PMID:19655024

  6. [Developmental origins of cardiovascular disease and early intervention windows].

    PubMed

    Mi, J

    2016-01-01

    Cardiovascular diseases are the major threat to human health and underlie almost half of all deaths in China. Even more serious, obesity and cardiometabolic risk factors have emerged to be prevalent in children and adolescents of some affluent regions. As scientific knowledge emerges on the role of nutritional factors and exposures to environmental risk factors in the developmental origins of health and disease, evidence suggests that it is imperative to create and implement early effective prevention strategies, including optimisation of nutrition at first 1 000 days in life course and reduction of risk factors of obesity exposures during whole childhood, to suppress the rising trend of cardiovascular disease, otherwise, the future costs of diagnosis and treatment are likely to be unaffordable. PMID:26792495

  7. Autophagy as a Therapeutic Target in Cardiovascular Disease

    PubMed Central

    Nemchenko, Andriy; Chiong, Mario; Turer, Aslan; Lavandero, Sergio; Hill, Joseph A.

    2011-01-01

    The epidemic of heart failure continues apace, and development of novel therapies with clinical efficacy has lagged. Now, important insights into the molecular circuitry of cardiovascular autophagy have raised the prospect that this cellular pathway of protein quality control may be a target of clinical relevance. Whereas basal levels of autophagy are required for cell survival, excessive levels or perhaps distinct forms of autophagic flux contribute to disease pathogenesis. Our challenge will be to distinguish mechanisms that drive adaptive versus maladaptive autophagy and to manipulate those pathways for therapeutic gain. Recent evidence suggests this may be possible. Here, we review the fundamental biology of autophagy and its role in a variety of forms of cardiovascular disease. We discuss ways in which this evolutionarily conserved catabolic mechanism can be manipulated, discuss studies presently underway in heart disease, and provide our perspective on where this exciting field may lead in the future. PMID:21723289

  8. MOUSE MODELS OF ARRHYTHMOGENIC CARDIOVASCULAR DISEASE: CHALLENGES AND OPPORTUNITIES

    PubMed Central

    Nerbonne, Jeanne M.

    2014-01-01

    Arrhythmogenic cardiovascular disease is associated with significant morbidity and mortality and, in spite of therapeutic advances, remains an enormous public health burden. The scope of this problem motivates efforts to delineate the molecular, cellular and systemic mechanisms underlying increased arrhythmia risk in inherited and acquired cardiac and systemic disease. The mouse is used increasingly in these efforts owing to the ease with which genetic strategies can be exploited and mechanisms can be probed. The question then arises whether the mouse has proven to be a useful model system to delineate arrhythmogenic cardiovascular disease mechanisms. Rather than trying to provide a definite answer, the goal here is to consider the issues that arise when using mouse models and to highlight the opportunities. PMID:24632325

  9. C-Reactive Protein, Fibrinogen, and Cardiovascular Disease Prediction

    PubMed Central

    2013-01-01

    BACKGROUND There is debate about the value of assessing levels of C-reactive protein (CRP) and other biomarkers of inflammation for the prediction of first cardiovascular events. METHODS We analyzed data from 52 prospective studies that included 246,669 participants without a history of cardiovascular disease to investigate the value of adding CRP or fibrinogen levels to conventional risk factors for the prediction of cardiovascular risk. We calculated measures of discrimination and reclassification during follow-up and modeled the clinical implications of initiation of statin therapy after the assessment of CRP or fibrinogen. RESULTS The addition of information on high-density lipoprotein cholesterol to a prognostic model for cardiovascular disease that included age, sex, smoking status, blood pressure, history of diabetes, and total cholesterol level increased the C-index, a measure of risk discrimination, by 0.0050. The further addition to this model of information on CRP or fibrinogen increased the C-index by 0.0039 and 0.0027, respectively (P<0.001), and yielded a net reclassification improvement of 1.52% and 0.83%, respectively, for the predicted 10-year risk categories of “low” (<10%), “intermediate” (10% to <20%), and “high” (≥20%) (P<0.02 for both comparisons). We estimated that among 100,000 adults 40 years of age or older, 15,025 persons would initially be classified as being at intermediate risk for a cardiovascular event if conventional risk factors alone were used to calculate risk. Assuming that statin therapy would be initiated in accordance with Adult Treatment Panel III guidelines (i.e., for persons with a predicted risk of ≥20% and for those with certain other risk factors, such as diabetes, irrespective of their 10-year predicted risk), additional targeted assessment of CRP or fibrinogen levels in the 13,199 remaining participants at intermediate risk could help prevent approximately 30 additional cardiovascular events over the course of 10 years. CONCLUSIONS In a study of people without known cardiovascular disease, we estimated that under current treatment guidelines, assessment of the CRP or fibrinogen level in people at intermediate risk for a cardiovascular event could help prevent one additional event over a period of 10 years for every 400 to 500 people screened. (Funded by the British Heart Foundation and others.) PMID:23034020

  10. A Review of Calcium Supplements and Cardiovascular Disease Risk12

    PubMed Central

    Heaney, Robert P.; Kopecky, Stephen; Maki, Kevin C.; Hathcock, John; MacKay, Douglas; Wallace, Taylor C.

    2012-01-01

    A group of academic and industry experts in the fields of nutrition, cardiology, epidemiology, food science, bone health, and integrative medicine examined the data on the relationship between calcium supplement use and risk of cardiovascular events, with an emphasis on 4 of the Bradford Hill criteria for causal inference: strength, consistency, dose-response, and biological plausibility. Results from 2 epidemiological studies and a meta-analysis of randomized, controlled clinical trials, including a subgroup analysis from the Womens Health Initiative, have prompted concern about a potential association between calcium supplement use and a small increase in the risk of adverse cardiovascular events. However, a number of issues with the studies, such as inadequate compliance with the intervention, use of nontrial calcium supplements, potential bias in event ascertainment, and lack of information on and adjustment for known cardiovascular risk determinants, suggest that bias and confounding cannot be excluded as explanations for the reported associations. Findings from other cohort studies also suggest no detrimental effect of calcium from diet or supplements, with or without vitamin D, on cardiovascular disease risk. In addition, little evidence exists for plausible biological mechanisms to link calcium supplement use with adverse cardiovascular outcomes. The authors do not believe that the evidence presented to date regarding the hypothesized relationship between calcium supplement use and increased cardiovascular disease risk is sufficient to warrant a change in the Institute of Medicine recommendations, which advocate use of supplements to promote optimal bone health in individuals who do not obtain recommended intakes of calcium through dietary sources. PMID:23153730

  11. Tetrahydrobiopterin Improves Endothelial Function in Cardiovascular Disease: A Systematic Review

    PubMed Central

    Wang, Qiongying; Yang, Mina; Xu, Han; Yu, Jing

    2014-01-01

    Background. Tetrahydrobiopterin (BH4) is a cofactor of nitric oxide synthase (NOS). Nitric oxide (NO) bioavailability is reduced during the early stage of vascular diseases, such as coronary artery disease, hypercholesterolemia, hypertension, and diabetic vasculopathy, and even throughout the entire progression of atherosclerosis. Methods. A literature search was performed using electronic databases (up to January 31, 2014), including MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL), using an established strategy. Results. Fourteen articles were selected with a total of 370 patients. Ten of the fourteen studies showed a significant improvement in the endothelial dysfunction of various cardiovascular disease groups with BH4 supplementation compared with the control groups or placebos. Three studies showed no positive outcome, and one study showed that low-dose BH4 had no effect but that high-dose BH4 did have a significantly different result. Conclusions. This review concludes that supplementation with BH4 and/or augmentation of the endogenous levels of BH4 will be a novel approach to improve the endothelial dysfunction observed in various cardiovascular diseases. BH4 might be considered to be a new therapeutic agent to prevent the initiation and progression of cardiovascular disease. PMID:25548592

  12. HDAC and HDAC Inhibitor: From Cancer to Cardiovascular Diseases

    PubMed Central

    Yoon, Somy

    2016-01-01

    Histone deacetylases (HDACs) are epigenetic regulators that regulate the histone tail, chromatin conformation, protein-DNA interaction, and even transcription. HDACs are also post-transcriptional modifiers that regulate the protein acetylation implicated in several pathophysiologic states. HDAC inhibitors have been highlighted as a novel category of anti-cancer drugs. To date, four HDAC inhibitors, Vorinostat, Romidepsin, Panobinostat, and Belinostat, have been approved by the United States Food and Drug Administration. Principally, these HDAC inhibitors are used for hematologic cancers in clinic with less severe side effects. Clinical trials are continuously expanding to address other types of cancer and also nonmalignant diseases. HDAC inhibition also results in beneficial outcomes in various types of neurodegenerative diseases, inflammation disorders, and cardiovascular diseases. In this review, we will briefly discuss 1) the roles of HDACs in the acquisition of a cancer's phenotype and the general outcome of the HDAC inhibitors in cancer, 2) the functional relevance of HDACs in cardiovascular diseases and the possible therapeutic implications of HDAC inhibitors in cardiovascular disease. PMID:26865995

  13. Understanding the application of stem cell therapy in cardiovascular diseases.

    PubMed

    Sharma, Rakesh K; Voelker, Donald J; Sharma, Roma; Reddy, Hanumanth K

    2012-01-01

    Throughout their lifetime, an individual may sustain many injuries and recover spontaneously over a period of time, without even realizing the injury in the first place. Wound healing occurs due to a proliferation of stem cells capable of restoring the injured tissue. The ability of adult stem cells to repair tissue is dependent upon the intrinsic ability of tissues to proliferate. The amazing capacity of embryonic stem cells to give rise to virtually any type of tissue has intensified the search for similar cell lineage in adults to treat various diseases including cardiovascular diseases. The ability to convert adult stem cells into pluripotent cells that resemble embryonic cells, and to transplant those in the desired organ for regenerative therapy is very attractive, and may offer the possibility of treating harmful disease-causing mutations. The race is on to find the best cells for treatment of cardiovascular disease. There is a need for the ideal stem cell, delivery strategies, myocardial retention, and time of administration in the ideal patient population. There are multiple modes of stem cell delivery to the heart with different cell retention rates that vary depending upon method and site of injection, such as intra coronary, intramyocardial or via coronary sinus. While there are crucial issues such as retention of stem cells, microvascular plugging, biodistribution, homing to myocardium, and various proapoptotic factors in the ischemic myocardium, the regenerative potential of stem cells offers an enormous impact on clinical applications in the management of cardiovascular diseases. PMID:24198536

  14. Understanding the application of stem cell therapy in cardiovascular diseases

    PubMed Central

    Sharma, Rakesh K; Voelker, Donald J; Sharma, Roma; Reddy, Hanumanth K

    2012-01-01

    Throughout their lifetime, an individual may sustain many injuries and recover spontaneously over a period of time, without even realizing the injury in the first place. Wound healing occurs due to a proliferation of stem cells capable of restoring the injured tissue. The ability of adult stem cells to repair tissue is dependent upon the intrinsic ability of tissues to proliferate. The amazing capacity of embryonic stem cells to give rise to virtually any type of tissue has intensified the search for similar cell lineage in adults to treat various diseases including cardiovascular diseases. The ability to convert adult stem cells into pluripotent cells that resemble embryonic cells, and to transplant those in the desired organ for regenerative therapy is very attractive, and may offer the possibility of treating harmful disease-causing mutations. The race is on to find the best cells for treatment of cardiovascular disease. There is a need for the ideal stem cell, delivery strategies, myocardial retention, and time of administration in the ideal patient population. There are multiple modes of stem cell delivery to the heart with different cell retention rates that vary depending upon method and site of injection, such as intra coronary, intramyocardial or via coronary sinus. While there are crucial issues such as retention of stem cells, microvascular plugging, biodistribution, homing to myocardium, and various proapoptotic factors in the ischemic myocardium, the regenerative potential of stem cells offers an enormous impact on clinical applications in the management of cardiovascular diseases. PMID:24198536

  15. Sexual dysfunction and cardiovascular diseases: a systematic review of prevalence

    PubMed Central

    Nascimento, Elisabete Rodrigues; Maia, Ana Claudia Ornelas; Pereira, Valeska; Soares-Filho, Gasto; Nardi, Antonio Egidio; Silva, Adriana Cardoso

    2013-01-01

    The aim of this study was to conduct a systematic review of the literature regarding the prevalence of sexual dysfunction in patients with cardiovascular diseases. An article search of the ISI Web of Science and PubMed databases using the search terms "sexual dysfunction, cardiovascular diseases, coronary artery disease", myocardial infarct" and prevalence was performed. In total, 893 references were found. Non-English-language and repeated references were excluded. After an abstract analysis, 91 references were included for full-text reading, and 24 articles that evaluated sexual function using validated instruments were selected for this review. This research was conducted in October 2012, and no time restrictions were placed on any of the database searches. Reviews and theoretical articles were excluded; only clinical trials and epidemiological studies were selected for this review. The studies were mostly cross-sectional, observational and case-control in nature; other studies used prospective cohort or randomized clinical designs. In women, all domains of sexual function (desire, arousal, vaginal lubrication, orgasm, sexual dissatisfaction and pain) were affected. The domains prevalent in men included erectile dysfunction and premature ejaculation and orgasm. Sexual dysfunction was related to the severity of cardiovascular disease. When they resumed sexual activity, patients with heart disease reported significant difficulty, including a lack of interest in sex, sexual dissatisfaction and a decrease in the frequency of sexual activity. PMID:24270960

  16. Extracellular vesicles as therapeutic tools in cardiovascular diseases.

    PubMed

    Fleury, Audrey; Martinez, Maria Carmen; Le Lay, Soazig

    2014-01-01

    Extracellular vesicles (EVs), including microvesicles (MVs) and exosomes, are small vesicles secreted from a wide variety of cells. Whereas MVs are particles released by the outward budding of the plasma membrane, exosomes are derived from endocytic compartments. Secretion of EVs can be enhanced by specific stimuli, and increased plasma circulating levels of EVs have been correlated with pathophysiological situations. MVs, already present in the blood of healthy individuals, are considerably elevated in several cardiovascular diseases associated with inflammation, suggesting that they can mediate deleterious effects such as endothelial dysfunction or thrombosis. Nonetheless, very recent studies also demonstrate that MVs may act as biological information vectors transferring proteins or genetic material to maintain cell homeostasis, favor cell repair, or even promote angiogenesis. Additionally, exosomes have also been shown to have pro-angiogenic and cardio-protective properties. These beneficial effects, therefore, reveal the potential therapeutical use of EVs in the field of cardiovascular medicine and regenerative therapy. In this review, we will provide an update of cellular processes modulated by EVs of specific interest in the treatment of cardiovascular pathologies. A special focus will be made on the morphogen sonic hedgehog (Shh) associated with EVs (EVs(Shh+)), which have been shown to mediate many pro-angiogenic effects. In addition to offer a potential source of cardiovascular markers, therapeutical potential of EVs reveal exciting opportunities to deliver specific agents by non-immunogenic means to cardiovascular system. PMID:25136343

  17. Exercise Prevention of Cardiovascular Disease in Breast Cancer Survivors

    PubMed Central

    Kirkham, Amy A.; Davis, Margot K.

    2015-01-01

    Thanks to increasingly effective treatment, breast cancer mortality rates have significantly declined over the past few decades. Following the increase in life expectancy of women diagnosed with breast cancer, it has been recognized that these women are at an elevated risk for cardiovascular disease due in part to the cardiotoxic side effects of treatment. This paper reviews evidence for the role of exercise in prevention of cardiovascular toxicity associated with chemotherapy used in breast cancer, and in modifying cardiovascular risk factors in breast cancer survivors. There is growing evidence indicating that the primary mechanism for this protective effect appears to be improved antioxidant capacity in the heart and vasculature and subsequent reduction of treatment-related oxidative stress in these structures. Further clinical research is needed to determine whether exercise is a feasible and effective nonpharmacological treatment to reduce cardiovascular morbidity and mortality in breast cancer survivors, to identify the cancer therapies for which it is effective, and to determine the optimal exercise dose. Safe and noninvasive measures that are sensitive to changes in cardiovascular function are required to answer these questions in patient populations. Cardiac strain, endothelial function, and cardiac biomarkers are suggested outcome measures for clinical research in this field. PMID:26339243

  18. [Cardiovascular risk in polycystic kidney disease].

    PubMed

    Di Lorenzo, Adelaide; Stallone, Giovanni; Infante, Barbara; Grandaliano, Giuseppe; Schena, Francesco Paolo

    2015-09-01

    Hypertension is common and occurs in the majority of autosomal dominant polycystic kidney disease (ADPKD) patients prior to loss of kidney function. Hypertension relates to progressive kidney enlargement, and is a significant independent risk factor for progression to end-stage renal disease. The pathogenesis of hypertension in ADPKD is complex and depends on many factors that influence each other. High expression of PKD1 and PKD2 genes is present in the cilia of tubular epithelial cells, in endothelial cells and in vascular smooth muscle cells. Decreased or absent polycystin-1 or -2 expression is associated with abnormal vascular structure and function. PKD1/PKD2 deficiency results in reduced nitric oxide levels, altered endothelial response to shear stress with attenuation in vascular relaxation. Activation of the renin-angiotensin-aldosterone system occurs in ADPKD due to decreased nitric oxide production as well as bilateral cyst expansion and intra-renal ischemia. With increasing cyst size, further activation of the renin-angiotensin-aldosterone system occurs, blood pressure increases and a vicious cycle ensues with enhanced cyst growth and hypertension ultimately leading to end-stage renal disease. Inhibition of the angiotensin-aldosterone system is possible with angiotensin-converting enzyme inhibitors and seems to be the first-line treatment for hypertension in these subjects. As suggested by the HALT-PKD study, an aggressive blood pressure control is safe and recommended and is associated with preservation of kidney function and a reduction in total kidney volume over time. A collaborative multidisciplinary approach between nephrologists and cardiologists is necessary for the monitoring of kidney and heart complications. PMID:26418387

  19. Cardiovascular disease in patients with chronic inflammation: mechanisms underlying premature cardiovascular events in rheumatologic conditions

    PubMed Central

    Mason, Justin C.; Libby, Peter

    2015-01-01

    A variety of systemic inflammatory rheumatic diseases associate with an increased risk of atherosclerotic events and premature cardiovascular (CV) disease. Although this recognition has stimulated intense basic science and clinical research, the precise nature of the relationship between local and systemic inflammation, their interactions with traditional CV risk factors, and their role in accelerating atherogenesis remains unresolved. The individual rheumatic diseases have both shared and unique attributes that might impact CV events. Understanding of the positive and negative influences of individual anti-inflammatory therapies remains rudimentary. Clinicians need to adopt an evidence-based approach to develop diagnostic techniques to identify those rheumatologic patients most at risk of CV disease and to develop effective treatment protocols. Development of optimal preventative and disease-modifying approaches for atherosclerosis in these patients will require close collaboration between basic scientists, CV specialists, and rheumatologists. This interface presents a complex, important, and exciting challenge. PMID:25433021

  20. Cardiovascular disease in patients with chronic inflammation: mechanisms underlying premature cardiovascular events in rheumatologic conditions.

    PubMed

    Mason, Justin C; Libby, Peter

    2015-02-21

    A variety of systemic inflammatory rheumatic diseases associate with an increased risk of atherosclerotic events and premature cardiovascular (CV) disease. Although this recognition has stimulated intense basic science and clinical research, the precise nature of the relationship between local and systemic inflammation, their interactions with traditional CV risk factors, and their role in accelerating atherogenesis remains unresolved. The individual rheumatic diseases have both shared and unique attributes that might impact CV events. Understanding of the positive and negative influences of individual anti-inflammatory therapies remains rudimentary. Clinicians need to adopt an evidence-based approach to develop diagnostic techniques to identify those rheumatologic patients most at risk of CV disease and to develop effective treatment protocols. Development of optimal preventative and disease-modifying approaches for atherosclerosis in these patients will require close collaboration between basic scientists, CV specialists, and rheumatologists. This interface presents a complex, important, and exciting challenge. PMID:25433021

  1. Increased Atherothrombotic Burden in Patients with Diabetes Mellitus and Acute Coronary Syndrome: A Review of Antiplatelet Therapy

    PubMed Central

    Balasubramaniam, Karthik; Viswanathan, Girish N.; Marshall, Sally M.; Zaman, Azfar G.

    2012-01-01

    Patients with diabetes mellitus presenting with acute coronary syndrome have a higher risk of cardiovascular complications and recurrent ischemic events when compared to nondiabetic counterparts. Different mechanisms including endothelial dysfunction, platelet hyperactivity, and abnormalities in coagulation and fibrinolysis have been implicated for this increased atherothrombotic risk. Platelets play an important role in atherogenesis and its thrombotic complications in diabetic patients with acute coronary syndrome. Hence, potent platelet inhibition is of paramount importance in order to optimise outcomes of diabetic patients with acute coronary syndrome. The aim of this paper is to provide an overview of the increased thrombotic burden in diabetes and acute coronary syndrome, the underlying pathophysiology focussing on endothelial and platelet abnormalities, currently available antiplatelet therapies, their benefits and limitations in diabetic patients, and to describe potential future therapeutic strategies to overcome these limitations. PMID:22347666

  2. Angiotensin converting enzyme genotype in cardiovascular disease

    SciTech Connect

    Summers, K.M.; Huggard, P.R.; West, M.J.

    1994-09-01

    Angiotensin converting enzyme (ACE) catalyses formation of angiotensin II and degradation of bradykinin, vasoactive peptides with opposing properties. The result of ACE action is to promote vasoconstriction and cell growth. PCR is used to detect a common polymorphism due to the insertion of an Alu repeat element of 287 bp into intron 16. ACE genotype has been implicated in risk for myocardial infarction (MI) and hypertension in humans. We have studied a group of 640 patients (61% male aged 64 {plus_minus} 11 years) with myocardial ischaemic syndromes, followed for 12 months after initial hospital admission. In this group, the frequency of the insertion (I) allele was 0.47 (N=1170 chromosomes), not significantly higher than the frequency of 0.46 in 112 local blood donors (50% male aged 59 {plus_minus}5 years). In the 300 patients with diagnosed MI, I allele frequency was 0.48. This is significantly higher ({chi}{sup 2}=5.78, P=0.015) than the frequency of 0.42 reported in a multi-centre study of ACE genotype in 600 male European patients with MI . There was a non-significant increase in the frequency of a cardiac event within 6 months of hospital admission in those of II genotype (N=464, 47 events to date). These results suggest that in our population, the I allele and/or II genotype may be associated with risk of MI. This contrasts with the study cited above, where the D (deletion) allele and DD genotype frequency were raised in patients compared with controls. Hypertension is associated with the ACE D allele, and does not explain the heart disease risk, which may be associated with the I allele, in this group of survivors of myocardial ischaemic disease. The difference between our results and the previous study may be due to ascertainment or ethnic differences or to problems amplifying the I allele in some heterozygotes. Clearly, the role of ACE genotype in these diseases is complex.

  3. Integrative Treatments to Reduce Risk for Cardiovascular Disease

    PubMed Central

    Bradley, Ryan; Oberg, Erica

    2010-01-01

    Recognizing the contribution and interrelatedness of lipoprotein risk factors is critical to prioritizing treatment strategies for cardiovascular risk reduction. Lipoprotein factors still dominate risk for developing cardiovascular disease, including myocardial infarction. Some emerging risk factors such as C-reactive protein are gaining acceptance due to recent prospective clinical trials demonstrating clinical benefit in reducing these markers. Other emerging risk factors, including lipoprotein particle size, remain to be validated. In this second article of a 2-part series, we will begin with a review of formal risk assessment, discussing the contribution of multiple “risky” and “healthy” components that play a part in overall cardiovascular health. Following risk assessment, we will discuss evidence-based integrative therapies that can be used to modify any risky lipoprotein and inflammatory patient profiles, including medications, functional foods, supplements, and lifestyle approaches. The focus is on low-density lipoproteins, high-density lipoproteins, triglycerides, and C-reactive protein. Understanding the interrelatedness of lipoprotein risk factors, and finding efficient methods of treating multiple risk factors simultaneously, will not only improve the long-term health of patients but will also save on the expenditure of healthcare dollars for unnecessary testing and ineffective treatments. Integrative practitioners who understand the contribution of lifestyle factors, and who have numerous effective treatment options at their disposal, are well positioned to counsel patients on cardiovascular disease prevention. PMID:21461347

  4. The Advancing Clinical Impact of Molecular Imaging in Cardiovascular Disease

    PubMed Central

    Osborn, Eric A; Jaffer, Farouc A

    2013-01-01

    Molecular imaging seeks to unravel critical molecular and cellular events in living subjects by providing complementary biological information to current structural clinical imaging modalities. In recent years, molecular imaging efforts have marched forward into the clinical cardiovascular arena, and are now actively illuminating new biology in a broad range of conditions, including atherosclerosis, myocardial infarction, thrombosis, vasculitis, aneurysm, cardiomyopathy, and valvular disease. Development of novel molecular imaging reporters is occurring for many clinical cardiovascular imaging modalities (PET, SPECT, MRI), as well in translational platforms such as intravascular fluorescence imaging. The ability to image, track, and quantify molecular biomarkers in organs not routinely amenable to biopsy (e.g. the heart and vasculature) open new clinical opportunities to tailor therapeutics based on a cardiovascular disease molecular profile. In addition, molecular imaging is playing an increasing role in atherosclerosis drug development in Phase II clinical trials. Here we present state-of-the-art clinical cardiovascular molecular imaging strategies, and explore promising translational approaches positioned for clinical testing in the near term. PMID:24332285

  5. Targeting BMP signalling in cardiovascular disease and anaemia.

    PubMed

    Morrell, Nicholas W; Bloch, Donald B; Ten Dijke, Peter; Goumans, Marie-Jose T H; Hata, Akiko; Smith, Jim; Yu, Paul B; Bloch, Kenneth D

    2016-02-01

    Bone morphogenetic proteins (BMPs) and their receptors, known to be essential regulators of embryonic patterning and organogenesis, are also critical for the regulation of cardiovascular structure and function. In addition to their contributions to syndromic disorders including heart and vascular development, BMP signalling is increasingly recognized for its influence on endocrine-like functions in postnatal cardiovascular and metabolic homeostasis. In this Review, we discuss several critical and novel aspects of BMP signalling in cardiovascular health and disease, which highlight the cell-specific and context-specific nature of BMP signalling. Based on advancing knowledge of the physiological roles and regulation of BMP signalling, we indicate opportunities for therapeutic intervention in a range of cardiovascular conditions including atherosclerosis and pulmonary arterial hypertension, as well as for anaemia of inflammation. Depending on the context and the repertoire of ligands and receptors involved in specific disease processes, the selective inhibition or enhancement of signalling via particular BMP ligands (such as in atherosclerosis and pulmonary arterial hypertension, respectively) might be beneficial. The development of selective small molecule antagonists of BMP receptors, and the identification of ligands selective for BMP receptor complexes expressed in the vasculature provide the most immediate opportunities for new therapies. PMID:26461965

  6. Systemic Adiponectin Malfunction as a Risk Factor for Cardiovascular Disease

    PubMed Central

    Lau, Wayne Bond; Tao, Ling; Wang, Yajing; Li, Rong

    2011-01-01

    Abstract Adiponectin (Ad) is an abundant protein hormone regulatory of numerous metabolic processes. The 30?kDa protein originates from adipose tissue, with full-length and globular domain circulatory forms. A collagenous domain within Ad leads to spontaneous self-assemblage into various oligomeric isoforms, including trimers, hexamers, and high-molecular-weight multimers. Two membrane-spanning receptors for Ad have been identified, with differing concentration distribution in various body tissues. The major intracellular pathway activated by Ad includes phosphorylation of AMP-activated protein kinase, which is responsible for many of Ad's metabolic regulatory, anti-inflammatory, vascular protective, and anti-ischemic properties. Additionally, several AMP-activated protein kinase-independent mechanisms responsible for Ad's anti-inflammatory and anti-ischemic (resulting in cardioprotective) effects have also been discovered. Since its 1995 discovery, Ad has garnered considerable attention for its role in diabetic and cardiovascular pathology. Clinical observations have demonstrated the association of hypoadiponectinemia in patients with obesity, cardiovascular disease, and insulin resistance. In this review, we elaborate currently known information about Ad malfunction and deficiency pertaining to cardiovascular disease risk (including atherosclerosis, endothelial dysfunction, and cardiac injury), as well as review evidence supporting Ad resistance as a novel risk factor for cardiovascular injury, providing insight about the future of Ad research and the protein's potential therapeutic benefits. Antioxid. Redox Signal. 15, 18631873. PMID:21091079

  7. Vitamin D and Cardiovascular Disease: An Appraisal of the Evidence

    PubMed Central

    Schnatz, Peter F.; Manson, JoAnn E.

    2013-01-01

    Background Supplementation with vitamin D (VitD) has received attention as a potential cardioprotective strategy. Biologically plausible mechanisms have been proposed to link VitD to coronary heart disease (CHD) prevention and observational studies suggest an inverse association between serum 25-hydroxyvitamin D (25OHD) concentrations and CHD. Few randomized clinical trials of VitD supplementation and CHD have been conducted, however, and no completed trial has been done with CHD as the primary pre-specified outcome. Content A search was conducted in PubMed to find prospective studies on the use of vitamin D supplementation and cardiovascular risk factors (RFs) and/or cardiovascular disease. The exact search query was ((vitamin D supplement*[Title/Abstract]) AND cardiovascular [Title/Abstract]) AND prospective [Title/Abstract]. This query yielded 42 results. Randomized Controlled Trial (article type) was employed as a filter in a subsequent query with the same search terms. We review the evidence that VitD supplementation modifies coronary RFs, such as blood pressure, lipids, and glucose tolerance, and/or affects the development of clinical CHD events. We address potential sources of confounding in observational epidemiologic studies of the relationship between serum 25OHD and CHD. We also address laboratory assay issues relevant to the reliable measurement of 25OHD. Summary Most VitD supplementation trials have not demonstrated improvement in cardiovascular disease, but have tested relatively low doses of VitD. Thus, the evidence remains inconclusive, highlighting the need for rigorous randomized trials of higher VitD doses, with cardiovascular events as prespecified outcomes. While awaiting ongoing trial results, the recommended dietary allowances from the Institute of Medicine remain the best guidepost for nutritional requirements. PMID:24193116

  8. MicroRNAs and Cardiovascular Diseases

    PubMed Central

    Akasaka, Takashi

    2015-01-01

    Coronary artery diseases (CAD) and heart failure have high mortality rate in the world, although much progress has been made in this field in last two decades. There is still a clinical need for a novel diagnostic approach and a therapeutic strategy to decrease the incidence of CAD. MicroRNAs (miRNAs) are highly conserved noncoding small RNA molecules that regulate a large fraction of the genome by binding to complementary messenger RNA sequences, resulting in posttranscriptional gene silencing. Recent studies have shown that specific miRNAs are involved in whole stage of atherosclerosis, from endothelium dysfunction to plaque rupture. These findings suggest that miRNAs are potential biomarkers in early diagnosis and therapeutic targets in CAD. In the present review, we highlight the role of miRNAs in every stage of atherosclerosis, and discuss the prospects of miRNAs in the near future. PMID:25710020

  9. [Cardiovascular disease: a view from global health perspective].

    PubMed

    Salinas Botrn, Alejandro; Ramos Rincn, Jos Manuel; de Grgolas Hernndez-Mora, Miguel

    2013-09-01

    Globalization has facilitated the movement of large number of people around the world, leading modern clinicians to attend patients with rare or forgotten diseases. In the last few years many doctors are working in developing countries as volunteers or expatriates. The aim of this article is to summarize the basic epidemiological, clinical and therapeutic knowledge of the main cardiovascular diseases that a medical doctor from a developed country may attend in a tropical rural hospital, or with challenging diseases in patients coming from developing countries. PMID:23522729

  10. Emerging issues in radiogenic cataracts and cardiovascular disease

    PubMed Central

    Hamada, Nobuyuki; Fujimichi, Yuki; Iwasaki, Toshiyasu; Fujii, Noriko; Furuhashi, Masato; Kubo, Eri; Minamino, Tohru; Nomura, Takaharu; Sato, Hitoshi

    2014-01-01

    In 2011, the International Commission on Radiological Protection issued a statement on tissue reactions (formerly termed non-stochastic or deterministic effects) to recommend lowering the threshold for cataracts and the occupational equivalent dose limit for the crystalline lens of the eye. Furthermore, this statement was the first to list circulatory disease (cardiovascular and cerebrovascular disease) as a health hazard of radiation exposure and to assign its threshold for the heart and brain. These changes have stimulated various discussions and may have impacts on some radiation workers, such as those in the medical sector. This paper considers emerging issues associated with cataracts and cardiovascular disease. For cataracts, topics dealt with herein include (i) the progressive nature, stochastic nature, target cells and trigger events of lens opacification, (ii) roles of lens protein denaturation, oxidative stress, calcium ions, tumor suppressors and DNA repair factors in cataractogenesis, (iii) dose rate effect, radiation weighting factor, and classification systems for cataracts, and (iv) estimation of the lens dose in clinical settings. Topics for cardiovascular disease include experimental animal models, relevant surrogate markers, latency period, target tissues, and roles of inflammation and cellular senescence. Future research needs are also discussed. PMID:24824673

  11. Cardiovascular Disease Mortality in Asian Americans (2003–2010)

    PubMed Central

    Jose, Powell O.; Frank, Ariel TH; Kapphahn, Kristopher I.; Goldstein, Benjamin A.; Eggleston, Karen; Hastings, Katherine G.; Cullen, Mark R.; Palaniappan, Latha P

    2014-01-01

    Background Asian Americans are a rapidly growing racial/ethnic group in the United States. Our current understanding of Asian-American cardiovascular disease mortality patterns is distorted by the aggregation of distinct subgroups. Objectives To examine heart disease and stroke mortality rates in Asian-American subgroups to determine racial/ethnic differences in cardiovascular disease mortality within the United States. Methods We examined heart disease and stroke mortality rates for the 6 largest Asian-American subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, and Vietnamese) from 2003–2010. U.S. death records were used to identify race/ethnicity and cause of death by ICD-10 coding. Using both U.S. Census and death record data, standardized mortality ratios (SMR), relative SMRs (rSMR), and proportional mortality ratios (PMR) were calculated for each sex and ethnic group relative to Non-Hispanic Whites (NHW). Results 10,442,034 death records were examined. While NHW men and women had the highest overall mortality rates, Asian Indian men and women and Filipino men had greater proportionate mortality burden from ischemic heart disease. The proportionate mortality burden of hypertensive heart disease and cerebrovascular disease, especially hemorrhagic stroke, was higher in every Asian-American subgroup compared to NHWs. Conclusions The heterogeneity in cardiovascular disease mortality patterns among diverse Asian-American subgroups calls attention to the need for more research to help direct more specific treatment and prevention efforts, in particular with hypertension and stroke, to reduce health disparities for this growing population. PMID:25500233

  12. Dysfunctional HDL and atherosclerotic cardiovascular disease.

    PubMed

    Rosenson, Robert S; Brewer, H Bryan; Ansell, Benjamin J; Barter, Philip; Chapman, M John; Heinecke, Jay W; Kontush, Anatol; Tall, Alan R; Webb, Nancy R

    2016-01-01

    High-density lipoproteins (HDLs) protect against atherosclerosis by removing excess cholesterol from macrophages through the ATP-binding cassette transporter A1 (ABCA1) and ATP-binding cassette transporter G1 (ABCG1) pathways involved in reverse cholesterol transport. Factors that impair the availability of functional apolipoproteins or the activities of ABCA1 and ABCG1 could, therefore, strongly influence atherogenesis. HDL also inhibits lipid oxidation, restores endothelial function, exerts anti-inflammatory and antiapoptotic actions, and exerts anti-inflammatory actions in animal models. Such properties could contribute considerably to the capacity of HDL to inhibit atherosclerosis. Systemic and vascular inflammation has been proposed to convert HDL to a dysfunctional form that has impaired antiatherogenic effects. A loss of anti-inflammatory and antioxidative proteins, perhaps in combination with a gain of proinflammatory proteins, might be another important component in rendering HDL dysfunctional. The proinflammatory enzyme myeloperoxidase induces both oxidative modification and nitrosylation of specific residues on plasma and arterial apolipoprotein A-I to render HDL dysfunctional, which results in impaired ABCA1 macrophage transport, the activation of inflammatory pathways, and an increased risk of coronary artery disease. Understanding the features of dysfunctional HDL or apolipoprotein A-I in clinical practice might lead to new diagnostic and therapeutic approaches to atherosclerosis. PMID:26323267

  13. The relationship among restless legs syndrome (Willis-Ekbom Disease), hypertension, cardiovascular disease, and cerebrovascular disease.

    PubMed

    Ferini-Strambi, Luigi; Walters, Arthur S; Sica, Domenic

    2014-06-01

    Untreated sleep disorders may contribute to secondary causes of uncontrolled hypertension, cardiovascular disease (CVD), and stroke. Restless legs syndrome, or Willis-Ekbom Disease (RLS/WED), is a common sensorimotor disorder with a circadian rhythmicity defined by an uncontrollable urge to move the legs that worsens during periods of inactivity or at rest in the evening, often resulting in sleep disruptions. Sleep disorders such as insomnia and obstructive sleep apnea (OSA) are established risk factors for increased risk of hypertension and vascular diseases. This literature review outlines the lessons learned from studies demonstrating insomnia and OSA as risk factors for hypertension and vascular diseases to support the epidemiologic and physiologic evidence suggesting a similar increase in hypertension and vascular disease risk due to RLS. Understanding the relationships between RLS and hypertension, CVD, and stroke has important implications for reducing the risks associated with these diseases. PMID:23963470

  14. Cardiovascular Disease Could be Contained based on Currently Available Data!

    PubMed Central

    Ofodile, Okom Nkili F.C.

    2006-01-01

    Largely due to better control of infectious diseases and significant advances in biomedical research, life expectancy worldwide has increased dramatically in the last three decades. However, as the average age of the population has risen, the incidence of chronic age-related diseases such as arthritis, Alzheimer's, Parkinson's, cardiovascular disease, cancer, osteoporosis, benign prostatic hyperplasia, and late-onset diabetes have increased and have become serious public health problem, as well. The etiology of these disorders is still incompletely understood, therefore, neither preventive strategies nor long-term effective treatment modalities are available for these disorders. In keeping with the aforementioned, the ultimate goal in cardiovascular research is to prevent the onset of cardiovascular episodes and thereby allow successful ageing without morbidity and cognitive decline. Herein, I argue that cardiovascular episodes could be contained with relatively simple approaches. Cardiovascular disorder is characterized by cellular and molecular changes that are commonplace in age-related diseases in other organ system, such alterations include increased level of oxidative stress, perturbed energy metabolism, and horror autotoxicus largely brought about by the perturbation of ubiquitin -proteasome system, and excessive oxidative stress damage to the cardiac muscle cells and tissues, and cross-reactions of specific antibodies against human heat shock protein 60 with that of mycobacterial heat shock protein 65. Horror autotoxicus, a Latin expression, is a term coined by Paul Ehrlich at the turn of the last century to describe autoimmunity to self, or the attack of self by immune system, which ultimately results to autoimmune condition. Based on the currently available data, the risk of cardiovascular episodes and several other age-related disorders, including cancer, Alzheimer's disease and diabetes, is known to be influenced by the nature and level of food intake. Now, a wealth of scientific data from studies of rodents and monkeys has documented the significant beneficial effects of calorie restriction (CR) or dietary restriction (DR), and multiple antioxidant agents in extending life span and reducing the incidence of progeroid-related diseases. Reduced levels of cellular oxidative stress, protection of genome from deleterious damage, detoxification of toxic molecules, and enhancement of energy homeostasis, contribute to the beneficial effects of dietary restriction and multiple antioxidant agents. Recent findings suggest that employment of DR and multiple antioxidant agents (including, catalase, gluthatione peroxidase, CuZn superoxide dismutase, and Mn superoxide dismutase = enzymes forming the primary defense against oxygen toxicity), and ozone therapy may mount an effective resistance to pathogenic factors relevant to the pathogenesis of cardiovascular episodes. Hence, while further studies will be needed to establish the extent to which CR and multiple antioxidant agents will reduce incidence of cardiovascular episodes in humans, it would seem prudent to recommend CR and multiple antioxidant agents as widely applicable preventive approach for cardiovascular disorders and other progeroid-related disorders. PMID:18648594

  15. Cardiovascular disease could be contained based on currently available data!

    PubMed

    Ofodile, Okom Nkili F C

    2006-01-01

    Largely due to better control of infectious diseases and significant advances in biomedical research, life expectancy worldwide has increased dramatically in the last three decades. However, as the average age of the population has risen, the incidence of chronic age-related diseases such as arthritis, Alzheimer's, Parkinson's, cardiovascular disease, cancer, osteoporosis, benign prostatic hyperplasia, and late-onset diabetes have increased and have become serious public health problem, as well. The etiology of these disorders is still incompletely understood, therefore, neither preventive strategies nor long-term effective treatment modalities are available for these disorders. In keeping with the aforementioned, the ultimate goal in cardiovascular research is to prevent the onset of cardiovascular episodes and thereby allow successful ageing without morbidity and cognitive decline. Herein, I argue that cardiovascular episodes could be contained with relatively simple approaches. Cardiovascular disorder is characterized by cellular and molecular changes that are commonplace in age-related diseases in other organ system, such alterations include increased level of oxidative stress, perturbed energy metabolism, and "horror autotoxicus" largely brought about by the perturbation of ubiquitin -proteasome system, and excessive oxidative stress damage to the cardiac muscle cells and tissues, and cross-reactions of specific antibodies against human heat shock protein 60 with that of mycobacterial heat shock protein 65. "Horror autotoxicus", a Latin expression, is a term coined by Paul Ehrlich at the turn of the last century to describe autoimmunity to self, or the attack of "self" by immune system, which ultimately results to autoimmune condition. Based on the currently available data, the risk of cardiovascular episodes and several other age-related disorders, including cancer, Alzheimer's disease and diabetes, is known to be influenced by the nature and level of food intake. Now, a wealth of scientific data from studies of rodents and monkeys has documented the significant beneficial effects of calorie restriction (CR) or dietary restriction (DR), and multiple antioxidant agents in extending life span and reducing the incidence of progeroid-related diseases. Reduced levels of cellular oxidative stress, protection of genome from deleterious damage, detoxification of toxic molecules, and enhancement of energy homeostasis, contribute to the beneficial effects of dietary restriction and multiple antioxidant agents. Recent findings suggest that employment of DR and multiple antioxidant agents (including, catalase, glutathione peroxidase, CuZn superoxide dismutase, and Mn superoxide dismutase = enzymes forming the primary defense against oxygen toxicity), and ozone therapy may mount an effective resistance to pathogenic factors relevant to the pathogenesis of cardiovascular episodes. Hence, while further studies will be needed to establish the extent to which CR and multiple antioxidant agents will reduce incidence of cardiovascular episodes in humans, it would seem prudent to recommend CR and multiple antioxidant agents as widely applicable preventive approach for cardiovascular disorders and other progeroid-related disorders. PMID:18648594

  16. Strategies to increase nitric oxide signalling in cardiovascular disease.

    PubMed

    Lundberg, Jon O; Gladwin, Mark T; Weitzberg, Eddie

    2015-09-01

    Nitric oxide (NO) is a key signalling molecule in the cardiovascular, immune and central nervous systems, and crucial steps in the regulation of NO bioavailability in health and disease are well characterized. Although early approaches to therapeutically modulate NO bioavailability failed in clinical trials, an enhanced understanding of fundamental subcellular signalling has enabled a range of novel therapeutic approaches to be identified. These include the identification of: new pathways for enhancing NO synthase activity; ways to amplify the nitrate-nitrite-NO pathway; novel classes of NO-donating drugs; drugs that limit NO metabolism through effects on reactive oxygen species; and ways to modulate downstream phosphodiesterases and soluble guanylyl cyclases. In this Review, we discuss these latest developments, with a focus on cardiovascular disease. PMID:26265312

  17. [Alcohol and wine and cardiovascular diseases in epidemiologic studies].

    PubMed

    Sinkiewicz, W?adys?aw; Weglarz, Magdalena

    2009-01-01

    Moderate alcohol intake is associated with lower risk of cardiovascular diseases. A large number of epidemiologic studies have demonstrated a U- or J-shaped relation between alcohol consumption and total mortality, coronary heart disease and ischemic stroke. The lowest risk occurs in those who drink one or two drinks per day. Many studies have dealt with the question if specific alcoholic beverage (vodka, beer, wine, liquor) might offer a greater protection. Red wine containing polyphenols is believed to possess exceptional cardioprotective properties, especially if consumed with meals. However, alcohol beverages should not be recommended to patients as a substitute for the well-proven, cardiovascular risk reducing alternatives such as low fat diet, exercise and pharmacotherapy. PMID:19739580

  18. Mobile monitoring and reasoning methods to prevent cardiovascular diseases.

    PubMed

    Hervs, Ramn; Fontecha, Jess; Ausn, David; Castanedo, Federico; Bravo, Jos; Lpez-de-Ipia, Diego

    2013-01-01

    With the recent technological advances, it is possible to monitor vital signs using Bluetooth-enabled biometric mobile devices such as smartphones, tablets or electric wristbands. In this manuscript, we present a system to estimate the risk of cardiovascular diseases in Ambient Assisted Living environments. Cardiovascular disease risk is obtained from the monitoring of the blood pressure by means of mobile devices in combination with other clinical factors, and applying reasoning techniques based on the Systematic Coronary Risk Evaluation Project charts. We have developed an end-to-end software application for patients and physicians and a rule-based reasoning engine. We have also proposed a conceptual module to integrate recommendations to patients in their daily activities based on information proactively inferred through reasoning techniques and context-awareness. To evaluate the platform, we carried out usability experiments and performance benchmarks. PMID:23681093

  19. Sortilin, encoded by the cardiovascular risk gene SORT1, and its suggested functions in cardiovascular disease.

    PubMed

    Kjolby, Mads; Nielsen, Morten Schallburg; Petersen, Claus Munck

    2015-04-01

    Several genome-wide association studies have linked novel loci to a wide range of cardiovascular phenotypes including low-density lipoprotein (LDL)-cholesterol, early onset myocardial infarction, coronary artery calcification, coronary artery stenosis, and abdominal aorta aneurysm. Especially, one locus, namely, 1p13.3, has attracted much attention. This locus harbors four candidate genes, CELSR2, PSRC1, MYBPHL, and SORT1. SORT1 encodes sortilin, a type I sorting receptor that has recently been implicated in LDL-cholesterol metabolism, VLDL secretion, PCSK9 secretion, and development of atherosclerotic lesions. Furthermore, sortilin also seems to be involved in the development of atherosclerosis, by mechanisms not directly involving LDL-cholesterol, but possibly resulting from the attenuated secretion of proinflammatory cytokines, such as IL6 and TNF?, which accompanies lack of sortilin in immune cells. Sortilin seems to play an important role in the development of cardiovascular disease and have functions beyond regulating LDL-cholesterol. PMID:25702058

  20. Obesity and Cardiovascular Disease: a Risk Factor or a Risk Marker?

    PubMed

    Mandviwala, Taher; Khalid, Umair; Deswal, Anita

    2016-05-01

    In the USA, 69 % of adults are either overweight or obese and 35 % are obese. Obesity is associated with an increased incidence of various cardiovascular disorders. Obesity is a risk marker for cardiovascular disease, in that it is associated with a much higher prevalence of comorbidities such as diabetes, hypertension, and metabolic syndrome, which then increase the risk for cardiovascular disease. However, in addition, obesity may also be an independent risk factor for the development of cardiovascular disease. Furthermore, although obesity has been shown to be an independent risk factor for several cardiovascular diseases, it is often associated with improved survival once the diagnosis of the cardiovascular disease has been made, leading to the term "obesity paradox." Several pathways linking obesity and cardiovascular disease have been described. In this review, we attempt to summarize the complex relationship between obesity and cardiovascular disorders, in particular coronary atherosclerosis, heart failure, and atrial fibrillation. PMID:26973130

  1. Diet, nutrition and the prevention of hypertension and cardiovascular diseases.

    TOXLINE Toxicology Bibliographic Information

    Srinath Reddy K; Katan MB

    2004-02-01

    Cardiovascular diseases (CVD) are growing contributors to global disease burdens, with epidemics of CVD advancing across many regions of the world which are experiencing a rapid health transition. Diet and nutrition have been extensively investigated as risk factors for major cardiovascular diseases like coronary heart disease (CHD) and stroke and are also linked to other cardiovascular risk factors like diabetes, high blood pressure and obesity. The interpretation of evidence needs to involve a critical appraisal of methodological issues related to measurement of exposures, nature of outcome variables, types of research design and careful separation of cause, consequence and confounding as the basis for observed associations. Adequate evidence is available, from studies conducted within and across populations, to link several nutrients, minerals, food groups and dietary patterns with an increased or decreased risk of CVD. Dietary fats associated with an increased risk of CHD include trans-fats and saturated fats, while polyunsaturated fats are known to be protective. Dietary sodium is associated with elevation of blood pressure, while dietary potassium lowers the risk of hypertension and stroke. Regular frequent intake of fruits and vegetables is protective against hypertension, CHD and stroke. Composite diets (such as DASH diets, Mediterranean diet, 'prudent' diet) have been demonstrated to reduce the risk of hypertension and CHD. Sufficient knowledge exists to recommend nutritional interventions, at both population and individual levels, to reduce cardiovascular risk. That knowledge should now be translated into policies which promote healthy diets and discourage unhealthy diets. This requires coordinated action at the level of governments, international organizations, civil society and responsible sections of the food industry.

  2. Epigenetic programming and risk: the birthplace of cardiovascular disease?

    PubMed

    Vinci, Maria Cristina; Polvani, Gianluca; Pesce, Maurizio

    2013-06-01

    Epigenetics, through control of gene expression circuitries, plays important roles in various physiological processes such as stem cell differentiation and self renewal. This occurs during embryonic development, in different tissues, and in response to environmental stimuli. The language of epigenetic program is based on specific covalent modifications of DNA and chromatin. Thus, in addition to the individual identity, encoded by sequence of the four bases of the DNA, there is a cell type identity characterized by its positioning in the epigenetic "landscape". Aberrant changes in epigenetic marks induced by environmental cues may contribute to the development of abnormal phenotypes associated with different human diseases such as cancer, neurological disorders and inflammation. Most of the epigenetic studies have focused on embryonic development and cancer biology, while little has been done to explore the role of epigenetic mechanisms in the pathogenesis of cardiovascular disease. This review highlights our current knowledge of epigenetic gene regulation and the evidence that chromatin remodeling and histone modifications play key roles in the pathogenesis of cardiovascular disease through (re)programming of cardiovascular (stem) cells commitment, identity and function. PMID:22773406

  3. Dietary lignans: physiology and potential for cardiovascular disease risk reduction

    PubMed Central

    Peterson, Julia; Dwyer, Johanna; Adlercreutz, Herman; Scalbert, Augustin; Jacques, Paul; McCullough, Marjorie L

    2010-01-01

    We reviewed lignan physiology and lignan intervention and epidemiological studies to determine if they decreased the risks of cardiovascular disease in Western populations. Five intervention studies using flaxseed lignan supplements indicated beneficial associations with C-reactive protein and a meta-analysis, which included these studies, also suggested a lowering effect on plasma total and low-density lipoprotein cholesterol. Three intervention studies using sesamin supplements indicated possible lipid and blood pressure lowering associations. Eleven human observational epidemiological studies examined dietary intakes of lignans in relation to cardiovascular disease risk. Five showed decreased risk with either increasing dietary intakes of lignans or increased levels of serum enterolactone (an enterolignan used as a biomarker of lignan intake), five studies were of borderline significance, and one was null. The associations between lignans and decreased risk of cardiovascular disease are promising, but are yet not well established, perhaps due to low lignan intakes in habitual Western diets. At the higher doses used in intervention studies, associations were more evident. PMID:20883417

  4. Endothelial Barrier and Its Abnormalities in Cardiovascular Disease

    PubMed Central

    Chistiakov, Dimitry A.; Orekhov, Alexander N.; Bobryshev, Yuri V.

    2015-01-01

    Endothelial cells (ECs) form a unique barrier between the vascular lumen and the vascular wall. In addition, the endothelium is highly metabolically active. In cardiovascular disease such as atherosclerosis and hypertension, normal endothelial function could be severely disturbed leading to endothelial dysfunction that then could progress to complete and irreversible loss of EC functionality and contribute to entire vascular dysfunction. Proatherogenic stimuli such as diabetes, dyslipidemia, and oxidative stress could initiate endothelial dysfunction and in turn vascular dysfunction and lead to the development of atherosclerotic arterial disease, a background for multiple cardiovascular disorders including coronary artery disease, acute coronary syndrome, stroke, and thrombosis. Intercellular junctions between ECs mediate the barrier function. Proinflammatory stimuli destabilize the junctions causing the disruption of the endothelial barrier and increased junctional permeability. This facilitates transendothelial migration of immune cells to the arterial intima and induction of vascular inflammation. Proatherogenic stimuli attack endothelial microtubule function that is regulated by acetylation of tubulin, an essential microtubular constituent. Chemical modification of tubulin caused by cardiometabolic risk factors and oxidative stress leads to reorganization of endothelial microtubules. These changes destabilize vascular integrity and increase permeability, which finally results in increasing cardiovascular risk. PMID:26696899

  5. Dietary polyphenols regulate endothelial function and prevent cardiovascular disease.

    PubMed

    Yamagata, Kazuo; Tagami, Motoki; Yamori, Yukio

    2015-01-01

    Vascular endothelial cell (EC) dysfunction strongly induces development of cardiovascular and cerebrovascular diseases. Epidemiologic studies demonstrated a preventative effect of dietary polyphenols toward cardiovascular disease. In studies using cultured vascular ECs, polyphenols were recognized to regulate nitric oxide and endothelin-1 (ET-1) production. Furthermore, epigallocatechin-3-gallate inhibited the expression of adhesion molecules by a signaling pathway that is similar to that of high-density lipoprotein and involves induction of Ca(2+)/calmodulin-dependent kinase II, liver kinase B, and phosphatidylinositol 3-kinase expression. The effects of polyphenols on ECs include antioxidant activity and enhancement of the expression of several protective proteins, including endothelial nitric oxide synthase and paraoxonase 1. However, the observed effects of dietary polyphenols in vitro do not always translate to an in vivo setting. As such, there are many questions concerning their physiological mode of action. In this review, we discuss research on the effect of dietary polyphenols on cardiovascular disease and their protective effect on EC dysfunction. PMID:25466651

  6. Endothelial Progenitor Cells for Diagnosis and Prognosis in Cardiovascular Disease.

    PubMed

    Aragona, Caterina Oriana; Imbalzano, Egidio; Mamone, Federica; Cairo, Valentina; Lo Gullo, Alberto; D'Ascola, Angela; Sardo, Maria Adriana; Scuruchi, Michele; Basile, Giorgio; Saitta, Antonino; Mandraffino, Giuseppe

    2016-01-01

    Objective. To identify, evaluate, and synthesize evidence on the predictive power of circulating endothelial progenitor cells (EPCs) in cardiovascular disease, through a systematic review of quantitative studies. Data Sources. MEDLINE was searched using keywords related to "endothelial progenitor cells" and "endothelium" and, for the different categories, respectively, "smoking"; "blood pressure"; "diabetes mellitus" or "insulin resistance"; "dyslipidemia"; "aging" or "elderly"; "angina pectoris" or "myocardial infarction"; "stroke" or "cerebrovascular disease"; "homocysteine"; "C-reactive protein"; "vitamin D". Study Selection. Database hits were evaluated against explicit inclusion criteria. From 927 database hits, 43 quantitative studies were included. Data Syntheses. EPC count has been suggested for cardiovascular risk estimation in the clinical practice, since it is currently accepted that EPCs can work as proangiogenic support cells, maintaining their importance as regenerative/reparative potential, and also as prognostic markers. Conclusions. EPCs showed an important role in identifying cardiovascular risk conditions, and to suggest their evaluation as predictor of outcomes appears to be reasonable in different defined clinical settings. Due to their capability of proliferation, circulation, and the development of functional progeny, great interest has been directed to therapeutic use of progenitor cells in atherosclerotic diseases. This trial is registered with registration number: Prospero CRD42015023717. PMID:26839569

  7. Air particulate matter and cardiovascular disease: the epidemiological, biomedical and clinical evidence

    PubMed Central

    Du, Yixing; Xu, Xiaohan; Chu, Ming; Guo, Yan

    2016-01-01

    Air pollution is now becoming an independent risk factor for cardiovascular morbidity and mortality. Numerous epidemiological, biomedical and clinical studies indicate that ambient particulate matter (PM) in air pollution is strongly associated with increased cardiovascular disease such as myocardial infarction (MI), cardiac arrhythmias, ischemic stroke, vascular dysfunction, hypertension and atherosclerosis. The molecular mechanisms for PM-caused cardiovascular disease include directly toxicity to cardiovascular system or indirectly injury by inducing systemic inflammation and oxidative stress in peripheral circulation. Here, we review the linking between PM exposure and the occurrence of cardiovascular disease and discussed the possible underlying mechanisms for the observed PM induced increases in cardiovascular morbidity and mortality. PMID:26904258

  8. Dysregulation of Histone Acetyltransferases and Deacetylases in Cardiovascular Diseases

    PubMed Central

    Wang, Yonggang; Miao, Xiao; Liu, Yucheng; Li, Fengsheng; Liu, Quan; Sun, Jian; Cai, Lu

    2014-01-01

    Cardiovascular disease (CVD) remains a leading cause of mortality worldwide despite advances in its prevention and management. A comprehensive understanding of factors which contribute to CVD is required in order to develop more effective treatment options. Dysregulation of epigenetic posttranscriptional modifications of histones in chromatin is thought to be associated with the pathology of many disease models, including CVD. Histone acetyltransferases (HATs) and deacetylases (HDACs) are regulators of histone lysine acetylation. Recent studies have implicated a fundamental role of reversible protein acetylation in the regulation of CVDs such as hypertension, pulmonary hypertension, diabetic cardiomyopathy, coronary artery disease, arrhythmia, and heart failure. This reversible acetylation is governed by enzymes that HATs add or HDACs remove acetyl groups respectively. New evidence has revealed that histone acetylation regulators blunt cardiovascular and related disease states in certain cellular processes including myocyte hypertrophy, apoptosis, fibrosis, oxidative stress, and inflammation. The accumulating evidence of the detrimental role of histone acetylation in cardiac disease combined with the cardioprotective role of histone acetylation regulators suggests that the use of histone acetylation regulators may serve as a novel approach to treating the millions of patients afflicted by cardiac diseases worldwide. PMID:24693336

  9. Peripheral artery disease assessed by ankle-brachial index in patients with established cardiovascular disease or at least one risk factor for atherothrombosis - CAREFUL Study: A national, multi-center, cross-sectional observational study

    PubMed Central

    2011-01-01

    Background To investigate the presence of peripheral artery disease (PAD) via the ankle brachial index (ABI) in patients with known cardiovascular and/or cerebrovascular diseases or with at least one risk factor for atherothrombosis. Methods Patients with a history of atherothrombotic events, or aged 50-69 years with at least one cardiovascular risk factor, or > = 70 years of age were included in this multicenter, cross-sectional, non-interventional study (DIREGL04074). Demographics, medical history, physical examination findings, and physician awareness of PAD were analyzed. The number of patients with low ABI (< = 0.90) was analyzed. Results A total of 530 patients (mean age, 63.4 8.7 years; 50.2% female) were enrolled. Hypertension and dyslipidemia were present in 88.7% and 65.5% of patients, respectively. PAD-related symptoms were evident in about one-third of the patients, and at least one of the pedal pulses was negative in 6.5% of patients. The frequency of low ABI was 20.0% in the whole study population and 30% for patients older than 70 years. Older age, greater number of total risk factors, and presence of PAD-related physical findings were associated with increased likelihood of low ABI (p < 0.001). There was no gender difference in the prevalence of low ABI, PAD symptoms, or total number of risk factors. Exercise (33.6%) was the most common non-pharmacological option recommended by physicians, and acetylsalicylic acid (ASA) (45.4%) was the most frequently prescribed medication for PAD. Conclusion Our results indicate that advanced age, greater number of total risk factors and presence of PAD-related physical findings were associated with increased likelihood of low ABI. These findings are similar to those reported in similar studies of different populations, and document a fairly high prevalence of PAD in a Mediterranean country. PMID:21247449

  10. Cardiovascular Disease and Sleep-Disordered Breathing in Acromegaly.

    PubMed

    Powlson, Andrew S; Gurnell, Mark

    2016-01-01

    Treatment goals in acromegaly include symptom relief, tumour control and reversal of the excess morbidity and mortality associated with the disorder. Cardiovascular complications include concentric biventricular hypertrophy and cardiomyopathy, hypertension, valvular heart disease and arrhythmias, while metabolic disturbance (insulin resistance/diabetes mellitus, dyslipidaemia) further increases the risk of cardiovascular and cerebrovascular events. Sleep-disordered breathing (in the form of sleep apnoea) is also common in patients with acromegaly and may exacerbate cardiovascular dysfunction, in addition to contributing to impaired quality of life. Accordingly, and in keeping with evidence that cardiorespiratory complications in acromegaly are not automatically reversed/ameliorated simply through the attainment of 'safe' growth hormone and insulin-like growth factor 1 levels, recent guidelines have emphasised the need not only to achieve stringent biochemical control, but also to identify and independently treat these comorbidities. It is important, therefore, that patients with acromegaly are systematically screened at diagnosis, and periodically thereafter, for the common cardiovascular and respiratory manifestations and that biochemical targets do not become the only treatment goal. PMID:26227953

  11. Targeting chromatin remodeling to prevent cardiovascular disease in diabetes.

    PubMed

    Costantino, Sarah; Paneni, Francesco; Cosentino, Francesco

    2015-01-01

    Diabetes is a major cause of cardiovascular morbidity and mortality and its prevalence is rapidly increasing worldwide. Despite clear advances in developing effective glucose-lowering drugs, clinical trials have recently shown that intensive glycemic control failed to reduce cardiovascular events in the diabetic population. These findings support the concept that the hyperglycemic environment may be remembered in the cardiovascular system. This phenomenon has been recently defined as "metabolic memory" and may contribute to explain the progression of diabetic vascular complications despite achievement of target HbA1c levels. In this regard, epigenetic changes of DNA/histone complexes are emerging as important modulators of oxidant and inflammatory genes, thus leading to persistent cardiac and vascular dysfunction. Over the last few years, the rapid development of many compounds (i.e. histone deacetylase and histone acetyltransferase inhibitors) able to erase adverse chromatin signatures led to the perception that reverting hyperglycemic damage might be possible and represents an attractive challenge. Here we critically discuss recent evidence supporting the concept that chromatin alterations are key drivers of cardiovascular disease and describe the emerging potential of chromatin modifying agents for the reprogramming of detrimental epigenetic signatures in patients with cardiometabolic disturbances. PMID:25860064

  12. Is oxidative stress a therapeutic target in cardiovascular disease?

    PubMed

    Mnzel, Thomas; Gori, Tommaso; Bruno, Rosa Maria; Taddei, Stefano

    2010-11-01

    An abnormal production of reactive oxygen species (ROS) and the subsequent decrease in vascular bioavailability of nitric oxide (NO) have long been proposed to be the common pathogenetic mechanism of the endothelial dysfunction, resulting from diverse cardiovascular risk factors such as hypercholesterolaemia, diabetes mellitus, chronic smoking, metabolic syndrome, and hypertension. Superoxide produced by the nicotinamide dinucleotide phosphate (NADPH) oxidase, mitochondrial sources, or the xanthine oxidase may react with NO, thereby resulting in excessive formation of peroxynitrite, a reactive nitrogen species that has been demonstrated to accelerate the atherosclerotic process by causing direct structural damage and by causing further ROS production. Despite this sound biological rationale and a number of pre-clinical and clinical lines of evidence, studies testing the effects of classical antioxidants such as vitamin C, vitamin E, or folic acid in combination with vitamin E have been disappointing. Rather, substances such as statins, angiotensin-converting enzyme inhibitors, or AT1-receptor blockers, which possess indirect antioxidant properties mediated by the stimulation of NO production and simultaneous inhibition of superoxide production (e.g. from the NADPH oxidase), have been shown to improve vascular function in pre-clinical and clinical studies and to reduce the incidence of cardiovascular events in patients with cardiovascular disease. Today, oxidative stress remains an attractive target for cardiovascular prevention and therapy. However, a deeper understanding of its source, and of its role in vascular pathology, is necessary before new trials are attempted. PMID:20974801

  13. Optimal Vitamin D Supplementation Levels for Cardiovascular Disease Protection

    PubMed Central

    Lugg, Sebastian T.; Howells, Phillip A.; Thickett, David R.

    2015-01-01

    First described in relation to musculoskeletal disease, there is accumulating data to suggest that vitamin D may play an important role in cardiovascular disease (CVD). In this review we aim to provide an overview of the role of vitamin D status as both a marker of and potentially causative agent of hypertension, coronary artery disease, heart failure, atrial fibrillation, stroke, and peripheral vascular disease. The role of vitamin D levels as a disease marker for all-cause mortality is also discussed. We review the current knowledge gathered from experimental studies, observational studies, randomised controlled trials, and subsequent systematic reviews in order to suggest the optimal vitamin D level for CVD protection. PMID:26435569

  14. Common genetic factors for depression and cardiovascular disease.

    PubMed

    Bondy, Brigitta

    2007-01-01

    There is increasing knowledge regarding the considerable comorbidity between depression and cardiovascular disease, which are two of the most common disorders in developed countries. The associated vulnerability is not unidirectional, as the presence of cardiovascular disease can also influence mood states. Although this may be the result of psychological factors, common biological mechanisms, including genetic ones, are thought to be responsible for this interaction; we can thus question whether variations in genes could be predisposing factors. Regarding the multiple interactions in the mechanisms between depression and cardiovascular system disorders, e.g., dysfunctions in the hypothalamic-pituitary-adrenocortical and sympathoadrenal axis and the response to stress, the importance of the serotonergic and immune systems, or the impact on the renin-angiotensin system, several candidate genes are being investigated. However, despite the interest in unraveling the potential susceptibility genes for both disorders, most available studies have so far dealt with the impact of polymorphisms in relation to either depression or cardiovascular disease. A few recent studies have now examined the effects of gene-gene or gene-environment interactions, and are investigating the impact of "depression-related" variants on cardiac response to stress. The first promising results were obtained with the serotonin transporter, and it may be hypothesized that this polymorphism interacts via the impact of the S allele on depression and via the effect of the L allele on platelet activation. However, the role played by various other candidate genes remains to be determined, especially regarding the question as to whether they are indicative of common pathophysiological mechanisms, or for identifying a subgroup of patients with somatic disorders that are more closely related to psychiatric symptoms. PMID:17506223

  15. Circadian misalignment increases cardiovascular disease risk factors in humans.

    PubMed

    Morris, Christopher J; Purvis, Taylor E; Hu, Kun; Scheer, Frank A J L

    2016-03-01

    Shift work is a risk factor for hypertension, inflammation, and cardiovascular disease. This increased risk cannot be fully explained by classic risk factors. One of the key features of shift workers is that their behavioral and environmental cycles are typically misaligned relative to their endogenous circadian system. However, there is little information on the impact of acute circadian misalignment on cardiovascular disease risk in humans. Here we show-by using two 8-d laboratory protocols-that short-term circadian misalignment (12-h inverted behavioral and environmental cycles for three days) adversely affects cardiovascular risk factors in healthy adults. Circadian misalignment increased 24-h systolic blood pressure (SBP) and diastolic blood pressure (DBP) by 3.0 mmHg and 1.5 mmHg, respectively. These results were primarily explained by an increase in blood pressure during sleep opportunities (SBP, +5.6 mmHg; DBP, +1.9 mmHg) and, to a lesser extent, by raised blood pressure during wake periods (SBP, +1.6 mmHg; DBP, +1.4 mmHg). Circadian misalignment decreased wake cardiac vagal modulation by 8-15%, as determined by heart rate variability analysis, and decreased 24-h urinary epinephrine excretion rate by 7%, without a significant effect on 24-h urinary norepinephrine excretion rate. Circadian misalignment increased 24-h serum interleukin-6, C-reactive protein, resistin, and tumor necrosis factor-α levels by 3-29%. We demonstrate that circadian misalignment per se increases blood pressure and inflammatory markers. Our findings may help explain why shift work increases hypertension, inflammation, and cardiovascular disease risk. PMID:26858430

  16. Outline of the report on cardiovascular disease in China, 2010.

    PubMed

    Hu, Sheng Shou; Kong, Ling Zhi; Gao, Run Lin; Zhu, Man Lu; Wang, Wen; Wang, Yong Jun; Wu, Zhao Su; Chen, Wei Wei; Liu, Ming Bo

    2012-06-01

    Major and profound changes have taken place in China over the past 30 years. Rapid socioeconomic progress has exerted a great impact on lifestyle, ranging from food, clothing, working and living conditions, and means of transportation to leisure activities and entertainment. At the same time, new health problems have emerged, and health services are facing new challenges. Presently, cardiovascular diseases (CVD) are among the top health problems of the Chinese people, and pose a serious challenge to all engaged in the prevention and control of these diseases. An epidemic of CVD in China is emerging as a result of lifestyle changes, urbanization and longevity. Both national policy decision-making and medical practice urgently need an authoritative report which comprehensively reflects the trends in the epidemic of CVD and current preventive measures. Since 2005, guided by the Bureau of Disease Prevention of the Ministry of Health of the People's Republic of China and the National Center for Cardiovascular Diseases of China, nationwide experts in the fields of epidemiology, clinical medicine and health economics in the realms of CVD, cerebrovascular disease, diabetes and chronic kidney disease, completed the Report on Cardiovascular Diseases in China every year. The report aims to provide a timely review of the trend of the epidemic and to assess the progress of prevention and control of CVD. In addition, as the report is authoritative, representative and readable, it will become an information platform in the CVD field and an important reference book for government, academic institutes, medical organizations and clinical physicians. This publication is expected to play a positive role in the prevention and control of CVD in China. We present an abstract from the Report on Cardiovascular Diseases in China (2010), including trends in CVD, morbidity and mortality of major CVDs, up-to-date assessment of risk factors, as well as health resources for CVD, and a profile of medical expenditure, with the aim of providing evidence for decision-making in CVD prevention and control programs in China, and of delivering the most authoritative information on CVD prevention and control for all citizens. PMID:22840574

  17. [Cardiovascular diseases in medico-legal opinions on work disability].

    PubMed

    Mizerska, Ma?gorzata; Mizerska, Katarzyna; Barzdo, Maciej; Berent, Jaros?aw

    2006-01-01

    The paper presents the results of a study of cases judged by the District Court in Piotrkw Trybunalski in 2004, in which petitioners sought permanent work-disability benefits on grounds of cardiovascular diseases. The largest group of petitioners included those with hypertension, coronary disease and a history of myocardial infarction. The largest percentage of persons judged to be work-disabled were those having suffered a myocardial infarction, but this was true also for individuals with cardiomyopathies, as well as cardiac rhythm and conduction disturbances. Disorders judged to pose the least limitation on the ability to work encompassed non-specific pain in the thoracic cavity, and hypertension. PMID:16970079

  18. Central Adiposity and Subclinical Cardiovascular Disease in Police Officers

    PubMed Central

    Baughman, Penelope; Fekedulegn, Desta; Andrew, Michael E.; Joseph, Parveen Nedra; Dorn, Joan M.; Violanti, John M.; Burchfiel, Cecil M.

    2013-01-01

    Given the associations between obesity and cardiovascular disease (CVD), we evaluated a related but less well-established association between waist circumference and brachial artery reactivity (BAR), a functional measurement of subclinical CVD, where lower levels indicate dysfunction. Regression models examined trends in mean BAR across waist circumference tertiles in police officers, a high-stress occupational group with increased risk for CVD. Mean BAR decreased across increasing waist tertiles among men, but not women, and this association was stronger among officers who consumed more alcohol. Larger waist circumference may be associated with lower BAR, providing an opportunity for intervention prior to disease development. PMID:24555157

  19. [Effect of fats on cardiovascular disease prevention in Denmark.

    PubMed

    Astrup, Arne; Larsen, Mogens Lytken; Stender, Steen; Dyerberg, Jørn

    2014-05-01

    In Denmark death from cardiovascular disease (CVD) has decreased, mainly due to a 72% reduction since 1990 in death from ischaemic heart disease from reduced smoking, elimination of industrial trans fatty acids in the diet, and more effective medical treatment. Replacement of saturated fat by carbohydrate and/or n-6 polyunsaturated fat may increase CVD, but it is reduced by substitution with n-3 fats, monounsaturated fat, or low glycaemic index carbohydrates. Despite a high saturated fat content dark chocolate and cheese may reduce CVD and diabetes risk and eggs may be neutral, and less restrictive dietary recommendations are indicated. PMID:25351669

  20. Endocan: A novel inflammatory indicator in cardiovascular disease?

    PubMed

    Balta, Sevket; Mikhailidis, Dimitri P; Demirkol, Sait; Ozturk, Cengiz; Celik, Turgay; Iyisoy, Atila

    2015-11-01

    Endothelial dysfunction is considered as an early change in atherogenesis. Raised levels of systemic inflammatory markers are associated with cardiovascular disease (CVD). Endocan (previously known as endothelial cell specific molecule-1, ESM-1), is a potential immunoinflammatory marker that may be linked to CVD. Endocan is released by vascular endothelial cells in several organs. Endocan may play an important role in regulating cell adhesion and raised plasma levels may reflect endothelial dysfunction. Endocan levels are elevated in conditions such as chronic kidney disease, renal transplant rejection, tumor progression and hypertension. Endocan is a potential inflammatory and CVD marker. Further studies are needed to assess the relevance of endocan in clinical practice. PMID:26448266

  1. The protective functions of omentin in cardiovascular diseases.

    PubMed

    Tan, Yu-Lin; Zheng, Xi-Long; Tang, Chao-Ke

    2015-08-25

    Adipose tissue is considered as a large gland that can produce paracrine and endocrine hormones. Growing evidence suggests that adipocytes may link obesity to cardiovascular diseases (CVD). Adipose tissue produces a large number of mediators, which affect metabolism, inflammation and coagulation. Omentin, a novel adipocytokine, has come into the center of interest due to its favorable effects on inflammation, glucose homeostasis and CVD. The present review provides a concise and general overview on the roles of omentin in CVD. The knowledge of these concepts may provide a new strategy to reduce disease risks on CVD in the future. PMID:26079253

  2. Epigenetics in the development, modification, and prevention of cardiovascular disease.

    PubMed

    Whayne, Thomas F

    2015-04-01

    Epigenetics has major relevance to all disease processes; cardiovascular (CV) disease and its related conditions are no exception. Epigenetics is defined as the study of heritable alterations in gene expression, or cellular phenotype, and goes far beyond a pure genetic approach. A more precise definition is that epigenetics represents all the meiotically and mitotically inherited changes in gene expression that are not encoded on the deoxyribonucleic acid (DNA) sequence itself. Major epigenetic mechanisms are modifications of histone proteins in chromatin and DNA methylation (which does not alter the DNA sequence). There is increasing evidence for the involvement of epigenetics in human disease such as cancer, inflammatory disease and CV disease. Other chronic diseases are also susceptible to epigenetic modification such as metabolic diseases including obesity, metabolic syndrome, and diabetes mellitus. There is much evidence for the modification of epigenetics by nutrition and exercise. Through these modifications, there is infinite potential for benefit for the fetus, the newborn, and the individual as well as population effects. Association with CV disease, including coronary heart disease and peripheral vascular disease, is evident through epigenetic relationships and modification by major CV risk factors such as tobacco abuse. Aging itself may be altered by epigenetic modification. Knowledge of epigenetics and its relevance to the development, modification, and prevention of CV disease is in a very preliminary stage but has an infinite future. PMID:25205125

  3. Hydroxytyrosol and potential uses in cardiovascular diseases, cancer, and AIDS.

    PubMed

    Vilaplana-Prez, Cristina; Aun, David; Garca-Flores, Libia A; Gil-Izquierdo, Angel

    2014-01-01

    Hydroxytyrosol is one of the main phenolic components of olive oil. It is present in the fruit and leaf of the olive (Olea europaea L.). During the past decades, it has been well documented that this phenolic compound has health benefits and a protective action has been found in preclinical studies against several diseases. Here, we review its bioavailability in human beings and several assays showing significant results related with cardiovascular diseases, cancer, and acquired immunodeficiency syndrome (AIDS). Mechanisms of action include potent anti-oxidant and anti-inflammatory effects, among others. The importance of hydroxytyrosol in protection of low-density lipoproteins and consequently its implication in the reduction of cardiovascular disease risk has been highlighted by the European Food Safety Authority, concluding that 5?mg of hydroxytyrosol and its derivatives should be consumed daily to reach this effect at physiological level. We discuss the potential uses of this compound in supplements, nutraceutic foods, or topical formulations in the disease risk reduction. Finally, we conclude that more studies are needed to sustain or reject many other health claims not yet fully documented and to validate these newly available hydroxytyrosol-based products, because it seems to be a good candidate to reduce the risk of diseases mentioned. PMID:25988120

  4. Hydroxytyrosol and Potential Uses in Cardiovascular Diseases, Cancer, and AIDS

    PubMed Central

    Vilaplana-Pérez, Cristina; Auñón, David; García-Flores, Libia A.; Gil-Izquierdo, Angel

    2014-01-01

    Hydroxytyrosol is one of the main phenolic components of olive oil. It is present in the fruit and leaf of the olive (Olea europaea L.). During the past decades, it has been well documented that this phenolic compound has health benefits and a protective action has been found in preclinical studies against several diseases. Here, we review its bioavailability in human beings and several assays showing significant results related with cardiovascular diseases, cancer, and acquired immunodeficiency syndrome (AIDS). Mechanisms of action include potent anti-oxidant and anti-inflammatory effects, among others. The importance of hydroxytyrosol in protection of low-density lipoproteins and consequently its implication in the reduction of cardiovascular disease risk has been highlighted by the European Food Safety Authority, concluding that 5 mg of hydroxytyrosol and its derivatives should be consumed daily to reach this effect at physiological level. We discuss the potential uses of this compound in supplements, nutraceutic foods, or topical formulations in the disease risk reduction. Finally, we conclude that more studies are needed to sustain or reject many other health claims not yet fully documented and to validate these newly available hydroxytyrosol-based products, because it seems to be a good candidate to reduce the risk of diseases mentioned. PMID:25988120

  5. Cardiovascular Disease Susceptibility and Resistance in Circumpolar Inuit Populations.

    PubMed

    Tvermosegaard, Maria; Dahl-Petersen, Inger K; Nielsen, Nina Odgaard; Bjerregaard, Peter; Jrgensen, Marit Eika

    2015-09-01

    Cardiovascular disease (CVD) is a major public health issue in indigenous populations in the Arctic. These diseases have emerged concomitantly with profound social changes over the past 60 years. The aim of this study was to summarize the literature on CVD risk among Arctic Inuit. Literature on prevalence, incidence, and time trends for CVD and its risk factors in Arctic Inuit populations was reviewed. Most evidence supports a similar incidence of coronary heart disease and a higher incidence of cerebrovascular disease among Arctic Inuit than seen in western populations. Factors that may increase CVD risk include aging of the population, genetic susceptibility, and a rapid increase in obesity, diabetes, and hypertension in parallel with decreasing physical activity and deterioration of the lipid profile. In contrast, and of great importance, there has been a decrease in smoking and alcohol intake (at least documented in Greenland), and contaminant levels are declining. Although there have been marked socioeconomic and dietary changes, it remains unsolved and to some extent controversial how this may have influenced cardiovascular risk among Arctic Inuit. The increase in life expectancy, in combination with improved prognosis for patients with manifest CVD, will inevitably lead to a large increase in absolute numbers of individuals affected by CVD in Arctic Inuit populations, exacerbated by the rise in most CVD risk factors over the past decades. For preventive purposes and for health care planning, it is crucial to carefully monitor disease incidence and trends in risk factors in these vulnerable Arctic populations. PMID:26239003

  6. Red blood cell distribution width and cardiovascular diseases

    PubMed Central

    Danese, Elisa; Lippi, Giuseppe

    2015-01-01

    Background The red blood cell distribution width (RDW) is a rather simple measure of red blood cell (RBC) size heterogeneity (i.e., anisocytosis), which is easily calculated by dividing the standard deviation (SD) of erythrocyte volumes for the mean corpuscular volume (MCV). Emerging evidence suggests that, besides RBC abnormalities, many human disorders may be frequently associated with a high degree of anisocytosis. Methods In this narrative review, we analyzed the current scientific literature about the putative role and the potential epidemiologic association between RDW and cardiovascular diseases. The findings of the most representative epidemiological studies were summarized and discussed. Results Overall, considerable and convincing evidence has been brought that an increased RDW value is associated with acute coronary syndrome (ACS) [including acute myocardial infarction (AMI)], ischemic cerebrovascular disease (including stroke), peripheral artery disease (PAD), as well as with atrial fibrillation (AF), heart failure (HF) and hypertension. Higher anisocytosis also significantly and independently predicts adverse outcomes in patients with these conditions. Conclusions Although the role of anisocytosis in the pathogenesis of cardiovascular diseases remains uncertain, the considerable evidence available so far suggests that the clinical use of RDW may be broadened beyond the conventional boundaries of erythrocyte disorders, in particular for assisting the diagnosis and prognostication of patients with ACS, ischemic cerebrovascular disease, PAD, HF and AF. PMID:26623117

  7. Resistin: functional roles and therapeutic considerations for cardiovascular disease

    PubMed Central

    Jamaluddin, Md S; Weakley, Sarah M; Yao, Qizhi; Chen, Changyi

    2012-01-01

    Resistin, originally described as an adipocyte-specific hormone, has been suggested to be an important link between obesity, insulin resistance and diabetes. Although its expression was initially defined in adipocytes, significant levels of resistin expression in humans are mainly found in mononuclear leukocytes, macrophages, spleen and bone marrow cells. Increasing evidence indicates that resistin plays important regulatory roles apart from its role in insulin resistance and diabetes in a variety of biological processes: atherosclerosis and cardiovascular disease (CVD), non-alcoholic fatty liver disease, autoimmune disease, malignancy, asthma, inflammatory bowel disease and chronic kidney disease. As CVD accounts for a significant amount of morbidity and mortality in patients with diabetes and without diabetes, it is important to understand the role that adipokines such as resistin play in the cardiovascular system. Evidence suggests that resistin is involved in pathological processes leading to CVD including inflammation, endothelial dysfunction, thrombosis, angiogenesis and smooth muscle cell dysfunction. The modes of action and signalling pathways whereby resistin interacts with its target cells are beginning to be understood. In this review, the current knowledge about the functions and pathophysiological implications of resistin in CVD development is summarized; clinical translations, therapeutic considerations and future directions in the field of resistin research are discussed. LINKED ARTICLES This article is part of a themed section on Fat and Vascular Responsiveness. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2012.165.issue-3 PMID:21545576

  8. Wine, Beer, Alcohol and Polyphenols on Cardiovascular Disease and Cancer

    PubMed Central

    Arranz, Sara; Chiva-Blanch, Gemma; Valderas-Martínez, Palmira; Medina-Remón, Alex; Lamuela-Raventós, Rosa M.; Estruch, Ramón

    2012-01-01

    Since ancient times, people have attributed a variety of health benefits to moderate consumption of fermented beverages such as wine and beer, often without any scientific basis. There is evidence that excessive or binge alcohol consumption is associated with increased morbidity and mortality, as well as with work related and traffic accidents. On the contrary, at the moment, several epidemiological studies have suggested that moderate consumption of alcohol reduces overall mortality, mainly from coronary diseases. However, there are discrepancies regarding the specific effects of different types of beverages (wine, beer and spirits) on the cardiovascular system and cancer, and also whether the possible protective effects of alcoholic beverages are due to their alcoholic content (ethanol) or to their non-alcoholic components (mainly polyphenols). Epidemiological and clinical studies have pointed out that regular and moderate wine consumption (one to two glasses a day) is associated with decreased incidence of cardiovascular disease (CVD), hypertension, diabetes, and certain types of cancer, including colon, basal cell, ovarian, and prostate carcinoma. Moderate beer consumption has also been associated with these effects, but to a lesser degree, probably because of beer’s lower phenolic content. These health benefits have mainly been attributed to an increase in antioxidant capacity, changes in lipid profiles, and the anti-inflammatory effects produced by these alcoholic beverages. This review summarizes the main protective effects on the cardiovascular system and cancer resulting from moderate wine and beer intake due mainly to their common components, alcohol and polyphenols. PMID:22852062

  9. Endothelial Progenitor Cells for Diagnosis and Prognosis in Cardiovascular Disease

    PubMed Central

    Cairo, Valentina; D'Ascola, Angela; Scuruchi, Michele; Basile, Giorgio; Mandraffino, Giuseppe

    2016-01-01

    Objective. To identify, evaluate, and synthesize evidence on the predictive power of circulating endothelial progenitor cells (EPCs) in cardiovascular disease, through a systematic review of quantitative studies. Data Sources. MEDLINE was searched using keywords related to “endothelial progenitor cells” and “endothelium” and, for the different categories, respectively, “smoking”; “blood pressure”; “diabetes mellitus” or “insulin resistance”; “dyslipidemia”; “aging” or “elderly”; “angina pectoris” or “myocardial infarction”; “stroke” or “cerebrovascular disease”; “homocysteine”; “C-reactive protein”; “vitamin D”. Study Selection. Database hits were evaluated against explicit inclusion criteria. From 927 database hits, 43 quantitative studies were included. Data Syntheses. EPC count has been suggested for cardiovascular risk estimation in the clinical practice, since it is currently accepted that EPCs can work as proangiogenic support cells, maintaining their importance as regenerative/reparative potential, and also as prognostic markers. Conclusions. EPCs showed an important role in identifying cardiovascular risk conditions, and to suggest their evaluation as predictor of outcomes appears to be reasonable in different defined clinical settings. Due to their capability of proliferation, circulation, and the development of functional progeny, great interest has been directed to therapeutic use of progenitor cells in atherosclerotic diseases. This trial is registered with registration number: Prospero CRD42015023717. PMID:26839569

  10. Mortality and Cardiovascular Disease among Older Live Kidney Donors

    PubMed Central

    Reese, PP; Bloom, RD; Feldman, HI; Rosenbaum, P; Wang, W; Saynisch, P; Tarsi, NM; Mukherjee, N; Garg, AX; Mussell, A; Shults, J; Even-Shoshan, O; Townsend, RR; Silber, JH

    2014-01-01

    Over the past two decades, live kidney donation by older individuals (?55 years) has become more common. Given strong associations of older age with cardiovascular disease, nephrectomy could make older donors vulnerable to death and cardiovascular events. We performed a cohort study among older live kidney donors who were matched to healthy older individuals in the Health and Retirement Study. The primary outcome was mortality ascertained through national death registries. Secondary outcomes ascertained among pairs with Medicare coverage included death or cardiovascular disease ascertained through Medicare claims data. During the period from 1996 2006, there were 5717 older donors in the United States. We matched 3368 donors 1:1 to older healthy non-donors. Among donors and matched pairs, the mean age was 59 years; 41% were male and 7% were black race. In median follow-up of 7.8 years, mortality was not different between donors and matched pairs (p=0.21). Among donors with Medicare, the combined outcome of death/CVD (p=0.70) was also not different between donors and non-donors. In summary, carefully selected older kidney donors do not face a higher risk of death or CVD. These findings should be provided to older individuals considering live kidney donation. PMID:25039276

  11. Acute Phase Reactants as Novel Predictors of Cardiovascular Disease

    PubMed Central

    Ahmed, M. S.; Jadhav, A. B.; Hassan, A.; Meng, Qing H.

    2012-01-01

    Acute phase reaction is a systemic response which usually follows a physiological condition that takes place in the beginning of an inflammatory process. This physiological change usually lasts 1-2 days. However, the systemic acute phase response usually lasts longer. The aim of this systemic response is to restore homeostasis. These events are accompanied by upregulation of some proteins (positive acute phase reactants) and downregulation of others (negative acute phase reactants) during inflammatory reactions. Cardiovascular diseases are accompanied by the elevation of several positive acute phase reactants such as C-reactive protein (CRP), serum amyloid A (SAA), fibrinogen, white blood cell count, secretory nonpancreatic phospholipase 2-II (sPLA2-II), ferritin, and ceruloplasmin. Cardiovascular disease is also accompanied by the reduction of negative acute phase reactants such as albumin, transferrin, transthyretin, retinol-binding protein, antithrombin, and transcortin. In this paper, we will be discussing the biological activity and diagnostic and prognostic values of acute phase reactants with cardiovascular importance. The potential therapeutic targets of these reactants will be also discussed. PMID:24049653

  12. Use of medication for cardiovascular disease during pregnancy.

    PubMed

    Pieper, Petronella G

    2015-11-20

    One-third of women with heart disease use medication for the treatment of cardiovascular disease (CVD) during pregnancy. Increased plasma volume, renal clearance, and liver enzyme activity in pregnant women change the pharmacokinetics of these drugs, often resulting in the need for an increased dose. Fetal well-being is a major concern among pregnant women. Fortunately, many drugs used to treat CVD can be used safely during pregnancy, with the exception of high-dose warfarin in the first trimester, angiotensin-converting-enzyme inhibitors, angiotensin-receptor blockers, amiodarone, and spironolactone. A timely and thorough discussion between the cardiologist and the pregnant patient about the potential benefits and adverse effects of medication for CVD is important. Noncompliance with necessary treatment for cardiovascular disorders endangers not only the mother, but also the fetus. This Review is an overview of the pharmacokinetic changes in medications for CVD during pregnancy and the safety of these drugs for the fetus. The implications for maternal treatment are discussed. The Review also includes a short section on the cardiovascular effects of medication used for obstetric indications. PMID:26585398

  13. [Cardiovascular diseases in workers engaged into metal mining industry and mechanical engineering].

    PubMed

    Korzeneva, E V; Sineva, E L

    2007-01-01

    Peculiarities of cardiovascular diseases among workers exposed to noise and vibration include hyperkinetic hemodynamic type supporting early terms of cardiovascular functions disorder. Veloergometry and echocardiography are highly informative and diagnostic value, so helpful in early diagnosis of circulatory disorders. The authors specified objective criteria of risk associated with occupationally related cardiovascular diseases. PMID:18051846

  14. Cardio-metabolic risk prediction should be superior to cardiovascular risk assessment in primary prevention of cardiovascular diseases.

    PubMed

    Rosolova, Hana; Nussbaumerova, Barbora

    2011-03-01

    Cardiovascular atherosclerotic diseases represent the main cause of death in the developed and developing populations. Although major progress has been made in the management of the classical modifiable cardiovascular risk factors, unhealthy lifestyle conduces to an increasing prevalence of overweight, obesity, metabolic disorders, type 2 diabetes mellitus, premature atherosclerosis and cardiovascular diseases. That is why cardio-metabolic risk prediction should be superior in the primary prevention of atherosclerosis and cardiovascular diseases. Up-to-date primary preventive strategies according to the European Guidelines, especially the high risk strategy approach, are being implemented. Individual cardiovascular and better cardio-metabolic risk assessment represents the basic approach in the individualized primary prevention of cardiovascular diseases and type 2 diabetes mellitus. Cardio-metabolic biomarkers, especially high sensitivity C-reactive protein, albuminuria, N-terminal pro-brain natriuretic peptide, and imaging procedures (carotid intima-media thickness measured by ultrasound) could improve the prediction of cardiovascular diseases and type 2 diabetes beyond that using traditional risk factors. PMID:23199124

  15. Disparities in heart failure and other cardiovascular diseases among women

    PubMed Central

    McSweeney, Jean; Pettey, Christina; Lefler, Leanne L; Heo, Seongkum

    2012-01-01

    This article reviews literature pertinent to cardiovascular disparities in women, focusing primarily on heart failure (HF). It provides an in-depth look at causes, biological influences, self-management and lack of adherence to HF-treatment guidelines in women. Disparities in treatment of causative factors of HF, such as myocardial infarction and hypertension, contribute to women having poorer HF outcomes than men. This article discusses major contributing reasons for nonadherence to medication regimes for HF in women, including advanced age at time of diagnosis, likelihood of multiple comorbidities, lack of social support and low socioeconomic status. Limited inclusion of women in clinical trials and the scarcity of gender analyses for HF and other cardiovascular diseases continues to limit the applicability of research findings to women. PMID:22757737

  16. Effects of Some Common Food Constituents on Cardiovascular Disease

    PubMed Central

    Yang, Yaling; Chan, Sze Wa; Hu, Miao; Walden, Richard; Tomlinson, Brian

    2011-01-01

    Cardiovascular diseases are the major cause of morbidity and mortality worldwide, and there is considerable interest in the role of dietary constituents and supplements in the prevention and treatment of these disorders. We reviewed the major publications related to potential effects on cardiovascular risk factors and outcomes of some common dietary constituents: carotenoids, flavonoid-rich cocoa, tea, red wine and grapes, coffee, omega-3 fatty acids, and garlic. Increased intake of some of these has been associated with reduced all-cause mortality or reduced incidence of myocardial infraction, stroke, and hypertension. However, although the evidence from observational studies is supportive of beneficial effects for most of these foodstuffs taken as part of the diet, potential benefits from the use of supplements derived from these natural products remain largely inconclusive. PMID:22347642

  17. Understanding Air Pollution and Cardiovascular Diseases: Is It Preventable?

    PubMed Central

    Morishita, Masako; Thompson, Kathryn C.

    2015-01-01

    Fine particulate matter (<2.5 m, PM2.5) air pollution is a leading risk factor for morbidity and mortality worldwide. The largest portion of adverse health effects is from cardiovascular diseases. In North America, PM2.5 concentrations have shown a steady decline over the past several decades; however, the opposite trend has occurred throughout much of the developing world whereby daily concentrations commonly reach extraordinarily high levels. While air quality regulations can reduce air pollution at a societal level, what individuals can do to reduce their personal exposures remains an active field of investigation. Here, we review the emerging evidence that several interventions (e.g., air filters) and/or behavioral changes can lower PM pollution exposure and as such, may be capable of mitigating the ensuing adverse cardiovascular health consequences. Air pollution remains a worldwide epidemic and a multi-tiered prevention strategy is required in order to optimally protect global public health. PMID:26097526

  18. Epidemiology and Mechanisms of Uremia-Related Cardiovascular Disease.

    PubMed

    Tonelli, Marcello; Karumanchi, S Ananth; Thadhani, Ravi

    2016-02-01

    Patients with chronic kidney disease and end-stage renal disease are at 5- to 10-fold higher risk for developing cardiovascular disease (CVD) than age-matched controls. Clinically, CVD in this population manifests as coronary artery disease, arrhythmias, stroke, or congestive heart failure. Beyond the traditional risk factors (eg, diabetes mellitus and hypertension), uremia-specific factors that arise from accumulating toxins also contribute to the pathogenesis of CVD. In this review, we summarize the literature on the epidemiology of both traditional and uremia-related CVD and focus on postulated mechanisms of the latter. In the context of current and emerging diagnostics and therapies for CVD, we highlight what we interpret as major gaps in the medical management of this growing population that need to be addressed with targeted epidemiological and translational research. Finally, we describe the global challenges associated with the recognition and management of uremia-related CVD in developed and developing nations. PMID:26831434

  19. Lipophilic chemical exposure as a cause of cardiovascular disease

    PubMed Central

    2013-01-01

    Environmental chemical exposure has been linked to numerous diseases in humans. These diseases include cancers; neurological and neurodegenerative diseases; metabolic disorders including type 2 diabetes, metabolic syndrome and obesity; reproductive and developmental disorders; and endocrine disorders. Many studies have associated the link between exposures to environmental chemicals and cardiovascular disease (CVD). These chemicals include persistent organic pollutants (POPs); the plastic exudates bisphenol A and phthalates; low molecular weight hydrocarbons (LMWHCs); and poly nuclear aromatic hydrocarbons (PAHs). Here it is reported that though the chemicals reported on differ widely in chemical properties and known points of attack in humans, a common link exists between them. All are lipophilic species that are found in serum. Environmentally induced CVD is related to total lipophilic chemical load in the blood. Lipophiles serve to promote the absorption of otherwise not absorbed toxic hydrophilic species that promote CVD. PMID:24179429

  20. Epigenomes: the missing heritability in human cardiovascular disease?

    PubMed Central

    Monte, Emma; Vondriska, Thomas M.

    2014-01-01

    Cardiovascular disease is a tremendous burden on human health and results from malfunction of various networks of biological molecules in the context of environmental stress. Despite strong evidence of heritability, many common forms of heart disease (heart failure in particular) have not yielded to genome-wide association studies to identify causative mutations acting via the disruption of individual molecules. Increasing evidence suggests, however, that genetic variation in non-coding regions is strongly linked to disease susceptibility. We hypothesize that epigenomic variation may engender different chromatin environments in the absence of (or in parallel with) changes in protein or mRNA sequence and abundance. In this manner, distinctgenetically encodedchromatin environments can exhibit distinct responses to environmental stresses that cause heart failure, explaining a significant portion of the altered susceptibility that is observed in human disease. PMID:24957631

  1. Psoriasis, non-alcoholic fatty liver disease, and cardiovascular disease: Three different diseases on a unique background

    PubMed Central

    Ganzetti, Giulia; Campanati, Anna; Molinelli, Elisa; Offidani, Annamaria

    2016-01-01

    Psoriasis is a chronic inflammatory immune-mediated skin disease, frequently associated with systemic comorbidities. According to recent data, patients with psoriasis show a greater prevalence of metabolic syndrome, which confers a higher cardiovascular risk. The link between these pathological conditions appears to be a chronic low-grade inflammatory status. The aim of this review is to focus on the multiple epidemiological and physio-pathogenetic aspects linking non-alcoholic fatty liver disease, psoriasis, and cardiovascular disease. PMID:26981209

  2. Etiology of cardiovascular disease in patients with schizophrenia: current perspectives

    PubMed Central

    Emul, Murat; Kalelioglu, Tevfik

    2015-01-01

    Cardiovascular morbidity and mortality are important problems among patients with schizophrenia. A wide spectrum of reasons, ranging from genes to the environment, are held responsible for causing the cardiovascular risk factors that may lead to shortening the life expectancy of patients with schizophrenia. Here, we have summarized the etiologic issues related with the cardiovascular risk factors in schizophrenia. First, we focused on heritable factors associated with cardiovascular disease and schizophrenia by mentioning studies about genetics–epigenetics, in the first-episode or drug-naïve patients. In this context, the association and candidate gene studies about metabolic disturbances in schizophrenia are reviewed, and the lack of the effects of epigenetic/posttranscriptional factors such as microRNAs is mentioned. Increased rates of type 2 diabetes mellitus and disrupted metabolic parameters in schizophrenia are forcing clinicians to struggle with metabolic syndrome parameters and related issues, which are also the underlying causes for the risk of having cardiometabolic and cardiovascular etiology. Second, we summarized the findings of metabolic syndrome-related entities and discussed the influence of the illness itself, antipsychotic drug treatment, and the possible disadvantageous lifestyle on the occurrence of metabolic syndrome (MetS) or diabetes mellitus. Third, we emphasized on the risk factors of sudden cardiac death in patients with schizophrenia. We reviewed the findings on the arrhythmias such as QT prolongation, which is a risk factor for Torsade de Pointes and sudden cardiac death or P-wave prolongation that is a risk factor for atrial fibrillation. For example, the use of antipsychotics is an important reason for the prolongation of QT and some other cardiac autonomic dysfunctions. Additionally, we discussed relatively rare issues such as myocarditis and cardiomyopathy, which are important for prognosis in schizophrenia that may have originated from the use of antipsychotic medication. In conclusion, we considered that the studies and awareness about physical needs of patients with schizophrenia are increasing. It seems logical to increase cooperation and shared care between the different health care professionals to screen and treat cardiovascular disease (CVD)-risk factors, MetS, and diabetes in patients with psychiatric disorders, because some risk factors of MetS or CVD are avoidable or at least modifiable to decrease high mortality in schizophrenia. We suggested that future research should focus on conducting an integrated system of studies based on a holistic biopsychosocial evaluation. PMID:26491327

  3. Etiology of cardiovascular disease in patients with schizophrenia: current perspectives.

    PubMed

    Emul, Murat; Kalelioglu, Tevfik

    2015-01-01

    Cardiovascular morbidity and mortality are important problems among patients with schizophrenia. A wide spectrum of reasons, ranging from genes to the environment, are held responsible for causing the cardiovascular risk factors that may lead to shortening the life expectancy of patients with schizophrenia. Here, we have summarized the etiologic issues related with the cardiovascular risk factors in schizophrenia. First, we focused on heritable factors associated with cardiovascular disease and schizophrenia by mentioning studies about genetics-epigenetics, in the first-episode or drug-naïve patients. In this context, the association and candidate gene studies about metabolic disturbances in schizophrenia are reviewed, and the lack of the effects of epigenetic/posttranscriptional factors such as microRNAs is mentioned. Increased rates of type 2 diabetes mellitus and disrupted metabolic parameters in schizophrenia are forcing clinicians to struggle with metabolic syndrome parameters and related issues, which are also the underlying causes for the risk of having cardiometabolic and cardiovascular etiology. Second, we summarized the findings of metabolic syndrome-related entities and discussed the influence of the illness itself, antipsychotic drug treatment, and the possible disadvantageous lifestyle on the occurrence of metabolic syndrome (MetS) or diabetes mellitus. Third, we emphasized on the risk factors of sudden cardiac death in patients with schizophrenia. We reviewed the findings on the arrhythmias such as QT prolongation, which is a risk factor for Torsade de Pointes and sudden cardiac death or P-wave prolongation that is a risk factor for atrial fibrillation. For example, the use of antipsychotics is an important reason for the prolongation of QT and some other cardiac autonomic dysfunctions. Additionally, we discussed relatively rare issues such as myocarditis and cardiomyopathy, which are important for prognosis in schizophrenia that may have originated from the use of antipsychotic medication. In conclusion, we considered that the studies and awareness about physical needs of patients with schizophrenia are increasing. It seems logical to increase cooperation and shared care between the different health care professionals to screen and treat cardiovascular disease (CVD)-risk factors, MetS, and diabetes in patients with psychiatric disorders, because some risk factors of MetS or CVD are avoidable or at least modifiable to decrease high mortality in schizophrenia. We suggested that future research should focus on conducting an integrated system of studies based on a holistic biopsychosocial evaluation. PMID:26491327

  4. Cardiovascular risk factors for acute stroke: Risk profiles in the different subtypes of ischemic stroke

    PubMed Central

    Arboix, Adrià

    2015-01-01

    Timely diagnosis and control of cardiovascular risk factors is a priority objective for adequate primary and secondary prevention of acute stroke. Hypertension, atrial fibrillation and diabetes mellitus are the most common risk factors for acute cerebrovascular events, although novel risk factors, such as sleep-disordered breathing, inflammatory markers or carotid intima-media thickness have been identified. However, the cardiovascular risk factors profile differs according to the different subtypes of ischemic stroke. Atrial fibrillation and ischemic heart disease are more frequent in patients with cardioembolic infarction, hypertension and diabetes in patients with lacunar stroke, and vascular peripheral disease, hypertension, diabetes, previous transient ischemic attack and chronic obstructive pulmonary disease in patients with atherothrombotic infarction. This review aims to present updated data on risk factors for acute ischemic stroke as well as to describe the usefulness of new and emerging vascular risk factors in stroke patients. PMID:25984516

  5. Role of Adipokines in Atherosclerosis: Interferences with Cardiovascular Complications in Rheumatic Diseases

    PubMed Central

    Scotece, Morena; Conde, Javier; Gmez, Rodolfo; Lpez, Vernica; Pino, Jess; Gonzlez, Antonio; Lago, Francisca; Gmez-Reino, Juan J.; Gualillo, Oreste

    2012-01-01

    Patients with rheumatic diseases have an increased risk of mortality by cardiovascular events. In fact, several rheumatic diseases such as rheumatoid arthritis, osteoarthritis, systemic lupus erythematosus, and ankylosing spondylitis are associated with a higher prevalence of cardiovascular diseases (CVDs). Although traditional cardiovascular risk factors have been involved in the pathogenesis of cardiovascular diseases in rheumatic patients, these alterations do not completely explain the enhanced cardiovascular risk in this population. Obesity and its pathologic alteration of fat mass and dysfunction, due to an altered pattern of secretion of proinflammatory adipokines, could be one of the links between cardiovascular and rheumatic diseases. Indeed, the incidence of CVDs is augmented in obese individuals with rheumatic disorders. Thus, in this paper we explore in detail the relationships among adipokines, rheumatic diseases, and cardiovascular complications by giving to the reader a holistic vision and several suggestions for future perspectives and potential clinical implications. PMID:22910888

  6. Pathophysiologic and treatment strategies for cardiovascular disease in end-stage renal disease and kidney transplantations.

    PubMed

    Ghanta, Mythili; Kozicky, Mark; Jim, Belinda

    2015-01-01

    The inextricable link between the heart and the kidneys predestines that significant cardiovascular disease ensues in the face of end-stage renal disease (ESRD). As a point of fact, the leading cause of mortality of patients on dialysis is still from cardiovascular etiologies, albeit differing in particular types of disease from the general population. For example, sudden cardiac death outnumbers coronary artery disease in patients with ESRD, which is the reverse for the general population. In this review, we will focus on the pathophysiology and treatment options of important traditional and nontraditional risk factors for cardiovascular disease in ESRD patients such as hypertension, anemia, vascular calcification, hyperparathyroidism, uremia, and oxidative stress. The evidence of erythropoietin-stimulating agents, phosphate binders, calcimimetics, and dialysis modalities will be presented. We will then discuss how these risk factors may be changed and perhaps exacerbated after renal transplantation. This is largely due to the immunosuppressive agents that are both crucial yet potentially detrimental in the posttransplant state. Calcineurin inhibitors, corticosteroids, and mammalian target of rapamycin inhibitors, the mainstay of transplant immunosuppression, are all known to increase the risks of developing new onset diabetes as well as the metabolic syndrome. Thus, we need to carefully negotiate between patients' cardiovascular profile and their risks of rejection. Finally, we end by considering strategies by which we may minimize cardiovascular disease in the transplant population, as this modality still confers the highest chance of survival in patients with ESRD. PMID:25420053

  7. Strategic Approaches to Unraveling Genetic Causes of Cardiovascular Diseases

    PubMed Central

    Marian, A.J.; Belmont, John

    2011-01-01

    DNA sequence variants (DSVs) are major components of the causal field for virtually all-medical phenotypes, whether single-gene familial disorders or complex traits without a clear familial aggregation. The causal variants in single gene disorders are necessary and sufficient to impart large effects. In contrast, complex traits are due to a much more complicated network of contributory components that in aggregate increase the probability of disease. The conventional approach to identification of the causal variants for single gene disorders is genetic linkage. However, it does not offer sufficient resolution to map the causal genes in small size families or sporadic cases. The approach to genetic studies of complex traits entails candidate gene or Genome Wide Association Studies (GWAS). GWAS provides an unbiased survey of the effects of common genetic variants (common disease - common variant hypothesis). GWAS have led to identification of a large number of alleles for various cardiovascular diseases. However, common alleles account for a relatively small fraction of the total heritability of the traits. Accordingly, the focus has shifted toward identification of rare variants that might impart larger effect sizes (rare variant-common disease hypothesis). This shift is made feasible by recent advances in massively parallel DNA sequencing platforms, which afford the opportunity to identify virtually all common as well as rare alleles in individuals. In this review, we discuss various strategies that are used to delineate the genetic contribution to medically important cardiovascular phenotypes, emphasizing the utility of the new deep sequencing approaches. PMID:21566222

  8. Overnutrition, mTOR signaling, and cardiovascular diseases

    PubMed Central

    Jia, Guanghong; Aroor, Annayya R.; Martinez-Lemus, Luis A.

    2014-01-01

    The prevalence of obesity and associated medical disorders has increased dramatically in the United States and throughout much of the world in the past decade. Obesity, induced by excess intake of carbohydrates and fats, is a major cause of Type 2 diabetes, hypertension, and the cardiorenal metabolic syndrome. There is emerging evidence that excessive nutrient intake promotes signaling through the mammalian target of rapamycin (mTOR), which, in turn, may lead to alterations of cellular metabolic signaling leading to insulin resistance and obesity-related diseases, such as diabetes, cardiovascular and kidney disease, as well as cancer. While the pivotal role of mTOR signaling in regulating metabolic stress, autophagy, and adaptive immune responses has received increasing attention, there remain many gaps in our knowledge regarding this important nutrient sensor. For example, the precise cellular signaling mechanisms linking excessive nutrient intake and enhanced mTOR signaling with increased cardiovascular and kidney disease, as well as cancer, are not well understood. In this review, we focus on the effects that the interaction between excess intake of nutrients and enhanced mTOR signaling have on the promotion of obesity-associated diseases and potential therapeutic strategies involving targeting mTOR signaling. PMID:25253086

  9. An investigation of changes in regional gray matter volume in cardiovascular disease patients, pre and post cardiovascular rehabilitation?

    PubMed Central

    Anazodo, U.C.; Shoemaker, J.K.; Suskin, N.; St. Lawrence, K.S.

    2013-01-01

    Cognitive function decline secondary to cardiovascular disease has been reported. However, little is known about the impact of coronary artery disease (CAD) on the aging brain macrostructure or whether exercise training, in the context of cardiovascular rehabilitation, can affect brain structure following a coronary event. This study employed voxel-based morphometry of high resolution structural MRI images to investigate; 1) changes in regional gray matter volume (GMV) in CAD patients compared to age-matched controls, and 2) the effects of a six-month exercise-based cardiovascular rehabilitation program on CAD-related GMV decline. Compared to controls, significant decreases in regional GMV were found in the superior, medial and inferior frontal gyrus; superior and inferior parietal gyrus; middle and superior temporal gyrus and in the posterior cerebellum of CAD patients. Cardiovascular rehabilitation was associated with the recovery of regional GMV in the superior frontal gyrus, superior temporal gyrus and posterior cerebellum of the CAD patients as well as the increase in GMV in the supplementary motor area. Total and regional GMV correlated with fitness level, defined by the maximal oxygen consumption (VO2max), at baseline but not after cardiovascular rehabilitation. This study demonstrates that cardiovascular disease can adversely affect age-related decline in GMV; and that these disease-related effects could be mitigated by moderate levels of exercise training as part of cardiovascular rehabilitation. PMID:24273722

  10. Strategies for reducing the risk of cardiovascular disease in patients with chronic obstructive pulmonary disease.

    PubMed

    Ferri, Claudio

    2015-06-01

    Chronic obstructive pulmonary disease (COPD) is frequently accompanied by multimorbidities in affected patients. Even though the majority of these comorbidities are also related to advanced age and cigarette smoke, also COPD itself has significant impact on insurgence, or worsening of these conditions. As a consequence, COPD is regarded as a complex disease with pulmonary and extra-pulmonary involvement. According to current guidelines for the management of COPD patients, the comprehensive treatment of this condition should target respiratory symptoms as well as comorbidities. Cardiovascular disease is one of the most frequent comorbidities in COPD patients and there are several strategies for reducing the risk of cardiovascular disease in COPD patients. These include smoking cessation, pharmacologic prevention of cardiovascular disease, and the treatment of COPD. Beta-blockers for the prevention of cardiovascular disease have been traditionally limited in COPD patients, albeit current evidence supporting their efficacy and safety in these patients. With regard to COPD medications, corticosteroids are generally not recommended, except for exacerbations, while long-acting beta2-agonists have demonstrated an acceptable profile of cardiovascular safety. Long-acting anticholinergic bronchodilators, in particular tiotropium in the mist inhaler formulation, have been associated with an increased risk of major cardiovascular events and mortality. Data on this issue remain, however, controversial. Glycopyrronium, a recently introduced anticholinergic, demonstrated. a rapid and sustained relief of respiratory symptoms with a favorable safety profile and no increase in cardiovascular risk, in monotherapy and in combination with a long-acting beta2-agonist in a comprehensive trial program indicating a valid option for COPD patients with CV comorbidities. PMID:25655487

  11. Fcγ Receptors and Ligands and Cardiovascular Disease

    PubMed Central

    Tanigaki, Keiji; Sundgren, Nathan; Khera, Amit; Vongpatanasin, Wanpen; Mineo, Chieko; Shaul, Philip W.

    2015-01-01

    Fcγ receptors (FcγR) classically modulate intracellular signaling upon binding of the Fc region of IgG in immune response cells. How FcγR and their ligands impact cardiovascular health and disease has recently been interrogated in both preclinical and clinical studies. The stimulation of activating FcγR in endothelial cells, vascular smooth muscle cells and monocytes/macrophages causes a variety of cellular responses that may contribute to vascular disease pathogenesis. Stimulation of the lone inhibitory FγcR, FcγRIIB, also has adverse consequences in endothelial cells, antagonizing NO production and reparative mechanisms. In preclinical disease models, activating FcγR promote atherosclerosis whereas FcγRIIB is protective, and activating FcγR also enhance thrombotic and non-thrombotic vascular occlusion. The FcγR ligand C-reactive protein (CRP) has undergone intense study. Although in rodents CRP does not impact atherosclerosis, it causes hypertension and insulin resistance and worsens myocardial infarction. Massive data has accumulated indicating an association between increases in circulating CRP and coronary heart disease in humans. However, Mendelian randomization studies reveal that CRP is not likely a disease mediator. CRP genetics and hypertension warrants further investigation. Studies to date of genetic variants of activating FcγR are insufficient to implicate the receptors in coronary heart disease pathogenesis in humans. However, a link between FcγRIIB and human hypertension may be emerging. Further knowledge of the vascular biology of FcγR and their ligands will potentially enhance our understanding of cardiovascular disorders, particularly in patients whose greater predisposition for disease is not explained by traditional risk factors, such as individuals with autoimmune disorders. PMID:25593280

  12. Phosphoinositide 3-kinase: friend and foe in cardiovascular disease

    PubMed Central

    Ghigo, Alessandra; Li, Mingchuan

    2015-01-01

    Class I phosphoinositide 3-kinases (PI3Ks) are a family of lipid kinases activated by cell membrane receptors, either receptor tyrosine kinases (RTKs) or G proteincoupled receptors (GPCRs), to catalyze the production of the lipid second messenger phosphatidylinositol (3,4,5)-trisphosphate (PIP3). These enzymes engage multiple downstream intracellular signaling pathways controlling cell proliferation, survival and migration. In the cardiovascular system, the four class I PI3K isoforms, PI3K?, PI3K?, PI3K?, and PI3K? are differentially expressed in distinct cell subsets which include cardiomyocytes, fibroblasts, endothelial, and vascular smooth muscle cells as well as leukocytes, suggesting specific functions for distinct PI3K isoenzymes. During the last decades, genetic disruption studies targeting different PI3K genes have elucidated the contribution of specific isoenzymes to cardiac and vascular function regulation, highlighting both beneficial and maladaptive roles. New layers of complexity in the function of PI3Ks have recently emerged, indicating that distinct PI3K isoforms are interconnected by various crosstalk events and can function not only as kinases, but also as scaffold proteins coordinating key signalosomes in cardiovascular health and disease. In this review, we will summarize major breakthroughs in the comprehension of detrimental and beneficial actions of PI3K signaling in cardiovascular homeostasis, and we will discuss recently unraveled cross-talk and scaffold mechanisms as well as the role of the less characterized class II and III PI3K isoforms. PMID:26321955

  13. Cardiovascular disease risk factors: epidemiology and risk assessment.

    PubMed

    Dahlf, Bjrn

    2010-01-01

    Current epidemiologic predictions show that the world is heading for a vascular tsunami of pandemic proportions. The number of people at high risk from cardiovascular disease is increasing; recent cohort studies suggest that only 2%-7% of the general population have no risk factors at all, and >70% of at-risk individuals have multiple risk factors. The recently published Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial (ONTARGET) study, which showed that telmisartan was as effective as ramipril in the prevention of a range of cardiovascular outcomes, enrolled a broad cross section of high-risk patients. This population was chosen to reflect the type of patients encountered in general practice, and because the proportion of high-risk individuals is increasing worldwide, the ONTARGET results will be relevant for most at-risk patients. Further analysis of the ONTARGET results may also aid in the development of risk estimation scores populated with real-life data and could also determine the impact of treatment on the long-term reduction of total cardiovascular burden (ie, absolute risk reduction). This may be a particularly useful exercise because current risk estimation charts have limitations in their scope, sensitivity, and the ability to reflect changes in risk. PMID:20102968

  14. Troponin in Cardiovascular Disease Prevention: Updates and Future Direction.

    PubMed

    Hoff, Jason; Wehner, William; Nambi, Vijay

    2016-03-01

    Cardiac troponin has been well described as the preferred biomarker for diagnosis of myocardial infarction due to the high sensitivity and specificity for myocardial injury. Numerous other conditions apart from acute coronary syndrome can also lead to small elevations in troponin levels. However, the use of cTn as prognostic biomarker for the primary assessment of cardiovascular risk in asymptomatic patient has only recently been described. And with the development of newer generations of high-sensitivity cardiac troponin assays that can detect 10-fold lower concentrations of troponin, the potential value cTn in the prevention and management of asymptomatic cardiovascular disease has come to the fore. This review provides an overview of the transition of cardiac troponin as a marker of acute myocardial injury to one that detects sub-clinical injury. Evidence continues to show that high-sensitivity troponin is emerging as one of the most powerful prognostic biomarkers for the assessment of cardiovascular risk in the general population. PMID:26879078

  15. Shared Risk Factors in Cardiovascular Disease and Cancer.

    PubMed

    Koene, Ryan J; Prizment, Anna E; Blaes, Anne; Konety, Suma H

    2016-03-15

    Cardiovascular disease (CVD) and cancer are the 2 leading causes of death worldwide. Although commonly thought of as 2 separate disease entities, CVD and cancer possess various similarities and possible interactions, including a number of similar risk factors (eg, obesity, diabetes mellitus), suggesting a shared biology for which there is emerging evidence. Although chronic inflammation is an indispensable feature of the pathogenesis and progression of both CVD and cancer, additional mechanisms can be found at their intersection. Therapeutic advances, despite improving longevity, have increased the overlap between these diseases, with millions of cancer survivors now at risk of developing CVD. Cardiac risk factors have a major impact on subsequent treatment-related cardiotoxicity. In this review, we explore the risk factors common to both CVD and cancer, highlighting the major epidemiological studies and potential biological mechanisms that account for them. PMID:26976915

  16. A Global Perspective on Cardiovascular Disease in Vulnerable Populations.

    PubMed

    Yeates, Karen; Lohfeld, Lynne; Sleeth, Jessica; Morales, Fernando; Rajkotia, Yogesh; Ogedegbe, Olugbenga

    2015-09-01

    Cardiovascular disease (CVD) is a major contributor to the growing public health epidemic in chronic diseases. Much of the disease and disability burden from CVDs are in people younger than the age of 70 years in low- and middle-income countries, formerly "the developing world." The risk of CVD is heavily influenced by environmental conditions and lifestyle variables. In this article we review the scope of the CVD problem in low- and middle-income countries, including economic factors, risk factors, at-risk groups, and explanatory frameworks that hypothesize the multifactorial drivers. Finally, we discuss current and potential interventions to reduce the burden of CVD in vulnerable populations including research needed to evaluate and implement promising solutions for those most at risk. PMID:26321432

  17. Inflammation, a Link between Obesity and Cardiovascular Disease

    PubMed Central

    Wang, Zhaoxia; Nakayama, Tomohiro

    2010-01-01

    Obesity, the most common nutritional disorder in industrialized countries, is associated with an increased mortality and morbidity of cardiovascular disease (CVD). Obesity is primarily considered to be a disorder of energy balance, and it has recently been suggested that some forms of obesity are associated with chronic low-grade inflammation. The present paper focuses on the current status of our knowledge regarding chronic inflammation, a link between obesity and CVDs, including heart diseases, vascular disease and atherosclerosis. The paper discusses the methods of body fat evaluation in humans, the endocrinology and distribution of adipose tissue in the genders, the pathophysiology of obesity, the relationship among obesity, inflammation, and CVD, and the adipose tissue-derived cytokines known to affect inflammation. Due to space limitations, this paper focuses on C-reactive protein, serum amyloid A, leptin, adiponectin, resistin, visfatin, chemerin, omentin, vaspin, apelin, and retinol binding protein 4 as adipokines. PMID:20847813

  18. Whole grain intake and cardiovascular disease: a review.

    PubMed

    Jacobs, David R; Gallaher, Daniel D

    2004-11-01

    Prospective epidemiologic and feeding studies find possible health benefits of whole cereal grain foods (which include the bran, germ, and endosperm in their naturally occurring proportions), especially for prevention of atherosclerotic cardiovascular diseases and type 2 diabetes. We review 17 articles that consistently found a 20% to 40% reduction in long-term risk of these diseases comparing habitual consumers of whole grains to those who rarely eat these foods. Another 12 studies found a similar risk reduction according to amount of cereal fiber consumed. Feeding studies show improvements in risk factors for these diseases when whole grain foods are consumed. Some authors have tried to explain the reduced risk by invoking cereal fiber, with no attention to nonfiber constituents. We interpret the data as supportive of a synergy of the whole grain constituents, including fiber as only one such constituent. PMID:15485586

  19. How Does Cardiovascular Disease First Present in Women and Men?

    PubMed Central

    Rapsomaniki, Eleni; Pujades-Rodriguez, Mar; Shah, Anoop Dinesh; Denaxas, Spiros; Herrett, Emily; Smeeth, Liam; Timmis, Adam; Hemingway, Harry

    2015-01-01

    Background Given the recent declines in heart attack and stroke incidence, it is unclear how women and men differ in first lifetime presentations of cardiovascular diseases (CVDs). We compared the incidence of 12 cardiac, cerebrovascular, and peripheral vascular diseases in women and men at different ages. Methods and Results We studied 1 937 360 people, aged ?30 years and free from diagnosed CVD at baseline (51% women), using linked electronic health records covering primary care, hospital admissions, acute coronary syndrome registry, and mortality (Cardiovascular Research Using LInked Bespoke Studies and Electronic Records [CALIBER] research platform). During 6 years median follow-up between 1997 and 2010, 114 859 people experienced an incident cardiovascular diagnosis, the majority (66%) of which were neither myocardial infarction nor ischemic stroke. Associations of male sex with initial diagnoses of CVD, however, varied from strong (age-adjusted hazard ratios, 3.65.0) for abdominal aortic aneurysm, myocardial infarction, and unheralded coronary death (particularly >60 years), through modest (hazard ratio, 1.52.0) for stable angina, ischemic stroke, peripheral arterial disease, heart failure, and cardiac arrest, to weak (hazard ratio <1.5) for transient ischemic attack, intracerebral hemorrhage, and unstable angina, and inverse (0.69) for subarachnoid hemorrhage (all P<0.001). Conclusions The majority of initial presentations of CVD are neither myocardial infarction nor ischemic stroke, yet most primary prevention studies focus on these presentations. Sex has differing associations with different CVDs, with implications for risk prediction and management strategies. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT01164371. PMID:26330414

  20. Cardiovascular disease. Physician attitudes toward prevention and treatment.

    PubMed Central

    Grant, A. M.; Niyonsenga, T.; Dion, I.; Delisle, E.; Xhignesse, M.; Bernier, R.

    1998-01-01

    OBJECTIVE: Survey of physician attitudes toward practising cardiovascular disease prevention. DESIGN: Questionnaire administered via telecommunication from 1992 through 1994. SETTING: The FAMUS (Family Medicine, University of Sherbrooke) project, between 1992 and 1996, used weekly telecommunication to collect data from 200 general practitioners throughout the province of Quebec on cardiovascular disease risk factors and their treatment. PARTICIPANTS: Of 200 physicians contributing to the FAMUS project, 156 completed questionnaires (response rate 78%). MAIN OUTCOME MEASURES: Variations in attitudes to prevention policy and risk factor interventions. RESULTS: Survey results revealed physicians knew important risk factors for cardiovascular disease but differed in attitudes toward efficacy of treatment. Intervention to control cholesterol was thought to be very effective by 21.2% (95% confidence interval [CI] 21.2 +/- 6.4) and without effect by 10.3% (95% CI 10.3 +/- 4.8). Intervention to improve dietary habits was considered ineffective by 48.1% (95% CI 48.1 +/- 7.8). Confidence in managing risk factors varied; most respondents described themselves as only moderately skilled. A few practitioners (30.1%; 95% CI 30.1 +/- 7.2) acknowledged practice guidelines as an important source of information on which to base preventive interventions. Only 14.7% (95% CI 14.7 +/- 5.6) of those surveyed included remuneration as contributing to their implementation of prevention activities in practice. CONCLUSIONS: Variations in physician attitudes could influence risk factor intervention. Interventions to change lifestyle are associated with uncertainty about patient compliance, efficacy of treatment, and ability to effect lifestyle changes. PMID:9585851

  1. Alcohol and Cardiovascular DiseaseModulation of Vascular Cell Function

    PubMed Central

    Cahill, Paul A.; Redmond, Eileen M.

    2012-01-01

    Alcohol is a commonly used drug worldwide. Epidemiological studies have identified alcohol consumption as a factor that may either positively or negatively influence many diseases including cardiovascular disease, certain cancers and dementia. Often there seems to be a differential effect of various drinking patterns, with frequent moderate consumption of alcohol being salutary and binge drinking or chronic abuse being deleterious to ones health. A better understanding of the cellular and molecular mechanisms mediating the many effects of alcohol consumption is beginning to emerge, as well as a clearer picture as to whether these effects are due to the direct actions of alcohol itself, or caused in part by its metabolites, e.g., acetaldehyde, or by incidental components present in the alcoholic beverage (e.g., polyphenols in red wine). This review will discuss evidence to date as to how alcohol (ethanol) might affect atherosclerosis that underlies cardiovascular and cerebrovascular disease, and the putative mechanisms involved, focusing on vascular endothelial and smooth muscle cell effects. PMID:22606372

  2. Periodontal associations in cardiovascular diseases: The latest evidence and understanding.

    PubMed

    Nguyen, C M; Kim, J W M; Quan, V H; Nguyen, B H; Tran, S D

    2015-01-01

    Periodontal and cardiovascular diseases (CVD) are inflammatory diseases. Recent epidemiological studies have associated the effect of periodontitis on CVD progression. Findings of oral pathogens in carotid atheromas provided a plausible relationship between these two diseases. One possible mechanism is the infiltration of oral/periodontal pathogens through inflamed and ulcerated gingival epithelium. This results in translocation of oral pathogens throughout the systemic circulation affecting vascular tissues, and initiating a cascade of inflammatory reactions detrimental to the cardiovascular system. In addition, leakage of pro-inflammatory cytokines/chemokines from the ulcerated periodontium into the bloodstream may cause the production of hepatic acute-phase proteins. Moreover, as chronic bacteremia occurs, the adaptive immune system is activated. Antibodies produced in response to periodontal pathogens trigger a cross-reaction between endothelial cells and modified low-density lipoprotein to enhance the movement of lipids into cells within the vessel wall. Some antibodies and inflammatory cytokines promote the Th1 response, thereby further activating macrophages within the atheroma. These plausible mechanisms are contributing factors in initiating and propagating atherogenesis. This review discusses the current understanding of CVD pathology/periodontitis, potential underlying mechanisms regarding this association, and general guidelines for treating patients with CVD risks. PMID:26587382

  3. Periodontal associations in cardiovascular diseases: The latest evidence and understanding

    PubMed Central

    Nguyen, C.M.; Kim, J.W.M.; Quan, V.H.; Nguyen, B.H.; Tran, S.D.

    2015-01-01

    Periodontal and cardiovascular diseases (CVD) are inflammatory diseases. Recent epidemiological studies have associated the effect of periodontitis on CVD progression. Findings of oral pathogens in carotid atheromas provided a plausible relationship between these two diseases. One possible mechanism is the infiltration of oral/periodontal pathogens through inflamed and ulcerated gingival epithelium. This results in translocation of oral pathogens throughout the systemic circulation affecting vascular tissues, and initiating a cascade of inflammatory reactions detrimental to the cardiovascular system. In addition, leakage of pro-inflammatory cytokines/chemokines from the ulcerated periodontium into the bloodstream may cause the production of hepatic acute-phase proteins. Moreover, as chronic bacteremia occurs, the adaptive immune system is activated. Antibodies produced in response to periodontal pathogens trigger a cross-reaction between endothelial cells and modified low-density lipoprotein to enhance the movement of lipids into cells within the vessel wall. Some antibodies and inflammatory cytokines promote the Th1 response, thereby further activating macrophages within the atheroma. These plausible mechanisms are contributing factors in initiating and propagating atherogenesis. This review discusses the current understanding of CVD pathology/periodontitis, potential underlying mechanisms regarding this association, and general guidelines for treating patients with CVD risks. PMID:26587382

  4. Cardiovascular Risk Factors and Chronic Kidney Disease—FGF23: A Key Molecule in the Cardiovascular Disease

    PubMed Central

    Jimbo, Rika

    2014-01-01

    Patients with chronic kidney disease (CKD) are at increased risk of mortality, mainly from cardiovascular disease. Moreover, abnormal mineral and bone metabolism, the so-called CKD-mineral and bone disorder (MBD), occurs from early stages of CKD. This CKD-MBD presents a strong cardiovascular risk for CKD patients. Discovery of fibroblast growth factor 23 (FGF23) has altered our understanding of CKD-MBD and has revealed more complex cross-talk and endocrine feedback loops between the kidney, parathyroid gland, intestines, and bone. During the past decade, reports of clinical studies have described the association between FGF23 and cardiovascular risks, left ventricular hypertrophy, and vascular calcification. Recent translational reports have described the existence of FGF23-Klotho axis in the vasculature and the causative effect of FGF23 on cardiovascular disease. These findings suggest FGF23 as a promising target for novel therapeutic approaches to improve clinical outcomes of CKD patients. PMID:24678415

  5. The Equine Neonatal Cardiovascular System in Health and Disease.

    PubMed

    Marr, Celia M

    2015-12-01

    The neonatal foal is in a transitional state from prenatal to postnatal circulation. Healthy newborn foals often have cardiac murmurs and dysrhythmias, which are usually transient and of little clinical significance. The neonatal foal is prone to infection and cardiac trauma. Echocardiography is the main tool used for valuation of the cardiovascular system. With prompt identification and appropriate action, dysrhythmias and other sequel to cardiac trauma can be corrected. With infection, the management and prognosis are driven by concurrent sepsis. Congenital disease represents an interesting diagnostic challenge for the neonatologist, but surgical correction is not appropriate for most equids. PMID:26612747

  6. Epidemiology and Management of Antiretroviral-Associated Cardiovascular Disease

    PubMed Central

    Chastain, Daniel B; Henderson, Harold; Stover, Kayla R

    2015-01-01

    Risk and manifestations of cardiovascular disease (CVD) in patients infected with human immunodeficiency virus (HIV) will continue to evolve as improved treatments and life expectancy of these patients increases. Although initiation of antiretroviral (ARV) therapy has been shown to reduce this risk, some ARV medications may induce metabolic abnormalities, further compounding the risk of CVD. In this patient population, both pharmacologic and nonpharmacologic strategies should be employed to treat and reduce further risk of CVD. This review summarizes epidemiology data of the risk factors and development of CVD in HIV and provides recommendations to manage CVD in HIV-infected patients. PMID:25866592

  7. Management of Hypertriglyceridemia for Prevention of Atherosclerotic Cardiovascular Disease.

    PubMed

    Brinton, Eliot A

    2016-03-01

    Mendelian randomization data strongly suggest that hypertriglyceridemia (HTG) causes atherosclerotic cardiovascular disease (ASCVD), and so triglyceride (TG) level-lowering treatment in HTG is now more strongly recommended to address the residual ASCVD risk than has been the case in (generally earlier) published guidelines. Fibrates are the best-established agents for TG level lowering and are generally used as first-line treatment of TG levels greater than 500mg/dL. Statins are the best-established agents for ASCVD prevention, and so are usually used as first-line treatment of TG levels less than 500mg/dL. PMID:26893005

  8. Cardiovascular diseases in Ghana within the context of globalization

    PubMed Central

    Garcia, Daireen

    2016-01-01

    This paper discusses how globalization and its elements are influencing health dynamics and in particular Cardiovascular diseases (CVDs) in Ghana. It assesses the growing burden of CVDs and its relationship with globalization. It further describes the conceptual framework on which to view the impact of globalization on CVDs in Ghana. It also set out the dimensions of the relationship between CVD risk factors and globalization. The paper concludes with a discussion on strategies for tackling the growing burden of CVDs in Ghana. PMID:26885494

  9. Cardiovascular diseases in Ghana within the context of globalization.

    PubMed

    Ofori-Asenso, Richard; Garcia, Daireen

    2016-02-01

    This paper discusses how globalization and its elements are influencing health dynamics and in particular Cardiovascular diseases (CVDs) in Ghana. It assesses the growing burden of CVDs and its relationship with globalization. It further describes the conceptual framework on which to view the impact of globalization on CVDs in Ghana. It also set out the dimensions of the relationship between CVD risk factors and globalization. The paper concludes with a discussion on strategies for tackling the growing burden of CVDs in Ghana. PMID:26885494

  10. Lysophosphatidic acid metabolism and elimination in cardiovascular disease

    NASA Astrophysics Data System (ADS)

    Salous, Abdelghaffar Kamal

    The bioactive lipids lysophosphatidic acid (LPA) and sphingosine 1-phosphate (S1P) are present in human and mouse plasma at a concentration of ~0.1-1 microM and regulate physiological and pathophysiological processes in the cardiovascular system including atherothrombosis, intimal hyperplasia, and immune function, edema formation, and permeability. PPAP2B, the gene encoding LPP3, a broad activity integral membrane enzyme that terminates LPA actions in the vasculature, has a single nucleotide polymorphism that been recently associated with coronary artery disease risk. The synthesis and signaling of LPA and S1P in the cardiovascular system have been extensively studied but the mechanisms responsible for their elimination are less well understood. The broad goal of this research was to examine the role of LPP3 in the termination of LPA signaling in models of cardiovascular disease involving vascular wall cells, investigate the role of LPP3 in the elimination of plasma LPA, and further characterize the elimination of plasma LPA. The central hypothesis is that LPP3 plays an important role in attenuating the pathological responses to LPA signaling and that it mediates the elimination of exogenously applied bioactive lipids from the plasma. These hypotheses were tested using molecular biological approaches, in vitro studies, synthetic lysophospholipid mimetics, modified surgical procedures, and mass spectrometry assays. My results indicated that LPP3 played a critical role in attenuating LPA signaling mediating the pathological processes of intimal hyperplasia and vascular leak in mouse models of disease. Additionally, enzymatic inactivation of lysophospholipids by LPP and PLA enzymes in the plasma was not a primary mechanism for the rapid elimination of plasma LPA and S1P. Instead, evidence strongly suggested a transcellular uptake mechanism by hepatic non-parenchymal cells as the predominant mechanism for elimination of these molecules. These results support a model in which LPP3 is critical to regulating localized rather than systemic LPA signaling and elimination and provide a potential mechanistic explanation for the association of LPP3 polymorphism with cardiovascular disease as well as implications for lysophospholipid therapeutic drug design. KEYWORDS: Lysophosphatidic acid, Lipid Phosphate Phosphatas; Lipid Signaling, Transcellular Uptake, Hepatic Extraction

  11. Corrosiveness of drinking water and cardiovascular disease mortality

    SciTech Connect

    Haring, B.J.A.; Zoeteman, B.C.J.

    1980-10-01

    Hard drinking water is statistically correlated with low mortality from cardiovascular diseases. Possible explanations for this association are: (1)calcium and/or magnesium intake by consumption of hard water diminishes a deficiency of these essential elements in the total diet and suppresses the toxic effect of some heavy metals/ or (2)heavy metals in soft drinking water, released from the piping as a result of a supposedly higher corrosiveness of the softer waters during distribution, have toxic effects. Further investigation is recommended to determine the actual cause(s) of this statistical association. (10 references, 4 tables)

  12. [Drug methods of preventing stroke in cardiovascular diseases (a lecture)].

    PubMed

    Vereshchagin, N V; Varakin, Iu Ia; Arabidze, G G; Oshchepkova, E V

    1997-01-01

    Basing on the results of numerous investigations it is possible to single out 4 main directions in prevention of acute failure of cerebral circulation (AFCC) in cardiovascular diseases: stroke prevention in hypertensive subjects, prevention of cardioembolic stroke in patients with cardiac arrhythmia, prevention of recurrent AFCC episodes in patients with transitory ischemic attacks and minor stroke, prevention of the stroke by inhibition of progression of carotid atherosclerosis. The best population effect in stroke prevention belongs to active detection and adequate treatment of AH because AH is involved in development of the majority of the mechanisms underlying both hemorrhagic and ischemic stroke. PMID:9471795

  13. Mitochondrial redox status as a target for cardiovascular disease.

    PubMed

    Walters, James W; Amos, Deborah; Ray, Kristeena; Santanam, Nalini

    2016-04-01

    Mitochondria are major players in cellular energetics, oxidative stress and programmed cell death. Mitochondrial dynamics regulate and integrate these functions. Mitochondrial dysfunction is involved in cardiac hypertrophy, hypertension and myocardial ischemia/reperfusion injury. Reactive oxygen species generation is modulated by the fusion-fission pathway as well as key proteins such as sirtuins that act as metabolic sensors of cellular energetics. Mitochondrial redox status has thus become a good target for therapy against cardiovascular diseases. Recently, there is an influx of studies garnered towards assessing the beneficial effects of mitochondrial targeted antioxidants, drugs modulating the fusion-fission proteins, sirtuins, and other mitochondrial processes as potential cardio-protecting agents. PMID:26894468

  14. Self-Reported Experiences of Discrimination and Cardiovascular Disease

    PubMed Central

    Lewis, Ten T.; Williams, David R.; Tamene, Mahader; Clark, Cheryl R.

    2014-01-01

    Researchers have long speculated that exposure to discrimination may increase cardiovascular disease (CVD) risk but compared to other psychosocial risk factors, large-scale epidemiologic and community based studies examining associations between reports of discrimination and CVD risk have only emerged fairly recently. This review summarizes findings from studies of self-reported experiences of discrimination and CVD risk published between 20112013. We document the innovative advances in recent work, the notable heterogeneity in these studies, and the considerable need for additional work with objective clinical endpoints other than blood pressure. Implications for the study of racial disparities in CVD and clinical practice are also discussed. PMID:24729825

  15. Drug and Gene Delivery using Sonoporation for Cardiovascular Disease.

    PubMed

    Castle, Jason; Feinstein, Steven B

    2016-01-01

    Using the improvements made in diagnostic contrast enhanced ultrasound, researchers have made significant progress in the field of ultrasound-mediated sonoporation for drug delivery. Many programs take advantage of commercial products; both ultrasound imaging systems and contrast agents to better enable translation from preclinical to first-in-man studies (Kotopoulis et al., Med Phys 40:072902, 2013). Particularly well-suited targets for this novel therapy are diseases of the cardiovascular system. This chapter will highlight several recent studies addressing treatment of both acute and chronic conditions. PMID:26486346

  16. Endothelium and Its Alterations in Cardiovascular Diseases: Life Style Intervention

    PubMed Central

    Paganelli, Corrado; Buffoli, Barbara; Rodella, Luigi Fabrizio; Rezzani, Rita

    2014-01-01

    The endothelium, which forms the inner cellular lining of blood vessels and lymphatics, is a highly metabolically active organ that is involved in many physiopathological processes, including the control of vasomotor tone, barrier function, leukocyte adhesion, and trafficking and inflammation. In this review, we summarized and described the following: (i) endothelial cell function in physiological conditions and (ii) endothelial cell activation and dysfunction in the main cardiovascular diseases (such as atherosclerosis, and hypertension) and to diabetes, cigarette smoking, and aging physiological process. Finally, we presented the currently available evidence that supports the beneficial effects of physical activity and various dietary compounds on endothelial functions. PMID:24719887

  17. Glycated Hemoglobin Measurement and Prediction of Cardiovascular Disease

    PubMed Central

    Angelantonio, Emanuele Di; Gao, Pei; Khan, Hassan; Butterworth, Adam S.; Wormser, David; Kaptoge, Stephen; Kondapally Seshasai, Sreenivasa Rao; Thompson, Alex; Sarwar, Nadeem; Willeit, Peter; Ridker, Paul M; Barr, Elizabeth L.M.; Khaw, Kay-Tee; Psaty, Bruce M.; Brenner, Hermann; Balkau, Beverley; Dekker, Jacqueline M.; Lawlor, Debbie A.; Daimon, Makoto; Willeit, Johann; Njlstad, Inger; Nissinen, Aulikki; Brunner, Eric J.; Kuller, Lewis H.; Price, Jackie F.; Sundstrm, Johan; Knuiman, Matthew W.; Feskens, Edith J. M.; Verschuren, W. M. M.; Wald, Nicholas; Bakker, Stephan J. L.; Whincup, Peter H.; Ford, Ian; Goldbourt, Uri; Gmez-de-la-Cmara, Agustn; Gallacher, John; Simons, Leon A.; Rosengren, Annika; Sutherland, Susan E.; Bjrkelund, Cecilia; Blazer, Dan G.; Wassertheil-Smoller, Sylvia; Onat, Altan; Marn Ibaez, Alejandro; Casiglia, Edoardo; Jukema, J. Wouter; Simpson, Lara M.; Giampaoli, Simona; Nordestgaard, Brge G.; Selmer, Randi; Wennberg, Patrik; Kauhanen, Jussi; Salonen, Jukka T.; Dankner, Rachel; Barrett-Connor, Elizabeth; Kavousi, Maryam; Gudnason, Vilmundur; Evans, Denis; Wallace, Robert B.; Cushman, Mary; DAgostino, Ralph B.; Umans, Jason G.; Kiyohara, Yutaka; Nakagawa, Hidaeki; Sato, Shinichi; Gillum, Richard F.; Folsom, Aaron R.; van der Schouw, Yvonne T.; Moons, Karel G.; Griffin, Simon J.; Sattar, Naveed; Wareham, Nicholas J.; Selvin, Elizabeth; Thompson, Simon G.; Danesh, John

    2015-01-01

    IMPORTANCE The value of measuring levels of glycated hemoglobin (HbA1c) for the prediction of first cardiovascular events is uncertain. OBJECTIVE To determine whether adding information on HbA1c values to conventional cardiovascular risk factors is associated with improvement in prediction of cardiovascular disease (CVD) risk. DESIGN, SETTING, AND PARTICIPANTS Analysis of individual-participant data available from 73 prospective studies involving 294 998 participants without a known history of diabetes mellitus or CVD at the baseline assessment. MAIN OUTCOMES AND MEASURES Measures of risk discrimination for CVD outcomes (eg, C-index) and reclassification (eg, net reclassification improvement) of participants across predicted 10-year risk categories of low (<5%), intermediate (5%to <7.5%), and high (?7.5%) risk. RESULTS During a median follow-up of 9.9 (interquartile range, 7.6-13.2) years, 20 840 incident fatal and nonfatal CVD outcomes (13 237 coronary heart disease and 7603 stroke outcomes) were recorded. In analyses adjusted for several conventional cardiovascular risk factors, there was an approximately J-shaped association between HbA1c values and CVD risk. The association between HbA1c values and CVD risk changed only slightly after adjustment for total cholesterol and triglyceride concentrations or estimated glomerular filtration rate, but this association attenuated somewhat after adjustment for concentrations of high-density lipoprotein cholesterol and C-reactive protein. The C-index for a CVD risk prediction model containing conventional cardiovascular risk factors alone was 0.7434 (95% CI, 0.7350 to 0.7517). The addition of information on HbA1c was associated with a C-index change of 0.0018 (0.0003 to 0.0033) and a net reclassification improvement of 0.42 (?0.63 to 1.48) for the categories of predicted 10-year CVD risk. The improvement provided by HbA1c assessment in prediction of CVD risk was equal to or better than estimated improvements for measurement of fasting, random, or postload plasma glucose levels. CONCLUSIONS AND RELEVANCE In a study of individuals without known CVD or diabetes, additional assessment of HbA1c values in the context of CVD risk assessment provided little incremental benefit for prediction of CVD risk. PMID:24668104

  18. Prognostic value of very early seizures for in-hospital mortality in atherothrombotic infarction.

    PubMed

    Arboix, Adri; Comes, Emili; Garca-Eroles, Luis; Massons, Juan B; Oliveres, Montserrat; Balcells, Miquel

    2003-01-01

    We studied the influence of very early seizures (within 48 h of stroke onset) on in-hospital mortality in a cohort of 452 consecutive patients with atherothrombotic infarction. These patients were selected from 2000 consecutive acute stroke patients registered in a prospective hospital-based stroke registry in Barcelona, Spain. A comparison of data between the nonseizure (n = 442) and seizure (n = 10) groups was made. Predictors of very early seizures were assessed by multivariate analysis. The in-hospital mortality rate was significantly higher in atherothrombotic stroke patients with very early seizures than in those without seizures (70 vs. 19.5%, p < 0.001). Independent predictors of in-hospital mortality included very early seizures, congestive heart failure, atrial fibrillation, 85 years of age or older, altered consciousness, dizziness, parietal and pons involvement, and respiratory and cardiac complications. After multivariate analysis, atherothrombotic infarction of occipital topography and decreased consciousness appeared to be independent predictors of atherothrombotic stroke with very early seizures. Very early seizures constitute an important risk factor for in-hospital mortality after atherothrombotic stroke. PMID:12944711

  19. The epidemiology of cardiovascular disease in the UK 2014

    PubMed Central

    Bhatnagar, Prachi; Wickramasinghe, Kremlin; Williams, Julianne; Rayner, Mike; Townsend, Nick

    2015-01-01

    Cardiovascular disease (CVD) presents a significant burden to the UK. This review presents data from nationally representative datasets to provide up-to-date statistics on mortality, prevalence, treatment and costs. Data focus on CVD as a whole, coronary heart disease (International Classification of Diseases (ICD):I2025) and cerebrovascular disease (ICD:I6069); however, where available, other cardiovascular conditions are also presented. In 2012, CVD was the most common cause of death in the UK for women (28% of all female deaths), but not for men, where cancer is now the most common cause of death (32% of all male deaths). Mortality from CVD varies widely throughout the UK, with the highest age-standardised CVD death rates in Scotland (347/100?000) and the North of England (320/100?000 in the North West). Prevalence of coronary heart disease is also highest in the North of England (4.5% in the North East) and Scotland (4.3%). Overall, around three times as many men have had a myocardial infarction compared with women. Treatment for CVD is increasing over time, with prescriptions and operations for CVD having substantially increased over the last two decades. The National Health Service in England spent around 6.8 billion on CVD in 2012/2013, the majority of which came from spending on secondary care. Despite significant declines in mortality in the UK, CVD remains a considerable burden, both in terms of health and costs. Both primary and secondary prevention measures are necessary to reduce both the burden of CVD and inequalities in CVD mortality and prevalence. PMID:26041770

  20. Atherosclerotic cardiovascular disease: a review of initiators and protective factors.

    PubMed

    Ellulu, Mohammed S; Patimah, Ismail; Khaza'ai, Huzwah; Rahmat, Asmah; Abed, Yehia; Ali, Faisal

    2016-02-01

    Atherosclerotic cardiovascular disease (CVD) is a collective term comprising of a group of disorders of the heart and blood vessels. These diseases are the largest cause of morbidity and premature death worldwide. Coronary heart disease and cerebrovascular disease (stroke) are the most frequently occurring diseases. The two major initiators involved in the development of atherosclerotic CVD are vascular production of reactive oxygen species (ROS) and lipid oxidation. In atherosclerosis development, ROS is associated with rapid loss of anti-inflammatory and anti-atherogenic activities of the endothelium-derived nitric oxide (NO()) resulting in endothelial dysfunction. In part involving activation of the transcription factor NF-?B, ROS have been involved in signaling cascades leading to vascular pro-inflammatory and pro-thrombotic gene expression. ROS is also a potent activator of matrix metalloproteinases (MMPs), which indicate plaque destabilization and rupture. The second initiator involved in atherosclerotic CVD is the oxidation of low-density lipoproteins (LDL). Oxidation of LDL in vessel wall leads to an inflammatory cascade that activates atherogenic pathway leading to foam cell formation. The accumulation of foam cells leads to fatty streak formation, which is the earliest visible atherosclerotic lesion. In contrast, the cardiac sarco/endoplasmic reticulum Ca(2+)-ATPase (SERCA2a) and hepatic apolipoprotein E (apoE) expression can improve cardiovascular function. SERCA2a regulates the cardiac contractile function by lowering cytoplasmic calcium levels during relaxation, and affecting NO() action in vascular cells, while apoE is a critical ligand in the plasma clearance of triglyceride- and cholesterol-rich lipoproteins. PMID:26750181

  1. Work Stress as a Risk Factor for Cardiovascular Disease.

    PubMed

    Kivimäki, Mika; Kawachi, Ichiro

    2015-09-01

    The role of psychosocial work stress as a risk factor for chronic disease has been the subject of considerable debate. Many researchers argue in support of a causal connection while others remain skeptical and have argued that the effect on specific health conditions is either negligible or confounded. This review of evidence from over 600,000 men and women from 27 cohort studies in Europe, the USA and Japan suggests that work stressors, such as job strain and long working hours, are associated with a moderately elevated risk of incident coronary heart disease and stroke. The excess risk for exposed individuals is 10-40 % compared with those free of such stressors. Differences between men and women, younger versus older employees and workers from different socioeconomic backgrounds appear to be small, indicating that the association is robust. Meta-analyses of a wider range of health outcomes show additionally an association between work stress and type 2 diabetes, though not with common cancers or chronic obstructive pulmonary disease, suggesting outcome specificity. Few studies have addressed whether mitigation of work stressors would reduce the risk of cardiovascular disease. In view of the limited interventional evidence on benefits, harms and cost-effectiveness, definitive recommendations have not been made (e.g. by the US Preventive Services Taskforce) for the primary prevention of cardiovascular disease via workplace stress reduction. Nevertheless, governments are already launching healthy workplace campaigns, and preventing excessive work stress is a legal obligation in several countries. Promoting awareness of the link between stress and health among both employers and workers is an important component of workplace health promotion. PMID:26238744

  2. The epidemiology of cardiovascular disease in the UK 2014.

    PubMed

    Bhatnagar, Prachi; Wickramasinghe, Kremlin; Williams, Julianne; Rayner, Mike; Townsend, Nick

    2015-08-01

    Cardiovascular disease (CVD) presents a significant burden to the UK. This review presents data from nationally representative datasets to provide up-to-date statistics on mortality, prevalence, treatment and costs. Data focus on CVD as a whole, coronary heart disease (International Classification of Diseases (ICD):I20-25) and cerebrovascular disease (ICD:I60-69); however, where available, other cardiovascular conditions are also presented. In 2012, CVD was the most common cause of death in the UK for women (28% of all female deaths), but not for men, where cancer is now the most common cause of death (32% of all male deaths). Mortality from CVD varies widely throughout the UK, with the highest age-standardised CVD death rates in Scotland (347/100?000) and the North of England (320/100?000 in the North West). Prevalence of coronary heart disease is also highest in the North of England (4.5% in the North East) and Scotland (4.3%). Overall, around three times as many men have had a myocardial infarction compared with women. Treatment for CVD is increasing over time, with prescriptions and operations for CVD having substantially increased over the last two decades. The National Health Service in England spent around 6.8 billion on CVD in 2012/2013, the majority of which came from spending on secondary care. Despite significant declines in mortality in the UK, CVD remains a considerable burden, both in terms of health and costs. Both primary and secondary prevention measures are necessary to reduce both the burden of CVD and inequalities in CVD mortality and prevalence. PMID:26041770

  3. Exaggerated Exercise Blood Pressure Response and Future Cardiovascular Disease.

    PubMed

    Tzemos, Nikolaos; Lim, Pitt O; Mackenzie, Isla S; MacDonald, Thomas M

    2015-11-01

    Exaggerated blood pressure (BP) response to exercise predicts future hypertension. However, there is considerable lack of understanding regarding the mechanism of how this abnormal response is generated, and how it relates to the future establishment of cardiovascular disease. The authors studied 82 healthy male volunteers without cardiovascular risk factors. The participants were categorized into two age-matched groups depending on their exercise systolic BP (ExSBP) rise after 3 minutes of exercise using a submaximal step test: exaggerated ExSBP group (hyper-responders [peak SBP ? 180 mm Hg]) and low ExSBP responder group (hypo-responders [peak SBP <180 mm Hg]). Forearm venous occlusion plethysmography and intra-arterial infusions of acetylcholine (ACh), N(G)-monomethyl-L-arginine (L-NMMA), sodium nitroprusside (SNP), and norepinephrine (NE) were used to assess vascular reactivity. Proximal aortic compliance was assessed with ultrasound, and neurohormonal blood sampling was performed at rest and during peak exercise. The hyper-responder group exhibited a significantly lower increase in forearm blood flow (FBF) with ACh compared with the hypo-responder group (?FBF 215% [14] vs 332.3% [28], mean [standard error of the mean]; P<.001), as well as decreased proximal aortic compliance. The vasoconstrictive response to L-NMMA was significantly impaired in the hyper-responder group in comparison to the hypo-responder group (?FBF -40.2% [1.6] vs -50.2% [2.6]; P<.05). In contrast, the vascular response to SNP and NE were comparable in both groups. Peak exercise plasma angiotensin II levels were significantly higher in the hyper-responder group (31 [1] vs 23 [2] pg/mL, P=.01). An exaggerated BP response to exercise is related to endothelial dysfunction, decreased proximal aortic compliance, and increased exercise-related neurohormonal activation, the constellation of which may explain future cardiovascular disease. PMID:26235814

  4. Cognitive impairment and cardiovascular disease: so near, so far.

    PubMed

    Picano, Eugenio; Bruno, Rosa Maria; Ferrari, Gian Franco; Bonuccelli, Ubaldo

    2014-07-15

    In the spectrum of cognitive impairment, ranging from "pure" vascular dementia to Alzheimer's disease (AD), clinical interest has recently expanded from the brain to also include the vessels, shifting the pathophysiological focus from the leaves of synaptic dysfunction to the sap of cerebral microcirculation and the roots of cardiovascular function. From a diagnostic viewpoint, a thorough clinical evaluation of individuals presenting cognitive impairment might systematically include the assessment of the major cardiovascular rings of the chain linking regional perfusion to brain function: 1) lung (with assessment of asthma, chronic obstructive pulmonary disease, obstructive sleep apnea syndrome); 2) heart function (with clinical examination and echocardiography) and cardiovascular risk factors; 3) orthostatic hypotension (with medical history and measurement of heart rate and blood pressure in supine and upright positions); 4) aorta and large artery stiffness (with assessment of pulse wave velocity); 5) large cerebro-vascular vessel status (with neuroimaging techniques); 6) assessment of microcirculation (with cerebrovascular reactivity testing with transcranial Doppler sonography or MRI perfusion imaging); and 7) assessment of venous cerebral circulation. The apparent difference in approaches to "brain" and "vascular" environmental enrichment with physical, cognitive and sensorial training is conceptually identical to that of a constant gardener caring for an unhealthy tree, watering the leaves ("train the brain") or simply the roots ("mind the vessel"). The therapeutic difference probably consists in the amount and quality of water added to the tree, rather than by where one pours it, with either a top-down (leaves to roots) or bottom-up (roots to leaves) approach. PMID:24856805

  5. Vorapaxar in the secondary prevention of atherothrombotic events.

    TOXLINE Toxicology Bibliographic Information

    Morrow DA; Braunwald E; Bonaca MP; Ameriso SF; Dalby AJ; Fish MP; Fox KA; Lipka LJ; Liu X; Nicolau JC; Ophuis AJ; Paolasso E; Scirica BM; Spinar J; Theroux P; Wiviott SD; Strony J; Murphy SA; TRA 2PTIMI 50 Steering Committee and Investigators

    2012-04-12

    BACKGROUND: Thrombin potently activates platelets through the protease-activated receptor PAR-1. Vorapaxar is a novel antiplatelet agent that selectively inhibits the cellular actions of thrombin through antagonism of PAR-1.METHODS: We randomly assigned 26,449 patients who had a history of myocardial infarction, ischemic stroke, or peripheral arterial disease to receive vorapaxar (2.5 mg daily) or matching placebo and followed them for a median of 30 months. The primary efficacy end point was the composite of death from cardiovascular causes, myocardial infarction, or stroke. After 2 years, the data and safety monitoring board recommended discontinuation of the study treatment in patients with a history of stroke owing to the risk of intracranial hemorrhage.RESULTS: At 3 years, the primary end point had occurred in 1028 patients (9.3%) in the vorapaxar group and in 1176 patients (10.5%) in the placebo group (hazard ratio for the vorapaxar group, 0.87; 95% confidence interval [CI], 0.80 to 0.94; P<0.001). Cardiovascular death, myocardial infarction, stroke, or recurrent ischemia leading to revascularization occurred in 1259 patients (11.2%) in the vorapaxar group and 1417 patients (12.4%) in the placebo group (hazard ratio, 0.88; 95% CI, 0.82 to 0.95; P=0.001). Moderate or severe bleeding occurred in 4.2% of patients who received vorapaxar and 2.5% of those who received placebo (hazard ratio, 1.66; 95% CI, 1.43 to 1.93; P<0.001). There was an increase in the rate of intracranial hemorrhage in the vorapaxar group (1.0%, vs. 0.5% in the placebo group; P<0.001).CONCLUSIONS: Inhibition of PAR-1 with vorapaxar reduced the risk of cardiovascular death or ischemic events in patients with stable atherosclerosis who were receiving standard therapy. However, it increased the risk of moderate or severe bleeding, including intracranial hemorrhage. (Funded by Merck; TRA 2P-TIMI 50 ClinicalTrials.gov number, http://clinicaltrials.gov/ct2/show/NCT00526474 target=new>NCT00526474.).

  6. Atrial Fibrillation and Non-cardiovascular Diseases: A Systematic Review

    PubMed Central

    Ferreira, Cátia; Providência, Rui; Ferreira, Maria João; Gonçalves, Lino Manuel

    2015-01-01

    Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with an unfavorable prognosis, increasing the risk of stroke and death. Although traditionally associated with cardiovascular diseases, there is increasing evidence of high incidence of AF in patients with highly prevalent noncardiovascular diseases, such as cancer, sepsis, chronic obstructive pulmonary disease, obstructive sleep apnea and chronic kidney disease. Therefore, considerable number of patients has been affected by these comorbidities, leading to an increased risk of adverse outcomes. The authors performed a systematic review of the literature aiming to better elucidate the interaction between these conditions. Several mechanisms seem to contribute to the concomitant presence of AF and noncardiovascular diseases. Comorbidities, advanced age, autonomic dysfunction, electrolyte disturbance and inflammation are common to these conditions and may predispose to AF. The treatment of AF in these patients represents a clinical challenge, especially in terms of antithrombotic therapy, since the scores for stratification of thromboembolic risk, such as the CHADS2 and CHA2DS2VASc scores, and the scores for hemorrhagic risk, like the HAS-BLED score have limitations when applied in these conditions. The evidence in this area is still scarce and further investigations to elucidate aspects like epidemiology, pathogenesis, prevention and treatment of AF in noncardiovascular diseases are still needed. PMID:26577719

  7. Heart valve disease: investigation by cardiovascular magnetic resonance.

    PubMed

    Myerson, Saul G

    2012-01-01

    Cardiovascular magnetic resonance (CMR) has become a valuable investigative tool in many areas of cardiac medicine. Its value in heart valve disease is less well appreciated however, particularly as echocardiography is a powerful and widely available technique in valve disease. This review highlights the added value that CMR can bring in valve disease, complementing echocardiography in many areas, but it has also become the first-line investigation in some, such as pulmonary valve disease and assessing the right ventricle. CMR has many advantages, including the ability to image in any plane, which allows full visualisation of valves and their inflow/outflow tracts, direct measurement of valve area (particularly for stenotic valves), and characterisation of the associated great vessel anatomy (e.g. the aortic root and arch in aortic valve disease). A particular strength is the ability to quantify flow, which allows accurate measurement of regurgitation, cardiac shunt volumes/ratios and differential flow volumes (e.g. left and right pulmonary arteries). Quantification of ventricular volumes and mass is vital for determining the impact of valve disease on the heart, and CMR is the 'Gold standard' for this. Limitations of the technique include partial volume effects due to image slice thickness, and a low ability to identify small, highly mobile objects (such as vegetations) due to the need to acquire images over several cardiac cycles. The review examines the advantages and disadvantages of each imaging aspect in detail, and considers how CMR can be used optimally for each valve lesion. PMID:22260363

  8. Developmental basis of adult cardiovascular diseases: valvular heart diseases.

    PubMed

    Markwald, Roger R; Norris, Russell A; Moreno-Rodriguez, Ricardo; Levine, Robert A

    2010-02-01

    In this chapter, we review the working hypothesis that the roots of adult valvular heart disease (VHD) lie in embryonic development. Valvulogenesis is a complex process in which growth factors signal the process of endocardium-to-mesenchyme transformation (EMT) resulting in formation of prevalvular "cushions." The post-EMT processes, whereby cushions are morphogenetically remolded into valve leaflets, are less well understood, but they require periostin. Mice with targeted deletion of periostin develop degenerative changes similar to human forms of VHD. Mitral valves are also abnormally elongated in hypertrophic cardiomyopathy (HCM), which plays an important role in clinical disease expression. However, the mechanism for this is unclear, but correlates with enhanced expression of periostin in a specific population of ventricular cells derived from the embryonic proepicardial organ, which accumulate at sites where valvular endocardial EMT is reactivated. Collectively, these findings suggest that developmental mechanisms underlie adult valve responses to genetic mutations in degenerative VHD and HCM. PMID:20201901

  9. Nox1in cardiovascular diseases: regulation and pathophysiology.

    PubMed

    Gimenez, Marcela; Schickling, Brandon M; Lopes, Lucia R; Miller, Francis J

    2016-02-01

    Since its discovery in 1999, a number of studies have evaluated the role of Nox1 NADPH oxidase in the cardiovascular system. Nox1 is activated in vascular cells in response to several different agonists, with its activity regulated at the transcriptional level as well as by NADPH oxidase complex formation, protein stabilization and post-translational modification. Nox1 has been shown to decrease the bioavailability of nitric oxide, transactivate the epidermal growth factor receptor, induce pro-inflammatory signalling, and promote cell migration and proliferation. Enhanced expression and activity of Nox1 under pathologic conditions results in excessive production of reactive oxygen species and dysregulated cellular function. Indeed, studies using genetic models of Nox1 deficiency or overexpression have revealed roles for Nox1in the pathogenesis of cardiovascular diseases ranging from atherosclerosis to hypertension, restenosis and ischaemia/reperfusion injury. These data suggest that Nox1 is a potential therapeutic target for vascular disease, and drug development efforts are ongoing to identify a specific bioavailable inhibitor of Nox1. PMID:26678171

  10. Links between Vitamin D Deficiency and Cardiovascular Diseases

    PubMed Central

    Marginean, Otilia

    2015-01-01

    The aim of the present paper was to review the most important mechanisms explaining the possible association of vitamin D deficiency and cardiovascular diseases, focusing on recent experimental and clinical data. Low vitamin D levels favor atherosclerosis enabling vascular inflammation, endothelial dysfunction, formation of foam cells, and proliferation of smooth muscle cells. The antihypertensive properties of vitamin D include suppression of the renin-angiotensin-aldosterone system, renoprotective effects, direct effects on endothelial cells and calcium metabolism, inhibition of growth of vascular smooth muscle cells, prevention of secondary hyperparathyroidism, and beneficial effects on cardiovascular risk factors. Vitamin D is also involved in glycemic control, lipid metabolism, insulin secretion, and sensitivity, explaining the association between vitamin D deficiency and metabolic syndrome. Vitamin D deficit was associated in some studies with the number of affected coronary arteries, postinfarction complications, inflammatory cytokines and cardiac remodeling in patients with myocardial infarction, direct electromechanical effects and inflammation in atrial fibrillation, and neuroprotective effects in stroke. In peripheral arterial disease, vitamin D status was related to the decline of the functional performance, severity, atherosclerosis and inflammatory markers, arterial stiffness, vascular calcifications, and arterial aging. Vitamin D supplementation should further consider additional factors, such as phosphates, parathormone, renin, and fibroblast growth factor 23 levels. PMID:26000280

  11. miRNA therapeutics in cardiovascular diseases: promises and problems

    PubMed Central

    Nouraee, Nazila; Mowla, Seyed J.

    2015-01-01

    microRNAs (miRNAs) are a novel class of non-coding RNAs which found their way into the clinic due to their fundamental roles in cellular processes such as differentiation, proliferation, and apoptosis. Recently, miRNAs have been known as micromodulators in cellular communications being involved in cell signaling and microenvironment remodeling. In this review, we will focus on the role of miRNAs in cardiovascular diseases (CVDs) and their reliability as diagnostic and therapeutic biomarkers in these conditions. CVDs comprise a variety of blood vessels and heart disorders with a high rate of morbidity and mortality worldwide. This necessitates introduction of novel molecular biomarkers for early detection, prevention, or treatment of these diseases. miRNAs, due to their stability, tissue-specific expression pattern and secretion to the corresponding body fluids, are attractive targets for cardiovascular-associated therapeutics. Explaining the challenges ahead of miRNA-based therapies, we will discuss the exosomes as delivery packages for miRNA drugs and promising novel strategies for the future of miRNA-based therapeutics. These approaches provide insights to the future of personalized medicine for the treatment of CVDs. PMID:26175755

  12. Evidence For and Against Dietary Recommendations to Prevent Cardiovascular Disease

    PubMed Central

    2015-01-01

    Evidence-based dietary guidelines for the prevention of cardiovascular disease have changed significantly over the past 9 years. Now less emphasis is placed on total dietary fat and cholesterol restriction and more emphasis on restricting saturated fat. The public outcry to stop demonizing saturated fats has been around for some time. We are now hearing more agreement from medical researchers and clinicians alike, as they become aware of evidence that some saturated fatty acids are not harmful and some are actually beneficial. Another criticism of the dietary guidelines is their failure to look at more meaningful outcomes in research. Instead of using low-density-lipoprotein cholesterol to measure risk, they should use markers for inflammation, obesity, diabetes mellitus, and metabolic syndrome—all well-known risk factors for cardiovascular disease. Perhaps the recommendations that arise from dietary research would be more meaningful if they were presented more simply: in terms of whole foods (like dairy products and fresh meat), rather than nutrients (like saturated fat). PMID:26175635

  13. CNP Signal Peptide in Patients with Cardiovascular Disease

    PubMed Central

    Lee, Jacqui; Than, Martin; Aldous, Sally; Troughton, Richard; Richards, Mark; Pemberton, Chris J.

    2015-01-01

    We have previously reported that signal peptide fragments of C-type natriuretic peptide (CNP) are present in the human circulation. Here, we provide the first preliminary assessment of the potential utility of CNP signal peptide (CNPsp) measurement in acute cardiovascular disease. Utilizing our specific and sensitive immunoassay, we assessed the potential of CNPsp measurement to assist in the identification of acute coronary syndromes in 494 patients presenting consecutively with chest pain. The diagnostic and prognostic potential of CNPsp were assessed in conjunction with a contemporary clinical troponin I assay, an investigational highly sensitive troponin T assay and NT-proBNP measurement. Utility was assessed via receiver operator curve characteristic analysis. CNPsp did not identify patients with myocardial infarction (MI) or those with unstable angina, nor did it assist the diagnostic ability of clinical or investigational troponin measurement. CNPsp levels were significantly elevated in patients presenting with atrial fibrillation (P?cardiovascular disease. While CNPsp does not have utility in acute diagnosis, it may have potential in assisting risk prognosis with respect to mortality and re-infarction. PMID:26664899

  14. Metal Pollutants and Cardiovascular Disease: Mechanisms and Consequences of Exposure

    PubMed Central

    Solenkova, Natalia V.; Newman, Jonathan D.; Berger, Jeffrey S.; Thurston, George; Hochman, Judith S.; Lamas, Gervasio A.

    2014-01-01

    Introduction There is epidemiological evidence that metal contaminants may play a role in the development of atherosclerosis and its complications. Moreover, a recent clinical trial of a metal chelator had a surprisingly positive result in reducing cardiovascular events in a secondary prevention population, strengthening the link between metal exposure and cardiovascular disease (CVD). This is, therefore, an opportune moment to review evidence that exposure to metal pollutants, such as arsenic, lead, cadmium, and mercury, are significant risk factors for CVD. Methods We reviewed the English-speaking medical literature to assess and present the epidemiological evidence that 4 metals having no role in the human body (xenobiotic), mercury, lead, cadmium, and arsenic, have epidemiologic and mechanistic links to atherosclerosis and CVD. Moreover, we briefly review how the results of the Trial to Assess Chelation Therapy strengthen the link between atherosclerosis and xenobiotic metal contamination in humans. Conclusions There is strong evidence that xenobiotic metal contamination is linked to atherosclerotic disease and is a modifiable risk factor. PMID:25458643

  15. [Preoperative preparation of patients with cardiovascular disease for noncardiac surgery].

    PubMed

    Doser, Martin; Eberle, Balthasar

    2009-07-01

    Preoperative preparation of patients with cardiovascular disease is best initiated by the general practitioner. Updated Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery have been published by the American Heart Association und American College of Cardiology (2007). Individual cardiac evaluation must take into account active cardiac conditions, functional capacity, additional clinical risk factors and surgical risk. Stable, asymptomatic patients with normal functional capacity can proceed to elective anesthesia and surgery without further cardiac evaluation. Active cardiac conditions require evaluation and treatment by a cardiology service prior to elective surgery. In stable patients with poor (<4 metabolic equivalents, MET) or unknown functional capacity and clinical risk factors, who are scheduled for intermediate- or high-risk surgery, further cardiac evaluation and preparation is to be considered. Established indicated beta blocker and statin medication is to be continued; timely institution of beta blocker medication (target heart rate, <65 bpm) may be required depending on the risk of surgery, the presence of coronary heart disease, and the number of clinical risk factors present. Following percutaneous coronary intervention, specific waiting periods are required prior to elective surgery. In patients on antiplatelet therapy, the risk of stopping it should be weighed against the benefit of reduction in bleeding complications from the planned surgery. PMID:19565447

  16. Socioeconomic disparities in risk factors for cardiovascular disease.

    PubMed Central

    Millar, W J; Wigle, D T

    1986-01-01

    Despite a general decline in mortality rates in recent decades, these rates are substantially higher among lower socioeconomic groups. To determine target groups for preventive health promotion programs, the prevalence of risk factors for cardiovascular disease by socioeconomic group in Canadian adults aged 20 to 69 years was examined through comparison of estimates from the 1978-79 Canada Health Survey, the 1981 Canada Fitness Survey and the labour force smoking surveys of 1975 and 1983. Level of education was used as a measure of socioeconomic status. The risk factors considered were cigarette smoking, overweight, obesity, elevated diastolic blood pressure, physical inactivity, excessive alcohol consumption, elevated serum cholesterol level, diabetes mellitus and the conjoint use of oral contraceptives and cigarettes. The prevalence of the risk factors tended to be higher among men and women with a low level of education. The results were consistent with those of recent Canadian studies showing that both men and women in lower socioeconomic groups are more likely to die from cardiovascular disease. PMID:3484656

  17. Role of advanced glycation end products in cardiovascular disease

    PubMed Central

    Hegab, Zeinab; Gibbons, Stephen; Neyses, Ludwig; Mamas, Mamas A

    2012-01-01

    Advanced glycation end products (AGEs) are produced through the non enzymatic glycation and oxidation of proteins, lipids and nucleic acids. Enhanced formation of AGEs occurs particularly in conditions associated with hyperglycaemia such as diabetes mellitus (DM). AGEs are believed to have a key role in the development and progression of cardiovascular disease in patients with DM through the modification of the structure, function and mechanical properties of tissues through crosslinking intracellular as well as extracellular matrix proteins and through modulating cellular processes through binding to cell surface receptors [receptor for AGEs (RAGE)]. A number of studies have shown a correlation between serum AGE levels and the development and severity of heart failure (HF). Moreover, some studies have suggested that therapies targeted against AGEs may have therapeutic potential in patients with HF. The purpose of this review is to discuss the role of AGEs in cardiovascular disease and in particular in heart failure, focussing on both cellular mechanisms of action as well as highlighting how targeting AGEs may represent a novel therapeutic strategy in the treatment of HF. PMID:22558488

  18. Evidence for and against dietary recommendations to prevent cardiovascular disease.

    PubMed

    Dildy, Theresa

    2015-06-01

    Evidence-based dietary guidelines for the prevention of cardiovascular disease have changed significantly over the past 9 years. Now less emphasis is placed on total dietary fat and cholesterol restriction and more emphasis on restricting saturated fat. The public outcry to stop demonizing saturated fats has been around for some time. We are now hearing more agreement from medical researchers and clinicians alike, as they become aware of evidence that some saturated fatty acids are not harmful and some are actually beneficial. Another criticism of the dietary guidelines is their failure to look at more meaningful outcomes in research. Instead of using low-density-lipoprotein cholesterol to measure risk, they should use markers for inflammation, obesity, diabetes mellitus, and metabolic syndrome-all well-known risk factors for cardiovascular disease. Perhaps the recommendations that arise from dietary research would be more meaningful if they were presented more simply: in terms of whole foods (like dairy products and fresh meat), rather than nutrients (like saturated fat). PMID:26175635

  19. Clinical Implications of Lipid Genetics for Cardiovascular Disease

    PubMed Central

    Strong, Alanna

    2011-01-01

    Cardiovascular disease is the leading cause of morbidity and mortality in the developed world. Epidemiologic data support a strong relationship of atherosclerotic cardiovascular disease (ASCVD) with both elevated low-density lipoprotein cholesterol (LDL-C), and reduced high-density lipoprotein cholesterol (HDL-C). The study of the human genetics of plasma lipid traits, both rare Mendelian disorders as well as common variants, has illuminated multiple genes and pathways involved in the regulation of LDL-C and HDL-C levels. Mendelian disorders of extremes of LDL-C and Mendelian randomization studies of common gene variants associated with LDL-C strongly support a causal relationship between LDL-C and ASCVD, independent of mechanism. In contrast, Mendelian disorders of extremes of HDL-C and Mendelian randomization studies of common genetic variants for HDL-C are inconsistent in their support of a causal relationship between HDL-C and ASCVD. In contrast to LDL-C, a causal relationship between HDL-C and ASCVD may be dependent on the specific mechanism leading to variation in HDL-C levels. PMID:21853159

  20. Role of estrogen in angiogenesis in cardiovascular diseases

    PubMed Central

    Barnabas, Oche; Wang, Hong; Gao, Xiu-Mei

    2013-01-01

    The formation of new blood vessels from existing ones is a major process of angiogenesis and it is most effective in the vascular systems. The physiological process like hypoxia inducible factors involved in the regeneration of damaged tissues varies within the vascular systems in the endothelium and could be limited due to some major angiogenic growth factors like vascular endothelial growth factor, fibroblast growth factors and epidermal growth factor among others which bring about this cellular vascular regrowth. These physiological processes leading to cellular vascular regrowth could be a major function for the treatment of cardiovascular diseases such as ischemia and atherosclerosis. Estrogens are one of the known factors within the cellular mechanisms that could initiate repairs to the damaged vascular tissues, since estrogens are known inducers of angiogenesis leading to this cellular regrowth. Research has also shown that this cellular regrowth is induced by vascular angiogenic growth factors via the estrogen receptors. In this review we will attempt to summarize the main angiogenic growth factors involved in these physiological processes leading to angiogenesis and possible new mechanisms that could lead to this vascular regrowth. And also we will try to summarize some reports on the effect of estrogen on these physiological processes leading to angiogenesis in cardiovascular diseases. PMID:24454332

  1. Lactation and maternal subclinical cardiovascular disease among premenopausal women

    PubMed Central

    MCCLURE, Candace K.; CATOV, Janet M.; NESS, Roberta B.; SCHWARZ, Eleanor Bimla

    2012-01-01

    Objective Examine the association between lactation and maternal subclinical cardiovascular disease (sCVD). Study Design The Women and Infants Study of Healthy Hearts enrolled 607 mothers who delivered a singleton between 1997 and 2002. In 2007, participating mothers underwent measurements of carotid intima-media thickness, lumen diameter (LD), adventitial diameter (AD), and carotid-femoral pulse wave velocity. Multivariable linear and logistic regression were used to estimate the associations between lactation and sCVD. Results Compared with mothers who breastfed for ?3 months after every birth, mothers who never breastfed exhibited a 0.13mm larger LD (95%CI 0.04,0.22) and a 0.12mm larger AD (95%CI 0.02,0.22) in models adjusting for age, parity, birth outcome, sociodemographic variables, health-related behaviors, family history, gestational weight gain, early adult BMI, current BMI, CRP, blood pressure, cholesterol, triglyceride, HDL, glucose and insulin levels. Conclusions Mothers who do not breastfeed have vascular characteristics associated with a greater risk of cardiovascular disease. PMID:22727348

  2. Transforming growth factor beta signaling in adult cardiovascular diseases and repair

    PubMed Central

    Doetschman, Thomas; Barnett, Joey V.; Runyan, Raymond B.; Camenisch, Todd D.; Heimark, Ronald L.; Granzier, Henk L.; Conway, Simon J.; Azhar, Mohamad

    2011-01-01

    The majority of children with congenital heart disease now live into adulthood due to the remarkable surgical and medical advances that have taken place over the past half century. Because of this, the adults now represent the largest age group with adult cardiovascular diseases. They include patients with heart diseases that were not detected or not treated during childhood, those whose defects were surgically corrected but now need revision due to maladaptive responses to the procedure, those with exercise problems, and those with age-related degenerative diseases. Because adult cardiovascular diseases in this population are relatively new, they are not well understood. It is therefore necessary to understand the molecular and physiological pathways involved if we are to improve treatments. Since there is a developmental basis to adult cardiovascular disease, transforming growth factor beta (TGFβ) signaling pathways that are essential for proper cardiovascular development may also play critical roles in the homeostatic, repair and stress response processes involved in adult cardiovascular diseases. Consequently, we have chosen to summarize the current information on a subset of TGFβ ligand and receptor genes and related effector genes that when dysregulated are known to lead to cardiovascular diseases and adult cardiovascular deficiencies and/or pathologies. A better understanding of the TGFβ signaling network in cardiovascular disease and repair will impact genetic and physiologic investigations of cardiovascular diseases in elderly patients and lead to an improvement in clinical interventions. PMID:21953136

  3. The Hispanic paradox in cardiovascular disease and total mortality.

    PubMed

    Medina-Inojosa, Jose; Jean, Nathalie; Cortes-Bergoderi, Mery; Lopez-Jimenez, Francisco

    2014-01-01

    Health statistics and epidemiologic studies have shown that Hispanics live longer than Non Hispanic Whites, despite a high prevalence of cardiovascular disease (CVD) risk factors and an average low socioeconomic status, both strong predictors of CVD and mortality. This phenomenon has been dubbed "The Hispanic paradox" and has been demonstrated in old and contemporary cohorts. To date, no factor has been identified that could explain this phenomenon, but socio demographic factors, dietary intake and genetic predisposition have been proposed as possible explanations for the Hispanic paradox. As with the French paradox, where French were found to have a lower rate of coronary heart disease (CHD), helped to identify the role of the Mediterranean diet and wine consumption in the prevention of CHD, the Hispanic paradox could help identify protective factors against CHD. This article describes the current evidence supporting the existence of the Hispanic paradox and provides a brief review on the possible explanations. PMID:25246267

  4. The contributory role of gut microbiota in cardiovascular disease.

    PubMed

    Tang, W H Wilson; Hazen, Stanley L

    2014-10-01

    Our group recently discovered that certain dietary nutrients possessing a trimethylamine (TMA) moiety, namely choline/phosphatidylcholine and L-carnitine, participate in the development of atherosclerotic heart disease. A meta-organismal pathway was elucidated involving gut microbiota-dependent formation of TMA and host hepatic flavin monooxygenase 3-dependent (FMO3-dependent) formation of TMA-N-oxide (TMAO), a metabolite shown to be both mechanistically linked to atherosclerosis and whose levels are strongly linked to cardiovascular disease (CVD) risks. Collectively, these studies reveal that nutrient precursors, gut microbiota, and host participants along the meta-organismal pathway elucidated may serve as new targets for the prevention and treatment of CVD. PMID:25271725

  5. Biofield therapies in cardiovascular disease management: a brief review.

    PubMed

    Anderson, Joel G; Taylor, Ann Gill

    2011-01-01

    Though there have been advances over the last 30 years in the therapeutic approaches to cardiovascular disease (CVD), heart disease and stroke remain the leading cause of mortality and morbidity worldwide. Many medical therapies for CVD are associated with a number of side effects, often leading patients to seek non-pharmacological treatments to complement standard care. Referred to as complementary and alternative medicine (CAM), these therapies consist of a heterogeneous group of modalities used in addition to conventional health care. Biofield therapies exist within this CAM domain and involve the direction of healing energy to facilitate general health and well-being by modifying the energy field. What follows is a brief overview of three biofield therapies developed or used within the field of nursing (Therapeutic Touch, Reiki, and Healing Touch), surveying the use of these interventions for individuals with CVD, and outcomes that may impact CVD risk factors and health-related quality of life. PMID:21697661

  6. The contributory role of gut microbiota in cardiovascular disease

    PubMed Central

    Tang, W.H. Wilson; Hazen, Stanley L.

    2014-01-01

    Our group recently discovered that certain dietary nutrients possessing a trimethylamine (TMA) moiety, namely choline/phosphatidylcholine and L-carnitine, participate in the development of atherosclerotic heart disease. A meta-organismal pathway was elucidated involving gut microbiota–dependent formation of TMA and host hepatic flavin monooxygenase 3–dependent (FMO3-dependent) formation of TMA–N-oxide (TMAO), a metabolite shown to be both mechanistically linked to atherosclerosis and whose levels are strongly linked to cardiovascular disease (CVD) risks. Collectively, these studies reveal that nutrient precursors, gut microbiota, and host participants along the meta-organismal pathway elucidated may serve as new targets for the prevention and treatment of CVD. PMID:25271725

  7. Risk Factors in the Initial Presentation of Specific Cardiovascular Disease Syndromes

    ClinicalTrials.gov

    2013-03-03

    Heart Diseases; Cardiovascular Diseases; Acute Myocardial Infarction; Unstable Angina; Chronic Stable Angina; Ischemic Stroke; Cerebrovascular Accident; Subarachnoid Hemorrhage; Transient Ischemic Attack; Abdominal Aortic Aneurysm; Peripheral Arterial Disease; Sudden Coronary Death; Ventricular Arrhythmia; Sudden Death; Cardiac Arrest; Heart Failure

  8. Global Overview of the Epidemiology of Atherosclerotic Cardiovascular Disease.

    PubMed

    Barquera, Simon; Pedroza-Tobas, Andrea; Medina, Catalina; Hernndez-Barrera, Luca; Bibbins-Domingo, Kirsten; Lozano, Rafael; Moran, Andrew E

    2015-07-01

    Atherosclerotic cardiovascular disease (ACD) is the leading cause of mortality worldwide. The objective of this paper is to provide an overview of the global burden of ACD and its risk factors and to discuss the main challenges and opportunities for prevention. Publicly available data from the Global Burden of Disease Study were analyzed for ischemic heart disease (IHD), ischemic stroke and ACD risk factors. Data from the WHO Global Health Observatory were used to describe prevalence of diverse cardiometabolic risk factors. World Bank Gross Domestic Product per capita (GDPc) information was used to categorize countries according to income level. Cardiovascular mortality decreased globally from 1990-2010 with important differences by GDPc; during 1990 there was a positive association between IHD mortality and GDPc. Higher-income countries had higher rates compared to those of lower-income countries. High levels of body mass index (BMI), blood pressure, glucose and cholesterol have a differential contribution to mortality by income group over time; high-income countries have been able to reduce the contribution from these risk factors in the last 20 years, whereas lower/middle income countries show an increasing trend in mortality attributable to high BMI and glucose. Although age-adjusted ACD mortality rate trends decreased globally, the absolute number of ACD deaths is increasing in part due to the growth of the population and aging, as well as to important lifestyle and food-system changes that likely attenuate gains in prevention. Population and individual level preventable causes of ACD must be aggressively and efficiently targeted in countries of lower economic development in order to reduce the growing burden of disease due to ACD. PMID:26135634

  9. Novel circulating fatty acid patterns and risk of cardiovascular disease: the Cardiovascular Health Study123

    PubMed Central

    Lemaitre, Rozenn N; King, Irena B; Song, Xiaoling; Lichtenstein, Alice H; Matthan, Nirupa R; Herrington, David M; Siscovick, David S; Mozaffarian, Dariush

    2012-01-01

    Background: Complex interplays of diet and metabolism influence circulating fatty acids (FAs), possibly constituting FA patterns related to cardiovascular disease (CVD) risk. Objectives: We aimed to derive FA patterns from circulating FAs, relate the patterns to CVD incidence, and extend the derived patterns to atherosclerosis progression in another independent cohort. Design: We used principal component analysis (PCA) to derive FA patterns from 38 plasma phospholipid FAs in 2972 older adults in the Cardiovascular Health Study (CHS). Identified patterns were evaluated for prospective associations with 14-y incidence of CVD [ischemic heart disease (IHD) or stroke]. In another independent cohort of postmenopausal women with IHD, we evaluated associations of the CHS-derived patterns with 3.2-y progression of angiographically defined coronary atherosclerosis. Results: Three distinct patterns were identified, characterized by higher proportions of trans FAs, de novo lipogenesis (DNL) FAs, and long-chain MUFAs (LCMUFAs). During 32,265 person-years, 780 incident CVD events occurred. The trans FA pattern was associated with higher CVD risk (multivariable-adjusted HR for the highest compared with the lowest quintiles = 1.58; 95% CI: 1.17, 2.12; P-trend = 0.006), primarily attributable to higher risk of stroke (HR: 2.46; 95% CI: 1.54, 3.92; P-trend = 0.005). The DNL and LCMUFA patterns were not associated with CVD incidence or with IHD or stroke (P-trend > 0.11 each). In the second cohort, the trans FA pattern, but not the other 2 patterns, was positively associated with progression of coronary atherosclerosis (P-trend < 0.05). Conclusions: PCA appears to provide informative circulating FA patterns. A pattern driven mainly by trans FA levels related to greater CVD risk in older adults and coronary atherosclerosis progression in women with IHD. PMID:23097270

  10. Refined phenotyping identifies links between preeclampsia and related diseases in a Norwegian preeclampsia family cohort

    PubMed Central

    Thomsen, Liv Cecilie V.; Melton, Phillip E.; Tollaksen, Kjersti; Lyslo, Ingvill; Roten, Linda T.; Odland, Maria L.; Strand, Kristin M.; Nygård, Ottar; Sun, Chen; Iversen, Ann-Charlotte; Austgulen, Rigmor; Moses, Eric K.; Bjørge, Line

    2015-01-01

    Objective: Preeclampsia is a complex genetic disease of pregnancy with a heterogenous presentation, unknown cause and potential severe outcomes for both mother and child. Preeclamptic women have increased risk for atherothrombotic cardiovascular disease. We aimed to identify heritabilities and phenotypic correlations of preeclampsia and related conditions in the Norwegian Preeclampsia Family Biobank. Methods: By applying a variance components model, a total of 493 individuals (from 138 families with increased occurrence of preeclampsia) were classified according to 30 disease-related phenotypes. Results: Of parous women, 75.7% (263/338) had experienced preeclampsia and 35.7% of women with and 22.4% without preeclampsia delivered children small for gestational age (SGA). We identified 11 phenotypes as heritable. The increased occurrence of preeclampsia was reflected by the presence [heritability (H2r) = 0.60)] and severity (H2r = 0.15) of preeclampsia and being born in a preeclamptic pregnancy (H2r = 0.25). Other heritable phenotypes identified included SGA (H2r = 0.40), chronic hypertension (H2r = 0.57), severity of atherothrombotic cardiovascular disease (H2r = 0.31), BMI (H2r = 0.60) and pulmonary disease (H2r = 0.91). The heritable phenotype preeclampsia overlapped with SGA (P = 0.03), whereas pulmonary disease was phenotypically correlated with atherothrombotic cardiovascular disease (P < 0.01), SGA (P = 0.02) and BMI (P = 0.02). Conclusion: This is the first study identifying the H2r of a range of health-related conditions in preeclamptic families. Our study demonstrates how refinement of phenotypes leads to better H2r estimation and the identification of a biological relationship between preeclampsia and related traits. PMID:26259119

  11. Generalized seizure, the only manifestation of a small ischemic atherothrombotic infarction

    PubMed Central

    Marjan, Assadollahi; Mahtab, Ramezani; Ehsan, Karimialavijeh; Hadi, Mirfazaelian

    2016-01-01

    BACKGROUND: According to the literature, generalized seizure as a presenting sign of stroke is rare, and in the reported cases it was accompanied by a focal neurological deficit. Presentation of a small ischemic atherothrombotic brain infarction with convulsive generalized seizure is very rare. METHODS: We reported a patient with acute small ischemic atherothrombotic infarction associated with an episode of generalized tonic-clonic seizure, a rare clinical manifestation in this type of stroke. The patient was treated with anti-epileptic therapy after admission. RESULTS: The patient was discharged with oral administration of phenytoin 100 mg TDS, aspirin 80 mg daily, and atorvastatin 40 mg daily. CONCLUSION: Small ischemic atherothrombotic infarction can present only with a seizure without any focal neurological deficit. PMID:27006744

  12. Genetic markers of cardiovascular disease in rheumatoid arthritis.

    PubMed

    Rodrguez-Rodrguez, Luis; Lpez-Mejas, Raquel; Garca-Bermdez, Mercedes; Gonzlez-Juanatey, Carlos; Gonzlez-Gay, Miguel A; Martn, Javier

    2012-01-01

    Cardiovascular (CV) disease is the most common cause of premature mortality in patients with rheumatoid arthritis (RA). It is the result of an accelerated atherosclerotic process. Both RA and atherosclerosis are complex polygenic diseases. Besides traditional CV risk factors and chronic inflammation, a number of studies have confirmed the role of genetic factors in the development of the atherogenesis observed in RA. In this regard, besides a strong association between the HLA-DRB1?04 shared epitope alleles and both endothelial dysfunction, an early step in the atherosclerotic process, and clinically evident CV disease, other polymorphisms belonging to genes implicated in inflammatory and metabolic pathways, located inside and outside the HLA region, such as the 308 variant (G > A, rs1800629) of the TNFA locus, the rs1801131 polymorphism (A > C; position + 1298) of the MTHFR locus, or a deletion of 32 base pairs on the CCR5 gene, seem to be associated with the risk of CV disease in patients with RA. Despite considerable effort to decipher the genetic basis of CV disease in RA, further studies are required to better establish the genetic influence in the increased risk of CV events observed in patients with RA. PMID:22927710

  13. Reduction of cardiovascular risk in chronic kidney disease by mineralocorticoid receptor antagonism.

    PubMed

    Epstein, Murray

    2015-12-01

    Cardiovascular disease is the leading cause of death and morbidity in people with chronic kidney disease, but there are few evidence-based treatments for reducing cardiovascular events in these patients. The failure of novel drug candidates to delay progression to end-stage renal disease and limit or abrogate cardiovascular morbidity and mortality has led to increased interest in a mineralocorticoid receptor (MR) antagonist-based treatment model to reduce cardiovascular risk in patients with chronic kidney disease and end-stage renal disease. Aldosterone concentrations and MR signalling are associated with an enhanced risk of cardiovascular injury and the incidence of sudden death, and MR blockade decreases the risk of cardiovascular events and sudden death in patients with reduced glomerular filtration rate. Since evidence from clinical trials shows that treatment with MR antagonists confers a morbidity and mortality advantage for patients with cardiovascular disorders, similar benefits might also accrue in patients with chronic kidney disease. Large prospective trials are urgently needed to answer this question. In this Review, I argue that despite differences in the pathophysiology and clinical features of cardiovascular disease in patients with and without chronic kidney disease, MR antagonists could provide cardiovascular benefit in patients with chronic kidney disease. PMID:26429402

  14. On the potential of acarbose to reduce cardiovascular disease

    PubMed Central

    2014-01-01

    In the emerging landscape of cardiovascular (CV) outcome trials evaluating the effects of blood glucose lowering drugs in individuals with type 2 diabetes, it is becoming increasingly apparent that since the promising signals coming from the United Kingdom Prospective Diabetes Study (UKPDS) no unequivocal benefits have been established for any single therapy thus far. There is an unmet need for introducing an effective pharmacological agent which could target both correlates of glycaemic regulation and CV risk factors, to ameliorate the enormous burden of fatal and non-fatal CV events in diabetic patients. Acarbose, like other alpha-glucosidase inhibitors (AGIs), has been proven to be an effective antidiabetic treatment for decades, but the overall significant impact of this class of drugs on modulating CV risk has only recently been appreciated. Accumulating evidence has shown that apart from its multiple effects on primarily postprandial glucose dysmetabolism, a key component of mechanisms linked to increased incidence of CV events, acarbose therapy also associates with a favorable impact on an array of surrogate markers of CV disease. Data stemming from in vitro testing of human cell lines as well as from preliminary trials in diabetic populations, like the Study to Prevent Non-Insulin-Dependent Diabetes Mellitus (STOP-NIDDM) trial, have highlighted – though not undisputed – the potential beneficial effects of the drug on CV morbidity. Large scale trials, like the ongoing Acarbose Cardiovascular Evaluation (ACE) trial, aim at conclusively establishing such a positive effect in patients with coronary heart disease and impaired glucose tolerance. In view of its usually acceptable level of side effects that are, if they occur, mostly limited to transient gastrointestinal symptoms, acarbose could well be a strong future player in CV disease secondary prevention. Current discouraging results from many trials of antidiabetic medications to significantly lower CV event rates in diabetic patients, should only draw further attention on alternative glucose lowering agents, among which acarbose is indeed promising. PMID:24742256

  15. Atheroprotective immunity and cardiovascular disease: therapeutic opportunities and challenges.

    PubMed

    Nilsson, J; Lichtman, A; Tedgui, A

    2015-11-01

    Emerging knowledge of the role of atheroprotective immune responses in modulating inflammation and tissue repair in atherosclerotic lesions has provided promising opportunities to develop novel therapies directly targeting the disease process in the artery wall. Regulatory T (Treg) cells have a protective role through release of anti-inflammatory cytokines and suppression of autoreactive effector T cells. Studies in experimental animals have shown that blocking the generation or action of Treg cells is associated with more aggressive development of atherosclerosis. Conversely, cell transfer and other approaches to expand Treg cell populations invivo result in reduced atherosclerosis. There have been relatively few clinical studies of Treg cells and cardiovascular disease, but the available evidence also supports a protective function. These observations have raised hope that it may be possible to develop therapies that act by enforcing the suppressive activities of Treg cells in atherosclerotic lesions. One approach to achieve this goal has been through development of vaccines that stimulate immunological tolerance for plaque antigens. Several pilot vaccines based on LDL-derived antigens have demonstrated promising results in preclinical testing. If such therapies can be shown to be effective also in clinical trials, this could have an important impact on cardiovascular prevention and treatment. Here, we review the current knowledge of the mode of action of atheroprotective immunity and of the ways to stimulate such pathways in experimental settings. The challenges in translating this knowledge into the clinical setting are also discussed within the perspective of the experience of introducing immune-based therapies for other chronic noninfectious diseases. PMID:25659809

  16. On the potential of acarbose to reduce cardiovascular disease.

    PubMed

    Standl, Eberhard; Theodorakis, Michael J; Erbach, Michael; Schnell, Oliver; Tuomilehto, Jaakko

    2014-01-01

    In the emerging landscape of cardiovascular (CV) outcome trials evaluating the effects of blood glucose lowering drugs in individuals with type 2 diabetes, it is becoming increasingly apparent that since the promising signals coming from the United Kingdom Prospective Diabetes Study (UKPDS) no unequivocal benefits have been established for any single therapy thus far. There is an unmet need for introducing an effective pharmacological agent which could target both correlates of glycaemic regulation and CV risk factors, to ameliorate the enormous burden of fatal and non-fatal CV events in diabetic patients. Acarbose, like other alpha-glucosidase inhibitors (AGIs), has been proven to be an effective antidiabetic treatment for decades, but the overall significant impact of this class of drugs on modulating CV risk has only recently been appreciated. Accumulating evidence has shown that apart from its multiple effects on primarily postprandial glucose dysmetabolism, a key component of mechanisms linked to increased incidence of CV events, acarbose therapy also associates with a favorable impact on an array of surrogate markers of CV disease. Data stemming from in vitro testing of human cell lines as well as from preliminary trials in diabetic populations, like the Study to Prevent Non-Insulin-Dependent Diabetes Mellitus (STOP-NIDDM) trial, have highlighted - though not undisputed - the potential beneficial effects of the drug on CV morbidity. Large scale trials, like the ongoing Acarbose Cardiovascular Evaluation (ACE) trial, aim at conclusively establishing such a positive effect in patients with coronary heart disease and impaired glucose tolerance. In view of its usually acceptable level of side effects that are, if they occur, mostly limited to transient gastrointestinal symptoms, acarbose could well be a strong future player in CV disease secondary prevention. Current discouraging results from many trials of antidiabetic medications to significantly lower CV event rates in diabetic patients, should only draw further attention on alternative glucose lowering agents, among which acarbose is indeed promising. PMID:24742256

  17. Angiotensin Peptides and Nitric Oxide in Cardiovascular Disease

    PubMed Central

    Patel, Kaushik P.

    2013-01-01

    Abstract Significance: The renin-angiotensin system (RAS) plays an important role in the normal control of cardiovascular and renal function in the healthy state and is a contributing factor in the development and progression of various types of cardiovascular diseases (CVD), including hypertension, diabetes, and heart failure. Recent Advances: Evidence suggests that a balance between activation of the ACE/Ang II/AT1 receptor axis and the ACE2/Ang-(1–7)/Mas receptor axis is important for the function of the heart, kidney, and autonomic nervous system control of the circulation in the normal healthy state. An imbalance in these opposing pathways toward the ACE/Ang II/AT1 receptor axis is associated with CVD. The key component of this imbalance with respect to neural control of the circulation is the negative interaction between oxidative and NO• mechanisms, which leads to enhanced sympathetic tone and activation in disease conditions such as hypertension and heart failure. Critical Issues: The key mechanisms that disrupt normal regulation of Ang II and Ang-(1–7) signaling and promote pathogenesis of CVD at all organ levels remain poorly understood. The reciprocal relation between ACE and ACE2 expression and function suggests they are controlled interdependently at pre- and post-translational levels. Insights from neural studies suggest that an interaction between oxidative and nitrosative pathways may be key. Future Directions: The role of redox mechanisms in the control of expression and activity of RAS enzymes and Ang receptors may provide important insight into the function of local tissue RAS in health and disease. Antioxid. Redox Signal. 19, 1121–1132. PMID:22462736

  18. A review of the epidemiologic literature on the role of environmental arsenic exposure and cardiovascular diseases

    SciTech Connect

    Wang, C.-H.; Hsiao, C.K.; Chen, C.-L.; Hsu, L.-I; Chiou, H.-Y.; Chen, S.-Y.; Hsueh, Y.-M.; Wu, M.-M.; Chen, C.-J.

    2007-08-01

    Cardiovascular disease is the leading cause of mortality worldwide. Arsenic is a ubiquitous metalloid in the crust of the earth. Chronic arsenic poisoning is becoming an emerging epidemic in Asia. Epidemiological studies have shown that chronic arsenic poisoning through ingestion of arsenic-contaminated water is associated with various cardiovascular diseases in dose-response relationships. These cardiovascular disorders include carotid atherosclerosis detected by ultrasonography, impaired microcirculation, prolonged QT interval and increased QT dispersion in electrocardiography, and clinical outcomes such as hypertension, blackfoot disease (a unique peripheral vascular disease endemic in southwestern Taiwan), coronary artery disease and cerebral infarction. Chronic arsenic poisoning is an independent risk factor for cardiovascular disease. The adverse cardiovascular effects of long-term arsenic exposure may be persistent and/or irreversible. Arsenic-induced cardiovascular diseases in human population may result from the interaction among genetic, environment and nutritional factors. The major adverse cardiovascular effect of chronic arsenic poisoning has been established qualitatively and quantitatively in the high arsenic exposure areas, but the low-dose effect of arsenic on cardiovascular diseases remains to be explored. Cardiovascular death is the major cause of mortality worldwide, and a small increased risk may imply a large quantity of excess mortality.

  19. NSAIDs and Cardiovascular Diseases: Role of Reactive Oxygen Species

    PubMed Central

    Ghosh, Rajeshwary; Alajbegovic, Azra; Gomes, Aldrin V.

    2015-01-01

    Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most commonly used drugs worldwide. NSAIDs are used for a variety of conditions including pain, rheumatoid arthritis, and musculoskeletal disorders. The beneficial effects of NSAIDs in reducing or relieving pain are well established, and other benefits such as reducing inflammation and anticancer effects are also documented. The undesirable side effects of NSAIDs include ulcers, internal bleeding, kidney failure, and increased risk of heart attack and stroke. Some of these side effects may be due to the oxidative stress induced by NSAIDs in different tissues. NSAIDs have been shown to induce reactive oxygen species (ROS) in different cell types including cardiac and cardiovascular related cells. Increases in ROS result in increased levels of oxidized proteins which alters key intracellular signaling pathways. One of these key pathways is apoptosis which causes cell death when significantly activated. This review discusses the relationship between NSAIDs and cardiovascular diseases (CVD) and the role of NSAID-induced ROS in CVD. PMID:26457127

  20. Childhood obesity and cardiovascular disease: links and prevention strategies

    PubMed Central

    Nadeau, Kristen J.; Maahs, David M.; Daniels, Stephen R.; Eckel, Robert H.

    2015-01-01

    The prevalence and severity of pediatric obesity have dramatically increased since the late 1980s, raising concerns about a subsequent increase in cardiovascular outcomes. Strong evidence, particularly from autopsy studies, supports the concept that precursors of adult cardiovascular disease (CVD) begin in childhood, and that pediatric obesity has an important influence on overall CVD risk. Lifestyle patterns also begin early and impact CVD risk. In addition, obesity and other CVD risk factors tend to persist over time. However, whether childhood obesity causes adult CVD directly, or does so by persisting as adult obesity, or both, is less clear. Regardless, sufficient data exist to warrant early implementation of both obesity prevention and treatment in youth and adults. In this Review, we examine the evidence supporting the impact of childhood obesity on adult obesity, surrogate markers of CVD, components of the metabolic syndrome, and the development of CVD. We also evaluate how obesity treatment strategies can improve risk factors and, ultimately, adverse clinical outcomes. PMID:21670745

  1. Vitamin D analogs: novel therapeutic agents for cardiovascular disease?

    PubMed

    Reinhart, Glenn A

    2004-09-01

    Vitamin D3 plays a key role in regulating calcium and mineral homeostasis in support of normal development and maintenance of bone. The classic effects of vitamin D3 include promoting absorption of dietary calcium in the gut and, through its actions as a steroid endocrine hormone, regulating the synthesis and secretion of parathyroid hormone. The effects of the vitamin D3 system are mediated through the highly regulated generation of the potent, active metabolite 1,25-dihydroxyvitamin D3 (calcitriol). Vitamin D3 exerts its effects through the vitamin D3 receptor (VDR), a ligand-activated nuclear receptor expressed in a wide array of tissue and cell types. Studies performed in mice rendered deficient for VDR suggest that calcitriol and VDR may inhibit the renin-angiotensin system and reduce blood pressure in the long-term. Clinical studies suggest that administration of vitamin D3 analogs produces differential benefit with regards to mortality in dialysis patients; other studies suggest that vitamin D3 analogs may provide cardiovascular benefit in both dialysis and nondialysis patients. This paper reviews clinical and preclinical studies, which suggest that vitamin D3 analogs may provide therapeutic utility in the treatment of cardiovascular disease independent of those mechanisms typically associated with the vitamin D3 endocrine system. PMID:15503649

  2. Common swine models of cardiovascular disease for research and training.

    PubMed

    Crisstomo, Vernica; Sun, Fei; Maynar, Manuel; Bez-Daz, Claudia; Blanco, Virginia; Garcia-Lindo, Monica; Usn-Gargallo, Jess; Snchez-Margallo, Francisco Miguel

    2016-01-27

    Cardiovascular diseases are a major health concern and therefore an important topic in biomedical research. Large animal models allow researchers to assess the safety and efficacy of new cardiovascular procedures in systems that resemble human anatomy; additionally, they can be used to emulate scenarios for training purposes. Among the many biomedical models that are described in published literature, it is important that researchers understand and select those that are best suited to achieve the aims of their research, that facilitate the humane care and management of their research animals and that best promote the high ethical standards required of animal research. In this resource the authors describe some common swine models that can be easily incorporated into regular practices of research and training at biomedical institutions. These models use both native and altered vascular anatomy of swine to carry out research protocols, such as testing biological reactions to implanted materials, surgically creating aneurysms using autologous tissue and inducing myocardial infarction through closed-chest procedures. Such models can also be used for training, where native and altered vascular anatomy allow medical professionals to learn and practice challenging techniques in anatomy that closely simulates human systems. PMID:26814353

  3. Radiation-induced cardiovascular disease: impact of dose and volume.

    PubMed

    Mantini, Giovanna; Smaniotto, Daniela; Balducci, Mario; Dinapoli, Nicola; Campitelli, Maura; Corvari, Barbara; Simili, Andrea; Ciarniello, Vincenzo

    2005-01-01

    The radiation-induced cardiovascular pathology represents a major cause of morbidity and mortality in patients undergoing therapeutic chest irradiation. There is a broad range of clinical manifestations probably associated with dose, volume and technique of irradiation. From the assumption that prevention is the best way to manage radiation-induced cardiotoxicity, based on the pathophysiogenesis of heart structures, a number of reports of the literature are reviewed. They consider the incidence of cardiovascular disease in patients affected by Hodgkin's lymphoma and breast cancer. The dosimetric prevention is takled in terms of therapeutic procedures and doses (IMRT, 3DCRT) with particular reference to the impact on cardiotoxicity of parameters as maximum heart distance (MHD), mean lung dose (MLD), normal tissue complication probability (NTCP) and V30. The different evaluation criteria of cardiotoxicity are reported, based on the review of the major scoring scales of acute and late complications, which have been worked out in the course of time (LENT-SOMA, RTOG, CTC v.2.0 and CTC v.3.0). The monitoring system of late toxicity used by the authors is presented. PMID:16294909

  4. Pleiotropic preventive effects of dietary polyphenols in cardiovascular diseases.

    PubMed

    Kishimoto, Y; Tani, M; Kondo, K

    2013-05-01

    Polyphenols are common constituents of the diet, and research on their health benefits has developed quickly over the past few years. Our purpose is to review recent findings highlighting daily dietary polyphenol intake and the diverse function of polyphenols and their possible relationships to cardiovascular disease (CVD). Several cohort studies have reported an inverse relationship between the daily consumption of polyphenols and CVD risk. Many studies showed that beverages could be a large source of polyphenols. Our previous findings provide that Japanese people intake polyphenols mainly from beverages, especially coffee and green tea (in descending order of polyphenol content). Many kinds of polyphenols act as an antioxidant against low-density lipoprotein oxidation, which is known to promote atherosclerosis. Recent accumulating evidence suggests that dietary polyphenols could exert their cardioprotective actions through their potential to improve metabolic disorder and vascular inflammation. These findings raise the possibility that polyphenols have a wide variety of roles in the intestine, liver and vascular tissue. In addition to identifying mechanisms of polyphenol bioactivity by basic research, much more epidemiological and clinical evidence linking reduced cardiovascular risk with dietary polyphenols intake are needed. PMID:23403879

  5. Statins for the primary prevention of cardiovascular disease

    PubMed Central

    Taylor, Fiona; Ward, Kirsten; Moore, Theresa HM; Burke, Margaret; Smith, George Davey; Casas, Juan P; Ebrahim, Shah

    2014-01-01

    Background Reducing high blood cholesterol, a risk factor for cardiovascular disease (CVD) events in people with and without a past history of coronary heart disease (CHD) is an important goal of pharmacotherapy. Statins are the first-choice agents. Previous reviews of the effects of statins have highlighted their benefits in people with coronary artery disease. The case for primary prevention, however, is less clear. Objectives To assess the effects, both harms and benefits, of statins in people with no history of CVD. Search methods To avoid duplication of effort, we checked reference lists of previous systematic reviews. We searched the Cochrane Central Register of Controlled Trials (Issue 1, 2007), MEDLINE (2001 to March 2007) and EMBASE (2003 to March 2007). There were no language restrictions. Selection criteria Randomised controlled trials of statins with minimum duration of one year and follow-up of six months, in adults with no restrictions on their total low density lipoprotein (LDL) or high density lipoprotein (HDL) cholesterol levels, and where 10% or less had a history of CVD, were included. Data collection and analysis Two authors independently selected studies for inclusion and extracted data. Outcomes included all cause mortality, fatal and non-fatal CHD, CVD and stroke events, combined endpoints (fatal and non-fatal CHD, CVD and stroke events), change in blood total cholesterol concentration, revascularisation, adverse events, quality of life and costs. Relative risk (RR) was calculated for dichotomous data, and for continuous data pooled weighted mean differences (with 95% confidence intervals) were calculated. Main results Fourteen randomised control trials (16 trial arms; 34,272 participants) were included. Eleven trials recruited patients with specific conditions (raised lipids, diabetes, hypertension, microalbuminuria). All-cause mortality was reduced by statins (RR 0.84, 95% CI 0.73 to 0.96) as was combined fatal and non-fatal CVD endpoints (RR 0.70, 95% CI 0.61 to 0.79). Benefits were also seen in the reduction of revascularisation rates (RR 0.66, 95% CI 0.53 to 0.83). Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects. There was no clear evidence of any significant harm caused by statin prescription or of effects on patient quality of life. Authors conclusions Reductions in all-cause mortality, major vascular events and revascularisations were found with no excess of cancers or muscle pain among people without evidence of cardiovascular disease treated with statins. Other potential adverse events were not reported and some trials included people with cardiovascular disease. Only limited evidence showed that primary prevention with statins may be cost effective and improve patient quality of life. Caution should be taken in prescribing statins for primary prevention among people at low cardiovascular risk. PMID:21249663

  6. Develop Anti-Inflammatory Nanotherapies to Treat Cardiovascular Disease

    NASA Astrophysics Data System (ADS)

    Tang, Jun

    Cardiovascular disease (CVD) is the leading cause of disease-related death in the world, accounting for 30 % global mortality. The majority of CVD is caused by atherosclerosis, a chronic inflammatory disease of major arteries featured by the deposition of lipids and cholesterol. Inflammation of atherosclerosis is mainly promoted by the pathological macrophages and monocytes, and modulating their functions has been proposed as a promising therapeutic target. This dissertation first presents the development of a novel simvastatin-loaded high-density lipoprotein (HDL) based nanoparticle ([S]-rHDL), which was able to deliver anti-inflammatory simvastatin preferentially to inflammatory monocytes in the blood and to macrophages in advanced atherosclerotic plaques, leading to the reduced inflammation in the tissue. Second, extensive in vivo characterization of [S]-rHDL in a mouse atherosclerosis model revealed that the anti-inflammatory capability of [S]-rHDL derived from its effects on blood monocytes, endothelial layer, monocyte recruitment, and plaque macrophage function. Third, a translational study that integrated the use of [S]-rHDL into oral statin treatment demonstrated a great potential for this nanomedicine as an attractive addition to the current high-dose oral statin standard-of-care for acute coronary syndrome. Finally, preliminary results suggested potential applications of the rHDL platform to other macrophage-implicated diseases.

  7. The evidence for dietary prevention and treatment of cardiovascular disease.

    PubMed

    Van Horn, Linda; McCoin, Mikelle; Kris-Etherton, Penny M; Burke, Frances; Carson, Jo Ann S; Champagne, Catherine M; Karmally, Wahida; Sikand, Geeta

    2008-02-01

    During the past few decades numerous studies have reported the atherogenic potential of saturated fatty acids, trans-fatty acids, and cholesterol, and beneficial effects of fiber, phytostanols/phytosterols, n-3 fatty acids, a Mediterranean diet, and other plant-based approaches. The purpose of this article is to provide a comprehensive and systematic review of the evidence associated with key dietary factors and risk of cardiovascular disease-an umbrella term encompassing diseases that affect the heart and blood vessels, including coronary heart disease, coronary artery disease, dyslipidemia, and hypertension-in conjunction with the work of the American Dietetic Association Evidence Analysis Library review on diet and lipids, updated with new evidence from the past 2 years. The criteria used and results cited provide scientific rationale for food and nutrition professionals and other health professionals for counseling patients. Details of these searches are available within the American Dietetic Association Evidence Analysis Library online (http://adaevidencelibrary.com). Potential mechanisms and needs for future research are summarized for each relevant nutrient, food, or food component. PMID:18237578

  8. Fibrosis-Related Biomarkers and Incident Cardiovascular Disease in Older Adults: The Cardiovascular Health Study

    PubMed Central

    Agarwal, Isha; Glazer, Nicole L.; Barasch, Eddy; Biggs, Mary L.; Djousse, Luc; Fitzpatrick, Annette L.; Gottdiener, John S.; Ix, Joachim H.; Kizer, Jorge R.; Rimm, Eric B.; Sicovick, David S.; Tracy, Russell P.; Mukamal, Kenneth J.

    2014-01-01

    Background Fibrotic changes in the heart and arteries have been implicated in a diverse range of cardiovascular diseases (CVD), but whether circulating biomarkers that reflect fibrosis are associated with CVD is unknown. Methods and Results We determined the associations of two biomarkers of fibrosis, transforming growth factor- ? (TGF-?) and procollagen type III N-terminal propeptide (PIIINP), with incident heart failure, myocardial infarction (MI), and stroke among community-living older adults in the Cardiovascular Health Study. We measured circulating TGF-? (n=1,371) and PIIINP (n=2,568) from plasma samples collected in 1996 and ascertained events through 2010. Given TGF-?s pleiotropic effects on inflammation and fibrogenesis, we investigated potential effect modification by C-reactive protein (CRP) in secondary analyses. After adjustment for sociodemographic, clinical, and biochemical risk factors, PIIINP was associated with total CVD (hazard ratio [HR] per standard deviation [SD]=1.07, 95% confidence interval [CI]: 1.01-1.14) and heart failure (HR per SD=1.08, CI: 1.01-1.16), but not MI or stroke. TGF-? was not associated with any CVD outcomes in the full cohort, but was associated with total CVD (HR per SD=1.16, CI: 1.02-1.31), heart failure (HR per SD=1.16, CI: 1.01-1.34), and stroke (HR per SD=1.20, CI: 1.01-1.42) among individuals with CRP above the median, 2.3 mg/L (P-interaction < 0.05). Conclusions Our findings provide large-scale, prospective evidence that circulating biomarkers of fibrosis, measured in community-living individuals late in life, are associated with CVD. Further research on whether TGF-? has a stronger fibrogenic effect in the setting of inflammation is warranted. PMID:24963008

  9. The bidirectional relation between psychiatric disorders with selected cardiovascular and endocrinal diseases: an Egyptian perspective.

    PubMed

    Okasha, Tarek; Radwan, Ash-Shayma

    2015-01-01

    Cardiovascular and endocrine diseases may act as burdens for individuals suffering from one of these medical illnesses, and whether through the ensuing psychological distress, or some biological mechanisms, these medical diseases can eventually lead to the development of psychiatric morbidities. Moreover, psychiatric morbidities negatively affect the prognosis of both cardiovascular and endocrine diseases. Despite transcultural differences, Egyptian patients with ischemic heart diseases (ISHD), heart failure (HF), diabetes mellitus (DM), or thyroid diseases (TD) endure the same psychological distress as their Western counterparts. Psychiatric assessment and evaluation should be regularly repeated among patients with cardiovascular and endocrinal diseases, and patients who are at risk should be closely followed up. PMID:25413635

  10. Leukocytes Link Local and Systemic Inflammation in Ischemic Cardiovascular Disease: An Expanded "Cardiovascular Continuum".

    PubMed

    Libby, Peter; Nahrendorf, Matthias; Swirski, Filip K

    2016-03-01

    Physicians have traditionally viewed ischemic heart disease in a cardiocentric manner: plaques grow in arteries until they block blood flow, causing acute coronary and other ischemic syndromes. Recent research provides new insight into the integrative biology of inflammation as it contributes to ischemic cardiovascular disease. These results have revealed hitherto unsuspected inflammatory signaling networks at work in these disorders that link the brain, autonomic nervous system, bone marrow, and spleen to the atherosclerotic plaque and to the infarcting myocardium. A burgeoning clinical published data indicates that such inflammatory networks-far from a mere laboratory curiosity-operate in our patients and can influence aspects of ischemic cardiovascular disease that determine decisively clinical outcomes. These new findings enlarge the circle of the traditional "cardiovascular continuum" beyond the heart and vessels to include the nervous system, the spleen, and the bone marrow. PMID:26940931

  11. microRNAs in the onset and development of cardiovascular disease

    PubMed Central

    VICKERS, Kasey C.; RYE, Kerry-Anne; TABET, Fatiha

    2013-01-01

    Physiological and pathological roles for small non-encoding miRNAs (microRNAs) in the cardiovascular system have recently emerged and are now widely studied. The discovery of widespread functions of miRNAs has increased the complexity of gene-regulatory processes and networks in both the cardiovascular system and cardiovascular diseases. Indeed, it has recently been shown that miRNAs are implicated in the regulation of many of the steps leading to the development of cardiovascular disease. These findings represent novel aspects in miRNA biology and, therefore, our understanding of the role of these miRNAs during the pathogenesis of cardiovascular disease is critical for the development of novel therapies and diagnostic interventions. The present review will focus on understanding how miRNAs are involved in the onset and development of cardiovascular diseases. PMID:24102098

  12. The Role of Alcohol Consumption in the Aetiology of Different Cardiovascular Disease Phenotypes: a CALIBER Study

    ClinicalTrials.gov

    2013-05-28

    Chronic Stable Angina; Unstable Angina; Coronary Heart Disease Not Otherwise Specified; Acute Myocardial Infarction; Heart Failure; Ventricular Arrhythmias; Cardiac Arrest; Abdominal Aortic Aneurysm; Peripheral Arterial Disease; Ischaemic Stroke; Subarachnoid Haemorrhagic Stroke; Intracerebral Haemorrhagic Stroke; Stroke Not Otherwise Specified; Sudden Cardiac Death; Unheralded Coronary Death; Mortality; Coronary Heart Disease (CHD); Cardiovascular Disease (CVD); Fatal Cardiovascular Disease (Fatal CVD); ST Elevation Myocardial Infarction (STEMI); Non-ST Elevation Myocardial Infarction (nSTEMI); Myocardial Infarction Not Otherwise Specified (MI NOS)

  13. Surveillance of cardiovascular diseases using a multivariate dynamic screening system.

    PubMed

    Qiu, Peihua; Xiang, Dongdong

    2015-06-30

    In the SHARe Framingham Heart Study of the National Heart, Lung and Blood Institute, one major task is to monitor several health variables (e.g., blood pressure and cholesterol level) so that their irregular longitudinal pattern can be detected as soon as possible and some medical treatments applied in a timely manner to avoid some deadly cardiovascular diseases (e.g., stroke). To handle this kind of applications effectively, we propose a new statistical methodology called multivariate dynamic screening system (MDySS) in this paper. The MDySS method combines the major strengths of the multivariate longitudinal data analysis and the multivariate statistical process control, and it makes decisions about the longitudinal pattern of a subject by comparing it with other subjects cross sectionally and by sequentially monitoring it as well. Numerical studies show that MDySS works well in practice. PMID:25757653

  14. Internet-Based Support for Cardiovascular Disease Management

    PubMed Central

    Jarvis-Selinger, Sandra; Bates, Joanna; Araki, Yuriko; Lear, Scott A.

    2011-01-01

    With significant declines in cardiovascular disease (CVD) mortality, attention has shifted to patient management. Programs designed to manage CVD require the involvement of health professionals for comanagement and patients' self-management. However, these programs are commonly limited to large urban centers, resulting in limited access for rural patients. The use of telehealth potentially overcomes geographical barriers and can improve access to care for patients. The current research explores how an Internet-based platform might facilitate collaboration among healthcare providers comanaging patients and enhance behavioural change in patients. Forty-eight participants were interviewed including: (a) patients (n = 12), (b) physicians (n = 11), (c) nurses (n = 13), and (d) allied health professionals (n = 10). The results were organized and analyzed in three central themes: (1) role of technology for CVD management, (2) challenges to technology adoption, and (3) incentives for technology adoption. Health care providers and patients supported future implementation of Internet-based technology support for CVD management. PMID:21822430

  15. Immigration disparities in cardiovascular disease risk factor awareness.

    PubMed

    Langellier, Brent A; Garza, Jeremiah R; Glik, Deborah; Prelip, Michael L; Brookmeyer, Ron; Roberts, Christian K; Peters, Anne; Ortega, Alexander N

    2012-12-01

    The association between immigration status and cardiovascular disease (CVD) risk factor awareness is unknown. Using physical examination-based data and participants' self-report of prior diagnosis, we assessed immigration-based disparities in awareness of diabetes, hypertension, hypercholesterolemia, and overweight among 12,124 participants in the 2003-2008 National Health and Nutrition Examination Survey. Unawareness of CVD risk factors is high among all groups, but tends to be higher among foreign-born English and non-English speaking participants than among US-born participants. After adjusting for demographic factors and access to health care, foreign-born participants appear more likely to be unaware of their hypertension and overweight than US-born participants. Immigrants are more likely than those born in the US to be unaware of their CVD risk factors, and therefore may be less motivated to seek treatment and modify their behavior to prevent negative CVD outcomes. PMID:22210443

  16. Assessment of Cardiovascular Disease Risk in South Asian Populations

    PubMed Central

    Hussain, S. Monira; Oldenburg, Brian; Zoungas, Sophia; Tonkin, Andrew M.

    2013-01-01

    Although South Asian populations have high cardiovascular disease (CVD) burden in the world, their patterns of individual CVD risk factors have not been fully studied. None of the available algorithms/scores to assess CVD risk have originated from these populations. To explore the relevance of CVD risk scores for these populations, literature search and qualitative synthesis of available evidence were performed. South Asians usually have higher levels of both classical and nontraditional CVD risk factors and experience these at a younger age. There are marked variations in risk profiles between South Asian populations. More than 100 risk algorithms are currently available, with varying risk factors. However, no available algorithm has included all important risk factors that underlie CVD in these populations. The future challenge is either to appropriately calibrate current risk algorithms or ideally to develop new risk algorithms that include variables that provide an accurate estimate of CVD risk. PMID:24163770

  17. Adherence behavior in the prevention and treatment of cardiovascular disease.

    PubMed

    Miller, Nancy Houston

    2012-01-01

    Adherence is critical to the overall management of individuals at risk for and with cardiovascular disease. It forms an interplay between the patient, provider, and health care system and includes barriers that have been encountered within all 3 domains. Improving adherence to exercise, diet, and medication as well as focusing on addictive disorders such as smoking cessation requires patient, provider, and health care system approaches. The use of the cognitive/behavioral elements of health behavior change and communication strategies such as motivational interviewing and coaching serve to enhance overall adherence. Continuous quality improvement initiatives at the system level of change also increase the likelihood that teams will succeed in helping individuals change their behavior. Cardiac rehabilitation programs offer a unique opportunity for health care professionals to play a key role in supporting individuals through the health behavior change process. PMID:22193934

  18. Assessing the burden of mortality from cardiovascular diseases.

    PubMed

    Lopez, A D

    1993-01-01

    The present estimate of global mortality caused by cardiovascular diseases is accompanied by a considerable degree of uncertainty, which, in so far as monitoring their emergence in developing countries is concerned, undoubtedly represents one of the major obstacles to effective public health interventions for their control. In much of the developing world, vital registration data are lacking and it would be unreasonable to expect rapid progress in the recording of causes of death because resources are so limited. The most promising avenue is that of the progressive implementation of clearly defined mortality surveillance systems that cover all deaths and permit the attribution of probable causes via lay reporting. The reliability of the data largely depends on the specificity and clarity of the verbal autopsy algorithm employed and on the availability of medically trained personnel to validate the returns. PMID:8303909

  19. Racial/ethnic residential segregation and cardiovascular disease risk

    PubMed Central

    Kershaw, Kiarri N.; Albrecht, Sandra S.

    2015-01-01

    A growing body of research has examined whether racial/ethnic residential segregation contributes to health disparities