Disease Cardiovascular Disease Research Articles

Particulate Matter 2.5 Pollution Impact on Comorbid Cancer and Cardiovascular Disease Mortality in the U.S.

BackgroundEvidence regarding the effect of long-term exposure to particulate matter (PM) 2.5 and comorbid cancer and cardiovascular disease (CVD) mortality is limited. ObjectivesIn this study, the author report the association between long-term exposure to PM 2.5 and CVD mortality, cancer mortality and comorbid cancer and CVD mortality in the U.S. population. MethodsThe Centers for Disease Control and Prevention (CDC) WONDER (Wide-Ranging Online Data for Epidemiologic Research) multiple-cause-of-death database was used to obtain U.S. county-level mortality and population estimates from 2016 to 2020. Data on average daily density of PM 2.5 were abstracted from the 2018 CDC’s National Environmental Public Health Tracking system. Counties were divided into quartiles with Q1 representing counties with least average daily density and Q4 representing counties with maximum average daily density of PM 2.5. Age-adjusted mortality rates were abstracted for each quartile, for the overall population and subgroups of population. ResultsThe age-adjusted mortality rates for CVD, cancer, and comorbid cancer and CVD mortality were 505.3 (range: 505.0-505.7), 210.7 (range: 210.5-210.9), and 62.0 (range: 61.8-62.1) per 100,000 person-years, respectively. CVD mortality had the highest percentage excess mortality in Q4 compared with Q1, followed by comorbid cancer and CVD. Cancer had the least percentage excess mortality. A disproportionate effect of PM 2.5 exposure was noted on vulnerable and minority groups, based on Social Vulnerability Index and race stratification, respectively. ConclusionsHigher levels of long-term PM 2.5 exposure reported increased CVD mortality, cancer mortality and comorbid cancer and CVD disease mortality, with a pronounced detrimental effect in vulnerable and minority population.

Active Commuting as a Factor of Cardiovascular Disease Prevention: A Systematic Review with Meta-Analysis.

Active commuting (AC) may have the potential to prevent the incidence of cardiovascular disease (CVD). However, the evidence for a correlation between AC and the risk of CVD remains uncertain. The current study thoroughly and qualitatively summarized research on the relationship between AC and the risk of CVD disease. From conception through December 2022, researchers explored four databases (PubMed, PEDro, Cochrane, and Bibliothèque Nationale of Luxembourg [BnL]) for observational studies. The initial findings of the search yielded 1042 references. This systematic review includes five papers with 491,352 participants between 16 and 85 years old, with 5 to 20 years of follow-up period. The exposure variable was the mode of transportation used to commute on a typical day (walking, cycling, mixed mode, driving, or taking public transportation). The primary outcome measures were incident CVD, fatal and non-fatal (e.g., ischemic heart disease (IHD), ischemic stroke (IS), hemorrhagic stroke (HS) events, and coronary heart disease (CHD). Despite methodological variability, the current evidence supports AC as a preventive measure for the development of CVD. Future research is needed to standardize methodologies and promote policies for public health and environmental sustainability.

The Potential of Flavonoid Derivative Compounds as Inhibitors of the HMG-CoA Reductase Enzyme for Candidate of Hypercholesterolemia Drugs

Cardiovascular disease (CVD) is a disease that causes death in the world. Behavioral risk factors are crucial in dealing with CVD disease. High levels of cholesterol in the blood are associated with hypercholesterolemia. It can increase the risk of CVD disease. The HMG-CoA reductase enzyme is an enzyme that plays a role in cholesterol synthesis. It will convert the HMG-CoA compound into the mevalonate. Inhibition of this enzyme can reduce cholesterol synthesis because it inhibits the formation of mevalonate, which is the initial stage of cholesterol synthesis. Herbal compounds are compounds produced by plants. It has good benefits for the body. Flavonoid compounds can be beneficial for health. Molecular docking is a method used to determine the binding affinity and interaction values ​​of the enzyme protein interaction with the ligand to be bound. The results of Apigenin binding affinity values is -7.7 kcal/mol, Luteolin is -8 kcal/mol, Quercetin is -8.2 kcal/mol, Kaempferol is -7.4 kcal/mol, Phloretin is -6.8 kcal/mol, Chalconaringenin is -6.9 kcal/mol, Cyanidin is -7.9 kcal/mol, Delphinidin is -7.8 kcal/mol, Hesperetin is -7.7 kcal/mol, Narigenin is -7.8 kcal/mol, Daidzein is -6.8 kcal/mol, Genistein is -7 kcal/mol, Rutin is -9.2 kcal/mol, Taxifolin is -8 kcal /mol, Diosmetin is -7.6 kcal/mol, and its native ligand Rosuvastatin is -8.5 kcal/mol. Flavonoid derivative compounds can bind to the HMG-CoA reductase enzyme. They can be candidates for antihyperlipidemia drugs.

Ceramides: a potential cardiovascular biomarker in young adult childhood cancer survivors?

The aim of this study was to investigate circulating ceramides involved in cardiovascular disease (CVD) in young adult childhood cancer survivors (CCS) and their correlations to previously reported adverse cardiovascular changes in this cohort. Fifty-seven CCS and 53 healthy controls (age 20-30 years) were studied. Plasma long-chain ceramides, known to be cardiotoxic (C16:0, C18:0, C24:0, and C24:1), were analysed by mass spectrometry. The coronary event risk test 2 (CERT2) score was calculated from the ceramide data. Cardiac and carotid artery ultrasound data and lipid data available from previous studies of this cohort were used to study partial correlations with ceramide and CERT2 score data. All four analysed ceramides were elevated in CCS compared with controls (P ≤ 0.012). The greatest difference was noted for C18:0, which was 33% higher in CCS compared with controls adjusted for sex, age, and body mass index (BMI) (P < 0.001). The CERT2 score was higher in CCS compared with controls (P < 0.001). In the CCS group, 35% had a high to very high CERT2 score (7-12) when compared with 9% in the control group (P < 0.001). The CCS subgroup with a CERT2 score ≥ 7 had higher heart rate, systolic blood pressure, and higher levels of apolipoprotein B compared with CCS with a CERT2 score < 6 (P ≤ 0.011). When adjusted for age, sex, and BMI, CERT2 score was significantly correlated with arterial stiffness, growth hormone, and cranial radiotherapy (P < 0.044). Ceramides could be important biomarkers in understanding the pathophysiology of CVD and in predicting CVD disease risk in young adult CCS.

Effect of high-intensity interval training in physiotherapy primary care for patients with inflammatory arthritis: the ExeHeart randomised controlled trial

ObjectivesTo assess the effect of high-intensity interval training (HIIT) delivered in physiotherapy primary care on the primary outcome of cardiorespiratory fitness (CRF) in patients with inflammatory arthritis (IA). Additionally, to...

Association of fatty acid binding protein-4 (FABP-4) T87C and rs8192688 gene polymorphisms and FABP-4 level with cardiovascular disease susceptibility in type 2 diabetic patients

Type 2 Diabetes Mellitus (T2DM) is known to cause dyslipidemia and increase the risk of cardiovascular disease (CVD). Fatty acid binding protein (FABP)-4 plays a significant role in various stages of T2DM and CVD. Although it has been demonstrated that genetic variations of the FABP-4 gene can affect insulin sensitivity, the results obtained so far are controversial. The aim of this study was to investigate the possible association between T87C and rs8192688 polymorphisms and serum levels of FABP-4 with CVD susceptibility in T2DM patients. The study included 70 healthy controls, 70 individuals with T2DM, and 70 T2DM patients with CVD. Genomic DNA was extracted, and FABP-4 T87C and rs8192688 gene polymorphic sites were amplified using the ARMS-PCR method. Lipid profile and FABP-4 serum levels were significantly higher in T2DM patients with CVD compared to those with only T2DM (p < 0.05). Additionally, FABP-4 T87C gene polymorphism (TC genotypes) and dominant model (TT vs. TC + CC) were significantly associated with a decreased risk of both T2DM and T2DM with CVD patients (p < 0.05). Patients carrying TC + CC genotypes had significantly lower levels of triglyceride and FABP-4 compared to those carrying the TT genotype (p < 0.05). There was no significant association between FABP-4 rs8192688 polymorphism and either T2DM or CVD disease. It appears that FABP-4 T87C polymorphism decreases FABP-4 levels leading to decreased serum TG levels. Since both T2DM and CVD have inflammatory backgrounds, reducing inflammation can improve insulin sensitivity and lower TG levels in these patients.

Associations between cardiovascular risk factors, disease activity and cardiorespiratory fitness in patients with inflammatory joint disease: a cross-sectional analysis

BackgroundInflammatory joint diseases (IJD) are accompanied by an increased risk of cardiovascular disease (CVD). Cardiorespiratory fitness (CRF) is a modifiable CVD risk factor and low levels of CRF associate with an elevated CVD risk. This study aimed to investigate the associations between CVD risk factors, disease activity and CRF in patients with IJD and to explore differences between patients with normal versus low levels of CRF.MethodsCRF was measured as peak oxygen uptake (VO2peak) with a cardiopulmonary exercise test. Participants were also evaluated for: Body composition, blood pressure, blood lipids, inflammatory markers and disease activity. Patient-reported use of cigarettes/snuff, medication, disease duration, pain, fatigue, CVD history, habitual physical activity and exercise beliefs and self-efficacy were collected by questionnaire. Cross-sectional associations between CVD risk factors, disease-related factors and CRF were analyzed by multiple linear regression. CRF was categorized to normal CRF (VO2peak ≥ 80%) or low CRF (VO2peak < 80%) according to age- and gender-stratified reference data. Differences in demographic, CVD and disease-related factors between patients with normal versus low CRF were explored.ResultsIn 60 Norwegian patients with IJD [34 females, age 59 years (IQR: 52–63)], mean VO2peak was 30.2 (± 6.9) mL/kg/min, corresponding to 83% (± 18) of normative reference values. Age (coefficient: − 0.18 years, p = 0.01) and fat mass (coefficient: − 0.67 %, p < 0.001) were inversely associated with CRF, while physical activity index (coefficient: 0.13 points, p = 0.05) was positively associated with CRF (R2 = 0.66). There were no significant associations between CRF, classical CVD risk factors and disease-related variables. Compared to patients with low CRF (n = 30), patients with normal CRF (n = 30) had higher peak oxygen uptake (+ 9.4 mL/kg/min, p < 0.001), high-density lipoprotein cholesterol (+ 0.5 mmol L−1, p < 0.001), and exercise self-efficacy (+ 6.9, p < 0.01) as well as lower fat mass (− 8.7%, p < 0.001), resting heart rate (− 8.0 beats/min, p < 0.01) and triglycerides (− 0.5 mmol L−1, p < 0.01).ConclusionsIn this sample of IJD-patients, age, fatmass and physical activity level were associated with CRF. CRF was lower than reference values and patients with normal CRF presented with a more favorable health profile. There is a continued need for exercise interventions to improve CRF in patients with IJD.Trial registration: NCT04922840.

PD26-12 FLACCID PENILE ULTRASOUND: A NEW POTENTIAL TOOL TO PREDICT THE INDIVIDUAL 10-YEAR RISK OF CARDIOVASCULAR DISEASE

You have accessJournal of UrologyCME1 Apr 2023PD26-12 FLACCID PENILE ULTRASOUND: A NEW POTENTIAL TOOL TO PREDICT THE INDIVIDUAL 10-YEAR RISK OF CARDIOVASCULAR DISEASE Giovanni Cochetti, Giuseppe Maiolino, Michele Del Zingaro, Alessio Paladini, Graziano Felici, Giulia Manfredini, Angelica Tancredi, and Ettore Mearini Giovanni CochettiGiovanni Cochetti More articles by this author , Giuseppe MaiolinoGiuseppe Maiolino More articles by this author , Michele Del ZingaroMichele Del Zingaro More articles by this author , Alessio PaladiniAlessio Paladini More articles by this author , Graziano FeliciGraziano Felici More articles by this author , Giulia ManfrediniGiulia Manfredini More articles by this author , Angelica TancrediAngelica Tancredi More articles by this author , and Ettore MeariniEttore Mearini More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003304.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Cardiovascular risk has become a hot topic in evaluation of patients with vasculogenic erectile dysfunction (ED). Recently, European Society of Cardiology (ESC) designed a cardiovascular disease (CVD) Risk Calculation App to calculate individual 10-year risk of CVD for healthcare professionals based on specific population-target scores. Aim of our study is to evaluate the association between mean basal peak systolic velocity of cavernosal arteries and the 10-year risk in men with vasculogenic ED. METHODS: We prospectively evaluated all patients with vasculogenic ED who underwent penile ultrasound between September 2021 and July 2022. All patients were examined in the same setting: quiet and warm room, one expert operator, sampling of basal PSV in the first third of cavernosal artery with an angle of doppler between 40-50° and calculation of mean basal PSV (mbPSV) between right and left cavernosal artery. Exclusion criteria were: neurological disease or spinal injury, psychogenic (clinical suspicious and/or Beck Inventory Scale ≥14) erectile disfunction. For each patient we calculated 10-year risk of CVD disease using SCORE2 for patients between 40 and 69 years without history of cardiovascular disease and diabetes mellitus, SMART score for patients with a history of cardiovascular disease and ADVANCE score for patients with diabetes mellitus. All risk scores were calculated by CVD Risk Calculation App of ESC. Ethical Committee approval has been obtained. RESULTS: We enrolled 80 consecutive patients. Mean age and BMI were 57,9 years and 26,8 Kg/m2, respectively. Median IIF-5 was 13,7. Average mbPSV and 10-year risk of CVD disease resulted 13,6 cm/sec (range: 5,3 -32,4 cm/sec) and 10,8% (range: 1,9-34%), respectively. We found an inverse and significant correlation between mbPSV and 10-year risk of CVD disease (r: -0.29; p: 0,02). The correlation resulted significant in patients with a history of cardiovascular disease which were evaluated by SCORE2 (r: -0.34; p: 0,017) and a stronger significant inverse correlation was found between mbPSV and 10-year risk of CVD in patients with diabetes mellitus in which the cardiovascular risk was calculated by ADVANCE score (r: -0.61; p: 0,021). mbPSV resulted significantly correlated also with age (r: -0.28; p: 0,021). CONCLUSIONS: MbPSV is a useful screening tool in patients with vasculogenic ED to evaluate 10-year risk of cardiovascular (CVD) disease. A lower mbPSV is correlated with a higher cardiovascular risk, especially in patients with diabetes mellitus where risk is calculated by ADVANCE score. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e739 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Giovanni Cochetti More articles by this author Giuseppe Maiolino More articles by this author Michele Del Zingaro More articles by this author Alessio Paladini More articles by this author Graziano Felici More articles by this author Giulia Manfredini More articles by this author Angelica Tancredi More articles by this author Ettore Mearini More articles by this author Expand All Advertisement PDF downloadLoading ...

Evaluating Social Determinants of Health Variables in Advanced Analytic and Artificial Intelligence Models for Cardiovascular Disease Risk and Outcomes: A Targeted Review

Introduction/PurposePredictive models incorporating relevant clinical and social features can provide meaningful insights into complex interrelated mechanisms of cardiovascular disease (CVD) risk and progression and the influence of environmental exposures on adverse outcomes. The purpose of this targeted review (2018–2019) was to examine the extent to which present-day advanced analytics, artificial intelligence, and machine learning models include relevant variables to address potential biases that inform care, treatment, resource allocation, and management of patients with CVD.MethodsPubMed literature was searched using the prespecified inclusion and exclusion criteria to identify and critically evaluate primary studies published in English that reported on predictive models for CVD, associated risks, progression, and outcomes in the general adult population in North America. Studies were then assessed for inclusion of relevant social variables in the model construction. Two independent reviewers screened articles for eligibility. Primary and secondary independent reviewers extracted information from each full-text article for analysis. Disagreements were resolved with a third reviewer and iterative screening rounds to establish consensus. Cohen's kappa was used to determine interrater reliability.ResultsThe review yielded 533 unique records where 35 met the inclusion criteria. Studies used advanced statistical and machine learning methods to predict CVD risk (10, 29%), mortality (19, 54%), survival (7, 20%), complication (10, 29%), disease progression (6, 17%), functional outcomes (4, 11%), and disposition (2, 6%). Most studies incorporated age (34, 97%), sex (34, 97%), comorbid conditions (32, 91%), and behavioral risk factor (28, 80%) variables. Race or ethnicity (23, 66%) and social variables, such as education (3, 9%) were less frequently observed.ConclusionsPredictive models should adjust for race and social predictor variables, where relevant, to improve model accuracy and to inform more equitable interventions and decision making.

Deep Learning Enabled Intelligent Healthcare Management System in Smart Cities Environment

In recent times, cities are getting smart and can be managed effectively through diverse architectures and services. Smart cities have the ability to support smart medical systems that can infiltrate distinct events (i.e., smart hospitals, smart homes, and community health centres) and scenarios (e.g., rehabilitation, abnormal behavior monitoring, clinical decision-making, disease prevention and diagnosis postmarking surveillance and prescription recommendation). The integration of Artificial Intelligence (AI) with recent technologies, for instance medical screening gadgets, are significant enough to deliver maximum performance and improved management services to handle chronic diseases. With latest developments in digital data collection, AI techniques can be employed for clinical decision making process. On the other hand, Cardiovascular Disease (CVD) is one of the major illnesses that increase the mortality rate across the globe. Generally, wearables can be employed in healthcare systems that instigate the development of CVD detection and classification. With this motivation, the current study develops an Artificial Intelligence Enabled Decision Support System for CVD Disease Detection and Classification in e-healthcare environment, abbreviated as AIDSS-CDDC technique. The proposed AIDSS-CDDC model enables the Internet of Things (IoT) devices for healthcare data collection. Then, the collected data is saved in cloud server for examination. Followed by, training and testing processes are executed to determine the patient’s health condition. To accomplish this, the presented AIDSS-CDDC model employs data pre-processing and Improved Sine Cosine Optimization based Feature Selection (ISCO-FS) technique. In addition, Adam optimizer with Autoencoder Gated Recurrent Unit (AE-GRU) model is employed for detection and classification of CVD. The experimental results highlight that the proposed AIDSS-CDDC model is a promising performer compared to other existing models.

Prevalence and knowledge of cardiovascular disease risk factors among young adults in Saudi Arabia

Cardiovascular diseases (CVDs) are common disorders affecting a large portion of the population. The current study aims to assess the prevalence of CVDs risk factors among university students. Furthermore, to determine their knowledge level of CVD-related risk factors, such as lipid profile, blood sugar, and hypertension. In this cross-sectional study, 294 students were randomly recruited from a Saudi Arabian university. Blood glucose, cholesterol profile (total, HDL, and LDL cholesterol), and triglycerides were measured using standard protocols. Demographic characteristics and awareness about CVDs risk factors were obtained using a questionnaire. Data from 294 undergraduate students aged 18 and 22 were analyzed. The percentage of female participants was 35.4%. The prevalence of CVDs risk factors among the participants was as follows: there were 91 (31%) participants with elevated fasting blood sugar, 93 (31.6%) with high cholesterol levels, 92 (31.3%) with high triglyceride levels, 62 (21.4%) with high LDL cholesterol levels, 77 (26.2%) were smokers, and 105 (35.7%) were with elevated blood pressure. Chi-square analysis showed that smoking, Cholesterol among males, hip waist ratio, body mass index, and blood pressure among females were significantly associated with CVD events compared to other estimated risk factors. This study showed a high prevalence of CVD disease risk factors among Saudi University students. In addition, males who had high cholesterol levels were more likely to develop CVDs than females. • Saudi Arabian young adults are at a high risk of CVD and possess partial knowledge of risk factors. • The most common CVDs risk factor among young adults was excess weight. • Males with high cholesterol levels were more likely to develop CVDs than females. • Hip waist ratio, BMI, and BP risk factors among females were significantly associated with the development of CVD events.

Sleep and Circadian Disturbance in Cardiovascular Risk.

We discuss the relationship between sleep and circadian factors with cardiovascular disease (CVD) risk, including physiologic, behavioral, and psychological mechanisms along this pathway. The relationship between short and long sleep duration, as well as insomnia, with CVD risk is well-established. Recent work has highlighted how other sleep factors, such as sleep regularity (i.e., consistency of sleep timing), multidimensional sleep health, and circadian factors like chronotype and social jetlag, relate to CVD risk. Sleep-focused interventions (e.g., cognitive behavioral therapy for insomnia and sleep extension) may be effective to reduce CVD risk and disease burden. Sleep is increasingly recognized as an integral component of cardiovascular health. This was underscored by the recent inclusion of sleep duration as a health behavior in the American Heart Association's Life's Essential 8 for defining optimal cardiovascular health.

ODP412 High Frequency of Erythrocytosis in Hypogonadal Men on Testosterone Replacement Therapy

Abstract Introduction Erythrocytosis is a frequent side effect of testosterone replacement therapy (TRT) in hypogonadal males and can be deleterious by increasing blood viscosity, which can lead to headaches, hypertension, and thromboembolic complications. Main causes of erythrocytosis are short-acting testosterone injections, smoking habit and obesity. Aim Study the frequency of erythrocytosis induced by TRT and its predictive factors in hypogonadal men in our setting. Subjects and methods: A retrospective study in hypogonadal males on TRT for at least 3 months was conducted. Age, age at treatment onset, months on treatment, initial hematocrit (IHt), highest hematocrit during follow-up (MaxHt), hematocrit on last visit (FHt), hematocrit increase (HtIn), maximum hematocrit increase (HtMaxIn), anthropometric measures, sex hormones and biochemical parameters on the last visit were recorded. In addition, testosterone formulation, smoking status, dyslipidemia, hypertension, diabetes, type of hypogonadism and presence of cardiovascular disease (CVD) were also documented. A hematocrit ≥ 50% (Ht≥50) was considered erythrocytosis and one ≥ 53% was indication for phlebotomy (Ht≥53). Results 108 patients were included, age 54 ± 19 years, age at THT onset 44 ± 18 years, BMI 30 ± 5 Kg/m 2 . On the last visit, 29% had FHt≥50 and 11% had FHt≥53, while during follow-up 58% had MaxHt≥50 and 35% had MaxHt≥53. Moreover, 18% were smokers, 61% had dyslipidemia, 48% had hypertension, 36% were diabetic, 59% were on short acting IM testosterone injections (cypionate), 25% were on extended-release IM testosterone injections (undecanoate) and 16% were on transdermal testosterone. On the other hand, 13% had CVD at onset and 6% developed CVD during follow-up. None of the hematocrit or hematocrit increase values was related to the type of testosterone formulation, smoking habit or appearance of CVD during follow-up. They also did not correlate with serum total testosterone, other sexual hormones and lipids levels or BMI. Interestingly, there was no difference in total testosterone levels between the three testosterone preparations groups. FHt (44 vs 48%, p=0,018) and HtIn values (1.86 vs 5.31%, p=0,036) were lower in those with previous CVD disease. This fact cannot be explained by BMI since there was no difference between patients with and without CVD. Although it could be due to a lower percentage of smokers in the group of patients with CVD, that could not be demonstrated. Discussion The occurrence of erythrocytosis secondary to TRT in hypogonadal men in our setting was very common and higher than reported previously: 58% of patients during follow-up and 35% required phlebotomy. Hematocrit and hematocrit increase values were independent of BMI, smoking status, type of testosterone formulation and presence of CVD. This lack of association could be due in part to the small number of individuals in some of the subgroups. Presentation: No date and time listed

Associations of combined lifestyle behaviors with all-cause and cardiovascular mortality in adults: A population-based cohort study in Jiangxi Province of China.

Data are limited on the impact of combined lifestyle behaviors on mortality in Jiangxi Province, China. The study examined the association between combined lifestyle behaviors and all-cause and cardiovascular disease (CVD) mortality in Jiangxi province. The baseline survey was completed in Jiangxi Province from November 2013 to August 2014. We conducted a follow-up on 12,608 participants of 35 years of age or older from July 2019 to October 2020. Four known lifestyle behaviors were evaluated: alcohol consumption, smoking, diet (AHEI scores), and physical activity. Cox regression analysis was performed to determine the association of combined lifestyle behaviors with all-cause and CVD mortality. During 65,083 person-years of follow-up, among the 11,622 participants (mean age 59.1 years; 40.1% men) 794 deaths occurred, including 375 deaths from CVD disease in this study. Compared to the favorable lifestyle group, the adjusted HR of all-cause mortality was 1.25 (95% CI, 1.03-1.53) for the intermediate lifestyle group and 1.37 (95% CI, 1.11-1.71) for the unfavorable lifestyle group. Compared to the favorable lifestyle group, the adjusted HR of CVD mortality was 1.50 (95% CI, 1.11-2.03) for the intermediate lifestyle group and 1.58 (95% CI, 1.14-2.20) for the unfavorable lifestyle group. Significant interactions of lifestyle and BMI (P for interaction <0.05) with the risk of all-cause mortality and CVD mortality were observed. In the current study, we reaffirm the associations of combined lifestyle factors with total and CVD mortality in Jiangxi Province, our data suggest that an unfavorable lifestyle was associated with a substantially increased risk of all-cause and CVD mortality.

Cardiovascular Disease Prevention in Patients With Atherosclerotic Renovascular Disease-Induced Resistant Hypertension: Further Considerations for 24-Hour BloodPressure Profiles.

Cardiovascular Disease Prevention in Patients With Atherosclerotic Renovascular Disease-Induced Resistant Hypertension: Further Considerations for 24-Hour BloodPressure Profiles.

RISK ANALYSIS AND CLASSIFICATION OF MYOCARDIAL INFARCTION FROM CAROTID INTIMA MEDIA THICKNESS OF B-MODE ULTRASOUND IMAGE USING VARIOUS MACHINE LEARNING AND DEEP LEARNING TECHNIQUES

Myocardial infarction (MI) is a life threatening condition that causes death in developing nations due to blockage in the blood vessel of the coronary artery that supplies blood to the heart. Any blockage in blood vessel of carotid artery located in the neck region can predict the risk of heart failure. Carotid Intima-Media Thickness (CIMT) measured from carotid artery supports in the estimation of heart failure. In this study, cardiovascular risk is considered based on the CIMT thickness of carotid artery blood vessels. In this paper, CIMT and Framingham risk score (FRS) boundary have been determined for both normal and cardiovascular disease (CVD) subjects, which aids in the prediction of heart failure. For 55 subjects with normal condition and 55 subjects with CVD disease, CIMT values were measured by utilizing an effective ultrasound examination system. Biochemical parameters were also measured for all the 110 subjects to predict the FRS score. Student t-test and Spearmans correlation performed showed significant results with p-value less than 0.01 for CIMT, biochemical parameters and FRS score. Receiver operating characteristic (ROC) has been plotted for measured CIMT value and FRS value indicates with an accuracy of 71%. The performance was also determined by comparing various classification techniques using machine learning and deep learning. Results observed through machine learning show that random forest, multilayer perceptron and K-nearest neighbor classifiers used in classification techniques give more superior accuracy of 79% and sensitivity of 78%. To improvise the investigation, deep learning technique using carotid artery ultrasound image of 1909 dataset has been used. Deep learning CNN architecture using VGG19 implemented gave an accuracy of 98% with sensitivity 98% and specificity 99%. It was also observed from the 20% data used for validation that 199 subjects are without risk of MI and 178 subjects were predicted with a risk of MI in future. Further relative risk analysis performed with FRS and CIMT showed that a person with low risk of FRS has 26% chances of getting abnormal CIMT and MI risk in future.

Short-term exposure to six air pollutants and cause-specific cardiovascular mortality of nine counties or districts in Anhui Province, China.

Recently, the burden of cardiovascular disease (CVD) has attracted global attention. Meanwhile, CVD has become the leading cause of death in China. Some epidemiological studies have indicated that ambient air pollution may contribute to increased mortality from CVD diseases. Many studies have found a strong association between air pollutants and the risk of CVD deaths in some big cities, but few have focused on the effects of six pollutants in rural areas. Our study aimed to investigate the effects of six air pollutants (CO, NO2, O3, PM2.5, PM10, and SO2) on CVD deaths of rural areas in Anhui Province and to further clarify which populations were susceptible to air pollution. First, the generalized additive models were combined with the distributed lag nonlinear models to evaluate the individual effects of air pollution on CVD deaths in each area. Then, random-effects models were used to aggregate the associations between air pollutants and CVD mortality risk in nine regions. Overall, all six pollutants had a statistically significant effect on the risk of CVD deaths on the lag 07days. The associations between PM2.5, PM10, and SO2 and daily CVD deaths were strongest, with maximum cumulative RR (lag 07) of 1.91 (1.64-2.18), 2.27 (1.50-3.05), and 2.13 (1.44-2.82). In general, we found that six air pollutants were the important risk factors for CVD and specific CVD deaths in Anhui Province. The elderly were susceptible to PM2.5, PM10, and SO2.

Abstract 169: Assessment Of Adverse Childhood Experiences In The South Bronx On Risk Of Developing Chronic Diseases As Adults

Background: Adverse Childhood Experiences (ACE) are understood to have a negative impact on health outcomes. Events such as abuse, neglect, family dysfunction early in life have shown a strong association with cardiovascular disease (CVD), as well as, premature death in adulthood. Our objective was to identify the prevalence of ACE events within the South Bronx, NY population and the relationship these stressors have with chronic disease affecting CVD health and high-risk behaviors in adults. Methods: Patients were recruited from a hospital-based ambulatory primary care. The survey was conducted between September 2017 and January 2018 with questions on demographics, ACE events, high-risk behavior (smoking, alcohol dependence, substance abuse), mental health, and chronic disease (hypertension, diabetes, hyperlipidemia) with patients of the S. Bronx. The chronic disease was stratified to assess for association with ACE score (1 to 11) and ACE event subcategories. Results: A total of 454 patients participated in the study. The overall age was 53.1±14.2 years and females were 49%. Hispanic were 54% followed by Black at 20%. Subjects had a high prevalence of both chronic disease (82%) and ACE events (69%) within the community. Our findings demonstrated a significant relationship between ACE events with chronic disease and high-risk behavior with higher odds among subjects with exposure to childhood stressors (OR 1.26, 95% CI- 1.1-1.5, p&lt;0.01). Each ACE category - Physical &amp; Sexual abuse, Household substance abuse, Separation from parents, Incarcerated household member, Parental separation/divorce, and Bullying - was associated with one and more chronic CVD diseases (OR-2.03, 21.53, 2.82, 2.94, 2.61, 3.83, &amp; 4.84, respectively) significantly, p&lt;0.01. High-risk behaviors were significant and correlated with an ACE score of more than 4. Conclusion: Among residents of the S. Bronx, having one or more ACE events had a significant association with chronic disease. Socio-economically deprived regions, such as S. Bronx, should entail ACE surveillance to detect exposure to risk factors that stimulate a need for evidence-based interventions that can be assigned to social determinants of health and aid with mental health and early screening for CVD risk factors.

Uremic toxin indoxyl sulfate induces dysfunction of vascular smooth muscle cells via integrin-β1/ERK signaling pathway.

Protein-bound uremic toxins (PBUTs) are reported to be one of the major culprits in chronic kidney disease-cardiovascular disease (CKD-CVD) development, yet its mechanism is not fully clear. Our previous study confirmed elevated expression of integrin-β1 (ITGβ1) in vascular smooth muscle cells of uremic patients. Thus, this study aimed to explore the relationship between PBUTs and ITGβ1 in uremic vasculature injury. Human umbilical vein smooth muscle cells (HUVSMCs) and endothelial cells (HUVECs) were treated with two representative PUBTs, indoxyl sulfate (IS) and p-cresyl sulfate (PC). Both cells were measured for the expression of ITGβ1 and downstream signaling pathways and assayed for proliferation, migration, adhesion and apoptosis. The IS treatments were observed with significantly up-regulated ITGβ1 in HUVSMCs but not in HUVECs, while PC did not induce ITGβ1 alteration in either HUVSMCs or HUVECs. Furthermore, overexpression of ITGβ1 revealed activated downstream signal-regulated kinase (ERK) signaling pathway with promoted focal adhesion, migration, proliferation but no apoptosis in HUVSMCs by IS. These functional and pathway alterations could be significantly suppressed by RNA interference of ITGβ1. More importantly, the application of ERK1/2 inhibitor significantly suppressed the focal adhesion, migration and proliferation of HUVSMCs. We first demonstrated that ITGβ1/ERK signaling pathway mediated abnormal focal adhesion, migration and proliferation of vascular smooth muscle cells stimulated by IS. ITGβ1/ERK signaling may serve as a novel therapeutic target for CKD-CVD.

Correlation Pattern of oxLDL, cortisol, hsCRP, and Adiponectin Levels in Atherosclerosis Risk Population-Based on Framingham Risk Score

Background: The central pathology of cardiovascular disease (CVD) is atherosclerosis. Therefore, it is necessary to examine proteins involved in the and CVD disease mechanism to predict the occurrence of cardiovascular disease due to atherosclerosis. Purpose: This study analysed the correlation pattern of hsCRP, oxLDL, cortisol, and adiponectin levels in atherosclerotic risk population based on the Framingham Risk Score (FRS) to determine the risk of atherosclerosis. Methods Participants were selected using the purposive sampling method,158 participants classes were fired into three risk groups according to FRS. Blood samples were collected, a hsCRP, oxLDL, cortisol, and adiponectin levels were measured using Enzyme-linked Immunosorbent Assay (ELISA). Results and Discussion: Using the inner model test result, four significant direct relationships are formed, indicated by p-value< 0.000. It was FRS to oxLDL, cortisol adiponectin, cortisol to oxLDL, and oxLDL to adiponectin. Based on the indirect effect analysis, it is known that the indirect effect of FRS on Adiponectin through the increase in hs-CRP levels (0.211), FRS on Adiponectin increases in OxLDL levels is significant (-0.224). The coefficient of the effect of the FRS on Adiponectin levels through an increase in OxLDL levels is negative, and also FRS on Adiponectin. The indirect effect of FRS on Adiponectin is that the indirect effect and is not significant (4.083) through the increase in cortisol levels. Conclusion: All variables used in this study are correlated with each other. FRS with hsCRP and adiponectin form a relationship that directly affects each other. Meanwhile, FRS affect adiponectin through OxLDL and cortisol. Key words: Adiponectin, Atherosclerosis, Cardiovascular disease, Framingham Risk Factor, hsCRP.