Prevalence Of Cardiovascular Disease Research Articles

Summary of the 2023 European Society of Cardiology clinical guidelines on the management of cardiovascular disease in patients with diabetes mellitus

The prevalence of cardiovascular diseases (CVDs) is well known. According to the World Health Organization (WHO), almost 18 million people die from CVDs worldwide every year, accounting for 31% of all causes of death [1]. CVDs often develop concomitantly with diabetes mellitus (DM), with approximately 20% of cardiovascular deaths attributed to elevated blood glucose levels [2]. Notably, CVDs are the leading cause of death among patients with type 2 diabetes (T2DM). Based on data from the Federal Register of Diabetes 2022 in Russia, chronic heart failure was the direct cause of death in 24.2% of T2DM cases, followed by acute heart failure (13.1%), cerebrovascular events (10.0%), and myocardial infarction (3.7%) [3].The pathophysiological interplay between atherosclerotic cardiovascular disease and DM has led to a situation where cardiologists are increasingly involved in the treatment of patients with DM, while endocrinologists are encountering a growing number of patients with CVDs. This association has become so apparent that in a recent article published in the European Journal of Cardiology, Yu. Braunwald speculated about the emergence of a new subspecialty - diabetocardiology [4]. Unfortunately, experts predict that the global number of diabetic patients will reach 783 million [5].Recent data on the CV benefits of certain hypoglycemic drugs (primarily, certain SGLT2 inhibitors, several GLP-1 receptor agonists, and a novel non-steroidal mineralocorticoid receptor antagonist finerenone) prove the need for a unified interdisciplinary approach to managing CVDs and DM.Given the importance of integrated and coordinated efforts in managing patients with CVD and DM, the Task Force of the ­European Society of Cardiology (ESC) updated, formulated, and published clinical guidelines on the treatment of CVD in diabetic patients in 2023 [6]. This article provides a concise overview of the key provisions outlined in the guidelines.

Global burden of cardiovascular diseases: projections from 2025 to 2050.

The prediction of future trends in cardiovascular disease (CVD) mortality and their risk factors can assist policy-makers in healthcare planning. This study aims to project geospatial trends in CVDs and their underlying risk factors from 2025 to 2050. Using historical data on mortality and disability-adjusted life years (DALYs) from the Global Burden of Disease (GBD) 2019 study, encompassing the period of 1990 to 2019, Poisson regression was performed to model mortality and DALYs associated with CVD and its associated risk factors from 2025 to 2050. Subgroup analysis was based on GBD super-regions. Between 2025 and 2050, a 90.0% increase in cardiovascular prevalence, 73.4% increase in crude mortality, and 54.7% increase in crude DALYs are projected, with an expected 35.6 million cardiovascular deaths in 2050 (from 20.5 million in 2025). However, age-standardized cardiovascular prevalence will be relatively constant (-3.6%), with decreasing age-standardized mortality (-30.5%) and age-standardized DALYs (-29.6%). In 2050, ischaemic heart disease will remain the leading cause of cardiovascular deaths (20 million deaths) while high systolic blood pressure will be the main cardiovascular risk factor driving mortality (18.9 million deaths). Central Europe, Eastern Europe, and Central Asia super-region is set to incur the highest age-standardized cardiovascular mortality rate in 2050 (305 deaths per 100 000 population). In the coming decades, the relatively constant age-standardized prevalence of global CVD suggests that the net effect of summative preventative efforts will likely continue to be unchanged. The fall in age-standardized cardiovascular mortality reflects the improvement in medical care following diagnosis. However, future healthcare systems can expect a rapid rise in crude cardiovascular mortality, driven by the ageing global populace. The continued rise in CVD burden will largely be attributed to atherosclerotic diseases. Not applicable.

Preclinical modeling of metabolic syndrome to study the pleiotropic effects of novel antidiabetic therapy independent of obesity

Cardiovascular-kidney-metabolic health reflects the interactions between metabolic risk factors, chronic kidney disease, and the cardiovascular system. A growing body of literature suggests that metabolic syndrome (MetS) in individuals of normal weight is associated with a high prevalence of cardiovascular diseases and an increased mortality. The aim of this study was to establish a non-invasive preclinical model of MetS in support of future research focusing on the effects of novel antidiabetic therapies beyond glucose reduction, independent of obesity. Eighteen healthy adult Beagle dogs were fed an isocaloric Western diet (WD) for ten weeks. Biospecimens were collected at baseline (BAS1) and after ten weeks of WD feeding (BAS2) for measurement of blood pressure (BP), serum chemistry, lipoprotein profiling, blood glucose, glucagon, insulin secretion, NT-proBNP, angiotensins, oxidative stress biomarkers, serum, urine, and fecal metabolomics. Differences between BAS1 and BAS2 were analyzed using non-parametric Wilcoxon signed-rank testing. The isocaloric WD model induced significant variations in several markers of MetS, including elevated BP, increased glucose concentrations, and reduced HDL-cholesterol. It also caused an increase in circulating NT-proBNP levels, a decrease in serum bicarbonate, and significant changes in general metabolism, lipids, and biogenic amines. Short-term, isocaloric feeding with a WD in dogs replicated key biological features of MetS while also causing low-grade metabolic acidosis and elevating natriuretic peptides. These findings support the use of the WD canine model for studying the metabolic effects of new antidiabetic therapies independent of obesity.

Haemodynamic Forces: Emerging Markers of Ventricular Remodelling in Multiple Myeloma Cardiovascular Baseline Risk Assessment.

Multiple myeloma (MM) affects a population with a high prevalence of cardiovascular (CV) disease. These patients benefit from an accurate CV risk evaluation in order to choose the safest drug regimen. Haemodynamic forces (HDFs) analysis allows for the earlier detection of myocardial damage compared with standard markers; the role played by MM in HDFs alteration, with or without the influence of hypertension, is yet to be studied. Therefore, we aimed to identify differences in HDFs analysis in patients with MM, hypertension or both versus normotensive non-oncologic subjects. A total of 173 patients (MM hypertensive patients, MMHT; MM normotensive patients, MMNT; non-oncologic hypertensive patients, CoHT; and non-oncologic normotensive patients, CoNT) underwent transthoracic echocardiography for HDFs analysis and pulse wave velocity (PWV) assessment. Hypertensive patients (MMHT, CoHT) showed decreased ejection fraction (EF), global longitudinal strain (GLS) and HDFs values compared with CoNT, whereas ventricular mass (LVMi) and PWV increased. MMNT displayed a significant reduction in systolic HDFs (p < 0.006) and systolic ejection HDFs (p < 0.008) compared with CoNT, without significant change in EF, GLS, LVMi or PWV. In conclusion, MM leads to ventricular remodelling regardless of hypertension; HDFs application for MM patients could help detect early myocardial damage, especially in patients receiving cardiotoxic drugs.

In adult Americans, there is an association between IBI levels and the prevalence of CVD in adult Americans: evidence from NHANES 2005–2010

AimsWe aimed to assess the association between Inflammatory Burden Index (IBI) and cardiovascular disease (CVD) in adult Americans. MethodsThis cross-sectional investigation included people with comprehensive data on IBI and CVD from the National Health and Nutrition Examination Survey (NHANES) 2005–2010 database. C-reactive protein (CRP) × neutrophil/lymphocyte (NLR) count was used to calculate IBI. CVD included angina pectoris, stroke, congestive heart failure (CHF), and coronary heart disease (CHD). Subgroup analysis and weighted multivariate regression were utilized to analyze the independent association between CVD and IBI. ResultsA total of 15,325 adult Americans were involved. There were 9.57 % of subjects having CVD, which was increased with increasing IBI quartiles (Tertile 1: 4.64 %; Tertile 2: 7.71 %; Tertile 3: 10.63 %; Tertile 4: 15.29 %; p < 0.001). After full adjustment, multivariate logistic regression analysis demonstrated a positive correlation between IBI level and CVD prevalence (OR = 1.43; 95 % CI, 1.16–1.76, p < 0.001). Subgroup analyses and interaction tests showed that the association between IBI and the prevalence of CVD was not affected by sex, age, body mass index, race, hypertension, and diabetes mellitus. ConclusionsIn adult Americans, There is an association between IBI levels and the prevalence of CVD. More large-scale future research is required to assess the effect of IBI on CVD.

Integrative Metabolomics Differentiate Coronary Artery Disease, Peripheral Artery Disease, and Venous Thromboembolism Risks.

Arterial and venous cardiovascular conditions, such as coronary artery disease (CAD), peripheral artery disease (PAD), and venous thromboembolism (VTE), are genetically correlated. Interrogating underlying mechanisms may shed light on disease mechanisms. In this study, we aimed to identify (1) epidemiological and (2) causal, genetic relationships between metabolites and CAD, PAD, and VTE. We used metabolomic data from 95 402 individuals in the UK Biobank, excluding individuals with prevalent cardiovascular disease. Cox proportional-hazards models estimated the associations of 249 metabolites with incident disease. Bidirectional 2-sample Mendelian randomization (MR) estimated the causal effects between metabolites and outcomes using genome-wide association summary statistics for metabolites (n=118 466 from the UK Biobank), CAD (n=184 305 from CARDIoGRAMplusC4D 2015), PAD (n=243 060 from the Million Veterans Project), and VTE (n=650 119 from the Million Veterans Project). Multivariable MR was performed in subsequent analyses. We found that 196, 115, and 74 metabolites were associated (P<0.001) with CAD, PAD, and VTE, respectively. Further interrogation of these metabolites with MR revealed 94, 34, and 9 metabolites with potentially causal effects on CAD, PAD, and VTE, respectively. There were 21 metabolites common to CAD and PAD and 4 common to PAD and VTE. Many putatively causal metabolites included lipoprotein traits with heterogeneity across different sizes and lipid subfractions. Small VLDL (very-low-density lipoprotein) particles increased the risk for CAD while large VLDL particles decreased the risk for VTE. We identified opposing directions of CAD and PAD effects for cholesterol and triglyceride concentrations within HDLs (high-density lipoproteins). Subsequent sensitivity analyses including multivariable MR revealed several metabolites with robust, potentially causal effects of VLDL particles on CAD. While common vascular conditions are associated with overlapping metabolomic profiles, MR prioritized the role of specific lipoprotein species for potential pharmacological targets to maximize benefits in both arterial and venous beds.

Abstract P142: Cross Sex Steroid Therapy and Cardiac Function in a Rodent Model of Gender Affirming Hormone Therapy in the Male Rat.

Transgender females ( TGF ) are individuals born biologically male, but identify as female. Gender-Affirming Hormone Therapy ( GAHT ) consists of 17β-Estradiol ( E2 ) supplementation with androgen suppression or a surgical intervention in order to match physical characteristics with perceived gender. Whether the prevalence of cardiovascular ( CV ) disease is enhanced in TGFs on GAHT is not clear. We previously reported that baseline cardiac morphology and function is not altered in a rat model of cross sex hormone therapy ( CSHT ) that mimics GAHT in the TGF. This study tested the hypothesis that myocardial ischemia will result in enhanced cardiac susceptibility in the male rat on CSHT. Adult male Sprague Dawley rats (13 weeks of age) were randomly assigned to either Control or E2+CTX ; E2 at 5 mg/day, pellet sc, replaced every 3 weeks with castration ( CTX ) performed at 15 weeks of age. At 25 weeks of age, rats in each group were randomly subdivided into Sham (n=8) or myocardial ischemia/reperfusion ( MIR ) , 1 hour occlusion, n=6-7. Statistics: Two-way ANOVA with Tukey’s post-hoc test. *Denotes significance vs. Control Sham. Results ( Table ): At 27 weeks of age, total lean mass (EchoMRI) was significantly decreased in Sham and I/R E2+CTX (p&lt;0.05). At one week post I/R, stroke volume and cardiac output (echocardiogram, VEVO 3100) were significantly decreased in E2+CTX Sham vs. Control Sham (p&lt;0.05); yet, ejection fraction, end-diastolic volume, and end-systolic volume did not differ. Thus, these data suggest that the biological effects of CSHT in the male does not enhance susceptibility to cardiac ischemia in young adulthood; yet, the long-term effect of CSHT on CV health remains unknown.

Comparison of Risk Factors Between Lean and Nonlean Metabolic Dysfunction-Associated Steatotic Liver Disease in Individuals With Type 2 Diabetes: A Multicenter Study

ObjectiveA multicenter study in patients with type 2 diabetes mellitus (T2DM) was performed to assess the differences of liver steatosis and fibrosis between lean and nonlean individuals. MethodsPatients with T2DM from 16 centers were recruited and underwent transient elastography examination for diagnosis of liver steatosis and fibrosis. Clinical information, such as diabetes status, serum lipids profiles, and inflammatory markers, were collected. Potential risk factors of liver steatosis and fibrosis in lean (body mass index [BMI] < 23 kg/m2) and nonlean (BMI ≥ 23 kg/m2) groups were analyzed. ResultsA total of 1762 patients were included. The prevalence of liver steatosis and fibrosis in the lean group was 44.7% and 23.4%, respectively. The prevalence of hypertension and cardiovascular disease was higher in lean patients when compared with nonlean group. Lean patients with liver steatosis or fibrosis were older, had longer diabetes duration, lower levels of HOMA-IR and serum lipids. The BMI, visceral fat area, and triglyceride were among the most significant correlators of liver steatosis for both nonlean and lean patients. However, lipid profiles were different between the two groups. Besides, insulin resistance, BMI, and lipid levels were not observed to be associated with fibrosis in the lean group. ConclusionIn lean patients with T2DM, liver steatosis and fibrosis were less associated with insulin resistance. Risk factors of liver steatosis were different between lean and nonlean patients, indicating the necessity of risk stratification and tailored management strategies.

Prevalence of Hypertension among Asymptomatic Patients During Screening in the Primary Health Care Center, Riyadh, Saudi Arabia

Background: Hypertension is a significant public health problem globally, its prevalence and incidence are commonly seen in the Mideast countries, particularly in Saudi Arabia. It is a chronic disease that can harm many systems with its prevalence varying across different populations. The asymptomatic pattern of hypertension makes it a challenging disease. Screening for hypertension in asymptomatic individuals is crucial for early detection and management to prevent complications. Aim: we aim in our study to clarify prevalence of hypertension between asymptomatic patients during screening at primary health care centers in Saudi Arabia.Methods: In Riyadh, Saudi Arabia, Prince Sultan Medical City, observational research was carried out. Participants in the study were asymptomatic people getting regular checkups at primary health care centers. Blood pressure (BP) was taken using standardized protocols, with hypertension being defined as a systolic blood pressure (SBP) reading of at least 140 millimeters of mercury and/or a diastolic blood pressure (DBP) measurement of no fewer than 90 millimeters of mercury. Data were collected and analyzed to determine the prevalence of hypertension individuals in the study population. Results: A total of three hundred asymptomatic patients were incorporated into the study. The mean patient age was 41.22 years, with 25.7 % being male and 74.3 % female. The overall incidence of hypertension between asymptomatic patients during screening was found to be 20%. Subgroup analysis using age, sex, and other relevant factors will also be presented in the final report. Conclusion: Our study sheds light on the high incidence of hypertension among asymptomatic individuals during evaluation at primary health care centers in Prince Sultan Medical City, Saudi Arabia. The findings underline the importance of routine BP screening in the early identification and treatment of hypertension, which reduces the prevalence of cardiovascular disease in the general population.

Cardiovascular Risk in Rheumatoid Arthritis: Considerations on Assessment and Management.

In the context of holistic therapeutic practices, the cardiovascular risk of patients with rheumatoid arthritis (RA) needs to be addressed as a major factor of compromised disease prognosis and increased mortality. The elevated prevalence of cardiovascular disease (CVD) by more than twofold in RA has been attributed, inter alia, to chronic inflammation exacerbating arterial stiffness, increased onset of hypertension, dyslipidaemia and diabetes mellitus, sedentary lifestyle, and antirheumatic drug complications. CVD risk in RA can be currently assessed by practitioners through accessible adapted calculators, but it remains problematic as their diagnostic accuracy is not superior to calculators designed for the general population. Implementation of guideline-oriented personalised interventions remains the cornerstone for cardiovascular risk management in RA. Remarkably, there is lack of a consortium that brings together different health care providers engaged in the care of patients with RA (e.g., rheumatologists, cardiologists, general practitioners, etc), to guide cardiovascular risk assessment and management. This narrative review aims at providing an overview of current CVD risk assessment and management options, highlighting their pivotal role in the comprehensive treatment of RA patients.

Application of a high-performance grey prediction model to predict the cardiovascular disease mortality in elderly Chinese residents

With the acceleration of urbanization and aging process, an increasing number of Chinese senior citizens are suffering from cardiovascular diseases (CVDs). Therefore, reducing the prevalence and mortality of CVD has become one of the priorities of the public health department. And the scientific prediction of CVD morality is of great significance in the prevention and treatment of CVD among the elderly. Given the characteristics of “small sample, complex causes and long duration” of CVD among the senior citizens, grey prediction models which aim at handling the data with “small sample, poor information” are more feasible in forecasting its developing trend. In this paper, a new discrete grey prediction model is designed to forecast the CVD morality among Chinese senior citizens, in which a non-linear function is introduced to expand the model structure and the order and background value coefficient are optimized. In all the three sets of experiments, the errors of the new model are close to but smaller than those of the other three mainstream grey prediction models, indicating that the simulation and prediction performance of the new model is more accurate and stable. The research provides a new modelling approach to predicting the CVD mortality among Chinese senior citizens, which is conducive to the prevention of CVD prevalence and the sustainable development of public health.

Generalizability and treatment with sodium-glucose co-trasporter-2 inhibitors (SGLT2i) among patients with type 2 diabetes: an assessment using an Italian primary care database.

This study aimed to assess the proportions of type 2 diabetes (T2D) subjects meeting cardiovascular outcome trials (CVOTs) criteria for sodium-glucose cotransporter-2 inhibitors (SGLT-2i) and estimate SGLT2i utilization, along with associated demographic and clinical characteristics, in a primary care setting. T2D patients in Italy were selected between January 1, 2021, and December 31, 2022, from The Health Improvement Network (THIN®) database. Representativeness was determined by dividing patients meeting key inclusion criteria for four CVOTs (CANVAS, DECLARE-TIMI 58, EMPA-REG OUTCOME, VERTIS-CV) to the total T2D population. Demographic and clinical characteristics of eligible T2D subjects and SGLT2i users were compared, and logistic regression models assessed the likelihood of receiving SGLT2i. Out of 17,102 T2D patients, 8,828 met eligibility criteria for at least one CVOT. DECLARE-TIMI 58 exhibited the highest representativeness (51.1%), compared to CANVAS (21.1%), EMPA-REG OUTCOME (5.5%), and VERTIS-CV (4.9%) trials. Eligible CVOTs patients were older (74.6 vs. 68.3 years), with a longer disease duration (10.2 vs. 9.7 years), and higher established cardiovascular disease (CVD) prevalence (36.0 vs. 27.3%) compared to SGLT2i users. Less than 10% of eligible T2D patients received SGLT2i. Males (OR: 1.43; 95%CI: 1.24-1.66) were more likely to be prescribed SGLT2i than other antidiabetic drugs, while the elderly (80 + vs. 40-64 years, OR: 0.17; 95% CI: 0.14-0.22) were less likely. Eligible T2D patients with CVD reported an increased likelihood of receiving SGLT2is compared to other antidiabetics. This study highlights significant variability in the proportion of T2D subjects meeting SGLT2i CVOT inclusion criteria, with DECLARE-TIMI-58 being the most represented. Low SGLT2i prescription rates in the Italian primary care setting, along with substantial demographic and clinical differences between SGLT-2i users and T2D eligible patients, emphasize the need for targeted interventions to optimize the use of these medications in primary care settings.

Cardiovascular disease risk in people of African ancestry with HIV in the United Kingdom.

Our objective was to describe the prevalence of cardiovascular disease (CVD) risk factors in people of African ancestry with HIV in the UK. We conducted a cross-sectional analysis of CVD risk factors in Black people with HIV aged ≥40 years and estimated the 10-year CVD risk using QRISK®3-2018. Correlations between body mass index (BMI) and CVD risk factors were described using Pearson correlation coefficients, and factors associated with 10-year CVD risk ≥5% were described using logistic regression. We included 833 Black people with HIV and a median age of 54 years; 54% were female, 50% were living with obesity (BMI ≥30 kg/m2), 61% had hypertension, and 19% had diabetes mellitus. CVD risk >5% ranged from 2% in female participants aged 40-49 years to 99% in men aged ≥60 years, and use of statins ranged from 7% in those with CVD risk <2.5% to 64% in those with CVD risk ≥20%. BMI was correlated (R2 0.1-0.2) with triglycerides and diastolic blood pressure in women and with glycated haemoglobin, systolic and diastolic blood pressure, and total:high-density lipoprotein (HDL) cholesterol ratio in men. In both female and male participants, older age, blood pressure, diabetes mellitus, and kidney disease were strongly associated with CVD risk ≥5%, whereas obesity, total:HDL cholesterol, triglycerides, and smoking status were variably associated with CVD risk ≥5%. We report a high burden of CVD risk factors, including obesity, hypertension, and diabetes mellitus, in people of African ancestry with HIV in the UK. BMI-focused interventions in these populations may improve CVD risk while also addressing other important health issues.

Relationship between the caries-cardiovascular disease axis and immunological aspects: a systematic review

Introduction: According to the World Dental Federation, the hypothesis is that more than 90.0% of the world's population will have any oral disease in their lifetime. In addition, only 60.0% of the population has access to oral hygiene. In childhood and adolescence, caries and periodontal diseases are the most common diseases in the world, and in Brazil, caries is the main oral health problem. Many recent studies have focused on the association between dental caries and systemic diseases such as cardiovascular disease. Objective: It was to systematically analyze the world literature to list the main considerations regarding the relationship between the axis of caries and cardiovascular diseases, highlighting the immunological aspects. Methods: The PRISMA Platform systematic review rules were followed. The search was conducted from April to July 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument, and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 148 articles were found, 40 studies were evaluated, and 25 were included in this systematic review. Considering the Cochrane tool for risk of bias, the global assessment resulted in 22 studies with a high risk of bias and 28 studies that did not meet GRADE. Most studies showed homogeneity in their results, with X2 =92.7% &gt;50%. It was concluded that there is an important network and cascade of defense events between immunological processes and caries disease. Thus, it is necessary to have a healthy immune response to reduce the incidence of cavities. Dental caries was independently associated with the risk of ischemic stroke and death, with the effect being greatest in African-American participants. Regular dental care was associated with a lower chance of cavities, highlighting its relevance in preventing these events. Higher scores of decayed, missing, and filled teeth correlated positively with increased prevalence of cardiovascular disease. Among patients with type 2 diabetes, dental disease, and oral hygiene care are important determinants of the development of heart failure.

Quality of life and functional capacity in patients after cardiac surgery intensive care unit.

Coronary heart disease and aortic stenosis are prevalent cardiovascular diseases worldwide, leading to morbidity and mortality. Coronary artery bypass grafting (CABG) and surgical aortic valve replacement (SAVR) have therapeutic benefits, including improved postoperative quality of life (QoL) and enhanced patient functional capacity which are key indicators of cardiac surgery outcome. In this article, we review the latest studies of QoL outcomes and functional capacity in patients who underwent cardiac surgery. Many standardized instruments are used to evaluate QoL and functional conditions. Preoperative health status, age, length of intensive care unit stay, operative risk, type of procedure, and other pre-, intra-, and postoperative factors affect postoperative QoL. Elderly patients experience impaired physical status soon after cardiac surgery, but it improves in the following period. CABG and SAVR are associated with increases of physical and mental health and functional capacity in the immediate postoperative and the long long-term. Cardiac rehabilitation improves patient functional capacity, QoL, and frailty following cardiac surgery.

Anti-ageing interventions for the treatment of cardiovascular disease.

As the global demographic landscape continues to shift towards an aged population, so does the medical and socioeconomic burden of cardiovascular diseases. Indeed, ageing is one of, if not the, key risk factor for the development of cardiovascular diseases. However, there are currently no approved cardiovascular therapeutics that primarily target the molecular and cellular mechanisms underlying the ageing process itself. In this review, we present the potential of emerging anti-ageing strategies, including epigenetic rejuvenation, metabolic reprogramming, autophagy activation, as well as senolytic and anti-inflammatory therapies, in delaying or reversing the development of age-related cardiovascular disorders, while considering potential sex differences. In doing so, we implicate cellular ageing processes in the pathogenesis of several prevalent cardiovascular diseases, such as atherosclerosis, hypertension, various types of cardiomyopathies (including its hypertrophic, ischemic, dilated, diabetic, and arrhythmogenic forms) and heart failure, particularly that with preserved ejection fraction. Finally, we outline future challenges and steps needed for the implementation of these novel anti-ageing strategies in the clinical setting, with the aim of challenging the long-held notion of ageing as a 'nonmodifiable' risk factor for cardiovascular diseases.

Metabolic syndrome and cardiovascular disease among adult cancer patients: results from NHANES 2007–2018

BackgroundMetabolic syndrome (MetS) is a risk factor for cardiovascular disease (CVD), and CVD is a major challenge for cancer patients. This study aimed to investigate the prevalence and association of MetS and CVD among adult cancer patients.MethodsThis cross-sectional study included cancer patients aged > 18 years from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018. The prevalence of MetS and CVD was calculated using weighted analysis. Multivariable logistic regression was used to assess the association between MetS and CVD.ResultsThe study included 2658 adult cancer patients, of whom 1260 exhibited MetS and 636 had CVD. The weighted prevalence of MetS and CVD in cancer patients was 45.44%, and 19.23%, respectively. Multivariable logistic regression showed a 79% increased risk in higher CVD prevalence in cancer patients with MetS, with the OR (95% CI) of 1.79 (1.31, 2.44). Notably, obesity, elevated blood pressure (BP), high glucose, and low high density lipoprotein cholesterol (HDL-C) in the MetS components were significantly associated with higher CVD prevalence after adjusting for covariates. Moreover, the risk of CVD prevalence in cancer patients increased with more MetS components. Notably, MetS was more strongly linked to CVD in patients aged < 65 and women.ConclusionsAmong adult cancer patients, over two-fifths (45.44%) were estimated to have MetS, while about one-fifth (19.23%) were considered to have CVD. Notably, obesity, elevated BP, high glucose, low HDL-C, and higher number of MetS components were found to be significantly associated with higher CVD prevalence among cancer adults. Cancer patients under 65 and women with MetS may be at increased risk of CVD.

From Cell to Gene: Deciphering the Mechanism of Heart Failure With Single-Cell Sequencing.

Heart failure (HF) is a prevalent cardiovascular disease with significant morbidity and mortality rates worldwide. Due to the intricate structure of the heart, diverse cell types, and the complex pathogenesis of HF, further in-depth investigation into the underlying mechanismsis required. The elucidation of the heterogeneity of cardiomyocytes and the intercellular communication network is particularly important. Traditional high-throughput sequencing methods provide an average measure of gene expression, failing to capture the "heterogeneity" between cells and impacting the accuracy of gene function knowledge. In contrast, single-cell sequencing techniques allow for the amplification of the entire genome or transcriptome at the individual cell level, facilitating the examination of gene structure and expression with unparalleled precision. This approach offers valuable insights into disease mechanisms, enabling the identification of changes in cellular components and gene expressions during hypertrophy associated with HF. Moreover, it reveals distinct cell populations and their unique roles in the HF microenvironment, providing a comprehensive understanding of the cellular landscape that underpins HF pathogenesis. This review focuses on the insights provided by single-cell sequencing techniques into the mechanisms underlying HF and discusses the challenges encountered in current cardiovascular research.

The association between weight-adjusted waist circumference index and cardiovascular disease and mortality in patients with diabetes

Cardiovascular disease (CVD) is a significant health concern, particularly among patients with diabetes. The weight-adjusted waist circumference index (WWI), a novel metric that accounts for central obesity, has shown potential in predicting obesity-related health risks. This study aimed to evaluate the association of WWI with CVD and mortality in patients with diabetes. Utilizing data from the National Health and Nutrition Examination Survey from 1999 to 2020, WWI was calculated by dividing waist circumference (WC) by the square root of body weight. Multivariate logistic regression, multivariate Cox regression and restricted cubic spline curves were used to assess the association between WWI and the prevalence of CVD and mortality in patients with diabetes, subgroup and sensitivity analyses were carried out to delve into the stability of the findings. The predictive performance of WWI was evaluated using the area under the receiver operating characteristic curve (ROC). This study included 8,005 individuals with diabetes. With the increase in WWI values, the risk of developing CVD and the likelihood of mortality progressively rise. The fully adjusted continuous model indicated a 28% higher chance of developing CVD and a 25% higher risk of all-cause mortality for each one-unit increase in WWI. When using the lowest quartile of WWI as the reference category, the highest quartile was linked to an increased risk of CVD (OR 1.66; 95% CI 1.10–2.50, p = 0.015) and all-cause mortality (HR 1.53, 95% CI 1.27–1.83, p < 0.001) among patients with diabetes. Subgroup and sensitivity analyses confirmed that these associations were consistent and stable in most different demographics. The ROC analysis indicated that WWI had a higher predictive capacity for CVD and all-cause mortality than WC, waist to hip ratio, and weight to height ratio. The WWI was significantly associated with the prevalence of CVD and all-cause mortality among patients with diabetes in the United States and may serve as a useful tool for identifying individuals at risk.

Diet and Physical Activity Interventions for People from Minority Ethnic Backgrounds in the UK: A Scoping Review Exploring Barriers, Enablers and Cultural Adaptations.

Type 2 diabetes (T2D) and cardiovascular disease (CVD) are a global pandemic, driven by obesity, poor diet and physical inactivity. In the UK, the prevalence of T2D and CVD is higher in minority ethnic groups. Lifestyle prevention interventions can be effective but uptake amongst minority ethnic groups in the UK is low and the extent of cultural adaptations to increase engagement unknown. To explore barriers, enablers and culturally adapted lifestyle interventions in UK minority ethnic groups. Four electronic databases were searched from to January 2013-2023. Two independent reviewers carried out manuscript selection and data extraction. Barriers and enablers were mapped to the Capability + Opportunity + Motivation = Behaviour (COM-B) theoretical model. Intervention adaptations were linked to behaviour change strategies and reported within a Cultural Adaptation framework. Twenty-three studies were included, reporting barriers/enablers, culturally adapted interventions or both. Barriers and enablers mostly mapped to social and physical opportunity, and reflective motivation. Common adaptation strategies considered behavioural influences related to culture, values, religious beliefs and/or traditions. Most impactful strategies were associated with using credible sources of information and reorganising social and environmental contexts. The current umbrella approach to preventative intervention delivery is unlikely to promote sustained participation in behaviour change amongst UK ethnic minorities. Engagement strategies for this population should consider key determinants such as social contexts, beliefs and cultural norms. Important research gaps include interventions investigating tailored interventions for Black populations, and the impact of negative social experiences (e.g., racism) on engagement.