Cardiovascular Disease In Women Research Articles

Association of breast arterial calcifications and coronary calcification: implications for the prevention of cardiovascular diseases in women

Association of breast arterial calcifications and coronary calcification: implications for the prevention of cardiovascular diseases in women

RISK FACTORS FOR WOMEN’S CARDIOVASCULAR DISEASE

Risk factors specific to women such as hypertension in pregnancy, premature births, gestational diabetes and menopause are among the unique aspects of cardiovascular health in women.Objective: Women of childbearing age were considered protected and CVD were considered male diseases. A report from the European Heart Health Strategy (EuroHeart) finds that women are less likely to receive the same preventive advice as men and that women are still underrepresented in cardiovascular researchRisk factors are important for both men and women, but differ their impact was stronger in men and women. Especially in women, the presence of diabetes, hypertension and smoking is associated with a higher risk than in men. Female sex-specific risk factors related to hormonal and reproductive status that affect the risk of cardiovascular disease in women. These risk factors are related to hormonal status, pregnancy, some non-cardiac diseases with a higher prevalence in women and their treatment.Conclusions. To improve the care of women with cardiovascular disease, it is necessary to realize that the diagnosis of acute coronary syndromes can be problematic in women due to differences in symptoms. and presenting symptoms. At the same time, it is necessary to understand the importance of specific approaches in the diagnosis, treatment and prevention of CVD in women.

Impact of menopause on anthropometric indices and sympathetic nervous system activity – A comparative study

Background: Obesity and metabolic syndrome is very common now a days in postmenopausal women. Increased deposition of visceral fat can lead to autonomic dysfunction. Obesity and autonomic derangements can cause various cardiovascular diseases in women after menopause. Early detection of changes in body weight and autonomic disturbances can help formulate preventive strategies for menopausal women. Aims and Objectives: The aim of the study is to compare anthropometric indices and sympathetic nervous system activity between menstruating and postmenopausal women. Materials and Methods: The study included two groups of 50 women each. Group I included menstruating women of age 25–35 years while Group II included postmenopausal women of age group 50–60 years. Anthropometric parameters such as body weight, height, body mass index, and waist hip ratio were recorded in both the groups. Sympathetic function tests such as cold pressor test, handgrip tests, and blood pressure response to standing was performed on all the participants. Statistical analysis was done using Student’s t-test. Results: There was statistically significant difference in anthropometric indices and sympathetic function tests in both the groups. Conclusion: There is increased incidence of obesity with sympathetic hyperactivity in menopausal women as compared to menstruating women.

WINCARS: Looking to the Future, Working to Change the Past

The Indian Journal of Cardiovascular Disease in Women (IJCDW) is an open access peer-reviewed journal committed to publishing high-quality articles in the field of Cardiovascular Investigations in female patients of different age groups.

Battle beyond Borders... Bows to Bravery and Brilliance

The Indian Journal of Cardiovascular Disease in Women (IJCDW) is an open access peer-reviewed journal committed to publishing high-quality articles in the field of Cardiovascular Investigations in female patients of different age groups.

Women Power

The Indian Journal of Cardiovascular Disease in Women (IJCDW) is an open access peer-reviewed journal committed to publishing high-quality articles in the field of Cardiovascular Investigations in female patients of different age groups.

Progress ofIJCDWin 2021

The Indian Journal of Cardiovascular Disease in Women (IJCDW) is an open access peer-reviewed journal committed to publishing high-quality articles in the field of Cardiovascular Investigations in female patients of different age groups.

Environmental Contaminants Acting as Endocrine Disruptors Modulate Atherogenic Processes: New Risk Factors for Cardiovascular Diseases in Women?

The number of aged individuals is increasing worldwide, rendering essential the comprehension of pathophysiological mechanisms of age-related alterations, which could facilitate the development of interventions contributing to “successful aging” and improving quality of life. Cardiovascular diseases (CVD) include pathologies affecting the heart or blood vessels, such as hypertension, peripheral artery disease and coronary heart disease. Indeed, age-associated modifications in body composition, hormonal, nutritional and metabolic factors, as well as a decline in physical activity are all involved in the increased risk of developing atherogenic alterations that raise the risk of CVD development. Several factors have been reported to play a role in the alterations observed in muscle and endothelial cells and that lead to increased CVD, such as genetic pattern, smoking and unhealthy lifestyle. Moreover, a difference in the risk of these diseases in women and men has been reported. Interestingly, in the past decades attention has been focused on a potential role of several pollutants that disrupt human health by interfering with hormonal pathways, and more specifically in non-communicable diseases such as obesity, diabetes and CVD. This review will focus on the potential alteration induced by Endocrine Disruptors (Eds) in the attempt to characterize a potential role in the cellular and molecular mechanisms involved in the atheromatous degeneration process and CVD progression.

Improving Outcomes for Women With Heart Disease: Implications for Nurse Practitioners

Each year the first Friday of February is designated National Wear Red Day® by the American Heart Association to raise awareness that cardiovascular disease (CVD) is the number cause of death and disability for women. 1 American Heart AssociationGo Red for Women®: Wear Red and Give. https://www.goredforwomen.org/en/get-involved/give/wear-red-and-giveDate accessed: November 18, 2021 Google Scholar Despite the fact that approximately 335,000 women are hospitalized yearly for acute coronary syndrome, the acute manifestation of coronary artery disease (CAD), 2 Virani S.S. Alonso A. Benjamin E.J. et al. on behalf of the American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics SubcommitteeHeart disease and stroke statistics—2020 update: a report from the American Heart Association. Circulation. 2020; 141: e139-e596https://doi.org/10.1161/CIR.0000000000000757 Crossref PubMed Scopus (2259) Google Scholar the significance of CVD in women is largely underappreciated. Furthermore, care provided for women with CVD continues to be based heavily on men’s experiences because far fewer women have been enrolled in cardiovascular studies to date. 3 Jin X. Chandramouli C. Allocco B. Gong E. Lam C.S.P. Yan L.L. Women’s participation in cardiovascular clinical trials from 2010 to 2017. Circulation. 2020; 141: 540-548https://doi.org/10.1161/CIRCULATIONAHA.119.043594 Crossref PubMed Scopus (47) Google Scholar This partially explains why women with CVD experience worse outcomes compared with men. 2 Virani S.S. Alonso A. Benjamin E.J. et al. on behalf of the American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics SubcommitteeHeart disease and stroke statistics—2020 update: a report from the American Heart Association. Circulation. 2020; 141: e139-e596https://doi.org/10.1161/CIR.0000000000000757 Crossref PubMed Scopus (2259) Google Scholar Leslie L. Davis, PhD, ANP-BC, is an associate professor at the University of North Carolina at Chapel Hill. Dr. Davis teaches research and evidence-based practice and maintains a part-time nurse practitioner position in the Division of Cardiology at the University of North Carolina at Chapel Hill School of Medicine. She can be reached at [email protected] .

Arterial hypertension in women: Menopause as a risk window.

Cardiovascular diseases (CVD) exert a heavy toll on health of women, mainly due to hypertension said to cluster around the period of transition to menopause. This makes this period a good window to target for prevention and control. We therefore sought to determine if this period really heralds arterial hypertension and CVD in women in our environment. We secondarily analysed our population data on CVD risk factors in free living rural residents. The data considered were blood pressure, anthropometric and biochemical variables in women stratified based on menstruation status. There were 488 females, with 218 still menstruating. They were younger (p = .000), had lower systolic and diastolic blood pressures (p = .000), lower anthropometric indices attaining significance only with waist circumference (p = .001) and lower total cholesterol (p = .001). Controlling for age, statistically significant differences remained for systolic and diastolic blood pressures, body mass index, waist and hip circumferences, and total cholesterol. The menopause transition comes with a worse CVD profile. Blood pressure rises and so are the anthropometric variables and some biochemical parameters that fuel CVD. This could be ascribed to age which is higher with those post-menopausal. Controlling for age in this cohort still showed that transiting from pre- to post-menopause still came with CVD burden. Clinicians should take the opportunity presented by menopause transition to screen for CVD risk factors and initiate either preventive or control measures to mitigate morbi-mortality consequences.

Why We Need Specialised Centres for Women's Hearts: Changing the Face of Cardiovascular Care for Women.

Although cardiovascular disease (CVD) is the leading cause of mortality in women globally, cardiovascular care for women remains suboptimal, with poorer outcomes than for men. During the past two decades, there has been an incremental increase in research and publications on CVD in women, addressing sex-specific risk factors, symptoms, pathophysiology, treatment, prevention and identification of inequities in care. Nonetheless, once women have manifested CVD, they continue to have increasingly worse outcomes than men. An approach to addressing these global disparities has been the worldwide establishment of specialised centres providing cardiovascular care for women. These women’s heart centres (WHCs) allow a comprehensive approach to the cardiovascular care of women across the lifespan. The purpose of this article is to define the need for and role of these specialised centres by outlining sex-specific gaps in CVD care, and to provide guidance on components within WHCs that may be considered when establishing such programmes.

The application of the theory of planned behavior to nutritional behaviors related to cardiovascular disease among the women

BackgroundNutritional factors have been identified as preventable risk factors for cardiovascular disease; this study aimed to investigate the application of the Theory of Planned Behavior (TPB) in nutritional behaviors related to cardiovascular diseases among the women in Fasa city, Fars province, Iran.MethodsThe study was conducted in two stages. First, the factors affecting nutritional behaviors associated with cardiovascular disease on 350 women who were referred to Fasa urban health centers were determined based on the TPB. In the second stage, based on the results of a cross-sectional study, quasi-expeimental study was performed on 200 women covered by Fasa health centers. The questionnaire used for the study was a questionnaire based on TPB. The questionnaire was completed by the experimental and control groups before and three months after the intervention. Data were analyzed by SPSS software using logistic regression, paired t-test, independent sample t-test, and chi-square test. The level of significance is considered 0.05.ResultThe constructs of attitude, subjective norms, and perceived behavioral control (PBC) were predictors of nutritional behaviors associated with cardiovascular disease in women. The constructs predicted 41.6% of the behavior. The results showed that mean scores of attitude, subjective norms, PBC, intention, nutritional performance related to the cardiovascular disease before intervention were, respectively, 24.32, 14.20, 18.10, 13.37 and 16.28, and after the intervention, were, respectively, 42.32, 25.40, 33.72, 30.13 and 41.38. All the constructs except the attitude in the intervention group were significantly higher (p < 0.001) than the control group.ConclusionThe results of the present study showed that the educational intervention based on the TPB would be consider an effective educational and promotinal strategy for the nutritional behaviors to prevent cardiovascular disease in women. Considering the role of mothers in providing family food baskets and the effect of their nutritional behaviors on family members, the education of this group can promote healthy eating behaviors in the community and family.

Nω-nitro-L-arginine methyl ester hydrochloride (L-NAME) induced hypertension in pregnant rat model: An analysis on the effectiveness of administration methods to induce high blood pressure in pregnancy

Hypertensive disorders of pregnancy (HDP) contribute to high percentage for both maternal and foetal morbidity and mortality and associate with long term complications. A history of having HDP is a known risk factor for women's cardiovascular disease later in their life even though blood pressure normalizes during postpartum period. L-NAME is a drug that has been used to pharmacologically induce hypertension by inhibition of nitric oxide synthase (NOS). In the previous study, there are various administration methods used to induce hypertension in pregnant rat model by using L-NAME, but they produced inconsistent outcomes.

Abstract 14155: Exposure to sFlt1-Induced Preeclampsia Enhances the Future Vascular Response to Hypertensive Stimuli in Mice in a Smooth Muscle Mineralocorticoid Receptor Dependent Manner

Preeclampsia (PE), a syndrome of high blood pressure (BP) and renal damage in late pregnancy, is associated with increased soluble VEGF receptor (sFlt1) and survivors have increased risk of future hypertension with increased angiotensin II (AngII) and salt sensitivity. Since smooth muscle cell mineralocorticoid receptor (SMC-MR) can be activated by hypertensive stimuli, we hypothesized that high sFlt1 exposure during pregnancy may induce a post-partum state of enhanced vascular sensitivity via SMC-MR activation. A PE model was induced by transient viral expression of sFlt1 in pregnant C57Bl6 mice. Elevated serum sFlt1, BP and glomerular endotheliosis was confirmed which all resolve post-partum. Two months later, resistance arteries from post-PE mice show no change in vasoconstriction to AngII but with increased mRNA ratio of the pro-constrictive AngII receptor-1(ATR1) to the vasodilatory ATR2. In a small cohort of women with prior PE, we confirm salt sensitivity of BP thus, postpartum mice were implanted with telemetric BP monitors and exposed to high salt or AngII (600mg/kg/day) infusion. Mice with prior PE had a significantly increased BP response to hypertensive stimuli. Microvessels from mice after PE and hypertensive stimuli had enhanced ex vivo myogenic tone and AngII vasoconstriction. To test the direct impact of sFlt1 on SMC-MR function, cultured SMC (Pac1) were transiently exposed to sFlt1 (24 hours on then off) to mimic the post-PE state. SMC-MR transcriptional activity in response to aldosterone and AngII were significantly increased after sFlt1 exposure as measured by luciferase reporter assay. SMC-MR activation and target gene expression was also enhanced after sFlt1 exposure (including AT1R/AT2R ratio). Finally, the role of SMC-MR in the post-PE phenotype was tested in vivo by PE induction in SMC-MR-KO vs MR-intact littermates. Post partum, SMC-MR-KO mice were protected from the PE-induced increase in aortic stiffness, microvascular myogenic tone and AngII vasoconstriction. sFlt1-induced PE produces a state of enhanced sensitivity to AngII that may be mediated by increased activation of SMC-MR. These data support the use of MR antagonists to mitigate the increased risk of cardiovascular disease in women exposed to PE.

Abstract 11522: The Risk of Cardiovascular Diseases in Women with Recurrent Pregnancy Loss: A Systematic Review and Meta-Analysis

Introduction: Recurrent pregnancy loss (RPL) is defined as two or more ultrasound confirmed pregnancy losses or three or more pregnancy losses at any location. Evidence suggests that women with a history of RPL have an increased risk of coronary heart disease. However, the association between cardiovascular diseases (CVD) and RPL remains unclear. We aim to conduct a systematic review and meta-analysis to investigate whether RPL is a risk factor for CVD. Methods: Population-based studies on MEDLINE, CINAHL, Web of Science, and Embase that investigated the risk of CVD in women with or without a history of RPL were included. The incidences of CVD events and its composite endpoints myocardial infarction/coronary heart diseases (MI/CHD), stroke/cerebrovascular diseases (stroke/CeVD), circulatory system diseases (CSD) were extracted and presented with odds ratio (OR) with 95% confidence interval (CI). Heterogeneity was analyzed with I 2 . Results: A total of 809 articles were retrieved and 6 studies were included. The incidences of CVD events was significantly increased (OR=1.49, 95% CI 1.11 to 1.99, P=0.008, I 2 =96%) in 13176 women with RPL (≥2 pregnancy losses) compare to 403278 controls; a borderline increase of MI/CHD risk was also found (OR=1.45, 95% CI 1.00 to 2.08, P=0.05, I 2 =78%), whereas no significant differences of stroke/CeVD (OR=1.25, 95% CI 0.79 to 1.98, P=0.35, I 2 =73%) and CSD risks (OR=1.17, 95% CI 0.83 to 1.67, P=0.05, I 2 =93%) were observed. In 1594 women with three or more pregnancy losses, an increased incidence of CVD events was found compared to 311385 women without (OR=1.59, 95% CI 1.04 to 2.40, P=0.03, I 2 =71%). The risks of MI/CHD (OR=3.03, 95% CI 1.45 to 6.35, P=0.003, I 2 =78%) and stroke/CeVD (OR=1.63, 95% CI 1.38 to 1.93, P&lt;0.00001, I 2 =0%) were significantly increased in these women but not CSD (OR=1.27, 95% CI 0.92 to 1.76, P=0.13, I 2 =57%). Conclusion: Our study suggested an association between RPL and increased risks of CVD and MI/CHD. The risks of stroke/CeVD may be elevated in women with three or more pregnancy losses. Our work provides a better understanding of the sex-specific risk factors of CVD. Further research may help to identify the causal link between RPL and CVD and determine the need for early screening and intervention in women at risk.

Sex Differences in Cumulative Exposure to Metabolic Risk Factors Before Hypertension Onset: The Cohort of the Tehran Lipid and Glucose Study.

BackgroundPrevious studies have shown a sex difference in the association between hypertension and cardiovascular disease; however, the precise mechanism remains unclear. Because there are strong associations between metabolic risk factors (MRFs) and hypertension, a sex‐specific analysis of MRFs before hypertension onset could offer new insights and expand our understanding of sex differences in cardiovascular disease. We evaluated cumulative exposure to major MRFs and rate of change of those factors, including body mass index, waist circumference, systolic blood pressure, diastolic blood pressure, fasting plasma glucose, total cholesterol, triglycerides, and high‐density lipoprotein cholesterol among individuals who did and did not develop hypertension at follow‐up.Methods and ResultsWe included 5374 participants (2191 men) initially without hypertension with age range of 20–50 years at baseline who participated in the Tehran Lipid and Glucose Study, and had been examined at least 3 times during the study period (1999–2018). In both sexes, the cumulative exposure to all MRFs (except for fasting plasma glucose and high‐density lipoprotein cholesterol in men) were higher in those who developed hypertension, compared with those who did not develop hypertension. However, women experienced greater cumulative exposure to major MRFs, compared with their male counterparts. Also, they experienced a faster increase in waist circumference, systolic blood pressure, diastolic blood pressure, and high‐density lipoprotein cholesterol than men. Furthermore, rapid increase in systolic blood pressure began earlier in women than men, at the age of 30 years. We also found that those men who developed hypertension experienced unfavorable change in major MRFs during young adulthood (<50 years of age).ConclusionsWomen exhibited more metabolic disturbances than men before onset of hypertension, which may explain the stronger impact of hypertension for major types of cardiovascular disease in women, compared with men.

Secondary Prevention of Cardiovascular Disease in Women: Closing the Gap.

Cardiovascular disease (CVD) remains the leading cause of death in women globally. Younger women (<55 years of age) who experience MI are less likely to receive guideline-directed medical therapy (GDMT), have a greater likelihood of readmission and have higher rates of mortality than similarly aged men. Women have been under-represented in CVD clinical trials, which limits the generalisability of results into practice. Available evidence indicates that women derive a similar benefit as men from secondary prevention pharmacological therapies, such as statins, ezetimibe, proprotein convertase subtilisin/kexin type 9 inhibitors, icosapent ethyl, antiplatelet therapy, sodium–glucose cotransporter 2 inhibitors and glucagon-like peptide-1 receptor agonists. Women are less likely to be enrolled in cardiac rehabilitation programs than men. Mitigating risk and improving outcomes is dependent on proper identification of CVD in women, using appropriate GDMT and continuing to promote lifestyle modifications. Future research directed at advancing our understanding of CVD in women will allow us to further develop and tailor CVD guidelines appropriate by sex and to close the gap between diagnoses, treatment and mortality.

A Machine Learning-Based Prediction Model for Cardiovascular Risk in Women With Preeclampsia.

Objective: Preeclampsia affects 2–8% of women and doubles the risk of cardiovascular disease in women after preeclampsia. This study aimed to develop a model based on machine learning to predict postpartum cardiovascular risk in preeclamptic women.Methods: Collecting demographic characteristics and clinical serum markers associated with preeclampsia during pregnancy of 907 preeclamptic women retrospectively, we predicted the cardiovascular risk (ischemic heart disease, ischemic cerebrovascular disease, peripheral vascular disease, chronic kidney disease, metabolic system disease or arterial hypertension). The study samples were divided into training sets and test sets randomly in the ratio of 8:2. The prediction model was developed by 5 different machine learning algorithms, including Random Forest. 10-fold cross-validation was performed on the training set, and the performance of the model was evaluated on the test set.Results: Cardiovascular disease risk occurred in 186 (20.5%) of these women. By weighing area under the curve (AUC), the Random Forest algorithm presented the best performance (AUC = 0.711[95%CI: 0.697–0.726]) and was adopted in the feature selection and the establishment of the prediction model. The most important variables in Random Forest algorithm included the systolic blood pressure, Urea nitrogen, neutrophil count, glucose, and D-Dimer. Random Forest algorithm was well calibrated (Brier score = 0.133) in the test group, and obtained the highest net benefit in the decision curve analysis.Conclusion: Based on the general situation of patients and clinical variables, a new machine learning algorithm was developed and verified for the individualized prediction of cardiovascular risk in post-preeclamptic women.

Defective Uteroplacental Vascular Remodeling in Preeclampsia: Key Molecular Factors Leading to Long Term Cardiovascular Disease.

Preeclampsia is a complex hypertensive disorder in pregnancy which can be lethal and is responsible for more than 70,000 maternal deaths worldwide every year. Besides the higher risk of unfavorable obstetric outcomes in women with preeclampsia, another crucial aspect that needs to be considered is the association between preeclampsia and the postpartum cardiovascular health of the mother. Currently, preeclampsia is classified as one of the major risk factors of cardiovascular disease (CVD) in women, which doubles the risk of venous thromboembolic events, stroke, and ischemic heart disease. In order to comprehend the pathophysiology behind the linkage between preeclampsia and the development of postpartum CVD, a thorough understanding of the abnormal uteroplacental vascular remodeling in preeclampsia is essential. Therefore, this review aims to summarize the current knowledge of the defective process of spiral artery remodeling in preeclampsia and how the resulting placental damage leads to excessive angiogenic imbalance and systemic inflammation in long term CVD. Key molecular factors in the pathway—including novel findings of microRNAs—will be discussed with suggestions of future management strategies of preventing CVD in women with a history of preeclampsia.

Students Corner—6

The Indian Journal of Cardiovascular Disease in Women (IJCDW) is an open access peer-reviewed journal committed to publishing high-quality articles in the field of Cardiovascular Investigations in female patients of different age groups.