Causes Of CVD Research Articles

The Link between miRNAs and PCKS9 in Atherosclerosis.

Cardiovascular disease (CDV) represents the major cause of death globally. Atherosclerosis, as the primary cause of CVD, is a chronic immune-inflammatory disorder with complex multifactorial pathophysiology encompassing oxidative stress, enhanced immune-inflammatory cascade, endothelial dysfunction, and thrombosis. An initiating event in atherosclerosis is the subendothelial accumulation of low-density lipoprotein (LDL), followed by the localization of macrophages to fatty deposits on blood vessel walls, forming lipid-laden macrophages (foam cells) that secrete compounds involved in plaque formation. Given the fact that foam cells are one of the key culprits that underlie the pathophysiology of atherosclerosis, special attention has been paid to the investigation of the efficient therapeutic approach to overcome the dysregulation of metabolism of cholesterol in macrophages, decrease the foam cell formation and/or to force its degradation. Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a secretory serine proteinase that has emerged as a significant regulator of the lipid metabolism pathway. PCSK9 activation leads to the degradation of LDL receptors (LDLRs), increasing LDL cholesterol (LDL-C) levels in the circulation. PCSK9 pathway dysregulation has been identified as one of the mechanisms involved in atherosclerosis. In addition, microRNAs (miRNAs) are investigated as important epigenetic factors in the pathophysiology of atherosclerosis and dysregulation of lipid metabolism. This review article summarizes the recent findings connecting the role of PCSK9 in atherosclerosis and the involvement of various miRNAs in regulating the expression of PCSK9-related genes. We also discuss PCSK9 pathway-targeting therapeutic interventions based on PCSK9 inhibition, and miRNA levels manipulation by therapeutic agents.

ASSESSMENT OF NUTRITIONAL KNOWLEDGE OF WOMEN SUFFERING FROM CARDIOVASCULAR DISEASES

Cardiovascular diseases are becoming a prominent cause of morbidity and mortality across the globe. An increase has been seen in its cases due to the unhealthy eating habits and sedentary lifestyle human population is moving towards. Some other major causes of CVD can be hereditary, stress, other diseases that might lead to it. Nutrition plays a very important role in its prevention and cure because medicines alone can never work if you don’t eat healthy along with it. So, to eat right is the main goal in preventing and curing CVD. This study aims at studying the pattern of eating and nutrition consumption in the women who suffer from cardiovascular diseases. Furthermore, it helps in any future research to find the better practices in terms of nutrition to fight against CVD by studying the already seen pattern of nutrition consumption in CVD patients. Keywords : Cardiovascular, Diseases, Mortality, Nutrition, CVD Patients

Multi-country collaborative citizen science projects to co-design cardiovascular disease prevention strategies and advocacy: findings from Ethiopia, Malawi, Rwanda, and South Africa

BackgroundCardiovascular diseases (CVD) were responsible for 20.5 million annual deaths globally in 2021, with a disproportionally high burden in sub-Saharan Africa (SSA). There is growing evidence of the use of citizen science and co-design approaches in developing interventions in different fields, but less so in the context of CVD prevention interventions in SSA. This paper reports on the collaborative multi-country project that employed citizen science and a co-design approach to (i) explore CVD risk perceptions, (ii) develop tailored prevention strategies, and (iii) support advocacy in different low-income settings in SSA.MethodsThis is a participatory citizen science study with a co-design component. Data was collected from 205 participants aged 18 to 75 years in rural and urban communities in Malawi, Ethiopia and Rwanda, and urban South Africa. Fifty-one trained citizen scientists used a mobile app-based (EpiCollect) semi-structured survey questionnaire to collect data on CVD risk perceptions from participants purposively selected from two communities per country. Data collected per community included 100–150 photographs and 150–240 voice recordings on CVD risk perceptions, communication and health-seeking intentions. Thematic and comparative analysis were undertaken with the citizen scientists and the results were used to support citizen scientists-led stakeholder advocacy workshops. Findings are presented using bubble graphs based on weighted proportions of key risk factors indicated.ResultsNearly three in every five of the participants interviewed reported having a relative with CVD. The main perceived causes of CVD in all communities were substance use, food-related factors, and litter, followed by physical inactivity, emotional factors, poverty, crime, and violence. The perceived positive factors for cardiovascular health were nutrition, physical activity, green space, and clean/peaceful communities. Multi-level stakeholders (45–84 persons/country) including key decision makers participated in advocacy workshops and supported the identification and prioritization of community-specific CVD prevention strategies and implementation actions. Citizen science-informed CVD risk screening and referral to care interventions were piloted in six communities in three countries with about 4795 adults screened and those at risk referred for care. Health sector stakeholders indicated their support for utilising a citizen-engaged approach in national NCDs prevention programmes. The citizen scientists were excited by the opportunity to lead research and advocacy.ConclusionThe collaborative engagement, participatory learning, and co-designing activities enhanced active engagement between citizen scientists, researchers, and stakeholders. This, in turn, provided context-specific insights on CVD prevention in the different SSA settings.

Acute, but not chronic, aerobic exercise alters the impact of ex vivo LDL and fatty acid stimulation on monocytes and macrophages from healthy, young adults.

Elevated low-density lipoprotein (LDL) and triglyceride concentrations are associated with future cardiovascular risk in young adults. Conversely, chronic physical activity is generally accepted to reduce CVD risk. Atherosclerosis is a major underlying cause of CVD, and atherogenesis is mediated by peripheral monocytes and monocyte-derived macrophages. The study aimed to determine if an individual's physical activity level impacts the phenotype of monocytes and monocyte-derived macrophages when stimulated with LDL and fatty acid ex vivo. Peripheral blood mononuclear cells (PBMCs) were obtained from healthy, young adults of differing physical activity levels before and after a single bout of moderate intensity exercise (25min at 60% of VO2peak). PBMCs were stimulated with LDL and palmitate ex vivo prior to differentiation into macrophages. Monocyte subset percentages and monocyte-derived macrophage expression of phenotypic (CD86, CD206) and functional (CCR2, ERK 1/2) markers were evaluated by flow cytometry. Compared to baseline, ex vivo LDL and palmitate stimulation decreased (p = 0.038) non-classical monocyte percentage from 24.7 ± 3.2 to 21.5 ± 2.6% in all participants. When ex vivo lipid stimulation was preceded by acute exercise, non-classical monocyte percentage was similar to baseline levels (p = 0.670, 25.8 ± 2.15%). Macrophage CD86/CD206 was increased from 1.30 ± 0.14 to 1.68 ± 0.19 when preceded by acute exercise in all participants. No differences were observed between participants of differing physical activity levels. Findings suggest that acute exercise modulates monocyte phenotype after LDL and palmitate stimulation in a protective manner, however, chronic physical activity does not alter monocyte/macrophage responses to any experimental condition in this population.

Saturated fat: villain and bogeyman in the development of cardiovascular disease?

Cardiovascular disease (CVD) is the leading global cause of death. For decades, the conventional wisdom has been that the consumption of saturated fat (SFA) undermines cardiovascular health, clogs the arteries, increases risk of CVD, and leads to heart attacks. It is timely to investigate whether this claim holds up to scientific scrutiny. The purpose of this paper is to review and discuss recent scientific evidence on the association between dietary SFA and CVD. PubMed, Google scholar, and Scopus were searched for articles published between 2010 and 2021 on the association between SFA consumption and CVD risk and outcomes. A review was conducted examining observational studies and prospective epidemiologic cohort studies, randomized controlled trials (RCTs), systematic reviews and meta-analyses of observational studies and prospective epidemiologic cohort studies, and long-term RCTs. Collectively, neither observational studies, prospective epidemiologic cohort studies, RCTs, systematic reviews, and meta-analyses have conclusively established a significant association between SFA in the diet and subsequent cardiovascular risk and coronary artery disease, myocardial infarction, or mortality nor a benefit of reducing dietary SFAs on CVD rick, events, and mortality. Beneficial effects of replacement of SFA by polyunsaturated or monounsaturated fat or carbohydrates remain elusive. Findings from the studies reviewed in this paper indicate that the consumption of SFA is not significantly associated with CVD risk, events, or mortality. Based on the scientific evidence, there is no scientific ground to demonize SFA as a cause of CVD. SFA naturally occurring in nutrient-dense foods can be safely included in the diet.

Study Protocol: Effects of Daily Prune Consumption on Lipid Profile, Inflammation, and Oxidative Stress

ObjectivesCardiovascular disease (CVD) is the leading cause of death and disability worldwide. Atherosclerosis is recognized as a primary underlying cause of CVD resulting from oxidative stress, chronic inflammation, and excess low-density lipoprotein cholesterol (LDL). Prunes (Prunus domestica L.) are a nutritious food with components associated with improved cardiovascular health, including soluble fiber and polyphenolic compounds. The objective of this study is to investigate the cardioprotective benefits of prunes and determine the extent to which daily prune consumption effects blood lipids, oxidative stress, and chronic inflammation in men.MethodsHealthy osteopenic men aged 55 to 80 years old with body mass index of <18 to >40 data were included in this 12-month, parallel design, randomized controlled trial. Participants were placed into one of three treatment groups: 50 g/day prune, 100 g/day prune, or control (multivitamin only) for 12 months. All groups consumed a multivitamin containing 450 mg calcium and 800 IU vitamin D. During each visit (baseline, 3, 6, and 12 months) height, body weight, waist and hip circumference, heart rate, and blood pressure were assessed. Fasting blood and urine samples were collected at each time point, and participants completed a 3-day food record and validated physical activity questionnaire. Blood total cholesterol (TC), LDL-C, triglycerides, and high-density lipoprotein cholesterol (HDL-C) and biomarkers of inflammation and oxidative stress including high-sensitivity C-reactive protein (hsCRP), Tumor necrosis factor alpha (TNF-α), Interleukin 1 beta (IL-1β), lipid peroxidation (LPO), and total antioxidant capacity (TAC) will be measured.ResultsStudy recruitment and retention is complete. Data analysis has yet to begin.ConclusionsBased on the literature, whole foods high in polyphenols and soluble fiber, such as prunes, are beneficial in reducing chronic inflammation and circulating LDL-C. In the current study, we expect that long-term daily consumption of prunes will improve CVD risk factors including reductions in LDL and TC and provide antioxidant and anti-inflammatory cardiovascular benefits in older men. Findings from this research will further our understanding of the role that prunes may have in improving cardiovascular health.Funding SourcesUSDA, California Prune Board, and Shaklee.

Abstract P032: Specialized Care Is Associated With Higher Cardiovascular Disease Awareness In Young Women

Introduction: Awareness of CVD and its risk factors is low among young women. This study compared CVD knowledge and preventive behaviors among women ages 15-24 years seen in primary care versus a preventive cardiology clinic. Hypothesis: Young women seen in a preventive cardiology clinic would demonstrate more knowledge about CVD and its causes, and be more likely to engage in preventive behaviors. Methods: We recruited 403 females ages 15-24 years from two clinics in Boston, MA: a primary care clinic (n=331) and a preventive cardiology clinic (n=72). We modified the AHA Women’s Health Survey to assess CVD knowledge and lifestyle behaviors. Using logistic regression, we examined the relationship between clinic type and 1) knowledge about CVD and 2) engagement in preventive behaviors, controlling for age group, primary caregiver education level, and race/ethnicity. Results: Young women in preventive cardiology clinic were more likely to identify CVD as the leading cause of death for women (PR: 1.65, 95% CI: 0.96-2.85) and identify major causes of CVD, such as high cholesterol and family history of CVD (Figure). Preventive cardiology patients were more likely to report maintaining a healthy cholesterol level (PR: 1.33, 95% CI: 1.03-1.71) and were over twice as likely to discuss CVD risk with their provider within the past two years (PR: 2.34, 95% CI: 1.84-2.97), including topics such as nutrition and exercise. Notably, 41 (70%) preventive cardiology patients did not identify CVD as the major cause of mortality in women despite being able to identify CVD risk factors. Additionally, engagement in behaviors targeted in the specialized clinic remained suboptimal (Figure). Conclusion: Young women in a preventive cardiology clinic were more aware of CVD and its risk factors than those seen in primary care. However, gaps remained in knowledge and behavior despite specialized care. Opportunities remain in primary care and preventive cardiology clinics to increase knowledge and promote healthy behavior to reduce CVD risk in women.

Assessment of Cardiovascular Risk and Knowledge on Risk Factors among a Rural Population in Mangalore, Karnataka

Introduction: The major causes of CVD in low and middle income countries includes globalization, rapid unplanned urbanization and increasing sedentary lifestyle. Awareness of CVD and the risk factors of the same are significant in preventing and reducing CVD deaths. Aims &amp; Objectives: To assess the magnitude of association between the knowledge regarding the risk factors for cardiovascular disease and risk of developing CVD in next 10 years. Methodology: A cross sectional study conducted in Rural Mangalore among 230 participants, selected based on simple random sampling. A pre – validated, pre – tested and semi structured questionnaire to observe socio demographic characteristics, WHO/ISH Risk prediction algorithm was used to predict risk of CVD and likert scale was used to assess knowledge. Chi Square test was done to test the significance (p&lt;0.05). Results: 64.8% had &lt; 10% risk of which, 40.4% were males and 24.3% were females. 5.2% had &gt; 40% risk which is the highest risk score of which 3.9% were males and 1.3% were females. Males (53.9%) had better knowledge on CVRF than females (28.3%). As age increases, knowledge decreases. Conclusion: Education was directionally proportional to the knowledge whereas age was inversely proportional to the Knowledge.

From syndrome X to cardiometabolic risk: clinical and public health implications.

Although the first description of a syndrome defined by the co-existence of atherogenic and diabetogenic metabolic abnormalities is debated in the literature, it was Gerald Reaven who proposed, in his landmark 1988 Banting award lecture, that a significant proportion of individuals (with diabetes or not) were characterised by insulin resistance causing prejudice to cardiovascular health. However, Reaven was influenced by seminal observations made more than 50 years earlier by Himsworth who proposed that there were two forms of diabetes (insulin resistant v. insulin sensitive). Reaven went further in proposing the theory that insulin resistance was the most prevalent cause of CVD associated with metabolic abnormalities that he named syndrome X. Because there was a syndrome X documented in cardiology, the term evolved to insulin resistance syndrome. As Reaven could also find insulin-resistant individuals in non-obese subjects, he did not include obesity as a feature of syndrome X. Imaging studies then revealed that excess adipose tissue in the abdominal cavity, a condition described as visceral obesity, was the form of overweight/obesity associated with insulin resistance and its related abnormalities. As obesity risk assessment and management remain largely based on body weight (BMI) and weight loss, it is proposed that our clinical approaches and public health messages should be revisited. First, patients should be educated about the importance of monitoring their waistline as a crude index of abdominal adiposity. Secondly, public health approaches focussing on 'lifestyle vital signs' including achieving healthy waistlines rather than healthy body weights should be developed.

The Interaction of C - Reactive Protein, Bisphenol A, &amp; Cardiovascular Disease: A Demographical Analysis

&lt;p&gt;&lt;strong&gt;OBJECTIVE: &lt;/strong&gt;The main objective of the study was to investigate the role of C-reactive protein on the relationship between Bisphenol A &amp;amp; Cardiovascular Disease, where the C-reactive protein has been taken as a moderating variable.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;METHODS: &lt;/strong&gt;Quantitative research design has been incorporated for evaluating the role of C-reactive protein. Similarly, non-parametric Spearman correlation test has been conducted to assess the relationship between BPA and CVD. The data was taken out from the National Health and Nutrition Examination Survey (NHANES), which was collected in the year 2009-2010.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;RESULTS: &lt;/strong&gt;The impact of urinary Bisphenol A on serum C-reactive protein was found statistically significant according to the Spearman correlation coefficient, &lt;em&gt;r&lt;/em&gt;s&lt;em&gt;= &lt;/em&gt;.06, &lt;em&gt;p &lt;/em&gt;= .015. The scatter plots found that there is no relationship between the two variables; this observation held true after filtering the outliers from the plot.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;CONCLUSION:&lt;/strong&gt; The results might have positive change by contributing to the body of knowledge on bisphenol A and by rising scientific examination of substances used by the people in the daily life. Further research to identify other possible causes of CVD and elevation of CRP is recommended.&lt;/p&gt;

Dyslipidemia: A Cardiovascular Risk Factor in Type 1 Diabetes and Its Correlations

Background: The prevalence of T1DM is increasing markedly. It is suggested that it will be an epidemic of type 1 diabetes (T1DM) by 2025. T1DM is a major risk factor for CVD. The mortality and morbidity of CVD are markedly increased in diabetic individuals compared with the non-diabetic population Dyslipidemia is a preventable cause of CVD. Objective: To evaluate the pattern of dyslipidemia in Egyptian children and adolescents with type 1 DM (T1DM), to study the correlations between different lipid parameters and different variables in the study, in addition to estimate the predictable cardiovascular risk in the study group through calculation of different lipoprotein risk ratios as predictive values of cardiovascular risk. Methods: In this cross-sectional study, fasting lipid profile was done for sixty patients with T1DM (34 males and 26 females, with a mean age of 12.5 ± 2.4 years) and different lipid parameters were correlated to different variables. Results: The most common abnormality was high LDL-C either alone or in combination with other parameters (50%). Regarding LDL-C of the patients, there was a positive significant correlation with their BMI (p=0.039, r=0.268) while the correlation with WC was of borderline significance (p=0.061, r=0.243). There was a significant positive correlation between WC and the insulin dosage, BMI and BMI SDS and a positive significant correlation between TG and the age (p=0.048, r=0.256). There were 46.2% of the dyslipidemic patients at risk of developing CVD according to TC/HDL-C ratio (Castelli index I) and 20.5% according to LDL-C/HDL-C ratio (Castelli index II). Conclusion: The most common abnormality was high LDL-C (50%). There was a positive correlation between LDL-C and BMI and WC. The risk for developing CVD was 46.2% according to TC/HDL-C ratio (Castelli index I) and 20.5% according to LDL-C/HDL-C ratio (Castelli index II).

MECHANISMS OF PERIODONTITIS - INDUCED ATHEROSCLEROSIS

Nowadays CVD become the most common cause of death in US and worldwide. Atherosclerosis plays an important role in CVDs pathogenesis. Atherosclerosis decreases the elasticity of the vascular. Atherosclerosis shares the same risk factor as CVD, in which obesity, hyperlipidemia, hypertension and lack of physical activity may initiate it. However, 50% of all CVD patients are lack of the usual causes of CVD. The purpose of this review is to reveal the mechanism of periodontitis-induced atherosclerosis. Inflammation and autoimmune disease might play an important role in initiate the CVD. Periodontitis is one of the oral diseases which can cause systemic inflammation and may induce the atherosclerosis. Porphyromonas gingivalis (Pg) which is the major cause of periodontitis can induce it by expressing protein gp130 in its fimbriae. Periodontics patients are prone to have bacteremia by daily routine oral hygiene activity. Chronic bacteremia may alter the endothelial physiology, which is resulted in neointima formation, EC dysfunction, and lipid accumulation. It is concluded that periodontitis may play an important role in initiation and progression of atherosclerosis.

Insufficient Evidence for the Efficacy of Homocysteine-Lowering Treatment on Cardiovascular Disease: The Homocysteine Hypothesis Revisited

A large body of observational studies has suggested that a moderate increase of plasma total homocysteine (tHcy) concentration is a modest risk factor for CHD and a somewhat stronger risk factor for stroke, at least in nonfortified populations. Folic acid and vitamin B6 and B12 supplementation can lower tHcy levels. However, recent clinical trials in populations at high risk for CVD have failed to show treatment benefits with homocysteinelowering dietary interventions. There is continued controversy with regard to whether high homocysteine level is a cause of CVD and whether homocysteinelowering therapy can protect against the development of CVD. [N A J Med Sci. 2008; 1(1):30-33.]

CVD risk in South Asians: the importance of defining adiposity and influence of dietary polyunsaturated fat

The prevalence of the metabolic syndrome (MetS), CVD and type 2 diabetes (T2D) is known to be higher in populations from the Indian subcontinent compared with the general UK population. While identification of this increased risk is crucial to allow for effective treatment, there is controversy over the applicability of diagnostic criteria, and particularly measures of adiposity in ethnic minorities. Diagnostic cut-offs for BMI and waist circumference have been largely derived from predominantly white Caucasian populations and, therefore, have been inappropriate and not transferable to Asian groups. Many Asian populations, particularly South Asians, have a higher total and central adiposity for a similar body weight compared with matched Caucasians and greater CVD risk associated with a lower BMI. Although the causes of CVD and T2D are multi-factorial, diet is thought to make a substantial contribution to the development of these diseases. Low dietary intakes and tissue levels of long-chain (LC) n-3 PUFA in South Asian populations have been linked to high-risk abnormalities in the MetS. Conversely, increasing the dietary intake of LC n-3 PUFA in South Asians has proved an effective strategy for correcting such abnormalities as dyslipidaemia in the MetS. Appropriate diagnostic criteria that include a modified definition of adiposity must be in place to facilitate the early detection and thus targeted treatment of increased risk in ethnic minorities.

Plasma lipids pattern in hypertensives on treatment in Illorin, Nigeria

Hypertension, a major cause of CVD, is frequently associated with dyslipidaemia and overweight. These risk factors have sex differences that need local study. This work aims to evaluate the pattern of plasma lipids and BMI in male and female hypertensives. Fifty hypertensives attending the Cardiology Clinic of University of Ilorin Teaching Hospital, and fifty sex matched controls, were involved in the study. Conditions that can cause dyslipidaemia were ruled out in the subjects. Plasma TC, TG, HDL-C, LDL-C and BMI were determined. Plasma TC (4.80mmol/L ± 2.27 vs. 3.20mmol/L), HDL-C (1.16mmol/L ± 0.37 vs. 0.93mmol/L ± 0.41), LDL-C (3.62mmol/L ± 1.30 vs. 2.28mmol/L ± 1.01) and BMI (27.20kg/m2 ± 6.57 vs. 23.37kg/m2 ± 4.75) were higher in hypertensives. Plasma TG (1.14mmol/L ± 0.71 vs. 0.83mmol/L ± 0.29) and HDL-C (1.22mmol/L ± 0.42 vs. 1.05mmol/L ± 0.25) were higher in female hypertensives than in male hypertensives. Management of hypertension in our environment should involve the screening and control of dyslipidaemia and overweight. It should recognize possible differences in the pattern of dyslipidaemia. The finding of higher LDL-C and lower HDL-C in male hypertensives, suggest that they are more likely to have poorer lipid pattern than females. Nigerian Medical Practitioner Vol. 49(1&2) 2006: 3-6