Cerebro-cardiovascular Diseases Research Articles

Mucus reduction promotes acetyl salicylic acid-induced small intestinal mucosal injury in rats

BackgroundAcetyl salicylic acid (ASA) is a useful drug for the secondary prevention of cerebro-cardiovascular diseases, but it has adverse effects on the small intestinal mucosa. The pathogenesis and prophylaxis of ASA-induced small intestinal injury remain unclear. In this study, we focused on the intestinal mucus, as the gastrointestinal tract is covered by mucus, which exhibits protective effects against various gastrointestinal diseases. Materials and MethodsASA was injected into the duodenum of rats, and small intestinal mucosal injury was evaluated using Evans blue dye. To investigate the importance of mucus, Polysorbate 80 (P80), an emulsifier, was used before ASA injection. In addition, rebamipide, a mucus secretion inducer in the small intestine, was used to suppress mucus reduction in the small intestine of P80-administered rats. ResultsThe addition of P80 reduced the mucus and exacerbated the ASA-induced small intestinal mucosal injury. Rebamipide significantly suppressed P80-reduced small intestinal mucus and P80-increased intestinal mucosal lesions in ASA-injected rats, demonstrating that mucus is important for the protection against ASA-induced small intestinal mucosal injury. These results provide new insight into the mechanism of ASA-induced small intestinal mucosal injury. ConclusionMucus secretion-increasing therapy might be useful in preventing ASA-induced small intestinal mucosal injury.

Comprehensive risk management for the prevention of cerebro-cardiovascular diseases in Japan

Comprehensive risk management for the prevention of cerebro-cardiovascular diseases in Japan

Comprehensive risk management for the prevention of cerebro-cardiovascular diseases in Japan.

Comprehensive risk management for the prevention of cerebro-cardiovascular diseases in Japan.

Mechanism of Development of Atherosclerosis and Cardiovascular Disease in Diabetes Mellitus.

Diabetic macroangiopathy, atherosclerosis secondary to diabetes mellitus (DM), causes cerebro-cardiovascular diseases, which are major causes of death in patients with DM and significantly reduce their quality of life. The alterations in vascular homeostasis due to endothelial and vascular smooth muscle cell dysfunction are the main features of diabetic macroangiopathy. Although multiple metabolic abnormalities that characterize diabetes are involved in the progression of atherosclerosis in patients with DM, it may be said that prolonged exposure to hyperglycemia and insulin resistance clustering with other risk factors such as obesity, arterial hypertension, and dyslipidemia play crucial roles. Laboratory and clinical researches in the past decades have revealed that major biochemical pathways involved in the development of diabetic macroangiopathy are as follows: overproduction of reactive oxygen species, increased formation of advanced glycation end-products (AGEs) and activation of the AGEs-receptor for AGE axis, polyol and hexosamine flux, protein kinase C activation, and chronic vascular inflammation. Among them, oxidative stress is considered to be a key factor.

The effect of long working hours on cerebrovascular and cardiovascular disease; A case-crossover study.

This study investigated the relationship between weekly working hours and the occurrence of cerebro-cardiovascular diseases using a case-crossover study design. We investigated average working hours during the 7 days before the onset of illness (hazard period) and average weekly working hours between 8 days and 3 months before the onset of cerebro-cardiovascular diseases (control period) for 1,042 cases from the workers' compensation database for 2009. Among all subjects, the odds ratio by conditional logistic regression for the risk of cerebro-cardiovascular diseases with a 10 hr increase in average weekly working hours was 1.45 (95% confidence interval [CI]: 1.22-1.72), a significant association. An increase in average weekly working hours may trigger the onset of cerebro-cardiovascular disease. Am. J. Ind. Med. 60:753-761, 2017. © 2017. Wiley Periodicals, Inc.

COMORBIDITY, COGNITIVE, FUNCTIONAL, AND FRAILTY STATUS: SIMILARITIES OF THEIR LEVELS AND OVERLAPS

Globally, centenarians living in a nursing home were in a worst health status: 4 fold higher risk of dementia (OR=3.8), 3 to 5 fold worse functional mobility (walk, get out of bed or chair) and 2 fold more weakness assessed by grip strength. Sweden and Denmark had the significantly highest mean MMSE (24 ± 3.7; 23.8 ± 5.1); France and Switzerland the lowest (18.7 ± 6.2; 18.9 ± 8.0) (p<0.001). In all the 5 countries, cerebro-cardiovascular diseases were the most prevalent comorbidities and they were equally prevalent independently from the living place: hypertension (from 28% in France to 55% in Japan), stroke (from 10% in France and Denmark to 19% in Sweden), and myocardial infarction (from 9% in Denmark to 56% in France). Multivariate analysis of the associations between comorbidity, cognitive, functional and frailty status will be presented regarding similarities or differences among countries while taking into account survey participation.

Economic analysis of costs with enteral and parenteral nutritional therapy according to disease and outcome.

ABSTRACTObjective To conduct an economic analysis of enteral and parenteral diet costs according to the type of disease and outcome (survivors versus deaths).Methods It is a cross-sectional, observational, retrospective study with a qualitative and quantitative design, based on analysis of hospital accounts from a healthcare insurance provider in the Southern region of Brazil.Results We analyzed 301 hospital accounts of individuals who used enteral and parenteral diets. The total cost of the diet was 35.4% of hospital account total costs. The enteral modality accounted for 59.8% of total dietary costs. The major costs with diets were observed in hospitalizations related to infections, cancers and cerebro-cardiovascular diseases. The major costs with parenteral diet were with admissions related by cancers (64.52%) and dementia syndromes (46.17%). The highest ratio between total diet costs with the total of hospital account costs was in dementia syndromes (46.32%) and in cancers (41.2%). The individuals who died spent 51.26% of total of hospital account costs, being 32.81% in diet (47.45% of total diet value and 58.81% in parenteral modality).Conclusion Enteral and parenteral nutritional therapies account for a significant part of the costs with hospitalized individuals, especially in cases of cancers and dementia syndromes. The costs of parenteral diets were higher in the group of patients who died.

Critics of Supreme Court’s test and Industrial Accident Compensation Insurance Act (IACIA) for Overwork or Stress-related Karoshi or cerebrocardiovascular diseases (CCVD) Based on Clinical Studies

최근 한국에서 과다한 업무량과 직무스트레스와 관련하여 과로사나 심뇌혈관으로 고통받고 있는 숫자가 급격히 증가하였고 이에 따라 산업재해로 신청하는 경우도 급속히 늘고 있다. 하지만 현재까지 과로나 스트레스와 관련된 심뇌혈관질환을 업무상 재해로 인정하는 법률과 판례가 과학적으로 합당한것인 지에 대하여 현재까지 연구된 바 없다. 따라서 이 논문에서는 과로 및 스트레스와 심뇌혈관질환과 관련된 임상연구들을 문헌고찰하여 현재의 업무상 재해의 인정기준이 과학적으로 합리적이고 타당한 지에 대하여 비교분석하였다. 결과적으로 여러 임상연구들에서 표준근로시간보다 과도한 근로시간은 심뇌혈관질환의 유병률을 그 정도에 비례하여 증가시킨다고 보고하였다. 특히 현재 고용노동부 고시에서 정하고 있는 주 평균 60시간 이하의 근로시간에서도 유의하게 심뇌혈관질환의 유병률이 증가함을 알 수 있었다. 또한 업무와 관련된 급성, 아급성 및 만성 스트레스도 심뇌혈관질환의 증가와 관련이 있었다고 보고하였다. 하지만 발병 일주일 전 일상 업무의 증가가 뇌심혈관질환의 유병률의 증가와 관련이 있는지 여부를 검증한 논문은 확인할 수 없었다. 현재까지의 여러 연구결과를 종합한다면 현재 업무상 재해 인정과 관련하여 산업재해보상보험법 시행령 및 고용노동부 고시에서 제시하고 있는 기준은 과학적 근거가 부족하며 따라서 현재의 연구결과와 합당하게 개정이 필요하다고 생각한다. 결론적으로 여러 임상연구 결과들을 바탕으로 현재의 과다한 업무량이나 직무상 스트레스와 관련된 업무상 재해 여부를 결정하는 법령의 기준에 대한 재검토가 필요할 것으로 생각한다.

Influences of statin treatment on MR vessel wall imaging-observed characteristics of atherosclerotic plaque in the thoracic aorta in the elderly

Objective To evaluate the influences of statin treatment on MR vessel wall imaging-observed characteristics of atherosclerotic plaque in the thoracic aorta of the elderly. Methods Elderly subjects(≥60 years)without any serious cerebro-cardiovascular diseases were recruited.Thoracic aorta was imaged on MR scanner for all the subjects.The plaque burden was calculated quantitatively, the composition of plaque in thoracic aorta was evaluated qualitatively, and the contributions of statin treatment to these characteristics were also compared by image interpretation personals.The thoracic aorta was divided into three segments(AAO: ascending aorta; AOA: aortic arch, and DOA: descending aorta)on the imaging. Results Totally 55 recruited subjects had atherosclerotic plaque in thoracic aorta, with 24 subjects receiving statin treatment, and 50 %(12/24)male, aged 73.8±6.3 years.The level of LDL-C〔(2.4±0.7)mmol/L vs.(3.1±0.8)mmol/L(P 0.05). Conclusions Statin treatment decreases LDL-C level, reduces the burden of atherosclerotic plaque in thoracic aorta, and maintains the atherosclerotic plaque stability. Key words: Kininogens; Aorta, thoracic; Atherosclerosis; Magnetic resonance imaging

A Useful Tool As a Medical Checkup in a General Population-Bioelectrical Impedance Analysis.

Accumulation of visceral fat leads to metabolic syndrome and increases risks of cerebro-cardiovascular diseases, which should be recognized and improved at the early stage in general population. Accurate measurement of visceral fat area (VFA) is commonly performed by the abdominal cross-sectional image measured by computed tomography scan, which is, however, limited due to the radiation exposure. The bioelectrical impedance analysis (OMRON, HDS-2000 DUALSCANR) has been recently developed to measure VFA, which is more easily accessible modality. In the present study, we investigated the clinical usefulness of DUALSCANR in 226 subjects who received health examination, including blood chemistries, electrocardiography, cardio, and carotid ultrasonography. VFA was measured within only just 5 min. Average of VFA was 83.5 ± 36.3 cm2 in men, and 64.8 ± 28.0 cm2 in women, which was correlated to weight (r = 0.7404, p < 0.0001), body mass index (BMI) (r = 0.7320, p < 0.0001), and waist circumstance (r = 0.7393, p < 0.0001). In multivariate analyses, VFA was significantly associated with weight (p < 0.0001), BMI (p < 0.0001), and waist circumstance (p < 0.0001). Compared to the group of smaller waist and normal BMI, VFA was significantly increased (p < 0.0001) in the group of larger waist and obese subjects. In conclusion, these results indicated that DUALSCANR is useful to measure VFA easily in general population, even in a large number of subjects.

Hepatitis C – Human Immunodeficiency Virus Coinfection and the Risk of Cerebro-Cardiovascular Diseases: Is There Enough Evidence to Draw Conclusion and Establish Guideline?

Hepatitis C – Human Immunodeficiency Virus Coinfection and the Risk of Cerebro-Cardiovascular Diseases: Is There Enough Evidence to Draw Conclusion and Establish Guideline?

Comprehensive risk management for the prevention of cerebro-cardiovascular diseases in Japan

Comprehensive risk management for the prevention of cerebro-cardiovascular diseases in Japan

PS 09-08 HABITUAL COFFEE INTAKE REDUCES HEART RATE AND DECREASES ALL-CAUSE MORTALITY — THE TANUSHIMARU PROSPECTIVE STUDY —

Objective: Recently, the favorable effects of coffee consumption on atherosclerotic diseases have been discussed. We have reported that coffee consumption was inversely associated with metabolic syndrome, and higher heart rate was strongly associated with all-cause mortality. We hypothesized that higher coffee consumption may reduce resting heart rate and may decrease all-cause death. Design and Method: A total of 1,920 residents aged over 40 years (794 males and 1,126 females) recruited from a population-based survey. We measured components of metabolic syndrome (blood pressure, waist circumference, fasting plasma glucose, and lipid profiles) and eating and drinking patterns were evaluated by a food frequency questionnaire. Resting heart rate was measured using a 12-lead electrocardiogram. Results: Of 1,920 subjects, information on dietary habits was obtained from 1,902 subjects (785 men and 1,117 women). Significant relationships were found between heart rate and coffee consumption (p = 0.004 for trend). Furthermore, we followed these subjects for 15 years. During the periods, 343 of the participants died (102 subjects died of cancer, 48 of cerebro-cardiovascular diseases, and 44 of infectious diseases). Multivariate analyses after adjustments for confounding factors revealed that higher coffee consumption is inversely associated with all-cause death (p < 0.05). Conclusions: Our prospective study indicates that coffee consumption was associated with lower mortality possibly due to a reduction in resting heart rate in a population of community-dwelling Japanese.

Cardiovascular risk calculators: understanding differences and realising economic implications.

In recent years, the concept of "global cardiovascular risk assessment" has grown in interest for its role in primary prevention of cerebro-cardiovascular diseases. Interventions for reducing the risk of relapse for persons with past history of these diseases are well agreed-on. On the contrary, the risk status of persons without such a history varies greatly, and this variability implies a range in the intensity of interventions. In several countries, guidelines for general practitioners have been diffused about pharmaceutical prescriptions in presence of various risk degrees. In particular, in Italy, a governmental drug management commission has established that statins, the most used cholesterol lowering medicines, can be refunded by the National Healthcare System only if prescribed to hyper-cholesterol patients with a global risk greater than 20%. The question is: how to calculate the risk? We performed a review of both the web and the literature and we found a lot of different "risk calculators". By means of a simulation study, we showed that these tools, when applied to the same person, may lead to very different results. We estimated the economic impact of using one or another calculator.

Biohumoral and comorbidity determinants of low HDL-C during acute phase response in a setting of in-hospital patients

Aim: To evaluate, in a large population, differences in HDL levels between subjects with acute phase reaction (APR) and subjects without different HDL decreases depending on disease causing APR and correlations between HDL and APR parameters. Materials & methods: In 902 patients we retrospectively evaluated alpha-2-globulins, white blood cells, C-reactive protein (CRP) and lipid profiles. APR was defined by CRP >1.5 mg/dl. Patients were reselected in seven subsets: infections, rheumatic diseases, neoplasms, cerebro-cardiovascular diseases, traumatic/mental disorders, endocrine/metabolic diseases and controls. Results: Subjects with APR showed significantly lower HDL-C (age and gender adjusted). Subset ‘infections’ showed the lowest HDL-C values and the highest CRP values. HDL-C had inverse significant correlation with all APR parameters. At stepwise regression analysis gender, albumin, TG and CRP were independent predictors of HDL-C. Conclusion: Our data produced the observation that subjects with APR sho...

Occupational Diseases Among Office Workers and Prevention Strategies

Objective:In this review we discuss the health effects among office workers. Background: Even if office workers are not exposed hazardous or harmful environment frequently, some problems could be happened to the office workers. Although serious occupational diseases rarely occur to the office workers, it is important to consider occupational risk factors for the office worker because the portion of the office workers is relatively high in all industries. Method: We divided possible health effects for the office workers into three categories; musculoskeletal disorders, indoor environment, and cerebro-cardiovascular diseases. We reviewed related articles, textbooks, and statistical materials non-systematically and described risk factors, related illnesses, and prevention strategies on each category. Results: Office workers have various musculoskeletal disorders to be intervened. By medical treatment, improving working environment, and ergonomic intervention, office workers can be prevented from musculoskeletal injuries. Poor indoor environment can cause many building-related illnesses or sick building syndrome. Although the etiology of some problems by poor indoor environment is not clear, it helps to maintain adequate humidity, temperature, and clarity of indoor air. Cerebrocardiovascular diseases are a rising issue because office workers in Korea tend to work for a lot of time. To prevent the diseases, it is needed to work for adequate time, lengthen activity level, and manage other medical risk factors for the diseases. Conclusion: There is no distinct occupational disease for office workers. However, there are some aspects to consider the health effects of office workers and it is important to prevent the possible health problems. Application: A strategy against occupational diseases among office workers can be established by reviewing this article.

남녀 근로자의 직업 관련 특성과 대사증후군 - 국민건강영양조사 자료를 이용하여 -

Purpose: This study is performed to help manage the metabolic syndrome in work place by identifying the effect on metabolic syndrome with subjects of Korean adult workers. Methods: Using part of data of "The Fourth Korean National Health and Nutrition Examination survey 2nd year (2008)" which center for disease control is investigating. The general characteristics include age, educational level, occupation and marital status as factors affecting the metabolic syndrome of workers in this study. Results: Work-related factors are the working environment in which they are working while they are pressed for time due to work status and overload. If the work status of worker is unpaid family member, the risk is increased by more than twice compared to paid workers. The risk for metabolic syndrome in work environment to work while fighting the clock is decreased compared to the work environment without time pressure. Conclusion: In order to manage the metabolic syndrome of workers, health promotion program to change management of both working condition and working environment can contribute to prevent the metabolic syndrome and ultimately prevent the cerebrocardiovascular diseases.

Elevated Homocysteine Levels Are Associated With the Metabolic Syndrome and Cardiovascular Events in Hypertensive Patients.

Hyperhomocysteinemia and the metabolic syndrome are established cardiovascular risk factors and are frequently associated with hypertension. The relationship of plasma homocysteine (Hcy) with the metabolic syndrome and insulin resistance, however, is debated and studies in hypertensive patients are limited. In this study, we have investigated the association of Hcy with the metabolic syndrome and cerebro- cardiovascular events in hypertension. In 562 essential hypertensive patients who underwent accurate assessment of fasting and postload glucose metabolism, insulin sensitivity, and renal function, we measured plasma levels of Hcy, vitamin B12, folate, and fibrinogen and assessed the prevalence of the metabolic syndrome and of coronary heart and cerebrovascular disease (CVD). Patients with the metabolic syndrome had significantly higher plasma Hcy levels. After correction for covariates, increasing Hcy levels were associated with an increasing prevalence of the metabolic syndrome, coronary heart disease, and CVD. Plasma Hcy was directly correlated with age, waist circumference, fasting glucose, triglyceride, uric acid, and fibrinogen levels, and homeostatic model assessment index and inversely with creatinine clearance and high-density lipoprotein cholesterol, vitamin B12, and folate levels. Logistic regression analysis showed an independent association of Hcy levels with age, male gender, vitamin B12 and folate levels, and the metabolic syndrome. Logistic regression indicated also an independent association of Hcy with cerebro-cardiovascular disease that was independent of the metabolic syndrome. Elevated plasma Hcy is associated with the metabolic syndrome in hypertensive patients. Prevalence of events increases with increasing plasma Hcy levels suggesting a contribution of Hcy to cerebro-cardiovascular diseases in these patients.

Valproic acid increases NO production via the SH-PTP1–CDK5–eNOS-Ser116 signaling cascade in endothelial cells and mice

Valproic acid (VPA) with its inhibitory activity of histone deacetylase has been used in the treatment of epilepsy and bipolar disorder associated with cerebrovascular dysfunction. Because nitric oxide (NO) produced by endothelial NO synthase (eNOS) plays a role in the maintenance of vascular function, NO is likely to mediate VPA׳s drug effect, but its effect on NO production remains controversial. We investigated whether and how VPA regulates NO production in bovine aortic endothelial cells (BAECs) and mice. VPA increased NO production in BAECs, which was accompanied by a decrease in phosphorylation of eNOS at serine 116 (eNOS-Ser116) and cyclin-dependent kinase 5 at tyrosine 15 (CDK5-Tyr15). Ectopic expression of p25, a CDK5 activator, restored the VPA-inhibited eNOS-Ser116 phosphorylation. In silico analysis revealed that the CDK5-Tyr15 residue might be a substrate for SH2 domain-containing protein tyrosine phosphatase 1 (SH-PTP1), and CDK5 actually interacted with SH-PTP1. VPA increased SH-PTP1 expression and its activity. Stibogluconate, a specific SH-PTP1 inhibitor, reversed the VPA-inhibited phosphorylation of CDK5-Tyr15 and eNOS-Ser116. Knockdown of SH-PTP1 using small interfering RNA also reversed all the observed effects of VPA. Finally, both serum NO level and acetylcholine-induced aortic relaxation increased in VPA-medicated male mice. These increases were accompanied by increased SH-PTP1 expression and decreased phosphorylation of CDK5-Tyr15 and eNOS-Ser116 in mouse aortas. In conclusion, VPA increases NO production by inhibiting the CDK5-Tyr15–eNOS-Ser116 phosphorylation axis; this process is mediated by SH-PTP1. VPA may be useful in the treatment of NO-related cerebrocardiovascular diseases.

Circulating Inflammatory and Hemostatic Biomarkers are Associated with All-Cause Death and Cancer Death in a Population of Community-Dwelling Japanese: the Tanushimaru Study.

BACKGROUNDIn patients with cardiovascular diseases, inflammatory and hemostatic biomarkers are significant indicators of prognosis. We investigated whether circulating inflammatory and hemostatic biomarkers were predictive markers for all-cause death and cancer death in a population of community-dwelling Japanese.METHODSWe studied 1,920 healthy Japanese adults who underwent health examinations in 1999. Those who reported a history of inflammatory diseases and malignancy on a baseline questionnaire were excluded. Inflammatory and hemostatic biomarkers were measured in the remaining 1,862 participants, who were followed up periodically for 10 years. Multivariate proportional hazards regression analysis was used to estimate all-cause and cancer mortality.RESULTSA total of 258 participants died during follow-up: 87 from cancer, 38 from cerebro-cardiovascular diseases, and 133 from other diseases. Mean C-reactive protein (CRP) levels at baseline were significantly higher in decedents than in survivors. Mean von Willebrand factor (vWF) levels at baseline were significantly higher in decedents than in survivors. The Cox proportional hazards model after adjustments for age and sex showed that CRP (hazard ratio [HR], 1.26; 95% confidence interval [CI], 1.06–1.51) and vWF (HR, 1.01; 95% CI, 1.00–1.01) were independent predictors of all-cause death. CRP (HR, 1.40; 95% CI, 1.06–1.86) and vWF (HR, 1.01; 95% CI, 1.00–1.02) were also independent predictive markers for cancer death.CONCLUSIONSSerum CRP and vWF were predictors of all-cause death and cancer death in the population of community dwelling Japanese.