Development Of Other Cardiovascular Diseases Research Articles

Association between Anemia Severity and Ischemic Stroke Incidence: A Retrospective Cohort Study

Stroke patients presenting with anemia at the time of stroke onset had a higher risk of mortality and development of other cardiovascular diseases and comorbidities. The association between the severity of anemia and the risk of developing a stroke is still uncertain. This retrospective study aimed to evaluate the association between stroke incidence and anemia severity (by WHO criteria). A total of 71,787 patients were included, of whom 16,708 (23.27%) were identified as anemic and 55,079 patients were anemia-free. Female patients (62.98%) were more likely to have anemia than males (37.02%). The likelihood of having a stroke within eight years after anemia diagnosis was calculated using Cox proportional hazard regression. Patients with moderate anemia had a significant increase in stroke risk compared to the non-anemia group in univariate analyses (hazard ratios [HR] = 2.31, 95% confidence interval [CI], 1.97-2.71, p < 0.001) and in adjusted HRs (adj-HR = 1.20, 95% CI, 1.02-1.43, p = 0.032). The data reveal that patients with severe anemia received more anemia treatment, such as blood transfusion and nutritional supplementation, and maintaining blood homeostasis may be important to preventing stroke. Anemia is an important risk factor, but other risk factors, including diabetes and hyperlipidemia, also affect stroke development. There is a heightened awareness of anemia's severity and the increasing risk of stroke development.

Etiological Diagnosis and Personalized Therapy for Hypertension: A Hypothesis of the REASOH Classification.

With the epidemic of risk factors such as unhealthy lifestyle, obesity and mental stress, the prevalence of hypertension continues to rise across the world. Although standardized treatment protocols simplify the selection of antihypertensive drugs and ensure therapeutic efficacy, the pathophysiological state of some patients remains, which may also lead to the development of other cardiovascular diseases. Thus, there is an urgent need to consider the pathogenesis and selection of antihypertensive drug for different type of hypertensive patients in the era of precision medicine. We proposed the REASOH classification, based on the etiology of hypertension, including renin-dependent hypertension, elderly-arteriosclerosis-based hypertension, sympathetic-active hypertension, secondary hypertension, salt-sensitive hypertension and hyperhomocysteinemia hypertension. The aim of this paper is to propose a hypothesis and provide a brief reference for the personalized treatment of hypertensive patients.

INTERDEPENDENCE BETWEEN LEFT VENTRICULAR DIASTOLIC DYSFUNCTION AND ARTERIAL ELASTICITY ALTERATION

Objective: In HT, both arterial elasticity of the central arteries (C1) and of the distal circulation (C2) has been reported to be reduced and this condition favours the development of other cardiovascular diseases. Diastolic dysfunction (DD) identifies hypertensives with high cardiovascular risk independent of LV mass and BP level. Several studies have shown that the extent of diastolic function's impairment could be interdependent on the level of arterial elasticities’ alteration. PURPOSE: To evaluate the correlation between the elasticity of large and small arteries and DD Design and method: Arterial elasticity indices (C1, C2) were derived from pulse wave analysis based on a modified Windkessel model in 101 hypertensive subjects, (mean age 51.08 ± 0.79 yrs; 48.51% of men, SBP/DBP: 202.49 ± 7.41/106.7 ± 5.54 mmHg, BMI- 29.38 ± 0.22 kg/m2), without other co-morbidities. Ambulatory blood pressure monitoring (ABPM), transthoracic echocardiography (TE)were performed at baseline and after 6, 12- months period of treatment. DD patterns were appreciated according to ASE/EACVI 2016 guidelines. Altered arterial elasticity was considered for C1 &lt; 10 ml/mm Hg × 10, C2 &lt; 6 ml/mm Hg × 1. Correlation analysis was performed using Pearson's test. The correlation coefficient was considered weak at &lt; 0.3, medium-0.3–0.7 and strong &gt; 0.7–1.0. Statistical significance was appreciated at a P-value &lt; 0.05 and highly significant at a P-value &lt; 0.001 Results: Diastolic dysfunction and C1 and C2 indices demonstrated a statistically significant correlation (p &lt; 0.001). More advanced patterns of diastolic dysfunction were associated with higher C1 and C2 abnormalities (Tab. 1,). Conclusions: Diastolic dysfunction is associated with arterial elasticity's alteration, and this association appears to have a particularly strong relationship with the extent of diastolic function's impairment. The more advanced patterns of diastolic dysfunction occurred, the stronger is the interdependence with arterial elasticity abnormalities.

Advances in Cardiovascular Biomarker Discovery.

Cardiovascular diseases are the leading causes of mortality worldwide. Among them, hypertension and its pathological complications pose a major risk for the development of other cardiovascular diseases, including heart failure and stroke. Identifying novel and early stage biomarkers of hypertension and other cardiovascular diseases is of paramount importance in predicting and preventing the major morbidity and mortality associated with these diseases. Biomarkers of such diseases or predisposition to their development are identified by changes in a specific indicator’s expression between healthy individuals and patients. These include changes in protein and microRNA (miRNA) levels. Protein profiling using mass spectrometry and miRNA screening utilizing microarray and sequencing have facilitated the discovery of proteins and miRNA as biomarker candidates. In this review, we summarized some of the different, promising early stage protein and miRNA biomarker candidates as well as the currently used biomarkers for hypertension and other cardiovascular diseases. Although a number of promising markers have been identified, it is unlikely that a single biomarker will unambiguously aid in the classification of these diseases. A multi-marker panel-strategy appears useful and promising for classifying and refining risk stratification among patients with cardiovascular disease.

Epigenetic role of N6-methyladenosine (m6A) RNA methylation in the cardiovascular system.

As the most prevalent and abundant transcriptional modification in the eukaryotic genome, the continuous and dynamic regulation of N6-methyladenosine (m6A) has been shown to play a vital role in physiological and pathological processes of cardiovascular diseases (CVDs), such as ischemic heart failure (HF), myocardial hypertrophy, myocardial infarction (MI), and cardiomyogenesis. Regulation is achieved by modulating the expression of m6A enzymes and their downstream cardiac genes. In addition, this process has a major impact on different aspects of internal biological metabolism and several other external environmental effects associated with the development of CVDs. However, the exact molecular mechanism of m6A epigenetic regulation has not been fully elucidated. In this review, we outline recent advances and discuss potential therapeutic strategies for managing m6A in relation to several common CVD-related metabolic disorders and external environmental factors. Note that an appropriate understanding of the biological function of m6A in the cardiovascular system will pave the way towards exploring the mechanisms responsible for the development of other CVDs and their associated symptoms. Finally, it can provide new insights for the development of novel therapeutic agents for use in clinical practice.

Use of Antihypertensive Drugs During Preeclampsia.

Treatment of pregnancy-related hypertensive disorders, such as preeclampsia (PE), remain a challenging problem in obstetrics. Typically, aggressive antihypertensive drug treatment options are avoided to prevent pharmacological-induced hypotension. Another major concern of administering antihypertensive drugs during pregnancy is possible adverse fetal outcome. In addition, management of hypertension during pregnancy in chronic hypertensive patients or in patients with prior kidney problems are carefully considered. Recent studies suggest that PE patients are at increased cardiovascular risk postpartum. Therefore, these patients need to be monitored postpartum for the subsequent development of other cardiovascular diseases. In this review article, we review the antihypertensive drugs currently being used to treat patients with PE and the advantages or disadvantages of using these drugs during pregnancy.

Novel Inflammatory Indices in Aortic Disease.

Inflammation plays a critical role in the atherosclerotic process in various vascular beds, starting from endothelial dysfunction and counting all stages of plaque development. The significant contribution of inflammation in the initiation and progression of atherosclerosis has been documented over many years but its contribution to the development of other cardiovascular disease remains unclear. Inflammatory process constitutes a basic part of pathogenic cascade of aortic diseases including those of aortic valve stenosis and aortic aneurysms. Thus, both of these entities are related with high rates of morbidity and mortality. Therefore, the need to detect and investigate indices representative of inflammation that will be easily measured and may reflect the process of these diseases, is mandatory. However, such biomarkers for aortic diseases that could have a significant prognostic value on survival via the early identification of high risk patients, in general, remain few. Therefore, the illumination of role of such biomarkers, will facilitate the understanding of the mechanisms in molecular and/or cellular level that are responsible for the creation of aortic disease. Such an approach may provide a pathophysiological basis for early diagnosis.

REDUÇÃO DAS CONCENTRAÇÕES DE CLORETO DE SÓDIO NA ALIMENTAÇÃO VISANDO A HOMEOSTASE DA PRESSÃO ARTERIAL

Arterial hypertension (AH) is a multifactorial clinical condition characterized by high levels of blood pressure. Excessive intake of sodium, mineral often present in food, has been correlated with the HA. This review aims to describe the relationship between excessive consumption of sodium and the development and/or aggravation of hypertension and how their reduction in the diet can control blood pressure levels. The survey was conducted from a literature review of the literature, consulted with scientific articles published by 2013 and further consultation with academic books to complement the information. Studies based on dietary surveys show that the Brazilian population has a high sodium intake which stems primarily of salt and condiments with this ingredient, but also indicate that there is a linear increase of total heavy and sodium coming from processed foods, been described in several studies that excessive sodium intake increases blood pressure enhancing the development of other cardiovascular diseases.

Proanthocyanidin-enriched extract of Rumex acetosa L. inhibits the in vitro adhesion of Porphyromonas gingivalis to KB cells and decreases the biofilm formation

Porphyromonas gingivalis is a gram-negative periodontal pathogen, which plays a significant role in the progression of chronic periodontitis and may even be involved in the development of other cardiovascular diseases. The first critical step for the initiation of periodontitis is the specific adhesion of bacteria to tissue cells. By forming complex biofilms, anaerobic bacteria as P. gingivalis evade the hosts immune defense. In contrast to conventional antibacterial therapy approaches, an acetone-water extract of Rumex acetosa L. (RA1) [1] was tested for in vitro antiadhesive activity on KB cells by flow cytometrie in order to initiate a development against the first step of the infection.

Usefulness of the Blood Hematocrit Level to Predict Development of Heart Failure in a Community

Current data suggest that increases in hemoglobin may decrease nitric oxide and adversely affect vascular function. In the preclinical setting, these changes could precipitate the development of heart failure (HF). We hypothesized that higher hematocrit (HCT) would be associated with an increased incidence of new-onset HF in the community. We evaluated 3,523 participants (59% women) from the Framingham Heart Study who were 50 to 65 years old and free of HF. Participants were followed prospectively until an HF event, death, or the end of 20 years of follow up. HCT was subdivided into 4 gender-specific categories (women: HCT 36.0 to 40.0, 40.1 to 42.0, 42.1 to 45.0, >45.0; men: 39.0 to 44.0, 44.1 to 45.0, 45.1 to 49.0, >49.0). Gender-pooled multivariable Cox proportional hazards models were used to estimate the association of HCT with incident HF, adjusting for clinical risk factors. During the follow-up period (61,417 person-years), 217 participants developed HF (100 events in women). There was a linear increase in risk of HF across the 4 HCT categories (p for trend = 0.002). Hazards ratios for HF in the low-normal, normal, and high HCT categories were 1.27 (95% confidence interval 0.82 to 1.97), 1.47 (1.01 to 2.15), and 1.78 (1.15 to 2.75), respectively, compared to the lowest HCT category (p for trend <0.0001). Adjustment for interim development of other cardiovascular diseases and restriction of the sample to nonsmokers did not alter the results. In conclusion, higher levels of HCT, even within the normal range, were associated with an increased risk of developing HF in this long-term follow-up study.

A Hypertension Gene: Are We There Yet?

Cardiovascular diseases are the leading cause of death worldwide. Essential hypertension is a major risk factor for the development of other cardiovascular diseases and is caused by a combination of environmental and genetic factors, with up to 50% of blood pressure variance currently attributed to an individual's genetic makeup. By studying genes that cause monogenic forms of hypertension and pathways relevant to blood pressure control, a number of polymorphisms have been identified that increase an individual's risk of developing high blood pressure. We report on candidate gene association studies and genome-wide association studies that have been performed to date in the field of hypertension research. It is becoming clear that for the majority of people there is no single gene polymorphism that causes hypertension, but rather a number of common genetic variants, each having a small effect. Using pharmacogenomics to personalize the treatment of hypertension holds promise for achieving and sustaining normotensive pressures quickly, while minimizing the risk of adverse reactions and unwanted side-effects. This will decrease the risk of stroke and myocardial infarction in individuals and lead to a reduced burden of disease upon society as a whole.

Crianças e adolescentes com história familiar de hipertensão arterial: indicadores de risco cardiovasculares

Objetivo: Identificar emum grupo de crianças e adolescentes com história familiar de hipertensão arterial a presença de indicadores do risco para hipertensão arterial. Métodos: Estudo desenvolvido com 141 indivíduos de seis a 18 anos em uma comunidade de Fortaleza com coleta de dados realizada no domicílio. Resultados: Os indicadores de risco mais presentes foram a ingesta de sal, sedentarismo e ingesta inadequada de legumes. As médias de pressão arterial foram maiores nos indivíduos do sexo masculino. Aqueles que referiram fazer uso de sal na alimentação e não consumir diariamente frutas e legumes apresentaram menores médias. Conclusão: Considera-se a necessidade da identificação precoce de indicadores de risco para hipertensão arterial a fim de prevenir eventos cardiovasculares.

Ostium Secundum Atrial Septal Defect in the Elderly

Atrial septal defect (ASD) is one of the most common congenital cardiac anomalies in adults. Life expectancy is shortened, and almost 90% of patients die by the age of 60 years. The progression of this congenital disease to congestive heart failure has been related to several factors such as the onset of pulmonary hypertension, arrhythmias, bronchopulmonary infections, or the development of other cardiovascular disease. We describe three cases of very old patients with significant ASDs and late development of symptoms. Given the higher risks and poorer long-term results of surgical closure of the defect in advanced age, the indications for such an intervention in elderly patients should be carefully evaluated.

The hypertensive diseases. Evidence that systemic hypertension is a greater risk factor to the development of other cardiovascular diseases than previously suspected: Roberts WC: Am J Med 59: 523–532, 1975

The hypertensive diseases. Evidence that systemic hypertension is a greater risk factor to the development of other cardiovascular diseases than previously suspected: Roberts WC: Am J Med 59: 523–532, 1975

The hypertensive diseases: Evidence that systemic hypertension is a greater risk factor to the development of other cardiovascular diseases than previously suspected

This report summarizes the clinical frequencies of systemic hypertension and necropsy evidence of cardiomegaly in various cardiovascular conditions (Table I), termed “the hypertensive diseases” because of their frequent association with systemic hypertension. Although long recognized as a major risk factor, systemic hypertension appears to be an even greater risk factor to the development of various cardiovascular conditions than previously appreciated. Hypertension by itself appears to be the sole underlying factor in most cases of nontraumatic cerebral arterial or aortic (dissection = partial rupture) rupture. In association with hyperlipidemia, hypertension clearly accelerates atherosclerosis and its devastating consequences.