Impact Of Cardiovascular Disease Research Articles

The role of Lesotho community pharmacists in preventing and controlling cardiovascular diseases: The perceived facilitators and barriers.

Cardiovascular diseases are a leading cause of mortality globally. The impact of cardiovascular diseases can be minimized by addressing modifiable risk factors at primary health care level. Community pharmacists are well-positioned to identify patients at risk of cardiovascular diseases for early detection and initiation of treatment. However, the role of Lesotho community pharmacists in preventing and controlling cardiovascular diseases is not well understood. The purpose of this study was to explore the Lesotho community pharmacists' role in preventing and controlling cardiovascular diseases. The methodological reporting of this study was guided by the consolidated criteria for reporting qualitative studies. A list of registered community pharmacists was obtained from the Ministry of Health. Pharmacists were selected based on their close proximity to the researcher and invited to participate. Semi-structured interviews were conducted until data saturation was reached. The interviews were audio-recorded, transcribed verbatim, and analysed thematically. Five themes were identified namely: 1) Current roles 2) Future role 3) Facilitators, 4) Barriers, and 5) Community pharmacists' perceptions of their roles. Generally, community pharmacists were involved in medication counselling, health promotion, and referral of patients. Lack of support from government, patients' lack of adherence, poor interprofessional relationship, and lack of clear community pharmacy practice guidelines were identified as barriers. Despite the challenges, community pharmacists are motivated by patients' gratitude for their services. Lesotho community pharmacists can potentially improve cardiovascular diseases' health outcomes at primary healthcare level through early detection of CVD risk factors, and health promotion.

Bridging Metabolic-Associated Steatotic Liver Disease and Cardiovascular Risk: A Potential Role for Ketogenesis.

The prevalence of cardiovascular diseases (CVDs) is a growing global health concern. Recent advances have demonstrated significant reductions in acute cardiovascular events through the management of modifiable cardiovascular risk factors. However, these factors are responsible for about 50% of the global cardiovascular disease burden. Considering that CVDs are one of the top mortality causes worldwide, the concept of residual cardiovascular risk is an important emerging area of study. Different factors have been proposed as sources of residual risk markers, including non-HDL particles characterization, as well as inflammation measured by serum and imaging technics. Among these, metabolic-associated steatotic liver disease (MASLD) remains controversial. Two opposing viewpoints contend: one positing that fatty liver disease merely reflects classical risk factors and thus adds no additional risk and another asserting that fatty liver disease independently impacts cardiovascular disease incidence. To address this dilemma, one hypothetical approach is to identify specific hepatic energy-yielding mechanisms and assess their impact on the cardiovascular system. Ketogenesis, a metabolic intermediate process particularly linked to energy homeostasis during fasting, might help to link these concepts. Ketogenic metabolism has been shown to vary through MASLD progression. Additionally, newer evidence supports the significance of circulating ketone bodies in cardiovascular risk prediction. Furthermore, ketogenic metabolism modification seems to have a therapeutic impact on cardiovascular and endothelial damage. Describing the relationship, if any, between steatotic liver disease and cardiovascular disease development through ketogenesis impairment might help to clarify MASLD's role in cardiovascular risk. Furthermore, this evidence might help to solve the controversy surrounding liver steatosis impact in CVD and might lead to a more accurate risk assessment and therapeutic targets in the pursuit of precision medicine.

Assessing the effect of cardiovascular disease on work productivity and financial loss among school teachers in Peninsular Malaysia: a nested case-control study.

School teachers may have an increased risk of cardiovascular disease (CVD), potentially affecting their work productivity. However, limited data exists on the impact of CVD on teachers' productivity in Malaysia. Our objectives were to assess work productivity loss (absenteeism and presenteeism) as well as to determine the associated annual monetary loss among school teachers who experienced incident CVD in Peninsular Malaysia. We adopted a nested case-control design within a cohort of school teachers. Working teachers from six states of Peninsular Malaysia, and had experienced incident CVD before a right-censored date (31st December 2021) were defined as cases. Incident CVD was operationally defined as the development of non-fatal acute coronary syndrome (ACS), stroke, congestive cardiac failure, deep vein thrombosis or peripheral arterial disease before the censored date. Controls were working teachers who did not acquire an incident CVD before the similar right-censored date. All controls were randomly selected, with a ratio of one case to four controls, from among the working teachers in one of the states in Peninsular Malaysia. We used a shortened version of the Malay-validated World Health Organization-Health and Work Performance Questionnaire (WHO-HPQ) to estimate the workplace productivity effect among teachers with incident CVD (cases). The same questionnaire was distributed to teachers in a single state of Peninsular Malaysia who did not experience incident CVD (controls). Absenteeism, presenteeism and annual monetary loss were computed based on the scoring rules in the WHO-HPQ. Analysis of covariance was performed with covariate adjustment using propensity scores. The bootstrapping method was applied to obtain better estimates of marginal mean differences, along with standard errors (SE) and appropriate effect sizes. We recruited 48 cases (baseline mean age = 42.4 years old, 54.2% females) and 192 randomly selected controls (baseline mean age = 36.2 years old, 99.0% females). The majority of the cases had ACS (73.9%). No significant difference was observed in absenteeism between cases and controls. The mean self-rated job performance score was lower for cases (7.63, SE = 0.21) compared to controls (8.60, SE = 0.10). Marginal mean scores of absolute presenteeism among cases (76.30) were lower (p<0.05, eta squared = 0.075) than controls (85.97). The marginal mean annual cost of presenteeism was higher in cases (MYR 21,237.52) compared to controls (MYR 12,089.74) (p<0.05, eta squared = 0.082). Absolute presenteeism was lower among school teachers who experienced incident CVD and the annual cost of presenteeism was substantial. Implementing supportive work strategies in school settings is recommended to increase absolute presenteeism, which can lead to a reduction in the annual cost of presenteeism among teachers experiencing incident CVD.

RETHINKING UKRAINIAN MEDICAL TRAINING: STRATEGIES FOR MEDICAL EDUCATION AND SYSTEM IMPROVEMENT

This article delves into the current state and future prospects of Ukraine's healthcare system. It critically examines the strategic framework laid out in the “Strategy for the Development of the Healthcare System until 2030”. A pivotal aspect of the article is its analysis of the burden of cardiovascular diseases (CVDs) in Ukraine compared to the European Union. It highlights that the prevalence and impact of CVDs in Ukraine. &#x0D; The article underscores the necessity for comprehensive knowledge among medical professionals, especially in the context of the rising burden of cardiovascular diseases. It points out the inadequacies in the current medical education and training system in Ukraine in imparting this comprehensive knowledge. Drawing a comparison with the Chinese medical internship system, the article suggests that adopting a similar approach could significantly benefit Ukraine’s medical education system.&#x0D; In its conclusion, the authors emphasize the need to integrate foreign policies in training young physicians to build a more effective healthcare system.

Impact of cardiovascular disease on health-related quality of life among older adults in eastern China: evidence from a national cross-sectional survey.

This study explores the health-related quality of life (HRQoL) scores of Chinese older adults with Cardiovascular Disease(CVD) using the EQ-5D-3L, the aim of this study is to investigate the association between health and HRQoL in older adults with CVD. The data for this study were obtained from a cross-sectional study involving older adults residing in Chinese communities The EQ-5D-3L is used to measure the HRQoL scores in the older adults with CVD. One-way analyses were conducted using the Wilcoxon rank sum test and the Kruskal-Wallis H test to assess differences between groups. A binary logistic regression model was employed to analyze the influence each variable has on the presence of "any problem" on each dimension of EQ-5D-3L in older adults with CVD. An ordinal least squares (OLS) model is used to assess the relationship between older adults with CVD and HRQoL. The mean EQ-5D-3L score for older adults with CVD is 0.774. 40.0% of older adults with CVD reported problems with pain/discomfort, followed by Mobility (35.9%), Self-care (31.5%), and Anxiety/depression (17.0%). Binary logistic regression models show that financial resources were the main factor influencing the five dimensions of EQ-5D-3L. The OLS model further indicates that younger age, financial resources, and a lower number of chronic conditions among older adults with CVD are associated with higher HRQoL scores. Chinese older adults with CVD have low HRQoL scores. Variousfactors influence both overall HRQoL scores and scores on each EQ-5D-3L dimension. This study is helpful in enhancing society's attention to the HRQoL of older adults with CVD and taking targeted measures to improve them.

Risk Stratification and Treatment of Obesity for Primary and Secondary Prevention of Cardiovascular Disease.

In this review, we discuss contemporary and emerging approaches for risk stratification and management of excess adiposity for the primary and secondary prevention of cardiovascular disease. Obesity is simultaneously a pandemic-scale disease and major risk factor for the incidence and progression of a wide range of cardiometabolic conditions, but risk stratification and treatment remain clinically challenging. However, sex-, race-, and ethnicity-sensitive anthropometric measures, body composition-focused imaging, and health burden-centric staging systems have emerged as important facilitators of holistic risk prediction. Further, expanding therapeutic approaches, including comprehensive lifestyle programs, anti-obesity pharmacotherapies, device/endoscopy-based interventions, metabolic surgery, and novel healthcare delivery resources offer new empowerment for cardiovascular risk reduction in individuals with obesity. Personalized risk stratification and weight management are central to reducing the lifetime prevalence and impact of cardiovascular disease. Further evidence informing long-term safety, efficacy, and cost-effectiveness of novel approaches targeting obesity are critically needed.

HPB P17 Preoperative cardiovascular disease and outcomes ofpancreatoduodenectomy performed for malignancy

Abstract Background Despite improvements to morbidity and mortality rates in recent decades, pancreatoduodenectomy (PD) remains a high-risk operation. Patients with pre-existing cardiovascular disease (CVD) are known to be at increased risk of perioperative morbidity and mortality. Evidence is lacking on the impact of CVD on long-term outcomes. This study aimed to compare the outcomes of PD patients with preoperative CVD to those without. Methods Data was extracted from the Recurrence After Whipple’s (RAW) study, a multicentre retrospective cohort study of outcomes of PD performed for pancreatic head malignancy (29 centres in 8 countries, n=1484). Pre-existing CVD included any of the following: hypertension (HTN), atrial fibrillation (AF), other cardiac arrhythmia, ischaemic heart disease (IHD), previous cardiovascular surgery, heart failure, peripheral vascular disease (PVD), previous stroke, previous transient ischaemic attack (TIA), pulmonary HTN, deep vein thrombosis, valve disease, cardiomyopathy, subarachnoid haemorrhage, peri-/myocarditis and myocardial infarction. Several outcomes were compared: length of stay, 30-day readmission, 90-day mortality, unplanned return to theatre rate, and five-year survival. Results From 1484 cases, 590 patients (39.8%) had pre-existing CVD. HTN, AF, other cardiac arrhythmia, IHD, previous cardiovascular surgery, heart failure and PVD affected 33.0%, 3.6%, 1.0%, 5.3%, 1.9%, 1.3% and 1.5% of patients, respectively. Remaining pathologies surmounted to &amp;lt;1%. 30-day readmission (10.5% vs 8.1%, p=0.1), 90-day mortality (4.4% vs 3.2%, p=0.3), unplanned return to theatre (5.2% vs 4.8%, p=0.7) and five-year survival (31.2% vs 32.1%, p=0.7) were similar between the patient groups, however, median LoS was significantly longer in those with CVD (14 vs 12 days, p&amp;lt;0.0001). Similar results were obtained when hypertension was not classified as a cardiovascular comorbidity. Conclusions In our multicentre study of PD outcomes, patients with a preoperative cardiovascular comorbidity had longer length of stay than those who did not but the other studied outcomes were unaffected.

The pathogenesis of post-stroke osteoporosis and the role oxidative stress plays in its development

Cardiovascular disease and osteoporotic fractures (OF) are the main diseases affecting the health of middle-aged and elderly people. With the gradual increase of population aging in China and even the world, the incidence of the two and the prevalence of high-risk groups are also showing a continuous upward trend. The relationship between the two, especially the impact of cardiovascular disease on the risk and prognosis of OF, has attracted more and more attention. Therefore, it is of great significance to fully understand the pathogenesis of cardiovascular and cerebrovascular diseases and the resulting osteoporosis and to provide targeted interventions to prevent the occurrence of diseases and fractures. This article reviews the relationship between one of the Cardiovascular disease—stroke and related therapeutic drugs and the risk of OF, and the role of oxidative stress in its pathophysiological mechanism by reviewing relevant domestic and foreign literature in recent years, in order to gain a more comprehensive understanding of the association between stroke and OF, and then provide a basis and reference for screening high-risk groups of fractures and reducing the burden on the health system caused by the disease.

Using RNA-based therapies to target the kidney in cardiovascular disease.

RNA-based therapies are currently used for immunisation against infections and to treat metabolic diseases. They can modulate gene expression in immune cells and hepatocytes, but their use in other cell types has been limited by an inability to selectively target specific tissues. Potential solutions to this targeting problem involve packaging therapeutic RNA molecules into delivery vehicles that are preferentially delivered to cells of interest. In this review, we consider why the kidney is a desirable target for RNA-based therapies in cardiovascular disease and discuss how such therapy could be delivered. Because the kidney plays a central role in maintaining cardiovascular homeostasis, many extant drugs used for preventing cardiovascular disease act predominantly on renal tubular cells. Moreover, kidney disease is a major independent risk factor for cardiovascular disease and a global health problem. Chronic kidney disease is projected to become the fifth leading cause of death by 2040, with around half of affected individuals dying from cardiovascular disease. The most promising strategies for delivering therapeutic RNA selectively to kidney cells make use of synthetic polymers and engineered extracellular vesicles to deliver an RNA cargo. Future research should focus on establishing the safety of these novel delivery platforms in humans, on developing palatable routes of administration and on prioritising the gene targets that are likely to have the biggest impact in cardiovascular disease.

Impact of Cardiovascular Disease on the Death Certificate Diagnosis of Heart Failure, Ischemic Heart Disease, and Cerebrovascular Disease - The Japan Public Health Center-Based Prospective Study.

There is considerable interest in the trending discrepancy between ischemic heart disease (IHD) and heart failure (HF) in vital statistics. Clinically, acute myocardial infarction (AMI) and stroke are closely associated with HF, but their contribution to HF as the underlying cause of death (UCD) is unclear.Methods and Results: In 1990 and 1992-1993, we enrolled a total of 140,420 residents of Japanese nationality (aged 40-69 years) from 11 public health center areas. We prospectively examined the occurrence of cardiovascular disease (CVD), including AMI, sudden cardiac death within 1 h (SCD), and stroke, and analyzed the 14,375 participants without a history of CVD at baseline who died during the 20-year follow-up. A time-dependent Cox proportional hazards model was used to estimate hazard ratios and the population attributable fraction (PAF) of AMI, AMI+SCD, stroke, and CVD for deaths due to HF, IHD, and cerebrovascular disease as the UCD, adjusted for individuals' lifestyles and comorbid conditions. The PAF of AMI for HF deaths was 2.4% (95% confidence interval [CI] 1.7-2.9%), which increased to 12.0% (95% CI 11.6-12.2%) for AMI+SCD. The PAF of CVD-attributed HF deaths was estimated to be 17.6% (95% CI 15.9-18.9%). HF as the UCD was partly explained by CVD. The data imply that most HF deaths reported in vital statistics may be associated with underlying causes other than CVD.

HEART ATTACK PREDICTION SYSTEM USING MACHINE LEARNING TECHNIQUE

Cardiovascular disease is currently the leading cause of death in high-income countries and is projected to become the top global cause of death by 2030. In the United States, heart disease, including conditions like coronary heart disease, hypertension, and stroke, remains the primary cause of death. According to the American Heart Association's 2019 update, approximately 46% of US adults, equivalent to 116.4 million people, are estimated to have hypertension based on the new 2017 Hypertension Clinical Practice Guidelines. The impact of cardiovascular disease is profound, with a person dying from CVD every 38 seconds, resulting in approximately 2,303 CVD-related deaths per day based on 2016 data. Stroke, as a critical cardiovascular event, accounts for about 389.4 deaths daily, with a stroke-related death occurring every 3.70 minutes, according to the same data. The heart's essential function of pumping blood throughout the body makes any malfunction potentially fatal, leading to organ failure, including the brain, within minutes. Contributing factors to the rising incidence of heart-related diseases include unhealthy lifestyle choices, work-related stress, and poor dietary habits, posing a significant global health concern. According to the World Health Organization, heart-related diseases cause approximately 17.7 million deaths annually, representing 31% of all global deaths. This worrisome trend is also apparent in India, where heart-related diseases have become the leading cause of mortality. To combat the increasing rates of heart- related diseases, particularly among younger individuals, it is vital to develop an early detection system for heart stroke symptoms to prevent fatalities. This project aims to analyze heart disease datasets and utilize feature selection techniques to construct a high-accuracy model using the best-performing machine learning algorithms. By deriving valuable insights from the data, the objective is to contribute to the prevention and improved management of heart- related conditions.

The impact of cardiovascular disease on all-cause and cancer mortality: results from a 16-year follow-up of a German breast cancer case–control study

BackgroundCardiovascular disease (CVD) is the leading cause of death worldwide. The aim of this study was to examine if CVD affects the mortality of women after a breast cancer diagnosis and population controls differently.MethodsThe analysis included a total of 3,555 women, diagnosed with primary stage 1–3 breast cancer or in situ carcinoma between 2002 and 2005 and 7,334 controls breast cancer-free at recruitment, all aged 50–74 years, who were followed-up in a German breast cancer case–control study until June, 30 2020. Kaplan–Meier and cumulative incidence function were calculated for all-cause mortality and mortality from any cancer, stratified for case–control status and CVD, separately for women aged < 65 and ≥ 65 years. Cox regression and Fine-Gray subdistribution hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI) for the association between case–control-status, CVD and mortality from all causes/any cancer.ResultsThe median follow-up was 16.1 years. In total, 1,172 cases (33.0%) and 1,401 initial controls (19.1%) died. CVD prevalence at recruitment was 15.2% in cases and controls. Cases with CVD had the highest and controls without CVD the lowest mortality during the entire observation period in both age groups (< 65 and ≥ 65 years). CVD was identified as a risk factor for all-cause mortality in both cases and controls aged < 65 years (HR 1.22, 95%CI 0.96–1.55 and HR 1.79, 95%CI 1.43–2.24) as well as at ages of ≥ 65 years (HR 1.44, 95%CI 1.20–1.73 and HR 1.59, 95%CI 1.37–1.83). A significant association of CVD and cancer mortality was found only for cases aged ≥ 65 years.ConclusionCVD was significantly associated with all-cause mortality of both cases and controls and CVD was identified as a risk factor for cancer mortality of cases aged ≥ 65 years at recruitment. Therefore, attention should be paid on monitoring and preventing CVD in breast cancer patients, especially in those diagnosed at older ages.

LncRNAs and CircRNAs in Endoplasmic Reticulum Stress: A Promising Target for Cardiovascular Disease?

The endoplasmic reticulum (ER) is a principal subcellular organelle responsible for protein quality control in the secretory pathway, preventing protein misfolding and aggregation. Failure of protein quality control in the ER triggers several molecular mechanisms such as ER-associated degradation (ERAD), the unfolded protein response (UPR) or reticulophagy, which are activated upon ER stress (ERS) to re-establish protein homeostasis by transcriptionally and translationally regulated complex signalling pathways. However, maintenance over time of ERS leads to apoptosis if such stress cannot be alleviated. The presence of abnormal protein aggregates results in loss of cardiomyocyte protein homeostasis, which in turn results in several cardiovascular diseases such as dilated cardiomyopathy (DCM) or myocardial infarction (MI). The influence of a non-coding genome in the maintenance of proper cardiomyocyte homeostasis has been widely proven. To date, the impact of microRNAs in molecular mechanisms orchestrating ER stress response has been widely described. However, the role of long noncoding RNAs (lncRNAs) and circular RNAs (circRNAs) is just beginning to be addressed given the potential role of these RNA classes as therapeutic molecules. Here, we provide a current state-of-the-art review of the roles of distinct lncRNAs and circRNAs in the modulation of ERS and UPR and their impact in cardiovascular diseases.

The impact of tumor characteristics on cardiovascular disease death in breast cancer patients with CT or RT: a population-based study.

Previous studies focused on the impact of cardiovascular diseases (CVD) risk factors in breast cancer patients with chemotherapy (CT) or radiotherapy (RT). This study aimed to identify the impact of tumor characteristics on CVD death in these patients. Data of female breast cancer patients with CT or RT between 2004 and 2016 were included. The risk factors of CVD death were identified using Cox regression analyses. A nomogram was constructed to evaluate the predicted value of tumor characteristics, and then validated by the concordance indexes (C-index) and calibration curves. A total of 28,539 patients were included with an average follow-up of 6.1 years. Tumor size > 45 mm (adjusted HR = 1.431, 95% CI = 1.116-1.836, P = 0.005), regional (adjusted HR = 1.278, 95% CI = 1.048-1.560, P = 0.015) and distant stage (adjusted HR = 2.240, 95% CI = 1.444-3.474, P < 0.001) were risk factors of CVD death for breast cancer patients with CT or RT. The prediction nomogram of tumor characteristics (tumor size and stage) on CVD survival was established. The C-index of internal and external validation were 0.780 (95% Cl = 0.751-0.809), and 0.809 (95% Cl = 0.768-0.850), respectively. The calibration curves showed consistency between the actual observation and nomogram. The risk stratification was also significant distinction (P < 0.05). Tumor size and stage were related to the risk of CVD death for breast cancer patients with CT or RT. The management of CVD death risk in breast cancer patients with CT or RT should focus not only on CVD risk factors but also on tumor size and stage.

Exercise-induced release of cardiac troponin is attenuated with repeated bouts of exercise: impact of cardiovascular disease and risk factors.

Prolonged exercise can induce cardiac troponin release. As single bouts of exercise may protect against cardiac injury, we explored the hypothesis that the magnitude of exercise-induced release of troponin attenuates upon successive days of exercise. We also examined whether effects of successive exercise bouts differ between healthy participants and individuals with cardiovascular risk factors (CVRFs) and established cardiovascular disease (CVD). We examined cardiac troponin I (cTnI) concentrations from whole venous blood samples collected from the antecubital vein (10 mL) in 383 participants (61 ± 14 yr) at rest and immediately following four consecutive days of long-distance walking (30-50 km/day). Participants were classified as either healthy (n = 222), CVRF (n = 75), or CVD (n = 86). Baseline cTnI concentrations were significantly higher in participants with CVD and CVRF compared with healthy (P < 0.001). Exercise-induced elevations in cTnI were observed in all groups following all days of walking compared with baseline (P < 0.001). Tobit regression analysis on absolute cTnI concentrations revealed a significant day × group interaction (P = 0.04). Following day 1 of walking, post hoc analysis showed that exercise-induced elevations in cTnI attenuated on subsequent days in healthy and CVRF, but not in CVD. Odds ratios for incident cTnI concentrations above the upper reference limit were significantly higher compared with baseline on day 1 for healthy participants (4.90 [95% CI, 1.58-15.2]) and participants with CVD (14.9 [1.86-125]) and remained significantly higher than baseline on all subsequent days in CVD. The magnitude of postexercise cTnI concentrations following prolonged walking exercise significantly declines upon repeated days of exercise in healthy individuals and those with CVRF, whereas this decline is not present in patients with CVD.NEW & NOTEWORTHY We show the magnitude of postexercise cardiac troponin concentrations following prolonged walking exercise significantly declines upon repeated days of exercise in healthy individuals and those with cardiovascular risk factors, while this decline is not present in patients with established cardiovascular disease.

Impact of cardiovascular disease on health care economic burden and resource utilization: a retrospective cohort study in adults in the United States with type 2 diabetes with or without stroke, myocardial infarction, and peripheral arterial disease

Objectives To evaluate incidence of stroke, myocardial infarction (MI), and peripheral artery disease (PAD) in patients with type 2 diabetes mellitus (T2DM) and assess associated health care resource utilization (HCRU) and costs in the United States. Methods Patients ≥18 years of age with a T2DM diagnosis, with or without incident stroke/MI/PAD, were indexed between 1 January 2012 and 31 December 2020, from the deidentified Optum Clinformatics Data Mart claims database. Incidence of stroke, MI, and PAD was evaluated in the year following T2DM. HCRU and costs were measured in the 12 months following study entry in patients with T2DM + stroke, T2DM + MI, and T2DM + PAD (experimental cohorts) and compared to HCRU and costs in patients with T2DM alone (control cohorts). Results Incidence of stroke, MI, and PAD in patients with T2DM was 0.9% (n = 16,034), 0.7% (n = 13,681), and 4.1% (n = 68,479), respectively. Compared to matched patients with T2DM alone, patients with T2DM + stroke/MI/PAD had significantly higher total healthcare costs in the year post-index date (T2DM + stroke: +$5962 per patient per month [PPPM]; T2DM + MI: +$7932 PPPM; T2DM + PAD: +$2652 PPPM; p < .05). Patients with T2DM + stroke/MI/PAD had significantly higher mean HCRU than patients without stroke/MI/PAD in all categories measured. Conclusion Having stroke, MI, or PAD was associated with increases in HCRU and costs in patients with T2DM. Although PAD was associated with smaller per patient increases in total healthcare costs than patients with T2DM + stroke/MI, the higher frequency of incident PAD may make it more costly than MI or stroke in a large population of patients with T2DM.

Impact of Cardiovascular Diseases on Ischemic Stroke Outcomes.

Stroke induces complex pathological cascades in the affected brain area, leading to brain injury and functional disability. To fight against cerebral ischemia/reperfusion-induced neuronal death, numerous neuroprotective strategies and reagents have been studied. However, translation of these neuroprotective drugs to clinical trials has been unsuccessful. To date, the tissue plasminogen activator is still the only FDA-approved drug for treating ischemic stroke. Thus, it is obligatory to identify and validate additional therapeutic strategies for stroke. A stroke rarely occurs without any other pathophysiological condition; but instead, it often has multi-morbidity conditions, one of which is cardiac disease. Indeed, up to half of the stroke cases are associated with cardiac and large artery diseases. As an adequate blood supply is essential for the brain to maintain its normal function, any pathophysiological alterations in the heart are frequently implicated in stroke outcomes. In this review, we summarize some of the cardiovascular factors that influence stroke outcomes and propose that considering these factors in designing stroke therapies should enhance success in clinical trials. We also highlight the recent advances regarding the potential effect of protein aggregates in a peripheral organ, such as in the heart, on ischemic stroke-caused brain injury and functional recovery. Including these and other comorbidity factors in the future therapeutic strategy designs should facilitate translational success toward developing effective combinational therapies for the disorder.

Cardiovascular disease risk in women living with HIV.

To synthesize current evidence on the impact of cardiovascular disease among women living with HIV (WLWH) with a particular focus on disease prevalence, mechanisms and prevention. HIV-related cardiovascular disease risk is 1.5-fold to 2-fold higher for women than for men. Mechanisms of enhanced risk are multifactorial and include reinforcing pathways between traditional risk factors, metabolic dysregulation, early reproductive aging and chronic immune activation. These pathways influence both the presentation of overt syndromes of myocardial infarction, stroke and heart failure, as well as subclinical disease, such as microvascular dysfunction and cardiac fibrosis. Cardiovascular disease, therefore, remains a consistent threat to healthy aging among WLWH. Although no specific prevention strategies exist, patient-centered risk mitigation approaches that are adaptable to the needs of aging individuals are essential to combat disparities in cardiovascular outcomes among WLWH. Further research into the optimal prevention approach for CVD among WLWH, particularly for women living in under-resourced health systems, is needed.

Impact of cardiovascular diseases on life quality of older people

Objectives: The study aims to assess the Quality of Life of Elderly People with Cardiovascular Diseases. To find out the relationship between socio-demographic data for Elderly people with cardiovascular diseases and quality of life. Methods: A cross-section descriptive study design is used for a period from December 2022 to the 15th of May 2022; the study was conducted in the Babylon province. Results: The majority of patients aged ranged from 60-69 years old and constituted (72.5%) of the study sample. In regards to gender, most of the studied sample was female. general health (M=1.12) was the most common associated with poor quality of life, followed by physical health (M=1.38), followed by environmental health (M=1.39) and psychological health (M=1.64). as well, social health records the highest mean score (M=2.71) as a good quality related to social health. Conclusions and Recommendations: The study concludes that the medical history of the sample revealed most people had a history of coronary artery disease and the duration of the disease by more than 2 years with the disease. The majority of individuals were elderly People with Cardiovascular Conditions who did not have any chronic diseases.

The Impact of Cardiovascular Diseases on Maternal Deaths in the Nordic Countries

(Acta Obstet Gynecol Scand. 2021;100:1273–1279) Between 2005 and 2017 cardiovascular diseases (CVD) accounted for the most common cause of maternal death in Nordic countries. This increased maternal mortality is likely associated with a rise in pregnant women with congenital and acquired CVD, but in nearly 60% of deaths, there was no known CVD. The current study objective was to identify the incidence and type of CVD contributing to the cause of maternal death, and identify points of substandard care to improve clinical management and reduce CVD-related mortality.