Major Risk Factor For Cardiovascular Disease Research Articles

Risk Assessment for Non Communicable Diseases among Adults in a Rural Area of Eastern India: A Single Centre Cross-sectional Study

Introduction: Non Communicable Diseases (NCDs) cause significant premature mortality. Prevention of major cardiovascular disease risk factors, like diabetes and hypertension, is a priority for public health. Aim: To estimate the risk assessment of NCD using the Community-Based Assessment Checklist (CBAC) scoring system developed by the Government of India among adults in rural areas. Materials and Methods: This community-based cross-sectional study was conducted among 400 adults attending the hospital at the rural health training centre of Kalinga Institute of Medical Sciences (KIMS), Bhubaneswar, Odisha, India, from March 2023 to August 2023 using consecutive sampling. Face-toface interviews using a structured CBAC questionnaire and socio-demographic variables were used to gather data on age, tobacco consumption, alcohol intake, waist measurement, physical inactivity, and family history. Data were analysed using IBM Statistical Package for Social Sciences (SPSS) version 21.0 and interpreted in frequencies, percentages, and the Chi-square test. A p-value <0.05 was considered statistically significant. Results: The overall risk of NCD was estimated to be 57.25%. The risk of NCD was significantly associated with age (p-value <0.00001), tobacco consumption (p-value <0.0001), alcohol consumption (p-value <0.0001), waist circumference (p-value <0.0001), physical activity (p-value=0.000018), family history of diabetes mellitus, hypertension, and cardiovascular illness (p-value <0.00001), education (p-value=0.0079), and socioeconomic status (p-value=0.0415). Conclusion: The overall risk of NCD was estimated to be 57.25%. Most of the CBAC variables were found to have a significant association with NCD risk. However, no significant association was found between CBAC variables and gender. CBAC is a simple and economical screening tool employed at the community level so that early intervention strategies can be planned for those at risk of NCDs.

Investigating the inhibition of catabolic enzymes for implications in cardiovascular diseases and diabetes

Non-communicable diseases (NCDs) are chronic health conditions characterized by their prolonged duration and non-infectious nature. These diseases, such as cardiovascular disease (CVD) and diabetes, are often influenced by a complex interplay of genetic, dietary, and lifestyle factors. Obesity, a major risk factor for both diabetes and CVDs, has been linked to excess consumption of carbohydrates and lipids. The enzymes α-amylase and lipase play key roles in the digestion and metabolism of carbohydrates and lipids, respectively. We hypothesized that four different natural substances, ginger, Aloe vera, lemon, and mint leaves, could inhibit the activity of α-amylase and lipase as a potential strategy to mitigate the risk of developing NCDs associated with obesity, CVD, and diabetes. Experimental model as follows: four natural substances were prepared at different concentrations. Solutions containing the enzymes amylase and lipase mixed with their respective buffers, were also made. The polyphenol solutions were then tested for their ability to inhibit the activity of α-amylase and lipase enzymes on their respective substances. Absorbance measurements were taken, and the percentage of enzyme inhibition was calculated for each natural remedy solution at varying concentrations. Experimental data showed that Aloe vera was more effective at inhibiting α-amylase, while ginger had the greatest inhibitory effect on lipase. Data also suggested a higher concentration of these natural substances had a higher inhibitory effect on both α-amylase and lipase enzymes. This study provides insights into natural alternatives that could potentially aid in the management and prevention of NCDs by targeting key enzymes involved in the metabolism of carbohydrates and lipids.

Evaluating the pharmacokinetic parameters of a single dose of oral disintegrating tablets in elderly patients with hypertension and hyperlipidemia

Cardiovascular diseases (CVDs) are the leading cause of death worldwide, particularly in underprivileged areas such as Pakistan. Hypertension and hyperlipidemia are major risk factors for CVDs and often require medication for effective management. This study aimed to develop and validate a high-performance liquid chromatography (HPLC) method to assess the bioavailability of orally disintegrating tablets (ODTs) of atenolol and atorvastatin in elderly volunteers with high blood pressure and cholesterol levels by comparing the pharmacokinetic parameters of these ODTs with those of conventional tablet formulations. The study was conducted in Sargodha, Punjab Province, Pakistan, by recruiting 30 male and female elderly volunteers aged 45-65 years and weighing 60-90 kilograms. Each participant was administered a single dose of atenolol (25 mg), atorvastatin (10 mg), or an ODT containing both drugs. Blood samples were collected at specific intervals up to 48 hours postadministration. The concentrations of atenolol, atorvastatin, and the ODTs were measured using HPLC, and various pharmacokinetic parameters, including the area under the curve (AUC), maximum plasma concentration (Cmax), and elimination half-life (t½), were analyzed. The maximum concentration (Cmax) of 10 mg atorvastatin occurred at 4 hours (9.50 ng/mL), while for 25 mg atenolol, it peaked at 4 hours (150.00 ng/mL). The ODTs showed comparable pharmacokinetic profiles, with the Cmax values for atorvastatin and atenolol at 4 hours being 4.00 ng/mL and 165.00 ng/mL, respectively. The elimination half-life (t½) for the ODTs was 4.62 hours for atorvastatin and 4.95 hours for atenolol. The pharmacokinetic analysis indicated that the AUC and Cmax of the ODTs met the bioequivalence criteria, demonstrating absorption and elimination properties similar to those of conventional tablet formulations. The study concluded that the pharmacokinetic parameters of the ODT formulations atenolol and atorvastatin are comparable to those of conventional tablets. ODTs offer a viable and effective alternative for delivering these medications, particularly for patients who have difficulty swallowing pills, thereby potentially improving patient compliance.

RED BLOOD CELL DISTRIBUTION WIDTH: WHAT CAN IT TELL US?

Abstract Red blood cell distribution width (RDW), a measure of red blood cell size variability used in evaluating anemia, has been found to predict cardiovascular disease (CVD) morbidity and mortality. RDW increases with age, but the determinants of age-associated elevation in RDW independent of CVD and associated risk factors is limited. Therefore, we examined the association of RDW within the normal range (11.5-15.0%) with age, sex, race, other red blood cell properties, major cardiovascular disease risk factors, and other physiologic data. Data were from 606 men and 627 women (aged 50-95) participating in the Baltimore Longitudinal Study of Aging. Candidate correlates of RDW were included in multiple linear regression models; a reduced model was then obtained by backward selection. RDW was higher with age and female sex. Differences in RDW by sex were explained by hemoglobin, mean corpuscular hemoglobin, and mean corpuscular volume. Further, mean platelet volume (STβ=0.0779, P=0.007), interleukin-6 (STβ=0.0774, P=0.011), erythrocyte sedimentation rate (STβ=0.0746, P=0.028), institutional normalized ratio (STβ=0.0836, P=0.004), thyroid stimulating hormone (STβ=0.0653, P=0.023), and body mass index (STβ=0.1725, P=8.98E-8) were all independently associated with RDW. In the final model, age remained a strong correlate of RDW (STβ=0.2412, P=2.91E-12). In summary, inflammation, metabolic rate, and body habitus independently predict RDW, but do not completely explain its association with age. Future investigation of longitudinal change in RDW with age and its association with these and other factors is needed to advance knowledge on the timing and potential mechanisms of age-associated increases in RDW, and its implication for health outcomes.

Low Awareness of Diabetes as a Major Risk Factor for Cardiovascular Disease in Middle- and High-Income Countries.

Awareness of diabetes as a major risk factor for cardiovascular disease (CVD) may enhance uptake of screening for diabetes and primary prevention of CVD. The American Heart Association conducted an online survey in 50 countries. The main outcome of this study was the proportion of individuals in each country who recognized diabetes as a CVD risk factor. We also examined variation by sex, age, geographic region, and country-level economic development. Among 48,988 respondents, 15,747 (32.1%) identified diabetes as a major CVD risk factor. Awareness was similar among men and women, but increased with age, and was greater in high-income than in middle-income countries. Two-thirds of adults in surveyed countries did not recognize diabetes as a major CVD risk factor. Given the increasing global burden of diabetes and CVD, this finding underscores the need for concerted efforts to raise public health awareness.

Minimizing Metabolic and Cardiac Risk Factors to Maximize Outcomes After Liver Transplantation.

Cardiovascular disease (CVD) is a leading complication after liver transplantation and has a significant impact on patients' outcomes posttransplant. The major risk factors for post-liver transplant CVD are age, preexisting CVD, nonalcoholic fatty liver disease, chronic kidney disease, and metabolic syndrome. This review explores the contemporary strategies and approaches to minimizing cardiometabolic disease burden in liver transplant recipients. We highlight areas for potential intervention to reduce the mortality of patients with metabolic syndrome and CVD after liver transplantation.

Recovery From Idiopathic Sudden Sensorineural Hearing Loss: Association With Cardiovascular Disease Risk.

The purpose of this study is to investigate the association between cardiovascular disease (CVD) risk factors and idiopathic sudden sensorineural hearing loss (ISSNHL) disease severity and recovery. A retrospective medical chart review was performed on 90 patients (n = 48 men; Mage = 59.8 years, SD = 15.8) evaluated for ISSNHL. Major CVD risk factors (current tobacco smoking, diabetes, total cholesterol ≥ 240 mg/dl or treatment, and hypertension [systolic blood pressure [BP]/diastolic BP ≥ 140/ ≥ 90 mmHg or treatment]) determined two CVD risk groups: lower (no major risk factors) and higher (one or more risk factors). Two pure-tone averages (PTAs) were computed: PTA0.5,1,2 and PTA3,4,6,8. Complete recovery of ISSNHL was defined as PTAinitial - PTAfollow-up ≥ 10 dB. Logistic regression estimated the odds of ISSNHL recovery by CVD risk status adjusting for age, sex, body mass index, noise exposure, and treatment. Most patients (67.8%) had one or more CVD risk factors. Severity of initial low- and high-frequency hearing loss was similar between CVD risk groups. Recovery was 53.2% for PTA0.5,1,2 and 32.9% for PTA3,4,6,8. With multivariable adjustment, current/former smoking was associated with lower odds of PTA0.5,1,2 recovery (OR = 0.27; 95% CI [0.08, 0.92]). Neither higher CVD risk status nor individual CVD risk factors had a significant association with recovery. For every one-unit increase in Framingham Risk Score, odds of PTA3,4,6,8 recovery were 0.95 times lower (95% CI [0.90, 1.00]) after accounting for age, sex, body mass index, noise exposure, and treatment/time-to-treatment grouping (p = .056). The prognosis of low-frequency ISSNHL recovery is worse among current/former smokers than nonsmokers. Other CVD risk factors and aggregate risk are not significantly related to recovery.

Changes of Serum Angiotensin Peptides, Pro-Endothelin-1 Levels in Women One Year After Preeclampsia and their Association with Cardiovascular Risk Factors

Abstract Introduction Women who suffered preeclampsia (PE) have two to four times higher risk for development of cardiovascular disease (CVD) compared with women with a history of normotensive pregnancy. Microvascular and endothelial dysfunction, mediated by different vasoactive factors have been suggested as attainable pathophysiological pathways. The study aimed to: (1) determine changes in circulating levels of key vasoactive peptides in sera of women with history of PE and in women who had a normal pregnancy 1 year after delivery and (2) investigate whether an association exists between these molecules and cardiovascular risk factors. Materials and methods The current research examined 32 women one year after preeclampsia (mean age 25.3 ± 6.3 years) and control group of 20 women one year after normal pregnancy (mean age 25.6 ± 5.6 years). The enzyme-linked immunosorbent assay (ELISA) was used to determine serum levels of angiotensin II (AngII), angiotensin-(1-7) [Ang-(1-7)] and pro-endothelin-1 (Pro-ET-1). Results We found that at 1 year after delivery 38.46% of women who suffered PE have developed hypertension and 5.77% have developed diabetes mellitus. Women who had normal pregnancy developed neither hypertension, nor diabetes mellitus 1 year after delivery. Serum AngII levels in women one year after PE were statistically significantly lower than in women one year after normotensive pregnancy 0.9 (0.55÷1.7) vs. 2.3 pg/ml (2.0 ÷ 2.9) (KW = 20.849; p = 0.0001). Ang-(1-7) concentrations in women one year after PE were lower than in women one year after normal pregnancy, but not significantly 1.7 (0.3÷4.5) vs. 3.2 ng/ml (0.2÷8.0) (p>0.05). Levels of serum Pro-ET-1 in women one year after PE were statistically significantly higher than in women one year after normal pregnancy 322.65 (261.75÷391.85) vs. 248.7 pmol/L (231.05÷282.15) (KW = 6.639; p = 0.009). AngII showed correlation with AH grade (r = -0.33; 0.02), Ang-(1-7) (r = 0.27; 0.05), DBP (r = -0.28; p = 0.04), mean arterial pressure (r = -0.43; p = 0.002), pulse pressure (r = -0.28; p = 0.04), BMI (r = -0.30; p = 0.03), TC (r = -0.31; p = 0.03) and LDL (r = -0.30; p = 0.03). Pro-ET-1 correlated with age (r = 0.30; p = 0.03), mean arterial pressure (r = -0.25; p = 0.05) and pulse pressure (r = 0.41; p = 0.003). Conclusion Our data showed an association between key vasoactive peptides and major CVD risk factors in women one year after PE. We suggest that imbalance between AngII, Ang-(1-7) and Pro-ET-1 could have a potential imply on the vascular wall after PE, reflecting persistent microvascular and endothelial injury/dysfunction postpartum. Further studies are warranted to clarify these vasoactive peptides’ role in the ongoing vascular endothelial function after delivery and the pathogenic mechanisms determining development of CVD in previously PE women.

Genetic Polymorphisms and Risk of Cardiovascular Disease

<p><span style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-fareast-font-family: PMingLiU; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: EN-US;">Cardiovascular disease (CVD) is the major cause of death and disability worldwide. Major and well-established cardiovascular disease risk factors include advancing age, male sex, hypertension, smoking, diabetes, elevated total serum low-density lipoprotein (LDL) cholesterol, and decreased high-density lipoprotein (HDL) cholesterol. Genetic polymorphism represents an additional risk factor for cardiovascular disease and is not explored and researched thoroughly. In this review article, a total of 31 scientific articles studying the association between different genetic polymorphisms and the risk of cardiovascular disease were studied. <a name="_Hlk80393453"></a>Different genetic polymorphisms were found to be associated with an increased risk of cardiovascular disease and coronary heart disease incidence, and genotyping of these different genetic polymorphisms should be considered as routine screening for cardiovascular disease.</span></p>

Risk Factors for Cardiovascular Disease: Knowledge Gained from the Hispanic Community Health Study/Study of Latinos.

The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) has made important contributions on the prevalence of and factors associated with cardiovascular disease (CVD) risk factors among diverse Hispanic/Latino adults in the US. This article summarizes the knowledge gained thus far on major CVD risk factors from this landmark study. HCHS/SOL demonstrated the sizeable burdens of CVD risk in all major Hispanic/Latino groups in the US, as well as the marked variations in prevalence of hypertension, hypercholesterolemia, diabetes, obesity, and smoking by sex and background. It also identified sociodemographic, lifestyle, and sociocultural characteristics associated with risk factors. HCHS/SOL has yielded an expanding body of literature on characteristics associated with adverse CVD risk factors in this population. Long-term follow-up of this cohort will shed further light on the observed heterogeneity in CVD risk across Hispanic/Latino groups and identify specific risk/protective factors driving these variations.

Acute Vascular Events: Cellular and Molecular Mechanisms

Cardiovascular diseases (CVDs) are the leading cause of death worldwide. An estimated 17.9 million individuals died from CVDs in 2019, representing 32% of all global deaths. Of these deaths, 85% were due to heart attack and stroke. Cardiometabolic risks, such as hypertension, excess weight, obesity, type 2 diabetes, and vascular diseases, contribute significantly to the progression of coronary artery disease. Known sequelae of events that lead to these cardiometabolic diseases include oxidative stress, inflammation, development of dysfunction of vascular adipose tissue, altered blood pressure and blood lipids, altered glucose metabolism, hardening of the arteries, endothelial dysfunction, development of atherosclerotic plaques, and activation of platelet and coagulation pathways. The Framingham Heart Study Group has developed a Risk Score that estimates the risk of developing heart disease in a 10-year period. This group of experts has developed mathematical functions for predicting clinical coronary disease events. These prediction capabilities are derived by assigning weights to major CVD risk factors such as sex, age, blood pressure, total cholesterol, low-density lipoprotein, high-density lipoprotein cholesterol, smoking behavior, and diabetes status. Currently, there is a growing interest in the use of artificial intelligence and machine learning applications. AI-based mimetic pattern-based algorithms seem to be better than the conventional Framingham Risk Score, in predicting clinical events related to CVDs. However, there are limitations to these applications as they do not have access to data on the specific factors that trigger acute vascular events, such as heart attack and stroke. This overview briefly discusses some salient cellular and molecular mechanisms involved in precipitating thrombotic conditions. Further improvements in emerging technologies will provide greater opportunities for patient selection and treatment options. Several clinical studies have demonstrated that most CVDs can be prevented by addressing behavioral risk factors such as tobacco use, unhealthy diet and obesity, physical activity, and harmful use of alcohol. Early detection and better management of the modifiable risks seem to be the only way to reduce, reverse, or prevent these diseases.

Aortopathies: From Etiology to the Role of Arterial Stiffness.

The aorta and aortic wall have a complex biological system of structural, biochemical, biomolecular, and hemodynamic elements. Arterial stiffness could be considered a manifestation of wall structural and functional variations, and it has been revealed to have a strong connection with aortopathies and be a predictor of cardiovascular risk, especially in patients affected by hypertension, diabetes mellitus, and nephropathy. Stiffness affects the function of different organs, especially the brain, kidneys, and heart, promoting remodeling of small arteries and endothelial dysfunction. This parameter could be easily evaluated using different methods, but pulse-wave velocity (PWV), the speed of transmission of arterial pressure waves, is considered the gold standard for a good and precise assessment. An increased PWV value indicates an elevated level of aortic stiffness because of the decline in elastin synthesis and activation of proteolysis and the increase in fibrosis that contributes to parietal rigidity. Higher values of PWV could also be found in some genetic diseases, such as Marfan syndrome (MFS) or Loeys-Dietz syndrome (LDS). Aortic stiffness has emerged as a major new cardiovascular disease (CVD) risk factor, and its evaluation using PWV could be very useful to identify patients with a high cardiovascular risk, giving some important prognostic information but also being used to value the benefits of therapeutic strategies.

Epigenetic Modifications as Predictive Biomarkers for Cardiovascular Disease: A Longitudinal Study on DNA Methylation Patterns and Disease Risk

Cardiovascular disease (CVD) is a leading cause of death worldwide, and early detection and prevention are essential to reduce its burden. Although traditional risk factors such as hypertension and lipid levels are standard predictors, they tend to identify the risk of disease at a later date There is an urgent need to develop more accurate, leading-edge biomarkers indicating molecular changes that occur before the onset of clinical symptoms. Epigenetic changes, in particular DNA methylation, provide a promising approach to identify individuals at risk for CVD. Despite advances in understanding the genetic underpinnings of CVD, little is known about how dynamic epigenetic modifications influenced by environmental and lifestyle factors can serve as early predictive biomarkers the risk of the disease. This study aims to address this gap by investigating whether DNA methylation patterns can predict future CVD risk before clinical manifestations. The primary objective of this study was to systematically investigate the association between DNA methylation patterns and CVD risk. Specifically, the study seeks to identify regions where DNA methylation changes are associated with cardiovascular outcomes and investigate the predictive potential of these epigenetic changes for future disease. 1,000 participants aged 30-75 years were followed for 5 to 10 years. Periodic blood samples were collected for DNA methylation analysis by bisulfite sequencing and microarrays. Major CVD risk factors such as adiposity, hypertension and smoking status were also controlled. Comprehensive statistical models were used to assess the association between DNA methylation changes and CVD incidence. Participants who developed CVD showed significant differences in DNA methylation in regions associated with lipid metabolism (e.g., APOA5) and inflammation (e.g., TNF-α) Over time, those who developed heart disease and vascular events revealed progressive hyper methylation of key genes, with 85% sensitivity 78 to predict future CVD risk % and specificity skin. These methylation patterns were discovered years before the appearance of conventional clinical pathology. This study shows that DNA methylation patterns are determinants of acute cardiovascular risk, providing a novel approach for early detection and prevention The findings suggest the inclusion of epigenetic biomarkers in routine risk assessment about may improve the identification of individuals at high risk for CVD It is important to inform individuals at high risk of CVD of the diagnosis and to explore possible interventions that can alter change a occurs in this epigenetic and reduced CVD risk.

0282 Behavioral–social rhythms and metabolic syndrome prevalence in retired night shift and day workers

Abstract Introduction Disrupted sleep and circadian rhythms, such as those occurring during night shift work, are established cardiovascular disease (CVD) risk factors like hypertension, obesity, and insulin resistance. However, we do not know whether the effects of shift work on CVD risk factors persist into retirement. Conversely, regularity in behavioral-social rhythms – the systematic patterning or timing of daily routines like work/housework, sleeping, eating and social interactions – may keep endogenous circadian rhythms synchronized to the 24-hour day and reduce CVD risk. This study examined: 1) whether behavioral–social rhythms are associated with a major CVD risk factor, prevalent metabolic syndrome, in retired night shift workers and day workers; and 2) whether past night shift work exposure moderates the associations between behavioral–social rhythm and metabolic syndrome prevalence. Methods Participants were 71 retired night shift workers (39 women (54.9%), 32 men (45.1%)) and 83 retired day workers (46 women (55.4%), 37 men (44.6%)), with mean age 68.4 (5.4) years. Logistic regression models were used to examine associations between behavioral–social rhythms and metabolic syndrome prevalence. Independent variables included Social Rhythm Metric-5 (SRM5; a 5-item scale to quantify rhythms of daily life) score and actigraphy rest-activity rhythm inter-daily stability (IS; rhythm stability across days) and intra-daily variability (IV; rhythm fragmentation within days). The dependent variable was metabolic syndrome prevalence. Results More regular behavioral-social rhythms were associated with lower odds of having metabolic syndrome (SRM5: OR=0.57, 95%CI [0.35, 0.88]; IV (Higher score means lower regularity): OR=2.05, 95%CI [1.23, 3.44]). In addition, more regular behavioral-social rhythms were associated with lower odds of having two individual components of metabolic syndrome , body mass index (SRM5: OR=0.56, 95%CI [0.37, 0.85]; IV: OR=2.05, 95%CI [1.30, 3.23]) and high-density lipoprotein cholesterol level (SRM5: OR=0.49, 95%CI [0.30, 0.80]; IV: OR=1.78, 95%CI [1.06, 2.98]). Shift work exposure did not moderate the association between behavioral–social rhythms and metabolic syndrome prevalence. Conclusion Behavioral–social rhythms are related to metabolic syndrome prevalence in retired adults regardless of prior shift work exposure. Older retired workers may benefit from interventions that promote behavioral–social rhythm regularity. Support (if any) This research was supported by the NIH grants AG047139, HL082610, MH019986, and AG07517

Influence of Age on Hyperoxia-Induced Cardiac Pathophysiology in Type 1 Diabetes Mellitus (T1DM) Mouse Model.

Mechanical ventilation often results in hyperoxia, a condition characterized by excess SpO2 levels (>96%). Hyperoxia results in changes in the physiological parameters, severe cardiac remodeling, arrhythmia development, and alteration of cardiac ion channels, all of which can point toward a gradual increase in the risk of developing cardiovascular disease (CVD). This study extends the analysis of our prior work in young Akita mice, which demonstrated that exposure to hyperoxia worsens cardiac outcomes in a type 1 diabetic murine model as compared to wild-type (WT) mice. Age is an independent risk factor, and when present with a major comorbidity, such as type 1 diabetes (T1D), it can further exacerbate cardiac outcomes. Thus, this research subjected aged T1D Akita mice to clinical hyperoxia and analyzed the cardiac outcomes. Overall, aged Akita mice (60 to 68 weeks) had preexisting cardiac challenges compared to young Akita mice. Aged mice were overweight, had an increased cardiac cross-sectional area, and showed prolonged QTc and JT intervals, which are proposed as major risk factors for CVD like intraventricular arrhythmias. Additionally, exposure to hyperoxia resulted in severe cardiac remodeling and a decrease in Kv 4.2 and KChIP2 cardiac potassium channels in these rodents. Based on sex-specific differences, aged male Akita mice had a higher risk of poor cardiac outcomes than aged females. Aged male Akita mice had prolonged RR, QTc, and JT intervals even at baseline normoxic exposure. Moreover, they were not protected against hyperoxic stress through adaptive cardiac hypertrophy, which, at least to some extent, is due to reduced cardiac androgen receptors. This study in aged Akita mice aims to draw attention to the clinically important yet understudied subject of the effect of hyperoxia on cardiac parameters in the presence of preexisting comorbidities. The findings would help revise the provision of care for older T1D patients admitted to ICUs.

The AMD ANNALS: A continuous initiative for the improvement of type 2 diabetes care

AimsSince 2006, the Italian AMD (Associations of Medical Diabetologists) Annals Initiative promoted a continuous monitoring of the quality of diabetes care, that was effective in improving process, treatment and outcome indicators through a periodic assessment of standardized measures. Here, we show the 2022 AMD Annals data on type 2 diabetes (T2D). MethodsA network involving ∼1/3 of diabetes centers in Italy periodically extracts anonymous data from electronic clinical records, by a standardized software. Process, treatment and outcome indicators, and a validated score of overall care, the Q-score, were evaluated. Results295 centers provided the annual sample of 502,747 T2D patients. Overall, HbA1c value ≤7.0% was documented in 54.6% of patients, blood pressure <130/80 mmHg in 23.0%, and LDL-cholesterol levels <70 mg/dl in 34.3%, but only 5.2% were at- target for all the risk factors. As for innovative drugs, 29.0% of patients were on SGLT2-i, and 27.5% on GLP1-RAs. In particular, 59.7% were treated with either GLP1-RAs or SGLT2-i among those with established cardiovascular disease (CVD), 26.6% and 49.3% with SGLT2-i among those with impaired renal function and heart failure, respectively. Notably, only 3.2% of T2D patients showed a Q score <15, which correlates with a 80% higher risk of incident CVD events compared to scores >25. ConclusionsThe 2022 AMD Annals data show an improvement in the use of innovative drugs and in the overall quality of T2D care in everyday clinical practice. However, additional efforts are needed to reach the recommended targets for HbA1c and major CVD risk factors.

Previous pre-eclampsia, gestational diabetes mellitus and the risk of cardiovascular disease: A nested case-control study in Sweden.

Pre-eclampsia and gestational diabetes mellitus (GDM) are two common pregnancy complications that affect birth outcomes and are associated with a long-term risk of cardiovascular disease (CVD). The aims of this study were to investigate if the pre-eclampsia association with CVD is independent of GDM and modified by body mass index (BMI) or GDM. Case-control study. Sweden. Cases were women with a first CVD event between 1991 and 2008 and a previous pregnancy who were matched with controls without CVD (1:5) by year of birth, age and region of birth. Conditional logistic regression was used to evaluate the associations of GDM, pre-eclampsia and maternal BMI with CVD adjusted for potential confounders and effect modifications with interaction tests. CVD. There were 2639 cases and 13 310 controls with complete data. Pre-eclampsia and GDM were independent risk factors for CVD (adjusted odds ratio [aOR] 2.59, 95% CI 2.12-3.17 and aOR 1.47, 95% CI 1.04-2.09, respectively). After stratifying by maternal BMI, the adjusted association of pre-eclampsia with CVD did not differ notably between BMI groups: normal weight (aOR 2.65, 95% CI 1.90-3.69), overweight (aOR 2.67, 95% CI 1.52-4.68) and obesity (aOR 3.03, 95% CI 0.74-12.4). Similar findings were seen when stratifying on GDM/non-GDM. Pre-eclampsia and GDM are independent risk factors for later CVD and having both during pregnancy is a major risk factor for later CVD. The association between pre-eclampsia and CVD is not modified by BMI. Effective CVD preventive programs for high-risk women are urgently needed in order to improve women's long-term health.

Fat-to-heart crosstalk in health and disease.

According to the latest World Health Organization statistics, cardiovascular disease (CVD) is one of the leading causes of death globally. Due to the rise in the prevalence of major risk factors, such as diabetes mellitus and obesity, the burden of CVD is expected to worsen in the decades to come. Whilst obesity is a major and consistent risk factor for CVD, the underlying pathological molecular communication between peripheral fat depots and the heart remains poorly understood. Adipose tissue (AT) is a major endocrine organ in the human body, with composite cells producing and secreting hormones, cytokines, and non-coding RNAs into the circulation to alter the phenotype of multiple organs, including the heart. Epicardial AT (EAT) is an AT deposit that is in direct contact with the myocardium and can therefore influence cardiac function through both mechanical and molecular means. Moreover, resident and recruited immune cells comprise an important adipose cell type, which can create a pro-inflammatory environment in the context of obesity, potentially contributing to systemic inflammation and cardiomyopathies. New mechanisms of fat-to-heart crosstalk, including those governed by non-coding RNAs and extracellular vesicles, are being investigated to deepen the understanding of this highly common risk factor. In this review, molecular crosstalk between AT and the heart will be discussed, with a focus on endocrine and paracrine signaling, immune cells, inflammatory cytokines, and inter-organ communication through non-coding RNAs.

Emerging roles of interferon-stimulated gene-15 in age-related telomere attrition, the DNA damage response, and cardiovascular disease.

Population aging and age-related cardiovascular disease (CVD) are becoming increasingly prevalent worldwide, generating a huge medical and socioeconomic burden. The complex regulation of aging and CVD and the interaction between these processes are crucially dependent on cellular stress responses. Interferon-stimulated gene-15 (ISG15) encodes a ubiquitin-like protein expressed in many vertebrate cell types that can be found both free and conjugated to lysine residues of target proteins via a post-translational process termed ISGylation. Deconjugation of ISG15 (deISGylation) is catalyzed by the ubiquitin-specific peptidase 18 (USP18). The ISG15 pathway has mostly been studied in the context of viral and bacterial infections and in cancer. This minireview summarizes current knowledge on the role of ISG15 in age-related telomere shortening, genomic instability, and DNA damage accumulation, as well as in hypertension, diabetes, and obesity, major CVD risk factors prevalent in the elderly population.

Abstract P351: Prevalence of Diabetes in a Sub-Saharan African Community

Background: Diabetes is a major cardiovascular disease (CVD) risk factor. There has been a epidemiological shift and chronic CVD is increasing in Sub-Saharan Africa, however, the extent is unknown. Methods: Data were collected between March and April 2013 from 3 regions of the Northern Senegal (i.e., Saint-Louis, Matam etand Louga) using a cluster sampling method and the survey base of the national statistical and demographical agency, we included subjects aged between 18 and 80 years old. Participants underwent a face-to-face questionnaire to collect demographics and data on cardiovascular history/risk factors. Blood pressure and anthropometric measurements were measured in addition to blood tests including fasting plasma glucose. Diabetes was defined as fasting plasma glucose &gt;= 1.26 g/L. Continuous data were reported as mean ± standard deviation (SD). Comparisons used the chi-squared test for categorical variables and Student’s t test for continuous variables. Multivariable adjusted logistic regression was used to identify factors associated with diabetes. Covariates with significant association (P&lt;0.05) in univariate analysis were included in the model. Results: Among the 2440 subjects in this study (mean age: 44 years old, SD: 15.99), 692 (28%) were male. Nearly half of the sample never attended school (48%, 95%CI: 46-50%). Body mass index (BMI) higher than 25 was present in 43% of the sample (95%CI: 29-35%), with a significant increase in women (51% vs 22%, p&lt;0,001).. The prevalence of diabetes was 5.9% (95%CI: 5-6,9%). Among them, 93% had at least two cardiovascular diseases (95% CI: 87-96%), 71% had dyslipidemia (95%CI: 63-78%) and 67% had a BMI over 25 (95%CI: 58-74%). Conclusion: This community-based study revealed a low prevalence of diabetes. However, the prevalence of additional CVD risk factors in this population was high. Preventive measures should be implemented to avoid increasing rates of diabetes in Sub-Saharan Africa.