Markers Of Cardiovascular Health Research Articles

Association Between Behavioral, Biological, and Genetic Markers of Cardiovascular Health and MRI Markers of Brain Aging: A Cohort Study.

The life's simple 7 approach was proposed to define cardiovascular health (CVH) metrics. We sought to investigate the associations between behavioral, biological, and genetic markers for CVH and vascular brain aging in older adults. This population-based cohort study included participants who had repeated brain MRI measures from 2001 to 2003 to 2007-2010 (i.e., count of perivascular spaces, volumes of white matter hyperintensity [WMH] and gray matter, and lacunes). At baseline, global, behavioral, and biological CVH metrics were defined and scored following the life's simple 7 approach and categorized into unfavorable, intermediate, and favorable profiles according to tertiles. The metabolic genetic risk score was calculated by counting 15 risk alleles associated with hypertension, diabetes, or dyslipidemia. Data were analyzed using linear mixed-effects and Cox proportional hazards models, adjusting for age, sex, and education. The study sample consisted of 317 participants (age 60 years or older; 61.8% women). Favorable and intermediate (vs unfavorable) global CVH profiles were related to slower WMH progression, with β-coefficients (95% CI) being -0.019(-0.035-0.002) and -0.018(-0.034-0.001), respectively. Favorable and intermediate (vs unfavorable) biological CVH profiles were significantly related to slower WMH increase only in people aged 60-72 years. CVH profiles were not related to progression of other brain measures. Furthermore, a higher metabolic genetic risk score (range: 6-21) was associated with faster WMH increase (β-coefficient = 0.005; 95% CI: 0.003-0.008). There were statistical interactions of metabolic genetic risk score with global and behavioral CVH profiles on WMH accumulation. A higher metabolic genetic risk score was related to faster WMH accumulation, with β-coefficients being 0.015(0.007-0.023), 0.005(0.001-0.009), and 0.003(-0.001 to 0.006) among people with unfavorable, intermediate, and favorable global CVH profiles, respectively; the corresponding β-coefficients were 0.013(0.006-0.020), 0.006(0.003-0.009), and 0.002(-0.002 to 0.006) among people with unfavorable, intermediate, and favorable behavioral CVH profiles. Intermediate to favorable global CVH profiles in older adults are associated with slower vascular brain aging. The association of metabolic genetic risk load with accelerated vascular brain aging was evident among people with unfavorable to intermediate, but not favorable, CVH profiles. These findings highlight the importance of adhering to favorable CVH profiles, especially healthy behaviors, in vascular brain health.

The role of protein intake in the relationship between egg consumption and body composition in young adults. A mediation analysis

Background & aimsTo date, the literature examining the effects of whole-egg consumption on health outcomes focuses primarily on cardiovascular health markers; however, a significant gap exists in the literature about how egg consumption may influence body composition indicators. The aim of this study was to estimate the association between egg consumption and body composition indicators and to examine whether this relationship is mediated by protein intake in young adults. MethodsA cross-sectional study was conducted involving 355 first-year university students (aged 18–30 years) from a Spanish public university. Body composition was measured using bioimpedance and dual-energy X-ray absorptiometry (DXA) and fitness components were determined using the course-navette test. Egg consumption and protein intake (both in g/day/kg of body weight) were determined using a 137-item Food-Frequency Questionnaire. ANCOVA models were used to test the mean differences in body composition indicators (body mass index [BMI], ratio waist circumference/height [WC/height], body fat mass percentage, and body lean mass percentage) by egg consumption categories (<1 egg/week, 1–4 eggs/week, ≥5 eggs/week). Hayes's PROCESS macro was used for mediation analyses. ResultsParticipants reporting high egg consumption (≥5 eggs/week) showed significantly lower BMI, WC/height and body fat mass percentage values and higher body lean mass percentage values than those reporting low egg consumption (<1 egg/week) (p < 0.05). However, these relationships were not maintained after adjusting for protein intake. Protein intake acted as a full mediator of the relationships of egg consumption with BMI (indirect effect [IE] = −1.19; 95% CI [−3.33; −0.36]), WC/height (IE = −0.01; 95% CI [−0.04; −0.01]) and body lean mass percentage (IE = 2.99; 95% CI [1.26; 5.73]) as a partial mediator of the relationship be-tween egg consumption and body fat mass percentage (IE = −2.19; 95% CI [−4.92; −0.46]). ConclusionsThe association between egg consumption and body composition is mediated by protein intake. This finding is important from a public health perspective, suggesting that higher egg consumption (≥5 eggs/week) may lead to a healthier body composition, especially due to higher protein intake.

Self-recorded heart rate variability profiles are associated with health and lifestyle markers in young adults.

To quantify associations between self-recorded heart rate variability (HRV) profiles and various health and lifestyle markers in young adults. Otherwise healthy volunteers (n = 40, 50% male) recorded 60-s, post-waking HRV with a cost-free mobile application in supine and standing positions for 7days. The 7-day average and coefficient of variation (CV, reflects daily fluctuation) for the mean RR interval and root mean square of successive differences (LnRMSSD) were assessed. 7-day sleep duration and physical activity profiles were characterized via wrist-worn accelerometer. Subsequent laboratory assessments included aerobic fitness ([Formula: see text]O2peak) and markers of cardiovascular, metabolic, and psychoemotional health. Associations were evaluated before and after [Formula: see text]O2peak adjustment. Bivariate correlations (P < 0.05) demonstrated that higher 7-day averages and/or lower CV values were associated with higher activity levels and superior cardiovascular (lower systolic and diastolic blood pressure [BP] and aortic stiffness [cf-PWV]), metabolic (lower body fat percentage, fasting glucose, and low-density lipoprotein cholesterol [LDL-C]), and psychoemotional health (lower perceived stress) markers, with some variation between sexes and recording position. In males, associations between HRV parameters and cf-PWV remained significant following [Formula: see text]O2peak adjustment (P < 0.05). In females, HRV parameters were associated (P < 0.05) with numerous cardiovascular (systolic and diastolic BP, cf-PWV) and metabolic (fasting glucose and LDL-C) parameters following [Formula: see text]O2peak adjustment. Higher or more stable supine and standing HRV were generally associated with superior health and lifestyle markers in males and females. These findings lay groundwork for future investigation into the usefulness of self-recorded ultra-short HRV as a health-promoting behavior-modification tool in young adults.

Cardiovascular Health in India - a Report Card from Three Urban and Rural Surveys of 22,144 Adults.

Background:Markers of ideal cardiovascular health (CVH) predict cardiovascular events. We estimated the prevalence of ideal CVH markers in two levels of cities and villages in India.Methods:We did pooled analysis of individual-level data from three cross sectional surveys of adults ≥ 30 years over 2010–14 (CARRS: Centre for cArdiometabolic Risk Reduction in South Asia; UDAY and Solan Surveillance Study) representing metropolitan cities; smaller cities and rural areas in diverse locations of India. We defined ideal CVH using modified American Heart Association recommendations: not smoking, ≥ 5 servings of fruits and vegetables (F&V), high physical activity (PA), body mass index (BMI) <25 Kg/m2, blood pressure (BP) <120/80 mm Hg, fasting plasma glucose (FPG) <100 mg/dl, and total cholesterol (TC) <200 mg/dL. We estimated (1) age-and sex-standardized prevalence of ideal CVH and (2) prevalence of good (≥6 markers), moderate (4–5), and poor CVH (≤3) adjusted for age, sex, education, and stratified by setting and asset tertiles.Results:Of the total 22,144 participants, the prevalence of ideal CVH markers were: not smoking (76.7% [95% CI 76.1, 77.2]), consumed ≥5 F&V (4.2% [3.9, 4.5]), high PA (67.5% [66.8, 68.2]), optimum BMI (59.6% [58.9, 60.3]), ideal BP (34.5% [33.9, 35.2]), FPG (65.8% [65.1, 66.5]) and TC (65.4% [64.7, 66.1]). The mean number of ideal CVH metrics was 3.7(95% CI: 3.7, 3.8). Adjusted prevalence of good, moderate, and poor CVH, varied across settings: metropolitan (3.9%, 41.0%, and 55.1%), smaller cities (7.8%, 49.2%, and 43%), and rural (10.4%, 60.9%, and 28.7%) and across asset tertiles: Low (11.0%, 55.9%, 33.1%), Middle (6.3%, 52.2%, 41.5%), and High (5.0%, 46.4%, 48.7%), respectively.Conclusion:Achievement of ideal CVH varied, with higher prevalence in rural and lower asset tertiles. Multi-sectoral and targeted policy and program actions are needed to improve CVH in diverse contexts in India.

Efficacy of interval exercise training to improve vascular health in sedentary postmenopausal females.

BackgroundMenopause represents a turning point where vascular damage begins to outweigh reparative processes, leading to increased cardiovascular disease (CVD) risk. Exercise training reduces CVD risk in postmenopausal females via improvements in traditional risk factors and direct changes to the vasculature. We assessed the effect of moderate (MODERATE‐IT) versus heavy (HEAVY‐IT) intensity interval exercise training upon markers of cardiovascular health and vascular repair in postmenopausal females.MethodsTwenty‐seven healthy postmenopausal females (56 ± 4 yr) were assigned to 12 weeks of either MODERATE‐IT or HEAVY‐IT, twice per week. MODERATE‐IT consisted of 10s work, and 10s active recovery repeated for 30 min. HEAVY‐IT comprised 30s work, and 30s active recovery repeated for 21 ± 2 min. Endothelial function (flow‐mediated dilation), arterial stiffness (pulse wave velocity), and V̇O2peak were assessed pre‐training and post‐training. Blood samples were obtained pre‐training and post‐training for enumeration of circulating angiogenic cells (CACs), culture of CACs, and lipoprotein profile.ResultsV̇O2peak increased 2.4 ± 2.8 ml/kg/min following HEAVY‐IT only (p < 0.05). Brachial blood pressure and endothelial function were unchanged with exercise training (p > 0.05). Peripheral pulse wave velocity reduced 8% with exercise training, irrespective of intensity (p < 0.05). Exercise training had no effect on lipoprotein profile or endothelin‐1 (p > 0.05). CAC adhesion to vascular smooth muscle cells (VSMC) increased 30 min post plating following MODERATE‐IT only (p < 0.05).ConclusionsHEAVY‐IT was more effective at increasing V̇O2peak in postmenopausal females. The ability of CACs to adhere to VSMC improved following MODERATE‐IT but not HEAVY‐IT. Interval training had the same effect on endothelial function (no change) and arterial stiffness (reduced), regardless of exercise intensity.

A Randomized Controlled Trial of Mobile Health Intervention in Patients With Heart Failure and Diabetes

Mobile health (mHealth) platforms can affect health behaviors but have not been rigorously tested in randomized trials. We sought to evaluate the effectiveness of a pragmatic mHealth intervention in patients with heart failure (HF) and diabetes (DM). We conducted a multicenter randomized trial in 187 patients with both HF and DM to assess an mHealth intervention to improve physical activity and medication adherence compared to usual care. The primary endpoint was change in mean daily step count from baseline through 3 months. Other outcomes included medication adherence, health-related quality of life and metabolomic profiling. The mHealth group had an increase in daily step count of 151 steps/day at 3 months, whereas the usual-care group had a decline of 162 steps/day (least squares mean between-group difference = 313 steps/day; 95% CI: 8 619; P = 0.044). Medication adherence, measured using the Voils Adherence Questionnaire, did not change from baseline to 3 months (LS-mean change -0.08 in mHealth vs -0.15 in usual care; P = 0.47). The mHealth group had an improvement in Kansas City Cardiomyopathy Questionnaire Overall Summary Score compared to the usual-care group (LS-mean difference = 5.5 points, 95% CI: 1.4, 9.6; P = 0.009). Thirteen metabolites, primarily medium- and long-chain acylcarnitines, changed differently between treatment groups from baseline to 3 months (P < 0.05). In patients with HF and DM, a 3-month mHealth intervention significantly improved daily physical activity, health-related quality of life and metabolomic markers of cardiovascular health but not medication adherence. Heart failure (HF) and diabetes (DM) have overlapping biological and behavioral risk factors. We conducted a multicenter randomized, clinical trial in 187 patients with both HF (regardless of ejection fraction) and DM to assess whether an mHealth intervention could improve physical activity and medication adherence. The mHealth group had an increase in mean daily step count and quality of life but not in medication adherence. Medium- and long-chain acylcarnitines changed differently in treatment groups from baseline to 3 months (P < 0.05). These data have important implications for designing effective lifestyle interventions in HF and DM.

Impact of sports participation on cardiovascular health markers of children and adolescents: Systematic review and meta-analysis.

BACKGROUNDCardiovascular diseases have a high prevalence in adults and their development begins in the first decades of life. On the other hand, sports participation in childhood and adolescence provides benefits which can delay the onset of these diseases.AIMTo synthesize the available literature on the impact of sports participation on cardiovascular outcomes in children and adolescents.METHODSThis systematic review was conducted on studies of children and adolescents (aged 8-18 years) who regularly practiced a sport and had reported cardiovascular outcomes (blood pressure and intima-media thickness) recorded. The Medline/PubMed, SciELO, Reference Citation Analysis (https://www.referencecitationanalysis.com/) and Bireme databases were searched.RESULTSIn total, 3314 publications for blood pressure and 122 publications for intima-media thickness were identified in the databases. After exclusions (e.g., duplicate articles, animal studies and those that did not meet the inclusion criteria), four publications for blood pressure (449 adolescents) and two publications for intima-media thickness were included (402 adolescents). For blood pressure, all publications were longitudinal in design (follow-up ranging from 12 wk to 12 mo) and involved adolescents aged from 8 years to 18 years of age. For intima-media thickness, both publications were longitudinal in design and involved adolescents aged from 11 years to 18 years of age.CONCLUSIONSports participation seems to promote benefits to cardiovascular structure and function in adolescents. However, studies with adolescents are scarce and further research is needed to understand this phenomenon.

Exposures to low-levels of fine particulate matter are associated with acute changes in heart rate variability, cardiac repolarization, and circulating blood lipids in coronary artery disease patients

Exposure to air pollution is a major risk factor for cardiovascular disease, disease risk factors, and mortality. Specifically, particulate matter (PM), and to some extent ozone, are contributors to these effects. In addition, exposures to these pollutants may be especially dangerous for susceptible populations. In this repeated-visit panel study, cardiovascular markers were collected from thirteen male participants with stable coronary artery disease. For 0–4 days prior to the health measurement collections, daily concentrations of fine PM (PM2.5) and ozone were obtained from local central monitoring stations located near the participant's homes. Then, single (PM2.5) and two-pollutant (PM2.5 and ozone) models were used to assess whether there were short-term changes in cardiovascular health markers. Per interquartile range increase in PM2.5, there were decrements in several heart rate variability metrics, including the standard deviation of the normal-to-normal intervals (lag 3, -5.8%, 95% confidence interval (CI) = −11.5, 0.3) and root-mean squared of successive differences (five day moving average, −8.1%, 95% CI = −15.0, −0.7). In addition, increases in PM2.5 were also associated with changes in P complexity (lag 1, 4.4%, 95% CI = 0.5, 8.5), QRS complexity (lag 1, 4.9%, 95% CI = 1.4, 8.5), total cholesterol (five day moving average, −2.1%, 95% CI = −4.1, −0.1), and high-density lipoprotein cholesterol (lag 2, -1.6%, 95% CI = −3.1, −0.1). Comparisons to our previously published work on ozone were conducted. We found that ozone affected inflammation and endothelial function, whereas PM2.5 influenced heart rate variability, repolarization, and lipids. All the health changes from these two studies were found at concentrations below the United States Environmental Protection Agency's National Ambient Air Quality Standards. Our results imply clear differences in the cardiovascular outcomes observed with exposure to the two ubiquitous air pollutants PM2.5 and ozone; this observation suggests different mechanisms of toxicity for these exposures.

Impact of the COVID-19 pandemic on cardiometabolic health parameters in children with preexisting dyslipidemia

BackgroundThe COVID-19 pandemic has raised concerns for worsening cardiometabolic health in children.ObjectiveThis study evaluates the impact of the COVID-19 pandemic and subsequent social restrictions on pediatric cardiometabolic health factors.MethodsRetrospective review of patients in a pediatric lipid clinic in the year prior to (3/18/2019-3/17/2020) and during (3/18/2020-3/17/2021) the COVID-19 pandemic was performed. Physical findings (body mass index [BMI], waist circumference [WC], and blood pressure), laboratory markers of cardiometabolic health (lipid panel, insulin resistance, and liver transaminases), self-reported exercise time, and lipid-lowering medications (metformin, statin, omega-3 fatty acids, fenofibrate) were compared.Results297 subjects met inclusion criteria. Among subjects prescribed no medications or on stable medication doses (n=241), there were few changes in lipid panels. Among subjects with new or increased medication doses between pre-pandemic and pandemic intervals (n=62), there were increases in triglycerides (p= 0.019) and HgbA1c (p=0.046). There was no change in z-scores for both BMI and WC for either group.ConclusionWe observed concerning trends in markers of cardiovascular disease health (dyslipidemia, insulin resistance, and diabetes), independent of changes in weight, in at-risk children during the recent COVID pandemic. Our findings suggest that this vulnerable population may benefit from more frequent monitoring and intense management during such events.

Effects of weight-loss on adipokines, total and regional body composition and markers of metabolic syndrome in women who are overweight and obese

Obesity among aging women is associated with increased risk for metabolic and cardiovascular diseases. Weight-loss has been shown to reduce disease risk; however, it remains unclear how changes in adipokines following weight-loss are associated with markers of metabolic and cardiovascular health in women. The aim of this study was to determine the effects of a 3-month intensive lifestyle management-focused weight-loss program on the interactions between adipokines, total and regional body composition, and biomarkers of cardiovascular and metabolic health. Women who were overweight or obese (n = 43, age = 49.2 ± 1.5 years, body mass index (BMI) = 34.5 ± 0.9 kg/m2; waist circumference (WC) = 99.8 ± 2.2 cm) completed a 3-month weight-loss program consisting of a reduced energy intake to 1200–1500 kcals/day combined with a progressive walking program targeting 300 min/wk. At 3-months, average body mass was reduced 8.3 % (ΔBMI −8.0 %; ΔWC −6.6 %). Weight-loss lowered fasting glucose (−12.1 %), insulin (−23.2 %), total cholesterol (−11.0 %), and LDL-C (−12.2 %) concentrations, and HOMA-IR (−32.4 %). Leptin was decreased 32.6 %, high molecular weight (HMW) adiponectin increased 25.0 %, and adiponectin:leptin ratio increased 1.27-fold. The change in fat mass was positively correlated with Δleptin (r = 0.527) and inversely correlated with Δadiponectin:leptin ratio (r = −0.547). The ΔHMW adiponectin inversely correlated with Δinsulin (r = −0.360) and ΔHOMA-IR (r = −0.304), and ΔLDL-C (r = −0.305), whereas Δleptin correlated with Δtriglyceride (r = 0.366) and Δtotal cholesterol (r = 0.402). Weight-loss in women who were overweight and obese was associated with a reduction in leptin and increase in HMW adiponectin and adiponectin:leptin ratio. Correlations revealed that changes in these adipokines were uniquely associated with improvements in select markers of metabolic and cardiovascular disease risk.

Analysis of Clinical Traits Associated With Cardiovascular Health, Genomic Profiles, and Neuroimaging Markers of Brain Health in Adults Without Stroke or Dementia

The American Heart Association (AHA) Life's Simple 7 (LS7) score captures 7 biological and lifestyle factors associated with promoting cardiovascular health. To test whether healthier LS7 profiles are associated with significant brain health benefits in persons without stroke or dementia, and to evaluate whether genomic information can recapitulate the observed LS7. This genetic association study was a nested neuroimaging study within the UK Biobank, a large population-based cohort study in the United Kingdom. Between March 2006 and October 2010, the UK Biobank enrolled 502 480 community-dwelling persons aged 40 to 69 years at recruitment. This study focused on a subset of 35 914 participants without stroke or dementia who completed research brain magnetic resonance imaging (MRI) and had available genome-wide data. All analyses were conducted between March 2021 and March 2022. The LS7 (blood pressure, low-density lipoprotein cholesterol, hemoglobin A1c, smoking, exercise, diet, and body mass index) profiles were ascertained clinically and genomically. Independent genetic variants known to influence each of the traits included in the LS7 were assessed. The total LS7 score ranges from 0 (worst) to 14 (best) and was categorized as poor (≤4), average (>4 to 9) and optimal (>9). The outcomes of interest were 2 neuroimaging markers of brain health: white matter hyperintensity (WMH) volume and brain volume (BV). The final analytical sample included 35 914 participants (mean [SD] age 64.1 [7.6] years; 18 830 [52.4%] women). For WMH, compared with persons with poor observed LS7 profiles, those with average profiles had 16% (β = -0.18; SE, 0.03; P < .001) lower mean volume and those with optimal profiles had 39% (β = -0.39; SE, 0.03; P < .001) lower mean volume. Similar results were obtained using the genomic LS7 for WMH (average LS7 profile: β = -0.06; SE, 0.014; P < .001; optimal LS7 profile: β = -0.08; SE, 0.018; P < .001). For BV, compared with persons with poor observed LS7 profiles, those with average LS7 profiles had 0.55% (β = 0.09; SE, 0.02; P < .001) higher volume, and those with optimal LS7 profiles had 1.9% (β = 0.14; SE, 0.02; P < .001) higher volume. The genomic LS7 profiles were not associated with BV. These findings suggest that healthier LS7 profiles were associated with better profiles of 2 neuroimaging markers of brain health in persons without stroke or dementia, indicating that cardiovascular health optimization was associated with improved brain health in asymptomatic persons. Genomic information appropriately recapitulated 1 of these associations, confirming the feasibility of modeling the LS7 genomically and pointing to an important role of genetic predisposition in the observed association among cardiometabolic and lifestyle factors and brain health.

Inhalation of low-dose basil (Ocimum basilicum) essential oil improved cardiovascular health and plasma lipid markers in high fat diet-induced obese rats.

This study investigated the antiobesogenic effects of the inhalation of volatile compounds derived from basil essential oil (BEO) in high fat diet-induced obese rats. A total of 47 volatile compounds were identified in BEO using gas chromatography-mass spectrometry. Major volatile compounds identified by olfactory testing include linalool oxide, linalool, 1-menthene, and carvone. White adipose tissue significantly decreased in the rats that inhaled 0.3% BEO (more than +10%) compared to the control. Plasma marker analysis showed increased high-density lipoprotein-cholesterol (ca. double fold) and decreased low-density lipoprotein-cholesterol (more than -30%) levels in inhaled 1% BEO group compared to the control. Leptin significantly decreased in the 0.3 and 1% BEO groups (more than -70 and -85%, respectively). Last, systolic blood pressure at week 12 was significantly lower in inhaled 1% BEO group (more than -15%) compared to the control. The results of this study suggest that BEO inhalation may be effective in managing plasma lipid markers (cholesterols and leptin) and possibly metabolic disorders such as obesity. Practical Application: Changes in metabolic health markers, which are effected by inhalation of volatiles in basil (Ocimum basilicum) essential oil, will provide physiological variations in vivo to the public. In this study, the opposite effects were identified between 0.3% and 1% inhalation, respectively. Therefore, our findings will provide optimized and useful guidance for inhalation of basil essential oil.

Effects of Acute Exercise on Cardiac Autonomic Response and Recovery in Non-Dialysis Chronic Kidney Disease Patients

ABSTRACT Purpose: Heart rate variability (HRV) has gained acceptance as a key marker of cardiovascular health. We compared HRV responses after continuous moderate-intensity exercise (CMIE) and high-intensity interval exercise (HIIE) matched for intensity and duration in individuals with midspectrum chronic kidney disease (CKD). Methods: Twenty men and women (age 62.0 ± 10 yrs.) diagnosed with CKD stages G3a and G3b participated in a 2 (condition) x 4 (time point) repeated cross-over measures design study. HRV time-domain indices were based on the standard deviation of all NN intervals (SDNN) and the square root of the mean of the sum of the squares of differences between adjacent NN intervals (RMSSD) and frequency domain. High-frequency (HF), low-frequency (LF), total power (TP) were examined. CMIE consisted of treadmill walking for 30 minutes at a 2% incline and speed corresponding to 60%–65% of reserve volume of oxygen (VO2R). HIIE included five intervals of 3 minutes at 90% of VO2R and 2 minutes at 20% VO2R intervals. Conditions were designed to be of the same average intensity (60% to 65% of VO2R) and caloric expenditure (~144 kcal). Results: Immediately following exercise SDNN, RMSSD, HF, LF, and TP were significantly lower compared to before exercise (p <.05). HRV responses were not different between conditions and conditions X time (p >.05). Conclusions: Thirty minutes of either CMIE or HIIE decreased HRV indices, pointing to an autonomic imbalance favoring vagal mediation. HRV’s responses regarding HIIE were no different from CMIE, therefore, from an autonomic function point of view this similarity may be useful for CKD exercise prescription and programming.

No evidence of differential impact of sunflower and rapeseed oil on biomarkers of coronary artery disease or chronic kidney disease in healthy adults with overweight and obesity: result from a randomised control trial

PurposeThe perceived benefits and risks associated with seed oil intake remain controversial, with a limited number of studies investigating the impact of intake on a range of compounds used as cardiometabolic markers. This study aimed to explore the proteomic and cardiometabolic effects of commonly consumed seed oils in the UK, with different fatty acid profiles.MethodsIn a parallel randomised control design, healthy adults (n = 84), aged 25–72 with overweight or obesity were randomised to one of three groups: control (habitual diet, CON); 20 mL rapeseed oil per day (RO), or 20 mL sunflower oil per day (SO). Blood, spot urine and anthropometric measures were obtained at 0, 6 and 12 weeks. Proteomic biomarkers analysis was conducted for coronary arterial disease (CAD) and chronic kidney disease (CKD) using capillary electrophoresis coupled to mass spectrometry (CE-MS). Blood lipids, fasting blood glucose, glycative/oxidative stress and inflammatory markers were also analysed.ResultsNo differences in change between time points were observed between groups for CAD or CKD peptide fingerprint scores. No change was detected within groups for CAD or CKD scores. No detectable differences were observed between groups at week 6 or 12 for the secondary outcomes, except median 8-isoprostane, ~ 50% higher in the SO group after 12-weeks compared to RO and CON groups (p = 0.03).ConclusionThe replacement of habitual fat with either RO or SO for 12 weeks does not lead to an improvement or worsening in cardiovascular health markers in people with overweight or obesity.Trial registrationTrial registration clinicaltrials.gov NCT04867629, retrospectively registered 30/04/2021.

The physiological and clinical importance of cardiorespiratory fitness in people with abdominal aortic aneurysm.

New Findings What is the topic of this review? This review focuses on the physiological impact of abdominal aortic aneurysm (AAA) on cardiorespiratory fitness and the negative consequences of low fitness on clinical outcomes in AAA. We also discuss the efficacy of exercise training for improving cardiorespiratory fitness in AAA. What advances does it highlight? We demonstrate the negative impact of low fitness on disease progression and clinical outcomes in AAA. We highlight potential mechanistic determinants of low fitness in AAA and present evidence that exercise training can be an effective treatment strategy for improving cardiorespiratory fitness, postoperative mortality and disease progression. An abdominal aortic aneurysm (AAA) is an abnormal enlargement of the aorta, below the level of the renal arteries, where the aorta diameter increases by >50%. As an aneurysm increases in size, there is a progressive increase in the risk of rupture, which ranges from 25 to 40% for aneurysms >5.5 cm in diameter. People with AAA are also at a heightened risk of cardiovascular events and associated mortality. Cardiorespiratory fitness is impaired in people with AAA and is associated with poor (postoperative) clinical outcomes, including increased length of hospital stay and postoperative mortality after open surgical or endovascular AAA repair. Although cardiorespiratory fitness is a well‐recognized prognostic marker of cardiovascular health and mortality, it is not assessed routinely, nor is it included in current clinical practice guidelines for the management of people with AAA. In this review, we discuss the physiological impact of AAA on cardiorespiratory fitness, in addition to the consequences of low cardiorespiratory fitness on clinical outcomes in people with AAA. Finally, we summarize current evidence for the effect of exercise training interventions on cardiorespiratory fitness in people with AAA, including the associated improvements in postoperative mortality, AAA growth and cardiovascular risk. Based on this review, we propose that cardiorespiratory fitness should be considered as part of the routine risk assessment and monitoring of people with AAA and that targeting improvements in cardiorespiratory fitness with exercise training might represent a viable adjunct treatment strategy for reducing postoperative mortality and disease progression.

Health Benefits of Apple Juice Consumption: A Review of Interventional Trials on Humans.

Although numerous studies have reported the benefits of apple consumption on cardiometabolic health parameters and chronic disease prevention, few have focused on the effects of apple juice specifically. Juice consumption may be a convenient way to take advantage of the health effects of the bioactive components present in apples. The present review aims to summarize the current literature on health benefits of apple juice as reported in clinical trials in humans. Of the 67 studies retained, 20 interventional studies on humans were reviewed. Overall, cloudy apple juice consumption was found to be associated with several markers of cardiovascular health that may ultimately be relevant for cancer and neurodegenerative diseases. Most of the documentation was found regarding oxidative stress, as well as observations with other parameters such as markers of inflammation, lipid profile, and diabetes. This review suggests that, in 20 studies, apple juice consumed in moderation exerts positive effects on markers of cardiovascular disease risk (particularly on oxidative stress).

Relationship of Blood Pressure and White Matter Hyperintensity Burden With Level of and Change in Cognition in Older Black Adults.

Elevations in blood pressure (BP) and associated white matter hyperintensities (WMHs) are chronic comorbid conditions among older Black adults. We investigated whether WMHs modify the association between late-life BP and cognition within older Black adults. A total of 167 Black adults (age, ~75 years; without dementia at baseline) participating in neuroimaging studies at the Rush Alzheimer's Disease Center were evaluated for BP markers of cardiovascular health, including systolic BP, diastolic BP, pulse pressure, mean arterial pressure (MAP), and hypertension, and were assessed for global and domain-specific cognition at baseline and annually for up to 8 years. WMHs adjusted for intracranial volume were quantified at baseline. Models adjusted for relevant confounders and the interaction of these variables with time revealed differential associations between BP markers and baseline cognition; however, only elevated diastolic BP predicted faster cognitive, that is, episodic memory, decline (estimate = -0.002, standard error = 0.0009, p = .002). Although WMH burden did not modify the association between diastolic BP and episodic memory decline, it did interact with diastolic BP to lower episodic memory at baseline (estimate = -0.051, standard error = 0.012, p = .0001); that is, greater WMHs combined with higher diastolic BP resulted in the lowest baseline episodic memory scores. A similar profile was noted for WMHs, MAP, and baseline episodic memory. Hypertension was neither associated with cognition nor modified by WMH burden after multiple comparisons correction. Late-life diastolic BP was associated with faster rates of episodic memory decline in older Black adults; together with higher WMH burden, it (and MAP) lowered the point at which individuals begin their course of decline toward pathological aging.

Effect of Stress on Heart Rate Variability in Medical Students: A Cross-sectional Study

Introduction: Medical education can impose significant psychological stress on undergraduate students. A considerable degree of psychological morbidity has been reported among medical students ranging from stress, interpersonal problems, and suicidal ideation to psychiatric disorders and they tend to have greater psychological distress than the general population. Stress is one of the factors known to cause variation in heart rate variability. Heart Rate Variability (HRV) is a proven reliable non invasive marker of cardiovascular health and has been used in cardiovascular risk stratification. Aim: To study the effect of stress on heart rate variability in medical students. Materials and Methods: The cross-sectional study was conducted in the Department of Physiology at JSS Medical College, Mysuru, Karnataka, India, from December 2017 to February 2018. Total 58 healthy first-year MBBS medical students aged between 18-25 years with normal Body Mass Index (BMI) were included in the study. The Medical Student Stressor Questionnaire (MSSQ), a validated instrument to identify sources of stress in medical students was used to assess the level of stress. AD Instruments PowerLab (Data Acquisition System) was used to record the frequency and time domain analysis of HRV from the limb leads. Kruskal-Wallis test was applied to assess the association between stress domains and HRV domains, using Statistical Package for Social Sciences (SPSS) version 23.0. Results: Most of the medical students had mild to moderate degrees of stress in all the domains of the MSSQ. There was no statistically significant (p-value&gt;0.05) association found between domains of stress with the time and frequency domains of the HRV. Conclusion: Though it was found that medical students were exposed to significant stressors during their medical training, the stress was of mild to a moderate degree which had no significant effect on HRV.

The Effects of Acute Exposure to Prolonged Sitting, with and Without Interruption, on Peripheral Blood Pressure Among Adults: A Systematic Review and Meta-Analysis.

Previous reviews have shown that exposure to acute prolonged sitting can have detrimental effects on several cardiovascular and cardiometabolic health markers. However, to date, there has been no synthesis of peripheral blood pressure data (including systolic blood pressure, diastolic blood pressure and mean arterial pressure), an important and translatable marker of cardiovascular health. Similarly, no previous study has consolidated the effects of sitting interruptions on peripheral blood pressure. We aimed to (1) assess the effect of exposure to acute prolonged sitting on peripheral blood pressure and (2) determine the efficacy of sitting interruption strategies as a means of offsetting any negative effects. Subgroup analyses by age and interruption modality were performed to explore heterogeneity. Electronic databases (PubMed, Web of Science and, SPORTDiscus) were searched from inception to March 2021. Reference lists of eligible studies and relevant reviews were also screened. Inclusion criteria for objective (1) were: (i) peripheral blood pressure was assessed non-invasively in the upper limb pre-sitting and post-sitting; (ii) studies were either randomised controlled, randomised crossover or quasi-experimental pre-test vs post-test trials; (iii) the sitting period was ≥ 1h; (iv) pre-sitting and post-sitting measures were performed in the same posture; and (v) participants were adults (aged ≥ 18years), free of autonomic or neuromuscular dysfunction. Additional criteria for objective (2) were: (i) the interruption strategy was during the sitting period; (ii) there was an uninterrupted sitting control condition; and (iii) the interruption strategy must have involved participants actively moving their upper or lower limbs. In total, 9763 articles were identified, of which 33 met inclusion criteria for objective (1). Of those articles, 22 met inclusion criteria for objective (2). Weighted mean difference (WMD), 95% confidence intervals (95% CI), and standardised mean difference (SMD) were calculated for all trials using inverse variance heterogeneity meta-analysis modelling. Standardised mean difference was used to determine the magnitude of effect, where < 0.2, 0.2, 0.5 and 0.8 were defined as trivial, small, moderate and large, respectively. (1) Prolonged uninterrupted sitting resulted in trivial and small significant increases in systolic blood pressure (WMD = 3.2mmHg, 95% CI 0.6to 5.8, SMD = 0.14) and mean arterial pressure (WMD = 3.3mmHg, 95% CI 2.2to 4.4, SMD = 0.37), respectively, and a non-significant trivial increase in diastolic blood pressure. Subgroup analyses indicated that the increases in systolic blood pressure and mean arterial pressure were more pronounced in younger age groups. (2) Interrupting bouts of prolonged sitting resulted in significantly lower systolic blood pressure (WMD = - 4.4mmHg, 95% CI - 7.4 to - 1.5, SMD = 0.26) and diastolic blood pressure (WMD = - 2.4mmHg, 95% CI - 4.5 to - 0.3, SMD = 0.19) compared with control conditions, particularly when using aerobic interruption strategies. Exposure to acute prolonged uninterrupted sitting results in significant increases in systolic blood pressure and mean arterial pressure, particularly in younger age groups. Regularly interrupting bouts of prolonged sitting, particularly with aerobic interruption strategies may reduce negative effects.

Does strawberry supplementation ameliorate markers of cardiovascular and metabolic health? A systematic review and meta-analysis

PurposeThis study aims to identify the effect of strawberry supplementation on some metabolic, inflammatory and oxidative parameters in adults with cardiovascular (CV) risk factors.Design/methodology/approachA systematic literature search was performed up to November 2020 using PubMed, Embase, Cochrane, Web of Sciences and Scopus databases. The pooled mean difference (MD) with 95% confidence interval (CI) was used to analyze the data by random-effects model. I2 statistics and Cochrane risk of bias tool were used for investigating heterogeneity and quality of included studies, respectively.FindingsIn total, 13 randomized controlled trials with 488 participants were included. Strawberry supplementation significantly reduced diastolic blood pressure (MD = −2.1, 95% CI [−3.7, −0.42], P = 0.01), low-density lipoprotein cholesterol (−0.16, −0.30, −0.02, P = 0.03), high-sensitivity C-reactive protein (CRP) (−0.76, −1.4, −0.05, P < 0.001) and CRP (−0.31, −0.43, −0.18, P = 0.04). Leptin levels were raised in control group compared with participants who had received strawberry (0.65, 0.09 and 1.2, P = 0.02). The results of subgroup analysis based on the follow-up duration and supplementation dose showed that consumption of strawberry for more than eight weeks and 50 g day−1 can significantly decrease some other CV risk factors compared to control group. Further, both higher follow-up duration and supplementation dose were more effective in increasing leptin levels of control group compared to intervention group.Originality/valueThe use of some useful plant foods such as strawberries by the pharmaceutical industry and the community health sector can greatly help improve people’s CV and metabolic health.