Cardiovascular Risk Markers Research Articles

SERUM PARATHORMONE, VITAMIN D AND CARDIOVASCULAR RISK FACTORS

Objective: The aim of this study is to evaluate the associations of serum 25-OHD and PTH concentrations with blood pressure and hypertension mediated target organ damage including left ventricular hypertrophy (LVH) and carotid intima-media thickness (IMT). Design and method: This observational retrospective study included 98 patients admitted at Hypertension Research Center of Federico II University Hospital in Naples without CKD. We collected serum 25-OHD, PTH, creatinine, BMI, lipid profile, blood glucose and office blood pressure. All patients underwent carotid doppler ultrasound and echocardiography. Results: Mean age of the participants was 53±17 years and 69% were men. Pearson's correlation analysis indicated that PTH levels correlated directly with age, diabetes, dyslipidemia, hypertension, fasting glucose, on statin therapy, left ventricular mass and inversely with the GFR, total cholesterol, LDL and vit D level. Vit. D levels correlated inversely with PTH, diabetes and carotid plaque. Multivariate regression models indicated that PTH was significantly associated with higher fasting glucose and with vit D while Vit D was associated with lower GFR and PTH level. Conclusions: In a population at high cardiovascular risk, Vit. D and PTH are not directly associated with hypertension but might influence association with other cardiovascular risk factors and markers.

0858 Associations between Sleep Duration and Cholesterol Levels among Hispanics: Findings from the National Health Interview Survey

Abstract Introduction Short sleep (< 7 hours of sleep/24 hr. period) duration is associated with unhealthy cholesterol levels, a significant cardiovascular risk marker. Precious epidemiological studies indicate that Hispanics are at increased risk for hypercholesteremia. However, little is known about whether sleep duration contributes to high cholesterol levels, among Hispanics. We sought to investigate the following: 1) Examine whether sleep duration predicts cholesterol levels; 2) Examine whether this relationship differs in Hispanics in comparison to non-Hispanics. Methods This study was based on the 2020 National Health Interview Survey. Cholesterol, the outcome, is defined as whether an individual had high cholesterol during the last 12 months. Sleep quantity was categorized as follows: short sleep (< 7 hours), healthy sleep (7-8 hours), and long sleep (≥9 hours). For stratified analyses, we investigated whether the relationship between sleep duration and cholesterol differed between Hispanics and non-Hispanics. We performed unadjusted and fully adjusted binary logistic regression analyses, with age, sex, education, income, and BMI as covariates. Results In our unadjusted models, Hispanic short sleepers had increased odds of high cholesterol (OR: 1.39 p<.01 ), while long sleepers (OR: 1.25, n.s. p=.129) did not, compared to individuals who slept 7-8 hours. Non-Hispanic short (OR: 1.14 p<.01) and long (OR: 1.47, p< .01) sleepers had greater odds of high cholesterol, compared to individuals who slept 7-8 hours. For our fully adjusted models, Hispanic short sleepers had increased odds of high cholesterol (OR: 1.29, p<.05), while long sleepers did not (OR: 1.15, n.s. p=.55), compared to individuals who slept 7-8 hours. Non-Hispanics short sleepers had greater odds of high cholesterol (OR: 1.13 p<.01), while among long sleepers, no significant relationship was observed (OR: 1.05, p=.46), compared to individuals who slept 7-8 hours. Overall, Hispanic short sleepers had greater odds of high cholesterol compared to their non-Hispanic counterparts. Conclusion Hispanic short sleepers have an increased risk for high cholesterol. Further studies are needed to elucidate the pathophysiological mechanisms that affect the relationship between short sleep and cholesterol levels among Hispanics. This will enable tailored risk and protective profiling of Hispanic individuals to reduce their risk for high cholesterol. Support (if any) K01HL135452, K07AG052685, R01AG072644, and R01HL152453

Nocturnal pulse wave amplitude attenuations are associated with long-term cardiovascular events

ObjectivesPhotoplethysmography (PPG) is an established technology for detecting pulse rate and pulse wave irregularities. However, whether temporal variations in pulse wave amplitudes, reflecting a combination of acute hemodynamic or autonomic responses to changes in overall vascular function, carry prognostic information remains unclear. To quantify nocturnal temporal pulse wave amplitude (PWA) attenuations and evaluate its association with long-term cardiovascular (CV) events in a large, racially diverse sample of men and women. MethodsTemporal PWA attenuations were determined based on the slopes between the upper and lower envelopes of PPGs derived from overnight polysomnography of 1957 participants (899 men, 1058 women, mean age 68.2 ± 9.1 years) of the Multi-Ethnic Study of Atherosclerosis. The nocturnal PWA attenuation index was defined as the cumulative duration of all PWA attenuation events relative to total sleep duration. ResultsNocturnal PWA attenuation index was greater in men than in women by almost 13% (16.3 ± 8.9% vs. 14.4 ± 7.9%, p < 0.001). The nocturnal PWA attenuation index was highest in Chinese-American participants (17.9 ± 9.2%) and lowest in African-Americans (13.5 ± 8.1%). During a median follow-up of 4.9 years, 94 CV events occurred. In multivariable Cox proportional hazard analysis adjusted for typical confounders, the nocturnal PWA attenuation index <15.2% was associated with CV events (HR = 1.58 [1.02–2.45], p = 0.042). ConclusionsNocturnal PWA attenuation index is inversely associated with the risk of CV events, particularly in men and African-Americans. The PPG-derived nocturnal PWA attenuation index could be simply obtained from smart wearable consumer devices and may provide a low-cost, accessible and scalable CV risk marker.

Food insecurity is associated with glycemic markers, and socioeconomic status and low-cost diets are associated with lipid metabolism in Mexican mothers

The association between socioeconomic status (SES) and chronic disease has recently become more evident in middle- and low-income countries. We hypothesized that poor socioeconomic conditions, such as food insecurity, low educational level, or low SES, may restrict access to a healthy diet and may be associated with cardiometabolic risk independently of body fat. This study examined the relation between socioeconomic indicators, body fat, and cardiometabolic disease risk markers in a random sample of mothers living in Queretaro, Mexico. Young and middle-aged mothers (n = 321) answered validated questionnaires to determine SES, food insecurity, and educational level and a semiquantitative food frequency questionnaire to determine dietary patterns and the cost of individual diet. Clinical measurements included anthropometry, blood pressure, lipids profile, glucose, and insulin. Obesity was present in 29% of the participants. Women with moderate food insecurity had higher waist circumference, glucose, insulin, and homeostasis model assessment of insulin resistance than women with food security. High triglyceride concentration and lower levels of high-density lipoprotein and low-density lipoprotein cholesterol were associated with lower SES and lower educational level. Women who consumed a lower carbohydrate diet had higher SES, higher education, and better cardiovascular risk markers. The higher carbohydrate diet profile was the least expensive diet. There was an inverse association between the cost and energy-density of foods. In conclusion, food insecurity was associated with glycemic control markers, and lower SES and education were related to a low-cost, higher carbohydrate diet and to a greater cardiovascular risk. The influence of the social environment on obesity and cardiovascular diseases needs to be further explored.

EVALUATION OF HBA1C IN THE DIAGNOSIS OF DIABETES MELLITUS

Diabetes mellitus is a prevalent metabolic disorder that requires early detection and effective management. Glycated hemoglobin (HbA1c) evaluation has emerged as a valu- able tool in diagnosing diabetes mellitus. This study evaluated 62 cases, with 21 diabetic and 41 non-diabetic, and found a significant p-value for HbA1c levels. The mean HbA1c level was 6.36, with a standard deviation of 1.90 and a variance of 3.6189. Comparative analysis showed an increased case detection rate in HbA1c testing. HbA1c testing improves accuracy and convenience of diabetes diagnosis, correlates with long-term glycemic control, and is a prognostic marker for cardiovascular risk. The study highlights the importance of incorporating HbA1c testing into clinical practice, monitoring treatment effectiveness and guiding therapeutic decisions. The findings support the growing recognition of HbA1c as a reliable diagnostic tool for diabetes mellitus, with its ability to reflect average blood glucose levels over a prolonged period. Further research is needed to explore its applicability across different populations and establish standardized guidelines for HbA1c interpretation and utilization. Keywords: Diabetes mellitus, HbA1c, Diagnostic tool, Glycemic control, Fasting, Post prandial

Evaluation of Triglycerides-glucose (TyG) index in a cardiac rehabilitation program. Looking for associations and outcomes

Abstract Funding Acknowledgements Type of funding sources: None. The Triglyceride-glucose (TyG) index is emerging as a novel marker of insulin resistance, metabolic syndrome and cardiovascular risk. The TyG index is calculated as Ln[(triglyceride [mg/dl]*fasting plasma glucose[mg/dl])/2]. It is being assessed in both primary and secondary prevention. The aim of this study was to measure the TyG index in a group of patients in cardiac rehabilitation (CH) and relate it to cardiovascular events, the severity of coronary arterial disease (CAD) and compare it with other indexes for cardiovascular disease. This unicenter, retrospective and observational study recruited patients who attended to CH program of a tertiary-level hospital between 1st January and 31st December, 2020. New cardiovascular events were registered until 15th October 2022. The TyG index was estimated according to the first blood sample at admission, we considered it abnormal above 8.8. The severity of CAD was measured using coronariography and stratified as single or multi-vessel (50% of stenosis in ≥2 main coronary arteries). MACCE was defined as myocardial infarction, stroke or cardiovascular death. We also calculated TG/HDL ratio (Triglycerides [mg/dl]/HDL cholesterol [mg/dl]), TC/HDL ratio (Total Cholesterol [mg/dl]/HDL [mg/dl]) and Remnant Cholesterol (non-HDL cholesterol [mg/dl] – LDL [mg/dl]). Statistical analyses were performed using R project. A total of 238 patients were enrolled, 190 (79.8%) were men, mean age 60.5 ± 11.3 years. The main indication for CH was CAD. Percutaneous coronary intervention was done in 175 patients (73.5%), coronary artery bypass grafting was performed in 9 (3.8%); 36 (15.1%) individuals had suffered MACCE previously. During the follow up, 12 underwent another MACCE. The TyG index was statistically higher between patients who suffered MACCE (8.9±0.6, p&amp;lt;0.01). This connection was also found with TG/HDL ratio (p=0.03), TC/HDL ratio (p&amp;lt;0.01) and remnant (p=0.03)(Figure1). As for our cutoff of 8.8 the TyG index established a sensitivity of 49.7%, specificity of 72.5% and positive predictive value of 86.9% for MACCE. TyG index predicted better a second event (AUC=74.6%)(Figure2A) than TC/HDL (AUC=59.03%)(Figure2B). An elevated TyG index was linked with abnormal TG/HDL, TC/HDL remnants particles, VLDL, non-HDL, lower HDL and higher HbA1c and lower HDL but not with higher LDL and total cholesterol. There was no statistical relationship between TyG index with body mass index (p=0.14)(Figure2C) nor abdominal circumference (p=0.38)(Figure2D). Among patients with CAD, the average of stenotic vessels was 1.5±0.8. There were 7 in-stent-restenosis (ISR). We didn´t find a correlation between TyG index and multivessel disease (p=0.37), nor ISR (p=1.0). TyG index is an easy and early sign of diabetic dyslipemia. In association with others indicators, it can help us to focus on those patients at high cardiovascular risk or with higher residual risk, specially nowadays that new non-statin therapies are about to come.

(357) Nocturnal Penile Tumescence Test in Patients with Erectile Dysfunction Associates With Penile and Systemic Vascular Disease

Abstract Introduction Erectile dysfunction (ED) is the most frequent male sexual dysfunction along with premature ejaculation. Moreover, its prevalence is increasing worldwide due to ageing of the population and spreading of risk factors like obesity, diabetes, hypercholesterolemia, hypertension, etc. Also, it represents an important cardiovascular risk marker because of its demonstrated tight association with cardiovascular disease (CVD). We dispose of many diagnostic tools to assess ED and a proper workup includes the anamnesis, a physical exploration, blood tests for hormonal and metabolic evaluation, and ED grading through validated questionnaires such as the International Index of Erectile Function (IIEF). One of the instrumental tests we may indicate is the nocturnal penile tumescence (NPT) test or “Rigiscan”. This test measures the spontaneous erections overnight and helps discriminating between organic and psychological ED. However, this is a highly specific but low sensitive test since a positive (normal) result can roll out an organic ED and suggest a psychological etiology while a negative result cannot confirm or exclude an organic condition. Objectives In this context the aim of this study is to investigate the predictive role of Rigiscan in discriminating patients with an organic ED and the presence of vascular disease in patients with ED. Methods We conducted a prospective study in patient 25 patient who underwent a Rigiscan test as part of ED assessment. Each patient had blood tests for hormonal and metabolic analysis, a measurement of the carotid intima-media thickness (cIMT), a brachial flow-mediated vasodilation test (FMD), and a penile color doppler ultrasound (PCDU) to assess penile hemodynamics. Results Our patients had a mean age of 47.9 ± 13.7 years, with a mean IIEF score of 9.0 ± 6.5. Among them 13 (54.2%) were active smokers, 5 (20.8%) were diabetics, 8 (32%) had dyslipidemia, and 4 (16.7%) had hypertension. Eleven patients (44%) had a normal Rigiscan while 14(56%) had a pathological result. We found that patient with a pathological Rigiscan presented with a cluster of impaired vascular function at different levels. In particular, they had statistically lower peak systolic velocity (PSV) in the PCDU (52.5 vs 80.2 cm/s p=0.014) and a higher prevalence of arterial insufficiency (42.9% vs 0.0% p=0.020). Moreover, in patients with negative Rigiscan, there was a higher cIMT (0.9 vs 0.7 mm) and lower response to FMD (7.7% vs 9.6%) with a more frequent diagnose of impaired FMD (63.6% vs 46.2%) but without reaching a statistically significance. Conclusion We can conclude that a negative Rigiscan is indicative of altered penile hemodynamics and may suggests the presence of systemic vascular disease. Therefore, while a positive Rigiscan excludes organic ED, a negative Rigiscan should be considered a cardiovascular risk marker and induce the clinician to address the cardiovascular risk in that patient. More studies with larger population are warranted to confirm and further investigated these findings. Disclosure No

High 1-h glucose in youths with obesity as marker of prediabetes and cardiovascular risk.

Testing 1-h glucose (1HG) concentration during oral glucose tolerance test is cost-effective to identify individuals at risk of incident type 2 diabetes. Aim of the study was to define 1HG cutoffs diagnostic of incident impaired glucose tolerance (IGT) in youths with obesity, and to evaluate prevalence and association of cutoffs identified in the cohort and from the literature (133 and 155mg/dl) to cardiovascular disease (CVD) in a population of youths with obesity. This is a longitudinal study of 154 youths to identify 1HG cutoffs, and cross-sectional study of 2295 youths to estimate prevalence of high 1HG and association to CVD. Receiver-operating characteristic curves (ROC) were used to establish 1HG cutoffs, and univariate regression analysesto testassociation of 1HG to blood pressure, lipids and aminotransferases. ROC analysis identified the 1HG cutoff of 159mg/dl as having diagnostic accuracy of IGT with area under the ROC 0.82 (95% CI 0.66-0.98), sensitivity 0.86% and specificity 0.79%. In the cross-sectional population, prevalence of high 1HG was 36% and 15% for 133 and 155mg/dl cutoffs, respectively, and 17% for the 159mg/dl value. All the examined cutoffs were significantly associated with worse lipid profile, liver function test, reduced insulin sensitivity, secretion and disposition index. High 1HG is marker of persistent IGT and increased risk of metabolic abnormalities in youths. The 155mg/dl cutoff is a convenient estimate in young people but longitudinal studies with retinopathy and overt diabetes as end points are advised to verify the 1HG cutoff with the best diagnostic accuracy.

Endothelial function predicts 5-year adverse outcome in patients hospitalized in an emergency department chest pain unit.

Although endothelial function is a marker for cardiovascular risk, endothelial dysfunction assessment is not routinely used in daily clinical practice. A growing challenge has emerged in identifying patients prone to cardiovascular events. We aim to investigate whether abnormal endothelial function may be associated with adverse 5-year outcomes in patients presenting to a chest pain unit (CPU). Following endothelial function testing using EndoPAT 2000 in 300 consecutive patients without a history of coronary artery disease, patients underwent coronary computerized tomographic angiography (CCTA) or single-photon emission computed tomography according to availability. Mean 10-year Framingham risk score (FRS) was 6.6 ± 5.9%; mean 10-year atherosclerotic cardiovascular disease (ASCVD) risk was 7.1 ± 7.2%; median reactive hyperemia index (RHI) as a measure of an endothelial function 2.0 and mean was 2.0 ± 0.4. During a 5-year follow-up, the 30 patients who developed major adverse cardiovascular events (MACE), including all-cause mortality, nonfatal myocardial infarction, hospitalization for heart failure or angina pectoris, stroke, coronary artery bypass grafting, and percutaneous coronary interventions, had higher 10-year FRS (9.6 ± 7.8 vs. 6.3 ± 5.6%; P = 0.032), higher 10-year ASCVD risk (10.4 ± 9.2 vs. 6.7 ± 6.9%; P = 0.042), lower baseline RHI (1.6 ± 0.5 vs. 2.1 ± 0.4; P < 0.001) and a greater degree of coronary atherosclerotic lesions (53 vs. 3%, P < 0.001) on CCTA compared with patients without MACE. Multivariate analysis demonstrated that RHI below the median was an independent predictor of 5-year MACE (odds ratio 5.567, 95% confidence interval 1.955-15.853; P = 0.001). Our findings suggest that noninvasive endothelial function testing may contribute to clinical efficacy in triaging patients in the CPU and in predicting 5-year MACE. NCT01618123.

Current Insights into the Significance of the Renal Resistive Index in Kidney and Cardiovascular Disease.

Initially, the renal resistive index (RRI) was investigated with the aim of improving diagnosis in kidney diseases, but this goal was not met. Recently, many papers have highlighted the prognostic significance of the RRI in chronic kidney disease: specifically, in estimating the revascularization success of renal artery stenoses or the evolution of the graft and the recipients in renal transplantation. Moreover, the RRI has become significant in the prediction of acute kidney injury in critically ill patients. Studies in renal pathology have revealed correlations of this index with parameters of systemic circulation. The theoretical and experimental premises of this connection were then reconsidered, and studies analyzing the link between RRI and arterial stiffness, central and peripheral pressure, and left ventricular flow were conducted with this purpose. Many data currently indicate that RRI is influenced more by pulse pressure and vascular compliance than by renal vascular resistance-assuming that RRI reflects the complex interplay between systemic circulation and renal microcirculation and should be considered a marker of systemic cardiovascular risk beyond its prognostic relevance for kidney disease. In this review, we overview the clinical research that reveals the implications of RRI in renal and cardiovascular disease.

Elevated pulse pressure and cardiovascular risk associated in Spanish population attended in primary care: IBERICAN study.

Elevated pulse pressure (ePP) is an independent marker of cardiovascular risk (CVR) in people older than 60, and a functional marker of subclinical target organ damage (sTOD) which can predict cardiovascular events in patients with hypertension (HTN), regardless of sTOD. To evaluate the prevalence of ePP in adult population seen in primary care and its association with other vascular risk factors, sTOD and with cardiovascular disease (CVD). Observational multicentre study conducted in Spain (8,066 patients, 54.5% women) from the prospective cohort study IBERICAN recruited in Primary Care. Pulse pressure (PP) was defined as the difference between the systolic blood pressure (SBP) and the diastolic blood pressure (DBP) ≥60 mmHg. Adjusted (for age and sex) ePP prevalence were determined. Bivariate and multivariate analyses of the possible variables associated with ePP were carried out. The mean of PP was 52.35 mmHg, and was significantly higher (p < 0.001) in patients with HTN (56.58 vs. 48.45 mmHg) The prevalence of ePP adjusted for age and sex was 23.54% (25.40% men vs. 21.75% women; p < 0.0001). The ePP prevalence rates increased linearly with age (R2 = 0.979) and were significantly more frequent in population aged ≥65 than in population aged <65 (45.47% vs. 20.98%; p < 0.001). HTN, left ventricular hypertrophy, low estimated glomerular filtration rate, alcohol consumption, abdominal obesity, and CVD were independently associated with ePP. 66.27% of patients with ePP had a high or very high CVR, as compared with 36.57% of patients without ePP (OR: 3.41 [95% CI 3.08-3.77]). The ePP was present in a quarter of our sample, and it was increased with the age. Also, the ePP was more frequent in men, patients with HTN, other TOD (as left ventricular hypertrophy or low estimated glomerular filtration rate) and CVD; because of this, the ePP was associated a higher cardiovascular risk. In our opinion, the ePP is an importer risk marker and its early identification lets to improve better diagnostic and therapeutic management.

Association Between Ferritin Levels and Altitude-Dependent Cardiorespiratory Fitness in Mountain Guides.

Pühringer, Reinhard, Martina Muckenthaler, and Martin Burtscher. Association between ferritin levels and altitude-dependent cardiorespiratory fitness in mountain guides. High Alt Med Biol. 24:139-143, 2023. Background: Higher ferritin levels may be associated with lower cardiorespiratory fitness (CRF; i.e., maximal oxygen uptake, VO2max) and may represent early markers of cardiovascular risk but may also support high-altitude acclimatization. To evaluate these potential associations, data recordings from a large sample of male mountain guides have been analyzed. Methods: A total of 154 data sets (including anthropometric data, VO2max, blood lipids, hemoglobin, ferritin, and transferrin levels) of regularly physically active and well-acclimatized mountain guides were available for analyses. Participants performed equal incremental cycle ergometer tests to exhaustion at low (600 m) and (∼1 week later) at moderate altitude (2,000 m). Results: Ferritin levels were positively correlated with levels of hemoglobin (r = 0.29, p < 0.01), total cholesterol (r = 0.18, p < 0.05), triglycerides (r = 0.23, p < 0.01), and low-density lipoprotein (r = 0.22, p < 0.01), and negatively with high-density lipoprotein levels (r = -0.16, p < 0.05) and also with baseline (taken at low altitude) VO2max values (r = -0.19, p < 0.05). In contrast, higher ferritin levels were associated with less VO2max decline from low-to-moderate altitude (r = 0.26, p < 0.01). Conclusion: Higher ferritin levels in male mountain guides are weakly associated with lower CRF and higher prevalence of cardiovascular risk factors but with slightly less reduction in VO2max when acutely exposed to moderate altitude. The clinical relevance of these observations needs further investigation.

Effect of cognitive processing therapy on markers of cardiovascular risk in posttraumatic stress disorder patients: A randomized clinical trial

ObjectivePosttraumatic stress disorder (PTSD) is associated with elevated risk of coronary heart disease (CHD); however, the effects of PTSD treatment on CHD biomarkers is unknown. This study examined whether cognitive processing therapy (CPT) improves 24-hourheart rate variability (HRV), a predictor of CHD mortality. MethodsIndividuals between the ages of 40 and 65 years with PTSD (n = 112) were randomized to receive 12 sessions of CPT or a Waiting List (WL) intervention comprised of 6 weekly telephone checks of emotional status. The primary outcome variable was 24-hour HRV estimated from the standard deviation of all normal R-R intervals (SDNN); secondary outcomes were the root mean square of successive differences between heart beats (RMSSD), low-frequency HRV (LF-HRV) and high-frequency HRV (HF-HRV). Secondary outcomes also included 24-hour urinary catecholamine excretion, plasma C-reactive protein (CRP), and flow-mediated dilation (FMD) of the brachial artery. For outcomes, linear mixed longitudinal models were used to estimate mean differences (Mdiff). ResultsParticipants randomized to the CPT group did not show improved SDNN (Mdiff = 9.8; 95%CI, −2.7 to 22.3; p = 0.12), the primary outcome variable, but showed improved RMSSD (Mdiff = 3.8; 95% CI, 0.5 to 7.1; p = 0.02), LF- HRV (Mdiff =0.3; 95% CI, 0.1 to 0.5; p = 0.01), and HF-HRV (Mdiff = 0.3; 95% CI, 0.0 to 0.6; p = 0.03) compared to WL. There were no differences between groups in catecholamine excretion, FMD, or inflammatory markers. ConclusionTreating PTSD may not only improve quality of life but may also help ameliorate heightened CHD risk characteristics of PTSD.

Evolution of cardiovascular risk markers in polycystic ovary syndrome: Results from a long-term monocentric cohort study

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Vascular Changes in Hypertension: Is There Cell Death Involved? – A Narrative Review

"Background: Cardiovascular disease can be triggered and accelerated by hypertension and the underlying changes in the structure and function of arteries. The purpose of this review is to explore some vascular changes that occur in hypertension as a consequence of the imbalance between cell proliferation and cell death, processes that play an important role in stabilizing the thickness of the arterial wall during vascular remodeling. Methods: The authors conducted research through PubMed and Google Scholar databases using the following search formula: (hypertensive*) AND ((vascular modifications)) OR (vascular changes)) AND (cell death). Results: From 40 articles, only 17 publications were included in this study, taking into account four processes that can be preceded or followed by inflammation and depend on the interaction between local growth factors, vasoactive substances, and hemodynamic stimuli: Cell proliferation and growth; Cell migration; Cell death; Degradation or reorganization of extracellular matrix. Conclusions: To summarize, maladaptive vascular changes in hypertension can represent a major argument for prompt and maximal therapeutic intervention in patients with high cardiovascular risk. Moreover, they can represent an important step in discovering new markers of cardiovascular risk and in the development of new targeted therapies for different pathways of cellular signaling through which the reversibility of abnormal vascular changes could be obtained. "

Cardiovascular and Diabetes Risk in Preschoolers

Objective: To perform an exploratory analysis of possible alterations in clinical markers of cardiovascular risk and type 2 diabetes in preschoolers living in urban and suburban areas of the municipality of Hermosillo, Sonora, Northwest Mexico. Methods: An observational and cross-sectional study was carried out on children from urban and suburban areas. Their weight, height, waist circumference, body fat percentage, and blood pressure were measured, and their lipid profile, glucose, and insulin concentrations were evaluated. Results: Eighty-two children with an average age of five were included in the study; 48 from the conurbation and 34 from the urban area. We found that malnutrition, overweight, and high body fat percentage (27 ± 0.52) coexist. In the suburban area, there was a higher percentage of children with pre-hypertension and alterations in lipids: elevated triglycerides (35%) and low HDL-c (25%) (p &lt; 0.01). In the urban area, there was a higher percentage of children with altered glucose (12%), elevated insulin concentrations, and insulin resistance. Conclusion: The findings of this study show that cardiovascular risk factors and type 2 diabetes are prevalent in children aged three to six living in urban and conurbation areas of Hermosillo, Sonora.

Cardiovascular risk markers in patients with spinal cord injury: the Austrian wheelchair dancer study

Journal Article Accepted manuscript Cardiovascular Risk Markers in Patients with Spinal Cord Injury: The Austrian Wheelchair Dancer Study Get access Barbara Mayr, Barbara Mayr Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Lindhofstraße 20, 5020 Salzburg, Austria https://orcid.org/0000-0002-2835-3938 Search for other works by this author on: Oxford Academic Google Scholar Michelle Felber, Michelle Felber Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Lindhofstraße 20, 5020 Salzburg, Austria Search for other works by this author on: Oxford Academic Google Scholar Vanessa Frey, Vanessa Frey Department of Neurology, Christian Doppler University Hospital, Paracelsus Medical University and Centre for Cognitive Neuroscience Salzburg, Austria. Member of the European Reference Network EpiCARE https://orcid.org/0000-0002-5337-1273 Search for other works by this author on: Oxford Academic Google Scholar Nora Renz, Nora Renz Department of Neurology, Christian Doppler University Hospital, Paracelsus Medical University and Centre for Cognitive Neuroscience Salzburg, Austria. Member of the European Reference Network EpiCARE https://orcid.org/0000-0001-8011-6684 Search for other works by this author on: Oxford Academic Google Scholar Kerstin Schwenker, Kerstin Schwenker Department of Neurology, Christian Doppler University Hospital, Paracelsus Medical University and Centre for Cognitive Neuroscience Salzburg, Austria. Member of the European Reference Network EpiCAREKarl Landsteiner Institute for Neurorehabilitation and Space Neurology, Salzburg, AustriaNeuroscience Institute, Christian Doppler University Hospital, Center for Cognitive Neuroscience Salzburg, Paracelsus Medical University, Salzburg, AustriaSpinal Cord Injury and Tissue Regeneration Center Salzburg, Paracelsus Medical University Salzburg, Austria https://orcid.org/0000-0002-0316-6108 Search for other works by this author on: Oxford Academic Google Scholar Eugen Trinka, Eugen Trinka Department of Neurology, Christian Doppler University Hospital, Paracelsus Medical University and Centre for Cognitive Neuroscience Salzburg, Austria. Member of the European Reference Network EpiCAREKarl Landsteiner Institute for Neurorehabilitation and Space Neurology, Salzburg, AustriaNeuroscience Institute, Christian Doppler University Hospital, Center for Cognitive Neuroscience Salzburg, Paracelsus Medical University, Salzburg, AustriaSpinal Cord Injury and Tissue Regeneration Center Salzburg, Paracelsus Medical University Salzburg, Austria https://orcid.org/0000-0002-5950-2692 Search for other works by this author on: Oxford Academic Google Scholar Josef Niebauer Josef Niebauer Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Lindhofstraße 20, 5020 Salzburg, Austria Corresponding author: Prof. Josef Niebauer, MD, PhD, MBA, University Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University, Lindhofstraße 20, 5020 Salzburg, Austria. ph.:+43(0)5 7255-23200, fax: +43(0)5 7255-23299. E-mail: j.niebauer@salk.at https://orcid.org/0000-0002-2811-9041 Search for other works by this author on: Oxford Academic Google Scholar European Journal of Preventive Cardiology, zwad128, https://doi.org/10.1093/eurjpc/zwad128 Published: 24 April 2023 Article history Received: 06 March 2023 Revision received: 18 April 2023 Accepted: 20 April 2023 Published: 24 April 2023

Low concentrations of medium-sized HDL particles predict incident CVD in chronic kidney disease patients

Patients with chronic kidney disease (CKD) are at high risk for CVD. However, traditional CVD risk factors cannot completely explain the increased risk. Altered HDL proteome is linked with incident CVD in CKD patients, but it is unclear whether other HDL metrics are associated with incident CVD in this population. In the current study, we analyzed samples from two independent prospective case-control cohorts of CKD patients, the Clinical Phenotyping and Resource Biobank Core (CPROBE) and the Chronic Renal Insufficiency Cohort (CRIC). We measured HDL particle sizes and concentrations (HDL-P) by calibrated ion mobility analysis and HDL cholesterol efflux capacity (CEC) by cAMP-stimulated J774 macrophages in 92 subjects from the CPROBE cohort (46 CVD and 46 controls) and in 91 subjects from the CRIC cohort (34 CVD and 57 controls). We tested associations of HDL metrics with incident CVD using logistic regression analysis. No significant associations were found for HDL-C or HDL-CEC in either cohort. Total HDL-P was only negatively associated with incident CVD in the CRIC cohort in unadjusted analysis. Among the six sized HDL subspecies, only medium-sized HDL-P was significantly and negatively associated with incident CVD in both cohorts after adjusting for clinical confounders and lipid risk factors with odds ratios (per 1-SD) of 0.45 (0.22–0.93, P = 0.032) and 0.42 (0.20–0.87, P = 0.019) for CPROBE and CRIC cohorts, respectively. Our observations indicate that medium-sized HDL-P—but not other-sized HDL-P or total HDL-P, HDL-C, or HDL-CEC—may be a prognostic cardiovascular risk marker in CKD.

Astaxanthin, a natural antioxidant, lowers cholesterol and markers of cardiovascular risk in individuals with prediabetes and dyslipidaemia.

To determine the effects of astaxanthin treatment on lipids, cardiovascular disease (CVD) markers, glucose tolerance, insulin action and inflammation in individuals with prediabetes and dyslipidaemia. Adult participants with dyslipidaemia and prediabetes (n = 34) underwent baseline blood draw, an oral glucose tolerance test and a one-step hyperinsulinaemic-euglycaemic clamp. They were then randomized (n = 22 treated, 12 placebo) to receive astaxanthin 12 mg daily or placebo for 24 weeks. Baseline studies were repeated after 12 and 24 weeks of therapy. After 24 weeks, astaxanthin treatment significantly decreased low-density lipoprotein (-0.33 ± 0.11 mM) and total cholesterol (-0.30 ± 0.14 mM) (both P < .05). Astaxanthin also reduced levels of the CVD risk markers fibrinogen (-473 ± 210 ng/mL), L-selectin (-0.08 ± 0.03 ng/mL) and fetuin-A (-10.3 ± 3.6 ng/mL) (all P < .05). While the effects of astaxanthin treatment did not reach statistical significance, there were trends toward improvements in the primary outcome measure, insulin-stimulated, whole-body glucose disposal (+0.52 ± 0.37 mg/m2 /min, P = .078), as well as fasting [insulin] (-5.6 ± 8.4 pM, P = .097) and HOMA2-IR (-0.31 ± 0.16, P = .060), suggesting improved insulin action. No consistent significant differences from baseline were observed for any of these outcomes in the placebo group. Astaxanthin was safe and well tolerated with no clinically significant adverse events. Although the primary endpoint did not meet the prespecified significance level, these data suggest that astaxanthin is a safe over-the-counter supplement that improves lipid profiles and markers of CVD risk in individuals with prediabetes and dyslipidaemia.

Age of onset defines two distinct profiles of atopic dermatitis in adults.

The incidence of adult-onset atopic dermatitis (AOAD) is increasing. However, the unique characteristics of AOAD compared to pediatric-onset AD persisting into adulthood (POAD) are underexplored, hampering the development of targeted-therapeutics for this growing population. We thus assessed the profile of AOAD in skin and blood compared to that of POAD. We collected skin biopsies and blood from adults with AOAD, POAD, and healthy controls (n = 15 in each group). Skin samples were analyzed by RNA sequencing, qRT-PCR, and immunohistochemistry, and Olink Proseek multiplex assay was used to identify the serum proteomic profile. Compared to healthy controls, both AOAD and POAD showed cutaneous immune and barrier dysregulations with a shared Th2/Th22 hyperactivation. Overall, POAD showed greater inflammation in lesional skin, with more prominent expression of Th2/Th17/Th22 markers (CCL17/22, S100A8/9, IL-36A, PI3/Elafin, DEFB4) in POAD compared to AOAD (p-value < .05). In contrast, higher Th1-(IFN-γ, IL-2, IL-15, CCL5) upregulation and Th1-skewing were seen in AOAD. The epidermal barrier was also more compromised in POAD, with greater epidermal hyperplasia and lower expression of markers related to terminal differentiation, lipids, and cell adhesion. In parallel with increased rates of cardiovascular comorbidities, AOAD demonstrated many more significantly dysregulated proteins in serum (n = 148) compared to POAD (n = 86), including pro-inflammatory and cardiovascular-risk markers. Th1-related products showed significant correlations between their skin and blood expressions only in AOAD subjects. Age-of-onset delineates two distinct endophenotypes in adult AD potentially suggesting the need for broader (beyond Th2) therapeutic targeting in AOAD.