Prevalence Of Coronary Heart Disease Research Articles

Abstract 23: Sexual Dimorphism In Genetic Associations Of Testosterone And Sex-hormone Binding Globulin With Coronary Heart Disease

Introduction: Men have higher prevalence and mortality of coronary heart disease (CHD) than women. Sex differences in associations of testosterone (T) and sex-hormone binding globulin (SHBG) with CHD risk have been recognized. But mechanisms underlying sex differences in CHD are unknown. Hypothesis: Genetic regulations of T and SHBG may differ by sex; such genetic heterogeneity may contribute to sex differences in CHD. Methods: We carried out a sex-stratified genome-wide association study for T, SHBG, and CHD in 187,888 men and 221,014 women from the UK Biobank, to identify sex-specific ( P <5х10 -8 in one sex and P ≥5х10 -8 in the other) and sex-differed ( P <5х10 -8 in both sexes but effects differed significantly by sex) loci for each trait. Plasma T and SHBG were measured by immunoassay. Genetic correlations were estimated using linkage disequilibrium score regressions. We used cross-traits meta-analyses to identify loci that coregulate a biomarker (T or SHBG) and CHD. Results: The median T levels in men were 10-12 times higher than that in women across all age groups. Women had higher SHBG levels. We identified 344 sex-specific/sex-differed loci for T and 89 for SHBG ( Fig. A ). Genetic correlations between sexes were 0.02 for T, suggesting mostly sex-specific genetic regulation, and were 0.86 for SHBG and 0.94 for CHD, suggesting partially sex-differed genetic regulation. We observed a significant inverse genetic correlation between T and CHD in men ( r g =-0.15; P =1.4х10 -5 ) but not in women. The inverse genetic correlation between SHBG and CHD was stronger in women ( r g =-0.33; P =5.2х10 -11 ) than men ( r g =-0.18; P =2.8х10 -7 ). We identified 31 sex-specific loci coregulating T and CHD (26 for men and 5 for women), and 48 sex-specific loci coregulating SHBG and CHD (35 for men and 13 for women) ( Fig. B ). Tissue-specific gene expression regulations at some loci (e.g. LPA ) were also differed by sex ( Fig. C ). Conclusions: The between-sex heterogeneity in genetic coregulations of T and SHBG with CHD may contribute to the sex-differences in CHD etiology.

Comparative Study between Diabetic and non- Diabetic Patients Regarding Prevalence of Coronary Artery Disease and Plaque Composition by Multi-detector CT Coronary Angiography

Abstract Diabetes is known to be a major cardiovascular risk factor associated with significantly increased morbidity and mortality and particularly increased risk of major cardiac events especially myocardial infarction as a manifestation of highly incident coronary artery disease (CAD).This can lead to decreased life expectation and life quality. Major cause for myocardial infarction is plaque rupture. Prevalence of obstructive and non-obstructive plaques is increased in diabetic patients. Background and Objectives The prevalence of coronary heart disease in diabetic patients compared to non- diabetics and evaluating the composition of the plaque in diseased individuals in both groups by usage of multislice computed tomography (MSCT) angiography . Subjects and Methods A total of 80 consecutive MSCT angiography examinations were performed between August 2017 and June 2018. Of these, the patients were evaluated for the presence and type of atherosclerotic plaque and severity of luminal narrowing. Results Eighty (40 in the diabetic group and 40 in the non-diabetic group) patients underwent MSCT angiography with DM prevalence of 0.212 (95% Cl for AOR 0.056 -1.896). Among them, 20 patients (50 %) in the diabetic group and 14 patients (35 %) in the non-diabetic group had +ve coronary heart disease, 33.3 % had significant and moderately significant coronary narrowing on diabetic group and 31.3 % in non-diabetic group on MSCT angiography. Diabetic patients had more soft plaque compared with non-diabetic patients. Conclusion DM is not an independent factor for the disease occurrence in coronary artery disease but is a dependent factor in the association of other risk factors such as smoking ,hypertension and dyslipidemia.

Efficacy trials of Indian bread developed from sorghum based composite flour mix on blood lipid profile of experimentally induced hyperlipidemic rats

The aim of this study was to compare the effect of different experimental diet model on experimentally induced hyperlipidemic rats. Hyperlipidemia has been ranked as one of the greatest risk factors contributing to the prevalence and severity of coronary heart diseases. Hyperlipidemia is characterized by elevated serum total cholesterol (TC), low density lipoprotein (LDL), and very low density lipoprotein (VLDL) and decreased high density lipoprotein (HDL) levels. Inducing hypercholesterolemia in rats is done through a high fat, high cholesterol diet, with the fat source varying from lard to canola, coconut, soybean or palm oil. The present study was carried out to evaluate the efficacy of Indian bread developed from unprocessed cereals and legumes and other functional ingredients in reducing the risk of CVD’s as they are rich source of dietary fiber, phytonutrients and with potent antioxidant activity. Besides medication, diet also plays an important role in the management of lipid and lipoprotein concentrations in blood. In the present study an approach was made to assess the functional efficacy of Indian bread developed sorghum based composite flour mix for a period of 21 days on the blood lipid profile of the experimentally induced hyperlipidemic rats.

Features of the course of gallstone disease in patients with non-alcoholic fatty liver disease

To update information about comorbidity of non-alcoholic fatty liver disease (NAFLD) and gallstones disease (GD), evaluation of clinical and laboratory data, including insulin, leptin and adiponectin in individuals with NAFLD in combination with GD. According to the design, we conducted an open comparative study of 169 patients with NAFLD. The following comparison groups were formed: group 1 (n=95) patients with NAFLD without GD, group 2 (n=35) patients with NAFLD and GD and group 3 (n=39) patients with NAFLD, GD and previous cholecystectomy. A high prevalence of coronary heart disease was found in the group of patients with GD and cholecystectomy (2=6.198,p0.05); positive, statistically significant correlation relationships of cholelithiasis, cholecystectomy with ischemic heart disease (rs=0.172,p0.05 andrs=0.241,p0.05, respectively). There was a statistically significant decrease in total bilirubin and total protein in patients of group 3 (H=7.376,p0.03 and H=6.345,p0.04). The level of leptin is statistically significantly higher and positively interrelated with cholecystectomy (H=5.812,p0.05,rs=0.313,p0.05). Patients with NAFLD, GD and previous cholecystectomy have a high prevalence of coronary heart disease; the phenomenon of insulin and leptin resistance, high level of adiponectin were revealed in patients with NAFLD and gallstones; hyperleptinemia was observed among patients with NAFLD, GD after cholecystectomy.

Patterns of Chronic Conditions and Their Association With Visual Impairment and Health Care Use

Visual impairment and visual disorders often co-occur with other chronic conditions. Understanding patterns of multimorbidity is important for reducing health care use and improving health outcomes. To identify chronic condition patterns and their association with visual impairment and health care use in a nationally representative sample. This cross-sectional study used National Health Interview Survey data for 387 780 individuals aged 18 years and older, representative of the civilian noninstitutionalized US population, from January 1, 2002, to December 31, 2014. Statistical analysis was performed from June to November 2018. Participants were classified in subgroups with different combinations of self-reported chronic conditions using latent class analysis. Self-reported visual impairment, emergency department visit, and hospitalization use in the previous 12 months. Among the 387 780 individuals included in the study, 51.8% were female, 77.6% were white, and the mean (SD) age was 46.2 (18.0) years. Latent class analysis identified 5 different classes, with 70.5% of the participants belonging to the healthy group. The other 4 groups represented various degrees and patterns of multimorbidity. The hypertensive group (19.6%) had a high prevalence of hypertension (62.6%), the respiratory conditions group (4.4%) had a high prevalence of emphysema (47.7%) and asthma (45.6%), the heart disease group (3.6%) had high prevalence of coronary heart disease (69.8%), and the severely impaired group (1.8%) had higher prevalence of most conditions compared with the other groups. In the adjusted analysis, compared with the healthy group, participants in all 4 disease groups had elevated risk of visual impairment: heart condition group (odds ratio [OR], 3.19; 95% CI, 2.92-3.48), hypertensive group (OR, 3.28; 95% CI, 3.10-3.48), respiratory condition group (OR, 3.87; 95% CI, 3.56-4.20), and severely impaired group (OR, 10.19; 95% CI, 9.20-11.28). All 4 disease groups had elevated risk of reporting emergency department use and hospitalization. For the severely impaired group, the OR for emergency department use was 9.39 (95% CI, 8.53-10.34), and the OR for hospitalization was 10.80 (95% CI, 9.80-11.92). In this study, individuals in all 4 multimorbidity groups had an elevated risk of visual impairment and health care use compared with the healthy group. Characteristics of high-risk groups identified by this study may help in the development and implementation of interventions to avert the more serious consequences of having multiple chronic conditions.

Multi-Omics Analysis Reveals MicroRNAs Associated With Cardiometabolic Traits.

MicroRNAs (miRNAs) are non-coding RNA molecules that regulate gene expression. Extensive research has explored the role of miRNAs in the risk for type 2 diabetes (T2D) and coronary heart disease (CHD) using single-omics data, but much less by leveraging population-based omics data. Here we aimed to conduct a multi-omics analysis to identify miRNAs associated with cardiometabolic risk factors and diseases. First, we used publicly available summary statistics from large-scale genome-wide association studies to find genetic variants in miRNA-related sequences associated with various cardiometabolic traits, including lipid and obesity-related traits, glycemic indices, blood pressure, and disease prevalence of T2D and CHD. Then, we used DNA methylation and miRNA expression data from participants of the Rotterdam Study to further investigate the link between associated miRNAs and cardiometabolic traits. After correcting for multiple testing, 180 genetic variants annotated to 67 independent miRNAs were associated with the studied traits. Alterations in DNA methylation levels of CpG sites annotated to 38 of these miRNAs were associated with the same trait(s). Moreover, we found that plasma expression levels of 8 of the 67 identified miRNAs were also associated with the same trait. Integrating the results of different omics data showed miR-10b-5p, miR-148a-3p, miR-125b-5p, and miR-100-5p to be strongly linked to lipid traits. Collectively, our multi-omics analysis revealed multiple miRNAs that could be considered as potential biomarkers for early diagnosis and progression of cardiometabolic diseases.

Case-Control Study on the Interaction Effects of rs10757278 Polymorphisms at 9p21 Locus and Traditional Risk Factors on Coronary Heart Disease in Xinjiang, China.

Objective:To study the interaction effects of rs10757278 polymorphisms at 9p21 locus and traditional risk factors on coronary heart disease (CHD) in Xinjiang, China.Methods:This case–control study consecutively enrolled 310 unrelated consecutive CHD patients aged 18–70 years old. All study participants were recruited between January and December 2017 from The Heart Center of The First Affiliated Hospital of Xinjiang Medical University. CHD patients were confirmed by coronary angiography (≥50% diameter stenosis in at least one of the major coronary arteries) according to the American Heart Association criteria for the confirmation of CHD. Healthy subjects were randomly selected from the occupational population, who received physical examination in our hospital and matched to cases on the basis of age (±3 years) and sex, those without medical history of cardiovascular diseases, and 536 subjects were selected as the control group after medical history inquiry, physical examination, cardiac ultrasound, electrocardiogram, and other blood biochemical examinations in the hospital. The occupational stress was evaluated by an effort-reward imbalance questionnaire. An epidemiological survey was conducted to collect clinical data. Chi-squared test, analysis of variance, and binary logistic regression analysis were adopted.Results:Both the case and the control groups showed significant difference in smoking, drinking, physical activity, hypertension, diabetes mellitus, family history of CHD, and body mass index (BMI) (all P < 0.05); prevalence of CHD was not related to occupational stress. There was no significant difference in occupational stress level between the 2 groups (P > 0.05); Differences in rs10757278 genotype between the case group and the control groups were statistically significant; binary logistic regression analysis was used to evaluate the risk factors of CHD. After adjustment for age and sex, significant increased risk effects for CHD were found to be associated with smoking [odds ratio (OR) = 2.311; 95% confidence interval (CI): 1.04–2.499; P < 0.001], physical exercise (OR = 1.365; 95% CI: 1.137–1.639; P < 0.001), hypertension (OR = 4.627; 95% CI: 2.165–10.764; P < 0.001), family history of CHD (OR = 4.103; 95% CI: 3.169–6.892; P < 0.001), BMI (OR = 2.484; 95% CI: 2.036–3.03; P < 0.001), and GG genotype at rs10757278 (OR = 1.978; 95% CI: 1.413–2.769; P < 0.001); We noted that a significant interaction association between GG genotype at rs10757278 and CHD differs across categories of smoking, hypertension, family history of CHD, and BMI.Conclusion:GG genotype at rs10757278 may be a risk factor for CHD. And there are interaction effects between GG genotype of rs10757278 in region 9p21 gene and traditional risk factors.

Prevalence and Influencing Factors of Coronary Heart Disease and Stroke in Chinese Rural Adults: The Henan Rural Cohort Study.

Background: Epidemiological studies about cardiovascular disease in rural areas of developing countries are rare. This study aimed to estimate the prevalence and influencing factors of coronary heart disease (CHD) and stroke in Chinese rural population.Methods: 39,259 subjects (15,490 males) aged 18–79 years were enrolled from the Henan Rural Cohort Study. Age-standardized prevalence was calculated according to Chinese 6th Population Census. Associations between risk factors and diseases were estimated by the odds ratios and 95% confidence intervals with generalized linear mixed model.Results: Among the participants, 1,734 with CHD and 2,642 with stroke were identified. Crude prevalence of CHD was 4.42%, and prevalence in male (4.01%) was significantly lower than female (4.68%). Corresponding age-standardized prevalence was 2.23% (2.05% for male and 2.37% for female). Crude prevalence of stroke was 6.73%, and in male (7.92%) was higher than female (5.95%). Age-standardized prevalence was 2.98% (3.42% for male and 2.69% for female). The results identified that old age, female, smoking, obesity, hypertension, diabetes, and dyslipidemia were positively associated with CHD. Being Female and a higher level of physical activity were negatively related to stroke, while old age, high-risk drinking, and chronic disease were positively related to stroke.Conclusion: CHD and stroke were not rare in Chinese rural area. Healthy lifestyles and control of chronic disease should be improved to curb the epidemic of cardiovascular disease among rural population.Clinical Trial Registration: The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). http://www.chictr.org.cn/showproj.aspx?proj=11375.

Prevalence of coronary artery disease in the indigenous population of Gornaya Shoria (the results of epidemiological studies in 1998-2001 and 2013-2017)

Aim. To study the features of the prevalence of coronary heart disease (CHD) in the period 1998–2001 and 2013–2017 in the indigenous population of Gornaya Shoria.Methods. In the first period of the study (from 1998 to 2001), 550 respondents of indigenous nationality living in rural areas of Gornaya Shoria (v. Orton and v. Ust-Kabyrza) were included. In the second period (from 2013 to 2017) – 937 people in the same villages, as well as in the urban village Sheregesh and city Tashtagol. The presence of coronary artery disease was estimated by the sum of three epidemiological criteria: based on the analysis of ECG by Minnesota code, Rose questionnaire and a history of myocardial infarction. Statistical analysis was performed using the program Statistica 6.0 (StatSoft Inc., USA.) Qualitative features were described using frequencies as a percentage. To determine the statistical significance of these differences, Pearson's criterion c2 was evaluated. In the study, the critical level of significance when testing statistical hypotheses was taken p&lt;0.05.Results. The frequency of CHD in the first stage of the study in the village was 6.2%, in the survey of the rural population in the Gornaya Shoria in 2013–2017 this figure was 8.0%. Comparative analysis at the second stage of the study showed a higher prevalence of this disease among urban residents (12.6%) compared with rural (8.0%, p = 0.048). These differences reach statistical significance due to the female population in the age groups of 40–49 years and 50–59 years (7.1% vs. 0% (p = 0.051) and 15.4% vs. 4.1% (p = 0.031)). In males living in the city, revealed an earlier debut of CHD in 40–49 years (5.6%).Conclusion. The study revealed an increase in the prevalence of CHD in women in the indigenous small population of Gornaya Shoria from 1998–2001 to 2013–2017, as well as a number of significant statistically significant differences in the frequency of CHD among the urban and rural population.

Association Between Obesity Type and Common Vascular and Metabolic Diseases: A Cross-Sectional Study.

Background: The association between different types of obesity and some chronic diseases in Dehui, Jilin province, China, is still unclear. The aim of our study was to clarify the association between different types of obesity and chronic diseases.Methods: Residents aged 40 years or older were randomly selected using a multistage stratified cluster sampling method. Data were collected by means of face-to-face interview, physical examination, and laboratory examination. Descriptive data analyses were performed, and multiple logistic regression analyses were used to explore the adjusted association between different types of obesity and common vascular and metabolic diseases.Results: The prevalence of general obesity alone, central obesity alone and compound obesity were 0.15, 54.29, and 14.36%, respectively. The prevalence of coronary heart disease, stroke, hypertension, dyslipidemia, and diabetes mellitus was highest in the compound obesity group, and lowest in the non-obesity group. Hypertension, dyslipidemia, and diabetes mellitus were associated with compound obesity and central obesity alone [compound obesity (OR = 4.703, 95% CI: 3.714–5.956 for hypertension; OR = 4.244, 95% CI: 3.357–5.365 for dyslipidemia; OR = 4.575, 95% CI: 3.194–6.552 for diabetes mellitus); central obesity alone (OR = 2.210, 95% CI: 1.901–2.570 for hypertension; OR = 2.598, 95% CI: 2.241–3.012 for dyslipidemia; OR = 2.519, 95% CI: 1.834–3.459 for diabetes mellitus)]. Coronary heart disease was associated with compound obesity (OR = 1.761, 95% CI: 1.141–2.719) but not central obesity alone (OR = 1.409, 95% CI: 0.986–2.013). Stroke was associated with neither compound obesity (OR = 1.222, 95% CI: 0.815–1.833) nor associated with central obesity alone (OR = 1.080, 95% CI: 0.786–1.485).Conclusions: Central obesity alone and compound obesity are associated with the risk of hypertension, hyperlipidemia, and diabetes mellitus. Compound obesity but not central obesity alone is associated with the risk of coronary heart disease, but further research is needed to confirm it. There are no significant relationship between stroke and central obesity alone or compound obesity.

Markers of Endothelial Dysfunction: E-selectin, Endothelin-1 and von Willebrand Factor in Patients with Coronary Heart Disease, Including in Combination with Type 2 Diabetes Mellitus

The prevalence of coronary heart disease (CHD) and type 2 diabetes mellitus (type 2 diabetes) in Russia and in the world continues to increase. Despite the prevention and optimization of therapy, CHD retains its leadership among all causes of death, and the mortality rate from type 2 diabetes and its complications gradually increases too. To improve the treatment of the above mentioned diseases, it is necessary to clarify the pathogenetic mechanisms of their development. The formation of endothelial dysfunction, characterized by an increase in the level of cell adhesion molecules and vasoconstriction, is a common link characteristic for the course and progression of CHD and type 2 diabetes. This article presents an analysis of preand clinical studies on the role of endothelial dysfunction markers: cell adhesion molecules (E-selectin), vasoconstriction (endothelin-1) and von Willebrand factor in patients with CHD, including those with type 2 diabetes mellitus.

Dietary and serum selenium in coronary heart disease and all-cause mortality: An international perspective.

The objective of this study was to explore the associations of dietary selenium and serum selenium concentration with coronary heart disease (CHD) prevalence and all-cause mortality among participants in United States. Using data collected from the National Health and Nutrition Examination Survey (NHANES) 1999-2006, 17867 individuals were included. Logistic regression analyses were used to explore the associations between dietary selenium intake and serum selenium concentration and prevalent of CHD. Multivariable Cox regression was used to identify the association between dietary selenium intake and all-cause mortality. The nonlinear relationships were assessed using generalized additive models. A U-shaped association between dietary intake of selenium and all-cause mortality was observed. Compared with the lowest quartile, the second quartile of dietary intake of selenium was inversely associated with all-cause mortality (Hazard ratio [HR]: 0.802, 95% confidence interval [CI]: 0.658, 0.977, p=0.029). There was no evidence of association between dietary selenium intake and CHD risk (Odds ratio [OR]: 1.001, 95% CI: 0.999, 1.003, p=0.206). Furthermore, serum selenium concentration was negatively associated with CHD risk (OR: 0.989, 95% CI: 0.981, 0.997, p=0.006). Comparing with the lowest quartile, participants with the highest serum selenium concentration had a statistically significant decreased prevalence of CHD, with OR (95% CI) of 0.417 (0.259, 0.669) (p<0.001). The smoothing curve also showed a non-linear relationship between serum selenium and risk of CHD. This analysis suggested that a higher serum selenium concentration was associated with reduced risk of CHD, and that the relationship was non-linear. In addition, an appropriate dietary selenium intake might reduce all-cause mortality.

An analysis of differences in risk factors, clinical features, Angiographic profiles and outcomes in young versus older adults with myocardial infarction (Morrocan experience)

The prevalence of Coronary heart disease (CHD) is continuously increasing. There is a lack of clinical data concerning Myocardial infarction (MI) in “young” individuals. This study was designed to evaluate the differences in risk factors, clinical characteristics, angiographic findings and outcomes between young and older patients with MI. This study contained both retrospective and prospective components and was fully conducted within the Department of Cardiology at the University Hospital Center of Casablanca between December 2016 and March 2018. This study included patients with MI who underwent coronary angiography aged less than 45 years (group I), compared to the control group (group II) which included patients older than 55 years. Overall, the study included 350 patient of which 110 were ≤ 45 years of age. The mean age of the younger cohort was 39.57 vs. 66.25 years. In both groups, the male sex was more common. In group I, Smoking was the most frequent risk factor (60.7% vs. 35.8%; P < 0.001). Hypertension was significantly more common in group II (59.7% vs. 32.4%; P = 0.02). Family history of CHD was found mostly in group I (35,4% vs. 7,6%; P < 0.001). No statistically significant differences were observed between the two groups with regards to the presence of diabetes mellitus, obesity and dyslipidemia. In younger patients, 53% had single vessel disease vs. 23% in group II. Multi-vessel disease was more common in older patients (75% in group II vs. 42% in group I; P < 0.001). Normal angiography findings were observed in 5% of cases in group I versus 2% in group II. Younger patients had also better in-hospital outcomes (1% in group I vs. 6% in group II) Myocardial infarction in young adults presents several characteristics, with an identifiable risk factor profile, measurable angiographic findings and better outcomes. Screening for Smoking should be strongly considered as early as possible.

Evaluating the effect of nurse-led telephone follow-ups (tele-nursing) on the anxiety levels in people with coronavirus.

Background:Nowadays, the prevalence of coronary heart disease has challenged the lives of families around the world. Anxiety is one of the most important consequences of coronavirus. The nurse-led telephone follow-ups (tele-nursing) are a way to train nurses to further improve nursing services and increase the patients' well-being. The aim of this study was to determine the effect of nurse-led telephone follow-ups (tele-nursing) on the level of anxiety of people with coronavirus who spend their quarantine and treatment at home.Methods:In this semi-experimental study, the number of sample was 100 newly diagnosed patients with Corona, who were tested positive using the CT scan of the lungs and were selected by continuous sampling. In this study, Spielberger's state-trait anxiety inventory was used to collect data before and after the intervention. Samples were randomly divided into control and intervention groups (50 subjects in each group) after receiving initial training in the form of lectures on the corona disease, and the tele-nursing program was implemented on the intervention group every other day for 21 consecutive days. Finally, after the end of the 21st day and the completion of the tele-nursing intervention, the questionnaire was again completed by the control and intervention groups and the results of both groups were compared.Results:The results indicated that the level of anxiety in the two groups after the training program and tele-nursing were significantly different (p < 0.001) and the mean score of the anxiety level after the training program and tele-nursing was significantly reduced (p < 0.001).Conclusion:This study showed that tele-nursing has had a significant effect on reducing the anxiety level of people with Cavid-19 virus. As the telephone technology is available in most clients' homes and its use is easy and accessible, it is recommend including this technology in the field of nursing care and training especially in relation to people with coronavirus.

Динамический мониторинг сердечно-сосудистых заболеваний у пациентов с сахарным диабетом по данным обследования в мобильном медицинском центре (Диамодуль) в регионах России

Background. Diabetes mellitus (DM) is a powerful factor in the development and progression of cardiovascular diseases (CVD), it produces poor prognosis, in-cluding disability and premature mortality in this category of patients. Aim. To carry out dynamic monitoring of the prevalence of CVD in adult DM patients with type 1 and type 2 (coronary heart disease, myocardial infarction, ce-rebrovascular diseases and arterial hypertension) based on a comprehensive examination in a mobile medical center (Diamodule) with repeated visits to the re-gions in 2019 compared to data of the Federal Program "Diabetes mellitus" (2005–2006). Materials and methods. The object of the study: adult patients with DM1 and DM2 (≥18 years old) who underwent examination in Diamodule (n=1480): 882 patients were in 2005/2006 (337 with DM1 and 545 with DM2) and 598 were in 2019 (275 with DM1 and 323 with DM2). Examination at the medical center in-cludes: assessment of anthropometric data (height, weight, body mass index), biochemical data of blood lipids and creatinine levels with calculation of glomerular filtration rate, measurement of glycated hemoglobin (HbA1c), blood pressure, ECG, cardiologist’s consultation with an assessment of the anamnesis data, la-boratory data, ECG. Results. Over the past 13–14 year period in both types of DM, the prevalence of coronary heart disease significantly decreased: in DM1 by 4,42% by 2 times (p=0,037), in DM2 by 18,34% by 2,7 times (p&lt;0,001); myocardial infarction in DM1 by 1,97% by 1,9 times (p=0,172), in DM2 by 3,28% by 1,5 times (p=0,1); cerebrovascular diseases in DM1 by 2,17% by 3 times (p=0,074), in DM2 by 1,45% by 1,2 times (p=0,44). There was an improvement in the diagnosis of arterial hypertension compared to 2005/2006: in DM1 by 6,4% from 44,5 to 51% (p=0,115), in DM2 by 3,6% from 86,8 to 90,4% (p=0,096). It was revealed that the incidence of CVD with active screening in Diamodule is higher than the recorded data on referral compared with the data of the DM register. DM1 patients in the 2019 were significantly older (39 vs 38 years), with a shorter DM duration (18 vs 25 years), with a better HbA1c level (8,7 vs 9,1%). DM2 patients in the 2019 were significantly older (66 vs 58 years), differed in age of diabetes onset (52 vs 51 years), longer duration of DM2 (14 vs 7 years), lower glomerular filtration rate (54 vs 90,6 ml/min/1,73 m2), they had better level of total cholesterol (4,6 vs 5,1 mmol/L), triglycerides (1,3 vs 2,1 mmol/L), while they did not differ in the level of HbA1c and body mass index. Conclusions. The analysis showed a significant decrease in the prevalence of CVD in DM patients compared with the data obtained in the period 2005–2006, this is the result of CVD prevention programs and improving the quality of medical care for this category of patients.

Epidemiology and Adverse Consequences of Hookah/Waterpipe Use: A Systematic Review.

Hookah smoking is becoming a popular trend globally. Waterpipe smoking is the second most prevalent form of alternate tobacco products. The rapid increase in hookah use is because of the misconception prevalent in society that hookah smoking is less harmful than cigarette smoking. Smoking ban policies had given impetus of switching from cigarette smoking to alternate tobacco products like waterpipe. Hookah users regard hookah to be more socially acceptable, less stigmatizing with flavors and to alleviate cigarette craving symptoms. Newer basic science research on animal models and human cells has shown consistently mutagenic, oxidative, and inflammatory changes that could cause possible health effects of premalignant oral lesion and chronic diseases like atherosclerosis and chronic obstructive pulmonary disease. Studies on the chemistry of waterpipe smoke had shown alarming results with the smoke containing seven carcinogens, 39 central nervous system depressants, and 31 respiratory irritants. Enormous data exist showing waterpipe smoking causing various health effects. Hookah smoking effects on cardiovascular disease is additive with hookah containing a significant amount of nicotine, tar, and heavy metals causing both acute and chronic effects on the cardiovascular system. These effects include increased heart rate, blood pressure, prevalence of coronary heart disease, heart failure, ST-segment elevation myocardial ischemia, recurrent ischemia, and worse outcomes including mortality related to these diseases. The objectives of the review are to assess the factor associated with the increasing use of hookah, its health effects, options for hookah smoking cessation, and public health policy initiatives to mitigate waterpipe use.

Physical Exercise and Selective Autophagy: Benefit and Risk on Cardiovascular Health.

Physical exercise promotes cardiorespiratory fitness, and is considered the mainstream of non-pharmacological therapies along with lifestyle modification for various chronic diseases, in particular cardiovascular diseases. Physical exercise may positively affect various cardiovascular risk factors including body weight, blood pressure, insulin sensitivity, lipid and glucose metabolism, heart function, endothelial function, and body fat composition. With the ever-rising prevalence of obesity and other types of metabolic diseases, as well as sedentary lifestyle, regular exercise of moderate intensity has been indicated to benefit cardiovascular health and reduce overall disease mortality. Exercise offers a wide cadre of favorable responses in the cardiovascular system such as improved dynamics of the cardiovascular system, reduced prevalence of coronary heart diseases and cardiomyopathies, enhanced cardiac reserve capacity, and autonomic regulation. Ample clinical and experimental evidence has indicated an emerging role for autophagy, a conservative catabolism process to degrade and recycle cellular organelles and nutrients, in exercise training-offered cardiovascular benefits. Regular physical exercise as a unique form of physiological stress is capable of triggering adaptation while autophagy in particular selective autophagy seems to be permissive to such cardiovascular adaptation. Here in this mini-review, we will summarize the role for autophagy in particular mitochondrial selective autophagy namely mitophagy in the benefit versus risk of physical exercise on cardiovascular function.

Age at menarche and heart failure risk: The EPIC-NL study

AimsEarly age at menarche has been reported to be associated with increased risks of developing type 2 diabetes (T2D) and coronary heart disease (CHD) in adulthood, but a late menarche has also been found to be associated with an increased risk of CHD. Both T2D and CHD are important risk factors for developing heart failure (HF). We examined the relationship between age at menarche (AAM) and HF incidence in women from the European Prospective Investigation into Cancer and Nutrition – Netherlands (EPIC-NL) cohort study. Methods and resultsThe EPIC-NL cohort comprised 28,504 women aged 20–70 years at baseline (1993–1997). Mean age at menarche was 13.3 (standard deviation 1.6) years. During a median follow-up of 15.2 years HF occurred in 631 women. Cox proportional hazard regression models, stratified by cohort and adjusted for potential confounders, were used to investigate the associations between AAM and HF incidence. After confounder adjustment, each year of older age at menarche was associated with a 5% lower risk of HF (hazard ratio 0.95 (95% CI, 0.91–1.00), p-value 0.048). Further adjusting for body mass index (BMI), prevalent CHD, hypertension, or prevalent T2D as potential mediators between early menarche and risk of HF attenuated the associations between AAM and risk of HF to non-significance. ConclusionOlder AAM reduced the risk of HF in this study. BMI, prevalent CHD, hypertension and prevalent T2D seemed to mediate this association. Future research with a longer follow-up should establish whether there is an independent effect of AAM on HF risk. Also, further phenotyping of HF cases is necessary to enable whether the associations differ for the various subtypes of HF.

PCV79 PREVALENCE OF CARDIOVASCULAR DISEASES AND ASSOCIATED RISK FACTORS BY SEX AMONG ADULTS IN UNITED STATES

The aim of this study is to assess whether risk factors for cardiovascular disease (CVD) are similar by sex. We conducted a pooled analysis using National Health Interview Survey (NHIS) - National Cardiovascular Disease Surveillance Data (2000-2015) to determine period prevalence of major CVD, acute myocardial infarction (AMI), coronary heart disease (CHD), and stroke along with the commonly known risk factors stratified by sex among the adults in the United States. Descriptive statistics were used to summarise the results. Analyses were conducted using SAS. Between 2000 and 2015, age-standardised prevalence (ASP) for major CVD, AMI, CHD, and stroke were 7.56%, 3.14%, 4.10%, and 2.47%, respectively. ASP of all the CVD categories were higher among males compared to females (major CVD: 9.07% vs. 6.29%; AMI: 4.34% vs. 2.11%; CHD: 5.54% vs. 2.90%; Stroke: 2.50% vs. 2.43%). Interestingly, ASP of some of the known risk factors such as smoking, physical inactivity and hypertension were higher in females as compared to males (smoking: 80.59% vs. 78.81%; physical inactivity: 36.04% vs. 31.73%; hypertension: 94.00% vs. 89.20%). Prevalence of CVD was higher among males whereas, females had a more diverse profile of CVD risk factors. This suggests substantial scope for risk factors such as sex, in probably being able to predict CVD more accurately and improve management of the disease.

Association of Circulating Metabolites With Risk of Coronary Heart Disease in a European Population

Risk stratification for coronary heart disease (CHD) remains challenging because of the complex causative mechanism of the disease. Metabolomic profiling offers the potential to detect new biomarkers and improve CHD risk assessment. To evaluate the association between circulating metabolites and incident CHD in a large European cohort. This population-based study used the Biomarkers for Cardiovascular Risk Assessment in Europe (BiomarCaRE) case-cohort to measure circulating metabolites using a targeted approach in serum samples from 10 741 individuals without prevalent CHD. The cohort consisted of a weighted, random subcohort of the original cohort of more than 70 000 individuals. The case-cohort design was applied to 6 European cohorts: FINRISK97 (Finland), Monitoring of Trends and Determinants in Cardiovascular Diseases/Cooperative Health Research in the Region of Augsburg (MONICA/KORA; Germany), MONICA-Brianza and Moli-sani (Italy), DanMONICA (Denmark), and the Scottish Heart Health Extended Cohort (United Kingdom). Associations with time to CHD onset were assessed individually by applying weighted and adjusted Cox proportional hazard models. The association of metabolites with CHD onset was examined by C indices. In 10 741 individuals (4157 women [38.7%]; median [interquartile range] age, 56.5 [49.2-62.2] years), 2166 incident CHD events (20.2%) occurred over a median (interquartile range) follow-up time of 9.2 (4.5-15.0) years. Among the 141 metabolites analyzed, 24 were significantly associated with incident CHD at a nominal P value of .05, including phosphatidylcholines (PCs), lysoPCs, amino acids, and sphingolipids. Five PCs remained significant after correction for multiple testing: acyl-alkyl-PC C40:6 (hazard ratio [HR], 1.13 [95% CI, 1.07-1.18]), diacyl-PC C40:6 (HR, 1.10 [95% CI, 1.04-1.15]), acyl-alkyl-PC C38:6 (HR, 1.11 [95% CI, 1.05-1.16]), diacyl-PC C38:6 (HR, 1.09 [95% CI, 1.04-1.14]) and diacyl-PC C38:5 (HR, 1.10 [95% CI, 1.05-1.16]). Lower levels of these metabolites were associated with increased risk of incident CHD. The strength of the associations competes with those of classic risk factors (C statistics: acyl-alkyl-PC C40:6, 0.756 [95% CI, 0.738-0.774], diacyl-PC C40:6, 0.754 [95% CI, 0.736-0.772], acyl-alkyl-PC C38:6, 0.755 [95% CI, 0.736-0.773], diacyl-PC C38:6, 0.754 [95% CI, 0.736-0.772]), diacyl-PC C38:5, 0.754 [95% CI, 0.736-0.772]). Adding metabolites to a base risk model including classic risk factors high-sensitivity C-reactive protein and high-sensitivity troponin I did not improve discrimination by C statistics. Five PCs were significantly associated with increased risk of incident CHD and showed comparable discrimination with individual classic risk factors. Although these metabolites do not improve CHD risk assessment beyond that of classic risk factors, these findings hold promise for an improved understanding of the pathophysiology of CHD.