Prevention Of Cardiovascular Complications Research Articles

Possibilities of reproductive function realization in patients with premature ovarian insufficiency

Premature ovarian insufficiency (POI) directly affects the reproductive health of women all over the world. Currently, the study of this pathology is becoming an increasingly important issue due to the widespread prevalence of premature menopause in the female population. In addition to genetic predisposition, an important role in the development of premature menopause is played by the increasing number of ovarian surgeries due to the development of surgery, as well as radiation and chemotherapy for cancer, leading to premature depletion of the follicular reserve in the ovaries. An important component of treatment for women with POI is not only the management of undesirable symptoms of menopause, prevention of cardiovascular complications and fractures due to decreased bone mineral density, but also the possibility of realizing their reproductive function in the future. Therefore, other treatment options may be offered to women with POI in the absence of spontaneous pregnancy in the natural cycle. Oocyte donation may be recommended for such women, but this treatment option may not be suitable if the patient wishes to have genetically related children. In such a case, oogonal stem cell transplantation, ovarian cortex fragmentation or PRP therapy are possible. In women who will undergo chemotherapy and radiation therapy for cancer, reimplantation of ovarian cortical tissue is recommended to preserve fertility. If there is a risk of malignant cell transfer with this treatment modality, primordial follicles can be isolated from ovarian tissue, cultured and activated in vitro, fertilized, and transferred into the uterine cavity. IVF with surrogate embryo transfer may be an alternative choice for a woman with NPT, which allows her to realize her reproductive plans.

Strategies for choosing combination therapy for hypertension in metabolic syndrome - focus on inflammation

The article substantiates the need for adequate fixed combination therapy for metabolic syndrome and arterial hypertension (AH). The issues of inflammation in the initiation and stabilization of arterial hypertension in patients with metabolic syndrome (MS) are considered. Taking into account the results of international and Russian studies, a differentiated approach is proposed to select a fixed combination of antihypertensive drugs for the treatment of hypertension and prevention of cardiovascular complications in patients with MS.

Aspirin and meloxicam co-administration with leaf extract of Terminalia catappa; prevention of red blood cell related cardiovascular complications in alloxan induced diabetic rats

Hyperglycemia induced alterations in red blood cell parameters are associated with cardiovascular complications in diabetes mellitus. This study was designed to investigate abnormalities in red blood cell parameters and changes due to aspirin and meloxicam administrations in diabetic rats. Thirty-six (36) healthy male Wistar rats weighting 150-200g were used for the study. The animals were randomly distributed into six groups of six rats each. Group 1 and 2 respectively served as control and diabetic groups administered with 5 ml/kg body weight of distilled water orally. Groups 3 and 4 were diabetic rats treated with aspirin and meloxicam at 30 mg/kg and 2 mg/kg body weight respectively. A combined administration of aspirin and meloxicam at their respective doses with 130mg/kg body weight of Terminalia catappa extract was in groups 5 and 6. The results showed that RBC count, PCV, HGB and MCV were reduced significantly (p<0.05) in diabetic group but significantly (p<0.05) increased in aspirin, meloxicam and in combined extract treated groups of diabetic rats. Therefore, diabetic induced alterations in red blood cell parameters which maybe attributed to inflammation were reversed by aspirin and meloxicam. Co-administration of these NSAID with T. catappa leaf extract would enhance their safety use in prevention of cardiovascular complications in diabetes mellitus.

GLP-1 RECEPTOR AGONISTS AND CARDIOVASCULAR OUTCOMES AND MORTALITY IN TYPE 2 DIABETES. A NEW APPRAISAL

Diabetes mellitus is a chronic disease prevalence of which is high and continually growing. Cardiovascular disease continues to be the leading cause of death in patients with T2DM. The prevention of cardiovascular complications and the cardiovascular safety of treatments should be a primary objective when selecting treatment. Among all the drugs available, the compounds known as glucagon-like peptide-1 receptor agonists (GLP-1 RAs) appear to be not just innocuous in terms of CVD but indeed to be beneficial. GLP-1 RA actions not only translate on an improvement of well-known cardiovascular risk factors such as glycaemic control, dyslipidaemia, weight, or arterial hypertension but also might show benefits on endothelial function, coronary ischaemia, and heart failure. On the other hand, recent clinical trials aimed at studying cardiovascular episodes have been conducted with GLP-1 RAs. Only liraglutide and semaglutide have shown superiority in cardiovascular benefit compared with placebo. Although many of the mechanisms by which liraglutide and semaglutide produce a cardiovascular benefit are still unknown it would be desirable for these benefits to be incorporated into the therapeutic algorithms routinely used in clinical practice. The purpose of this review is to explore GLP-1 RA actions not only in cardiovascular risk factors (glucose, weight, and hypertension) but also the possible effects on established cardiovascular disease.

PREVENTION OF SUPERIMPOSED PREECLAMPSIA WITH LOW-DOSE ASPIRIN : A SYSTEMATIC REVIEW

Background: Aspirin is currently the most widely prescribed treatment in the prevention of cardiovascular complications. At low doses, aspirin is also widely used to prevent pregnancy-related vascular disorders, such as preeclampsia and intrauterine growth restriction, and maternal disorders like antiphospholipid syndrome. The indications for the use of aspirin during pregnancy are, however, the subject of much controversy. The aim: This study aims to show prevention of superimposed preeclampsia with low-dose aspirin. Methods: By comparing itself to the standards set by the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020, this study was able to show that it met all of the requirements. So, the experts were able to make sure that the study was as up-to-date as it was possible to be. For this search approach, publications that came out between 2013 and 2023 were taken into account. Several different online reference sources, like Pubmed and SagePub, were used to do this. It was decided not to take into account review pieces, works that had already been published, or works that were only half done. Result: In the PubMed database, the results of our search brought up 39 articles, whereas the results of our search on SagePub brought up 106 articles. The results of the search conducted for the last year of 2013 yielded a total 25 articles for PubMed and 50 articles for SagePub. The result from title screening, a total 10 articles for PubMed and 22 articles for SagePub. In the end, we compiled a total of 10 papers. We included five research that met the criteria. Conclusion: Aspirin initiated at or before 16 weeks of gestation is associated with a greater reduction in the incidence of PE, perinatal death, and other adverse perinatal outcomes as compared to aspirin initiated after 16 weeks of gestation.

Gliflozins and their beneficial hypoglycaemic effect profile and prevention of cardiovascular complications in patients treated for type II diabetes mellitus

Introduction: Diabetes mellitus type 2 (DM2) is a population disease, it is predicted that by 2030 the DM2 will affect 7% of the population. Patients due to progress of the disease in case of micro and macro angiovascular changes develop organ complications mainly in terms of cardiovascular disease (CV). Sodium-glucose cotransporter 2 (SGLT2) inhibitors are relatively new group of drugs that apart from the hypoglycemic effect, also have other beneficial effects. Due to the scale and importance of the problem of diabetes complications researchers from around the world are working on its solution. Aim of the study: The aim of this study was to present the effects of SGLT2 inhibitors on cardiovascular complications in DM2 patients. Methods and materials We reviewed the literature contained in the PubMed database, using keywords: „Diabetes type 2”; „SGLT2 inhibitors”; „Cardiovascular disease”; „Heart failure” Results: In addition to their hypoglycaemic effects, SGLT2 inhibitors have also been shown to have beneficial effects on the CV system. Studies have shown that in DM2 patients treated with gliflozins, the risk of hospitalisation for heart failure decreased by 35% and the risk of death from cardiovascular causes by 38%. Retrospective studies have been carried out in which the efficacy of all drugs in the group in question, and not just individual substances, has been proven. In clinical experiments, phlazines were confirmed to reduce the risk of CV complications, including heart failure, myocardial infarction, angina, stroke or atrial fibrillation. Conclusions: SGLT2 drugs reduce the risk of cardiovascular complications and reduce hospitalisations for heart failure in patients with DM2. Future studies should seek to determine at what stage treatment should be implemented to maximise the resulting benefits to the patient.

Assessment of Indices of Vascular Involvement in Children with Idiopathic Nephrotic Syndrome: A Case-control Study

Introduction: Nephrotic Syndrome (NS) is characterised by proteinuria, oedema, hypoalbuminaemia, and hypercholesterolemia. The latter is a risk factor for atherosclerosis, suggesting a higher risk of cardiovascular disease in children with NS. Atherosclerosis is proposed to be caused by vascular endothelial dysfunction, reflecting the inflammatory response to tissue damage. Aim: To investigate indices of early vascular involvement in children with Idiopathic Nephrotic Syndrome (INS). Materials and Methods: This case-control study was conducted at a tertiary-care hospital, Pt. BD Sharma PGIMS Rohtak, Haryana, India, over a period of two years and two months. The study included 50 children aged <14 years with NS. Vascular indices, including Carotid Intima Media Thickness (CIMT), highsensitive C Reactive Protein (hs-CRP), and Atherogenic Index of Plasma (AIP), were evaluated. Analysis was performed using Statistical Package for the Social Sciences (SPSS) version 22.0 (IBM SPSS Statistics Inc., Chicago, Illinois, USA) Windows software program. The correlation of cardiovascular risk in children with NS was calculated by measuring CIMT, AIP, and CRP levels, and the relationship was analysed using the Chisquare test. A p-value of <0.05 was considered statistically significant. Results: The study found that the thickness of CIMT in group 1 was 0.67±1.39 mm, while in group 2, it was 0.31±0.04 mm. The calculated p-value was <0.001, which was statistically significant. The hs-CRP level in group 1 was 4.64±5.87 mg/L, higher than the control group (0.85±0.10 mg/L), with p-value of <0.001. Furthermore, AIP was higher in children with NS (0.80±0.19) compared to the control group (0.02±0.16). There was a statistically significant difference between both groups (p<0.001). Conclusion: Early assessment of indices of vascular involvement, such as CIMT, hs-CRP, and AIP, in children with INS can aid in the early identification and prevention of cardiovascular complications.

Assessment of Indices of Vascular Involvement in Children with Idiopathic Nephrotic Syndrome: A Case-control Study

Introduction: Nephrotic Syndrome (NS) is characterised by proteinuria, oedema, hypoalbuminaemia, and hypercholesterolemia. The latter is a risk factor for atherosclerosis, suggesting a higher risk of cardiovascular disease in children with NS. Atherosclerosis is proposed to be caused by vascular endothelial dysfunction, reflecting the inflammatory response to tissue damage. Aim: To investigate indices of early vascular involvement in children with Idiopathic Nephrotic Syndrome (INS). Materials and Methods: This case-control study was conducted at a tertiary-care hospital, Pt. BD Sharma PGIMS Rohtak, Haryana, India, over a period of two years and two months. The study included 50 children aged <14 years with NS. Vascular indices, including Carotid Intima Media Thickness (CIMT), highsensitive C Reactive Protein (hs-CRP), and Atherogenic Index of Plasma (AIP), were evaluated. Analysis was performed using Statistical Package for the Social Sciences (SPSS) version 22.0 (IBM SPSS Statistics Inc., Chicago, Illinois, USA) Windows software program. The correlation of cardiovascular risk in children with NS was calculated by measuring CIMT, AIP, and CRP levels, and the relationship was analysed using the Chisquare test. A p-value of <0.05 was considered statistically significant. Results: The study found that the thickness of CIMT in group 1 was 0.67±1.39 mm, while in group 2, it was 0.31±0.04 mm. The calculated p-value was <0.001, which was statistically significant. The hs-CRP level in group 1 was 4.64±5.87 mg/L, higher than the control group (0.85±0.10 mg/L), with p-value of <0.001. Furthermore, AIP was higher in children with NS (0.80±0.19) compared to the control group (0.02±0.16). There was a statistically significant difference between both groups (p<0.001). Conclusion: Early assessment of indices of vascular involvement, such as CIMT, hs-CRP, and AIP, in children with INS can aid in the early identification and prevention of cardiovascular complications.

Endothelial dysfunction in patients with obesity

Endothelial dysfunction has been considered in the pathogenesis of obesity widespread in the population. The purpose of this review was to provide updated information about pathogenetic features and markers of endothelial dysfunction in obese patients. We mentioned systemic disorders in obesity, such as oxidative stress, an increase in pro-inflammatory cytokines – tumor necrosis factor alpha, interleukin-6, and arginase activity. We also discussed the role of insulin resistance in the development of endothelial dysfunction, as well as the product of adipose tissue metabolism – monocyte chemoattractant protein-1. The participation of perivascular adipose tissue, hyperoxia of adipose tissue in the regulation of inflammation was considered. We illustrated the influence of atherogenic concentrations of oxidized low-density lipoproteins, the asymmetric dimethyl-L-arginine level on endothelial function. Changes in laboratory parameters were analyzed: endothelin-1, levels of microalbuminuria, homocysteine and uric acid. We also described cytological (circulating vascular cells, endothelial microparticles) and instrumental (endothelium-dependent vasodilation, peripheral arterial tonometry, intima-media complex thickness of the common carotid artery, ultrasound kidneys examination with duplex scanning of the renal arteries) methods for assessing endothelial function. Factors that influence the risk of cardiovascular complications were arterial hypertension and arterial stiffness, high levels of low-density lipoprotein and triglycerides, reduced physical activity. The determination of endothelial function in patients with obesity can be important for predicting the pathology of the cardiovascular system. Information on the assessment of markers of endothelial dysfunction in such patients may expand the possibilities of early diagnosis and prevention of cardiovascular complications.

Macroangiopathy In Diabetic Patients. Role Of The Nurse In The Prevention Of Cardiovascular Complications

The subject of this paper concerns fundamental aspects of complications, management and education of the diabeticpatient, especially the patient with macroangiopathic complications .The increase in the prevalence of diabetes mellitus is now exponential and its impact on cardiovascular diseases isincreasingly evident.In fact, the patient with diabetes has a significantly increased risk of developing major cardiovascular events.This is due to the particular aggressiveness of atherosclerotic disease at the level of the vessels, favored by endothelialdysfunction linked to the hyperglycemic state.Diabetes is a chronic disease with very widespread diffusion all over the world, destined to increase in the near futurewith the progressive aging of the population and the increasing occurrence of risk conditions that precede its onset.We are in fact in the presence of a real pandemic confirmed by epidemiological data, which indicate that more than300 million people in the world are affected by diabetes.In Italy, the treatment for diabetes absorbs 6.65% of the overall health expenditure, with a cost per patient that is morethan double the national average.Given the significant burden diabetes places on public health, preventing and improving the care of people with diabetes should be a primary goal for most communities and health systems.The consequences for individuals are due to the complications that the person with diabetes can develop, in terms ofa reduction in both the expectation and the quality of life, with significant repercussions, including economic ones.The organizational quality and efficiency of diabetic care 4 are correlated with better disease control, with a betterprognosis of complications, leading to a lower diabetes-related mortality rate.Reducing morbidity and mortality and improving the quality of life of people with diabetes mellitus represent oneof the current challenges for healthcare professionals, healthcare organizations and medical staff working in publichealthcare facilities.The selection and subsequent implementation of therapeutic education interventions, whose efficacy and congruencewith needs have been demonstrated, are essential steps towards improving the conditions of people with diabetes.Diabetes is a chronic disease and as such requires responsible management by those affected. Often people withdiabetes forget to live with a silent disease which, in addition to acute complications, also manifests long-term complications which can become fatal.A structured intervention is therefore necessary that increases the motivation and adherence of patients to the therapeutic plan, thus leading to a good metabolic control, to an acquisition of knowledge that allows them an adequatemanagement of the disease and a consequent better quality of life.The aim of this thesis is to research the results of lifestyle modification among the most important scientific evidence,taking into consideration aspects such as: metabolic control, acquired knowledge, self-management, self-efficacy,quality of life and satisfaction of the subjects.The research was carried out by consulting international databases such as “ Pubmed ” and “ google scholar “.The articles report that education for lifestyle change increases knowledge of one’s illness, self-management skillsand thus 2 an improvement in the quality of life.As a result, there will be a reduction in the incidence of diabetes and an improvement in numerous cardiovascularfactors. Furthermore, the nurse plays a role of fundamental importance both at the educational level through specificstructured interventions, and at the psychological level.

Macroangiopathy In Diabetic Patients. Role Of The Nurse In The Prevention Of Cardiovascular Complications

The subject of this paper concerns fundamental aspects of complications, management and education of the diabetic patient, especially the patient with macroangiopathic complications . The increase in the prevalence of diabetes mellitus is now exponential and its impact on cardiovascular diseases is increasingly evident. In fact, the patient with diabetes has a significantly increased risk of developing major cardiovascular events. This is due to the particular aggressiveness of atherosclerotic disease at the level of the vessels, favored by endothelial dysfunction linked to the hyperglycemic state. Diabetes is a chronic disease with very widespread diffusion all over the world, destined to increase in the near future with the progressive aging of the population and the increasing occurrence of risk conditions that precede its onset. We are in fact in the presence of a real pandemic confirmed by epidemiological data, which indicate that more than 300 million people in the world are affected by diabetes. In Italy, the treatment for diabetes absorbs 6.65% of the overall health expenditure, with a cost per patient that is more than double the national average. Given the significant burden diabetes places on public health, preventing and improving the care of people with diabetes should be a primary goal for most communities and health systems. The consequences for individuals are due to the complications that the person with diabetes can develop, in terms of a reduction in both the expectation and the quality of life, with significant repercussions, including economic ones. The organizational quality and efficiency of diabetic care 4 are correlated with better disease control, with a better prognosis of complications, leading to a lower diabetes-related mortality rate. Reducing morbidity and mortality and improving the quality of life of people with diabetes mellitus represent one of the current challenges for healthcare professionals, healthcare organizations and medical staff working in public healthcare facilities. The selection and subsequent implementation of therapeutic education interventions, whose efficacy and congruence with needs have been demonstrated, are essential steps towards improving the conditions of people with diabetes. Diabetes is a chronic disease and as such requires responsible management by those affected. Often people with diabetes forget to live with a silent disease which, in addition to acute complications, also manifests long-term complications which can become fatal. A structured intervention is therefore necessary that increases the motivation and adherence of patients to the therapeutic plan, thus leading to a good metabolic control, to an acquisition of knowledge that allows them an adequate management of the disease and a consequent better quality of life. The aim of this thesis is to research the results of lifestyle modification among the most important scientific evidence, taking into consideration aspects such as: metabolic control, acquired knowledge, self-management, self-efficacy, quality of life and satisfaction of the subjects. The research was carried out by consulting international databases such as “ Pubmed ” and “ google scholar ". The articles report that education for lifestyle change increases knowledge of one's illness, self-management skills and thus 2 an improvement in the quality of life. As a result, there will be a reduction in the incidence of diabetes and an improvement in numerous cardiovascular factors. Furthermore, the nurse plays a role of fundamental importance both at the educational level through specific structured interventions, and at the psychological level.

Macroangiopathy In Diabetic Patients. Role Of The Nurse In The Prevention Of Cardiovascular Complications

The subject of this paper concerns fundamental aspects of complications, management and education of the diabetic patient, especially the patient with macroangiopathic complications . The increase in the prevalence of diabetes mellitus is now exponential and its impact on cardiovascular diseases is increasingly evident. In fact, the patient with diabetes has a significantly increased risk of developing major cardiovascular events. This is due to the particular aggressiveness of atherosclerotic disease at the level of the vessels, favored by endothelial dysfunction linked to the hyperglycemic state. Diabetes is a chronic disease with very widespread diffusion all over the world, destined to increase in the near future with the progressive aging of the population and the increasing occurrence of risk conditions that precede its onset. We are in fact in the presence of a real pandemic confirmed by epidemiological data, which indicate that more than 300 million people in the world are affected by diabetes. In Italy, the treatment for diabetes absorbs 6.65% of the overall health expenditure, with a cost per patient that is more than double the national average. Given the significant burden diabetes places on public health, preventing and improving the care of people with diabetes should be a primary goal for most communities and health systems. The consequences for individuals are due to the complications that the person with diabetes can develop, in terms of a reduction in both the expectation and the quality of life, with significant repercussions, including economic ones. The organizational quality and efficiency of diabetic care 4 are correlated with better disease control, with a better prognosis of complications, leading to a lower diabetes-related mortality rate. Reducing morbidity and mortality and improving the quality of life of people with diabetes mellitus represent one of the current challenges for healthcare professionals, healthcare organizations and medical staff working in public healthcare facilities. The selection and subsequent implementation of therapeutic education interventions, whose efficacy and congruence with needs have been demonstrated, are essential steps towards improving the conditions of people with diabetes. Diabetes is a chronic disease and as such requires responsible management by those affected. Often people with diabetes forget to live with a silent disease which, in addition to acute complications, also manifests long-term complications which can become fatal. A structured intervention is therefore necessary that increases the motivation and adherence of patients to the therapeutic plan, thus leading to a good metabolic control, to an acquisition of knowledge that allows them an adequate management of the disease and a consequent better quality of life. The aim of this thesis is to research the results of lifestyle modification among the most important scientific evidence, taking into consideration aspects such as: metabolic control, acquired knowledge, self-management, self-efficacy, quality of life and satisfaction of the subjects. The research was carried out by consulting international databases such as “ Pubmed ” and “ google scholar ". The articles report that education for lifestyle change increases knowledge of one's illness, self-management skills and thus 2 an improvement in the quality of life. As a result, there will be a reduction in the incidence of diabetes and an improvement in numerous cardiovascular factors. Furthermore, the nurse plays a role of fundamental importance both at the educational level through specific structured interventions, and at the psychological level.

Macroangiopathy In Diabetic Patients. Role Of The Nurse In The Prevention Of Cardiovascular Complications

The subject of this paper concerns fundamental aspects of complications, management and education of the diabetic patient, especially the patient with macroangiopathic complications . The increase in the prevalence of diabetes mellitus is now exponential and its impact on cardiovascular diseases is increasingly evident. In fact, the patient with diabetes has a significantly increased risk of developing major cardiovascular events. This is due to the particular aggressiveness of atherosclerotic disease at the level of the vessels, favored by endothelial dysfunction linked to the hyperglycemic state. Diabetes is a chronic disease with very widespread diffusion all over the world, destined to increase in the near future with the progressive aging of the population and the increasing occurrence of risk conditions that precede its onset. We are in fact in the presence of a real pandemic confirmed by epidemiological data, which indicate that more than 300 million people in the world are affected by diabetes. In Italy, the treatment for diabetes absorbs 6.65% of the overall health expenditure, with a cost per patient that is more than double the national average. Given the significant burden diabetes places on public health, preventing and improving the care of people with diabetes should be a primary goal for most communities and health systems. The consequences for individuals are due to the complications that the person with diabetes can develop, in terms of a reduction in both the expectation and the quality of life, with significant repercussions, including economic ones. The organizational quality and efficiency of diabetic care 4 are correlated with better disease control, with a better prognosis of complications, leading to a lower diabetes-related mortality rate. Reducing morbidity and mortality and improving the quality of life of people with diabetes mellitus represent one of the current challenges for healthcare professionals, healthcare organizations and medical staff working in public healthcare facilities. The selection and subsequent implementation of therapeutic education interventions, whose efficacy and congruence with needs have been demonstrated, are essential steps towards improving the conditions of people with diabetes. Diabetes is a chronic disease and as such requires responsible management by those affected. Often people with diabetes forget to live with a silent disease which, in addition to acute complications, also manifests long-term complications which can become fatal. A structured intervention is therefore necessary that increases the motivation and adherence of patients to the therapeutic plan, thus leading to a good metabolic control, to an acquisition of knowledge that allows them an adequate management of the disease and a consequent better quality of life. The aim of this thesis is to research the results of lifestyle modification among the most important scientific evidence, taking into consideration aspects such as: metabolic control, acquired knowledge, self-management, self-efficacy, quality of life and satisfaction of the subjects. The research was carried out by consulting international databases such as “ Pubmed ” and “ google scholar ". The articles report that education for lifestyle change increases knowledge of one's illness, self-management skills and thus 2 an improvement in the quality of life. As a result, there will be a reduction in the incidence of diabetes and an improvement in numerous cardiovascular factors. Furthermore, the nurse plays a role of fundamental importance both at the educational level through specific structured interventions, and at the psychological level.

Cardiovascular risk in patients with selected cutaneous diseases

Introduction and purpose: Cardiovascular diseases (CVD) are the leading cause of death worldwide. The classic cardiovascular risk factors include age, gender, obesity, diabetes, hypertension, dyslipidemia, smoking and genetic factors. Some dermatological disorders are also potential risk factors for the development of CVD. The aim of the study is to review recent knowledge on the impact of dermatological diseases on cardiovascular risk.
 Description of the state of knowledge: The relationship between skin diseases and cardiovascular risk is influenced by various common dependencies such as: shared pathophysiological basis of disorders, risk factors, presence of a chronic inflammatory process, genetic susceptibility and environmental influences. Increased cardiovascular risk has been reported for several dermatological conditions, including psoriasis, systemic lupus erythematosus, systemic sclerosis, pemphigus, hidradenitis suppurativa, rosacea, atopic dermatitis. Chronic systemic inflammation, typically present in skin conditions, is a cardiovascular risk factor, because inflammation accelerates atherosclerosis, and furthermore may predispose patients to the development of metabolic syndrome, insulin resistance and diabetes mellitus. In patients who are initially metabolically unbalanced, these processes may be even more intense. Cardiovascular disorders, the frequency of which increases in patients with skin diseases, include atherosclerosis, coronary artery disease, ischemic heart disease, cardiac dysfunction, arrhythmias, heart failure, cerebrovascular disease (stroke, TIA) and peripheral arterial disease.
 Summary: Many cutaneous disorders, in addition to significantly increasing cardiovascular morbidity and mortality, also reduce the patient's quality of life. The cooperation of dermatologists and cardiologists in the care of patients with dermatological diseases is crucial for the proper treatment of the disease and prevention of cardiovascular complications.

Translation, Cultural Adaptation and Validation of the Hill Bone Compliance to High Blood Pressure Therapy Scale to Nepalese Language.

BackgroundControl of high blood pressure and prevention of cardiovascular complications among hypertensive patients depends on patients’ adherence to therapy. The Hill–Bone Compliance to High Blood Pressure Therapy Scale (HBCTS) is one of the most popular scale to assess hypertensive patients’ adherence behaviour. Unfortunately, no questionnaire in the Nepalese language is available to date to assess adherence to anti-hypertensive therapy.AimTo translate, culturally adapt and validate the English original version of the HBCTS into Nepalese language to measure treatment adherence of Nepalese hypertensive patients.MethodsThe cross-sectional study was conducted to translate, culturally adapt and validate the HBCTS into Nepalese version. The standard translation process was followed and was evaluated among 282 hypertensive patients visiting selected primary healthcare centers (PHCCs) of Kathmandu district, Nepal. Cronbach’s alpha was measured to assess the reliability of the tool. Exploratory factor analysis using principal component analysis with varimax rotation was used to evaluate structural validity.ResultsThe mean±SD age of 282 participants was 58.49±12.44 years. Majority of participants were literate (75.2%), and consumed at least one anti-hypertensive medication per day (85.5%). Nearly half (42.2%) of the participants had a family history of hypertension, and almost half (48%) of them had comorbid conditions. Mean ±SD score for overall adherence was 17.85±3.87 while those of medication taking, reduced salt taking, and appointment keeping subscales were 10.63±2.55, 4.16±1.12 and 3.06±1.07, respectively. Kaiser Meyer Olkin (KMO) was found to be 0.877. Exploratory factor analysis revealed a three-component structure; however, the loading of components into medication adherence, reduced salt intake and appointment keeping constructs were not identical to the original tool. Cronbach’s alpha score for the entire HBCTS scale was 0.846.ConclusionThe translated Nepali version of the HBCTS demonstrated acceptable reliability and validity to measure adherence to antihypertensive therapy among hypertensive patients in clinical and community settings in Nepal.

Effects of Vitamin E in the Management of Dyslipidemia in Combination with Statin Therapy

Aim: To determine the effects of vitamin E therapy in the management of dyslipidemia with combination of statin drugs and also to determine the efficacy of statin drugs with combination of vitamin E therapy. Methodology: This case control study was conducted at LUMHS Jamshoro. Total 200 patients of dyslipidemia with the age between 30 to 50 years were included with mentioned inclusion and exclusion criteria & aere divided in to two groups; control group who received only statin drugs for treatment of dyslipidemia and case control group who received station drugs along with Vitamin E 800 mgs in divided dose.The fasting blood glucose level was measured by glucose oxidase method while lipid profile parameters serum cholesterol, TG’s, Serum LDL levels were estimated byenzyme caloric method on Cobas auto analyzer (model c-111 ACN 435 GERMANY) while HbA1c% was estimated on microlab. The statistical analysis was done on SPSS version 21 by applying unpaired student t test and ANOVA. The p value less than 0.05 consider as significant. Results: Finally after treatment phase the Mean & SD value of serum cholesterol in control group was 209.13 ± 5.15 mg/dl while in case study group was 189.51 ± 6.11 mg/dl , serum TG’s levels in control group was 191.52 ± 7.83 mg/dl & case study group was 168.56 ± 7.81 mg/dl, serum LDL levels in control group was 120.44 ± 4.67 mg/dl & in case study group was 97.15 ± 5.76 mg/dl. All parameters of lipid profile significantly decline in case study group. Conclusion: This research concluded that there is strong positive impact of vitamin E along with statin therapy on the management of dyslipidemia and in prevention of cardiovascular complications. Keywords: Dyslipidemia, Vitamin E, Statin Drugs.

Exercise and Urtica Dioica extract ameliorate mitochondrial function and the expression of cardiac muscle Nuclear Respiratory Factor 2 and Peroxisome proliferator-activated receptor Gamma Coactivator 1-alpha in STZ-induced diabetic rats

IntroductionDiabetes mellitus can affect and disrupt the levels of PGC1α and NRF2 proteins in the mitochondrial biogenesis pathway. Considering the anti-diabetic properties of Urtica Dioica extract and exercise, this study aimed to investigate the beneficial effects of Urtica Dioica extract and endurance activity on PGC1α and NRF2 protein levels in the streptozotocin-induced diabetic rat heart tissue. Materials and methods58 male Wistar rats were divided into five groups (N = 12) including: healthy control (HC), diabetes control (DC), diabetes Urtica Dioica (D-UD), diabetes exercise training (DT), and diabetes exercise training Urtica Dioica (DT-UD). Diabetes was induced intraperitoneally by STZ (45 mg/kg) injection. Two weeks after the induction of diabetes, the rats were stimulated to carry out the exercise (moderate intensity/5day/week) and the gavage of UD extract (50 mg/kg/day) was administered to the rats for six weeks.In this study, the western blotting method was used to measure the levels of PGC1α and NRF2 proteins. Moreover, cardiography was used to evaluate the functional parameters of the heart (ejection fraction & fractional shortening). Finally, the bioluminescence and ELISA methods were used to determine the content of adenosine triphosphate and citrate synthase. ResultsThe cardiac function parameters, the mitochondrial ATP and the CS content in DC group mice were impaired in comparison with the other study groups and showed a decreasing trend (P < 0.001). The treatment with EX + UD extract was able to minimize the rate of these disorders and acted as a protector of mitochondrial function. There were significant differences in the expression levels of NRF2 (F = 17.7, P = 0.001) and PGC-1α (F = 43.7, P = 0.001) mitochondrial proteins among the different groups. The levels of these proteins were significantly reduced in the DC group in comparison with the HC group (P < 0.001). The treatment with EX or UD extract increased the expression of PGC-1α and NRF2 proteins in the heart muscle of animals in the DT and D-UD groups in comparison with the DC group (P < 0.05). Moreover, the expression of these proteins was more pronounced in the DT-UD group. There was not a significant difference between the DT-UD group and the HC group regarding the expression of these proteins (P > 0.05). ConclusionsThe results of this study showed that treatment with EX and UD extract could treat the disorders which were caused by diabetes in the parameters of cardiac function. Moreover, it was able to improve the expression of the levels of proteins which were involved in mitochondrial biogenesis and its function. Finally, this kind of treatment could attract more attention to the roles of EX and UD extract in the prevention of cardiovascular complications in future studies.

Vitamin D receptor gene polymorphism predicts left ventricular hypertrophy in maintenance hemodialysis

BackgroundTo verify that the single nucleotide polymorphisms (SNP) of vitamin D receptor (VDR) may lead to genetic susceptibility to left ventricular hypertrophy (LVH), the present study was designed to study four SNPs of VDR associated with LVH in maintenance hemodialysis (MHD) patients of Han nationality.Methods120 MHD patients were recruited at Department of Nephrology, Zhongnan Hospital of Wuhan University to analyze the expression of genotype, allele and haplotype of Fok I, Bsm I, Apa I and Taq I in blood samples, and to explore their correlation with blood biochemical indexes and ventricular remodeling.ResultsThe results showed that the risks of CVD included gender, dialysis time, heart rate, SBP, glycated hemoglobin, calcium, iPTH and CRP concentration. Moreover, LAD, LVDd, LVDs, IVST and LVMI in B allele of Bsm I increased significantly. Fok I, Apa I and Taq I polymorphisms have no significant difference between MHD with LVH and without LVH. Further study showed that VDR expression level decreased significantly in MHD patients with LVH, and the B allele was positively correlated with VDR Expression.ConclusionVDR Bsm I gene polymorphism may predict cardiovascular disease risk of MDH patients, and provided theoretical basis for early detection and prevention of cardiovascular complications.

Optimum Treatment Strategy in Chronic Coronary Syndromes: the New Trials vs the Current Guidelines

Coronary revascularization is one of the most studied types of interventions in cardiology, but there is no consensus among specialists about the indications for its implementation in patients with chronic coronary syndromes (CCS). The data of recently completed clinical trials on the role of revascularization in CCS clearly contradict the current Guidelines, emphasizing the high effectiveness of modern conservative therapy. This paper discusses the main recommendations of the most significant American and European Guidelines on myocardial revascularization, and also analyzes the appropriateness of revascularization to improve the prognosis and symptoms in chronic coronary syndromes in view of the new research data, primarily the ISCHEMIA study (NCT01471522). Its strengths and limitations are discussed in detail. The data on the expediency of revacularization in CCS, obtained after the completion of ISCHEMIA and its potential significance, as well as subgroup analyses of ISCHEMIA, including in the most important ‘problem’ subgroups (3-vessel disease, proximal LAD disease, severe ischemia on stress test, etc.) are discussed. The paper also discusses the important achievements in modern drug therapy of chronic coronary syndromes, primarily antithrombotic therapy. The data of the COMPASS study (NCT01776424) are discussed, based on which the addition of a second antithrombotic drug – rivaroxaban in a small dose (2.5 mg BID) – is recommended for patients with CCS without atrial fibrillation who have high-risk characteristics. Indications the administration of dual antithrombotic therapy to patients with CCS, comparative results of its various regimens in relation to the prevention of cardiovascular complications, the risk of bleeding and the net clinical effect are given.

Choosing an antianginal therapy strategy in patients with stable coronary artery disease in real clinical practice: the advantages of trimetazidine

Cardiovascular diseases (CVD) are the leading cause of death among adults worldwide, including in the Russian Federation. At the same time, the leading position in the structure of causes of death from CVD is occupied by coronary heart disease (CHD) (16% of the total number of deaths in the world per year). The new clinical guidelines of the Ministry of Health of the Russian Federation for the management of patients with stable coronary heart disease in 2020 identify two main goals of conservative therapy – the elimination of symptoms of the disease and the prevention of cardiovascular complications (CVD). In this connection, when choosing antianginal therapy in patients with stable angina, it is necessary to consider the possibility of using combinations of both first-line and second-line drugs in order to really improve the effectiveness of treatment and achieve the goals set. It is advisable and justified to use more widely 2-line drugs, in particular trimetazidine, at any stage of therapy to enhance the antianginal effectiveness of b-blockers, calcium antagonists and prolonged-acting nitrates, especially in patients with hemodynamic features (arterial hypotension, rhythm and conduction disorders), which is demonstrated in the given clinical example. The effective addition of tremetazidine to the arsenal of traditional antianginal drugs is legislated in practice and is reflected in the new clinical recommendations of the Ministry of Health of the Russian Federation in 2020. The accumulated experience of using trimetazidine allows a pathogenetically sound approach to the treatment of stable CHD, restoring the balance between the need and delivery of oxygen to the heart muscle, and the safety profile expands the possibilities of use in patients with comorbid pathology.