Risk Factor For Vascular Disease Research Articles

Circ_CHFR regulates ox-LDL-mediated cell proliferation, apoptosis, and EndoMT by miR-15a-5p/EGFR axis in human brain microvessel endothelial cells.

Oxidized low-density lipoprotein (ox-LDL) is a significant risk factor for various brain vascular diseases. Circular RNA (circRNA) is involved in the pathogenesis of brain vascular diseases. This study revealed the roles of circ_CHFR in ox-LDL-mediated cell proliferation, apoptosis, and endothelial-to-mesenchymal transition (EndoMT). Our results showed that circ_CHFR and EGFR expressions were dramatically upregulated, while miR-15a-5p expression was downregulated in ox-LDL-induced human brain microvessel endothelial cells (HBMECs) relative to control groups. circ_CHFR knockdown hindered the effects of ox-LDL exposure on cell proliferation, cell cycle, apoptosis, and EndoMT in HBMECs, whereas these impacts were abolished by miR-15a-5p inhibitor. In addition, circ_CHFR functioned as a sponge of miR-15a-5p and miR-15a-5p bound to EGFR. Thus, we concluded that circ_CHFR silencing hindered ox-LDL-mediated cell proliferation, apoptosis, and EndoMT by downregulating EGFR expression through sponging miR-15a-5p in HBMECs. Our findings provide a new mechanism for studying circRNA-directed therapy in ox-LDL-induced human brain vascular diseases.

Ангіопатія при анкілозуючому спондиліті

Актуальність. Анкілозуючий спондиліт є хронічним прогресуючим системним автоімунним ревматичним захворюванням хребта, периферичних суглобів, крижово-клубових зчленувань, ентезисів, зв’язкового апарату й внутрішніх органів, належить до факторів ризику тяжкої судинної патології. Мета дослідження: вивчити при анкілозуючому спондиліті клініко-інструментальний перебіг ангіопатії, з’ясувати патогенетичні зв’язки з імунними показниками. Матеріали та методи. Під наглядом перебували 79 хворих віком від 15 до 66 років (в середньому 38 років), серед яких чоловіки становили 95 %, жінки — 5 %. Тривалість хвороби від перших її проявів дорівнювала 11 рокам, І ступінь активності відмічався в 32 % спостережень, ІІ — у 39 % і ІІІ — у 29 %, а співвідношення повільнопрогресуючого та швидкопрогресуючого перебігу патологічного процесу становило 4 : 1. Периферичний моноолігоартрит констатовано в 47 % від числа хворих, поліартрит — у 53 %. Пацієнтам виконували ехокардіографію, ультра­звукову допплерографію судин й біомікроскопію судин кон’юнктиви. Результати. Ангіопатія спостерігається у 85 % від числа хворих на анкілозуючий спондиліт, розвиток якої прямо пов’язаний зі ступенем активності патологічного процесу й обернено — із серопозитивністю за ревматоїдним фактором. Шкірний васкуліт залежить від віку пацієнтів, увеїт, склерит, синдром Рейно, ураження центральної та периферичної нервової системи — від особливостей перебігу суглобового синдрому. Інтегральні клінічні й інструментальні судинні показники вірогідно співвідносяться з імунними параметрами — рівнями ревматоїдного фактора, С-реактивного протеїну, циркулюючих імунних комплексів, значеннями імуноглобулінемії, а ураження судин перебігає з підвищенням значень легеневого артеріального тиску та судинного опору, у генезі яких бере участь C-реактивний протеїн, що має прогностичну значущість.

A Complicated Case of Stroke, Epilepsy, and Mood Disorder: Hyperhomocysteinemia or Medication Cascade

Introduction: Hyperhomocysteinemia is a risk factor for atherosclerosis and vascular disease, which is correlated with cerebral problems and various neurological disorders. Case presentation: We report a 20-year-old lady with a history of hyperhomocysteinemia affected with stroke, seizure, and mood disorder. By initiating medication for these illnesses, different complications appeared. During the hospital stay, drugs for treating a disease deteriorated the other. We encountered a complex patient and numerous ambiguities in her management. Conclusions: For patients with elevated serum homocysteine and psychiatry disorders, it is important to consider MTHFR gene mutation. A challenge in these patients is to select the medication that does not deteriorate hyperhomocysteinemia. In this complex case, we used carbamazepine that was accompanied by clinical improvement.

High-fat diet-induced atherosclerosis promotes neurodegeneration in the triple transgenic (3 \xd7 Tg) mouse model of Alzheimer\u2019s disease associated with chronic platelet activation

BackgroundEpidemiological studies link vascular disease risk factors such as atherosclerosis, hypertension, and diabetes mellitus with Alzheimer’s disease (AD). Whether there are direct links between these conditions to β-amyloid (Aβ) aggregation and tau pathology is uncertain.MethodsTo investigate the possible link between atherosclerosis and AD pathology, we subjected triple transgenic (3 × Tg) AD mice to a high-fat diet (HFD) at 3 months of age, which corresponds to early adulthood in humans.ResultsAfter 9 months of treatment, HFD-treated 3 × Tg mice exhibited worse memory deficits accompanied by blood hypercoagulation, thrombocytosis, and chronic platelet activation. Procoagulant platelets from HFD-treated 3 × Tg mice actively induced the conversion of soluble Aβ40 into fibrillar Aβ aggregates, associated with increased expression of integrin αIIbβ3 and clusterin. At 9 months and older, platelet-associated fibrillar Aβ aggregates were observed to obstruct the cerebral blood vessels in HFD-treated 3 × Tg mice. HFD-treated 3 × Tg mice exhibited a greater cerebral amyloid angiopathy (CAA) burden and increased cerebral vascular permeability, as well as more extensive neuroinflammation, tau hyperphosphorylation, and neuron loss. Disaggregation of preexisting platelet micro-clots with humanized GPIIIa49-66 scFv Ab (A11) significantly reduced platelet-associated fibrillar Aβ aggregates in vitro and improved vascular permeability in vivo.ConclusionsThese findings suggest that a major contribution of atherosclerosis to AD pathology is via its effects on blood coagulation and the formation of platelet-mediated Aβ aggregates that compromise cerebral blood flow and therefore neuronal function. This leads to cognitive decline.

Study on Homocysteinemia as a Risk Factor of Ischemic Stroke

Despite recent advances, only two-third of all strokes can be attributed to known causal risk factors. Homocysteine (tHcy), a sulfur-containing amino acid, is now considered to be an important risk factor for vascular diseases, along with the established risk factors like hyperlipidemia, hypertension, diabetes mellitus, and smoking. Elevated homocysteine levels play a causal role in the pathogenesis of atherosclerosis, thromboembolism and vascular endothelial dysfunction with an increased incidence of ischemic stroke. This study aimed to find out the association of hyperhomocysteinemia with ischemic stroke. A total of 100 subjects were included in this study, 50 were ischemic stroke patients enrolled as case, and 50 were normal healthy individuals enrolled as control. Serum homocysteine level was measured in both case and control groups. The comparison was made in both groups regarding other common risk factors like diabetes mellitus, hypertension, smoking, dyslipidemia, family history, etc. Among 100 patients, 50 had ischemic stroke and 50 were healthy individuals. In this study, out of all patients, abnormal serum homocysteine level was found in 32% of cases and 12% of controls. The mean (±SD) serum homocysteine level was found 16.50±13.86 μmole/L in cases and 9.46±3.49 μmole /L in the control group. Significant (p<0.05) difference was found between the case and the control. The incidence of hyperhomocysteinemia is higher in ischemic stroke cases than that in age-sex-matched healthy controls. In our study, serum homocysteine was high in both younger age group patients (16.65±14.55 μmole/L vs. 9.52±3.19 μmole/L) and older age group patients (16.33±9.87 vs. 9.35±3.97 μmole/L,) in case and control group respectively. Significant (p<0.05) difference was found between the case and the control. Multiple logistic regression analysis showed that abnormal serum homocysteine is an independent risk factor of ischemic stroke. So we conclude that hyperhomocysteinemia is an important and independent risk factor for the development of ischemic stroke. Hypertension and smoking are important contributory to elevated serum homocysteine.
 TAJ 2021; 34: No-1: 33-39

ALKBH1 reduces DNA N6-methyladenine to allow for vascular calcification in chronic kidney disease.

Vascular calcification is a common complication of chronic kidney disease (CKD), and one of the main risk factors for increased cardiovascular morbidity and mortality in patients with CKD. In this issue of the JCI, Ouyang and Su et al. report that Alkb homolog 1 (ALKBH1), a DNA demethylase, reduced DNA N6-methyladenine (6mA) in vascular smooth muscle cells (VSMCs) and leukocytes, thus leading to aortic arch calcification in the patients with CKD. During the progression of vascular calcification, increased ALKBH1 expression was linked to decreased 6mA levels, findings that the authors noted in both patients with CKD and CKD mouse models. The kidney and vascular disease risk factor soluble urokinase receptor (suPAR) was also elevated in the plasma. Notably, lower 6mA levels induced BMP2-mediated osteogenic reprogramming in the VSMCs. These findings present a function of ALKBH1 in vascular calcification and provide a framework for therapeutic strategies.

Obstructive Sleep Apnea, Hypercoagulability, and the Blood-Brain Barrier.

Obstructive sleep apnea (OSA) is characterized by repeated episodes of intermittent hypoxia (IH) and is recognized as an independent risk factor for vascular diseases that are mediated by a multitude of mechanistic pathophysiological cascades including procoagulant factors. The pro-coagulant state contributes to the development of blood clots and to the increase in the permeability of the blood–brain barrier (BBB). Such alteration of BBB may alter brain function and increase the risk of neurodegenerative diseases. We aim to provide a narrative review of the relationship between the hypercoagulable state, observed in OSA and characterized by increased coagulation factor activity, as well as platelet activation, and the underlying neural dysfunction, as related to disruption of the BBB. We aim to provide a critical overview of the existing evidence about the effect of OSA on the coagulation balance (characterized by increased coagulation factor activity and platelet activation) as on the BBB. Then, we will present the emerging data on the effect of BBB disruption on the risk of underlying neural dysfunction. Finally, we will discuss the potential of OSA therapy on the coagulation balance and the improvement of BBB.

A Review on Prevalence of Medication Adherence among Hypertensive Patients in India

Prevalence of hypertension is increasing exponentially in India. Hence hypertension has become a crucial public health problem in India. High blood pressure (BP) could be a major risk factor for cardio vascular disease and better control can result in prevention of 300,000 of the 1.5 million annual deaths from cardiovascular diseases in India. Various studies among Indian patients evident that not adherence to their antihypertensive regimen and this might end in poor blood pressure control. Adherence to medication among the hypertensive people from the current studies is poor. A comprehensive strategy to enhance adherence to antihypertensive medications is the need of the hour. In this article an attempt has been made to compile all the research evidence on prevalence of Medication Adherence among hypertensive patients in India. Keywords: Medication, Adherence, Prevalence, Hypertension, India.

Comprehensive management of risk factors in peripheral vascular disease. Expert consensus

IntroductionThere is currently a degree of divergence among the main clinical practice guidelines on the management of risk factors for peripheral arterial disease (PAD). This project aims to gain understanding of the management of PAD risk factors in clinical practice and to reach a multidisciplinary consensus on the strategies to be followed in order to optimize its identification, treatment, and follow-up. MethodologyA multidisciplinary consensus following the Delphi methodology. ResultsProfessionals (n = 130) with extensive experience in PAD participated in this consultation. The results suggest that in order to optimize the control of risk factors, efforts should be aimed at: (1) promoting the involvement and awareness of all specialists in the identification of and screening for the disease; (2) guaranteeing the possibility of evaluating the ankle-brachial index (ABI) in all the medical specialties involved; (3) promoting strategies for patients to quit smoking through the use of drugs, programs, or referrals to specialized units; (4) promoting an appropriate Mediterranean-based diet and the prescription of daily exercise; (5) raising awareness of the importance of ensuring LDL cholesterol values below 70 mg/dL, especially in symptomatic but also in asymptomatic patients (<55 mg/dL following the publication of the ESC/EAS guide); (6) recommending the use of antiplatelet therapy in asymptomatic patients with diabetes mellitus (DM) and/or a pathological ABI; and (7) protocolizing the annual evaluation of ABI in high-risk patients. ConclusionThis document presents the 22 agreed-upon strategies which are intended to help professionals optimize multidisciplinary management of PAD risk factors.

Methanolic Extract of Piper sarmentosum Attenuates Obesity and Hyperlipidemia in Fructose-Induced Metabolic Syndrome Rats.

Obesity and hyperlipidemia are metabolic dysregulations that arise from poor lifestyle and unhealthy dietary intakes. These co-morbidity conditions are risk factors for vascular diseases. Piper sarmentosum (PS) is a nutritious plant that has been shown to pose various phytochemicals and pharmacological actions. This study aimed to investigate the effect of PS on obesity and hyperlipidemia in an animal model. Forty male Wistar rats were randomly divided into five experimental groups. The groups were as follows: UG—Untreated group; CTRL—control; FDW—olive oil + 20% fructose; FDW-PS—PS (125 mg/kg) + 20% fructose; FDW-NGN—naringin (100 mg/kg) + 20% fructose. Fructose drinking water was administered daily for 12 weeks ad libitum to induce metabolic abnormality. Treatment was administered at week 8 for four weeks via oral gavage. The rats were sacrificed with anesthesia at the end of the experimental period. Blood, liver, and visceral fat were collected for further analysis. The consumption of 20% fructose water by Wistar rats for eight weeks displayed a tremendous increment in body weight, fat mass, percentage fat, LDL, TG, TC, HMG-CoA reductase, leptin, and reduced the levels of HDL and adiponectin as well as adipocyte hypertrophy. Following the treatment period, FDW-PS and FDW-NGN showed a significant reduction in body weight, fat mass, percentage fat, LDL, TG, TC, HMG-CoA reductase, and leptin with an increment in the levels of HDL and adiponectin compared to the FDW group. FDW-PS and FDW-NGN also showed adipocyte hypotrophy compared to the FDW group. In conclusion, oral administration of 125 mg/kg PS methanolic extract to fructose-induced obese rats led to significant amelioration of obesity and hyperlipidemia through suppressing the adipocytes and inhibiting HMG-CoA reductase. PS has the potential to be used as an alternative or adjunct therapy for obesity and hyperlipidemia.

Correlation between the ankle-brachial index and microalbuminuria with certain risk factors in type 2 diabetes patients.

BackgroundThe ankle–brachial index (ABI) is a fast, simple, noninvasive method that provides accurate results in the early diagnosis of peripheral artery disease. Microalbuminuria is considered a predictor of renal and cardiovascular complications in patients with diabetes. This study was conducted to determine the correlation between ABI and microalbuminuria with certain risk factors in patients with type 2 diabetes.Subjects and research methodsA cross-sectional descriptive study was performed on 62 inpatients with type 2 diabetes. All patients were measured for ABI as well as microalbuminuria, HbA1c, glucose and lipidemia in the blood.ResultsThe study results showed that in patients with dyslipidemia, the risk of having microalbuminuria (+) increased 5.7 times and ABI ≤0.90 increased 8.6 times (P = 0.004 and 0.021, respectively). Fasting blood glucose >7.2 mmol/L had 5.7 times higher microalbuminuria (+) risk and 8.6 times higher ABI ≤0.90 (P = 0.004 and 0.021, respectively). Patients with HbA1c ≥7% were 2.9 times more likely to have microalbuminuria (+) and ABI ≤0.90 (P = 0.043 and 0.048, respectively).ConclusionsPeripheral vascular disease risk factors such as hypertension, dyslipidemia and waist circumference and the effectiveness of fasting blood glucose and HbA1c control increased the risk of high microalbuminuria and ABI in patients with type 2 diabetes.

Knowledge, Attitude and Practice of Cardiac Patients Regarding Reversible Risk Factors

The major aim of this study was to assess the knowledge, attitude and practice of numerous risk factors of cardio vascular disease among the local population of Sukkur district. Embracing of western culture and quick conversion of rural areas into urbanization leads to enhance the cardio vascular burden on the population of modern world. Developing countries has not enough medical facilities to overcome the burden of Cardio vascular Disease (CVD) and it is co-related with education and awareness about the cardiac disease.&#x0D; Descriptive Crossectional study was carried out at National Institute of Cardio Vascular Disease (NICVD) Sukkur for the period of 06 months from July 2020 to December 2020. Total 186 patients were included in the study and the selection criteria for study subjects was depends on the different factors such as patients, who had admitted in the hospital for more than 03 days with positive Troponin T and disturbed ECG reports. A well designed questionnaire was used for the collection of demographic and clinical data from the patients regarding research.&#x0D; From the obtained data 123 were male patients and area of residency of mostly patients was rural areas. 39 patients complain about chest pain, 74 about shoulder pain, 44 had severe headache and 29 were presented with cardiac arrest. 109 patients were diagnosed with hypertension, 34 had Diabetes Mellitus, 26 had gastric issues. Trop T test was positive among 91 patients, 109 had disturbed ECG. 64 patients were aware about various risk factors of CVD.&#x0D; In our research it was concluded that people of interior Sindh were unaware of modifiable risk factor for cardiovascular disease when presented with heart problem, most of the population even couldn’t identify the obesity, physical exercise, heavy diets and smoking as major reversible risk factors for CVD. Mass counseling and seminar should be conducted from time to time in order to overcome the raising issues of cardio vascular disease and its risk factors.

Unraveling the Complexities of the Lipoprotein(a) Particle and its Metabolism

Lipoprotein (a) [Lp(a)], was discovered more than 60 years ago, however, its link to human disease has just begun to unfold. Recent findings in large genome association studies and Mendelian randomization studies have highlighted its role as a causal risk factor in coronary and atherogenic vascular disease. Despite years of research into the mechanisms regulating plasma levels of Lp(a), specific sites and pathways of regulation are poorly characterized. Lp(a) contains two main apolipoproteins, apolipoprotein (a) [apo(a)] and apolipoprotein B100 (apoB100), these are bound by covalent bounds but also weak lisine binding sites are present. The most significant determinant of the level of Lp(a) is the number of DNA-base repeats coding a highly polymorphic sequence of the LPA gene called Kringle IV Type 2 (KIV-2). Importantly, the number of KIV-2 repeats range from about 3-40 resulting in a range of apo(a) mass from 200 – 700 kDA. Almost all individuals, therefore, have two apo(a) isoforms that differ in the size and the size of the apoB bound to the apo(a) has not been well characterize. The mechanism(s) by which KIV-2 isoform size affect Lp(a) concentrations remain minimally defined. Previous studies, using isolated and exogenously radio-iodinated apo(a) isoforms, indicated that the hepatic secretion rate (SR) of apo(a), rather than its fractional clearance rate (FCR), determined plasma levels of Lp(a), and that smaller isoforms (fewer KIV-2 repeats) were associated with greater SRs and higher plasma levels of Lp(a). However isoform size does not account for all the variation in plasma Lp(a) concentration. Indeed, more recent studies using stable isotopes by our group and by others provide a much more complex picture. We will present data on recently completed mechanistic studies using stable isotope in human volunteers with high and low levels of Lp(a). The studies describe the clearance and production of apo(a) and apoB100 from isolated Lp(a). Additionally proteomic composition of the isolated Lp(a) particles and isoforms and the implications of these proteins on disease will be discussed. The studies presented will highlight the complexity of Lp(a) and provide novel insights into the regulation of this cardiovascular risk.

Chronic kidney disease as a potential risk factor for retinal vascular disease: A 13-year nationwide population-based cohort study in Taiwan.

We investigate whether patients with chronic kidney disease (CKD) are at increased risk of retinal vascular disease (RVD). Data was collected from the Taiwan National Health Insurance system and included patients newly diagnosed with CKD between 2000 and 2012. The endpoint of interest was a diagnosis of RVD. Follow-up data of 85,596 patients with CKD and 85,596 matched comparisons (non-CKD) from 2000 to 2012 were analyzed. Patients with CKD were found to have a significantly higher cumulative incidence of RVD (Kaplan–Meier analysis, log-rank test P < .0001). Through multivariate Cox regression analysis, the CKD group was found to have higher risk of developing RVD (adjusted hazard ratio (HR) [95% confidence interval (CI)]: 2.30 [2.16–2.44]) when compared to the control cohort. When comparison of CKD group and non-CKD group was stratified by gender, age and comorbidities (hypertension, diabetes, and hyperlipidemia), the higher risk of RVD in patients with CKD remained significant in all subgroups. Patients with CKD were found to have higher risk of developing RVD in this cohort study. In addition, CKD imposed the same risk for RVD development in all age groups and in patients with or without hypertension or diabetes. Thus, patients with CKD should be vigilant for symptoms of RVD. Understanding the link between CKD and RVD could lead to the development of new treatment and screening strategies for both diseases.

Association of Hyperhomocysteinemia with Early Onset Atherosclerotic Peripheral Arterial Occlusive Diseases

Background: Homocysteine is increasingly recognized as an independent risk factor for vascular disease specially peripheral arterial occlusive diseases. In the present study, an attempt was made to find out the association between the raised fasting plasma total homocysteine level and early onset atherosclerotic peripheral arterial occlusive diseases (PAOD).&#x0D; Methods: In this prospective observational study a total of 50 study subjects were included. All patients were clinically and angiographically documented for atherosclerotic PAOD. All patients underwent surgical intervention as well as estimation of serum total homocysteine level. Arterial segment was sent for histopathological examination to find out whether atherosclerosis was present or not. Patients were divided into two groups- Group-1 included patients of 20-40 years of age and group-II included those of 41-60 years of age. The groups were compared to see association between elevated level of plasma homocysteine and atherosclerotic peripheral arterial occlusive diseases in elderly as well as in early age.&#x0D; Results: 41 (82%) patients were male and 9 (18%) patients were female. Serum homocysteine level was higher in group I than group II (71.4% vs. 40.9%). Besides, the level of mean serum homocysteine level was significantly (p=0.02) higher in group I than group II (21.18±9.53 vs. 17.24±8.92 μmol/L).&#x0D; Conclusion: In conclusion, this study suggests that serum homocysteine has an association with early onset atherosclerotic PAOD. Therefore, a raised serum homocysteine level can be used as an independent biochemical predictor of early onset atherosclerotic PAOD.&#x0D; Cardiovasc. j. 2021; 13(2): 120-127

Vascular Disease Risk Factors in Multiple Sclerosis (MS) is Associated with Brain Adenosine Triphosphate Abnormalities: Dysmetabolism May Drive MS Disease Progression (2398)

Vascular Disease Risk Factors in Multiple Sclerosis (MS) is Associated with Brain Adenosine Triphosphate Abnormalities: Dysmetabolism May Drive MS Disease Progression (2398)

English

BACKGROUND Relationship between serum uric acid and cardiovascular system has been recognised since years. High-sensitivity C-reactive protein (hs-CRP) is a known risk factor for cardiovascular and cerebrovascular events. The role of uric acid as a risk factor for vascular disease and acute stroke is controversial and there is little information about it.1 It is unclear as to whether high uric acid concentrations promote or protect against the development of cerebrovascular disease, or simply acts as a passive marker of increased risk. As serum hs-CRP is an established risk factor for stroke, its positive correlation with serum uric acid levels would suggest that high serum uric acid could predict stroke risk. Also, it would prove to be a more cost-effective investigative tool in our present set up. METHODS In this cross-sectional study, we assessed 100 patients admitted with acute stroke in Victoria and Bowring and Lady Curzon Hospital from October 2016 to November 2018. Clinical records, routine investigations, radiological imaging, serum uric acid and hs-CRP of the patients were investigated. RESULTS Majority of the patients (33 %) belonged to the age group of &gt; 70 yrs., followed by 61 - 70 yrs. (26 %). 69 % of the patients were males and 31 % were females. 67 % of them were hypertensive and 32 % were diabetic. 91 % had an hs-CRP level of &gt; 3.0 mg / L and 8 % had hs-CRP levels between 1.0 and 3.0 mg / L. None of the female patients had a serum uric acid value &gt; 6.5 mg / dL and none of the male patients had a uric acid level of &gt; 7.0 mg / dL. There was a correlation between serum uric acid levels and serum hs-CRP levels in patients ≤ 50 yrs. of age. There was no correlation between serum hs-CRP levels and serum uric acid levels in patients more than 50 yrs. of age. CONCLUSIONS Our study showed that stroke is most common in persons &gt; 70 yrs. of age and is more common in males compared to females. Hypertension is an independent risk factor for stroke. hs-CRP is a well-established risk marker for stroke, being raised in majority of stroke patients. Serum uric acid is not raised in all patients of acute stroke. So, it cannot be used as a risk marker for stroke. KEY WORDS hs-CRP, Serum Uric Acid, Acute Stroke

Neurology of Preeclampsia and Related Disorders: an Update in Neuro-obstetrics.

Preeclampsia and related hypertensive disorders of pregnancy affect up to 10% of pregnancies. Neurological complications are common and neurologists often become involved in the care of obstetric patients with preeclampsia. Here, we review the definition(s), epidemiology, clinical features, and pathophysiology of preeclampsia, focusing on maternal neurological complications and headache as a common presenting symptom of preeclampsia. Neurological symptoms are early and disease-defining features of preeclampsia. Neurological complications of preeclampsia may include headaches, visual symptoms, cerebral edema, seizures, or acute cerebrovascular disorders such as intracerebral hemorrhage or reversible cerebral vasoconstriction syndrome. A history of migraine is an independent risk factor for vascular diseases during pregnancy, including preeclampsia and maternal stroke. The pathophysiology of both preeclampsia and migraine is complex, and the mechanisms linking the two are not fully understood. Overlapping clinical and pathophysiological features of migraine and preeclampsia include inflammation, vascular endothelial dysfunction, and changes in vasoreactivity. Neurological complications are recognized as a major contributor to maternal morbidity and mortality. Pregnant and postpartum women commonly present with headache, and red flags in the clinical history and examination should prompt urgent neuroimaging and laboratory evaluation. A focused headache history should be elicited from patients as part of routine obstetrical care to identify patients at an increased risk of preeclampsia and related hypertensive disorders of pregnancy. Collaborative models of care and scientific investigation in the emerging field of neuro-obstetrics have the common goal of reducing the risk of maternal neurological morbidity and mortality from preeclampsia.

A Novel Vasoactive Peptide "PG1" from Buffalo Ice-Cream Protects from Angiotensin-Evoked High Blood Pressure.

Background: Arterial hypertension is the most important risk factor for cardiovascular diseases, myocardial infarction, heart failure, renal failure and peripheral vascular disease. In the last decade, milk-derived bioactive peptides have attracted attention for their beneficial cardiovascular properties. Methods: Here, we combined in vitro chemical assay such as LC-MS/MS analysis of buffalo ice cream, ex vivo vascular studies evaluating endothelial and smooth muscle responses using pressure myograph, and translational assay testing in vivo the vascular actions of PG1 administration in murine models. Results: We demonstrate that a novel buffalo ice-cream-derived pentapeptide “QKEPM”, namely PG1, is a stable peptide that can be obtained at higher concentration after gastro-intestinal digestions (GID) of buffalo ice-cream (BIC). It owns potent vascular effect in counteract the effects of angiotensin II-evoked vasoconstriction and high blood pressure levels. Its effects are mediated by the inhibitory effect on AT1 receptor leading to a downregulation of p-ERK½/Rac1-GTP and consequent reduction of oxidative stress. Conclusions: These results strongly candidate PG1, as a novel bioactive peptide for the prevention and management of hypertension, thus expanding the armamentarium of preventive strategies aimed at reducing the incidence and progression of hypertension and its related cardiovascular complications.

Magnetic resonance white matter changes in patients with obstructive sleep apnoea. The subset of the PURE-MIND (Prospective Urban and Rural Epidemiological) cohort study

IntroductionChanges typical for cerebral small vessel disease (i.a. white matter hyperintensities – WMHs) are often found accidentally in neuroimaging studies. Although asymptomatic, this condition increases the risk of future ischaemic incidents and neurodegenerative disorders. Sleep apnoea is a recognised risk factor for vascular diseases. The aim of our study was to assess the prevalence of, and association between, obstructive sleep apnea (OSA) and cerebral small vessel disease in the studied population.Material and methodsTwo hundred and seven patients (participants of Prospective Urban Rural Epidemiology Study) took part in our study. The study group consisted of 31 patients with OSA (11 women and 20 men). Nine of them were diagnosed with mild OSA, nine with moderate OSA, and 13 with severe OSA. The control group consisted of 176 patients (133 women and 43 men) who scored 0–2 points in the STOP-BANG questionnaire. All patients underwent brain magnetic resonance imaging. We evaluated the occurrence and severity of WMHs.ResultsSignificantly higher incidence of WMHs was found in the study group compared to controls. In univariate analyses, age was a significant predictor of periventricular white matter changes. For subcortical area, age and waist-to-hip ratio were significant predictors.ConclusionsSignificantly higher incidence of WMHs in the studied group suggests that patients with OSA may have a higher risk of neurodegeneration.