Indicator Of Cardiovascular Disease Risk Research Articles

Effect of depression treatment on health behaviors and cardiovascular risk factors in primary care patients with depression and elevated cardiovascular risk: data from the eIMPACT trial.

Depression is an independent risk factor for cardiovascular disease (CVD), but it is unknown if successful depression treatment reduces CVD risk. Using eIMPACT trial data, we examined the effect of modernized collaborative care for depression on indicators of CVD risk. A total of 216 primary care patients with depression and elevated CVD risk were randomized to 12 months of the eIMPACT intervention (internet cognitive-behavioral therapy [CBT], telephonic CBT, and select antidepressant medications) or usual primary care. CVD-relevant health behaviors (self-reported CVD prevention medication adherence, sedentary behavior, and sleep quality) and traditional CVD risk factors (blood pressure and lipid fractions) were assessed over 12 months. Incident CVD events were tracked over four years using a statewide health information exchange. The intervention group exhibited greater improvement in depressive symptoms (p < 0.01) and sleep quality (p < 0.01) than the usual care group, but there was no intervention effect on systolic blood pressure (p = 0.36), low-density lipoprotein cholesterol (p = 0.38), high-density lipoprotein cholesterol (p = 0.79), triglycerides (p = 0.76), CVD prevention medication adherence (p = 0.64), or sedentary behavior (p = 0.57). There was an intervention effect on diastolic blood pressure that favored the usual care group (p = 0.02). The likelihood of an incident CVD event did not differ between the intervention (13/107, 12.1%) and usual care (9/109, 8.3%) groups (p = 0.39). Successful depression treatment alone is not sufficient to lower the heightened CVD risk of people with depression. Alternative approaches are needed. ClinicalTrials.gov Identifier: NCT02458690.

Effects of muscle strength training combined with aerobic training versus aerobic training alone on cardiovascular disease risk indicators in patients with coronary artery disease: a systematic review and meta-analysis of randomised clinical trials

ObjectiveTo compare the effects of aerobic training combined with muscle strength training (hereafter referred to as combined training) to aerobic training alone on cardiovascular disease risk indicators in patients with...

In vivo, histopathological evaluation, and molecular docking of the antiatherosclerotic potential of Pangium edule leaf extract in cholesterol- and fat-enriched diet Wistar rats

Background: Pangi leaves, from the Pangium edule plant, are rich in flavonoids and saponins. Research has shown that flavonoids can lower blood cholesterol by blocking the activity of the enzyme HMG Co-A reductase. Saponins are linked to a lower risk of atherosclerosis because they can bind to cholesterol. However, the impact of pangi on high cholesterol levels has not been well-studied. This research aimed to explore how an ethanol extract from pangi leaves affects the lipid profiles of Wistar rats on a diet high in cholesterol and fat. Methods: The study involved four groups of ten rats each. One group served as a normal control, while the second consumed a high cholesterol and fat diet. The remaining two groups ate the same diet but also received 150 mg/kg or 450 mg/kg body weight of the pangi leaf extract. After 28 days, the rats' blood was tested for total cholesterol, triglycerides, HDL, and LDL. Results: The results showed significant differences in triglycerides and HDL levels among the groups. The pangi extract notably reduced triglycerides and increased HDL levels, even at the lower dose. It also lowered the atherogenic index and the TG/HDL ratio, both indicators of cardiovascular disease risk. These findings were supported by pathological examinations of the rats' aortas and computational analysis, which identified compounds in the pangi leaves that bind effectively to HMG-CoA reductase. Specifically, compounds such as (5.beta.) Pregnane-3,20.beta.-diol and psi.,psi.-Carotene showed strong interactions with this crucial cholesterol-producing enzyme, indicating their promise as potent agents to reduce cholesterol levels. The identified compounds exhibit favorable characteristics akin to drugs, enhancing their prospects as candidates for therapeutic use. Conclusion: The collective findings of this research indicate that the ethanol extract of pangi leaves positively influences the lipid profile in rats on a diet high in cholesterol and fat, suggesting its potential utility as a novel treatment option for hyperlipidemia.

Kidney and Cardiovascular Protection Using Dietary Acid Reduction in Primary Hypertension: A Five-Year, Interventional, Randomized, Control Trial.

High fruit and vegetable diets are associated with reduced chronic kidney disease and cardiovascular disease but are infrequently used in hypertension treatment. Low acid diets are also associated with reduced chronic kidney disease and cardiovascular disease, and fruits and vegetables or oral sodium bicarbonate (NaHCO3) lowers dietary acid. We randomized 153 hypertensive macroalbuminuric patients receiving pharmacologic chronic kidney disease and cardiovascular disease protection to get fruits and vegetables, oral NaHCO3, or Usual Care. We assessed the course of kidney disease progression and cardiovascular disease risk indices over five years. Chronic kidney disease progression was slower in participants receiving fruits and vegetables or oral NaHCO3 than Usual Care [mean (SE)] [-1.08 (0.06) and -1.17 (0.07) vs. -1.94 (0.11) mL/min/1.73m2/ year, respectively, P's< .001). Yet, systolic blood pressure was lower, and cardiovascular disease risk indices improved more in participants receiving fruits and vegetables than in those receiving NaHCO3 or Usual Care. These cardiovascular benefits of fruits and vegetables were achieved despite lower doses of pharmacologic chronic kidney disease and cardiovascular disease protection. The trial supports fruits and vegetables as foundational hypertension treatment to reduce chronic kidney disease progression and cardiovascular disease risk.

Ten-Year Review of the Postpartum Maternal Health Clinic at the Kingston Health Sciences Centre

ObjectivesThe postpartum Maternal Health Clinic (MHC) sees patients who have experienced pregnancy complications identified as pregnancy-related cardiovascular disease (CVD) risk indicators (hypertensive disorders of pregnancy, gestational diabetes, placental abruption, idiopathic preterm delivery, and intrauterine growth restriction) at 6 months postpartum for CVD risk screening. This project aimed to summarise the past 10 years of the MHC and identify trends in patient characteristics, patient CVD risk assessments, and clinic attendance over time. MethodsPatients included in this study have experienced 1 or more pregnancy-related CVD risk indicator(s) and have delivered between April 2011 and April 2021. MHC patient data and the Better Outcomes Registry Network database were utilised to compare eligible and participating patient data during clinically significant time periods. ResultsThe clinic has seen 1030 patients in the last 10 years and their characteristics have remained largely consistent. However, there has been an increase in the proportion of patients seen because of a hypertensive disorder and an increase in the proportion of patients with obesity, abnormal total cholesterol, and elevated fasting glucose. Additionally, CVD risk scores and the prevalence of metabolic syndrome have remained consistent over the years. Regarding the clinic’s outreach, patient eligibility for the MHC has been increasing while attendance has been decreasing over time. ConclusionsOverall, there remains a need to screen these patients for CVD risk and counsel them on risk reduction. There is also an opportunity to increase patient recruitment to improve attendance and to address the increased need for CVD risk screening and counselling in the community.

Identifying Risk Indicators of Cardiovascular Disease in Fasa Cohort Study (FACS): An Application of Generalized Linear Mixed-Model Tree.

Today, cardiovascular disease (CVD) is the most important cause of death around the world. In this study, our main aim was to predict CVD using some of the most important indicators of this disease and present a tree-based statistical framework for detecting CVD patients according to these indicators. We used data from the baseline phase of the Fasa Cohort Study (FACS). The outcome variable was the presence of CVD. The ordinary Tree and generalized linear mixed models (GLMM) were fitted to the data and their predictive power for detecting CVD was compared with the obtained results from the GLMM tree. Statistical analysis was performed using the RStudio software. Data of 9499 participants aged 35‒70 years were analyzed. The results of the multivariable mixed-effects logistic regression model revealed that participants' age, total cholesterol, marital status, smoking status, glucose, history of cardiac disease or myocardial infarction (MI) in first- and second-degree relatives, and presence of other diseases (like hypertension, depression, chronic headaches, and thyroid disease) were significantly related to the presence of CVD (P<0.05). Fitting the ordinary tree, GLMM, and GLMM tree resulted in area under the curve (AUC) values of 0.58 (0.56, 0.61), 0.81 (0.77, 0.84), and 0.80 (0.76, 0.83), respectively, among the study population. In addition, the tree model had the best specificity at 81% but the lowest sensitivity at 65% compared to the other models. Given the superior performance of the GLMM tree compared with the standard tree and the lack of significant difference with the GLMM, using this model is suggested due to its simpler interpretation and fewer assumptions. Using updated statistical models for more accurate CVD prediction can result in more precise frameworks to aid in proactive patient detection planning.

Abstract 1040: Investigating The Role Of Lipoproteins In Macrophage Er Stress

Atherosclerosis, a major cause of cardiovascular disease (CVD), is an inflammatory disease defined by the progressive buildup of lipid-laden macrophages and cholesterol-filled plaques. Low-density lipoprotein (LDL) and high-density lipoprotein (HDL) play critical roles in the pathogenesis of atherosclerosis due to their roles in transporting cholesterol between tissues and cell types, including macrophages. Epidemiological studies have shown that high levels of HDL-cholesterol (HDL-C) are correlated with decreased CVD. However, HDL-C raising therapeutics failed to show clinical benefits, suggesting that HDL function may be a better indicator of CVD risk. Recent studies from our lab demonstrated that HDL modified by reactive aldehydes has impaired cardioprotective functions in macrophages. Other studies have also shown that oxidized LDL triggers ER stress in vascular cells and macrophages, a process that can be blunted by the presence of HDL. Therefore, we tested the hypothesis that HDL modified by reactive aldehydes triggers ER stress in macrophages, with the goal of identifying mechanisms by which dysfunctional HDL contributes to atherosclerosis progression. Primary murine macrophages were incubated with native or modified forms of lipoproteins and ER stress markers (XBP1, BiP, p-eIF2a, ATF6) were assessed by immunoblot analysis or semi-quantitative PCR. Through a comprehensive and extensive analysis, our findings led us to discover three novel findings in primary murine macrophages: (i) oxLDL alone was unable to induce ER stress; (ii) co-incubation with oxLDL or HDL in the presence of thapsigargin (an inducer of ER stress) resulted in increased and prolonged expression of ER stress markers as compared to cells treated with thapsigargin alone; and (iii) neither HDL nor HDL modified by reactive aldehydes was able blunt the ER stress induced by thapsigargin in the presence or absence of oxLDL. In summary, our highly systematic approach to assess the role of lipoproteins in mediating ER stress in primary macrophages generated convincing data that refutes previously-published findings, thus resulting in an inability to make definitive conclusions on the role of HDL modification in ER stress.

Discrimination, Smoking, and Cardiovascular Disease Risk: A Moderated Mediation Analysis With MESA.

Carotid intima-media thickness (cIMT) and carotid plaque are reliable indicators of cardiovascular disease risk, and research highlights that racial and ethnic minority individuals generally exhibit higher cIMT and carotid plaque than White individuals. At present, the mechanisms driving these disparities among different racial and ethnic and biological sex groups are poorly understood. Data came from the baseline examination of MESA (Multi-Ethnic Study of Atherosclerosis). A total of 6814 participants aged 45 to 84 years free of clinical cardiovascular disease completed assessments on health behavior and perceived discrimination. Four sex-stratified moderated mediation models examined associations between discrimination, cigarette smoking, and mean cIMT and plaque. We hypothesized that cigarette use would mediate the association between discrimination and carotid artery disease features, and that these would differ by race and ethnicity. Indirect effects of discrimination on plaque were observed among Hispanic women such that discrimination was associated with cigarette use and, in turn, higher plaque (β=0.04 [95% CI, 0.01-0.08]). Indirect effects of discrimination on mean cIMT were found among Hispanic (β=0.003 [95% CI, 0.0001-0.007]) and White men (β=0.04 [95% CI, 0.01-0.08]) such that discrimination was associated with cigarette use and, in turn, higher cIMT. Finally, a positive indirect effect of discrimination on plaque was observed among Hispanic men (β=0.03 [95% CI, 0.004-0.07]). No other racial and ethnic differences were observed. To understand and address social determinants of cardiovascular disease, researchers must incorporate an intersectional framework that will allow us to understand the complex nature of discrimination and cardiovascular disease risk for individuals of varying intersecting identities and social positions.

Evidence of increased cardiovascular disease risk in left-handed individuals.

Approximately 10% of the world is left-handed (LH). Research suggests that LH individuals may have shorter lifespans compared to right-handed (RH) individuals. LH individuals also appear to have more cardiovascular disease (CVD) related conditions like diabetes and cancer. Thus, the present study sought to test the hypothesis that vascular function and heart rate variability (HRV), both key indicators of CVD risk, would be lower in LH compared to RH individuals. Three hundred seventy-nine participants, 18-50 years old, were enrolled. Flow-mediated dilation (FMD), a bioassay of vascular endothelial function and standard deviation of R-R interval (SDNN), a parameter of HRV, were evaluated as indices of CVD risk. Data are reported as mean ± SD. 12.1% of the participants were LH. No differences in demographics or clinical laboratory values were observed between groups, except high-density lipoprotein (HDL) was higher (p = 0.033) in RH. FMD was significantly (p = 0.043) lower in LH (6.1% ± 3.2%) compared to RH (7.6% ± 3.8%), independent of age, sex, race, BMI, and HDL. Total power (p = 0.024) and low-frequency power (p = 0.003) were lower in LH compared to RH. Additionally, SDNN was lower (p = 0.041) in LH (47.4 ± 18.8 ms) compared to RH (54.7 ± 22.3 ms). A negative correlation between FMD and mean arterial pressure (r = -0.517; p < 0.001) was observed in LH; no relationships were observed in RH (all p > 0.05). Vascular endothelial function and HRV are lower in LH compared to RH. In addition, relationships between FMD and traditional CVD risk factors were only observed in LH. These data support an increased risk of CVD in LH.

The Fruit and Veggies for Kidney Health Study: A Prospective Randomized Trial

Providing fruits and vegetables (F&Vs) to health care system patients with elevated urine albumin-creatinine ratio (ACR) reduced ACR, slowed chronic kidney disease (CKD) progression and reduced cardiovascular disease (CVD) risk factors in previous studies. This study evaluated a community-based strategy in lower-income populations to identify African Americans with elevated ACR before health care system involvement and sustain them in a 6-month F&V protocol with (F&V+Cook) and without (F&V Only) cooking instructions, with the hypothesis that adjuvant cooking instructions with F&Vs would further reduce ACR. Prospective, randomized, parallel 2-arm design. African American adults with ACR>10mg/g creatinine randomized to 1 of 2 study arms. Two cups/day of F&Vs with or without cooking instructions in participants followed 6 months. Participants sustaining the F&V protocol and between-group indicators of CVD risk, kidney injury, and dietary intake at 6 weeks and 6 months. A total of 142 African American adults (mean age, 57.0 years; ACR, 27.4mg/g; body mass index, 34.4; 24.9% CKD 1; 24.8% CKD 2; 50.4% CKD 3; 55% female) randomized to F&V Only (n=72) or F&V+Cook (n=70), and 71% were retained at 6 months. Participants received 90% of available F&V pick-ups over 6 weeks and 69% over 6 months. In the adjusted model, 6-month ACR was 31% lower for F&V+ Cook than F&V Only (P=0.02). Net 6-week F&V intake significantly increased and biometric variables improved for participants combined into a single group. Small sample size, low-baseline ACR, and potential nonresponse bias for 24-hour dietary recall measure. These data support the feasibility of identifying community-dwelling African Americans with ACR indicating elevated CVD and CKD risk and sustaining a F&V protocol shown to improve kidney outcomes and CVD risk factors and provides preliminary evidence that cooking instructions adjuvant to F&Vs are needed to lower ACR. National Institute on Diabetes, Digestive, and Kidney Diseases grant "Reducing chronic kidney disease burden in an underserved population" (R21DK113440). NCT03832166. African Americans, particularly those in low-income communities, have increased rates of chronic kidney disease (CKD) with worsening outcomes over time. Giving fruits and vegetables to individuals with CKD identified in health care systems was previously shown to reduce kidney damage, measured by urine protein albumin, and slow kidney function decline. We recruited African Americans in low-income communities with increased urine albumin levels. They received fruits and vegetables for 6 months, and we tested whether added cooking instructions further reduced urine albumin levels. Most participants continued to receive fruits and vegetables throughout the 6 months. Those given cooking instructions had lower urine albumin levels after 6 months, indicating decreased kidney damage. Providing cooking instructions with fruits and vegetables appears to lessen kidney damage more than just fruits and vegetables alone.

A Case-Control Study of the Carotid Intima Media Thickness as a Good Predictor of Subclinical Atherosclerosis in South Indian Women Diagnosed With Polycystic Ovarian Syndrome in a Tertiary Care Hospital

Background and Objective: Polycystic ovarian syndrome (PCOS) is a diverse condition whose likelihood of heightened cardiovascular disease (CVD) risk in the future is often disregarded. We need to predict the risk sooner due to the intrinsic propensity for CVD in Indians, increased prevalence in South Indians, and PCOS patients. The objectives are: 1. To elicit the presence of CVD risk factor in pcos patients 2. Considering CIMT (Carotid Intima Media Thickness) as a good predictor for CVD risk Methods: A total of 50 cases and 50 age and weight (+/-2 kg) matched controls were included in this study. We assessed the CIMT by the Doppler system with electrical linear transducer midfrequency of 10 MHz. Results: Women with PCOS had a greater CIMT (0.05 ± 0.01 cm in cases vs. 0.03 ± 0 cm in controls; p &lt; 0.001). The CIMT of the cases is increased over their controls by 42.4% (014mm), P ≤0.001. The r value of age and CIMT is more when compared to the r value of weight and CIMT in both cases and controls (Age and CIMT: cases: r= 0.431 &amp; controls: r =0.312) (Weight and CIMT: cases: r = 0.164 &amp; controls: r =0.233). Conclusion: In PCOS , CIMT is a good indicator of CVD risk. When opposed to an individual's weight, age shows a stronger positive correlation with CIMT. Hence, PCOS patients must get an early CIMT scan. CIMT must be a crucial component of PCOS management and CVD risk alleviation.

Comparison of Cardiovascular Disease Risk Indicators in Bipolar Disorder Patients with Healthy Controls

Aim: It is important to assess the likelihood of cardiovascular disease in patients with bipolar disorder (BD). In this study, indicators of increased cardiovascular disease risk on electrocardiogram (ECG) and laboratory were evaluated. Material and Methods: In the present investigation, we studied the demographic details, ECG variables, and blood test results of 90 healthy controls (HC) and 97 patients we followed for BD diagnosis. Results: Age and gender trends were similar between the BD and HC groups (p=0.844 and p=0.664). BD had a higher mean number of fragmented QRS (fQRS) than the HC group, and fQRS was more frequent (p=0.002 and p=0.007). The frontal QRS-T angle was wider in the BD group than it was in the HC group (p=0.038). Monocyte-to-lymphocyte ratio (MLR), monocytes to high-density lipoprotein cholesterol (HDL-C) ratio (MHR), and atherogenic index of plasma (AIP) were statistically greater in BD patients (p=0.021, p&amp;lt;0.001, and p&amp;lt;0.001). Conclusion: In brief, the report indicates that impaired ventricular repolarization is related to an elevation in the frontal QRS-T angle in BD. As a result, BD patients have a greater risk of cardiovascular mortality and ventricular arrhythmias. As a result, clinicians ought to have a greater understanding of the frontal QRS-T angle and conduct an ECG examination on regular controls.

Central androgen action reverses hypothalamic astrogliosis and atherogenic risk factors induced by orchiectomy and high-fat diet feeding in male mice.

Hypogonadism in males confers elevated cardiovascular disease (CVD) risk by unknown mechanisms. Recent radiological evidence suggests that low testosterone (T) is associated with mediobasal hypothalamic (MBH) gliosis, a central nervous system (CNS) cellular response linked to metabolic dysfunction. To address mechanisms linking CNS androgen action to CVD risk, we generated a hypogonadal, hyperlipidemic mouse model with orchiectomy (ORX) combined with hepatic PCSK9 overexpression. After 4 wk of high-fat, high-sucrose diet (HFHS) consumption, despite equal body weights and glucose tolerance, androgen-deficient ORX mice had a more atherogenic lipid profile and increased liver and leukocyte inflammatory signaling compared with sham-operated control mice. Along with these early CVD risk indicators, ORX markedly amplified HFHS-induced astrogliosis in the MBH. Transcriptomic analysis further revealed that ORX and high-fat diet feeding induced upregulation of inflammatory pathways and downregulation of metabolic pathways in hypothalamic astrocytes. To interrogate the role of sex steroid signaling in the CNS in cardiometabolic risk and MBH inflammation, central infusion of T and dihydrotestosterone (DHT) was performed on ORX mice. Central DHT prevented MBH astrogliosis and reduced the liver inflammatory signaling and monocytosis induced by HFHS and ORX; T had a partial protective effect. Finally, a cross-sectional study in 41 adult men demonstrated a positive correlation between radiological evidence of MBH gliosis and plasma lipids. These findings demonstrate that T deficiency in combination with a Western-style diet promotes hypothalamic gliosis concomitant with increased atherogenic risk factors and provide supportive evidence for regulation of lipid metabolism and cardiometabolic risk determinants by the CNS action of sex steroids.NEW & NOTEWORTHY This study provides evidence that hypothalamic gliosis is a key early event through which androgen deficiency in combination with a Western-style diet might lead to cardiometabolic dysregulation in males. Furthermore, this work provides the first evidence in humans of a positive association between hypothalamic gliosis and LDL-cholesterol, advancing our knowledge of CNS influences on CVD risk progression.

Stroke Risk Factor Profile in an Urban Population: A Community-Based Descriptive Study in Mojo Sub-District, Surabaya, Indonesia

Highlight: The stroke risk of the urban population in Mojo sub-district, Surabaya, was high (more than 10% risk for 36.3% of the population) . The risk factor for stroke is highly prevalent in Indonesia's urban communities, such as Surabaya. The Indonesian version of the Cardiovascular Disease Risk Index chart aids in determining stroke risk factors. The development of a stroke-spesific index chart has been done before but requires validation for the Indonesian population ABSTRACT Introduction: Stroke is still a major cardiovascular disease in Indonesia. Locally published data regarding stroke risk factors is still rarely reported. This condition complicates the regulation, policy-making, and community empowerment efforts to reduce modifiable stroke risk factors. Thus, a study is necessary to provide an overview of stroke risk factors and risks in cities in Indonesia, such as Surabaya. Objective: This study aimed to describe stroke risk factors in an urban Indonesian community, such as the Mojo sub-district in Surabaya. Methods: This was a descriptive study to describe stroke risk factors like age, gender, history of comorbidities, and history of cardiovascular disease, as well as patient clinical data like neurological symptoms, cardiovascular symptoms, anthropometry, vital signs, simple laboratory values, and cardiovascular risk categorization in the next ten years based on the Cardiovascular Disease Risk Index chart, Indonesian version. Results: In this study, 33 participants were included. Risk factors showed that many participants had histories of active smoking (18.2%), hypertension (45.5%), and diabetes (24.2%). One-third of the participants had a history of dyslipidemia. Based on the risk chart for cardiovascular disease, 36.3% of participants were at &gt;10% risk of developing cardiovascular disease in the next ten years. Conclusion: The risk index of cardiovascular disease in the Mojo sub-district, Surabaya, was still high. A combination of government policies, public awareness improvement, and community empowerment are urgently required to manage these risk factors epidemiologically.

Adverse childhood experiences are associated with vascular changes in adolescents that are risk factors for future cardiovascular disease

BackgroundAdverse childhood experiences (ACEs), such as abuse, neglect, and household dysfunction, are associated with a higher risk of cardiovascular disease (CVD) and indicators of future CVD risk in adulthood, such as greater vascular stiffness. The impact of ACEs in adolescence is unclear, and understanding how ACEs relate to blood pressure (BP) and vascular function during early life is key for the development of prevention strategies to reduce CVD risk. We hypothesized that exposure to ACEs would be associated with changes in central hemodynamics such as increased vascular stiffness and higher BP during adolescence.MethodsThis pilot study enrolled 86 adolescents recruited from the Children’s of Alabama. A validated ACE questionnaire was employed, and ACEs were modeled both as a continuous variable and a categorical variable (ACE ≥ 1 vs. ACE = 0). The primary outcomes used are considered to be indicators of future cardio-renal disease risk: aortic augmentation index normalized to 75 bpm (Alx75, a surrogate for vascular stiffness), carotid-femoral PWV (m/s), and ambulatory BP patterns.ResultsAdolescents with ACE ≥ 1 had significantly higher Alx75 (ACE: 5.2% ± 2.2 compared to no ACE: − 1.4% ± 3.0; p = 0.043). PWV only reflected this trend when adjustments were made for the body mass index. Adolescents with ACEs showed no differences in ambulatory BP patterns during the 24-h, wake, or sleep periods compared to adolescents with no ACEs.ConclusionsACEs were associated with higher AIx75 in adolescence, which is a risk factor for future CVD. Adolescence could present an opportunity for early detections/interventions to mitigate adverse cardiovascular outcomes in adulthood.Graphical abstractA higher resolution version of the Graphical abstract is available as Supplementary information

The study of electrocardiographic changes in type II diabetes mellitus

Background: The predictions of the silent ischemia in the asymptomatic patients were done with the Electrocardiographic (ECG) abnormalities findings. The high risk of the cardiac morbidity and mortality was statistically associated with abnormal ECG findings. Aims and Objectives: To reduce patient mortality and morbidity, the current analysis was performed on diabetes patients to look for ECG alterations. Materials and Methods: A total of 100 people were used, 50 of whom had type-2 diabetes mellitus and 50 of whom were healthy, non-diabetic volunteers whose ages and sexes matched the patients with type-2 diabetes. The 12-lead ECG instrument was used to record the electrographic markings. For fasting blood sugar blood was collected after a minimum 8 h overnight fasting and for PP2BS blood was collected 2 h after lunch. Results: In people with type II diabetes mellitus, the P wave’s amplitude significantly decreased. When compared to controls, type II diabetics’ QRS complex duration was noticeably longer. When compared to controls, (type II DM) Type 2 diabetes mellitus sufferers had a significantly longer QT and QTC interval. When type II diabetics were compared to controls, the ST segment alterations were significantly different. When compared to controls, type II diabetes showed a considerable T-wave alteration. Conclusion: The ST segment deviation from the isoelectric line is a predictor of coronary events in an asymptomatic diabetic population. The incidence of sudden mortality due to cardiovascular disease in diabetics is reduced as a result of early detection of QT and QTC alterations, which are good indicators of cardiovascular disease risk in diabetics.

Changes in Lp-PLA 2 are associated with elevated alanine aminotransferase levels: A nested case-control study in a three-year prospective cohort

Background/Aim: Elevation in liver enzymes and hepatic fat may indicate a higher susceptibility to cardiovascular disease (CVD). This research sought to find anthropometric/biochemical variables significantly related to the alanine aminotransferase (ALT) increase in healthy populations. Methods: Nine hundred healthy subjects were included in a 3-year prospective cohort study. The initial screening revealed that 538 were found to be nondiabetic (fasting glucose &lt; 126 mg/dL) and had normal ALT levels. Among them, 79 individuals with slightly elevated ALT levels after three years were assigned to the elevated ALT group. Of the remaining 459 participants, 241 subjects matched to the increased ALT group were the control group. Results: After three years of follow-up, individuals with elevated ALT showed notably higher aspartate aminotransferase (AST), ALT, gamma-glutamyl-transferase (g-GT), high sensitivity C-reactive protein (hs-CRP), lipoprotein-associated phospholipase A2 (Lp-PLA2 ) activity, oxidised low-density lipoprotein (ox-LDL), urinary 8-epi-prostaglandin F2a (8-epi-PGF2a) levels and brachial-ankle pulse wave velocity (ba-PWV) in comparison to the control group. Changes (D) in ALT showed a positive correlation with D AST, D gammaGT, D hs-CRP, D Lp-PLA2 activity, D ox-LDL, D urinary 8-epi-PGF2a and D ba-PWV. Furthermore, a direct positive link was observed between the D Lp-PLA2 activity and D AST, D ox-LDL and D ba-PWV. Conclusion: Increased Lp-PLA2 activity and other CVD risk indicators were observed to have a pronounced association with elevated ALT levels. This mild ALT elevation could potentially contribute to chronic low-grade inflammation.

Association between shift work and serum homocysteine level in female electronic manufacturing services workers.

Shift work has been shown to increase the risk of cardiovascular disease (CVD) based on several evidences. The classic risk factors of CVD include age, hypertension, smoking, obesity and diabetes. Recently, the serum homocysteine level has been reported to be a valuable indicator of CVD risk. This study aimed to determine the variation in serum homocysteine level as a cardiovascular risk indicator among female workers according to shift work. The data of regular health examination of workers at an electronic manufacturing services company in Yeongnam region, South Korea in 2019 were examined in this study. The investigation was based on a cross-sectional study conducted on 697 female workers (199 day workers and 498 shift workers). The sociodemographic and biochemical characteristics were compared between day workers and shift workers. Through a logistic regression analysis, the odds ratio (OR) of the increased serum homocysteine level in relation to shift work was determined. Compared to female day workers, female shift workers showed significantly higher level of serum homocysteine (8.85 ± 2.16 vs. 9.42 ± 2.04 μmol/mL; p = 0.001). The OR of day workers against shift workers was 1.81 (95% confidence interval [CI]: 1.25-2.63). With the adjustment of variables that may influence the level of serum homocysteine, the adjusted OR was 1.68 (95% CI: 1.09-2.60). The serum homocysteine level was significantly higher in shift workers than in day workers. It is thus likely to be a useful predictor of CVD in shift workers.

Enhancing stability in cardiovascular disease risk prediction: A deep learning approach leveraging retinal images

BackgroundThe retina provides valuable insights into vascular health within the body. Prior studies have demonstrated the potential of deep learning in predicting Cardiovascular Disease (CVD) risk using color fundus photographs. PurposeTo use fundus images to more consistently predict the World Health Organization (WHO) CVD score and to address the problem of year-to-year fluctuations associated with the traditional CVD risk score calculation. MethodsUtilizing 55,540 fundus images from 3,765 participants with 6-year follow-up data, we designed a DL model named Reti-WHO based on the Swin Transformer to predict CVD risk regression scores. Multiple regression and classification metrics such as coefficient of determination (R2-score), Mean Absolute Error (MAE), sensitivity and specificity were employed to assess the accuracy of the Reti-WHO. Significance differences between WHO CVD scores and Reti-WHO scores were also assessed. Vessel measurements were employed to interpret the model and evaluate the association between Reti-WHO and vascular conditions. ResultsThe deep learning model achieved good classification and regression metrics on the validation set, with an R2-score of 0.503, MAE of 1.58, sensitivity of 0.81, and specificity of 0.66. There was no statistically significant difference between WHO CVD scores and Reti-WHO scores (P value = 0.842). The model exhibited a stronger correlation with vascular measurements, including mean and variance of arc and chord in arteries and veins. Comparing box plots and Vyshyvanka plots depicting changes in patients' CVD over the years, the Reti-WHO calculated by our model demonstrated greater stability compared to non-deep learning-based WHO CVD risk calculations. ConclusionsOur Reti-WHO scores demonstrated enhanced stability compared to WHO CVD scores calculated solely from the patient's physical indicators, suggesting that the features learned from retinal fundus photographs serve as robust indicators of CVD risk. However, the model may still exhibit false negatives in high-risk predictions, requiring ongoing research for refinement. Future directions involve validating the model across diverse populations and exploring multi-image and multi-modal approaches to enhance prediction accuracy.

THE FORMULA FOR CARDIOVASCULAR HEALTH AND WELL-BEING IN ADULTS WITH CEREBRAL PALSY

Abstract Persons with cerebral palsy (CP) have mobility limitations, heightened sedentary behavior, and are at increased risk for cardiovascular disease (CVD). Dr. McPhee will cover his innovative work to develop a core outcome set for cardiometabolic disease risk assessment in adults with CP, and will further discuss recent findings from ongoing work pertaining to novel CVD risk indicators showing accelerating cardiovascular aging in CP. Dr. McPhee will also present recent work on the role of exercise, sleep, and healthy nutrition in the context of healthy aging for individuals with CP across the lifespan.