Risk Of Developing Cardiovascular Disease Research Articles

Risk for cardiovascular disease development in rheumatoid arthritis

BackgroundPatients with rheumatoid arthritis have significant cardiovascular mortality and morbidity.ObjectiveTo investigate the effects of chronic inflammation in rheumatoid arthritis on cardiovascular morbidity association with cardiovascular risk factors risk factors. Mortality report is secondary just to show trends without sufficient statistical power as it is accidental endpoint.MethodsA total of 201 individuals without previous cardiovascular disease, 124 with rheumatoid arthritis (investigation group) and 77 with osteoarthritis (control group), were included in the study and followed up for an average of 8 years to assess the development of fatal or non-fatal cardiovascular diseases. The incidence and prevalence of cardiovascular risk factors were also investigated.ResultsThe total incidence of one or more fatal or nonfatal cardiovascular events was 43.9% in the investigation group and 37.5% in the control group. Of these patients, 31.7% and 30.9% survived cardiovascular events in the investigation and control groups, respectively. The most common cardiovascular disease among participants who completed the study and those who died during the study was chronic heart failure. The results of the subgroup analysis showed that strict inflammation control plays a central role in lowering cardiovascular risk.ConclusionA multidisciplinary approach to these patients is of paramount importance, especially with the cooperation of immunologists and cardiologists for early detection, prevention, and management of cardiovascular risks and diseases.

Analysis of the Associations of Measurements of Body Composition and Inflammatory Factors with Cardiovascular Disease and Its Comorbidities in a Community-Based Study.

The associations of cardiovascular disease (CVD) with comorbidities and biochemical and body composition measurements are repeatedly described but have not been studied simultaneously. In the present cross-sectional study, information on CVD and comorbidities [type 2 diabetes mellitus (T2DM), hypertension (HTN), and hyperlipidemia (HDL)], body composition, levels of soluble markers, and other measures were collected from 1079 individuals. When we examined the association of each comorbidity and CVD, controlling for other comorbidities, we observed a clear pattern of the comorbidity-related specific associations with tested covariates. For example, T2DM was significantly associated with GDF-15 levels and the leptin/adiponectin (L/A) ratio independently of two other comorbidities; HTN, similarly, was independently associated with extracellular water (ECW) levels, L/A ratio, and age; and HDL was independently related to age only. CVD showed very strong independent associations with each of the comorbidities, being associated most strongly with HTN (OR = 10.89, 6.46-18.38) but also with HDL (2.49, 1.43-4.33) and T2DM (1.93, 1.12-3.33). An additive Bayesian network analysis suggests that all three comorbidities, particularly HTN, GDF-15 levels, and ECW content, likely have a main role in the risk of CVD development. Other factors, L/A ratio, lymphocyte count, and the systemic inflammation response index, are likely indirectly related to CVD, acting through the comorbidities and ECW.

Autonomic Regulation of T-Lymphocyte Inflammation after Psychological Trauma

Post-traumatic stress disorder (PTSD) is a complex psychiatric condition that is accompanied by systemic inflammation, increased sympathetic activity, and an elevated risk of cardiovascular disease development. These physiological alterations hint at disturbances in the immune system, yet the precise signaling mechanisms linking psychological trauma to immune responses remain poorly understood. In a preclinical murine model of PTSD, termed repeated social defeat stress (RSDS), we previously demonstrated that psychological trauma induces systemic inflammation, notably the production of interleukin 17A (IL-17A) and 22 (IL-22) from T-lymphocytes. Targeted denervation of the spleen successfully abolished the T-lymphocyte inflammatory response following psychological trauma, suggesting a neural origin for the signal. Furthermore, we showed that T-lymphocytes lacking tyrosine hydroxylase (i.e., devoid of the ability to produce catecholamines) were unable to produce IL-17A and IL-22 after RSDS, further suggesting an autonomic role in the expression of these proinflammatory cytokines. Therefore, we postulated that psychological trauma elicits T-lymphocyte inflammation via sympathetic modulation. To investigate this hypothesis, we employed chemogenetic technology known as Designer Receptors Exclusively Activated by Designer Drugs (DREADDs) to inhibit sympathetic signaling from the rostral ventrolateral medulla (RVLM), a central region of sympathetic signaling, during RSDS. RVLM DREADD-injected RSDS mice showed blunted blood pressure (-1.17 fold, p<0.0001) and heart rate (-1.07 fold, p=0.0026) compared to wild-type RSDS mice, confirming the effcacy of the sympathetic blockade. Moreover, after RSDS with sympathetic blockade, mice possessed completely ablated systemic circulating protein levels of IL-17A and IL-22 (-5.8 fold and -4.7 fold, respectively) compared to control GFP injected RSDS mice. To investigate the role of sympathetic regulation further, we next examined mice lacking beta 1 and 2-adrenergic receptors, given the previously described abundance of these receptors on T-lymphocytes. Confirming the results of the sympathetic blockade, mice lacking beta 1 and 2 adrenergic receptors had significantly diminished systemic circulating protein levels of IL-17A and IL-22 (-7.5 fold, p=0.0011; -31.5 fold, respectively) compared to wild-type mice after RSDS. Moreover, systemic infusion of the beta 1 and 2-adrenergic receptor antagonist propranolol also showed attenuated circulating levels of IL-17A and IL-22 (-2.57 fold and -14.59 fold, respectively) in wild-type mice after RSDS. Taken together, these data support a role for sympathetic modulation of T-lymphocyte inflammation after psychological trauma, which provides new insights into how mental health leads to somatic pathophysiology. R01HL158521. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

The 10-year cardiovascular risk of physicians estimated by the Thai CV risk score and its association with current coronary artery disease: A retrospective study.

To assess the 10-year cardiovascular disease (CVD) risk among Thai physicians. The risk compared to the general population and their relationship with the current coronary artery disease (CAD) were also examined. This retrospective study collected data of Thai physicians who underwent cardiovascular assessments between February 14, 2022, and October 31, 2022. The CVD risk was calculated using the Thai CVD risk (TCVR) score, which incorporated variables of age, gender, smoking, diabetes mellitus, blood pressure, and total cholesterol. Additional collected data included family history of CAD, weekly work hours, fiber diet, exercise, body mass index, coronary artery calcium (CAC) score, and presence of CAD. The association between the risk levels with presence of CAD and clinical features including CAC score were analyzed. Of 1225 physicians, the risk for CVD development was categorized as low in 80.0%, moderate in 11.2%, high in 4.9%, and very high in 3.9%. Among these, 33.6% were found to have higher relative risk compared to the general population of the same age and gender. The overall prevalence of CAD was 11.2%. This prevalence was escalated by risk or relative risk groups: 4.9% in low-, 33.8% in moderate-, 35.1% in high-, and 46.8% in very high-risk groups or 7.2% in lower risk, 8.0% the same risk, and 18.4% higher relative risk groups. Approximately, 20% of Thai physicians in the study exhibited a moderate to very high 10-year risk of CVD. Furthermore, 33.6% of the physicians had higher risk than individuals of the same age and gender in the general population. The prevalence of CAD increased with higher CVD risk and higher relative risk.

Blood Homocysteine Levels Mediate the Association Between Blood Lead Levels and Cardiovascular Mortality

Lead is a heavy, toxic metal and its exposure to humans can lead to increased risk of cardiovascular disease development and mortality. Lead exposure has been shown to induce hyperhomocysteinemia (HHCy) which may be a major pathogenic risk for the risk of CVDs. The aim of this study was to investigate whether homocysteine (Hcy) mediates the effect of lead on cardiovascular mortality. A total of 17,915 adults aged ≥ 20 who participated in the National Health and Nutrition Examination Survey (1999 to 2006). Information on mortality was ascertained via probabilistic matching to the death certificates from the National Death Index recorded up to December 31, 2015. Cox proportional hazards regression was performed to assess the association between blood lead levels and mortality. Mediation via Hcy was examined using a logit model. During a mean follow-up of 11.6 years, the incidences of CVD mortality were 0.73, 2.18, 3.03 and 4.94 per 1000 person-years across quarterlies of blood lead levels from low to high. Following multivariable adjustment, blood lead levels were strongly associated with CVD mortality in all mortality models (p-trend < 0.001). This association remained statistically significant after further adjusting for quartiles of homocysteine (model 3; HR 1.38 (95% CI 1.01—1.89) p-trend < 0.001). Furthermore, blood lead levels increased the odds of CVD mortality via homocysteine (indirect effect) (OR 1.42 (95% CI 1.30—1.55)), demonstrating the mediatory effect of homocysteine. This the first study that demonstrates that increased homocysteine mediates nearly half of CVD mortality related to blood lead levels.

Cardiovascular diseases across OSA phenotypes: A retrospective cohort study

BackgroundDespite the considerable knowledge of Obstructive Sleep Apnea (OSA) implications for cardiac diseases, the evidence regarding cardiovascular complications across OSA phenotypes including Rapid Eye Movement OSA (REM-OSA) and Positional OSA (POSA) is limited. In this study, we aimed to evaluate the risk of cardiovascular diseases development and progression among patients with REM-OSA and POSA. MethodsBased on a retrospective cohort analysis, we included polysomnography studies done in the sleep lab at the Jordan University Hospital. Regarding cardiovascular diseases, primary outcomes were Heart Failure, and 1-years Major Adverse Cardiac Events while secondary outcomes were atrial fibrillation, pulmonary hypertension, other arrhythmia, metabolic profile, and echocardiographic measurements of the heart. ResultsThe total number of the included patients was 1,026 patients. POSA group had significantly lower percentage of patients with hypertension (P-value = 0.004). Additionally, systolic blood pressure and HbA1c were significantly lower among patients with POSA compared to the NPOSA group (P-value<0.050). Left ventricular end diastolic dimension was significantly higher among patients with POSA while ejection fraction was significantly lower (P-value<0.050). Patients with diabetes and mean HbA1c were significantly lower among patients with REM-OSA compared to patients with NREM-OSA (P-value = 0.015, P-value = 0.046). Multivariate regression analysis revealed that after adjusting for age, gender and preexisting comorbidities, POSA was significantly associated with lower ejection fraction and higher left ventricular diastolic diameter. ConclusionIn conclusion, our findings indicate that POSA might be associated with huge and clinically significant heart strain and poor cardiac functions, yet it might not have a clinically significant atherogenic effect. This study should guide clinicians to identify OSA phenotypes to imply the best treatment plan to reduce its detrimental impact on cardiac muscle.

Cardiovascular outcomes in breast cancer survivors: a systematic review and meta-analysis.

It is unclear whether the future risk of cardiovascular events in breast cancer (Bc) survivors is greater than in the general population. This meta-analysis quantifies the risk of cardiovascular disease development in Bc patients, compared to the risk in a general matched cancer-free population, and reports the incidence of cardiovascular events in patients with Bc. We searched PubMed, Scopus, and Web of Science databases (up to 23 March 2022) for observational studies and post hoc analyses of randomized controlled trials. Cardiovascular death, heart failure (HF), atrial fibrillation (AF), coronary artery disease (CAD), myocardial infarction (MI), and stroke were the individual endpoints for our meta-analysis. We pooled incidence rates (IRs) and risk in hazard ratios (HRs), using random-effects meta-analyses. Heterogeneity was reported through the I2 statistic, and publication bias was examined using funnel plots and Egger's test in the meta-analysis of risk. One hundred and forty-two studies were identified in total, 26 (836 301 patients) relevant to the relative risk and 116 (2 111 882 patients) relevant to IRs. Compared to matched cancer-free controls, Bc patients had higher risk for cardiovascular death within 5 years of cancer diagnosis [HR = 1.09; 95% confidence interval (CI): 1.07, 1.11], HF within 10 years (HR = 1.21; 95% CI: 1.1, 1.33), and AF within 3 years (HR = 1.13; 95% CI: 1.05, 1.21). The pooled IR for cardiovascular death was 1.73 (95% CI 1.18, 2.53), 4.44 (95% CI 3.33, 5.92) for HF, 4.29 (95% CI 3.09, 5.94) for CAD, 1.98 (95% CI 1.24, 3.16) for MI, 4.33 (95% CI 2.97, 6.30) for stroke of any type, and 2.64 (95% CI 2.97, 6.30) for ischaemic stroke. Breast cancer exposure was associated with the increased risk for cardiovascular death, HF, and AF. The pooled incidence for cardiovascular endpoints varied depending on population characteristics and endpoint studied. CRD42022298741.

No impact of biological sex on nitric oxide contribution to cutaneous vascular response to 39ºC local heating

Purpose: The contribution of endothelial nitric oxide (NO) to vasodilation (%NO contribution) is a significant indicator of risk of cardiovascular disease development. Local skin heating to either 42 ºC or 39 ºC is used to determine mechanisms of vasodilation in health and disease, specifically to investigate %NO contribution. Women have lower %NO contribution in the cutaneous vasculature than men in the early follicular phase of the menstrual cycle, when the circulating vasoactive reproductive hormones are at their lowest concentration. However, this phase represents only a brief portion of the menstrual cycle. We aimed to determine the overall impact of biological sex on %NO contribution to cutaneous vasodilation utilizing a 39ºC local heating protocol, which better isolates the endothelial NO-synthase pathway. We tested women randomly during any phase of the menstrual cycle. We hypothesized that women would demonstrate greater NO-dependent cutaneous vasodilation than men in response to 39ºC local heating. Methods: Data are represented as mean(SD). An intradermal microdialysis fiber was placed in the ventral forearms of 12 men and 13 women [24.2(4.6) years]. Local heaters and laser-Doppler flowmetry probes were used to measure red blood cell flux (perfusion units, PU). Cutaneous vascular conductance (CVC) was calculated as laser-Doppler PU/mean arterial pressure. A standard 39ºC local heating protocol was conducted wherein PU was continuously collected at rest (10 minutes), then the local temperature was increased to 39ºC. After PU reached a steady plateau (~40 minutes), the NO synthase inhibitor 15 mM NG-nitro-L-arginine methyl ester (L-NAME) was perfused. Maximal vasodilation was induced by heating to 43ºC and perfusing 28 mM sodium nitroprusside and normalized to %CVCmax. %NO contribution was calculated as the absolute percentage difference between %CVCmax of 39ºC plateau and %CVCmax of L-NAME steady-state. We compared both CVC and %CVCmax between groups with two-way ANOVA and the %NO contribution with unpaired t-tests. Results: The %NO contribution was not different between sexes [men 48(23)%, women 39(17)%; P = 0.26]. There was no effect of sex on either absolute CVC [men 0.717(0.29) PU, women 0.73(0.48) PU at 39ºC phase] or %CVCmax [men 69(31)%, women 54(20)% at 39ºC phase] at any stage of the 39ºC local heating protocol (main effects P ≥ 0.08). Conclusion: These data indicate there is no impact of biological sex on the vasodilatory response of the cutaneous vasculature to 39ºC local heating in young healthy adults when women are tested at random across the menstrual cycle. Funding: National Institutes of Health Grant T-32-5T32AG049676 This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Sex-based differences in risk of cardiovascular disease development and cardiovascular risk factors among individuals with hypertension: A cross-sectional study from primary care facilities

BackgroundOver the last two decades, the understanding of cardiovascular disease (CVD) has expanded in Asian countries. Despite this progress, there have been limited investigations into sex-based differences in the development of CVD and cardiovascular risk factors (CVRFs). AimWe investigated whether males and females with hypertension had different risks of developing CVD and CVRFs. MethodsWe used a stratified multi-stage sampling design involving 15 primary care centers in Thailand. We recruited 1,448 individuals aged 35–74 years old. The Framingham cardiovascular risk algorithm was used to determine the risk of CVD development. ResultsFemale patients were overall more likely to have lower CVD risk scores. However, they demonstrated higher scores in the moderate-risk (p < 0.001) and high-risk (p < 0.001) groups as compared with males. One in four females was at a high risk of developing CVD. Females had higher rates of all CVRFs against males across sub-risk groups, with the highest odds ratio observed in the high-risk group, which persisted after adjusting for covariations. Overall, female patients had higher rates of diabetes, hyperlipidemia, obesity, and abdominal obesity as compared with males. Females in the overall group had a lower prevalence of uncontrolled hypertension than males, in contrast to the high-risk group. Female patients also had a lower prevalence of cigarette smoking and alcohol consumption than males. ConclusionThere is evidence of sex-based differences in the risk of CVD development in hypertensive individuals. The interaction of CVRFs with a high risk of developing CVD was noted in females.

FUNCTIONAL ROLE OF THE TP53 GENE SINGLE NUCLEOTIDE POLYMORPHISM P72R (C&gt;G) IN PATIENTS WITH TYPE 2 DIABETES MELLITUS OF THE EAST UKRAINIAN POPULATION

Recently, the role of stress-regulatory pathways in the development and progression of type 2 diabetes mellitus (T2DM) and associated cardiovascular diseases has been widely investigated. The aim of the study was to assess the relationship of polymorphic variants P72R (C&gt;G) of the TP53 gene with the functional and metabolic characteristics of type 2 diabetic patients in the East Ukrainian population. Materials and methods. 50 T2DM patients (female/male: 21/29) aged 53.34±1.43 yrs., with diabetes duration of 6.25±0.89 yrs., HbA1c level of 7.12±0.21%, body mass index of 31.19±0.93 kg/m2, with waist-to-hip ratio of 0.96±0.01, with the presence of coronary heart disease in 38 cases, hypertension in 46 cases, and their combination in 37 cases. Characteristics of carbohydrate/lipid metabolism, parameters of insulin resistance, chronic inflammation, and a number of adipokines were determined in the subjects. Genotyping for single nucleotide polymorphism P72R (C&gt;G) TP53 was performed by the method of polymerase chain reaction with appropriate primers and BstUI endonuclease. Testing of null hypotheses was carried out using the t, F and c2 criteria at the significance level of P≤0.05. Results. There was a noticeable tendency (P=0.05) to increase in frequency of the recessive allele G, mainly in men, which requires further extended studies. In addition, carriers of the minor genotype are characterized by a significantly younger age of T2DM manifestation. Under the statistically similar parameters that characterize the degree of obesity and glucose metabolism compensation, the connection of the G-allele with insulin resistance, both hepatic (HOMA-IR) and associated with adipose tissue (HOMA-IR/adiponectin, adiponectin/leptin) was observed. Carriers of the recessive allele are also characterized by an increased atherogenic coefficient relative to the dominant CC genotype, a significant decrease in the levels of adiponectin (total and high molecular weight) and omentin, and an increase in the levels of leptin and vaspin in the circulation. According to the recessive model, the presence of the G-allele is accompanied by a weak but probable increase in the levels of highly sensitive C-reactive protein (CC vs. CG+GG: 1.92±0.42 mg/l vs. 4.62±0.94 mg/l, P &lt;0.05). The above suggests that the G-allele may be a predictor of a greater risk of cardiovascular disease development in patients with T2DM. Conclusions. It has been proven that the P72R polymorphism of the TP53 gene is functional for the East Ukrainian population, because against the background of a comparable degree of obesity and glucose metabolism compensation, carriers of the minor G-allele are characterized by a greater degree of insulin resistance and a proatherogenic shift in the hormonal activity of adipose tissue. A tendency to increase in frequency of the G-allele in men with type 2 diabetes was revealed, and it was determined that carriers of the minor genotype are characterized by a significantly younger age of diabetes manifestation. The obtained results substantiate the need for further research to assess the role of this polymorphism in the Ukrainian population.

Prevalence, incidence and relative risk of cardiovascular disease risk factors in adults with atopic dermatitis: A systematic review

AbstractAtopic dermatitis (AD) has been associated with cardiovascular disease (CVD). A better understanding of CVD risk factors in AD populations may help dermatologists better counsel their patients regarding potential risks and treatment choices. This systematic literature review evaluated the prevalence, absolute risk (i.e., incidence) and relative risk of CVD risk factors in adults with AD. MEDLINE, Embase and The Cochrane Library were searched for English‐language articles published between January 2005 and the search date (16–17 March 2021) using terms for AD, prevalence/risk and CVD risk factors. Observational studies that reported the prevalence, absolute risk and/or relative risk of CVD risk factors in adults with AD were eligible. Of the 1277 unique articles identified, 71 met the inclusion criteria. Most studies were cross‐sectional or retrospective cohort studies from Europe, North America or Asia; many used national databases. Studies were heterogeneous, with inconsistent definitions of AD and risk factors (especially smoking and obesity), different methodologies and different populations (e.g., ethnicity). Within most controlled studies, the prevalence of several risk factors, particularly obesity, hypertension and dyslipidemia, was higher for AD than for controls. Where assessed, the prevalence of most CVD risk factors increased with increasing AD severity. Relative risks varied across studies. Only nine studies reported the temporal relationship between AD and CVD risk factors. Six studies reported absolute or relative risk of developing CVD risk factors (diabetes, hypertension and smoking) in AD populations; only one of these reported an elevated risk (hypertension). Despite the high number of studies to date, conclusive data regarding the relationship between AD and many CVD risk factors are lacking, and additional, carefully designed, prospective studies are required. Video content can be heard at https://onlinelibrary.wiley.com/doi/10.1002/jvc2.87none

S-34-5: PERSPECTIVES FROM LONGITUDINAL COHORT STUDY IN NORTHERN JAPAN -HYPERTENSION, METABOLIC DISORDERS AND CARDIOVASCULAR DISEASE-

The percentage of obese in the population of middle-aged Japanese has been increasing in recent years. With obese, population of metabolic disorder to be accompanied with diabetes mellitus, IGT increases explosively.The similar tendency is observed in the whole Asian countries. Recently, for the purpose of preventing cardiovascular disease, the conception of metabolic syndrome is proposed. Obesity, hypertension, glucose intolerance and lipid metabolism abnormality are included in this conception. On the basis of data obtained through annual health examinations on about 2,000 residents in the two communities, we performed analysis and are currently reviewing cardiovascular disease and its relevant risk factors in this population. On the basis of the analysis, at this seminar, I will lecture on metabolic syndrome among the Japanese population in terms of frequency and characteristics as well as its impact on the onset of cardiovascular disease. Diagnosis of metabolic syndrome is based on the Japanese Criteria. When the sample consisted of those without a history of cardiovascular disease and not undergoing treatment for hypertension, diabetes, or hyperlipidemia, frequency of the syndrome was 20–25 percent for men and 5–7 percent for women, levels that have remained unchanged over the past 10 years. Those frequencies appeared to be on a level with those observed in other regions around the country. We also conducted a six-year follow-up of the male group. We found as a result that the relative risk of cardiovascular disease development, including coronary heart disease, was 2.3 times higher in syndrome males than in non-syndrome males.These studies suggest that the Japanese population exhibited a certain level of metabolic syndrome incidence due to accumulation of visceral fat, even though the rate of obesity is lower in this population than in the U.S., that metabolic syndrome affected a variety of atherosclerosis-related factors, and that the syndrome could practically serve as a predictive factor for cardiovascular disease. Obesity is a basic factor in the onset of metabolic syndrome, and the BMI average among the Japanese population has increased over time. The significance of coronary heart disease against the backdrop of diabetes and metabolic syndrome will likely increase in the future. It is therefore necessary to develop primary preventive measures against coronary heart disease, tailored for the Japanese population, with a particular focus on improvement of lifestyle.

Association between the Change in Blood Pressure during Normotensive Pregnancy and the Development of Hypertension in Later Life.

Women who experience maternal complications, including pre-eclampsia, have a higher risk of cardiovascular disease development. Although the mechanism remains unclear, there is a hypothesis that pregnancy would be a stress test for cardiovascular disease. This study aimed to investigate whether changes in blood pressure during pregnancy would be associated with developing hypertension, which is a main risk of cardiovascular disease. We conducted a retrospective study by collecting Maternity Health Record Books from 735 middle-aged women. Of these, 520 women were selected based on our criteria. 138 were defined as the hypertensive group according to the criteria of receiving antihypertensive medications or blood pressures of >140/90 mmHg at the survey. The rest 382 were defined as the normotensive group. We compared the blood pressures of the hypertensive group with those of the normotensive group during pregnancy and postpartum. Then, 520 women were divided into quartiles (Q1-Q4) according to their blood pressures during pregnancy. After the changes in blood pressure for each gestational month relative to nonpregnant measurements were calculated, the changes in blood pressure were compared among the four groups. Additionally, the rate of developing hypertension was evaluated among the four groups. The average age of the participants was 54.8 years (range: 40-85 years) at the time of the study and 25.9 years (range: 18-44 years) at delivery. There were significant differences in blood pressure during pregnancy between the hypertensive group and the normotensive group. Meanwhile, these two groups did not indicate any differences in blood pressure in postpartum. Higher mean blood pressure during pregnancy was associated with smaller changes in blood pressure during pregnancy. The rate of development of hypertension in each group of systolic blood pressure was 15.9% (Q1), 24.6% (Q2), 29.7% (Q3), and 29.7% (Q4). The rate of development of hypertension in each group of diastolic blood pressure (DBP) was 18.8% (Q1), 24.6% (Q2), 22.5% (Q3), and 34.1% (Q4). Changes in blood pressure during pregnancy are small in women who have a higher risk of hypertension. Levels of blood pressure during pregnancy may be reflected in individual stiffness of blood vessels by the burden of pregnancy. If so, levels of blood pressure would be used to facilitate highly cost-effective screening and interventions for women with a high risk of cardiovascular diseases.

Prevalence of hypertension among the indigenous population in North-East India: Is this a consequence of "nutritional transition"?

This article aims to understand the influence of residential status on the prevalence of cardiovascular disease (CVD) risk factors among adult Angami Naga of Nagaland. A total number of 194 (100 rural and 94 urban) adult Angami Naga participated in the study. Blood pressure, both systolic and diastolic, was measured for each participant. Nutritional status was evaluated through body mass index. Metabolic health was measured through waist circumference, waist-hip ratio and percent body fat (%BF). Multiple regression analysis was done to examine the influence of residential status and other bio-social factors on the prevalence of obesity and hypertension. Results indicate high prevalence of systolic hypertension among urban residents, in both males (29.6%Urban vs. 20.4%Rural ; p > .05) and females (17.4%Urban vs. 11.6%Rural ; p > .05), with gender inequality favoring females. Similar trend was observed in diastolic hypertension as well. On the other hand, obesity was found to be greater in rural males (8.3%Urban vs.10.2%Rural ; p=.002), and urban females (11.6%Urban vs. 3.5%Rural ; p > .05). However in %BF, only negligible percentages of urban females (2.3%Urban vs. 0.0%Rural ; p > .05) were found to be moderately overweight or obese and no males were found to be overweight. Further, regression analyzes indicate that age, sex, and residential status are the most important (p < .001) causal factors behind the prevalence of obesity and hypertension among the Angami Naga. It was observed that elderly urban males were the most susceptible section of this community in developing CVD risk factors related vulnerabilities. However, we propose understanding this prevalence from an evolutionary approach of physiological mechanism toward nutritional transition in Angami Naga, like many other indigenous populations of northeast India.

Quality of Beef Burgers Formulated with Fat Substitute in a Form of Freeze-Dried Hydrogel Enriched with Açai Oil.

The growing number of people at high risk of cardiovascular disease development contributed to both changes in diets by consumers and the reformulation of food products by food producers. Cardiovascular diseases are caused by the i.a. consumption of meat that contains animal fat rich in saturated fatty acids (SFA). The use of fat substitutes in meat seems to be a promising tool for the reduction of cardiovascular disease occurrence. In the presented study, beef fat was replaced at 0 (CO), 25 (S-25%), 50 (S-50%), 75 (S-75%), and 100% (S-100%) by a fat substitute in a form of a lyophilized hydrogel emulsion enriched with encapsulated açai oil. The chemical (TBARS, volatile compound profile, fatty acid profile, pH), and physical (TPA, consumer rating, L*a*b* color, cooking loss) analyses were performed on raw and grilled burgers subjected to storage at cold conditions (4 °C) in days 0 and 7. Burgers formulated with hydrogels had a higher content of polyunsaturated fatty acids (PUFAs) of about 32% (p < 0.05) and reduced SFAs by 22%. Reformulation of the burger resulted in lower nutritional indices of the atherogenicity index (AI) (0.8 for CO, 0.3 for S-100%, p < 0.05) and thrombogenicity index (TI) (1.8 for CO, 0.6 for S-100%, p < 0.05), as well as led to an increased h/H ratio (1.3 for CO, 3.9 for S-100%, p < 0.05). Furthermore the application of freeze-dried hydrogels reduced cooking loss. Moreover, consumers did not observe significant differences (p < 0.05) between the control and S-25% and S-50% burgers. Thus, the use of lyophilized hydrogels formulated with konjac flour and sodium alginate and enriched with encapsulated acai oil can be successfully applied as a fat substitute in beef burgers.

Systematic Review of the Impact of Nutrition and Physical Activity on Cardiovascular Disease Risk Among Firefighters

ObjectivesThe objective of this systematic review was to summarize the literature on non-occupational cardiovascular disease (CVD) risk factors experienced by firefighters, specifically those related to nutrition, physical fitness, and physical activity. MethodsTwo electronic databases (PubMed and Scopus) were used for this review. Search terms included those related to CVD, nutrition, physical fitness, and physical activity among firefighters. The PRISMA checklist was followed to ensure a rigorous review. The Academy of Nutrition and Dietetics Quality Criteria Checklist for Primary Research was also used for critical appraisal of the included studies. The review process was performed by one researcher and is in the process for a second independent researcher to reduce bias. ResultsTwenty-six (n = 26) articles were included in the final qualitative synthesis (4 nutrition, 4 nutrition and physical fitness/activity, and 18 physical fitness/activity). The outcomes were that firefighters do not engage in regular physical activity, tend to have substandard fitness levels and poor dietary habits, and work in a poor food environment. These factors have been shown to relate with higher prevalence of CVD and its indicators. These studies also suggest that firefighters want information, programs, and resources related to improving nutrition and physical activity to reduce CVD. ConclusionsAmong firefighters, numerous studies exist regarding increased CVD risk related to inadequate physical fitness and activity levels, however, few studies address the role of a healthy diet in the development of CVD risk. This review is beneficial for public health practitioners, researchers, and fire service leaders, as it provides insight into the need to further investigate how diet affects CVD risk among the firefighting population. Funding SourcesNone.

Association of lipid abnormalities with thyroid dysunction in patients of subclinical hypothyroidism

Background: Dyslipidemia is thought to associated with the risk of cardiovascular disease development. Overt hypothyroidism is associated with lipid abnormalities. However, the relationship between subclinical hypothyroidism (SCH) and pattern of lipid abnormalities is not well eastablished. The aim of this study was to find the lipid abnormalities in patients of subclinical hypothyroidism (SCH) and determine relationship between lipid level and TSH. Methods: Serum lipid levels of 92 patients with subclinical hypothyroidism (SCH) and 110 age and sex matched healthy controls were evaluated in this cross sectional case control study. Results: In this study total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) were significantly higher (p value&lt;0.05) in patients with subclinical hypothyroidism (SCH) as compared to control group. Triglycerides (TG) and very low density lipoprotein cholesterol (VLDL-C) were also increased in these patients as compared to control but the difference was not statistically significant. High density lipoprotein cholesterol (HDL-C) was found to be marginally lower in these patients than control. Conclusions: Total cholesterol (TC) and low density lipoprotein (LDL-C) are higher in patients with subclinical hypothyroidism (SCH) as compared to healthy controls.

Association of cardiorespiratory fitness with the risk factors of cardiovascular disease: Evaluation using the Japan step test from the National Institute of Occupational Safety and Health.

ObjectiveCardiorespiratory fitness (CRF) is an important factor for evaluating cardiovascular disease (CVD) risk. We recently developed a novel method (National Institute of Occupational Safety and Health, Japan step test [JST]) for evaluating CRF in workers; its criterion validity has been investigated. However, its association with health risk must be confirmed before its application in the workplace. Therefore, we aimed to determine the association of JST‐evaluated CRF with the prevalence of CVD risk among Japanese workers.MethodsFor CRF evaluation, working adults completed the JST, which comprised a 3‐minute stepping exercise and a 2‐minute recovery period. Data on CVD risk factors and clinical history were collected through medical certification within 1 year from the date of the JST measurements. Participants were divided into three groups for multiple logistic regression analyses based on the JST values (low, moderate, and high). Odds ratios (ORs) for the prevalence of CVD risk were calculated.ResultsWe recruited 885 working adults (46.4% women). The prevalence of CVD risk in the total population was 18.6%. When compared to the reference group (low CRF), the ORs for CVD risk prevalence after adjustments for lifestyle factors (smoking status, alcohol consumption status, and exercise habits) were 0.42 (95% confidence interval [CI], 0.28–0.63) and 0.29 (95% CI, 0.18–0.45) for the moderate and high groups, respectively.ConclusionAn inverse association was noted between the JST‐evaluated CRF and CVD risk prevalence. JST may be helpful for identifying workers at risk for CVD development.

Role of Transcription Factor 7 like 2 and Silent Information Regulator 1 Genes in the Development of Cardiovascular Complications in a Group of Egyptian Patients with Chronic Kidney Disease

BACKGROUND: Sirtuins silent information regulator 1 (SIRT) is histone deacetylases that act as antioxidants and involved in the pathogenesis of cardiovascular diseases (CVD) which are the major complications of chronic kidney disease (CKD). Transcription factor 7-like 2 (TCF7L2) genetic polymorphisms could contribute to the risk of CVD as TCF7L2 proteins regulate vascular remodeling. AIM: We tried to demonstrate the role of genetic polymorphisms: rs7069102 and rs10823108 in SIRT1 gene and rs7903146 in TCF7L2 gene in the development of CVD in CKD Egyptian patients. METHODS: This study included 120 CKD patients (60 with CVD and 60 without CVD) and 60 age and sex-matched healthy subjects as a control group. Routine laboratory investigations were performed and genotyping for candidate single nucleotide polymorphisms was done by Taqman-real-time polymerase chain reaction. RESULTS: The frequency of the C allele of rs7069102 was significantly higher in CKD patients with CVD as compared to the normal control group (p &lt; 0.001) and as compared to CKD patients without CVD (p &lt; 0.001). Percentages of AG and GG genotypes of rs10823108 were significantly higher in CKD patients with CVD as compared to the normal control group (p = 0.002, 0.035, respectively). The frequency of the T allele of rs7903146 was significantly higher in CKD patients with CVD as compared to the normal control group (p &lt; 0.001). CONCLUSION: We found that C allele of rs7069102, GG and AG genotypes of rs10823108 in the SIRT1 gene and T allele of rs7903146 in TCF7L2 gene have a potential role in the pathogenesis and the risk of CVD development in CKD Egyptian patients.

Predictors for coronary artery calcium score and differences in its distributions between populations with and without diabetes

Cardiometabolic disease encompasses a variety of metabolic dysfunctions including major public health issues such as insulin resistance, obesity, Type 2 Diabetes (T2DM), and cardiovascular disease (CVD). Inflammation drives the pathogenesis of cardiometabolic disease in clinical, epidemiological, and translational models. T2DM is an established inflammatory condition with many cardiometabolic relationships and is often associated with dyslipidemia and insulin resistance. In this review, psoriasis, a chronic inflammatory disease, is used as a model to explain the relationship between systemic inflammation and the onset and progression of cardiometabolic disease in an effort to better understand T2DM. Future efforts should focus on developing CVD risk scores to reflect the importance of inflammatory states such as T2DM and its contribution to cardiovascular morbidity and mortality.